메티실린 내성 황색 포도알균에 의한 연조직 및 골 감염에 대한 전환요법으로서의 경구 Rifampin의 유용성

손종원,김신우,하상우,이응갑,정덕원,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 메티실린 내성 황색 포도알균에 의한 연조직및 골 감염의 치료 시 glycopeptide약물의 정주 요법에 이은 경구 항생제로의 처방 전환이 요구되는 경우가 많으나 마땅한 경구 약제의 선택이 어려운 실정이다. 이에 경구 rifampin을 메티실린 내성 황색 포도알균에 의한 연조직 및 골 감염에 사용하여 치료한 경우를 분석하여 그 유용성 정도와 실패한 경우 실패의 위험인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월부터 2004년 9월까지 메티실린 내성 황색 포도알균에 의한 연조직 및 골 감염 환자를 대상으로 rifampin을 그 치료 목적으로 사용한 44명의 환자를 의무 기록과 X선 사진을 통해 후향적으로 분석하였다. 기초 자료를 분석하였고 감염이 재발하여 치료 실패로 판정된 환자들에 대해 치료 실패의 원인이 될 만한 주요 변수에 대한 Chi-square 검증과 로지스틱 회귀분석을 시행하였다. 결과 : 치료 후 재발은 20.5% (8/39)였으며 재발 예와 사망에 대한 위험요소에 대한 단변량 분석에서 고관절 보형물이 있는 경우 흔하였으나 통계적 차이에는 미치지 못하였다(P=0.065). 고관절 보형물 외에 동반된 질환들, 쇼크의 동반, 균혈증의 동반, 경구 시 ciprofloxacin과 rifampin의 병합 복용 기간 등을 혼란 변수로 사용한 다변량 로지스틱 회귀분석에서는 고관절 보형물 만이 통계적으로 유의하였다(P=0.044). 결론 : 메티실린 내성 황색 포도알균에 의한 연조직및 골 감염에 rifampin과 다른 약제를 병합하여 치료하는 경우 재발은 적었다. 치료 실패의 경우는 고관절 부위 감염과 같이 보형물을 쉽게 제거하기 어려운 상황과 관계되는 것을 보여준다. Background : Rifampin is sometimes used in combination with other anti-staphylococcal agents to treat methicillin-resistant Staphylococcus aureus (MRSA) infections but few reports are available about the usefulness of rifampin against MRSA infections, especially in soft tissue and bone infections. Thus, we evaluated the efficacy of rifampin as switch therapy for soft tissue and bone infections caused by MRSA and assessed the risk factors for treatment failure. Materials and Methods : We retrospectively studied 44 patients who had soft tissue and bone infections caused by MRSA and were treated with rifampin in combination or as monotherapy as switch therapy from January 2001 to September 2004. Results : The mean age of the subjects was 50.2 years and the number of male and female were 34 and 10, respectively. Median duration of rifampin use was 32 days and 25% of the patients had artificial prostheses. Thirty one patients (79.5%, 31/39) were cured with parenteral glycopeptide followed by rifampin in combination or as monotherapy. Eight patients (8/39) recurred after the completion of treatment. The presence of hip prosthesis was the only significant risk factor (P= 0.027) in multivariate logistic regression test. Rifampin was tolerable in all cases. Conclusion : Rifampin as switch therapy for soft tissue and bone infection caused by MRSA was effective in 79.5% (31/39) of sujects. The treatment failure seems to be associated with unremovable infected prosthesis.

영구형 항서맥 심박조율기 환자의 장기추적관찰

최현석,이무용,최영진,최성준,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우,이명용 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

물-공기 계면에서 긴 사슬 양 말단 작용기 분자인 α,ω-13,16-Dimethyloctacosanedioate Dimethylester(C_30DME)의 거동에 관한 연구

