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.

제주 우수 수영 선수들의 년중 훈련효과 분석 및 처방

김철원,임상용,김승곤,오만원,김성찬,이창준,남사웅,이세형,류재청 濟州大學敎 體育科學硏究所 1996 체육과학연구 Vol.2 No.-

The study was undertaken to analysis, evaluate, and prescribe the annual effect of training of periodically anaerobic and erobic motor ability for Che-Ju representive team of elementary, middle and high school athletes, first the performance can be obtained when it was prescribed proper training after analysis of physical fitness by each events, second individually fitness scientific analysis. prescription. proper management of athlete will be necessary to apply.

국가 대표급과 제주도 고교 대표급 수영선수들의 그랩 스타트의 운동학적 분석

김철원,김승곤,오만원,임상용,김성찬,이창준,남사웅,이세형,류재청,신석종,김세민 濟州大學敎 體育科學硏究所 1998 체육과학연구 Vol.4 No.-

The purpose of the study was to undertaken to analysis the Grab starting technique between national representive team(3) and Cheju's representive team(3) with 3D cinematography. The conclusions obtained were as follows: Cheju's showed more elapsed time than national representive team on starting block. and more vertical than horizontal direction of COG position, more concentrated vertical velocity & acceleration than forward direction. Therefore It is necessory for cheju's to train balanced trust force in horizontal and vertical direction in grab starting technique.

제주 우수 육상경기 선수들의 년중 훈련효과 분석 및 처방

김철원,임상용,김승곤,오만원,김성찬,이창준,남사웅,이세형,류재청 濟州大學敎 體育科學硏究所 1996 체육과학연구 Vol.2 No.-

The study was undertaken to analysis, evaluate, and prescribe t h e annual effect of training of periodically anaerobic and aerobic motor ability for Che-Ju representive team of elementary, middle and high school athletes. first. the performance can be obtained when it was prescribed proper training after analysis of physical fitness by each events. second, individually fitness. scientific analysis. prescription. proper management of athlete will be necessary to apply. In addition to physiology aspect, it is essential to consider sport biomechanics. sport psychology when we prescribe specific events and necessary approach in demension coach-athlete-researcher for individual.

