two Cases of Scrub typhus Presenting with Guillain-Barre Syndrome with respiratory Failure

( Il Nam Ju ),( Jung Woo Lee ),( Sung Yeoun Cho ),( Seung Jee Ryu ),( Youn Jeong Kim,),( Sang Il Kim ),( Moon Won Kang ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4

표면 항원 음성인 건강 검진 수진자와 만성 음주자에서 B형 간염 바이러스 잠재 감염

오성남 ( Sung Nam Oh ),연종은 ( Jong Eun Yeon ),한우식 ( Woo Sik Han ),최도원 ( Do Won Choi ),김지현 ( Ji Hyun Kim ),김연호 ( Yeoun Ho Kim ),박종재 ( Jong Jae Park ),김재선 ( Jae Seon Kim ),변관수 ( Kwan Soo Byun ),박영태 ( Young 대한내과학회 2008 대한내과학회지 Vol.75 No.5

목적: B형 간염 및 만성 음주는 우리나라 만성 간질환의 가장 중요한 원인으로 두 가지 요인간의 상관관계는 확실치 않으나 알코올 투여는 B형 간염 바이러스의 활동성을 증가시킬 수 있다는 실험적 보고가 있다. B형 간염의 잠재감염은 표면항원 음성인 환자의 혈청에서 HBV DNA가 검출되는 것으로 정의되며 만성 음주자에서는 잠재감염의 빈도가 높다는 보고도 있다. 본 연구의 목적은 B형 간염 표면항원 음성이며 만성 음주력이 없는 건강검진 수진자와 표면 항원음성인 만성 음주자에서의 B형 간염의 잠재감염 발생 빈도를 조사하여 비교하고자 하였다. 방법: 만성 음주력이 없고 간기능이 정상이며 HBsAg 음성인 건강검진 수진자 198명(1군)과 HBsAg 음성인 만성음주자 85명(2군), 총 283명을 대상으로 혈청 ALT, anti-HBs, IgG anti-HBc 검사를 하였으며 혈청 HBV DNA는 real time PCR로 검출하였다. 2군에서 간경변증을 동반하지 않은 경우가 60명이었고, 동반한 경우가 25명이었다. 결과: B형 간염바이러스에 대한 노출여부를 표시하는 혈청 IgG anti-HBc의 경우 1군에서 43.4%로 2군의 64.7%에 비하여 통계적으로 의미있게 낮았다(p=0.01). anti-HBs 양성율은 각각 65.7%, 67.1%로 양 군 간의 차이는 없었다. 혈청 HBV DNA는 전체 대상 환자 283명 중 11명(3.2%)에서 검출되었는데 1군에서 7명(3.5%), 2군에서 4명(4.7%)이 양성이었고 양 군 간의 차이는 없었다(p=0.640). 2군에서 간경변을 동반한 25명 중 3명(12.0%)이 양성으로 간경변을 동반하지 않은 60명 중 1명(1.7%)이 양성인 것보다 높았으나 통계적으로 유의하지는 않았다(p=0.740). 혈청 HBV DNA 농도는 9명이 300 copies/mL 미만이었고, 단 1명만이 1000 copies/mL 이상이었다. 결론: 만성적이고 습관적인 음주의 습관을 가진 사람들은 그렇지 않은 사람들에 비해 B형 간염 바이러스에 대한 과거 감염의 혈청학적 양성률이 높았으나, 잠재 감염의 빈도는 유의한 차이가 없었다. B형 간염 표지자가 양성인 경우에 잠재 감염의 빈도가 높다는 기존 보고들을 감안할 때, 만성 음주자에서의 잠재 감염의 유병률에 대해서는 향후 보다 큰 규모의 환자를 대상으로 한 연구가 필요할 것으로 생각된다. Backgrounds/Aims: Hepatitis B virus (HBV) infection and chronic alcoholism are major risk factors for chronic liver disease in Korea. Methods: We investigated the prevalence of occult HBV infection in 198 non-alcoholic (group I) and 85 chronic alcoholic subjects (group II), none of whom showed the hepatitis B surface antigen (HBsAg). Among chronic alcoholics, 25 patients showed cirrhosis. Using serum samples stored at -70℃, liver enzymes, anti-Hbs, and IgG anti-HBc were measured via EIA and serum HBV DNA was quantified via real time PCR. Results: IgG anti-HBc seropositivity, an indicator of past infection, was higher in group II (64.7%) than in group I (43.4%; p<0.01). Eleven of 283 patients (3.2%) were seropositive for HBV DNA, indicating occult infection, but this value did not differ between groups (group I: 3.5%, 7/198; group II: 4.7%, 4/85; p=0.64). In group II, HBV DNA seropositivity was higher in cirrhotic patients (12%, 3/25) than in non-cirrhotic alcoholic liver disease (1.7%, 1/60; p=0.074). Conclusions: Past HBV infection was more prevalent in alcoholics than non-alcoholics, but the prevalence of occult HBV infection did not differ between groups. However, alcoholics with cirrhosis tended to show a higher prevalence of occult HBV infection. (Korean J Med 75:539-545, 2008)

