중추신경계 합병증을 동반한 삼일열 말라리아 1례

김문석,김가연,강유민,김낙현,전재현,박완범,김홍빈,김남중,박상원,홍윤호,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Plasmodium vivax malaria is an endemic disease in Korea, which rarely causes severe complications including those occurring in the cerebrum. There are limited numbers of complicated cases that have been reported around the world. We experienced a case of vivax malaria with cerebral complication: cognitive impairment and ataxia. A 55-year-old female with diabetes mellitus presented to the emergency department with acute fever of two days’ duration. She did not have any history of travelling abroad or receiving blood transfusions. Peripheral blood smear revealed vivax malaria with parasitemia density of 0.53 percent. She demonstrated loss of orientation, especially regarding time and place, and ataxia. Although the initial hydroxychloroquine treatment for malaria was successful, cognitive impairment and ataxia persisted and were not recovered. Brain MRI showed no structural abnormality. Brain PET showed diffuse hypometabolism in right parieto-temporal lobe of the brain.

비혈연간 동종골수이식에 의해 치료된 중증 재생불량성빈혈 1예

김현중,이홍기,이방훈,이창근,이종태,정현식,김원석,윤성수,강원기,박근칠,김대식,고영혜,박찬형 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

비혈연간 동종골수이식은 혈연간 동종골수이식이 불가능한 환자에서 기존의 면역역제요법으로 효과가 없었던 경우나 재발한 경우에 적응증이 될수 있다. 이식 거부와 이식편대숙주병의 발생이 골수 이식의 성공률을 감소시키므로, 보다 강력한 conditioning regimen의 사용과 T cell이 제거된 골수를 사용하는 것이 필요하다. 기존의 high dose corticosteroid나 cyclosporine에 대하여 불응성인 이식편대숙주병의 치료를 위해서 ATG와 Mycophenolate mofetil (Cellcept®) 의 사용이나 Tacrolimus, Methotrexate와 같은 다른 면역억제제치료를 고려해 볼 수 있다. It is known that allogenic bone marrow transplantation is the most effective treatment for aplastic anemia. However, this treatment is only applicable to a minority of patients because the proportion of patients who have HLA-matched siblings about 25% to 30% of all the aplastic anemia patients. In the case of the absence of HLA-matched donor, unrelated allogenic bone marrow transplantation is considered. However, (because of severe acute and chronic GVHD and graft failure) the success rate of this approach is only 20~30%. Recently, it was reported that increased immunosuppressive condition combined with T cell depletion of the marrow graft would result in greater success. There was no case of successfully treated aplastic anemia patient by unrelated allogenic bone marrow transplantation in Korea. Here, we report a case of severe aplastic anemia successfully treated with unrelated allogenic bone marrow transplantation.

판별분석법을 이용한 관상동맥질환 고위험군의 예측

김성률,김기현,정갑열,김정만,박경일,김준연,이상주,김원술 동아대학교 부설 산업의학연구소 1995 산업의학연구소 논총 Vol.- No.2

The objective of this study is to predict the high risk group of coronary artery disease from body mass index, blood pressure, fasting blood sugar and serum lipids level using the method of discriminant analysis. Variables with significant difference between coronary artery disease group and normal group were HDS-C, LDL-C/HDL-C, LDL-C, and TG. But the acuity did not exceed 70% in any single variable. As the results of discriminant analysis, statistically significant discriminant variables were HDL-C, T-chol, FBS and TG. The discriminant equation was(Y) = -0.06759(HDL-C) + 0.01498(T-chol),+0.01923(FBS) - 0.01421(TG) + 0.5187, and the overall discriminant power using the above 4 variables was 79.3%

유도 허벅다리걸기 기술발휘 시 받기의 자세와 저항수준에 따른 운동학적 특성 분석 사례연구[Ⅰ]