신경정신증상을 동반한 트리클로로에틸렌 중독 1예

김자현,유성진,김병권,전형준,박종태,김해준 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

배경: 트리클로로에틸렌은 중추신경계에 주로 작용하는 유해 발암물질로서 사용 및 관리 에 주의가 필요하다. 최근까지도 영세사업장을 중심으로 트리클로로에틸렌을 사용함으로 인해 지속적으로 트리클로로에틸렌 중독에 의한 산업재해가 발생하고 있음에도 불구하고 트리클로로에틸렌 중독에 관한 연구 및 보고가 많지 않다. 사례: 환자는 장기간 금속부품 세척 공장에서 트리클로로에틸렌에 노출되었으며,건망증 및 말더듬 증상과 함께 식욕감소와 성욕감소를 동반한 전반적 의욕부진과 우울감정이 양손의 이상감각 및 저림, 통증과 함께 나타났다. 신경전도검사에서 자율신경계의 이상소견을 보였으나,자기공명영상 검사 결과 소뇌의 위축 등의 기질적 이상 소견 및 중추신경계의 감염이나 종양 등은 없었으며 대사 장애나 전해질 이상도 보이지 않았다. 저자들은 환자가 전자부품 세척 공정에서 트리클로로에틸렌을 사용하였다는 점을 중시하여 요중 총삼염화물의 농도를 검사한 결과 과량의 요중 총삼염화물이 검출되어 임상적으로 트리클로로에틸렌 중독을 진단할 수 있었다. 노출은 입원과 동시에 중단되었다. 요중 총삼염화물의 농도는 입원직후 3,331.1 mg/g creatinine, 입원 후 3일째 347.9 mg/g creatinine,입원 후 5일째 64.6 mg/g creatinne으로 감소하였다. 주요 증상이었던 손발 저림과 통증의 급격한 호전을 보였고,우울감 등의 기분장애와 술 취한 느낌,발기부전,말더듬 등의 증상이 입원 후 시행 한 요중 총삼염화물의 농도 감소에 따라 단계적인 회복을 보였다. 결과: 트리클로로에틸렌의 저농도 만성 노출에서 신경 정신증상을 동반한 중독 증상이 나타날 수 있으며,이로 인해 발생한 신경정신증상이 정신과적 절환으로 판단되어 적절한 진단,치료 및 노출 평가가 어려울 수 있다. 트리클로로에틸렌 취급 근로자에서 신경정신증상이 나타나는지를 검토하여 이것이 트리클로로에틸렌 노출로 인한 것인지를 조기에 파악하려는 노력이 필요하다. Background: Trichloroethylene (TCE) has been widely used as a typewriter correction fluid, Paint remover, adhesive, spot removers and, particularly, as a degreasing agent in metal-fabricating operation. However, few studies have reported on the effects of TCE intoxication, in spite of numerous occupation al accidents arising from TCE intoxication, even until quite recently used in small companies. TCE affects mainly the central nervous system (CNS) and is carcinogenic, even when carefully used and managed. Case report: A 48-year-o1d male worker visited our hospital complaining of decreased motivation and general weakness, In history taking, the patient had suffered insomnia, memory disturbance, stuttering, loss of interest and sexual desire, depressive mood for 4 years, dysesthesia with tingling sensation and pain in both extremities, and a nauseas feeling similar to a hangover which had been aggravated for 4 months before admission. The patient had been engaged in metal degreasing with TCE for 8 years. Electromyography indicated disturbance of autonomic function, but there was neither peripheral neuropa-thy nor cervical radiculopathy. Organic abnormalities including cerebellar atrophy and CNS infection were ruled out, while there was no indication of malignancy in magnetic resonance imaging (MRI) and metabolic disorders and electrolyte imbalances in laboratory test. The authors performed biological monitoring for the possible exposed chemicals. Urinary 2,5-hexanedione, a metabolite of n-hexane, was undetected but 3,331.1 mg/g creatinine of urinary trichloro-compounds, a metabolite of TCE, was detected. The patient was diagnosed as TCE intoxication due to a level of urinary trichloro-compounds in excess of the normal range (300 mg/g creatinine), in addition to an occupational history and clinical symptoms. TCE exposure was stopped in admission and the neuropsychiathc symptoms of the patient were improved as the urinary thchloro-compounds were decreased from 3,331.1 mg/g creatinine to 64.6 mg/g creatinine in 5 days. Conclusion: Low-dose, chronic TCE intoxication shows neuropsychiatric symptoms, which are often misrecognized merely as a psychiatric disorder; its appropriate diagnosis, early treatment and exposure assessment are therefore difficult. The neuropsychiatric symptoms in workers who have been exposed to TCE should be monitored, detailed job history should be taken and biological monitoring should be conducted to gain early insight of chronic TCE exposure.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

