포스터 전시 : 감염, 알레르기 ; 경구 amoxicillin에 의한 아나필락시스 1예

홍경욱,박용범,반준우,이재영,모은경,정기석 대한내과학회 2005 대한내과학회 추계학술대회 Vol.69 No.10

급성 골수성 백혈병 환자에서 발생한 아스페르길루스 및 Enterococcus faecium 간 농양: 증례보고 및 문헌고찰

홍경욱,권재철,전현지,이동건,김희제,민우성 대한감염학회 2011 Infection and Chemotherapy Vol.43 No.4

We report a case of liver abscess caused by Aspergillus and Enterococcus faecium in a patient with acute myeloid leukemia. As far as we know, this is the first case of hepatic aspergillosis in Korea. After remission induction chemotherapy, the female patient presented with abdominal pain and was found to have liver abscess. The patient was treated with antibiotics against E. faecium, which was isolated from the abscess drainage. However, the therapeutic response was unsatisfactory and a left lateral sectionectomy of the liver was conducted after 21 days of treatment. The liver tissue showed typical pathologic findings of aspergillosis and voriconazole was administered. Allogeneic hematopoietic stem cell transplantation was performed successfully after 4 months. The possibility of aspergillosis should be considered when an immunocompromised patient with hepatic abscess poorly responds to the use of broad spectrum antibiotics.

삼일열 말라리아에 합병된 비장 파열 1예

홍경욱,이정아,김원진,박철민,권혜리,박혜원,엄중식 대한감염학회 2007 Infection and Chemotherapy Vol.39 No.5

Plasmodium vivax has been the predominant Plasmodium species in the Republic of Korea and reemerged in 1993. Spontaneous rupture of malarial spleen is a rare but important complication associated with P. vivax infection. Only one case of spontaneous rupture of malarial spleen was reported in Korea in 1999. Splenectomy is still accepted as the treatment of choice in cases of spontaneous rupture of the spleen. But, considering increased risk of postsplenectomy infecion, splenectomy should be reserved for those patients with severe rupture or those with continued or recurrent bleeding. And conservative treatment should be considered in selected, closely monitored patients. We report a patient with P. vivax malaria who developed a spontaneous splenic rupture and was improved by conservative treatment. 국내의 토착형 말라리아는 삼일열 말라리아로, 1993년부터 재유행이 시작되었다. 말라리아의 중요한 합병증으로 드물지만 비장 파열이 있는데, 이는 주로 삼일열 말라리아에 의해서 발생되며, 국내에서는 1999년 말라리아에 의한 비장 파열로 비장 절제술을 시행한 예가 보고된 바 있다. 현재까지는 비장 파열이 있을 때 비장 절제술이 일차적인 치료로 되어 있으나, 비장 절제술 후의 감염 위험성이 크므로, 활력 징후가 불안정하거나, 출혈이 지속되는 소견이 보이지 않으면 가급적 보존적 치료를 하는 것이 추천된다. 저자들은 비장 파열이 동반된 말라리아 환자에서 비장 절제술을 시행하지 않고 보존적 치료로 호전된 예를 경험하여 보고하는 바이다.

Transient phosphorylation of tumor associated microtubule associated protein (TMAP)/cytoskeleton associated protein 2 (CKAP2) at Thr-596 during early phases of mitosis

홍경욱,최용복,Jung-Hwa Lee,Hyun-Jun Kim,Hye-Rim Kwon,성연선,김흥태,박주배,배창대,홍경만 생화학분자생물학회 2008 Experimental and molecular medicine Vol.40 No.4

Tumor associated microtubule associated protein (TMAP), also known as cytoskeleton associated protein 2 (CKAP2) is a mitotic spindle-associated protein whose expression is cell cycle-regulated and also frequently deregulated in cancer cells. Two monoclonal antibodies (mAbs) against TMAP/CKAP2 were produced: B-1-13 and D-12-3. Interestingly, the reactivity of mAb D-12-3 to TMAP/CKAP2 was markedly decreased specifically in mitotic cell lysate. The epitope mapping study showed that mAb D-12-3 recognizes the amino acid sequence between 569 and 625 and that phosphorylation at T596 completely abolishes the reactivity of the antibody, suggesting that the differential reactivity originates from the phosphorylation status at T596. Immunofluorescence staining showed that mAb D-12-3 fails to detect TMAP/CKAP2 in mitotic cells between prophase and metaphase, but the staining becomes evident again in anaphase, suggesting that phosphorylation at T596 occurs transiently during early phases of mitosis. These results suggest that the cellular functions of TMAP/CKAP2 might be regulated by timely phosphorylation and dephosphorylation during the course of mitosis.

