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.

전치태반의 임상적 고찰

정갑인,이해혁,이효환,유정완,남계현,이임순,이권해 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Objective : Our purpose was to make preparations of what for proper emergency care and delivery in order to improve maternal and fetal well-being. Methods : The study was undertaken for the clinical evaluation and statistical analysis on the patients with placenta previa who had been admitted and delivered at Soonchunhyang University Hospital from January, 1994 to May, 1998, retrospectively. Results : The incidence of placenta previa was 2.0%. Placenta previa has occurred more often in multigravida(92%) than primigravida(8%). Vaginal bleeding was most frequent(37.3%) presentation. The mean gestational age at the first bleeding episode was 31~35 weeks(46.4%). The type of placenta previa was totalis (31.3%), Partialis(18%), marginalis(32.7%), low lying(18%). Conclusion . This study indicates that the obstetrician and the pediatrician should be prepared for emergency care and delivery of the placenta previa patients, with the improvement of delivery room and neonatal intensive care unit.

경도관 동맥색전술을 이용한 비정상 자궁출혈의 치료

양승부,최교창,이상진,정영진,임한혁,한효상,황인철,조환성 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Objective : Our purpose of this study is to evaluate the effectiveness of the transcatheter arterial embolization for the management of abnormal uterine bleeding. Materials and Methods : 14 patients with massive or recurrent uterine bleeding underwent percutaneous transcatheter arterial embolization between February 2003 and September 2004. We reviewed 14 cases of uterine artery or internal iliac artery embolization using gelfoam or PVA particles. Results : Good management of uterine bleeding was achieved in 13 of 14(93%) cases. The cause of abnormal uterine bleeding was myoma(5 case), post D & E bleeding(3), acquired vascular malformation(3), pseudoaneurysm(1), adenomyosis(1), and endometrial hyperplasia(1). Conclusion : Transcatheter artery embolization is an effective and life-saving procedure in massive or recurrent uterine bleeding. Early diagnosis and prompt transcatheter arterial embolization is a useful mangement of uterine bleeding.

만성특발성 변비 및 당뇨병성 변비 환자에 대한 대장통과시간의 비교 연구

노임환(Im Hwan Roe),정현채(Hyun Chae Jung),김성연(Sung Yun Kim),이효석(Hyo Suk Lee),윤용범(Yong Bum Yoon),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim),최병인(Byun In Choi) 대한내과학회 1990 대한내과학회지 Vol.39 No.5

N/A Measurement of colonic transit time with radiopaque markers is a simple and useful modality in evaluating canstipation. We calculated the segmental colonic transit time in healthy controls (n=34), chronic idiopathic constipated patients, and constipated patients with diabetic autonomic neuropathy (n=14), Total colonic transit time was 24.1±8.1 hrs for the healthy controls, 21.1±8.8 hrs for men, and 25.8±5.3 hrs in women. Also, the segmental transit time was 3.9±1.7 hrs for the right colon, 11.8±5.2 hrs for the left colon, and 8.5±5.5 hrs for the rectosigmoid. The mean colonic transit time did not differ significantly by age or sex. The proportion of the transit time in the right colon, left colon, and the rectosigmoid were 17.4%, 51.6%, and 32.4%, respectively. The chronic idiopathic constipated patients were 14 females, whose total and segmental transit times were delayed markedly; 74.2±40.9, 18.7±14.4, 33.4±51.6, and 22.1±15.7 hrs for the total colon, right colon, left colon, and rectosigmaid, respectively (p<0.001). These proportions showed no significant difference compared with the healthy controls: 24.0%, 50,5%, and 24.7% for the right colon, left colon, and rectosigmoid, respectively, In 14 cases with constipated diabetic autonomic neuropathy, the colonic transit time was also delayed: 55.1±16.8, 16.2±7.0, 17.0±8.8, and 22.0±11.7 hrs for the total colon, right colon, left colon, and rectosigmoid, respectively. These proportions showed a significant delay of transit time in the rectosigmoid: 29.9%, 31.0%, and 41.2% in the right colon, left colon, and rectosigmoid, respectively, p<0.05, Also, in the non-constipated patients with diabetic autonomic neuropathy, the proportion of colonic transit in the rectosigmoid was as high as 46.6%, even though the transit time was not delayed compared with the healthy controls. It was remarkable that transit in the rectosigmoid was prolonged in the diabetic autonomic neuropathy.

