결핵환자에 있어서 세포성 면역의 변화 (1)

김주옥,김선영 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

It is well established that cell-mediated immunity including T cell activation is the most important mechanism for the host defence against Mycobacterium tuberculosis. There are some indices for describing the mitogen-induced lymphocyte transformation such as stimulation index (SI). Recently curnmulative index (CI) was suggested to describe lymphocyte blastogenic function more accurately. To evaluate the abnormalities of cell-mediated immunity and usefulness of CI, we measured the T cell subsets and compared the indices (SI and CI) of lymphocyte transformation of peripheral mononuclear cells in patients with tuberculous patients (17 with pulmonary tuberculosis, 5 with tuberculous pleurisy). The postitive scores of skin test using CMI multitest kit were significantly decreased in patients group compared to normal controls. The percentage of total T lymphocytes in patients was not significantly different from normal controls, but that of helper T cells was significantly decreased and that of suppressor T cells was significantly increased, resulting significant decrease in T_4/T_8 ratio in patients group. The SI in patients was not significantly different from controls because of wide standard deviation, but CT was significantly decreased in patients group. As a result of this study, we could confirm the abnormal cell-mediated immunity in tuberculous patients and suggest that CI is a more useful parameter for describing the mitogen-induced lymphocyte transformation.

기관지경 생검상 확진된 폐암환자에서 기관지세척 세포진과 다른 지표들과의 관계

김주옥,서지원 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Bronchoscopic examination is an essential tool for diagnosis and treatment of the lung cancer. Various method with bronchoscopy are possible, such as cytologic examination (washing, brushing, bronchoalveolar lavage and transbronchial needle aspiration0, mucosal biopsy and transbronchial lung biopsy. There are many reports on the bronchial washing cytology, but there were few reports on the relations between bronchial washing cytology and other various parameters(age, sex, celltype, bronchoscopic location and shape of lesion). To evaluate the relationships between washing cytologic yield, age, sex, celltype, bronchoscopic location and shape of lesion in lung cancer, we have studied in 189 patients(males 170, females 19; ages, mean 60.7yrs) with histologically proven lung cancer who showed direct signs of lung cancer bronschoscopically. All cases were collected washing cytology specimens simultaneously. :There were no significant relationship between age and washing cytology positivity, celltype or bronchoscopic shape of lesion, between sex and washing cytology positivity, bronchoscopic location or shape of lesion, There was significant relationship between sex and celltype, that is, NSCLC in male vs SCLC in female. There were no significant relationship between cytology positivity and celltype, bronchoscopic location or shape of lesion. There was significant relationship between celltype and bronchoscopic location of lesion, that is, squamous and SCLS in both upper lobes va adenocarcinoma in RLL. There was no significant relationship between bronshoscopic location and shape of lesion, but significant between celltype and shape of lesion.(mass in squamous vs non-mass in SCLC). In conclusion, lung cancer has more prevalent in older males than females and both upper lobes, and squamous cell carcinoma has more mass-shaped and SCLS has more infiltrated lesion bronchoscopically. The cytologic positivity was not depended on the bronchoscopic shape of lesion.

PCR을 이용한 Rat 기관지 세척액에서의 Pneumocystis carinii DNA의 검출 : 기초실험 A pilot study

김주옥,홍석철,한표성,이종진,김선영,이영하,신대환 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.1

Background: Pneumocystis carinii (PC) is a opportunistic pathogen causing serious pneumonia (Pneumocystis carinii pneumonia : PCP) in immunosuppressed patients including AIDS. Laboratory diagnosis of PCP is dependent on microscopic demonstration of the PC by using cytochemical staining or by immunocytochemical staining with monoclonal antibodies. However, these staining methods are not highly sensitive. The development of the polymerase chain reaction (PCR) has made it possible to detect very small numbers of pathogens in clinical specimens. To establish the usefulness of PCR for detection of PC DNA, We performed PCR as a pilot study. Methods: PCP was induced on Spraque-Dawley rats with prednisolone 5mg IM twice a week. Bronchial lavages, impression smears, and permanent sections were performed from the 3rd week to 7th week of cortisonized rats. PC DNA was extracted with bead beater / 10% CTAB method. Results: Impression smears showed PC cyst after the 4th week (100%, 28/28 rats), and permanent sections showed 27/28 rats. Control rats showed some PC cysts (2/7). PCR result was positive only one case among the 6th week rats (1/7), But positive 6 cases at the 7th week rats, (6/7). Among control rats. 2 cases were positive (2/7). ??This data is a pilot study for the PC DNA detection using a PCR. PCP were successfully cortisonized rats. If adequate bronchial washing technique will be used, PCR can be a sensitive for PC DNA detection.

