폐암과 동반되어 나타난 기관기관지병증 골연골형성증 1예

이영진,전현수,박시형,김모세,김현주,이승헌,이영민,이현욱,이현경 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Tracheobronchopathia osteochondroplastica (TPO) is a rare benign disease of unknown etiology characterized by multiple cartilaginous or bony submucosal nodules, which project into the tracheobronchial lumen. Although some disorders were reported combined with TPO, these seemed to be considered casual. We report a case of TPO that combined with adenocarcinoma of lung. She was 50-year-old non smoking woman presented with chronic cough with right chest pain. Lung mass on right lower lobe was found on chest x-ray, so lung cancer was suspected. Multiple scattered whitish small elevations from trachea to bronchial trees were found on bronchoscopic exam. We mistook these lesions for metastases from lung cancer and biopsies of these lesions were done. Transbronchial biopsy for right lower lobe mass lesion was also done. But biopsies from trachea and bronchus revealed TPO rather than lung cancer. Transbronchial lung biopsy of right lower lobe mass was diagnosed adenocarcinoma of lung. So TPO combined with adenocarcinoma of lung was diagnosed.

학교평생교육에 대한 현직교사의 인식 조사 연구 : 서울시 초등학교 교사를 중심으로

전주성,유은수,한수연,이현주,임희연,이희송 한국성인교육학회 2007 Andragogy Today : International Journal of Adult & Vol.10 No.3

Baculovirus Vector System에 의해 발현된 재조합 Pseudorabies Virus Major Capsid Protein의 면역원성

전무형,안동준,장경수,조용성,박종현,송재영,현방훈,안수환 충남대학교 생물공학연구소 1997 생물공학연구지 Vol.5 No.-

The recombinant pseudorabies virus major capsid protein (rMCP) was produced by expression of the MCP gene in Sf-9 cell using baculovirus transfer vector system. Following evaluation of the immunochemical properties of the rMCP, the immunogenicity of the recombinant subunit protiens were investigated in guinea pig and swine to obtain the preliminary guide line for the subunit vaccine using rMCP and gP50. It was proved that ultrasonication and 30% ammonium sulfate was most efficient to concentrate and purify the protein. The rMCP was safe in mice, guinea pigs and piglets. In guinea pigs, rMCP mixed with various adjuvants induced substantial degree of serum neutralizing antibody titers, but revealed incomplete protecivity against challenge. In swine, the combination of rMCP and gP50 showed the higher serum neutralizing antibody titers and cellular immune responses than rMCP alone. However, the protectivity was lower in comparison with the commercial gI-deleted inactivated vaccine. We expect these results to contribute to characterization of MCP gene of Korean isolate of PRV and to ultilize as preliminary information for prodution and evaluation of PRV recombinant subunit vaccines.

구강암 환자에 대한 임상통계학적 분석

조준현,김진수 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

2인과 3인의 기본 심페소생술 비교

정준영,이창현,김현정,도호석,이삼범,도병수 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

Study objectives: To compare the quality of CPR provided by medical students and pre-EMTs perfoming three-rescuer CPR with that achieved by same students trained to provide standard two-rescuer CPR and to find the most effective method of resuscitation and to educate this methods to students. Material and methods: From July 1 to September 30, 1996, we had trained 60 groups consisted of the medical students, students of EMS technology and pre-EMT. Each group practiced two-rescuer CPR and three-rescuer CPR for 120 minutes with Resusci? Anne and perfomed CPR for at least 3 minutes without feedback. To eliminate any visual cues of perfomance the mannequin's recorder was hidden. Each actions were recorded by Resusci? skillmeter and Laerdal printer. To compare the quality of two-rescuer CPR and three-rescuer CPR, we analyzed the data by SPSS with paired t-test. Results: Three-rescuer teams delivered a mean minute ventilation and a mean minute cardiac compression substantially greater than that produced by two-rescuer teams(11.30±1.85 vs 9.09±2.22, p<0.001; 99.22±12.42 vs 95.12±15.75, p<0.001). Three-rescuer teams produce the more correct actions in chest compression and ventilation(93.84±7.56% vs 83.49±16.94%, 90.90±9.33% vs 77.00±17.06%). Conclusion: Three-rescuers can produce better CPR than two rescuers when a bag-valve-mask devices is used and the technique is easily learned and readily retrained, so we think that repeated education and training of this CPR methods to students is needed.

