성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

면역화학분석법을 이용한 뇌종양의 증식능력 측정 : A Kinteics Study with Bromodeoxyuridine and Proliferating Cell Nuclear Antigen

이규성,이규창,정상섭,최중언,서정호,김태승,양우익 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12

Bromodeoxyuridine(BUdR) labeling study provides valuable cell kinetic information for individual tumors and could suggest the prognosis of each patient with the tumor. Recently, a monoclonal antibody against the proliferating cell nuclear antigen(PCNA or cyclin), a nuclear protein expressed in proliferating cells, was developed. One of the main purpose of this study was to correlate the histological grade of brain tumor with the BUdR labeling study and the PCNA method in the same patient. The relationship between labeling indices of BUdR incorporated into S-phase and behavior of the tumor was studied in 96 patients. In 31 among those patients. PCNA expressed by cycling cells was also investigated. Both of the LIs showed good correlation with histological grade of the tumor. When both LIs were studied in the same patient, the values of the PCNA LI were parallel but higher than those of the BUdR LI, and the relation PCNA LI=2.2×BUdR LI+0.8(r²=0.86) was obtained. The results of this study show that PCNA could replace the BUdR method for identifying the proliferating cells, and the major advantage of PCNA method is that it could be done without any pretreatment and avoid injection of the teratogenic agent for diagnostic purpose.

선삭변수 최적화를 위한 진화 알고리듬 응용

이성열,곽규섭 한국경영과학회 2001 經營 科學 Vol.18 No.2

This paper presents a machining parameter selection approach using an evolutionary computation (EC). In order to perform a successful material cutting process, the engineer is to select suitable machining parameters. Until now, it has been mostly done by the handbook look-up or solving optimization equations which is inconvenient when not in handy. The main thrust of the paper is to provide a handy machining parameter selection approach. The EC is applied to rapidly find optimal machining parameters for the user's specific machining conditions. The EC is basically a combination of genetic algorithm and microcanonical stochastic simulated annealing method. The approach is described in detail with an application example. The paper concludes with a discussion on the potential of the proposed approach.

유리 광배근피판을 이용한 하지의 재건

이규윤,김용배,이영만,양순재,박종섭 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

Significant soft-tissue defects in the lower extremity including the tibia and the foot are best managed with free skin-muscle of skin-grafted free muscle transfers. While free flap donor sites useful for lower exremity reconstruction include the latissimus dorsi, the rectus abdominis, the gracilis, and the scapular flaps, the latissimus dorsi seems ideal. This muscle has a reliably long vascular pedicle of wide diameter, making microsurgical anastomosis of the thoracodorsal vessels straightforward. Because it is so large, it can cover virtually and size defect. Furthermore, its flat configuration makes it especially easy to fold on itself to that it can be used to closure wounds with complex three-dimensional geometry and dead space. Although the gracilis and rectus abdominis muscles have their roles, in most cases the latissimus dorsi should serve well. We described technical considerations in each case and the advantages of free latissimus dorsi myocutaneous flap on the reconstruction of the soft tissue defect in the lower extremity.

농아에서의 측두골 전산화 단층촬영 소견과 다른검사 요인과의 연관성

조태환,이상흔,권대구,엄규상,성창섭,김용선,한기원 경북대학교 병원 1998 경북대학교병원의학연구소논문집 Vol.2 No.1

Temporal bone high resolution computed tomogram(TBHRCT)is a essential diagnostic tool in considering for cochlear implantation in patients with profound sensorineural hearing loss. This study was designed for an effort to provide and efficacy of TBHRCT in determination of inner ear malformations for the patients who have profound sensorineural hearing loss and to examine the relationships between TBHRCT findings and other preoperative evalutions for cochlear implantation in that patients. Authors examined 68 deaf patients to provide fundamental data for cochlear implantation. Inner ear abnormalities were founded in 13(19%) patients, among which 10(14.7%) patients had Mondini'dysplasia in which 5 patients were hypoplastic type and 5 patients were hydrops type. Other inner ear abnormalities were as follows : lateral semicircular canal hypoplasia ; internal auditory canal abnormality ; cochlear aqueduct widening ; vestibular aqueduct widening. No relationships were found between TBHRCT findings and other test results. : promontory test, K-WISC cognitive test etc.(Korean J Otolaryngol 39 : 8, 1996)

