항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

고삼투압성 비케톤성 상태의 예후인자

안성훈,김양원,김미란,진헌철,안지영,이상래,류석용,김홍용,김성준,이병권,김경환 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: A hyperosmolar nonketotic state has been known to have a high mortality, and even now, despite this high mortality, only a few studies of this disease have been performed. We studied the prognostic factors for the hyperosmolar nonketotic state. Methods: We retrospectively studied the cases of 40 patients who were in a hypersomolar nonketotic state when admitted to Sanggye Paik Hospital during the 6-year Period from 1995 through 2000. We divided the hyperosmolar nonketotic patients into two groups, the complete recovery group and the incomplete recovery group, and compared the clinical features, the laboratory findings, and the precipitating factors between two groups. Results: 1) A total of 40 patients were studied: 24 in the complete recovery group and 16 patients in the incomplete recovery group. The mortality rate was 32.5%. 2) No significant statistical difference existed among the clinical features of the two groups, except for the sex(p<0.01). 3) Among the laboratory findings of both groups, analysis revealed that the effective osmolarity was significantly higher among those in the incomplete recovery group(p<0.01). Serum sodium concentration was also significantly higher among those in the incomplete recovery group(p<0.01). Serum creatinine was also significantly higher among those in the incomplete recovery group(p<0.05). Serum bicarbonate concentration, on the other hand, was significantly lower among those in that group(p<0.05).4) Infection was identified as the most common precipitating factor(62.5%). Among the precipitating factors of the two groups, there were significant statistical difference in pneumonia, UTI, and inappropriate glucose control. 5) A significant statistical difference existed among the initial level of consciousness of both groups(p<0.05). 6) The only significant independent factor responsible for prognosis of nonketotic hyperosmolar state patients was the sex. Conclusion: The sex was only significant independent prognostic factor of nonketotic hyperosmolar state patients.

마라톤 동호인과 일반인의 체력 및 건강관련 변인의 비교

김혜란 ( Hye Ran Kim ),이만균 ( Man Gyoon Lee ),성순창 ( Soon Chang Sung ) 한국스포츠정책과학원(구 한국스포츠개발원) 2007 체육과학연구 Vol.18 No.4

본 연구는 크게 두 가지의 과제로 구성되어 있다. 제 1과제에서는 중년 남성 마라톤 동호인 45명과 운동습관이 없는 일반인 30명을 대상으로 체격 및 체력수준을 비교하였다. 측정항목은 신장, 체중, 신체질량지수, 체지방률, 1200m달리기, 윗몸일으키기, 팔굽혀펴기, 앉아 윗몸앞으로굽히기, 제자리멀리뛰기, 그리고 50m달리기였다. 제 2과제에서는 중년 남성 마라톤 동호인 15명과 운동습관이 없는 일반인 8명을 대상으로 최대산소섭취량, 젖산역치 수준에서의 산소섭취량, 젖산역치 수준에서의 심박수, 1초 강제 호기량, 그리고 혈액변인을 비교하였다. 두 집단의 데이터를 비교하여 분석한 결과를 요약하면 다음과 같다. 1. 마라톤 동호인과 일반인의 체격을 비교한 결과 체중, 신체질량지수, 가슴 피부두겹 두께, 복부와 대퇴 피부두겹 두께, 그리고 체지방률은 마라톤 동호인이 일반인에 비해 유의하게 낮게 나타났다. 2. 마라톤 동호인과 일반인의 체력을 비교한 결과 윗몸일으키기, 팔굽혀펴기, 앉아윗몸앞으로굽히기, 제자리멀리뛰기, 50m달리기, 그리고 1200m달리기 모두 마라톤 동호인이 일반인에 비해 유의하게 높은 것으로 나타났다. 3. 마라톤 동호인과 일반인의 호흡순환계 변인을 비교한 결과는 최대산소섭취량, 최대심박수, 그리고 VO2LT에서 유의한 차이가 나타났다. 그러나 HR(LT), FEV1.0은 유의한 차이가 나타나지 않았다. 4. 마라톤 동호인과 일반인의 대사관련 변인을 비교한 결과 TG, 그리고 HDL-C는 유의한 차이가 나타났으나, 혈중 글루코스, 인슐린, FFA, TC, 그리고 LDL-C에서는 유의한 차이가 나타나지 않았다. 이상의 결과를 종합해 볼 때, 마라톤 동호인이 일반인에 비해 높은 체력 및 건강수준을 갖고 있는 것으로 나타나 마라톤 동호회 활동이 건강 유지 및 증진, 노화의 지연에 긍정적인 효과가 있을 것으로 판단 되어 진다. 따라서 일반인들이 건강한 삶을 위해 마라톤 동호회의 활동에 적극적으로 참여하기 위한 다양한 방법이 강구되어야 할 것으로 사료된다. The purposes of the study were twofold. The first study was designed to compare physical fitness between 45 marathon club participants(MCP) and 30 general individuals(GI) who have not participated in any systematic exercise training before. Test items in the first study included the standing height, body weight, body mass index, percent body fat, 1200m run/walk, sit-up, push up, sit-and-reach, standing long jump, and 50m dash. The second study was designed to compare maximal oxygen consumption, maximal heart rate, oxygen consumption at lactate threshold(VO2LT), heart rate at lactate threshold(HR(LT)), forced expiratory volume in one second(FEV1.0), and blood variables between 15 MCP and eight GI. All data obtained in the two studies were analyzed by independent-t test and the results were as follows: 1) The body weight, body mass index, chest thickness, abdomen thickness, anterior thigh thickness, and percent body fat of MCP were significantly lower than them of GI. 2) Sit-up, push up, sit-and-reach, standing long jump, 50m dash, and 1200m run/walk of MCP were significantly superior than them of GI. 3) There were significant differenced in maximal oxygen consumption, maximal heart rate, and VO2LT between the two groups. However, there was not significant difference in HR(LT), and FEV1.0 between the two groups. 4) There were significant differences in TG, and HDL-C between the two groups, whereas no significant difference was found in blood glucose, insulin, free fatty acid, TC, and LDL-C between the two groups. The aforementioned results indicated that MCP had higher level of physical fitness than them of GI, concluding that the activities in the marathon club could enhance health and physical fitness and prevent aging. The efforts should put for the general individuals into participate sports club activities.

