Methicillin 내성 황색 포도상구균 감염증의 임상적 고찰

홍명기(Myeong Ki Hong),김준명(June Myeong Kim),김응(Eung Kim),박성삼(Sung Sam Park),홍천수(Chein Soo Hong),정윤섭(Yun Sop Chong) 대한내과학회 1988 대한내과학회지 Vol.35 No.4

N/A The methicillin resistant Staphylococcus aureus (MRSA) strains can produce clinically serious infections. Recently, MRSA infections have had very important clinical significance because of the increasing incidence of MRSA infections and the resistance of MRSA to various antimicrobial agents. The purpose of this study was to evaluate the clinical aspects of MRSA infections treated at Yonsei University Severance Hospital from Jan. lst, 1986 to Dec, 31st, 1987. The results are as follows: 1) The incidence of MRSA isolated was 27.8% of the total Staphylococcus aureus isolated. It was found to be present at frequent of 38.6% in sputum, 23.9% in pus, 38.6% in urine and 18.2% in blood. 2) The sites of MRSA infections were wouod infection (51.2%), pneumonia (25.2%), sepsis (8.1%) and urinary tract infection (8.1%). 3) The risk factors associated with MRSA infection were previous use of antimicrobial agents (80.9%), previous operation (69.7%) and previous care in an intersive care unit (50%). The diagnoses at admission in patients with MRSA infection were trauma (30.3%), neurologic disease (12.3%), disease of the reapiratory system (11.5 %), oncologic disease (5.7%) and burn (4.9%). 4) The treatment failure rate of MRSA infections was 35%, the mortality rate of MRSA infections was 12%. 5) According to in vitro susceptibility tests, sensitivity to MRSA was 100% for vancomycin,99% for fusidic acid, 88% for sulfamethoxazole-trimethoprim,27 % for clindamycin,25% for amikacin,3% for tobramycin and 3% for gentamicin. This study suggests that MRSA infection can be decreased by early recognition of the risk factors associated with MRSA infections, administration of adquate antimicrobial agents and detailed epidemiologic surveillance.

이달의 엑스선 사진 : 공동을 형성한 폐염양 병변

홍명기 ( Myeong Ki Hong ),김세규 ( Se Kyu Kim ),차동훈 ( Dong Hun Cha ),김성규 ( Sung Kyu Kim ),소동문 ( Dong Moon Soh ),조범구 ( Bum Koo Cho ),박광화 ( Kwang Hwa Park ),이유복 ( Yoo Bock Lee ) 대한결핵 및 호흡기학회 1989 Tuberculosis and Respiratory Diseases Vol.36 No.1

The Applications of Intravascular Ultrasound to the Intracoronary Intervention

Myeong-Ki Hong(홍명기) 대한인터벤션영상기술학회 2001 대한인터벤션영상기술학회지 Vol.4 No.1

안전사고 예측모형 개발 방안에 관한 연구(군 교통사고 사례를 중심으로)

기재석,홍명기,Ki, Jae-Sug,Hong, Myeong-Gi 한국재난정보학회 2021 한국재난정보학회 논문집 Vol.17 No.3

연구목적: 본 연구는 군에서 가장 많이 발생하는 교통사고의 예방을 위해 부대별로 교통사고가 발생할 확률을 사전에 예측하는 모형의 개발 방안을 제시하는 것이다. 연구방법: 이를 위해 CRISP-DM(Cross Industry Standard Process for Data Mining) 방법론을 적용하였다. CRISP-DM 프로세스는 6단계로 구성되어 있고, 각 단계는 Waterfall Model처럼 일방향으로 구성되어 있지 않고 단계 간 피드백을 통하여 단계별 완성도를 높이게 되어 있다. 연구결과:전체 집단을 대상으로 기 구축된 사고조사 데이터와 동일한 데이터 세트(data set)를 구축하여 모델링한 결과 분류기준 0.5로 했을 때, 교통사고예측을 위한 모형의 정확도, 특이도, 민감도, AUC에서 의미있는 결과치를 도출하였다. 결론: 예측모형을 설계하는 과정에서 데이터의 부족으로 인해 의미 있는 예측값을 얻기 어려운 문제점이 확인되었다. 이를 해결하기 위해 합리적 추론이 가능한 데이터 세트(data set)를 재구성 및 확대하여 데이터 부족을 해소하고, 이를 활용한 예측모형을 설계할 수 있는 방법론을 제시하였다. Purpose: This study proposes a method for developing a model that predicts the probability of traffic accidents in advance to prevent the most frequent traffic accidents in the military. Method: For this purpose, CRISP-DM (Cross Industry Standard Process for Data Mining) was applied in this study. The CRISP-DM process consists of 6 stages, and each stage is not unidirectional like the Waterfall Model, but improves the level of completeness through feedback between stages. Results: As a result of modeling the same data set as the previously constructed accident investigation data for the entire group, when the classification criterion was 0.5, Significant results were derived from the accuracy, specificity, sensitivity, and AUC of the model for predicting traffic accidents. Conclusion: In the process of designing the prediction model, it was confirmed that it was difficult to obtain a meaningful prediction value due to the lack of data. The methodology for designing a predictive model using the data set was proposed by reorganizing and expanding a data set capable of rational inference to solve the data shortage.

