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Perception and Attitudes of Korean Obstetricians about Maternal Influenza Vaccination
노지윤,서유빈,송준영,최원석,이재갑,정은주,강성휘,최민주,전지호,윤진구,이샘나,현학준,이진수,정호진,정희진,김우주 대한의학회 2016 Journal of Korean medical science Vol.31 No.7
Pregnant women are prioritized to receive influenza vaccination. However, the maternal influenza vaccination rate has been low in Korea. To identify potential barriers for the vaccination of pregnant women against influenza, a survey using a questionnaire on the perceptions and attitudes about maternal influenza vaccination was applied to Korean obstetricians between May and August of 2014. A total of 473 respondents participated in the survey. Most respondents (94.8%, 442/466) recognized that influenza vaccination was required for pregnant women. In addition, 92.8% (410/442) respondents knew that the incidence of adverse events following influenza vaccination is not different between pregnant and non-pregnant women. However, 26.5% (124/468) obstetricians strongly recommended influenza vaccination to pregnant women. The concern about adverse events following influenza vaccination was considered as a major barrier for the promotion of maternal influenza vaccination by healthcare providers. Providing professional information and education about maternal influenza vaccination will enhance the perception of obstetricians about influenza vaccination to pregnant women and will be helpful to improve maternal influenza vaccination coverage in Korea.
Voriconazole로 치료한 경막외 농양을 동반한 칸디다 척추간판염
노지윤,최원석,조유미,송준영,정희진,허중연,김우주 대한의진균학회 2009 대한의진균학회지 Vol.14 No.3
Candida spondylodiscitis with epidural abscess is rarely reported and known to be the late complication of candidemia. A 48-years-old man presented with 4 weeks of progressively aggravating low back pain. He had a history of fungemia caused by Candida albicans 4 months earlier, for which he had been treated successfully with systemic fluconazole. The MRI of lumbar spine demonstrated the spondylodiscitis with multiple epidural abscesses at the L2/3 level. Along with the surgical interventions including abscess drainage, the intravenous amphotericin B administration was begun. Culture of drained pus yielded the growth of Candida albicans. After therapy with parenteral amphotericin B for 2 weeks followed by oral fluconazole for 8 weeks, the back pain resolved. However the low back pain and inflammation relapsed during oral fluconazole therapy. Thereafter oral voriconazole had been administered for 24 weeks and the patient showed complete recovery and no recurrence.
노지윤,김석진,강은해,서보경,노경호,채양석,김병수 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.4
Pseudomembranous necrotizing bronchial aspergillosis (PNBA) is a rare form of invasive aspergillosis with a very poor prognosis. The symptoms are non-specific, and the necrotizing plugs cause airway obstruction. Atelectasis and respiratory failure can be the initial manifestations. Recently, we treated an immunocompromised patient with PNBA, who presented with a sudden onset of atelectasis and acute respiratory failure. There were no preceding signs except for a mild cough and one febrile episode. Bronchoscopy revealed PNBA, and Aspergillus nidulans was cultured from the bronchial wash.
Influenza Vaccines: Unmet Needs and Recent Developments
노지윤,김우주 대한감염학회 2013 Infection and Chemotherapy Vol.45 No.4
Influenza is a worldwide public health concern. Since the introduction of trivalent influenza vaccine in 1978, vaccination hasbeen the primary means of prevention and control of influenza. Current influenza vaccines have moderate efficacy, good safety,and acceptable tolerability; however, they have unsatisfactory efficacy in older adults, are dependent on egg supply for production,and are time-consuming to manufacture. This review outlines the unmet medical needs of current influenza vaccines. Recentdevelopments in influenza vaccines are also described.
대유행 인플루엔자(H1N1 2009)의 역학, 임상적 특성: 일개 거점병원의 경험
노지윤,임선영,허중연,최원석,송준영,김우주,정희진 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.2
Background: Since early outbreaks in North America in April 2009, the new influenza virus spread rapidly all over the world, and WHO declared a pandemic in June 2009. The objective of this article is to describe the epidemiological and clinical characteristics of patients confirmed with pandemic influenza (H1N1 2009). Material and Methods: Among all patients confirmed with pandemic influenza (H1N1 2009) in Korea University Guro Hospital from 2 May 2009 to 31 March 2010,we selected 10% of patients aged more than 15 years randomly. Medical records were reviewed retrospectively and clinical findings were analyzed: social history,underlying disease, initial symptoms, and clinical course. Comparative analysis of initial symptoms was performed by time to presentation and age groups: 15-29years, 30-49 years, 50-59 years, and more than 60 years. In addition, we described fatal cases of pandemic influenza (H1N1 2009). Results: From 2 May 2009 to 31 March 2010, total number of laboratory-confirmed cases of pandemic influenza (H1N1 2009) was 7,888. The most cases (1,632)developed at epidemic week 46, 2009. The median age of patients was 13 years and more than half of patients (55.4%) were less than 15 years. The median time to presentation was 1 day from onset of symptom. Clinical symptoms were cough (86.9%), sore throat (69.4%), myalgia (63.3%), chill (60.6%), rhinorrhea (57.7%),headache (57.6%), nausea or vomiting (27.4%), and diarrhea (9.3%). Fever was noted more frequently at 15-29 years group than ≥30 years group. Antiviral agent was administered to 274 patients (77.8%): 267 cases with oseltamivir and 7 cases with zanamivir. The median time to administration was 2 days and mean time to defervescence was 3 days. Cough was the most persistent symptom: initial visit (94.1%), on third day (82.4%), and on sixth day (52.9%) by the serial follow up at the same patients. Case fatality rate was 0.05%, and all fatal cases occurred in patients aged ≥50 years. Conclusions: Children and adolescents were the most affected group. Clinical symptoms were similar to seasonal influenza. Gastrointestinal symptoms were relatively common, and cough was the most long-lasting symptom.
