조직학적 진단된 chronic necrotizing pulmonary aspergillosis 2예

김연숙,정숙인,기현균,김춘관,김신우,한정호,김성민,백경란,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

CNPA는 기존의 폐질환 및 폐절제술로 인해 국소방어기전에 저하가 있거나 비특이적 전신면역상태저하를 갖고 있는 환자들에게서 주로 발생하는 만성적인 공동성 폐질환이다. 현재까지 우리나라에서는 CNPA의 보고가 없는 상태이고, 저자들은 최근 조직학적으로 진단된 CNPA 2예를 경험하였기에 보고하는 바이다. 저자들이 경험한 CNPA 환자들은 만성알코올 중독 및 기관지확장증과 같은 기저질환과 폐절제술을 받은 병력이 있었다. Aspergillus가 폐실질을 침윤하고 있는 조직소견과 조직배양에서 Aspergillus가 검출되어 조직학적 진단이 가능하였고, amphotericin B의 정주요법 및 경구 itraconazole 투여와 폐절제술 등으로 성공적으로 치료되었다. 아직 많은 임상의들에게는 낯선 질환인 CNPA의 치료성적은 환자의 동반질환 및 CNPA 자체의 중증도, 진단과 치료 시작의 지연 등에 의해 크게 좌우되므로 만성적으로 진행하는 공동성 폐병변을 갖고 있는 환자에게서 CNPA를 감별하는 것이 중요하다. Chronic necrotizing pulmonary aspergillosis (CNPA) is a chronic cavitary form of pulmonary aspergillosis. Dozens of CNPA cases have been reported in patients with systemic immunologic dysfunction or altered local defense mechanism from preexisting pulmonary disease. Review of literatures revealed that no CNPA cases have been reported in Korea yet. We experienced two cases of CNPA proven by lung biopsy. A 53-year-old alcoholic male in poor nutritional state was admitted with generalized weakness and weight loss. Chest CT revealed a cavitary nodule surrounded with ground-glass attenuation. CT-guided fine needle aspiration and biopsy was done. The biopsy specimen demonstrated dichotomously branching septated hyphae consistent with those of Aspergillus sp. Another case was a 39-year-old man with bronchiectasis who was admitted with persistent hemoptysis. He had a past history of pulmonary tuberculosis. A parahilar lesion with intracavitary soft tissue mass was incidentally detected in high-resolution GT. Left lingular segmentectomy was done due to uncontrolled hemoptysis and CNPA was histologically diagnosed. Both patients were successfully treated with intravenous amphotericin B followed by oral itraconazole. Even though CNPA is unfamiliar to most clinicians, it should be included in differential diagnoses of chronic progressive cavitary pulmonary lesion, especially in patients with immunologic dysfunction.

토끼 수막염 모델을 이용한 다제내성 폐렴구균에 대한 Meropenem의 치료 효과

김신우,진정화,강수정,정숙인,김연숙,기현균,김춘관,이혁,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

