첫 경련이 간질 중첩증으로 발현된 소아의 특성

박석우(Seok Woo Park),장지연(Ji Yeon Chang),권영세(Young Se Kwon),홍영진(Young Jin Hong),손병관(Byong Kwan Son) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.2

목 적 : 간질 중첩증은 신속한 치료를 요하는 신경학적 응급 질환으로 때로는 심각한 신경학적 후유증이 발생할 수 있으므로 원인 질환과 예후에 영향을 미치는 인자들에 대해 정확한 이해가 필요하다. 이에 저자들은 첫 경련이 간질 중첩증으로 발현된 소아의 원인, 임상 양상, 치료, 예후 및 신경학적 후유증의 발생 빈도의 연관 관계를 알아보고자 이 연구를 시행하였다. 방 법 : 1996년 7월부터 2002년 6월까지 인하대학교병원 소아과 및 응급실에서 첫 발작이 간질 중첩증으로 진단받은 1개월에서 5세 사이의 환아 25명을 대상으로 나이에 따른 분포, 원인 질환, 경련 형태, 지속 시간, 사용 약물, 뇌파 및 MRI의 소견, 예후를 기록지를 통하여 후향적으로 분석하였다. 결 과 : 1) 대상 환아의 남녀의 비는 2.1:1이었고 대상 환자 25명 중 남아 17명(68%), 여아 8명(32%)이었으며 연령은 20±1.6개월로 대부분 3세 이상(80%)에서 발생하였다. 2) 경련 형태는 전신 강직-간대형이 60%, 전신 강직형 16%, 부분 간대형이 16%, 부분 발작형이 8%이었다. 3) 원인 질환과 예후는 증후성인 경우가 64%였으며 특발성인 경우가 36%였다. 증후성의 경우 발열이 40%, 중추 신경계 감염이 20%, 허혈성 손상이 4%이었으며 원인 질환이 있는 경우와 그렇지 않은 경우와의 통계학적 유의성은 없었다. 4) 경련의 지속시간은 30분-1시간이 17례(68%), 1-2시간이 4례(16%), 2시간 이상이 4례(16%) 이었다. 지속 시간이 짧을수록 예후가 좋은 경향을 보였다. 5) 사용 약물은 phenobarbital, phenytoin, midazolam, valium, valproic acid이었다. 약물 한 가지로 조절된 경우 13례(52%), 두 가지로 조절된 경우 11례(44%), 세 가지로 조절 된 경우 2례(4%)이었으며 세 군간의 예후를 비교해 보았을 때 한 가지로 조절된 군이 다른 군 보다 예후가 좋은 경향으로 나타났다. 6) 뇌파는 20례에서 시행하였는데 정상 7례(35%)이었고, 13례(65%)는 비정상이었다. 비정상은 전기적인 지속경련을 보인 경우 6례(30%), 배경파 이상을 보인 경우 6례(30%), 국소적인 간질파를 보인 경우 1례(5%)이었다. MRI는 19례에서 시행하였는데 정상 소견 10례(53%), 이상 소견 9례(47%)이었다. 7) 원인이 발열인 경우에서의 예후는 정상을 보인 경우가 6례, HHE를 보인 경우가 2례, 복합 부분 발작을 보인 경우가 1례, 정신 지체를 동반한 뇌성 마비가 1례였다. 결 론 : 첫 경련이 간질 중첩증으로 발현된 소아는 대부분 3세 이하였다. 경련 시간이 1시간 이내, 한 가지 항경련제로 경련이 조절되는 경우는 예후가 좋았고, 경련 시간이 1시간 이상이거나, 여러 가지 항경련제를 사용하거나, 원인 질환이 있는 경우는 예후가 나빴다. Purpose : Status epilepticus(SE) is a pediatric and neurologic emergency associated with significant morbidity and mortality. Prompt recognition and management are needed for successful outcomes. We evaluated, clinical manifestations, treatment and prognosis of the patients whose first seizure attacks were presented as SE. Methods : According to the department of pediatrics and the emergency room in Inha University Medical Center, there were a total of 25 children between 1 month and 5 years old who were diagnosed as status epilepticus from July 1996 to June 2002. Also, their medical records were reviewed and analyzed interms of age distribution, accompaning diseases, the types and duration of convulsion, medications, EEG and MRI findings and prognosis. Results : Twenty-five cases were studied. The mean age at the time of the diagnosis was 20±1.6 months and 80% of the patients were less than 3 years old. The most common type of the status epilepticus was generalized tonic clonic seizure comprising 15 cases(60%). 64% of the patients were symptomatic: fever(40%), CNS infection(20%), ischemic injury(4%) while 36% were idiopathic. Seizure attacks were terminated within an hour in seventeen patients(68%) and they controlled by one antiepileptic drug in thirteen patients(52%). Of the 20 EEGs, abnormal findings were shown in 13 cases(65%); namely, electrical seizure(30%), abnormal background(30%), and focal epileptiform discharge(5%). Of the 19 brain MRIs, abnormal findings were shown in 9 cases(47%). Conclusion : The children whose first seizure attack were presented as SE were less than 3 years old. The prognosis is good in that most of the seizure attacks were terminated within an hour and controlled by one epileptic drug. However those seizure attacks with longer duration, multiple antiepileptic druge and underlying causeare had poor prognosis.

