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T : 목차정보

Journal of Korean medical science : JKMS 33건

  1. [국내논문]   Vancomycin-resistant Enterococcal Bacteremia in a Hematology Unit: Molecular Epidemiology and Analysis of Clinical Course  

    Yoo, Jin-Hong (Department of Internal Medicine, The Catholic Haematopoietic Stem Cell Transplantion Center, The Catholic University of Korea, College of Medicine, Seoul, Korea. ) , Lee, Dong-Gun (Department of Internal Medicine, The Catholic Haematopoietic Stem Cell Transplantion Center, The Catholic University of Korea, College of Medicine, Seoul, Korea. ) , Choi, Su Mi (Department of Internal Medicine, The Catholic Haematopoietic Stem Cell Transplantion Center, The Catholic University of Korea, College of Medicine, Seoul, Korea. ) , Choi, Jung-Hyun (Department of Internal Medicine, The Catholic Haematopoietic Stem Cell Transplantion Center, The Catholic University of Korea, College of Medicine, Seoul, Korea. ) , Shin, Wan-Shik (Department of Internal Medicine, The Catholic Haematopoietic Stem Cell Transplantion Center, The Catholic University of Korea, College of Medicine, Seoul, Korea. ) , Kim, Myungshin (Department of Internal Medicine, The Catholic Haematopoietic Stem Cell Transplantion Center, The Catholic University of Korea, College of Medicine, Seoul, Korea. ) , Yong, Dongeun (Department of La) , Lee, Kyungwon , Min, Woo-Sung , Kim, Chun-Choo
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 169 - 176 , 2005 , 1011-8934 ,

    초록

    An increase in vancomycin-resistant enterococcal (VRE) bacteremia in hemato-oncological patients (n=19) in our institution from 2000 through 2001 led us to analyze the molecular epidemiologic patterns and clinical features unique to our cases. The pulsed field gel electrophoresis of the isolates revealed that the bacteremia was not originated from a single clone but rather showed endemic pattern of diverse clones with small clusters. A different DNA pattern of blood and stool isolates from one patient suggested exogenous rather than endogenous route of infection. Enterococcus faecium carrying vanA gene was the causative pathogen in all cases. Patients with VRE bacteremia showed similar clinical courses compared with those with vancomycin-susceptible enterococcal (VSE) bacteremia. Vancomycin resistance did not seem to be a poor prognostic factor because of similar mortality (5/8, 62.5%) noted in VSE bacteremia. Initial disease severity and neutropenic status may be major determinants of prognosis in patients with VRE bacteraemia.

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  2. [국내논문]   The Efficacy of Clinical Strategies to Reduce Nosocomial Sepsis in Extremely Low Birth Weight Infants  

    Hwang, Jong Hee (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Choi, Chang Won (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Chang, Yun Sil (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Choe, Yon Ho (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Park, Won Soon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Shin, Son Moon (Department of Pediatrics, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Lee, Munhyang (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Lee, Sang Il (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 177 - 181 , 2005 , 1011-8934 ,

    초록

    The aim of this study was to evaluate the efficacy of clinical strategies to reduce nosocomial sepsis (NS) in extremely low birth weight infants (ELBWI) less than 1,000 g. Data from the period before (P1, 1995-2000) and after (P2, 2001-2002) implementation of the strategies were collected and analyzed. The intervention strategies included restriction of antibiotic therapy, less use of invasive procedures such as umbilical vessel catheterization and endotracheal intubation, establishment of guidelines for hand-washing, infant handling, and central intravascular line management. NS was defined as positive blood cultures in symptomatic patients after the third day of life with the use of antibiotics for more than 5 days. Although the gestational age (GA) and birth weight (BW) were significantly lower in P2 (GA 26.7±2.1 wk; BW 796±130 g) compared to P1 (GA 27.2±1.6 wk; BW 857±121 g), the incidence of NS decreased significantly from 70% (69/99) in P1 to 17% (24/71) in P2 with the implementation of the intervention strategies. The coagulase negative Staphylococcus infection was also significantly reduced from 34% in P1 to 11% in P2. The implementation of the clinical strategies was quite effective in reducing the incidence of NS in ELBWI.

