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.

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.

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.

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.

畓에서의 有效雨量에 關한 硏究

金成俊,朴承禹,張秉郁,權純國,鄭夏禹 서울大學校 農科大學 1986 서울대농학연구지 Vol.11 No.1

In this study, a daily water balance model for effective rainfall in paddy fields is descrived, and compares the results with field data. The model was used to simulate seasonal effective rainfall for ideal plots with different irrigation scheduling. The followings are a summary of this study results: 1. Effective rainfall during irrigation season of paddy fields in 1985 ranged from 172.3mm at 4cm ridge to 206.7mm at 6cm ridge. They were 63.1% and 75.7% of total precipitation during that span, respectively. The water balance model simulated that 60.5% and 69.5% precipitation may be considered to be effective rainfall. 2. Daily rainfall appears to be important to the ratios of effective rainfall to the total. 3. Measured and estimated effective rainfall had a high correlation. R=0.9805

위장질환에 따른 H.pylori 감염빈도와 검사방법의 비교분석

김대현,조재현,금민수,최성곤,이창형,탁원형,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : H. pylori가 위장관 질환의 병인에 깊은 관련이 있어 이의 적절한 진단 및 치료가 중요하게 대두되고 있다. 이에 저자들은 소화기 증상을 주소로 내원한 환자들을 대상으로 내시경 검사를 실시하여 H. pylori검출을 위한 CLO검사, IgG 항체검사 및 H&E 염색 등을 시행하여 각 질환별로 H. pylori 감염의 양성율을 알아보고 검사법에 따른 민감도 및 특이도를 그 유용성에 대하여 조사하였다. 대상 및 방법 : 1996 4월에서 8월까지 경북대학교병원에 소화기증상을 주소로 내원한 총 313명의 환자를 대상으로 내시경 검사를 실시하여 H. pylori 검출을 위한 CLO 검사, IgG 항체검사, 조직염색 검사를 실시하였다. 결과 : 전체 대상 환자수는 313명이었고 연령별 분포는 16세부터 80세 까지 다양하였으며 그중40대, 50대, 60대가 각각 69예(22%), 73예(23.3%), 65예(20.8%)로 전체 환자중 66%를 차지하였다. 남녀비는 2.07 대 1로 남자가 많았다. 대상환자의 평균나이는 52±15세였고, 전체 대상환자에서 H. pylori 양성군과 음성군의 평균나이는 각각 50±15세, 54±15세 였고, 궤양환자군에서 H. pylori 양성군과 음성군사이의 평균나이는 각각 49±14.8세, 55±13.8세로 나타났다. 각 질환별분포는 위염이 72명(23%), 십이지장 궤양이 85명(27.2%), 위궤양이 80명(25.6%), 위암이 20명(6.4%), 비궤양성 소화불량이 13명(4.2%), 기타가 43명(13.7%)이었으며, H. pylori 감염 양성율은 위염이 71%, 십이지장 궤양이 86.8%, 위궤양이 58.3%, 위암이 75%, 비궤양성 소화불량이 75%였으며 특히 유문륜 궤양에서는 100%의 양성율을 보였다. 소화성 궤양군과 비궤양군에서의 H. pylori 양성율을 비교해 본 결과 궤양군에서는 73.1%, 비궤양군에서는 72%로 통계학적으로 차이는 없었다(P=0.91). 소화성 궤양환자에서 출혈이 동반된 군과 동반되지 않은 군에서의 H. pylori 양성율을 비교해 본 결과 출혈이 동반된 군에서의 양성율은 54.5%였고, 출혈이 동반되지 않은 군에서는 77.5%의 양성율을 보여 출혈이동반되지 않은 군에서 통계학적으로 유의하게 높았다(P=0.014). 나이에 따른 양성율을 알아본 결과 50세 이하에서는 78.5%였고, 50세 이상에서는 67.5%로서 양성율이 낮았으나 통계학적으로 유의성은 없었다(P=0.052). 각 검사법에 따른 민감도 및 특이도는 전체 환자중에서는 CLO검사가 88.9%, 96.1%, IgG항체검사 90.8%, 58.5%, H&E 염색검사 86.9%, 79.2%로서 민감도는 비슷하게 나왔으나 CLO검사는 상대적으로 특이도가 다른 검사법에 비해 높았다. 궤양군에서의 CLO검사의 민감도와 특이도는 92.0%, 95.6%였고, 비궤양군에서의 민감도와 특이도는 84.3%, 96.8%로서 비궤양군에서는 CLO검사의 민감도는 약간 낮았다. 나이에 따른 CLO 검사의 민감도 및 특이도는 50세 이하에서는 91.5%, 93.1% 였고, 50세 이상에서는 86.3%, 97.9%로서 50세 이상에서는 상대적으로 CLO검사의 민감도가 낮았다. 결론 : 본 연구에서는 위장질환에 따른 H. pylori 양성율을 알아보았는데, 다른 보고에서 처럼 높게 나왔으며, 진단 방법으로 사용한 CLO검사, IgG항체 검사, 조직염색검사 등은 모두 비교적 높은 예민도를 나타냈고, 그중 CLO검사가 간편하고 경제적이라는 면에서 임상적으로 유용한 검사로 여겨지나 상대적으로 CLO검사의 민감도가 낮은 비궤양성 질환과 50세 이상의 환자군에서는 CLO검사 외에 다른 검사방법을 병행함으로써 H. pylori의 진단율을 높일 수 있을 것으로 사료된다. Background: Gastric colonization by Helicobacter. pylori is common among patients with peptic ulcer and gastritis. And various diagnostic tests are available in confirming H. pylori infection. The aim of this paper is to estimate the prevalence of H. pylori infection in Gastroduodenal disorders and compare the sensitivity and specificity of the most widely available tests. Methods: A total of 313 patients were tested for H. pylori infection by IgG Ab, CLO test and H&E stains. Results: The prevalence of H. pylori infection was significantly higher in duodenal ulcer(86.8%) than in gastric cancer(75%), gastritis(71%) and gastric ulcer(58.3%)(P=0.009). The sensitivity and specificity of each test was as follows: CLO test(88.9%, 96.1%), IgG Ab test(90.8%, 58.5%), H&E stain(86.9%, 79.2%). Sensitivity of CLO test in peptic group was 92.0%, whereas in non-peptic group, it was 86.3%. Sensitivity of CLO test in age under 50 was 91.5%, that over 50 it was 86.3%. Conculsions: There is a strong association between H. pylori and gastrointestinal disorders. CLO tests have relatively high sensitivity and specificity, especially in peptic group and younger age(below 50 yr)group. But in those patients in which CLO tests are less sensitive (age>50 or non-peptic group), more than one test may be necessary to diagnose the presence of the organism.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

