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손경목,정두련,백진양,김소현,주은정,하영은,고관수,강철인,백경란,송재훈,김영호 대한의학회 2012 Journal of Korean medical science Vol.27 No.3
Panton-Valentine leukocidin (PVL)-positive USA300 clone has been the most successful community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone spreading in North America. In contrast, PVL-negative ST72-CA-MRSA has been predominant in Korea, and there has been no report of infections by the USA300 strain except only one case report of perianal infection. Here, we describe the first case of pneumonia caused by the USA300 strain following pandemic influenza A (H1N1) in Korea. A 50-year-old man was admitted with fever and cough and chest radiograph showed pneumonic consolidation at the right lower lung zone. He received a ventilator support because of respiratory failure. PCR for pandemic influenza A (H1N1) in nasopharyngeal swab was positive, and culture of sputum and endotracheal aspirate grew MRSA. Typing of the isolate revealed that it was PVL-positive, ST 8-MRSA-SCCmec type IV. The analysis of the PFGE patterns showed that this isolate was the same pulsotype as the USA300 strain.
손경목,Sung-Gwon Lee,김현지,Shin hyea Cheon,정형석,이주연,김인수,프라산타 실왈,김영재,Seungwha Paik,정재욱,Chungoo Park,김연숙,조은경 대한의학회 2020 Journal of Korean medical science Vol.35 No.38
Background: Observational studies of the ongoing coronavirus disease 2019 (COVID-19) outbreak suggest that a ‘cytokine storm’ is involved in the pathogenesis of severe illness. However, the molecular mechanisms underlying the altered pathological inflammation in COVID-19 are largely unknown. We report here that toll-like receptor (TLR) 4-mediated inflammatory signaling molecules are upregulated in peripheral blood mononuclear cells (PBMCs) from COVID-19 patients, compared with healthy controls (HC). Methods: A total of 48 subjects including 28 COVID-19 patients (8 severe/critical vs. 20 mild/ moderate cases) admitted to Chungnam National University Hospital, and age/sex-matched 20 HC were enrolled in this study. PBMCs from the subjects were processed for nCounter Human Immunology gene expression assay to analyze the immune related transcriptome profiles. Recombinant proteins of severe acute respiratory syndrome coronavirus-2 (SARS- CoV-2) were used to stimulate the PBMCs and monocyte-derived macrophages, and real-time polymerase chain reaction was performed to quantify the mRNA expressions of the pro- inflammatory cytokines/chemokines. Results: Among the most highly increased inflammatory mediators in severe/critically ill patients, S100A9, an alarmin and TLR4 ligand, was found as a noteworthy biomarker, because it inversely correlated with the serum albumin levels. We also observed that recombinant S2 and nucleocapsid proteins of SARS-CoV-2 significantly increased pro- inflammatory cytokines/chemokines and S100A9 in human primary PBMCs. Conclusion: These data support a link between TLR4 signaling and pathological inflammation during COVID-19 and contribute to develop therapeutic approaches through targeting TLR4-mediated inflammation.
지역 사회에서 발생한 ESBL 생성 E. coli에 의한 치골결합 골수염 1예
손경목,김연숙,천신혜,정현,구선회,황득수 대한감염학회 2011 Infection and Chemotherapy Vol.43 No.3
Osteomyelitis of the pubic symphysis or pubic osteomyelitis is a rare disease entity. Predisposing factors include trauma, pelvic or urologic surgery, intravenous drug abuse, pelvic malignancy, parturition and cardiac catheterization. Pathogens vary depending on the risk factors. The most frequent causative organism is Staphylococcus aureus . Gram-negative bacteria such as Pseudomonas aeruginosa and Escherichia coli are also common pathogens. However, pubic osteomyelitis due to community-onset extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has not previously been described. We present a patient with pubic osteomyelitis caused by ESBL-producing Escherichia coli without known predisposing factors except for diabetes.