Effects of dietary supplementation of Pediococcus pentosaceus strains from kimchi in weaned piglet challenged with Escherichia coli and Salmonella enterica

송동철,Ji Hwan Lee,Kangheung Kim,오한진,Jae Woo An,Se Yeon Chang,조현아,Sehyun Park,Kyeongho Jeon,Yohan Yoon,유윤정,Younghyun Cho,Jin Ho Cho 한국축산학회 2023 한국축산학회지 Vol.65 No.3

Escherichia coli (E. coli) and Salmonella enterica (SE) infections in pigs are major source associated with enteric disease such as post weaning diarrhea. The aim of this study was to investigate the effects of Pediococcus pentosaceus in weaned piglets challenged with pathogen bacteria. In Experiment.1 90 weaned piglets with initial body weights of 8.53 ± 0.34 kg were assigned to 15 treatments for 2 weeks. The experiments were conducted two trials in a 2 × 5 factorial arrangement of treatments consisting of two levels of challenge (challenge and non-challenge) with E. coli and SE, respectively and five levels of probiotics (Control, Lactobacillus plantarum [LA], Pediococcus pentosaceus SMFM2016-WK1 [38W], Pediococcus acidilactici K [PK], Lactobacillus reuteri PF30 [PF30]). In Experiment.2 a total of 30 weaned pigs (initial body weight of 9.84 ± 0.85 kg) were used in 4 weeks experiment. Pigs were allocated to 5 groups in a randomized complete way with 2 pens per group and 3 pigs per pen. Supplementation of LA and 38W improved (p < 0.05) growth performance, intestinal pathogen bacteria count, fecal noxious odor and diarrhea incidence. In conclusion, supplementation of 38W strains isolated from white kimchi can act as probiotics by inhibiting E. coli and SE.

Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

Chang, Oliver,Choi, Eun-Kyung,Kim, Im-Ryung,Nam, Seok-Jin,Lee, Jeong Eon,Lee, Se Kyung,Im, Young-Hyuck,Park, Yeon Hee,Cho, Juhee Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.20

Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

바닥輻射 煖房시스템의 熱傳達 特性

연인모,김대기,이세균 충북대학교 건설기술연구소 2002 建設技術論文集 Vol.21 No.2

The object of this study is to investigate the thermal characteristics of heating system with floor radiation for residential building. As a first step, the thermal resistance of floor constructed with mortar and concrete has been studied while hot water is supplied through pipe under the floor surface. A heat transfer model of floor heating system which has natural convection and radiation from floor surface to the heating space has been developed to predict the heat transfer and the temperature of floor surface. Also, expriments have been performed and the results have been compared with those of heat transfer model. This study does not include all the heat transfer characteristics associated with typical heating system with radiant floor in detail. However, heat transfer modeling developed in this study can be a first step in design of comfortable floor temperature. Therefore, the results of this study can provide important informations to construct and optimize such a system.

