복강경하 질식 자궁적출술 30예의 임상적 고찰 : A Review of 30 Cases

윤병일,김소정,정두용,김수녕,손인숙,이지영 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Hysterectomy is the most common gynecologic operation. Traditionally, hysterectomy was performed either through an abdominal approach or through a vaginal approach. Recently, laparoscopic hysterectomy is quite often tried. To evaluate the effectiveness and value of LA VH(Laparoscopy Assisted Vaginal Hysterectomy), and to evaluate the possibility whether to rep;ace abdominal hysterectomy to LAVH, we analyzed our clinical cases. This clinical study is a retrospective review of 30 cases of LAVH from May 2002 to February 2003 at the department of Obstetrics and Gynecology, Chung- Ju hospital, Konkuk University. We evaluated age, parity, previous abdominal operations, indications of hysterectomy, combined operation, operating time, hemoglobin change, weight of uterus, hospital stay and postoperativeThe average operating time was 146 ± 42 minutes, the uterine weight was 239 ± 126 grams, and the mean postoperative hemoglobin loss was 1.7 ± 1.4 g/dl. The most common pathologic finding was myoma uteri(37%), and the second most pathologic finding was adenomyosis(20%) and myoma uteri with adenomyosis (20%). Serious complications were not appeared. LAVH provides a shorter hospital stay, quicker recovery, and the acceptable complication rate except incerased operating time than abdominal hysterectomy. This study suggests that LAVH appears more useful than TAH(Total Abdominal Hysterectomy) and could replace abdominal hysterectomy.

림프절 종창의 임상적 관찰

김삼용,김현수,김종숙,박상준,최지영,윤환중,조덕연 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Objectives : Clinical management of patient with lymphadenopathy requires judicious judgement of clinicians. Careful evaluation of lymph node enlargement by various clinical parameters will help to disclose the etiology of lymph node enlargement. This study was conducted to identify the clinical manifestations and etiology of lymphadenopathy in korean patients. Methods : A total 192 patients with lymph node enlargement were studied retrospectively. All patients who underwent excisional lymph node biopsy during the period from January 1992 to July 1994 were included. The lymph node biopsy and clinical records were reviewed and patient characteristics were analyzed by various clinical parameters. Results : A female predominance was noted in lymphadenopathy of tuberculosis (58.5%), Kikuchi's syndrome (70%). In lymphadenopathy of nonspecific, tuberculosis, kikuchi syndrome, per centage of patients younger than 40 years of age were 84.5%, 75.6%, 100%, respectively. In lymphadenopathy of tuberculosis and metastatic cancer, the duration of lymphadenopathy below 30days were 51.2%, 73.9%, respectively. The two most common etiology of cervical lymphadenopathy were nonspecific lymphadenitis (47.7%) and tuberculous (26.8%). The two most frequent etiology of supraclavicular lymphadenopathy were nonspecific lymphadenitis (46.3%) and metastatic lymphadenopathy (26.8%) and the most common etiology of axillary lymphadenopathy was nonspecific lymphadenopathy (34.5%). The most common frequent of lymph node enlargement with size below 1㎠ was nonspecific lymphadenitis, while above 2.25㎠ it was metastatic lymphadenopathy. Conclusion : Careful evaluation regarding patient age, sex, size of lymph node, consistency, location of lymph node, presence or absence of systemic symptoms should be pursued before performing a biopsy and management.

