자매에서 발생한 중증 마이코플라즈마 폐렴에서 스테로이드 치료

김도희,이경일,김명숙,윤유숙,황자영,임정우,강진한,이준성 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Numerous evidences support the pathogenesis that M. pneumonias pneumonia is associated with cell-mediat-ed immune reaction. We report 2 cases of severe M. pneumoniae pneumonia in previously healthy sisters, who were both admitted during an epidemic of M. pneumoniae pneumonia. The elder sister, who was 16 years old, was admitted with M. pneumoniae pneumonia. She showed no response to treatment with clarithroycin and levo-floxacin, and eventually progressed to severe ARDS, requiring mechanical ventilation. After treatment with hydrocortisone (200 mg/day), there were rapid improvements in clinical manifestations and chest radiographic findings. The younger sister, who was 14 years old, was admitted 10 days later, Presenting with fever but no pneumonic lesions on chest radiograph. Just like her sister, the infection showed no response to clarithromycin. Fever persisted and pneumonic consolidation with mild pleural effusion was noticed in the left lower lobe on the 5th hospital-day. After treatment with oral prednisolone (1 mg/kg), she showed rapid defervescence and on the 8th hospital day, no pneumonic lesions were detectable on chest radiograph. Given the fact that the pathogenesis of pneumonia and extrapulmonary manifestations in M. pneumoniae infection is immune-mediated, an immuno-suppressive therapy would be validated for selected patients with M. pneumoniae infections.

人蔘이 自然發生高血壓쥐에 있어서 血壓 및 血漿 Renin 活性度에 미치는 影響에 關한 實驗的 硏究

孫宜錫,朴陞哲,許鳳烈,李禎均,林憲吉,咸駿洙,梁忠模,韓哲洙,朴贊雄,金海中 대한의학협회 1979 대한의학협회지 Vol.22 No.9

기관지경 검사로 확진된 소아의 기관지 결핵 3예

임경심,박영기,이인구,이준성,전정식 최신의학사 1988 最新醫學 Vol.31 No.8

체표면 위전도를 이용한 잡견 위 수축의 추정

김인영,박경남,김종성,이민호,박헌진,함준수,이풍렬,이종철,손정일,임헌길,한완택 대한소화기학회 1998 대한소화기학회지 Vol.32 No.2

Background/Aims: The aim of this study was to assess canine gastric contraction by surface electrogastrography (EGG). Methods: Serosal EGG, surface EGG and measurement of gastric contraction by strain gauge were performed simultaneously in 20 unconscious dogs during the motor quiescence period and the contraction period induced by bethanechol. Amplitude, wave form, frequency and vector analysis of EGG were performed. Results: During motor quiescence period, normal smooth sine wave was maintained. During gastric contraction, the amplitude of slow wave was increased and the wave form of it changed into a late peak and descending arm in cutaneous wave was dominated. On the frequency analysis of the motor quiescence period, a single dominant wave of three cycles per minute (3 cpm) was observed. During the contraction, the dominant frequency was 3.5 cpm, and a marked increment was observed in first harmonic compared to motor quiescence period. There was rough correlation between the power of first harmonic and gastric contractions. In the vector analysis of motor quiescence period, the average axis of EGG vector was 62.7, y=0.00512+1.935x and the coefficient of determination was 0.476. During gastric contraction, the average axis of EGG vector was 12.6, y=0.00377+0.228x, and the coefficient of determination was 0.00281 (p$lt;0.05). Conclusions: Gastric contractions could be assessed by surface EGG in terms of such parameters.

선천성 백혈병과 유사질환 4예

임재균,이경준,강신혜,양창현,김길영 大韓血液學會 1989 大韓血液學會誌 Vol.24 No.1

위기의 청소년들: 자살 생각, 계획, 시도에 영향을 미치는 요인 비교

김은영 ( Eun Young Kim ),이서준 ( Seo Joon Lee ),박수진 ( Su Jin Park ),이성규 ( Sung Kyu Lee ),임국환 ( Kook Hwan Rhim ) 대한보건협회 2014 대한보건연구 Vol.40 No.3

