저등급 자궁경부세포이상의 처치에 있어서의 인유두종 바이러스 DNA의 검색의 의의

연정은(Jung Eun Yeon),김재욱(Jae Wook Kim),김영태(Young Tae Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10

목적: 1988년 Bethesda system이 제정된 이래 ASCUS와 LSIL의 진단과 치료에 많은 논란과 문제점이 제기되고 있다. 본 저자들은 세포진 검사에서 이러한 저등급 자궁경부세포이상을 보인 환자에서 고위험 인유두종바이러스 감염사실이 고등급 편평상피내손상 및 침윤성 암을 예측하는 지표로 사용할 수 있는지 알아보고자 하였으며, 또한 저등급 자궁경부세포이상에 대한 처치에 관한 지침을 마련하고자 하였다. 연구대상 및 방법: 1995년 1월부터 1999년 3월까지 연세대학교 세브란스병원 산부인과 외래에서 세포진 검사를 실시하였던 18,942명의 환자를 대상으로 하였다. 이중 ASCUS 및 LSIL의 결과를 보인 249명의 환자에서 조직검사를 시행, 분석하였다. 또한 115명의 환자에서 중합효소연쇄반응을 이용하여 고위험 인유두종바이러스(type 16, 18) 감염여부를 조사하였다. 결과: 112명의 ASCUS 환자 중에서 CIN II 3례(2.7%), CIN III 및 CIS 22례(19.6%), 편평상피암이 18례(16.1%)이었다. 137명의 LSIL 환자 중에서는 CIN II 22례(16.1%), CIN III 및 CIS 36례(26.3%), 편평상피암이 7례(5.1%)이었다. PCR법을 이용하여 고위험 인유두종바이러스(HPV 16/18)를 검사한 경우는 전체 환자 중 ASCUS 51명, LSIL 64명이었다. 고위험 인유두종바이러스에 대한 PCR 검사를 시행한 51명의 ASCUS 환자 중 바이러스 검출 결과가 음성인 경우 22.5%(9/40)에서 CIN II, III 및 편평상피암의 병변이 확인되었으나, 양성인 경우에는 54.5%(6/11)로 고위험 병변 및 편평상피암이 많았다. ASCUS군에서 고위험 인유두종바이러스와 고위험 병변 및 편평상피암과의 연관성을 알아본 결과 민감도 40.0%, 특이도 86.1%, 양성예측률 54.5%, 음성예측률 77.5%이었다. 고위험 인유두종바이러스에 대한 PCR 검사를 시행한 64명의 LSIL 환자 중 바이러스 검출 결과가 음성인 경우 39.6%(21/53)에서 CIN II, III 및 편평상피암의 병변이 확인되었으나, 양성인 경우에는 81.8%(9/11)로 고위험 병변 및 편평상피암이 많았다. LSIL군에서 고위험 인유두종바이러스와 고위험 병변 및 편평상피암과의 연관성을 알아본 결과 민감도 30.0%, 특이도 94.1%, 양성예측률 81.8%, 음성예측률 60.4%이었다. 결론: 본 연구의 결과를 토대로 세포진검사에서 ASCUS 및 LSIL이 진단된 경우 질확대경조준하생검 등과 같은 적극적인 처치를 해야 할 것으로 사료되며, HPV DNA test인 PCR방법이 진단에 보조적인 도움을 줄 수 있으며 특히 고위험인유두종바이러스 양성인 경우 고등급자궁경부 상피내손상이나 편평상피암의 위험도가 높음을 예측할 수 있을 것으로 사료된다. Objectives: Objective: The diagnosis of ASCUS(atypical squamous cells of undetermined significance) and LSIL(low-grade squamous intraepithelial lesion) was introduced in 1988 by the Bethesda system for reporting cervical/vaginal cytologies. A significant proportion of women referred for colposcopy with low grade cervical cytologic abnormalities(ASCUS and LSIL) will have high grade cervical intraepithelial neoplasia(CIN II or CIN III) and therefore require adequate management. The purposes of this study were to evaluate the usefulness of high risk type HPV(human papillomavirus) DNA detection using PCR(polyerase chain reaction) in patients with low grade cervical cytologic abnormalities in the prediction of high grade CIN and invasive cancer and to determine the clinical triage in the management of low grade cervical cytologic abnormalities. Methods: We reviewed 18,942 cases of Papanicolau smears that were performed at our hospital from Jan. 1995 to Mar. 1999. Colposcopically directed biopsy or LLETZ(large loop excision of transformation zone) or hysterectomy were performed on 318 patients with abnormal PAP smears of low degree. HPV PCR testing of high risk types(16 and 18) was also performed on 115 patients. Results: Histologic outcome of ASCUS included 43 cases(38.4%) of high grade CIN and invasive cancer, and that of LSIL included 65 cases(47.5%) of high grade CIN and invasive cancer. In cases of high risk HPV type, 19 patients(73.1%) were at age over 30 years. A highly significant correlation was found between a positive test for high risk types of HPV and finding of high grade CIN and invasive cancer. Among 51 women with ASCUS, a positive test for high risk type had a sensitivity and specificity of 40.0% and 86.1%, and positive predictive value(PPV) and negative predictive value(NPV) of 54.5% and 77.5%, respectively. In 64 women with LSIL, a positive high risk type test was associated with sensitivity and specificity of 30.0% and 94.1%, and PPV and NPV of 81.8% and 60.4%, respectively. Conclusion: Our results suggest that high risk type HPV may be positively predictive of and may act as a surrogate marker for high grade CIN and invasive cancer in women with low grade cervical cytologic abnormalities. The management of women with a low grade cervical cytologic abnormalities should be active such as colposcopically directed biopsies.