포도상구균 초항원과 연관된 만성 비·부비동염의 병인에서 감마 인터페론 생산 T세포의 역할

김창수,조규섭,이현순,박희영,노환중 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Background and Objectives: The etiology and pathogenesis of chronic rhinosinusitis (CRS) is multifactorial and the role of infectious agents in CRS is not clear. S. aureus is the most frequent cultured pathogen in CRS and it expresses toxin, SEA, SEB and TSST-l, with superantigen (SAG) activity. Recently an importnat role of these staphylococcal toxins in CRS with nasal polyposis (CRSwNP) has been suggested. CRSwNP is a severe chronic inflammation characterized by massive infiltration of lymphocytes and eosinophils in the sinonasal mucosa and nasal polyp. However, there has been no further studies evaluating the properties of infiltrating T lymphocytes in CRSwNP and the cytokine profiles in activated T-Iymphocyte relating with SAGs. The aims of this study was to know what kind of T lymphocytes infiltrates in nasal mucosa and polyp tissue of CRSwNP, to analyze the cytokine profiles in infiltrating T cells, and to determine whether infiltrating T lymphocytes are specific for SAGs. Patients and Methods: Ethmoid sinus mucosa and polyp tissue samples were collected from 13 patients with CRSwNP and control sinus mucosa were obtained from 10 patient without CRS. Tissue infiltrating cells and T cells were isolated from tissue samples and flow cytometry, enzyme-linked immunosorbent assay, reverse transcriptase-polymerase chain reaction, in vitro T lymphocyte stimulation with S. aureus toxin were performed. Results: The mean total CD3+ T cell count was significantly higher in the mucosa and polyp tissue of patients with CRSwNP compared with control mucosa. Most infiltrating T cells in mucosa and polyp tissue were activated type, expressing CD45RO. CD8+ T cells were significantly increased in mucosa and polyp tissue of patients with CRSwNP compared with CD4+ cells IFN-γ was highly expressed in infiltrating T cells in both mucosa and polyp tissue, whereas IL-10 was expressed a small amount and IL-4 was not expressed. IFN-γ levels were significantly higher than IL-4 and IL-10 when isolated T cells were stimulated with SAGs in vitro. Conclusion: CD8+ T-cytotoxic and IFN-γ producing Th1 cells could paly an important role in the CRSwNP if sinonasal chronic inflammation is induced by SAGs.

