서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

프로야구 손상의 임상적 분석

김철준,김명화,김미정,신명진,윤준오,김상규 대한스포츠의학회 1995 대한스포츠의학회지 Vol.13 No.1

Baseball is rapidly getting popularity in Korea as it has been in U.S.A and Japan. During the last decade, threre were several studies about baseball injuries which oriented mainly to the overuse injuries of growing baseball players. But there was no study the professional baseball players systematically. This study was surposed to see the general characteristics of baseball injuries and to provide the prevention and rehabilitation programs if recommended. The number of 83 injuries of 60 baseball players was analysed according to the position, injury site, diagnosis, injury mechanism and duration of injury. The mean age and height of 60 subjects were 24.6 years old and 180.65㎝, respectively. The baseball position of 82 injured cases were composed of 27 pitchers, 30 infielder, 19 outfielder and 6 catchers. The characteristics of injury were as follows: 1.The number of chronic injury was 56 cases(68.3%) and the percentage of chronic injury of pitchers was up to 81.5% compared 73.3% of infielder and 47.4% of outfielder. 2. The injury rate of both lower and upper extremitis were equal and the rate of lower back problems was the second, which should be concerned. 3. The number of cases injured by direct collison is as low as 15(18.3%). The most common secondary cause of injury was aggressive throwing itself and 26 out of 49 cases injured not by direct collision. 4. More concern should be payed about the low back problems and about the catcher and the field players as much as pitchers from now one.

소에서 盲腸擴張을 동반한 第4胃食滯 手術 1例

김명철,김덕환,신상태,임준호,김남중,김종만 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Abomasal impaction with cecal dilatation was diagnosed in a 3 years old holstein cow. The clinical signs were loss of appetite, scant feces and moderate distension of the abdomen. Ping sound was revealed in the right 11th intercostal space by auscultation. Cecal dilatation and abomasal impaction were ascertained by right flank laparotomy and abdominal exploration, and intestinal content and gas were removed from the cecal apex incised. One day later, 2.5㎏ of sand was removed by ventral paramedian abomasotomy.

Callus distraction method를 이용한 하악골 신장술 : 계단골절단술식의 적용

김명진,윤필영,신동준,김수경,김종원,김규식 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regeneracted bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1974 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

자가 말초혈액 조혈모세포 이식술의 임상적용

김혁,안명주,오석중,이영열,김인순,정태준,최일영,오미란,임호준,이항,김신규 한양대학교 의과대학 1999 한양의대 학술지 Vol.19 No.1

Responses to chemotherapy correlate with the increased dose of chemotherapeutic agents in some cancers, e.g. breast cancer, Ewing's sarcoma, Hodgkin's disease(HD) and non-Hodgkin's lymphoma(NHL), then for the improvement of the chemotherapy responsiveness, high-dose chemotherapy(HDCT) was proposed. But, it's application was limited due to complications, especially bone marrow suppression. HDCT and succeeding autologous peripheral blood stem cell transplantation(APBSCT) was introduced to overcome this problem. This study was designed to determine the clinical pictures including clinical parameters and the responsiveness of HDCT followed by APBSCT in Hanyang University Hospital. Ten patients were enrolled. They were 8 adults (3 breast cancers, 3 multiple myelomas, 1 HD, 1 NHL) and 2 children (1 acute myelogenous leukemia (AML), 1 neuroblastoma). Mobilization chemocherapy(MCT) followed by Granulocyte Colony Stimulating Factor(G-CSF) was administered to mobilize stem cells from bone marrow to peripheral blood. The stem cells were collected by using CS-3000 and cryopreserved at -196℃ with programmed controlled rate freezer as the mixture with 10% dimethyl sulfoxide(DMSO). HDCT was administered and cryopreserved peripheral stem cells were infused on day 0 as planned. Patients' mean age was 41 years old. After induction chemotherapy three patients achieved complete response and 5 partial response. The median time for bone marrow recovery after MCT was 11.5 days for neutrophil(〉500/㎣) and 4.8 days for platelet(〉20,000/㎣). There were three cases of neutropenic fever and one case of gingivitis. After HDCT with APBSCT, one patient was converted partial response to complete response, and one patient achieved complete response after HDCT without induction chemotherapy. The median time for bone marrow recovery was 12.7 days for neutrophil(〉500/㎣) and 14.7 days for platelet(〉20,000/㎣). Eight patients developed neutropenic fever and required systemic antibiotics. Transfusion was required 1.6 pints for packed red cell and 23.4 pints for platelet concentrates. Toxicity consisted mainly of vomiting, diarrhea, and mucositis which were mild. HDCT with APBSCT can be performed safely with minimal complications. For the evaluation of the exact role of HDCT with APBSCT in malignant diseases, further studies are required as a large scale of patients and lung-term follow up.

