정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

‘헤테로토피아’적 지성, 90년대 시적 주체의한 갈래(1) -장정일을 중심으로

김정현(Kim Jung-Hyun) 한국현대소설학회 2022 현대소설연구 Vol.- No.87

This study has a big point of discussion about the authenticity and indefinableness of 90s literature. Under this point of view, this paper discussed Jang Jung-ils intelligence behind ‘sincerity that destroys sincerity’. The core of Jang Jung-ils poem is the masochistic text composition method. Behind this masochistic poetic narrator, the self-consciousness of the poetic subject is implicitly mediated. This symptomatic and symptomatic utterance(écriture) is an important constituent principle in Jang Jung-ils poem. Jang Jung-ils thorough artistic self-consciousness, which tried to reveal his fundamental desires only as signs and surpluses without departing from the principle of producing text, is considered to be the culmination of individuality and internality produced by the 1990s. The desire of the poetic subject, which is revealed only by traces and surpluses in the text, actually corresponds to his efforts in intellectual literature. For Jang Jung-il, the allegorical images of ‘Burning Book’ and ‘death’ show how the poetic subject created his poem through intelligence as a result. Jang Jung-il maintained his literary style and ‘arrogant’ despite the chaos of the 1990s. Jang Jung-ils ‘language’ aspect and peculiarity are the origins of contemporary Korean poetry. The purpose of this study is to examine the multi-layered aspects of authenticity in the 1990s along with the research on Yu Ha.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

초음파 유도하 맘모톰 생검을 이용한 병변의 완전제거 : 6개월 추적 초음파 검사를 통해 알아본 유용성

김혜성,한부경,최연현,김지영,고영혜,양정현,남석진,김정한 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.1

Smad에 의한 alkaline phosphatase 유전자의 발현 조절기전

김난진,류현모,김현정,김영진,남순현 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.2

본 실험은 탁월한 골유도능으로 관심의 대상이 되고 있는 RMP의 세포내 신호 전달자로 알려진 Smad 1과 Smad 5가 조 골세포 초기 분화표지인자인 ALP 유전자의 발현에 미치는 영향 및 그 조절기전을 알아보고자 하였다. BMP 처리 없이도 Smad에 의해 ALP가 발현되는가를 알아보기 위해 Smad 1과 Smad 5가 각각 stably transfection된 C2C12 세포를 3일간 배양후 histochemical assay를 하였고, Smad 1과 Smad 5의 expression vector와 ALP promoter vector를 transient co-transfectiongksgn ALP promoter activity를 측정하였다. Smad에 의한 BMP의 효과를 알아보기 위해서 100ng/ml의 BMP-2를 처리한 군과 처리하지 않은 군으로 나누어 세포를 배양한후 ALP 유전자의 발현을 northern blot analysis로 확인하였다. Smad가 ALP 유전자의 발현을 직접적으로 조절하는가를 알아보기 위여서는 단백질 합성억제제인 cycloheximide를 전처리하여 ALP 유전자의 발현을 northern blot analysis하였다. 이상의 실험결과 다음과 같은 결론을 얻었다. ·Smad 1과 Smad 5가 과발현된 세포에서는 BMP 처리없이도 ALP가 발현된다. ·Smad 1과 Smad 5가 과발현된 세포에서 RMP 처리후 ALP 발현 증가율이 대조군 보다 현저히 높게 나타나 Smad가 BMP 효과를 증가시킨다는 것을 알수있다. ·Smad는 새로운 단백질의 합성을 통해 ALP 유전자를 발현시킨다. Bone morphogenetic proteins(BMPs), members of the transforming growth factor β(TGF-β) superfamily were first identified as the factors that induce ectopic bone formation in vivo, when implanted into muscular tissue. Especially BMP-2 inhibits terminal differentiation of C2C12 myoblasts and converts them into osteoblast lineage cells. In the molecular mechanism of the signal transduction of TGF-β and related factors, intracellular signaling proteins were identified as Smad. In previous study, it has been reported that Smad 1 and Smad 5, which belong to the R-Smad family mediate BMP signaling, were involved in the induction of osteoblast differentiation in C2C12 cells. To understnad the role of Smads involved in osteogenic transdifferentiation in C2C12 cell, in present study, after we stably transfected C2C12 cells with each. Smad(Smad 1, Smad 5) expression vector, cultured for 3 days and stained for alkaline phophatase activity. ALP activity positive cells appeared in the Smad 1, Smad 5 stably transfected cell even in the abscence of BMP. After transiently co-transfected C2C12 cells with each Smad expression vector and ALP promoter, it was excence of MBP. These result suggested that both Smad 1 and Smad 5 were involved in the intracellular BMP signals which induce osteoblast differentiation in C2C12 cells. The effect of BMP on C2C12 cells with Smad 1, Smad 5 transfected were studied by using northern blot analysis. the treatment of BMP upregulated ALP mRNA level in three groups, especially upregulation of ALP was larger in Smad 1, Smad 5 transfected cell than control group. Pretreatment with cycloheximide(10㎍/ml), a protein synthesis inhibitor resulted in blocking the ALP gene expression even in BMP(100ng/ml) treated cell. These results suggested that Smad increased the level of ALP mRNA via the synthesis of a certain transcriptional regulatory protein.