일개 대학병원에서 일년간 분리된 반코마이신 내성 장구균의 임상 분자역학적 연구

송진영,김창억,김성욱,우흥정,김미란,이규만,이란,장미화,정희진,김우주 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.4

목적 : 한강성심병원에서는 2000년 3월 반코마이신내성 장구균이 처음 분리되어, 원내전파를 막기 위한 노력을 하였으나, 분리가 지속되었다. 따라서 이에 대한 좀더 자세하고 객관적인 자료를 얻기 위해 본원에서 분리된 반코마이신내성 장구균에 대한 임상분자 역학적 연구를 시행하게 되었다. 방법 : 2000년 3월부터 2001년 2월까지 한림대학교 한강성심병원에서 분리된 장구균을 대상으로 디스크 확산법, 최소발육억제 농도등의 측정을 통해 반코마이신 내성여부를 확인하였으며, 반코마이신내성 장구균을 대상으로 PFGE를 시행하여 형별 분석을 하였다. 결과 : 분리된 균주는 총 32균주로 모두 E. faecium이었다. 항생제 내성 검사 결과 모두 Van A형이었다. PFGE 결과 1a형이 8검체, 1b형이 5검체, 2a형이 4검체, 2b형이 4검체, 3a형이 2검체, 3b형이 5검체였고, 그 외 4, 5, 6형이 각각 1검체씩이었다. 총 32균주 중 56%(18/32)의 균주가 같은 시기, 같은 병실에서 동일한 PFGE 형을 보이면서 분리되었다. 결론 : 반코마이신내성 장구균의 PFGE 분석 결과 여러 종류의 반코마이신내성 장구균이 유행하였음을 알 수 있다. 그러나 같은 기간, 같은 병실에서 분리된 균주의 PFGE 형이 같은 것이 상당수 있었다. 이는 반코마이신내성 장구균의 원내 전파가 있었음을 의미한다. 따라서 반코마이신내성 장구균의 전파의 발생 및 전파 방지를 위해서는 보다 효과적인 감염관리 활동이 필요할 것으로 생각된다. Background: Vancomycin-resistant enterococci(VRE) have been a rising problem worldwide. In March 2000, VRE was first isolated from a patient in Hangang Sacred Heart hospital. Although efforts to prevent transmission of VRE were performed, isolations continued. So molecular epidemiological study of VRE was done. Method : The minimal inhibitory concentration(MIC) to vancomycin and teicoplanin, and pulsed field gel electrophoresis(PFGE) pattern of VRE isolated from March 2000 to February 2001 were evaluated. Results : 32 VRE were isolated. All of the VRE were Enterococcus faecium and showed Van A resistance phenotype. We found out that a significant number of VRE isolated during same period and in same room, were same PFGE patterns. (18 cases/ 32 isolates= 56%) Conclusion: This study demonstrated the spread of VRE of same PFGE patterns. It suggests the nosocomial spreads of VRE.