음낭외상시 고환파열에 대한 초음파 검사의 진단적 유용성

김경영,한동준,신대은,노준,문형윤,임동훈,김철성,박성운 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3

Purpose: We determined the use of scrotal ultrasonography in the initial diagnosis and management of testicular injuries due to blunt scrotal trauma. Mateiials and Methods: We reviewed 54 patients of scrotal trauma in the last 8 years. Forty patients were evaluated by ultrasonography preoperatively. A heterogeneous echo pattern of the testicular parenchyma with loss of oval shape, contour definition was the basis for diagnosis of testicular rupture. Among them, 33 cases underwent scrotal exploration and 7 cases were managed conservatively. The remaining 14 patients were evaluated only by physical examination, 8 patients of them were explored immediately because of suspicious testicular mpture. The accuracy of ultrasonography were determined by comparing radiographic interpretations with intraoperative findings. Results: Among the 33 patients who were evaluated by ultrasonography and explored immediately, there were 26 suspected testicular ruptures on ultrasonography. Surgical exploration revealed testicular rupture in 23 and simple hematoma in 10. The testicular rupture was correctly diagnosed by ultrasonography in the 22 cases, and there were 4 false-positive and 1 false-negative diagnoses of testicular rupture. The sensivity and specificity for the diagnosis of testicular rupture are 96% and 60%, and the positive and negative predictive values are 85% and 86%, respectively, Conclusions: Scrotal ultrasonography, with the main radiographic finding of a heterogeneous echo pattern of the testicular parenchyma with loss of oval shape, contour definition, is highly sensitive on the diagnosis of testicular rupture. And it increases the salvage rate for testicular rupture with preservation of the testicular function and prevents delayed complications of chronic pain, atrophy and orchiectomy associated with missed testicular rupture.