원발성 피부 CD30 음성 대형 T세포 림프종 1예

송지연,양진석,김미연,박영민,김형옥,박경신,강창석 대한피부과학회 2003 대한피부과학회지 Vol.41 No.10

Primary CD30 negative large T cell lymphomas consist of CD30 negative large tumor cells without prior or concurrent mycosis fungoides. Clinically, it presents with solitary, localized or generalized plaques, nodules, or tumors and most cases show an aggressive clinical course. The histologic apperance may be identical to that of classic mycosis fungoides undergoing transformation into large cell lymphoma and large tumor cells represent at least 30 percent of the total tumor cell population. We experienced a case of CD30 negative large T cell lymphoma and report it with a review of literatures.(Korean J Dermaton 2003;41(10) : 1402~1405)

흉추의 병적골절을 보인 심한 신성 골이영양증 1례 : 증례 보고

이송주,이은미,임학,정연순,장재호 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

A 33-year-old woman presented with tingling sensation and weakness in the both hands and feet. She had a diagnosis of secondary hyperparathyroidism caused by renal failure. Her height was shortened due to severe kyphosis. On plain radiograph, there were fractures on both femoral necks and pathologic fracture on thoracic vertebra. An MRI scan of the spine demonstrated a expansile, heterogeneous hypointense lesion of the 2nd thoracic spine, which remained hypointense on T2 images. Following total parathyroidectomy the patient underwent a thoracic decompression and spinal stabilization from the back. Hyperparathyroidism may cause brown tumor and tumor associated pathologic fracture in the spine. Involvement of the spine with neural compression is extremely rare. An early spinal decompression with parathyroidectomy leads to remission of symptoms.

국내에서 발생하고 있는 사람 브루셀라증의 임상적 특성

김연숙,최영실,오원섭,권기태,이혁,이선희,손준성,김신우,장현하,정숙인,고관수,박미연,백경란,송재훈 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

배경 : 2002년 내국인에서의 첫 사람 브루셀라증의 증례 보고 이후 국내에서 사람 브루셀라증이 빠른 증가를 보이고 있다. 이에 연구자들은 국내에서 발생하는 브루셀라증의 임상적 특성을 연구하고자 하였다. 방법 : 2003년부터 2006년 7월까지 7개 대학병원에 내원한 환자들을 대상으로 WHO의 진단기준에 의하여 확진된 브루셀라증 환자들의 의무기록을 후향적으로 조사분석 하였다. 배양된 균은 삼성서울병원에 의뢰하여 16S rRNA 유전자 분석방법을 이용하여 종을 확인하였고, 표준시험관응집검사는 국립보건원에 의뢰하여 시행하였다. 결과 : 34예의 환자들이 브루셀라증으로 확진되었고, 31명이 남자였다. 혈액에서 B. abortus가 증명된 경우가 8예, 표준시험관 응집검사상 의미 있는 항체가 상승을 보인경우가 26예이었다. 환자들은 대부분 축산업관련 종사자였고, 추후 브루셀라증으로 확진된 소와의 직접 접촉을 통해 감염된 것으로 여겨진다. 국내 사람 브루셀라증의 가장 흔한 증상은 발열이었고, 위장관계 합병증이 가장 흔히 동반되었다. 치료로는 doxycycline/rifampicin이 24예의 환자에서 doxycycline/aminoglycoside (streptomycin 혹은 gentamicin)이 10예의 환자에서 6주 이상의 기간 동안 투여되었다. 치료에 반응을 보이지 않는 환자는 없었고, 재발이 1예 있었다. 결론 : 국내에서 발생하는 사람 브루셀라증의 원인균으로 현재까지 분리 동정된 것은 B. abortus이며, 소 브루셀라증의 증가로 인해 인체감염사례가 함께 증가하는 것으로 사료된다. 위험 직업군 종사자들에서 감염된 소와의 직접 접촉을 통해 주로 발생하고 있는 브루셀라증의 임상종상은 국외에서 발생하는 경우와 유사한 양상을 보이고 있으며 치료에 대한 반응은 비교적 좋은 편이긴 하나, 추후 보다 많은 환자들을 대상으로 한 연구가 필요하리라 사료된다. 사람 브루셀라증의 조절을 위해서는 소 브루셀라증의 조절이 필수적이며, 브루셀라증의 조절에 성공한 선진국의 사례를 적극적으로 도입해야 할 것으로 생각된다. Background : Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. Materials and Methods : Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). Results : A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies ≥1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. Conclusion : Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.

