항레트로바이러스 치료를 받는 한국인 HIV 감염자에서 당뇨병 발생 양상

최희경 ( Hee Kyoung Choi ),정수진 ( Su Jin Jeong ),이한성 ( Han Sung Lee ),진범식 ( Bum Sik Chin ),최석훈 ( Suk Hoon Choi ),한상훈 ( Sang Hoon Han ),김명수 ( Myung Soo Kim ),김창오 ( Chang Oh Kim ),최준용 ( Jun Yong Choi ),송영구 대한내과학회 2008 대한내과학회지 Vol.74 No.5

목적: HAART의 도입은 HIV에 감염된 환자들의 AIDS 발병률을 의미있게 감소시켰으나, 장기적인 부작용 중의 하나로 특히 단백효소 억제제와 관련된 당뇨병 발생이 보고되고 있다. 서구의 보고들과는 달리, 국내에서는 고강도 항레트로바이러스 치료를 받는 HIV 감염자에서 발생하는 당뇨병에 대한 연구는 부족하다. HAART를 받고 있는 한국인 HIV 감염자들에게서 발생하는 당뇨병의 빈도와 임상양상, 위험인자를 알아보고자 본 연구를 시행하였다. 방법: 1991년부터 2006년까지 연세대학교 의과대학 세브란스 병원에서 HAART를 6개월 이상 받은 215명의 감염자를 대상으로 후향적 코호트 연구 및 환자 대조군 연구를 통해 당뇨병 발생 빈도와 양상, 위험인자를 분석하였다. 결과: 215명의 감염자에서 1,079인년를 추적관찰하였으며 당뇨병의 발생률은 발생률은 100인년 당 1.39예, 공복혈당장애는 100인년 당 6.02예였다. 비비만형의 제2형 당뇨병이 주로 발생하였으며 서구의 보고 및 국내 비감염인 당뇨병 환자의 특성과 달리 인슐린 저항성 증가와 인슐린 분비능 저하를 모두 나타내었다. 당뇨병 발생의 위험인자를 분석한 결과 연령 증가와 바이러스 혈중농도 감소폭, indinavir 노출 여부가 당뇨 발생의 위험인자로 작용하는 것으로 나타났다. 결론: 이상의 결과로, 고강도 항레트로바이러스 치료를 받는 감염자들의 당뇨병 발생율은 서구의 보고보다 낮은 것으로 나타났으며 일반적인 당뇨병의 위험인자 보다는 약제의 사용력이 당뇨병 발생에 영향을 미치는 것으로 나타났다. 따라서 고강도 항레트로바이러스 치료를 받는 감염자들에서 이러한 약제를 선택할 때 주기적인 감시가 필요할 것으로 사료되며 앞으로 더 많은 환자를 대상으로 한 전향적 연구가 진행되어야 할 것으로 생각된다. Background/Aims: The introduction of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV infection. However, the HAART regimens, and especially those including protease inhibitors (PIs), have been shown to cause diabetes mellitus. We evaluated the incidence and clinical manifestations of HIV-infected Koreans who received HAART and the risk factors for diabetes mellitus in those patients. Methods: We conducted a retrospective cohort study and a case-control study to evaluate the clinical manifestations, the incidence and the risk factors for diabetes mellitus in 215 HIV-infected patients who were on HAART at Yonsei University College of Medicine from 1991 to 2006. Results: 215 patients were analyzed and the total duration of follow up was 1079 person-years. The incidences of diabetes mellitus and impaired fasting glucose were 1.39 case/100person-years and 6.02 case/100person-years. Most of the cases were non-obese type II diabetes and these patients showed insulin resistance and impaired β cell function. On the risk factor analysis, the factors contributing to the development of diabetes were age, a decrease of the viral load and indinavir use. Conclusions: In our study, the incidence of diabetes among Korean HIV-positive patients on HAART was 1.39case/100person-years. Age, a decrease of the viral load and indinavir use were the risk factors for development of diabetes mellitus.(Korean J Med 74:506-514, 2008)

