조혈모세포이식 후 발생한 주폐포자층 폐렴에 대한 고찰

주지현,최정현,이동건,백지연,고윤호,이혜정,김세희,신호진,박윤희,박지영,김유진,신완식,김춘추 대한감염학회 2001 감염 Vol.33 No.4

Background : Pneumocytitis cainii pneumonia (PCP) can occur in immunocompromised hosts especially such as AIDS or cancer patients. Although recent research had focused on PCP in AIDS patients, few studies have described the clinical presentations of PCP in recipients of stem cell transplantation (SCT). We evaluated the clinical manifestations of PCP in SCT patients admitted at St. Mary's hospital, Seoul, Korea. Methods : The medical records of 17 PCP patients undergoing SCT between Feb. 1998 and Feb. 2000 were reviewed. The diagnosis of PCP was confirmed through the demonstration of Pneumocytitis cainii via either cytology of brochoalveolar lavage (BAL) or histological technique of lung biopsy. CMV disease and CMV infection were confirmed by BAL culture and antigenemia respectively . Results : Seventeen patients were all recipients of allogeneic SCT and 7 of 17 patients were performed non-sibling SCT. Patients presented with symptoms including brief period (4 ∼23 days) of fever (76%), dyspnea (70%), cough (64%), and signs such as rare(58.8%), Sixteen patients (94%) had been receiving immunosuppressive agent such as cyclosporine A (64%) or Fk506 (35%) without PCP prophylaxis. Eleven patients (64%) were treated with corticosteroid with mean dose of 16 mg/day prednisolone and mean duration of 4.6 months after post-SCT period. Twelve patients were co-infected with CMV. Another co-infected miCroorganisms were Pseudomonas aeruginosa, Mycobacterium tuberculosis, herpes simplex virus, parainfluenza virus, Average duration of treatment with trimethoprim-sulfamethoxazole (TMP/SMX) was 21 ±9 days. Four patients died, and three of them were related with PCP. Conclusion : PCP developed frequently in patients who were taking immunosuppressive drug due to graft versus host disease or were not taking TMP/SMX prophylaxis. High risk patients showing fever, cough, or dyspnea should be considered to take early bronchoscopic intervention for detection of PCP. When treat for PCP, it also be considered to the possibility of coinfection such as CMV. (Korean J Infect Dis 33:273∼279, 2001)

그레이트 데인에서 발생한 위확장염전 증례

신희승,안지영,이영원,최호정 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 4-month-old female Great Dane dog with abdominal distention and non-productive retching after gulping of food and water yesterday was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. Depression and abdominal distention with tympany were observed on physical examination. Decreased RBC and PCV were observed on CBC. And ALKP, BUN, Glu and P were increased on a serum chemistry. Severe gas filled distention of the stomach and intestines were shown on the abdominal radiographs. Pylorus was displaced craniodorsally toward the left side and gastric body was deviated to the right side on the abdominal radiographs. Deviating cranially of the diaphragm and decreased size of the heart were observed on thoracic radiographs. Therefore this case was diagnosed as gastric dilatation-volvulus.

섬유강화형 포스트를 이용한 치관-치근 파절의 치료: 증례 보고

임화신,라지영,이광희,안소연,김윤희,금기석,이상봉 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

The crown-root fracture is defined as a fracture of tooth that contains enamel, dentin and cementum with or without pulp exposure. Generally the fracture lines place obliquely from labial surface, between incisal edge of the crown and marginal gingiva, to palatal surface subgingivally. If the fracture line is located supragingivally, the removal of tooth fragment and supragingival restoration can be performed. In subgingival fracture line, the surgical exposure, orthodontic eruption or surgical eruption can be considered. If the fracture line is too deep to restorate, extraction or decoronation can be selected. In children and adolescents, the extraction should be the last option. Another option to select before extraction is the restoration using fiber-reinforced post and the reattachment of tooth fragment. The fiber-rainforced post enhances the retention and the durability of tooth fragment. The reattachment of crown fragment using resin adhesive system is considered minimal invasive treatment biologically. This case reports the treatment of crown-root fracture using the reattachment of crown fragment and the insertion of fiber-reinforced post. 치관-치근 파절은 법랑질, 상아질, 백악질이 모두 포함된 치아의 파절로, 파절선이 대부분 절단연이나 순측의 변연부 치은 에서 구개측 치은열구 하방으로 사선으로 진행된다. 파절선의 위치가 치은 연상이라면 파절편의 제거 및 치은연상 수복을 시 행하고, 치은 연하라면 파절면의 외과적 노출술, 교정적 정출술, 외과적 정출술을 이용한 치아의 수복이 이루어진다. 그 외에 섬유 강화형 포스트를 삽입하여 치관 수복물의 유지력을 높이고, 레진 접착 시스템을 사용하여 치관 파절편을 재부착함으로 써 생물학적으로 최소한으로 침습적인 치료를 하는 방법도 있다. 만약 파절의 정도가 치은 연하로 깊은 경우 발치나 치관절제 술을 이용한 치근의 유지 등을 고려할 수 있다. 본 증례는 치관-치근파절로 내원한 12세 환아로 섬유강화형 포스트를 사용하여 치관 파절편 재부착을 시행하였으며 양호 한 경과를 보여 이를 보고하는 바이다.