Lower Respiratory Tract Diseases Caused by Common Respiratory Viruses among Stem Cell Transplantation Recipients: A Single Center Experience in Korea

홍경욱,이동건,최수미,조성연,이효진,최재기,김시현,박선희,최정현,유진홍,이종욱 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.2

Purpose: To describe the incidence, clinical courses, and risk factors for mortality of lower respiratory tract diseases (LRDs) caused by common respiratory viruses (CRVs) in stem cell transplantation (SCT) recipients. Materials and Methods: We retrospectively reviewed the medical records of 1038 patients who received SCT between January 2007 and August 2011 at a single center in Korea. Results: Seventy-one CRV-LRDs were identified in 67 (6.5%) patients. The human parainfluenza virus (HPIV) was the most commoncausative pathogen of CRV-LRDs at 100 days [cumulative incidence estimate, 23.5%; 95% confidence interval (CI), 3.3–43.7] and 1 year (cumulative incidence estimate, 69.2%; 95% CI, 45.9–92.5) following SCT. The 30-day overall mortality rates due to influenza-LRDs, respiratory syncytial virus-LRDs, HPIV-LRDs, and human rhinovirus-LRDs were 35.7, 25.8, 31.6, and 42.8%, respectively. Co-pathogens in respiratory specimens were detected in 23 (33.8%) patients. The overall mortality at day 30 after CRV-LRD diagnosis was 32.8% (22/67). High-dose steroid usage (p=0.025), a severe state of immunodeficiency (p=0.033), and lymphopenia (p=0.006) were significantly associated with death within 30 days following CRV-LRD diagnosis in a univariate analysis. Multivariate logistic regressionanalysis revealed that high-dose steroid usage [odds ratio (OR), 4.05; 95% CI, 1.12–14.61; p=0.033] and lymphopenia (OR, 6.57; 95% CI, 1.80–24.03; p=0.004) were independent risk factors for mortality within 30 days of CRV-LRDs. Conclusion: CRV-LRDs among SCT recipients showed substantially high morbidity and mortality rates. Therefore, the implement of an active diagnostic approaches for CRV infections is required for SCT recipients with respiratory symptoms, especially those receivinghigh-dose steroids or with lymphopenia.

삼일열 말라리아에 합병된 비장 파열 1예

홍경욱,이정아,김원진,박철민,권혜리,박혜원,엄중식 대한감염학회 2007 감염과 화학요법 Vol.39 No.5

국내의 토착형 말라리아는 삼일열 말라리아로, 1993년부터 재유행이 시작되었다. 말라리아의 중요한 합병증으로 드물지만 비장 파열이 있는데, 이는 주로 삼일열 말라리아에 의해서 발생되며, 국내에서는 1999년 말라리아에 의한 비장 파열로 비장 절제술을 시행한 예가 보고된 바 있다. 현재까지는 비장 파열이 있을 때 비장 절제술이 일차적인 치료로 되어 있으나, 비장 절제술 후의 감염 위험성이 크므로, 활력 징후가 불안정하거나, 출혈이 지속되는 소견이 보이지 않으면 가급적 보존적 치료를 하는 것이 추천된다. 저자들은 비장 파열이 동반된 말라리아 환자에서 비장 절제술을 시행하지 않고 보존적 치료로 호전된 예를 경험하여 보고하는 바이다. Plasmodium vivax has been the predominant Plasmodium species in the Republic of Korea and reemerged in 1993. Spontaneous rupture of malarial spleen is a rare but important complication associated with P. vivax infection. Only one case of spontaneous rupture of malarial spleen was reported in Korea in 1999. Splenectomy is still accepted as the treatment of choice in cases of spontaneous rupture of the spleen. But, considering increased risk of postsplenectomy infecion, splenectomy should be reserved for those patients with severe rupture or those with continued or recurrent bleeding. And conservative treatment should be considered in selected, closely monitored patients. We report a patient with P. vivax malaria who developed a spontaneous splenic rupture and was improved by conservative treatment.

Characterization of mitosis-specific phosphorylation of tumor-associated microtubule-associated protein

홍경욱,Hyun-Jun Kim,배창대,박주배 생화학분자생물학회 2009 Experimental and molecular medicine Vol.41 No.11

Tumor-associated microtubule-associated protein (TMAP), also known as cytoskeleton associated protein 2 (CKAP2), has been recently shown to be involved in the assembly and maintenance of mitotic spindle and also plays an essential role in maintaining the fidelity of chromosome segregation during mitosis. We have previously reported that TMAP is phosphorylated at multiple residues specifically during mitosis, and characterized the mechanism and functional importance of phosphorylation at one of the mitosis-specific phosphorylation residues (i.e., Thr-622). However, the phosphorylation events at the remaining mitotic phosphorylation sites of TMAP have not been fully characterized in detail. Here, we report on generation and characterization of phosphorylated Thr-578- and phosphorylated Thr-596-specific antibodies. Using the antibodies, we show that phosphorylation of TMAP at Thr-578 and Thr-596 indeed occurs specifically during mitosis. Immunofluorescent staining using the antibodies shows that these residues become phosphorylated starting at prophase and then become rapidly dephosphorylated soon after initiation of anaphase. Subtle differences in the kinetics of phosphorylation between Thr-578 and Thr-596 imply that they may be under different mechanisms of phosphorylation during mitosis. Unlike the phosphorylation- deficient mutant form for Thr-622, the mutant in which both Thr-578 and Thr-596 had been mutated to alanines did not induce significant delay in progression of mitosis. These results show that the majority of mitosis-specific phosphorylation of TMAP is limited to pre-anaphase stages and suggest that the multiple phosphorylation may not act in concert but serve diverse functions.

