서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

급성 심근경색후 생존심근 진단에서 Dobutamine 심초음파도와 Thallium 심근스캔의 정확성 비교

이근,강덕현,송재관,이철환,최기준,홍명기,김재중,박성욱,박종훈,박승정 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

관동맥연축의 비침습적 진단에 있어 Ergonovine Echocardiogrpahy의 유용성

송재관,박성욱,김재중,두영철,김원호,박승정,이종구 울산대학교 의과대학 1992 울산의대학술지 Vol.1 No.1

관동맥연축의 비침습적인 진단방법의 확립은 침습적인 관동맥조영술 및 연축유발검사에 비해 반복적용이 가능한 이론적인 장점이 있어 선별검사(screening test)로서의 기능뿐만 아니라 치료로 이용되는 약물의 효과비교 및 추적검사를 통한 관동맥연축의 임상ㄹ활동도 평가등에 손쉽게 이용될 수 있으라라 예상된다. 이에 저자들은 ergonovine 투여시 기록된 좌심실벽운동장애 유무가 갖는 관동맥연축에 의한 심근허혈의 진단적 가치를 평가하기 위해 Beside Ergonovine Echocardiography Test를 시행하였다. 관동맥조영술 및 연축유발검사에서 변이형협심증으로 증명된 30명(남자 27명, 평균연령 54세)과 비특이적인 흉통질환군 20명(여자 12명, 평균연령 55세)을 대상으로 관동맥조영술 다음날 ergonovine test를 시행하였다. 운동부하검사가 음성인 환자들을 대상으로 6시간 공복시킨 뒤 앙와위에서 상지정맥을 통하여 25-50microgram(이하 mcg)을 5뷴 간격으로 투여하여 흉통의 유무, 심전도 및 이면성심초음파를 5분마다 기록하였으며 총투여량이 350mcg에 도달하거나 양성반응을 보이는 경우 nitroglycerin 250mcg 정주 및 설하투여로 종료하였다. 좌심실벽운동의 분석은 side-by-side continuous cine-loop display가 가능한 QUAD screen 방법으로 판별하였다. 가역적인 심전도 변화나 국소적인 심실벽운동장애가 유발되는 경우를 양성으로 판정하였다. Ergonovine Echocardiography의 전체 민감도는 90%, 특이도는 100%로 동시에 기록된 심전도 변화의 민감도(73%)보다 높았으며 특히 흉통이 있으나 심전도 변화가 전혀 없었던 5례 모두에서 좌심실벽운동장애가 관찰되어 본 검사법의 우월성을 확인할 수 있었다. 양성반응을 보인 ergonovine 평균 투여량이 173±95mcg 이었으며 흉통발작의 빈도를 기준으로한 임상활동도가 높은 경우 활동도가 낮은 군에 비해 양성반응을 의한 총 ergonovine 투여량이 적었으며(123±86 vs 213±83mcg, p<0.01) 관동맥협착이 연축에 동반되어 있는 경우 정상 관동맥에 연축이 있는 경우보다 민감도가 더 높았다(100% va 60%, P=0.02). Ergonovine 투여로 혈압은 기저치 보다 약 17%정도 증가되었으나 맥박수는 큰 변화를 나타내지 않아 안전하게 시행될수 있었으며 오심, 두통, 견갑부통증, 심실기외수축, 방실차단 등이 소수례에서 관찰되었으나 검사로 인한 사망례는 없었다. Ergonovine 주입후 기록된 좌심실벽운동동장애는 심전도 변화보다 더 민감하게 관동맥연축에 의한 심근허혈을 진단할 수 있었으며 Ergonovine Echocardiography는 운동부하검사 등으로 심한 관동맥협착이 배제된 선별된 흉통환자들에서 관동맥연축의 진단에 안전하게 시행될 수 있는 민감하고 특이도가 높은 검사방법이며 변이형협심증의 임상활동도와 관동맥협착의 동반유무가 본 검사법의 결과에 영향을 미칠 수 있으리라 사료된다. The purpose of this study was to evaluate the clinical feasibility of bedside intravenous ergonovine test with echocardiography as a noninvasive diagnostic method for coronary vasospasm. Bedside ergonovine test was performed in 50 patients with chest pain one day after coronary angiography with spasm provocation test;30 patients showed positive results of provocation test while in 20 patients there was no evidence of coronary vasospasm. A bolus of ergonovine maleate(.025 or .05mg) was injected at 5 min intervals up to total cumulative dosage of 0.35mg, and 12-leads ECG and 2-D Echo were recorded every 3min after each injection. Left ventricular wall motion was analyzed with a commercially available ' QUAD' system. The positive criteria of beside ergonovine test included reversible ST segment elevation or depression, T wave changes in ECG(ECG criteria) and reversible regional wall motion abnormalities(RWMA) in Echo(Echo criteria). The overall sensitivity and specificity of ECG criteria were 73%(22/30) and 100% respectively ; The sensitivity of Echo criteria increased up to 90%(27/30) without the change of the specificity. Among 22 patients with reversible ECG changes only 73%(16/22) showed typical ST segment elevation while ST depression was recorded in 2 patients(9%) and minor T wave peaking or flattening without ST segment displacement in 4 patients(18%). Concomitant fixed coronary lesion does increase the sensitivity of the test compared to pure coronary vasospasm with ECG criteria(100% vs 60%, p<0.05). Mean does of ergonovine with positive results was 173±95 microgram(mcg) and the amount of does of ergonovine for positive result was significantly larger in patients with low disease activity (chest pain <5times/자) than those with high disease activity(213±83 vs 123±86mcg, p<0.01). There was no procedure related mortality or fatal arrhythmias. Ergonovine echocardiography is a highly sensitive and specific test for coronary vasospasm and is safe in selected patients in whom the exercise test is negative and severe fixed coronary artery disease has been excluded. Presence of concomitant fixed coronary artery disease and the degree of clinical activity of coronary vasospasm may influence the results of this test.

