녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.

관상동맥내 스텐트 삽입후 발생한 관상동맥류 2례

제인수,허민영,문치숙,이재호,정수룡,조길현,이영민,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3

Coronary artery aneurysms are detected with increasing frequency because of the routine use of coronary angiography in the diagnosis and management of coronary artery disease. Although some coronary artery aneurysms are congenital or inflammatory, most are atherosclerotic. The prognosis of atherosclerotic coronary artery aneurysm may depend on the morphology of the aneurysm or the presence of coexisting obstructive disease. Coronary artery aneurysms have been also reported to occur after ballon angioplasty, directional athrectomy, laser angioplasty, and stent implantation with a frequency of 2% to 4%. The long-term outcome of post-intervention coronary artery aneurysm is unknown. We report two cases of the development of a coronary aneurysm 6 months after stent implantation as a treatment of severe obsructive coronary artery disease.

고반복 펄스형 CO₂ 레이저 전원장치의 개발

김희제,정현주,김도완,이동훈 釜山大學校生産技術硏究所 1999 生産技術硏究所論文集 Vol.57 No.-

본 연구에서는 1㎑ 부근의 펄스 반복율을 가지는 경제적이고 컴팩트한 펄스형 CO₂레이저의 동작 특성에 관해서 기술하였다. 고압·고주파 펄스 변압기와 수 십 ㎑의 스위칭에 적합한 IGBT를 사용한 고압 펄스전원 장치를 레이저 공진기에 접목시켜 새로운 방식의 고반복 CO₂레이저 전원장치를 개발하였다. 공진기는 수냉방식의 저속축류형으로 제작되었고 제어부에는 전원장치에 사용된 2개의 IGBT를 정밀하게 제어하기 위해서 PIC 마이크로프로세서가 사용되었다. 완성된 장치의 펄스 반복율과 동작압력 그리고 레이저 매질 가스의 혼합비의 변화에 따른 레이저빔의 출력 특성실험을 통하여 가스 배압비 CO₂: N₂: He = 1 : 9 : 15, 펄스 반복율 700 ㎐, 동작압력 15 Torr에서 최대 레이저 출력 약 20.5W, 최대 효율 약 8 %였다. In this study, we aim to develope a cheap and compact pulsed CO₂laser with pulse repetition rate range of 1 ㎑. We used a IGBT as the switching element of a power supply, which is cheap and simple comparing to others. PIC one-chip microprocessor was used for precise. control of a laser power supply on the control part. And the laser cavity was fabricated as an axial and water cooled type. The laser performance characteristics as various parameters, such as pulse repetition rate, gas pressure, and gas mixture rate have been investigated. The experiment was done under the condition of three gas mixture rates of CO₂: N₂: He = 1 : 3 : 10, 1 : 1.5 : 5, and 1 : 9 : 15. For this experiment, working pressure was from 6 Torr to 15 Torr and pulse repetition rate from 100 ㎐ to 900 ㎐. As a result, the maximum average output was about 20.5 W at the working pressure of 15 Torr, the gas mixture CO₂: N₂: He = 1 : 9 : 15 and the pulse repetition rate of 700 ㎐.