Kidney Toxicity Induced by 13 Weeks Exposure to the Fruiting Body of Paecilomyces sinclairii in Rats

Jeong, Mi-Hye,Kim, Young-Won,Min, Jeong-Ran,Kwon, Min,Han, Beom-Suk,Kim, Jeong-Gyu,Jeong, Sang-Hee Korean Society of ToxicologyKorea Environmental Mu 2012 Toxicological Research Vol.28 No.3

Paecilomyces sinclairiis (PS) is known as a functional food or human health supplement. However concerns have been raised about its kidney toxicity. This study was performed to investigate the kidney toxicity of PS by 13 week-oral administration to rats. Blood urea nitrogen (BUN), serum creatinine, and kidney damage biomarkers including beta-2-microglobulin (${\beta}2m$), glutathione S-transferase alpha (GST-${\alpha}$), kidney injury molecule 1 (KIM-1), tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), vascular endothelial growth factor (VEGF), calbindin, clusterin, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and osteopontin were measured during or after the treatment of PS. BUN, creatinine and kidney damage biomarkers in serum were not changed by PS. However, kidney cell karyomegaly and tubular hypertrophy were observed dose-dependently with higher severity in males. KIM-1, TIMP-1 and osteopontin in kidney and urine were increased dose dependently in male or at the highest dose in female rats. Increased urinary osteopontin by PS was not recovered at 2 weeks of post-exposure in both genders. Cystatin C in kidney was decreased at all treatment groups but inversely increased in urine. The changes in kidney damage biomarkers were more remarkable in male than female rats. These data indicate that the PS may provoke renal cell damage and glomerular filtration dysfunction in rats with histopathological lesions and change of kidney damage biomarkers in kidney or urine. Kidney and urinary KIM-1 and cystatin C were the most marked indicators, while kidney weight, BUN and creatinine and kidney damage biomarkers in serum were not influenced.

Kidney Toxicity Induced by 13 Weeks Exposure to the Fruiting Body of Paecilomyces sinclairii in Rats

Mihye Jeong,Young-Won Kim,Jeong-Ran Min,Min Kwon,Beom-Suk Han,Jeong-Gyu Kim,Sang-Hee Jeong 한국독성학회 2012 Toxicological Research Vol.28 No.3

Paecilomyces sinclairiis (PS) is known as a functional food or human health supplement. However concerns have been raised about its kidney toxicity. This study was performed to investigate the kidney toxicity of PS by 13 week-oral administration to rats. Blood urea nitrogen (BUN), serum creatinine, and kidney damage biomarkers including beta-2-microglobulin (β2m), glutathione S-transferase alpha (GST-α), kidney injury molecule 1 (KIM-1), tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), vascular endothelial growth factor (VEGF), calbindin, clusterin, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and osteopontin were measured during or after the treatment of PS. BUN, creatinine and kidney damage biomarkers in serum were not changed by PS. However, kidney cell karyomegaly and tubular hypertrophy were observed dose-dependently with higher severity in males. KIM-1, TIMP-1 and osteopontin in kidney and urine were increased dose dependently in male or at the highest dose in female rats. Increased urinary osteopontin by PS was not recovered at 2 weeks of post-exposure in both genders. Cystatin C in kidney was decreased at all treatment groups but inversely increased in urine. The changes in kidney damage biomarkers were more remarkable in male than female rats. These data indicate that the PS may provoke renal cell damage and glomerular filtration dysfunction in rats with histopathological lesions and change of kidney damage biomarkers in kidney or urine. Kidney and urinary KIM-1 and cystatin C were the most marked indicators, while kidney weight, BUN and creatinine and kidney damage biomarkers in serum were not influenced.

