혈액암환자에서 조혈모세포 이식 후 따르는 헤르페스 바이러스 감영 양상

이호섭,탁희상,신성훈,김양수,남성진,김혜수,박진희,정수현,김성빈,김예나 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

배경 : 헤르페스바이러스과에는 단순포진 바이러스(HERPES SIMPLEX VIRUS, HSV), 수두대상포진 바이러스 (VARICELLA-ZOSTER VIRUS, VZV), 엡스타인-바 바이러스 (EPSTEIN-BARR VIRUS, EBV), 그리고 거대세포 바이러스 (CYTOMEGALOVIRUS, CMV) 등이 있다. 헤르페스바이러스 감염은 혈액암환자에서 조혈모세포 이식 환자에서 전파 (dissemination), 이차감염, 세균 중복 감염의 심각한 합병증을 일으킬 수 있다. 하지만 항암약물치료를 받는 림파종 환자에서 항 바이러스 약제의 사용 용량과 기간에 대한 concensus는 없다. 헤르페스바이러스 감염에 대한 발생율과 위험인자를 후향성으로 분석하였다. 방법 : 고신대학교 복음 병원에서 1995년 6월부터 2009 년 2월 사이에 새롭게 진단되어 조혈모세포 이식을 받은 전체 58명의 환자들이 후향적으로 현 연구에 등록했다. 헤르페스 바이러스 감염은 임상적 진단, 혈청학적 검사 또는 병리학적 진단에 기초하여 확진한다. 환자들의 특성은 다음과 같다: 평균 연령은 44세 (범위 19-62세)였고 남녀비는 30:28이었다. 등록된 질환은 백혈병 (n=9, 15.5%), 림프종 (n=30, 51.7%), 다발성 골수종 (n=12, 20.7%), 재생불량성 빈혈 (n=6, 10.3%) 그리고 골수이형성증후군 (n=1, 1.7%)이 포함되었다. 결과는 chi-squre test나 independent samples T test를 사용하여 분석되었다. Multivariate analysises에 대해 logistic regression test를 사용하였다. 결과 : 15명의 환자들 (25.9%)에서 조혈모세포 이식후 헤르페스 바이러스 감염이 발생하였다. 조혈모세포 이식 5년간 누적 발생율은 53.9%였다. Univariate analyses에서 헤르페스 바이러스 감염에 대한 유의한 위험 인자는 없었다. 하지만 조혈모세포 이식후 생존 기간(40.18 ± 30.14 months vs 20.06 ± 26.67 months, p=0.018)은 헤르페스 바이러스 감염의 낮은 발병율과 유의한 관련성이 있었다. 이식 편대 숙주질환 (GVHD)의 존재 (37.5% in developed GVHD vs 0% in no GVHD, p=0.200), 동종조혈 모세포 이식에서 면역억제요법의 기간 (15.98 ± 14.02 months vs 6.78 ± 3.67 months, p = 0.374)은 헤르페스 바이러스 감염에 대한 위험인자가 아니었다. 결론 : 조혈모세포 이식 후 생존 기간은 어사이클로비어 예방을 받은 혈액암 환자에서 헤르페스 바이러스 감염의 낮은 발병율과 연관성이 있는 것으로 보인다. 저용량의 어사이클로비어 예방은 헤르페스 바이러스 감염의 고위험군인 조혈모세포 이식을 받은 혈액암 환자에 필요하리라 생각된다. Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI. Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28. The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%), aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysis, we used logistic regression test. Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy (IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI. Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.

