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      • Solar urticaria in Korean patients

        ( Sung Min Kim ),( Young Ah Cho ),( Ji Su Lee ),( Ji Youn Hong ),( Jin Hee Kim ),( Joo Ran Hong ),( Hye In Cheon ),( Yang Won Lee ),( Yong Beom Choe ),( Kyu Joong Ahn ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

        Background: Solar urticaria (SU) is an uncommon type of photodermatoses characterized by erythematous wheal with pruritus after sunlight exposure, which shows a female predominance. Only a few studies to analyze the clinical features of SU were reported in Asia. Objectives: We aimed to analyze the clinical and photobiological characteristics of SU in Korea. Methods: We retrospectively investigated the medical records of patients with SU who visited the department of dermatology, Konkuk university medical center from January 2005 to January 2020. Results: Of a total of 44 patients, 36 (81.8%) were male and 8 (18.2%) were female. The mean age at onset was 17.6 years (range, 5-47) and the mean threshold time was 19.7 minutes. Among 32 patients who underwent phototesting, the action spectrum most commonly implicated was ultraviolet (UV) A only in 12 (37.5%), and then visible light (415nm) only was responsible for SU in 8 (25.0%). Three patients (9.4%) were induced by both UVA and visible light (415nm). Even 4 patients (12.5%) were triggered by only natural sunlight. Serum immunoglobulin E levels were measured in 33 patients, and 17 (51.5%) showed values higher than normal. The treatment most widely used were oral antihistamine (43.2%), followed by phototherapy (13.6%). Conclusion: SU is a rare photodermatosis in Korea, which shows a male preponderance. In this study, UVA and visible light (415nm) were predominant action spectrum of SU.

      • 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.

      • KCI등재
      • KCI등재후보

        병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성

        김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

        목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.

      • SCOPUSKCI등재

        한국인 여성에서 비타민 D 수용체 유전자 , 에스트로겐 수용체 유전자 및 제 1 형 콜라겐 α1유전자의 다형성과 최대골량의 연관성에 관한 연구

        김은숙,김상욱,김기수,김홍규 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.1

        Background: Genetic suggest that strongest effect is observed in the premenopausal peak bone mass, which become less with age. However, the evaluation of candidate genes polymorphisms has been most frequently done in postmenopausal women and the results have been controversial. Therefore, we studied the possible association of the peak bone mass and candidate for osteoporosis genes polymorphism in premenopausal women. Methods: The associations between BMD and polymorphisms of the vitamin D receptor (3'-end region by BsmI restriction enzyme and start codon by FokI restriction enzyme), estrogen receptor (by PvuII and XbaI restriction enzyme), and type I collagen al (Spl binding site by MscI and Ball restriction enzyme) genes were examined in 100 healthy young Korean women who had a peak bone mass (age 20 35 years). Bone mineral densities were measured by dual energy X-ray absorptiometry (DEXA). Dietary calcium intake was also measured using a food frequency questionnaire. Results: The frequencies of the B allele of the vitamin D receptor gene BsmI polymorphism and the X allele in the estrogen receptor gene, XbaI polymorphisms were lower in Koreans than those in Caucasians. The allelic frequencies of the vitamin vitamin D receptor gene Fokl polymorphism and the estrogen receptor gene PvuII polymorphism were similar to those of Caucasians. No significant association was found between BMD and the vitamin D receptor genotype according to Bsml or FokI polymorphisms. There was also no significant relation between the PvuII or XbaI polymorphisms of the estrogen receptor gene and BMD. The associations between BMD and cross-genotypes combining the vitamin D receptor gene (BsmI and FokI) and estrogen receptor gene (PvuII and XbaI) polymorphisms were also analyzed. Among the subjects who lacked the Bf haplotype of the vitamin D receptor gene, the BMD of the femoral neck area was significantly higher in subjects lacking Px haplotypes of the estrogen receptor gene than in those having Px haplotype (p $lt; 0.05). When dietary calcium intake was taken into consideration, there were significant differences in BMD according to the cross-genotype in the group having a low calcium intake ($lt; 500 mg/day). The subjects that lacked the Bf and Px haplotypes had a significantly higher BMD in the femoral neck (p $lt; 0.01), Wards triangle (p $lt; 0.0~5), and in the trochanteric area (p $lt; 0.05) than those who lacked Bf but a Px haplo~type. We did not find a polymorphism in the Spl bindi~ng site of the type I ~collagen ~al gene in our subjects. Conclusion: These data suggest that a complex interaction of vitamin D and the estrogen receptor gene with the dietary calcium intake, rather than a polymorphism of a sing~le gene, may influence peak bone mass in healthy young Korean women (J Kor Soc Endocrinol 16:97-114, 2001).