목적 : 다제내성 폐렴구균에 의한 수막염은 기존과 단일 항생제로는 근치가 어려워 ceftriaxone과 vancomycin 혹은 rifampin의 병용요법이 권유되고 있다. 다제내성 폐렴구균에 사용할 수 있는 다른 약제 중 meropenem은 시험관내 폐렴구균에 대한 항균력이 좋고 경련 등의 중추신경계 부작용이 거의 없어 다제내성 폐렴구균에 의한 수막염의 치료에 이용할 수 있을 것으로 기대되나 이에 대한 자료가 매우 부족한 상태이다. 이에 연자 등은 meropenem과 meropenem+vancomycin의 병용요법이 다제내성 폐렴구균 수막염의 치료에 효과가 있는지를 토끼 수막염 동물 모델을 이용하여 검증하고자 하였다. 방법 : 인체에서 수막염을 일으킨 다제내성 폐렴구균 균주(penicillin MIC 2, ceftriaxone MIC 4, meropenem MIC 0.5㎍/㎖)를 토끼 척수강 내에 직접 주입하여 수막염을 유발한 후 ceftriaxone, vancomycin, rifampin, meropenem의 단일 항균요법, ceftriaxone+vancomycin, ceftriaxone+rifampin, meropenem+vancomycin의 병용요법 간에 치료 효과의 차이를 비교 하였다. 각 치료군은 6 마리의 토끼를 대상으로 하였다. 각각의 항생제는 5 시간 간격으로 2번 정주하였으며, ceftriaxone은 1회 투여하였다. 균주 주입 후 각 치료군이 토끼에서 치료 후 0, 5, 10, 24 시간에 척수액을 채취하여 균주의 수를 측정하여 24시간째의 살균 여부를 최종 치료 효과로 판정하였다. 결과 : meropenem 단독 요법은 10시간째에 모든 균주를 살균하였으나 24시간 째에 다시 균의 성장이 관찰되었으며, meropenem+vancomycin의 병용요법은 단독 약제보다 우수한 살균효과를 보였으나 상승작용은 없었다. 결론 : meropenem+vancomycin의 병용요법은 기존의 ceftriaxone+vancomycin보다 24시간째에 더 큰 균의 감소 경향을 보여(P=0.054) 임상에서 사용이 가능할 것으로 기대되며 향후 실제 수막염 환자에서의 임상효과를 증명하는 연구가 필요할 것으로 생각된다. Background : Because antimicrobial monotherapy for pneumococcal meningitis caused by penicillin-resistant strains is not satisfactory, ceftriaxone+vancomycin [C+V] or ceftriaxone+rifampin [C+R] regimens are recommended. Meropenern [M] is one of the monotherapy options for penicillin-resistant pneumococcal meningitis due to good in-vitro activity against pneumococci and rare adverse reactions in CNS. But there have been few reports in the efficacy of meropenern against pneumococcal meningitis. We evaluated therapeutic efficacy of the meropenern and meropenem+vancomycin in a rabbit model of meningitis caused by penicillin-resistant S. pneumoniae (PRSP). Methods : Meningitis was induced by intracistemal inoculation of a pneumococcal strain isolated from a patient with meningitis (MIC; penicillin 2, ceftriaxone 4, meropenem 0.5 g/㎖). Bacterial concentrations in the CSF were measured at 0, 5, 10, and 24 h after therapy was started. Therapeutic efficacy was evaluated by the final bacterial concentration in the CSF at 24 h. Results : C+V cleared the CSF at 10 h, but regrowth of bacteria was noted at 24 h. Meropenem monotherapy resulted in sterilization at 10 h but regrowth at 24 h. M+V was superior to M or V monotherapy but did not show synergism. Therapeutic efficacy of M+V was at least equal or superior to that of C+V (P = 0.054). Conclusion : Meropenem+vancomycin regimen could be one of the useful options in the treatment of PRSP meningitis. Clinical trials to evaluate the M or M +V are warranted in the future.

전선 : 사학분쟁조정위원회의 대법원 판례 해석과 정이사 선임원칙 등의 문제점 -상지학원의 정이사 선임 사례를 중심으로-

송기춘 ( Ki Choon Song ),김명연 ( Myoung Youn Kim ) 민주주의법학연구회 2011 민주법학 Vol.0 No.46

2010년 사학분쟁조정위원회(이하 "사분위")는 상지학원의 ``정상화``를 위하여 과거 교육비리로 이사에서 해임되었고 형벌까지 받았던 김문기 씨쪽이 추천한 인사를 정이사로 선임하고 교육과학기술부는 이를 승인하였다. 사분위는 이 결정이 대법원의 판결을 충실하게 따른 것이라고 강변하고 있지만, 사분위가 만든 정이사 선임기준은 이 대법원 판결을 자의적으로 왜곡한 것일 뿐 아니라 사립학교법이나 민법의 일반원칙에 비춰 봐도 받아들이기 힘든 것이다. 사분위의 결정은 대법원의 다수의견이 아닌 다수의견에 대한 보충의견을 다수의견인 양 인용하면서 자신들의 정이사 선임원칙을 정당화하고 있을 뿐이다. 또한 사학의 정상화를 위한 기준은 심의 당시의 민법, 사립학교법 등의 일반원칙에 따라 결정되어야 한다는 판결에도 불구하고 현행 사립학교법의 취지와 전혀 반대되는 결정을 하고 있다. 이 글은 사분위가 대법원 판결을 어떻게 왜곡하고 있는지, 정이사 선임원칙은 어떠한 문제가 있는지를 종합적으로 평가하고 아울러 사분위의 권한남용의 원인이라 할 수 있는 사립학교법의 사분위 심의기준에 대한 입법적 보완 또는 사분위의 폐지를 주장하고 있다. The Private School Dispute Resolution Committee has the power to appoint the ad-hoc directors, discharge them or appoint the regular directors to normalize private schools. It made a decision regarding Sangji Educational Foundation last year. The decision is to appoint the directors recommended by the ex-director Moonki Kim who was discharged because of his crime regarding illegal operations of the Foundation as a director. The Committee says that the decision is based on the judgement of the Supreme Court relating to the Sangji Educational Foundation in 2007. But the Committee distorted the judgement to justify its own decision. It regards the concurring opinion of two Associate Justices as the binding opinion of the Supreme Court. Only the opinion of the Court has the binding power, but the concurring one does not. The Committee even made its decision arbitrarily because there is no regulation on the way and scope to normalize private schools. The power of regulation is delegated to the Committee too comprehensively. It`s the defect of the legislation which should be corrected by the legislative body. It was wrong for the Committee to appoint the crime-related people as directors of Sangji Educational Foundation. It should have considered the moral aspects of the ex-director Kim. He has the critical defect to become an educator.