Newcastle Disease Virus의 Fusion 단백 유전자의 제한효소분절형태(RELP)의 특이성

장경수,김지영,김석,김태용,송영환,허지연,김현수,송희종,전무형 충남대학교 수의과대학 동물의과학연구소 2001 動物醫科學硏究誌 Vol.9 No.-

To evaluate the specificity of restriction fragment length polymorphism (RFLP) of Newcastle disease virus (NDV) fusion (F) protein gene for various NDV strains. F protein genes of NDV CBP-1 isolate, LaSota, B1 and Kyojungwon (KJW) were amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) and RFLP were examined. In RT-PCR using F primer sets for 1.7 kb F gene, the amplified products were observed in CBP-1, LaSota and B1 except KJW. However, F2 primer set for 521 bp yielded the amplified bands with all strains. The amplified F genes (1.7 kbp) were treatd with 15 different restriction enzymes to analyze RFLP and the cleavage patterns. CBP-1 showed various cleavage patterns with 8 enzymes, LaSota, with 11 enzymes and B1, with 11 enzymes. According to the cleavage patterns, the physical maps were constructed, and it was found that CBP-1, LaSota and B1 strains had specific cleavage sites with HinfI, XbaI and XhoI. These findings suggest that RFLP are worth applying in the diagnosis and molecular epidemiological studies of Newcastle disease.