하악 매복 지치의 외과적 발거시 Methylprednisolone의 안면 부종 감소 효과에 대한 임상적 연구

신지훈,박진배,한지용,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : The third molars, expecially mandibular wisdom teeth, are commonly obliquely impacted, and surgical procedure with odontomy and osteotomy is necessary for their extraction. The surgical extracion of impacted wisdom teeth occasionally in duces variable discomfort. Especially, postoperative swelling, pain and limitation of mouth opening determine the degree of discomfort. For the reduction of these complicaions, drug therapy(antihistamine, enzyme, steroid), cole pack and pressure technique have been studied. It is known that the steroids are the most effective. Methods and Meterial : We selected fifty patients in their twenties, who visited Department of Dentistry, Pusan Paik Hospital from March to August in 1998. All of 50 patients has no other medical problems. Total 50 patients were randomly divided to 30 of experimental group and 20 of control group. The experimental group had orally administration of methyprednisolone 5㎎ every 8 hours 2 times preoperatively and 7 times postoperatively. Five points were marked on the patients' face, and the distances between the points were measured just before operation and 48 hours after operation. Results : Methyprednisolone reduces swelling about 50% after surgical extraction of obliquely impacted mandibular third molars with osteotomy and odontomy. The difference in the amount of tissue edema between experimental and control group was significant(p<0.01). However, there was no significant difference according to the operation time. Conclusion : It seems that the use of methylprednisolone is effective to reduce postoperative swelling following surgical extraction of third molars.

Acylthiocholine의 합성

정두희,이지현,박유미,정대일,곽문정,신영주 東亞大學校附設基礎科學硏究所 1998 基礎科學硏究論文集 Vol.15 No.2

Choline esters that are used with substrate of EE-AChE-catalyzed hydrolyses were synthesized by two methods. 2-Chloroethyl thiohexanoate 4a, 2-chloroethyl thioheptanoate 4c, and 2-chloroethyl thiooctanoate 4b were synthesized by treatment of hexanoyl chloride 3a, heptanoyl chloride 3c, and octanoyl chloride 3b with ethylene sulfide 2. Hexanoylthiocholine 6a and octanoylthiocholine 6b were synthesized by using 4a and 4b with trimethylamine 5. Secondly after reaction ethylene sulfide 2 with dimethyl amine 7 and acylation by acid anhydride 8, heptanoylthiocholine 6c, decanoylthiocholine 6d were synthesized by treatment of methyl iodide.

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

신체형 환자의 애착 특성

김용희,송지영,반건호,김종우,신용선 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The purpose of this study was to evaluate the relationship betseen attachment style and somatization in patients with somatoform disorder. Methods : Data was collected by self-report questionnaires. 134 normal subjects and 30 patients with somatoform disorder were enrolled in this study. All subjects completed a psychometric assessment that consisted the Revised Adults Attachment Scale(RAAS), Inventory of Parent and Peer Attachment (IPPA), Sungshin Self-concept Inventory (SSCI), and SCL-90-R. Results : 1) Somatoform patients showed more anxious attachment style than normal control. 2) Anxious attachments were combined with mistrust of their parents, emotional instability, and interpersonal mistrust which may play a significant portion of variance in somatization. Conclusion : We found that patients with somatoform disorder had more anxious attachment style than normal subjects. Insecure attachment patterns may significantly explain the phenomenon of somatization.

