한국인 남녀 알코올 의존 환자에서의 알코올 대사 효소 유전자 다형성에 관한 연구

강철중(Cheol-Joong Kang),김성곤(Sung-Gon Kim),김현경(Hyeun-Kyeung Kim),황인복(In-Bok Hwang),변원탄(Won-Tan Byun) 대한생물치료정신의학회 2006 생물치료정신의학 Vol.12 No.1

Objective : Alcohol is metabolized in hepatocyte through alcohol dehydrogenase(ADH), microsomal ethanol oxidizing system (MEOS) and catalase. In cases of alcohol dependence, the activity level of the MEOS increases, especially Cytochrome P₄?? 2E1 (CYP2E1). The goal of this study was to investigate whether the CYP2E1 polymorphism is associated with alcohol dependence, and to investigate gender differences in the frequencies of CYP2E1 genotypes and allels. Method : The subjects were Korean male(n=104) and female(n=40) alcohol dependent patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-Ⅳ). Control groups were healthy Korean male(n=79) and female(n=59) subjects who do not drink over five standard drinks per month. Subjects' CYP2E1 polymorphisms(RsaⅠ+PstⅠ, OraⅠ and TaqⅠ) were determined by a polymerase chain reaction(PCR) and restriction fragment length polymorphism (RFLP). Results : 1) In male subjects, there was no association between alcoholics and control groups in the genotype frequency and the allele frequency of the three polymorphisms of CYP2E1. 2) In female alcoholics, the frequency of the A1A1 and A1A2 genotypes of the Taql polymorphism was significantly higher than in the female control groups(df=2, χ²=6.42, p=0.04), while other frequency levels of genotypes and alleles were not significant. Conclusion : These findings suggest genetic associations between CYP2E1 polymorphism and female alcohol dependence but not male. 목적 : 알코올 의존의 발생에서 유전적 원인이 남녀간에 다를수 있음을 보여주는 선행 연구 결과들이 있다. 따라서 알코올 대사 효소 유전자들의 유전적 중요성이 남녀간 차이가 있을 것이라는 가설 하에 한국인 알코올 의존 환자와 정상인을 대상으로 cytochrom P4502El(CYP2E1) 유전자의 5’ -flank 부위(제한효소 Rsa Ⅰ과 Pst Ⅰ), intron 6 부위 (제한효소 DraⅠ) 및 intron 7 부위 (제한효소 Taq Ⅰ)의 유전자형의 빈도를 조사하고 남녀 각각 차이가 있는지를 비교 분석하였다. 방법 : 알코올 의존 환자 144명 (남자 104명, 여자 40명)과 정상인 138영(남자 79명, 역자 59명)을 대상으로 CYP2E1유전자의 5’ -flank 부위(제한효소 Rsa Ⅰ과 Pst Ⅰ) 의 c1c1과 c1c2 및+c2c2(이하 c2+) 유전자형, intron 6 부위(제한효소 Dra Ⅰ) 의 DD와 DC+CC(이하 C+) 유전자형 및 intron 7 부위(제한효소 Taq Ⅰ) 의 A2A2와 A2A1+A1A1(이하 A1+) 유전자형에 빈도를 남녀 각각 비교하였다. 유전자형의 분석은 말초혈액 백혈구에서 DNA를 분리한 후 PCR-RFLP 방법을 이용하여 실시하였다. 결과 : CYP2E1 유전자의 5’ -flank 부위의 유전자형의 빈도와 intron 6 부위 유전자형의 빈도에서는 남자 혹은 여자 알코올 의존환자 모두 남자 혹은 여자 정상대조군과 유의한 차이가 없었다. 한편, intron 7 부위 유전자형의 빈도에 있어서는 여자 알코올 환자가 여자 정상대조군에 비하여 A1A1, A1A2의 빈도가 유의하게 높게 나타났으나, 남자는 유의한 차이가 없었다. 결론 : 이러한 결과는 여성에서의 알코올 의존 발생에 CYP2E1 유전자의 intron 7 부위(제한효소 Taq Ⅰ) 유전적 다형성이 중요하다는 것을 제시하고 있다.

