최근 4년간 동국대 포항병원의 변검체에서 분리된 장영세균의 분포와 항균제 감수성양상

김문연,하경임 동국대학교 경주대학 1997 東國論集 Vol.16 No.2

세균성 장감염의 원인균으로는 Salmonella, Shigella, Vibrio외에도 여러 가지가 있다. 한국에서는 Salmonella와 Shigella가 장감염에서 가장 흔히 발견된다. 1970년대 중반까지는 장티푸스균이 가장많이 발견되었으나, 이후 다른 Salmonella균종들의 빈도가 증가하기 시작하였고 항균제 감수성검사에서도 변화를 보였다. 저자들은 1994년 1월부터 1997년 10월사이에 동국대학 포항병원에서 의뢰된 변검체를 대상으로 Salmonella, Shigella등 장염원인균의 발생빈도와 감수성양상의 변화를 알아보고자 하였다. 이 기간중에 의뢰된 1229검체로부터 배양된 55명의 환자 중에서 장티푸스균은 4명, 그 외의 Salmonella균은 48명, Shigella균은 3명이었다. 장티푸스 외의 균주에서는 D군이 17명으로 제일 많았고, B군과 C군 은 각각 13명식이었다. 항균제 감수성검사에서 장티푸스균은 모든 항균제에 대하여 감수성을 보였고, 이 외의 Salmonella 균종들에서는 ampicillin, carbenicillin, chloramphenicol에 일부 내성을 보였으나, ampicilin, chloramphenicol, cephalothin에는 내성이 해마다 감소하는 양상을 보였고, imipenem, cefuroxime-axetil, ceftazidime에는 모든 균주가 감수성을 보였다. In enteropathogenic bacterial infection, there are many a causative agents such as Salmonella, Shigella, Vibrio, etcs. Salmonella and Shigella species are the most frequent causes in Korea. In the middle of 1970th, Salmonella typhi had been known the most frequent agents, before soon after other Salmonella became to increase and show antimicrobial resistance. In this study, we tried to know the incidences and susceptibility changes in Salmonella, Shigella. From January in 1994 to October in 1997, stool specimens at Phohang hospital in Dongguk university were cultured and identified for Salmonella, Shigella, and other enteropathogenic bacteria, followed by tested for susceptibility test. During a 4 years period, 55 patients yielded positive cultures from 1229 stool of rectal samples. Isolated bacteria were that Salmonella typhi were 4, other Salmonella were 48, Shigella were 3. In Salmonella except S. typhi, Group D were 17, Group B and C were 13, respectively. The most frequently isolated group were Group D. S. typhi were susceptible to all antimicrobials. Other some Salmonella species were resistant to ampicillin, and carbenicillin, chloramphenicol, but showed decreased resistance in ampicilin, chloramphenicol, and cephalothin. All isolated Salmonella were susceptible to imipenem, cefuroxime axetil, and ceftazidime.

개 대뇌겉질에서 Platelet-Derived Growth Factor α-Receptor의 출생 후 발달에 관한 면역조직화학적 연구

윤영,안병수,김인정,양경철,박선홍,김기훈,박도영,김장만,문정석,장인엽,조하영 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background and Objectives : The localization of platelet-derived growth factor-α receptor (PDGF-α R) was commonly restricted to oligodendrocyte progenitors during late embryonic and postnatal development. However, several studies recently demonstrated that mature neurons could also synthesize PDGF-α, Materials and Methods : In the present study, to analyze the distributional pattern of PDGF-αR during postnatal development of the canine cerebral cortex, we used immunohistochemistry on sections of canine brain tissue. Results : We found that neurons of various regions of cerebral cortex exhibited the immunoreactivity to PDGF-αR as early as postnatal day 0, and slightly decreased after postnatal day 14. Whereas neuronal PDGF-αR were maintained at all ages, the oligodendroglia-like expression of PDGF-αR could not be confirmed. Conclusion : The localization of PDGF-αR in immature and mature neurons supports the several roles of PDGF during development, protection and survival of neurons.

