수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

지하철역과의 거리와 건물의 가치, 그리고 보행상권 : 종로구와 중구의 비주거용 건물을 중심으로

정은상(Jung, Eun-Sang),김준형(Kim, Jun-Hyung) 대한국토·도시계획학회 2020 國土計劃 Vol.55 No.3

The general view is that the more accessible a subway station, the higher the value of the building. However, the existing empirical analyses indicate that the relationship between distance to the subway station and building value is not consistently negative. Therefore, this study carries out various analyses based on the hypothesis that the price of the building is affected by the presence of a pedestrian commercial area and the width of the road. According to a survey of 746 non-residential buildings located in Jongno-gu and Jung-gu (in Seoul), this study finds that the closer the subway station, the higher the price of the building. However, buildings located in a pedestrian area showed a positive relationship between distance from the subway station and price of the building. Based on the results, we can infer that the assumption that a building is worth more when it is closer to a subway station cannot be generalized for all regions. In some areas, less accessible but walkable environments should be welcomed in light of the value of buildings and districts.

A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

노인 인구에서 신경인지기능저하와 혈청 지질농도와의 상관성

유영선,최석주,정성수,김지은,윤성욱,전동욱,백준형,박성우,이정구,추일한,김영훈 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.6

Objectives : In this study, the authors evaluated the correlation between eurocognitive impairments and serum lipids levels among Korean elderly over the age of 65. Methods : A total of 609 elderly individuals participated in this study. Screening for cognitive impairments were carried out using the Mini-Mental Status Examination-Korean version (MMSE-KC). There were 197 subjects above 1.5SD Of MMSE- KC and they were evaluated using the Korean versions of the Consortium to Establish a Registry for Alzheimer's Disease (AD) (CERAD-KC) and Geriatric Depression Scale (GDS-K). Results : There was a correlation between old age/low levels of education and AD (p<0.05, P<0.01). There was an inverse correlation between the serum level of total cholesterol and the word list recognition test scores. The serum levels of LDL cholesterol were inversely correlated with the scores on the constructional praxis test, word list recall test and word list recognition test. Inverse correlations between the serum level of triglyceride and scores on the word list recall test and word list recognition test were also observed. Conclusion : There were inverse correlations between the serum levels of lipids and language/memory function in subjects with AD.

스코폴라민의 흰쥐 피부투과에 대한 투과촉진제들의 영향

정재영,감성훈,김건남,지상철,박은석 한국약제학회 2003 Journal of Pharmaceutical Investigation Vol.33 No.2

The transdermal therapeutic system (TTS) of scopolamine has various advantages over its oral dosage forms. The ideal scopolamine TTS requires high skin permeation rate in short time after it is applied on the skin. In order to increase the initial skin permeation rate of scopolamine from TTS, various permeation enhancers were employed. Enhancers employed were fatty acids(oleic and linolenic acids), cyclic monoterpenes(menthol, camphor, cineole and limonene) and others(isopropyl myristate, sodium lauryl sulfate and glyceryl monostearate). The concentration of enhancers in the base were fixed to 5% (w/w). While fatty acids had little enhancing effect on the skin permeation of scopolamine, cyclic monoterpenes, isopropyl myristate and sodium lauryl sulfate resulted in 1.5∼2.36-fold higher skin permeation rate of the drug compared to the control. However, lag time was not affected by enhancers studied.

방향족 화합물의 생물학적 변환이 인체에 미치는 영향

정은상 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

The three fluidized bed techniques have some common features and process variables, but each has unique advantages and limitations, Criteria such as economics, product and process variables, and desired product performance affect the selection of the process from the laboratory scale to commercialization.

