혈액투석 중에 발생한 헤파린에 의한 전신 두드러기

박한정 ( Han Jung Park ),성준모 ( Jun Mo Sung ),김무정 ( Moo Jung Kim ),최길순 ( Gil Soon Choi ),예영민 ( Young Min Ye ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2009 천식 및 알레르기 Vol.29 No.1

Heparin is used for thromboprophylaxis in patients on hemodialysis, hemofiltration or continuous renal replacement therapies. Heparin-related immediate-type hypersensitivity reactions such as urticaria, angioedema or bronchospasm are very rare, and only a few cases of anaphylaxis-like responses have been described. We experienced the case of a 67-year-old female patient with an end-stage renal disease who presented generalized urticaria induced by heparin during hemodialysis. She began to experience recurrent itching and generalized urticaria after 2 weeks of the initiation of hemodialysis. The episodes started within 30 minutes of hemodialysis with heparin infusion; either sodium heparin or dalteparin (low molecular weight heparin) was used. Utilization of different dialyzers was unable to avoid the episodes, and these symptoms could be reduced when she was treated with heparin-free hemodialysis. She had no previous history of allergic diseases. In order to confirm the causative agent, we measured serum specific IgE antibodies against ethylene oxide, latex and formaldehyde using immunoCAP (Phadia, Sweden) and obtained negative results. Although skin prick tests and intradermal tests to the used heparin showed negative results, the intravenous provocation test using 1,500 U of heparin (with a bolus-loading dose of 1,000 U and a continuous intravenous infusion of 500 U for 3 hours) reproduced an immediate-onset generalized urticaria with itching sensation. We report herein a case of heparin-induced urticaria during hemodialysis in Korea. Because of increasing use of heparin in medical practice, physicians should be aware of possible immediate hypersensitivity reactions to this medication. (Korean J Asthma Allergy Clin Immunol 2009;29:69-73)

저온 환경에서의 열풍융착 속도별 화학적 침식이 EVA 방수시트의 접합부 인장강도에 미치는 영향에 대한 연구

박진상(Jin-Sang Park),최수영(Su-Young Choi),박완구(Wan-Goo Park),정해춘(Hae-Choon Jung),김병일(Byoung-Il Kim),오상근(Sang-Keun Oh) 한국건설순환자원학회 2017 한국건설순환자원학회 논문집 Vol.5 No.3

본 연구는 EVA시트의 접합부 시공에 열풍융착 방법을 적용하여 저온 환경에서의 열풍융착 속도의 변화와 화학적 침식에 따른 접합부 인장 강도의 성능 변화 분석을 목적으로 진행하였다. 연구는 시트 간 접합 방식을 간접가열 방식인 열풍융착을 적용하여 열풍융착 속도를 조절하고 화학처리 과정을 가지는 조건에서 진행하였으며, 시공 기온은 –10℃, -5℃, 0℃, 20℃로 온도 조건을 한정하여 연구를 진행하였다. 접합부의 인장성능 시험결과, 저온 환경에서 열풍융착 속도가 3~4m/min일 때 접합부 인장강도가 높게, 20℃에서는 열풍융착 속도가 5~6m/min일 때 접합부 인장강도가 높게 나타나는 것으로 확인되었다. This study is based on the hot air welding application method of EVA sheet to test the tensile strength performance changes due to the hot air welding speed, temperature and chemical attack. For the parameters of the study, the hot air welding method that directly heats the overlap between the sheets and the adhesion surface was controlled, and the maximum temperature for application was set to 20°C, 0°C, -5°C, -10°C. According to the results of the testing, the tensile strength of the overlap area was the highest between the temperatures of 20 at 5~6m/min and between the low temperatures at 3~4m/min of hot air welding speed.

