고압하에서 순수한 산소에 노출된 백서폐장의 병리조직학적 연구

강명재,이인기 공군본부 의무감실 1991 항공의학 Vol.39 No.1-2

단백질분해효소를 생성분비하는 호알칼리성 Coryneform bacterium TU-19의 분리 및 동정

최명철,양재섭,강선철 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.2

토양으로부터 알칼리성 단백질분해효소를 생성분비하는 호알칼리성 미생물을 분리하였다. 이 균의 형태적 특징은 Gram 양성이었으며, 포자를 형성하지 않고, 운동성이 없으며, 불규칙적인 간균의 형태를 하고 있는 호기성 미생물이었다. 또한 기타 다른 형태적, 생리생화확적 특징과 종합적으로 비교해 볼 때 이 균주는 Coryneform 세균과 매우 유사하였다. 따라서 본 분리균주는 Coryneform bacterium TU-19로 잠정적으로 동정하였다. 그러나 화학적 분석 결과 및 부분적인 생리생화적 특징들에 있어서는 Coryneform bacteria의 어느 종과도 정확히 일치하지 않았다. An alkalophilic bacterium producing alkaline protease(s) was isolated from soil. It was a Gram-positive, non-sporulating, immotile, irregular rod, strictly aerobic, and weak acid-forming bacterium. The morphological, physiological, and biochemical characteristics of the isolate resembled those of the Coryneform bacteria. However, there was not any species within this genera to which microorganism can be closely matched. Therefore, it is provisionally identified as a Coryneform bacterium TU-19.

Rhinocerebral Mucormycosis 2예

오명돈,최강원,김병국,김재중,이홍규,김상윤 대한감염학회 1986 감염 Vol.18 No.2

Mucormycosis is an acute suppurative opportunistic mycosis that produce predominantly rhinocerebral disease in patient with diabetic ketoacidosis and immunosuppressed patient. We experienced two cases of rhinocerebral mucormycosis recently. The one occurred in patient with diabetic ketoacidosis and the other in acute leukemia. They showed nasal discharge, orbital cellulitis and proptosis. Their condition rapidly deteriorated. Biopsy from palate and sinus revealed broad, nonseptate, right-angled branching hyphae, a finding compatible with mucormycosis.

후천성 면역부전증후군 환자에서 발생한 Cryptosporidium parvum 감염 2예의 보고

오명돈,최강원,신형식,김성민,최희정,강현재,김윤준,채종일 대한감염학회 1996 감염 Vol.28 No.5

Cryptosporiduim is an intracellular protozoan parasite and known as an important pathogen causing diarrheal illness in animals and man since 1970's. With the advance of epidemic of Acquired Immunodeficiency Syndrome(AIDS), Cryptosporidium has emerged as one of important pathogens in AIDS patients and is responsible for chronic diarrhea, cholecystitis, biliary tree obstruction and respiratory illness. Despite frequent reports of cryptosporidial diarrhea in other countries there has been no report of human cryptosporidial infection in AIDS patients so far in Korea. We report two cases with chronic cryptosporidial diarrheal illness in AIDS patients. C. parvum oocyst was identified by fecal smear with modified acid fast staining. In one patient the diarrheal illness was improved after 4 weeks supportive management only. But fecal excretion of oocyst continued after clinical improvement of the diarrheal illness. Another patient was died of respiratory failure after recurrent diarrheal illness. Cryptosporidial infection should be considered in differential diagnosis of chronic diarrhea especially, in AIDS patients.

중추신경계 합병증을 동반한 삼일열 말라리아 1례

김문석,김가연,강유민,김낙현,전재현,박완범,김홍빈,김남중,박상원,홍윤호,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Plasmodium vivax malaria is an endemic disease in Korea, which rarely causes severe complications including those occurring in the cerebrum. There are limited numbers of complicated cases that have been reported around the world. We experienced a case of vivax malaria with cerebral complication: cognitive impairment and ataxia. A 55-year-old female with diabetes mellitus presented to the emergency department with acute fever of two days’ duration. She did not have any history of travelling abroad or receiving blood transfusions. Peripheral blood smear revealed vivax malaria with parasitemia density of 0.53 percent. She demonstrated loss of orientation, especially regarding time and place, and ataxia. Although the initial hydroxychloroquine treatment for malaria was successful, cognitive impairment and ataxia persisted and were not recovered. Brain MRI showed no structural abnormality. Brain PET showed diffuse hypometabolism in right parieto-temporal lobe of the brain.

