국내 혈액질환 환자에서 침습성 아스페르길루스증의 구제치료로서 Voriconazole의 효과와 안전성

권재철,김시현,최수미,최재기,이동건,박선희,최정현,유진홍,신완식 대한감염학회 2010 감염과 화학요법 Vol.42 No.1

Background: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in patients with hematologic malignancies. We investigated the efficacy and safety of voriconazole (VCZ) when used as salvage therapy for IA in Korean adults with hematologic malignancies who had not responded to prior antifungal therapy. Materials and Methods: We retrospectively reviewed data, collected from January 2007 to October 2008, from patients with proven or probable cases of IA. All were probable IA cases, except for one proven case. All cases were refractory or intolerant to antifungal therapy prior to administration of VCZ. Efficacy and safety were assessed in patients treated with VCZ for more than 3 days and for more than one dose, respectively. A favorable response [complete (CR) or partial (PR)] was defined by significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results: Fifty patients who met the inclusion criteria were enrolled. There were 27 male and 23 female patients with mean age of 44.4 years (range, 15-65 years). Underlying diseases were acute leukemia (35 cases), chronic myelogenous leukemia (4 cases), myelodysplastic syndrome (3 cases), lymphoma (3 cases) and other hematologic diseases (5 cases). Twenty-two patients had received chemotherapy and 13 patients had undergone hematopoietic stem cell transplantation. The lung was the main infection site (94%) followed by the sinus (6%). Amphotericin B deoxycholate alone was the most frequent previous antifungal therapy. The mean duration of antifungal therapy prior to VCZ therapy was 13.9±8.8 days (2-44 days). The median duration of VCZ therapy was 19 days (interquartile range, 49 days). Sixteen patients (32.0%) showed favorable responses (CR:PR=8:8) at the end of VCZ therapy. The numbers of patients with stable disease, progression and death were, 6 (12%), 6 (12%) and 22 (44%) respectively. Most of those with unfavorable responses had relapsed underlying malignancies or refractory graft versus host diseases. Twelve patients developed drug-related adverse events but only one patient stopped VCZ treatment prematurely. Conclusions: VCZ demonstrated an acceptable level of toxicity in patients with hematologic malignancies but further studies are required to prove its efficacy as salvage therapy.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

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.

숫자 음성 인식을 위한 효율적인 LPNN

최재호,홍광석 成均館大學校 科學技術硏究所 1997 論文集 Vol.48 No.1

In this paper, we proposed an algorithm that improve the ability of Linked Predictive Neural Network, which considered both the non-linear time alignment of speech signals and the time varying property of adjacent frame. The proposed algorithm presented a new constrainted path in LPNN by using pre-processed segment informations of phoneme. As the result, the prediction error of MLP predictor was reduced in phoneme transition boundary and the recognition rate was increased. Moreover, for the test, the recognition system used combined model of phoneme and diphone in consideration of the effect of phoneme segmentation. This experiment have been carried out by using seven male speakers pronounced Korean digit every 10 times. As a result of this experiment, the recognition performance improved by 0.33% and 14.25% for speaker-dependent and speaker-independent respectively. In case of used the combined model of phoneme and diphone, we achieved better performance by increasing 1% and 8% respectively.

파킨슨 증후군을 동반한 조발형 알쯔하이머병 1예

최은정,방현,임주혁,이재홍 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

Extrapyramidal signs (EPSs) frequently accompany Alzheimer's disease(AD). However, the pathogenesis or pathologic basis for the EPSs in AD remains unclear. We report a case of presenile onset progressive dementia later associated with hemiparkinsonism. Brain biopsy showed neurofibrillary tangles and amyloid plaques. compatible with Alzheimer's disease. There are a few report about dopamine transporter imaging of AD with EPSs. 1-123 IPT SPECT revealed a decreased uptake in both basal ganglia, more severe on the left side and in the caudal putamen, which is consistent with the finding of idiopathic Parkinson's disease. Alzheimer's disease and Parkinson's disease are thought to be coexistent in our patient.

