Mycobacterium mageritense에 의한 당뇨병성 족부 감염증 1예

김충종,김낙현,김문석,김계형,전재현,박문석,박경운,박완범,박상원,김홍빈,김남중,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Diabetic foot infection is one of the important complications in patients with advanced diabetes mellitus. Limb threatening infections such as osteomyelitis, abscess, and necrotizing fasciitis are frequently accompanied by the disease. Non-tuberculous mycobacterium (NTM) is a rare causative organism of diabetic foot infection. Thus, if one is not suspicious or meticulous, infection due to NTM will be easily overlooked and this will result in delayed diagnose and treat. Therefore, it is necessary to consider NTM as the causative organism if the wound does not respond to the conventional antibiotic treatment and the culture from the adequately obtained specimen reveals atypical acid-fast bacilli. We present a case of diabetic foot infection with osteomyelitis and abscess due to Mycobacterium mageritense, one of the rapid growing mycobacteria, that was successfully treated with surgical debridement and appropriate antibiotic treatment.

항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구

김우진,심주철,공보금,강제욱,문정준,김정은,김민걸,박민경,김성진,김현정,정도운 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:This study was to identify weight & metabolic changes in first-episode psychotic patients with antipsychotics use and investigate the differences of weight & metabolic changes between first-episode psychotic patients and controls with antipsychotics use. Method:In this retrospective study, twenty eight first-episode psychotic patients and twenty eight controls with schizophrenia, schizoaffective or bipolar disorder defined by DSM-IV criteria were included. Information about demographic and clinical characteristics of the subjects was gathered from the medical records. Also body weight, sBP, dBP, fasting glucose, lipid profile and WBC count were evaluated before and after antipsychotics use. Rogistic regression was conducted to assess factors associated with weight gain. Results:First-episode psychotic patients showed more weight and BMI changes than controls after antipsychotics use, and these changes continue over 12 months. On the other hand, there were no significant factors associated with weight gain. Conclusion:The results of present study suggest that antispychotics is one of the major causes inducing weight gain of psychotic patients and antipsychotics-induced weight gain is more vulnerable to drug-naive first-episode psychotic patients.

금궤요략 증상에 근거한 진료기록부 작성에 대한 제언

김상운 ( Sang-un Kim ),정현종 ( Hyun-jong Jung ) 대한한의진단학회 2015 大韓韓醫診斷學會誌 Vol.19 No.1

Objectives This study intends to present the writing of standardized medical records based on Korean medicine on the basis of Geum-gwe-yo-ryak symptoms. Methods 1. Excluding the sentences unrelated to the Geum-gwe-yo-ryak symptoms, the symptoms in the rest of sentences were extracted. 2. Classifying the extracted symptoms as per the review of system, the similar symptoms were integrated. 3. Calculating the frequencies of each symptom, each strain rate was calculated. 4. The above results were compared with the results of existing similar study on Sang-han-ron(『傷寒論』) symptoms Results Conclusion 1. Resulting from the analysis on all sentences in Geum-gwe-yo-ryak, a total of 1486 different symptoms were extracted. 2. As results out of total, the symptom related to the temperature sensation accounted for 12.4%, that related to sweat did 3.8%, that related to thirst did 3.8%, that related to edema did 3.4%, that related to musculoskeletal system did 6.9%, that related to breathing did 8.6%, that related to chest and hypochondrium did 6.2%, that related to abdomen did 9.5%, that related to digestive system did 9.6%, that related to stool did 6.4%, that related to urination and urinary system did 5.7%, that related to mouth, eye, ear, nose, throat did 5.3%, that related to skin did 4.5%, that related to language, mind, sleep and emotion did 6.7%. 3. Compared with Sang-han-ron, Edema appear only in Geum-gwe-yo-ryak. Therefore, edema may be a characteristic symptoms of miscellaneous disease.

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

비만 여중생과 정상 여중생의 혈중지질 비교분석

김태운,신군수,김종인,이광무,김성헌,안병철,고기준 釜山大學校 附設 體育科學硏究所 1995 體育科學硏究所 論文集 Vol.11 No.-

The purpose of this study was to analyze and identify the serum lipids of the middle school girls in order to utilize them as the basic data for the prevention of the middle school girls against arteriosclerosis and diabetes tending to lower age. We used total of twelve middle school girls as subject and devided them into two groups : obese group(n=6), normal group(n=6). The measurement items were the Total-cholesterol, HDL-cholesterol, LDL-cholesterol, TG, FFA. The conclusion of this study was as follows : 1. Total-cholesterol 1) All two groups was a little increased by maximal exercise, but there was no significant difference statistically. 2) Normal group was a little higher than obese group, but there was no significant difference. 2. HDL-cholesterol 1) All two groups was a little increased by maximal exercise, but there was no significant difference. 2) In comparison of two groups, normal group was a little high on empty stomach and obese group was a little high before and after exercise, but there was no significant difference. 3. LDL-cholesterol 1) All two groups was a little increased on post-exercise than pre-exercise, but there was no significant difference statistically. 2) In comparison of two groups, normal group was a little higher than obese group, but there was no significant difference. 4. Triglyceride 1) All two groups was a little increased by maximal exercise, but there was no significant difference. 2) In comparison of two groups, normal group was a little higher than obese group on empty stomach and obese group was a little higher than normal group on pre and post-exercise, but there was no significant difference. 5. T-chol./HDL-chol. 1) All two groups was a little increased by maximal exercise, but there was no significant difference. 2) In comparison of two groups, normal group was a little higher than obese group, but there was no significant difference. 6. Free Fatty Acid 1) All two groups was a little decreased by maximal exercise, but there was no significant difference. 2) In comparison of two groups, obese group was a little higher than normal group, but there was no significant difference.

