Creatine kinase 증가가 없었던 다발성근염

박민선 ( Min Sun Park ),권오경 ( Oh Kyung Kwon ),김효선 ( Hyo Sun Kim ),신원재 ( Won Jae Shin ),한상학 ( Sang Hak Han ),홍명선 ( Myung Sun Hong ),손경민 ( Kyeong Min Son ) 대한내과학회 2014 대한내과학회지 Vol.86 No.2

Proximal muscle weakness can be induced by many diseases, such as muscular dystrophies, inflammatory muscle diseases, and polymyalgia rheumatica. Differential diagnosis of these diseases is important. The patient had proximal muscle weakness with a normal creatine kinase (CK) level. Our initial diagnosis was polymyalgia rheumatica because the CK level was normal. The patient was treated with low-dose corticosteroid. However, the muscle weakness did not improve. The diagnosis of polymyositis was confirmed by a muscle biopsy. We suggest that if the patient has typical symptoms with normal CK, then evaluations for inflammatory muscle diseases are essential. (Korean J Med 2014;86:258-262)

항암화학요법을 받는 암환자에게 적용한 전화상담이 디스트레스, 불안과 우울 및 치료관련 부작용 발생에 미치는 효과

옥오남(Ok, Oh Nam),남민선(Nam, Min Sun),이미선(Yi, Mi Sun),조선미(Cho, Seon Mi),김은지(Kim, Eun Ji),함윤희(Ham, Yun Hee),권인각(Kwon, In Gak) 대한종양간호학회 2017 Asian Oncology Nursing Vol.17 No.1

This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. Methods: This was a randomized controlled trial (pretestposttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. Results: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. Conclusion: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.

대용량 원심분리기와 Differex™ system을 병용한 효율적인 정자분리법 개발

이동섭(Lee, Dong Sub),박민선(Park, Min Sun),최지원(Choi, Ji Won),신설희(Sun, Seol Hee),최성경(Choi, Sung Kyoung),오대건(Oh, Dae Geon),김응수(Kim, Eung Soo) 경찰대학 경찰학연구편집위원회 2018 경찰학연구 Vol.18 No.4

범죄 사건은 정자세포에서 남성의 단일 DNA 프로필을 확보하는 것이 사건 해결 및 재판 결과에 중요한 영향을 미친다. Differential extraction의 효율은 정자 분획에서 상피세포의 DNA 양을 얼마나 줄이는지와 정자세포로부터 남성 DNA를 얼마나 회수 할 수 있는지에 달려있다. 정자 분리를 위한 Differential extraction 과정은 법생물학 분야에서 시간과 노력이 가장 많이 투입되는 과정이다. 이를 해결하기 위한 자동화 방법들이 개발되어 있지만, 과정 중에 정자세포가 손실되거나 많은 양의 상피세포의 DNA가 존재하여 결과에 영향을 미치는 등 자동화에 따른 단점이 있을 가능성이 있다. 본 연구에서는 Differential extraction 과정 중 원심분리작업을 효율화하기 위해, 자동화 시스템을 도입하지 않으면서도 일괄 처리 할 수 있는 방법을 연구하였다. 먼저 Eppendorf사의 대용량 원심분리기 5810을 사용하여 한 번에 취급할 수 있는 샘플의 수를 늘렸고, 또한 파이펫 작업을 효율적으로 수행하기 위해 팁 사이의 간격이 조절되는 멀티채널 파이펫을 사용하여, 파이펫 작업을 효율화하였다. 이때 다수의 샘플을 한 번에 취급할 때 발생하는 감정의 질 하락을 방지하기 위해, Differex™ system을 같이 사용함으로써 감정의 능률과 감정의 질을 같이 높일 수 있었다. 결론적으로 대용량 원심분리기와 멀티채널 파이펫 그리고 Differex™ system을 조합하여 사용함으로써, 노동력과 전체작업시간을 줄이면서 감정 결과의 질은 오히려 좋아지는 결과를 얻을 수 있었다. It is very important to get the single profile from the male offender’s sperm cells for the verdict of courts in the sexual crimes. The efficiency of differential extraction is depend on the ratio of male sperm’s DNA vs female victim’s epithelial cell DNA. Differential extraction for the sperm cell separation is the most time consuming procedure in the forensic biology. There are many ways to automate that procedure, but there are also some possibilities of sperm cell loss and insufficient exclusion of epithelial cells. In this report, we have studied batch process method to facilitate the centrifuge process of differential extraction, even though not using automation. Eppendorf large scale centrifuge 5810 has been used to increase the sample handling capacity. And We have used adjustable spacer multichannel pipette to increase the throughput. In addition, we used Differex<SUP>TM</SUP> system to prevent dropping down of test quality when using the multichannel pipette. In conclusion, We have reduced the labour and hand-on time and enhanced the quality of result in sexual crime DNA analysis, by using large scale centrifuge, multichannel pipette and Differex<SUP>TM</SUP> system at the same time all together.

