• Journal of Yeungnam Medical Science
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• 제33권2호
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• pp.146-149
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• 2016

Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.

• Journal of Preventive Medicine and Public Health
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• 제38권4호
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• pp.425-430
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• 2005

Objectives : To investigate the prevalence of Clonorchis Sinensis infestation and to determine the associated risk factors among a population in a part of the rural area of Gyeongsangnam-do, Korea, which is an area known to have a high mortality from liver cancer and a high infection of C. sinensis. Methods : The study populat ion consisted of those people who have lived in rural areas and who were over 40 years old. This study was performed in 5 areas during the period from 1999 to 200 3. Informed consents were obtained from the 2,381 study participants, and these people were interviewed about their life style habits with using the structured questionnaire that was administered by trained staff members. The subjects underwent blood sampling and their stool specimens were examined by using the Formalin-ether sedimentation technique. Results : Among the study subjects (N=2,381), the positivity for C. sinensis in the stool was 34.4% (95% CI=36.3-42.5); it was 39.4% (95% CI=36.3-42.5) in the males and 30.9% (95% CI=28.5-33.3) in the females . The positivity for C. sinensis was associated with current alcohol drinking (odds ratio=1.8, 95% CI: 1.5-2.1) and raw fish consumption (odds ratio 1.2, 95% CI: 0.9-1.6). Conclusion : The present study confirmed the high prevalence of C. sinensis in the study subjects. It is necessary to establish consistent medical management and education programs for the treatment and prevention of C. sinensis infestation in the rural inhabitants of Korea.

• 농촌의학ㆍ지역보건
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• 제12권1호
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• pp.80-93
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• 1987

Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.

• 농촌의학ㆍ지역보건
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• 제22권2호
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• pp.239-252
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• 1997

A questionnaire survey including stool examination for the parasite ova, skin test, and enzyme-linked immunosorbent assay (ELISA) of the liver fluke to find the factors related with the prevalence of the parasite infestation was done toward 118 residents living in three villages of Song-jung, Yi-jung, and Chim-gok of Okok-myun, Goksung County, South Cholla Province. The results are as follows : 1. The prevalence of Clonorchis sinensis ova by the stool examination was 46.6%. The sensitivity and specificity of skin test to egg-positive cases were 63.5% and 68.9%. The sensitivity and specificity of ELISA to egg-positive clonorchiasis were 100% and 34.9%. 2. The prevalence of Clonchiasis was higher in male than in female. 45~64 year old group was the highest among age groups, and the longer the duration of living in the present residence was, the higher the prevalence was shown statistically significantly (p<0.01). 3. The present drinker had higher prevalence of Clonorchiasis significantly than the past drinker or non-drinker, and the more the frequency of drinking the higher the prevalence was shown significantly (p<0.05). 4. Those who took raw fish had significantly higher than persons who didn't take it or take cooked fish(p<0.05) and prevalence showed the tendency to be increased as the frequency to take raw fishes increased significantly(p<0.05). 5. Those who had taken a raw sweet fish(Plecoglossus altivelis) or snake-headed fish(Ophicephalus argus) showed significantly higher prevalence of infection with liver fluke than persons who didn't take the raw fish. 6. While 56.4% of persons infected with Clonorchiasis answered that they were healthy, only 13.0% of the subjects were careful for their health, and 41.8% experienced tests to diagnose liver flukes before they were examined by this survey. 7. While 56.4% of infected persons thought the prevalence was high in their community, 54.0% were afraid to be infected, 47.1% thought the infection might destroy their health, 25.5% took treatment drugs, and 18.2% took raw fish continuously after treatment. The above results confirmed that Goksung area was highly prevalent in Clonorchiasis, so it was necessary to push effective preventive program against liver fluke infection together with the program to diagnose and treat existing infected persons.

