조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

서울 서남부지역 노인 인구에서 비만증 유병률과 고지혈증과의 상관성

최경묵,조영직,김경오,김동림,김난희,백세현,안정천,서홍석,오동주,최동섭 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

현대패션에 표현된 스트라이프패턴의 이미지 분석

신주동(Ju Dong Shin) · 김희숙(Hee Sook Kim) · 최종명(Jong Myoung Choi) 충북대학교 생활과학연구소 2008 생활과학연구논총 Vol.12 No.2

The purpose of this study was to analyze the image of stripe pattern expressed in contemporary fashion. For this research, the fashion magazines, Dong-a TV, Internet sites were used as references. In the middle age, the use of stripe pattern was banned because it was regarded as the pattern of the devil in Europe. But nowadays the stripe pattern plays the role of symbolizing health, youth, and personality. The stripe pattern is being used in various kinds of patterns like alternate stripe, block stripe, candy stripe, chalk stripe, herringbone stripe, hombre stripe, pekin stripe, pin stripe, rope stripe, sports stripe, and stitch stripe. The stripe patterns were expressed by the techniques of weaving, printing, sewing, knitting, and embroidery. The image of stripe pattern appeared during 2006 S/S∼2008 S/S collections could be classified into five images of modern, mannish, elegant, exotic, and sporty image.

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.

광주권 호텔산업의 재무분석에 관한 연구 : A, B호텔을 중심으로

崔東烈,李康熙 서강대학 지역발전연구소 1995 지역발전연구 : 서강전문대 Vol.1 No.-

To sum up the result of this study, in case of A, B Hotel is as follows. 1. Analysis shows that there is little stability including an aspect of a fund rasing, the ability to pay and working fund. 2. Analysis shows that there is little earnings. 3. Analysis shows that operations are sluggish. Therefore, ① It should be prevented the state of encroaching upon capital, through expansion of equity capital and lowering the standard of dependence upon borrowed capital. ② It is demanded that a company-wide cost reduction and a reduction the number of employees. ③ It should be excluded wasteful leakage which is appeared from the cost of management and maintenance, and controlled financial expence. ④ It should be given consideration to minimizing spare plant capacity, application of unwhol--esome stock-in-trade, daring restraint of investment, decreasing allotment of charges for custody and maintenance and the other expenses, and inclusion or not of inferiority credit caused by business fluctuations.

대안기계를 갖는 Job Shop scheduling을 위한 발견적기법의 개발

최동순,정병희 한국경영과학회 1996 한국경영과학회 학술대회논문집 Vol.- No.2

This paper proposes a heuristic method for job shop scheduling with alternative machines. Our heuristic suggests four machine-selecting rules and two priority dispatching rules for modifying existent ones considering alternative machines, and then it extends existing nondelay/active job shop schedule generation. This heuristic provides good criteria(rules) in the selection of a proper machine among those performing a specific operation and for the dispatch of an operation to a selected machine and thus these rules permit the efficient job shop scheduling with alternative machines. The performances of our four machine-selecting rules in addition to the two priority dispatching rules, applied together with the existing 17 rules, are experimented and evaluated, respectively.

디지털카메라를 이용한 3차원 측량 기법 개발에 관한 연구

崔哲淳,崔勝弼,韓元浩,金東熙 관동대학교 1997 關大論文集 Vol.25 No.2

Photographic survey is possible that it can survey the simultaneous three-dimensional survey about so many points, therefore it is so fast and precisely. We takes a snap the objects with digital carema, and input the data to the computer from this data. We can take the three-dimensional coordinate through relative orientation, absolute orientation and have to check the merit of three-dimensional suveying. Otherwise we can get the error in one centimeter after analysis three-dimension coordinate and we can get the higher precise accuracy cause to set the camera angle of 20∼45 degrees.

서울대학교 치과대학 구강악안면방사선학교실

최순철,고재희,박태원,유동수,이삼선 大韓口腔顎顔面 放射線學會 1997 Imaging Science in Dentistry Vol.27 No.1

The aneurysmal bone cyst is a nonmalignant reactive bone lesion. Developing rarely in the craniofacial region, and more commonly affecting the long bones and the spine, the lesion has variable etiopathogenic characteristics. The authors diagnosed a 33-year-old female as aneurysmal bone cyst after undergoing clinical, radiological and histological examinations. The characteristics were as followed: 1. The patient complained of pain and swelling of the right preauricular area. 2. The conventional radiograms showed a relatively well defined radiolucent lesion with partially scalloping margin. The cortical bone of the right condyle was thinned and expanded by the lesion. 3. Bone scintigraphy with ?Tc demonstrated ring-like or doughnut-pattern accumulation of radioactivity. 4. On T1-weighted imaging of MRI, the lesion on the right condyle had middle signal intensity. T2-weighted MRI demonstrated multiple high signal intensities separated by septa which had low signal intensity. Finger in ballon appearance was seen. 5. Histologically, the lesion was composed of large sinusoidal blood spaces lined by fibroblasts and histiocytes. Its fibrous stroma consisted of fibroblstic element, multinucleated giant cells, extravasated erythrocytes and focal hemosiderin pigmentation. New bone formation was also observed around larger sinusoidal spaces.