감자에 의한 접촉성 두드러기

박한정 ( Han Jung Park ),성준모 ( Jun Mo Sung ),김무정 ( Moo Jung Kim ),최길순 ( Gil Soon Choi ),신유섭 ( Yoo Seob Shin ),예영민 ( Young Min Ye ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2008 천식 및 알레르기 Vol.28 No.2

Immediate hypersensitivity to raw potato has been presented as one or a combination of wheezing, rhinorrhea, sneezing, contact urticaria and contact dermatitis. We experienced a case of contact urticaria caused by raw potato in a 25-year-old female patient with allergic rhinitis and conjunctivitis. She had experienced itching and generalized urticaria after application of raw potato on her face 10 years earlier. Allergy skin tests showed positive results to common inhalant allergens, including D. pteronyssinus, D. farina, ragweed pollen, mugwort pollen and several kinds of grass pollens, but showed a negative result to raw potato e×tract. However, the provocation test by applying raw potato on her forearm produced an immediate onset of contact urticaria with itching sensation. High serum-specific IgE to raw potato compared to normal healthy controls was detected by ELISA. We first report here in a case of raw potato-induced contact urticaria in Korea, which suggested an IgE-mediated mechanism. (Korean J Asthma Allergy Clin Immunol 2008;28:148-151)

운전자 인지곡선반경 모형 개발

박다정(Park, Da Jung),권성대(Kwon, Sung Dae),박제진(Park, je jin),하태준(Ha, Hae jun) 대한토목학회 2012 대한토목학회 학술대회 Vol.2012 No.10

호산구증가증 환자에서 Toxocara canis에 대한 특이 IgE 항체의 진단적 의의

박한정 ( Han Jung Park ),최성진 ( Sung Jin Choi ),김현미 ( Hyun Mi Kim ),최길순 ( Gil Soon Choi ),성준모 ( Jun Mo Sung ),이진우 ( Jin Woo Lee ),예영민 ( Young Min Ye ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2009 천식 및 알레르기 Vol.29 No.2

Background: Toxocariasis is one of the major causes of peripheral eosinophilia and it provokes eosinophilic infiltration in the internal organs. Diagnosis of toxocariasis has relied mainly on the immunological methods including measurement of serum specific IgG to Toxocara canis excretory-secretory antigen (TES-Ag) in which the detection rate by ELISA was 68% in patients with eosinophilia. Objective: The aim of this study is to measure serum specific antibodies to TES-Ag in patients with peripheral eosinophilia in order to evaluate the clinical significance. Method: Twenty-one patients with peripheral eosinohilia (>500 cells/uL or >10% of total white blood cell count), who have no identifiable cause of eosinophilia such as drugs, well known parasite infection, malignancy or allergic diseases, were enrolled. Serum specific IgE, IgG1 and IgG4 antibodies to TES-Ag were determined by ELISA (Phadia, Uppsala, Sweden) which were compared to those of specific IgE by immunoCAP system (Phadia), and specific IgG to TES-Ag by ELISA (Bordier). Serum total IgE and ECP levels were measured by immunoCAP system. Result: The detection rate of serum specific IgE by ELISA was the highest (90.5%) followed by serum specific IgG1 (65%) and IgG4 (75%). Concordance rate of specific IgE by ELISA and immunoCAP was 100%, while that between specific IgE by ELISA (home-made) and specific IgG by ELISA (Bordier) was 60%. The most commonly involved organ was liver (57.1%). Serum total IgE level in patients with liver involvement was significantly higher than those without it (P<0.01). Conclusion: Toxocariasis should be considered as one of the major causes of the patients with eosinophilia in this country. Measurement of serum specific IgE to TES-Ag may be useful to evaluate the Toxocara canis infection. (Korean J Asthma Allergy Clin Immunol 2009;29:105-111)

임상연구 : 혈액가스 분석기와 휴대용 혈당측정기로 측정된 혈당 수치의 평가

박휴정 ( Hue Jung Park ),박철수 ( Chul Soo Park ),박종민 ( Chong Min Park ),유건희 ( Keon Hee Ryu ),장혜원 ( Hae Wone Chang ),조은정 ( Eun Jeong Cho ),이윤기 ( Yoon Ki Lee ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5

