선천성 완전방실차단이 동반된 신생아 루프스 1예

정재현,이은지,이은주,황진원,송영진,최병진,김일환,김종윤,허민영,김동욱 인제대학교 2009 仁濟醫學 Vol.30 No.-

Neonatal lupus is a rare syndrome occurring In neonates with tranplacentally acquired maternal autoantibodies, In particular anti-SSA/Ro-SSB/Ra antibodies. Manifestations include congenital heart block, cutaneous lesions, thrombocytopenia, neutropenia, pulmonary or neurological disease and hepatitis. The non-cardiac manifestations resolve by 6 months of age, congenital heart block is irreversible. We experienced a case of neonatal lupus with congenital complete heart block in a newborn of asyptomatic mother with anti-SSA/Ro-SSB/Ra antibodies.

항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구

김우진,심주철,공보금,강제욱,문정준,김정은,김민걸,박민경,김성진,김현정,정도운 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:This study was to identify weight & metabolic changes in first-episode psychotic patients with antipsychotics use and investigate the differences of weight & metabolic changes between first-episode psychotic patients and controls with antipsychotics use. Method:In this retrospective study, twenty eight first-episode psychotic patients and twenty eight controls with schizophrenia, schizoaffective or bipolar disorder defined by DSM-IV criteria were included. Information about demographic and clinical characteristics of the subjects was gathered from the medical records. Also body weight, sBP, dBP, fasting glucose, lipid profile and WBC count were evaluated before and after antipsychotics use. Rogistic regression was conducted to assess factors associated with weight gain. Results:First-episode psychotic patients showed more weight and BMI changes than controls after antipsychotics use, and these changes continue over 12 months. On the other hand, there were no significant factors associated with weight gain. Conclusion:The results of present study suggest that antispychotics is one of the major causes inducing weight gain of psychotic patients and antipsychotics-induced weight gain is more vulnerable to drug-naive first-episode psychotic patients.

유용성 도료와 수용성 도료의 유해성 비교에 관한 연구 : 자동차 보수용 도료를 중심으로

권은혜,김광식,오정룡,최정근,정윤석,이유진,김은아,송세욱,정호근 한국산업위생학회 2001 한국산업보건학회지 Vol.11 No.1

The purpose of this study is to substitute water-based painting materials for the current solvent-based ones used in motor-repairing process to minimize the exposure of organic solvents to the painters. This study assessed the exposure of organic solvents to the painters using water-based and solvent-based painting materials and compared compositions, painting processes and the health hazards of the application of these alternative painting materials. The results of this study are as follows. 1. solvent-based painting materials used in motor-repairing process consist of various organic solvents, which consist primarily of toluene, xylene, ethyl benzene, ethyl methyl bezene, trimethyl bezene, ethyl acetate, butyl acetate, methyl isobutyl ketone, 2-ethoxy ethanol, 2-ethoxy ethyl acetate and toluene-2.4-diisocianate and the others. These organic solvents are know as health-hazardous substances. But water-based painting materials are high-solid, low-solvent ones and consist of such two organic solvents as 2-butoxy ethanol and 2-heptanone and the others. 2. The painters using solvent-based painting materials in motor-repairing process are exposed to various organic acetate, methyl isobutyl ketone, trimethyl benzene, 2-ethoxy ethanol, and 2-ethoxy ethyl acetate. But the painters using solvent-based ones are only exposed to 2-butoxy ethanol and 2-heptanone. 3. By using water-based painting materials in stead of solvent-based painting materials containing health-hazardous organic solvents, the exposure of such organic solvents in the painter's breathing zone can be largely prevented. 4. This study recommends water-based painting materials as substitutes for the current solvent-based ones used in motor-repairing process to minimize the exposure of organic solvents to the painters.

외과적 노출술을 이용한 매복된 하악 제 1 대구치의 자발적 맹출 유도

김은정,김난진,조호진,김현정,김영진,남순현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

하악 제 1대구치 매복의 발생 빈도는 전체 인구의 0.01%로 드물게 나타난다. 매복의 원인으로는 맹출 공간의 부족, 과잉치, 치성 종양이나 낭과 같은 맹출로상의 장애물, 유전적 요인, 내분비 질환, 외상 등이 있다. 하악 제 1대구치의 매복으로 인해 하안면 고경의 감소, 낭의 형성, 치관 주위염, 인접치의 치근 흡수, 부정 교합 등의 부작용이 생길 수 있으며, 치료 방법으로는 외과적 노출술, 교정적 견인, 외과적 재위치술, 발거 등이 있다. 다음의 두 증례는 하악 제 1대구치의 미맹출을 주소로 내원한 환아에게 외과적 노출술을 시행하여 원심 경사 매복된 하악 제 1대구치의 자발적 맹출을 유도한 증례들이다. Impaction of mandibular first molar is relatively rare and its overall frequency has been reported to be 0.01%. The etiology of impaction are lack of eruption space, physical obstacles such as supernumerary teeth, odontomas or odontogenic tumors, hereditary factors, functional disturbances of endocrine glands and traumas. Impaction of mandibular first molar can result in a short lower facial height, formation of a follicular cyst, pericoronal inflammation, resorption of the roots of neighboring teeth and malocclusion. The treatment options available for impacted teeth include surgical exposure, orthodontic forced eruption, surgical repositioning and surgical removal of unerupted molar. This report presents two cases of distally tilted and impacted mandibular first molars which were treated by surgical exposure. In these cases, we could observe spontaneous eruption of the impacted mandibular first molars after surgical exposure.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

경막 내 colistimethate 투여로 치료한 다제 내성 cinetobacter baumannii 뇌실염

홍유아,유진홍,김진진,모은영,안건희,정희경,김진석,이현정,정미향,윤승배 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Acinetobacter species is a non-fermentative aerobic gram-negative coccobacillus that is an important pathogen found in nosocomial infections. Recently, multi-drug resistant Acinetobacter baumannii (MDR-AB) infections have been increasing and pose a serious problem. Most such infections present as bacteremia, pneumonia, or a wound infection; however, CNS infections are very rare. We herein present a case of ventriculitis caused by MDR-AB in a 37-year old man after a neurosurgical intervention. The patient was successfully treated with intrathecal colistimethate.

자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.