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.

한국형 후각검사 KVSS Test의 개발

홍석찬,유영석,김은서,김석천,박수홍,김진국,강성호 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.7

Free Communications : P2 ; Cannabinoid Receptors : Its Impact in Epidermal Differentiation and Possible Role in Treatment of Psoriasis

( Ji Seok Kim ),( Chan Hee Nam ),( Ji Yeon Yoo1 ),( Hyun Jung Kim ),( Se Kyoo Jeong ),( Sung Ku Ahn ),( Seung Phil Hong ) 한국피부장벽학회 2014 한국피부장벽학회지 Vol.16 No.2

Purpose: There are researches indicating that in human skin, the cannabinoid receptors exist, which take a part of endocannabinoid system. Nonetheless, the possible association of cannabinoid receptors with the pathogenesis of psoriasis has not yet been fully elucidated. Through this research, we tried to document the association between cannabinoid system, epidermal differentiation and psoriasis. Methods: Using human keratinocyte (KC), the expression of cannabinoid receptor-1 (CB1R) and -2 (CB2R) was analyzed according to the degree of differentiation. Also we examined for changes in differentiation marker of KC after application of CBR agonist. In addition, murine model applied with imiquimod to induce psoriasis symptoms was used to evaluate the effect of topical CBR agonist on inflammation and skin barrier function. Results: Compared to normal human skin, CBR expression was reduced in epidermis of psoriasis skin. Western blotting revealed the expression of both CB1R and CB2R in undifferentiated KC. The expression level of CB1R increased as the differentiation progressed in KC as with involucrin, K1 and K10. On the other hand, there was no change of CB2R in the process of differentiation. Furthermore, CB1R agonist partly increased expression of proteins associated with epidermal differentiation. Through this we could speculate that the CB system may be associated with proteins related to epidermal differentiation. Moreover, inflammation and barrier function in murine models with psoriasis symptoms were improved after 3 days-application of topical CB1R agonist. Conclusion: Cannabinoid receptors in human skin might be related to the differentiation of KC, and since its activation could improve skin barrier condition in murine psoriasis model, it can be expected to be a new therapeutic target for treatment of psoriasis.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

산업장 근로자들의 건강증진 프로그램에 대한 수요

유중선,김석범,강복수 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

산업장 근로자들의 건강과 관련된 변수 및 행태를 조사하고, 그들이 원하는 건강증진 내용을 각 근로자의 특성별로 조사하여 비용-효과적인 근로자 건강 증진 프로그램을 개발하기 위해 1995년 12월부터 1996년 1월 사이에 실시된 40개의 근로자 일반 건강검진 및 특수검진 사업장에 근무하는 근로자 500명을 무작위로 추출하여 검진 실시와 병행하여 이 연구를 위해 개발된 설문지를 이용하여 자기기입식 방법에 의해 자료를 수집하였다. 현재 직장에서 실시하고 있는 건강증진 활동으로는 야외운동이 14.8%로 가장 많았으며, 정기적 건강검진, 실내운동 및 맨손체조 순이었다. 남자에서는 야외운동이 가장 많이 수행하는 건강증진 활동이었으며, 여자에서는 정기적 건강검진이 가장 많았다. 전체적으로 여자에 비해 남자의 건강증진 활동률이 더 높았다. 앞으로 현재근무하는 직장에서 실시되기를 희망하는 건강증진 활동은 정기적 건강검진이 26.2%로 가장 많았으며, 건강상담, 실내운동 및 야외운동 순이었다. 남자에서는 정기적 건강검진이 33.7%로 가장 많았으며, 그 외에도 건강상담, 실내운동, 야외운동 순으로 희망하였다. 여자에서는 체중관리 프로그램이 21.4%로 가장 많았고, 정기적 건강검진, 건강상담 등의 순이었다. 근무부서별 희망 건강증진 활동은 생산직의 경우 남녀근로자 모두 정기적 건강검진을 가장 선호하였고, 사무직의 경우 남자는 정기적 건강검진을, 여자는 체중관리 프로그램을 가장 많이 희망하였다. BMI 지수별 희망 건강증진 활동은 저체중 근로자 중 남자는 영양교육을, 여자는 체중관리 프로그램을 가장 선호하였다. 정상체중에 속하는 여자 근로자들도 체중관리 프로그램을 가장 선호하였다. 규칙적인 운동 및 식사를 하는 근로자는 남녀 모두 정기적 건강검진을 가장 선호하였으며, 규칙적인 운동 및 식사를 하지 않는 근로자 중 여자는 체중관리 프로그램을 가장 선호하였다. 남자 근로자는 음주 및 흡연 여부에 관계없이 정기적 건강검진, 건강상담 및 실내운동 순으로 선호하였다. 이상의 결과로 앞으로 가장 우선적으로 실시해야 할 건강증진프로그램은 정기적 건강검진이며 현대 실시중인 근로자 정기신체검사에 대한 만족도가 낮아 검진의 내용과 방법에 대한 개선이 요구되며 여성근로자들에 대한 체중 및 영양에 대한 올바른 지식 및 태도를 갖도록 하는 교육프로그램과 흡연근로자들을 대상으로 하는 금연프로그램의 필요성을 고취시켜야 하겠다. This study was conducted to identify the demand of work-site health promotion program of employees. A self-administered questionnaire method was used to collect data from 492 employees from 40 work-sites in Taegu City and Kyungpook Provincial area. The work-site health screening programs conducted for several years were placed low value by employees. The out-door exercise was the most popular health promotion activity implemented at work-site as a whole. The employees expressed that periodic health check-up, the health counseling, indoor exercise would be implemented as a health promotion program in the future. The male employees regarded that the periodic health check-up program should be established preferentially at work-site. However, the female employees gave priority to fitness program. The health related behavioral patterns slightly influenced the preference of health promotion program. The health screening program for employees should be improved and the health education of nutrition and diet for female employees should be implemented.