이정근,손대원,이관수,송석호,김현명,정선호 한양대학교 자연과학연구소 2001 自然科學論文集 Vol.20 No.-

물-공기 계면에서 표면압력의 증가에 따른 C30DME 분자의 구조 변화를 살펴보았다. 표면압력(π)-표면적(A) 등온선을 통해 표면적이 줄어들 때 C30DME 분자가 선형으로부터 역 U 자형 구조로 변하는 것을 확인하였다. C30DME의 역 U 자형 구조의 형성을 확인하기 위하여 Surface Plasmon Resonance (SPR)와 ellipsometry를 이용하여 Langmuir-Blodgett (LB) film 의 두께를 측정하였고 이 두께는 C30DME 분자의 역 U 자형 구조의 높이와 일치함을 관찰하였다. 또한 Atomic Force Microscope (AFM)을 이용한 표면 거침도 측정의 결과는 선형으로부터 역 U자형 구조로의 구조적 변화가 불연속이라는 것을 보여주었다. We investigated the conformational change of C30DME molecule with an increase on surface pressure at the air-water interface. The surface pressure (π)-area (A) isotherm indicates that the structure of C30DME changed from linear to reverse U-shape as the surface area was compressed. In order to confirm the formation of reverse U-shape, we examined the thickness of Langmuir-Blodgett (LB) film by a surface plasmon resonance (SPR) and an ellipsometry. The result of surface roughness measurement using an atomic force microscope (AFM) showed that the conformational change from linear to reverse U-shape is discontinuous.

경막 외 스테로이드 주사에 반응 없는 추간판성 요통에 대한 추간판 내 시술 효과

신용범,고현윤,손현주,장재혁,박형욱,신명준,김수연 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.23

Objective: To determine the effect of intradiscal therapy with discography in patients with back pain of no effect using epidural steroid. Subject and methods: Thirty patients with herniated nucleus pulposus (HNP) who had not have any improvement using repeated epidural steroid were studied. Degree of disc degeneration, provocation pain and intradiscal pressure were evaluated in 41 discs. Intradiscal triamcinolone was injected to degenerated discs and intradiscal electrothermal therapy (IDET) was performed to the patients who had no improvement using intradiscal steroid. Patients were asked to report pain according to a visual analogue scale (VAS). Results: Thirty of 41 discs showed significant degeneration. In 19 of 30 (63.3%) patients, VAS was reduced over 50% after intradiscal steroids. Low intradiscal pressure without provocation pain and ruptured discs were significantly higher in these patients (p<0.05). After IDET, 8 of 9 patients noted over 50% reduction of VAS. Conclusions: In patients with discogenic back pain combined with radicular pain, intradiscal therapy according to discography may be helpful in patients with no improvement using epidural steroid.

근치적 위절제술을 시행한 위암 환자에서 보조요법으로서 5-Fluorouracil, Epirubicin과 5-Epirubicil,Cisplatin의 복합화학요법의 효과 비교

최정혜,안명주,한동수,손주현,전용철,박훤겸,백홍규,이홍기,남영수 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.2

To compare 5-fluorouracil plus epirubicin (FE) to 5-fluorouracil plus cisplatin (FP) chemotherapy as adjuvant therapy for patients with resected gastric cancer. Between August 1995 and March 2000, 46 patients with completely resected gastric cancer received six courses of FE (5-fluorouracil 1000mg/m2/day, D2-D5, epirubicin 70mg/m2, D1) or FP (5-fluorouracil 1000mg/m2/day, D2-D5, cisplatin 70mg/m2, D1) chemotherapy. The 23 patients were assigned to each treatment group. A total of 127 courses of treatment were given both FE and FP group. The FP group tended to show more risk of overall death rate. But there were no differences between FE and FP groups in terms of overall survival or disease-free survival. Both treatment arms were generally well tolerated to chemotherapy. We concluded to be no significant differences between FE and FP groups in terms of overall survival or disease-free survival. To define the efficacy of adjuvant chemotherapy for gastric adenocarcinoma, further prospective randomized trials with large number of patients should be warranted.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

Use of Intravenous Immunoglobulin in the Treatment of Childhood Atopic Dermatitis

Sohn, Myung Hyun,Kim, Kyu-Earn The Korean Academy of Asthma, Allergy and Clinical 2011 Allergy, Asthma & Immunology Research Vol.3 No.2

Surgical Treatment of Spontaneous Subacute Epidural Hematoma without Risk Factors in Lumbar Spine

Hyun-Yoon Jeong,Hong-Moon Sohn,Seung Myung Lee 조선대학교 의학연구원 2014 The Medical Journal of Chosun University Vol.39 No.4

Globally, as well as domestically, patients without risk factors for spontaneous spinal epidural hematoma (SSEH) have rarely been reported. SSEH often results from trauma, epidural catheter insertion for anesthesia and invasive spinal procedures. It could also occur in patients with risk factors such as hypertension, coagulopathy, pregnancy, and vascular anomaly. We encountered a case of a 51-year-old female without prior medical history or any risk factors. Magnetic resonance imaging (MRI) showed subacute SSEH at lumbar spine regions. The patient was treated successfully by surgical decompression. Therefore, we report this case with a review of the relevant literature.