2016년도 한의 교의 프로그램의 교사들의 만족도에 관한 연구 - 성남시 중고등학교를 대상으로 -

성현경,신선미,고호연,고재언,김효선,최석훈,박정수,Sung, Hyun Kyung,Shin, Seon Mi,Go, Ho-Yeon,Ko, Jae-Un,Kim, Hyo-Sun,Choi, Suk-Hoon,Park, Jeong-Su 대한한방소아과학회 2018 대한한방소아과학회지 Vol.32 No.1

Objectives This study aims to build the baseline data for promoting school health care program by identifying satisfaction level and improvement point through the satisfaction survey after Korean medicine doctor's student health and wellness program in 2016. Methods An association of Korean medicine doctor in Seongnam city conducted Korean medicine doctor's student health and wellness program for 12 middle schools, 6 high schools and 1 special-need school in Seongnam city in 2016. The participating Korean medicine doctor visited each school for 8 times and conducted health consultations, health education classes and Korean medicine treatment for the school students and the school employees. Teachers and administrators from the participating schools answered the self-reported satisfaction questionnaires and the results were analyzed by SPSS 22.0. Results 35 people responded the program satisfaction questionnaires, the overall satisfaction average was $9.40{\pm}0.88$ (out of 10). In the course of the program, satisfaction average regarding the student's health check-ups was $9.05{\pm}0.88$, satisfaction average regarding the informatory brochures for the parents was $9.08{\pm}1.09$, satisfaction average regarding the participation enrollment process was $9.06{\pm}1.16$, and the satisfaction average regarding the questionnaire statistics and the result reports was $8.86{\pm}1.93$. The satisfaction average of the program was as follows: health consultation ($9.20{\pm}1.08$), treatment ($9.31{\pm}0.90$), and health education classes ($8.78{\pm}1.68$). Some of the good things about program were 'Telling students about their physical condition' (57.1%), 'Curing the sick student quickly' (48.6%), 'Providing students with useful information about the health' (48.6%), 'Teaching students how to manage their health and how to manage symptoms' (42.9%). Average satisfaction about sustainability and needs of the program was $9.15{\pm}0.91$, and the participant teachers wanted to learn more about how to manage internet addiction (22.9%), stress (45.7%), atopy (28.6%), neck pain (42.9%), allergic rhinitis (37.1%), and low back pain (34.3%) from the future wellness programs. Conclusions Student health care is one of the most important issue in national health policies. We have designed a bridge model that a local community, school, and doctors can work together to develop. After the implementation of the program, the results of the satisfaction survey showed a very high satisfaction level. This study can be the basis for further improvement of the bridge program as well as the expansion of the program in other settings.

옻나무(Rhus vernicflua) 목질부에서 분리한 화합물의 항산화활성

안은미 ( Eun Mi Ahn ),박상재 ( Sang Jae Park ),최원철 ( Won Cheol Choi ),최석훈 ( Suk Hoon Choi ),백남인 ( Nam In Baek ) 한국응용생명화학회 2007 Applied Biological Chemistry (Appl Biol Chem) Vol.50 No.4

호두까기 식도증과 동반된 피부근염

인병현 ( Byung Hyun Im ),박민찬 ( Min Chan Park ),최석훈 ( Suk Hoon Choi ),박용범 ( Yong Beom Park ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.4

In dermatomyositis, involvement of the skeletal muscles of upper esophagus has been reported in many literatures. However, a number of published reports have suggested that motility disturbances of distal esophagus may also be a cause of dysphagia in dermatomyositis and dysphagia in these cases are mainly caused by crico-pharyngeal obstruction or hypomotility of esophagus. The nutcracker esophagus is the one of common esophageal hypermotility disorders causing dysphagia which is characterized manometrically by high pressure in distal esophagus. Recently, we experienced a patient with dermatomyositis who had complained of dysphagia and was diagnosed as having nutcracker esophagus by mannometry. The association of nutcracker esophagus and dermatomyositis has not been reported in the literature. Moreover, the mechanism of nutcracker esophagus differs with that of esophageal involvement in dermatomyositis. Thereby, we report a patient with dermatomyositis who had nutcracker esophagus in the course of her disease.

