Fever of Unknown Origin: An Unusual Presentation of Anti-N-Methyl-D-Aspartate Receptor Encephalitis

허지안 대한감염학회 2015 Infection and Chemotherapy Vol.47 No.2

Encephalitis associated with antibodies to the N-methyl-D-aspartate receptor (NMDAR) has variable clinical manifestations. Patients are often diagnosed with infectious processes because of prodromal symptoms and autonomic manifestations. Approximately 70% of patients have prodromal symptoms consisting of headache, fever, nausea, vomiting, and diarrhea, along with frequent autonomic manifestations, including tachycardia, and fluctuating blood pressure. A 36-year-old woman presented with uncontrolled fever and skin and soft tissue infections. She had shown psychiatric symptoms and abnormal behavior, and had been diagnosed with bipolar disorder. Antibodies to NMDAR were positive in cerebrospinal fluid (CSF) and serum samples, and pelvic computed tomography detected a large ovarian teratoma. The patient improved dramatically after removal of the teratoma and administration of corticosteroid therapy. When confronted with a young woman with uncontrolled fever and acute psychiatric symptoms, physicians should suspect anti-NMDAR encephalitis.

H1N1 2009으로 사망한 임신부 1예

허지안 대한감염학회 2011 Infection and Chemotherapy Vol.43 No.2

Pregnant women is known to be at risk of high morbiding and mortality from H1N1 2009. Since the emergence of H1N1 2009 in Korean in April 2009, fatal case has not been reported in the Korean pregnant women yet. This is the first report of fatal case in pregnant women associated with H1N1 2009 infection in Korea. A 29-year-old woman at 32 weeks of gestation presented with pneumonia associated with H1N1 2009 infection, progressed into acute respiratory distress syndrome. On the fourth day of admission fetal distress development. The patient died from refractory critical hypoxemia and multiple organ failure on the 5th hospital day in spite of receiving extracorporeal membrane oxygenation therapy and intravenous peramivir.

포스터 전시 발표 : 혈액종양 ; 위장관계 침범을 동반한 T-Lymphoblastic Lymphoma 1례

허지안,도영록,조주연,장용석,권기영,송홍석 대한내과학회 2002 대한내과학회 추계학술발표논문집 Vol.2002 No.1

Pneumonia Caused by Corynebacterium macginleyi in HIV-infected Patient

허지안,김상일 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.5

Corynebacterium macginleyi is usually isolated from the eye surfaces and causes ocular infections such as conjunctivitis, keratitis, and endophthalmitis. However,cases that describe C. macginleyi as the causative agent for significant and lifethreatening infections in immunocompromised patients are increasingly reported. Herein we report the first documented case of C. macginleyi pneumonia in a human immunodeficiency virus (HIV) patient. A 42-year-old homosexual man with HIV infection was hospitalized with a 1-month history of fever and dry cough. Chest radiograph revealed ill defined ground glass opacities in both lung fields. Methenamine silver stain of bronchoalveolar lavage fluid was negative. He showed clinical improvement after treatment with trimethoprim/sulfamethoxazole and prednisolone for three weeks, and was discharged. One month later, he presented with dyspnea and more progressive pulmonary infiltrations. Bronchial washing fluid culture yielded >100,000 colonies/mL of C. macginleyi , and he was given a 14-day course of antibiotic therapy with vancomycin, after which the patient fully recovered. This case suggest the importance of not overlooking the significance of positive cultures for C. macginleyi obtained from representative clinical samples in patients with signs and symptoms of bacterial infection.

