발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

FIB 신뢰성 평가를 위한 나노패턴의 설계 및 측정

강현욱,이승재,조동우 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

FIB (Focused ion beam) system is one of the most important equipments for the nano-scale machining. Various researches have been performed, since it can etch the material and deposit 3-D structure with high-aspect-ratio in the nanometer scale. In spite of those researches, the definite method for the reliability of FIB system has not been reported. In this paper, we proposed the reliability assessment method through nano-pattern fabrication. In the fabricated nano-pattern, the characteristics of FIB system are included. Using this effect, we tried to assess the FIB reliability. First, we suggested reliability assessment items and nano-patterns. And, to know the suitableness of the proposed method, we fabricated several nano-patterns using Nova200(FEI Company) and SMI2050(SEIKO) which are FIB apparatuses. The fabricated nano-patterns are measured with SEM (Scanning Electron Microscope) and compared with designed dimensions. And the compared results showed that the proposed method is suitable for the assessment of FIB system reliability.

제주지역에서 발생한 변사체에 대한 통계적 고찰 : 1977년도 부검 및 검안례를 중심으로 An Analysis of Medico-Legal Autopsy and Inspection Cases

강현욱 大韓法醫學會 1998 대한법의학회지 Vol.22 No.2

The aim of this study was to reveal the current status of forensic practice in Cheju province. Data used for this study was based on both autopsy reports and records of postmortem inspection with brief history derived from criminal divisions of all of three police agencies in Cheju. The range of subjects was limited to unusual deaths occurring in Cheju province during the year of 1997. Traffic accidents were excluded in this in Cheju province during the year of 1997. Traffic accidents were excluded in this category. All subjects were reviewed with respect to age, sex, cause of death and manner of death. The results were as follows; 1. The total number of unusual deaths was 220, of these 170 cases(77.3%) were males and 50(22.7%) were females. 2. In age distribution, the age group of 40-49 occupied the highest proportion(25.9%). 3. According to the manner of death, the cases of violent deaths were 175(79.5%), natural deaths;33(15.0%), and unknown cases ;12(5.5%). 4. For the violent deaths, the percentage of accidental death was 50.9 and suicide;32.0, homicide;5.1, undetermined cases;12.0. 5. According to the cause of death, asphyxia was the most common (101cases, 45.9% of the unusual death), followed by injury(18.2%) and disease(15%). 6. Among 101 deaths of asphyxia, 61(60.4%) were deaths due to drowning. 7. The total number of autopsy was 56 (25.5% of total unusual death). 8. Twelve cases(5.5%) remained as deaths of unknown cause and unknown manner without further postmortem examination.

모성사망(母性死亡)에 대하여 : 1995년도 부검예를 중심으로 A study of autopsy cases in 1995

강현욱 內務部 國立科學搜査硏究所 1996 國立 科學 搜査 硏究所 年報 Vol.28 No.-

천추 전방에서 발생한 신경절 세포종 : 증례 보고 A Case Report

강현구,이승로,박동우,박충기,함창곡,박용욱 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2

We have experienced a case of presacral ganglioneuroma. So, we report a peripheral ganglioneuroma of sacral origin. The patient is 34-year-old man with intermittent low back pain and right sciatica. Myelographic computed tomography revealed extradural lobulated low attenuated tumor lesion within spinal canal at the level of L5 and S1. Tumor indented the thecal sac to the left side, and extended into the pelvic cavity through the intervertebral foramen between S1 and S2. The mass was surgically excised and turned out to be ganglioneuroma pathologically.

위선암에서 p53과 EGFR 및 PCNA 발현에 관한 연구

강현욱,양승하,강상균 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

Expression of oncogene in the gastric adenocarcinoma was considered as a determinant factor of cancer progression or prognosis by some authors, however, the results were so fluctuated according to the authors that there was no uniform agreement in their clinicopathological correlation as well as in its practical application. To evaluate correlation between the pathologic finding and the expression of p53, EGFR and PCNA, immunohistochemical studies were performed on paraffin-embedded sections of 84 gastric adenocarcinomas. Pathologic findings were classified as 4 subgroups by their histologic types, differentiation, invasion and lymph node metastasis. The correlation of PCNA labelling index with various clinicopathologic factors and oncogene expression was studied. The results were as follows; 1. p53 expression was seen in 47cases(55.56%) of gastric carcinoma, and correlation between p53 expression with tumor type, differentiation, invasion and lymph node metastasis was not proved. EGFR positive expression was found in 37(44.05%) cases and was increased in advanced gastric carcinoma, and cases of lymph node metastasis. 2. Co-expression of p53 and EGFR was observed in 18 cases(33.33%), suggesting existence of both oncogene in the same case, while both negative cases were 18 cases(33.33%) that suggest the possibility of presence of the other factors. 3. PCNA labelling index was higher in advanced gastric carcinoma and in cases of lymph node metastasis, but there was no statistical significance. 4. There was no statistical significance between PCNALI and p53 expression. 5. PCNALI and EGFR expression was parallel with pathologic finding such as differentiation, progression and metastasis of the carcinoma, these results suggest that there was significant correlation between PCNALI and EGFR. 6. PCNALI was statistically significant between two groups of both p53 and EGFR positive and both negative. 7. PCNALI showed statistical significance between EGFR positive and negative groups in cases of lymph node metastasis. In summary, the value of p53 expression as a prognostic factor was still doubtful but EGFR and PCNA expression tended to be associated with tumor progression and seemed to be objective and reliable prognostic factors, respectively. Combined method of EGFR and PCNA thought to be more helpful in preoperative decision or prediction of prognosis in gastric carcinoma.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

폐경후 여성에서 내피세포 의존성 혈관이완 반응에 에스트로겐의 급성효과 및 엔도쎌린(Endothelin)-1과의 연관성

강진호,김범수,이영욱,금동극,정현욱,이혜숙,이만호,박정로 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.7

급성 심근허혈에 의해 윤발된 승모판 폐쇄부전의 기전에 관한 실험적 연구

강덕현,송현,송재관,김현숙,이재환,임희영,이재원,박성욱,박승정,송명근 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.8

마이크로 광 조형 기술을 이용하여 미세 유체 시스템을 개발하기 위한 가상 조립 공정의 개발

강현욱,이인환,조동우 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

As it is difficult to construct a micro-fluidic system composed of micro-mixers, micro-channels and/or micro-chambers in a single process, an assembly process is typically used. The assembling and bonding of micro-parts, however, introduces other problems. In this work, a virtual assembly process was developed that can be used to design various micro-fluidic systems before actual fabrication commences. In the process, the information required for the micro-stereolithography process is generated automatically. Consequently, complex micro-fluidic systems can be fabricated in a single process, thereby avoiding the need for additional assembly or bonding processes. Using the developed process, several examples were fabricated.