정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

중환자실 전문간호사의 전문간호행위 분류와 수행분석

김진현,김명애,김미원,김경숙,유정숙,이은희 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.

Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 as biomarkers of patients with established acute kidney injury

( Won Yong Cho ),( Sung Yoon Lim ),( Ji Hyun Yang ),( Se Won Oh ),( Myung-gyu Kim ),( Sang-kyung Jo ) 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.3

Background/Aims: Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been recently discovered and validated as sensitive biomarkers that can predict stage 2 or 3 acute kidney injury (AKI) development in high-risk patients. We aimed to assess whether these biomarkers could predict adverse outcomes and renal recovery in established AKI patients. Methods: This was a single-center study prospectively enrolling 124 patients diagnosed with AKI. TIMP-2, IGFBP7, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule 1 (KIM-1) levels were measured at the time of diagnosis and the predictive performance of short-term outcomes and renal recovery was assessed. Results: Patients were divided into 4 quartiles according to the initial urinary TIMP-2/IGFBP7 levels. Stage 3 AKI (odds ratio [OR], 17.86), classified by the Kidney Disease Improving Global Outcomes (KDIGO), as well as the third and fourth quartiles of TIMP-2/IGFBP7 (OR, 5.75 and 44.98, respectively), were found to be independent predictors of renal replacement therapy at the time of AKI diagnosis. In addition, KDIGO stage 3 AKI (OR, 2.468) or the third of fourth quartiles of urinary TIMP-2/IGFBP7 (OR, 1.896 and 3.622, respectively) were also found to be useful in predicting nonrecovery of renal function. In a separate analysis of patients with renal recovery at discharge, initial urinary TIMP-2/IGFBP7 or urinary IGFBP7 at discharge could also predict new-onset or progressive chronic kidney disease (CKD). Conclusions: In AKI patients, urine TIMP-2/IGFBP7 could serve as a biomarker for predicting adverse outcomes, renal recovery, or the development and progression of CKD.

性別 및 年齡에 따른 體格과 體力의 特性과 變化에 關한 縱斷的 硏究Ⅱ : Emphasised on College Men of Department of Physical Education 體育專功 大學生을 中心으로

金尙國,姜東洹,張周鎬,金昇一,徐再均,金耕知,孫斗玉,鮮于攝,崔榮烈,尹宇相,金亨燉,方永鎭,朴英震,柳在忠 慶熙大學校 體育科學大學 1989 體育科學論叢 Vol.- No.2

The purpose of this study was to compare the characteristics, change in physique and physical function of college students majoring physical education and Taekwondo (454 males and 64 females of age groups ranging from 18 to 26). The results are as following: 1. The male group of 23yrs old in physical education showed highest values in 7 items(Weight, Chest Girth, Fore Arm Girth, Thigh Girth, Calf Girth, Scapular Skinfold Thickness and Suprailiac Skinfold Thickness). 2. In the Physical function, the male group of 18yrs old showed highest values in Power, Flexibility, and then 21yrs old at Back Strength, Vital Capacity, and 23yrs old at Grip Strength, and 25yrs old at Blood Pressure, respectively. 3. In the physique, the male group of 22yrs old showed highest values in Weight, Chest Girth, Thigh Girth, Calf Girth, and then 24yrs old Upper Arm Girth, Fore Arm Girth, and 19yrs old at Height, Upper Limb Length, respectively. 4. In Physical Function, the 22yrs old showed highest values in Back Strength, Vital Capacity, and then 23yrs old at Side Step, Trunk Extension, but 18yrs old showed lower Values in Grip Strength, Side Step, Vital Capacity and Blood Pressure. 5. The female group of 22yrs old showed highest values in 8 items(Height, Sitting Height, Waist Girth, Upper Limb Length, Lower Limb Length, Skinfold Thickness), and then 18yrs old at 5 items (Weight, Upper Arm Girth, Fore Arm Girth, Thigh Girth, Calf Girth), respectively. 6. In the physical function, the 22yrs old showed highest Values in Grip strength, Back Strength, Power, 5 Minute Run, and 18yrs old at flexibility, Harvard Step Test, respectively. 7. In the change of the physique for two years(1988-1989) in the male group, majoring Physical education the 22yrs old showed increase in 4 items, and the 20yrs old in 3 items, but 18yrs old showed decrease in 3 items. 8. In the change of the physical function for two years in the male group, the 20yrs old showed increase in 4 items, and the 21, 25, 26yrs old in 3 items, but the 19yrs old showed decrease in 6 items, and 18, 22 yrs old in 5 items, respectively. 9. The change of the physique for two years in all female group, of 18, 19, 20, 21yrs old showed increase in 11 items except Skinfold Thickness. 10. In the change of physical function for two years in female group, the 18yrs old showed increase in 3 items, and then 20yrs old in 5 items, but 19, 22yrs old decreased 12 items, respectively. 11. The highest significant difference in physique between male and female was found in weight(mean Value 17.5%), and the lowest difference was found Thigh Girth, Calf Girth(1,3%), Upper Limb Length, Lower Limb Length(2.5%). 12. The Highest difference in physical function was Strength (mean Value 40%), Vital Capacity (33%), Power(22%), but Lower Trunk Flexion, Foot Balance(3.4%). 13. In the difference of Physique and physical function between physical education major and taekwondo major, the physical education showed higher values in skinfold Thickines (mean Value 16.5%), Weight, Waist Girth(4.7%) and Strength(33%), Endurance(5.6%), but subjects majoring Taekwondo showed higher values in Flexibility and Foot Balance. 14. In all male groups, Waist Girth, Scapular Skinfold Thickness, Back Strength, Sargent Jump, Trunk Extension and Diastolic Blood Pressure were showed a significantly related at 0.001 level.