Genetic Variation in the Promoter Region of<i>Chitinase 3-Like 1</i>Is Associated with Atopy

Sohn, Myung Hyun,Lee, Ji Hyun,Kim, Kyung Won,Kim, So Won,Lee, Sung Hee,Kim, Kyu-Earn,Kim, Kyung Hwan,Lee, Chun Geun,Elias, Jack A.,Lee, Min Goo American Thoracic Society 2009 American journal of respiratory and critical care Vol.179 No.6

<P>RATIONALE: Atopy or atopic syndrome is an allergic hypersensitivity subject to hereditary influences. Aberrant expression of chitinase 3-like 1 (CHI3L1), also known as YKL-40 or HC gp-39, is involved in the pathogenesis of inflammatory and allergic diseases. OBJECTIVES: The genetic contribution of CHI3L1 gene to atopic susceptibility was investigated using an integrated population genetic and molecular analysis. METHODS: Genetic variations in CHI3L1 were identified and genotyped in 295 unrelated patients with atopy and 180 control subjects. Serum YKL-40 and IgE levels were analyzed according to genotype. The effects of a promoter polymorphism (g.-247C/T) on promoter activity were examined in reporter and protein binding assays. MEASUREMENTS AND MAIN RESULTS: In the case-control association analysis, the g.-247C/T polymorphism at the promoter region (rs10399805; P = 0.0062) and the IVS7+82C/T polymorphism at intron 7 (rs2275353; P = 0.0056) of CHI3L1 showed a significant association with atopy. Subjects with the g.-247T risk allele had significantly higher serum YKL-40 (P < 0.0001) and IgE (P = 0.012) levels. An in vitro promoter assay using THP-1 human monocyte cells revealed that the C to T conversion at g.-247 induced a more than twofold increase of reporter gene expression. Moreover, the g.-247T allele showed an increased affinity for CCAAT enhancer-binding protein, a well known transcriptional activator, by electrophoretic mobility shift assay. Accordingly, subjects with the g.-247TT genotype showed a 2.5-fold increase in CHI3L1 mRNA expression in peripheral blood cells compared with those with the g.-247CC genotype. CONCLUSIONS: These results strongly suggest that the g.-247C/T polymorphism in the CHI3L1 promoter region is associated with the risk of atopy.</P>

Calcium-Calmodulin Mediates House Dust Mite-Induced ERK Activation and IL-8 Production in Human Respiratory Epithelial Cells

Sohn, Myung Hyun,Lee, Kyung Eun,Kim, Kyung-Won,Kim, Eun-Soo,Park, Jun Young,Kim, Kyu-Earn S. Karger AG 2007 Respiration Vol.74 No.4

<P><I>Background:</I>House dust mites (HDM) have been shown to be important sources of indoor allergens associated with asthma and other allergic conditions. While exogenous proteases from allergens have a direct proinflammatory role in the respiratory tract, the precise mechanisms underlying the release of cytokines from the respiratory epithelium are unclear. <I>Objectives:</I> The present study examines that extracellular signal-regulated kinase (ERK) activated downstream of the Ca<SUP>2+</SUP>-sensitive tyrosine kinase plays an important role in the efficient activation of the HDM-induced IL-8 signaling pathway. <I>Methods:</I> We examined the effect of HDM, and the role of the Ca<SUP>2+</SUP>/calmodulin system and mitogen-activated protein kinases, on IL-8 expression in human lung epithelial cells. <I>Results:</I> In H292 cells, HDM induced IL-8 release in a time- and/or dose-dependent manner. This IL-8 release was abolished by treatment with intracellular Ca<SUP>2+</SUP> chelator (BAPTA-AM), but not by EGTA or nifedipine. Calmodulin inhibitor (calmidazolium) and tyrosine kinase inhibitor (genistein) almost completely blocked IL-8 release by HDM. PD98059, an ERK pathway inhibitor, completely abolished HDM-induced IL-8 release. Moreover, PD98059, BAPTA-AM, calmidazolium and genistein suppressed the HDM-induced ERK phosphorylation. <I>Conclusions:</I> HDM-induced IL-8 production is predominantly regulated by Ca<SUP>2+</SUP>/calmodulin signaling, and ERK plays an important role in signal transmission for efficient activation of the HDM-induced IL-8 signaling pathway.</P><P>Copyright © 2007 S. Karger AG, Basel</P>