Acid-base Imbalance is a Predictive Risk Factor of Mechanical Ventilation in Patients with Complicated Scrub Typhus: A Retrospective, Single-center Cohort Study

문경민,민경환 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-

Background: Scrub typhus is a febrile zoonotic disease caused by Orientia tsutsugamushi. ICU management is required in patients with severe complications. It is important that intensivists determine the proper timing of mechanical ventilation (MV). Aim: Estimation of acid-base imbalance (ABI) as a predictor of MV and comparison with conventional scoring systems. Methods: A retrospective cohort study was conducted at ICU of Eulji University Hospital. We identified patients with scrub typhus and excluded less than 18 years old from May 2004 to February 2016. Study database included the clinical parameters and the conventional scoring systems at admission. The factors related to MV application were established using decision tree and multiple logistic analysis. Results: There were 91 patients admitted to ICU due to scrub typhus. The predictive power of ABI correlated with MV was high as 0.926 of area under the ROC curve. The predictive power of NEWS, APACHE II, and SOFA were moderate as 0.763, 0.75 and 0.72 of area under the ROC curve, respectively. After multiple logistic regression analysis, ABI was significantly associated with MV application(OR: 2.216, 95% CI: 1.475-3.33, p < 0.001). The rate of MV application increased(p < 0.001) with progression of ABI. There was a significant(p = 0.019) difference in survival rates between low-, moderate-, and severe risk groups based on ABI using a decision tree. Conclusions: ABI can be helpful as a simple and easy-to-use tool to determine the appropriate timing of mechanical ventilation for patients admitted to ICU with scrub typhus.

Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis

문경민,김가은,백순구,최은희,김문영,김현아,조미연,신승용,김정민,박홍준,권상옥,엄영우 대한간학회 2013 Clinical and Molecular Hepatology(대한간학회지) Vol.19 No.4

Background/Aims: We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. Methods: Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0–F4) were evaluated. Results: The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0–F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4. Conclusions: The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis. (Clin Mol Hepatol 2013;19:389-398)

재활병원 종사자들의 스포츠 참여 활동과 직무만족도에 관한 연구

문경민,이현수 한국장애인재활협회 부설 재활연구소 2018 재활복지 Vol.22 No.4

The purpose of this study is to investigate the effect of participation of sports activities on job duties by analyzing job satisfaction of workers in rehabilitation hospital. From April to May 2015, 400 nurses, nursing assistants, physiotherapists, occupational therapists, and administrative staffs were selected from eight rehabilitation hospitals in Busan Metropolitan City. Analysis was performed by t-test, frequency analysis, exploratory factor analysis, Cronbach's alpha analysis, one-way ANOVA and Duncan tests. correlation analysis and regression analysis were conducted to obtain the following conclusions. As a result of the difference of job satisfaction according to participation form of sports activity, there was a significant difference in all factors such as exercise time, exercise frequency, sports item, and exercise period. As the exercise time and exercise frequency were higher and the athletic career was higher, Among the items, participation of aquarobic and aerobic was found to increase job satisfaction. Regression analysis showed that self - evaluation, job orientation, job commitment, and job satisfaction had positive effects among the five factors of job satisfaction. There is a significant difference. 본 연구는 재활병원에 종사하는 종사자를 대상으로 직무만족도 분석을 하여 스포츠 활동의 참여가직무에 어떠한 영향을 미치는지 알아보기 위한 것이다. 이를 위해 2015년 4월부터 5월까지 8개의 부산광역시 재활병원소속 간호사, 간호조무사, 물리치료사, 작업치료사, 행정직으로 종사자를 선정 후, 400 부의 설문지를 배포하여 분석하였다. 분석방법으로 t-검정, 빈도분석(frequency analysis), 탐색적 요인분석(exploratory factor analysis)과 Cronbach's α분석, 일원배치 분산분석(one-way ANOVA), 사후검증(Duncan)을 실시하였고, 상관관계(correlation analysis)와 회귀분석(regression analysis)을 이용하였다. 연구결과는 다음과 같다. 스포츠 활동 참여 형태에 따른 직무만족도 차이 검정 결과 운동시간, 운동빈도, 운동종목 그리고 운동기간 등 모든 요소에서 유의한 차이가 나타났고 운동시간과 운동빈도가 많고운동경력이 높을수록, 운동종목의 경우 아쿠아로빅과 에어로빅 종목을 참여하였을 때 직무만족도가높아진 것으로 분석되었고, 회귀분석 결과에서는 직무만족도 하위 5개 요인 중 자기평가성, 이직성향, 직무몰입 그리고 직무만족에서 정의 영향을 미치는 것으로 나타났고 참여빈도에서는 유의한 차이가나타나지 않았으며 참여빈도에서는 부의 영향을 미치는 것으로 나타났다. 결론적으로 스포츠 활동참여가 재활병원 종사자들의 직무만족도에 긍정적인 영향을 미치는 것으로 나타났고, 본 연구를 종합적으로 분석해 볼 때, 재활병원 내 직원 구성원들의 스포츠 동호회 활동과 체육시설 설치 그리고 운동시간에 대한 할애 등 지원을 통해 업무능률 향상과 활기찬 직장 분위기를 만들 수 있으므로 적극적으로 스포츠 활동을 장려해야 할 것으로 사료된다.