Background: A portable glucometer is commonly used to immediately check the blood glucose level. In the anesthetic field, some blood gas analyzers can also give a rapid indication of the blood sugar level but the accuracy is unknown. Therefore, this study assessed the accuracy of the blood glucose values measured by either a blood gas analyzer or portable glucometer. Methods: Venous blood from diabetic patients was used to measure the glucose level with either a blood gas analyzer or a portable glucometer. The difference and 5% deviation from reference values was analyzed. These values were also assessed using a Bland-Altman plot and clinical significance was examined using a Clarke error grid. Results: The differences from the reference values were smaller using the blood gas analyzer (1.3 ± 7.8 mg/dl) than using the portable glucometer (-5.1 ± 16.7 mg/dl)(P < 0.01). 73.4% of the values measured by the blood gas analyzer and 40.0% of those measured by the portable glucometer were within 5% of the reference value. The 95% limits of agreement in the difference ranged from -14.3 to 16.9 in the blood gas analyzer and -38.5 to 28.2 in the portable glucometer. Error grid analysis showed that 100% of the values measured by the blood gas analyzer were located in zone A. When locating the values measured using the portable glucometer, 95.6% were located in zone A, and the remaining 4.4% are located in zone B. Conclusions: The blood gas analyzer measures the blood glucose more accurately than the portable glucometer. However, the blood glucose values measured by the portable glucometer are clinically acceptable. (Korean J Anesthesiol 2006; 50: 506~10)

출생 및 영아사망 신고체계 및 전산정보체계 개발

박정한 ( Jung Han Park ),박순우 ( Soon Woo Park ),전혜리 ( Hae Ri Jun ),이영숙 ( Young Sook Lee ),이정애 ( Jung Ae Rhee ),조현 ( Hyun Cho ),정영해 ( Young Hae Chung ) 한국보건행정학회 1998 보건행정학회지 Vol.8 No.2

아목시실린에 의한 약물 과민반응 16예의 임상적 특성과 혈청학적 검사의 의의

박한정 ( Han Jung Park ),허규영 ( Gyu Young Hur ),김현아 ( Hyoun Ah Kim ),최길순 ( Gil Soon Choi ),최성진 ( Sung Jin Choi ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.3

Background: Amoxicillin is one of the broad spectrum antibiotics and is widely used in the treatment of various infective diseases. There are various forms of amoxicillin-induced hypersensitivity reactions including urticaria/angioedema, erythema multiforme and anaphylaxis. Objective: To observe the clinical features and evaluate the significance of in vitro testing of amoxicilin-induced hypersensitivity reactions. Method: We retrospectively reviewed medical records of patients diagnosed as having amoxicillin-induced hypersensitivity reactions from January 2002 to February 2007. Serum-specifc IgE antiboides to ampicilloyl (AMP) and amoxicilloyl (AXO) were determined using the immunoCAP Result: Sixteen subjects were enrolled in this study. Clinical features of amoxicillin-induced hypersensitivity reactions included erythema multiforme (n=6, 37.5%), urticaria/angioedema (n=4, 25.0%), anaphylaxis (n=3, 18.8%), maculopapular skin eruption (n=2, 12.5%) and fixed-drug eruptions (n=1, 6.3%). Six subjects had a high serum specific IgE to AMP and all anaphylaxis patients had a high serum specific IgE to AXO and/or AMP. Conclusion: These findings suggest that amoxicillin could induce various cutaneous manifestations in which the most common ones are erythema multiforme and urticaria/ angioedema. The serious reactions of anaphylaxis were noted in 18.8% of subjects in which IgE mediated responses to 2 antigenic determinants were involved. (Korean J Asthma Allergy Clin Immunol 2007;27:162-167)

Isocyanate 에 의한 직업성천식 환자에서 흡입성 항원에 대한 신감작의 발생률 및 예후에 미치는 영향

박한정 ( Han Jung Park ),김현아 ( Hyun Ah Kim ),허규영 ( Gyu Young Hur ),예영민 ( Young Min Ye ),서창희 ( Chang Hee Suh ),남동호 ( Dong Ho Nahm ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.3