프로 야구 투수들의 견관절 회전근력

김철준,김상규,김명화 대한스포츠의학회 1994 대한스포츠의학회지 Vol.12 No.2

This study was to investigate the biomechanics and characteristics of shoulder rotator muscles of korean professional baseball pitchers and to suggest the direction of training for them. The shoulder internal rotator and external rotator muscles of twenty-one korean professional baseball pitchers were evaluated with Cybex 6000^R isokinetic dynamometer. The test angular velocity was 120℃/sec as a low speed and 240℃/sec as high speed and the test was done in standing neutral position. The peak torque, peak torque % body weight and external/internal rotator peak torque ratio were analysed and compared with those of american professional baseball pitchers and concluded as followings; 1) The peak torque and peak torque % body weight were much smaller than those of american major league pitchers especially in shoulder internal rotator muscle. 2. The external/internal rotator peak torque ratio was higher than that of american major league pitchers especially in high speed test, 240℃/sec, in which the ratio of american pitchers was lower than that of 120℃/sec. 3. The more aggressive and continuous strength training of internal rotator muscle, combined with rotator cuff strengthening, is needed. 4. Additional studies of isokinetic dynamometer are requested in the field of shoulder rehabilitation and biomechanical reserch of pitching especially in much higher speed, both eccentric and concentric methods and various testing positions.

선천 섬유화 증후군 1예

김동섭,신정철,고명규,최준규,장세진 한양대학교 의과대학 1998 한양의대 학술지 Vol.18 No.1

The congential fibrosis syndorme is rare congenital disorder which is characterized by blepharoptosis, varying degrees of limitation of eye movement, especially in vertical gaze, and abnormal head position. These clinical findings result from the fibrous replacement of normal contractile extraocular muscle tissue. The authors report one sporadic case of congential fibrosis syndrome. The 14 year-old-girl showed bilateral ptosis, fixed ocular misalignment in downward gaze, limited ductions and versions, and characteristic chin up position. The surgical management attempted to achieve functional readjustment of the ocular alignment and lid position and to correct cosmetically unacceptable abnormal head position. Result of histopathologic examination obtained at surgery shows replacement of the extraocular muscles, conjuctiva and Tenon's capsule by collagen and dense fibrous tissue. The surgical outcome is considered satisfactory when compared with preoperative status although the limitation of vertical eye movement remains unchanged after surgery.

金屬 Fiber의 效率에 關한 硏究

김흥준,박세만,박명균,차경옥 明知大學校 産業技術硏究所 1994 産業技術硏究所論文集 Vol.13 No.-

In review of he current technical difficulties and weaknesses in producing filters, this investigation presents a method to evaluate metallic fiber filters by utilizing the theory of fluid dynamics. A method for evaluations of the efficiency of filters in estabilished. Also the filter configuration is analyzed and the filter media is characterized. A trial product of pleated type filter is designd and produced. The product has optimal filtering surface area per unit flow rate. Also tests for filtration efficiency and characterizations of the products were conducted.

정형물리치료의 적정 의료보험수가에 관한 연구

김명준,황성수,김호봉,김수형 대한정형물리치료학회 2000 대한정형도수물리치료학회지 Vol.6 No.2