심혈관 OCT의 임상적 응용

하진용,김중선,홍명기,Ha, Jinyong,Kim, Jung-Sun,Hong, Myeong-Ki 한국광학회 2015 한국광학회지 Vol.26 No.1

심혈관 질환은 심장마비의 가장 흔한 원인으로 관상동맥의 협착으로 심근에 산소와 영양분을 제대로 공급하지 못하게 되어 발생하게 된다. 이를 내과적으로 치료하기 위해 심혈관 중재술이 시행되는데 이때 스텐트 삽입 여부, 위치, 크기, 그리고 스텐트 삽입 후 혈관벽과의 밀착 여부를 평가하기 위해 혈관 내 광간섭단층촬영(OCT, optical coherence tomography) 내시경 진단검사를 시행한다. 본 논문에서는 이러한 심혈관 OCT 원리와 기술 동향, 그리고 실제 의료현장에서 심혈관 OCT의 임상적 응용 및 활용가치를 소개하고자 한다. The most common cause of a heart attack is known as coronary artery disease, which narrows the arteries and reduces the blood flow to the heart. To treat coronary artery stenosis, percutaneous coronary intervention (PCI) (a nonsurgical procedure to install a stent, which holds the artery wall open) is performed. Intracoronary optical coherence tomography (OCT) is a catheter-based, invasive optical imaging system. To determine whether PCI is appropriate, and to perform stent evaluation in a catheterization laboratory, OCT examinations are carried out. This review details the fundamental principles and technological status of intracoronary OCT imaging, and discusses the ongoing clinical applications to determine the benefits of OCT-guided PCI.

약물방출 스텐트의 최근 동향

김성환 ( Sung Hwan Kim ),홍명기 ( Myeong Ki Hong ) 대한내과학회 2008 대한내과학회지 Vol.75 No.4

The percutaneous coronary intervention (PCI) has been a great advance in the treatment of coronary artery disease since implantation of bare metal stents (BMS) decreased acute recoil and arterial shrinkage caused by balloon angioplasty. However, neointimal hyperplasia leading to in-stent restenosis after BMS implantation has been emerged a new obstacle. Recent introduction of drug-eluting stents (DES) contributes a powerful breakthrough to PCI. Many large well-controlled randomized trials have shown that DES remarkably reduces restenosis and target vessel revascularization in de novo lesions when compared with BMS. Therefore the application of DES have been expanded to the complex lesions such as left main, multi-vessel, bifurcation, in-stent restenosis, or chronic total occlusion. The safety and effectiveness of DES are still under evaluation with ongoing trials. However, some problems such as very late stent thrombosis remained to be solved. In this review article, we summarize the past, present and future of DES with updated result of clinical trials. (Korean J Med 75:370-382, 2008)

우위대동맥을 이용한 관상동맥 우회술을 시행받은 환자에서 관상동맥 조영술증 발생한 우위대망동맥의 경련

송현,임한중,이철환,홍명기,Song, Hyun,Lim, Han-Jung,Lee, Cheol-Whan,Hong, Myeong-Ki 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.5

In the mid 1980's, the ITA(internal thoracic artery) graft was clearly recognized to be superior to the sapheonous vein graft in respect to long term patency. Therefore, there has been growing interest in the arterial conduit with the possibility of improving the long term result. We have been performing CABG with GEA since 1998 with the same purpose. For mid-term and long-term follow up, we have been performing postoperative coronary angiography. In this paper, a case of GEA spasm, a purported drawback of this conduit, during postoperative coronary anigiography and relieved by direct infusion of 200$\mu\textrm{g}$ isoket into the GEA is reported. The current case which exemplifies the spastic nature of RGEA is accompanied with coronary angiography.

급성 백혈병에서의 항문 주위 감염증의 임상적 고찰

한지숙(Jee Sook Hahn),홍명기(Myeong Ki Hong),이선주(Sun Ju Lee),고윤웅(Yun Woong Ko) 대한내과학회 1989 대한내과학회지 Vol.36 No.4

