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.

혈액투석 환자의 가성 고칼륨혈증

최창렬,조형도,강태영,이준수,한호,정청일,이동규,유준호,한상웅,김호중 대한신장학회 2001 대한신장학회잡지 Vol.20 No.5

구내 접근법에 의한 하악골 골절 치료에 대한 임상적 고찰

정성훈,박형식,권준호 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

This is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans and extraoral approach. Among 92 sites of mandibular fractures 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

주요 우울증에서 종양괴사인자-베타 유전자의 다형성

전태연,배치운,김영호,장계호,이정태,박원명,김광수 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요 우울증은 역학적 유전연구 등을 통하여 유전적 영향이 높은 것으로 알려져 있으며 최근에는 분자 유전학적 연구로 유전자 다형성과 질병의 연관성을 밝히는 것이 정신질환의 유전학적 연구에서 중요한 부분을 차지하고 있다. 이에 본 연구는 중추신경계와 면역계간의 상호작용에 관여하는 싸이토카인 중 TNF-β 유전자의 다형성을 분석하여 주요 우울증과의 유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-IV에 의하여 주요 우울증으로 진단된95명을 환자군으로 선정하였고 가톨릭조혈모세포정보은행에서 보유하고 있는 정상 한국인 202명의 자료를 정상 대조군으로 사용하였다. 전혈에서 DNA를 추출하고 TNF-β 유전자 부위를 증폭한 후 제한효소 Nco Ⅰ으로 절단하여 555bp와 185bp의 절편을 갖는 TNFB*1과 Nco Ⅰ절단부가 없는 740bp의 절편 TNFB*2등 2가지 대립유전자의 제한효소절편길이 다형성을 조사하였다. 모든 자료의 분석은 x²검증을 이용하였다. 결 과 : 1) 주요 우울증과 정상 대조군 간에 TNFB유전자인 TNFB*1/1, TNFB*1/2 및 TNFB*2/2의 발현 빈도에는 유의한 차이가 없었다. 2) 두 군 간에 TNFB*1 과 TNFB*2 두 대립유전자의 빈도에는 유의한 차이가 없었다. 결 론 : 본 연구에서는 주요 울울증군과 정상 대조군 간에 TNFB*1과 TNFB*2의 두 대립유전자 발현 빈도에 유의한 차이를 발견하지 못하였다. 따라서 TNFB 유전자다형성과 주요 우울증과의 유전학적인 연관성이 없었다. 향후 연구에서는 다양한 임상변인을 포함하여 보다 통합적이고 체계적인 연구가 이루어져야 할 것으로 생각되었다. Objective : Major depressive disorder is known to have high genetic predisposition and the main focus of recent genetic studies in major depressive disorder has been concentrated on association studies between genetic polymorphism and disease, since molecular genetic methods have been developed. This study was designed to investigate the relationship between major depressive disorder and immunogenetic influences by analyzing polymorphism of TNFB gene, which is involved in interaction of immune system and CNS. Method : 95 persons who had been diagnosed of major depressive disorder were assigned as patient group and, 202 data obtained from Catholic hemopoietic stem cell bank, College of medicine, the Catholic University of Korea, were used as normal controls in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by Nco Ⅰ.After that procedure, we obtained and assessd restriction fragment length polymorphism of two alleles, TNFV*1 which has 555bp and 185bp fragments and carries the Nco Ⅰ restriction site, and TNFB*2 of 740 bp fragment lacks the Nco Ⅰ restriction site. All data were analyzed by x²test with two-tailed Fisher's exact test. Results : 1) The frequencies of TNFB*1/1, TNFB*1/2, and TNFB*2/2 were not statistically different between major depressive disorder patients and control group. 2) The frequencies of TNFB*2 and TNFB*1 were not statistically different between major depressive disorder patient group and normal control group. Conclusion : We did not verified the differences of frequency in TNFB*1/TNFB*2 gene between the major depressive disorder and normal controls, respectively. Consequently, there is no genetic relationship between major depressive disorder and gene polymorphism of TNFB. We do suggest that further systematic studies including various clinical variables should be conducted.