Clinical Factors Associated with the Early Reduction of Corneal Sensitivity in Herpes Zoster Ophthalmicus

Minjeong Kim,Yeoun Sook Chun,Nam Ju Moon,Kyoung Woo Kim 대한안과학회 2022 Korean Journal of Ophthalmology Vol.36 No.2

백내장수술 후 눈물 내 기질 금속단백분해효소 9 및 안구 표면 불편감의 단기 변화

이승현(Seung Hyeun Lee),전연숙(Yeoun Sook Chun),문남주(Nam Ju Moon),김경우(Kyoung Woo Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.4

목적: 백내장수술 후 눈물 내 기질 금속단백분해효소 9 (matrix metalloproteinase 9, MMP-9)를 비롯한 건성안 임상 지표의 단기 변화를 확인하고 안구 표면 불편감 변화와의 상관성을 분석하였다. 대상과 방법: 백내장수술 환자 106명(106안)을 대상으로 수술 전, 술 후 1주, 1개월째 마이봄샘 기능장애, 눈물 분비량, 각막지각, 눈물 막파괴시간, 각막미란, 안구표면염색지수, 눈물 내 삼투압, MMP-9 등급 및 안구표면질환지수(ocular surface disease index, OSDI)를 측정했다. 모든 환자는 술 후 1개월간 국소 목시플록사신 항생제, 스테로이드 및 비스테로이드 항염증제를 점안하였다. OSDI 점수의 1개월째 변화값과 건성안 지표들의 1개월째 변화값 간 상관성을 분석하였고, 술 후 1개월째 MMP-9 감소군과 MMP-9 비감소군간 수술 전후 건성안 지표 변화값들의 차이를 분석하였다. 결과: 대상자의 89.5%에서 수술 전 건성안이 있었다. 눈물 내 MMP-9는 술 후 1개월째 감소하였고, 쉬르머 I 검사상 눈물 분비량은 1주째 감소하였으며, OSDI 점수는 1주째, 1개월째 모두 술 전 대비 감소하였다. 수술 전후 1개월째 OSDI 변화값은 모든 건성안 지표들의 수술 전후 변화값과 유의한 상관관계를 보이지 않았다. 술 후 1개월째 OSDI 점수는 MMP-9 감소군에서 MMP-9 비감소군 대비 유의하게 더 많이 감소하였다. 결론: 백내장수술 후 통상적으로 시행하는 국소 항염증 치료하에서 술 후 단기간 내 눈물 내 MMP-9 발현이 감소할 수 있으며 이는 안구 표면의 불편감 증상 완화와 연관될 수 있다. Purpose: We explored changes in the various clinical parameters of dry eye disease (DED), including the tear matrix metalloproteinase 9 (MMP-9) level, soon after cataract surgery. We sought correlations between such changes and ocular surface discomfort. Methods: In 106 patients (106 eyes) who underwent cataract surgery, we evaluated meibomian gland dysfunction, tear secretion, corneal sensitivity, tear break-up time, corneal erosion status, the Sjögren’s International Collaborative Clinical Alliance (SICCA) ocular staining score, tear osmolarity, the tear MMP-9 level, and the ocular surface disease index (OSDI) before, and 1 week and 1 month after surgery. All eyes were instilled with topical moxifloxacin, a steroid, and a non-steroidal anti-inflammatory drug daily for 1 month postoperatively. The 1-month delta OSDI scores correlated with the 1-month delta DED parameters. We compared the latter parameters between patients in whom the MMP-9 level decreased (MMP-9-decreased group) at 1 month with those in whom it did not (MMP-9-not decreased group). Results: Overall, 89.5% of total patients exhibited preoperative DED. The tear MMP-9 level fell at 1 month postoperatively, tear secretion (evaluated using the Schirmer I test) decreased at 1 week, and the OSDI scores fell at both 1 week and 1 month. We found no significant correlation between the 1-month delta OSDI scores and the 1-month delta DED parameters. The 1-month OSDI score fell to a significantly greater extent in the MMP-9-decreased group. Conclusions: Routine, local anti-inflammatory treatment after cataract surgery may briefly reduce the tear MMP-9 level and ocular surface discomfort.

아지드화 나트륨(sodium azide) 음독 후 사망한 1례

남연우,김정언,조준호,정성필,이한식,김의중,Nam, Yeoun-Woo,Kim, Jung-Eon,Cho, Jun-Ho,Chung, Sung-Pil,Lee, Hahn-Shick,Kim, Eui-Chung 대한임상독성학회 2008 대한임상독성학회지 Vol.6 No.1

Sodium azide (NaN3) is a white to colorless, crystalline powder that is highly water soluble, tasteless, and odorless. It is used mainly as a preservative in aqueous laboratory reagents and biologic fluids and also as an automobile airbag gas generant. Although it has caused deaths for decades, the toxic properties and effects of sodium azide in humans remains unknown. A 31-year-old comatose female was transported to the emergency department with an empty bottle labeled sodium azide. She developed cardiac arrest 15 minutes after arrival and expired in spite of 30 minutes of resuscitative effort. Subsequently, resuscitation team members incidentally suffered from sodium azide's exposure and developed eye discomfort, skin rashes parasthesias, pruritus, sore throat, and headache.

