정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

On the Strengthening Effects Affecting Tensile and Low Cycle Fatigue Properties of Low-Alloyed Seismic/Fire-Resistant Structural Steels

Jung‑Ho Sim,Tae‑Yeong Kim,Jun‑Yeon Kim,Chi‑Won Kim,Jun‑Ho Chung,Joonoh Moon,Chang‑Hoon Lee,Hyun‑Uk Hong 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.2

In the present study, low carbon ferritic and bainitic steels with different contents of Mo, Ti, and Nb were designed for bothseismic and fire-resistant applications. The microstructure of steels containing 0.3 wt% Mo–0.02 wt% Nb (‘A’ hereinafter)was mainly composed of bainite. By contrast, the microstructure of steels with 0.2 wt% Mo–0.13 wt% Ti (‘B’ hereinafter)consisted of ferrite with a high density of nano-sized (Ti,Mo)-rich MX precipitates. The results showed that the bainiticmicrostructure (‘A’ steel) was quite favorable to high-temperature strength and thermal stability. The yield strength of ‘A’ steelat both room and 600 °C temperatures increased consistently with increasing thermal exposure time (600 °C/200–1000 h),since the precipitation of NbC particles occurred while maintaining bainitic ferrite platelets with a high density of dislocationsduring exposure. In the ‘B’ steel, the formation of nano-sized (Ti,Mo)-rich MX particles was effective to impededislocation movement, leading to excellent plasticity (lower yield ratio) at room temperature. However, their contributionto precipitation hardening was not so much at 600 °C, as compared to the bainitic strengthening. During low cycle fatiguetests at room temperature, the main different feature between the two steels is that the ‘A’ steel showed cyclic softeningwhile cyclic hardening was evident in the ‘B’ steel. The bainitic microstructure showed a better fatigue life due to increasedductility manifested by cyclic softening, by which dislocation cell was developed.

피질골 절제술을 응용한 견치 및 대구치의 후방 견인

김상철,김선영,김현숙,정혜승,김현태,조진우 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.2

빠르며 정확하고 안전한 치아이동을 목표로 삼고 있는 교정치료에서 최근 새로이 도입된 피질골 절제술과 견인 골형성술을 응용한 치아이동에 대하여 알아보았다. 특히 견치나 대구치의 후방이동은 기존의 치아 이동 양식으로는 조절이 어렵고, 장기적인 기간에 불가피한 치아이동이다. 피질골 절제술과 견인 골형성술을 동반하여 상당히 효과적인 원심이동을 기할 수 있었던 증례를 통하여 적용 술식, 견인 장치 등을 논하고 그효과를 파악하였다. 이런 술식을 통해 빠른 치아 이동과 이에 따른 전반적인 치료기간의 감소가 가능하였으며, 무리한 치아이동에서 발생할 수 있는 고정원 소실이나 치근흡수, 치주조직의 파괴 같은 부작용도 줄일 수 있었다. Tooth movement facilitated by corticotomy and distraction osteogenesis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed. Active bone deposition was then possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment, which lead to the reduction of the total treatment period. Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or periodontal breakdown.

우리나라 상차림의 영양적 평가

김영순,이정희,오순덕,김수현,이정민,남택수,박태식,천유정 高麗大學校 倂設 保健大學 保健科學硏究所 2002 保健科學論集 Vol.28 No.1

This study was carried out to investigate the current nutritional problems owing to the increased consumption of westernized food in Korea and also was conducted to compare the nutritional characteristics of Korean traditional meal with those of the Western diet in similar serving size. The results obtained from nutritional evaluation are as follows: 1. The percentage of calories represented by carbohydrate: lipid: protein was 65:15:20 respectively for Korean traditional meal (Table setting of 3 Chop) therefore these ratios meet the dietary recommended allowances for Koreans. 2. Nutrient values of Korean traditional 3-Chop were shown to be better balanced than those of Western diet when the nutrients of the two types of diet were estimated by similar serving sizes and calories. 3. Compared to the Korean traditional meal, most fast foods were nutritionally imbalanced especially in that most of them showed higher amounts of fats. These results show that Korean traditional meals supply ideal nutrient intakes in contrasts to the westernized diet, therefore much work remains in developing a variety of menus and standard recipes for Korean traditional meals according to the changes in diet trends as well as emphasing the importance of Korean traditional meals as part of an ideal, well-banlanced diet.