레티노인산이 배양 각질형성세포의 사이토카인 생성에 미치는 영향

김지윤,정승용,오성민,김수찬 大韓皮膚硏究學會 2003 大韓皮膚硏究學會誌 Vol.10 No.4

측두하악장애 환자 중 하악과두의 퇴행성 골 변화를 보이는 환자의 분포 및 임상적 특징

임용규,김민지,김연중,송윤헌,이동렬 대한치과교정학회 2006 대한치과교정학회지 Vol.36 No.6

측두하악장애 환자 중 하악과두의 퇴행성 골 변화를 보이는 환자의 분포와 임상적 특징을 규명하고자 측두하악장애로 진단받은 6,070명의 환자들을 대상으로 연구를 시행하였다. 환자들의 초진 시 파노라마와 TMJ 파노라마 사진을 관찰하여 하악과두의 퇴행성 골 변화 유무를 기준으로 환자들을 퇴행성 골 변화를 보이는 군(DJD군)과 골 변화를 보이지 않는 군(non-DJD군)으로 나누고, 환자들의 초진 의무기록을 바탕으로 두 군 간의 특징을 비교, 분석하였으며, 각종 변수들이 DJD 발병에 미치는 상대적 위험성을 측정하기 위하여 로지스틱 회귀분석을 시행하였다. 연구 결과 전체 환자 중 DJD군에 속한 환자는 31.7%였고, non-DJD군에 속하는 환자는 68.3%였다. DJD군은 성별에 따라 다른 분포를 보여 남자보다 여자의 이환율이 높았고, 10대와 20대에서 가장 높은 분포를 보였다. 환자의 내원 주소 중에서는 전치부 개방교합, 턱의 후퇴감, 안모 비대칭, 개구장애를 주소로 내원한 환자가 다른 주소로 내원한 환자들에 비해 DJD를 보일 위험성이 높았으며, 교정치료 경력이나 중심위-중심교합위 변위 그리고 염발음을 보이는 환자도 DJD군에 속할 위험성이 큰 것으로 나타났다. 따라서 측두하악장애를 가진 환자 중 30세 이하의 여성이 위와 같은 임상적 특징을 보이는 경우, 교정치료를 계획할 때 DJD에 이환 되었을 가능성에 대하여 충분히 주의를 기울여야 할 것으로 생각된다. (대치교정지 2006;36(6):402-11) Objective: This study was carried out to evaluate the distribution and clinical features of patients with degenerative change of the mandibular condyle. Methods: Six thousand and seventy patients with TMD (temporomandibular disorder) were selected for this study, who had complete initial clinical records and radiographs. Panorama and TMJ panorama radiographs were used to screen the degenerative change in the condyle, and the patients were divided into DJD (degenerative joint disease) and non-DJD groups. Results: The distribution and clinical features of the two groups were compared. Out of the total number of patients, 31.7% were in the DJD group, and 68.3% were in the non-DJD group. The portion of females was larger in the DJD group (80.8%) than in the non-DJD group (67.5%), and the DJD group had high prevalence in the second and third decades. Lack of incisal contact, retrusive chin, facial asymmetry, and mouth opening limitation were the chief complaints of the patients who had positive relation to DJD. Conclusion: Patients with an orthodontic treatment history, CO-CR discrepancy and crepitation were at possible risk of having DJD. (Korean J Orthod 2006;36(6):402-11)

Effect of Chlorella Diet Supplementation on Blood and Urine Cadmium Levels in Cadmium Poisoned Rats

김용호,--,--,--,--,-- THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 2003 Journal of biomedical laboratory sciences Vol.9 No.3

This study was conducted to investigate the influence of chlorella diet supplementation. Blood accumulation and urine excretion levels were measured after the Sprague-Dawley (SD) rats were fed on a chlorella diet supplementation mixed with 40 ppm of CdCl₂. Four groups tested for blood accumulation and urine excretion levels. All four groups fed on a basic diet with a cadmium mixture. The diet for the first group contained only basic diet and the cadmium added to the drinking water. The diet for the three other groups contained cadmium to the drinking water, and 1%, 5% and 10% of chlorella added to the basic diet. A concentration of cadmium for the first group showed a 3.2±0.4 ㎍/l blood accumulatior. level and 41.5±32.9 ㎍/l urinary excretion level, and the second group, which was fed on the basic diet with 1% of chlorella added and cadmium to the drinking water showed a 1.5±0.6 ㎍/l blood level and only 14.1±1.6 ㎍/l urinary excretion level. The other two groups, which were fed on 5% and 10% of chlorella concentration and cadmium to the drinking water did not exhibit any notable effects greater than the group fed on 1% concentration of chlorella. The results suggest that the blood accumulation and urinary excretion of Cadmium are influenced by the chlorella diet supplementation from the concentration of 1% of the basic diet.

