The role of third-generation cephalosporin for hospital acquired spontaneous bacterial peritonitis in patients with liver cirrhosis

허중연 ( Jung Yeon Heo ) 대한간학회 2017 간학회 싱글토픽 심포지움 Vol.2017 No.2

코로나바이러스감염병-19 초기 유행의 임상 역학적 특성

허중연 ( Jung Yeon Heo ) 대한내과학회 2020 대한내과학회지 Vol.95 No.2

In December 2019, a novel coronavirus, which is now designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified as the etiology of pneumonia of unknown cause in patients from Wuhan of central China. Since the first report of coronavirus disease 2019 (COVID-19), the disease became pandemic causing the large-scale outbreak all over the world. In this review, we discuss the clinical and epidemiological characteristics of COVID-19 in the early stage of outbreak based on recent reports from China. (Korean J Med 2020;95:67-73)

한국 훈련병에서 수막염균 보균에 대한 4가 수막염균 결합 백신의 영향

허중연 ( Jung Yeon Heo ),배송미 ( Song-mee Bae ),정희진 ( Hee Jin Cheong ),김우주 ( Woo Joo Kim ),김민영 ( Min Young Kim ),나원웅 ( Wonwoong Na ),최강원 ( Kang-won Choe ),천병철 ( Byung Chul Chun ) 국군의무사령부 2014 대한군진의학학술지 Vol.45 No.1

Background: Monovalent meningococcal conjugate vaccines against serogroup A or C had resulted in significant reduction of pharyngeal carriage rates against respective vaccine serogroup. However, the effect of quadrivalent meningococcal conjugate vaccine on meningococcal carriage has not been evaluated. We assessed on changing pharyngeal carriage rate of Neisseria meningitidis after the introduction of quadrivalent meningococcal conjugate vaccine in Korean military trainees. Methods: Twice oropharyngeal swabs were conducted at the beginning and end of army training period in Korean military trainees. First oropharyngeal swabs were undertaken prior to vaccination. Second round of swabbing was done 5 weeks later. Results: In 2013, overall carriage rate of N. meningitidis was higher at the end of training period (13.8%, 60 of 434 participants) than on entry of military service (8.9%, 39 of 434 participants). Although carriage rate of nongroupable and serogroup X isolates were increased over 5-week interval, carriage strains of vaccine serogroup, which were included serogroups in quadrivalent meningococcal vaccine, were relatively reduced from 7 to 2 isolates following vaccination. However, in 2014, overall carriage rate of N. meningitidis was significantly lower at the end of training period (5.2%, 23 of 443 participants) than on entry of military service (12.6%, 56 of 443 participants) (p=0.028). Carriage isolates of vaccine serogroups were significantly decreased with that of non-vaccine serogroup B over 5-week interval (p=0.006). Conclusion: Meningococcal vaccination in Korean military trainees resulted in reduction of pharyngeal carriage rates of not only vaccine serogroup meningococci but non-vaccine serogroup B. Quadrivalent meningococcal conjugate vaccine is likely to preventing carriage acquisition of meningococci in a closed population.

산업안전보건 영역에서 다국적 기업의 이중 기준 적용실태와 영향요인

기명,이준영,박희찬,윤석준,김남훈,허중연,최재욱,Ki, Myung,Lee, June-Young,Park, Hee-Chan,Yoon, Seok-Joon,Kim, Nam-Hoon,Heo, Jung-Yeon,Choi, Jae-Wook 대한예방의학회 2004 예방의학회지 Vol.37 No.1

Objectives : We intended to evaluate the double standard status and to identify factors of determining double standard criteria in multinational corporations of Korea, and specifically those in the occupational health and safety area. Methods : A postal questionnaire had been sent, between August 2002 and September 2002, to multinational corporations in Korea. A double standard company was defined as those who answered in more than one item as adopting a different standard among the five items regarding double standard identification. By comparing double standard companies with equivalent standard companies, determinants for double standards were then identified using logistic regression analysis. Results : Of multinational corporations, 45.1% had adopted a double standard. Based on the question naire's scale level, the factor of 'characteristic and size of multinational corporation' was found to have the most potent impact on increasing double standard risk. On the variable level, factors of 'number of affiliated companies' and 'existence of an auditing system with the parent company' showed a strong negative impact on double standard risk. Conclusion : Our study suggests that a distinctive approach is needed to manage the occupational safety and health for multinational corporations. This approach should be focused on the specific level of a corporation, not on a country level.

