다기관 기능부전을 초래한 치명적인 삼일열 말라리아 증례

박상원,김동우,박주원,이순일,신영학,김의종,오명돈,최강원 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

삼일열 말라리아는 국내에서 재유행하고 있는 감염질환으로, 일반적으로 양성의 임상경과를 거친다. 저자들은 특이한 질병력이 없이 건강하였던 젊은 성인이 국내에서 삼일열 말라리아에 걸린 후 다기관기능부전과 폐출혈으로 사망한 증례를 경험하였다. 환자의 중증 임상경과를 설명할 만한 특이한 인자가 발견되지 않았다. Vivax malaria is a re-emerging infectious disease in Korea with cumulating 19,416 cases as of December 2003 since 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there are only small number of case reports on severe complications. We experienced a fatal vivax malaria in a previously healthy young adult with severe multi-organ failure and fatal massive pulmonary hemorrhage. The patient presented with abdominal pain and shock. There were splenic hemorrhage, disseminated intravascular coagulation, oliguric acute renal failure requiring dialysis, and pulmonary hemorrhage leading the patient finally to death. The initial parasitemia was 2,046/μL. Thin smear and PCR revealed only Plasmodium Vivax. There was no explainable cause of death except for the only serological suggestion of Mycoplasma pneumoniae infection without correlating clinical evidence. This is a first case of fatal vivax malaria in Korea since its re-emergence in 1993. Further case monitoring is needed to define whether this is a index case or an isolated one.

중이진주종의 과증식성향에 대한 면역조직화학적 연구

엄주현,전영명,박기현 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

Human epidermis is a continuously dividing tissue, in which the keratinocytes gradually differentiate and mature while moving from the basal cell compartment to the upper cell layers. However, cholesteatoma is characterized by the presence of squamous epithelium invading the middle ear. This epithelium is believed to have hyperproliferative properties. Using immunohistochemical techniques, we investigated the reaction pattern of monoclonal antibody to PCNA and cytokeratin 16 as proliferating markers, and of monoclonal antibody to cytokeratin 13 and DBA as basal cell markers in the cholesteatoma to determine whether the number of proliferating cells is increased, and whether proliferating cells are found beyond the basal cell layer in cholesteatoma. The results were as follows: 1) When the tissues were stained with the proliferating markers PC10 and K8.12, the normal epithelium of ear canal showed focal staining in the basal cell layer, whereas epithelium of cholesteatoma showed dense, diffuse staining not only in the basal cell layer but also in the suprabasal cell layer. 2) When the tissues were stained with the basal cell markers KS-1A3 and DBA, both epithelium of the normal ear canal and of cholesteatoma showed staining in only a single basal cell layer. These results suggest that increased epidermal cell proliferation in cholesteatoma may be due to increased proliferative activity in suprabasal keratinocytes as well as in the basal compartment.

과민성 장 증후군의 증상 경감을 위한 비약물적 접근 고찰

최명애,김금순,안경주,채영란,최정안,홍해숙,박미정,이경숙,신기수,정재심 대한기초간호자연과학회 2005 Journal of korean biological nursing science Vol.7 No.2

There have been many trials of clinical efficacy of multicomponent and single component treatments for irritable bowel syndrome(IBS). We reviewed effects of non phamacological treatments in the IBS. Though the efficacy of multi-component approaches was unclear, several results suggest that cognitive behavioral therapy was effective in improving gastrointestinal symptoms of IBS. As a single component, cognitive therapy and relaxation with or without biofeedback could improve the symptoms and psychological health of IBS patients. Yoga, meditation, self-help information and hypnotherapy could be applicable to IBS.

스테로이드 치료 후 회복기의 규칙적인 운동이 쥐의 스테로이드 유발성 위축 뒷다리근에 미치는 영향

최명애,변영순,황애란,김희승,홍해숙,최스미,서화숙,이경숙,박미정,신기수,안경주,이윤경,임지회 대한기초간호자연과학회 2002 Journal of korean biological nursing science Vol.4 No.1

This study was conducted to determine whether low intensity regular exercise following steroid treatment could attenuate steroid-induced muscle atrophy. Thirty-eight Sprague-Dawley rats weighing 165~175g were divided into six groups;control group(C), dexamethasone administration group(D), sedentary after normal saline administration group(C+Se), exercise after normal saline administration group(C+Ex), sedentary group after dexamethasone administration(D+Se), exercise group after dexamethasone administration(D+Ex). Either dexamethasone(5mg/kg) or normal saline was injected for 7days accordingly. Exercise was started at 10m/min on the 10?grade treadmill and gradually increased up to 15m/min by the 7th day for 60minutes/day(20min×3). The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSS WIN 9.0 program. Body weight, muscle weight and myofibrillar protein content of both plantaris and gastrocnemius, Type I, II muscle fiber cross-sectional area of plantaris, and Type II muscle fiber cross-sectional area of gastrocnemis in D group were significantly lower than those of C group(p<.05) respectively. Hindlimb muscle weight, myofibrillar protein content of both plantaris and gastrocnemius, Type I muscle fiber cross-sectional area of soleus and Type I, II muscle fiber cross-sectional area of plantaris in D+Ex group tended to increase compared to those of D+Se group. Myofibrillar protein content of both plantaris and gastrocnemius, Type I muscle fiber cross-sectional area of plantaris in D+Ex group tended to increase compared to those of C+Se group. Based on these results, it is suggested that regular low-intensity exercise during recovery period after steroid treatment might facilitate the recovery from steroid-induced muscle atrophy.