일개 대학병원에서 경험한 방선균증의 임상상

정숙인,김연숙,기현균,김춘관,김신우,이혁,김성민,백경란,송재훈 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.3

배경 : 방선균증은 혐기성의 그람양성 간균에 의한 만성 화농성 감염으로, 경안면부, 흉부, 복부, 골반부 등을 주로 침범한다. 최근 구강 위생의 향상과 항생제의 사용으로 인해 방선균증의 빈도의 감소와 함께 그 임상양상 또한 크게 변화하였다. 저자들은 국내에서의 방선균증의 임상상을 분석하기 위해 본 연구를 시행하였다. 방법 : 1995년 5월부터 1998년 9월까지 삼성서울병원에서 방선균증으로 진단받은 환자를 대상으로 임상기록지를 토대로 감염병소와 임상경과 등을 후향적으로 조사하였다. 결과 : 방선균증 환자는 모두 12명으로 경안면부 1례, 흉부 3례, 복부 3례, 골반부 5례였다. 임상양상은 주로 종괴의 형태로 나타나 진단을 내리기까지 종양과의 감별에 어려웠으며 진단은 모두 조직검사나 흡인액에서 유황과립을 확인함으로써 이루어졌다. 방선균증으로 진단된 환자는 모두 호전소견을 보였다. 결론 : 국내에서도 방선균증이 드물지 않게 발생하고 있으며 임상양상이 다양하여 가장 많이 오진되는 질환 중의 하나이다. 방선균증은 조직검사나 균배양검사를 통해 진단하고 항생제를 통해 완치될 수 있는 질환이므로 환자 진단에 관심을 가지면 불필요한 수술을 피할 수 있을 것으로 생각된다. Background: Actinomycosis is an indolent, slowly progressive bacterial infection, caused by Actinomyces. a gram-positive, non-spore-forming anaerobic or microaerophilic rod. Actinomycosis affects nearly every organ and body site. The disease is classically divided into four types, depending on the anatomic sites involved: cervicofacial, thoracic, abdominal, and pelvic. It has been considered as a rare disease, and only several cases have been reported in Korea. We performed this study to analyse the clinical manifestations of actinomycosis in Korea. Method: We retrospectively reviewed the medical records of patients with actinomycosis at the Samsung Medical Center from May 1995 to December 1998. Results: During the study period, actinomycosis was diagnosed in 12 patients: 1 patient had cervicofacial lesion, 3 thoracic, 3 abdominal, and 5 pelvic. The male and female ratio was 1 : 2 and the mean age was 47.2 years. Sulfur granule was observed in the pathologic specimens from all cases, but organism did not grow at all. It was very difficult to differentiate actinomycosis from tumorous conditions without pathologic diagnosis. All patients were clinically improved with antibiotics or surgical procedures. Conclusion: Actinomycosis is not a rare disease nowadays and has various clinical manifestations. It can be diagnosed by pathologic examination or culture and cured by antibiotics without surgical management.