냉수 가글링과 젖은 거즈를 이용한 구강간호가 비강수술 환자의 갈증 및 구강상태에 미치는 효과 비교

이인선,심명숙,나은희,강재연,김지혜,황민영,윤계숙,성영희 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: This study researched the comparison of oral care methods between the wet gauze and the water gargling for nasal surgery patients. It executed to find out more effective method to relieve thirst. Method: We divided two groups; the wet gauze and the cold water garaling. We assessed patient's oral cavity state and sebjective oral dryness for three times; firstly before the intervention, secondly 15 minutes after 1st intervention and thirdly 15 minutes afrer 2nd intervention. Result: As the intervention, there was no difference on oral condition subhectvely, but there was a difference on thirsty reduction objectively. As the aral dryness has relieved through both methods. It showed the repeated gargling helps more to relieve oral dryness effectively than the wet gauge. At PACU, post nasal surgery patient's oral dryness was decreased with gauze more than two times, patient's oral dryness was relieved. Whereas the dryness was relieved after applying the cold water gargling for just one time. Conclusion: The water gargling is more effective intervention than the wet gauze. Especially, oral dryness was improved in the section of objetive oral assessment index.

우리나라 사람면역결핍바이러스(Human Immunodeficiency Virus) 감염환자에서 발병한 악성종양

최평균,송진수,조재현,김성한,박경화,방지환,박완범,김홍빈,김동완,김태유,허대석,오명돈,김남중,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : Since highly active antiretroviral therapy has lengthened the life span of individuals infected with human immunodeficiency virus (HIV), the importance of malignancy associated with HIV has been increased. The relative frequencies of malignancies in HIV infected patients may vary in different race and region. The aim of this study is to determine the prevalence and characteristics of malignancies in patients with HIV infection in South Korea. Materials and Methods : To identify HIV patients with malignancy, we reviewed the electronic database of pathological reports for all HIV-infected patients seen from January 1986 to December 2005 at the Seoul National University Hospital. We retrospectively reviewed the medical records of them. Results : Among 850 patients infected with HIV, 33 episodes of malignant diseases were diagnosed in 32 patients (3.76%). Thirty were males, and median age was 46 years (range 29-70). At the time of the diagnosis of malignancy, median CD4^(+) lymphocytes count was 100/uL (range 5-620) and in 27 (82%) patients, CD4^(+) lymphocytes count were less than 200/uL. For 13 patients (40%), malignancy was initial presentation of HIV infection. Excluding patients initially diagnosed as malignancy, median follow-up duration from the first visit to diagnosis of malignancy was 36 months (range 3-96). Non-Hodgkin's lymphoma was the most frequent malignancy (13 patients), followed by Kaposi's sarcoma (7), Hodgkin‘s disease (3), acute myeloid leukemia (1), and other solid cancer (9) including one case of anal cancer associated with human papillomavirus. Among 13 patients with non- Hodgkin's lymphoma, 4(31%) achieved the complete remission after chemotherapy and/or radiation therapy, and had been followed without evidence of recurrence. Conclusion : Malignancy was diagnosed in 3.76% of patients infected with HIV. Non-Hodgkin‘s lymphoma is the most prevalent malignancy in HIV patients in South Korea. 목적 : 효과적인 항레트로바이러스 다제요법이 도입됨에 따라, HIV 감염환자들의 수명이 증가되었고, 이에 따라 HIV 감염환자에서 악성종양의 중요성 또한 증가하고 있다. 본 연구의 목적은 우리나라 HIV 감염환자에서 악성종양의 유병률과 호발하는 악성종양의 특성을 밝히는 것이다. 재료 및 방법 : 1986년부터 2005년까지 서울대학교병원에서 치료를 받은 HIV 감염환자의 의무기록을 후향적으로 분석하였고, 병리학적 검사 결과를 검토하여 악성종양이 진단된 환자들을 대상으로 연구를 시행하였다. 결과 : 총 850명의 환자 중, 32명(3.76%)에서 33예의 악성종양이 진단되어, 악성종양의 발병률은 1,000인년 당13.0명(95% 신뢰구간: 8.6∼17.4명)이었다. 그 중 남자는 30명이었고, 악성종양 진단 당시 연령의 중간값은 46 (29-70)세이었다. 악성종양 진단받을 당시, CD4 림프구 수의 중간값은 lOO/uL (5-620 uL) 이었고, CD4 림프구수가 200/ uL 미만인 환자가 27명(82%)이었다. 악성종양에 대한 검사 도중에 HIV 감염사실이 밝혀진 환자가 13명(40%)이었다. HIV를 진단 받은 후 악성종양이 발병한 환자들에서, HIV 진단 후 악성종양의 발병까지는 평균 36개월(3-96개월)이 걸렸다. 13명의 HIV 감염 환자에서 진단된 비호지킨림프종이 가장 흔한 악성종양이었고, 이외에 카포시육종이 7명, 호지킨병이 3명, HPV와 연관된 항문암이 1명의 HIV 환자에서 진단되었다. 그 밖에 급성백혈병, 방광암, 췌장장, 폐암, 진행성위암, 갑상선암, 간세포암, 후두암이 각각 1예씩 진단되었다. 비호지킨림프종이 진단된13명 환자 중, 4명(31%)은 항암치료 및 방사선치료를 받아 완전관해가 되었고, 현재 재발의 증거 없이 외래에서 경과 관찰 중이다. 결론 : 우리나라 HIV 감염환자에서 악성종양의 유병률은 3.76%이었고, 비호지킨림프종이 가장 흔한 악성종양이었다.