위임법률과 표현의 자유의 영역에서의 명확성의 원칙 : 헌법재판소 2002. 6. 27. 선고 99헌마480 결정을 중심으로

김예나 이화여자대학교 법학전문대학원 2012 Ewha Law Review Vol.2 No.1

명확성의 원칙은 기본권을 제한하는 법률은 명확하여야 하며, 법률로써 기본권을 제한할 경우에 제한되는 기본권이 구체적으로 특정되어야 한다는 원칙으로 헌법재판소가 법령의 위헌 여부를 가리기 위하여 주요하게 적용해온 심사척도의 하나이다. 그러나 언어로 구성된 법률의 ‘명확성’에 대한 절대불변의 판단 기준이 있을 수 없으므로, 헌법재판소는 명확성 원칙의 판단 기준을 최소한의 명확성에 두고 일정한 ‘정도’의 명확성을 요구하고 있다. 문제는 이러한 명확성의 정도를 법률의 체계적 지위와 구체적인 영역에 따라 어떻게 요구하여야 하는가이다. 대상 판결은 「구 전기통신사업법」 제53조의 위헌 여부를 판단함에 있어 위임법률과 표현의 자유 영역에 명확성의 원칙을 적용하고 있다. 이 글에서는 대상 판결의 다수의견을 비판하면서 위임법률과 완결적 법률에서 같은 정도의 명확성이 요구되는지, 표현의 자유영역에서는 예외 없이 항상 고도의 명확성의 원칙이 요구되는 것인지에 대하여 논의하고 이에 대한 기준을 제시한다. 덧붙여 명확성의 원칙 위배시 별도의 과잉금지원칙을 판단하고 있는 대상 판결의 다수의견의 논증방식의 타당성을 검토하도록 한다. The principle of legality requires that all law should be clear and specific in discussing which fundamental rights, if any, it shall limit. The principle is one of the major criteria that the Constitutional Court has applied to decide on the constitutionality of regulations. Due to the inevitable and fundamental lack of clarity in legal language, the Constitutional Court depends on the minimum level of clarity from the written law and its appealable interpretation of the point of law. The court ruling applies the principle of legality to its interpretation of delegated legislation and freedom of expression to decide on the constitutionality of Article53 of the Telecommunication Business Act. This article criticizes the majority rule of the court ruling, discusses whether delegated legislation and concluded legislation should require similar levels of clarity, or the highest level of clarity is required without exception within the freedom of expression, and further suggests relevant standards. The article also examines the validity of the court ruling’s majority argument which decides the Less Restrictive Alternative should the principles of disclosure be breached.

Fogarty Catheter를 이용한 소아 기도 이물의 제거 1례 : 증례 보고

김예나,옥철호,장태원,정만홍 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Foreign body aspiration is a common problem in children necessitating prompt recognition and early treatment to minimize the potentially serious and sometimes even fatal conseqeunce. We report the case of a 7-year-old boy with a button lodged in his right main bronchus. Under general anesthesia, ultrathin bronchoscopy identified the foreign body which was then removed by the combined use of a Fogarty catheter and extraction forcep. This case differs from previous reports, in that the forcep extraction through working channel of ultrathin scope was used simultaneously with Fogarty catheter even in relately small airway of children.

만성 견비통에 대한 동씨침 치료의 무작위 대조군의 임상 연구

김찬영,권나현,신예지,남동우,김건형,김종인,최도영,이윤호,이재동 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objectives : To observe the effect of acupuncture treatment in chronic shoulder pain patients. Methods : 36 voluntary patients were randomly assigned to an acupuncture treatment group(E GrouP, n=18) and a control group(C GrouP, n=18). The E Group patients received acupuncture treatment on LI_(15), TE_(14), GB_(21) and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for four weeks. The C Group patients received no treatment. All patients in both groups were instructed to practise self exercise in their daily lives. Evaluations were made at baseline and after four weeks of study. The Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's subjective pain was measured by Visual Analogue Scale(VAS). The obtained data was analyzed. Results '. The E Group showed significant(p<0.05) improvement in CSA, SPADI and VAS after four weeks of treatment. The C Group showed significant(p<0.05) improvement in CSA, but the change of SPADI and VAS was insignificant(P>0.05). CSA and SPADI of E Group significantly(p<0.05) improved compared to the C GrouP, but the difference of VAS change in the two groups was insignificant(p>0.05). Conclusions : Four weeks of acupuncture treatment significantly improved CSA, SPADI and VAS. The improvement of CSA and SPADI was significant(p<0.05) compared to untreated patients.