한국 야생고양이에서 바르토넬라 감염

이지영,강재승,김미경,황태숙,곽이경,채민병,장철순,김일권,서동범,정문현 대한감염학회 2001 감염 Vol.33 No.5

Background : Cat scratch disease (CSD) is an emerging disease worldwide and is mainly caused by Bartonella henselae, a gram-negative bacterium. The most common clinical manifestation is regional lymphadenopathy, though clinical recognition may be difficult, as atypical manifestations occur. The condition can be complicated by neuroretinitis, endocarditis, and sometimes fatal encephalopathy. The reservoir of B. henselae is the cat, and the prevalence rates of B. henselae infection in cat populations range from 4 to 70% . The prevalence of Bartonella infection in Korea has not been studied, thus, in this study Bartonella infection was investigated in cats captured in the Inchon and Ansan areas. Methods : Twenty wild cats were captured and their livers and spleens were examined by polymerase chain reaction (PCR), bacterial culture, and histopathologically, PCR used two primers : Cat (sense : 5'-GAT TCA ATT GGT TTG AA(G/A) GAG GCT-3', antisense : 5'-TCA CAT CAC CAG G(A/G)C GTA TTC-3') and Barto (sense:5'-(C/T) CT TCG TTT CTC TTT CTT CA-3', antisense : 5'-AAC CAA CTG AGC TAC AAG CC-3'). Culture was performed by inoculating sliced spleen and liver into the ECV304 cell line and bacterial growth was observed over a period of 3 weeks. If no visible bacterial growth was identified, the presence of bartonella was examined by DNA staining, indirect immunofluorescent staining, and PCR. Liver and spleen were stained with H&E and scrutinized under the light microscope. Results : Nine pairs of culture cells inoculated with liver and spleen were examined by indirect immunofluorescent staining and PCR; no positive case was found. In addition, no positive case was identified by PCR in the liver and spleen specimens of eleven cats. Spleen and liver specimens of eleven cats were examined by light microscopy and none showed granuloma. Conclusion : This preliminary study suggests that the Bartonella infection is probably uncommon in the cat population of the Inchon and Ansan areas. Further studies should be undertaken to detail the prevalence of Bartonella infection in other areas and in human. (Korean J Infect Dis 33:319∼324, 2001)

폐암에서 CYFRA 21-1과 다른 종양표지자의 진단적 의의

이상구,이호현,전병철,김성자,이영현,김문연,하경임 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

