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Candida parapsilosis에 의한 관절염 1예
서동대,김양수,김백남,배인규,강재명,김미나,우준희,류지소 대한의진균학회 2001 대한의진균학회지 Vol.6 No.1
Candida parapsilosis was not considered pathogenic, until it had been reported as the cause of the fatal case of infective endocarditis in intravenous narcotic addicts in 1940. More recently this species has emerged as an important nosocomial pathogen in many clinical infections, such as fungemia, endocarditis, endophthalmitis, septic arthritis, and peritonitis. Among them C. parapsilosis arthritis is still very rare, which is mainly caused by invasive procedures such as prosthetic arthroplasty, intraarticular steroid injection and contamination of hyperalimentation solutions. We experienced a 53 year-old male patient who had chronic elbow pain and was diagnosed as the first case of C. parapsilosis arthritis in Korea. Herein we report the case with a review of the literature. [Kor J Med Mycol 6(1): 42-44]
마음건강수준과 사회적 지지, 심리적 고통이 지역사회 정신보건 서비스를 이용하는 만성 조현병 환자의 자살사고에 미치는 영향
서동대,유제춘,최경숙,박우리,이미림,김도윤 대한신경정신의학회 2014 신경정신의학 Vol.53 No.6
Objectives The objective of this study was to analyze the relationships of psychological distress, social support, mental fitness and suicidal idea among patients of chronic schizophrenia using community mental health services. Methods This study was conducted in patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 chronic schizophrenic patients were evaluated using Mental Fitness Scale (MFS), Kessler Psychological Distress Scale (K10), and Multidimensional Scale of Perceived Social Support (MSPSS). Results Results showed that 37% (n=146) of patients had suicidal ideas and 63% (n=249) of patients did not have suicidal ideas. The group that had suicidal ideas showed significantly lower scores on MFS, K10, and MSPSS than the group with no suicidal ideas (p=0.000). Logistic regression analysis showed a significantly lower score on MFS, K10 for the suicidal ideation group than the group with no suicidal ideas. Conclusion These results suggest that health care providers should consider mental fitness and psychological distress, in order to prevent suicidal idea of schizophrenic patients. 본 연구에서 만성 조현병 환자의 자살사고에 높은 마음건강수준과 낮은 심리적 고통 수준은 보호요인으로 밝혀졌다. 최근 지역사회 중심의 정신보건정책이 시행됨에 따라 높은자살위험을 갖고 있는 것으로 알려진 만성 조현병 환자들이지역사회에 더 많이 거주하게 되는 추세가 진행되고 있다. 따라서 이들을 관리하는 지역사회 정신보건기관들에서는 이들의 마음건강수준과 심리적 고통 수준에 관심을 가지고 자살로 생을 마감하지 않도록 관심을 기울여야 할 것으로 생각된다.
서동대(Dong Dae Seo),이윤정(Yun Jung Lee),박일권(Il Gwon Park),이현주(Hyun Ju Lee),박성제(Seong Je Park),표승일(Seung Il Pyo),윤길숙(Kil Sook Yun),서동완(Dong Wan Seo),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),김기락(Ki Rhack Kim) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.5
Endometriosis is defined as the presence of endometrial tissue outside the uterus. We experienced 51-year-old woman with symptom of epigastric pain and sign of a palpable mass on the left quadrant abdomen. A cystic mass in the tail area of the pancreas was found on CT scan and was removed surgically. It was a cystic mass originated from the mesentery and separated from the pancreas. It was diagnosed as endometrial cyst histopathologically. (Korean J Gastroenterol 2001;37:389-391)
수술로 호전되지 않은 췌장 농양을 내시경 치료로 완치한 1 예
서희영;전태주;김선영;강미선;허란;박지영;서동대;오태훈 인제대학교 백병원 2011 仁濟醫學 Vol.32 No.-
Necrotizing pancreatitis develops in about 10-20% of patients with acute pancreatitis, and pancreatic abscesses develop in 3% of them. The mortality of pancreatic abscess has been reported up to 40% in one study. Recently, there are several reports that show good results with n on-surgical therapy, such as percutaneous drainage and endoscopic drainage, but if the non-surgical drainage fails, surgical therapy are recommended. However, there is no definite therapeutic method which is suggested yet so far after the failure of the surgical drainage. So we report the case in which we experienced successful treatment of pancreatic abscess by endoscopic removal of necrotic tissue through the gastrocystostomy, after the failure of the surgical debridement and internal drainage through gastrocystostomy.