김의환,윤현,김성섭 한국운동역학회 2004 한국운동역학회지 Vol.14 No.3

E. H. KIM, H. YOON, S. S. KIM. A Case Study on Kinematical Traits Analysis when Performing of Uchimata(inner thigh reaping throw) by Posture and Voluntary Resistance Levels(VRL) of Like in Judo[ I ]. Korean Journal of Sport Biomechanics, Vol. 14, No. 3, pp. 235-257, 2004. The purpose of this study was to analyze the kinematical traits variables when performing Uchimata(inner thigh reaping throw) by Voluntary Resistance Levels(VRL) and two postures of Like in Judo. The subjects, who were one male judoka(YH) for 1992 Barcelona Olympic Games, and one male trainee Y. I. University representative member(SDK) and were filmed on two S-VHS 16 mm video cameras(60fields/sec.),that posture of Like were Shizenhontai(straight defensive posture) and Jigohontai(straight natural posture), VRL of like were 0% and 100%. The kinematical variables were temporal(total time-required:TR), potures and COG variables etc., The data of this study collection were digitized by SIMI Motion Program computed the mean values and the standard deviation calculated for each variables. When performing according to each posture and VRL, from the data analysis and discussion, the conclusions were as follows : 1. Temporal variables : total time-required(TR) when performing Uchimata was shown the shortest time YH than SDK by each posture and VRL. TR of each posture were shown the shorten trends or equal in DP by lower than NP, In existence and / or nonexistence of VRL was shown the shorten trends in VRL 0% than 100% of Like. 2. Posture variables : In attacking right knee angle, YH was performing flexion(147→103degree) from Tsukuri(set-up) to Kake(execution) in regardless of postures and VRLs, SDK was performing not exchange extension and flexion in VRL 100%, and extension(120i142degree) in VRL 0%, respectively. In supporting left knee angle, YH was perfoinring extension(1194163degree) from Tsukuri(set-up) to Kake(execution) in regardless of postures and VRLs, SDK extension(934 139degree), respectively. In attacking right hip angle, from Tsukuri to Kake, YH was performing extension(1334 169degree), except in VRL 0%(156 i137degree) NP, SDK was performing flexion(159i126degree) accept in VRL 100%(149 i152degree) NP, In left hip angle, from Tsukuri to Kake, YH was performing flexion NP(70, 50degree) more than DP(27, 57degree), SDK was performing flexion DP(73, 52degree) more than NP(34, 20degree). 3. COG variables : When performing Uchimata, vertical COG variables was shown YH(:2-8cm), SDK(:15-24cm) lower than Uke's COG level position, in existence and / or nonexistence of postures and VRL, during Kake as maximum force point of throwing techniques in Judo.

위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.

