조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

Characterization of a Constitutive β-Lactamase from a Pseudomonas aeruginosa

유진홍,허동호,최정현,김양리,신원식,강문원 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2

Objective : We analyzed some physicochermical chracteristics of a constitutive β-lactamase from a clinical isolate of a Pseudomonas aeruginosa which resistant to various β-lactams except imipenem and susceptible to aminoglycosides the proportion of its contribution to such resistance profile. Method : 1. Antimicrobial susceptibility test was done by the broth dilution method. 2. In hibition profile was done using EDTA, HgCl₂ and p-chloromercuribenzoate (pCMB). We also measured 50% inhibitory concentration(IC??) using β-lactamase inhibitors, such as clavulanic acid, sulbactam. 3. Kinetics study for substrate profile was performed by spectrophotometric assay using crude extracts and various antimicrobial agents. Relative hydropysis rates were determined. 4. The isoelectric point(pI) was determined by isoelectric focusing. The molecular weight was estimated by SDS-polycrylamide gel electrophoresis. Results : 1. The strain was resistant to ceftriaxone, sulperazon, piperacillin, ceftazidime, and aztreonam, while it was susceptible to gontamicin, tobramycin, amikacin and imipenem. 2. The β-lactamase was not inhibited by EDTA, and pCMB, whereas it was inhibited by HgCI₂. The IC?? of clavulanic acid was over 100μM and that of sulbactam was 22μM. 3. The relative maximal hydrolysis rate was calculated by setting V_(max) for cephaloridine at 100. The enzyme hydrolyzed cephalosporins more rapidly than penicillins. 4. The pI was 9.3 by isoelectric focusing. The molecular weight was estimated to be 40kDa. Conclusion : According to its substrate profile, pI and molecular weight, the β-lactamase from a clinical isolate of P. aeruginosa was a cephalosporinase belonging to group 1 in the Bush-Jacoby-Medeiros classification scheme.

류마티스성 심장판막질환, 우심방혈전 및 대동맥 협착증과 합병된 만성 혈전색전성 폐동맥고혈압 1예

유근배,심준,임양희,이진화,신길자 梨花女子大學校 醫科大學 醫科學硏究所 1998 EMJ (Ewha medical journal) Vol.21 No.4

폐동맥 혈전색전증은 비교적 드문 질환으로 주로 심부 정맥혈전에서 발생하는 것으로 알려져 있으며 류마티스성 심장판막질환을 가진 경우 합병되는 우심방 혈전이 드물게 폐혈전색전증의 원인이 될 수 있는데, 저자들은 대동맥의 동맥경화성 협착증을 동반한 류마티스성 심판막질환 환자에서 우심부전 및 우심방혈전에서 발생한 만성 혈전색전성 폐동맥고혈압1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Most pulmonary thromboemboli arise from the deep vein thrombosis, which have complete clinical and at least near complete roentgenographic and angiographic resolution within four to six week of the acute event. But chronic pulmonary hypertension and cor pulmonale from unresolved pulmonary embo-lism complicate acute embolic episode with a frequency of less than 1 percent. Rarely pulmo-nary thromboemboli can result from right atrial thrombi. We experienced a case of chronic thromoboembolic pulmonary hypertension, which wrose from right atrial thrombi in the patient with rheumatic valvaular heart disease and thoracic aorta atherosclerotics stenosis.

혈청이 마우스 간 세포주 BNL CL.2의 Nitric Oxide 생성에 미치는 영향

유지창,정헌택,김유현,진효상,김신무,배현옥 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1999 Journal of biomedical laboratory sciences Vol.5 No.1