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%

제 1형 신경섬유종증 환자에서 발생한 위장관 간질종양 1예

원경준,이준,변유미,조민근,한경택,김원,홍란,임성철,김경종,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract, but this tumor is rarely seen in association with type l neurofibromatosis (NFl) Generally, the majority of GISTs are isolated neoplasm and they are sporadically found in the stomach, but the GISTs in NFl patients are usually multiple and usually found in the small intestine. We report a case of multiple GISTs in the jejunum of a 63-year-old woman diagnosed as NFl accompanied by complication of gastrointestinal bleeding, In this case, Patient had multiple cafe-au lait spots and neurofibroma on skin and had freckling on axilla and groin, and then, we made a diagnosis of NFl. Gastrointestinal bleeding is controlled by resection of multiple GISTs. Generally, only 3-5% of all gastrointestinal bleeding comes from the small bowel. Causes of small intestinal bleeding are angiodysplasia, neoplasm, NSAIDs induced ulcer etc. but, If patients have NFl accompanied by complication of gastrointestinal bleeding, GISTs on small bowel must be considered.

중증 허혈성 지체질환 환자에서 시행된 vascular endothelial growth factor의 혈관신생 유전자치료 1예

김현중,장신이,김종묵,김선영,김병문,김원배,김덕경 대한내과학회 2003 대한내과학회지 Vol.64 No.1

저자 등은 기존의 치료에 반응하지 않은 중증 허혈성 지체질환 환자를 대상으로 하여 vascular endothelial growth factor를 이용한 혈관신생 유전자 치료를 시행하였다. 치료 후 환자의 허혈에 의한 하지 통증이 현격하게 감소하고 상처의 진행이 측부혈관이 많이 증가됨이 관찰되어 이에 문헌고찰과 함께 보고하는 바이다. We report VEGF-induced angiogenic gene therapy in a patient with critical limb ischemia, who did not respond to conventional treatment. This patient was the first case in a dose-escalating series of phase I clinical trial. The patient had severe resting pain, gangrene and diffuse ulcer in his left foot. Total 1,000㎍ of naked DNA encoding human VEGF165 was administered intramuscularly to 8 sites of the loft lower extremity. Four weeks after the first 1,000㎛ was administered to the same sites (total dose: 2,000㎛). After gene therapy, resting pain gradually reduced and the amount of analgesics taken by the patient decreased. The ischemic wound of lower extremity slightly improved. However, there was no complete wound healing at 12 weeks of treatment. Digital subtraction angiography at 12 weeks after gene therapy showed an increase in collateral vessels at the mid-tibial, ankle and foot arch levels. Immediately and up to 12 weeks, there was no complication related to gene therapy. These findings may be cautiously interpreted to indicate that intramuscular injection of naked plasmid DNA of VEGF_165 may induce therapeutic angiogencsis in a patient with critical limb ischemia. Further clinical evaluation of VEGF-induced gene therapy is needed to evaluate the safety and efficiency of this treatment.(Korean J Med 64:85-90, 2003)

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

Angiotensin Concerting Enzyme 유전자의 유전적 다형성(Genetic Polymorphism)이 관상동맥 질환 위험인자에 따른 혈중 Plasminogen Activator Inhibitor-1의 농도에 미치는 영향

김덕경,김종원,권현절,류재춘,박승우,김준수,이상훈,홍경표,박정의,이원로 대한고혈압학회 1996 대한고혈압학회지 Vol.2 No.2