이대생의 체력 및 건강도에 관한 조사 연구

강지용,김종선,윤남식,이희순,한성일 梨花女子大學校 韓國生活科學硏究院 1975 韓國生活科學硏究院 論叢 Vol.15 No.-

The following results were obtained from the survey of health status and the measurements of physical fitness of 914 students of Ewha Womans University by means of CMI, which were conducted from October 7 to October 27 for three weeks. The purpose of the research mainly consists in the improvement of university health adiministration and of physical education. A. Survey of Health Status 1. The average Number of Complaints are 26.8 for items A-L, 15.3 for items M-R, and 42.1 for items A-R. In terms of classes, the Numbers of Complaints are revealed on a decreasing scale as follows: sophomores, 44.0, the highest; seniors, 42.6; freshmen, 42.1; and juniors, 40.5. 2. Among all the items, the following figures of average Numbers of complaints per person are conspicuous: the seniors have shown 5.3 for item D, which is the highest; and the sophomores, 0,7, which is the lowest. Among the physiological item, D, which corresponds to the ailments of digestion system, shows the highest rate; and among the items for mental diseases, item M, which corresponds to non­adjustment, is 5.2, the highest. 3. The percentiles on the lower echelons of the Number of Complaints are the following: 26.1% for freshmen is the highest; 22.2% for sophomores, the lowest. The sophomores have shown 27.1%, the highest figure, of students who have Number of Complaints of four or above. 4. The percentile figures of 10 or above of Number of Complaints are displayed by seniors with 2.4% and by sophomores with 1.5%. On the other hand, the percentile figures of 80 or above are revealed by seniors with 5.4% and by sophomores with 5.3%. B. Physical Fitness Measurements The figures for the physical fitness measurements are found as given below: 1. Pull­up Freshmen 18.4 seconds Juniors 9.3 seconds Sophomores 7.5 seconds Seniors 7.0 seconds 2. 100 Meters Dash An approximation of 19 seconds is recorded by freshmen, and the tendency is to be slower as the years go up. 3. Sit­ups The freshmen recorded 13 sit­ups, and the tendency is to be fewer as the years go up. 4. Throwing An approximation of 19 meters is marked by freshmen, and the tendency is to be shorter as the years go up. 5. Long Jump The freshmen marked 249.5 centimeters, and the tendency decreases as the years go up. 6. 800 Meters Run 4'1"8"'(4 minutes 1 seconds 8 points) is obtained for freshmen, and the tendency is to be slower as the years go up. 7. Shuttle Run 12.5 seconds is recorded for freshmen, and the tendency is to be slower as the years go up. 8. Trunk Flexion 18 centimeters is marked by freshmen, and the tendency is to be decreasing as the years go up.

16S rRNA 유전자 염기서열 분석에 의해 확인된 Acinetobacter spp. 가성요로감염 유행

김수연,김진용,강지혜,박신영,이희승,박윤수,서일혜,조용균 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

목적 : 본 연구는 일개 대학병원의 한 병동에서 16SrRNA 유전자 염기서열 분석을 통해 확인된 Acinetobacter spp. 가성요로감염 집단 발생에 대한 조사이다. 재료 및 방법 : 일개 대학병원의 일반병동에서 2005년 9월 23일부터 26일까지 5명의 환자에서 Bordetelta bronchiseptica 세균뇨가 동시에 분리되었다. 해당 환자들에 대한 입원 진료 기록을 확인하고, 이학적 검사를 시행하였고, 의료진 면담 등의 역학적 조사와 의심되는 전파원의 환경 감시배양을 시행하였다. 또한 다섯 균주들의 상동성 확인을 위해 pulsed field gel electrophoresis (PFGE)를 하였고, 정확한 균 동정을 위해 16S rRNA 유전자 염기서열 분석을 하였다. 결과 : VITEK system에 의해 B. bronchiseptica로 보고된 다섯 균주들은 거의 유사한 항생제 감수성을 가지고 있었다. 유행조사에서 요로감염의 증상이나 균혈증을 보인 환자는 없었고, 환경 감시배양에서 공통의 전파원은 증명되지 않았다. 또한 PFGE와 16S rRNA 유전자 염기서열분석에서 상동성을 가진 동일 Acinetobacter spp.로 확인되어 이에 의한 가성요로감염의 유행으로 결론지었다. 결론 : 역학적 조사와 함께 PFGE와 16s rRNA 유전자염기서열 분석과 같은 분자생물학적인 조사를 시행하는 것은 희귀한 균에 의한 병원감염 유행조사에 도움이 될 것이다. Background : Acinetobacter spp. is increasingly implicated in hospital-acquired infections. We experienced a pseudooutbreak of Bordetella bronchiseptica bacteriuria identified with biochemical tests, that was later identified as Acinetobacter spp. by using 16S rRNA gene sequence analysis. Materials and Methods : Five in-ward patients were found to have B. bronchiseptica bacteriuria without symptoms of urinary tract infection between September 23 and 26 of 2005. We conducted pulsed field gel electrophoresis (PFGE) of the bacteria and epidemiological investigation of this pseudooutbreak. In addition, 16S rRNA gene sequence analysis was performed for the verification of the strains. Results : All 5 isolates were identified as B. bronchiseptica with similar antibiogram by VITEK system. There was no evidence of any symptom or sign of urinary tract infection. The source of this pseudooutbreak was not detected even after performing environmental culture and interviews with healthcare workers. We could not get the appropriate results from the first PFGE with XbaI restriction enzyme. B. bronchiseptica is an unusual organism in human so we conducted 16S rRNA gene sequence analysis for verification. The analysis of 16S rRNA gene sequence with 5 isolates demonstrated 99-100% similarity to a sequence of Acinetobacter spp. (AU1523). According to the results of 16S rRNA gene sequence analysis, we performed the second PFGE with SmaI restriction enzyme, which showed indistinguishable pattern among the all 5 isolates. Conclusion : This investigation suggests that the combined method of 16s rRNA gene sequence analysis and PFGE would be helpful for investigation of outbreak caused by unusual organisms.