폐굴껍질과 천연제올라이트를 이용한 피혁폐수 중의 질소 제거에 관한 연구

김은호,정유진,박성현,고현웅,성낙창,정왕석 東亞大學校 建設技術硏究所 1999 硏究論文集 Vol.23 No.1

In Korea, waste-oyster shells discharged from oyster culture industry cause a serious ocean environmental pollution. There is a need for developing low cost, easily and abundantly available adsorbent. So, waste-oyster shells could be recycled as a nitrogen adsorbent because of those large specific surface area. And natural zeolites are known as a good adsorbent of NH^(4+) ion. Thus, the objective of this research is to observe removal trends of nitrogen from tannery wastewater with waste-oyster shells and natural zeolite using continuous fixed bed reactors. 피혁폐수는 다양한 유기물을 함유하고 있을 뿐만 아니라, 가공공정상 질소화합물이 많이 사용되기 때문에 고농도의 유기질소 및 암모니아성 질소가 함유되어 있어 적절한 처리 없이 주변수계로 방류될 경우 자연정화작용을 방해하여 수계의 부영양화가 진행되어 남조 및 적조의 원인이 되고있다. 일반적으로 수역의 제한요인은 대개의 수역에서 질소 제한, 인 제한,질소·인 동시제한 중 어느 하나이며 계절이나 시대 추이에 따라 변화하므로 부영양화 대책으로 질소·인 모두 제거해야 한다. 최근에 천연제올라이트가 암모니아성 질소제거에 효과적인 것으로 보고되면서 이에 대한 연구가 많이 수행되었다. 암모니아를 포함하는 폐수를 침전 처리한 다음 2차 처리 공정에서 주로 활성탄 및 이온 교환수지 충전탑이 이용되고 있다. 이 중에서 활성탄 홉착은 간편성, 확실성 등으로 아주 효과적인 방법으로 각광받고 있지만 고가라는 단점을 가지고 있다. 이에 비해 상대적으로 저가인 천연 제올라이트에 의한 암모니아 제거공청은 다른 공정에 비하여 제거속도가 크고 수온의 변화에 영향이 적으며, 고농도 뿐만 아니라 저농도의 암모니아에 대해서도 안정적인 처리효율을 보이는 것으로 알려져 있다.또한 공정자체가 간단하며 기존의 정수 및 폐수 처리시설에 적용하기가 용이하며, 처리후 발생하는 물리, 화학, 생물학적 부작용이 거의 없는 것으로 알려져 있다. 한편, 국내 해안 양식업 중에 비중이 높은 굴양식업에서 부산물로 다량 발생하고 있는 폐굴껍질은 28만톤에 달하고 있고 그 중에 약 10%만이 종패 부착용(2만5천톤), 비료(2천톤)로 가공처리 되고 있을뿐 해양수산 폐기물인 굴 껍질의 처리방법과 자원으로 재활용 하기 위한 연구가 필요한 실정이다.

