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소아 만성 염증성 탈수초성 다발성 신경병증의 치료 및 효과
김우중(Woo Joong Kim),최선아(Sun Ah Choi),김수연(Soo Yeon Kim),김헌민(Hun min Kim),임병찬(Byung Chan Lim),황희(Hee Hwang),최지은(Ji eun Choi),김기중(Ki Joong Kim),채종희(Jong Hee Chae) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.4
목적: 본 연구는 소아 만성 염증성 탈수초성 다발성 신경병증 환자의 임상 양상을 분석하고 그에 따른 다양한 치료 방법과 예후에 대한 연구를 함이 목적이였다. 방법: 2004년부터 2014년 까지 서울대학교 어린이병원 뇌신경센터를 방문하였던 환자 중 EFNS/PNS 진단 기준에 의거하여 소아 만성염증성 탈수초성 다발성 신경병증으로 진단된 10명의 환자를 대상으로 후향적 의무기록 분석을 시행 하였다. 환자들은 일차 약제로 면역글로불린, 정맥용 스테로이드 또는 혈장교환술을 사용하였다. 일차 약제에 반응 하지 않을 경우 면역억제제를 추가하였다. 결과: 10명(남아 4명, 여아 6명)의 소아 만성 염증성 탈수초성 다발성 신경병증 환자들의 평균 진단 나이는 8세였고, 평균 추적관찰기간은 46.2개월이었다. 본 연구에서 소아 만성 염증성 탈수초성 다발성 신경병증 환자들은 8명(80%)에서 아급성 경과를 보였고, 6명(60%)에서 다상성 경과를 보였다. 4명의 단상성 경과를 보이는 환자들은 면역 글로불린(양호 반응 0%, 부분 반응 75%)에 비해 혈장교환술(양호반응 50%, 부분반응 50%)을 시행하였을 때 양호한 치료 결과를 보였다. 또한 진행성 경과에서 스테로이드는 효과가 없었다. 반면에 6명의 다상성 경과를 보이는 환자들은 면역 글로불린(양호 반응 50%, 부분반응 50%)과 혈장교환술(양호반응 40%, 부분 반응 60%)에서 유사한 치료 반응을 보였다. 5명의 다상성 환자들은 일차 치료에서 불응기 경과를 보였고, 그 중 4명의 환자들은 사이클로스포린 투약 후 양호 반응을 나타냈다. 8명의 환자들은 6개월 동안 재발을 보이지 않아 장기적인 치료 경과는 양호하였다. 결론: 진행하는 단상성 소아 만성 염증성 탈수초성 다발성 신경병증에는 조기 혈장교환술이 효과적이며 불응기 다상성 소아 만성 염증성 탈수초성 다발성 신경병증에는 사이클로스포린이 효과적이었다. Purpose: To investigate the clinical features of childhood chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) as well as the treatment responses and outcomes. Methods: We retrospectively analyzed clinical features and treatment outcomes of 10 cases of childhood CIDP followed up for more than a year. Intravenous immunoglobulin (IVIG), IV steroid and plasmapheresis was considered as the first line therapy and used according to patient’s response. Immunosuppresant agent was added when patients did not respond to the first line therapy. Results: 10 CIDP cases (4 male and 6 female) were enrolled, and the median age of onset was 8 years (range 3-15 years). The mean duration of follow up was 46.2 months (range 12-82 months). Our patients manifested more frequently with subacute onset (n=8, 80%) and polyphasic course (n=6, 60%). All ten patients had lower extremity weakness at presentation (100%), six patients complained of upper extremity weakness (60%), and three patients reported sensory changes (30%). In the monophasic course (n=4), plasmapheresis showed a better treatment response (good 50%, partial 50%) compared to IVIG (good 0%, partial 75%) and steroids (good 0%, partial 0%), especially in progressive phases. In the polyphasic course (n=6), IVIG (good 50%, partial 50%) and plasmapheresis (good 40%, partial 60%) showed similar treatment responses. Five patients were refractory to first line treatment and received immunosuppressants; four patients received cyclosporine and achieved successful disease control without significant side effects. The overall long-term outcomes were favorable, with eight patients (80%) showing minimal symptoms and no relapse within 6 months. Conclusion: Our results suggest that early administration of plasmapheresis in progressive monophasic course and cyclosporine in refractory polyphasic course may be effective in childhood CIDP.
김우중 ( Woo Joong Kim ),이경렬 ( Kyung Real Lee ),이상은 ( Sang Eun Lee ),이희정 ( Hee Jung Lee ),윤문수 ( Moon Soo Yoon ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.9
Background: Impetigo is a common bacterial infection caused by Staphylococcus aureus, and group Ab-hemolytic Streptococcus or both. Recently, S. aureus has been reported as the most frequently isolated pathogen of impetigo and the incidence of methicillin-resistant S. aureus (MRSA) among patients with impetigo has increased. Objective: To investigate the predominant microorganism and the antibiotic susceptibility of the impetigo causative pathogen. Methods: Bacterial culture and antimicrobial susceptibility testing were performed in patients with impetigo from June 2006 to May 2012. Results: Of 164 patients, bacteria were cultured from 139 patients. Among them, S. aureus was isolated from 114 (82%) patients. The others were Acinetobacter baumannii, Enterobactercloacae, Enterococcus species, Enterococcus faecium, Enterococcus faecalis, Klebsiella oxytoca, and Candida albicans. The resistance rates of S. aureus against antibiotics were as follows: penicillin, 95.6%; erythromycin, 43.9%; fusidicacid, 38.1%; clindamycin, 24.5%; gentamycin, 21%; tetracycline, 12.3%; trimethoprim-sulfamethoxazole, 0.9%; ciprofloxacin, 0%; habekacin, 0%; linezolid, 0%; teicoplanin, 0%; and vancomycin, 0%. Thirty-four (29.8%) S. aureus isolates were MRSA, and the prevalence of MRSA increased during the 6-year period. Conclusion: The most predominant pathogen in impetigo was S. aureus, which was sensitive to ciprofloxacin, habekacin, linezolid, trimethoprim-sulfamethoxazole, teicoplanin, and vancomycin. An increase in the prevalence of MRSA was observed during the 6-year period, and the effective antibiotics for MRSA were trimethoprim-sulfamethoxazole, teicoplanin and vancomycin.
