기왕 제왕절개 반흔 부위에 착상한 자궁외 임신의 보존적 치료 3례

박선영,박혜인,김윤숙,김종수,최승도,선우재근,배동한 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

In past decade, ectopic pregnancy developing in the previous cesarean section scar has been the rarest forms of ectopic pregnancy and very dangerous because of the risk of uterine rupture and hemorrhage. These pregnancies once carried a maternal mortality rate of 40% to 45%, and until recent years they usually resulted in abdominal hysterectomy as a life-saving procedure. However, increased awareness of the importance of preserving childbearing capacity has led to several successful attempts at conservative management that include intraamniotic and systemic methotrexate administration, suction curettage followed by insertion of an intracervical 30-mL Foley catheter ballooning and angiographic artery embolization. We present three cases of ectopic pregnancy developing in the previous cesarean section scar in which successfully treated with conservative management.

일 농촌지역의 우울 증상에 관한 역학연구 -위험요인 및 요인구조분석

하양숙,홍진표,김한규,이군희,한경자,조맹제,김용익,송미순,박성애,김창윤 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 세계적으로 널리 사용되는 우울증 척도인 the Center for Epidemiologic Studies Depression Scale(CES-D)을 이용하여 지역사회 주민의 우울증상의 정도를 평가하고, 우울증상의 위험요인을 분석하고, 한국인에서 우울증상의 요인구조를 알기 위해 본 연구를 실시하였다. 방 법 : 경기도 일 농촌 지역의 30세 이상 주민에 대해 무작위 군집 집락 추출을 실시하였고, 훈련된 면담원들이 가정 방문을 통하여 면접 및 자기보고 검사인 CES-D를 실시하였다. 총 1,315명에서 응답을 하였고 응답율은 59.3%이었다. 결 과 : CES-D에 의한 우울증 점수는 0∼5점이 57%정도를 차지하였고, 평균 점수는 남자 7.8점 여자 9.5점으로 비교적 낮은 편이었다. ANCOVA 분석 결과 비결혼, 저학력, 여성이라는 위험요인은 독립적으로 우울증상을 악화시키는 요인이었으나 연령은 통계적으로 유의하지 않았다. CES-D 결과를 요인분석을 시행한 결과 4가지 요인이 추출되었는데 우울증상 및 신체증상이 한 개의 요인으로, 다른 나라에서 보고되지 않는 정서적 고통이 별도의 요인으로 추출되었다. 결 론 : 국내 역학 조사에서도 외국과 유사한 우울점수 및 위험요인이 확인되었으나 우울증의 요인에서는 특이한 요인이 추출되었다. 한국인에 독특한 우울 반응에 관한 추가 연구가 필요하다. Objectives :The rates, correlates, and factor structure of depressive symptoms in a Korean rural sample were examined using Korean version of the Center for Epidemiologic Studies Depression Scale(CES-D). Methods : Door to door visiting survey was conducted by trained interviewers. A random cluster sample of 1,315 respondents, aged 30 and over completed the CES-D scale along with additional sociodemographic questionnaire. Results : In this sample, mean CES-D score of male and female were 7.8 and 9.5, respectively which were lower than those reported previously. Symptoms of depression were most common among the less educated, non-married and female according to ANCOVA. Age was not a significant risk factor for depressive symptoms. Different factor structures emerged from this sample as compared to other studies using this approach. Somatic symptoms and affective symptoms were combined as one factor and emotional hardship emerged as a separate factor. Conclusion : Symptoms scores and risk factors were similar to the results reported in other countries but unique factor structures were found in this study. Further research is needed about the Korean depressive symptomatology and related areas.

