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

어린이의 사시교정술시 인공호흡수와 심박수와의 상관관계

강종만,김종성,김희수,염명걸 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Correlation between Respiratory Rates and the Degree of Bradycardia in Strabismus Surgery in Children Jong-Man Kang, M.D., Hee-Soo Kim, M.D., Chong0Sung Kim, M.D. and Myung-Kul Yum, M.D.^* Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, and ^*Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea Background: Strabismus surgery is frequent in pediatric ophthalmic surgery. Traction on the extra-ocular muscles can trigger an oculocardiac rdflex. We investigated the correlation between respiratoy rates and the degree of bradycardia to find another management for preventing oculocardiac reflex. Methods: NO premedications were administered. They were induced with thiopental and vecuronium and maintained with O_@-enflurane-N_2O. The tidal volume was 10 ml/kg. Respiratory rate of group 1 (n = 18) was fixed at 24 bpm, group 2 (n = 18) at 20 bpm, and group 3 (n = 19) at 16 bpm. We measured the mean heart rate from intubation to the beginning of surgery and defined this as the basal heart rate. We defined the lowest heart rate after traction of the extraocular muscles as the minimal heart rate. We calculated the correlation coefficient between the respiratory rate and basal heart rate, minimal heart rate, the change of heart rates and E_tCO_2. Results: There was a positive correlation between the respiratory rate and the basal heart rate, and minimal heart rate. There was no correlation between the respiratory rate and the change of heart rate. There was no difference in E_tCo_2 among the 3 groups. Conclusions: Can be increased both basal heart rate in anesthetized patients and minimal heart rate induced by oculocardiac reflex by making the respiratory rate more rapid if there is no significant difference of E_tCO_2. The oculocardiac reflex may be reduced by making respiratory rate more rapid if there is no significant influence on minute ventilation. (Korean J Anesthesiol 2001; 41: 450~454)

질병진단에 중요한 효소들에 관한 비교 연구

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

닭 조직에 따른 Nebulin Isoform 단백질의 특이적 발현

김영희,김정락 대한의생명과학회 2000 Journal of biomedical laboratory sciences Vol.6 No.3

대부분 척추동물에서 골격근 내 filament들의 길이 조절은 근 수축 기작의 구조를 이해하는데 중요한 단서가 된다. Nebulin은 thin filament의 전체에 걸쳐있는 거대한 단백질로 골격근에만 특이적으로 존재하는 것으로 알려져 왔다. 본 연구에서는 닭의 근육과 비근육 조직에서 nebulin isoform 단백질들을 확인하기 위하여 전기영동과 immunoblot의 방법을 이용하였다. 각 조직의 단백질들은 soluble과 insoluble fraction으로 분리 준비하였다. 실험결과, 닭의 근육과 비근육 조직들에서 조직 특이성을 나타내는 다양한 nebulin isofrm 단백질들이 확인되었다. Nebulin은 성계의 골격근에서 500 kDa 정도의 크기로 나타났고, nebulett은 계배와 성계의 심장근에서 107 kDa 정도로 발현되었다. 그리고 계배의 비근육 조직인 뇌에서 380 kDa 정도의 거대 단백질이 확인되었다. 이 단백질은 뇌 조직의 soluble fraction에서 인지되었다. Nebulin isoform 단백질들이 서로 다른 조직에서 발현되는 양상을 보아 서로 다른 독자적인 기능을 가질 것으로 추정된다. The lengths of thick and thin filaments in the sarcomeres of most vertebrate skeletal muscles are precisely regulated and are important structural parameters in understanding muscle contraction. Nebulin is a usually large protein that spans the whole length of thin filaments in the sarcomeres of skeletal muscles. In this paper we used SDS-PAGE and immunoblot to identify nebulin isoform proteins in muscle and non-muscle tissues. We prepared embryonic chicken tissues including skeletal muscle, cardiac muscle, smooth muscle, brain liver to compare nebulin isoform proteins. The proteins were divided into soluble and insoluble fraction. As a result, we identified tissue specific expression of various nebulin isoform proteins in muscle and non-muscle tissues of chicken. Nebulin was detected in skeletal muscle of adult chicken about 500 kDa. Nebulett was expressed in cardiac muscle of embryonic and adult chicken about 107 kDa. A giant protein with molecular mass of about 380 kDa was identified in brain of non-muscle of chicken. This giant protein was detected in the soluble fraction of chicken embryo. The unequal distribution of the nebulin isoform proteins suggests tissue specific regulation of the isoform expression and indicates a functional specialization of the encoded isoform subtypes.

개에서 심실 조율부위 및 조율주기에 따른 혈역학적 변화

김희열,김재형,노태호,김종진,진승원,유기동,이만영,채장성,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9

大淸湖産 끄리(Opsariichythys bidens)에 寄生된 Metagonimus吸 蟲 피낭유충에 관한 硏究

金鍾煥,鄭全熙 충남대학교 자연과학연구소 1986 忠南科學硏究誌 Vol.13 No.2

A study of metacercariae of Metagonimus parasitized to the fish(Opsariichthys bidens) caught from the Daecheong freshwater lake was carried out, and the following results were obtained: 1. Prevalence rate of fish(O. bidens) infected with metacercariae of Metagonimus was 74.6% and the hightest rate of fish showed 94.7% in the fish caught from the upper side of lake. 2. The larger fishes were infected with more metacercariae of Metagonimus than that of the smaller ones, and the infection rates of fin, muscle and head were 96.5%, 2.6% and 0.9%, respectively. 3. When the mice were infected experimentally with 500 metacercaria, the recovery rate was 38.4% and the distribution of the worms in the lower part of small intestine of mouse showed 78.1%. 4. As a result of the morphological and anatomical observations, it was concluded that the worms were Metagonimus yokogawai miyata type.

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.