N/A Infected anal lesions occur not infrequently in patients with acute leukemia and they have been associated with a relatively high mortality. The proper management of infected anal lesions has been a subject of controversy in many reports. Therefore, we evaluated the clinical aspects and management of 19 cases of infected anal lesions in patients with acute leukemia from January 1980 to June 198H. The results were as follows: 1) Among 296 patients with acute leukemia, 19 cases (6.4%) of infected anal lesions were observed. 2) The most frequent symptom and sign were anal pain (73.7%) and anal mass (57.9%). 3) At the time of occurrence of the infected anal lesions, 63.1% of patients were granulocytopenic ( < 500/ mm3) and 84.2% of patients had fever. 4) Nine cases (47.7%) were treated by operative procedures, 1 case by radiotherapy and electrocauterization and 3 cases ruptured spontaneously. 5) The most common microorganism isolated was E. coli, both from wound culture (83.2%) and blood culture (21.1%). 6) Infected anal lesions were improved in 52.6% (10/ 19). The death rate of sepsis resulting from infected anal lesions was 31.6% (6/19) which was significantly low (p = 0.003) and it was 66.7% (6/9) in patients whose infected anal lesions did not improve. The complete remission rate of acute leukemia was significantly high (p = 0.02) in patients with improved infected anal lesions in comparison to those with unimproved infected anal lesions. 7) Complete remission was obtained in 41.7% (5/12). It is concluded that in spite of the high mortality associated with septicemia from infected anal lesions, the importance of prophylactic anal care and meticulous management for infected anal lesions in acute leukemia should be further stressed

좌심방이 혈전을 동반한 승모판 협착증 환자에서 풍선판막성형술 : 경구항응고 요법과 경식도 초음파의 역할

정상식(Sang Sig Cheong),박승정(Seung Jung Park),송재관(Jae Kwan Song),홍명기(Myeong Ki Hong),강덕현(Duk Hyun Kang),김재중(Jae Joong Kim),박성욱(Seong Wook Park),이종구(Jong Koo Lee) 대한내과학회 1996 대한내과학회지 Vol.50 No.6

N/A Objectives: The presence of left atrial thrombi is believed to be a contraindication to balloon dilatation in mitral stenosis. The purpose of this study is to determine whether balloon valvuloplasty is possible in mitral stenosis patients with left atrial thrombi after oral anticoagulation therapy and to evaluate the evolution of left atrial thrombi with oral anticoagulation by transesophageal echocardiography. Methods: Prospective oral anticoagulation with warfarin has been started in tight mitral stenosis with left atrial thrombi. Regular follow up has been performed by transesophageal echocardiography to determine whether the left atrial appendage thrombi are resolved. Percutaneous balloon valvuloplasty has been performed after resolution of left atrial appendage thrombi with oral anticoagulation. Results: Fourteen patients were included in this study period. Nine patients(64%) had been performed balloon valvuloplasty after average 8month oral anticoagulation. Mitral valve replacement had been performed in 3(21%) patients due to renal embolism, menorrhagia and no change of left atrial appendage thrombi. There are two cases in decreasing thrombi size with oral anticoagulation, Conculsion: Left atrial appendage thrombi in mitral stenosis could be resolved in a high proportion after oral anticoagulation treatment, which has been followed by transesophageal echocardiography. Percutaneous mitral halloon valvuloplasty could be safe and effective treatment modality despite of the presence of left atrial appendge thrombi after oral anticoagulation therapy.

양측 장골동맥협착을 동반한 환자에서 경대퇴동맥 접근법을 통한 경피적 대동맥판막 삽입술

이동준 ( Dong Jun Lee ),고영국 ( Young Guk Ko ),심지영 ( Ji Young Shim ),장병철 ( Myeong Ki Hong ),곽영란 ( Byung Chul Chang ),홍명기 ( Young Ran Kwak ),장양수 ( Yang Soo Jang ) 대한내과학회 2013 대한내과학회지 Vol.85 No.2

본 환자는 수술의 고위험군인 중증 대동맥판협착 환자이며 TAVI를 시행하려 하였으나 말초혈관 질환, 관상동맥 우회술 과거력, 중증의 석회화된 대동맥 등의 접근경로상의 문제로 접근이 용이하지 않은 환자였다. 이러한 환자에서 스텐트가 삽입된 장골동맥 협착병변에 경피적 혈관 성형술을 시행 후 성공적으로 TAVI를 시행할 수 있었다. 모든 환자에서 가능한 접근경로에 대한 세심한 평가가 필요하며 이에 따른 적절한 접근경로의 선택 및 시술이 중요하다. Transcatheter aortic valve implantation (TAVI) is an alternative treatment modality for surgical aortic valve replacement in patients at high surgical risk. Transfemoral access is not feasible in many cases with unfavorable iliofemoral anatomy or severe peripheral arterial disease (PAD). Elderly patients with severe aortic valve stenosis have a higher prevalence of PAD due to atherosclerotic degenerative changes in the large and small vessels. Transsubclavian, transapical, and direct access to the ascending aorta by thoracotomy are alternative routes for the TAVI procedure. In this case, we describe a patient with a previous coronary artery bypass graft and bilateral iliac artery stenosis who successfully underwent TAVI using a CoreValve® by transfemoral approach after balloon angioplasty of iliac artery stenosis. (Korean J Med 2013;85:188-193)