연구목적 : 청소년의 자살 생각, 계획, 시도에 영향을 미치는 중요한 위험 변수를 찾고자 하였다. 연구방법 : 대표성 있는 표본을 위해 복합표본 설계가 된 ‘2013년 청소년 건강행태 온라인 조사’ 데이터에 가중치를 부여하여 기술통계와 회귀분석을 하였다. 연구결과 : 청소년들은 자살생각(16.6%), 자살계획(5.7%), 자살시도(4.1%)를 하고 있었으며, 자살생각 경험이 있는 학생들중 30%가 자살계획을 세웠고, 그들 중 15%가 자살시도를 하였다. 남학생들 보다 여학생들이, 학년이 낮을수록, 가족이 없는 학생들이 그리고 흡연과 음주를 하는 학생들이 자살행동의 가능성이 높았다. 스트레스를 많이 받는다고 하는 학생들과 일상생활이 불가능할 정도의 절망감을 느낀 적이 있다고 한 학생들에게서 자살행동의 가능성은 매우 높았으며, 행복하다고 느끼는 학생일수록 자살행동의 가능성이 낮았다. 결론 : 청소년의 자살은 사회의 큰 손실이다. 청소년의 자살을 방지하기 위한 정책적인 개선이 필요하고 자살행동에 영향을 주는 요인을 고려한 자살방지프로그램의 운영이 요구된다. Objectives : To find significant risk factors which affect adolescents’ suicidal ideation, plans and attempt. Methods : Data was based on 2013 Korean Youth Risk Behavior Web-based Survey. We used the weights, strata and primary sampling unit information provided by the public use dataset to compute descriptive statistics and logistic regressions. Computations were done with SPSS version 20.0. Results : 16.6% of the total participants (72,435 of total adolescents aged 13-18 years old) had experienced suicide ideation, 5.70% of the participants planned suicide, and 4.10% actually attempted suicide. 30% of students with suicide ideation planned suicide and 15% of them attempted suicide among students who experienced suicide ideation. Girls showed a greater risk for suicidal ideation (20.39% of girls vs. 13.09% of boys, p<.001), suicide plans (6.72% of girls vs. 4.73% of boys, p<.001), and suicide attempts (5.54% of girls vs. 2.82% of boys, p<.001). The likelihood of all suicide behavior increased as the grades decreased among adolescents. Students with no family showed higher suicidal behavior than students with intact family (Suicide ideation; OR 2.38, 95% CI 1.78-3.18, Suicide plans; OR 4.90, 95% CI 3.79-6.87, Suicide attempt; OR 4.60, 95% CI 3.20-6.62). Students who smoke and drink alcohol were more likely to attempt suicide than those who don’t. Those with lower happiness status had higher odds on suicide behavior. Lastly, higher stress levels led to higher suicide ideation and higher sadness levels led to higher suicide ideation, plans and attempt. Conclusion : Given that adolescents’ suicide is a major public health concern, current suicide prevention programs for adolescents should be improved by strategically approaching the risk factors proven in this study.

증상이 있는 담낭결석 환자에서 내시경적역행성담도조영술의 필요성에 관한 연구

이진,김동준,박철희,김용범,주상언,계세협,임창재,박우정,곽상택,장웅기,유재영 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Background/Aims: Laparoscopic cholecystectomy(LC) has become the new therapeutic gold standard in uncomplicated symptomatic gallbladder stone. However, some patients with gallstones may be associated with bile duct stones or other biliary pathology. LC is not ideal for removal and evaluation of biliary duct stones even with advocated techniques. Although ERCP is the best way to demonstrate the biliary tree, ERCP is an invasive procedure that may causes complications. The aim of this study was to predict the neeessity for ERCP and to determine the indication of ERCP before LC using noninvasive methods of biliary tree associated liver biochemistry(LB) parameters and sonography. Methods: 270 symptomatic gallbladder stone patients were studied by both sonography and LB including total bilirubin, alkaline phophatase, r-glutamyltransferase and amylase. All patients were performd ERCP for evaluation of biliary tree pathology, Patients who were already found to have either tumors or bile duct stones on sonography were excluded. Patients were classified into normal and dilated biliary tree groups by sonographic findings, normal and abnormal LB groups, negative and positive ERCP groups. Positive ERCP were defined by bile duct stones, tumors, stricture and idiopathic common bile duct dilatation over 11 mm. Results: 1) There were positive ERP findings in 30.4% of all patients. 2) The male to female ratio was 1 : 2, and the patients of positive FRCP group(58.9 12.0) were significantly(p=0.000) older than negative group(52.7 13.1). 3) There was bile duct dilatation in 39.3% of patients by sonography. Bile duct dilatation on sonography had an 66.0% positive predictablity, 85.3% senstivity and 80.6% specificity for ductal pathology on FRCP. 4) There was abnormal LB kn 53.0% of patients. A single abnormal LB equated to a 46.2% positive predictablity, 80.5% sensitivity and 59.0% specificity for ductal pathology on ERCP. S) In patients with Math normal sonography and LB, 96.0% of patients had a negative ERCP study. Conclusion: FRCP is not necessary before LC for patients with symptomatic gallbladder stones who have both a normal biliary tree on sonograplty and normal LB. But, a patient with either a dilated bile duct on sonography or an abnormal LB does require ERCh study.