전문대학 미용관련학과의 발전방안

김춘일,송선영 제주한라대학 1999 論文集 Vol.23 No.-

At first two esthetics departments of college founded in 1991, since then there have been 60 more departments established in 56 colleges and one department in the university in 2000. Even though this department in a college has expanded quantitatively, we have to try to find the solutions for enhancing its quality as following the main stream that each of college should make their own characteristics. Therefore, on this study I suggest you several solutions to develop it. Firstly, we should make the most of its characteristics trying to specialize or subdivide our major studies. At the same time, the professors in this department should focus on the education to utility by participating in the scientific research or industrial training courses actively. Secondly, we should develop textbooks or curriculum being proper for a real situation that can be applied to college education in order to cope with changes in a rapidly specialized society. Thirdly, we have to strengthen on on-job training or an educational industrial complex that will be useful for the graduates of college. We also should activate industrial training courses for professors and an engagement system to industrial personage so that there will be conformity between college education and on the-spot education. Fourthly, we need to provide students more educational opportunities concentrated on the advanced course of esthetics and increase an on-job training in order to cope with the rapidly changing situation. Through these efforts, the students can gain the knowledge and skills of esthetics in many fields. Fifthly, we should try to create a good educational atmosphere and prepare the course of study such as the liberal arts course and the intensive training for major studies so as to provide students various experiences and foster the creative mind and ability of them, aimed to train them to a profession promoting their abilities and talents. Sixthly, we should introduce more flexible or open system in appointing professors to obtain more useful and educative information from the real sites. Finally, I suggest we need to establish more esthetics departments on the universities where have a four-year-course in order to accomplish the specialized training ? such as designing, creative working or achieving highly ? advanced skills.

유산소 운동 능력의 차이가 점증최대운동부하 후 피로회복과정에 미치는 영향

송영주,권대근,성동진,황정윤,박천조,김춘우 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

This study was conducted to investigate the effects of aerobic capacity on blood lactate changes after supramaximal progressive loaded exercise. The subjects were divided into Handball players(HB, n=6)group and Control(CT, n=6)group. All subjects exercised according to the protocol by bicycle erogometer. Blood lactate concentration was also measured during the test time. The RER values of CT group were relatively higher than that of HB group. In particular, the RER values of HR group at exercise 8 & 12min were significantly lower than that of CT group(P<0.05). The blood lactate concentration of HB group was significantly lower than that of CT group at 12min during the exercise(P<0.05). During the recovery times the blood lactate concentration of HB group were significantly lower than that of CT group. In addition, blood lactate clearance of HB group was also higher than that of CT group during the recovery time. From these results, it was suggested that lactate clearance during the supramaximal exercise may be affected by the level of endurance exercise performance.

아로마 요법(Aromatherapy)을 이용한 비만관리

김춘일,송선영 제주한라대학 2000 論文集 Vol.24 No.-

Obesity, a state of excessively accumulated fat inside the body, has frequently been generated due to the imbalance between the intaking calory and the consuming calory which was caused by the increase of intaking high-calory foods and at the same time by the decrease of people's physical activities in our convenient modern lives. In America's case, a third of American people are obese and obesity has become one of major health problems. Even in our country, as our way of eating habits are getting westernized and our way of life is getting convenient, obesity is gradually in the increase and can especially cause serious geriatric diseases. Accordingly various ways of losing weight such as alimentotheraphy, exercise theraphy, medicinal theraphy, operation theraphy, and aromatheraphy have been introduced and sometimes executed without any filtering. This can not only hurt people's health but also cause serious social problems, lowering the work efficiency and reducing the productivity. Most people, however, have an inclination to a faster and simplier way of losing weight. Especially the fact that the aromatheraphy gives powerful and positive influences both to the mind and the body, is favorably received among people all around the world including Japan, Australia, and some American countries. And it has been regarded as a practical and safe beauty theraphy these modern days when many people are interested in natural ways of keeping health. Lots of diet products based on this aromatheraphy have been recently introduced in our country. In this respect, a research & analysis of the aromatheraphy which uses Pachouli of suppressing the appetite centural nerve and Juniper, Geranium, Eucalyptus of showing excellency in urinating and in dissolving fat, is essentially required. On this, I wanted to analyze the effect of aromatheraphy in obesity control and went into a clinical research using aroma oil as a single theraphy. In spite of the only six-week clinical demonstrations, I could get the result of 4.8㎏ loss in weight and of 3.1% reduction in body fat. As you can see in the above result, aromatheraphy could reduce body fat as a single theraphy, but experimental researches and variously repeated studies should be continued to confirm its popularization by embodying its functions in reducing body fat and by securing concrete and relative evidences, I think.