미성숙영구치의 복합항생제 적용에 의한 변색의 처치: 증례보고

박소연,김영재,김정욱,장기택,이상훈,김종철,한세현,현홍근 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

The concept of revascularization of necrotic pulps regained interest and became an alternative conservative treatment option for young permanent teeth with immature roots. Revascularization of immature teeth with apical periodontitis depends mainly on disinfection of the canal. Since the infection of the root canal system is considered to be polymicrobial, a combination of drugs would be needed to treat the diverse flora. A triple antibiotic mixture of metronidazole, ciprofloxacin, and minocycline was used as an intracanal medicament. However, discoloration was developed after applying the triple antibiotic mixture. It is believed that the marked discoloration is related to the use of minocycline. The aim of this article was to present cases of coronal discoloration after triple antibiotic therapy in immature tooth and was treated with bleaching technique to control coronal discoloration. In conclusion, revascularization by using triple antibiotics promotes a paradigm shift in treating endodontically involved permanent teeth. However, we should understand that triple antibiotics containing minocycline induces tooth discoloration. Further research to prevent coronal discoloration should be investigated and suggested for the safe use of triple antibiotics. 괴사된 미성숙영구치의 치수치료에 있어서 치수의 재혈관화를 통해 치근단 발육 및 치근형성을 지속하려는 개념이 소개됨 으로써 현재 미성숙영구치의 치수치료의 대안으로 제시되고 있다. 이러한 치근단 염증을 가진 미성숙 영구치의 재혈관화를 위해서는 가장 중요한 것이 근관내 감염된 부분을 확실히 제거하는 살균(disinfection)이다. 근관 내 감염은 여러 세균의 복 합작용으로 일어나기 때문에 철저한 살균에 사용되는 약제의 조합은 다양한 범위의 균주를 모두 제거 가능해야한다. Metronidazole(MN), ciprofloxacin(CF), minocycline(MC)의 세 가지 복합항생제가 약제로 사용되고 있으나 이 복합항생 제 적용 후 치관변색을 일으키는 사례가 보고되고 있다. 이러한 치관변색은 항생제의 성분 중 MC에 의한 것으로 여겨지고 있으며, 본 증례에서는 복합항생제 적용에 의해 야기된 치관변색의 증례를 소개하고 이를 표백술로 처치하여 최종 수복한 증 례를 보고하였다. 복합항생제 적용을 통해 미성숙영구치의 치수치료에 새로운 패러다임을 제시한 것은 분명하지만 치관변색 등의 부작용이 있음을 인지하고 치관변색을 사전에 예방하고 최소화하기 위해 다양한 방법이 강구되어야 할 것이다.

신경섬유종증 환자에게서 발생한 특발성 혈소판 감소증 1예

권세훈,김형호,강지인,장재혁,원경준,장재현,김상용,배학연 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Idiopathic thrombocytopenic purpura is a disease characterized by thrombocytopenia in peripheral blood with positive anti-platelet antibody titer, no splenomegaly, the presence of megakarocyte. The causes of idiopathic thrombocytopenic purpura were usually related to autoimmune disease, infection and drugs. A 46-years-old man was admitted for evaluation of abdominal mass. He has many cafe-au-lait spots and nodules in almost skin for 30 years. Several years ago, he palpated mass in Lt. inguinal area. hIe has known the abdominal mass after checking abdomen CT in local clinic and visited our hospital for evaluation of abdominal mass. At admission, laboratory tests showed hemoglobin 12.5 g/dL, hematocrit 38.4 %, WBC 5,460 /㎣ (neutrophil 64.5%, lymphocyte 21.7%, monocyte 4.1%, eosinophil 5.4%), reticulocyte 0.7%, Platelet 52,000 /㎣, total protein 6.51 g/dL, albumin 3.80 g/dL, alkaline pohsphatase 161 IU/L, AST 110.7 IU/L, ALT 64.9 IU/L, total bilirubin 0.44 ㎎/dL, BUN 18.4 ㎎/dL, creatinine 0.79 ㎎/dL. Peripheral blood smear showed normocytic normochromic anemia, thrombocytopenia. Bone marrow aspiration smear showed normoplastic myeloid and erythroid precursor. The bone marrow biopsy section shows normocellular marrow (35%) for his age and mildly increasing myeloid cell lineage. We have experienced a case of idiopathic thrombocytopenic purpura in a patient being in neurofibromatosis and therefore reporting it with documentary records. 저자들은 신경섬유종증 환자에서 특별한 원인을 발견할 수 없었음에도 특발성 혈소판 감소증이 발생한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