실험적 녹농균성 각막염에 대한 Cefotetan의 치료 효과

오명주,박정규,백태현,최대경 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

This study was carried out for the purpose of evaluation of effect of cefotetan against the pseudomonas induced keratitis. The corneal infection caused by pseudomonas organisms have a poor prognosis and their increased prevalence and general resistance to therapy make them a serious problem for to ophthalmologists. So, the author introduced experimental keratitis in the rabbit cornea by Ps. aeruginosa and Compared effects of the cefotetan and tobramycin. The cefotetan is a new antibiotic of cephalosporin system which is effective in vivo and vitro against not only gram positive but also gram negative organism and is stable against the β-lactamase. The results obtained were as follows: 1. Clinically, cefotetan and gentamicin were both effective against experimentally induced .pseudomonas keratitis and there was no significant difference between the efficacy of cefotetan and that of tobramycin. 2. In culture study, the test after treatment showed significantly fewer colonies on the platesfrom the cefotetan, tobramycin treated groups than those from the saline treated group, and there was no significant difference between cefotetan treated, and tobramycin treated group.

실험차량과 실동하중에 의한 교량의 충격계수에 관한 연구

조명선,정태주,박영석 명지대학교 대학원 1997 대학원논문집 Vol.1 No.-

Impact factor by traveling vehicles on the bridge is one of the important factors that should be considered in the design phase. It is known that the impact factor depends on the dynamic characteristics of brides and the dynamic properties of traveling vehicles. The dynamic responses of test vehicle and normal traffic load are measured for the 14 bridges with different types, span lengths, and natural frequencies. We computed the impact factors using by Korean's bridge design specifications and compared with those specified in other countrys. The result is that 78% of estimated impact factors exceed the Korean's specification regulation. Therefore, we consider that the impact factor specified in the Korean standard bridge design code should be revised in the near future.

음주문제 수용인식에 따른 자기보고식 평가 척도(AUI 및 MAST)에서의 패턴 및 유형 분류와의 관련

이명주,박순환,이현제 대한신경정신의학회 2001 신경정신의학 Vol.40 No.1

연구목적: 본 연구에서는 음주문제 수용인식에 따라 AUI(Alcohol Use Inventory) 척도 및 MAST(Michigan Alcohol Screening Test)척도상에서 어떤 양상을 보이는 지를 알아보고, 음주문제 수용인식이 Bar-bor에 따른 유형분류(음주문제 발병연력과 가계력에 따라 유형 1과 유형 2로 분류)와 관련성이 있는지를 살펴보고자 하였다. 방법: 알코올 중독증 치료병동에 입원한 134명의 환자를 대상으로, AUI, 환자 MAST 및 보호자 MAST를 측정하였다. 먼저, 대상환자를 수용인식 점수에 따라 상위 30%에 해당하는 집단과 하위 30%에 해당하는 집단으로, 가계력이 있고 문제음주가 25세 이전에 발병한 집단을 유형 2집단으로 구분하였다. 그리고 수용인식 점수에 따른 T-test, 상관관계 및 회귀분석을 실시하였다. 결과: 1) 수용인식점수와 MAST차이값(환자의 MAST점수-보호자MAST점수)간에는 유의미한 부적인 상관이 있었고, AUI 2차척도 중에서는 불안염려척도가 가장 높은 상관을 보였다. 2) 수용인식이 높은 사람들은 낮은 사람들에 비해 음주이익을 제외한 대부분의 척도에서 높은 점수를보이고 있는 것으로 나타나고 있다. 3) 유형 1과 유형 2에 따라 수용인식 점수에서 의미있는 차이가 나타나고 있지 않다. 결론: 수용인식이 높은 사람은 음주로 인한 이익을 제외한 모든 척도에서 높은 점수를 보였다. 즉, 수용인식이 낮은 사람에 비해 자신의 문제에 대한 부정적인 결과를 더 많이 보고하고 더 많이걱정하는 경향이 있었으며, 자신의 문제를 받아드리 고 자신의 제를 욱 객관 로 가하고 있다고 볼 수 있겠다.하지만 유형분류에 따라서는 수용인식에 차이는 보이지 않았다. 즉, 음주문제의 발생시기 및 가계력은 그 사람이 음주문제에 대한 수용인식이 높은 지 낮은 지에 영향을 미치지는 않는 것 같다. Objectives : This Study was designed to investigate the pattern of AUI(Alcohol Use Inventory) and MAST(Michigan Alcohol Screening Test) according to the awareness of drinking problem and receptiveness to treatment, and to know whether the type(type 1 and type 2 according to Barbor's typology) has effects on the RECPAWAR(acknowledgement and awareness of use problem and receptive to treatment of these problem) score. Methods : Subjects were 134 alcoholic patients from Alcoholic treatment ward. They were requested to fill up the questionnaires of Korean version of AUI and MAST(MAST for patient and MAST for caretaker). At first, based on the RECPAWAR, they divided into high REC-PAWAR group(above 30 percentile) and low RECPAWAR group(below 30 percentile). Acc-ording to typology, they divided into type 1 and type 2. The data was analyzed by T-test, Correlation, and Regression Analysis. Results : 1) Significant negative correlation was observed between RECPAWAR score and MAST difference score(patient's MAST- caretaker's MAST). 2) High RECPAWAR group had significatly higher scores in the most scales than low RECPAWAR group, except ENHANCED scale in AUI. 3) There was not significant difference on RECPAWAR score between type 1 and type 2. Conclusion : Except ENHANCED scale, the high RECPAWAR group had higher score in the second level scale. As compared with the low RECPAWAR group, the high RECPAWAR group responds more negative in drinking, and is more anxious about their drinking problems. So, they seem to have the objective view about their drinking problems. However the type was not related to receptive and awareness of drinking problem.