서울 동북부지역 산발성 급성간염 환자에서 A형 간염바이러스 두 가지 유전자형의 분포 양상
유수진,서동대,최원충,권오중,박재찬,신보문 대한진단검사의학회 2008 Annals of Laboratory Medicine Vol.28 No.5
Background : In previous studies, most hepatitis A virus (HAV) isolates had been genotype IA in Korea. Recently, a small number of different genotypes were reported with an upsurge of acute hepatitis by HAV. We investigated the distribution of HAV genotypes. Methods : RNA was extracted from anti-HAV IgM positive sera which were collected from March 2007 to February 2008 at a tertiary care hospital in Northeastern Seoul, Korea. Nested reverse transcription (RT)-PCR and direct sequencing for VP1/P2A region of the HAV were performed. Results : A total of 699 cases with suspected acute hepatitis were tested for anti-HAV IgM, and positive results were obtained in 56 sera (8.0%), which were collected 2 to 15 days (median, 7 days) after the onset of symptoms. Of the 56 seropositive samples, 52 (92.9%) were positive for HAV RNA, among which 28 isolates (53.8%) belonged to genotype IA and the remaining 24 (46.2%) belonged to genotype IIIA. Both IA and IIIA genotypes were isolated from 6-7 neighboring administrative districts throughout the year without geographic or seasonal restrictions. Conclusions : Co-circulation of two distinct HAV genotypes (IA and IIIA) was observed from the northeastern Seoul for the year studied. (Korean J Lab Med 2008;28:371-7)
순수적혈구무형성증과 자가면역용혈성빈혈이 동반되어 발생한 급성 A형 간염 1예
조성균,서동대,서지영,최병돈,황미원,전태주,신원창,최원충 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
순수적혈구무형성증은 골수 내 적혈모구의 소실로 인하여 정상적혈구빈혈의 형태를 보이는 질환이며 자가면역용혈성빈혈은 자가항체에 의해 용혈이 발생하는 질환이다. 이들은 감염, 자가면역질환, 악성신생물, 약물 등 다양한 원인에 의해서 발생할 수 있는 드문 질환으로, 급성A형 간염에 의해 발생한 경우가 간혹 보고되나 두 질환이 함께 발생한 경우는 매우 드물어 전세계적으로도 2예만 보고 되었다. 특이병력이 없는 49세 여자환자가 근육통을 주소로 내원하였다. 혈액검사상 혈청 아미노전달효소의 현저한 상승과 혈청 총빌리루빈의 상승 및 프로트롬빈시간의 현저한 증가가 관찰되었고(AST 6122 IU/l이상, ALT 7451 IU/l, 총빌리루빈 5.1 mg/dl, PT(INR) 1.76), 혈청학적 검사상 IgManti-HAV 양성으로 급성 A형 간염으로 진단되었다. 대증적 치료 후 임상증상과 혈액검사가 호전되는 경과를 보여 환자는 입원 6일째 퇴원하였다. 퇴원 22일 후 환자는 피로감과 황달의 악화로 재입원하였다. 이전 입원 시와 비교하여 혈청 아미노전달효소와 프로트롬빈시간은 현저하게 호전되었으나 정상적혈구빈혈 및 혈청 총빌리루빈의 현저한 상승이 관찰되었다(AST 147IU/l, ALT 162IU/l, PT(INR) 1.14, 적혈구 7.9g/dl, 총빌리루빈 30.9 mg/dl). 위장관 출혈의 증거는 없었고 교정망상적혈구는 0.04%로 현저히 감소되었으며 말초혈액도말검사상 소구형적혈구가 관찰되었다. 젖산탈수소효소의 상승, 합토글로빈의 저하(LDH 1600IU, haptoglobin 20 mg/dl 미만), 직접 쿰즈검사 양성소견이 관찰되었다. 골수 흡인생검을 시행하였고, 골수 내 세포충실도는 정상이나 적혈모구의 현저한 감소가 확인되었다. 순수적혈구무형성증과 자가면역용혈성빈혈이 급성 A형 간염에 의해 발생한 것으로 판단하여 경구 프레드니솔론을 1 mg/kg/일 투여하였다. 4주간 유지 후 적혈구는 11.0g/dl로 유지되고 총빌리루빈은 13.9 mg/dl로 감소하여 퇴원하였고 이후 순차적으로 감량하며 투여하고 있다.