이민과 탈민족 국가 : 독일의 외국인 노동자 정책을 중심으로 the Case of the German Foreign Worker Policy

김세연 인제대학교 2002 仁濟論叢 Vol.17 No.1

국제화 시대에 독일은, 경제적으로는 국제화와 지역통합을 추진해야 하고 자본 시장 및 상품 시장과 함께 노동 시장을 개방해야 한다. 하지만 정치적으로는 민족주의에 입각해 국민을 통합하고 정치적 정당성을 확보하기 위해 개방된 시장을 통해 유입된 역외 외국인 노동자의 취업과 체류 및 복지 혜택과 참정권을 선택적으로 제한하게 된다. 이로써 독일은 자국민과 역내 외국인에게는 보장된 인권 및 시민권을 역외 외국인에게는 자국의 편의에 따라 선택적으로 차별하는 상황에 빠져들게 된다 그 결과 자국 중심의 선택적인 외국인 정책은 독일에 체류하는 외국인의 통합을 사실상 어렵게 만들고 있다. 이 때문에 이민을 통해 독일의 인구 감소와 노령화 및 노동력 부족 문제를 해결하기가 현재로서는 어렵다고 간주된다. In the modem states system as a rule one state should be consisted of one nation. The nationalism rationalizes this one nation - one state system. In the modern era multinational state, such as Austria - Hungarian Monarchy, was a exception. But since the end of the 1950es the west European nation states, such as England, France and Germany have imported millions of workers from the ex-colonial states or their neighboring countries. Already they have become multinational states. Now in these states is multinationalism or post-nationalism as an alternative to racism or nationalism under discussion. In the age of "the Global Village" only the multinational immigration state, such as the USA, which can successfully recruit efficient and flexible labor forces all over the world, can enhance its state power at its best and at its will. Without the integration of millions of immigrants on the base of the multinationalism or post-nationalism the advanced west European states can not overcome the problem of the decreasing labor population in the next generations. But the Germany's foreign worker policy has still been depressed and tuned by the ethnic-cultural nationalism. Because of its ethnic-cultural nationalism the degree of the integration of the foreign immigrants has stayed at lower level than in its neighboring states, such as England and France. Without more active introduction of the post-nationalist institution, such as ius soli principle than until now into the nationality law, Germany can not overcome its ethnic-cultural nationalism and problems of the alteration and decrease of its population at the end.