마우스 간 세포주인 BNL CL.2의 시험관내 배양에서 혈청과 IFN-γ가 세포주의 nitric oxide(NO) 생성과 세포 손상에 미치는 영향을 알아보기 위한 실험을 하였다. 혈청이 공급된 배양에서 IFN-γ에 의한 세포 생존율은 거의 변동이 없었으나, 혈청을 제거한 배양에서는 약 65%의 생존율이 유지되었으며, NO 생성 억제제인 N -monomethy-L-arginine (NMA)의 첨가는 농도 의존적으로 세포의 생존율을 감소시켰다. 혈청이 제거된 BNL CL.2세포주는 IFN-γ단독 처리에서도 NO 를 생성할 수 있었으며, IFN-γ와 lipopolysaccharide (LPS)의 복합 처리는 세포주의 NO 생성을 상승적으로 증가시켰다. 또한 protein tyrosine kinase (PTK) inhibitor인 herbimycin A와 genistein에 의해서 NO 생성이 억제되어 PTK의 활성이 혈청이 고갈된 BNL CL.2 세포에서 NO의 생성에 중요한 역할을 담당하고 있기 때문으로 판단된다. IFN-γ의 독성은 혈청을 제거시킬 때 NO 생성 억제제에 상승적으로 간 세포를 손상시키며, 이때 NO가 IFN-γ에 의해 유도된 손상을 어느 정도 억제시키는 것을 알 수 있었다. Nitric oxide (NO) plays an important role in immunologic defense, and influences upon the functioning of secretory tissues and cells. It also exhibits cytotoxic/cytostatic activity as one of major operating effectors of the cellular immunity system. We investigated the effects of serum on the cell damages and NO production in the mouse liver cell line BNL CL.2 to establish the role of NO. We observed that, when BNL CL.2 cells were cultured in serum-free medium, they were induced to cell damage by the stimulation of IFN-γalone or IFN-γplus LPS. Serumstarved cells showed large amount of nitrite accumulation and NO synthase (NOS) expression in response to IFN-γalone in dose-and time-dependent manners, but serum-supplied cells did not. The production of NO was blocked by protein tyrosine kinase (PTK) inhibitors, genistein and herbimycin. These results suggest that the deprivation of serum in the BNL CL.2 cell culture medium might primed with the cells to produce NO when the cells are triggered by IFN-γ and the involvement of PTK signal transduction pathway in the expression of NOS gene in murine hepatocytes.

아로마 요법이 뇌졸중환자의 자율신경계와 스트레스에 대한 신체 저항도에 미치는 효과

신유선,조영숙,정유진 대한기초간호자연과학회 2004 Journal of korean biological nursing science Vol.6 No.2

Purpose : The purpose of this study is to determine effects of aromatherapy on the activity and balance of autonomic nervous system and on physical resistance to stress. Methods : This research is a primitive experimental design which attempts to analyze aromatherapy EKG monitoring on real-time basis. Lavender & Chamomile, each 30 drops, were blended with 100ml Sweet Almond oil. Subjects was laid relaxed, and had insides of his wrists and ankles attached with electrodes for EKG. Right after applied with essential oil onto his philtrum and parotid, started on EKG monitoring. Results : The activities of parasympathetic and sympathetic nerve were changed as time elapsed, with significant differences(p=.000). In multiple comparison, the value was significantly different (p<.05).The balance of autonomic nerve was changed, becoming close to the normal level in accord with applicable international standards(1.5)(p=.011). In multiple comparison, the value showed a significant difference(p<.05). Physical resistance to stress increased with the passage of time, but not statistically significant. Conclusions : This suggests that aromatherapy can be used as a nursing intervention which aims at alleviating symptoms related to the imbalance of autonomic nerve system such as headache, hot flashes, irregular heartbeat, nervousness, depression and anxiety.

만성 알코올중동증의 치료에서 프리달의 임상효과

신윤오,신석철,왕성근,유진호,윤미숙 최신의학사 1992 最新醫學 Vol.35 No.4

연결재를 사용하지 않는 다축교차 접속구조 개발 : 생산에 적합한 모듈화와 실용화에 관한 연구

신유진 광운대학교 신기술연구소 1997 신기술연구소논문집 Vol.26 No.-

본 연구는 x축, y축, z축방향으로 배치되는 제1축 부재, 제2축 부재 및 제3축 부재를 접합하는 연속 교차 접합 구조의 개발에 관한 것이다. 제1축 부재는 각각 90도 위상차를 가지는 모서리부에 횡단면적의 1/4에 상당하는 부위에 결합핀 및 결합공이 있는 결합편을 가지는 제1축 상, 하부재로 분리 형성한다. 제2축 부재는 각각 90도 위상차를 가지는 모서리부에 종단면적의 1/4에 상당하는 부위에 결합핀 및/또는 결합공이 있는 결합편을 가지는 제2축 전, 후방부재로 분리 형성한다. 제3축 부재는 제1축 부재 및 제2축 부재의 교차부위에서 제1축 부재의 양측면에 접촉하는 제3축 좌우측부재와 이들 좌우측부재의 사이에서 이들 부재의 한 모서리를 포함하여 그 종단면적의 1/4에 상당하는 부위에 내접하는 원형단면의 연결간으로 구성한다. 그리하여 이들 각 부재들을 별도의 연결재 즉 못이나 볼트-너트 또는 접착제를 사용하지 않고서도 간편하게 접합할 수 있을 뿐만 아니라 접합된 상태에서 분해할 경우에도 각 부재의 원형이 변형되는 일이 없어 재사용이 가능하게 되며, 가구 등에 사용할 경우 다양한 형태로 변형 조립하여 사용할 수 있도록 한 것이다. 또한 가구용 뿐만 아니라 건축용 골조에도 적용할 수 있는 것이다. This research proposes the Multi-Axis Connecting Structure(MACS) which has three dimensional composing elements: X-axial(the first) element, Y-axial(the second) element, and Z-axis(the third) element. The first element consists of members which one separated into up and down part with a pin rectangular phase difference. The second element consists of members which one seperated into front and back part with a union element composed with a pin and/or a hole. It is placed at a quarter of vertical section with a conner part of rectangular phase difference. And the last element consists of members being a outer part and main part joined with column. It is placed at a conner part of rectangular phase difference with a quarter of vertical section of first and second member intersected. This systems enables us to easily assemble and disasemble complex without dmags, without using nails, bolt-nuts, glue, and etc. In funiture-manufacturing, residencial structures, and complex spatial structures.