폐암의 확실한 조직학적 진단이 어려울 경우 종양표지자의 검사가 보조적인 진단 수단이 되고, 조기 진단이나 경과 관찰에 이용되고 있다. 이에 저자는 CYFRA 21-1이 폐암의 종양표지자로서 효용성이 있는지 판정하고, CYFRA 21-1과 다른 폐암 종양표지자인 SCC Ag, CEA, NSE의 폐암의 조직학적 유형에 따른 민감도와 특이도를 비교하였다. 그리고 병기 진행에 따른 CYFRA 21-1치의 증가 여부를 관찰하고, 4가지 종양표지자를 동시에 측정하였을 때의 진단적 효용성을 비교하고자 하였다. 이 연구는 1994년 12월부터 1995년 11월까지 동국대학병원에 입원한 폐암 환자 40명과 양성 폐질환 환자 40명을 대상으로 하였다. 편평상피세포암 21명, 선암 10명, 소세포암 7명, 대세포암 2명이었다. 혈청 CYFRA 21-1의 cytokeratin 19 분절에 대한 쥐의 두 가지 단일 클론항체(KS 19-1과 BM 19-21)를 이용하는 RIA방법으로 측정하였다. CEA는 MEIA 방법으로, SCC 항원과 NSE는 RIA로 측정 하였다. 1. CYFRA 21-1의 혈중 농도는 폐암군 22.08±43.00ng/mL, 양성 폐질환군 1.14±1.04ng/mL로 폐암군에서 양성 폐질환군보다 유의하게 높았다(P<0.05). 폐암환자군에서 55%의 양성율을 보였고, SCC 항원 30%, CEA 44.7%, NSE 54.5%의 양성율을 나타내 CYFRA 21-1이 가장 높은 양성율을 보였다. 2.CYFRA 21-1은 비소세포암군 23.79±44.49ng/mL, 소세포암군 13.90±33.57ng/mL로 양군에서 유의한 차이를 보였다. 폐암환자군에서 민감도와 특이도는 CYFRA 21-1 55.0%와 96.7%, SCC항원 30.0%와 96.4%, CEA 42.5%와 92.8%, NSE 36.4%, 76.9%로 CYFRA 21-1에서 가장 높은 민감도와 특이도를 보였다. 폐암의 조직학적 유형에 따른 민감도는 편평상피세포암에서 CYFRA 21-1이 61.9%로 CYFRA 21-1의 민감도가 가장 높았고, 선암에서는 CEA가 88.8%로, 소세포암에서는 NSE가 85.7%로 가장 민감도가 높은 것으로 나타났다. 3. 비소세포암군에서 CYFRA 21-1치는 병기가 진행됨에 따라 증가하는 경향을 보였으나 통계학적으로 유의하지는 않았다. 4. 폐암환자에서 단일 종양표지자를 측정하는 것 보다 동시에 여러 종양표지자를 측정하는 것이 특이도는 떨어지나 민감도는 80.0%로 더 높은 것으로 나타났으며 정확도에는 큰 차이가 없었다. 양성 표지나 수에 따른 비교분석시 폐암의 상대 예측도는 두 표지자 양성인 경우가 76.5%, 3가지 표지자와 4가지 모든 표지자에서 양성으로 나온 경우는 100%로 나타났다. 본 연구 결과 CYFRA 21-1은 새로운 폐암의 종양표지자로 기존의 종양표지자 보다 민감도가 높고 비소세포암 특히, 편평상피세포암에 유용한 표지자로 사료되며, 폐암이 의심되는 환자에서 단일 종양 표지자를 측정하는 것 보다 수종의 종양표지자를 동시에 측정하는 것이 진단에 더욱 도움이 되리라 생각된다. Background: Cytokeratin 19 is a subunit of cytokeratin intermediate filament expressed in simple epithelia and their malignant counterparts. A fragment of cytokeratin subunit 19 can be measured in serum with a immunoradiometric assay using two mouse MoAb KS 19-1 and BM 19-21. Thus this cytokeratin 19 fragment is referred to as CYFRA 21-1. The aims of this study are to evaluate the clinical utility of CYFRA 21-1 in the diagnosis of lung cancer and to compare the diagnostic sensitivity and specificity of CYFRA 21-1 with those of CEA, SCC Ag, NSE according to histological type of lung cancer. Methods: In 40 patients with lung cancer(21 with squamous cell carcinoma, 10 with adenocarcinoma, 7 with small cell carcinoma, 2 with large cell carcinoma) and 40 patients with non-malignant lung disease, serum CYFRA 21-1 was measured by solid-phase immunoradiometric assay(CIS Bio International, France). Serum NSE and SCC Ag were measured by immunoradiometric assay, and CEA was measured by microparticle enzyme immunoassay. Results: 1) The mean value of CYFRA 21-1 was 22.08±43.00ng/mL in the lung cancer and 1.11±1.04ng/mL in me non-malignant lung disease group(P<O.O5). 2) Using the cut-off value of 3.3ng/mL, the sensitivity and specificity of CYFRA 21-1 were 55.0%, 96.7% in the lung cancer. The sensitivity of CYFRA 21.1 was 61.9% in squamous cell carcinoma 3) The level of CYFRA 21-1 was increasing tendency with the progression of stage in non-small cell carcinoma but statistically not significant. 4) Simultaneous determination of four tumor markers revealed increased sensitivity to 50.0% in lung cancer. As the number of positive markers was increased, the relative possibility of lung cancer was also increased. If two markers were positive, it increased to 76.5% and three markers were positive, it increased to 100%.5 Conclusions: CYFRA 21-1 is a useful serum marker for patients with lung cancer, especially in squamous cell carcinoma of the lung. The simultaneous measurement of CYFRA 21-1, CEA. SCC Ag and NSE would provide additional information for the diagnosis of lung cancer, especially in patients with high risk group of lung cancer.

