당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

출아효모에서 TAR 클론닝법을 이용한 고등동물의 게놈으로부터 특정 염색체 부위의 분리

박정은,윤영호,이윤주,김광섭,윤세련,안태진,임선희,선우양일 동아대학교 기초과학연구소 2003 基礎科學硏究論文集 Vol.20 No.1

복잡한 게놈 분석에 용이하도록 효모의 인공 염색체(YAC) 클론닝 시스템은 발달되어왔다. YAC은 박테리아의 인공 염색체(BAC)보다 더 큰 단편을 클론닝할 수 있고, 또한 클론된 단편을 쉽게 변형시킬 수 있다. 형질전환과 연계된 재조합법(Transformation-Associated Recombination; TAR)은 게놈 라이브러리를 만들지 않고 직접 게놈 DNA로부터 분리하고자 하는 유전자나 특정 염색체 부분을 클론닝 할 수 있는 방법이다. 이 방법은 spheroplast transformation을 수행하는 동안, 목적으로 하는 유전자의 5' 그리고 3' 염기 배열(hooks)을 지닌 TAR 벡터와 게놈 DNA 사이에서 일어나는 상동성 재조합에 의해 이루어진다. 효모 내의 in vivo 재조합을 이용한 TAR 클론닝법은 복잡한 게놈으로부터 목적의 염색체 부분을 원형 YAC의 형태로서 선택적으로 분리할 수 있다. 그러므로 TAR 클론닝 법은 특정 염색체로부터 YACs을 만드는데 매우 유용하여, 전체 게놈으로부터 특이적 유전자나 유전자의 family를 분리하는데 효과적인 방법으로 사료된다. Yeast artificial chromosome (YAC) cloning systems have advanced the analysis of complex genomes considerably. They permit the cloning of larger fragments than do bacterial artificial chromosome systems, and the cloned material is more easily modified. Transformation-associated recombination (TAR) is a cloning technique that allows specific chromosomal regions or genes to be isolated directly from genomic DNA without prior construction of a genomic library. This technique involves homologous recombination during spheroplast transformation between genomic DNA and a TAR vector that has 5' and 3' gene targeting sequences (hooks). Using in vivo recombination in yeast, TAR cloning selectively isolates, as circular YACs, desired chromosome segments or entire genes from complex genomes. We propose that TAR cloning can provide an efficient means for generating YACs from specific chromosomes and that TAR cloning may be useful for isolating families of genes and specific genes from total genome DNA.

연령의 증가에 따른 남성의 골밀도와 골교체율의 생화학적 표지자의 변화

민용기,안규정,정재훈,고은미,이명식,이문규,김광원,이종헌 대한골대사학회 1995 대한골대사학회지 Vol.2 No.2

자연임신에서 분만 및 주산기 예후에 대한 임상적 고찰

이윤희,안준모,김태성,박은희,정집광,이석민,이해혁 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Object: To compare pregnancy outcome between term pregnancy and postterm pregnancy. Method: A clinical observation has been made on 60 cases of postterm pregnancies out of 64 cases delivered at the Dept. of Obstetrics & Gynecology, Soonchunhyang University from January 1, 1997 to May 31, 2002. 100 cases of full term deliveries of 37 to 42 gestational weeks conducted in same period were used as the control group for this study. We analyzed their cesarean section rate, fetal weight, placental weight, meconium stain, perinatal morbidity. The statistical significance was defined as P<0.05. Result: The following results were obtained 1. The incidence of postterm pregnancy was 1.34%. 2. The cesarean delivery rate in postterm group(51.7%) was significantly higher than control group(26%). 3. The incidence of large fetus (weight over 4,000gm) in the postterm group(21.7%) was higher than control group(2%). 4. The weight of placenta was 757g and 706g in the postterm group and control group respectively. 5. 1, 5 minute Apgar score lower in the postterm group than control group. Conclusion : To decrease perinatal morbidity and cesarean rate at 42 or more weeks gestation, appropriate labor induction and twice weekly biophysical profile and USF(AI, Doppler) may be indicated.