Synthesis of Self-healable Polyimide with Excellent Weatherability Based on Charge Transfer Complex Interaction

문경민,홍평화,김진실,김기승,강정순,최기원,이성구,고민재,홍성우 한국고분자학회 2019 한국고분자학회 학술대회 연구논문 초록집 Vol.44 No.2

Agranulocytosis Induced by Ethambutol in a Patient with Pulmonary Tuberculosis

문경민,한민수,정소희,김주리,김진영,정선영,조용선 대한결핵및호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.2

We report a case of agranulocytosis caused by ethambutol in a 79-year-old man with pulmonary tuberculosis. He was referred for fever and skin rash developed on 21th day after antituberculosis drugs (isoniazid, rifampicin, ethambutol, and pyrazinamide) intake. Complete blood count at the time of diagnosis of pulmonary tuberculosis was normal. On the seventh admission day, agranulocytosis was developed with absolute neutrophil count of 70/μL. We discontinued all antituberculosis drugs, and then treated with granulocyte colony-stimulating factor. Three days later, the number of white blood cell returned to normal. We administered isoniazid, pyrazinamide, and ethambutol in order with an interval. However, fever and skin rash developed again when adding ethambutol, so we discontinued ethambutol. After these symptoms disappeared, we added rifampicin and ethambutol in order with an interval. However after administering ethambutol, neutropenia developed, so we discontinued ethambutol again. He was cured with isoniazid, rifampicin, and pyrazinamide for 9 months.

경막하혈종이 합병된 쯔쯔가무시병 1예

문경민,한민수,김동진,이양덕,조용선,나동집 대한감염학회 2007 Infection and Chemotherapy Vol.39 No.3

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi and manifested with fever, skin rash, myalgia, and hepatitis etc. Most of patients improve with antibiotics such as doxycycline. The spectrum of the clinical severity ranges from mild to severe with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. We report a case of a 72-year-old man with scrub typhus complicating subdural hematoma. 쯔쯔가무시병은 Orientia tsutsugamushi에 의해 발생되는 급성 발열 질환으로 고열, 발진, 근육통, 간염 등의 임상 양상을 나타내며 대부분의 환자들은 doxycycline으로 호전된다. 임상양상은 불현성 감염에서 사망에 이르기까지 다양하며 뇌수막염, 폐렴, 심근염 등의 합병증이 발생할 수 있다. 쯔쯔가무시병 환자에서 지속적인 혈압상승, 두통, 의식혼탁 등의 소견이 있는 경우 경막하혈종이 합병되었을 가능성을 고려해야 하겠다. 저자들은 쯔쯔가무시병 환자에서 경막하혈종이 합병된 1예를 경험하였기에 보고하는 바이다.