노인 감염성 질환 ; 노인 환자의 항생제 치료 원칙

강철인 ( Cheol In Kang ) 대한내과학회 2010 대한내과학회지 Vol.79 No.4

Older persons generally have greater susceptibility to infections than younger adults, probably because of the increased frequency of comorbidities and physiologic changes. There are many factors, both patient-related and treatment-related, which contribute to unique aspects of antimicrobial use in elderly persons that make prescribing complicated. Physiologic and pharmacokinetic changes associated with aging results in a higher risk of an adverse drug event and a harmful drug interaction, making antimicrobial dosing difficult. The risk of polypharmacy and more frequent adverse drug reactions in the elderly population justify a thorough consideration of the patient`s true need for antimicrobial therapy. Given the increase in the elderly population and in the incidence of adverse drug reaction among elderly persons, further efforts should be made to optimize approach to management of infectious diseases in elderly persons. (Korean J Med 79:362-365, 2010)

비선택성 제초제 Glufosinate-ammonium 오용이 사과나무의 품종별 생육반응 및 수확에 미치는 영향

이인용(In-Yong Lee),박용석(Yong Seog Park),김성민(Sung Min Kim),강철아(Cheol Ah Kang),전병철(Byeong Chul Chun),박재읍(Jae-Eup Park) 韓國雜草學會 2010 Weed&Turfgrass Science Vol.30 No.4

비선택성 제초제인 글루포시네이트암모늄액제를 농작업자의 오판에 의한 오용으로 사과나무에 직접 살포된 경우 품종별, 수령별로 나타나는 약해반응과 수확에 미치는 영향을 조사하였다. 사과나무 품종에 따라 약해정도가 다르게 나타났다. 약제살포 당해연도에는 산사 > 쓰가루 > 홍로 > 후지 순으로, 약제살포 다음해에는 후지 > 쓰가루 > 홍로 > 산사 순으로 피해가 나타났으나, 그 피해정도는 당년에 비해 경미하였다. 이듬해, 후지에서는 꽃과 착과정도에서만 30%정도 감소하였으나 쓰가루, 홍로, 산사에서는 개화상태, 착과율 등에서 전혀 피해증상이 관찰되지 않았다. 약해를 받은 당년에 조생종 쓰가루와 중만생종후지 대상으로 각각 수확기 10일전에 사과 중 잔류량을 검사한 결과, 잔류량은 검출한계(0.04ppm) 미만이었다. 그리고 오용 2년 후(2009년)에는 후지, 쓰가루, 홍로, 산사 모두에서 약해증상이 나타나지 않았다. This study was conducted to investigate the phytotoxic reaction and the impact on the growth of apple fruit included the yield amount by misuse of non-selective herbicide, glufosinate-ammonium in apple field and for the study, 4 cultivars of apple were tested. The results showed that the highest phytotoxic degree was observed on Sansa-cultivar and then the degree was diminished on Tsugaru, Hongro and Fuji in order in the application year. In one year after application, the highest phytotoxic degree was showed on Fuji and then diminished on Tsugaru, Hongro and Sansa in order. However, in one year after application, the phytotoxic symptom was negligible in comparison with the degree in the year of application and the flowering and fruiting were reduced 30% only in Fuji, but in the other cultivars, the phytotoxic symptoms were not observed. Meanwhile, the residue of glufosinate-ammonium was below the detection limit as 0.04ppm in all tested cultivars and in 2years after application, the phytotoxic symptom was not observed in all cultivars of the apple.

비선택성 제초제 Glufosinate-ammonium 오용이 사과나무의 품종별 생육반응 및 수확에 미치는 영향

이인용,박용석,김성민,강철아,전병철,박재읍,Lee, In-Yong,Park, Yong-Seog,Kim, Sung-Min,Kang, Cheol-Ah,Chun, Byeong-Chul,Park, Jae-Eup 한국잡초학회 한국잔디학회 2010 Weed&Turfgrass Science Vol.31 No.3