Background: It has been reported that half of toluene diisocyanate (TDI)-induced asthma patients had persistent asthmatic symptoms even after complete avoidance. We hypothesized that new sensitization to common inhalant allergens may contribute to persistent and aggravation of asthmatic symptoms. Objective: The aim of this study is to investigate the prevalence and clinical significance of new sensitization to common inhalant allergens in patients with TDI-induced asthma. Method: Thirty-six TDI-induced asthma patients who had been followed up for more than three years were enrolled. They were classified into two groups, newly-sensitized and not-sensitized groups, according to the results of the skin-prick test and serum specific IgE antibodies to common inhalant allergens monitored every year. The clinical features, drug requirements for systemic steroids, and airway hyper responsiveness were compared between the two groups. Result: Thirteen (36.1%) of 36 patients with TDI-asthma developed new sensitization to common inhalant allergens during the follow-up periods. The mean onset time were 4.93±2.49 years. The prevalence of atopic status and allergic rhinitis tended to be higher in the newly sensitized group. The duration of asthmatic symptoms before the diagnosis was significantly longer in the newly sensitized group (P<0.05). The drug requirements for systemic steroids tended to increase after the new sensitization in the newly sensitized group. Conclusion: The development of new sensitization to common inhalant allergen in TDI-asthma may be associated with chronic persistent asthmatic symptoms. New sensitization to common inhalant allergens should be monitored regularly in TDI-induced asthmatic patients. (Korean J Asthma Allergy Clin Immunol 2006;26:213-218)

웹 기반 동영상 프로그램 선택속성이 수술실 신규간호사의 간호 수행능력에 미치는 영향 -학습몰입의 매개효과 중심으로-

박정해(Jung-Hae Park) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.1

본 연구는 수술실 신규간호사의 웹 기반 동영상 프로그램 선택속성이 학습 몰입을 매개로 차후 간호 수행능력에 관한 확신에 미치는 영향을 검증하는 것이 목적이다. 연구대상은 인천 및 경기도 소재 대학병원의 수술실 근무 중인 간호사를 대상으로 하였으며, 250개의 표본을 분석에 활용하였다. 연구방법은 구조화된 설문지를 사용하여 2019년 7월 부터 8월까지 수집되었다. 참가자들은 인천과 경기에 있는 대학병원 수술실 250명의 간호사이다. 수집 된 데이터는 IBM SPSS Statistics 25.0과 AMOS 24.0을 사용하여 분석하였으며, 구조모형을 통해 위에 적합도 지표를 기반으로 직접효과와 간접효과를 측정하였다. 연구 결과, 수술실 신규간호사는 수술과 1차적으로 직결되는 위생 안전요인과 환자 관리요인을 상대적으로 더욱 중요하게 인지하였다. 학습 몰입을 통하여 차후 간호 수행능력에 관한 확신이 있었고, 위생 안전요인의 경우 학습 몰입이 없어도 수술실 신규간호사가 중요성을 인지하여 차후 간호 수행능력에 관한 확신에 긍정적 영향이 미침을 검증하였다. 따라서 향후 시각적 효과에 더 비중을 둔 웹 기반 동영상 프로그램 구성을 통해 간호의 위생 안전요인뿐만 아니라 환자 관리요인 그리고 간호 관련 요인 모두가 환자의 생명과 회복에 핵심적 단계임을 신규간호사에게 적합하게 이해시킬 필요가 있다. This study aimed to examine the effect of selected factors on confidence in nursing performance among new operating room nurses, with a focus on the mediating effect of learning flow. Data was collected from July to August 2019 using structured questionnaires. The participants were 250 new operating room nurses from university hospitals located in Incheon and Gyeonggi. The collected data was analyzed using the IBM SPSS Statistics 25.0 and AMOS 24.0. Structural equation modeling was performed to examine the effect of the selected factors namely web-based video programs on confidence in nursing performance, and the mediating effect of learning flow. Results: The factors of "hygiene & safety" and "patient care" from the web-based video programs had a positive effect on the learning flow. The higher the learning flow of the nurses, the greater their confidence in nursing performance. Just the "hygiene & safety" factor significantly increased nursing performance. Conclusion: The study results suggest that new nurses perceive that "hygiene & safety" is an important factor in building their confidence in nursing performance, even without the learning flow. Therefore, it is necessary to develop web-based video programs based on nurses" needs and to emphasize the importance of postoperative care.