입원 환자 영양검색 전산 프로그램 개발

안수미,윤기영,신연명,최경현,임근승,장문경,송윤미,공은희 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : About 30% of patients in the hospital are under nourishment. A large portion of people are undernourished when they are admitted to the hospital and in the majority of these, undernutrition develops further while in hospital. Patient-Generated subjective global assessment(PG-SGA), a method of nutritional assessment based on clinical judgment, has been widely used to assess the nutritional status of adults for both clinical and research purposes. Modified PG-SGA can be used as a nutrition screening tool, and a comprehensive nutrition assessment is desirable for those who are malnourished. The purpose of this study is to develop a simple, reliable and valid nutrition screening program(NSP). Methods : We applied the nutrition screening program(NSP) to adult inpatients who are at risk of malnutrition using the Modified Patient-Generated subjective global assessment(PG-SGA) and objective assessment(electrical medical record data). Results : Therefore simple and beneficial NSP is developed for patients with severe malnutrition. Using NSP. nutritional information of the severe malnutrition patient should be shared with the physicians and they should be taken care of by clinical dietitians to improve their nutritional status. Conclusion : The Modified PG-SGA and nutrition screening tool are simple, reliable and valid nutrition screening program(NSP).

일개 농촌지역의 지역사회 영양정보에 관한 조사연구 : 경기도 남양주군 수동면을 중심으로 Su-Dong Myun, Nam Yang-Ju Gun, Kyung-Gi Do

계난이,권계숙,송미희,이연주 이화여자대학교 의과대학 1988 梨花醫學誌 Vol.- No.20

From September to November in 1987, the study was conducted a survey of Su-Dong Myun, Nam Yang-Ju Gun, Kyung-Gi Do, a comprehensive rural care demonstration area of Ewha Womans University. The purpose of this survey has been to examine into community nutrition informathrough preventive medicine training of sophomores of medical course. The result were as follows 1) Female respondent was 88.2% of all whose age was the forties and fifties at the highest rate of 22.6% respectively and whose educational level was uneducated at rate of 31.2%. 2) Agriculture(66.7%) was the common householder's occupation whose main income was from their own farm products(67.7%). 3) A family of five(24.7%) and two generations(e.g parent and children) (55.9%) was the most common family. 4) The housewife(98.9%) was the most common cook and 35.5% of all cook was not able have sufficient time to prepare for their meal. 5) On food purchase, main food was largely self provided(65.6%) and subsidiary food with self-provision and outside purchase(51.6%). 6) On the self sufficient food rice(77.4%) was most common as main food and vegetable(81.7%) as subdiary food. 7) On the frequency of purchasing food, main food was about 2-3 times a month, subsidiary food 1-3 times a week. On the market place, main food mainly self sufficient(59.1%) and subsidiary food was largely purchased from the peddlers and market on the move(35.5%) 8) On the means of transportation of purchased food, main food was conveyed by bus or another kinds of vehicles and subsidiary food(52.7%) was in the same way. 9) On the consumer's difficulty in purchasing food, meat and fish were rated 76.3% and vegetable 78.5%, 76.3% of all consumer had difficulty in purchasing meat and fish, 78.5% in purchasing grocery. 10) 94.6% was in possession of electric refrierator and 89.2% possessed their own wells. 11) The respondent had such fuels for cooking as propanegas(66.6%), wood(18.3%) briquet(10.8%). 12) the present state of nutrition was that the mean points was 2.7 in the group 1, 2.2 in the group 2, 3.9 points in the group 3, 2.8 points in the group 4, 3.1 points in group 5 and 2.7 points in the group 6. 13) Most families' favorite food was kimchi or kimchi soup and distasteful was meat including dog meat. 14) 48.4% of all respondents took no interest in taking in adequate nutrition owing to the lack of money and time to spare.