Autologous, Allogeneic and Heterogeneic Cultured Dermal Fibroblasts Transplantation to Guinea Pig

( Gyoung Moon Kim ),( Sei Yeon Kim ),( Su Jean Chong ),( Hee Su Kim ),( Si Yong Kim ) 대한피부과학회 2005 초록집 Vol.43 No.20

Analysis of Late Effects of Skin Regenerated from Autologous Dermal Fibroblasts on Guinea Pig Wounds

( Gyoung Moon Kim ),( Sei Yeon Kim ),( Su Jean Chong ),( Hee Su Kim ),( Si Yong Kim ) 대한피부과학회 2005 초록집 Vol.43 No.20

Transarterial radioembolization versus tyrosine kinase inhibitor in hepatocellular carcinoma with portal vein thrombosis

Moon Haeng Hur,Yuri Cho,Do Young Kim,Jae Seung Lee,Gyoung Min Kim,Hyo-Cheol Kim,Dong Hyun Sinn,Dongho Hyun,Han Ah Lee,Yeon Seok Seo,In Joon Lee,Joong-Won Park,Yoon Jun Kim 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.3

Background/Aims: Transarterial radioembolization (TARE) has shown promising results in treating advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). However, whether TARE can provide superior or comparable outcomes to tyrosine kinase inhibitor (TKI) in patients with HCC and PVTT remains unclear. We compared the outcomes of TARE and TKI therapy in treatment-naïve patients with locally advanced HCC and segmental or lobar PVTT. Methods: This multicenter study included 216 patients initially treated with TARE (n=124) or TKI (sorafenib or lenvatinib; n=92) between 2011 and 2021. Baseline characteristics were balanced using propensity score matching (PSM) or inverse probability of treatment weighting (IPTW). The primary outcome was overall survival (OS). The secondary outcomes included progression-free survival (PFS) and objective response rate (ORR). Results: In the unmatched cohort, the median OS of the TARE and TKI groups were 28.2 and 7.2 months, respectively (P<0.001), and the TARE group experienced significantly and independently longer OS compared to the TKI group (adjusted hazard ratio=0.41, 95% confidence interval=0.28–0.60, P<0.001). Similar results were observed in the study cohorts balanced with IPTW (P=0.003) or PSM (P=0.004). Although PFS was comparable between the two groups, the TARE group showed a trend of prolonged PFS in a subpopulation of patients with Vp1 or Vp2 PVTT (P=0.052). In the matched cohorts, the ORR of the TARE group was 53.0–56.7%, whereas that of the TKI group was 12.3–15.0%. Conclusions: For patients with advanced HCC with segmental or lobar PVTT and well-preserved liver function, TARE may provide superior OS compared to sorafenib or lenvatinib.

Balloon Bronchoplasty for the Treatment of Bronchial Stenosis After Lung Transplantation: A Single-Center 10-Year Experience

Kim Dong Kyu,Kwon Joon Ho,Han Kichang,Kim Man-Deuk,Kim Gyoung Min,Moon Sungmo,Park Juil,Won Jong Yun,Kim Hyung Cheol,Chun Sei Hyun,Choi Seung Myeon 대한영상의학회 2023 Korean Journal of Radiology Vol.24 No.5