부하순환 하에서 제V급 복합레진 수복물의 미세변연누출에 대한 재접착제의 효과에 관한 연구

윤연희,김영재,김정욱,장기택,이상훈,김종철,한세현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

저점도의 레진을 복합레진 수복물 위에 도포하는 것은 미세누출방지와 변연 완전성(integrity) 유지를 위한 한 방법이다. 하지만 장기간 관찰하면, 수복물은 저작압에 의한 영향을 받게 되는데, 저점도의 레진으로 수복물 변연부를 재접착(rebonding)하였을 때 저작압에 의한 응력에 견디면서 계속하여 수복물에 긍정적인 영향을 주는지에 대한 연구는 미흡한 실정이다. 본 연구는 부하순환(load cycling) 하에서 제Ⅴ급 수복물의 미세변연누출에 대한 재접착제 (rebonding agent)의 효과를 알아보고자 하였다. 40개의 건전한 소구치의 협면에 제Ⅴ급 와동을 형성하고 제조사의 지시대로 광중합복합레진으로 수복하였다. 20개씩 무작위로 나누어 표면전색을 하지 않는 Ⅰ군과 표면을 산부식 후 재접착한 Ⅱ군으로 설정하였다. 열순환 후 각 군에서 10개씩의 하위군 (A군=No load cycling군, B군=Load cycling군)으로 나누어 이중 B군의 시편에 1 Hz의 속도로 수직력이 4-100까지 100,000회의 부하순환을 가하였다. methylene blue용액에 침윤시켜 변연의 미세누출릉도를 평가하여 다음과 같은 결과를 얻었다. 1. 교합변연에서는 재접착과 무관하게 유의한 차이가 없었다(ⅠA-ⅡA군, ⅠB-ⅡB군) (p>0.05). 2. 치은변연의 경우는 부하순환을 하지 않은 군의 경우 재접착을 한 군(ⅡA군)이 재접착을 하지 않은 군 (ⅠA군)에 비해 더 적은 미세누출결과를 보였다(p<0.05). 3. 치은 변연에서 부하순환을 시행한 군의 경우에는 재접착을 한 군(ⅡB군)과 재접착을 하지 않은 군 (ⅠB군)과 유의차가 없는 비슷한 미세누출의 결과를 보였다(p>0.05). One clinical technique recommended f3r improving marginal integrity is "rebonding" or application of unfilled resins to the surface of composite restoration. But continuously the restorations are affected with occlusal load. There is room for doubt that the rebonding agent has the positive effect on microleakage in spite of the stress generated by the occlusal load. This study determined the effect of rebonding on microleakage of Class Ⅴ resin composite restorations under load cycling. Class Ⅴ cavities were prepared on the buccal surface of 40 sound extracted premolars and restored with a hybrid light-cured resin composite according to manufacturers' directions. They wert randomly divided into two groups consisting of 20 samples a control(group Ⅰ), without surface sealing, and the other group (group Ⅱ) in which margins were etched and rebonded. After thermocycling, each of groups was divided into subgroups (group A, B), and load cycling(total 100,000 cycles with 4-100N load at a rate of 1 Hz) were applied on the group B. Assessment of microleakage utilized methylene blue dye penetration. The following results were obtained : 1. In the occlusal region, no significant difference was noted in the scores regardless of whether or not the rebonding agent was used (group ⅠA-ⅡA, ⅠB-ⅡB) (p>0.05). 2. In the cervical region, the control group with rebonding (group ⅡA) showed the better result than the group without rebonding (group ⅠA) (p<0.05). 3. In the cervical region, the rebonded group with load cycling(group ⅡB) showed similar results to the groupf·ithout rebonding(group ⅠB) and no significant difference was noted(p>0.05).

외과적 노축과 교정력에 의한 매복 상악 견치의 치험례

정수연,한세현 大韓小兒齒科學會 1993 大韓小兒齒科學會誌 Vol.20 No.2

Each patient with an impacted maxillary canine must undergo a comprehensive evaulation of the malocclusion. There are several methods to treat impacted canine. Surgical exposure of the canine and orthodontic treatment to bring the tooth into the line of occlusion is considered the most desirable approach. Conservative exposure, light movement, and light force will minimize the undesirable effects such as devitalization, ankylosis, root resorption, gingival recession, and alveolar bone loss. Three cases are repoted, which were treated with surgical intervention and orthodontic tooth movement.

코퍼스에 기반한 한국 중학생의 영어 유의어 연어능력에 관한 연구

정연창,염지민,장세은 새한영어영문학회 2006 새한영어영문학 Vol.48 No.4

This study investigates Korean middle school students' collocation ability of English synonymous verbs and adjectives. The focus is on how well Korean middle school students understand the difference in collocation between these synonymous words. The subjects are a total of 73 middle school students. They are divided into two groups according to their grade on midterm exams, a high level group and a low level group. Five pairs of verbs and adjectives, such as look/see, tell/say, large/big, little/small, tall/high were tested. The results are as follows. First, students are better in adjectives than verbs. Second, there are some questions which are pretty easy and familiar, but students do not answer correctly. This indicates that simple exposure to sentences with these words is not enough for foreign learners to acquire the appropriate use of these five pairs of synonymous words. Third, it is found that learners' general English ability correlates with their collocation ability. Fourth, no regularity can be found in their errors. This means that English grammar is not fully internalized, so that they answer the questions according to fragmentary knowledge of English and their familiarity with some particular English expressions.