삼출성 중이염 환자에서의 혈중 및 아데노이드 면역글로불린 E의 면역혈청학적 연구

장혁순,강성호,유창수,김성현,이병돈,박영진,윤세동,안희영,강주원 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

Otitis media with effusion (OME) is one of the most common disease in children but its pathogenesis is not clear. In particular the role of allergy has revealed conflicting support with widely varing opinions as to its importance. Within recent years, striking biochemical and immunochemical analytic techniques have opened a new approach the study of otitis media with effusion. So we focused on distributions of IgE in adenoid tissue and serum IgE levels. Authors compared the serum IgE and the distribution of IgE in adenoid tissue between the 20 patients underwent tonsillectomy, adenoidectomy and ventilating tube insertion and control group of 11 patients underwent tonsillectomy and adenoidectomy. The results were as follows; 1. In the distribution of IgE in adenoid tissue, there was a significant increase in the group of patients with OME compared to the control group (P<0.01). 2. In the analysis of serum IgE levels, the levels of IgE in the OME patients an control group were higher than normal level, although the level of IgE in the OME patients were less than that of control group, there was no significance P>0.05).

골수구성 백혈병 환자에게 발생한 결핵성 림프절염

이창섭,송진수,최평균,조재현,방지환,박경화,박완범,김홍빈,김남중,윤성수,박선양,김병국,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

혈액질환 가운데 결핵 발생이 증가한다고 알려진 것은 호지킨 림프종을 포함한 림프증식성질환 그리고 모양세포성 백혈병 등이 있다. 또한 동종 골수이식을 받은 환자에서도 결핵은 증가한다고 알려져있다. Kaplan 등은 골수구성 백혈병 환자에서 결핵 발생이 증가한다고 보고하였다. 그러나 골수구성 백혈병 환자에서 결핵의 발생이 증가하는 이유에 대해서는 아직까지 정확하게 밝혀지지 않았다. 저자들이 2년 동안 후향적으로 조사한 180명의 성인 골수구성 백혈병 환자들 가운데 결핵이 발생한 환자는 4명이었고, 발생 부위는 모두 림프절이었다. 결핵은 골수구성 백혈병의 특정 아형에만 국한되어 발생하지 않았지만, 50%에서 FAB 분류에 의한 M4였다. 림프절이 종대된 골수구성 백혈병 환자에서 특히, 결핵의 유병율이 높은 나라에서는 결핵성 림프절염도 감별진단에 포함시켜야 한다. During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서 보다 10.9배 높았다. 결론 : 2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background : This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods : A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results : In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion : The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

Thermosensitive Biodegradable Poly(organophosphazene) Gels and Their Blends

( Sung Bum Jung ),( Gyung Don Kang ),( Jung Yun Huh ),( Sung Sook Ahn ),( Estela C. Monge ),( Gil Son Khang ),( Soo Chang Song ) 한국조직공학과 재생의학회 2006 조직공학과 재생의학 Vol.3 No.2

Thermo-sensitive poly(organophosphazene) hydrogels with hydrophilic α-amino-ω-methoxy-poly(ethyleneglycol) (AMPEG), hydrophobic amino acid esters (L-isoleucine ethyl ester) and glycine lactate ethyl ester as a side group have been synthesized. The poly(organophosphazenes) were characterized by 1H-, 31P-NMR spectroscopies and GPC. The viscosities of the gels were measured by viscometer along with the temperature changes. The poly(organophosphazenes) synthesized form solutions in water at low temperature while they form gels as the temperature increases showing lower critical solution temperature. To control the gelation properties we have studied polymer blends system. We grouped the polymers synthesized in two group such as hard polymers with low Tmax and high Vmax and soft polymers with high Tmax and low Vmax. When these polymers were blended at the appropriate ratio, the blended aqueous solution changed into a transparent hydrogel at the targeted body temperature. According to DSC and IR measurements, the two polymers were blended homogeneously.

How We Have Treated Severe to Critically Ill Patients With Coronavirus Disease 2019 in Korea

Park Do Hyeon,Kang Chang Kyung,Choe Pyoeng Gyun,Kim Nam Joong,Park Wan Beom,Oh Myoung-don 대한의학회 2022 Journal of Korean medical science Vol.37 No.49

Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, and the coronavirus disease 2019 (COVID-19) pandemic currently continues. In response to this unprecedented pandemic, several researchers and medical staff have struggled to find appropriate treatments for COVID-19. Patients with mild symptoms can recuperate with symptomatic care, however establishing treatment for severe to critically ill patients who can have a high mortality has been essential. Accordingly, the guidelines for COVID-19 treatment have evolved through numerous trials and errors and have been relatively well established to date. In the Republic of Korea, several evidence-based guidelines for COVID-19 treatment were released and revised, reflecting various research and regional medical conditions. To date, approximately 3 years after the beginning of the COVID-19 pandemic, we are reflecting on the changes in the guidelines thus far and have summarized the treatment experience of severe to critically ill patients with COVID-19. The Korean guidelines for COVID-19 treatment have been updated continuously as the National Institutes of Health (NIH) guidelines have changed. Dexamethasone is currently used as the backbone for the treatment of severe to critically ill patients with COVID-19, and remdesivir, baricitinib, and tocilizumab can be added depending on a patient’s situation. In addition, venous thromboembolism prophylaxis is one of the important adjunctive therapies for patients with severe COVID-19. In the clinical field, treatment of severely ill patients with COVID-19 based on guidelines is widely practiced by medical staff and established currently.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