크론병에 동반된 장골동맥-회장루

김재학 ( Kim Jae Hak ),김원호 ( Kim Won Ho ),최창환 ( Choi Chang Hwan ),최석훈 ( Choi Suk Hoon ),전태주 ( Jeon Tae Joo ),김태일 ( Kim Tae Il ),김남규 ( Kim Nam Kyu ),김호근 ( Kim Ho Geun ) 대한소화기학회 2003 대한소화기학회지 Vol.42 No.1

Arterioenteric fistula is rare but can cause life-threatening bleeding. A case of Crohn`s disease with severe gastrointestinal hemorrhage caused by iliac arterioenteric fistula is presented. A 36-year-old male with Crohn`s disease was admitted because of massive lower gastrointestinal bleeding, which required transfusion of 16 units of packed RBCs over 2 days. Radioisotope RBC scan revealed intestinal bleeding directly from the right iliac artery. Emergent operation confirmed iliac arterioenteric fistulae with active bleeding, There was no further intestinal bleeding after surgery. Remission had been maintained for 3 years with mesalazine. (Korean J Gastroenterol 2003;42:77-80)

수소 생산을 위한 SI Cycle 공정에서의 중간 열교환 공정 모사 연구

신재선 ( Jae Sun Shin ),조성진 ( Sung Jin Cho ),최석훈 ( Suk Hoon Choi ),파라즈카심 ( Faraz Qasim ),이흥래 ( Heung N. Lee ),박제호 ( Jae Ho Park ),이원재 ( Won Jae Lee ),이의수 ( Euy Soo Lee ),박상진 ( Sang Jin Park ) 한국화학공학회 2014 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.52 No.4

열화학적인 수소 생산 공정 중 하나인 S-I Cycle은 요오드와 황을 이용한 수소 생산 공정으로써 물 분자로부터 수소분자를 얻어내는 순환 공정이다. 수소 생산 공정에 열을 공급하고자 하는 초고온 원자로(VHTR; Very High Temperature Reactor)는 원자로에서 수소 생산 공정으로 방사능 없이 안전하게 열을 전달하기 위하여 중간열교환기(IHX; Intermediate Heat Exchanger)가 필요하다. 본 연구에서는 수소 생산공정과 초고온 원자로간의 중간 열교환 공정을 모사하여 운전압력 및 작동 유체의 변화에 따른 중간 열교환기의 효율을 계산하고 가장 경제적인 중간 열교환기를 설계하기 위한 공정 조건을 도출하였다. SI Cyclic process is one of the thermochemical hydrogen production processes using iodine and sulfur for producing hydrogen molecules from water. VHTR (Very High Temperature Reactor) can be used to supply heat to hydrogen production process, which is a high temperature nuclear reactor. IHX (Intermediate Heat Exchanger) is necessary to transfer heat to hydrogen production process safely without radioactivity. In this study, the strategy for the optimum design of IHX between SI hydrogen process and VHTR is proposed for various operating pressures of the reactor, and the different cooling fluids. Most economical efficiency of IHX is also proposed along with process conditions.