Interleukin-2가 Mouse간의 인산염분해효소의 활성에 미치는 영향

이규식,김원규,정호삼,강성섭 한양대학교 의과대학 1989 한양의대 학술지 Vol.9 No.1

In recent years, interleukin-2, a lymphokine produced by antigen or mitogenstimulated lymphocytes, has been intensively with the development of immunooncology and chemoimmunotherapy of the malignant tumor. Interleukin-2 mediates antitumor effect by stimulating the proliferation of helperand cytotoxic T cells, augmenting the cytolytic activities of cytotoxic T-lymphocytes and differentiating T-lymphocytes into a lymphokine-activated killer cell in vivo. Thus interleukin-2 induces the therapeutic effects on various sarcoma and carcinoma and regresses the pulmonary, hepatic and peritoneal metastases of various tumors. Although interleukin-2 is very effective for the treatment of various malignancy, it develops many side effects including fever, chill, malaise, mental confusion, diarrhea, vomiting and oliguria and causes pulmonary, hepatic and renal toxicities. Especially interleukin-2 results in increase of capillary permeability with weight gain, pulmonary edema, and ascites. In this experiment, the author studied the effect of interleukin-2 on the mouse liver, histochemically observing the changes in the activities of alkaline phosphatase, acid phosphatase and adenosine triphosphatase. Male mice, DDY strain, weighing 20gm, were used as experimental animals. The experimental animals were sacrificed at 3, 6, 12, 24 and 48 hours after intraperitoneal administration of two milions unit of interleukin-2 per kilogram of body weight. The specimens obtained from the liver were fixed in 10% neutral buffered formalin solution for 24 hours at 4℃ and sliced at 16㎛ thickness in a frozen cryostat. The activities of alkaline phosphatase and acid phosphatase were observed by the Gomori's method and the activity of adenosine triphosphatase was observed by the Wachstein and Meisel's method for histochemical study. The results obtained were as follows. 1. The acid phosphatase activity was strong positive at 12 hours and 24 hours groups in the central and portal zones of the liver lobules, but weak positive and moderate positive at 48 hours group in the central and portal zones of the liver lobules, respectively. 2. The alkaline phosphatase activity was weak positive at 6 hours and 12 hours groups and moderate positive at 48 hours group in the central and portal zone of the liver lobules. 3. The adenosine triphosphatase activity was trace positive in the central zone and weak positive in the portal zone of the liver lobules at 6 hours group but moderate positive at 48 hours group in the central and portal zones of the liver lobules. Consequently, it is suggested that interleukin-2 induce degenerative changes of the hepatocytes of the mouse, but it is recovered with time.

내시경부비동수술후 비음형대, 스펙트럼 및 비·부비동의 용적변화의 분석

김창수,공수근,이현순,조규섭,왕수건,노환중 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.11

갑상선 수질암의 재발에 미치는 예후인자에 관한 연구

이주희<SUP>1<,SUP>,이규언<SUP>1,2<,SUP>,박경식<SUP>1,2<,SUP>,구도훈<SUP>1,2<,SUP>,오승근<SUP>1<,SUP>,윤여규<SUP>1,2<,SUP>,Ju Hee Lee,M,D,<SUP>1<,SUP>,Kyu Eun Lee,M,D,<SUP>1,2<,SUP>,Kyung Sik Park,M,D,<SUP>1,2<,SUP>,Do 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.3

<B>Purpose:</B> Medullary thyroid carcinoma (MTC) is an uncommon thyroid tumor and the clinical course is variable. Many prognostic factors for MTC have been studied, but the significance of some of these factors remains con</B>troversial. This study aimed to evaluate the prognosis of recurrent disease in patients suffering with MTC. <P><B>Methods: </B>Fifty three patients who were operated for MTC from 1987 to 2006 in Seoul National University Hospital (SNUH) was retrospectively analyzed. Their medical records were reviewed for the demographic data, the laboratory data and the clinical course, the treatment and the long-term outcome. The median duration of follow-up was 66.5 months. Forty-two patients who were operated on primarily in this hospital were analyzed for their recurrence free survival. <P><B>Results:</B> The mean age atdiagnosis was 41.8 years. There were 28 femaleand 25 male patients. Eleven patients (22.9%) had multifocal disease. There were 32 sporadic MTC patients, 15 MEN2A patients, 3 familial medullary thyroid carcinoma (FMTC) patients and 1 MEN 2B patient. The 10- and 15-year overall survival rates were 91.9% and 76.5%, respectively; the 5- and 10-year recurrence-free survival rates were 70.6% and 45.5%, respectively. By univariate statistical analysis, the stage (stage I/II vs. III/IV, P= 0.025), extrathyroidal extension (P=0.039), cervical lymph node metastasis (P=0.044), and the postoperative calcitonin level (≥25 pg/ml) (P=0.003) were the significant factors that influenced recurrence. <P><B>Conclusion:</B> The overall prognosis of MTC is favorable. The significantfactors for a poor prognosis were the presence of lymph node metastasis, TNM stage III and IV, positive extrathyroidal extension at the first diagnosis and a high postoperative calcitonin level.<B> (Korean J Endocrine Surg 2008;8:183-188)</B>

항-Xg^a항체 1예 보고

허미나,이규만,김종현,박경운,송은영,한규섭 大韓輸血學會 2001 大韓輸血學會誌 Vol.12 No.2