Controlling the Thermosensitive Gelation Properties of Poly(organophosphazenes) by Blending

Kang, Gyung Don,Heo, Jeong-Yun,Jung, Sung Bum,Song, Soo-Chang WILEY-VCH Verlag 2005 Macromolecular Rapid Communications Vol.26 No.20

<P>Summary: After synthesizing both hard poly(organophosphazenes), which acted as strong hydrogels at a temperature below 37 °C, and soft poly(organophosphazenes), which displayed the opposite properties, we blended the polymers. When these polymers were blended at an appropriate ratio, the blended aqueous solution changed into a transparent hydrogel with improved mechanical properties at a temperature of 37 °C. According to DSC and IR measurements, the two polymers blended homogeneously and exhibited a behavior characteristic of a completely different copolymer.</P><P> <img src='wiley_img/10221336-2005-26-20-MARC200500472-gra001.gif' alt='wiley_img/10221336-2005-26-20-MARC200500472-gra001'> Graphic An aqueous poly(organophosphazene) solution at room temperature (left) is reversibly and rapidly transformed into a transparent hydrogel at body temperature (right) when a hard poly(organophosphazene) is blended with a soft one at an appropriate ratio. </P>

식괴의 종류에 따른 식도운동의 변화에 관한 연구

이정환(Jung Whan Lee),송치욱(Chi Wook Song),허병원(Byung Won Hur),강창돈(Chang Don Kang),진윤태(Yoon Tae Jeen),전훈재(Hoon Jai Chun),이홍식(Hong Sik Lee),이상우(Sang Woo lee),엄순호(Soon Ho Um),최재현(Jai Hyun Choi),김창덕(Chang Duck 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.1

N/A Background/Aims: It is suggested that diffuse esophagenl spasm (DES), nutcracker esophagus (NUT), and hypertensive lower esophageal sphincter (HLES) could be re-classified together as a spastic esophageal motility disorder of similar clinical background. However, there were no studies to evaluate the pathophysiological characteristics of these motor abnormalities. The aim of the study was to evaluate the changes of esophageal motor function depending on the different types of the bolus (water vs semi-solid bolus). Methods: Twenty-one healthy subjects and 42 subjects with primary esophageal motility disorders (4 DES, 12 NUT, 5 HLES, 12 nonspecific esophageal motility disorders, 9 normal) underwent a perfusion manometry with a low compliance pneumo-hydraulic capillary infusion system. Consecutively, each patient had l0 swallows of water and 10 swallows of Jello, 5 ml each. Results: In the healthy controls, the Jello swallow showed an increased amplitude and duration of distal esophageal contraction, and the velocity of peristalsis was decreased (p<0.05). Among all patients diagnosed by manometry with the water swallow, 2 cases diagnosed with HLES (40%) and 4 with NUT (33%) were changed to a diagnoses of DES after the Jello swallow. Moreover, HLES was found in 1 patient with DES (25%) and in 6 patients with NUT (50%). Conclusions: Semi-solid bolus swallows increase the contractile force of the esophagus more than water swallows. A conventional manometric diagnosis could be changed to a different spastic motility disorder of the esophagus after a semi-solid bolus swallow. It is suggested that DES, NUT, and HLES can be considered as a spectrum of spastic esophageal motility disorders sharing a similar pathophysiology. (Korean Journal of Gastrointestinal Motility 2000;6;ll-19)

Changes in Anxiety Level and Personal Protective Equipment Use Among Healthcare Workers Exposed to COVID-19

Park Do Hyeon,Lee Eunyoung,Jung Jongtak,Kang Chang Kyung,Song Kyoung-Ho,Choe Pyoeng Gyun,Park Wan Beom,Bang Ji Hwan,Kim Eu Suk,Kim Hong Bin,Park Sang-Won,Kim Nam Joong,Oh Myoung-don 대한의학회 2022 Journal of Korean medical science Vol.37 No.16

Background: The relationship between changes in anxiety levels and personal protective equipment (PPE) use is yet to be evaluated. The present study assessed this relationship among healthcare workers (HCWs) involved in the care of patients with coronavirus disease 2019 (COVID-19). Methods: An online survey was conducted in a municipal hospital with 195 nationally designated negative pressure isolation units in Korea. Anxiety level was measured using the self-rating anxiety scale (SAS), and changes in anxiety levels were assessed based on the time when COVID-19 vaccine was introduced in March 2021 in Korea. Monthly PPE usage between June 2020 and May 2021 was investigated. Results: The mean SAS score (33.25 ± 5.97) was within normal range and was lower than those reported in previous studies conducted before COVID-19 vaccination became available. Among the 93 HCWs who participated, 64 (68.8%) answered that their fear of contracting COVID-19 decreased after vaccination. The number of coveralls used per patient decreased from 33.6 to 0. However, a demand for more PPE than necessary was observed in situations where HCWs were exposed to body fluids and secretions (n = 38, 40.9%). Excessive demand for PPE was not related to age, working experience, or SAS score. Conclusion: Anxiety in HCWs exposed to COVID-19 was lower than it was during the early period of the pandemic, and the period before vaccination was introduced. The number of coveralls used per patient also decreased although an excessive demand for PPE was observed.