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  3. [국내논문]   Low Birth Weight, Very Low Birth Weight Rates and Gestational Age-Specific Birth Weight Distribution of Korean Newborn Infants  

    Shin, Son-Moon (Department of Pediatrics, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Chang, Young-Pyo (Department of Pediatrics, Colleges of Medicine, Dankook University, Cheonan, Korea. ) , Lee, Eun-Sil (Department of Pediatrics, Yeungnam University, Daegu, Korea. ) , Lee, Young-Ah (Department of Pediatrics, Dong-A University, Busan, Korea. ) , Son, Dong-Woo (Department of Pediatrics, Bombit Hospital, Pyungchon, Korea. ) , Kim, Min-Hee (Department of Pediatrics, Colleges of Medicine, Kunkook University, Seoul, Korea. ) , Choi, Young-Ryoon (Department of Pediatrics, Chunnam National University, Gwangju, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 182 - 187 , 2005 , 1011-8934 ,

    초록

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. The mean birth weight and GA of a crude population are 3,188±518 g and 38.7±2.1 weeks, respectively. The LBW and the VLBW rates are 7.2% and 1.4%, respectively. The preterm birth rate (less than 37 completed weeks of gestation) is 8.4% and the very preterm birth rate (less than 32 completed weeks of gestation) is 0.7%. The mean birth weights for female infants, multiple births, and births delivered by cesarean section were lower than those for male, singletons, and births delivered vaginally. The risk of delivering LBW or VLBW infant was higher for the teenagers and the older women (aged 35 yr and more). We have also obtained the percentile distribution of GA-specific birth weight in infants over 23 weeks of gestation.

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  4. [국내논문]   A Retrospective Cohort Study on Obesity and Hypertension Risk among Korean Adults  

    Lee, Sung-Hee (Department of Family Medicine, Seoul Paik Hospital, Inje University, Seoul, Korea. ) , Kim, Young-Sik (Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ) , Sunwoo, Sung (Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ) , Huh, Bong-Yul (Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 188 - 195 , 2005 , 1011-8934 ,

    초록

    A retrospective cohort of adult Korean males and females was conducted to evaluate the influence of obesity on the development of hypertension and to determine the level of the body mass index at which the risk of hypertension significantly increases. The subjects of this study were 1,467 men and 944 women aged 20 to 75 yr who were normotensive at the time of their initial examinations from 1990 to 1991, who had a follow-up examination at least 1 yr after their initial examinations, or whose blood pressure status could be confirmed by reviewing their medical records until June 2000. During an average follow-up period of 6.2 yr, 234 new cases of hypertension were identified. An analysis using the Cox proportional hazards model showed that the risk of developing hypertension increased with increasing age, body mass index, and amount of daily alcohol consumption in men; and with increasing age and body mass index in women. Comparing men and women whose body mass indices were smaller than 23 kg/m 2 , the relative risks of hypertension were 2.56 times greater in men and 3.17 times greater in women, whose body mass indices were greater than 27 kg/m 2 . Our study confirmed that obesity is a strong risk factor for hypertension among Korean adults. In addition, high alcohol consumption may be a significant risk factor for men.

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  5. [국내논문]   Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting for Diabetics with Multivessel Coronary Artery Disease: The Korean Multicenter Revascularization Registry (KORR)  

    Gwon, Hyeon-Cheol (Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Choi, Seung Hee (Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Choi, Byung-Il William (Ajou University Hospital, Suwon, Korea. ) , Cho, Seung Yun (Yonsei University Severance Hospital, Seoul, Korea. ) , Ro, Young Moo (Korea University Hospital, Seoul, Korea. ) , Lee, Won Ro (Ilsan Baik Hospital, Inje University, Ilsan, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 196 - 203 , 2005 , 1011-8934 ,