한의학 교의 사업의 유효성에 관한 연구

김동수(Dong Su Kim),이혜림(Hye Lim Lee),성현경(Hyun Kyung Sung),박선주(Sun Ju Park),이주아(Ju Ah Lee),고재언(Jae-un Ko),박재만(Jae-Man Park),최석훈(Suk-Hoon Choi),김효선(Hyo-Sun Kim),고호연(Ho-Yeon Go) 대한한의학회 2017 대한한의학회지 Vol.38 No.3

진균혈증의 진단에 있어서 혈청 (1→3)-β-D-glucan 측정의 유용성

최석훈,한상훈,진범식,박윤선,조병철,김희만,김윤재,이꽃실,장경희,송영구,김준명 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 진균혈증의 신속한 진단은 진균혈증 치료의 핵심이다. 그러나 진균혈증의 전통적인 진단법은 어렵기 때문에 진단을 지연시킬 수 있다. 진균혈증의 진단에서 β-glucan의 임상적 유용성을 알아보기 위하여 본 연구자들은 진균혈증 환자의 혈청 β-glucan의 농도를 측정하기 위하여 대조군으로써 균혈증 환자와 건강한 성인과 비교하였다. 방법 : 2001년 8월에서 2002년 10월까지 16명의 진균혈증 환자, 13명의 균혈증 환자, 그리고 18명의 정상 성인의 혈청 β-glucan 농도를 측정하였다. 본 연구자들은 β-glucan 농도를 β-Glucan Test(Wako Pure Chemical Industries, Ltd., Osaka, Japan)를 이용하여 측정하였다. 진균혈증 환자와 다른 환자들 사이의 혈청 β-glucan 농도 비교는 t-검정을 이용하였다. 결과 : 진균혈증 환자 중에서 남자는 10명(62.5%)이었고, 여자는 6명(37.5%)이었으며, 평균연령은 52.9±16.2세였다. 균혈증 환자 중에서 남자는 6명(46.2%)이었고, 여자는 7명(53.8%)였으며, 평균연령은 52.3±17.1세였다. 정상 성인 중에서 남자는 15명(83.3%)이었고, 여자는 3명(16.7%)였다. 평균연령은 23.8±2.1세였다. Cut-off value는 11 pg/mL이었다. 총 16명의 진균혈증 환자 중에서 13명의 혈청 β-glucan의 농도가 cut-off value 이상이었고(범위:11.5-863 pg/mL, 민감도:81.3%, 특이도:100%), 평균 농도는 217.8±273.8 pg/mL이었다. 총 13명의 균혈증 환자의 혈청 β-glucan 농도는 전부 cut-off 이하였고, 평균 혈청 β-glucan 농도는 0.1±0.3pg/mL이었다. 총 18명의 정상 성인의 혈청 β-glucan의 농도는 전부 cut-off value 이하였고, 평균 혈청 β-glucan 농도는 0 pg/mL이었다. 진균혈증 환자의 혈청 β-glucan의 농도는 통계학적으로 유의하게 대조군인 균혈증 환자와 건강한 성인의 농도보다 높았다(P-value : 0.006 및 0.006). 결론 : 결론적으로 진균혈증 환자의 진단에서 혈청 β-glucan의 농도 측정은 임상적으로 의미가 있다. 그러나 본 연구가 임상적으로 더욱 유용하기 위하여는 혈청 β-glucan 농도 측정을 통한 진균혈증의 조기진단이 진균혈증 환자의 예후에 미치는 영향과 혈청 β-glucan 농도와 진균혈증 환자의 항진균제에 대한 치료반응과의 연관을 밝히는 연구가 진행되어야 할 것이다(본 연구는 WAKO사의 β-glucan Test (Wako Pure Chemical Industries, Ltd., Osaka, Japan)의 제공으로 이루어졌음) Background : Early recognition of fungemia is essential for successful treatment. However, methods to culture fungus specimen taken from fungemia patients are difficult and time consuming. To assess the clincal usefulness of β-D-glucan in the detection of fungemia. we compared serum (1→3)-β-D-glucan concentrations in fungemia, bacteremia, and healthy persons. Methods : From August 2001 to October 2002, serum (1→3)-β-D-glucan concentrations were measured by turbidometric assay in 16 fungemia patients, 13 bacteremia patients and 18 healthy persons. Differences in (1→3-β-D-glucan concentrations between fungemia patients and other groups were compared by t-test. Results : Fungemia patients were composed of 10 male and 6 female patients, and mean age was 52.9±16.2 years. The cut-off value for a positive result was 11 pg/mL. thirteen out of 16 fungemia patients had concentrations above the cul-off value (range: 11.5-863 pg/mL, sensitivity: 81.3%, specificity: 100%), and mean concentration in fungemia was 217.8±273.8 pg/mL. Mean concentration in bacteremia was 0.1±0.3 pg/mL, and all the patients with bacteremia had the concentrations below the cut-off value. Mean concentration in the healthy persons was 0 pg/mL and all healthy persons had concentration below the cut-off value. The concentration in fungemia was statistically significantly higher than those of the other two groups(p-value: respectively 0.006, 0.006) Conclusion : We concluded that serum (1→3)-β-D-glucan is useful for the diagnosis of fungemia. Further study on the usefullness of serum (1→3)-β-D-glucan for early detection of fungemia and therapeutic monitoring is warranted.