우측 부고환에 발생한 비호지킨성 악성림프종 1 예

김승정(Seung Jung Kim),심기남(Kee Nam Shim),오지영(Jee Young Oh),유승기(Sung Kee Ryu),이선영(Sun Young Yi),최진혁(Jin Hyuk Choi),이순남(Soon Nam Lee),박영요(Young Yo Park),심강섭(Kang Sup Shim),정운규(Woon Kyo Chung),조민선(Min Sun C 대한내과학회 1996 대한내과학회지 Vol.50 No.5

Involvement of the gonad by malignant lymphoma may be the primary extranodal disease, the initial manifestation of clinically occult nodal disease, or late complication of disseminated nodal lymphoma. Primary extra-nodal non-Hodgkin's lymphoma of epididymis is extremely rare. The prognosis of testicular or epididymal lymphoma is very poor due to rapid progression and systemic involvement. All patients with testicular or epididymal lymphoma should be treated with aggressive combination chemotherapy, with or without radiotherapy. In this report, we present a case of non-Hodgkin's lymphoma of the epididymis showing rapid systemic dissemination.

기상정보의 신뢰성을 높이기 위한 스마트폰 센서데이터의 분석

윤성호(Sung-Ho Yoon),김동원(Dong-Won Kim),오민선(Min-Sun Oh),남용욱(Yong-Wook Nam),김용혁(Yong-Hyuk Kim) 한국지능시스템학회 2015 한국지능시스템학회 학술발표 논문집 Vol.25 No.1

안내염과 대장암이 동반된 재발성 간농양

전승정,김태헌,류민선,오다연,송명은,이신아,류재인,김혜인,문일환,유권 이화여자대학교 의과학연구소 2011 EMJ (Ewha medical journal) Vol.34 No.2

The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.

중추성 요붕증의 감별진단에 있어서의 혈중 ADH의 중요성

이호종,양인명,민선기,노정현,박철영,오승준,김덕윤,우정택,김성운,김진우,김영설,최영길 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4

Background: Although the water restriction test (WRT) has been used as a standard test for the differential diagnosis of diabetes insipidus (DI), the measurement of plasma ADH concentration is also known to be useful method for differential diagnosis. Recent studies have shown that some patients with idiopathic central DI (CDI) were found to have a lesion on follow-up imaging studies. There have been no report in Korea on plasma ADH measurement for the differential diagnosis of DI, nor on follow-up imaging study of the idiopathic CDI. Methods: We retrospectively reviewed the clinical and laboratory findings of 26 patients (12 men, 14 women, age 9-65 years) with CDI, including pituitary MRI or CT scan, who had been diagnosed with WRT and had undergone plasma ADH concentration measurement. Results: 1) Clinical features of the patients with complete CDI did not differ from those of patients with partial CDI. 2) Maximal urine osmolality of complete CDI and partial CDI were 168±69 mOsm/㎏ and 431±141 mOsm/㎏, respectively, and the percentage increase in the urinary osmolality after ADH injection was 209±149% and 29±17%, respectively. 3) Among the 26 patients, 10 patients had their plasma ADH measured. Nine patients in this group were diagnosed as CDI by WRT and plasma ADH concentration of the 9 was compatible for CDI. The plasma ADH level was also inappropriately low in one patient who had been diagnosed with primary polydipsia by WRT, the patient was diagnosed as partial CDI. 4) The findings of follow-up MRI revealed isolated thickening of the pituitary stalk in two cases of idiopathic CDI diagnosed initially with MRI. Conclusion: This study suggests that the measurement of plasma ADH can ensure a better differential diagnosis between partial CDI and primary polydipsia, and that the patients with idiopathic CDI should be examined regularly with MRI brain scan, including the pituitary gland

Klebsiella 균혈증에 대한 임상적 고찰

이병욱,박병헌,오혜림,이호종,김수영,민선기,황유철,김경진,서환조 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.4