인스타그램에서의 페르소나와 패션을 통한 자기표현에 관한 연구 -20~30대 여성을 중심으로-

원연정 ( Yeon Jung Won ),신은정 ( Eun Jung Shin ),고애란 ( Ae-ran Koh ) 한국의류학회 2021 한국의류학회지 Vol.45 No.5

This study qualitatively explored the case of users utilizing multiple accounts on one social network service to create their own multiple spaces and different personas. The purpose of the study was to understand the behavior of people who use multiple accounts to express their identity online using Carl Jung's personality theory. We used in-depth interviews and the Zaltman metaphor elicitation technique (ZMET), targeting 19 people in their 20s and 30s who use more than one personal account on Instagram. Creating a shared consensus map using the configuration concept of ZMET derived six personas in relation to Instagram accounts. The motivations for the respondents' self-presentation associated with their personas and self-presentation types shown on Instagram were analyzed in terms of persona and fashion and subdivided into five dimensions: relationship management strategic presentation, self-monitoring presentation, competence demonstration presentation, anonymous presentation, and persona-centered presentation. Each respondent's persona and self-presentation formed by the Instagram account was analyzed.

산전 초음파로 진단된 무비증(無脾症)

연정은(Jung Eun Yeon),유용균(Yong Gyun Yoo),강은주(Eun Joo Kang),허혜경(Hea Kyoung Hur),박동희(Dong Hee Park),김경서(Kyoung Seo Kim),홍숙희(Sook Hee Hong),문화숙(Hwa Sook Moon) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9

The syndromes of left atrial isomerism and right atrial isomerism, called polysplenia and asplenia syndromes, respectively, consist of congenital heart defects with disturbances in normal left right isometry, and the etiology of atrial isomerism remains unclear. Right atrial isomerism is traditionally associated with severe cardiac defects, especially complete atrioventricular septal defect, transposition of great arteries, pulmonary atresia, and total anomalous pulmonary venous return. Recently, we encountered one case of asplenia diagnosed by prenatal ultrasonography. We report a case with brief review of the literatures.

동일산모에서 반복하여 발생한 무뇌아 2 예

유용균(Yong Gyun Yoo),김재욱(Jae Wook Kim),김세광(Sei Kwang Kim),김영한(Young Han Kim),연정은(Jung Eun Yeon),손용석(Yong Seok Sohn),정영내(Young Nae Jung),이윤정(Yun Jung Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

The etiology of neural tube defects, a category encompassing spina bifida, anencephaly and encephalocele, remains highly controversial and unclear, However, there is overwhelming evidence supporting a multifactorial etiology for this group of defects. Recent studies have shown that folic acid supplements taken periconceptionally can reduce a woman's risk of having a child with a neural tube defect. Qenetic screening could identify women who will require folic acid supplements periconceptionally to reduce their risk of having a child with a neural tube defects. Recently, we encountered two cases of recurrent anencephaly that had occurted in a same pregnant woman in our hospital. We report these two cases with brief review of the literatures.