Utility of QuantiFERON-TB In-Tube Test for Differentiating Active Tuberculosis from Latent Tuberculosis Infection in an Intermediate Burden Country

Choi, Suk Hoon,Chin, Bum Sik,Han, Sang Hoon,Lee, Han Sung,Kim, Chang Oh,Jeong, Su Jin,Choi, Hee Kyung,Kim, Myung Soo,Choi, Jun Yong,Song, Young Goo,Kim, June Myung 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Background : The aim of the present study was to assess the contribution of a QuantiFERON-TB Gold In-Tube test (QFT-IT) in differentiating active tuberculosis (TB) from latent tuberculosis infection (LTBI) by quantifying interferon-r levels. Materials and Methods : We retrospectively reviewed clinical records of 314 patients older than 15 years who had performed QFT-IT between July 2006 and August 2007 at a tertiary care teaching hospital. Results : Subjects with active TB (n=81, culture confirmed active TB in 40 subjects) and LTBI (n=76) were included. Mean±SD IFN-r levels were 4.961±3.98 lU/mL (range -0.08-10) for all subjects with active TB, 4.54±4.05 lU/mL (range -0.08-10) for culture confirmed active TB, and 4.11±3.57 lU/mL (range 0.35-10) for subjects with LTBI. The quantitative results of QFT-IT on IFN-7 levels between all the subjects with active TB and those with LTBI were not statistically significant (P=0.16). The result was similar when compared between those with culture confirmed active TB and those with LTBI, showing little statistical significance (P=0.554). Conclusion : The production of IFN-7 measured by QFT-IT showed no correlation between its level and the activity of Mycobacterium tuberculosis infection. These results suggest that measuring IFN-r using QFT-IT might not be useful for distinguishing active TB from LTBI.

베체트병 환자에서 발생한 주폐포자충 폐렴 1예

정지영,최석훈,박윤선,진범식,한상훈,허규연,심완섭,이재혁,정상윤,최한석,최준용,박윤수,조정호,장경희,송영구,이광훈,김준명 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

저자들은 면역 억제 치료를 받은 베체트 증후군 환자에서 발생된 주폐포자층 폐렴을 기관지 폐포 세축술 및 경기관지 폐생검을 통해 진단하고 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Pneumocystis carinii pneumonia (PCP) is one of the most common causes of infection in patients with HIV infection. With the development of effective prophylactic agent, the incidence of PCP in patients with HIV infection has been declining. On the other hand, however, the incidence of PCP has been increasing in immunocompromised hosts without HIV infection, such as rheumatoid arthritis, bone marrow transplantaion and Behcet syndrome. The increased occurrence of PCP in non-HIV-infected subjects has been attributed to several factors, such as use of stronger immunosuppressive regimens, higher awareness of PCP, advanced diagnostic technology and nosocomial spread of P. carinii. The occurrence of PCP in patients who receive immunosuppressive drugs for autoimmune disease has not been well known in Korea. We report a patient with Behcet syndrome who suffered from PCP after immunosuppressive drugs.