폐암환자에 있어서 T 세포 매개성 면역의 변화(Ⅰ)

김주옥,김선영 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Cell-mediated immunity (CMI) was evaluated in 30 patients with lung cancer by in vivo and in vitro methods. These included skin test with CMI multitest kit, determination of peripheral T lymphocytes, and lymphocyte response to phytohemagglutinin (PHA) and concanavalin A (Con A). The positive scores of skin test were significantly lower in lung cancer group than controls (p<0.05), and there were no significant differences in T cell subsets. The response to PHA and Con A were greatly depressed in lung cancer and it was more apparent in advanced stage. But there was no difference in stimulation index (SI) between cancer patients and normal controls. The cumulative index (Cl) was more significant difference in cancer patients and advanced stage. These results suggest that depressed CMI in patients with lung cancer might be caused by lymphocytic dysfunction and cumulative index is more accurate to describe lymphocyte blastogenic function than stimulation index.

객혈의 임상적 고찰 및 기관지 내시경의 역할

김주옥,이종진,서지원,김선영 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

118 patients with hemoptysis were reviewed retrospectively to identify etiologic factors, clinical features, and treatment and to evaluate the usefulness of fiberoptic bronchoscopy. 63 cases (53.4%) were blood-tinged sputum, 2 cases (1.7%) were more than 600ml a day in amount of hemoptysis. Pulmonary tuberculosis was 37 cases (31.36%), the most common cause of the known etiologic factors. Lung cancer was 6 cases (5.09%). 6 patients (5.09%) were treated with bronchial artery embolization, 1 patient (0.85%) treated with right lower lobectomy. 1 (4.3%) of 23 patients with hemoptysis and normal chest roentgenogram was found to have lung cancer. We suggest that in patients with hemoptysis and normal chest roentgenogram, routine fiberoptic bronchoscopy is not necessary to exclude malignancy.

급성 세균성 감염증에 대한 Cefotetan(Yamatetan^ⓡ)의 임상적 효과

김주옥,안원전,박종훈,노흥규,박종우 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.1

Total 20 cases of infectious diseases were treated with Cefotetan at the Dept. of internal medicine, Chung Nam National University Hospital, Dae Jeon, Korea, from January 1985 to April 1985. Among 20 cases, 6 were the patients with acute pyelonephritis, 7 were pneumonia, 2 were acute cholecystitis, 2 were chronic bronchitis, 2 were cellulitis and 1 was lung abscess. The response was good in 16 cases, and poor in 4 cases. The laboratory tests were normal except I which was reversible. (mild elevation of SGOT and SGPT) The side effects were noted in 2 cases, such as skin eruption and drug fever, which were improved with supportive care. Cefotetan was thought to be useful against acute bacterial infections of respiratory, urinary, biliary tracts and cutaneous tissue.

