경도인지장애(Mild Cognitive Impairment)에서 단축형 Samsung Dementia Questionnaire(S-SDQ)의 임상적 유용성

윤지혜,김지혜,안인숙,정재원,송미선,김도관 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Objuctives : Clinical utility of the Short Form of the Samsung Dementia Questionnaire (S-SDQ) as a screening instrument for Mild Cognitive Impairment (MCI). Methods : Three groups (n=27, Subjective Memory Impairment (SMI); n=41 MCI; n=79, Early Alzheimer's Di-sease(AD)) recruited from memory clinic were administered a battery of neuropsychological tests including S-SDQ and Korean version-Mini Mental State Examination (K.-MMSE). Results : S-SDQ, unlike the K-MMSE, had no association with the age and education ofthe subjects. Scores of S-SDQ was found to correlate (r=-.496) with scores of K-MMSE. Result of Receiver Operating Characteristic (ROC) analysis revealed that S-SDQ discriminated between the SMI and the MCI groups. Conclusion : S-SDQ may be a solution to the problem of contamination by education and age which affect traditional Cognitive screening instruments like K-MMSE, and it may be a useful tool for screening MCI.

경상북도 영덕 방언의 특징

윤지희,김해정 동국대학교 국어교육과 2000 동국어문학 Vol.12 No.-

전화번호안내원의 누적외상성 장애

정해관,최병순,김지용,유선희,임현술,김용민,어경윤,권용욱 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.1

To evaluate the prevalence of cumulative trauma disorders in relation to ergonomic evaluation of their work, 260 female directory assistance operators employed in three branch facilities of the nation-wide telecommunication company. Ergonomic evaluation of the work status was done by two industrial hygienists through inspection. Workers were surveyed with standardized self-administered questionnaire and examined by family physicians and an orthopaedician for cumulative trauma disorders. Laboratory examination of serum aspartate aminotransferase(AST), creatinine phosphokinase(CPK), aldolase and rheumatoid factor was done and X-ray of cervical spine and both shoulders was taken from all subjects and nerve conduction velocity test was done on 57 subjects with suspected nerve entrapment cases. Cumulative trauma disorders were categorized into 3 category according to work-relatedness of the disorders. On ergonomic evaluation of the working posture and work environment, improvement of work posture revealed inappropriate postures and devices. Mean age of the subjects were 39 years old and more than 80% graduated high school or above. Ninety-eight percent of the workers employed in the company for more than 15 years and 74.6% of the workers worked at the VDT job for more than 4 years. Mean daily work hours was 8.0 hours per day and mean break hours was 90.5 minutes per day with mean extra work hours of 10.7 hours per month. Mean daily calls were 1128.6 calls in maximum and 864-8 calls in minimum. On laboratory examination, 13.(5.0%) workers had abnormal AST, 53(20.4%) had abnormal CPK, and 1(0.4%) had abnormal aldolase level. On x-ray examination of cervical spine, 111(42.7%) had loss of or reversed normal cervical lordosis, 10(3.8%) had narrowing of intervertebral space. Nerve conduction velocity test was abnormal in 11(19.2%) among 57 workers. Among disorders categorized as work-related, 131(50.4%) were diagnosed to have fatigue myalgia of levator scapulae, 108(41.5%) had cervical strain or sprain, 47(18.1%) had fatigue arthralgia of phalangeal joints, and 47(18.1%) had probable carpal tunnel syndrome, in 10(3.8%) of those diagnosis was confirmed electrophysiologically. Age, seniority, work duration at present job, workload nor location of facilities were associated with the prevalence of symptoms nor specific diagnoses on simple statistical analysis and multiple logistic regression, which seems to be due to highly selected and homogeneous characteristics of the study subjects. Above results shows that cumulative trauma disorders are very prevalent among directory assistance operators and elaborate effort is needed to reduce the cumulative trauma disorders among the operators.

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.