비선택성 제초제인 글루포시네이트암모늄액제를 농작업자의 오판에 의한 오용으로 사과나무에 직접 살포된 경우 품종별, 수령별로 나타나는 약해반응과 수확에 미치는 영향을 조사하였다. 사과나무 품종에 따라 약해정도가 다르게 나타났다. 약제살포 당해연도에는 산사 > 쓰가루 > 홍로 > 후지 순으로, 약제살포 다음해에는 후지 > 쓰가루 > 홍로 > 산사 순으로 피해가 나타났으나, 그 피해정도는 당년에 비해 경미하였다. 이듬해, 후지에서는 꽃과 착과정도에서만 30%정도 감소하였으나 쓰가루, 홍로, 산사에서는 개화상태, 착과율 등에서 전혀 피해증상이 관찰되지 않았다. 약해를 받은 당년에 조생종 쓰가루와 중만생종후지 대상으로 각각 수확기 10일전에 사과 중 잔류량을 검사한 결과, 잔류량은 검출한계(0.04ppm) 미만이었다. 그리고 오용 2년 후(2009년)에는 후지, 쓰가루, 홍로, 산사 모두에서 약해증상이 나타나지 않았다. This study was conducted to investigate the phytotoxic reaction and the impact on the growth of apple fruit included the yield amount by misuse of non-selective herbicide, glufosinate-ammonium in apple field and for the study, 4 cultivars of apple were tested. The results showed that the highest phytotoxic degree was observed on Sansa-cultivar and then the degree was diminished on Tsugaru, Hongro and Fuji in order in the application year. In one year after application, the highest phytotoxic degree was showed on Fuji and then diminished on Tsugaru, Hongro and Sansa in order. However, in one year after application, the phytotoxic symptom was negligible in comparison with the degree in the year of application and the flowering and fruiting were reduced 30% only in Fuji, but in the other cultivars, the phytotoxic symptoms were not observed. Meanwhile, the residue of glufosinate-ammonium was below the detection limit as 0.04ppm in all tested cultivars and in 2years after application, the phytotoxic symptom was not observed in all cultivars of the apple.

한국인의 Epstein-Barr Virus 항체 양성률 변화양상에 대한 분석: 단일기관 연구

김수경,최준식,김동섭,강철인,정두련,백경란,강은숙,김예진,Kim, Su Kyung,Choi, Joon-Sik,Kim, Dongsub,Kang, Cheol-In,Chung, Doo Ryeon,Peck, Kyong Ran,Kang, Eun-Suk,Kim, Yae-Jean 대한소아감염학회 2020 Pediatric Infection and Vaccine Vol.27 No.2

Purpose: Epstein-Barr virus (EBV) infection is related to infectious mononucleosis or nasopharyngeal cancer, and its epidemiology may change according to the socioeconomic development of communities. This study aimed to evaluate the recent epidemiology of EBV seropositive rate in Korea. Methods: We retrospectively reviewed EBV serology test results obtained from a part of clinical care at Samsung Medical Center, Seoul, South Korea, from January 2000 to December 2017. Results: The EBV seropositive rate in 26,527 subjects during the study period was 81.0% (21,485/26,527): 44.4% (2,716/6,122) in subjects aged 0-9 years, 75.8% (2,077/2,739) in those aged 10-19 years, and 94.5% (16,692/17,666) in those aged ≥20 years. The EBV seropositive rate decreased from 89.4% (8,592/9,616) in 2000-2008 to 76.2% (12,893/16,911) in 2009-2017 (P<0.001). Especially, the EBV seropositive rate in subjects aged 0-19 years significantly decreased from 2000-2008 to 2009-2017 (0-9 years, 62.8% [1,172/1,866] in 2000-2008 and 36.3% [1,544/4,256] in 2009-2017; 10-19 years, 83.8% [745/858] in 2000-2008 and 70.8% (1,332/1,881) in 2009-2017) (P<0.001). Conclusions: The EBV seropositive rate in children has decreased in the last 20 years. As the age of patients with primary EBV infection increased, there is a need for interest in clinical manifestation, such as infectious mononucleosis, in adolescents and young adults.

황색포도알균에 의한 감염성 심내막염의 임상적 특성

백경란 ( Kyong Ran Peck ),송재훈 ( Jae Hoon Song ),김은석 ( Eun Seok Kim ),주은정 ( Eun Jeong Joo ),하영은 ( Young Eun Ha ),위유미 ( Yu Mi Wi ),정혜숙 ( Hae Suk Cheong ),이진서 ( Jin Seo Lee ),강철인 ( Cheol In Kang ),정두련 ( Doo 대한내과학회 2009 대한내과학회지 Vol.76 No.3