• 대한간호
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• 제33권3호
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• pp.56-69
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• 1994

This study was done to develop self - directed learning modules related to asepsis and elimination including urine and stool for Fundamentals in Nursing practice education contents and to measure the effectiveness of those modules. The subjects of this study were 96 sophomore students in the nursing college. Self-directed learning modules were developed by the researcher on the basis of the Lippincott Learning System of Kruger (1986) and Modules for Basic Nursing Care of Ellis (1992). Videotape was editted by using videotape made by the Lippincott Company and Film strip made by the Trainex Company with Korean dubbing. Self-directed learning was done for one week with the asepsis module and two weeks with the elimination modules after confirming the requiered level of knowledge acquisition through pre-test. For measuring proficiency in self-directed learning, a written test for cognitive domain, a sufficiency test for psychomotor domain, and a confidnece examination for affective domain were given. The data were analyzed using descritive statistics, and Pearson correlation coefficient using a SPSS-PC program. The results are summarized as follows: 1. Sufficiency test and confidence examination grades showed high levels in both asepsis and elimination. 2. Written test grades showed a high level in asepsis and elimination of urine but showed a medium level in eliminationin of stool. 3. Grades of sufficiency and confidence in asepsis and elimination practice were statistically significant with a moderate positive correlation (r=0.4- 0.5, p<0.001). 4. Grades of sufficiency and written tests in asepsis and elimination practice also were statistically significant with a moderate positive correlation (r=0.5-0.7, p<0.001). 5. Students showed relatively high contentment with the self-directed learning modules themselves but revealed relatively low contentment with video program and the self-directed learning process. In conclusion, this study disclosed that proficiency levels in cognitive, affective, and psychomotor domains were high when asepsis and elimination modules were applied. Also students showed high satisfaction with the modules themselves, but didn't show high contentment with the video programs. In considering low contentment with the self-directed learning process, it is estimated the students had experienced some difficulties about using self-directed learning modules because this was their first exposure to the self-directed learning module and they were already accustomed to the demonstration-practice method.

• Parasites, Hosts and Diseases
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• 제35권3호
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• pp.155-164
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• 1997

경북지역에 있어서 간흡충 감염상의 변화를 1993년 5월부터 1995년 4월가지 주민을 대상으로 간흡충 항윈피내반응과 충란검사를 할과 아울러 제2중간숙주인 담수어에서의 본 충 피낭유충 기생 상을 조사하였다. 주민들에 있어서 간흡충 감염률은 7 .7%로 비교적 높았으며. 남성에서 11.3% 여성에서 4.1%로 유의적 차를 인정할 수 있었다. Catalytic model의 특이형을 적용하였던 바. 관측치로부터 얻어진 이론곡선은 남성에서 y = 0.4776($1{\;}-{\;}e^{-0.0375t}$). 여성에서 y = 0.2085($1{\;}-{\;}e^{-0.0138t}$)이었다. Muench의 two-stage catalytic model로 연령별 감염률을 추정하여 y = 0.025($1{\;}-{\;}e^{-0.047t}{\;}-{\;}e^{-0.0235t}$). 즉, 매년 간흡충 감염자는 주민 1.000명에 대괘 4.7명의 비율로 산출되며 감염자 1,000명 중 23.5명의 비율로 음성으로 전환되고 있음을 알 수 있었다 간흡충 감염자에 있어서 EPG의 cumulative percentage와 Bliss의 probittable를 이용하여 회귀방정식을 계산하였던 바. 남자에서 y : 0.929 + 1.506 logx. 여자에서 y : 0.473 + 1.767 logx이었다. 채집된 9과 25종의 어류 중 7종에서 간흡충 피낭유충을 검출할 수 있었으며. 평균 감염량이 참붕어에서는 58.1개로 가장 많았고, 다음은 10.2개인 몰개였으며 납지리 및 두우쟁이에서는 각각 3.6 및 7.0개이었다. 이상의성적으로 미루어 보아 경북 지역의 간흡충증은 수십년전에 비해 적게 유행되고 있으며 계속 감소하고 있음을 확인하였다.