국내 대학병원에서 정주용 Ciprofloxacin 사용의 적정성 평가

김신우,박효정,오원섭,김연숙,장현하,정숙인,정두련,이혁,염준섭,기현균,손준성,백경란,우건조,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 병원에서의 정주 ciprofloxacin 사용의 적정성을 평가하고자 하였다. 재료 및 방법 : 2003년 9월 25일부터 8개의 대학병원에서 정주 ciprofloxacin을 받았던 290명의 연속적으로 모집한 성인환자를 대상으로 약제사용 평가(DUE)를 전향적으로 수행하였다. 이 연구에 사용된 DUE 기준은 미국병원약사회의 기준을 국내 실정에 맡게 수정하여 사용하였으며 1) 사용의 정당성에 관한 항목, 2) 사용 시 준수되거나 시행되어야 할 사항에 대한 항목, 3) 부작용에 대한 항목, 4) 치료 효과에 대한 항목으로 나누어 조사하였다. 결과 : 환자의 평균 나이는 54세였다. 33예(26.9%)에서만 약제 사용의 적정성 측면에서 기준을 만족하였고 91예(73.1%)에서는 사용이 적절하지 않았다. 정주 cipro-floxacin의 부적절한 사용의 흔한 원인은 수술 전후의 예방약 사용, 비뇨기계 처치 전의 예방적 사용, 열성 질환에 대한 경험적 사용 등의 순이었다. 사용 시 준수사항 의 측면에서는 사용 전 배양검사(73.8%)와 사용 중 배양검사(68.6%)가 낮은 수행 정도를 보였으나 그 외는 비교적 높은 적정성(82.4-100%)을 보여주었다. 정주 ciprofloxacin사용의 합병증은 드물었다. 치료 효과의 면에서 치료반응은 93.3%였다. 결론 : 약제 사용의 정당성 기준에 따른 정주 cipro-floxacin의 부적절한 사용은 연구에 포함된 대학병원에서 매우 흔하였다(73.1%). 그러므로 적절한 항생제 사용에 대한 교육과 제도적 장치가 매우 필요한 것으로 판단되었다. Background : To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. Materials and Methods : We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. Results : Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. Conclusion : Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.

경쟁적 효소면역검사를 이용한 혈청내 매독균 항체 검사의 유용성

최하영,박건,장숙진,박영진,문대수 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background : Laboratory methods for detection of syphilis are Venereal Disease Research Laboratory (VDRL) and rapid plasma reagin (RPR) test to non-treponemal tests, and fluorescent treponemal antibody absorption (FTA-ABS) and microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP) to treponemal tests. However, RPR card test had many false positive results and FTA-ABS IgM method required high degrees of technical ability and experience. Recently, enzyme immunoassay (EIA) kits for IgM and IgG antibodies to T. pallidum in syphilis have been developed. So, we evaluated that usefulness of competitive EIA for detection of T. pallidum antibody in serum. Methods : RPR positive 38 specimens and negative 6 specimens were compared by T. pallidum hemagglutination (TPHA), two commercial competitive EIA kits for detection of syphilis and FTA-ABS IgM. Those data were compared with concordant and discordant rate of each RPR, TPHA, EIA and FTA-ABS IgM. Results : 28 of 34 RPR positive specimens were TPHA(+) and EIA (+), and 6 of 6 RPR negative specimens were TPHA (-) and EIA (-). The data of two EIAs were same results with TPHA. 3 of 28 EIA positive specimens were FTA-ABS IgM (+), and 16 of 16 EIA negative specimens were FTA-ABS IgM (-). Conclusion: Two commercial competitive EIA kits for detection of syphilis were evaluated. The EIA method could be replaced with RPR and TPHA, and this method was possible to combination for detection of syphilis.

질트리코모나스(Trichomonas vaginalis)의 효소활성에 관한 전자현미경적 관찰

민득영,류재숙,박건채 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.2

Trichomonas vaginales is one of the parasitic flagellates found in the vaginal cavity of female and the urogenital tract of male. The presnet study was aimde to evaluate the effect of antiserum from immunized Wkstar rats on activities of acid phoshpatase (AcPase) and adenosine triphosphatase (ATPase) of T. vaginalis. Trophozoites were subcultured in Diamond's TPS-1 medium at 37℃ in CO₂ incubator. T. vaginalis were incubated in mixed medium containing 26%(v/v) of antiserum for minutes, then treated with substrates for enzyme activityes. Parasites were embedded in Epon and sectioned for transmission electron microscopy. The results observed are as follows: 1. AcPase activities. In normal prarsites strong activities were observed on Golgi complex and a few of wacuoles. Weak reactions also observed in nuclear matrix, kinetosome and hydrogenosome. In cases treated with antiserum plasma membrane were parially destroyed. Vacuoles were increased in number and revealed strong reactivites. 2. ATPase activities. In normal parasites ATPase were observed dominantly in nucleus. In parasites treated with antiserum activities in nucleus were stronger than those of normal ones, and weak activities were seen along plasma membrane. In conclusion it is assumed that antiserum does increase AcPase activity, but reduces ATPase activity in T. vaginalis.