산발성 장형 위선암 환자의 Microsatellite Instability와 병리학적 양상

조창희,홍유찬,안지현,최경현,이상호,신영명,윤기영,정민정,장희경 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Background : Through many researches, microsatellite is expected to be a good diagnositic and prognostic factor in colorectal cancer, endometrial cancer, gastric cancer, and the others. The prevalence of microsatellite instability (MSI) in gastric carcinoma has reported variously, 13~44%. Purpose : We aimed to determine the prevalence of MSI-high and the relationship between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma of stomach. Material and Methods : We analyzed 106 sporadic intestinal type adenocarcinoma specimens excised from patients who were over thirty-five years old to determine the statue of microsatellite by DNA sequencing. The tissues were formalin-fixed and paraffin embedded. DNA were extracted and amplified by polymerase chain reaction (PCR). MSI was determined using five markers recommended by National Cancer Institute (NCI). Specimens were also studied with five patholical factors-differenciation of tumor cells, depth of invasion, lymph node metastasis, vessel invasion, and perineural invasion- to determine pathological state. Result : The microsatellite statue was determined as MSI-High in 5 cases (4.7%), no MSI-low, and MSS (microsatellite stable) in 101 cases (95.3%). Within the frequency, there was no large gap in the distinction of gender in MSI cases, but in MSS cases, there was three-times more cases in male. MSI cases had moderate-to-poor differenciation and trend to invade toward serosa. All MSI cases showed no perineural invasion. But we could not find any statistical significance between MSI and pathological characteristics of sporadic intestinal type adenocarcinoma. Conclusion : Results suggest that MSI can not make any certain pathological significance in sporadic intestinal type adenocarcinoma. Even though less than 5% of sporadic intestinal type adenocarcinoma patients showed MSI, it can be used as a influential prediagnostic factor of gastric cancer. Further study with large scale of cases will be followed to verify these results.

키토산 가교처리된 면직물의 태 변화에 관한 연구 : 에피클로로히드린과 키토산 농도의 영향 Effect of Concentration of Epichlorohydrin and Chitosan

김민지,박정우,이신희 한국의류산업학회 2004 한국의류산업학회지 Vol.6 No.5

This article describes the change of hand value of chitosan crosslinked cotton fabrics. The chitosan crosslinked cotton fabrics were manufactured by mercerizing process using epichlorohydrin(ECH) as crosslinking agent, 2% aqueous acetic acid as a solvent of chitosan and ECH, and 20% aqueous sodium hydroxide as a mercerizing agent and crosslinking catalyst. Cotton fabrics were dipped in the mixed solution of chitosan and ECH, picked up by mangle, mercerized and crosslinked in NaOH solution, and finally wash and dry. Mechanical and physical properties of the chitosan crosslinked fabric were investigated using Kawabata Evaluation System(KES) and other instruments. Tensile energy and tensile strain were decreased with the increase of the concentration of chitosan. Tensile resilience, compression resilience, bending rigidity, bending hysteresis, shear stiffness, shear hysteresis, coefficient of friction, geometrical roughness, compression linearity, compressional energy; and thickness were increased with the increase of the concentration of chitosan. On the other hand, bending rigidity, bending hysteresis, coefficient of friction, geometrical roughness, compressional resilience, and thickness were increased with the increase of the concentration of crosslinking agent(epichlorohydrin).

백혈병환자에서 Liposomal Amphotericin B로 치료된 파종성 Fusarium 감염 1예

이지연,김성범,박대원,신성희,김용현,윤소영,엄중식,최철원,정희진,김우주,김준석,김장수,이갑노 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

Fusarium spp.는 사람에서 드물게 각막염, 조갑진균증, 상처나 화상부위감염 등을 유발하는 것으로 알려져 있으나 최근에는 면역저하자에서 기회감염의 원인균으로 증가하고 있는 추세이다. 면역저하자에서 파종성 감염이 있는 경우에 예후는 치명적이나, 증례가 많지 않고 진단방법이 제한되어 있어 조기 진단과 신속한 치료가 쉽지 않다. 그러나 특징적으로 피부병변의 동반이 흔하여 면역저하자에서는 피부 병변의 면밀한 관찰과 함께 Fusarium 감염을 조기에 의심하여 피부생검이나 배양을 하는 것이 진단에 도움이 되리라 생각된다. 파종성 Fusarium 감염의 치료로는 감염 부위의 국소적 외과적 절제와 전신적 항진균제의 사용이 필요하고 현재까지는 amphotericin B가 비교적 효율적인 항진균제로 알려져 있으나 면역저하자에서 이에 반응을 하지 않는 경우가 많다. 저자들은 급성골수성백혈병 환자에서 관해유도화학요법 시행 후 호중구감소상태에서 피부병변과 폐침윤이 발견되었고 피부의 중심부 궤양을 동반한 구진성 병변에서 배양검사를 통해 파종성 Fusarium 감염을 진단하였으며 liposomal amphotericin B (AmBisome )를 사용하여 성공적으로 치료한 예를 경험하여 보고하는 바이다. Fusarium spp., basically a superficial pathogen, is a newly emerging fungal pathogen of opportunistic infections in immunocompromised patients. At present, although Fusarium spp. are relatively resistant to amphotericin B, the combination of amphotericin B and surgical debridement appear to be optimal treatment for disseminated infection. Recently we experienced a 32-year-old neutropenic patient after induction chemotherapy for acute myelocytic leukemia presented with skin lesions and infiltrations in both lungs. We diagnosed with disseminated fusariosis by skin culture and successfully treated the patient with liposomal amphotericin B. We emphasize a high index of suspicion for skin lesions especially in immunocopromised patients.