서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

BCG 접종후의 결핵반응검사의 변화

김진경,김기홍,김행미,안두홍 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.1

신생아 시기에 BCG를 접종받은 영아를 대상으로 3±개월, 7-8개월 및 15-16개월에 Mantoux 검사를 시행하여 다음과 같은 결과를 얻었다. 3-4개월째 측정한 결절의 크기는 5.8±4.5㎜, 7-8개월째 7.9±4.9㎜,15-16개월째 6.7±4.9㎜로서 7-8개월째 의의있게 (p<0.55)증가되어 있었다. Mantoux 검사상 결절의 크기가 5㎜미만인 경우를 음성으로 간주하였을대 3-4개월째 38.5%, 7-8개월째 26.0% 및 15-16개월째 35.2%가 음성이었으며 15㎜이상의 강양성은 3-4개월째 1.9%, 7-8개월째 12%, 15-16개월째 7.5%를 차지하였다. 33례의 미숙아에 있어서 BCG 접종후 18개월 동안 5㎜ 이상의 반응을 보인 양전례는 63.6%인 21례로 이들 양전군과 비양전군 사이에는 출생시 제태연령, 체중 및 BCG 접종시기에 유의한 차이를 보이지 않았으며 만삭아의 양전율과 비교 하였을 때 의의있는 차이를 보이지 않았다. We conducted this study to evaluate the change of tuberculin reaction after neonatal BCG vaccination in Korea. Seventy-four infants were followed for 15-16 month after birth. BCG vaccination were given within 4 weeks after birht and 3 times of Mantoux test were performed at 3-4 months, 7-8 months and 15-16 month after birth. During the same period, Mantoux test were done on 238 cases of 3-4 months-old infants, 107 cases of 7-8 months-old infants and 85 cases of 15-16 months-old infants who were given BCG vaccination within 4 week after birth. We evaluated the results without distinction of these infants because there was no statistically significant difference between two groups. The size of induration was significantly increased at 7-8 months(7.9±4.9㎜) compare to the size at 3-4 months (5.8±4.5㎜) and 15-16months(6.7±4.9㎜) (P<0.05). But 38.5%, 26.8% andn 32.5% of infants were not converted ( < 5㎜) at 3-4months, 7-8 months and 15-16 months after birth respectively. Thirty-three preterm infants were followed for 18 months after birth. Twenty-one out of 33 (63.6%) were converted during this period. There was no difference of gestational age, birth weight, age on BCG vaccination between converters and nonconverters. There was no difference of conversion rate compatre to full term infants.

경안천의 애반딧불이 서식지 오염부하량 및 생태특성

김수복,고정문,홍순상,주덕현,홍윤기,김진성,김영규 용인대학교 자연과학연구소 2011 自然科學硏究所論文誌 Vol.16 No.1

The aim of this study was to research water quality, eco-nature and firefly habitant Keung An Stream from June to July. To conserve ecosystem of firefly habitant, We must manage to have a diverse aspect of ecology and water quality. This study was to research water quality, eco-nature and firefly habitant Keung We find 11 firefly habitat in Keung An Stream. To conserve ecosystem of firefly habitant, We must manage to have a diverse aspect of ecology and water quality.

구리 지역에서 조사한 고혈압의 인지도, 치료률 및 관리률

홍철호,김순길,홍택원,이제,신진호,이재웅,김경수,김정현,임헌길,이방헌 대한간질학회 2003 대한간질학회지 Vol.9 No.1

중증 만성정신질환자 수의 추산 : Through Two Community Surveys 두 지역사회 조사를 중심으로

홍진표,김윤,배재남,정유진,강영호,양병국,김용익,김병후,이철,조맹제 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

국내 중증 만성정신질환자 수를 추정하기 위하여 일 농촌 및 대도시 지역의 지역의료보험 및 의료보호 대상자 중 1993년 1년간 의료기관에서 정신증 상병(ICD-9 code 상 290-299) 및 알콜 남용/중독, 성격장애 및 정신박약 진단하에 치료를 받은 적이 있는 사람에 대해 설문조사를 실시하였다. 연구자들이 개발한 진단도구를 이용하여 진단을 평가하고, Strauss-Carpenter scale 등을 이용하여 기능 장애를 평가하고 유병기간 등을 조사하였다. 결과를 요약하면 다음과 같다. 1) 진단평가상 정신분열병군(61.1%)이 가장 많았으며, 정동장애군(23.7%), 알콜장애군(11.2%), 기질성 정신장애군(4.0%)의 순서이었다. 2) 직업활동정도는 진단군별로 차이가 많았다. 지난 1년간 직업활동이 6개월 미만이거나 전혀 없는 환자 비율이 정신분열병군은 67.2%, 알콜장애군 52.0%, 정동장애20.8%의 순으로 정신분열병군이 가장 불량하였다. 3) 사회활동도 진단군별로 차이가 많아서 지난 1년간 의도적, 사회활동이 없는 비율이 정신분열병군이 가장 높았고(72.3%), 알콜장애군(32.0%), 정동장애군(20.7%)의 순이었다. 4) 국내 의료보험 및 사회복지시설 이용 자료 등을 토대로 본 조사 결과를 적용한 결과 국내중증 만성 정신질환자의 수는 약 8만 7천명으로 추산되었다. Objectives: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. Methods : Study populations were recruited from medical insurance data of two district areas ; one rural and the other urban areas. Subject were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November,1994. Results : According to diagnostic assessment schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. Conclusions : Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

정신장애인 치료에 중요 역할 담당자의 정신질환에 대한 태도조사

김병후,정선욱,강연화,김윤,김창엽,홍진표,한오수,조맹제,김용익 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

Objectives : Attitudes of families of mentally ill, health personnels and community leaders to the mentally ill after the development and utilization of the community mental health program and reintegration of the chronically ill patients into society. This study was designed to compare the attitudes toward the mentally ill patient of the persons who have important role in treating the mentally ill and to find the variables influencing the attitudes. Methods : We measured attitudes toward mental illness in psychotic patients' families(N=139), community leaders(N=180) and health personnels(N=324) including mental health personnels before the implementation of community mental health services in Yonchon county and Seodaemun district area. The instrument used to measure attitudes was Opinion about Mental Illness(O. M. I.) scale. Results : 1) Health personnel showed lower Authoritarianism(Factor A) and higher Benevolence(Factor B) scores on the average than community leaders and psychotic patients families. 2) Current residence affect the attitudes in psychotic patients' families, not in community leaders and health personnels. Families in urban area showed lower Authoritarianism(Factor A) and Social Restrictiveness(Factor D) and higher Benevolence(Factor B) scores than in the rural areas. 3) Many patient variables were correlated to the attitudes of families. Duration of illness, number of recurrence, number of admission, age of patient and family burden were positively correlated mainly to Social Restrictiveness(Factor D). 4) Sex and religion of respondents showed no or weak relationship with the factor scores. Conclusions : Education for community leaders and families is required to achieve successful community mental health services. Community support program should be developed for chronic, recurrent and burdensome psychiatric patients in the first place.

주폐자충 폐렴으로 발현된 Felty 증후군 1예

김성호,남대근,문재현,김지홍,김보석,안진광,문태건,안병재,김성일 全南大醫大 2001 전남의대학술지 Vol.37 No.3

응급실을 내원한 65세 이상 노인 환자의 분석

김진년,김태훈,강양욱,오명,김상철,김성훈,권계형,남홍우,이홍순,유형준 대한노인병학회 2001 대한노인병학회지 Vol.5 No.3

대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.