주종석,손경목,지미숙,김연숙,천신혜,송창헌,신해진,김기대 조선대학교 의학연구소 2014 The Medical Journal of Chosun University Vol.39 No.3
Melioidosis, an infectious disease caused by the facultative intracellular gram-negative bacillus Burkholderia pseudomallei, is geographically restricted to Southeast Asia and Northern Australia. It commonly affects patients with underlying medical disease, such as diabetes mellitus or renal failure. In South Korea, only six cases of melioidosis have been reported in the literature. However, none of the patients had chronic kidney disease. We report on a case of melioidosis presenting as septicemic pneumonia in a 48-year old man undergoing hemodialysis. He was a returning traveler from Thailand.
기현균,손경목,위유미,이지영,문치숙,오원섭,백경란,송재훈,김성주,조재원,이석구,고영혜 대한감염학회 2006 Infection and Chemotherapy Vol.38 No.3
Background : Post-transplantation lymphoproliferative disorder (PTLD) after liver transplantation is a rare but potentially fatal disease. Clinical manifestations and prevalence of PTLD after liver transplantation in Korea have not been investigated thoroughly. Materials and Methods : A retrospective chart review was done for 284 liver transplant recipients at Samsung Medical Center, Seoul, Korea during the period from 1996 to 2003. Results : The incidence of PTLD after liver transplantation was 3.9% (11/284). PTLDs were more prevalent in children (9/55, 16.4%) than in adults (2/237, 0.9%; P<0.01). Among the PTLD patients, four cases were male (36.3%) and seven were female (63.7%). Median time from the transplantation to PTLD diagnosis was 9 months. The type of PTLD was as follows : early lesion (6 cases, 54.5%), polymorphic PTLD (3 cases, 27.3%), and B cell lymphoma (2 cases, 18.2%). PTLDs were more prevalent in the patients with cyclosporine use (OR 13.28, 95% CI : 1.29-136.31, P=0.03), acute rejection (OR 5.63, 95% CI : 1.03-30.62, P=0.04), and negative serology for EBV VCA IgG (OR 19.15, 95% CI : 1.99-183.98, P=0.01) by multivariate logistic regression. Three patients (27.3%) died of B cell lymphoma (2 cases) and polymorphic PTLD (1 case). The remaining patients were improved with reduction of immunosuppression and treatment with acyclovir. Conclusion : The incidence of PTLD was high in children. The risk factors of PTLD were negative serology for EBV VCA IgG, history of acute rejection, and cyclosporine use. Considering the poor prognosis of PTLD, effective strategies for prevention and early diagnosis for early treatment should be emphasized. 목 적 : 이식 후 발생하는 림프구 증식질환 (Post- transplantation lymphoproliferative disorder, PTLD)은 환자에게 치명적일 수 있는 합병증이지만 국내에서 간이식 후 PTLD 보고례가 많지 않아 이에 대한 임상적인 양상을 분석하였다.재료 및 방법 : 삼성서울병원 이식외과에서 1996년부터 2003년까지 간이식을 시행받은 총 284명의 환자들을 대상으로 후향적 연구를 진행하였다.결 과 : 총 284명의 간이식례 중 PTLD가 발생한 경우는 11례로 3.9%의 발생률을 보였다. 성인의 발생률은 0.9%, 소아의 발생률은 16.4%로 소아에서 발생률이 높았다. 남자가 4명, 여자가 7명이었고 이식 후 PTLD 발생까지의 중앙값은 9개월이었다. PTLD의 유형으로는 초기 병변이 6례, polymorphic PTLD가 3례, B cell lymphoma가 2례였으며 B cell lymphoma 환자 2명과 polymorphic PTLD 환자 1명은 사망하였다. PTLD의 발생과 관련된 요인으로는 cyclosporine 사용(OR 13.28, 95% CI : 1.29- 136.31, P=0.03), 급성 거부반응(OR 5.63, 95% CI : 1.03- 30.62, P=0.04), EBV-VCA IgG 음성인 환자(OR 19.15, 95% CI : 1.99-183.98, P=0.01)에서 발생빈도가 높았다.