    초록

    This study was designed to assess the relative merits of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD), particularly for Korean diabetics. Among 3,279 patients with MVCAD who were recommended for revascularization were enrolled from nine centers in Korea, 2,154 were selected after statistical adjustments for the disparities between two groups. Survival rates were not significantly different for three years between two groups. Among diabetic patients, the three-year mortality rate in PCI group was 1.9-fold higher than that of CABG group, although it was not statistically significant (PCI 19.8%, CABG 11.4%, p = 0.14). The three-year mortality rate was similar between the two groups in non-diabetics (PCI 8.3%, CABG 10.0%, p = 0.50). The 30-day rate of cerebrovascular event was higher in CABG group, for both diabetic (CABG 3.6%, PCI 0.0%, p p

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  6. [국내논문]   Changes of Coronary Blood Flow in Vasospastic Angina under Cold Stimulation by Transthoracic Doppler Echocardiography  

    Park, Seong Mi (Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea. ) , Shim, Wan Joo (Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea. ) , Ahn, Jung Cheon (Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea. ) , Lim, Do Sun (Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea. ) , Kim, Young Hoon (Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea. ) , Ro, Young Moo (Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 204 - 208 , 2005 , 1011-8934 ,

    초록

    This study was done to evaluate changes of microvascular function under cold stimulation by measuring coronary flow velocities (CFVs) in vasospastic angina (VA) patients using transthoracic Doppler echocardiography (TTDE). 14 patients with VA and 15 healthy controls were included. CFVs were measured at the distal left anterior descending coronary artery by TTDE at baseline and under cold stimulation. Hyperemia was induced by intravenous adenosine infusion (140 μg/kg/min). At baseline, CFVs and coronary flow reserve (CFR) were not different between controls and VA patients. Under cold stimulation, the degree of increment of CFV with adenosine was lower in VA patients than in controls. Comparing baseline with cold stimulation, coronary flow reserve (CFR) increased (3.1±0.7 to 3.8±1.0, p = 0.06) in controls. In contrast, in VA patients, CFR was decreased (2.8±0.9 to 2.6±0.7, p = 0.05) and coronary vascular resistance index markedly increased (0.35 to 0.43, p = 0.01). Throughout the study, no patient experienced chest pain or ECG changes. In VA patients, CFR was preserved at baseline, but coronary blood flow increase in response to cold stimulation was blunted and CFR was decreased. These findings suggest that endothelial dependent vasodilation is impaired at the coronary microvascular and the epicardial artery level in VA under cold stimulation.

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  7. [국내논문]   Successful Treatment of Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis with HLH-94 Protocol  

    Lee, Jin-Seok (Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea. ) , Kang, Jin-Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. ) , Lee, Geon-Kook (Department of Pathology, College of Medicine, Chungbuk National University, Cheongju, Korea. ) , Park, Hyeon-Jin (Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 209 - 214 , 2005 , 1011-8934 ,

    초록

    Hemophagocytic lymphohistiocytosis (HLH) is a rare, fatal disorder of children, affecting predominantly the mononuclear phagocytic system. Previous reports indicate that Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH) can also be fatal in many cases, although the prognosis for EBV-HLH is better than for the familial form of hemophagocytic lymphohistiocytosis. We treated four patients with EBV-HLH using immunochemotherapy including steroid, etoposide (VP-16), and cyclosporin, according to the HLH-94 protocol. All patients experienced persistent fever, cytopenia, and hypertriglyceridemia. Serological testing for EBV showed reactivated EBV infections in all patients. EBV DNA detected by PCR and EBV-encoded small RNA measured by in situ hybridization were confirmed in the patients' bone marrow specimens. Hemophagocytosis was shown in bone marrow aspirates and liver biopsy specimen. Complete remission was achieved in all patients after induction and continuation therapy for 4-10 months (median, 7 months) and was maintained for 15-27 months (median, 19 months) without the need for bone marrow transplantation. These results suggest that EBV-HLH can be effectively controlled by immunochemotherapy using the HLH-94 protocol.