임상검체에서 분리된 그람 음성 세균들에 대한 Isepamicin의 시험관내 항균력

권현희,박수진,소민욱,박현구,최성호,김미나,최상호,정진용,우준희,김양수 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : The increasing incidence of multidrug-resistant gram-negative bacteria causing nosocomial infections is an important clinical problem. Isepamicin is a recently developed aminoglycoside which has been known to have potent activity against gram-negative organisms. We evaluated the in vitro activities of isepamicin and other aminoglycosides against a large number of gram-negative organisms. Materials and Methods : We tested the in vitro antimicrobial activities of isepamicin, amikacin, gentamicin, and tobramycin against 566 gram-negative organisms collected between January 2006 and June 2006 in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined and interpreted according to the recommendations of Clinical and Laboratory Standard Institute (CLSI). The breakpoint MIC used for interpretation of isepamicin was MIC≤16 ㎍/mL as susceptible, 32 ㎍/mL as intermediate, and 64 ㎍/mL as resistant. Results : The MIC_(50)/MIC_(90) of isepamicln for Escherichia coli, Klebsiella pneumon/ae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae were 1/2, 0.5/>128, 4/16, 16/>128, and 1/2 ㎍/mL, respectively. The susceptibilities for E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, and E. cloacae were 100%, 86.4%, 89.7%, 50.0%, and 96.6%, respectively. For E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae, isepamicln had better in vitro activities than gentamicin and tobromycin, and had similar activities with amlkacin. For A. baumanii, all four tested aminoglycosides had similar in vitro activities. Conclusion : Isepamicin had excellent in vitro activities against gram-negative organisms, except A. baumanii. The overall in vitro activities were similar with amikacin. 목적 : 그람 음성 세균은 다양한 지역사회 및 병원 획득 감염의 원인균이다. 최근에는 병원 감염을 일으키는 그람 음성 세균에서 항균제 내성균의 출현과 확산이 큰 문제가 되고 있다. Isepamicin은 최근에 소개된 gentamicin B의 유도체로 외국에서의 연구에 의하면 그람 음성 세균들에 대한 항균력이 우수함이 보고 된 바 있다. 본 연구에서는 우리나라의 임상 균주들을 대상으로 그람 음성세균에서 isepamicin의 시험관내 항균력을 기존의 아미노배당체 제재들과 비교하여 평가하고자 하였다. 재료 및 방법 : 2006년 1월에서 6월 사이에 서울아산병원 환자에서 분리된 Escherichia coli 113 균주, Klebsiella pneumoniae 110 균주, Pseudomonas aeruginosa 117 균주, Acinetobacter baumannii 108 균주, 그리고 Enterobacter cloacae 118 균주를 대상으로 isepaimcin, amikacin, gentamicin, tobramycin에 대한 최소억제농도(minimal inhibitory concentration, MIC)를 한천 희석법(Mueller-Hinton Agar)을 이용하여 측정하였다. 감수성여부는 CLSI 기준에 따랐으며, isepamicin은 MIC≤16㎍/mL를 감수성, MIC=32 ㎍/mL를 중등도 내성, MIC≥64 ㎍/mL를 내성으로 판정하였다. 결과 : Isepamicm의 E. coli, K. pneumoniae, P. aeruginosa, A baumannii, E. cloacae에 대한 MIC_(50)/MIC_(90)은 각각 1/2, 0.5/>128, 4/16, 16/>128, 1/2 ㎍/mL였고, 항균제 감수성률은 차례대로 100%, 86.4%, 89.7%, 50.0%, 96.6%였다. 기존 아미노배당체 제재들과 비교하면 E. coli, K. pneumoniae, P. aeruginosa, E. cloacae에서는 amikacin과 비슷한 감수성률을 보였고, gentamicin과 tobramycin보다 높은 감수성률을 보였다. A baumannii의 경우 isepamicin의 감수성률이 50.0%로 비교적 낮았지만 amikacin, gentamicin, tobramycin도 각각 50.0%, 46.3%, 47.2%의 감수성률을 나타내어 4가지 항균제가 모두 비슷한 항균력을 보였다. 결론 : Isepamicin은 그람 음성 세균들에 있어 기존의 아미노배당체 제재들과 비교했을 때 amikacin과는 동등한 시험관내 항균력을 보이고 gentamicin, tobramycin보다 뛰어난 시험관내 항균력을 보여 사용이 유망한 아미노배당체 중 하나라 생각된다.

골격계의 원발성, 전이성 혈관외피세포종 : 증례 보고

김동수,김용민,최의성,손현철,박경진,조병기,이형준 충북대학교 의과대학 충북대학교 의학연구소 2009 忠北醫大學術誌 Vol.19 No.2

혈관악성종양은 혈관내피종(hemangioendothelioma), 혈관육종(angiosarcoma), 혈관외피세포종(hemangio pericytoma) 및 카포지 육종(Kposi's sarcoma) 등이 있으며, 이 중 혈관외피세포종은 비전형적인 외피 세포가 증식된 경우를 말한다. 골의 혈관외피세포종은 드문 악성종양으로 문헌상 보고되어 있는 예들은 주로 성인의 대퇴골, 골반골에 발생된 경우이다. 이 경우 원발성은 드물며 주로 비골격계에서 기원하여 골로 전이되어 발생하는 것으로 알려져 있다. 남녀 발생 빈도는 거의 동일하며, 12세부터 90세까지 어느 연령층에서도 발생할 수 있으나, 호발 연령은 40대에서 50대 사이 이다. 대개 연부조직 종양으로 신체 어디에서도 일어날 수 있고, 하지 특히 서혜부 및 대퇴부에서 가장 많이 발생하며, 후복막, 두경부 및 흉복부의 순으로 나타난다. 전이도 빈번하게 발생하는데, 그 경로는 주로 혈행성으로, 발생부위는 폐와 골이 제일 많다. 저자들은 8년 전, 우측 아래턱의 원발성 혈관외피세포종으로 절제술을 시행한 환자에서 술후 3년 뒤, 우 경골 근위부에 원격 전이가 발생하여 절제술, 예방적 골수강내 금속정 삽입술 및 골시멘트 충전술을 시행하였다. 현재 2차 수술 후 5년여가 경과한 상태로 경골에 재발의 증거가 없어 만족할 결과를 가져다주었다고 판단하여 문헌 고찰과 함께 보고하는 바이다. Hemangiopericytoma is a rare tumor of blood vessels, first described and named by Stout and Murray in 1942, arising from the contractile, elongated cells the pericytes of Zimmermann which surround capillaries. It can develop whereever there are capillaries and mostly in the connective tissue of the human body. It can also develop in any age from 12 to 90 years, and the rate of metastasis and prognosis depend on its histologic grade. We report a case of hemangiopericytoma metastasized to the right proximal tibia from the right mandible, resected three years ago. The hemangiopericytoma is a extremely rare primary malignant tumor in the bone and bone to bone metastasis is never been found in the literature before. So, we report this case and also report the good result.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