간호사의 이직의도 구조모형

김창희,양승순,김연자,손연정,유미애,송주은 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to construct and test a structural equation model of nurses' turnover intention. Method: The participants were 716 nurses at 4 university hospitals. Data were collected by a self-report questionnaire in 2008 and analyzed using SPSS 12.0 and AMOS 4.0 Win program. Results: The fit indices of modified model were x²=285.928(p<.001),x²/df=1.958GFI=0.964, RMSEA=0.037, AGFI=0.944, NFI=0.947, NNFI=0.961, CFI=0.973, PNFI=0.658 and showed high compatibility with the empirical data. In the final model, job stress and satisfaction were found to have significant direct effects on nurses' turnover intention, while organizational culture and emotional labor were very important factors to have indirect effects on turnover intention via job stress and satisfaction. Nurses' turnover intention was accounted for 41.2% of covariance by these factors. Conclusions: Comprehensive nursing interventions for decreasing nurses' turnover intention should be focused on reducing job stress and increasing job satisfaction. Also, Nursing strategy for enhancing positive organizational culture and decreasing emotional labor would be helpful for decreasing nurses' turnover intention, too. Further studies are needed to prospectively conduct to verify these causal relationships with larger sample.

알쯔하이머병 환자 혈청에서의 베타 아밀로이드 단백질에 대한 특이 항체량 측정 : 알쯔하이머병의 생화학적 진단지표 개발 Development of Biomarker for Alzheimer's Disease Diagnosis

소정온,허지연,심혜진,김종원,나덕렬,이필휴,정선주,박문호,주인수,송미숙,김영호,묵인희 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.1

Background:Alzheimer's disease (Ad) is a neurodegenerative disorder that is rapidly increasing with the aging society, requiring a need for early diagnosis and prevention. However, diagnosis on AD has only been possible through limited methods such as neuropsychological examination or MRI. AD is characterized by deposition of senile plaques and neurofibrillary tangles in the brain. Aβ peptide in senile plaques seems to play a central role in the neuropathology of AD. Several biochemical markers for AD are available, including reduced Aβ protein, a change in ratio between Aβ40 and 42 and increased level of tau protein in the cerebrospinal fluid (CSF). Methods:This study analyzes anti-Aβ antibody from serums of AD patients using the ELISA. The levels of anti-Aβ antibody from patients with idiopathic Parkinson's disease or stroke and from normal control were compared to that of AD patients. Results:Our results showed a significantly lower anti-Aβ antibody level in AD compared to those with other neurological diseases or control. Conclusions:These data showed that the anti-Aβ antibody level in the serum may be used to diagnose the presence of AD.

비만을 동반한 위암 환자에서 두 병을 같이 수술 치료한 경험(증례)

최경현,윤기영,문형환,신연명,서경원,안수미,송윤미,석정희,정경연,이은하 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Obesity is growing problem in Korea. We had a case of bariatric surgery during gastric cancer operation. Patient was 29 year old Korean lady with early gastric cancer located in the lesser curvature side of the middle 1/3 of the stomach. Her body weight was 89 kg, height 163 cm, and thus body mass index was 33.5 kg/m2. Preoperative blood pressure was 130/90 mmHg, hemoglobin 12.9 g/dL, total lymphocyte count 3,280/mL, serum albumin 4.3 g/dL, CEA 1.1 ng/mL, CA 19-9 9.1 ng/mL, and alpha fetoprotein 2 ng/mL. Another associated disease was right thyroid follicular neoplasm. The chest X-ray was normal. After IM injection of 2,500 units of heparin 30 minutes before the induction of general anesthesia, she received curative subtotal gastrectomy and Roux en Y gastrojejunostomy when a malabsorption loop of 120 cm jejunum was incorporated between the Treitz ligament and the end to side jejuno-jejunostmy site at May 29th 2006. Her postoperative course was uneventful except a minor wound seroma and the elevations of serum amylase(up to 4 folds) and lipase(up to 2 folds). She lost her body weight 9 kg in 5th, 21 kg in 7th, and 27 kg in 10th postoperative months to became 61.5 kg. On follow up exams in July 2008, she gained 4 kg to overcome her weakness and fatigue. From the above result, the incorporation of a malabsorption loop during reconstruction phase of gastric cancer operation was a good option for obese gastric cancer patients especially in cases of early gastric cancer.