국내에서 채집한 진드기에서 중합효소연쇄반응을 이용한 라임병균 및 Ehrlichiosis 원인체의 검출

김종배,엄용빈,박성언,박상욱,김영미,송혜원,안준환 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1998 Journal of biomedical laboratory sciences Vol.4 No.2

국내에서 채집한 진드기의 라임병 및 ehrlichiosis원인체 보균 상태를 조사하기 위하여 총 516마리 (Ixodes spp. 22마리, Haemaphysalis spp. 494마리)의 ixodid 진드기를 봄과 가을에 걸쳐 강원도 고산지대 일원에서 채집하였다. 수집한 진드기에서 DNA를 추출 ·정제한 후 추출한 DNA를 template로 이용하여 , Borrelia burgdorferi sensu lato 및 Ehrlichia spp.에 특이하게 반응하도록 제작한 primer를 이용한 중합효소연쇄반응 (polymerase chain reaction, PCR)을 실시하였으며, 이 결과를 oligonucleotide probe를 사용한 southern blotting을 통하여 다시 확인하였다. 총 516마리의 진드기중 B.garinii sensu lato DNA 양성 인 진드기는 68(13.2%)마리 (B. burgdorferi sensu stricto,2; B. afzelii,1; B. garinii,33; B.tanukii,8; B.turdae, 4)로 나타났으며 이 중 37 (7.2%)마리의 진드기 는 southern blot analysis에서도 양성으로 확인되었다. 또한 101 (19.2%)마리의 진드기가 Ehrlichia spp.에 대한 PCR에서 양성 이었으나, 이들 중 25 (4.8%)마리 만이 southern blot analysis에서 양성으로 확인되었다. 그러나 사람의 병인체로 추정 되는 human granulocytic ehrlichiosis (HGE) agent DNA를 보균한 진드기는 확인되지 않았다. 한편 라임병균과 ehrlichiosis원인체를 동시에 보균한 것으로 밝혀진 진드기가 3마리에서 (0.6%)확인되어,국내에서도 진드기 교상시 이들 두 가지 열성질환이 동시에 감염될 가능성이 있는 것으로 사료됨으로 진드기 매개성 열성질환에 대한 적절한 진단법 등을 보다 체계적으로 연구하여야 할 것으로 판단된다. To investigate the distribution of Borrelia Burgdorferi and human granulocytic ehrlichiosis(HGE) agent in ticks, adult ixodid ticks of Ixodes spp. and Haemaphysalis spp. were collected from the high mountain areas of Kangwon Province. Using DNAs extracted and purified in the collected ticks, polymerase chain reaction (PCR) was performed to amplify the specific nucleotide sequences of both agents. Of the 516 ticks, a total of 68 (13.2%) ticks was positive for Borrelia burgdorferi sensu lato with PCR analysis (2 for B. burgdorferi sensu stricto; 1 for B. afzelii; 33 for B. garinii; 8 for B.tanukii; 4 for B. turdae). However a little more than half of PCR-positive ticks (37/68) was found to be positive in the southern blot analysis with Bl6S oligonucleotide probe. One hundred and one (19.2%) ticks were positive for Ehrlichia spp. in PCR, and a quarter of them (25/101) was positive in southern blot with E16S oligonucleotide probe. But none of them was found to be the DNA of HGE agent. And 0.6% (3/516) ticks were positive for both of B. burgdorferi sensu lato and Ehrlichia spp. These findings might implicate the possibility of the outbreak of lyme borreliosis and ehrlichiosis in Korea, and more extensive studies may be need for the diagnosis of multiple tick-borne diseases.

여중생들의 신체조성과 심폐기능 및 심박수 회복율에 관한 비교 연구 : 비만 여중생과 정상 여중생을 중심으로

김태운,신군수,김종인,이광무,김성헌,안병철,고기준,한재웅,이재규 釜山大學校 附設 體育科學硏究所 1996 體育科學硏究所 論文集 Vol.12 No.-

The purpose of this study was to compare and analyze the relation between body composition, cardiorespiratory functions and percent heart rate recovery in obese and normal middle school female students. We used total of 12 middle school female students(3rd grade) as subject and devided them into two groups : The measurement items of cardiorespiratory functions were HR, VE, RQ, VO₂, VCO₂, VO₂/kg, O₂pulse, VE/VO₂, VE/VCO₂, before and after treadmill exercise load. The statistical analysis were M±SD and t-test for groups(α=.05) using ?? statistical package. The conclusion of this study was as follows ; 1. In 5 items(FM, LBM, %Fat, TBW, BMI) all of body composition, obese group has been significantly higher than normal group(P<0.01). 2. In heart rate and VO₂ of resting(before exercise loads) cardiorespiratory functions, normal group has been significantly higher than obese group(P<0.05). 3. In VEmax of cardiorespiratory functions after exercise loads, obese group has been significantly higher than normal group(P<0.05), and in VO₂max, obese group has been significantly higher than normal group(P<0.01). 4. In 1, 3, 5 minute percent recovery all of percent heart rate recovery after exercise loads, normal group has been higher than obese group but there was no statistical significant difference.