Scrub Typhus : 확진된 76예의 임상 소견에 대한 전향적 연구

김동민,김현리,박치영,윤성호,송현제,심수경 대한감염학회 2006 감염과 화학요법 Vol.38 No.4

배경 : Orientia tsutsugamushi에 의한 인체 감염은 혈액과 임파선을 타고 전신에 퍼져 혈관 염을 일으켜, 전신 장기의 침범 소견을 보인다. 그러나 아직 까지 전신장기 침범에 대한 임상 소견 및 검사 결과의 전향적인 추적 관찰에 대한 연구는 거의 없는 실정이다. 재료 및 방법 : 조선대학교병원에 내원한 환자 중 확진법(gold standard)인 간접형광항체법(IFA)으로. 확인된 76명의 환자를 대상으로 내원시 임상 양상 및 검사 결과의 평가 및 치료 후 검사 결과의 변화에 대한 전향적인 연구를 수행하였다. 결과 : 대부분의 환자에서 발열, 갈증, 전신 쇠약감, 두통을 호소하였으며, 특이 할만한 소견으로 현재까지 보고되지 않았지만, 대부분의 환자가 갈증을 심하게 호소한다는 것이다. 3명의 젊은 건강한 환자를 제외한 대부분의 환자에서 이러한 갈증 증상을 호소하였으며, 이러한 갈증은 발열이 호전되어도 지속되었으며, 퇴원 이후에 까지 지속되는 양상을 보였다. 혈액검사상 scrub typhus 초기에 나타날 수 있는 신기능 장애 및 간 기능 장애는 대부분 가역적으로 적절한 항생제 투여 후 모두 정상으로 회복됨을 확인할 수 있었다. 혈액 검사상 CRP, LDH, AST가 대부분의 환자에서 상승하였고, 특히 LDH의 상승이100% 환자에서 관찰된 것은 특이할 만 한데 적절한 치료후 CRP는 신속히 호전을 보이나, LDH는 서서히 호전됨을 확인하였다. DIC 검사상 DIC는 입원환자의 95.5%에서 확인되었으나, 비교적 일부의 환자에서 출혈 및 경색이 초래되는 것으로 생각된다. 결론 : Scrub typhus 초기에 나타 날수 있는 신기능 장애, 간기능 장애 및 DIC는 대부분 가역적으로 적절한 항생제 투여 후 모두 정상으로 회복되며, 이러한 관찰이scrub typhus 환자의 진단 및 임상 경과의 이해에 도움이 되리라 사료된다. Background : Orientia tsutsugamushi spreads to the entire body through the blood and lymphatics, and it induces vasculitis that results in the patients manifesting symptoms of systemic organ involvement. Materials and Methods : We conducted a prospective study to evaluate the clinical manifestations and the change of the laboratory results after instituting treatment for scrub typhus. Results : Most patients presented with fever (100%), malaise (96.1%) and thirst (96.1%). It was remarkable that most patients presented with severe thirst, except for 3 healthy, young patients. This thirst was persistent even after the resolution of fever. The renal and hepatic dysfunction were reversible after the administration of appropriate antibiotics. For the blood testing, it was deteded that the CRP, and LDH were elevated in most patients (95.9% and 100% respectively). DIC could be diagnosed in 95.5% of the patients at the time of admission Conclusion : Most patients presented with fever, malaise and severe thirst, and the renal and hepatic dysfunction were reversible after the administration of appropriate antibiotics. DIC was observed in most of our patients, but hemorrhage and infarction were not present. CRP showed a rapid improvement, nonetheless, the LDH and DIC test results improved slowly.

백서의 심실세동성 심정지 모델에서 해마신경세포 손상에 대한 단백질 합성저해제의 효과

오동렬,채장성,박승현,김세경,최세민,박제영 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: The goal of successful resuscitation is not only to stop the process of ischemia as soon as possible but also to overcome the secondary injury process after resuscitation, which involves a complex interplay of mechanisms. Brain damage accompanying cardiac arrest and resuscitation is frequent and devastating. Cells die by one of two mechanisms: necrosis or delayed neuronal death. Delayed neuronal death may require protein synthesis. Neurons in the CA1 subfield of the hippocampus are selectively vulnerable to death after injury by ischemia and reperfusion. Death of these neurons occurs after an interval of 1 or 2 days. We assessed the effects of a protein synthesis inhibitor, cycloheximide(CHX), on hippocampal neuronal death of rats by using the ventricular fibrillation cardiac arrest(VFCA) model. Methods: The effect of CHX(3 mg/kg, s.c.) on hippocampal neuronal death was studied in two groups of 18 rats each, one group being subjected to a 2-min VFCA and the other to a 3-min VFCA. Each group was divided into three subgroups: control(groupⅠ,Ⅱ) without subcutaneous injection of CHX, "esp-12" of group Ⅰ/Ⅱ treated with CHX 12 hours after return of spontaneous circulation (ROSC), and "exe-24" of group Ⅰ/Ⅱ treated with CHX 24 hours after ROSC. The coronal sections of the hippocampus levels were stained with hematoxylin-eosin after 72 hours of survival. The histologic damage score(HDS) was used to assign a score to the total number of damaged neurons counted in each of the hippocampal CA1 subfields. Results: 1. There were not significant differences in heart rates, blood pressures, blood sugar, and blood gas in group I & Ⅱ during the pre-arrest steady state or at 5 min and 30 min after ROSC. 2. In group I & Ⅱ, the HDS, were significantly reduced in rats(I exp-12, 1.1 ±0.6;Ⅰexp-24, 1.3 ±0.5;Ⅱ exp-12, 1.4±0.7; and Ⅱ exp-24, 1.8±0.8) treated with CHX 12 hours or 24 hours after ROSC than control rats(1,2.5 ±0.9;Ⅱ,2.9±0.8)(p<0.05). Conclusion: These results suggest that delayed hippocampal neuronal death from ischemic insult after ventricular fibrillation cardiac arrest followed by resuscitation can be prevented by a protein synthesis inhibitor, CHX. Further experimental studies of the action mechanism of protein synthesis inhibitors to delayed neuronal death and clinical applications are required.