세포질내 정자주입법(ICSI)에 있어서 정자흡입 및 난자내 주입방법에 관한 연구

이택후,김항진,송건호,김대근,전상식,박윤규,서태광,전병균,류은경,이은숙,문진수,김광철 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1

Study on Method of Sperm Aspiration and Injection into an Oocyte in Intracytoplasmic Sperm Injection(ICSI) Immobilization of spermatozoa prior to intracytoplasmic sperm iniection(ICSI) sometimes results in crooked tail and this makes it difficult to aspirate sperm into an injection pipette tail first. Head-first sperm aspiration into an injection pipette avoid this problem due to the bigger size of the sperm head. The effect of head or tail-first sperm injection into an oocyte on fertilization cleavage, percentage of grade I embryos and development to blastocyst stage in ICSI program has been studied. A single living immobilized spermatozoa from oligoasthenozoospermic patient was injected into an oocyte head-first or tail-first according to the treatment. Eighteen hours after microinjection, oocytes ware inspected for survival and fertilization Fertilized oocytes with two pronuclei were cultured in 30μl drop of mHTF supplemented with 10% heat-inactivated follicular fluid(FF) at 37℃. On day 2. embryo transfer was performed with cleaved embryos. The remaining 2-8 cell stage embryos were co-cultured with BRL cells in mHTF + 10% FF for 72 hours and the developmental stage was observed. The data were analyzed by Analysis of Variance. A total of 164 oocytes from 36 cycles were assigned to earth treatment and ICSI was performed(88 head-first, tail-first). The rates of normal fertilization were 81.8% and 76.3% for head-first and tail-first, respectively. Of the fertilized oocytes, the percentage of cleaved embryos and the percentage of grade 1 embryo among cleaved embryos were 88.9% and 68.8%, 93.1% and 74.1% for head-first and tail-first, respectively. Of the 2-8 cell embryos cultured, 44.4%(16/36) and 50.0%(10/20) for head first and tail first, respectively developed to blastocyst stage. There were no differences in fertilization, cleavage, rates of grade 1 embryos, and development to blastocyst stage. In conclusion, head-first or tail-first sperm injection into an oocyte in ICSI program does not affect fertilization and subsequent embryo development to blastocyst stage in vitro.

공동주택 주차장의 축적먼지 중 미량원소성분 분석과 오염원 평가

배건호(Gun Ho Bae),정철수(Cheol Su Jung),박규태(Kyu Tae Park),이명숙(Myoung Sook Lee),신동찬(Dong Chan Shin),김용혜(Yong Hye Kim),윤민혜(Min Hye Yoon),한영진(Young Jin Han),최혁(Hyuek Choi),백성옥(Sung Ok Baek) 大韓環境工學會 2011 대한환경공학회지 Vol.33 No.10

공동주택 주차장의 먼지오염실태를 연구하기 위하여 2010년 3월말에서 6월초까지 대구지역 공동주택 36곳의 지상주차장(36지점)과 지하주차장(36지점)을 대상으로 채취한 총 72개의 시료를 100 μm 이하로 체거름하고 산추출한 후 ICP로 14개원소를 분석하였다. 농축계수를 이용한 미량원소성분의 발생원 평가결과는 지상주차장과 지하주차장 모두 Fe, K, Mg, Mn, Na, V의 성분은 자연적인 발생원에 의한 영향을 받고 있는 반면에 Cd, Cr, Cu, Ni, Pb, Zn의 성분은 인위적인 발생원에 의한 영향을 받고 있는 것으로 나타났다. 한편 Ca은 지상주차장의 경우에는 자연적인 발생원의 영향을 받았고, 지하주차장의 경우에는 인위적인 발생원의 영향을 받은 것으로 나타났다. 미량원소성분의 농도분석 결과는 자연적인 발생원과 관련된 성분이 인위적인 발생원과 관련된 성분보다 매우 높은 농도를 보였다. 인위적인 발생원성분의 기여도는 지하주차장이 지상주차장보다 높았으며, 미량원소성분의 평균농도 또한 지하주차장이 지상주차장보다 높았다. 오염지수를 이용한 중금속성분의 오염도를 평가한결과는 지하주차장이 지상주차장보다 5.5배정도 높게 오염된 것으로 나타났다. 미량원소성분간의 상관성 분석결과는 지상주차장이 지하주차장에 비해 유의한 상관성을 나타내는 항목이 많았으며, 특히 자연적 발생원 성분간 유의한 상관성이 더욱 크게 나타났다. 또한 유해 중금속성분과 지하주차장의 영향인자간의 상관성을 분석한 결과는 주차대수(공간)가 적은 지점이 큰 지점보다, 환기장치를 가동하지 않은 지점이 가동한 지점보다, 그리고 최근 도색년도와 청소일이 오래된 지점이 상대적으로 유해중금속을 많이 함유하고 있었다. In order to investigate the degree of apartment parking lot dust contamination, total 72 samples of parking lot dust (36 from ground parking lots and 36 from the underground parking lots) were collected in Daegu city from the end of March to the early June 2010. The dust samples were sieved below 100 μm, and analysed by ICP for 14 elements after an acid extraction. Results obtained from the source assessment of trace element using enrichment factor showed that Fe, K, Mg, Mn, Na and V were influenced by natural sources, while Cd, Cr, Cu, Ni, Pb and Zn were influenced by anthropogenic sources in both the ground parking lot and the underground parking lot. And results showed that Ca were influenced by natural sources in the ground parking lot, but influenced by anthropogenic sources in the underground parking lot. The measured values were remarkably higher in components from natural sources than in components from anthropogenic sources. Underground parking lot dust was more affected by anthropogenic sources and contaminated compared with the ground parking lot dust. Pollution index of heavy metals revealed that underground parking lot dust was 5.5 times more contaminated with heavy metal components than the ground parking lot dust. The results of correlation analysis among trace elements indicated that components in the ground parking lot were more correlated than those in the underground parking lot, and especially more correlated with natural sources-natural sources. Analysis for correlations between components and influencing factors in the underground parking lot showed that concentrations of heavy metals were higher with smaller number of parking spaces and no ventilation system, and older apartments in last paint and cleaning had relatively higher contents of heavy metals than those of recently painted and cleaned.

