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.

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.

측뇌실내 수막종 : 임상분석 및 수술접근법 Clinical Analysis and Surgical Approach

양희진,김동규,정희원,이현구,김현집,조병규,최길수,한대희 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10

The authors present six cases of lateral ventricle meningiomas treated at Seoul National University Hospital between 1979 and 1991. These six cases of lateral ventricular meningiomas constitute 1.8 percent of all intracranial meningiomas and 16.7 percent of mass lesions of the lateral ventricle. The mean age was 29 years ranging from 11 to 50 years, younger than that or intracranial meningiomas with a statistical significance(p<0.01). Four of the patients were women and two were men. All cases were located in the trigonal area. The most common clinical symptoms and signs were related to increased intracranial pressure such as headache, nausea and vomiting. Based on the clinical presentation and radiological features(CT. MRI and angiography), correct preoperative diagnosis was possible in five cases. Gross total removal of the tumor was achieved in all cases. There was no operative mortality. A temporal gyrus approach was used in five cases with good surgical results. The benefits and drawbacks of each surgical approach for meningiomas of the lateral ventricle is discussed with review of pertinent literatures.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

임상검체에서 분리된 그람 음성 세균들에 대한 Isepamicin의 시험관내 항균력

권현희,박수진,소민욱,박현구,최성호,김미나,최상호,정진용,우준희,김양수 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : The increasing incidence of multidrug-resistant gram-negative bacteria causing nosocomial infections is an important clinical problem. Isepamicin is a recently developed aminoglycoside which has been known to have potent activity against gram-negative organisms. We evaluated the in vitro activities of isepamicin and other aminoglycosides against a large number of gram-negative organisms. Materials and Methods : We tested the in vitro antimicrobial activities of isepamicin, amikacin, gentamicin, and tobramycin against 566 gram-negative organisms collected between January 2006 and June 2006 in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined and interpreted according to the recommendations of Clinical and Laboratory Standard Institute (CLSI). The breakpoint MIC used for interpretation of isepamicin was MIC≤16 ㎍/mL as susceptible, 32 ㎍/mL as intermediate, and 64 ㎍/mL as resistant. Results : The MIC_(50)/MIC_(90) of isepamicln for Escherichia coli, Klebsiella pneumon/ae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae were 1/2, 0.5/>128, 4/16, 16/>128, and 1/2 ㎍/mL, respectively. The susceptibilities for E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, and E. cloacae were 100%, 86.4%, 89.7%, 50.0%, and 96.6%, respectively. For E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae, isepamicln had better in vitro activities than gentamicin and tobromycin, and had similar activities with amlkacin. For A. baumanii, all four tested aminoglycosides had similar in vitro activities. Conclusion : Isepamicin had excellent in vitro activities against gram-negative organisms, except A. baumanii. The overall in vitro activities were similar with amikacin. 목적 : 그람 음성 세균은 다양한 지역사회 및 병원 획득 감염의 원인균이다. 최근에는 병원 감염을 일으키는 그람 음성 세균에서 항균제 내성균의 출현과 확산이 큰 문제가 되고 있다. Isepamicin은 최근에 소개된 gentamicin B의 유도체로 외국에서의 연구에 의하면 그람 음성 세균들에 대한 항균력이 우수함이 보고 된 바 있다. 본 연구에서는 우리나라의 임상 균주들을 대상으로 그람 음성세균에서 isepamicin의 시험관내 항균력을 기존의 아미노배당체 제재들과 비교하여 평가하고자 하였다. 재료 및 방법 : 2006년 1월에서 6월 사이에 서울아산병원 환자에서 분리된 Escherichia coli 113 균주, Klebsiella pneumoniae 110 균주, Pseudomonas aeruginosa 117 균주, Acinetobacter baumannii 108 균주, 그리고 Enterobacter cloacae 118 균주를 대상으로 isepaimcin, amikacin, gentamicin, tobramycin에 대한 최소억제농도(minimal inhibitory concentration, MIC)를 한천 희석법(Mueller-Hinton Agar)을 이용하여 측정하였다. 감수성여부는 CLSI 기준에 따랐으며, isepamicin은 MIC≤16㎍/mL를 감수성, MIC=32 ㎍/mL를 중등도 내성, MIC≥64 ㎍/mL를 내성으로 판정하였다. 결과 : Isepamicm의 E. coli, K. pneumoniae, P. aeruginosa, A baumannii, E. cloacae에 대한 MIC_(50)/MIC_(90)은 각각 1/2, 0.5/>128, 4/16, 16/>128, 1/2 ㎍/mL였고, 항균제 감수성률은 차례대로 100%, 86.4%, 89.7%, 50.0%, 96.6%였다. 기존 아미노배당체 제재들과 비교하면 E. coli, K. pneumoniae, P. aeruginosa, E. cloacae에서는 amikacin과 비슷한 감수성률을 보였고, gentamicin과 tobramycin보다 높은 감수성률을 보였다. A baumannii의 경우 isepamicin의 감수성률이 50.0%로 비교적 낮았지만 amikacin, gentamicin, tobramycin도 각각 50.0%, 46.3%, 47.2%의 감수성률을 나타내어 4가지 항균제가 모두 비슷한 항균력을 보였다. 결론 : Isepamicin은 그람 음성 세균들에 있어 기존의 아미노배당체 제재들과 비교했을 때 amikacin과는 동등한 시험관내 항균력을 보이고 gentamicin, tobramycin보다 뛰어난 시험관내 항균력을 보여 사용이 유망한 아미노배당체 중 하나라 생각된다.