여성 복압성 요실금에서 질전벽슬링수술의 효과

신홍석,유진욱,정희창,박동춘 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.1

Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication, success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication, bladder perforation occurred in one patient(2.4%), residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instablility were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.

혈액질환 환자에서 조혈모세포 이식과 화학요법 후의 침습성 진균감염의 분석

유진홍,최정현,이동건,최수미,신완식,김춘추 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 조혈모세포 이식이나 화학요법을 받은 혈액질환 환자에서 침습성 진균감염의 양상을 분석하고 예후 인자를 정하기 위하여 이 연구를 실시하였다. 방법 : 2000년 3월부터 2001년 2월까지 가톨릭 조혈모세포이식센터에 입원한 318명의 환자들 중 진균 감염으로 의심되어 항진균제를 투여받은 122명의 환자를 대상으로 후향적 분석을 실시하였다. 결과 : 74명의 환자가 EORTC/MSG 기준에 의해 침습성 진균증으로 판정되었다. 이들 중 6명이 확진이었고, 46명이 추정, 22명이 가능 증례이었다. 가장 많이 침습된 장기는 하부 호흡기이었다(72/74). 사망률은 32.4%이었다. 단변량 분석으로 예후 인자를 도출한 결과 입원 기간, 진단까지 걸린 시일, 그리고 amphotericin B의 총 투여량이 유의한 인자로 나왔다. 그러나 다변량 분석을 시행한 결과 입원 기간만이 독립적으로 유의하게 영향을 미치는 예후 인자로 산출되었다. 결론 : 침습성 진균 감염은 현재도 조혈모세포 이식이나 화학요법 후의 중요한 합병증으로 작용하고 있음을 알 수 있었다. 진균 감염 합병증의 예후에 영향을 미치는 요소로 입원 기간이외에 진단의 신속성과 항진균제의 투여도 유의한지에 대해서는 후속 연구를 통해 재치 규명해야 할 것으로 생각된다. Background : Invasive fungal infections (IFI) are one type of representing total infections in compromised patients. To analyze the characteristics and to determine the prognostic factors of IFI in patients with hematologic diseases undergoing hematopoietic stem cell transplantation (HSCT) and/or chemotherapy. Methods : We retrospectively reviewed consecutive patients (n=122) who received antifungal treatment with the impression of fungal infection complicating post-HSCT or chemotherapy from March-2000 to February-2001. Results : Seventy-four out of 122 registered patients belonged to the IFI on the basis of EORTC/MSG criteria. Six patients were proven IFI, 46 were probable, and 22 were in the category of possible one. The most commonly involved organ was lower respiratory tract (72/74). The mortality was 32.4%. Univariate analysis revealed duration of hospitalization, days to diagnosis of IFI, and total amount of amphotericin B as significant prognostic factors. But multivariate analysis determined only duration of hospitalization from these variables as an independently influencing factor on the prognosis. Conclusion : Invasive fungal infection is still the major threatening complication of HSCT and chemotherapy. Further follow-up and extension of this study is necessary to elucidate more prognostic factors.

[논문]다른 온도로 소성한 왕겨를 콘크리트 흔화재로 사용한 콘크리트의 강도특성에 관한 연구

신상엽,정의창,정유진,박문석,백계승,최세윤,김영수 釜山大學校生産技術硏究所 2007 生産技術硏究所論文集 Vol.66 No.-

본 논문은 다른온도로 소성한 왕겨를 콘크리트 흔화재로 사용한 콘크리트의 강도특성을 알아보기 위한 것으로 물결합재비를 35% 로 고정하고 왕겨의 혼입률을 각기 달리하여 소성온도에 따른 압축강도 특성과 왕겨의 혼입률에 따른 강도특성을 평가하였다. 실험결과 왕겨가 혼화재로서 성능을 발휘하는 최저 온도가 600℃인 것으로 나타났으며, 700℃로 소성한 경우 가장 우수한 강도 값을 나타내었다. 또한 혼입률별 압축강도 특성에서는 혼입률 10% 에서 가장 우수한 강도발현을 나타내었다.