경추 손상후 사망례에 대한 분석

정호성,김상은,이준형,박철완,이 근 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Mortality after cervical spine injury(CSI) is reported as high as 10∼30%, and it is intimately related to the initial management and cardiopulmonary function. We analyzed the cause of death for 29 patients who expired at Chung Ang Gil Hospital after CSI between 1990 and 1994. Of 198 patients with CSI, 43 patients(21m7%) died. Except 14 cases with concomitant fatal head injury and/or multiple systemic injuries, the mortality rate of CSI was 14.6%. Male to female ratio was over 6:1. Fourth to sixth decades constituted 69.0%. Common causes of CSI were traffic accidents(58.6%) and fall/slip(34.5%). The level of CSI was above C5(upper cervical group: UCG) in 65.5%, and below C4(lower cervical group: LCG) in 34.5%. Most of them(86.2%) died within four weeks after CSI. Early death(within 7 days) was more common in the UCG(57.9%) than the LCG(20.0%). Associated injuries were found in 72.4%, and the head injury was the most common one. The higher the Injury Severity Score(ISS), the earlier the patients expired(Fisher`s test, P<0.05). On arrival, hypotension(systolic blood pressure below 90mmHg), bradycardia(less than 60/min), and respiratory arrest was found in 31.0%, 34.5% and 17.2%, respectively. The episode of bradycardia was found in 58.6%. It was more common in cases of early death(69.2%) than those of the late death(50.0%). Hypoxia, hypercarbia, and acidosis was observed in 20.7%, 17.2%, and 51.7%, respectively. Respiratory failure was responsible for the majority(89.7%) of death. In UCG and the cases of the early death, primary respiratory dysfunction was the main cause of death, while in LCG and the cases of the late death, pulmonary complication was the major reason(Fisher`s test P<0.01, P<0.01, respectively).

Cadmium Chloride가 Mouse 의 췌장도 β-세포에 미치는 영향

전영희,백태경,정호삼,이규식,김영호 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

As the industrial use of cadmium has become more common, the question of its toxicity has become more important. The present was undertaken to study effects of cadmium on the structure of β-cells in the Langerhans islet of the mouse pancreas. Healthy mice of ICR strain weighing around 39gm were used in this experiment. The each animal of the experimental group was interperitoneally administrated cadmium chloride 5.0mg/kg diluted in the water for injection. The experimental animals were sacrified at 3, 6, 12, 24, 48 and 72 hours after administration of cadmium chloride and pancreatic tissues was excised. Some specimens were stained with Halmi stain to observe the morphological changes in the endocrine portion of the pancreas, the islet of Langerhan, and the others were prefixed in the 2.5% glutaraldehyde-2% paraformaldehyde phosphate buffer solution (pH7.0) and postfixed in the 1% osmic acid. Ultrathin sections were made and double strained with uranyl acetate and lead citrate. These preparations were observed with light microscope and electron microscope as well. The results obtained were as follow; 1. The number of β-cells throughout the pancreatic islets were markedly reduced in the 12 hours group and the β-cells were increased slowly in the 24 hours group. 2. The cristae of mitochondria disappeared and electron-density of matrix in mitochondria is decreased in the 3 hours after treatment of animals with cadmium chloride. The mitochomdria appeared almost like normal group, in the 12 hours group. 3. The cisternae of rough endoplasmic reticulum were dilatated in the 3hours group and change in rough endoplasmic reticulum were completely restored to normal in the 24 hours group. 4. The Golgi complexes were very hypertophied in the 3 hours. The Golgi complexes were observed like normal group, in the 12 hours group. 5. The sectetory granules were hypertrophied a halo and loss a dense core and the electron dense core and the electron dense of core in secretory granules decreased in the 3 hours, 12 hours group. But the secretory granules were slightly restored in the 48 hours group and appeared almost like normal group in the 72 hours group. Consequently, it is concluded that cadmium chloride exerts several toxic effects to β-cells of Langerhan's islet, especially, the damage to secretory granule in mouse.

