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.

여호와의 증인 환자에서 산과적 출혈 후 무수혈 치료 2예

김재령,여소진,이해혁,김정식,김태희,남계현,이권해,이임순,박진화,황경호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Jehovah's Witness comprise a unique obstetric population. Their refusal of blood stems from an interpretation of a literal translation of the Bible, and it is this belief that puts them at an increased risk of morbidity and mortality if hemorrhage occurs. We report two cases of a Jehovah's Witness who bled massively due to obstetric hemorrhage, refused blood transfusion and had profound anemia. The patients were treated with recombinant human erythropoietin, parenteral iron and oxygen. And they were treated on an intensive care unit with intermittent positive pressure ventilation. We reviewed with literature considering the therapy for acutely anemic patients who refuse transfusion to decrease the duration of the most severe anemia.

간세포암과 하대정맥 막성폐쇄의 치료 후 호전된 백혈구파괴혈관염 1예

이준엽 ( Jun Yeob Lee1 ),이주원 ( Ju Won Lee1 ),이진욱 ( Jin Wook Lee ),박현준 ( Hyun Joon Park ),장국환 ( Gook Hwan Jang ),김다정 ( Da Jung Kim ),김선민 ( Sun Min Kim ),한병훈 ( Byung Hoon Han ),정규식 ( Gyoo Sik Jung ),김근태 ( 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

Vasculitis is a heterogeneous group of diseases that destroy blood vessel walls by inflammation. Approximately half of vasculitis cases are idiopathic, but sometimes associated with genetic factors, medicines, chronic infection, autoimmune diseases, and malignancies. Although the mechanism remains unclear, vasculitis secondary to malignancy, also known as paraneoplastic vasculitis, has been reported. It is generally associated with hematologic malignancies rather than solid malignancies and commonly presents as leukocytoclastic vasculitis or polyarteritis nodosa. We experienced a case of leukocytoclastic vasculitis in a patient with hepatocellular carcinoma and membranous obstruction of the inferior vena cava. Here, we report this case with a brief review of literature. (J Rheum Dis 2015;22:322-326)

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

생체분해성 고분자를 이용한 사시수술용 제형개발 및 효용성에 대한 연구

민병무,김용백,김승영,김창식,박근성,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A new device, muscle clamping system was developed to facilitate exact quatifying technique A strabismus surgery, and reduce the risk of complications. The device is composed of a lower fixing body with three jaws and an upper supporting body. They are used to clip an extraocular muscle and fix it to the sclera with a single bite. Superior rectus recession on 16 rabbit eyes were performed with this new device. Conjunctival injection, muscle adhesion strength, and light microscopic findings were examined at 1, 2, 4 and 8 weeks postoperatively. The Conjunctival injection were minimal, adhesion power ranged from 420 to 600 gram gravity, which is sufficient in withstand the normal pull of human extraocular muscle. In microscopic exam, some Inflammatory cells and fibrosis were found. The new device was technically easy, fast, and accurate, so it may be useful in stabismus surgery.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

慶北 永川郡 大勝池에서 採集한 淡水魚의 吸蟲類 肝吸蟲 被囊幼蟲 奇生狀의 變動

李鎭植,文柱煥,鄭東一,崔東翊 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.3

1990年 4月부터 同年 9月까지 慶北 永川郡 大勝池(사근다리못)에서 採集되는 各種 淡水魚에서 肝吸蟲 被囊幼蟲의 寄生狀을 調査하여 1980年 同貯水池에서 調査한 成績과 比較한 바 採集魚種과 寄生狀의 差異를 觀察하였으므로 報告하는 바이다. 1980년 大勝池에서 採集된 魚種은 붕어(Carassius carassius), 강준치(Erythroculter erythropterus), 버들치(Moroco oxycepharus), 납지리(Paracheilognathus rhombea), 참붕어(Pseudorasbora parva), 참중고기(Sarcocheilichthys sinensis)의 6種이었으나 1990年에는 붕어, 파랑볼우럭(Lepomis macrorchirus), 참붕어의 3種만이 採集되었다. 1980年에 採集한 淡氷魚에서의 肝吸蟲 被囊幼蟲의 寄生率과 寄生程度는 강준치 25.0%, 5.4개, 납지리 13.0%, 0.5개, 참붕어 71.1%, 24.4개, 참중고기 46.7%, 5.8개였고, 1990年에는 참붕어에서만 25.0%, 7.7개로 檢出되었다. 以上의 成績으로 미루어 보아 大勝池는 지난 10年間 生態界가 變化하였고 그간에 移植된 파랑볼우럭이 生態界變化에 多少의 影響을 미친 것으로 생각된다. From April to September, 1990, fresh-water fish were collected in Daesong pond and examined for the presence of Clonorchis sinensis metacercaria in order to compare the infestation with C. sinensis metacercaria with that in 1980. Six species of fresh-water fish, Carassius carassius, the crusian carp, Erythroculter erythropterus, the white fish, Moroco oxycepharus, the fat minnow, Paracheilognathus rhombea, the flat bitterling, Pseudorasbora parva, the southern top-mouthed minnow, and Sarcocheilichthys sinensis, the oily shiner, had been collected in the pond in 1980. In 1990, however, only 3 species of fresh-water fish, C. carassius, P. parva and Lepomis macrorchirus, the blue gill, were collected. The rates and intensity of infestation with C. sinensis had been 71.1% and 24.4 cysts per gram of flesh in P. parva, followed by 46.7% and 5.8 in S. sinensis, 25.0% and 5.4 in E. erythropterus, 13.0% and 0.5 in P. rhombea in 1980. The metacercaria were demonstrated from P. parva alone, with the rate 27.3% and the intensity 7.7, in 1990. In the light of these results, it is likely that L. macrorchirus caused the ecosystem of the pond to be changed.