폐주변부 병변 진단 시 기관지솔질에 의한 출혈이 병소확인에 주는 유용성 연구

김예나,정수현,김혜수,옥철호,장태원,정만홍,천봉권 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Background : Diagnosis of peripheral pulmonary lesion by conventional bronchoscopy is still challenging. The sheathed bronchial brush has been used to collect samples from the visible endobronchial lesion. Recently developed endobronchial ultrsonography (EBUS). can obtain image of peripheral pulmonary lesion at bronchus suspected by bleeding sign of sheathed brush. This study evaluated availibility of detected lesions by bleeding after bronchial brushing in pheripehal pulmonary lesions before transbronchial lung biopsy Methods : Between August 2006 and November 2008, 50 patients(38 men and 12 women, median age, 65 yrs) whose peripheral pulmonary lesions could not be detected with flexible bronchoscopy were included in this study. Among 50 patients, 40 cases were malignant lesion(non-small cell carcinoma 35, small cell carcinoma 5), and 10 cases were benign lesions(inflammatory disease 7, others 3) Results : Of the 50 patients, lesions detected bleeding after bronchial brushing was 34 cases(68%) and lesions detected by EBUS was 33 cases(66%). Sensitivity was 90.0-95.4%, Specificity was 83.3-80%, Positive predictive value(PPV) was 83.3-95.4% and Negative predictive value(NPV) was 80-90.9%. Diagnostic rates in visualized lesion by EBUS and otal peripheral lesions were 75%(25/33), 58%(29/50) respectively. There was no significant complication related with bronchial brushing. Conclusions : Bleeding sign by bronchial brushing was safe and effective method to predict location of peripheral pulmonary lesion with sufficient diagnostic yield

Ethephon 수상처리가 참다래 과실의 숙기 및 품질에 미치는 영향

나양기,조혜성,임경호,김월수 전남대학교 농업과학기술연구소 2000 農業科學技術硏究 Vol.35 No.-

This experiment was carried out to investigate the effects of overhead irrigation of Ethrel on after-ripening of kiwi fruit, and to improve marketability and decrease operating cost as to ripen kiwi fruit at the stage of consumption. In 1994, the eight-year-old Hayward which were planted in farm field at Haenam Okchen were treated with 100ppm, 150ppm and 200ppm overhead irrigation of ethephon on September 25, September 30 and October 5 respectively. In 1995, the nine-year-old Hayward which were planted in windbreak net house at Moonlae Haenam were treated with 40, 70 and 100ppm overhead irrigation of Ethephon on October 5, October 10 and October 15 respectively. As the result of at 10 and 20 days after treatment, in 1994, the firmness was much low as to show 0.8 to 0.95kg at 10 days after treatment, 0.2 to 0.33kg at 20 days after treatment. And sduble solid content was 10.6 to 11.7˚ Bx and abscission rate was 10.3 to 35.9%. Therefore, the marketability were tended to be showed low. In 1995, as that firmness was 3.2 to 3.7kg, last soluble solid content after harvesting was 13.8 to 14.0˚ Bx and abscission rate was 0%, there was no problems in marketability and marketing. Therefore, this results were demonstrated that the treatment after October 10 in 70 to 100ppm ethephon can be improved marketability and marketing of kiwifruit.

갓김치에서 분리한 캡사이신-내성 세균,Leuconostoc mesenteroides GK-10의 생리활성

김유진,나예린,이현호,오계헌 순천향대학교 기초과학연구소 2021 순천향자연과학연구 논문집 Vol.27 No.1.2

The aim of this work was to investigate the physiological activities of capsaicin-resistant bacterium, Leuconostoc mesenteroides GK-10 isolated from fully fermented mustard leaf kimchi. Initially, the morphological, physiological and biochemical characteristics of strain GK-10 were examined. Based on phylogenetic analysis using 16S rRNA sequencing, the isolate was identified as L. mesenteroides GK-10 and phylogenetic tree of the strain was plotted. L. mesenteroides GK-10 grew well in the different concentrations of capsaicin (0-600 μg/mL). Various physiological activities (e.g., tyrosinase inhibitory activity, ACE inhibitory activity, antioxidant activity, SOD-like activity, depletion of sodium nitrite) of L. mesenteroides GK-10 cultures with different concentrations of capsaicin were evaluated and compared to the cultures of L. mesenteroides DK-3 as a standard strain. According to the results, all of the physiological activities evaluated in this work were considerably higher in L. mesenteroides GK-10 cultures with 600 μg/mL capsaicin compared to L. mesenteroides DK-3 cultures with the same capsaicin concentration, although the physiological activities of GK-10 were higher or lower compared to those of DK-3 in the absence of capsaicin. In consequence, this work showed that L. mesenteroides GK-10 strains can maintain their physiological activities despite the presence of high concentrations of capsaicin.