호흡기 감염에서 Sparfloxacin 의 임상적 유용성에 대한 Enoxacin과의 비교 검토

김주옥,김선영,김관형,서지원,박석영,이종진,박성학 대한감염학회 1995 감염 Vol.27 No.4

목적:폐렴, 기관지염, 만성기관지염에서 fluoroquinolone제제로서 항균력이 강하고, 혈중 반감기가 길고, 객담과 조직내 농도가 높은 sparfloxacin의 안전성과 효과를 enoxacin과 비교하기 위해 본 연구를 시행 하였다. 방법:1994년 10월부터 1995년 4월까지 충남대 부속병원과 대전 성모병원에 내원한 폐렴, 급성기관지염, 만성기관지염이 급성으로 악화된 환자 63명을 대조군(32명)(enoxacin 100 mg 1일 3회 경구투여), 실험군(31명)(sparfloxacin 200mg 1일 1회 경구투여)으로 나누어 임상증상, 세균학적 객담 검사, 혈액검사, 실험실내 항균력검사로 그 치료율 및 안전성을 비교하였다. 결과: 1) 임상종합 평가, 세균학적 균소실, 안전성, 유용성에서 두군간에 의미 있는 차이는 없었다. 2) 시험관내 항균력검사상 MIC가 실험군이 대조군보다 현저하게 낮았다.(p<0.05). 3) 경미한 두통, 식욕감퇴, 상복부 불쾌감, 설사등이 대조군 9예, 실험군 7예에서 발생하였고, 검사실 소견상 SGOT 혹은 SGPT 의 일시적 경미한 상승이 대조군 2명, 실험군 3명에서, 혈중 creatinine 상승이 실험군 2명에서 있었으나 경미하였다. 결론:이상의 결과로 sparfloxacin은 폐렴, 급성기관지염, 만성기관지염의 악화에서 하루 한번 투여로 enoxacin 하루 3번 투여와 유사하게 효과적이고 안전하며, 시험관내 항균력이 enoxacin보다 월등히 우수하여 임상에서도 유용하게 사용될수 있을것으로 생각된다. Background: Sparfloxacin, a new oral quinolone, has a broad spectrum, potent antimicrobial activity, prolonged half life, high concentration in sputum. The clinical efficacy and safety of sparfloxacin have been reported by some previous clinical studies performed in Japan. The objectives of this study were to evaluate the clinical and antimicrobial efficacy of this drug in respiratory tract infections compared to those of enoxacin. Methods:We performed an open controlled, randomized study in 63 patients with acute bronchitis, pneumonia, and exacerbation of chronic bronchitis at Chung Nam University hospital and Dae Jeon St. Mary's hospital from October, 1994 to April, 1995. In the control group(n=32), 100 mg enoxacin was administered orally 3 times a day and in the test group(n=31), 200 mg sparfloxacin once a day. Results: The results were as follows; 1) There were no significant differences between the two groups in clinical efficacy, bacteriological finding, and usefulness. 2) Means and SD of MICs were 0.44±0.89 ㎍/ml in the control group, 0.13±0.24 ㎍/ml in the test group. There was a significant difference in MICs between the two groups(p<0.05). 3) Headache, epigastric discomfort, and loss of appetite were observed in 7 cases of the control group and in 9 cases of the test group, and transient elevations of hepatic enzyme in 2 cases of the control group, and in 3 cases of the test group. There was mild elevation of serum creatinine in 2 cases of the test group. Those laboratory abnormalities by therapy might be associated with their underlying diseases. There were no significant adverse effects caused by the drugs Conclusion:In conclusion, sparfloxacin of 200 mg once a day was as effective and well tolerated as enoxacin of 100 mg three times per day in the treatment of respiratory tract infections. Sparfloxacin is more potent antibiotics because MICs of sparfloxacin were very lower than those of enoxacin.

호흡기감염증에 대한 Cefuroxime Axetil(Zinnat�)의 임상효과

김주옥,홍석철,김남재,서지원,김선영,노흥규 中央醫學社 1991 中央醫學 Vol.56 No.2

To evaluate the efficacy and safety of Zinnat in patients with respiratory tract infections, 20 patients were treated with Zinnat (250 mg b.i.d). Among 20 cases, 5 cases had pneumonia, 5 cases exacerbation of chronic bronchitis, 4 cases acute bronchitis, 3 cases bronchiectasis with infection, and acute tonsilitis, bronchial asthma with infection and emphysema with infection 1 case, respectively. The response was cure in 12 cases, partial response in 6 cases and no response in 2 cases. There were no significant clinical and laboratory side effects except dyspepsia and nausea (1 case) and diarrhea (1 case). Zinnat was considered to be useful agent against bacterial respiratory tract infections.