단기배양을 통한 말초혈액 CD34 양성세포의 체외증폭

박상준,김철희,배광봉,김현수,김종숙,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Background: It is suggested that clinical practice in the areas of bone marrow transplantation and gene therapy might rely on the ex vivo expansion of hematopoietic stem/progenitor cells. However, the condition for ex vivo expansion of hematopoietic progenitor cells is not well established. The authors pursued a series of experiments to define the proper conditions for the expansion of hematopoietic cells in the short-term liquid suspension culture of mobilized peripheral blood CD34+ cells. Methods: 1.0ml cultures were initiated with 9×10^3 PB CD34+ cells, which were isolated from PB mononuclear cells (MNCs) by high-gradient cell sorting, in 12 well plates with the various combinations of hematopoietic growth factors(HGF). The following recombinant human HGFs were used: stem cell factor(SCF) 100ng/ml, granulocyte colony-stimulating factor(G-CSF) 100ng/ml, GM-CSF(granulocyte, macrophage colony-stimulating factor) 100ng/ml, interleukin-1 beta(IL-1B) 1ng/ml, interleukin-3(IL-3) 20ng/ml, interleukin-6 (IL-6) 100ng/ml. At the end of culture, colony-forming cells were evaluated by semisolid clonogenic assay. Results: 1) Using the high-gradient magnetic sorting system, CD34^+ cells were isolated with a yield of 40 3% 2) In 7 day culture of PB CD34^+ cells(9×10^3 cells), nucleated cells expanded mean 10×10^3(range, 9 to 20×10^3) with the addition of SCF alone, 35×10^3(range, 10 to 60×10^3) with SCF plus G-CSF plus GM-CSF, and 130×10^3(range, 40 to 300×10^3) with the combination of SCF, G-CSF, IL-1, IL-3, IL-6, GM-CSF. In 14 day culture, nucleated cells expanded 10×10^3 to 1,860×10^3 with combination of human hematopoietic growth factors. 3) In 10 day culture without medium change of PB CD34^+ cells, CFU-GM numbers expanded 16. 5 fold(range, 7 to 59 fold) with the addition of SCF plus G-CSF plus Il-1 plus IL-3, 31.3 fold(range, 20.5 to 101.1 fold) with the combination of SCF, G-CSF, IL-1, IL-3, GM-CSF. In 14 day culture with or without medium change of PB CD34^+ cells was inferior to 10 day culture for CFU-GM expansion. 4) There was no significant difference for CFU-GM expansion between five growth factors(SCF,G-CSF,IL-1,IL-3,GM-CSF) and six growth factors(five growth factors plus IL-6). Conclusion: The authors could confirm that short-term suspension culture of peripheral blood CD34+ cells could expand hematopoietic progenitor cells. Ten-day culture with medium change of CD34+ cells with the addition of five growth factors, i.e. SCF, G-CSF, IL-1B, IL-3, and GM-CSF, might be the most efficient in this system.