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

수평 매복된 상악 중절치의 교정적 견인 : 증례 보고

김미니,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

본 증례는 수평 변위 매복과 치근 만곡을 가진 상악 중절치를 폐쇄 노출법을 이용한 교정적 견인을 시행하여 영구 전치의 기능과 심미성을 회복하였다. 상악 영구 전치가 수평으로 매복된 경우,가급적 조기에 발견하는 것이 중요하며, 촉진,시진,방사선 사진 등을 이용한 적절한 치료 계획의 수립이 필요하다. 상악 영구 전치의 매복이 조기에 적절히 치료되지 못하면 정중선의 변위,인접치의 이동에 의한 맹출 공간의 감소,치조골 높이의 차이 뿐만 아니라,이로 인한 심미적인 문제를 야기하여 소아 심리 발달에 해로운 영향을 줄 수 있기 때문이다. 매복치의 치료는 매복치의 형태,위치,상태에 따라 다양하나,주기적 관찰 방법,상부 연조직과 경조직을 단순히 제거하여 맹출을 유도하는 방법,외과적 노출 후 매복치를 교정적으로 견인하는 방법,치아 이식술,발치 등을 시행할 수 있다. 이중 이번 증례에서 시행한 매복치의 교정적 견인은 매복치의 치축이 정상 맹출로와 일치되지 않으며,주기적인 관찰 후 더 이상의 맹출이 기대되지 않을 때 시행하는 가장 일반적으로 적용되는 방법으로 매복의 심도,치아의 발육단계,만곡의 부위와 정도,수술방법과 견인방향 등을 고려하여 치료의 예후를 향상 시킬 수 있다. Maxillary central incisor impactions occur infrequently. Their origins include various local causes, such as odontoma, supernumerary teeth, space loss, and disturbances in the eruption path, also trauma and apical follicular cysts. Impacted teeth can cause serious dental and aesthetic difficulties as well as psychological problems especially in anterior regions. Although the impaction of maxillary incisor occurs less frequently than that of the maxillary canine. it is of concern to parents during the early mixed dentition stage because of the uneruption of the tooth. Forced eruption of impacted teeth should be considered in young patients because this technique can lead to suitable results from a periodontal, occlusal, and esthetic perspective at an earlier stage better than with other treatment options. This report presents the surgical and orthodontic treatment of cases with horizontally impacted and dilacerated maxillary central incisors. For each patient. we used the closed eruption method. placed an attachment on the impacted tooth on surgery, and fully closed the flap. Traction was applied immediately. The impacted tooth erupts through the healed tissue in a manner resembling normal eruption.

자궁내막암 환자에서 복강경하 자궁적출술과 복식 자궁적출술의 비교 연구

김종혁,이상수,김천복,김대연,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 자궁내막암 환자에서 시행된 복강경 수술의 임상적 결과를 평가하고 수술적 지표 및 재발률에 대하여 기존의 개복 수술과 비교하고자 하였다. 연구 방법 : 1997년 8월부터 2003년 11월까지 저자들은 임상적 병기 I기인 79명의 자궁내막암 환자에서 복강경하 자궁적출술과 골반 및 부대동맥 림프절 절제술을 시행하였다. 총 79명의 환자 중, 수술적 병기 I기와 II기로 판명된 74명의 환자를 연구 대상으로 하였다. 대조군으로는 같은 기간 동안에 개복수술을 시행한 환자중 복강경 수술군과 병기가 같은 168예를 선정하였다. 결과 : 평균 수술 기간, 수혈량은 양군에서 비슷하였으며, 평균 재원 기간은 복강경 수술군에서 유의하게 짧았다. 수술전후 및 만성 합병증의 발생은 개복 수술군에서 유의하게 증가되었으며, 획득한 림프절의 수는 복강경 수술군에서 유의하게 더 많았다. 복강경 수술군에서 1예, 개복 수술군에서는 2예에서 재발하였고, 2년 무병 생존률은 복강경 수술군과 개복 수술군에서 각각 97.5%와 98.6%으로 유의한 차이는 관찰되지 않았다. 결론 : 자궁내막암 치료로서 복강경 수술은 기존의 개복술을 대신할 수 있는 안전하고 효과적인 시술 방법이다. 개복 수술과 비교해 볼 때, 재발 및 생존율 면에서 차이가 없었지만, 향후 전향적이고 더 오랜 추적기간을 갖는 연구가 필요하다고 사료된다. Objective : To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer. Methods : From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, We selected 168 cases for the laparotomy group of the same stages. Results : The mean duration of surgery, the amount of blood transfusion and hemoglobin chamges were similar in both the laparoscory and the convertional alparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763). Conclusion : Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective altematives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.