난소 및 난소 종양 염전의 초음파 소견

오연희,이현경,이원재,이성우,박수성,윤혜원,임문환,심재철,김용탁,김성숙,김정란 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Acute torsion of the ovary and ovarian mass is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. The sonographic findings in 14 cases of surgically proven torsion of the ovary and ovarian mass are described. Mostly cystic ovarian mass, engorged vessel, dilated uterine tube, beak-like echo(torsion site), smooth mass wall thickening an free-fluid collection in cul-de-sac are described. More significant in terms of specificity were the demonstration in 6 cases(42.9%) of the smooth mass wall thickening and in 8 cases(57.1%) of a free fluid in the cul-de-sac. We report the sonographic findings of ovary and ovarian mass torsion that may suggest the preoperative diagnosis of this condition.

실용음악 전공 학생들의 발성치료 전후 성대 및 음성 특성 비교

황연신,심미란,김철준,최용석,김상연,최찬호,선동일,Hwang, Yeon Shin,Shim, Mi Ran,Kim, Chul Jun,Choi, Yong Suk,Kim, Sang Yeon,Choi, Chan Ho,Sun, Dong Il 대한후두음성언어의학회 2016 대한후두음성언어의학회지 Vol.27 No.2

Background and Objectives : Many students major in applied music singing have various difficulties in phonation when they sing or perform. But the studies about this cause are lack. The purpose of this study is whether singing voice therapy based on vocal music is effective or not to applied music singing students that have difficulties in phonation. Materials and Methods : Singing voice therapy program had been done to 8 students major in applied music singing during 7 weeks. We did laryngeal stroboscope, perceptual, acoustic and aerodynamic examination before and after singing voice therapy to this students. And we studied post examination results have differences or improvements compared to pre examination results. Results : Four male students don't have effective improvement after singing voice therapy but they shows slight improvement in aerodynamic examination values compared to pre examination values. Four female students shows improvement in aerodynamic examination values and pitch range increasing. Above all, one student's vocal nodules disappeared after singing voice therapy. Conclusion : Singing voice therapy based on music singing is very effective to the students major in applied music singing. Above all, their curriculum in applied music singing should include phonation training based on music singing before training perform and technic practices.

제 1형 신경섬유종증 환자에서 발생한 위장관 간질종양 1예

원경준,이준,변유미,조민근,한경택,김원,홍란,임성철,김경종,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract, but this tumor is rarely seen in association with type l neurofibromatosis (NFl) Generally, the majority of GISTs are isolated neoplasm and they are sporadically found in the stomach, but the GISTs in NFl patients are usually multiple and usually found in the small intestine. We report a case of multiple GISTs in the jejunum of a 63-year-old woman diagnosed as NFl accompanied by complication of gastrointestinal bleeding, In this case, Patient had multiple cafe-au lait spots and neurofibroma on skin and had freckling on axilla and groin, and then, we made a diagnosis of NFl. Gastrointestinal bleeding is controlled by resection of multiple GISTs. Generally, only 3-5% of all gastrointestinal bleeding comes from the small bowel. Causes of small intestinal bleeding are angiodysplasia, neoplasm, NSAIDs induced ulcer etc. but, If patients have NFl accompanied by complication of gastrointestinal bleeding, GISTs on small bowel must be considered.

심리적 연습이 아동의 폐쇄기능 수행 및 학습에 미치는 영향

김상규,김성문,류상구,조주란 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.3

The purpose of this thesis is, through the positive study, to clarify the effects of mental practice on performance and learning to the closed skill of children, what differences there are between mental practice and physical practice, whether or not the mental practice is effective in case it is performed simultaneously with physical practice, and when the effects of mental practice come out. The subjects are all right-handed elementary school students who are in the fifth grade and divided into four groups through four-step preliminary test. The subjects throw balls toward the five-meter apart target whose center is one meter high from the ground with their feet stuck on the ground. The points are treated 'ANOVA with repeated measured'-practice conditions(four variables) times practice periods(four variables)- making use of PC-SAS. If meaningful differences are found, they are put under the afterward identification - 'Turkey's HSD.' The material analysis brought the following conclusions. First, the skill performance effects are not found according to the practice conditions, but the practice performance effects are found according to the practice period. Second, the learning effects are not found according to the practice conditions, but the skill learning effects are found according to the practice period. Third, in the latter part of the practice period are the learning effects of the mental practice found.