노후저층주거지의 도시재생 집수리사업의 만족도 및 개선방안 연구 - 창원특례시 구암지구 및 소계지구를 중심으로

허지안,조형규 대한건축학회지회연합회 2024 대한건축학회연합논문집 Vol.26 No.5

본 연구는 도시재생 집수리사업을 수행한 창원 구암지구, 소계지구를 대상으로 설문조사를 통한 만족도 조사 및 전문가 인터뷰 조사를 바탕으로 집수리사업의 항목별 만족도를 도출하고 집수리사업의 개선방안을 제시하고자 하였다. 설문조사를 바탕으로 한 만족도 조사 결과, 집수리사업 지원대상 선정방식에 대한 만족도는 두 지구 모두 높게 나타났고, 선정방식으로는 절반이 넘는 응답자가 ‘평가’라고 답하였으며, 평가에서 우선 고려해야 할 사항은 ‘경제수준’인 것으로 나타났다. 집수리사업의 수리가능 지원범위에 대한 만족도는 비교적 높은 편이었고, 주민들은 ‘외부경관개선’ 보다는 ‘성능개선중심’에 보다 많은 지원이 이루어지길 기대하고 있었다. 집수리사업 전체 만족도는 모두 높게 나타났고 마을의 외부경관개선에 기여한 정도에 대한 평가는 구암지구보다 소계지구가 더 높게 나타났다. 표준디자인 가이드라인 필요 여부에 대한 질문에 대다수가 ‘필요하다’라고 응답하였다. This study aimed to derive satisfaction levels for each item of the housing repair project and suggest improvement measures based on a satisfaction survey and expert interviews conducted on the Guam and Sogye districts of Changwon. The satisfaction survey results based on the survey showed that both districts were highly satisfied with the selection method for housing repair project support targets. More than half of the respondents answered ‘evaluation’ as the selection method, and the most important factor to consider in the evaluation was ‘economic level.’ The satisfaction level for the scope of possible support for housing repair projects was relatively high, and residents expected more support to be provided for ‘performance improvement’ rather than ‘external landscape improvement.’ Overall satisfaction with the housing repair project was high in all areas, and the evaluation of the degree of contribution to improving the external landscape of the village was higher in Sogye district than in Guam district. When asked whether standard design guidelines were necessary, the majority responded that they were ‘necessary.’

Physicochemical properties and physiological activity of bean sprouts extract containing Hovenia dulcis Thunb concentrates

허지안,박울림,민혜지,김정호,원영선,서권일 한국식품저장유통학회 2023 한국식품저장유통학회지 Vol.30 No.4

Reactive oxygen species are the byproducts of metabolic processes in the body, However, excessive amount may cause side effects such as cancer. Therefore, to reduce the production of these species, but their long-term administration at high doses may induce side effects. Hence, natural materials with antioxidant activities are attracting attention. Two of these natural materials are soybean sprouts and Hovenia dulcis Thunb. fruits, but few studies have evaluated the effects of their combination. Thus, we prepared a soybean sprout extract containing 1.5% H. dulcis Thunb. fruit concentrate (BHM) to develop a functional food material derived from natural products and then confirmed its physicochemical properties and physiological activity. Among the organic acids detected in BHM, malic acid exhibited the highest content of 1,451.03 ppm, and the main free sugars were glucose (645.48 ppm) and fructose (738.11 ppm). Taurine was the most abundant free amino acid at a concentration of 11.95 ppm, followed by those of arginine (10.97 ppm) and glutamic acid (10.16 ppm). Analyses of the mineral components revealed large amounts of Zn and Fe in BHM, and the respective total polyphenol and flavonoid contents in BHM were 957.16 and 601.93 ppm. The DPPH radical and H2O2 scavenging activities and reducing power indicated excellent antioxidant efficacy compared to the positive controls. Furthermore, blood alcohol and acetaldehyde concentrations were measured to confirm the hangover-relieving effects of BHM, with both significantly decreased (p<0.05). BHM displays potential for development as a functional food, and the results of this study may be used as basic data in further research.

알부민이 첨가된 시험관내 약역학 감염모델을 이용한 폐렴알균 치료에서 Ceftriaxone 일일 1회 요법

허지안,전혜선,박선희,최수미,김시현,이동건,최정현,유진홍,신완식 대한감염학회 2006 Infection and Chemotherapy Vol.38 No.6