Energy 槪念形成과 學習指導에 關한 硏究

金泰亨,金成俊,卞茂永 晋州敎育大學校 科學敎育硏究所 1975 科學敎育硏究 Vol.1 No.-

For this study, a experiment school (No. of student: 591), inquired schools (No. of studert 2,214) and 180 teachers were participated. ○Contents of the study is as table 1. Table Ⅰ -------------------------------------------------------------------------------------------- Concept Basic concept Unit School year level -------------------------------------------------------------------------------------------- Ⅵ 6. Energy is accompanied with chemical ○Chemical change 6 change of matter. -------------------------------------------------------------------------------------------- Ⅴ 5. An energy changes into another ○Exchange of energy 5 energy. -------------------------------------------------------------------------------------------- Ⅳ 4. Light is one kind of energy. ○Properties of light -------------------------------------------------------------------------------------------- Ⅲ 3. Heat brings a change of substance. ○Heat and change of 4 substance 3 -------------------------------------------------------------------------------------------- Ⅱ 2. Electricity has energy. ○Electric circuit 3 -------------------------------------------------------------------------------------------- Ⅰ 1. Earth receives energy from the sun. ○Light and shadow 2 -------------------------------------------------------------------------------------------- Basic concept : Energy is always accompanied with natural penomena. -------------------------------------------------------------------------------------------- ○Major subjects of the study. 1) Is it possible to decide the knowledge order of energy concept by the analysis and investigation for the relation between recognition development progress of student and scientific concept formation of student about heat, light, electricity, sound, dynamic (potential and kinetic) and chemical energy? 2) What is the answer for the problem of present teaching method for energy concept formation in primary school science? Data for the study are as follows : Table Ⅱ -------------------------------------------------------------------------------------------- School year 2 3 4 5 6 ------------------------------------------------------------------------------ Unit Light & Electric Properties Exchange Chemical Average(%) Subject\ shadow circuit of light of energy change -------------------------------------------------------------------------------------------- Experiment 71.71% 59.58 65.97 74.83 67.56 69.13 (116) (120) (118) (118) (119) (591) -------------------------------------------------------------------------------------------- Inquired 66.24 46.33 52.82 55.89 57.25 55.71 (414) (461) (431) (452) (450) (2,214) -------------------------------------------------------------------------------------------- * Figures in parenthesis is the number of students. Difference of the means of two populations on table Ⅱ is 13.43%. And it is recognized that experiment school subject is prior in score to that of inquired school and the experiment application is significant. Table Ⅲ -------------------------------------------------------------------------------------------- Unit 2 3 4 5 6 -------- Ability ----------------------------------------------------------- Average(%) Light & Electric Properties Energy Chemical Subject shadow circuit of light exchange change -------------------------------------------------------------------------------------------- Scientific 86.68 69.58 68.26 75.50 70.00 74.00 concept Experi- ----------------------------------------------------------------------------------- Scientific 73.75 58.17 78.09 73.05 81.26 72.86 ment attitude ----------------------------------------------------------------------------------- Scientific 69.50 72.77 72.62 74.06 57.94 57.79 ability -------------------------------------------------------------------------------------------- Scientific 73.58 59.95 51.49 60.96 58.76 60.95 concept Inquired ----------------------------------------------------------------------------------- Scientific 64.84 44.17 57.17 62.05 67.43 59.13 attitude ----------------------------------------------------------------------------------- Scientific 57.11 43.83 52.01 59.16 52.89 53.00 ability -------------------------------------------------------------------------------------------- Difference of mean scores in scientific concept formation is 13.05%, for scientific attitude, 13.73% and for scientific ability, 4.79%, according to the table Ⅲ above. Score of experiment school is prior to that of inquired school and it means that students grow up and progress under the influence of educational environment. A little difference of mean scores in scientific ability is considered as a result of systematic and intensive teaching. The result of inquired school for light and shadow unit, is 66.24%. This is recognized that student's experienced concrete thinking, which was made already before when he did not attend a school yet, was cohered with his daily life and it brought active to learn and improvement of formation. 46.23% of electricity circuit unit is concluded that student are not enough to think yet for practical operation of it. Energy concept formation of student, found out from this study, is the order of Sound energy →Light energy →Electric energy →Movement energy → Heat energy →Chemical energy. Study results for problem 2) are 51.31% in mountain & farm village, 54.71% in fishing village, 55.29% in suburb and 68.57% in urban area. This data may indicate a problem of environment and education. Table Ⅳ. -------------------------------------------------------------------------------------------- School Location Mountain & Fishing Suburb Urban area Total year Unit farm village village -------------------------------------------------------------------------------------------- 2 Light & shadow 59.09 67.83 57.68 97.38 66.24(414) -------------------------------------------------------------------------------------------- 3 Electricity circuit 43.06 44.17 47.16 52.29 66.33(467) -------------------------------------------------------------------------------------------- 4 Properties of light 51.27 52.59 56.45 55.27 52.82(431) -------------------------------------------------------------------------------------------- 5 Energy & exchange 55.35 63.91 57.34 65.88 55.89(452) -------------------------------------------------------------------------------------------- 6 Chemical exchange 49.80 45.05* 60.84 71.96 57.25**(450) -------------------------------------------------------------------------------------------- Total 51.31 54.71 55.29 68.57 -------------------------------------------------------------------------------------------- It is emphasized to formulate experimental process and materials and carriculum involving, selection of teaching materials for location, selection of concept suitable to recognition progress of student, precise experimental guidance, step by step with-out jump, series, and order. ○Response of the teachers who participated in primary school science course, are 76.11% as difficult, 54.45% as too much curriculum but teaching time short. Teacing activities which have the student fully understood through lesson guidance of reliable predicting results for unknown matter, are required. The study results are summarized as follows : 1) In concept formation about energy, light, sound, heat and chemical energy was fixed but electricity & dynamic energy was infixed and weak. 2) An order of energy concept recognition, considering growth and progress of student, is sound-light-electricity-dynamic-heat-chemical energy. 3) Results of lesson for energy concept indicates attitude and ability are poor, regardless of school year and location. 4) Responses of primary school teachers for the science are that curriculum is difficult but destination is hopeful and teaching material is short. 5) They want individual examination, such as test of experimental process with material.

