서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

만성 기관지염 및 재발성 급성 호흡기감염 치료에 있어서 경구용 Broncho-Vaxom에 대한 임상 연구

김세규,김병일,장준,김성규,이원영 최신의학사 1991 最新醫學 Vol.34 No.1

Aspergillus candidus F1484 균주가 생산하는 항진균 화합물의 분리 및 특성

김성옥,이소영,김성규,손광희,김영국,문석식,복성해 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.5

Candida albicans의 효모형태에 대해 활성을 나타내는 항진균 물질의 탐색 중에 Aspergillus candidus F1484 균주의 발효액으로부터 항진균 화합물 F1484를 단리하고 ethyl acetate 추출, silica gel column chromatography, ODS column chromatography 및 preparative HPLC를 행하여 분리정제하였다. F1484 화합물은 EI-MS, ^13C-, ^1H-NMR, DEPT, HMQC 및 HMBC에 의한 구조분석을 행한 결과 이 화합물은 항진균 물질인 chloroflavonin과 동일한 구조를 나타내었으며 효모형태의 Candida albicans에 대한 항진균 활성뿐만 아니라 여러 종류의 인체 종양 세포주에 대해서도 세포독성을 나타내었다. In the course of screening for the antifungal compounds against Candida albicans, an antifungal compound (F1480) was isolated from the culture broth of Aspergillus candidus F1484. Isolation and purification of compound F1484 were performed using ethyl acetate extraction, silica gel column chromatography, ODS column chromatography, and preparative HPLC. The structure of compound F1484 was determined by the spectroscopic analyses of EI-MS, ^13C-, ^1H-NMR, DEPT, HMQC, and HMBC. This compound appeared to have a structure of antifungal agent, chloroflavonin. In addition to antifungal activities against the yeast phase of Candida species, compound F1484 showed cytotoxic effect against various human tumor cell lines.

한국인 여성에서 비타민 D 수용체 유전자 , 에스트로겐 수용체 유전자 및 제 1 형 콜라겐 α1유전자의 다형성과 최대골량의 연관성에 관한 연구

김은숙,김상욱,김기수,김홍규 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.1

Background: Genetic suggest that strongest effect is observed in the premenopausal peak bone mass, which become less with age. However, the evaluation of candidate genes polymorphisms has been most frequently done in postmenopausal women and the results have been controversial. Therefore, we studied the possible association of the peak bone mass and candidate for osteoporosis genes polymorphism in premenopausal women. Methods: The associations between BMD and polymorphisms of the vitamin D receptor (3'-end region by BsmI restriction enzyme and start codon by FokI restriction enzyme), estrogen receptor (by PvuII and XbaI restriction enzyme), and type I collagen al (Spl binding site by MscI and Ball restriction enzyme) genes were examined in 100 healthy young Korean women who had a peak bone mass (age 20 35 years). Bone mineral densities were measured by dual energy X-ray absorptiometry (DEXA). Dietary calcium intake was also measured using a food frequency questionnaire. Results: The frequencies of the B allele of the vitamin D receptor gene BsmI polymorphism and the X allele in the estrogen receptor gene, XbaI polymorphisms were lower in Koreans than those in Caucasians. The allelic frequencies of the vitamin vitamin D receptor gene Fokl polymorphism and the estrogen receptor gene PvuII polymorphism were similar to those of Caucasians. No significant association was found between BMD and the vitamin D receptor genotype according to Bsml or FokI polymorphisms. There was also no significant relation between the PvuII or XbaI polymorphisms of the estrogen receptor gene and BMD. The associations between BMD and cross-genotypes combining the vitamin D receptor gene (BsmI and FokI) and estrogen receptor gene (PvuII and XbaI) polymorphisms were also analyzed. Among the subjects who lacked the Bf haplotype of the vitamin D receptor gene, the BMD of the femoral neck area was significantly higher in subjects lacking Px haplotypes of the estrogen receptor gene than in those having Px haplotype (p $lt; 0.05). When dietary calcium intake was taken into consideration, there were significant differences in BMD according to the cross-genotype in the group having a low calcium intake ($lt; 500 mg/day). The subjects that lacked the Bf and Px haplotypes had a significantly higher BMD in the femoral neck (p $lt; 0.01), Wards triangle (p $lt; 0.0~5), and in the trochanteric area (p $lt; 0.05) than those who lacked Bf but a Px haplo~type. We did not find a polymorphism in the Spl bindi~ng site of the type I ~collagen ~al gene in our subjects. Conclusion: These data suggest that a complex interaction of vitamin D and the estrogen receptor gene with the dietary calcium intake, rather than a polymorphism of a sing~le gene, may influence peak bone mass in healthy young Korean women (J Kor Soc Endocrinol 16:97-114, 2001).