2기 매독 환자에서 발생한 간질성 폐렴 양상의 Jarisch-Herxheimer 반응 1예

허중연,노지윤,김미정,최원석,조유미,송준영,정희진,김우주 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Jarisch-Herxheimer reaction (JHR) is a self-limited, acute febrile hypersensitivity reaction that occurs after antibiotic therapy against spirochetes disease. When occurring in the text of syphilis therapy, the JHR begins typically 1-2 hour after the administration of penicillin and is characterized by fever, chills, myalgias, and exacerbation of skin lesions. Rarely, severe JHR can occur in the form of endocarditis, fulminant hepatitis, and hypersensitivity pneumonitis. Recently, we experienced an interesting case of JHR complicated by the hypersensitivity pneumonitis after treating secondary syphilis. Proper differential diagnosis is required to differentiate this reaction from drug-induced hypersensitivity reaction.

Voriconazole로 치료한 침습성 아스페르길루스부비동염 1예

은채령,허중연,노지윤,윤영경,이현주,신봉경,이재갑,송준영,정희진,김우주 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

두개저를 침범한 침습성 아스페르길루스증은 드물지만 이환되었을 경우 사망률이 높은 심각한 질환이다. 하지만, 임상양상이 비 특이적이기 때문에 진단이 쉽지 않고, 치료 방법이 명확하게 확립되어 있지 않다. 제 2형 당뇨병력이 있는 52세 여자 환자가 우안 시력 저하 및 우측 안구통 주소로 내원하였다. 뇌 자기공명영상 촬영에서 부비동-안와를 포함하고 두 개저까지 침범한 병변을 확인하였고 치료 및 진단적 수술을 통해서 침습성 아스페르길루스증을 진단하였다. 진단 후 amphotericin B로 치료를 시작하였으나 치료 반응이 좋지 않아 vohconazole로 치료 약제를 변경하였다. Voriconazole은 1일 째에 300 mg씩 2회 부하 용량으로 정맥 투여한 후, 총 7주간 200 mg씩 1일 2회 정맥 투여하고, 이어서 총 7주간 200mg씩 1일 2회 경구 투여하였다. 뇌 자기공명영상으로 치료 반응을 추적 관찰하였으며, 치료 종료 1년 후까지 추적한 결과 임상 소견 및 영상 검사 결과 모두 호전된 것을 확인하였다. 당뇨 환자에서 발생한 두개저를 침범한 침습성 아스페르길루스증에 대해서 종괴에 대한 조대술(marsupialization) 후 voriconazole 3개월 치료로 완치를 보인 증례를 문헌고찰과 함께 보고하는 바이다. Skull base-invading, invasive aspergillosis is rare, but it is a potentially life-threatening disease. Nevertheless, the standard method and the optimal duration of treatment are not known yet. A 52-year-o1d female diabetic patient complained of ophthalmalgia and decreased visual acuity. MRI and CT scan revealed an enhancing mass in the right orbital fissure and showed an infiltratina process in the skull base around the right orbit apex and paranasal sinuses. The histological investigation revealed invasive aspergillosis of paranasal sinuses and the skull base. Clinical improvement occurred after marsupialization and post-operative systemic antifungal therapy with voriconazole for 14 weeks. We suggest that voriconazole treatment could show effective results for invasive aspergillosis of skull base and paranasal sinuses.