배 경 : Penicillin 내성 폐렴알균이 증가하는 지역에서 대안 중의 하나로 사용되는 ceftriaxone (CTR)의 적절한 용법, 용량을 파악하는 것이 중요하다. 본 연구는 임상에서 분리된 폐렴알균을 대상으로 시험관내 약역학 감염모델을 이용하여 알부민이 첨가된 경우와 첨가되지 않은 경우 CTR의 일일 1회 요법의 효과를 비교해 보고자 하였다. 재료 및 방법 : Penicillin 감수성(SM24), 중간내성(SM47), 내성(SM60)주를 대상으로 2-구획 시험관내 약역학 감염모델을 적용하였다. CTR 주입은 2 g씩 24시간마다로 사람의 약동학을 모의하였다. 알부민은 모델에서 4 g/ dL가 유지되도록 하였다. 살균효과는 0, 2, 4, 6, 24, 30, 48시간째 집락수 변화로 측정하였다. 결 과 : 모든 균주에서 알부민이 첨가되지 않은 경우 6시간 이내에 살균력이 관찰되었다. 최저억제농도 및 알부민 첨가유무에 관계없이 3주 모두 24시간째 살균력이 관찰되었고, 48시간째는 모두 측정한계 이하의 집락수로 감소하였다. 전 실험과정에서 CTR에 대한 내성주는 출현하지 않았다. 결 론 : CTR의 일일 1회 요법은 알부민이 첨가되었을 때, 감수성, 중간내성, 내성주 모두에서 살균력 발현이 지연되었으나 최종효과는 알부민이 없을 때와 다르지 않았다. 앞으로 알부민 결합효과와 관련된 기초적인 추가 연구가 필요할 것으로 생각된다 Background : During the era of increasing penicillin resistant Streptococcus pneumoniae, it is important to have knowledge about adequate dosage and dosing interval of ceftriaxone (CTR). We examined efficacies of once-daily CTR and compared results in an in vitro pharmacodynamic infection model (IVPDIM) supplemented with albumin and those without albumin. Methods : Using three clinically isolated S. pneumoniae that were susceptible (SM24), intermediate (SM47) and resistant (SM60) against CTR, we utilized a two-compartment IVPDIM. CTR 2 g was administered intravenously every 24 h. Human albumin was added with concentration of 4 g/dL. Samples were removed at multiple time points over a 48-h period to determine the colony counts. Results : In SM24 and SM60, bactericidal effects were observed within 6 hours in groups without albumin. The number of colonies during 1st 6 hours were more decreased in albumin-free groups than in albumin-supplemented groups (P<0.05). In SM47, similar results were found during 1st 6 hours (P=0.03). But, regrowth was observed in albumin supplemented group at 30 h. Irrespective of results of minimal inhibitory concentrations and albumin supplementation, bactericidal effects were shown at 24 h in all 3 strains. All groups were decreased below the detection limit at 48 h. Development of resistance was not detected throughout the entire study period in either strain. Conclusions : Although extents of killing in albumin supplemented broth of once-daily CTR dosing were delayed in all 3 strains compared with those of albumin free broth, final efficacies were not different between the two groups.

알부민이 첨가된 시험관내 약역학 감염모델을 이용한 폐렴알균 치료에서 Ceftriaxone 일일 1회 요법

허지안,전혜선,박선희,최수미,김시현,이동건,최정현,유진홍,신완식 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

배경 : Penicillin 내성 폐렴알균이 증가하는 지역에서 대안 중의 하나로 사용되는 ceftriaxone (CTR)의 적절한 용법, 용량을 파악하는 것이 중요하다. 본 연구는 임상에서 분리된 폐렴알균을 대상으로 시험관내 약역학 감염모델을 이용하여 알부민이 첨가된 경우와 첨가되지 않은 경우 CTR의 일일 1회 요법의 효과를 비교해 보고자 하였다. 재료 및 방법 : Penicillin 감수성(SM24), 중간내성(SM47), 내성(SM60)주를 대상으로 2-구획 시험관내 약역학 감염모델을 적용하였다. CTR 주입은 2 g씩 24시간마다로 사람의 약동학을 모의하였다. 알부민은 모델에서 4g/ dL가 유지되도록 하였다. 살균효과는 0, 2, 4, 6, 24, 30, 48시간째 집락수 변화로 측정하였다. 결과 : 모든 균주에서 알부민이 첨가되지 않은 경우 6시간 이내에 살균력이 관찰되었다. 최저억제농도 및 알부민 첨가유무에 관계없이 3주 모두 24시간째 살균력이 관찰되었고, 48시간째는 모두 측정한계 이하의 집락수로 감소하였다. 전 실험과정에서 CTR에 대한 내성주는 출현하지 않았다. 결론 : CTR의 일일 1회 요법은 알부민이 첨가되었을 때, 감수성, 중간내성, 내성주 모두에서 살균력 발현이 지연되었으나 최종효과는 알부민이 없을 때와 다르지 않았다. 앞으로 알부민 결합효과와 관련된 기초적인 추가 연구가 필요할 것으로 생각된다. Background : During the era of increasing penicillin resistant Streptococcus pneumoniae, it is important to have knowledge about adequate dosage and dosing interval of ceftriaxone (CTR). We examined efficacies of once-daily CTR and compared results in an in vitro pharmacodynamic infection model (IVPDIM) supplemented with albumin and those without albumin. Methods : Using three clinically isolated S. pneumoniae that were susceptible (SM24), intermediate (SM47) and resistant (SM60) against CTR, we utilized a two-compartment IVPDIM. CTR 2 g was administered intravenously every 24 h. Human albumin was added with concentration of 4 g/dL. Samples were removed at multiple time points over a 48-h period to determine the colony counts. Results : In SM24 and SM60, bactericidal effects were observed within 6 hours in groups without albumin. The number of colonies during 1st 6 hours were more decreased in albumin-free groups than in albumin-supplemented groups (P<0.05). In SM47, similar results were found during 1st 6 hours (P=0.03). But, regrowth was observed in albumin supplemented group at 30 h. Irrespective of results of minimal inhibitory concentrations and albumin supplementation, bactericidal effects were shown at 24 h in all 3 strains. All groups were decreased below the detection limit at 48 h. Development of resistance was not detected throughout the entire study period in either strain. Conclusions : Although extents of killing in albumin supplemented broth of once-daily CTR dosing were delayed in all 3 strains compared with those of albumin free broth, final efficacies were not different between the two groups.

