안지오텐신 변환효소 억제제와 안지오텐신 II 수용체 차단제 투여 후 발생한 급성 신부전과 폐부종으로 전원된 선천성 단일신 환자의 치료 1예

백두현,김경진,홍성철,강석형,송하응,김혜인,김수현,오현정,강혜원,김서우,유민아,류동열,최규복,강덕희 이화여자대학교 의과대학 2010 EMJ (Ewha medical journal) Vol.33 No.1

Blockers of renin-angiotensin system(RAS) including ACE inhibitor or ARB are one of the most frequently prescribed medications for the treatment of hypertension, heart failure and proteinuria. One of the major side effects of these RAS blockers is the deterioration of renal function, mainly due to a reduction of intraglomerular pressure. Therefore, close monitoring of renal function is recommended when RAS blockers are initially prescribed, especially for the patients with impaired renal function. We report a patient who was transferred to our hospital due to the sudden development of oliguria and dyspnea after treatment for hypertension with ACEi and ARB. She was finally diagnosed as RAS blocker-induced acute renal failure with pulmonary edema complicated on congenital solitary kidney. After hemodialysis and conservative treatment, her renal function was recovered with maintenance of normal urine output. Conclusion:This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.

정상인 직장도찰 피검물에서의 혐기균의 분리빈도

백상홍,이상원,진동찬 全北大學校 學徒護國團 1981 全國大學生學術硏究發表論文集 Vol.6 No.-

This study was made to isolate anaerobic bacteria from the rectal swabs of normal healthy persons and determine the normal flora of the intestine. Rectal swab specimens were obtaianed from normal healthy adults in Seoul. As the processes of bacteriological study, anaerobic bacteria were cultured in thioglycollate semisolid broth and isolated on brain heart infusion blood supplement agar plates, and biological properties were examined including the hemolysis on blood agar plated, gas production in the fluid media. Biochemical test was performed by Minitek Anaerobic Set (BBL^*) in anaerobic Gas Pak Jar (BBL^*) The result is as followings: 1. Among the 110 rectal swab specimens, 187 strains of anaerobic bacteria were isolated. The isolates included 88 straing (47.1%) of Gram positive bacilli, 74 strains (39.5%) of Gram negative bacilli and 25 strains (13.3%) of Gram positive cocci. 2. After preservation at-80 C in thioglycollate broth, only 134 strains (71.1%) of isolates survived. Theses survivors included 76 strains of Gram positive bacilli (survival rate 86.4%), 38 strains of Gram negative bacilli (survival rate 51.4%), and 20 strains of Gram positive cocci (survival rate 80.8%). 3. From these strains, 50 strains were randomly selected by the ratio of morphologic groups of isolates for the sugar fermentation and other biochemical tests. Among these selectes and tested straing, the determined were : Eubacterium aeroficiens 27 strains(54.0%) Bacteroiaes melaninogenicus 7 strains (14.0%) Peptostreptococcus produtus 6 strains (12.0%) Eubacterium limosum 1 strains (2.0%) and the undetermined strains were : Gram negative bacilli 7 strains (14.0%) Gram positive bacilli 1 strain (2.0%) Gram negative cocci 1 strain (2.0%)

Pyriminobac-methyl과 azimsulfuron 합제의 신규제형인 분산형 정제에 대한 독성 평가

백경진,이동연,이상훈,김태원,정두순,임종환,김명석,박병권,윤효인 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

Dispersible tablets disintegrate either to form a stabilized suspension rapidly in water, or to disperse instantaneously in the rice field without the aid of water. In this study, the newly formulated dispersible tablet form of herbicidal combination, pyriminobac-methyl and azimsulfuron, was evaluated the safety for human and animals in the toxicological viewpoints. The LD_(50) value of dispersible tablet form for pyriminobac-methyl and azimsulfuron was above 2,500 mg/kg for the oral route and above 2,000 mg/kg for the dermal route. It is considered to have low acute oral and dermal toxicity based on the findings of the present studies. In addition, the combination of pyriminobac-methyl and azimsulfuron showed mild skin irritant under the conditions of this study and conjunctival redness and slight opacity on cornea appeared from 1 hour after application.

신규개발된 제초제 metamifop 현탁농축액제에 대한 급성독성평가

이동연,이상훈,백경진,김태원,정두순,임종환,김명석,박병권,윤효인 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

Metamifop, (R)-2-[4-[(6-chloro-2-benzoxazolyloxyphenoxy]-N-(2-fluorophenyl)-N-methyl propanamide, was newly developed by Dongbu Hannong Chemicals in Korea. In the present study we conducted acute oral toxicity and acute dermal toxicity test. The values of LD_(50) of metamifop was found to be over 5,000 mg/kg for ICR mice. On the other hand, metamifop showed no acute dermal toxicity to SD rats.