Immunogenicity and safety assessment of a trivalent, inactivated split influenza vaccine in Korean children: Double-blind, randomized, active-controlled multicenter phase III clinical trial

Han, Seung Beom,Rhim, Jung-Woo,Shin, Hye Jo,Lee, Soo Young,Kim, Hyun-Hee,Kim, Jong-Hyun,Lee, Kyung-Yil,Ma, Sang Hyuk,Park, Joon Soo,Kim, Hwang Min,Kim, Chun Soo,Kim, Dong Ho,Choi, Young Youn,Cha, Sung TaylorFrancis 2015 Human Vaccines & Immunotherapeutics Vol.11 No.5

<P>A multicenter, double-blind, randomized, active-control phase III clinical trial was performed to assess the immunogenicity and safety of a trivalent, inactivated split influenza vaccine. Korean children between the ages of 6 months and 18 y were enrolled and randomized into a study (study vaccine) or a control vaccine group (commercially available trivalent, inactivated split influenza vaccine) in a 5:1 ratio. Antibody responses were determined using hemagglutination inhibition assay, and post-vaccination immunogenicity was assessed based on seroconversion and seroprotection rates. For safety assessment, solicited local and systemic adverse events up to 28 d after vaccination and unsolicited adverse events up to 6 months after vaccination were evaluated. Immunogenicity was assessed in 337 and 68 children of the study and control groups. In the study vaccine group, seroconversion rates against influenza A/H1N1, A/H3N2, and B strains were 62.0% (95% CI: 56.8–67.2), 53.4% (95% CI: 48.1–58.7), and 54.9% (95% CI: 48.1–60.2), respectively. The corresponding seroprotection rates were 95.0% (95% CI: 92.6–97.3), 93.8% (95% CI: 91.2–96.4), and 95.3% (95% CI: 93.0–97.5). The lower 95% CI limits of the seroconversion and seroprotection rates were over 40% and 70%, respectively, against all strains. Seroconversion and seroprotection rates were not significantly different between the study and control vaccine groups. Furthermore, the frequencies of adverse events were not significantly different between the 2 vaccine groups, and no serious vaccination-related adverse events were noted. In conclusion, the study vaccine exhibited substantial immunogenicity and safety in Korean children and is expected to be clinically effective.</P>

신경외과 영역의 통증에서 Zomepirac Sodium 의 제통효과에 관한 임상분석

정상섭,최중언,김영수,임승철,이규성,이규창 최신의학사 1982 最新醫學 Vol.25 No.12

상행 결장을 침범한 제 1형 신경섬유종증 1예

변태준,이오영,양선영,박성현,현일식,이항락,한동수,전용철,윤병철,최호순,함준수,이흥우,박문향,임현철 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2

Type I neurofibromatosis (NF-1), first clearly described by von Recklinghausen in 1881, is a dominantly inherited neuroectodermal dysplagia occurring in one of 3,000 births. It is fundamentally characterized by the existence of multiple neurofibromas, 'cafe au lait' spots and Lisch nodules (pigmented hamartomas of the iris). NF-1 may affect the gastrointestinal tract in about 25% of cases. Most NF-1 are located in the jejunum or stomach. In up to 40% of patients, there may be acute or recurrent gastrointestinal bleeding. We report the case of a 36-year-old patient diagnosed as having NF-1 in the stool occult blood test accidentally that was located in ascending colon with a review of literature.