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김서린 ( Seo Rin Kim ),류은경 ( Eun Kyung Rheu ),설영미 ( Young Mi Seol ),차동혁 ( Dong Heuck Cha ),이수진 ( Su Jin Lee ),윤연경 ( Yeun Kyung Yoon ),박순미 ( Soon Mi Park ),김형회 ( Heyung Hoe Kim ),류학선 ( Hak Sun Rheu ),안순철 대한내과학회 2007 대한내과학회지 Vol.73 No.3
목적: 최근 내원한 치료력이 없는 사람면역결핍바이러스 감염환자에서 전파된 내성바이러스의 빈도를 알아 보고자 하였다. 방법: 2005년 3월 1일부터 2006년 7월 30일까지 부산대학교병원에 처음 내원한 사람면역결핍바이러스 감염환자 중 항레트로바이러스제 치료력이 없는 환자들을 대상으로 하였다. HIV-1 유전형 내성 검사는 ViroSeq(TM) HIV-1 Genotyping System을 사용하였다. 유전형 내성은 International AIDS Society-USA panel의 2005년 합의 지침을 근거로 하여 한 가지 이상의 내성관련 돌연변이가 존재할 때로 정의하였으며, 유전적 아형은 pol 유전자 염기서열을 염기서열분석 프로그램(REGA HIV-1 Subtyping Tool-Version 2.0 과 NCBI Blast genotyping tool)을 이용하여 분석하였다. 결과: 대상 기간 중 42명의 환자에서 유전형 내성 검사가 시행되었다. 환자들의 평균 나이는 42세였으며 남자 37명(88%), 여자가 5명(12%)이었다. 정중 CD4 세포 수는 136/mm3, 평균 혈장 HIV-1 RNA 정량 검사 결과 역가는 4.98 log copies/mL이었다. 유전적 아형은 B형이 38명이었으며 CRF01 AE 2명, CRF02 AG 1명 및 A 형이 1명이었다. 42명 중 2 (4.8%)명에서 뉴클레오시드 역전사효소 억제제(NRTI)에 내성관련 돌연변이가 존재하였으며(V118I), 비뉴클레오시드 역전사효소 억제제 내성과 단백분해효소 억제제에 주 내성인 경우는 없었다. 42명 중 37명(88%)은 발견된 지 1년 미만이었으며, 이들에서 유전형 내성 빈도는 약 4.8%이었다. V118I를 제외하면 NRTI 내성도 없었다. 결론: 이전 치료력이 없는 사람면역결핍바이러스 감염 환자에서 유전형 내성 빈도는 약 4.8%였다. V118I를 제외하면 전파된 고도내성은 없었다. Background: The prevalence of HIV drug resistance mutations in drug-naive patients has been shown to differ with geographic origin. The purpose of this study is to assess the prevalence of transmitted antiretroviral drug resistance mutations in drug-naive patients in Korea. Methods: Genotypic resistance was determined by the use of the Viroseq Genotyping System in 42 antiretroviral treatment naive HIV-infected patients between March 2005 and July 2006. Transmitted drug resistance was estimated according to the IAS-USA 2005 definition, taking into account only major mutations in the protease and all mutations in the reverse transcriptase, including revertant mutations at codon 215. Results: The median age of the patients was 42 years and 37 (88%) were male. The median CD4+T cell count was 136/mm3 and the mean plasma RNA level was 4.98 log copies/mL. Among 42 patients studied, 37 (88%) were newly diagnosed patients. None of the patients were recent seroconverters; 38 patients (90%) were infected with subtype B and 4 patients were infected (10%) with the non-B subtype strains (2 patients with CRF01-AE 1 as CRF02-AG; 1 patient with subtype A). Of the 42 subjects tested, we found 2 (4.8%) mutations in NRTI (V118I), but did not find a mutation in NNRTI as well as in the PI region. Conclusions: The prevalence of transmitted antiretroviral drug resistance in drug-naive patients is still low in Korean patients.(Korean J Med 73:243-250, 2007)
김서우 ( Seo Woo Kim ),김현경 ( Hyun Kyung Kim ),전승정 ( Sung Joung Jeun ),박혜성 ( Hye Sung Park ),장중현 ( Jung Hyun Jang ),이진화 ( Jin Hwa Lee ),류연주 ( Yon Ju Ryu ),심성신 ( Sung Shin Sim ),천은미 ( Eun Mi Chun ) 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.4
Lymphadenopathy in the thoracic cavity is frequently caused by inflammatory diseases. In very rare cases, the node-bronchial fistula has been reported to be the cause of complications of pulmonary tuberculosis. A male patient with necrotizing pneumonia and mediastinal lymph node enlargements identified by chest computed tomography was also found to have a node-bronchial fistula caused by lung cancer. The patient was treated for tuberculosis with pneumonia for one week before a definitive diagnosis was made. A further investigation revealed him to have non-small cell lung cancer (NSCLC, adenocarcinoma) and multiple mediastinal lymphadenopathies accompanied with the node-bronchial fistula. We report this specific case that had been previously treated for tuberculosis but was later revealed to be NSCLC accompanied with a node-bronchial fistula.
김수선 ( Su Sun Kim ),최보윤 ( Bo Youn Choi ),서승인 ( Seung In Seo ),정민영 ( Min Young Jung ),최혁수 ( Hyuk Su Choi ),안성민 ( Sung Min Ahn ),최원혁 ( Won Hyuk Choi ),김형수 ( Hyoung Su Kim ),김경호 ( Kyung Ho Kim ),장명국 ( Myo 대한소화기학회 2011 대한소화기학회지 Vol.58 No.5
Background/Aims: The tumor-node-metastasis (TNM) staging is an useful system to assess the prognosis of any solid cancer. As new TNM staging classification of 7th stomach cancer was revised in 2009, we evaluated the prognostic predictability of the 7th International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) TNM classification compared to 6th UICC/AJCC TNM classification in gastric cancer. Methods: From January 2000 to December 2009, 5-year survival rates of 266 patients with gastric cancer were calculated by the 6th and 7th UICC/AJCC TNM classification. Results: Using the 7th UICC/AJCC TNM classification, there was no significant difference in the 5-year cumulative survival rates (5 YSR) between stage IIA and IIB, IIB and IIIA, and IIIA and IIIB (70% vs. 71%, p=0.530; 71% vs. 80%, p=0.703; 80% vs. 75%, p=0.576, respectively) though significant differences of the survival rates were observed among stages of 6th edition. Using T stage of 7th edition, 5 YSR was not different between T2 and T3 (86% vs. 82%, p=0.655). Using N stage of 7th edition, 5 YSR were not different between N1 and N2, N3a and N3b (79% vs. 81%, p=0.506; 41% vs. 17%, p=0.895, respectively). Conclusions: The 7th UICC/AJCC TNM classification had poor prognostic predictability in gastric cancer compared to the 6th edition. (Korean J Gastroenterol 2011;58:258-263)