Squalene Adjuvant를 이용한 단백질 항원의 세포성 면역반응 유도

도현주,김성열,안종성,하영주,이승찬,오재택,장명호,정홍석,문홍모,박해준 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.3

To investigate the role of adjuvant for cytotoxic T lymphocytes (CTL) induction, squalene-based adjuvant was studied its capability eliciting to the induction of cellular immunity as well as humoral immunity to exogeneous proteins. Ovalbumin (OVA) was used as model proteins. It was demonstrated that antigen formulation consisted of metabolizable oil squalene mixed with Tween 80 and pluronic L121 (S/TJ121) could induced the antigen specific CTL responses and antibodies irrespective of immunization routes in mice. We also demonstrated that this antigen formulation was a inducer of CD8+, major histocompatibility complex(MHC) class I-restricted, and antigen-specific C;1'Ls. These data suggest that the squalene-based emulsion system is a potent adjuvant inducing cellular immunity as well as humoral immunity.

황색포도구균의 균혈증에서 초기 항생제 치료가 예후에 미치는 영향

김성한,박완범,이기덕,강철인,최영주,김홍빈,박상원,김의석,오명돈,김의종,최강원 대한감염학회 2002 감염 Vol.34 No.5

결핵균 30-kDa와 32-kDa 단백항원의 분리정제와 마우스 비장세포 증식에 미치는 영향

백태현,오명주,김화중,조은경,박정규,최대경 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Identification and characterization of individual components of M.tuberculosis have long been a focus of research on tuberculosis. The 30-kDa and 32-kDa antigens are major constituents of M bovis BCG and M. tuberculosis culture fluids. Because 30-kDa and 32-kDa antigens are partially identical, these antigens are difficult to purify in large amounts by biochemical techniques. This study was performed to purify the 30-kDa and 32-kDa antigens complexes primarily purified by 50% ammonium sulfate precipitation, hydroxylapatite chromatography and Sephadex G-75 gel filtration. And then further purification for separation of the two antigens was accomplished on preparative isoelectric focusing. Recovery of 30-kDa and 32-kDa antigens during above the purification procedures were 28% and 14%, respectively, and 147.0 and 59.8-fold purification were showed, respectively. On silver stained SDS-PAGE gels, the purified 32-kDa antigen gave a single band at 32-kDa molecule, while 30-kDa antigen gave one major band at 30-kDa molecule and faint additional band at 32-kDa. The pI of 30kDa-and 32-kDa antigens were 4.3 and 4.6, respectively. The partial identity between these two antigens was observed through the same pattern of reactivity of antigens in the ELISA and precipitation pattern of immunodiffusion. We also examined the immunological activities of both purified antigens by splenocyte proliferation of BCG-infected mice. Proliferative response to the 30-kDa and 32-kDa antigens did not show significant difference. However, macrophage-like cells existed in spleen cells from BCG-infected mice were involved in the suppression of the proliferative response to mycobacterial antigen. These results suggest that the 30-kDa and 32-kDa antigens could be effectively purified by the IEF and reactions of partial identity between the two antigens were found. However, 30-kDa antigen was the more immunogenic antigen than 32-kilodalton.