Effects of Phenytoin and Diazepam on the Seizure Activity in the Cortical Dysplasia Animal Models

Kim, Si-Hyung,Choi, In-Sun,Cho, Jin-Hwa,Park, Eun-Ju,Jang, Il-Sung,Choi, Byung-Ju,Kim, Hyun-Jung,Kim, Young-Jin,Nam, Soon-Hyeun The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Dysplasia-associated seizure disorders are markedly resistant to pharmacological intervention. Relatively little research has been conducted studying the effects of antiepileptic drugs(AEDs) on seizure activity in a rat model of dysplasia. We have used rats exposed to methylazoxymethanol acetate(MAM) in utero, an animal model featuring nodular heterotopia, to investigate the effects of AEDs in the dysplastic brain. Pilocarpine was used to induce acute seizure in MAM-exposed and age-matched vehicle-injucted control animals. Field potential recordings were used to monitor amplitude and numbers population spikes, and paired pulse inhibition in response to stimulation of commissural pathway. Two commonly used AEDs were tested: diazepam 5, 2.5mg/kg;phenytoin 40, 60mg/kg. Diazepam(DZP) and phenytoin(PHT) reduced the amplitude of population spike in control and MAM-exposed rats. However, the amplitude of population spike was nearly eliminated in control rats as compared to the MAM-exposed rats. Pharmaco-resistance was tested by measuring seizure latencies in awake rats after pilocarpine administration(320mg/kg, i.p.) with and without pretreatment with AEDs. Pre-treatment with PHT 60 mg prolonged seizure latency in control rats, but not in MAM-exposed animals. The main findings of this study are that acute seizures initiated in MAM-exposed rats are relatively resistant to standard AEDs assessed in vivo. These data suggest that animal model with cortical dysplasia can be used to screen the effects of potential AEDs.

불순물 첨가 BGO 섬광체 단결정의 육성과 열형광 특성

김성철,김중환,김종일,정중현,도시홍,김기동,이대원 동의대학교 기초과학연구소 1996 基礎科學硏究論文集 Vol.6 No.1

Eu or Fe doped BGO scintillation crystals were grown by Czochralski method. In order to get information about traps in the grown BGO crystals, we measured trap parameters including activation energy, frequency factor and the kinetic order of thermoluminescence, and compared such parameters with thermoluminescent characteristics of pure BGO scintillation crystals. In addition, optical transmittance of the grown BGO crystals was measured.

상행 대동맥을 이환한 대동맥 벽내출혈과 대동맥 박리의 임상적 비교

김현숙,송재관,강덕현,김준,이철환,홍명기,김재중,박성욱,박승정 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

人 諸臟器 Alkaline Phosphatase Isoenzyme의 電氣泳動 및 定量

金在植,金京善,金重明,金榮泰,蔣卓仙,李鉉基 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

著者들은 家兎와 人體로부터 採取한 血淸과 諸臟器組織을 使用하여 ALPI 電氣泳動像을 觀察하고 生化學的 定量法을 利用하여 ALP의 活性度를 測定試圖하였으며 臟器特異性 沮害因子에 對한 影響을 觀察하였다. 家兎 血淸 및 諸臟器組織 ALPI電氣泳動에서 血淸은 ±의 活性度를 가진 α2와 α2/β分劃을 나타내었으며 肝組纖은 血淸보다 빠른 移動度를 가진 ??의 α_1과 α_2分劃을 나타내었다. 그리고 肝, 骨, 腎 淋巴腺, 脾臟 및 腸組織에서는 顯著하게 높은 活性度를 나타내는 各各 서로 相異한 分劃을 볼 수 있었으며 人體諸 臟器와大體로 類似하였으나 家兎 血淸의 ALP는 사람에서 와는 다르게 肝組織의 分劃과 一致하지 않고 오히려 骨組織과 더 잘 一致되는 것 같았다. ALPI 活性度에 있어서 家兎의 諸臟器는 生化學的 定量法으로 腎 ALP의 活性度가 49.5B.L. units로 다른 臟器組織에 비하여 顯著하게 높았으며, 그 다음은 脾臟, 脊椎骨, 肝, 肺淋巴腺 및 脾 順으로 높은 活性度를 나타내었으며 人體에 있어서는 胎盤, 骨, 小賜, 脾臟, 肝 및 腎臟의 順으로 높았다. 臟器 特異性 沮害因子에 對한 影響에 있어서 胎盤分劃은 特有하게 耐熱性을 나타내었고 보다 urea低抗性이며 肝分劃은 neuraminidase에 對하여 移動度의 遲延을 招來하였다. The studies upon cellulose acetate microzone electrophoretic patterns, quantitative estimation and effects of organspecific inhibitor on ALP isoenzyme of rabbit and human sera and various organ tissues were performed. On electrophoretic pattern the tissue ALP from the liver bone kidney lymph node spleen and intestine showed the characteristic fraction of high activities. The electrophoretic mobility of rabbit serum ALP was not correspond to the liver ALP as observed in human serum and it appeared to be rather corresponded to the bone ALP, which seemed to be the origin of ALP in serum of rabbit. In the quantitative measurement of tissue ALP activity the kidney ALP showed the highest level and the activity of the skeletal muscle ALP was the lowest(1.5 B. L. units), while higher activities were observable in placenta, bone, intestine, spleen, liver and kidney in order. On the effect of organ specific physico chemical agents the placental ALPI was highly stable to the heat and relatively resistant to urea while other organ ALPI were on the contrary. The neuraminidase seemed to effect to the motility of liver fraction.