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건강인에서 결핵균 30-kDa항원이 말초혈액 임파구증식에 미치는 영향
최대경,고석신,김화중,조은경,백태현,신철식 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1
T lymphocytes are thought to play a central role in cell mediated immune response. To Study the T lymphocyte proliferative response to 30-kDa antigen purified from Mycobacterium tuberculosis H37Rv, peripheral blood lymphocytes isolated from healthy subjects were stimulated with the 30kDa antigen, crude antigen or PHA. Healthy subjects were divided into three groups so that PPD(+), PPD(±) and PPD(-). The proliferations of lymphocytes were measured by the incroporation of ^3H-thyrnidine. The results were summarized as follows: 1. For the PPD(+) person, at concentration of < 1 ㎍/ml, the proliferative response to 30-kDa antigen resulted in a mild reduction but crude antigen showed relatively rapid reduction. For the PPD(-) person, decreasing the concentration of the both antigens showed rapid reduction of proliferation 2. The lymphocytes proliferations to 30-kDa antigen and crude antigen were significantly increased in PPD(+) group when compared to those in PPD(-) group, but PHA response was no significant difference. 3. The sensitivity and specificity of lymphocyte proliferation assay to 30-kDa antigen and crude antigen when compared with skin test results were 92.3%, 100% and 76.9%, 50%, respectively.
신철식,임영재,김영준,고석신,김문식,Shin, Cheol-Shick,Im, Young-Jae,Kim, Young-Jun,Koh, Seok-Shin,Kim, Moon-Shik 대한결핵및호흡기학회 1992 Tuberculosis and Respiratory Diseases Vol.39 No.2
PTA, CS, PAS, SM (KM 또는 TUM) 4제 요법의 임상효과를 알고자 지난 5년동안 국립 공주 병원에 입원하였던 도말양성 환자중 추적 가능한 112명을 대상으로 한 조사에서 다음과 같은 결과를 얻었다. 균 도말검사상 64%가 음전을 나타내었고 그 시기는 85%가 3개월 이내에 이루어졌다. 방사선 소견은 반응이 없는 경우가 약 반 정도이었으며, 세균학적 검사를 함께 고려하여 판단할 때 62% 정도만이 양호한 결과를 나타내었다. 양호한 결과는 병력이 짧고 내성정도가 적을수록 좋았다. 그리고 병력이 오래된 환자의 재치료 처방은 적어도 3제 이상의 감수성을 가진 약제를 선택해야 되며, 두가지 이하의 감수성이 있는 경우는 INH 단독 요법등의 고려가 필요할 것으로 사료된다. Background:In the management of patients whose primary chemotherapy has failed, very careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow-up of 112 smear positive cases, who were treated by four-drug regimen between July 1985 and June 1990. Four drugs were, namely prothionamide, cycloserine, para-aminosalicylic acid, and streptomycin (kanamycin or tuber-actinomycin). The duration of follow-up was over one year. Results: 1) Out of 112 cases with positive sputum AFB smear, 72 (64%) achieved the negative conversion. 2) Among the 72 patients, 85% achieved negative conversion within 3 months after treatment. 3) When the duration of patient's illness was less than 2 years, 2 to 4 years and more than 5 years, the favourable response to retreatment was 86%, 62% and 54%, respectively. 4) When the number of sensitive drugs was 4,3,2 and 1, the favourable response rate was 74%, 68%, 39% and 0%, respectively. Conclusion: The shorter the duration of patient's illness was, the larger the number of sensitive drugs was. And the larger the number of sensitive drugs was, the better the result of treatment was. Thus it is very crucial to successfully treat newly discovered patients with adequate regimens and proper case-holding.
김진수,이기남,이종현,문준일,고석신 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.1
Several methods for the management of intractable pain for various conditions including malignant disorders, herpes zoster, and low back pain and/or sciatica in 80 patients were described and analyzed. Neurolytic blodks of celiac plexus were given to the patienta suffering from intra-abdominal pain from malignant origin or chronic pancreatitis. Herpes zoster was treated mainly by chemical sympathectomy via paravertebral route and occassionaly corticosteroid was administered epidurally with the local anesthetic, bupivacaine. All the patients with low back pain and/or sciatica were given epidural corticosteroid one to three times. Other peripheral verve blocks and regional corticosteroid therapy were given to the rest of the patients. Fair to excellent result was obtained in 71% of the patients but the response was poor in the remaining 28% of the patients. It seems that the earlier the patients were referred to the pain clinic, the better the results were.
이기남,이종현,문준일,고석신,염승수 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.2
Pneumothorax was recognized as a potential hazard of mechanical ventilation shortly after the introduction of the technique of tracheal intubation in the 19 th century. Because the gases used in anesthesia are delivered from cylinders and wall outlets at higher than atmospheric pressure, the possibility of camage to the lung is ever present. Immediate, prompt and adequate management of bilateral tension pneumothorax are essential, otherwise the patient dies rapidly. We had a case of bilateral tension pneumnthorax in a 3 year-old boy who underwent a B-E amputation of a severely crushed hand. We report this case along with a review of the literature on pneumothorax.