Van der Woude 증후군 1예

최홍식,임재열,박준호,남지인 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.11

금속수은 폭로 근로자의 일시뇨를 이용한 생물학적 모니터링 평가

홍두루미,김순덕,염용태,최재욱 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.1

Biological monitoring for exposure permits estimation of organ doses or body burdens from exposures through all relevant portals of entry. Biological monitoring data may be used to estimate environmental concentrations when the latter cannot be measured directly. Biological indices are usually concentration of a chemical of its metabolites or its effect at the true receptors. Mercury concentration in urine has been most commonly recommended as a biological exposure index of mercury. for data based on urine analysis, variation in urine volume is the most significant. The urinary concentration related to excretion of the solute provides some correction for fluctuation of urine output. Sampling time must be carefully observed because distribution and elimination of a chemical are kinetic events. This study has evaluated mercury concentration in spot urine compared to the results of 24 hour collected urine by the adjustment methods(specific gravity, creatinine) and sampling time. The subjects were 43 workers who had been exposed to the metallic mercury. The results were as follows: 1. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0.639-0.715 and were not different by adjustment methods. 2. In the high exposure group who were over 100ug/l of urinary mercury, the correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0.687-0.824 and were not different by adjustment methods. 3. Mercury concentration in spot urine were very variable by sampling time or exposure time. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were most highest as 0.85-0.91 at first voiding urine in the morning, and were 0.77-0.86 at urine collected within four hours before end of shift. In the biological monitoring to exposure of mercury, sampling of spot urine were most proper at first voiding urine in the morning, and then at urine collected within four hours before end of shift. But the adjustment methods of specific gravity and creatinine were no difference of the results.

생검펀치를 이용한 점액낭종의 절제

홍은혜,최병재,이제호,최형준,손흥규,김성오 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

점액낭종은 소타액선 분비관의 폐쇄나 파열로 타액이 저류되어 발생하는 연조직 부종이고, 비교적 높은 빈도로 발생하는 구강내 가성 낭종으로 스스로 파열되어 치유되기도 하지만 대개는 만성적으로 진행되어 몇 주에서 몇 달간 지속되기 때문에 치료가 필요하다. 점액 낭종의 발생시, 주변에 이환된 소타액선을 포함하여 제거하는 완전절제술 외에 재발율을 낮추기 위한 스테로이드의 국소적 주입, 냉동동결요법(cryotherapy), 미세조대술(micromarsupialization) 등의 여러 가지 치료방법이 제시되고 있다. 완전절제술의 한 방법으로 생검펀치(biopsy punch)를 이용할 수 있는데, 조작이 간편하고 출혈이 적으며 술 후 처치가 거의 필요없다는 장점이 있다. 이 증례는 점액낭종이 있고 행동 조절이 힘든 소아에서 생검펀치를 사용하여 점액낭종을 완전히 제거한 경우로, 양호한 결과를 얻었다. Mucocele is a clinical term of the localized superficial mucosal swelling caused by salivary retention after the obstruction or the rupture of minor salivary ducts. Various treatment methods have been suggested to lower its recurrence rate, including complete excision of lesion Biopsy punch can be used easily and simply for complete excision of mucocele. It has several advantages, such as convenience in use, low bleeding tendency, and nearly no requirements for post-operative management. In this case, biopsy punch was used for the removal of mucocele in an uncooperative child, which enable fast, simple and safe procedure, with a good result.

충진탑에서 가스흡수에 의한 물질전달과 수력학적 거동에 관한 연구

최동훈,김재홍,김일배,김옥택,김장호 동아대학교 환경문제연구소 1997 硏究報告 Vol.20 No.1

The use of packed column which apply efficient thermal material separation method has been required for absorption process. Absorption is applicable to waste gas from industrial process and incineration and odor control. Since we have used the lattice packing which was recently discovered in Germany, We can prevent drop of efficiency from maldistribution and channeling which were occurred when we use conventional packing. The lattice packing is efficient within the range of thermal, easy to manufacture, low production cost and make a variety of materials. This study aims to control the waste gas and odor with absorption. The dimension of packed column in which used in experiment is 0.45(d) × 2.0 m(H), and the result of and mass transfer apply to practical industry and environmental protection. The systems adopted for the absorption are Air/Water and NH3-Air/Water. We still cannot apply packed column to the domestic industry and environmental protection and depend on foreign technology, but this study will contribute to the industry and environment.

유년기 안구적출술 및 방사선치료로 인하여 발생된 안와 열성장에 대한 재건 치험례

홍관석,김성문,김훈,임재석,최미숙,최성원,권종진 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

There are many reports of the surgical management for the craniofacial abnormalities arising from the irradiation of the head and face for treatment of childhood cancers. Since the mordern combined-modality theraphy for childhood cancers began in the late 1960s and the early 1970s, recent reports have described the occular, dental and maxillo-facial abnormalities after irradiation in long-term survivors of cancers of the head and face. The resultant deformities may be known to be difficult to reconstruct with surgical techniques. This paper describes the late reconstructive surgery for the unilateral orbital and malar hypoplasia after eyeball enucleation and irradiation during childhood to correct the facial asymmetry and expand the contracted orbital socket into the functional dimension for the retaining eyeball prosthesis with spherical implant. We reports the satisfactory preliminary results from the midfacial osteotomy through the supero-lateral orbital rim and malar bone and the antero-lateral repositioning with the autogenous bone grafting in 26 year-old female patient who will be planned to make the new eyeball prosthesis by the department of ophthalmology.