자발성 뇌내혈종환자의 치료에서 뇌정위 수술의 역할

하성일,이종수,이승재,박효일 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

Computerized tomography(CT) have been available for diagnosis and localization of intracerebral hematoma. CT-guided stereotactic evacuation of spontaneous intracerebral hematoma was performed in 34 cases : 25 basal ganglionic hematomas with or without ventricular perforation, 4 subcortical, 3 thalamic, 1 cerebellar and 1 pontine. The biplane CT image were taken to determine the coordinates of the target point, which was the center of the hematoma. The liquefied or solid portion of the hematoma was aspirated though a burr-hole under local anesthesia. And a silastic tube(3.3㎜ in outer diameter and 2.0㎜ in inner diameter) was then inserted into the center of the hematoma. Immediately after the first trial of hematoma aspiration, urokinase(6000 IU/5㎖ saline) was administered through the tube. Subsequently, aspiration and infusion of urokinase were repeated every 6 or 12 hours until the hematoma was almost completely evacuated. The follow-up results indicate that this procedure was more superior over the conventional craniotomy. This CT-guided stereotactic operation has the following advantages: 1) the procedure is simple and safe : 2) the procedure can be performed under local anesthesia: and 3) the hematoma can be completely drained with the aid of urokinase. This procedure can be used as standard treatment for intracerebral hematoma. We have draw the following conclusions : As a result of the above study. 1) Stereotactic surgery is more effective in the patients with neurologic grade 3 than conservative one(P<0.05). 2) To use of urokinase or perform the early surgery within 24 hours did not seem to be the cause of rebleeding. 3) In the case of pons or cerebellar hemorrhage, stereotactic surgery had definite benefit in the recovery of consciousness even if recovery of motor function was dismal. 4) In patients with spontaneous ICH, the favorable prognostic indicatiors were as follows : the size of hematoma less than 50㎖, no signs of transtentorial herniation and patient's age under 60.