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  8. [국내논문]   Lymphocyte Subsets and Mood States in Panic Disorder Patients  

    Park, Joo-Eon (Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Kim, Sang-Wook (Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Park, Quehn (Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Jeong, Do-Un (Department of Psychiatry, Seoul National University Hospital, Seoul, Korea. ) , Yu, Bum-Hee (Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 215 - 219 , 2005 , 1011-8934 ,

    초록

    This study was conducted to examine lymphocyte subset counts and mood states in panic disorder patients. Twenty patients with panic disorder and 20 age- and gender-matched normal healthy subjects were recruited for the study. We used the Spielberger State (STAIS) & Trait (STAIT) Anxiety Inventory, Hamilton Depression Rating scale (HAMD) and Hamilton Anxiety Rating scale (HAMA) to measure mood states in all subjects. Lymphocyte subsets counts were made by flow cytometry. Panic patients showed significantly higher scores for anxiety and depression than normal subjects. Panic patients showed no differences in terms of the numbers of immune cells, as compared with normal healthy subjects, other than a lower proportion of T suppressor cells and a higher T helper cell/T suppressor cell ratio. HAMA and STAIS scores were common factors that could predict T cell numbers and proportions, T helper cell numbers, and natural killer cell proportions in panic disorder patients. We suggest that anxiety levels are related to the T-cell population in panic disorder patients and that quantitative immune differences may reflect altered immunity in this disorder.

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  9. [국내논문]   Two Novel Mutations in the C7 gene in a Korean Patient with Complement C7 Deficiency  

    Ki, Chang-Seok (Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Kim, Jong-Won (Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Kim, Hee-Jin (Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Choi, Sung-Min (Department of Pediatrics, College of Medicine, Dongguk University, Gyeongju, Korea. ) , Ha, Gyoung-Yim (Department of Laboratory Medicine, College of Medicine, Dongguk University, Gyeongju, Korea. ) , Kang, Hee Jung (Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Korea. ) , Kim, Won-Duck (Department of Pediatrics, College of Medicine, Dongguk University, Gyeongju, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 220 - 224 , 2005 , 1011-8934 ,

    초록

    Complement C7 deficiency is an autosomal recessive disorder well known to be associated with increased susceptibility to meningococcal infection and has mostly been reported in Caucasians. In the Korean population, no case of C7 deficiency has been reported to date. Recently we experienced an 11-yr-old girl with meningococcal meningitis who was diagnosed as having C7 deficiency based upon the undetectable serum C7 protein on radial immunodiffusion and the undetectable serum total and C7 hemolytic activities. To identify the genetic basis of the C7 deficiency of the patient, we performed a mutation analysis for the C7 gene and found two novel mutations; a point mutation at the 3' splice acceptor site of intron 4 (c.281-1G>T) and a large deletion mutation encompassing almost the whole C7 gene from exon 1 to exon 17 (c.1-?_2350+?del). A haplotype analysis showed that the large deletion mutation was inherited from the patient's father. To the best of our knowledge, this is the first confirmed case of C7 deficiency in Korea.

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  10. [국내논문]   Seroprevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in Stable Asthma and Chronic Obstructive Pulmonary Disease  

    Park, Seoung-Ju (Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea. ) , Lee, Yong-Chul (Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea. ) , Rhee, Yang-Keun (Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea. ) , Lee, Heung-Bum (Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.)
    Journal of Korean medical science : JKMS v.20 no.2 = no.102 ,pp. 225 - 228 , 2005 , 1011-8934 ,

    초록

    Mycoplasma pneumoniae and Chlamydia pneumoniae have been suggested to take part in the acute exacerbation of bronchial asthma and chronic obstructive pulmonary disease (COPD). Several studies have questioned whether they may play pathogenic roles in connection with bronchial asthma and COPD. This study was designed to evaluate the seroprevalences of M. pneumoniae and C. pneumoniae in stable asthma and COPD patients, and to compare with control patients. The medical records of one hundred forty patients who underwent M. pneumoniae and C. pneumoniae serology were retrospectively reviewed. Seroprevalences of M. pneumoniae and C. pneumoniae in the asthma group (11.1% and 8.3%, respectively) were higher than in the control group (4.4% and 2.2%, respectively) without statistical significance. The seroprevalence of M. pneumoniae in the COPD group (16.9%) was significantly higher than in the control group, and the seroprevalence of C. pneumoniae in the COPD group (3.4%) was higher than in the control group without statistical significance. This study raises important questions about the relation of M. pneumoniae and C. pneumoniae infection with stable asthma or COPD.

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