상아질 접착에서 collagenase와 esterase가 미세인장결합강도에 미치는 영향

정영정,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

상아질-레진 접착강도에 대한 collagenase와 esterase의 영향을 살펴보기 위해, 소구치의 교합면 상아질에 Single Bond 2와 Clearfil SE Bond로 접착을 시행하고 미세 시편을 제작하여 PBS, collagenase 용액, esterase 용액에 4주간 보관한 후 미세인장결합강도를 측정, 비교하여 다음과 같은 결론을 얻었다. 1. 모든 보관 용액에서 Single Bond 2의 미세인장결합강도는 Clearfil SE Bond보다 유의하게 낮았다(p<0.05). 2. Single Bond 2의 미세인장결합강도는 collagenase군이 PBS군, esterase군보다 낮았다(p>0.05). 3. Clearfil SE Bond의 미세인장결합강도는 esterase군이 PBS군에 비해 낮았으나(p>0.05), collagenase군보다는 높았다(p>0.05). Collagenase군은 PBS군에 비해 유의하게 낮은 미세인장결합강도를 보였다(p<0.05). The purpose of this study was to evaluate the effect of collagenase and esterase on the microtensile bond strength (μTBS) in dentin bonding. After resin composites were bonded to occlusal dentin, μTBS specimens were formed and stored in PBS, collagenase, or esterase solution. After 4-week storage, μTBS was determined and, the results were as follows: 1. μTBS values of Single Bond 2 were lower than those of Clearfil SE Bond for all storage medium (p<0.05). 2. In single Bond 2 group, collagenase solution lowered bond strength more than PBS and esterase solution (p>0.05). 3. In Clearfil SE Bond group, esterase solution lowered bond strength more than PBS(p>0.05). Collagenase solution lowered bond strength more than esterase solution(p>0.05) and PBS(p<0.05).

축구선수의 Detraining과 Retraining이 혈청지질 및 호르몬농도에 미치는 영향

정정화,박재현,채종훈,성혜련,황지인,윤미숙,노금선,윤종관,윤영학,노순덕,정경숙,박일규,김은희,박현태,박상갑 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate the effects of detraining and retraining on serum lipid and hormones in soccer players. Subjects were seven male high-school soccer players. V˙O_2max was determined for each subjects by administering a treadmill test(initial speed: 90m/min, grade: 5%, increasing speed per 3 min: 30m/min). Serum lipid(T-C, TG, HDL-C LDL-C) and hormones(epinephrine, norepinephrine, growth hormones, cortisol) were assayed pre and post detraining in 10, 20, 30 days after retraining. The repeated ANOVA was used to determine significant differences. The 0.05 level of significance was as critical level for the study. The results of the study were as follows: 1. V˙O_2max(ml/min) were 3576.3±204.2ml/min pre detraining, 3234.1±198.9 ml/min post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/min) were 3601.4±170.9 ml/min. There were significantly(p<.05) increased in retraining periods. 2. V˙O_2max(ml/kg/min) were significantly(p<.05) decreased from 62.3±2.9 ml/kg/min to 55.9±4.7 ml/kg/min in detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/kg/min) were 62.4±3.4ml/kg/min, 62.7±2.3ml.kg/min, 67.3±7.2ml/kg/min respectively. There were significantly(p<.05) increased in retraining periods. 3. T-C were significantly (p<.05) increased from 166.6±8.5mg/dl to 175.3±10.3 mg/dl in detraining. In 10, 20, 30 days after retraining, T-C were 160.1± 3.2mg/dl, 156.7±3.7mg/dl, 140.3±9.0mg/dl. There were significantly(p<.05) decreased in retraining periods. 4. HDL-C were 61.4±6.6mg/di pre detraining, 5.3±6.6mg/dl post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, HDL-C were 56.9±7.1mg/dl, 56.4±9.2mg/dl, 57.7±9.1mg/dl respectively. There were no significant difference in retraining periods. 5. The hormones(epinephrine. norepinephrine, growth hormone, cortisol) were changed as same patterns. Epinephrine were 26.0±7.0[g/ml pre detraining, 24.6±3.2pg/ml post detraining. In 10, 20, 30 days after retraining, epinephrine were 26.9±5.6pg/ml, 30.6±6.2pg/ml, 29.4±5.6pg/ml respectively. There were no significant difference in retraining periods. In conclusion, HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were decreased, T-C, LDL-C and TG were increased in detraining. But HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were increased, T-C, LDL-C and TG were decreased in retraining.

아동들의 태권도 수련활동참가에 따른 열등감 및 자아존중감의 관계

정재엽,정국현,김지영,김현철,이용국 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

The purpose of this study was to identify the relationship between children's Inferiority and self-esteem during Taekwondo practice. In order to achieve this purpose, 480 subject were selected among participants of Taekwondo activity programs in the Seoul area by using the stratified cluster random sampling method. Out of the 480 questionnaires responded to. only 414 were used for data analyses because 66 were responded to incompletely or incorrectly. The instrument for data collection was a questionnaire in which Inferiority and self-esteem consisted of items identified by Jun(1999) and Jun(1993), respectively. The statistical methods utilized in the study for analyzing the collected data were reliability analysis, descriptive statistics, one-way ANOVA, standard multiple regression analysis and the following results were obtained: First, both Inferiority and self-esteem differ statistically and significantly according to both sociodemographic variables. Second, both Inferiority and self-esteem differ statistically and significantly according to Taekwondo practice. Third, Inferiority statistically and significantly influences self-esteem.