클럽 샤프트(Club Shaft) 특성에 따른 골프 스윙(Golf Swing)동작 분석

김성일,김기형,김형수,이현섭,김진욱,안찬규,김희진 한국운동역학회 2002 한국운동역학회지 Vol.12 No.2

본 연구는 클럽 샤프트의 대표적인 재질인 그라파이트(graphite)의 유연한(flexible) 클럽 샤프트(club shaft)의 특성에 따라 피험자가 운동학적(kinematics) 요인이 되는 관절의 각변위, 각속도, 각가속도, 클럽헤드의 속도와 가속도와 같은 변인들이 어떻게 적응하는지 비교 분석하여 보다 효율적인 드라이버 선택에 도움을 주며 샤프트 특성에 따른 신체관절의 움직임에 대한 자료를 제시하고자 하였다. 고속 카메라 2대의 속도는 500fps로 하였고 각 regylar,stiff, x-stiff, 자신의 클럽을 포함 각 4개의 클럽을 사용하여 각 클럽당 3번씩 촬영하였으며 목표방향에서 20m이상 벗어나는 경우의 촬영은 다시 촬영하였다. 본 연구에서는 디지타이징(digitizing)을 신체 9개 마커는 강체로 가정된 클럽과 신체분절 모델로 정의하였으며 2 대의 카메라(500fps)로부터 얻은 avi화일을 컴퓨터에 저장하고 자료로부터 Butterworth 6th order recursive digital filter를 사용하여 1차 자료를 smoothing 하고 DLT를 이용하여 3차원 좌표를 구성하도록 한다. 좌표값을 얻기 위하여 kwon3d v3.0을 이용하였다. 본 실험은 피험자 스스로 클럽의 특성에 따라 스윙의 속도를 달리 하기 때문에 스윙의 시간이 달라지며 어느 정도 클럽이 강성에 따라 스윙시간이 빨라지는 결과로 나타났다. 이것은 피험자가 샤프트가 강성(stiffness)에 따라 스윙 속도를 빨리 하게 되는 원인이 되는 것으로 생각된다. 어깨의 각변위는 클럽이 regular의 경우 임팩트에서 각속도를 계속 유지하고 있으며 stiff, x-stiff의 경우에는 어깨의 움직임이 임팩트에서 급격하게 감소되는 것을 알 수 있다. 이것은 팔의 동작과 클럽의 힘을 크게 하기 위한 동작으로 생각된다. 어깨 각속도는 클럽이 stiff할수록 각속도가 큰 감속하는 것으로 나타났다. 손목속도는 regular 클럽의 경우 손목의 감속이 늦게 되고 임팩트에서 손목의 감속이 적게 하는 것으로 나타났으며 stiff와 x-stiff의 클럽에서 임팩트 시에 순간적인 감가속으로 인해 클럽의 속도를 증가시키고 있다. 임팩트 시에 손목의 감가속은 클럽헤드의 임팩트 시 속도를 증가시키는 결과를 보였다. 클럽헤드는 regular 클럽이 임팩트전에는 속도 증가가 커지는 결과와 일치된 결과를 보이고 있다. The purpose of this study was to find the rational method to analyze golf swing with specific property of club shaft. Three subjects were filmed by two high speed digital cameras with 500fps. The phase analyzed was downswing of each subject. The three-dimensional coordinates of the anatomical landmarks were obtained with motion analysis system Kwon3d 3.0 version and smoothed by lowpass digital filter with cutoff frequency 6Hz. From these data, kinematic and kinetic variables were calculated using Matlab(ver 5.0) The variables for this study were angular velocity and accelerations, which were calculated and following conclusions have been made : 1) Golf swing time of stiff club is faster than that of regular club. 2) In shoulder joint motion of swing with the stiff club, x-stiff showed mort rapid negative acceleration than that of regular club. 3) In regular club, the velocity of club head would be more effective velocity, which was increasing, than those of other clubs before impact. 4) In wrist joint motion of swing with stiff club, x-stiff club showed faster than regular club in the downswing and impact more rapid negative acceleration.

Mycobacterium mageritense에 의한 당뇨병성 족부 감염증 1예

김충종,김낙현,김문석,김계형,전재현,박문석,박경운,박완범,박상원,김홍빈,김남중,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Diabetic foot infection is one of the important complications in patients with advanced diabetes mellitus. Limb threatening infections such as osteomyelitis, abscess, and necrotizing fasciitis are frequently accompanied by the disease. Non-tuberculous mycobacterium (NTM) is a rare causative organism of diabetic foot infection. Thus, if one is not suspicious or meticulous, infection due to NTM will be easily overlooked and this will result in delayed diagnose and treat. Therefore, it is necessary to consider NTM as the causative organism if the wound does not respond to the conventional antibiotic treatment and the culture from the adequately obtained specimen reveals atypical acid-fast bacilli. We present a case of diabetic foot infection with osteomyelitis and abscess due to Mycobacterium mageritense, one of the rapid growing mycobacteria, that was successfully treated with surgical debridement and appropriate antibiotic treatment.

OVERSHOOT를 제거한 개선된 큐빅 스플라인 보간법에 관한 연구

김성현,김진만,조상현,주동현,김두영 東亞大學校附設情報技術硏究所 2005 情報技術硏究所論文誌 Vol.12 No.2

This study presents the improvement of cubic spline interpolation without overshoot. The o-riginal cubic spline interpolation has overshoots between two data. They are noises in still image zoom because of getting out of the pixel value. But the improvement of cubic spline in-terpolation removes them and proffers better quality still image than other interpolations.