      • KCI등재

        Magnetization Analysis for Outer Rotor Brushless DC Motors Using Polar Anisotropic Ferrite Ring Magnets

        Sung‑Il Kim,Su‑Jin Lee,Jeong‑Jong Lee,Chang‑Eob Kim 대한전기학회 2020 Journal of Electrical Engineering & Technology Vol.15 No.3

        Ferrite-bonded magnets have been extensively used in small brushless DC (BLDC) motors for low torque applications such as fans and pumps. In particular, some motors of them with ferrite-bonded magnets, frequently called as plastic magnets, do not have a rotor core in order to reduce manufacturing costs and inertia of the rotating part. Accordingly, the magnetization distribution of the bonded magnets has a polar anisotropic direction to secure more magnetic fux. As a result, the magnetization orientation of the magnets is highly signifcant to accurately predict the performances of the BLDC motors. This paper deals with the magnetization analysis of the polar anisotropic ferrite ring magnet applied to an outer rotor type BLDC motor. The motor is employed for an electric water pump, and its rotor including the impeller consists of only the ferrite-bonded magnet material and made by injection molding. Consequently, a magnetizing fxture and an impulse magnetizer are not used for the magnetization of the outer rotor type motor. Instead, samarium–cobalt (SmCo) magnets having a relatively high curie temperature are applied for generating magnetic feld. Finally, this paper presents a process to determine the anisotropic orientations of a ferrite ring magnet by fnite element method. In addition, the validity of the analysis method is verifed by test results

      • KCI등재

        혈관질환 정보관리 시스템

        김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

        As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

      • KCI등재후보

        위절제술 환자의 표준진료지침 개발 및 적용 효과

        김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

        Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

      • 시상하부-뇌하수체 질환에서 종합적 뇌하수체전엽 기능검사의 진단적 의의

        김수동,김신우,김정국,하승우,김보완 慶北大學校 醫科大學 1993 慶北醫大誌 Vol.34 No.4

        시상하부-뇌하수체질환의 기저질환에 따른 종합적 뇌하수체전엽 자극검사의 진단적 가치를 알아보고자 81례의 뇌하수체 기능부전증환자를 대상으로 시상하부질환군과 Sheehan증후군, 말단비대증과 프로랙틴종, 그리고 뇌하수체선종에서 시야장애가 동반된 군과 장애가 없는 군으로 나누고 기능검사의 결과를 비교하였다. 1. Sheehan증후군 15례 가운데 GH 및 cortisol결핍이 전례(각각 100%)에서 FSH, LH 및 TSH결핍이 11∼12례(73∼80%)에서 관찰되었고 13례(86%)에서는 TRH에 대한 PRL분비증가가 저하 또는 소실되었다. 두개인두종 10례를 포함한 시상하부질환 14례 가운데 12례(86%)는 PRL의 기저지가 비정상직으로 증가되어 있었으며 TRH자극에 대해 PRL분비 증가가 11례(79%)에서 둔화되어 있었다. GH분비능도 11례(79%)에서 저하되었으며 그 밖의 cortisol, LH, TSH, FSH의 순으로 분비능이 저하되어 있었으나 그 빈도는 Sheehan증후군에 비해 전반적으로 낮았다. 2. 말단비대증 18례 가운데 14례(78%)에서 GH기저치가 비정상적으로 증가되어 있었고 13례(72%)는 저혈당자극에 대해 정상적인 GH의 증가를 보였으며 8례(44%)에서 고프로랙틴 혈증이 동반되었다. 프로랙틴종 18례 가운데 전례(100%)에서 PRL기저치가 증가되었고 13례(72%)에서 TRH에 대한 PRL의 증가반응이 둔화되었다. LH, FSH, cortisol 및 TSH분비능의 장애는 말단비대증군에서 프로랙틴종에 비해 다소 높은 빈도를 보이는 경향이었다. 3. 뇌하수체선종 가운데 시야장애가 동반된 21례에서 시야장애가 없는 23례에 비해 GH, cortisol및 LH의 분비반응이 저하된 빈도가 다소 높은 경향이었다. 이상의 결과로 보아 종합적 뇌하수체전엽 기능검사는 시상하부-뇌하수체질환의 기저질환을 진단하는데 중요한 정보를 제공할 수 있다고 생각한다. The combined stimulation test using TRH, LHRH and insulin has allowed investigation of the reserve of all pituitary tropic hormones under physiological and pathological conditions. To evaluate the diagnostic efficacy of this test for differentiating the underlying causes of hypopituitarism, we analyzed retrospectively the results of these tests done in 81 patients with proven hypothalamo-pituitary disorders. 1. In 15 patients with Sheehan's syndrome as a typical type of primary hypopituitarism, responses of both GH and cortisol to insulin-induced hypoglycemia were decreased in 15 cases all (100% in both) and of FSH, LH and TSH in 11 to 12 cases(73-80%). Incremental response of prolactin(PRL) to TRH was diminished or absent in 13 cases(86%). In 14 patients with hypothalamic diseases, including 10 cases of craniopharyn-gioma, as a representative secondary hypopituitarism, the basal PRL levels were abnormally elevated in 12 cases (86%) and both responses of PRL to TRH and of GH to hypoglycemia were blunted in 11 cases (79% in both). The frequency of impaired cortisol secretion was 50%, followed by LH, TSH and FSH secretion : overall frequency much lower than in Sheehan's syndrome. 2. In 18 acromegalics with pituitary adenoma, basal GH levels were abnormally elevated in 14 cases(78%) and incremental responses of GH to hypoglycemia were found in 13(72%). Hyperprolactinemia was accompanied in 8 (44%). In 18 patients with prolactinoma, basal PRL levels were moderately to markedly elevated in all of them(100%) and responses of PRL to TRH were blunted in 13(72%). The frequency of impaired secretion of LH, FSH, cortisol and TSH was slightly higher in acromegalics than in patients with prolactinoma. 3. The frequency of impaired secretion of GH, cortisol and LH tended to be slightly higher in patients with pituitary adenoma associated with visual field defect than those without visual field defect. These results suggest that the combined pituitary stimulation test will give us some of reliable information for evaluating the underlying causes of hypopituitarism.

      • KCI등재

        정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

        김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

        연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

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