급성 림프구성 백혈병 환자에서 아스페르길루스 감염을 동반한 호중구감소성 소장결장염에 의한 작은창자 천공

강동백,임태수,박원철,윤기중,이정균 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

저자들은 급성 림프구성 백혈병 치료 도중 아스페르길루스 감염을 동반한 호중구감소성 소장결장염에 의한 작은창자 천공을 경험하였다. 급성 림프구성 백혈병의 항암화학치료 중 발생 할 수 있는 호중구감소성 소장결장염은 다양한 위장관 증상을 보일 수 있으며, 이에 대한 발생 가능성을 고려하여 적극적인 조 기진단과 이에 대한 적극적 치료가 필요하며, 면역기능의 저하로 아스페르길루스 등의 진균 감염이 발생할 수 있으므로 호중구감소성 소장결장염의 치료에 증상의 호전이 없을 때 항진균제를 포함한 광범위한 치료가 고려되어야 한다. Though advancesin imumosuppressive therapy or chemotherapy which have lead to increased survival of leukemia and transplant patient, but the risk of infectious complication has been increasing. Neutropenic enterocolitis is a life threatening complication of chemotherapy for malignancies such as leukemia or lymphoma. Symptoms of neutropenic enterocolitis are nonspecific and it may rapidly lead to intestinal peforation. Aspergilus infection could involve the gastrointestinal tract as a result of neutropenia and mucosal injury after imumosuppressive therapy, chemoetherapy, or antibiotics use, but rarely reported a small bowel perforation combined aspergillus and neutropenic enterocolitis. We present a rare case of ileal perforation caused by neutropenic enterocolitis combined with aspergillus infection during chemotherapy for acute lymphocytic leukemia with a review of the literature.

집쥐에 의한 슴새 번식성공률 감소

남기백,유승화,김동원,유정칠 경희대학교 한국조류연구소 2002 연구보고 Vol.8 No.1

본 조사는 2001년 6월 25일부터 30일, 8월 12일부터 17일, 10월 20~25일까지 제주도 북제주군 추자면에 위치한 사수도에서 집단 번식하는 슴새의 번식성공률을 조사하였다. 현재 사수도에는 약 4000쌍 정도의 슴새가 번식을 하는 것으로 조사되었다. 총 110개의 둥지를 관찰한 결과, 부화률은 약 15%로 나타났으며, 전체 번식성공률은 약 3%로 나타났다. 전체 번식실패률은 96.4%로 나타났으며, 번식실패 요인으로 집쥐에 의한 포식이 92.5%로 가장 높게 나타났다. 또한 포란기와 부화기에 포식률이 각각 42%, 36%로 육추기의 포식률(11%)보다 높게 나타났다. The rate of breeding success of Streaked Shearwaters (Calonectris leucomelas) was studied at Sasu-islet, in chuja-do, cheju island during 25-30 June, 12-17 August, 20-25 October 2001. The breeding population of Streaked Shearwaters at Sasu-islet is estimated to be about 4,000 pairs. This study was based on detailed observations of 110 nests dispersed over a wide range of nest habitats within colony. Hatching success was 15% (n=17), breeding success was 3% (n=3) and breeding failure was 96% (n=106). Norway Rat(Rattus norvegicus) were responsible for failure of at least 89% of all the breeding failure. The predation rates of both incubation and hatiching periods was higher than that of rearing period.

대뇌 기저핵 신경세포 일차배양에서 망간에 의해 유도된 Appoptosis : 형태학적인 소견

신동훈,김상표,정용욱,배재훈,송대규,백원기 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 본 실험은 대뇌기저핵의 신경세포를 배양하여 망간(MnCl₂)을 투여한 후 망간독성에 의한 신경세포의 apoptosis를 형태학적인 소견으로 관찰하였다. 방법 : 배양된 신경세포에 0.01에서 10μM Mnc12를 48시간동안 처리한 후 TUNEL (TdT-mediated dUTP Nick End Labelling)법 및 투과전자현미경학적으로 관찰하였다. 결과 : TUNEL방법을 이용하여 관찰한 결과 TUNEL반응에 갈색으로 양성반응을 나타내는apoptotic 세포의 수가 대조군에 비해 MnCl₂를 투여한 군에서 유의하게 높게 나타났으며(P〈0.05), 투과전자현미경학적 소견상 대조군의 신경세포들은 핵인(nucleolus)이 두드러지게 특징적으로 보이면서 핵막과 세포질내 소기관들이 잘 보존되어 있으며, 세포질내망(ER)과 사립체(mitochondria)를 특히 많이 가지고 있었다. Mnc12를 48시간 동안 처리한 군에서 이질염색질(heterochromatin)이 핵막으로 이동하면서 응집되어 있었으며, 핵내 불규칙한 형태의 염색질이 나타나 분절이 진행되는 소견을 보였고, Apoptosis의 가장 특징적인 초기 소견인 막으로 둘러싸인 반달모양의 핵내염색질의 분절편(fragment-ed chromatin)과 주위의 상대적으로 정상적인 소기관으로 구성된 apoptotic body를 관찰할 수 있었다. 결론 : 신경세포에서 망간에 의해 apoptosis가 유도됨을 형태학적인 방법으로 확인할 수 있었으며 망간에 의한 세포사망양상에 apoptosis가 하나의 기전이 될 수 있을 것이다. Objectives : Manganese is cytotoxic to the central nervous system including basal gan-glia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study , we have investigated to manifest apoptosis in man-ganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. Methods : To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide (TdT) -mediated dUTP nick end-labelling (TUNEL) method and apoptotic changesin nuclei of neurons were observed by electron microscopy. Results : We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cyto-plasm in the treated with luM MnCl²for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. Conclusions : Apoptosis appears to be one mechanism in the manganese-induced net-ronal cell death. Manganese intoxication is a convenient model for apoptosis study.