• 한국임상수의학회지
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• 제30권2호
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• pp.119-122
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• 2013

암컷, 9개월, 2.2 kg의 단모종 고양이가 2주간의 심한 변비 증상을 주증으로 내원하였다. 보호자 보고에서 증상 발생 4개월 전 골반 골절이 있었음을 확인 하였다. 신체 검사에서 이급후중 및 오른쪽 고관절의 운동 제한을 확인 하였고, 직장 검사에서 양측 관골구의 내측 돌출과 치골의 배측 변위를 동반한 골반 강 협착을 확인할 수 있었다. 방사선 검사에서 확장 된 대장과 골반 강의 비정상적 구조를 동반한 골반 강 협착을 확인 하였다. 배변 유연제와 관장을 이용한 보존적 치료를 실시하였으나 심한 변비 증상이 개선 되지 않았다. 장골, 좌골, 치골, 관골구의 부분 절골술을 실시 하였다. 수술 후 방사선 검사와 직장검사에서 확장 된 골반 강을 확인 할 수 있었다. 수술 후 배변 유연제(5 ml, PO, q12h; Duphalac$^{(R)}$)를 2주간 투약 하였고 그 후 2주간은 2.5 ml 용량으로 투여 하였다. 수술 후 따뜻한 물을 이용한 관장을 2회 실시 하였다. 수술 후 14일 째 검사에서 배변과 보행에 문제가 없음을 확인 하였고 5개월 째 검사에서 심한 배변과 오른쪽 뒷다리 파행 증상이 관찰 되지 않았다.

• Parasites, Hosts and Diseases
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• 제30권2호
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• pp.141-146
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• 1992

Kato후층도말변법 (M.C.T.S.)과 Stoll 회석충란계산법(D.E.C.T)으로 회충, 괸충, 간흡 충란 양성자 197명에 대하여 충란 정량검사를 실시하고 그 결과를 비교하여 상관함수식을 도출하였다. M.C.T.S.법에 소요된 검경시간은 표본 1매당 평균 12.6분으로 D.E.C.T.법의 14.6분보다 짧았으며, 층계부하가 낮은 감염자에 있어서도 위음성이 적었다. 각 윤충류 충란에 있어서 M.C.T.S.으로 얻은 결과를 대변 1 g당 충란수(E.P.G.)로 바꾸어 주는 전환함수식은 회충의 경우 E.P.G.=47.86×100.87 logM.C.T.S., 편충은 E.P.G.=41.69×100.83 logM.C.T.S., 간흡충은 E.P.G=63.10×100.55 logM.C.T.S.이었다. 장내 윤충류 감염에 대한 정량적 대변검사법으로 Kato후층도말변법이 Stoll희석충란계산 법보다 더 유용하다고 생각되었다.

• Parasites, Hosts and Diseases
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• 제33권2호
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• pp.117-124
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• 1995

간흡충증의 진단에 흔히 쓰이는 초음파검사의 민감도와 특이도를 알아보기 위하여 1994년 3월부터 11월까지 유행지역인 형산강 유역 포항 통합시 근로자 609명을 대상으로 피내반응검사. 대변검사. 초음파검사 및 설문조사를 시행하였다. 초음파검사에서 진단적인 소견으로 간내 담관의 확장만을 인정할 경우의 민감도는 21%이었고, 담관주위 에코가 있는 경우까지 포함하면 민감도는 52%이었다. 피내반응검사의 민감도는 62%이었다. 피내반응검사 양성이면서 초음파 소견이 하나라도 있는 경우를 진단기준으로 삼으면 민감도는 46%이었다 본 조사에서는 간흡충 혹은 간흡충의 집합체에 의해 생성되는 것으로 알려진 초음파검사상 방추상이고 약하게 반향을 보이는 담관이나 담낭내의 비음영의 초점이 뚜렷하게 보이는 환자는 없었다. 초음파검사의 특이도는 간내 담관의 확장만을 진단적 소견으로 인정할 경우 95%. 담관주의 에코까지 진단적 소견에 포함하면 83%이었다. 피내반응검사의 특이도는 52%이었다. 피내반응검사 양성이면서 초음파 소견이 하나 라도 있는 경우를 진단기준으로 삼으면 특이도는 90%이었다.