흰쥐에서 가시오가피 발효물의 단회 및 반복투여 독성평가

조주현(Ju-Hyun Cho),박인재(In-Jae Park),백순옥(Soon-Ok Baik),최수영(Soo-Young Choi),최구희(Goo-Hee Choi) 한국식품과학회 2014 한국식품과학회지 Vol.46 No.2

본 연구에서는 사용된 가시오가피 영지버섯 발효물과 가시오가피 상황버섯 발효물에 대한 열수추출물을 최고 2 g/kg의 농도로 단회 투여한 SD-rats에 체중 변화, 임상증상 등에서 어떠한 독성도 관찰할 수 없었으며, 1 g/kg 이하의 농도로 4주간 반복 투여한 SD-rats에서도 체중변화, 임상증상, 장기 무게, 혈액학적 성상, 혈액생화학적 성상 등에서 어떠한 독성과 비정상적인 소견을 관찰할 수 없었다. 따라서, 본 연구의 결과로 볼 때 가시오가피 영지버섯 발효물 열수추출물(FM-5111)과 가시오가피 상황버섯 발효물 열수추출물(FM-5131)은 본 연구에서 사용한 농도 내에서의 안전성을 확인할 수 있었다. 황 함유 아미노산의 결핍은 여러 가지 간질환 등의 증상을 야기한다(27). 또한, Choi와 Ahn(28)은 오가피 부위별 50% (v/v) 메탄올 추출액의 전자공여능은 줄기 추출물에서 90.21%, 뿌리 추출물에서 85.71%로 높은 활성을 보고하여 오가피의 항산화능을 규명하였다. 따라서, 본 연구에 사용된 시료 또한 항산화능과 같은 기능성을 가질것으로 사료되며, 추가 연구로 아미노산 분석을 통해 황 함유 아미노산의 함량 변화를 분석하고 간 기능 개선 효능을 평가하여 안전성이 확보된 기능성 식품소재 개발 연구를 진행할 계획이다. In this study, the products of Acanthopanax senticosus fermentation were derived from the mycelia of 2 mushrooms, Ganoderma lucidum and Phellinus linteus, to determine their safety in Sprague-Dawley rats. Rats were orally administered the water extracts of A. senticosus fermentation products with G. lucidum (FM-5111) or P. linteus (FM-5131) at dose levels of 0.5, 1.0, or 2.0 g/kg for the single-dose toxicity test and 0.25, 0.5, or 1.0 g/kg for the repeated-dose toxicity test. There were no significant differences in body weight gain, feed intake, or water consumption between control and FM-5111- or FM-5131-treated rats. Hematological and blood biochemistry analysis revealed that none of the investigated parameters were affected by the A. senticosus fermentation products, and no remarkable lesions were observed upon histopathological analysis. We conclude that the A. senticosus fermentation products obtained from mushroom mycelia are safe for long-term administration and could be considered as multi-functional nutrients for the improvement of liver function and immunity.

운동이 정신지체 성인여성의 골밀도에 미치는 영향

장명재,최지우,최원현,최현희 경희대학교 체육과학연구소 2000 體育學論文集 Vol.28 No.-

The purpose of this study was to investigate the effect of exercise to mentally retarded women's bone mineral density. Subjects were divided into three groups: Group A(age:27.9yr, n=8)-This group was mentally retarded exercise women, who had been doing regularly exercise for over three years. Group B(age:28.8yr, n=8)-This group was mentally retarded non exercise women, who hadn't been doing it as usual. Group C(age:29.0yr, n=8) This group was normal women, who hadn't been doing it as usual. This study analysed and compared the bone mineral density between these three groups. The results were summarized as follow. 1.The BMI of group A(Mentally retarded exercise group) was 22.8±3.28 kg/m2, group B(mentally retarded non exercise group) was 22.6±5.6 kg/m2, and Group C(normal group)was 22.0±2.2 kg/m2. There were no significant differences in BMI between three groups. 2.There were significant difference in grip strength and back strength between three groups(p〈.001). The grip strength of group A was 16.9±6.5 kg, group B was 12.2±4.0 kg, and group C was 31.8±2.1 kg. The back strength of group A was 36.9±16.1 kg, group B was 34.2±8.4 kg, and group C was 96.9±32.7. 3.These were significant difference bone mineral density of lumbar between these groups. Group A was 0.1±0.08 g/cm2, Group B was 0.888±0.10 g/cm2, and group C was 1.05±0.04 g/cm2(p〈.01). 4.These were very significant difference bone mineral density of femur between these groups. Group A was 0.91±0.09g/cm2, group B was 0.74±0.08 g/cm2, and group C was 0.97±0.14 g/cm2(p〈.0001). 5.These were very significant difference bone mineral density of Forearm between these groups. Group A was 0.6±0.02 g/cm2, group B was 0.56±0.03 g/cm2, and group C was 0.63±0.02 g/cm2(p〈.0001). 6.Group A were correlations between bone mineral density of femur(neck) and BMI, weight(p〈.05). 7.Group B were correlations between bone mineral density of forearm(MID, total) and age(p〈.05). 8.Group C were correlations between bone mineral density of lumbar(L1) and age, BMI, back strength(L4).