축구선수의 Detraining과 Retraining이 혈청지질 및 호르몬농도에 미치는 영향

정정화,박재현,채종훈,성혜련,황지인,윤미숙,노금선,윤종관,윤영학,노순덕,정경숙,박일규,김은희,박현태,박상갑 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate the effects of detraining and retraining on serum lipid and hormones in soccer players. Subjects were seven male high-school soccer players. V˙O_2max was determined for each subjects by administering a treadmill test(initial speed: 90m/min, grade: 5%, increasing speed per 3 min: 30m/min). Serum lipid(T-C, TG, HDL-C LDL-C) and hormones(epinephrine, norepinephrine, growth hormones, cortisol) were assayed pre and post detraining in 10, 20, 30 days after retraining. The repeated ANOVA was used to determine significant differences. The 0.05 level of significance was as critical level for the study. The results of the study were as follows: 1. V˙O_2max(ml/min) were 3576.3±204.2ml/min pre detraining, 3234.1±198.9 ml/min post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/min) were 3601.4±170.9 ml/min. There were significantly(p<.05) increased in retraining periods. 2. V˙O_2max(ml/kg/min) were significantly(p<.05) decreased from 62.3±2.9 ml/kg/min to 55.9±4.7 ml/kg/min in detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/kg/min) were 62.4±3.4ml/kg/min, 62.7±2.3ml.kg/min, 67.3±7.2ml/kg/min respectively. There were significantly(p<.05) increased in retraining periods. 3. T-C were significantly (p<.05) increased from 166.6±8.5mg/dl to 175.3±10.3 mg/dl in detraining. In 10, 20, 30 days after retraining, T-C were 160.1± 3.2mg/dl, 156.7±3.7mg/dl, 140.3±9.0mg/dl. There were significantly(p<.05) decreased in retraining periods. 4. HDL-C were 61.4±6.6mg/di pre detraining, 5.3±6.6mg/dl post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, HDL-C were 56.9±7.1mg/dl, 56.4±9.2mg/dl, 57.7±9.1mg/dl respectively. There were no significant difference in retraining periods. 5. The hormones(epinephrine. norepinephrine, growth hormone, cortisol) were changed as same patterns. Epinephrine were 26.0±7.0[g/ml pre detraining, 24.6±3.2pg/ml post detraining. In 10, 20, 30 days after retraining, epinephrine were 26.9±5.6pg/ml, 30.6±6.2pg/ml, 29.4±5.6pg/ml respectively. There were no significant difference in retraining periods. In conclusion, HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were decreased, T-C, LDL-C and TG were increased in detraining. But HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were increased, T-C, LDL-C and TG were decreased in retraining.

저용량 Cyclosporine-A와 Diltiazem 병합요법에 의한 신증후군의 관해

김성은,정연순,임학 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Background : Cyclosporine-A (CsA) has been widely used as a treatment of nephrotic syndrome especially in patients with steroid-resistance or steroid-dependence. However, it can be nephrotoxic and its cost might also be a point to be considered. Diltiazem (DZ), one of calcium channel blockers, may have a potential benefit of renoprotection, which decreases acute tubular necrosis of renal transplants. DZ can also be used for reducing CsA dose because it slows down the metabolism of CsA by inhibition of cytochrome P-450 hepatic enzyme. In these points of view, low-dose CsA with DZ combination could be considered as an alternative to nephrotic syndrome treatment. However, such a kind of trial was hardly found so far. The purpose of this study was to evaluate the therapeutic effect of low-dose CsA with DZ in patients with steroid-resistant or steroid-dependent nephrotic syndrome. Methods : Low-dose of CsA (mean 1.7±0.5 mg/kg) and 90 mg of DZ were administered simultaneously to 15 patients of steroid-resistant or steroid-dependent nephrotic syndrome for 6 months with no alteration of dose. Blood pressure, body weight and random urine protein, 24-hour urine protein, serum creatinine, albumin, total cholesterol, and trough level of CsA were analyzed. Results : The random urine protein tended to decrease by CsA treatment. Twenty-four hour urine protein excretion decreased significantly at 6th months of treatment (from 7,211±5,374 mg to 1,094±1,688 mg, n=7, p=0.018). Complete remission was achieved in 10 patients and partial remission in 5 patients. Changes in serum albumin, total cholesterol, hemoglobin, body weight and blood pressure were statistically not significant. Conclusion : Low-dose CsA combined with DZ may be an effective in patients with steroid-resistant or steroid-dependent nephrotic syndrome.