서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

Multiple occurrence of recurrent nodular fasciitis after surgical extirpation: masquarding as in-transit metastasis of sarcomatous presentation

( Kyung-nam Bae ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Nodular fasciitis (NF) is a rare benign fibrous tumor related with a proliferative reactive process arising mostly from the muscular fascia or deep subcutaneous region. It distinctively appeared as solitary nodule in young-aged patient with rapid growth, which gives its other name as pseudosarcomatous fibromatosis. A 16-year old boy visited our clinic for the palpable mass on the left shoulder. The initial lesion had already been partially removed by the skin biopsy at local clinic. The biopsy specimen showed only fragments of fibrous mass consisting of collagenous stroma with spindle-shaped cells, but no atypia or mitotic figure. Surgical excision was performed, of which the surgical specimen showed invasion of spindle shaped cells involving subcutaneous layer interlacing with conspicious collagenous fiborus stroma without malignant features. After 3 months, two nodules reappeared near the operation sites and the following biopsy results showed the same as before. We decided to observe the remaining lesions and there had been no significant changes for 5 months. Multiple lesional occurrence is as quite uncommon feature of NF as the recurrence after surgical treatment. Herein, we report a rare case of multiple recurrence of NF after surgical extirpation, which presented with in-transit metastasis of sarcoma-like feature.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1994)

김재홍,안진균,정성재,김영태,김중환,김시영,이석종,이홍렬,서호석,김경훈,권혁진,정우권,고우석,이용석,안필수,오준규,오용섭 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.1

Background : In recent years gonorrhoea has been panendemic and remains one of the most common Sexually Transmitted Diseases in the world, especially in developing countries. Objective & Method : For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria Gonorrhoeae(PPNG), Ive have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1994, 168 strains of N. gonorrhoeae were isolated, among which 109 (64,9% ) were PPNG. Conclustion : Our results suggests that the prevalence of PPNG in Seoul is still increasing.

Erosive adenomatosis of the nipple presenting early improvement after short-term cryotherapy

( Kyung-nam Bae ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young ),( Yang Won-ku Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Erosive adenomatosis of the nipple (EAN) is a rare benign neoplasm characterized by the erosion of the nipple forming crust with serous or bloody discharge. Although there is no pronounced link between its nature course with the malignant transformation, the erosive deformity is directly related to the recurrent functional discomfort and cosmetic problem, resulting in deterioration of the quality of life. A 22-year old woman visited the breast clinic for her persistent deformity of the left nipple. She underwent a core-needle biopsy of a breast mass, which was incidentally found during a breast examination. However, no additional abnormalities were found except for fibrocystic change, and then visited to our clinic for evaluation of the skin lesion. The physical examination revealed serous and bloody erosion on top of the nipple with loss of half of its normal structure. The skin biopsy showed hyperplasia of the tubular structure composed of layers of cuboidal cells, but no atypia or pleomorphism. Then she received four times of cryosurgery every six-weeks, and after 6 months the nipple almost completely healed only remaining a tiny slit-like hole. Although the first choice of treatment for EAN is local excision, it is not quite feasible approach in young-aged female patients given the unsatifactory cosmetical outcomes and the anxiety for invasive procedure. Cryotherapy could be one of the acceptable option for the treatment of EAN.

독성물질의 세포사 기전 및 세포사 유발물질의 검색법 개발에 관한 연구(Ⅱ) : 망간 신경독성을 이용한 파킨슨증 모델의 세포사 Studies on the Mechanism of Parkinsonism induced by Manganese

김종민,박창원,오정자,이보경,서경원,서수경,김규봉,김종원,김광진,김영옥,전범석,박찬웅,이선희 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

1960년대 이후 파킨슨병의 유발물질 중 한 후보로서 망간이 주목받으면서 많은 역학적, 병러학적 연구가 수행죄브다. 그러나 망간이 파킨슨병을 직접 일으키는지, 혹은 파킨슨병과 관련된 부위의 신경세포를 파괴시쿡 파킨슨증만을 초래하는 것인지가 아직 정립되지 않은 실정이다 본 연구에서는 실험동물모델에서 행등학적 변화 측정 및 병리학적, 샐화학적 연구를 통하여 망간의 과다노출글 따른 파킨슨병 유발 여부를 확인하고자 하였다. Sprague-Datylet· 렛드에 망간을 1, 2, 5, 10 mgAg/day의 응량으로 30일 등안 복강 투여하였을 때 모든 망간투여군에서 운동성 감소가 관찰되었다. 뇌조직의 망간 함량을 ion chromatograph?로 측정한 결과 중뇌 흑질과 기저핵 선조체에서 망간 함량의 뚜렷한 증가 소견이 관찰되었으며, 니슬염색체서 선조체의 신경세포수의 유의성 있는 감소가 관찰되었다. 그러나, 흑질의 TH효소 면역염색, GFAP 면역염색, 흑질과 선조체의 T릿효소 western blot 결과는 대조군과 차이가 없었다. 이상의 결과에서, 망간-파킨슨증 모델에서 파킨슨증어 유발되는 기전은 흑질 도파민성 신경 세포의 신호를 받는 선조체 씬경세포의 사멸에 의한 것으로 생각된다. 결론적으로, 망간 독성에 의한 파킨스증 모델에서는 파킨슨 병과는 달리 흑질 도파민성 신경세포의 세포사는 관여하지 않는 것으로 관찰되었다. Manganese(Mn) intoxication causes a parkinsonian syndrome. It may be difficult to distinguish Mn-induced parkinsonism from idiopathic Parkinson disease(IPD). Neuropathological descriptions on the brains with Mn intoxication showed the perferential damage in the globus pallidus and substantia nigra pars reticularis. Pathological reports on the substantia nigra pars compacta(SNpc), a mafor focus of pathologic changes in IPD, are discordant and controversial. The SNpc involvement is of critical importance for the elucidation of pathogenesis of IPD. Therefore, the neurodegeneration in SNpc was investigated in the experimental model of Mn neurotoxicity. Sprague-Dawley rats were administered with manganese chloride(1, 2, 5, 10 mg/kg/day, i.p.) for 30 days. Treated animals showed low levels of distance-traveled from locomotor activity tests. Ion chromatography revealed that Mn accumulation was significant in SN and basal ganglia in Mn-treated animals. Nissl staining showed neuronal loss of the striatum in all treated animals. The degree of neurodegeneration in SN was determined by immunohistochemical staining of tyrosine hydroxylase(TH). The numbers of TH-positive cells on nigral sections were not different from each groups(P>0.05). The densities of glial fibrillary acidic protein immunoreactivity from SN were similar between groups. TH-westen blotting showed no differences between treated animals and controls. In conclusion, the SNpc remains intact in Mn intoxication, and Mn-induced parkinsonism may be caused by damages of output pathways downstream to the nigrostriatal dopminergic system.