Ta 상·하부 전극을 가진 Ta₂O_(5) 박막 커패시터의 전기적 특성

김현주,송재성,김인성,박문흠,김상수 昌原大學校 基礎科學硏究所 2003 基礎科學硏究所論文集 Vol.15 No.-

The electrical characteristics of Tazodtantdum pentoxide) films sputtered on Ta/Ti/SiO₂/p-Si substrate were investigated. Ta(tantalum1 was used for the bottom and top electrode for the purpose of simplifying the manufacturing process in IPD's(integrated passive devices). Dielectric materials deposited on Ta/Ti/SiO₂/p-Si were annealed at 700 ℃ for 60 sec in vacuum. The XRD results showed that as-deposited Ta had a highly preferred orientation, but Ta₂O_(5) film possessed amorphous structure, which was transformed to crystalline by rapid thermal annealing. We compared the C-F, C-V, and 1nJ-E of both as-deposited and annealed dielectric thin films deposited on Ta bottom electrode. From this results, we concluded that the leakage current could be reduced by heat treatment and dielectric constant was high than Ta₂O_(5) deposited on Pt, Au, etc.. Therefore, Ta as electrode material is thought that is suitable as material to replace the precious metal electrodes and to simplity the fabrication process of the Ta₂O_(5) MIM capacitor.

장기적 흡인 배액법을 이용한 척추 후방 기기 고정술 후 감염의 치료

김용민,김동수,최의성,손현철,박경진,김융성 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

연구 목적 : 척추경 나사못을 이용한 척추 후방 기기 고정술 후 심부 감염이 발생한 증례 들을 대상으로 관련 인자를 분석하고 Hemo-vac을 이용한 장기간의 폐쇄성 흡인 배액법을 통한 치료와 그 결과에 대해 알아보고자 하였다. 대상 및 방법 : 1996년 5월부터 2001년 8월까지 척추후방기기고정술 후 심부 감염이 발생 한 5례를 연구 대상으로 하여 전신 질환 동반, 감염의 발현 양상을 조사하였고, 창상 세척 등 감염 수술 후 장기적 배액법을 이용한 치료 과정 및 최종 결과를 후향적으로 분석하였다. 결 과 : 당뇨와 비만이 술후 심부 감염의 위험요인으로 분석되었다. 수술 환부로부터의 배농, 발열 등 감염 증상은 술후 평균 18.8(8-36)일에 발현되기 시작하였다. 일인당 단 1회의 세척술이 실시되었고 고정기기는 제거하지 않았다. 이후 평균 19.2일간의 지속적 흡인 배농 및 평균 43.6일간의 항생제 정맥투여에 이은 평균 33.8일간의 경구투여로 심부감염은 특별한 합병증 없이 모두 치료되었으며 양호한 임상적 결과와 후외방 골융합을 얻을 수 있었다. 결 론: 척추 후방 기기 고정술 후 발생한 심부 감염에 대해 창상의 세척 및 육아조직 제 거 후 항생제 투여와 Hemo-vac을 이용한 장기간의 장기적 흡인 배액법은 감염의 조절과 척추의 안정성을 동시에 얻을 수 있는 유용한 방법중 하나인 것으로 생각되었다 Purpose: Various treatment modalities have been applied to control deep infection after spinal instrumentation. Validity of removing implants to control the infection is still contro- versial because it may cause loss of spinal stability. Analysis of the inherent risk factors associated with deep infection and the efficacy of management with long-term suction drainage without removal of implants. Materials and Methods : Fiye cases of postoperative deep infection after posterior spinal fixation from May 1996 to August 2001 were investigated on combined general ill- ness, features of infection, various profiles on the management of infection with surgical irrigation and debridement followed by long-term suction drainage, and final outcomes. Results :Remarkable risk factors were diabetes and obesity. Evidences of infection such as discharge from the wound, dehiscence, or fever were observed on the average of 18.8th day postoperatively By only one additional surgical procedure for each patient followed by long-term suction drainage for mean 19.2 days and administration of intravenous antibiotics for average of 43.6 days, deep infections were controlled successfully without removal of implants and without any grave complications. All achieved favorable clinical results and posterolateral fusion. Conclusion : Irrigation and debridement accompanied by long-term suction drainage using Hemo-vac and administration of susceptible antibiotics seemed to be one of the effective methods to control deep infection after posterior spinal instrumentation and main than the postoperative stability of spine.