Alterations of Colonic Contractility in an Interleukin-10 Knockout Mouse Model of Inflammatory Bowel Disease

( Jae Hyung Park ),( Joong Goo Kwon ),( Sun Joo Kim ),( Dae Kyu Song ),( Seok Guen Lee ),( Eun Soo Kim ),( Kwang Bum Cho ),( Byung Ik Jang ),( Dae Hwan Kim ),( Jeong Im Sin ),( Tae Wan Kim ),( In Hwan 대한소화기기능성질환·운동학회 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.1

Background/Aims Inflammatory bowel disease is commonly accompanied by colonic dysmotility and causes changes in intestinal smooth muscle contractility. In this study, colonic smooth muscle contractility in a chronic inflammatory condition was investigated using smooth muscle tissues prepared from interleukin-10 knockout (IL-10./.) mice. Methods Prepared smooth muscle sections were placed in an organ bath system. Cholinergic and nitrergic neuronal responses were observed using carbachol and electrical field stimulation with L-NG-nitroarginine methyl ester (L-NAME). The expression of interstitial cells of Cajal (ICC) networks, muscarinic receptors, neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) was observed via immunofluorescent staining. Results The spontaneous contractility and expression of ICC networks in the proximal and distal colon was significantly decreased in IL-10./. mice compared to IL-10+/+ mice. The contractility in response to carbachol was significantly decreased in the proximal colon of IL-10./. mice compared to IL-10+/+ mice, but no significant difference was found in the distal colon. In addition, the expression of muscarinic receptor type 2 was reduced in the proximal colon of IL-10./. mice. The nictric oxide-mediated relaxation after electrical field stimulation was significantly decreased in the proximal and distal colon of IL-10./. mice. In inflamed colon, the expression of nNOS decreased, whereas the expression of iNOS increased.Conclusions These results suggest that damage to the ICC network and NOS system in the proximal and distal colon, as well as damage to the smooth muscle cholinergic receptor in the proximal colon may play an important role in the dysmotility of the inflamed colon.

Anatomic Localization of Motor Points for the Neuromuscular Blockade of Hand Intrinsic Muscles Involved in Thumb-in-Palm

Im, Sun,Han, Seung Ho,Choi, Jin Hwan,Lee, Je Hoon,Ko, Young Jin,Lee, Jong In,Kim, Hye Won Lippincott Williams Wilkins, Inc. 2008 AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITA Vol.87 No.9

Im S, Han SH, Choi JH, Lee JH, Ko YJ, Lee JI, Kim HW: Anatomic localization of motor points for the neuromuscular blockade of hand intrinsic muscles involved in thumb-in-palm. Am J Phys Med Rehabil 2008;87:703–709. OBJECTIVE:: To determine the location of the motor points and intramuscular branches for the muscles involved in thumb-in-palm and the abductor pollicis brevis muscle, the latter of which, because of its anatomic proximity, may be inadvertently blocked. DESIGN:: Hand intrinsic muscles from 20 fresh cadavers were dissected. The point of nerve entry to the muscle belly and the points where the intramuscular endings were located most proximally and distally were defined in relation to a reference line connecting the hook of hamate and the head of the first metacarpal bone. RESULTS:: We were able to define a region, located from 66.08% ± 8.67% to 70.28% ± 10.62% of the reference line, with the hook of hamate as starting point, where intramuscular endings for the thumb-in-palm muscles were dense and farther from the intramuscular endings for the abductor pollicis brevis. The region around 40% of the reference line was the point where the intramuscular endings were most dense for the abductor pollicis brevis. CONCLUSION:: The results may provide guidelines that could help in localizing the appropriate points for the neuromuscular blockade of thumb-in-palm muscles and, at the same time, help in minimizing the inadvertent block of the abductor pollicis brevis.

미세단백뇨를 보인 인슐린비의존성 당뇨병환자에서 혈압 및 맥박의 일중변동의 변화

김승준(Seung Jun Kim),배원엽(Won Yeop Bae),임석환(Seok Hwan Lim),이윤호(Yun Ho Lee),전인표(In Pyo Jeon),김순호(Sun Ho Kim),조상기(Sang Kee Cho),임중규(Joong Kyu Im),허진득(Jin Deuk Hur) 대한내과학회 1997 대한내과학회지 Vol.52 No.3