조혈모세포이식 후 발생한 주폐포자층 폐렴에 대한 고찰

주지현,최정현,이동건,백지연,고윤호,이혜정,김세희,신호진,박윤희,박지영,김유진,신완식,김춘추 대한감염학회 2001 감염 Vol.33 No.4

Background : Pneumocytitis cainii pneumonia (PCP) can occur in immunocompromised hosts especially such as AIDS or cancer patients. Although recent research had focused on PCP in AIDS patients, few studies have described the clinical presentations of PCP in recipients of stem cell transplantation (SCT). We evaluated the clinical manifestations of PCP in SCT patients admitted at St. Mary's hospital, Seoul, Korea. Methods : The medical records of 17 PCP patients undergoing SCT between Feb. 1998 and Feb. 2000 were reviewed. The diagnosis of PCP was confirmed through the demonstration of Pneumocytitis cainii via either cytology of brochoalveolar lavage (BAL) or histological technique of lung biopsy. CMV disease and CMV infection were confirmed by BAL culture and antigenemia respectively . Results : Seventeen patients were all recipients of allogeneic SCT and 7 of 17 patients were performed non-sibling SCT. Patients presented with symptoms including brief period (4 ∼23 days) of fever (76%), dyspnea (70%), cough (64%), and signs such as rare(58.8%), Sixteen patients (94%) had been receiving immunosuppressive agent such as cyclosporine A (64%) or Fk506 (35%) without PCP prophylaxis. Eleven patients (64%) were treated with corticosteroid with mean dose of 16 mg/day prednisolone and mean duration of 4.6 months after post-SCT period. Twelve patients were co-infected with CMV. Another co-infected miCroorganisms were Pseudomonas aeruginosa, Mycobacterium tuberculosis, herpes simplex virus, parainfluenza virus, Average duration of treatment with trimethoprim-sulfamethoxazole (TMP/SMX) was 21 ±9 days. Four patients died, and three of them were related with PCP. Conclusion : PCP developed frequently in patients who were taking immunosuppressive drug due to graft versus host disease or were not taking TMP/SMX prophylaxis. High risk patients showing fever, cough, or dyspnea should be considered to take early bronchoscopic intervention for detection of PCP. When treat for PCP, it also be considered to the possibility of coinfection such as CMV. (Korean J Infect Dis 33:273∼279, 2001)

7분 선별검사(7 Minute Screen Test) 각 하위 척도의 임상적 유용성

구형모,김지혜,고선규,고혜정,이형석,김상윤,김도관 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : We aimed to provide standard data of the individual tests in 7MS that could generalized for Korean elderly accor-ding to age and education. We also evaluated diagnostic efFicacy of each test in 7MS. Methods : Data on demographic characteristics of 311 normals were gathered for comparison. We also assessed two differences between normal and dementia group in individual tests of 7MS. Results : All individual tests of 7MS showed significant differences in sex, age, and education, except for ECR. But there were no significant differences in sex controlling age and education. As a result of ROC curve, the ability of the ECR test to discriminate between AD and normal subject appeared superior. The scores of the individual tests of 7MS among CDR 0.5 and 1 group and normal group were compared. It was also found that the ECR test stands out among 7MS tests. Conclusion : The 7MS, Particularly ECR, had the highest sensitivity and specificity for diagnosis of AD as well as early de-mentia. It suggests that the individual tests of 7MS are useful to predict early dementia, without using the complex logistic re-gression equation.