기저질환이 없는 사람에서 발생한 Campylobacter fetus에 의한 재발성 심내막염 1예

전재범,정진원,김성혜,송문희,오형철,안성기,최상호,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

C. fetus 심내막염은 드물게 발생하는 질환으로 주로 면역능이 저하된 환자에서 발병하고 대동맥판을 침범하는 경우가 많으며 적절한 치료가 되지 않을 경우 치사율이 높다. 저자들은 기저질환이 없던 69세 남자에서 C. fetus 심내막염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 발열로 내원하여 시행한 혈액배양 검사상 C. fetus가 동정되었고 경식도 초음파 검사상 삼첨판에 증식증이 발견되어 심내막염 진단하에 ceftriaxone에 이어 meropenem으로 총 4주간 항생제를 투여받고 호전되었다가 한달 후 다시 재발하였고 판막부전 소견 진행하여 삼첨판 치환술을 시행받고 전신상태 호전되어 퇴원하였다. Campylobacter fetus is a rare cause of endocarditis. To date, only about 30 cases of C. fetus endocarditis have been reported mainly in the elderly with chronic underlying illnesses. Most cases showed tendency to involve aortic valve. This report describes a case of native tricuspid valve infective endocarditis in a 69-year-old man without any underlying disease. Despite adequate antibiotic therapy for 4-weeks, endocarditis recurred and leading to surgical valve replacement.

2인과 3인의 기본 심페소생술 비교

정준영,이창현,김현정,도호석,이삼범,도병수 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

Study objectives: To compare the quality of CPR provided by medical students and pre-EMTs perfoming three-rescuer CPR with that achieved by same students trained to provide standard two-rescuer CPR and to find the most effective method of resuscitation and to educate this methods to students. Material and methods: From July 1 to September 30, 1996, we had trained 60 groups consisted of the medical students, students of EMS technology and pre-EMT. Each group practiced two-rescuer CPR and three-rescuer CPR for 120 minutes with Resusci? Anne and perfomed CPR for at least 3 minutes without feedback. To eliminate any visual cues of perfomance the mannequin's recorder was hidden. Each actions were recorded by Resusci? skillmeter and Laerdal printer. To compare the quality of two-rescuer CPR and three-rescuer CPR, we analyzed the data by SPSS with paired t-test. Results: Three-rescuer teams delivered a mean minute ventilation and a mean minute cardiac compression substantially greater than that produced by two-rescuer teams(11.30±1.85 vs 9.09±2.22, p<0.001; 99.22±12.42 vs 95.12±15.75, p<0.001). Three-rescuer teams produce the more correct actions in chest compression and ventilation(93.84±7.56% vs 83.49±16.94%, 90.90±9.33% vs 77.00±17.06%). Conclusion: Three-rescuers can produce better CPR than two rescuers when a bag-valve-mask devices is used and the technique is easily learned and readily retrained, so we think that repeated education and training of this CPR methods to students is needed.