Objectives: In diabetics the disturbance of circardian variation of blood pressure and heart rate has been supposed to be related to diabetic autonomic neuropathy and diabetic nephropathy. We performed this study to evaluate the circardian variation of blood pressure and heart rate and the difference of affecting factors between normoalbuminuric patients and microalbuminuric patients. Methods: We studied 50normotensive NIDDM patients without overt nephropathy, divided two grooups, which are normoalbuminuric patients(D1 group) and microalhuminuric patients(D2 group), according to the urinary albumine excretion rate(AER) on 24-h urine collection. We simultaneosly measured 24-hour blood pressure and heart rate by using of ambulatory 24-hour blood pressure monitoring (ABPM). Results: 1) In group Kb, 24-h systolic and diastolic blood pressure were significantly higher than in C(normal control group) and D1 2) 24-h heart rate values did not significantly differ between the groups, but night heart was significantly elevated in group D2 than C and D1. 3) The night/day ratio of SBP(systolic blood pressure) and HR(heart rate) was significantly higher in D2 than C and D1, but the night/day ratio of DBP(diastolic blood pressure) was significantly higher in D2 compaired with C only. 4) The night/day ratio of SBP correlated significantly with duration of diabetes, log of AER, HDL, HbAlc and 24-h DBP. The determinants selected in a multiple stepwise regression were duration of diabetes and HbAlc. 5) The night/day ratio of DBP was related to duration of diabetes, log of AER, 24-h DBP and night HR. The determinants selected in a multiple stepwise regression were duration of diabetes and 24-h DBP. 6) The night/day ratio of HB was related to neuropathy, 1/creatinine, HDL, night SBP, duration of diabetes and log of AER. The determinants selected in a multiple stepwise regression were neruopathy and night SBP. Conclusion: In this study, the normal circardian variation of blood pressure was disturbed in a group of micoralbuminuric patients. But it seems that AER was not a principle independent factor and circardian variation of blood pressure and heart rate were affected by different several factors identified in this study. The nocturnal heart rate was significantly elevated in microalbuminuric group, suggesting the possibility of the presence of parasympathetic neuropathy which is supposed to be related with sudden cardiac death. So it is thought that blunted circardian variation of blood pressure and heart rate can be a prognostic indicator and further prospective study is necessary.

위장관 폴립 치료에서의 전기소작절제술과 레이저조사술의 비교연구

송인성,이진호,김해련,노임환,유권,정현채,이효석,윤용범,김종룡 대한내과학회 1990 대한내과학회지 Vol.38 No.1

The gastrointestinal polyp is a premalignat lesion in varying degrees, according to the size, the pathology and the location of polyps. Polyps in the gastrointestinal tract can be removed by surgical excision, electrosurgery, cryotherapy, contact radiotherapy and laser therapy with each some limitations. We compared the effectiveness and the safety of electrosurgical polypectomy and laser irradiation conomonly used for polyp removal. The patients were diagnosed as having gastrointestinal polyps endoscopically and benign polyps pathologically with endoscopic biopsy(n= 143) from January in 1984 to April 1989. Then, the results were as followes by grouping gasting polyps(n=74) and colorectal polyps(n=69). 1) The mean age of patients were 54 years in gastric polyps group and 52 years in colorectal polyps group. The gastric polyps were more frequent in woment but colorectal polyps in men of men: women ratio, 1:1.5 and 2.3:1 respectively. 2) Epigastric discomfort were the most frequent symptoms in gastric polyp patients and anal bleeding in colorectal polyp patients(32%, 31%). 3) The gastric polyps were located in pyloric antrum most frequently(53%), and colorectal polyps in rectum ,and sigmoid colon(37%, 35%). 4) The gatric polyps were even in gross type of polyps, but the colorectal polyps were frequent of Yamada type Ⅳ(42%). The most gastric polyps were hyperplastic type in histological typs(75%), but the most colorectal polyps adenomatous type(72%), containing frequent villous component(16%). 5) The malignant foci were found in a case of gastric electrically polypectomized specimen(6.3%) and in 2 cases of colorectal electrically polypectomizd specimen(6.9%). 6) The mean size of polyps wer 0.95% cm in gastric polyps and 1.09 cm in colorectal polyps (p>0.05). 7) The effectiveness of each methods were assessed by session number of treatment. All electrosurgical polypectomy were completed in 2 sessions. But, laser therapy were extended over 3 sessions in 25% of cases. 8) The safety of each methods were assessed by the frequency of complications, such as ulcer and erosion of minor complications and massive bleeding requiring transfusion and bowel perforation of major complication. Ulcer and erosion developed in 24% and 6% of electrosurgical polypectomy patients and in 52% and 15% of laser therapy patients(p<0.05). One case of the massive bleeding and 2 cases of bowel perforation developed in electrosurgically polypectomized patients. But no case of major complications developed in laser irradiated patients. So, the electrosurgical polypectomy was more effective but laser therapy was safter than electrosurgical therapy. We recommended that the electrosurgical polypectomy be tried initially, especially in Yamada type Ⅳ polyps, and laser therapy in other cases including inoperable malignant polyps.