각종 난치성 혈액 질환에서의 비혈연간 골수이식

김동욱,한훈,김정아,김희제,민창기,엄현석,최정현,이종욱,한치화,홍영선,최일봉,신완식,민우성,김학기,김춘추,김원일,김동집 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

목적: 비혈연간 골수이식은 혈연내에 적절한 골수공여자가 없는 만성골수성백혈병, 고위험군의 급성별혁병, 면역억제치료에 실패한 재생불량성빈혈 및 각종 난치성 조혈모세포질환의 완치를 위한 표준적인 치료방법으로 정착되고 있다. 혈연간 표준적인 동종 이식에 비하여 비혈연간 이식시에는 생착부전, 이식편대숙주반응과 감염이 더 빈번하게 발생하며, 국내에서는 아직까지 체계적인 임상연구결과가 보고된 바 없었다. 이에 본 센터에서는 1995년 10월 이후로 약 20개월간 26예의 비혈연간 골수이식을 시행하였으며 3개월 이상의 추적관찰이 가능하여 이식초기 합병증의 관찰 및 분석이 가능하였던 20예의 환자를 대상으로 이식성적 및 문제점을 보고함으로써 새롭게 확대되고 있는 이 분야의 임상연구 및 진료의 활성화를 꾀하고자 한다. 방법: 각종 혈액 종양질환으로 비혈연간 이식을 시행한 총 26예의 환자중 3개월이상의 추적관찰이 가능하였던 20예를 대상으로 후향적으로 임상경과를 분석한 후 생존 분석을 시행하였고, 환자의 연령, 성별, 질병의 상태, 조식 적합 항원의 일치정도, 이식편대 숙주 반응의 유무와 생존기간과의 상관관계를 살펴보았다. 또한 표준위험군과 고위험군으로 나누어 생존율을 비교하였고 이식과 관계된 생착 부전, 이식편대숙주반응, 감염의 발생과 양상 그리고 그 합병증을 관찰하였다. 결과: 1. 환자와 공여자간에 HLA 불일치가 20예 중 4예에서 있었으며, 생착여부의 확인이 가능했던 17예 중 16예에서 생착이 확인되어 94.1%의 생착율을 보였다. 2. 급성이식편대숙주반응은 62.5%(10/16예)에서 발생하였으며 111도 이상의 급성의 이식편대숙주 반응은 25%(4/16예)에서 발생하였다. 만성이식편대숙주반응은 40%(2/5예)의 환자에서 발생하였으며 이들 모두 국소형으로 중증의 진행형 만성이식편대숙주반응이 관찰된 환자는 없었다. 3. 호흡기 합병증은 10예(50%)에서 발생하였으며 감염성 폐렴을 포함한 호흡기 합병증이 가장 흔한 일차적인 사망 원인이었다. 호흡기 합병증이 발생했던 10예중 6예가 감염에 의한 폐렴이 의심되었고 나머지 4예는 특발성 간질성 폐렴이었다. 4. 8.5개월의 중앙추적기간 중 35%의 생존율을 관찰할 수 있었고, 생존기간은0.5개월에서 15개월 (중앙치:4개월)이었다. 한편 고위험군은 25%(3/12예), 표준위험군은 50%(4/8)의 생존율을 관찰할 수 있었다. 5. 가장 흔한 사망 원인은 감염성 폐렴을 포함한 호흡기 합병증(6예)이었고, 이외의 사망 원인으로는 급성 이식편대숙주반응과 다장기부전이 각각 2예, 생착 부전, 간정맥 폐쇄, 그리고 재발이 각각 1예였다. Unrelated bone marrow transplantation(UBMT) has been increasingly recognized as the standard treatment for cure of chronic myelogenous leukemia, high risk acute leukemia, aplastic failed on immunotherapy, and the variety of refractory hematologic diseases in patients lacking a related donor. However, as compared to HLA identical sibing transplantation, UBMT carries higher incidence of graft failure, graft versus host disease(GVHD), and infection. In our center, 26 patients underwent UMBT between October 1995 and June 1997. The minimum follow-up of 3 months was possible in 20 patients, for whom early complications and clinical outcomes were assessed. The median age of the 20 patients was 24 years. 8 patients had standard risk disease and 12 patients had high risk disease. All patients received various preparative regimens including total body irradiation according to disease and disease status. 19 patients received CsA + short course MTX for GVHD prophylaxis. One patient received marrow that was depleted of T cells ex vivo using avidinbiotin column. The class I loci were typed by serological methods and HLA-A, HLA-B and HLA-DRB1. 3 additional pairs were one minor mismatched at the HLA-B locus. Another one patients was one major mismatched at the DRBI alleles. 17 patients were evaluable for engraftment. Successful enfraftment was confirmed in 16 patients(94.1%). Only one patient who was performed one major DRBI mismatched transplants experienced graft rejection. 16 patients were evaluable for acute GVHD. The overall incidence of acute GVHD developed in 4 patients(25%). Five patients were evaluable for the development of Ⅳ acute GVHD developed in 4 patients (25%). Five patients were evaluanle for the development of chronic GVHD. 2 patients(40%) developed limited chronic GVHD. Respiratory complications including pulmonary infection developed in 10 patients(50%) and these complications were the most common primary cause of death. Of these 10patients, 6 had pneumonia due to fungus(4 patients), pacterial (1 patient), and CMV infection (1 patient) and 4(20%) had idiopathic interstitial pneumonitis and/or adult respiratory distress syndrome. The duration of median follow- up was 8.5 months and 7 of 20 patients(35%) are alive at the time of this analysis with survival duration of 0.5 to 15 months(median survival duration: 4 months). The overall survival was 25% (3/12 patients) in high risk group and 50%(4/8 patients) in standard group. From these results, we can predict that the incidence and severity of GVHD in Korea are lesser than multiracial countries and the long-term survival of patients with standard risk disease can approach that of HLA matched sibling transplants. For the past two years, the performance of UBMT has been rapidly increasing and it will be possible to analyze much larger number of patients soon in Korea. In the future the problems of graft failure, GVHD, and infection due to long lasting immunocompromised status will need to be overcome by continued medical research. In addition, the volunteer donor pool will have to be expanded by the promotion of the national awareness of its need.