급성하벽심근경색에서 전흉부유도 ST절 하강의 의의

정병천,배호상,곽동훈,김영태,배용학,황종현,임현주,류재근,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 급성하벽심근경색증 환자에서 심전도상 흔히 동반되는 전흉부유도 ST절 하강의 의의를 알아보았다. 방법 : 심근경색후 24시간에서 48시간에 얻은 심전도를 기준으로 52명의 급성하벽심근경색증 환자를 전흉부유도에서 ST절의 하강이 있는 군과 없는 군으로 나누었으며 심도자, 관상동맥조영술, 심초음파도 및 방사성 핵종을 이용한 좌심구혈율 측정 등을 시행하였다. 결과 : 1) 좌심실확장기말압은 전흉부유도에서 ST절의 하강이 있는 경우에서 16.9±5.33mmHg로 없는 경우의 11.0±4.02mmHg보다 유의하게 높았다(p<0.05). 그러나 운동량 및 좌심구혈을은 흥부 유도상 ST절의 하강이 있는 경우 7.6±3.0 METs 및 53.9±9.1%로 없는 경우의 9.1±2.7 METs 및 54.6±9.5%보다 낮았으나 통계적 유의성은 없었다(p=0.180, p=0.823). 2) 관상동맥조영술상 전흉부 ST절의 하강이 동반된 군에서는 유의한 좌전하행지나 좌회선지의 협착이 있는 경우가 60.9% 및 57.9%로 ST절의 하강이 없는 군에서의 34.5% 및 7.7%와 비교해 좌관상동맥에 협착이 동반된 경우가 많았다(p=0.050, p=0.001). 3) 관상동맥조영술상 세 혈관질환의 빈도는 흉부유도상 ST절의 하강을 보인 23예에서 10예로 ST절 하강이 없었던 29예중 2예에 비하여 유의하게 많았고(P=0.007), 단 혈관질환의 빈도는 ST절의 하강을 보인 군에서 23예중 5예로 ST절 하강이 없었던 29예중 17예에 비하여 유의하게 적었다(P=0.002). 두 혈관질환의 경우에는 각각 8예와 10예로 양군간에 유의한 차이가 없었다. 4) 흉부유도상 ST절 하강의 빈도는 단 혈관질환 22예 중 5예에서, 두 혈관질환 18예중 8예, 세 혈관질환 12예 중 10예에서 관찰되어 협착이 있는 관상동맥의 수가 많을수록 ST절의 하강이 나타나는 빈도가 많음을 보였다(p=0.00308). 그러나 흉부유도상 나타난 ST절의 하강을 모두 합하여 구한 ST절 하강의 합은 협착이 있는 관상동맥의 수와 통계적인 유의성이 없었다. 5) 심초음파도상 좌심실 하벽의 벽운동은 ST절 하강을 보인 군에서는 akinesia가 83.3%, hypokinesia가 11.1%, 정상 벽운동이 5.6%로, ST절 하강이 없었던 군에서의 dyskinesia가 3.6%, akinesia가 39.3%, hypokinesia가 25.0%, 정상 벽운동이 32.1%와 비교하여 ST절의 하강이 있는 군에서 유의하게 벽운동의 장애가 빈번함을 보였다(p=0.03891). 그러나 좌심실전벽, 측벽 및 중격부위에서는 유의한 벽운동의 차이가 없었다. 결론 : 급성하벽심근경색증 환자의 전흉부유도에서 ST절의 하강이 동반되는 경우 다혈관 질환의 가능성이 높으며 좌심실확장기말압이 상승되었고 운동능력은 감소되어 있었다. 또한 심초음파도상 좌심실하벽의 벽운동장애도 심하였다. 따라서 전흉부 ST절의 하강을 동반한 급성하벽심근경색증 환자는 전흉부유도에 ST절 하강이 없는 경우보다 예후가 불량할 것으로 생각되며, 보다 적극적인 치료가 필요할 것으로 생각된다. The purpose of this study was to determine the significance of precordial ST segment depression appearing during acute inferior myocardial infarction and to assess the correlation of that with angiographic finding. 52 patients were allocated into two groups based on the existence of precordial ST segment depression : 23 patients with ST segment depression and 29 patients without ST segment depression. The extent of coronary artery disease as well as the prevalence of significant stenosis (≥70%) in left anterior descending artery were more frequent in patients showing precordial ST segment depression than in patients not showing them (p=0.050) and the result were similar in cases of left circumplex artery (p=0.001). On echocrdiographic examination of left ventricular (LV) wall motion, it showed more severely decreased inferior LV wall motion in patients showing precordial ST segment depression than in patients not showing them (p=0.03891) even though the other segment of LV wall motion didn't show the statistical difference between both groups. The other cardiac parameters such as LVEDP, exercise amount (METs) and ejection fraction were tend to showing bad profile in patients with precordial ST segment depression. From the above results, we could deduce that patients with precordial ST segment depression have relatively large infarction or concomitant left coronary artery disease, so they need more caution and intensive theraphy.

체육교육에서 피그말리온 효과

정명수,문호준 조선대학교 스포츠과학연구소 1995 스포츠科學硏究 Vol.7 No.-

A 1948 paper by Robert Merton established that certain social events were, to a large extent, influenced by the expectancy effects in different social settings. It wasn’t until 20 years later that Merton’s concept of the self-fulfilling prophecy came to the attention of educational researchers (Clark, 1963; Goldberg,1963). Since the Oak Elementary School experiment, researchers have conducted well over 100 studies relative to teacher expectations. It is also important to note that impressions about a certain student may not be the same for two or more teachers. Futhermore, after an extensive review of the literature, Brophy and Good(1974) concluded that teachers, irrespective of gender, are more negative toward young males, particularly regarding their potential as behavior problems. In a follow-up study(Martinek & Karper, 1984a), it was discovered that the attractiveness cue was more influential in expectancy formation for older age groups than for younger ones. These data suggested that as children get older, attractiveness becomes increasingly related to performance expectations.