한국인에서 Helicobacter pylori 감염의 진단에 있어 Genedia™ H . pylori ELISA 검사의 진단 정확도

정인식(In Sik Chung),김상우(Sang Woo Kim),고재성(Jae Sung Go),김나영(Na Young Kim),김재규(Jae Gyu Kim),김진호(Jin Ho Kim),김학양(Hak Yang Kim),김재준(Jae Jun Kim),노임환(Im Hwan Roe),심재건(Jae Geon Sim),안형식(Hyeong Sik Ahn),윤병철(By 대한내과학회 2001 대한내과학회지 Vol.61 No.1

Background: Genedia™ H. pylori ELISA is a newly developed diagnostic method which detects serum anti-H. pylori IgG antibody. The aim of this study was to assess the accuracy of Genedia™ H. pylori ELISA for the diagnosis of H. pylori infection in Korean population. Methods Genedia : H. pylori ELISA and GAP-IgG were performed in 353 adult sera and Pyloriset-IgG EIA in 184 subjects. In children, 43 serum samples were tested with Genedia™ H. pylori ELISA. H, pylori infection was determined by rapid urease test, histology, culture or (13)C-urea breath test in adults. In children, the subject was considered to he H. pylori positive if (13)C-urea breath test was positive. Results: In adults, the sensitivity and specificity of Genedia™ H. pylori ELISA were 93.2% and 83.5% with positive and negative predictive values of 85.1% and 92.5%. Those for GAP-IgG and Pyloriset-IgG EIA were 67.2%, 82.4%, 79.3%, 71.4% and 89.1%, 88.4%, 71.9%, 96.1%, respectively. In children, sensitivity, specificity, positive and negative predictive values of Genedia™ H. pylori ELISA were 80%, 84.8%, 61.5%, and 93.3%. Sensitivity and negative predictive value of Genedia™ H. pylori ELISA were significantly higher than those of GAP-IgG (93.2% vs. 67.2%, p<0.005 and 92.5% vs 71.4%, p<0.005, respectively). Conclusion : Genedia™ H pylori ELISA is a relatively accurate method for the serodiagnosis of H pylori infection in Korean subjects compared to GAP-IgG. These results may suggest the clinical use of Genedia™ H. pylori ELISA for epidemiological studies of H. pylori infection in Korea. (Korean J Med 61:17-23, 2001)

위십이지장질환에서 Helicobacter Pylori 의 DNA Variation 에 관한 연구

노임환(Im Hwan Roe),김창인(Chang In Kim),하동렬(Dong Ryul Ha),진영주(Young Joo Jin),송일한(Il Han Song),임창영(Chang Young Lim),김정원(Jung Won Kim),김정택(Jung Taik Kim),이종화(Jong Hwa Kim),염정선(Jung Sun Yeom) 대한내과학회 1997 대한내과학회지 Vol.53 No.4

Background: The evidence for H. pylori as a gastrointestnal pathogen is now very strong, if not overwhelming. Among the pathogenic factors of H. pylori, flagella and urease are considered to be major factors causing the gastrododenal disease. We observed the gene diversity of H. pylori using the PCR-amplified 1.4Kb fla A gene and 0.9Kb ure B gene and examined the relationship between the gene pattern and the gastroduodenal disease. Method: Fifty-one cases of isolated strains were cultured at the Helicobacter-selective blood agar plates. To compare the gene diversity among the isolates of gastroduodenal disease genotypes was analyzed by PCR-based RFLP. 1.4Kb fla A gene and 0.9Kb ure B genes from isolates were amplified by PCR and digested with Hae 3 restriction enzymes to observe the restriction fragment length polymophysm. Protein patterns were also compared to examine the antigenic variations. Total cell proteins, and octyl-glucose extracts from isolates were analyzed by SDS-PAGE gel electrophoresis. Results: 41 cases (80.4%) of H. pylori were isolated in the 51 cases of gastroduodenal diseases. We could classify theses isolates 3 types of PCR-RFLP in the fla A gene, 900+500bp, 500+500+400bp, 600+800bp, and 9 types in the ure B gene. PCR-RFLP in the fla A gene and ure B gene of the isolates was different from the standard strain of Australia and the genetic diversity was not related to the types of the gastroduodenal disease. We demonstrated variations in the protein pattern and antigenic profiles among the isolates by SDS-PAGE analysis. These data also did not show any relationship between protein pattern and types of gastroduodenal diseases. Conclusion: Tese studies showed many different gene diversity in the flagella and urease gene without any relationship with the types of gastoduodenal disease. And variable protein pattern were noted among the strains of H. pylori. Further studies to demonstrate the pathgenecity of H. pylori should be continued even if there was no relationship between the genomic diversity of the flagella or urease and the types of gastroduodenal disease.