백서 척수후근절로부터 슈반세포의 효과적인 체외 배양법

김성민,이종호,김남열,안강민,최원재,최시호,차미주,이주영,황순정,장정원,명훈,최진영,서병무,정필훈,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Schwann cells(SCs), an important component of the peripheral nervous system, intract with nerous to mutually support growth and replication for the peripheral nerve regentation. Recently, ading SCs to the lumen of guidance channel is widely tried to improve regeneration or to make regeneration possible over otherwise irreparable gaps. however, it is not easy to isolate and multiplicate SCs as much as enough to help the axonal regeneration. For the allogeneic SCs source for tubular nerve guidance, we developed a little bit improved technique of harvesting and multiplicating SCs. by culturing dispersed dorsal root ganglia in specially designed medium with growth factors and serial processing, we repeatedlly generate relatively homogenous SC cultures. Our technique was compared with other methods of literature using immunostaining methods such as GFAP, S100, BDNF and the total SC count assessment at different time interval after primary culture.

침습성 아스페르길수스증 진단을 위항 갈락토만난 항원검사의 유용성 평가

송경호,이신원,장희창,전재현,박완범,박경운,박상원,오명돈,최강원 대한감염학회 2009 감염과 화학요법 Vol.41 No.2

Background : Invasive aspergillosis (IA) is an important cause of morbidity and mortality among immunocompromised patients. However, 1A is difficult to diagnose, especially in the aforementioned patient group. Recently, galactomannan assay (GMA) using enzyme immunoassay has been introduced in Korea. We evaluated its diagnostic usefulness in the diagnosis of 1A and we analyzed the results according to the underlying diseases. Materials and Methods : All patients who underwent GMA during the period from October 2007 to June 2008 were evaluated retrospectively. According to the criteria of European Organization for Research and Treatment of Cancer/Mycoses Study Group, IA was classified into four clinical categories: proven', probable', possible', and 'non' IA. Patients with 'proven' and 'probable' IA were used as the reference standards for IA. GMA was performed using Platelia Aspergillus EIA (Bio-Rad, Hercules, CA, USA). Optical density index ≥0.5 was considered positive. Results : Of the 144 patients who underwent GMA, two patients were classificed as proven' IA and sixteen patients were probable' 1A. Overall sensitivity, specificity, positive predictive value, and negative predictive value of the assay were 50% (95% confidence interval [C195), 26-74%), 88% (C195, 81-93%), 38% (CI95, 19-59%), and 93% (CI95, 86-97%), respectively. Among the 99 patients with underlying hematologic diseases, GMA showed 67% (C195, 35-90%) sensitivity and 89% (C195, 80-94%) specificity, whereas in 45 patients with underlying diseases other than hematologic diseases, sensitivity and specificity of the assay were 17% (CI95, 0-64%) and 87% (CI95, 73-96%), respectively. Conclusions : GMA showed high specificity, irrespective of the patient population. However, sensitivity of GMA was low and the assay was less sensitive in patients with underlying diseases other than hematologic diseases than in patients with hematologic diseases.