재무정보의 국제적 비교가능성과 외국인 투자 효과

허지안 한국회계정보학회 2019 한국회계정보학회 학술대회발표집 Vol.2019 No.1

국제회계기준 도입 이후 한국기업과 해외기업간의 재무정보 비교가능성이 정보이용자 관점에서 향상되었는지 분석하고, 국제회계기준 의무도입이라는 제도적 변화요인과 외국인 투자자들의 투자의사결정과의 관련성을 분석하고자 함 2005년 IFRS를 의무도입한 EU가입국 기업들과의 국제비교가능성 측정치를 통해 재무정보의 국제비교가능성을 측정함. 한국기업들의 국제비교가능성 측정치를 바탕으로 IFRS 도입 전 후 비교가능성의 수준 변화와 외국인 지분율의 변화를 분석함. 코스피 및 코스닥 시장에 상장된 한국기업의 2006년부터 2017년까지 균형패널데이터를 사용하여 GLS분석을 실시함 IFRS 도입 이후 외국인 지분율도 유의하게 증가하였으며, 이러한 결과는 국내 자본시장의 외국인 총 투자규모를 통제하고도 설명력이 유의하였음. 특히 국제비교가능성이 높은 기업이 외국인 지분율도 높게 나타나는 결과가 나타나 국내에서 수행된 비교가능성 연구 중에서는 최초로 재무정보의 국제비교가능성과 외국인 지분율간의 양(+)의 관련성을 확인함. 한편, 코스피 상장기업들의 비교가능성 및 외국인 지분율 증가 효과가 코스닥 상장 기업들 보다 컸으나, 코스닥 상장기업이라 하더라도 Big4 감사인에게 외부감사를 받아 재무정보를 제공하는 기업들은 non-Big4 감사인에 의한 재무정보를 제공하는 코스피 기업에 비해 외국인 지분율이 높게 나타나고 있어, 재무정보의 품질과 신뢰성이 외국인 지분율 변화와 관련성이 있음을 확인함. 그간 IFRS 도입 이후 비교가능성의 변화, 외국인 지분율의 변화에 대한 연구는 이루어졌으나, 해외기업과의 비교가능성 증가와 외국인 지분율의 변화와의 양(+)의 관련성을 최초로 확인한 연구임.

Sacral Herpes Zoster Associated with Voiding Dysfunction in a Young Patient with Scrub Typhus

허지안 대한감염학회 2015 Infection and Chemotherapy Vol.47 No.2

When a patient presents with acute voiding dysfunction without a typical skin rash, it may be difficult to make a diagnosis of herpes zoster. Here, we present a case of scrub typhus in a 25-year-old man with the complication of urinary dysfunction. The patient complained of loss of urinary voiding sensation and constipation. After eight days, he had typical herpes zoster eruptions on the sacral dermatomes and hypalgesia of the S1-S5 dermatomes. No cases of dual infection with varicella zoster virus and Orientia tsutsugamushi were found in the literature. In the described case, scrub typhus probably induced sufficient stress to reactivate the varicella zoster virus. Early recognition of this problem is imperative for prompt and appropriate management, as misdiagnosis can lead to long-term urinary dysfunction. It is important that a diagnosis of herpes zoster be considered, especially in patients with sudden onset urinary retention.