우측 대장에 발생한 연소성 용종 1예

이준식,박성한,홍현진,안광순,김지연,배용목,이은영,박선자 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Juvenile polyp, also known as a retention polyp because they contain mucin cysts, is a relatively common hamartomatous lesion in chlidhood. It occurs in 1-2% of children and young adults; however it is uncommon in adulthood. Juvenile polyp is rare in the first year of life and is thus presumed to be acquired and not congenital. It is pedunculated, 2-3 cm in size, red-tan in colour, smooth and always shows fluid filled cystic spaces on cut surface. Histologically, Juvenile polyps are hamartomatous with distended, mucus-filled glands, often with cystic dilatation and edematous lamina propria containing abundant vasculature. The most common manifestation is rectal bleeding produced by auto-amputation of the polyp. Juvenile polyp has been considered not to be at increased risk of developing carcinoma. However, atypical epithelium is observed in some lesions, especially in larger polyps, which may give rise to adenoma and subsequent malignant transformation. Therefore the diagnosis of solitary juvenile polyp should not be made only with colonoscopy and biopsy, but should be totally resected endoscopically for pathologic evaluation. About 90% of the lesions are solitary and localized within 20cm from anal verge. In Korea, there are some reports of juvenile polyps located in the rectosigmoid colon. We report one case of juvenile polyp in adolescent that presented as a hematochezia & abdominal pain, which is located at right colon.

만성 신부전증 환자의 중중 고혈당에 따른 의식 변화 결정에 대한 연구

위형중,이창범,박성광,강성귀,임천규,박은주,윤경택,한상웅,안유헌,김호중· 대한신장학회 2000 대한신장학회잡지 Vol.19 No.6

One-Chip uP에 의한 CO₂가스메탈 아크용접기의 디지털 제어기 설계에 관한 연구

최규하,채영민,송성학,우동학,한광수,안기은 건국대학교 1997 學術誌 Vol.41 No.2

With the development of semiconductor devices, adaptation of microcontroller prevails in industrial area. But in arc welding industry, there has not been much progress in adoption microcontroller technology. Therefore, this paper shows the application of digital control technology to welding machine. This paper presents the design of microcontroller that is appropriate for three phase CO2 gas metal arc welding machine. By using microcontroller in CO2 gas metal arc welding machine, the overact cost can be reduced compared to analog type one. Also TMS370C850 microprocessor is used as overall microcontroller for the arc welding machine.

Increased Extracellular Survivin in the Synovial Fluid of Rheumatoid Arthritis Patients: Fibroblast-like Synoviocytes as a Potential Source of Extracellular Survivin

Ahn, Joong Kyong,Oh, Ji-Min,Lee, Jaejoon,Bae, Eun-Kyung,Ahn, Kwang-Sung,Cha, Hoon-Suk,Koh, Eun-Mi Springer-Verlag 2010 INFLAMMATION Vol.33 No.6

A Learning Set Up for Detecting Minimally Conscious State (MCS)

Eun Joo Kim,Jeong Mi Park,Wan Ho Kim,Kwang Lai Lee,Han Na Kim,Ko Eun Lee,Kwang Ok Ahn 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.3

Detecting signs of learning in persons diagnosed to be in a post-coma vegetative state and minimally conscious state (MCS) may modify their diagnosis. We report the case of a 65-year-old female in a vegetative state. We used microswitch-based technology that is based on patient response to eye-blinking. We followed an ABABCB design,in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. We observed the level of response during the B phases was higher than the level of A and C phases. Th is indicated the patient showed signs of learning. Th is state was confi rmed by an evaluation through the Coma Recovery Scale-Revised (CRSR) score, and after completion of this study her CRSR score changed from 4 to 10. We believe microswitch technology may be useful to make a diagnosis of MCS and off er new opportunities for education to MCS patients.

Analysis of the Conductor-Backed Multilayered Shielded Coplanar Waveguide

Kwang Eun Ahn,Dae Seok Chang,Sang Seol Lee 대한전자공학회 1995 JTC-CSCC : Joint Technical Conference on Circuits Vol.- No.-