고령자 급성 췌장염의 임상적 고찰

백용한,서정훈,송건훈,이진헌,송시영,정재복,강진경,박인서,이수진 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

동진강 수계 농업용수 수질평가

한수곤,최정식,문영훈,엄미정,김갑철 한국환경농학회 2000 한국환경농학회지 Vol.19 No.2

동진강 수계의 수질현황을 파악하기 1994∼1998년 까지 4∼9월에 월 1회에 걸쳐 5개년간 조사한 결과를 요약하면 다음과 같다. 월별로는 빗물에 의한 희석효과로 7, 8월에 수질이 가장 양호하였으며, 4월이 다소 불량하였으나 수도생육 피해 한계농도에는 미치지 못하는 수준이었다. 지점별 수질현황은 생활하수 유입지인 정읍천과 지천의 폭이 좁은 원평천의 무기성분 함량이 높았으며 동진천 상류지역에서 가장 양호하였다. 연도별 현황은 '94년 이후 '95년까지는 수질이 악화되는 경향을 보였으나 '95년 이후로는 각 성분 함량이 낮았지는 등 점점 양호해지고 있으며 COD함량으로 볼 때 특히, 정읍천의 수질이 개선되고 있음을 알 수 있었다. 양이온과 음이온의 총당량온 4월에 가장 높았고 7, 8월에 가장 낮았으며 양이온/음이온의 당량비는 5월에 높았고 7월이 가장 낮았으며 지점에 따라서는 총당량은 정읍천, 원평천, 동진천 하류, 중류, 상류의 순위였으며 양이온/음이온 총당량 비율은 원평천이 상대적으로 작은 수치를 보였지만 지역간 큰 차이는 보이지 않았다. 수질 중 각 성분 상호간의 상관관계를 보면, 대개의 성분 상호간에 유의성이 높게 나타났으나, NO₄^--N는 대개의 성분과 유의성이 없었고, PO₄^(3-)-P도 COD, NH₄^+-N, NO₃^--N, SO₄^(2-)과는 유의성을 보이지 않았다. This study was conducted to monitor the irrigation water qualities along Dong-Jin river watershed. The water quality was surveyed at 6 sites from April to september during 1994∼1998. And the results were as follows : In July and August, water quality was better than that of any other months due to dilution with rainwater. Whereas, it became worse in April but it involved lower contents than limitted contents affected to the crop damage. Content of inorganic components was higher at Jeong-up and Won-pyeong stream. The reason for it that Jeong-up stream was deteriorated with sewage water from Jeong-up city, and Won-pyeong stream has narrow width. Water quality in upstream of Dong-Jin river, was evaluated best conditions in all sampling sites. For investigated period, water quality got worse from 1994 to 1995 but it was getting better to 1998 after 1995, especially at Jeong-up stream. The total equivalent of cation and anion was the highest at April through all months and at Jeong-up stream in sampling sites. Equivalent ratio of cation to anions(∑C/∑A) was higher at May than any other months and lower at Won-pyeong streams than any other sites. The value of most inorganic components was highly correlated with those of other components. But the value of NO₃^--N was not correlated with that of most components, and PO₄^(3-)-P was not correlated with COD, NH₄^+-N, NO₃^--N, SO₄^(2-_.

개에서 이중 결찰법을 통한 동맥관 개존증의 완치 예

윤헌영,정순욱,박희명,박철,정만복,김준영,한현정,황민,노병국,박상혁,장하영,박정윤 한국임상수의학회 2004 한국임상수의학회지 Vol.21 No.1

A ten months old, female Yorkshire terrier weighing 2.88 kg referred to veterinary teaching hospital of college of veterinary medicine, Konkuk University because of syncope, cough and dyspnea. First hematological and serum chemical test revealed thrombocytopenia, mild anemia, and increase of concentration of ALP (195 U/L). On 57 days later, second hematological and serum chemical test revealed polycythemia, increase of concentration of ALP (211 U/L), and Tchol (387 mg/dl). Right atrium enlargement, main pulmonary artery bulge and cardiomegaly (VHS = 11.5) were observed in radiographic findings. Ultrasonographic images showed both right and left ventricular dilation and turbulent flow between the descending aorta and the main pulmonary artery in color Doppler imaging. ECG showed left ventricular enlargement, SA block, and electrical alternant. Thoracotomy was performed through left fourth intercostal incision under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. Cough and dyspnea disappeared on 5 days after operation. Turbulent flow was not found in color doppler imaging of ultrasonography on 10 days after operation. Ten months later after the operation, syncope could not exist any more.

Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

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.

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.