기능성척추측만증에 근막이완요법 및 전침치료 증례

김성욱,강영화,이상훈,권혜연,조태성,송춘호,안창범 동의대학교 한의학연구소 2001 동의한의연구 Vol.5 No.-

목적 : 우리는 신체를 근막의 통합된 전체로 보는 근막이완요법과 TrP를 파괴하는 전침요법을 기능성 척추측만증에 적용시킬수 있는지 알아보았다. 방법 : 22세의 기능성 척추측만증을 가진 남성에게 다양한 형태의 근막이완요법을 적용하였고, 중둔근, 요방형근, 슬괵근에 전침요법을 적용하였다. 결과 : 3주시술후 다리길이차이, 근막구축, Cobb's 각과 척추회전변위가 감소되었고 흉부압박감 같은 전신적증상이 호전되었다. 결론 : 근막이완요법과 전침병행치료가 신체를 근막의 일체로 보는 관점으로 인체의 구조적불균형을 바로 잡아줄수 있는 새로운 치료법의 기능성을 찾았다. Objective: We investigated this study in order to see the adaptation capability of myofascial release that translating the body being integrated fascial totality and electroacupuncture treatment that breaking trigger points in functional scoliosis. Methods: We applied myofascial relase by three patterns and electroacupuncture in TrPs of gluteus medius, Quadratus lumborum and Hamstring muscle to 22 year-old who have had functional scoliosis. Results: After 3 weeks, The leg length, fascial restriction. Cobb's angle and rotation scoliosis are decreased. Systemic symptoms, for example; chest discomfort are improved. conclusion: Myofascial release and electroacupuncture treatment is new methods that treating the sturctural unbalance in view of body's fascial network.

피부미용을 위한 아로마테라피(Aromatherapy)의 작용원리 및 활용방법

송선영,김춘일 제주한라대학 1999 論文集 Vol.23 No.-

Aromatherapy is a treatment which recovers the balance of mind and body. This is an application to human body, using aroma oil, that is, volatile oil contained in roots, fowers, leaves, stems, shells and seeds of special herbs and cells of fruits, etc. Aroma oil promotes immunocompetence, has an effect on all internal organs, glands and functions of hormones and heightens resistance to mold. And also it stimulates the nerves and rests our mind by intensifying or relaxing muscles, so it helps remove slight symptoms of everylife rather than severe diseases. This treatise shows you the usage and principles of aromatherapy good for beautiful skin. It counteracts poisonous characters of a body through bathing, foot-bathing, spreading, drinking, inhaling, massage and wet-compressing, promotes to renew cells and then cures and improves the quality of the skin. And also the fragrance of aroma oil stimulates the central nerve linked with the sense of the smell and stabilizes the balanced state of the mind. That has a good effect on mental improvement and stress management. This aromatherapy has been known good for beautiful skin and used in massage salons for 2 to 3 years. New aromatherapy is reported on its effects and approved in medical science as enough as doctors and herb doctors make the institute authorized. Aromatherapy is accessible to causes of diseases not to be seen which are coming from irregular living habits throughout long times and normalizes and improves functions of skin. So I hope the aromatherapy becomes stable and practical skin management and popularized so as to be vital tonics and living science as well as alternative medical science.

頭鍼이 中風患者의 단기간 NIHSS와 MBI에 미치는 영향

류재춘,박인범,김상우,김철홍,서정철,윤현민,장경전,송춘호,안창범 동의대학교 한의학연구소 2002 동의한의연구 Vol.6 No.-

Objective ; The aim of this study was to investigate the effect of Scalp acupuncture on recovery of motor disorders in stroke patients. Methods ; Twenty two patients with poststroke-hemiplegia were randomized into two groups. Ten patients(test group) treated by 2 methods-Scalp acupuncture and body acupuncture. The other twelve patients(control group) treated only by body acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale(NIHSS) and Modified Barthel Index(MBI). The therapy was performed one a day for 2 weeks. Results ; In terms of score of NIHSS, the test group showed statistically meaningful decrease after 2 week treatment, but the control group showed statistically meaningful decrease after 1 week(p<0.05). And in terms of score of MBI, the test group did not show statistically meaningful increase but the control group showed statistically meaningful increase after 1 week(p<O.05). There was no statistically meaningful difference after 1 and 2 week treatment between the groups. Conclusions ; These results support that test group has almost same effectness compared with control group in improvement of the activity of daily living of poststroke-hemiplegic patients.