국내 3개병원에서 분리된 메티실린 내성 황색포도상구균 균주간의 유전학적 연관성

백경란,김성민,송재훈,이혁,양지원,진정화,최강원,오명돈,배현주 대한감염학회 1997 감염 Vol.29 No.6

목적:본 연구는 병원감염의 주된 원인균인 MRSA의 병원 내 및 병원간의 전파양상을 파악하고, MRSA 균주 중 pathogen과 colonizer 간에 유전자형의 차이가 있는지 알아보고자 시행되었다. 방법:삼성의료원 중환자실에 1996년 1월에서 7월까지 입원한 26명의 환자로부터 분리되었던 MRSA 30균주와 서울대학교병원에서 1995년 9월에서 10월까지 37명의 환자로부터 분리되었던 MRSA 37균주, 그리고 단국대학교병원 신생아 중환자실에서 MRSA 감염증의 돌발적 발생에 연관되어 분리된 MRSA 균주 40주를 대상으로 하였다. 균주간의 상관성을 평가하기 위한 세균형별법으로 Pulsed field gel electrophoresis(PFGE, CHEF DR-II)를 이용하였고, 제한효소로 Smal I을 사용하였다. 결과:삼성의료원의 균주 30주 중 A 패턴이 10주(33.3%), B 패턴이 7주(23.3%)로 나타나, 주된 유행 균주가 있음을 확인하였다. 내과 중환자실에서 분리된 5 균주 중 4 주가 A패턴인 반면, 신생아 중환자실에서 분리된 9균주 중 4주가 B패턴에 속하여, 한병원내에서도 구역에 따라 유행균주가 다름을 알 수 있었다. 서울대학교병원 균주 중 23주(62.2%)가 동일한 A패턴으로 나타났고 단국대학교 병원 균쥬 중 27 균주(67.5%)가 B 패턴에 속하여, 세 병원의 MRSA 유행 균주 사이에 유전적 연관성이 있음을 시사하였다. Pahtogen과 colonizer간에 PFGE 패턴의 차이는, pathogen이 colonizer에 비해 유행균주에 많이 속하였으나 통계학적으로 유의한 차이가 없었다. 결론:PFGE를 이용한 세균형별법으로 분류한 MRSA 균주의 양상으로 볼 때, 한 병원 내에서 유행하는 MRSA 균주에는 소수의 주된 클론이 있었으며, 한 병원 내에서도 구역에 따라 유행균주는 서로 달랐다. 지역적으로 떨어져 있는 서울대학교병원과 단국대학교병원의 MRSA 유행균주는 삼성의료원의 유행균주 중 한 클론과 각각 일치하였다. 이 결과는 유행 MRSA 균주가 공동의 오염원에서 파급되어 지역적으로 다른 병원간에도 전파되고 있거나, 균주가 숙주의 요인에 의해 특정 MRSA 균주가 선택 분리되고 있을 가능성을 시사하였다. Background: Methicillin-resistant Staphylococcus aureus(MRSA) has become a major pathogen of nosocomial infection. In Korea, incidence of MRSA is alarmingly high up to 70-80% of total S. aureus strains isolated from teriary care hospitals. To investigate the mechanism of inra- and interhospital spread of MRSA, we evaluated the genetic relatedness of MRSA isolates recovered from 3 different hospitals in Korea. Methods:30 MRSA isolates obtained from Samsung Medical Center(SMC), 37 MRSA isolates from Seoul National University Hospital(SNUH) and 40 MRSA isolates from Dankook University Hospital(DUH) were classified into clonal types on the basis of pulsed field gel electrophoresis(PFGE). Results: Several PFGE patterns were predominant among the isolates from SMC(A-7/30[23.3%], B-6/30[20.0%], C-4/30[13.3%], G-3/30[10.0%]). The prevalent PFGE patterns were different between medical ICU(A-3/5[60.0%]) and newborn ICU(B-4/9[44.4%]0. The major clone of SMC. The major clone at DUH was PFGE type B, which was identical with another dominant clone of SMC. Although MRSA strains from SMC which caused clinical diseases belonged to major PFGE patterns more often than colonized strains, the association was not significant statistically. Conclusion: The presence of epidemic strains of MRSA suggests that epidemic MRSA clones may be originated from common sources and spread between different hospitals. Also, there may be virulence factors of stains or host factors, which could select specific strains.