알레르기비염 발생의 위험 인자와 현증 알레르기비염의 폐기능 및 기관지과민성

정은초 ( Eun Cho Chung ),박지원 ( Jee Won Park ),이소연 ( So Yeon Lee ),최연정 ( Yean Jung Choi ),홍수종 ( Soo Jong Hong ),박강서 ( Kang Seo Park ) 대한천식알레르기학회 2016 Allergy Asthma & Respiratory Disease Vol.4 No.1

Purpose: We analyzed the pulmonary function and risk factors of allergic rhinitis (AR) in dust mite-sensitized children with current AR and no history of asthma. Methods: In this cross-sectional study, demographic and disease-related information was obtained from 1,792 Korean children aged 9?12 years using a questionnaire, skin-prick testing, spirometric analysis, and methacholine challenge testing. Results: A total of 672 children were analyzed. The control group consisted of 583 children without any allergic diseases who were not sensitized to 16 common allergens. The group with current AR and dust mite sensitization consisted of 89 children. Binary logistic regression analysis showed that helminth infection (adjusted odds ratio [aOR], 2.88; 95% confidence interval [CI], 1.23?6.77) and antibiotic use during infancy (aOR, 1.89; 95% CI, 1.10?3.25) were the risk factors. Pet ownership (aOR, 0.32; 95% CI, 0.15?0.69) and older siblings (aOR, 0.58; 95% CI, 0.35?0.96) were protective factors. Spirometry results did not differ between the control and dust mite-induced AR groups. None of the children showed a bronchodilator response. However, 8.5%, 7.1%, and 2.1% of the control-group children and 28.7%, 23.0%, and 8.0% of the dust mite-induced AR-group children showed methacholine PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second) values of ≤25 mg/mL, ≤16 mg/mL, and ≤8 mg/mL, respectively (P<0.01). Conclusion: The prevalence of current dust mite-induced AR may be reduced by controlling environmental factors. Even though the spirometry results seemed to be normal, bronchial hyperresponsiveness occurred more frequently in children with dust mite-induced AR than in normal children.

간호학 학사과정 내 중환자 간호학 교육의 운영 현황과 발전 방향

이영희,손연정,강지연,김복자,김정연,이윤미,최수정,최은희,하이경,Yi, Young Hee,Son, Youn-Jung,Kang, Jiyeon,Kim, Bog Ja,Kim, Jung Yeon,Lee, Yun Mi,Choi, Su Jung,Choi, Eun Hee,Ha, Yi Kyung 한국중환자간호학회 2017 중환자간호학회지 Vol.10 No.3

Purpose : This study examined the status of critical care nursing education in bachelor of science in nursing (BSN) to suggest future directions. Methods : The target of the survey was 185 BSN programs that were certified by the Korean Accreditation Board of Nursing Education as of October 31, 2016. We structurally reviewed the curriculums and the course syllabi. Results : Forty-eight courses of 42 BSN programs were analyzed. Only five programs offered both theoretical and practical courses in critical care nursing; 22 offered theoretical courses and 26 offered practical courses. Most courses were offered as electives with 1 or 2 credits, and were taught by faculty who were experts in adult health nursing. Conclusion : The results show that there is a quantitative shortage of critical care nursing education in the curriculum of BSN programs in Korea. The lack of knowledge and skills on critical care can lead to a burden of new intensive care unit nurses and is a threat to patients' health. It is necessary to develop a practical and integrative curriculum for critical care nursing education.

학령전기 만성 기침 환아에서 알레르기 감작의 위험 요인

이은섭 ( Eun Seob Lee ),방지석 ( Ji Seok Bang ),오연정 ( Yeon Joung Oh ),이정원 ( Jung Won Lee ),성태정 ( Tae Jung Sung ),이용주 ( Yong Ju Lee ),이건희 ( Kon Hee Lee ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2