Tako-Tsubo Cardiomyopathy by Transient Dynamic Left Midventricular Obstruction

홍경욱,박대균,최현희,김성은,윤덕형,이준희,한규록,오동진 대한심장학회 2009 Korean Circulation Journal Vol.39 No.1

A 48-year-old woman visited the emergency department with shock due to a urinary tract infection. The patient, who had a history of hypertension and diabetes mellitus, presented with precordial ST-segment elevation and Q waves, along with an increase of cardiac enzymes. An echocardiography showed moderately reduced systolic function, severe apical left ventricular ballooning, and a dynamic left ventricular outflow tract obstruction with a pressure gradient of 109 mmHg. Coronary angiography demonstrated normal coronary arteries. At the 1-month echocardiographic follow-up, the apical ballooning and left ventricular systolic function had recovered completely. There was no residual left ventricular intra-cavity gradient at rest, but it was induced in low-dose dobutamine stress-echocardiography. We demonstrated that dynamic left midventricular obstruction in the setting of either increased catecholamine stress or hypovolemia could develop Tako-tsubo cardiomyopathy. A 48-year-old woman visited the emergency department with shock due to a urinary tract infection. The patient, who had a history of hypertension and diabetes mellitus, presented with precordial ST-segment elevation and Q waves, along with an increase of cardiac enzymes. An echocardiography showed moderately reduced systolic function, severe apical left ventricular ballooning, and a dynamic left ventricular outflow tract obstruction with a pressure gradient of 109 mmHg. Coronary angiography demonstrated normal coronary arteries. At the 1-month echocardiographic follow-up, the apical ballooning and left ventricular systolic function had recovered completely. There was no residual left ventricular intra-cavity gradient at rest, but it was induced in low-dose dobutamine stress-echocardiography. We demonstrated that dynamic left midventricular obstruction in the setting of either increased catecholamine stress or hypovolemia could develop Tako-tsubo cardiomyopathy.

간 이식 환자에서 발생한 아스페르길루스 심내막염 1예

홍경욱 ( Kyung Wook Hong ),이정아 ( Jeong A Lee ),박혜원 ( Hye Won Park ),권혜리 ( Hye Lee Kwon ),조성진 ( Seong Jin Cho ),김재석 ( Jae Seok Kim ),엄중식 ( Joong Sik Eom ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1

최근 장기 이식과 그 이후의 면역 억제제 복용에 의한 면역저하, 심장 수술, 후천성 면역 결핍증, 항암제, 장기간의 항생제 사용, 약물 남용 등의 선행 요인이 증가하면서 진균에 의한 심내막염의 빈도도 늘고 있다. 그러나 진균에 의한 심내막염은 혈액배양에서의 균 동정률이 낮아 진단과 치료가 지연되는 경우가 많다. 저자들은 간 이식을 받은 후 면역억제제 복용 중 심내막염을 진단 받았으나 경험적 항생제 요법에 호전되지 않아 인공판막 치환술을 시행한 뒤 사망한 환자에서, 증식편 배양검사 및 조직검사에서 아스페르길루스 감염이 의심되어서 증식편 조직에 있는 진균DNA의 염기서열을 분석하여 Aspergillus fumigatus를 확인했던 아스페르길루스 심내막염 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다. It is known that the incidence of fungal endocarditis is increasing as the precipitating factors, such as organ transplantation, use of immunosuppressive agents, previous cardiac surgery, AIDS, chemotherapy, and long-term antibiotic use are on the rise. However, the diagnosis and adequate treatment of fungal endocarditis is likely to be delayed as blood cultures are rarely positive. We report a case of native valve endocarditis in a patient who underwent liver transplantation and was taking immunosuppressive agents. Because of no improvement despite empirical antibiotic treatment, a mitral valve replacement was performed. Tissue culture and biopsy of the vegetations revealed Aspergillus spp., and A. fumigatus was identified by analysis of internal transcribed spacer DNA sequences of the pathogenic fungus using a polymerase chain reaction. Despite surgical intervention, she died of an acute cerebral infarction with cerebral edema. (Korean J Med 75:115-118, 2008)

관광호텔의 리더쉽 유형이 조직유효성에 미치는 영향

홍경욱 ; 박진영 ; 이현정 김천대학교 2000 김천대학교 논문집 Vol.21 No.-

The Leadership is very important for organizational behavior in every organization. Excellent leadership guide an organization to achievement. The leadership is more important in hotel organizations because which are highly dependent on human resources compare with other organizations. The Purpose of this research is to examine what influence leader-ship has on organizational performance. The variables of leadership are initiation structure leadership and consideration leadership. And the factors of organizational effective-ness are job satisfaction and job commitment. The results of this study revealed the followings : First, the initiation structure leadership and consideration leader-ship both effect on job satisfaction and the consideration leadership is more influence than initiation structure leadership. Second, the consideration leadership has positive effect on organi-zational commitment, but initiation structure leadership has not positive. This results means employees recognize more important the consideration leadership consist of friendship. confidence and respect.