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        조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

        김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

        Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

      • 한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

        양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

        The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

      • 넙치의 백화현상 규명에 관한 연구 : Ⅰ. 멜라닌 색소 생성에 미치는 효소와 기질의 영향 Ⅰ. Effects of Enzyme Activities and Substrates on Melanin Formation

        최영준,강석중,조창환,명정구,김종현 國立統營水産專門大學 附設 水産科學硏究所 1990 수산과학연구소보고 Vol.2 No.-

        멜라닌 색소의 생합성 과정에 관여하는 것으로 알려져 있는 효소 및 관련 인자와의 상관성을 검토하기 위하여 자연산 정상넙치와 양식산 백화넙치의 肉質과 表皮, 미립자 사료와 생물먹이인 Artemia 및 Rotifer에 대하여 단백질의 함량, 멜라닌 색소생성에 고나여하는 효소의 활성, 아미노산 조성 및 비타민A와 C의 함량을 비교하였다. 정상넙치表皮는 肉質에 비하여 단백질의 함량이 높았으나, 백화넙치인 경우는 대체로 비슷한 값이었다. 사료중의 단백질 함량은 미립자 사료 중 C1이 가장 높았다. catechal oxidase의 활성은 기질과 조효소 농도의 증가와 더불러 증가하였으며, 백화 유무에 관계없이 거의유사한 값으로 나타났다. 그리고 L-dopa oxidase활성도 동일한 결과였다. 정상넙치의 유리아미노산 함량은 백화개체에 비하여 높았으며, 表皮의 경우는 정상넙치가 백화너치에 비하여 7.5배 가량 높은 값을 나타내었다. 필수아미노산의 조성으로 비교했을 때, 미립자 사료는 Artemia와 Rotifer보다 우수한 단백질원이었다. 그리고 정상넙치의 함활아미노산의 함유량은 백화넙치의 6.3배에 달하였다. 비타민A는 정상 및 백화넙치의 肉質과 表皮에서 검출되지 않았으나 비타민C는 정상인 접치表皮가 백화넙치 表皮에 비해 약 7.8배였으며, 미립자 사료는 100.83mg/100ㅎ으로서 사료 중 가장 높았다. 따라서 넙치表皮의 멜라닌색소의 생성에는 기질인 방향족 아미노산과 함황아미노산이 큰 영향을 미치는 것으로 판단되었다. The albinic phenomenon of flat-fish (Paralichthys olivaceus) was investigated by measuring protein content, tyrosinase activity, amino acid composition, and contents of vitamin A and C. These materials in the flat-fish feed-stuff were also tested. The amount of skin protein was higher than that of muscle in normal flat-fish. Catechol and L-dopa oxidase activity did not differ between normal and albinic flat-fish. The free amino acid of skin in normal flat-fish was 7.5 times that in albinic one. Sulfur-containing amino acid in normal flat-fish was also 6.3 times that in albinic ones. Vitamin A was not detected in both of flat-fish. The content of vitamin C in normal flat-fish was 7.8 times that in albinic one. The contents of protein, sulfur-containing amino acid and Vitamin C in micro-encapsulated feed (one commercial feed in Japan) were the highest among the feed-stuff used in this experiment. The melanin formation of flat-fish skin was affected by substrates such as aromatic amino acid and cofactor such as sulfur amino acid.

      • 건강인에서 결핵균 30-kDa항원이 말초혈액 임파구증식에 미치는 영향

        최대경,고석신,김화중,조은경,백태현,신철식 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

        T lymphocytes are thought to play a central role in cell mediated immune response. To Study the T lymphocyte proliferative response to 30-kDa antigen purified from Mycobacterium tuberculosis H37Rv, peripheral blood lymphocytes isolated from healthy subjects were stimulated with the 30kDa antigen, crude antigen or PHA. Healthy subjects were divided into three groups so that PPD(+), PPD(±) and PPD(-). The proliferations of lymphocytes were measured by the incroporation of ^3H-thyrnidine. The results were summarized as follows: 1. For the PPD(+) person, at concentration of < 1 ㎍/ml, the proliferative response to 30-kDa antigen resulted in a mild reduction but crude antigen showed relatively rapid reduction. For the PPD(-) person, decreasing the concentration of the both antigens showed rapid reduction of proliferation 2. The lymphocytes proliferations to 30-kDa antigen and crude antigen were significantly increased in PPD(+) group when compared to those in PPD(-) group, but PHA response was no significant difference. 3. The sensitivity and specificity of lymphocyte proliferation assay to 30-kDa antigen and crude antigen when compared with skin test results were 92.3%, 100% and 76.9%, 50%, respectively.