肺癌患者에 있어서 治療前 後의 免疫機能 變異에 關한 硏究

김주옥,이복희 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.1

To analysis the changes of peripheral leukocyte count, lymphocyte count, percent of lymphocyte and T cell subsets(OKT₃, OKT₄, OKT_8, OKT₄,/OKT_8) in patients with bronchogenic carcinoma following treatment, a study was performed in 49 untreated and 23 treated (followed up) patients with bronchogenic carcinoma. The results were summarized as follows. 1. In the untreated group, peripheral lymphocyte count, percent of lymphocyte and OKT_8 were decreased compared to normal control. According to stage, OKT_8 was decreased in all stages of non-small cell cancer, OKT₄,/OKT_8 was increased in stage III significantly. According to histology, OKT_8 was decreased in squamous, adenocarcinoma and small cell carcinoma, and OKT₄,/OKT_8 was increased in adenocarcinoma significantly. 2. In the treated (followed up) group, OKT₄,/OKTB was decreased to normal range, which was more apparent in stage III. 3. According to mode of response, OKT_8 was decreased significantly compared to normal control in responder and nonresponder before treatment, and was persistently decreased in nonresponder after treatment. In responder, increased lymphocyte count and decreased OKT₃ were observed compared to nonresponder before treatment. In nonresponder, OKT₃ and OKT₄, were decreased significantly after treatment compared to before treatment. In conclusion, immunoabnormalities in patients with lung cancer might be improved following treatment, but further studies for quantitative and functional changes in lymphocytes following treatment (including radiation) are needed to analyse the role of immunologic changes for progression and recurrence of cancer and for the prognosis of the cancer patients.

고상추출카트리지를 이용한 잔류농약 다중분석과정에서 정제용매에 따른 회수율 비교

두옥주,정보경,김경식,정의근,김진곤,김명희 한국환경농학회 2002 한국환경농학회지 Vol.21 No.2

채소류 중 비교적 matrix효과가 적고, 수분 함량이 적절하여 회수율이 양호한 오이를 대상으로 하여 총 16종의 농약 성분을 A, B 두 group으로 나누어, 농약의 동시 다성분 분석의 전처리 과정 중 정제에 사용하는 용출용매로서 5%~20%의 acetone/hexane과 5%~20%의 ethyl acetate/hexane을 사용하여 각각의 회수율을 분석하여 얻은 결과는 다음과 같다. Acetone/hexane을 사용한 경우 5% acetone에서 총 16종의 농약 성분 중 ethalfluralin, trifluralin, chlorothalonil 등 11종의 농약은 높은 회수율을 보였으나, alachlor와 iprodione, endosulfan sulfate, bifenthrin, fenarimol은 매우 낮은 회수율을 나타내었고, 10% 이상의 acetone/hexane에서는 bifenthrin과 fenarimol 제외한 14종의 농약에서 높은 회수율을 얻을수 있었다. 그러나 bifenthrin은 20%의 acetone/hexane을 사용한 경우는 용출되지 않았고, fenarimol은 10% 이하의 acetone/hexane을 사용하였을 때는 낮은 회수율을 나타냈었다. Ethyl acetone/hexane을 사용하여 총 16 종의 농약 성분의 회수율 분석을 한 결과, 5% ethyl acetone에서 ethalfluralin, α-endosulfan, β-endosulfan (A group), vinclozolin, tetradifon, cyprethrin, fenvalerate (B group)에서만 70% 이상의 회수율을 얻었다. 10%의ethyl acetone/hexane을 사용하여 분석한 경우는 trifuralin, chlorothalonil, α-endosulfan, β-endosulfan, endosulfan sulfate(A group), vinclozolin, procymidone, tetradifon, cypermethrin, 그리고 fenvalerate(B group) 에서는 70% 이상의 회수율을 얻었고, 20%의 cthyl acetone/hexane 을 사용하여 분석한 경우는 5%나 10%의 ethyl acetone/hexan 을 사용하여 분석했을 때보다 좋은 결과를 나타내어 전체 16종의 농약 중 14종에서 75% 이상의 회수율을 얻었으나, alachlor와 bifenthrin은 매우 낮은 회수율을 보여서 ethyl acetate 와 hexane의 혼합용매가 이들 두 농약성분의 분석에는 적합하지 않은 용출 용매임을 알 수 있었다. A study was carried out to optimize the cleanup step using a solid-phase extraction (SPE) cartridge, SupelClean^(TM) Florisil, for multiresidue analysis of 16 pesticides in cucumber matrix. Eluting efficiencies of two solvent systems including acetone/n-hexane and ethyl acetate/n-hexane mixtures were critically evaluated by recoveries of target anaytes from the SPE Florisil column. Based on the recovery as a measure of eluting efficiency, an acetone/n-hexane (20/80,v/v) mixture provided more than 80% recovery for 15 pesticides except bifenthrin. In case of ethyl acetate/n-hexane, 14 pesticides showed recoveries higher than 75%, while those for alachior and bifenthrin were less than 30%.