A Case of Disseminated Tuberculosis with Miliary Central Nervous System Tuberculoma

Noh, Ji Yun,Heo, Jung Yeon,Lee, Kwang Gyun,Yoon, Young Kyung,Lee, Jacob,Song, Joon Young,Cheong, Hee Jin,Kim, Woo Joo 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Disseminated tuberculosis occurs through lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli. The exact incidence of disseminated tuberculosis is still unknown and its diagnosis presents a challenge since the symptoms are not specific of the disease. Brain tuberculoma is one of the complications of tuberculosis. The literary review of brain tuberculoma shows that it mainly occurs in the cerebrum and cerebellum, whereas involvement of the brainstem is rare. Recently, we have experienced a case of 46-year-o1d man with fever of 2 months duration who was diagnosed with disseminated tuberculosis with miliary central nervous system (CNS) tuberculomas; brain tuberculomas were found even in the brainstem and the spinal cord. Pulmonary, intestinal, renal, and choroidal involvements were also noted.

대유행 인플루엔자(H1N1 2009)의 역학, 임상적 특성 : 일개 거점병원의 경험

노지윤,임선영,허중연,최원석,송준영,정희진,김우주 대한감염학회 2010 감염과 화학요법 Vol.42 No.2

Background: Since early outbreaks in North America in April 2009, the new influenza virus spread rapidly all over the world, and WHO declared a pandemic in June 2009. The objective of this article is to describe the epidemiological and clinical characteristics of patients confirmed with pandemic influenza (H1N1 2009). Material and Methods: Among all patients confirmed with pandemic influenza (H1N1 2009) in Korea University Guro Hospital from 2 May 2009 to 31 March 2010, we selected 10% of patients aged more than 15 years randomly. Medical records were reviewed retrospectively and clinical findings were analyzed: social history, underlying disease, initial symptoms, and clinical course. Comparative analysis of initial symptoms was performed by time to presentation and age groups: 15-29 years, 30-49 years, 50-59 years, and more than 60 years. In addition, we described fatal cases of pandemic influenza (H1N1 2009). Results: From 2 May 2009 to 31 March 2010, total number of laboratory-confirmed cases of pandemic influenza (H1N1 2009) was 7,888. The most cases (1,632) developed at epidemic week 46, 2009. The median age of patients was 13 years and more than half of patients (55.4%) were less than 15 years. The median time to presentation was 1 day from onset of symptom. Clinical symptoms were cough (86.9%), sore throat (69.4%), myalgia (63.3%), chill (60.6%), rhinorrhea (57.7%), headache (57.6%), nausea or vomiting (27.4%), and diarrhea (9.3%). Fever was noted more frequently at 15-29 years group than ≥30 years group. Antiviral agent was administered to 274 patients (77.8%): 267 cases with oseltamivir and 7 cases with zanamivir. The median time to administration was 2 days and mean time to defervescence was 3 days. Cough was the most persistent symptom: initial visit (94.1%), on third day (82.4%), and on sixth day (52.9%) by the serial follow up at the same patients. Case fatality rate was 0.05%, and all fatal cases occurred in patients aged ≥50 years. Conclusions: Children and adolescents were the most affected group. Clinical symptoms were similar to seasonal influenza. Gastrointestinal symptoms were relatively common, and cough was the most long-lasting symptom.

대장암 환자에서 발생한 Clostridium septicum에 의한 감염성 대동맥류 파열 1예

최혜윤,박정원,노지윤,허중연,김미정,최원석,조유미,송준영,김우주,정희진 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Infected aortic aneurysm a life-threatening disease entity. Clostridium septicum is a very rare pathogen of infected aneurysms that carries a high mortality rate and demonstrates a strong association with derlying colonic or hematologic neoplasm. Herein, we report a case of ruptured aortic aneurysm infected by C. septicum in a patient with colon cancer. This is the first reported case of infected aneurysm caused by C. septicum in Korea. Early diagnosis, appropriate antibiotic therapy, and prompt surgical interventions are required considering the rapid downhill progression of C. septicum-induced infected aneurysm.