Purpose: Chronic cough is one of the major symptoms of asthma and allergic sensitization and may appear prior to the onset of asthma. The object of this study was to investigate the risk of allergic sensitization in preschool children with chronic cough. Methods: We reviewed the medical records of 99 preschool children presenting with chronic cough but not with allergic rhinitis, atopic dermatitis, recurrent wheezing, or lower respiratory tract infection between November 2011 and July 2013. Results: Fifty-four children (55%) were sensitized at least one of the following inhalant allergens: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cockroach, Alternaria alternata, dog dander, and cat epithelium. Children with allergic sensitization had a higher blood total IgE levels transformed by common logarithm (1.9±0.6 IU/mL vs. 1.3±0.5 IU/mL, P<0.001) and eosinophils (3.7%±2.5% vs. 2.7%±2.0%, P=0.043), more frequent parental history of allergy (68% vs. 48%, P=0.044) and less frequent history of breast milk feeding (68% vs. 86%, P=0.041) than those without. Conclusion: These results suggest that the ratio of allergic sensitization may be 50% or more in preschool children with chronic cough and that parental history of allergy and formula milk feeding may be associated with allergic sensitization. (Allergy Asthma Respir Dis 2015;3:105-108)

증례 : Sunitinib 투여로 유발된 혈전성 혈소판 감소성 자반증 1예

김은진 ( Eun Jin Kim ),최윤미 ( Yun Mi Choi ),이신원 ( Sin Won Lee ),하연정 ( Yeon Jung Ha ),이재련 ( Jae Lyun Lee ) 대한내과학회 2013 대한내과학회지 Vol.84 No.2

혈전성 혈소판 감소성 자반증 및 용혈성 요독성 증후군은 다발성 장기 손상 및 미세혈관병증 용혈빈혈을 보이는 급성 질환으로 치료하지 않을 경우 환자의 생명을 위협하는 치명적인 질환이다. 최근 VEGFR-TKI가 혈전성 혈소판 감소성 자반증을 유발할 수 있다는 보고가 나오고 있어, 저자들은 전이성 콩팥세포암종 환자에서 수니티닙을 사용한 뒤, 혈전성 혈소판 감소성 자반증이 발생한 1예를 경험하였기에 이를 보고하는 바이다. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP-HUS) is an acute condition with abnormalities of multiple organ systems. It is characterized by microangiopathic hemolytic anemia and thrombocytopenia. Several chemotherapeutic agents have been implicated in causing TTP-HUS. We report a case of TTP-HUS during treatment with sunitinib in a patient with metastatic renal cell carcinoma. A 53-year-old woman visited our hospital for fever and cough. She was diagnosed with sunitinib-induced TTP. Discontinuation of sunitinib and plasmapheresis improved her TTP. When she experienced disease progression after a prolonged period without treatment, sorafenib was tried, resulting in a partial response without recurrence of TTP-HUS. (Korean J Med 2013;84:303-307)

산전검사를 시행하지 않은 산모에서 태어난 신생아의단순 포진 바이러스 2형 뇌염 1례

이은섭 ( Eun Seob Lee ),김준영 ( Joon Young Kim ),이건희 ( Kon Hee Lee ),이정원 ( Jung Won Lee ),이용주 ( Yong Ju Lee ),오연정 ( Yeon Joung Oh ),방지석 ( Ji Seok Bang ),성태정 ( Tae-jung Sung ) 대한주산의학회 2014 Perinatology Vol.25 No.3

Neonatal herpes simplex virus (HSV) encephalitis is a rare disease nowadays because of prenatal screening test and management. It shows progressive central nervous system manifestations affecting predominantly temporal and frontal lobes. Early diagnosis of HSV encephalitis is important since even with the early initiation of high-dose intravenous acyclovir therapy, it results in serious morbidity among survivors. A 14-day-old neonate with fever and poor oral intake was admitted via emergency department. The next day she had seizures and the brain was damaged with permanent sequelae despite of early administration of intravenous acyclovir on day 2 of admission. We report a serious case of HSV encephalitis diagnosed as type 2 HSV by PCR and culture of a newborn who was delivered by a mother without proper prenatal screening test.

폐경색 및 다발성 동맥 혈전증을 보인 소아의 항인지질항체증후군 1례

구소은 ( So Eun Koo ),장주영 ( Ju Young Jang ),임연정 ( Yeon Jung Lim ),이소연 ( So Yeon Lee ),김효빈 ( Hyo Bin Kim ),홍수종 ( Soo Jong Hong ) 대한소아알레르기호흡기학회 2005 소아알레르기 및 호흡기학회지 Vol.15 No.3