한민족공동체 형성과제와 민족정체성 문제

정영훈 在外韓人學會 2002 在外韓人硏究 Vol.12 No.2

한민족공동체란 전세계에 흩어져서 살고 있는 한민족 성원들을 공동 번영을 위하여 서로 돕고 협조하는 하나의 공동체로 결속시키자는 취지 하에 제기되고 있는 용어로서, 지금 무한경쟁의 세계화 시대를 헤쳐갈 수 있는 민족적 생존발전 전략의 하나로 그 의의가 부각되어 가고 있다. 한민족공동체란 현실적으로 볼 때, 한민족이라는 민족적 정체성을 공유한 사람들로 구성된 상호협조의 연결망 또는 유대체제를 가리킨다. 따라서 성원들에게 공유된 민족정체성의 내용과 강도에 의해 그 성패와 방향이 결정된다고 해도 과언이 아니다. 이 연구는 한민족공동체를 형성하는 과제와 관련하여 제기되는 민족정체성 문제를 검토해본 것이다. 여기에서는 (1) 한민족공동체의 아이디어가 추구하는 이상과 과제에 대해 개략적으로 설명한 뒤, (2) 민족정체성의 개념과 의의 및 그것의 유지·소멸에 관여하는 요인들에 대해 살피고, (3) 한민족공동체 구성원으로서의 정체성은 지금 어떤 상황에 놓여 있는지의 문제와, (4) 한민족공동체의 민족정체성 형성을 위해서는 어떤 방향 설정과 노력이 필요한가라는 물음들을 중심으로 살피고 있다. 결론적으로 이 연구에서는 지구촌에 거주하는 다양한 한민족 성원들이 공유할 수 있는, 그리하여 모두를 하나의 공동체로 결속시킬 수 있는 민족정체성 내용을 채우는 작업이 시급하다는 점을 강조하였다. The idea of Global Korean Community is raising with the belief that the globally dispersed Korean people must be unified and seek the common benifit and prosperity. It is being watched especially as a strategy of national survival and development in the age of globalization and borderless struggles. The idea of Global Korean Community demands national solidarity and cooperation to the Korean people. And it also urges the positive national identity based on national homogeneity and we-feeling. This paper discusses the problem of national identity in reference to the idea of Global Korean Community which is raised actively since 1990. The idea of Global Korean Community requires nation members to love each other, to concede each other, and to stand together. But these virtues can only spring up when there are strong community spirit and national homogeneity. This paper considers the condition of Korean people's national identity and discusses the contents of it, and will inquire how can we make it strong.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

척수강내 Bupivavacain에 첨가한 소량의 Neostigmin의 진통효과와 부작용

소금영,정종달,김병철,유벙식,안태훈,김훈정,임경준 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Spinal cholinergic receptor has been shown to have a antinociceptive action, an effect that can be mimicked by spinal cholinesterase inhibitor. Intrathecal injection of neostigmine cause analgesia and adverse effect in a dose-dependent pattern in the patients. The purpose of this study was to determine whether small doses of intrathecal neostigmine (10, 25 and 50 ㎍) produce analgesia and any side effects. Method : After getting informed consents, 60 patients scheduled for orthopedic surgery of lower extremities under spinal anesthesia were randomly assigned to one of four groups. Using dose-ranging design, patients received either normal saline or neostigmine l0, 25 or 50 ㎍ in a 1-㎎ solution of 5% glucose in normal saline with heavy bupivacaine 12 ㎎. Heart rate, blood pressure, degree of motor and sensory block were recorded. The assessment of postoperative analgesia included time to first rescue, total number of rescue medication and pain score on visual analog scale (VAS) at 1, 3, 6, 9, 12, 24 hour. Nausea and vomiting were assessed by using the visual analog scale at 24 hr postperatively and the incidence of them was recorded postoperatively. Result : There were no significant differences among the four groups in characteristics of spinal blocks. Compared to saline, neostigmine groups significantly prolonged time to first rescue medication and decreased total number of rescue medication and pain visual analog scale score, but incidence of nausea and 24hr nausea VAS score were not increased in neostigmine group compared to control group. Conclusion : These data in patients injected intrathecal neostigmine suggest that analgesia may occur at doses less than neostigmine 50 ㎍ and neostigmine 50㎍ has a better analgesia effect with fewer side effects than other doses for postoperative analgesia.

상악동에 발생한 안면의 섬유성 이형성증 최연소 증례

유영삼,우훈영,조경래,최정환 인제대학교 2008 仁濟醫學 Vol.29 No.-

Fibrous dysplasia is a rare fibroosseous lesion characterized by replacement of normal spongiosa and filling of the medullary cavity of affected bones by an abnormal fibrous tissue. the skeletal structure. Its appearance in infancy is extremely rare. The authors report a case of maxillary fibrous dysplasia observed in a 36 days old infant as a left maxillary swelling. Excisional biopsy was performed to confirm diagnosis. At 1 year follow up, no new growth has been observed without further treatment. This is the youngest case never reported at any references.