• Parasites, Hosts and Diseases
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• 제21권2호
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• pp.246-256
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• 1983

폐흡충증의 유행정도를 측정하는 데 사용하여 온 피내반응과 충란검사가 각각 특이도와 민감도에 문제를 갖고 있어 주민 중 현증 환자를 적절히 찾았다고 하기가 어렵게 되어가고 있다. 이러한 점을 개선하는 방법으로 폐흡충 특이 IgG항체를 검사함으로써 항체양성자의 수를 현증 환자의 수로 하는 방법을 폐흡충증 역학조사에 응용하고자 하였다. 이 연구에서는 특이항체를 면역효소진단법으로 측정하였을 때 그 효용성을 평가하고자 하였다. 전라남도 해남군 북평면과 북일면의 6개 국민학교, 2개 중학교, 1개 고등학교 학생과 2개 부락 주민 등 모두 4,285명을 우선 피내 반응으로 검사하고 폐흡충 피내반응 양성자에서 가래 검사를 한번 실시하였고 혈청을 채취하여 면역효소진단법으로 폐흡충 특이 IgG항체를 측정하였다. 그 결과를 요약하면 다음과 같다. 1. 총 대상자 4,285명 중 폐홉충 피내반응 양성자는 244명 (5.7%)이었고, 피내반응 양성자 중 충란 양성자는 7명 (4.2%), 면역효소진단법에 의한 특이 IgG항체 양성자는 40명 (16.7%)이었다. 전체 조사 대상자에 대한 충란 양성자의 비율은 0. 16%, 특이 IgG항체 양성자는 0.93%에 해당하였다. 2. 폐흡충 특이 IgG항체 양성자는 충란 양성자에서는 100%, 폐흡충 피내 반응은 양성이나 충란검사 음성자에서는 14.2%에서 나타났으나, 간흡충 피내반응 양성자 또는 피내반응 음성 자에서는 나타나지 않았다. 3. 폐흡충 특이 IgG항체 양성자는 피내반응 구진의 크기 9mrn이하에서는 없었고, 10mm에서는 5.5%, 11∼12mm에서는 26.1% 및 18.2%, 13mm이상에서는 평균 42.4%에서 양성이었다. 4. 특이항체 양성자 31명을 임상적으로 조사한 바 검사소건(흉부 X-선, 충란검사 및 호산구 비율)에서 폐흡충증에 합치하는 이상소견이 24례에서 나타나 현증 폐홉충증 환자로 생각할 수 있었고, 나머지 7례중 3례는 폐흡충증의 과거력이나 쳔증 증상을 갖고 있었으며 4례에서는 특이항체 양성소견 이외에는 어느 검사로도 폐흡충증임을 증명할 수가 없었다. 5. 폐홉충 특이 IgG항체 양성자 수의 피내반응 양성자 수에 대한 비율은 연령별로 7∼9세에서는 16.6%, 10∼14세에서 25.4%, 15w18세 군에서는 18.3%이었고 20세 이상에서는 10.0%로 떨어지고 있었다. 6. 체홉충 특이 IgG항체 양성자는 북평면의 산골 마을에서 주로 나타나고 있었다. 이상과 같은 결과에서 면역효소 진단법에 의하여 폐흡충 특이 IgG항체 양성자를 조사함으로써 어느 지역의 폐흡충중 현증 환자를 피내 반응이나 충란 검사보다도 더 사실에 가깝게 측정할 수 있다고 생각하였다. (이 연구를 수행하는데 현지조사를 직접 간접으로 도와 주신 해남군 보건소 민 경 소장님과 김용팔 주사, 북평면 면사무소 직원여러분과 해남군 교육청, 각급학교 교직원 여러분께 감사드립니다. 환자의 흉부 X-선 사진을 판독하여 주신 중앙의대 부속 성심병원 방사선과 과장 정전상 부교수께 도 감사드립니다. )