리네졸리드와 반코마이신을 교대로 투여하여 치료한 지속성 메티실린 내성 황색포도알균 균혈증 1예

김낙현,김문석,장은선,강유민,김가연,장희창,박완범,김의종,김남중,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for ≥7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.

肺炎樣疾患의 臨床的 觀察

김기호,홍순조,이효식,강문원,김호연,정규원,정희영,전종휘,김선무,이종무,김정진 대한의학협회 1976 대한의학협회지 Vol.19 No.4

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

뇌성마비아의 모발내 망간 분석 연구

김희상,김종영,안경회 大韓再活醫學會 1999 Annals of Rehabilitation Medicine Vol.23 No.3

Foley 도뇨관을 이용한 소파술 및 분만 후 과다자궁 출혈의 보존적 치료

김종일,이지영,유은희 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.4

연구목적 : 자궁출혈에 대한 Foley 도뇨관을 이용한 압박지혈법의 효율성과 안전성을 알아보고자 한다. 방법 : 1991년 5월부터 1998년 4월까지 7년간 이화여자대학 동대문 병원에서 시행된 21예를 후향적으로 조사하였다. 모든 환자들에 있어 과다 자궁출혈의 지혈을 위해 자궁내에 Foley 도뇨관을 삽입후 생리식염수로 풍선 확장시키는 방법을 사용하였다. 결과 : Foley 도뇨관을 삽입한 평균 기간은 96시간이었으며 풍선 확장시킨 생리식염수의 양은 32.5㎖였다. 자궁경부괴사나 감염, 지혈실패로 인한 자궁적출술 등의 합병증은 없었다. 결론 : Foley 도뇨관을 이용한 풍선압박지혈법은 급성 자궁출혈 조절에 있어 빠르고 효과적이며 안전한 치료법으로 사료된다. Objective : To evaluate the safety and efficacy of Foley catheter balloon tamponade for uterine bleeding. Method : A retrospective data collection of sequential series of 21 patients were performed between May 1991 and April 1998. Treatment entailed controlled inflation with normal saline in an intrauterine balloon of Foley catheter. Result : The mean duration of the Foley catheter tamponade for uterine bleeding was 96 hours(range ; 48-144 hours) and mean amount of ballooning was 32.5㎖(range : 28-60㎖). There was no complication such as cervical necrosis, infection or hysterectomy. Conclusion : We propose the intrauterine balloon tamponade as an additional alternative for controlling hemorrhage before resorting to angiographic embolization or surgery.

항생제 사용과 관련된 Clostridium difficile 감염증

김홍빈,김남중,최희정,오명돈,김의종,최강원 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

목적 : Clostridium difficile 감염증은 중요한 원내 감염중의 하나로 최근 들어 항균제 사용의 증가와 함께 그 빈도가 늘어나고 있어 Clostridium difficile 감염의 빈도 및 임상양상을 알기 위해 본 연구를 시행하였다. 방법 : 102명의 정상 성인으로부터 대변에서 Clostridium difficile 배양을 시행하였으며, 92년 3월부터 93년 9월까지 서울대학교 병원에 입원한 환자중 대변배양 검사에서 Clostridium difficile이 배양된 61명의 환자를 대상으로 병록지를 토대로 조사하였다. 결과 : 정상 성인 중 3%에서 Clostridium difficile이 분리되었다. 대상환자의 기저 질환은 악성고형종양(29%), 혈액종양(6.5%), 뇌혈관 질환(6.5%), 간경변(4.9%) 등의 순이었으며, 대상 환자의 75%에서 균이 분리되기 6주 이내에 항균제가 사용되었다. 사용된 항균제는 aminoglycoside(60.8%), 1세대 cephalosporin(56.5%), 3 세대 cephalosporin(43.4%), ampicillin(15.2%), metronidazole(15.2%), clindamycin(8.6%)의 순이었다. 흔한 증상은 설사(77%), 복통(53.8%), 오심(37%), 빈맥(25%) 등이었며, 혈액 검사상 백혈구증가증은 21.6%, 저알부민혈증은 3.03%에서 관찰되었다. 44명의 환자중 24명의 환자가 대증적 치료 후 호전되었고, vancomycin이나 metronidazole을 투여받은 17명의 환자중 15명의 환자가 증상의 호전을 보였다. 4예가 사망하였으며, 3예(4.9%)는 재발하였다. 결론 : Clostridium difficile 장염은 항균제 사용시 흔히 발생하는 질환이다. 정상 성인의 3%에서 Clostridium difficile이 분리되었다. Objective : Clostridium difficile gastrointestinal disease is an important nosocomial infection and is associated with antibiotic use. This study evaluated the incidence and clinical characteristics of Clostridium difficile infections. Methods : Stool specimens from 102 normal adults were cultured for Clostridium difficile. Sixty-one patients with Clostridium difficile isolated from stool specimens were reviewed retrospectively. The patients were seen at the Seoul National University Hospital during the period from Mar., 1592 to Sep., 1993. Results : Clostridium difficile was isolated in 3% (3/102) of normal adult Population. Underlying diseases of the patients included solid tumor(29%), hematologic malignancy(6.5%), corebrovascular disease(6.5%), and liver cirrhosis(4.9%). Antibiotics associated with Clostridium difficile infections included aminoglycosides (60.8%), first generation cephalosporin(56.5%), third generation cephalosporin(43.4%), ampicillin(15.2%), metronidazole(15.2%), and clindamycin(8.6%). In 3/4 of the cases, these antibiotics had beer) administered within 6 weeks before Clostridium difficile isolated. Associated symptoms included diarrhea(77%), abdominal pain(53.8%), nausea(37%), fever(37.7%), and tachycardia(25%). Leukocytosis and hypealbuminemia were observed in 21.6% and 30.3%. Out of 44 cases received symptomatic treatment, 54% (24/44) improved. Of 17 cases treated with metronidazole or vancomycin, 88% (15/17) improved. Four cases expired and 3 cases(4.9%)were relapsed. Conclusion : Clostridium difficile gastroenteritis is frequently associated with antibiotic treatment. Three percent of normal adult population had Clostridium difficile.

Phenylhydrazine으로 處置한 토끼 赤血球의 Lactate Dehydrogenase Isozymes의 活性度에 關하여

金良均,朴在允,車鍾希,高光三,李根培 조선의대 1983 The Medical Journal of Chosun University Vol.8 No.1

질병진단에 중요한 효소들에 관한 비교 연구

김종호,김현희,심은숙 원광보건전문대 1997 원광보건전문대학논문집 Vol.20 No.-

Plerocercoid의 표피 및 그 관련조직의 구조에 관한 연구

金鍾煥,劉寬凞,金南萬 충남대학교 자연과학연구소 1984 忠南科學硏究誌 Vol.11 No.1

The tegument of the plerocercoid stage of Spirometra sp. from Natrix tigrina was examined by electron microscopy to determine whether the most anterior level was similar to the trunk portion of the integumental structure. Significant differences were observed in the shape and arrangement of microtriches, distribution of mitochondria and the different types of bodies in the tegument. A few and short microtriches were observed at the most anterior portion, while many microtriches with long and broad proximal portion were arranged densely in the trunk portion. Many mitochondria are distributed just beneath the microtricheal layer in the anterior portion, but they were observed on the basement layer in the trunk. In the tegument of the anterior portion the most cytoplasmic bodies were showed round and oval vesicular shape, while they were rod-shape in trunk portion. The basement layer of the trunk portion was thicker than that of the anterior portion and the location of muscular layers was replaced with circular and longitudinal muscle in the anterial and trunk portion.