수용-전념치료(ACT)가 과도하게 걱정하는 대학생들의 걱정증상, 상태 및 특성불안, 불확실성에 대한 인내력, 정서 조절 및 경험회피에 미치는 영향
노지윤,강혜자,손정락 한국건강심리학회 2016 한국심리학회지 건강 Vol.21 No.4
The purpose of this study is to explore the effects of Acceptance Commitment Therapy(ACT) on symptoms of worry, anxiety, tolerance of uncertainty, emotional regulation and experiential avoidance in university students with excessive worry. Four hundred university students completed the Penn State Worry Questionnaire(PSWQ), Spielberger State-Trait Anxiety Inventory(STAI), Intolerance of Uncertainty Scale(IUS), Korean Version of Difficulties in Emotional Regulation Scale(K-DERS) and Acceptance & Action Questionnaire(AAQ-16). Students were screened by cut-off point of PSWQ and STAI and randomized Some of them had an interview by researcher. Finally Sixteen participants were divided into an ACT group and waiting-list control group(eight each). The ACT program was administered for ten sessions. All participants completed the above scales as pre¬test, post¬test, and after 6 weeks. The results of this study were as follows: Symptoms of worry, anxiety, intolerance of uncertainty, emotional dysregulation level and experiential avoidance of the treatment group decreased more than in the waiting-list control group. The waiting-list control group remained unchanged statistically at the pretest, post¬test, and after 6 weeks. Finally, the implications and limitations of this study, along with suggestions for future studies were discussed. 본 연구의 목적은 수용-전념 치료 (ACT)가 과도하게 걱정하는 대학생들의 걱정, 상태 및 특성불안, 불확실성에 대한 인내력, 정서조절 및 경험회피에 미치는 영향을 알아보는 것이다. 4년제 대학교에 다니고 있는 학생 400명을 대상으로 펜실베니아 걱정증상 질문지, Spielberger 상태-특성불안척도, 불확실성에 대한 인내력 부족 척도, 한국판 정서 조절 곤란척도, 수용-행동 질문지를실시하였고, 이 중 걱정과 불안 수준이 높은 학생들을 선별하였다. 무선표집을 통하여 선별된 학생들과 사전면담을 실시하였고, 연구참여에 동의한 학생들을 수용-전념치료집단에 8명, 대기목록통제집단에 8명 배정하였다. 수용-전념치료 집단 참가자들은 주 2회, 총 10회의 치료를 받았으며, 치료 후, 6주 후 추적 조사를 진행하였다. 대기목록 통제집단 참가자들은 수용-전념 치료집단 치료 후, 6주 후 추적조사를 진행하였고, 추적 조사가 마무리 된 후 치료집단과 동일한 치료를 받았다. 연구결과는 다음과 같다. 수용-전념 치료 (ACT) 집단은 대기목록 통제집단보다 치료 후 걱정, 불안, 불확실성에 대한 인내력 부족, 정서조절곤란, 경험회피 수준이 감소되었고, 이러한 변화는 추적까지 유지되었다. 반면 대기목록 통제집단은 치료 전, 치료 후, 추적조사에서 유의한 변화가 없었다. 끝으로 연구의 의의 제한점 및 후속 연구에 대한 제언이 논의되었다.
대유행 인플루엔자(H1N1 2009)의 역학, 임상적 특성 : 일개 거점병원의 경험
노지윤,임선영,허중연,최원석,송준영,정희진,김우주 대한감염학회 2010 감염과 화학요법 Vol.42 No.2
Background: Since early outbreaks in North America in April 2009, the new influenza virus spread rapidly all over the world, and WHO declared a pandemic in June 2009. The objective of this article is to describe the epidemiological and clinical characteristics of patients confirmed with pandemic influenza (H1N1 2009). Material and Methods: Among all patients confirmed with pandemic influenza (H1N1 2009) in Korea University Guro Hospital from 2 May 2009 to 31 March 2010, we selected 10% of patients aged more than 15 years randomly. Medical records were reviewed retrospectively and clinical findings were analyzed: social history, underlying disease, initial symptoms, and clinical course. Comparative analysis of initial symptoms was performed by time to presentation and age groups: 15-29 years, 30-49 years, 50-59 years, and more than 60 years. In addition, we described fatal cases of pandemic influenza (H1N1 2009). Results: From 2 May 2009 to 31 March 2010, total number of laboratory-confirmed cases of pandemic influenza (H1N1 2009) was 7,888. The most cases (1,632) developed at epidemic week 46, 2009. The median age of patients was 13 years and more than half of patients (55.4%) were less than 15 years. The median time to presentation was 1 day from onset of symptom. Clinical symptoms were cough (86.9%), sore throat (69.4%), myalgia (63.3%), chill (60.6%), rhinorrhea (57.7%), headache (57.6%), nausea or vomiting (27.4%), and diarrhea (9.3%). Fever was noted more frequently at 15-29 years group than ≥30 years group. Antiviral agent was administered to 274 patients (77.8%): 267 cases with oseltamivir and 7 cases with zanamivir. The median time to administration was 2 days and mean time to defervescence was 3 days. Cough was the most persistent symptom: initial visit (94.1%), on third day (82.4%), and on sixth day (52.9%) by the serial follow up at the same patients. Case fatality rate was 0.05%, and all fatal cases occurred in patients aged ≥50 years. Conclusions: Children and adolescents were the most affected group. Clinical symptoms were similar to seasonal influenza. Gastrointestinal symptoms were relatively common, and cough was the most long-lasting symptom.