동일 작업공정에 대한 작업환경측정과 특수건강진단 내용의 기관간 비교

김지용,홍윤철 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

동일한 공정과 동일한 유해 물질을 사용하는 전구에 산재한 20 개 사업장을 대상으로 1997년 하반기에 실시한 작업환경측정 및 특수건강검진 결과 중 도장 공정 및 용접 공정에 종사하는 근로자에 대한 결과를 비교하였다. 용접 공정의 경우 측정 자체가 이루어지지 않은 사업장이 2 군데가 있었으며 중금속의 경우 측정 기관에 따라 측정 내역의 차이가 많았는데 그 중 망간이 11 군데로 가장 많았다. 용접 공정 근로자의 작업환경 측정내역과 특수건강진단 내역과의 관련성을 살펴본 결과 분진이나 용접 흄, 망간, 유해광선의 경우 작업환경을 측정하지 않은 채 특수건강진단을 한 경우가 많았으며 반대로 작업환경측정 상 측정하였으나 그에 대한 특수건강검진을 하지 않은 예가 중금속 관련에서 많았다. 도장 공정의 경우 작업환경측정 내역을 살펴보면 톨루엔과 트실렌은 대부분 측정을 한 반면 그 외의 유기 용제 내역들의 측정 기관간의 차이가 컸다. 유기 용제중 특수도장용으로 사용하고 있는 도료 성분중 포함되어 있는 이소시아네이트류를 측정한 곳은 3군데였다. 도장 공정 근로자의 작업 환경측정 내역과 특수건강진단 내역과의 관련성을 살펴보면 톨루엔의 경우 모두 동일하게 시행한 반면, 이소시아네이트류의 경우 작업환경측정을 하였으나 이에 대한 특수건강진단을 하지 않은 경우가 1 군데였고 기타 유기용제의 경우 측정만 하고 이에 대한 특수건강진단을 하지 않은 경우는 17 군데였다. 각각의 기관에 따라 작업환경측정 내역과 특수건강검진 내역의 차이를 보였으며 기관내 측정과 검진간의 관련성도 차이를 보였다. 이와 같은 문제점을 발전적으로 해결하기 위해서는 작업환경측정에서 유사 노출군에 대한 개념적용과 특수건강검진에서 보건문제별 접근방식을 통하여 이에 종사하는 근로자를 코호트 군으로 구축함으로서 작업에 기인한 건강장해를 파악하는 방법이 필요하다. The workplace environmental monitoring and specific health examination are performed routinely by occupational health service organizations in Korea. The methods of the monitoring and the examination are agent-oriented and workers for the monitoring and the examination are selected without a well defined rule. So the authors analyzed the contents of the monitoring and the examination for the welding workers and painting workers among occupational health service organizations, and compared the relationship between the contents of the monitoring and the examination for the workers. Twenty automobile service centers joined in this research. Because they belonged to one parent company, the work processes, equipments and materials were same. The authors reviewed the results of the monitoring and examination for the welding workers and painting workers performed by occupational health service organizations in 1997. The contents of the monitoring and examination for the welding workers and painting workers were different among the organizations especially in organic solvents and metals. In addition, the contents of the monitoring and examination are not correlated in each organizations. The authors concluded that the agent-oriented monitoring and examination methods should be complemented or replaced by the health effect-oriented methods. So we can establish the workers as the cohort groups and get the more detailed and comprehensive information about the job-related health effect.

가상현실을 이용한 뇌졸중 환자의 균형장애 평가와 임상평가 지수와의 상관성 연구

김연희,박지원,정준용,우영근,최종덕,김남균 최신의학사 2003 最新醫學 Vol.46 No.11-12

표피낭종에 발생한 전염성 연속종 1예

문지훈,문용주,최혜자,윤석권 대한피부과학회 2003 대한피부과학회지 Vol.41 No.6

We present an unusual case of molluscum contagiosum occurring in epidermal cyst on back of a 5-year-old girl. Histology showed an intradermal cyst containing lamellated horny materials and typical molluscum cclls. In Korean literature, 5 such case were reported. We report an additional case of molluscum occurring in epidermal cyst. (Korean J Dermatol 3003;41(6) : 790~792)