      • SCOPUSSCIEKCI등재

        뇌동맥류 파열 환자에서 증후성 뇌혈관연축의 발생 및 회복에 영향을 미치는 인자들

        최석민,석종식,권정택,민병국,황성남,김영백,홍현종 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

        To determine the factors affecting development and recovery of symptomatic vasospasm. the author analysed the results of patients with ruptured intracranial aneurysms treated by nimodipine and prophylactic “triple0H” therapy. From January 1991 to December 1995. 199 patients underwent surgery for ruptured intracerebral aneurysms. Combined hypervolemic hemodilution was initiated at the time of admission. Induced hypertension was added immediately after surgery(aneurysmal neck clipping). All patients received nimodipine intravenously or orally until the 14th day of SAH Sixty patients underwent surgery on Day 0 through 2 after attacks of subarachnoid hemorrhage(Goup A) 105 patients on Day 3 through 14(Group B). and 35 patients after Day 14(Group C). Of 199 patients. 76(38%) patients suffered from symtomatic vasospasm. Symptomatic vasospasm occured in 34% of Group A patients. 33% of Group B patients. and 5% of Group C patients. Symtomatic vasospasm occured more frequently in the older age group. the Fisher group 3 and Hunt & Hess grades 3, 4 and 5 groups. Of 76 patients who suffered from symptomatic vasospasm. 47(62%) patients recovered completely. The author analysed the relationship between recovery rate and sex, age. Hunt & Hess agrde and Fisher group among these 76 patients. Recovery rates between these groups were not significantly different. Based on this experience the author believes that Hunt-Hess grade. Fisher group and age are important factors affecting symptomatic vasospasm development.

      • 東醫壽世保元의 醫源論中 四象醫學의 醫源 및 特徵에 關한 硏究

        崔賢,文錫哉,嚴泰植 圓光大學校 漢醫科大學 1984 圓光漢醫大論文集 Vol.- No.2

        This thesis is an attempt to study in regard to a distinguishing mark and an origin of Sa-Sang (Four aspects) Medicine in Eui weun Noun (醫源論) : medical History) of the Domg-Eui-Su-Sae-Bo-Weun (東醫壽世保元) which was written by Lee Je Ma who was the one of the excellent oriental medical scholar in Korea, and futhermore to deep comprehension in Sa-Sang Constitutional medicine (四象體質醫學) which is Unique and sciantific. In this study, we has come to the conclusion ad follows ; 1. S.S.C.M. which was created by Dong-Moo (東武公) is the unique and excellent medicine. 2. In S.S.C.M. it is emphasized that an unballanced emotion is the one of the most important etiological factor. 3. S.S.C.M. come within the category of the traditional theory of the oriental medicine.

      • KCI등재
      • KCI등재

        유두상 에크린 한선종 1예

        최현성,이지현,윤석권,김한욱,임철완 대한피부과학회 2004 大韓皮膚科學會誌 Vol.42 No.3

        Papillary eccrine adenoma is a rare benign sweat gland neoplasm. It occurs most often as a solitary nodule in women and is located predominantly on the distal portion of the extremities. This tumor is similar to tubular apocrine adenoma in histological and clinical aspects, so distinction of these tumors is still controversial. We report a case of two papillary eccrine adenomas developed on the left popliteal and calf area of a 58-year-old-man, this is the first report of the multiple papillary eccrine adenomas in Korea. (Korean J Dermatol 2004;42(3):353~355)

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