하시모토 갑상선염을 동반한 갑상선 이형성증 1예

정현주,김예나,최영식,박요한 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.1

Thyroid hemiagenesis is a rare congenital anomaly, in which one thyroid lobe fails to develop. It is reported that thyroid hemiagenesis associated with thyroid diseases such as Graves' disease, Hashimoto's thyroiditis, colloidal goiter and thyroid follicular and papillary cancer. However, Thyroid hemiagenesis associated Hashimoto's thyroiditis haven't reported in Korea. A 31-year-old female patient was clinically hypothyroid with a left-sided goiter. Hemiagenesis of right thyroid lobe indicated on 99mTc pertechnete scan and later confirmed on ultrasonography. The authors report this case with literature review.

Engineering of Glyoxylate Carboligase from Escherichia coli K-12 for the Production of Glycolaldehyde from Formaldehyde

Ye-Na KIM,Hye-Jin JO,Hanna YU,Huijin CHEON,Jun-Hong KIM,Jeong-Sun KIM,Jin-Byung PARK 한국생물공학회 2021 한국생물공학회 학술대회 Vol.2021 No.4

Biological activities of a Water-soluble Polysaccharide(CPS) from Korean Capsosiphon fulvescens

Na, Ye Seul,Woo Jung Kim,Sung Min Kim,Yean Kyoung Koo,Hye Sook Yun,Yong-Il Park 한국당과학회 2009 한국당과학회 학술대회 Vol.2009 No.1

Seaweed extracts have recently been found to have biological activities including effects on the immune system, anticoagulant system, cancer, etc. Capsosiphon fulvescens is a green alga that is widely distributed in the Southern coastal area of Korea. Crude polysaccharides were obtained from this seaweed collected at a coastal area of Wando, Korea, mainly by dilute acid extraction, ethanol precipitation and CaCl2 precipitation. It was further purified by DEAE-cellulose column chromatography and its chemical composition, structural analysis, immunostimulating activity, anticoagulation activity, anticancer activity and osteogenesis was determined. From HPLC analysis molecular mass of this polysaccharide was determined to be approximately 385 kDa. Elemental analysis of CPS, The estimation of only four elements, that is carbon(31.9398% w/w), hydrogen(4.9022% w/w), nitrogen(0.6318% w/w) and sulfur(6.2166% w/w), was undertaken. CPS stimulated the production of TNF-α to a level 80 times greater than the normal. Also CPS induced IL-6 secretion from RAW264.7 cells in a dose-dependent manner. Moreover, Cf–PS treatment increased the expressions of cyclooxygenase-2 (COX-2) and the inducible form of nitric oxide (iNOS). The CPS could significantly increase anticoagulant activity, which was especially characterized by activated partial thrombloplastin time (APTT) and thrombloplatin time (TT). Two hundred ug/ml of CPS delayed the APTT up to 61 s. And TT of CPS reached up to 32 s. MTT assay showed that the CPS significantly inhibited the proliferation of cultured human MKN-45 gastric cancer cells in a dose-dependent manner. Also nitrite plays an important role in the formation of carcinogenic nitrosamine. One percentage of CPS eliminated the nitrite up to approximately 50%. CPS plays a role for osteoblastic bone metastasis by promoting both osteoblasts proliferation and apoptosis of osteoclasts. One mg/ml of CPS increased the osteoblast cell growth up to approximately 150% and decreased the osteoclast cell growth up to approximately 60% by induction of apoptosis.