運動負荷前後 肥滿女中生의 血中 Glucose, Insulin 및 Apolipoprotein 代謝變化

김태운,신군수,김종인,이광무,김성헌,안병철,고기준 釜山大學校 附設 體育科學硏究所 1994 體育科學硏究所 論文集 Vol.10 No.-

The purpose of this study was to determin a study on the change of blood glucose, insulin and apolipoprotein metabolism before and after maximal exercise in obese middle School girls. The subjects were included 2 groups (each group n=6) : obese group, non-obese group. The measurement variables were blood glucose, insulin and apolipoprotein before and after maximal exercise. The conclusion of this study was as follows: 1. Changes in glucose 1) Obese group had no significant differences by maximal exercise. 2) Non-obese group has been increased significantly by maximal exercise (P<.05). 3) No significant difference was found between two groups. 2. Changes in insulin 1) Obese group had non-obese group had no significant differences by maximal exercise. 2) Obese group has been increased significantly when comparing with non-obese group (P<.05). 3. Changes in apoliporprotein 1) Two groups in Apo-AI has been increased significantly pre and post maximal exercise(P<.05). 2) No significant difference on Apo-AI was found between two groups. 3) Obese group and non-obese group in Apo-B had no significant differences by maximal exercise. 4) No significant difference on Apo-B was found between two groups.

심질환자의 회복을 위한 운동 처방

김태운,김성헌 釜山大學校 附設 體育科學硏究所 1993 體育科學硏究所 論文集 Vol.9 No.-

This chapter has described in detail the manner in which exercise is prescribed to cardiac patients in an inpatient(phase-I), outpatient (phase-II), and community-based (phase-III) program setting. The risks of fatal or nonfatal coronary events were shown to be low and significantly reduced in more recent years. Although medical problems exist, it was shown that initiating programs early after MI or CABG surgery is safe and beneficial to the patient. Inpatient programs for patients without complications usually begin 3 days after MI or one to two days after open-heart surgery. Programs are conducted at a low intensity and emphasize ROM exercise, ambulation, and stair climbing. Outpatient programs are recommended for at least 8 to 12 weeks after hospital discharge, followed b 3 to 6 months in a community-based program. The importance of classifying patients as to low, medium, and high risk for future events was emphasized. Low-risk patients need little or no telemetric ECG monitoring and can safely conduct their exercise program at home or in a low-cost supervised setting. The standards of exercise prescription were outlined, and the common features of training programs for normal healthy adults tations of the cardiac patient, progression of exercise is slower, intensity is lower, frequency is greater, and duration is longer than in healthy individuals. The need for well-rounded training program for patients was discussed. It was recommended that strength training be included early in the recovery process(phase-II) so that patients may be better prepared to carry out work and leisure activities. In addition, the importance and need for ROM exercise in surgical patients as early as one to two days after surgery was stressed. Monitoring of exercise sessions was accomplished in a variety of ways. Early ambulation was usually monitored by direct wire or telemetry systems for HR and ECG rhythm. Although there were diverse opinions regarding how long and to what extent sophisticated monitoring should take place, most experts believed that 8 to 12 weeks of continuous or periodic monitoring was ideal for moderate-risk patients. Longer periods of monitoring were recommended for patients at high risk and with dangerous rhythm disturbances. Guidelines for BP monitoring and the use of RPE scale for exercise prescription were discussed. Most directors administered an SL-GXT 3 to 6 weeks after surgery or MI. The predischarge GXT or SL-GXT is a standard procedure for diagnosis, exercise prescription, and risk stratification. In general, exercise prescription for the cardiac patient should start early but progress slowly, include rhythmical activity of low intensity, emphasize greater frequency and longer duration, be individualized, and help the patient become independent and return to a normal life.

동기유발을 위한 ARCS이론을 적용한 수업이 수학과 문제해결력 신장에 미치는 영향

성열욱,김상운 한국학교수학회 2001 韓國學校數學會論文集 Vol.4 No.2

All men's achievement and behavior is always based on motivation. It has been reported that learning motivation plays an important role to get achievement of study to approximately 16∼38%. Therefore, a lot of researchers agree that learning motivation must be required for learning achievement. This study focuses on "How behavior induces learning motivation from learners?" I adapted "the Attention, Relevance, Confidence, Satisfaction" which is supported by John. M. Keller in the model of ARCS to the course of teaching-learning in order to improve them systematically. The effectiveness and results of adaptation must be considered to solve the math problems.