클로르헥시딘 바니쉬의 적용이 교정용 브라켓의 전단접착강도에 미치는 영향

임동혁,김태우,장영일,남동석,양원식,백승학 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

본 연구의 목적은 클로르헥시딘 처리가 교정용 브라켓의 전단접착강도와 탈락 양상에 미치는 영향을 비교하는 것이다. 실험군으로 4주간 4회의 클로르헥시딘 바니쉬를 도포한 22개의 사람 소구치를 선택하였고, 대조군으로 아무 처리도 하지 않은 22개의 사람 소구치를 선택하였다. 모든 치아는 37%의 phosphoric acid gel로 부식시키고 교정용 브라켓을 같은 조건으로 부착시켰다. 전단접착강도의 측정을 위해 Instron universal testing machine(model 4466)을 이용하였고, 법랑질과 브라켓 표면은 SEM으로 관찰하였다. 결과의 분석은 t-test를 이용하였으며 결과는 다음과 같다. 1.클로르헥시딘의 법랑질 처리는 전단접착강도에 영향을 미치지 않았다. 2.클로르헥시딘으로 법랑질을 처리한 경우와 그렇지 않는 경우에 브라켓 탈락 양상에 차이가 없었다. 따라서, 클로르헥시딘으로 법랑질을 처리하여도 브라켓 접착에 유해한 작용이 없었고, 따라서 임상사용에 적합하다고 생각된다. The purpose of this study was to determine whether the application of chlorhexidine varnish affects the shear bond strength and failure pattern of orthodontic brackets or not. The experimental group consisted of 22 human premolars which extracted after chlorhexidine vanish application(4 times for 1 week interval) in vivo, and the control group consisted of 22 human premolars which extracted without any pre-treatment. After all teeth were etched with 37% phosphoric acid gel, metal orthodontic brackets (Q-3002, RMO, USA) were bonded to each tooth using auto-polymerizing orthodontic resin (Ortho-One, Bisco, USA) with the same bonding procedure. The shear bond strength was measured with Instron universal testing machine (model 4466, Instron Ltd., England), and the failure pattern of each bracket was examined with Scanning Electron Microscope (SM 840A, JEOL, Japan). The data were analysed statistically with t-test. The results were as follows : 1.Application of chlorhexidine varnish had no significant effect on the shear bond strength of the orthodontic bracket. 2.There was no significant difference in the failure pattern of orthodontic bracket between the experimental group and the control group.

전신성 홍반성 루프스 환자에서 발생한 자가 면역성 간염 1례

김준재,백나나,김현정,전태주,서동대,오태훈,최원충 인제대학교 2008 仁濟醫學 Vol.29 No.-

SLE 환자에서 간 효소 수치의 상승은 여러 가지 원인에 의하여 드물지 않게 관찰될 수 있다. 이 중 자가 면역 기전에 의해 발생되는 질환으로 자가 면역성 간염과 SLE에 동반된 간염이 있으며, 두 가지 질환의 감별은 환자의 예후 및 치료에 중요하다. 따라서 간 조직 검사를 포함한 정확한 진단 기준으로 조기에 진단하여야 하며, 이에 따른 적절한 치료를 통해서 간 부전 및 비가역적 간경변증으로 진행을 방지할 수 있을 것으로 사료된다. Patients with systemic lupus erythematosus (SLE) have a 25-50% chance of developing abnormal liver tests in their lifetime and various causes are related to elevation of liver enzyme, such as hepatic involvement of lupus, hepatotoxic drug, viral infection, autoimmune hepatitis and so on. Discrimination of autoimmune hepatitis from SLE-associated hepatitis is important because complications and therapy are quite different, although both are autoimmune syndromes. Here we are presenting a case of SLE patient with type I autoimmune hepatitis proved with liver biopsy.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.