자기결정성 이론에 근거한 심리적 욕구 조사도구의 타당성 검증 연구 : 뇌손상 환자를 중심으로

문경민,정영기,이현수 한국특수체육학회 2019 한국특수체육학회지 Vol.27 No.3

The purpose of this study is to verify the validity and validity of the psychological needs survey tool, which is a subordinate factor of the self-determination theory, and to investigate the validity of the research tool. It became. The subjects of this study were 270 patients with normal and unilateral paralysis of the brain injury patients who were admitted to the rehabilitation hospital in Busan or outpatient rehabilitation exercise. In order to find out whether psychological needs, which are sub-factors of the self-deterministic theory, are valid for the application of the study to patients with brain injury, frequency analysis, exploratory factor analysis, reliability analysis, and confirmatory factor analysis were verified. As a result, first, the reliability of autonomy, competence, and relationship, which is a sub factor of psychological needs, was high. Second, as a result of analyzing fitness through the confirmatory factor analysis of autonomy, competence, and relationship, which are sub-factors of psychological needs, independence and relationship among variables were valid. 본 연구는 자기결정성 이론의 하위 요인인 심리적 욕구 조사도구의 신뢰성과 타당성을 검증하기 위한 연구로써 조사도구의 타당성을 규명한 후 향 후 뇌손상 환자들을 대상으로 한 여러 연구에 적용을 목적으로 수행되었다. 연구의 대상은 편의표본추출법으로 부산광역시 내 재활병원에 입원 혹은 외래로 통원 재활운동을 하고 있는 뇌손상 환자 중 두정엽 손상으로 인지는 정상이고 편측 마비 증상이 있는 환자 270명을 선정하였다. 자기결정성 이론의 하위 요인인 심리적 욕구가 뇌손상 환자들을 대상으로 한 연구의 적용에 타당한지의 여부를 알아보기 위하여 빈도분석, 탐색적 요인분석, 신뢰도 분석, 확인적 요인분석의 검증을 실시하였다. 그 결과를 살펴보면 첫째, 심리적 욕구의 하위요인인 자율성, 유능성, 관계성의 신뢰도는 높은 것으로 나타났다. 둘째, 심리적 욕구의 하위요인인 자율성, 유능성, 관계성의 확인적 요인분석을 통한 적합도를 분석한 결과 변인 간의 독립성과 관계성은 타당한 것으로 나타났다.

종격동기종으로 응급실을 내원한 대장천공환자 1례

문경민,양현웅,양영모,이웅철,임신형,박상현,최기영,이윤정,정성희,김안나,차상우 대한응급의학회 2007 大韓應急醫學會誌 Vol.18 No.5

Bleeding and perforation are serious and commonly observed complications of colonofibroscopy. Pneumoretroperitoneum and pneumomediastinum are also infrequently reported as complications of colonofibroscopy. Clinical symptoms of pneumomediastinum are variable, with chest pain being the most common symptom, and a definitive diagnosis can be made by chest X-ray. Most cases can be successfully managed with only conservative treatment. Infrequently surgical managements are required. We report an unusual case of pneumoretroperitoneum and pneumomediastinum as a complication of colonofibroscopy. Pneumomediastinum was treated successfully and simply with only antibiotics and fasting.

<6.15 남북공동선언 6주년> 경제협력에 괄목할 성과 견인, 농업분야 최우선적 지원 필요

문경민 열린전북 2006 열린전북 Vol.2006 No.6

경막하혈종이 합병된 쯔쯔가무시병 1예

문경민,한민수,김동진,이양덕,조용선,나동집 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

쯔쯔가무시병은 Orientia tsutsugamushi에 의해 발생되는 급성 발열 질환으로 고열, 발진, 근육통, 간염 등의 임상 양상을 나타내며 대부분의 환자들은 doxycycline으로호전된다. 임상양상은 불현성 감염에서 사망에 이르기까지 다양하며 뇌수막염, 폐렴, 심근염 등의 합병증이 발생할 수 있다. 쯔쯔가무시병 환자에서 지속적인 혈압상승,두통, 의식혼탁 등의 소견이 있는 경우 경막하혈종이 합병되었을 가능성을 고려해야 하겠다. 저자들은 쯔쯔가무시병 환자에서 경막하혈종이 합병된 1예를 경험하였기에 보고하는 바이다. Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi and manifested with fever, skin rash, myalgia, and hepatitis etc. Most of patients improve with antibiotics such as doxycycline. The spectrum of the clinical severity ranges from mild to severe with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. We report a case of a 72-year-old man with scrub typhus complicating subdural hematoma.