1988년 1월부터 1997년 12월까지 10년간 경희의료원에 입원했던 환자 중, 세균학적 검사로 확진된 157예의 Klebsiella 균혈증에 대한 임상적 관찰을 하여 다음과 같은 결과을 얻었다. 1) Klebsiella 균혈증의 발생빈도는 입원환자 1000명 3당, 0.79건이었다. 2) 성별로는 남자가 88(56%)명이었고, 여자가 69(44%)명이었으며, 연령별로는 신생아가 19명, 1세에서 39세 사이가 28명, 40세에서 59세 사이가 53명, 60세 이상은 57명이었고 평균 나이는 47.6세였다. 3) 분리빈도는 K. pneumoniae(146명 ; 94%), K. oxytoca(10명 ; 6.4%), K. ozaenae(1명 ; 0.6%)순이었고, 다균주가 배양된 경우는 8예(5.1%)에서 있었다. 4) 원외감염은 87명(55.4%)이었고, 원외감염은 70명(44.6%)이었다. 5) 원발병소는 비뇨기계(35명;22.3%), 간담도계(33명;21%), 호흡기계(27명;17.2%), 복막(6명;3.8%), 정막카데터(5명;3.2%), 기타(3명;1.9%) 순이었고, 원발병소가 밝혀지지 않은 경우는 48명(30.6%)이었다. 6) 기저질환으로는 당뇨병, 고형암, 뇌혈관질환, 담석증, 간경변, 미숙아, 혈액암, 알콜중독증, 만성신부전 등의 순으로 많았다. 7) 가장 흔한 임상양상은 발열(129명;82.2%)이었고, 백혈구 증다증은 117(74.5%)명에서 나타났으며, 범발성혈관내응고증, 패혈성쇽, 급성신부전은 각각 18.5%, 17.8%, 14.6%에서 나타났다. 8) 항균제 감수성 검사에서 β-lactam계열의 ampicillin, carbenicillin, cephlothin에는 각각 87.9%, 91.7%, 27.6%의 내성률을 나타냈고, aminoglycoside계통의 getamicin, tobramycin, kanamycin, amikacin에는 각각 22.3%, 22.9%, 17.4%, 1.3%의 내성률을 나타낸 반면, quinolone 계통의 ciprofloxacin과 ofloxacin에는 각각 3.6%, 0.9%의 내성을 보였으며 imipenem에 대해서는 모든 균주가 감수성을 보였다. 9) Klebsiella 균혈증의 사망률은 22.3%이었다. 10) 원발병소가 호흡기계와 복막인 경우, 부적절한 항균제 치료를 한 경우, 치료 도중 범발성혈관내응고증, 패혈성쇽, 급성신부전이 발생한 경우는 높은 사망률을 보였다. 11) 본 연구기간의 후반기에는 전반기보다 중증감염의 빈도가 많았다. 결론 : 이상의 결과에서 Klebsiella 균혈증은 신생아와 여러 가지 기저질환이 있는 성인환자에서 주로 발생하였고, 최근 들어 다약제 내성 균주의 급속한 출현에 의한 중증 감염이 증가하는 양상을 보이고 있으므로, 감수성 검사에 의한 적절한 항균제 선택이 환자의 치료 및 예후에 중요할 뿐만 아니라 내성 균주의 출현을 줄이는데 기여할 것이다. A clinical review on 158 patients with Klebsiella bacteremia among the patients who admitted to Kyunghee University Hospital from January 1988 to December 1997 was done. The incidence of Klebsiella bacteremia was 0.79 cases per 1000 admitted patients. The disease was community acquired in 55.4%. nosocomically acquired in 44.6%. 146 cases were caused by Klebsiella pneumoniae, 10 cases by Klebsiella oxytoca, one case by Klebsiella ozaenae, and 8 episodes were a part of a polymicrobial bacteremia. Portals of entry were urinary tract (22.3%), hepatobiliary tract (21%), pulmonary tract (17.2%), peritoneum (3.8%), intravenous tract (3.2%), and others (1.9%) in decreasing order of frequency. In 30.6% of patients, site of origin of the bacteremia could not be identified. Underlying diseases frequently encountered were diabetes, solid cancers, cerebrovascular accident and cholelithiasis. The most frequent clinical finding was fever (15 patients) , and the second was leukocytosis (117 patients). Disseminated intravascular coagulation septic shock and acute renal failure occurred in 18.5%. 17.8%. and 14.6% respectively. The isolated strains were resistant to ampicillin in 87.9% and to gentamicin in 22.3%, and all the isolates were sensitive imipenem. The overall mortality was 22.3%. THe higher mortality was shown in cases that patients received inappropriate antibiotic treatment, and disseminated intravascular coagulation, septic shock, and acute renal failure occurred during the disease courses, and portals of entry were pulmonary tract and peritoneum. In conclusion, Klebsiella bacteremia commonly occurred in neonates and adult patients with underlying diseases. Recently, the incidence of severe infections caused by multi-drug resistant strains is increasing. Appropriate antibiotic therapy is important in the prognosis and may reduce the appearance of resistant strains.

청소년에서 체형에 대한 만족도와 관련된 요인과 체중조절행태

최영인,유태우,강재헌,송홍지,박민선,오미숙,안성훈 대한가정의학회 1999 Korean Journal of Family Medicine Vol.20 No.4