Objective: To assess the safety and efficacy of balloon dilatation under dual guidance using fluoroscopy and bronchoscopy for treating bronchial stenosis following lung transplantation (LT), and to elucidate the factors associated with patency after the procedure. Materials and Methods: From September, 2012, to April, 2021, 50 patients (mean age ± standard deviation, 54.4 ± 12.2 years) with bronchial stenosis among 361 recipients of LT were retrospectively analyzed. The safety of balloon dilatation was assessed by evaluating procedure-related complications. Efficacy was assessed by evaluating the technical success, primary patency, and secondary patency. Primary and secondary cumulative patency rates were calculated using the Kaplan-Meier method. The factors associated with patency after the procedure were evaluated using multivariable Cox hazard proportional regression analysis. Results: In total, 65 bronchi were treated with balloon dilatation in 50 patients. The total number of treatment sessions was 277 and the technical success rate was 99.3% (275/277 sessions). No major procedure-related complications were noted. During the mean follow-up period of 34.6 ± 30.8 months, primary patency was achieved in 12 of 65 bronchi (18.5%). However, the patency rate improved to 76.9% (50 of 65 bronchi) after repeated balloon dilatation (secondary patency). The 6-month, 1-year, 3-year, and 5-year secondary patency rates were 95.4%, 90.8%, 83.1%, and 78.5%, respectively. The presence of clinical symptoms was a significant prognostic factor associated with reduced primary patency (adjusted hazard ratio [HR], 0.465; 95% confidence interval [CI], 0.220–0.987). Early-stage treatment ≤ 6 months (adjusted HR, 3.588; 95% CI, 1.093– 11.780) and prolonged balloon dilatation > 5 min (adjusted HR, 3.285; 95% CI, 1.018–10.598) were associated with significantly higher secondary patency. Conclusion: Repeated balloon dilatation was determined to be safe and effective for treating bronchial stenosis following LT. Early-stage treatment and prolonged balloon dilatation could significantly promote long-term patency.

Thoracic Duct Embolization for Treatment of Chyle Leakage After Thyroidectomy and Neck Dissection

Moon Sungmo,Park Juil,Kim Gyoung Min,Han Kichang,Kwon Joon Ho,Kim Man-Deuk,Won Jong Yun,Kim Hyung Cheol 대한영상의학회 2024 Korean Journal of Radiology Vol.25 No.1

Objective: This study aimed to evaluate the safety and efficacy of intranodal lymphangiography and thoracic duct embolization (TDE) for chyle leakage (CL) after thyroid surgery. Materials and Methods: Fourteen patients who underwent intranodal lymphangiography and TDE for CL after thyroid surgery were included in this retrospective study. Among the 14 patients, 13 underwent bilateral total thyroidectomy with neck dissection (central compartment neck dissection [CCND], n = 13; left modified radical neck dissection (MRND), n = 11; bilateral MRND, n = 2), and one patient underwent left hemithyroidectomy with CCND. Ten patients (76.9%) had high-output CL (> 500 mL/d). Before the procedure, surgical intervention was attempted in three patients (thoracic duct ligation, n = 1; lymphatic leakage site ligation, n = 2). Lymphangiographic findings, technical and clinical successes, and complications were analyzed. Technical success was defined as the successful embolization of the thoracic duct after access to the lymphatic duct via the transabdominal route. Clinical success was defined as the resolution of CL or surgical drain removal. Results: On lymphangiography, ethiodized oil leakage near the surgical bed was identified in 12 of 14 patients (85.7%). The technical success rate of TDE was 78.6% (11/14). Transabdominal antegrade access was not feasible due to the inability to visualize the identifiable cisterna chyli or a prominent lumbar lymphatic duct. Among patients who underwent a technically successful TDE, the clinical success rate was 90.1% (10/11). The median time from the procedure to drain removal was 3 days (with a range of 1–13 days) for the 13 patients who underwent surgical drainage. No CL recurrence was observed during the follow-up period (ranging from 2–44 months; median, 8 months). There were no complications, except for one case of chylothorax that developed after TDE. Conclusion: TDE appears to be a safe and effective minimally invasive treatment option for CL after thyroid surgery, with acceptable technical and clinical success rates.

The Study of Allogeneic Wound Healing Using Cultured Autologous Dermal Fibroblast of Guinea Pig

( Gyoung Moon Kim ),( Seung Jun Hyang ),( Woo Sun Lee ),( Young Chul Kye ),( Si Yong Kim ) 대한피부과학회 2004 초록집 Vol.42 No.20