골격형 Ⅲ급 부정교합자의 경추와 수완부 골 성숙도에 관한 연구

이진형,양원식 대한치과교정학회 1990 대한치과교정학회지 Vol.20 No.1

This study was undertaken to investigate the interrelationships between the degrees of skeletal maturity of cervical vertebrae and the hand-and-wrist in skeletal Class Ⅲ malocclusions. In 185 skeletal Class Ⅲ malocclusions (male 62, female 123) having the lateral cephalogram and hand-wrist radiogram which were taken on the same day, 6 skeletal maturity stages of cervical vertebrae were compared with 11 skeletal maturity indicators of the hand-and-wrist. On the basis of findings of this study, the following results were obtained: 1. The stages of cervical vertebral maturity are one of the methods possible to assess the individual maturity. 2. Mean ages of male and female were obtained in each cervical vertebral stage. 3. Cervical vertebral stages 1 and 2 are considered to the accelerative growth phase, cervical vertebral stages 3 and 4 are corresponded to the peak height velocity, and cervical vertebral stages 5 and 6 were observed to occur during the decelerative phase of growth after peak height velocity in both sexes. 4. In cervical vertebral stages 1, 2, 3, 4, and 5, the degrees of skeletal maturity of cervical vertebrae in males were more retarded than females. 5. There was the high correlation between the degrees of skeletal maturity of cervical vertebrae and hand-and-wrist.

Chemical-Looping Combustion을 위한 금속산화물 매체들의 산화 환원 반응특성

이진배,송영욱,박주식,최상일,김영호,양현수 忠南大學校 産業技術硏究所 2003 산업기술연구논문집 Vol.18 No.2

Chemical-looping combustion has been focused as a very promising combustion technology from the viewpoint of high energy efficiency, easy separation of CO_(2) and no formation of NO_(x). The key of this combustion technology is to develop oxygen carrier mediums with high oxygen capacity, and high machanical and thermal stability. In this study, various kinds of mediums were prepared by the combination of active metal oxides, such as NiO, CoO, Fe_(2)O_(3) or NiO-Fe_(2)O_(3), with YSZ(yttria stabilized zirconia) as a binder. The redox reactions on the mediums were also carried out by using the thermogravimetric reactor. The redox reaction rates on a NiO/YSZ medium were found to be most superior in comparison with those of other mediums. In addition, durability of the medium was also found to be appropriate for UC. For the purpose of high redox reaction rates, the optimum reaction temperatures of reduction and oxidation on a NiO/YSZ medium were observed as 600℃ and l000℃, respectively.

견적의사결정지원시스템(Ⅱ) : 원가예측을 중심으로 Cost Estimation

이성용,김진욱,이규식 國立 昌原大學校 産業技術硏究所 1996 産技硏論文集 Vol.10 No.-

In the plant engineering company, one of the most important thing is to accurately estimate the cost and the delivery time of the project. This is necessary for the company to win the bidding and to have some room for negotiation. Moreover, the company needs to have time to process information to make timely response to, and deal with the changing conditions as quickly as possible. One of the popular methodology dealing with this kind of situation is an effective decision support system, and many researches have been going on on this subject. In this article, we attempt to develop the decision support system which can provide automatic cost estimates from which plant engineering company may be benefited.