정신분열병 환자를 위한 인지재활훈련 프로그램의 개발 : Korean-Cognitive Differentiation Program 한국형 인지분화훈련 프로그램

현명호,안석균,이만홍,조현상,최충식,이연희,송선미,유계준,김장우,김태용,이희상 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구배경 : 정신분열병 환자들은 인지장애를 보이는바, 저자들은 이들을 대상으로 한국형 인지분화훈련 프로그램을 개발하여 정신분열병 환자들을 대상으로 인지재활훈련을 실시한 후 환자들의 인지기능, 정신병리 및 문제해결기술에 미치는 효과를 조사하였다. 방 법 : 28명의 정신분열병 환자를 훈련군(n=14)과 대조군(n=14)으로 나누어 훈련군에게 한국형 인지분화훈련 프로그램을 1회 60분씩, 주당 2회씩, 11주간 총 22회를 실시하였다. 환자들의 인지기능은 K-WAIS의 산수, 빠진곳찾기, 어휘, 공통점찾기 소검사로 측정하였고 정신병리는 양성 및 음성증상 척도로 측정하였으며 문제해결기술은 사회문제해결척도로 평가하였다. 인지재활훈련의 효과를 평가하기 위해 훈련 전후의 인지기능, 정신병리 및 문제해결기술의 변화를 종속변수로 하고 훈련 유무를 독립변수로 하여 반복측정에 의한 변량분석으로 자료를 분석하였다. 결 과 : 한국형 인지분화훈련이 시간에 따른 인지기능검사 중 산수 소검사, 문제해결기술 중 시회문제해결척도의 전체 점수와 문제해결기술 소척도의 점수의 변화에 유의한 영향을 미쳤으나, 시각적 주의력, 개념화 능력 및 정신병리의 점수의 변화에 유의한 영향을 미치지 않았다. 결 론 : 한국형 인지분화훈련 프로그램은 정신분열병 환자에서 청각적 주의력 및 문제해결기술의 호전을 꾀할 가능성이 있음을 시사한다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training program- Korean version(a training program of attention and conceptual abilities) on cognitive function, psychopathology and problem solving skills in patients with schizophrenia. Methods : A total of patients diagnosed as schizophrenia using DSM-Ⅳ were randomly assigned to 2 groups. The training group went through a total of 22 sessions of cognitive differentiation training(60 min/ session×2 sessions/wk×11 wks). The attention-placebo control group received psychoeducation program during the same period. Arithmetic, vocabulary, similarities, picture completion of Wechsler Adult Intelligence Scale-Korean version, Positive and Negative Syndrome Scale, and Social Problem Solving Scales were administered to all patients, both before and after the training program. Results : In the arithmetic scores(F=6.35, af=1, p=0.018) of Wechsler Adult Intelligence Scale-Korean version, and total scores(F=6.35, af=1, p=0.018) and problem solving skill scale scores(F=4.88, af=1, p=0.036) of social problem solving scale, interaction effects of training was significant. Conclusion : Our findings suggest that cognitive differentiation training program-Korean version is effective on improving auditory attention and problem solving skills in patients with schizophrenia.

Effect of Retinoic Acid on Proliferation and Differentiation of Preadipocytes from Male and Female Pigs

Song, Mi-Yeon,Dang, Chang-Gwon,Chung, Chung-Soo Korean Society of Animal Sciences and Technology 2011 한국축산학회지 Vol.53 No.3

The current study was undertaken to determine the effect of retinoic acid (RA) on proliferation and differentiation of preadipocytes from male and female pigs. The preadipocytes were isolated from new-born male and female pigs by collagenase digestion and washed three times one day after seeding (designated as day 0 of culture). RA was included in the media at various concentratives from day 0 to 2. The cell number was measured on day 2 with hematocytometer after trypsin digestion. Cell differentiation was determined on day 6 by measuring glycerol-3-phosphate dehydrogenase activity. RA (0.1, 1 and 10 uM) showed no effect on proliferation of preadipocytes from both male and female pigs. However, RA significantly decreased differentiation of pig preadipocytes. Degree of differentiation with 0.1 uM, 1 uM and 10 uM of RA treatment was 80%, 41% and 29% respectively, compared with control. Similar inhibitory effect was found in the female pigs; 77%, 28% and 16% respectively. It is interesting that RA treated on cell proliferation stage had no effect on proliferation but had a strong inhibitory effect on differentiation which is happening in the late stage of cell culture.