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.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

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.

고량강의 항염증 작용에 대한 연구

박히준,이제현,김수영,심범상,구헌종,강전모,최일환,이재동,김남재,이지숙,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The use of herbal therapy is becoming an increasingly attractive approach for the treatment of various inflammatory disorders. The Alpiniae officinari Rhizoma is popular in Aisa as a traditional herbal medicine. Alpiniae officinari Rhizoma is a species of the ginger family(Zingiberacease). Method : This study was performed to investigate the anti-inflammatory effect of Alpiniae officinari Rhizoma extract by the methods of "carrageenan induced paw edema" and "Lipopolysaccharide-induced inflammatory mediators in mouse macrophage RAW 264.7 cells". Result : We suggest that Alpiniae officinari Rhizoma extract decreased paw volume induced by plantar injection of carrageenan. Also Alpiniae officinari Rhizoma extract inhibited nitric oxide, prostaglandin E₂production and induced nitric oxide synthase, cyclooxygenase-2 protein expression in Mouse macrophage RAW 264.7 cells stimulated with lipopolysaccharide. Conclusion : This study shows that Alpiniae officinari Rhizoma extract seems to have anti-inflammatory effect by inhibition of nitric oxide, prostaglandin E_(2) production and nitric oxide synthase, cyclooxygenase-2 protein expression.