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.

Floristic characteristics of vascular plants and first distributional report of Pseudostellaria baekdusanensis M. Kim in Yongneup wetland protected area

Young-Chul Kim,Hyun-Hee Chae,Sang-Heock Oh,Seung-Ho Choi2,Moon-Pyo Hong3,Gi-Heum Nam,Jae-Yoon Choi,Hyun-Sook Choi,Kyu-Song Lee 한국환경생태학회 2015 한국환경생태학회지 Vol.29 No.2

Yongneup wetland protected area, the only high moor in Korea, is a core area to conserve biodiversity. Even though the Yongneup wetland protected area is relatively small, various plant species are distributed in the Yongneup wetland protected area because it includes various habitats showing different environmental gradients. Vascular plants distributed in the Yongneup wetland protected area were identified as a total of 376 taxa that is composed of 73 families, 217 genera, 322 species, 3 subspecies, 44 varieties and 7 forms. For endangered plants designated by the Ministry of Environment, 5 species including Trientalis europaea var. arctica, Lilium dauricum, Halenia corniculata, Lychnis wilfordii and Menyanthes trifoliata were found and 34 taxa were confirmed to be distributed only in the mountainous wetland habitats. Regarding naturalized plants, a total of 11 taxa were distributed, but most of them were distributed in the areas where artificial interference has occurred. And in areas inside the wetlands that are relatively well preserved, 2 species of Bidens frondosa and Erigeron annuus were observed. In this study, the occurrence and distribution of Pseudostellaria baekdusanensis M. Kim, which was recently found in Mt. Baekdu and reported as a new species, were identified in the Yongneup wetland protected area. A wetland is a very vulnerable area to drastic environmental changes and damages to its ecosystem could cause the extinction of rare plant species which are distributed only in the wetlands. Therefore, it is mandatory that current status of the Yongneup wetland protected area is evaluated and actions to prevent rapid environmental changes are taken. Fourteen separate investigations were conducted in 2013 and another four in 2014, to evaluate current status of the Yongneup wetland protected area. These investigations have provided us the basic information for future actions of conservation and restoration.

2007년 대한감염학회 권장 성인 예방접종 권장안

강진한,김홍빈,손장욱,이상오,정문현,정희진,최영화,최정현,최준용,최희정 대한감염학회 2008 감염과 화학요법 Vol.40 No.1

In 2007, the Korean Society of Infectious Diseases recommended an immunization schedule for adults residing in Korea. This recommendation includes four categories: standard immunization for healthy persons, supplementary immunization for persons with underlying illnesses, recommendations for health-care personnel and for international travelers. The Standard Immunization Schedule consists of universal vaccination (tetanus-diphtheria/tetanus-diphtheria-pertussis (Td/Tdap); hepatitis A vaccine for persons aged 20s; human papilloma virus vaccine for women under 26 years old; meningococcal vaccine for military recruits and college students in dormitories; influenza vaccination for persons aged 50 years or more and pregnant women; and pneumococcal vaccination for persons aged 65 years or more) and catch-up vaccination (hepatitis A vaccine for persons aged 30s; hepatitis B vaccine, varicella and MMR vaccines for persons who have uncertain specific immunities). The Supplementary Immunization Schedule recommends 4 vaccines, i.e., pneumococcal, influenza, meningococcal, and Haemophilus influenzae type b, appropriate to the underlying illnesses, and confirmation of the presence of antibodies to hepatitis A and hepatitis B. The Recommendation for Health-Care Personnel includes universal vaccination (influenza and pertussis) and catch-up vaccination (hepatitis B, measles-mumps-rubella and varicella for seronegative health-care personnel). The Recommended Immunization for International Travelers focuses reinforcement of vaccinations for healthy persons and includes certain immunizations necessary for international travel (yellow fever, meningococcal, plaque, tick-borne encephalitis, and cholera). These guidelines can be seen at www.ksid.or.kr.