http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Importance of Culture for Diagnosing Human Brucellosis
이흥범,전형구,황정환,이창섭 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.6
Human brucellosis is a newly emerging infectious disease in Korea, and the number of the patients with this disease has rapidly increased in recent years. To evaluate the most reliable method in diagnosing human brucellosis, a retrospective study was conducted. Medical records of patients admitted or followed-up at the outpatient department of a tertiary care university hospital during the past 5 years were reviewed. Among a total of 32 human brucellosis patients (24 males and 8 females),21 (65.6%) were positive for standard tube agglutination test (STA) but negative for blood or bone marrow culture, 7 (21.9%) were positive for both STA and culture,and 4 (12.5%) were STA negative but culture positive. Based on these findings, we recommend that physicians include blood and/or bone marrow culture to obtain definitive diagnosis when clinical symptoms and signs strongly suggest the human brucellosis, even when STA is negative.
이흥범,정치량 대한중환자의학회 2010 Acute and Critical Care Vol.25 No.3
When disease or trauma progresses to a critical state, the reaction of the endocrine system in creating homeostasis is essential for survival. The association between the severity of hormonal changes and outcome in terms of morbidity and mortality has led to the challenge of development of several endocrine treatments. During sepsis, nitric oxide-mediated apoptosis is observed in the neurons and glial cells of the cerebrovascular centers of the autonomic nervous system. It is probably one of the components of the circulatory dysfunction of sepsis. The regulation of different organs was neither linear nor independent however organs were found to behave as biological oscillators coupled to each other through neurological or hormonal communication pathways. Sepsis, because of systemic inflammatory responsive syndrome, disrupts these communication pathways and leads to organ failures. Endocrine hormonal issues related to the intensive care setting are common challenges to ICU specialists. Disruptions of the endocrine system in sepsis are characterized by 1) an increase in cortisol plasma levels with a loss of the circadian rhythm of its secretion; 2) hyperglycemia due to insulin resistance and rise in hyperglycemic hormones secretion; 3)relative vasopressin deficiency; and 4) euthyroid sick syndrome or non-thyroidal illness syndrome. This article discusses the dynamic changes of four main endocrine axes: hypothalamic-pituitary-adrenal axis, insulin, vasopressin and thyroid during grave states of disease, when a patient is in critical condition.
국내 사람 브루셀라증 환자에 대한 3년 간의 추적 관찰 연구
이창섭,권근상,백병걸,박상원,이흥범 대한감염학회 2007 감염과 화학요법 Vol.39 No.4
목적 : 2002년 증례 보고 이후, 사람 브루셀라증 환자는 급격하게 증가하고 있는 실정임에도, 이와 관련된 장기간의 임상 증상과 혈청학적 추적 관찰에 대해서는 아직까지 보고된 적이 없다. 본 연구에서는 2003년 전북 일부 지역에서 집단 감염된 11명의 사람 브루셀라증 환자를 대상으로 장기간의 임상 경과와 혈청학적 변화를 알아보고자 하였다. 재료 및 방법 : 2003년 전라북도 정읍 지역에서 사람 브루셀라증으로 진단된 11명의 환자를 대상으로 10명의 환자가 임상 증상에 대한 추적 관찰에, 11명의 환자가 혈청학적 추적 검사에 포함되었다. 사람 브루셀라증의 추적검사는 standard tube agglutination test (SAT)로 시행하였고, 혈청학적 음성 전환은 SAT titer 1:40 이하로 정의하였으며, 브루셀라의 임상 증상이 진단 전 1년 미만으로 지속되었던 경우를 조기 회복기로, 1년 이상 지속되었던 경우를 지연 회복기로 정의하였다 결과 : 대상은 남자 8명, 여자는 3명이었고 이들의 평균 연령은 45세였다. 11명 중 10명이 축산업자였으며, 1명은 수의사였다. 3년 후 까지도 임상 증상이 남아 있다고 호소하는 환자는 8명(80%)이었으며, 만성 피로, 관절통이대부분이었고, 그 외 발열(1), 두통(2), 안통(1), 체중감소(1), 어지럼증(2)이 일부 있었다. 그러나 3년 후 추적 관찰에서 60% 이상 지속적으로 남아있는 증상은 만성 피로와 관절통이었다. 치료 기간은 최소 6주에서 최고 52주까지 다양하였으며, 중앙값은 11주였다. 혈청학적 추적 검사는 최소 11개월에서 최고 39개월까지 실시하였으며, 중앙값은 22개월이었다. 혈청학적 음성으로 전환된 시점은 치료시작 후 최소 5개월에서 최고 16개월이었으며 중앙값은11개월이었다. 결론 : 사람 브루셀라증에 걸렸던 환자들은 피로나 관절통과 같은 임상 증상이 지속적으로 남아 있을 수 있다. 그러나 이러한 증상이 재발을 의미하는 것은 아니기 때문에 항생제의 지속 복용은 필요하지 않다. 본 연구에서 혈청학적으로 마지막 음전된 시점이 치료 시작 후 16개월이라는 점으로 보아, 혈청학적 추적 검사는 치료 시작 후 최소 16개월 이상은 필요하다고 생각된다. Background : The first probable case of human brucellosis in Korea was reported in 2002. Since then there has been a gradual increase in the incidence and prevalence of the disease. There has not been any long-term follow-up investigation of the clinical course and serologic profiles of the disease in Korea. The present investigation is a 3 year clinical and serologic follow-up of human brucellosis patients in Chonbuk province. Materials and Methods : The investigation involved a total of 11 patients who were positively diagnosed with brucellosis in 2003. Clinical manifestations were evaluated either directly or via telephone interviews. The serologic follow-up was done by standard tube agglutination test (SAT). Negative sero-conversion was defined as an SAT titer less than 1:40. Early convalescence was defined as clinical manifestations of brucellosis observed within 12 months of diagnosis, and delayed convalescence was defined as clinical symptoms persisting longer than 12 months. Results : A total of eleven patients (8 males and 3 females; with a mean age of 45 years) participated in the study. Ten patients were livestock workers and one was a practicing veterinarian. Three years after the initial diagnosis, chronic fatigue and arthralgia were persistently observed in more than 60% of the patients in delayed convalescence. There was no evidence of relapse or reinfection of the disease. The median duration of antibiotics treatment and serologic follow-up were 11 weeks and 22 months, respectively. Negative sero-conversion was noted between 5 and 16 months after the initiation of treatment (with a median 11 months). Conclusion : Although the human brucellosis patients developed chronic symptoms such as fatigue and arthralgia even after negative sero-conversion, there was no evidence of any relapse or reinfection. This may mean that antibiotic intervention is not a justifiable recommendation. We also suggest that serologic monitoring be performed for at least 16 months after the initiation of treatment.