Background/Aims: The risk factors and clinical outcome of infective endocarditis (IE) have changed over the past few decades. Recently, the incidence of Staphylococcus aureus IE (SAIE) has increased. We investigated the clinical and microbiological characteristics and clinical outcomes of SAIE. Methods: All patient cases that were diagnosed as IE according to the modified Duke criteria in Samsung Medical Center during the period of January 1995 to December 2006 were reviewed retrospectively. The clinical and microbiological characteristics of patients with SAIE were compared to those of non-SAIE patients with IE. Results: We enrolled 304 patients with IE. Of these, 240 cases were IE culture-positive, including 73 cases of SAIE. The mean age of patients with SAIE was 48.15±19.87 years, with male patients accounting for 71.2% of our study group. Congenital heart disease (8.2%) was less common among SAIE patients. Hospital-acquired IE was significantly more common in SAIE than in non-SAIE cohorts (p<0.05). Surgical treatment was performed in 33 cases (45.2%). Valvular regurgitation with heart failure was the most frequent cause of surgery (39.3%). Twenty-three cases exhibited complications, including extra cardiac embolization (16.4%) and heart failure (5.6%). Fever persisting for a period longer than seven days was more common among those in the SAIE group. Twelve patients (16.4%) died and four patients (5.4%) were discharged without hope of improvement. The in-hospital mortality rate was higher among SAIE patients (17.3%) compared to that among non-SAIE patients (11%), although this comparison was not statistically distinct (p>0.05). Methicillin resistance and non-surgical treatment were significant risk factors for in-hospital mortality. Conclusions: SAIE is more strongly associated with systemic embolization, persistent fever, and longer hospital stays compared to non-SAIE. Further studies are warranted to evaluate adequate treatment and to improve the outcome of patients with SAIE. (Korean J Med 76:329-337, 2009)

증례 : 건강한 젊은 성인의 결핵성 흉막염에 합병한 폐동맥 혈전색전증 1예

강철인 ( Cheol In Kang ),최창민 ( Chang Min Choi ),이병호 ( Byung Ho Lee ),김승호 ( Seung Ho Kim ),최평균 ( Pyoeng Gyun Choe ),윤호일 ( Ho Il Yoon ) 대한내과학회 2007 대한내과학회지 Vol.72 No.1S

다제내성 그람음성균 감염의 항생제 치료

강철인 ( Cheol In Kang ) 대한내과학회 2015 대한내과학회지 Vol.88 No.5

The incidence of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has increased over the past decade and extensively drug-resistant (XDR) infections are now on the rise, especially in non-fermenters such as Pseudomonas and Acinetobacter species. Unfortunately, our therapeutic options for these pathogens are extremely limited. Infections due to antimicrobial-resistant bacteria are associated with a greater likelihood of inappropriate antimicrobial therapy, which has adverse effects on the outcomes of patients with serious infections. Physicians who are treating immunocompromised patients should be aware of not only the current epidemiological status of antimicrobial resistance but also appropriate antimicrobial therapy for MDR pathogens. Although carbapenems are considered a mainstay for the treatment of extended-spectrum beta-lactamase (ESBL) or AmpC β-lactamase-producing pathogens, antimicrobial stewardship for the appropriate use of carbapenems should be implemented to preserve these important antimicrobial agents. For carbapenem-resistant XDR infections, colistin and tigecycline could be considered a therapeutic option, based on the in vitro antibacterial spectrum, although the optimum treatment has not been established. This review provides a recent update of the antimicrobial therapeutic strategies for serious infections due to MDR or XDR Gram-negative bacteria, such as ESBL-producers and carbapenem-resistant pathogens. (Korean J Med 2015;88:502-508)

카바페넴 내성 그람음성균 감염의 항생제 치료

위유미 ( Yu Mi Wi ),강철인 ( Cheol-in Kang ) 대한내과학회 2018 대한내과학회지 Vol.93 No.5

Carbapenem-resistance emerging in Gram-negative pathogens, such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, has become a major human health problem globally. The therapeutic options available for carbapenem- resistant pathogens are very limited. Antibiotics such as colistin, tigecycline, fosfomycin, and aminoglycosides are often the only ones that can be used to treat carbapenem-resistant pathogens. Carbapenem may still be an option in certain circumstances. The administration of combination therapy for carbapenem-resistant pathogens is controversial. This review presents the current knowledge of available antimicrobial therapeutic options for infections due to carbapenem-resistant pathogens in Korea. (Korean J Med 2018;93:439-446)

결핵 발병시 근접 폭로 집단의 추후 활동성 결핵환자 발생 예측 지표에 관한 연구

최창민 ( Chang-min Choi ),강철인 ( Cheol-in Kang ),김희진 ( Hee-jin Kim ) 국군의무사령부 2006 대한군진의학학술지 Vol.37 No.1