갑상선결절의 임상 및 초음차소견의 진단적 가치

박거운,박철진,박일구,신지혜,정중화,배학연,김상용 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Backgrounds: Thyroid nodule have been relatively common disease and it's prevalence estimated about 4-7%. Recently, high resolution ultrasonography has made the detection of small thyroid nodule possible, Increases in the detection of thyroid nodule have created a clinical dilemma on how to properly manage such thyroid nodules. We investigated the prevalence, clinical and ultrasonographic characterristics, and optimal diagnostic approach toward detected benign and malignant thyroid nodules. Methods: A retrosepctive review was undertaken on the 372 patients who was done Ultrasonograpy guided fine needle aspiration biopsy in Chosun University Hospital, Gwang-Ju, Korea between July 2003 and Spring 2005. Devided into four group such as benign and malignant thyroid nodule on the basis of size 1.5Cm. The review consisted of thyroid function test, antithyroid antibodies, thyroid autoantibodies, thyroid ultrasonography, fine needle aspiration biopsy in each group. Results: The prevalence of thyroid nodule malignancy rate was 18.0%. The prevalence of thyroid incidentaloma malignanct rate was 17.5%. There were no significant differences in age, sex, thyroid function test and size between the benign, malignant incidentalomas and nodule. Ultrasonographic characteristics, include ultrasonography index point showed meaningful diagnostic value for the detection of malignancy in thyroid nodule, Conclusion: Thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodule; however, ultrasonographic findings can be used to decision of optimal management strategies 배경: 최근갑상선 초음파의 빈번한 시행으로 갑상선 결절의 발견이 증가하고 있다. 이러한 갑상선 결절중 특히 갑상션우연종을 임상적으로 어떻게 접근하고 치료를해야하는지는 적지 않는 문제가 되고 있다. 본 연구에서는 갑상선 우연종 및 직경 1.5 cm 이상의 갑상션결절의 유병률, 임상적 특징, 초음파특정 및 초음파의 진단적 유용성에 대해 알아 보았다. 방법: 2003년 7윌부터 2005년 3월까지 조선 대학교병원 내과 및 일반외과및 건강검진 센터를 통해 갑상선 초음파, 경동맥 초음파 및 경부 CT등을 통해 우연히 발견된 갑상션결절을 가진 372명을 대상으로 후향적 연구를 시행하였다. 크기 1.5 cm 미만의 양성및 악성 갑상선 결절군과 크기 1.5 cm 이상의 양성 및 악성결절로 그룹을 나누고 각 군에서 나이, 성별, 갑상선 기능검사, 항갑상선 항체, 갑상선 초음파 및 미세침흡인세포검사등을 검토하였고, 모든 갑상선 결절에 Koike (6)가 제한한 초음파지표 점수(Ultrasonographie index point)를 부여하여 각 군을 비교하였다. 결과: 분석한 갑상선 결절 372예 중 악성결절의 유병율은 18.0% (67예)였다. 갑상선 우연 종의 유병율은 81.5% (303예)였다. 갑상선 우연 종에서의 악성률은 17.5% (53예)로 나왔다. 크기 1.5 cm 이상의 양성 및 악성 갑상선 결절과 양성 및 악성 갑상선 우연종에서 나이, 성별, 갑상선 기능검사, 항갑상선항체에는 의미있는 차이가 없었다. 또한 양성 및 악성우연종에서 의 갑상선 결절크기에도 의미있는 차이는 보이지 않았다. 갑상선 결절의 초음파 지표점수만이 양성 및 악성우연종과 양성 및 악성갑상선 결절의 감별에 의미있는 차이를 보였다. 갑상 선우연종과 크기 1.5 cm 이상의 갑상선 결절에 서 양성을 나타내는 초음파지표점수는 각각 3 점과 4점으로 다르게 나타났다. 양성 및 악성 갑상선우연종의 감별에서 초음파 지표점수의 민감도는 93.6%, 특이도는 52.8%, 양성예측율은 92.4%로 나왔고, 진단적 효율은 86.4% 였으며 크기 1.5 cm 이상의 양성 및 악성 갑상선 결정의 감별에서 초음파지수 민감도는 92.7%, 특이도가 42.9%, 양성 예측도 86%, 효율 82.6%를 보였다. 결론: 갑상선결절에서의 양성 및 악성의 유무는 임상적으로 판단하기 힘들지만 갑상선 결절에서의 초음파 소견 및 초음파 지표 점수를 도입하면 이에 대한 감별에 도움을 줄 수 있다. 따라서 갑상선 초음파검사시 초음파지표점수의 사용은 향후 갑상선 결절의 진단 방향을 제시하는 중요한 길잡이가 될 수 있으리라 사료된다.

뇌하수체 종양 제거술 시행 후 뒤늦게 발생한 횡문근 융해증과 동반된 중추성 열

장제혁,최규남,김일환,노은지,김윤정,유충헌,고정해,박봉수,김태균,권민정,이순희,박정현 인제대학교 2008 仁濟醫學 Vol.29 No.-

Body temperature is controlled by thermoregulatory center of the hypothalamus. We report a case of 24 years old man with central fever. He was subjected to a partial excision of pituitary tumor compressing optic chiasm four years ago. He has received hormonal therapy for panhypothyroidism after removal of pituitary tumor. And He received gamma knife operation for partially contrast-enhancing masses in suprasellar and both hypothalamic areas that is probably postoperatively remnant or recurrent tumor of pituitary adenoma. One year after gamma knife operation, he presented with a febrile syndrome of unknown origin including rhabdomyolysis. All usual investigations proved negative. We diagnosed him as central fever with rhabdomyolysis. He received medical ICU care with cooling bed, ice pack. And his symptom improved. Postoperative hyperthermia may result following resection of the pituitary tumor. When central fever is suspected taking note of past history, a quick recognition of course of fever can help reduce the using of unnecessary antibiotics and hospital stay.

A New Mid-Season Peach Cultivar, ‘Misshong’

Ji Hae Jun,Kyeong Ho Chung,Ik Koo Yun,Jung Hyun Kwon,Sung Ji Hae Jun,Sung Jong Kim,Yong Bum Kwack,Kyung Bok Ma,Jung Bae Kim 한국원예학회 2009 한국원예학회 학술발표요지 Vol.2009 No.5

Table Grape ‘Jinok’

Yun, Hae Keun,Park, Kyo Sun,Roh, Jeong Ho,Kwack, Yong Bum,Jun, Ji Hae,Jeong, Seok Tae,Jang, Han Ik,Kim, Seung Heui,Shin, Yong Uk American Society for Horticultural Science 2008 HortScience Vol.43 No.7