A Butanol Fraction of Rubus Coreanus that Suppression of Adipogenesis is Accompanied by Wnt/β-catenin Signaling Activation

Park, Hee-Sook;Kim, Gun-Hee 덕성여자대학교 식물자원연구소 2012 식물자원연구소 논문집 Vol.11 No.-

Obesity is a serious health problem in industrialized countries because it is implicated in various diseases, including type II diabetes, hypertension, cancer, and coronary heart disease. In this regard, natural compounds such as flavonoids and the active compounds derived from foods influencing lipid metabolism are growing attention. In preliminary study, extract and solvent fractions of Korean black raspberry (Rubus coreanus) inhibited adipogenesis in 3T3-L1 cells. We investigated the effects of Rubus coreanus fractions on cell growth, adipocyte differentiation, and Wnt signaling in 3T3-L1 cells. Butanol-soluble fraction (BURC) suppressed preadipocyte proliferation compared to a control group not only dose-dependent but time-dependent manner. Hormone-induced 3T3-L1 differentiation in the presence BURC reduced the intracellular lipid accumulation and reduced expression of adipogenesis-associated genes and proteins. While incubation with BURC fraction was lowered the cellular level of glucose in differentiated adipocytes. Treatment of BURC fraction resulted in increased expression of β-catenin, a Wnt signaling molecule and reduced the differentiation-stimulated expression of Axin, component of the destruction complex targeting β-catenin. Thus, BURC inhibited adipocyte differentiation by stimulating of Wnt signaling. Based on these results, we suggest that butanol fraction of Rubus coreanus inhibits adipocyte differentiation through the regulation of Wnt and transcriptional factors, PPARy and C/EBPa. Thus, Rubus coreanus is a possible candidate for regulating lipid accumulation in obesity.

The Application of Marine X-band Radar to Measure Wave Condition during Sea Trial

Park, Gun-Il,Choi, Jae-Woong,Kang, Yun-Tae,Ha, Mun-Keun,Jang, Hyun-Sook,Park, Jun-Soo,Park, Seung-Geun,Kwon, Sun-Hong The Society of Naval Architects of Korea 2006 Journal of ship and ocean technology Vol.10 No.4

The visual observation of wave condition depends on the observer's skill and experience. Also, the environmental conditions such as light and cloud heavily influence the visual measurement. In the speed test of sea trial, the wave measurement should be objective and accurate. In this paper, the problems of visual measurement and their effects on speed test are described. To overcome those problems, we developed the wave measurement system using commercial marine X-band radar, WaveFinder. The system installed at inland base was calibrated by waverider buoy and then the system's operability was defined. Onboard tests had also been performed three times for formal wave measurement to correct the ship speed. The results illustrated very good agreement with visual observation by experts. It can be concluded that the system would be useful to measure wave and swell information for the sea trial, irrespective of day and night.

세포암종의 DNA 분석 - 유세포 분석법과 화상 분석법의 비교 고찰 -

김성숙,박석건,한동선,허만하,김성숙,박석건,한동선 대한병리학회 1992 Journal of Pathology and Translational Medicine Vol.26 No.1