흰꽃독말풀 열매 달인 물 복용 후 발생한 의식 변화 환자 1례

유제성,남연우,이진희,정성필,김승호,박인철,You Je-Sung,Nam Yeoun-Woo,Lee Jin-Hee,Chung Sung-Pil,Kim Seung-Ho,Park In-Cheol 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Datura stramonium is a wild growing plant, consumption of which can result in severe toxicity. It contains a variety alkaloids include atropine, hyoscamine, and scopolamine that can all cause anticholonergic poisoning. It has been use of herb medicine in Korea. Side effects from ingesting Datura stramonium include dry mouth, blurred vision, photophobia, and may be followed by hyperthermia, confusion, agitation, hallucination, and aggressive behavior. In severe toxicity, it can cause seizure, coma, life-threatening arrhythmia, and death. We experienced one patient who developed stupor mentality caused by Datura stramonium. Severe presentation, especially mental change of Datura stramonium should draw attention. Poisoning associated with Datura stramonium can be prevented through educational public health program.

일반인의 대체의료 이용행태에 관한 연구

정양수,문봉경,남형우,박주성,엄세연,최병무,Jeong, Yang-Su,Moon, Bong-Kyung,Nam, Hyeong-Woo,Park, Joo-Sung,Eum, Se-Yeoun,Choe, Byeong-Moo 한국정신신체의학회 1998 정신신체의학 Vol.6 No.1

Alternative medicine is defined as the practices used for the prevention and the treatment of diseases that are not taught widely in medical schools, nor generally available inside hospitals. Alternative medicine or therapy is of growing interest to the general public. We conducted a survey to determine the prevalence and patterns of using alternative medicine such as herbal medicine acupuncture, folk medicine, health food and diet, yoga, qi therapy, shiatsu, chiropractics, homeopathy etc.. Based on 794 completed questionnaires, 484 respondents(61%) reported using at least one form of alternative medicine for their medical problems. The major medical conditions for which they used alternative medicine were back pain(85.6%), arthritis(85.4%), hypertension(85.2%), cerebrovascular disorders(86.4%), and insomnia(84.6%). The types of alternative medicine frequently used were herbal medicine, acupuncture, folk medicine, and health food. The reasons why the vast majority of people sought after alternative medicine was that: less side-effect, it is not harmful, it is more effective, there is a shorter waiting time, and a better explanation fur the conditions and a kinder therapist. We found that the frequency of using alternative medicine in the health care system was high. Physicians need to be more aware that many patients may be using alternative medicine. Further survey of the nation-wide prevalence of alternative medicine, and scientific study into the efficacy of this medicine should be followed. In the meantime, we suggest paying attention to possible harmful effects caused by some sorts of alternative medicine.

불량 기화기로 인한 할로탄의 과량 투여

김종래,김진수,이윤우,이영석,김수연,남승철 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.6

A Vaporizer should deliver a constant concentration of anesthetics under the varying conditions of gas flow, liquid volume, and ambient temperature. We had encountered 3 patients with arrhythmia and ST change on EKG monitoring and cardiovascular collapse which occurred immediately after turning on the halothane vaporizer (Drager Halothan Vapor 19.1 No. 24302). Sudden cardiovascular collapse during the induction of anesthesia in an otherwise healthy patient was suggestive of anesthetic overdose. Thus we checked this vaporizer with the Capnomac Datex and Drager Iris. The inspiratory concentration of the vaporizer was found to be much higher than that of the dial setting. Vaporizers are sensitive, accurate, and scientific instruments which are directly involved in critical life support. All vaporizers should be treated and tested with great care for performance after shipment, any major service repair, or equipment modification.

하중조건에 따른 보통 및 애쉬 및 점토계 경량골재 콘크리트의 열팽창변형

김규용(Kim Gyu-Yong),이태규(Lee Tae-Gyu),최경철(Choe Gyeong-Cheol),남정수(Nam Jeong-Soo),강연우(Kang Yeoun-Woo) 대한건축학회 2012 大韓建築學會論文集 : 構造系 Vol.28 No.5

In case of concrete, it should be deformed by many factors such as explosive spalling, thermal strain and creep at high temperature. structural fire design have been proposed to predict fire damage as national standard. It is general safer to use values obtained from tests of unstressed residual test in stead of stressed test. But most of thermal properties on concrete was conducted with normal aggregate. In this study, test was conducted to evaluate stressed effect concerning normal weight and light weight concrete of 60㎫. Our experimental procedure was based on RILEM recommendation. Loading level was 0, 20 and 40 percent of compressive strength at room temperature. And thermal strain properties of concrete was carried out by 100, 200, 300, 500 and 700℃. Also, results can be analyzed as compare thermal strain properties at elevated temperature with CEN and CEB code.