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      • KCI등재후보

        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.

      • 한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

        양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

        The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

      • KCI등재

        사후분해 시체에 대한 법의학적 접근

        최영식,이상용,김유훈,조갑래,이봉우,양경무,정낙은,서중석,이한영,이원태,강현욱 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

        Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.

      • SCOPUSSCIEKCI등재

        뇌동맥류 파열 환자에서 증후성 뇌혈관연축의 발생 및 회복에 영향을 미치는 인자들

        최석민,석종식,권정택,민병국,황성남,김영백,홍현종 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

        To determine the factors affecting development and recovery of symptomatic vasospasm. the author analysed the results of patients with ruptured intracranial aneurysms treated by nimodipine and prophylactic “triple0H” therapy. From January 1991 to December 1995. 199 patients underwent surgery for ruptured intracerebral aneurysms. Combined hypervolemic hemodilution was initiated at the time of admission. Induced hypertension was added immediately after surgery(aneurysmal neck clipping). All patients received nimodipine intravenously or orally until the 14th day of SAH Sixty patients underwent surgery on Day 0 through 2 after attacks of subarachnoid hemorrhage(Goup A) 105 patients on Day 3 through 14(Group B). and 35 patients after Day 14(Group C). Of 199 patients. 76(38%) patients suffered from symtomatic vasospasm. Symptomatic vasospasm occured in 34% of Group A patients. 33% of Group B patients. and 5% of Group C patients. Symtomatic vasospasm occured more frequently in the older age group. the Fisher group 3 and Hunt & Hess grades 3, 4 and 5 groups. Of 76 patients who suffered from symptomatic vasospasm. 47(62%) patients recovered completely. The author analysed the relationship between recovery rate and sex, age. Hunt & Hess agrde and Fisher group among these 76 patients. Recovery rates between these groups were not significantly different. Based on this experience the author believes that Hunt-Hess grade. Fisher group and age are important factors affecting symptomatic vasospasm development.

      • KCI등재
      • KCI등재
      • KCI등재후보

        족관절 내과골절에서 피질골 나사못을 이용한 변형된 긴장대 고정술

        최호림,도현우,김병흠,김규현,박종석,송준민 대한골절학회 2004 대한골절학회지 Vol.17 No.4

        목적 : 전위된 족관절 내과골절에 대해 피질골 나사못을 이용한 변형된 긴장대 고정술을 이용한 치료결과를 분석해 보고자 하였다. 대상 및 방법 : 2001년 1월부터 2003년 1월까지 전위된 내과골절에 대해 변형된 긴장대 고정술을 시행 받고 최소 1년 이상 추시관찰 가능 하였던 24례를 대상으로 하였다. 남자 13례, 여자 11례로 평균 연령은 46세였다. 골절은 Lauge-Hansen 분류법을 사용하였으며, 결과는 Meyer와 Kumler의 평가 방법을 이용하였다. 결과 : 13례 (54%)에서 우수의 결과를 얻었고, 9례 (38%)에서 양호의 결과를 얻었으며, 운동범위의 제한이 발생한 1례에서 보통, 후외상성 관절염이 발생한 1례에서 불량의 결과를 얻었다. 결론 : 전위된 족관절 내과골절에서 피질골 나사못을 이용한 변형된 긴장대 고정술은 견고한 내고정과 조기 관절 운동이 가능한 효과적인 수술 방법이 될 수 있을 것으로 사료된다. Purpose : To evaluate the clinical results of modified tension band wire technique using cortical screw for treatment of displaced medial malleolar fractures of the ankle. Materials and Methods : From January 2001 to January 2003, 24 patients were treated by modified tension band wiring using cortical screw for medial malleolar fracture. The follow-up period was 12~35 months (average 18 months). There were 13 males and 11 females, and the mean age was 46 years. Fractures were classified by Lauge-Hansen's classification. The results were analyzed by Meyer and Kumler's criteria. Results : There were 13 cases (54%) of excellent, 9 cases (38%) of good, and one case of fair because of limitation of motion of the ankle joint and one case of poor which showed post-traumatic arthritis of the ankle. Conclusion : Modified tension band wire technique using cortical screw can be an effective operative method for the treatment of displaced medial malleolar fractures of the ankle.

      • 상처치유시 Antisense TGF-β1 Oligodeoxynucleotides가 Inducible Nitric Oxide Synthase발현 조절에 미치는 영향

        최병민,곽현정,전창덕,임정식,박석돈,정헌택 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.4

        Wound healing in the skin may be complicated by both microbial invasion and inflammation. Following injury, platelet degranulation releases a number of chemotactic factors including transforming growth factor (TGF-fl) and platelet derived growth factor (PDGF). TGF-19 is a cytokines that modulates many cellular function and gene expression. However, it is not known whether TGF-P could regulate inducible nitric oxide synthase (iNOS) gene expression during wound healing. Here we report that down regulation of TGF-Q gene expression by antisense oligodeoxynucleotides increase iNOS during wound healing. Our reverse transcription- polymerase chain reaction (RT-PCR) result has shown that antisense TGF-fil oligodeoxynucleotides (ODN) targeting the TGF-J11 translation initiation region markedly reduced TGF-(il mRNA levels in wounded skin. Also, marked reduction in TGF-fl1 mRNA after antisense treatment invited that the increment of iNOS mRNA in wounded skin. Therefore, our irnmunohistochemical studies revealed a "pattern of iNOS product in wounded skin treated antisense TGF-fl1 ODN that was similar to the pattern of RNA synthesis detected by RT-PCR. In conclusion, our results indicated that the regulatory actions of TGF fl1 on iNOS. might be involved in the initiation and faciliates the resolution of inflammation following wounding.

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