Trichloroethylen의 직업적 노출에 의한 독성간염 및 박탈성 피부염 1례

채홍재,이성관,이강진,김종율,이승철,신동현,문재동 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

28세 남자가 trichloroethylene을 이용한 세척 및 탈지작업에 종사한지 한 달만에 발열, 오한 및 홍반을 동반한 피부발진 등의 증상이 발현되었다. 황달을 동반한 간기능 부전의 소견을 보였으며 피부는 박탈되었다. 부신피질호르몬, 항히스타민제 및 간기능 보조제를 이용한 치료로 간기능 및 피부 병변은 호전되었다. 검사소견상 Ig E가 상승되었고 trichloroethylene에 의한 과민반응으로 추정되었다. Trichloroethylene을 사용하는 소규모 사업장에서의 노출억제 방안을 포함한 보건관리가 요구되며 특수건강진단 주기에 대한 변경이 필요하리라 사료된다. A 28-year-old male began working as a degreaser. The solvent used in the degreasing operation was trichloroethylene. Over the next month the man experienced fever, chills, and an erythematous skin rash and itching. At that time he had a marked elevation in his liver enzyme, with cholestasis. Over the next few days the rash persisted then peeled. There was an elevation of Ig E, and a positive patch test reaction to trichloroethylene. His dermatitis and hepatitis were considered to be mediated by a hypersensitivity mechanism.

Squalene Adjuvant를 이용한 단백질 항원의 세포성 면역반응 유도

도현주,김성열,안종성,하영주,이승찬,오재택,장명호,정홍석,문홍모,박해준 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.3

To investigate the role of adjuvant for cytotoxic T lymphocytes (CTL) induction, squalene-based adjuvant was studied its capability eliciting to the induction of cellular immunity as well as humoral immunity to exogeneous proteins. Ovalbumin (OVA) was used as model proteins. It was demonstrated that antigen formulation consisted of metabolizable oil squalene mixed with Tween 80 and pluronic L121 (S/TJ121) could induced the antigen specific CTL responses and antibodies irrespective of immunization routes in mice. We also demonstrated that this antigen formulation was a inducer of CD8+, major histocompatibility complex(MHC) class I-restricted, and antigen-specific C;1'Ls. These data suggest that the squalene-based emulsion system is a potent adjuvant inducing cellular immunity as well as humoral immunity.

거주 형태에 따른 에너지 섭취량과 소비량의 균형도 조사

박순목,고성경,남인수,윤재만,임승현,전중기,이종삼 대구대학교 인문과학연구소 2008 人文科學硏究 Vol.31 No.-

We investigated that the effects of residential type on energy balance in college students. Total sixteen college students were participated in this study, all subjects were assigned one of three groups: either school attendee students group, self-governed living students group, dormitory students group. Routine physical activity level (for 5 days including three weekday and two weekend) and food intake were surveyed. For investigation of degree of physical activity, all subjects were requested to record on their physical movements as possible as detail should be obtained. To all subjects, five-day dietary log form was given, and used for examining of calorie intake from their routine diet. There was no statistical difference in energy intake and consumption in each. However energy consumption was significantly higher than energy uptake in school attendee students group. All other groups were shown a similar energy values between energy uptake and consumption. There were no significant differences in energy intake and consumption in any of experimental groups when comparisons were made between weekdays and weekend. As far as energy uptake was concerned it was no statistical difference in any of major nutrients among groups. In conclusion, partial imbalance was found between energy intake and uptake in school attendee groups. This may be due to their more active life style than other groups'. In future studies, better controlled study should be performed not only more subjects are recruited but also minor nutrients are included for examining of energy balance.

중학교 남자 테니스 선수의 운동기능수준별 시합 전 경쟁상태불안

남인수,최인태,전중기,윤재만,고성경,이종삼,임승현 대구대학교 인문과학연구소 2008 人文科學硏究 Vol.31 No.-

The purpose of this study was to investigate if there is any difference in the level of competitive state anxiety according to the level of motor skill before the game and to provide the players with basic data for the mental practice. The subjects of this study consist of 20 men's a middle school tennis players. The experimental group was divided into superior players group and inferior players group. And then by using a CSAI-2 questionnaire, three subfactors of competitive state anxiety, or cognitive state anxiety, somatic state anxiety and state self-confidence were measured. The method of measurement was carried out three times, or one week, one day and two hours before the game. The results of this study were as follows. First, About both cognitive state anxiety and somatic state anxiety, inferior players were significantly higher than superior players. Second, About state self-confidence, superior players were significantly higher than inferior players. Third, As the game was around, both cognitive state anxiety and somatic state anxiety which all the players including superior and inferior players had increased. But the state self-confidence of all players decreased.

한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.