Study on the Oxidation Treatment of Nanoparticles for the Critical Heat Flux
Woo-Joong Kim(김우중),Yong-Han Jeon(전용한),Nam-Jin Kim(김남진) 한국태양에너지학회 2017 한국태양에너지학회 논문집 Vol.37 No.6
Pool boiling, one of the key thermal-hydraulics phenomena, has been widely studied for improving heat transfer efficiencies and safety of nuclear power plants, refrigerating systems, solar-collector heat pipes, and other facilities and equipments. In the present study, the critical heat flux (CHF) and heat-transfer coefficients were tested under the pool-boiling state using graphene M-5 and M-15 nanofluids as well as oxidized graphene M-5 nanofluid. The results showed that the highest CHF increase for both graphene M-5 and M-15 was at the 0.01% volume fraction and, moreover, that the CHF-increase ratio for small-diameter graphene M-5 was higher than that for large-diameter graphene M-15. Also at the 0.01% volume fraction, the oxidized graphene M-5 nanofluid showed a 41.82%-higher CHF-increase ratio and a 26.7%-higher heat-transfer coefficient relative to the same nanofluid without oxidation treatment at the excess temperature where the CHF of distilled water occurs.
중남미와 북아시아 문화권의 조류(鳥類) 신화 비교 고찰
김우중 ( Woo Joong Kim ) 한국스페인어문학회(구-한국서어서문학회) 2010 스페인어문학 Vol.0 No.56
En la America Latina, hay varios cuentos difundidos de antiguo. Especialmente en Mexico, se han transmitido unas mitologias de aves tales como Huitzilopochtli de los aztecas.. Esta clase de mitologias aviarias tambien aparecio en varias regiones de Asia. Sobre todo, son bien conocidas varias mitologias aviarias de los normongoloides, presuntos antecedentes de los amerindios que se habrian trasladado al continente amreicano a finales del periodo glacial. Este trabajo se ha realizado con el objetivo de hacer estudio comparativo entre los cuentos relacionados con las aves de Asia del Norte y Latinoamerica para observar sobre la similitud cultural de ambos continentes y para buscar la posibilidad de mutuo intercambio cultural. Se podra admitir la sucesibilidad cultural entre ambas partes si son observados unos elementos semejantes con referencia a su sistema mitologico aparte de la analogia racial de los amerindios con los normongoloides. La mayoria de los dioses principales latinoamericanos tales como de Maya, Azteca e Inca tienen conexion o con el sol o con las imagenes aviarias cuyo modelo de trazo tiene en comun con el del sistema mitologico de los mongoloides. Para analizar estos elementos semejantes, hace falta definir la division en periodos cuando surgieron y en este trabajo se estudia brevemente como dividir los periodos respectivos. Para tratar de comprobar la inetrrelacion cultural entre ambos continentes, no hay que hacer un estudio parcial ni una observacion aislada sino una investigacion sucesiva de manera sintetica y se espera que estas observaciones y analisis sirvan de referencia y de base para los que en adelante investiguen este tipo de areas.
동맥류성 변형과 비정형성 변형을 보인 낭종 형태의 혼합형 피부섬유종
김우중 ( Woo Joong Kim ),최세림 ( Se Rim Choi ),이희정 ( Hee Jung Lee ),윤문수 ( Moon Soo Yoon ),김동현 ( Dong Hyun Kim ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.9
Dermatofibroma is a common benign fibrohistiocytic tumor that mainly presents as a brown papule or nodule. However, it can sometimes present with diverse clinical forms such as a cyst. Combined dermatofibroma is defined as a tumor that comprises two or more variants of dermatofibroma in a single lesion. We herein report on a case of combined dermatofibroma in a 40-year-old woman who presented with a cyst form on her lateral neck. The histological findings included the combined features of the aneurysmal and atypical variants of dermatofibroma such as cleft-like spaces with hemorrhage, some pleomorphic cells and multinucleated giant cells, as well as a feature of typical dermatofibroma. (Korean J Dermatol 2010;48(9):810~813)
김우중 ( Woo Joong Kim ),김진기 ( Jin Ki Kim ),이희정 ( Hee Jung Lee ),윤문수 ( Moon Soo Yoon ),김동현 ( Dong Hyun Kim ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.2
Turner`s syndrome (TS) is a genetic disorder caused by numeric and/or structural abnormalities of the X chromosome. It is characterized by a short stature, gonadal dysgenesis, and frequently by webbed neck, cubitus valgus, lymphedema, broad chest with wide spaced nipples, micrognathia, and brachimetacarpalia. Several cutaneous manifestations are associated with TS, including melanocytic nevi, hypertrophic scarring, and vitiligo. Rarely reported findings include hemangiomas, angiokeratomas, and halo nevi. We present a case of halo nevi and vitiligo in a 13-year-old girl with TS. To the best of our knowledge, halo nevi and vitiligo in TS has not been reported in the Korean literature. (Korean J Dermatol 2012;50(2):175~178)