Lithium이 家兎에서 電解質排泄에 미치는 影響

유석천,金光鎭 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.1

Lithium reabsorption occurred in the renal tubule and the lithium and sodium were conserved at that site by the same mechanism. This study was attempted to investigate the effect of lithium on the urinary excretion of electrolytes and water. Physiological saline was infused to hydrate the rabbit and collected the urine and plasma samples for control after reached steady state. After priming dose of LiCI(2mEq/kg) injected, during infusion of LiCI solution(0.2mEq/kg/hr) urine and plasma samples obtained for observation of Li^+ effect. And then 2% NaC1(NaCI group) or 0.3M sucrose(sucrose group) solution was infused to evaluate the effect on the renal function with the changes in plasma electrolyte concentration. The results obtained were summarized as follows: 1. Control urine flow rates in NaCL group was 2.28±0.03ml/10min. During Li^+ infusion the urine flow rate was increased significantly in both group. 2. Li^+ induced water diuresis with reduced urinary Na^+ and osmolar concentration while constant excretion of osmolar particles and Na^+. 3. Infusion of 2% NaC1 solution(with LiCI) persisted the water diuresis instead of increased plasma Na^+ and osmslar concentration. 4. Infusion of 0.3M sucrose solution also persisted the water diuresis with low plasma Na^+ and Li^+ concentration. 5. Plasma Li^+ concentration was significantly lowered during infusion of sucrose solution that of NaCl infusion. From the above resuls, it was suggested that water diuresis by the lithium was affected to ADH action and sucrose solution infusion reduced the effect of Li^+ on the kidney by the Na^+ countertransport mechanism with Li^+.

인체 연부조직 육종에서 Cyclin D1, CDK4,p16 및 Rb 단백의 발현

유진영,이아원,강석진,김병기 대한병리학회 2001 Journal of Pathology and Translational Medicine Vol.35 No.3

이질균 세포 단백의 분석에 있어서의 은 염색의 이용

김재석,이유철,조동택 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.3

To study the mechanism of virulence of Shigella, sodium dodecyl sulfate-polyacrylamide gel electro-phresis was conducted on membrane fractions from 2 strains of HeLa cell invasive Shigella flexneri. After electrophresis gel slab was stained first with Coomasie brilliant blue R-250 staining then followed by silver staining, more than tenfold increase in sensitivity was achieved over Coomasie brilliant blue R-250 stain. The total membrane fraction from Shigella flexneri 85DH38 stained with silver showed 12 protein bands; 180 kilodalton(K), 127K, 100K, 78K, 64K, 55K, 47K, 45K, 43K, 39K, 38K and 12.8K, but stained with Coomassie brilliant blue R-250 showed only 5 bands. The sodium lauryl sarcosinate (SLS) soluble membrane fraction showed prominent 100K band and less prominent 5 bands; 180K, 78K, 64K, 55K and 45K. The SLS insoluble membrane fraction showed prominent 47k, 39K, and 38K bands of porin proteins and less prominent 43K and 12.8K band. The total membrane fraction from Shigella flexneri 78B-1 showed 7 protein bands which also appeared in the fractions from Shigella flexneri 85DH38. There were 5 bands of low molecular weight proteins (10K to 20K) in gel run at 20 ㎃ but not appeared at 35 ㎃.

석청(Mad-honey) 복용 후 유발된 부정맥 1예

김용철,김남호,김승환,최준호,박은미,이상재,이은미,유남진,윤경호,오석규,정진원 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

석청에 포함된 grayanotoxin에 의해 독성 작용이 나올 수 있으며, 이러한 독성 작용은 일반적으로 24시간 이내 저절로 회복된다. 최근에 본 저자들은 석청 복용 후 발생한 심실빈맥을 경험하였기에 보고하는 바이다. 49세 남자가 호흡곤란으로 내원하였으며, 내원당시 분당 40회 정도의 동성 서맥이 관찰되었고, 수액을 투여하던 중 심실 빈맥이 발생하였다. 항부정맥제를 투여 후 정상 동율동으로 전환되었으며, 특별한 이상 없이 4일 후 퇴원하였다. Mad-honey intoxication caused by the consumption of honey producted from the nectar of rhododendrons. The grayanotoxins cause the intoxication. The toxic effects of mad-honey poisoning are rarely fatal and generally last for no more than 24 hours. We experienced one case, a 49 years-old man who presented with dyspnea after ingestion of mad-honey. He showed marked sinus bradycardia with < 40 beats per minute on admission. The cardiac rhythm was changed to ventricular tachycardia immediately. These features resolved completely in 24 hours with continuous infusion of amiodarone(600 mg per day) and fluids. We report the case of intoxication of mad-honey as a presentation of fatal cardiac arrhythmia.