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

재발 또는 불응성 비호즈킨 림프종 환자에서 CDME 구제항암화학요법 후 고용량 항암화학요법 및 자가말초혈액 조혈모세포이식의 효과

김세형,한강원,배상병,김찬규,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Background and objectives : The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional dose chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, we compared the outcome of patients undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation(APBSCT) with only salvage chemotherapy of cisplatin, dexamethasone, mitoxantrone, and etoposide(CDME). Materials and methods : From June 1993 to December 1999, 25 patients with relapsed or resistant NHL were treated with CDME regimen as salvage chemotherapy. Twelve patients were received four cycles of CDME chemotherapy, and 13 patients were received high-dose chemotherapy with APBSCT following two cycles of CDME chemotherapy. Results : The median follow-up duration was 12.8 months(range:4-68). The overall response rate was 41.7% (complete response rate 25%, partial response rate 16.7%) in 12 patients with CDME only. Thirteen patients who were treated with high-dose chemotherapy with APBSCT achieved 61.5% complete response rate and 15.4% partial response rate, with an overall response rate of 76.9%. The estimated 3-year progression-free survival rate was significantly higher among patients who received high-dose therapy than patients who received CDME only(41.5% vs 20.0%, p<0.05). And, 3-year overall survival rate was significantly higher among patients who received high-dose therapy(51.3% vs 25.0%, p <0.05). Conclusions : In relapsed or refractory NHL, CDME chemotherapy is an effective salvage chemotherapy and allow peripheral blood stem cell collection. Also, high-dose chemotherapy with APBSCT following CDME is superior to CDME salvage chemotherapy only.

위발성 위장관 악성림프종 환자에서 항암치료의 효과

김찬규,신영록,김현정,배상병,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Purpose: The gastrointestinal (GI) tract is the most common site of extranodal non-Hodgkin's lymphoma (NHL), which is increasing in incidence, but there is no established optimal treatment modality. Thus, this study was investigated the clinicohistologic feature, the therapeutic modalities, and the prognosis for GI-NHL, as well as the factors affecting it. Methods: We retrospectively analyzed 45 patients who had been diagnosed as having GI-NHL and had been followed up from July 1994 to February 2005 at Soonchunhyang University Hospital. The patients were divided into groups according to the site of origin and to various other features, and the survivals of the various groups were compared. The modified Ann Arbor system and WHO classification were adopted for staging and histopathologic classification, respectively. Results: GI-NHL of the stomach, small bowel, ileocecal region, and colon occurred in 28 patients (62.2%), 5 patients (11.1%), 3 patients (6.7%), and 8 patients (17.8%), respectively, In one patient, the entire gastrointestinal tract was diffusely involved. The median age of patients was b5 years (25~78 years), and male-to-female ratio was 1:1.1. Fourteen patients were in stage Ⅰ, 24 in stage Ⅱ, 4 in stage Ⅲ, and 3 in stage Ⅳ. Surgical resection was performed in 19 patients, and combination chemotherapy was performed in 43 patients. Surgical resection only was performed in 4 patients, Chemotherapy only was performed in 26 patients. The expected overall 5 year survival of 45 patients was 39.6%, and there was a significant survival difference between the stages, but between sites of origin (p=0.842). The most important factors influencing the survival was the stage and other factors were not significant. Conclusion: The stomach was the most common site of GI-NHL. Most GI-NHL were localized Stage was the most important prognostic factor. However, Prospective randomized studies are needed to approve the therapeutic modality.

연 착화제 효능에 관한 동물실험적 연구

김정만,김병권,김성환,서병성,김인식,김용규,정갑열,김준연 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.1

위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.

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.