가성부갑상선 기능저하증 환아의 구강 증상 : CASE REPORT

김성오,홍은경,최형준,이제호,손흥규 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.2

부갑상선 호르몬은 혈중 인농도를 낮추고, 칼슘농도를 증가시키는 호르몬으로 부갑상선기능저하증은 부갑상선이 존재하지 않거나 비정상적으로 기능하여 이 호르몬의 분비가 감소되는 질환이며, 가성부갑상선기능저하증은 부갑상선 호르몬 분비는 정상이나, 이 호르몬에 대한 괄과 신장의 반응이상으로 혈중 칼슘 농도가 감소되고 인농도가 증가되는 질환이다. 가성부갑상선기능저하증은 임상적으로 성장 및 발육부전, 둥근 얼굴, 조기 골단폐쇄로 인한 단지증, 이소성 연조직 석회화, 비만, 두개관의 비후, 정신지체, 백내장 등이 나타난다. 구강내 소견으로는 치아의 맹출지연, 법랑질형성부전이 가장 큰 특징이며, 그 외에 결손지, 부정교합, 높은 구개궁, 확장된 치근관과 짧은 치근, 치수강 내 석회화, 높은 우식 이환율, 치근막의 비후 등이 관찰된다. 본 증례에서 환아의 구강내 소견은 맹출한 하악 4전치와 상악 좌우측 영구 중절치, 상악 우측 영구 측절치, 상, 하악 제 1대 구치에서 법랑질형성부전을 보였고, 다수의 유치에서 심한 동요도를 보였다. 방사선 소견으로는 대부분의 미맹출된 영구치들도 법랑질형성부전이 관찰되었으며, 특히 영구 견치의 경우 심한 치관의 형태이상을 볼 수 있었다. 또한 유치의 비정상적인 치근흡수가 나타났고, 하악 전치의 경우 치근형태가 짧고, 치근단이 둥근 형태로 나타났다. 이에 저자는 가성부갑상선기능저하증인 환아의 구강내 소견에 대해 보고하고자 한다. The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view, severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

원발성 두개골내 수막종 : 1예 보고 A Case Report

김대호,홍현숙,조준희,박재성,박성진,차장규,백상현,이혜경 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Primary intraosseous meningioma of skull is rare, and often confused with a primary bone tumor. We report a case of a 71 years old female patient with an intraosseous calvarial meningioma of frontal bone presenting as a solitary osteolytic skull lesion. Plain skull radiograph, CT and MR images show sharply marginated expansile bony lesion in frontal skull vault, and a small well enhanced soft tissue mass within bone. The mass is extracranially protruded to scalp, and is partially attached to the underlying dura. Outer and inner table of skull vault is slightly bulged out, suggesting intradiploic origin of the tumor. The tumor was treated with surgical excision and cranioplasty. Histological examination revealed fibrous meningioma.

응급실 자의퇴원환자의 요인분석

김승환,김옥준,장석준,정구영,김승호 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Discharge against medical advice(AMA) in the emergency department is a frustrating, painful event to both patients and emergency physicians and emergency physicians. A retrospective chart review of 347 consecutive AMA patient from our emergency department from December 1992 to May 1993. Among them, 185 patients were interviewed with our researcher about primary cause of AMA through telephone contact. The results were as follows : 1. Total 9,705 patients visited our emergency department during 6-months period and there was 347 AMA patients(3.6%) 2. The main reasons for 185 AMA were ; 1) patients' or family's own problem in 114 cases(61.6%) 2) changes in patient condition(terminal case, improvement) in 56 cases(30.3%). 3) dissatisfaction to medical services in 15 cases(8.1%) 3. During same period, there was 117 cases of drug intoxication mainly due to suicidal attempt and 18 AMA was noted. Among 18 AMA cases, 16 patients discharged against medical advice due to patients' own problem(mainly due to economical problem) but none of them revisited OPD or emergency department. 4. Eight of 40 AMA patients with symptom improvement were managed in OPD, emergency department or other hospital but none of them admitted. In conclusion, we noticed that the main cause of AMA is non-medical problem in Korea and there should be continuous effert to improve our medical insurance system, emergency medical services system. Only through the judicious use of AMA, it can be used as a tool of determining patient satisfaction and quality improvement in emergency medical field.