腹腔渗出細胞를 移入받은 마우스에서의 肝吸蟲에 대한 免疫應答

權泰燦(Tae-Chan Kwon),姜眞無(Chin-Moo Kang),崔東翊(Dong-Wik Choi) 대한기생충학열대의학회 1987 The Korean Journal of Parasitology Vol.25 No.1

소아 알레르기성 자반증의 위장관 내시경 소견

이동훈,박철한,박지민,박근수,김흥식,강진무,Lee, Dong Hoon,Park, Chul Han,Park, Ji Min,Park, Geun Soo,Kim, Heung Sik,Kang, Chin Moo 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.6

목 적 : 알레르기성 자반증 환아에서 상부위장관 내시경 소견을 관찰하고, 또한 위장관 증상이 있는 환아와 없는 환아에서 상부위장관 내시경 소견의 차이가 있는지 보고자 이 연구를 시행하였다. 방 법 : 1996년 9월부터 2002년 10월까지 계명대학교 동산병원 소아과에 입원하였던 알레르기성 자반증 환아 중 위장관내시경 검사를 실시한 65명을 대상으로 하였다. 위장관 증상의 유무에 따른 내시경 소견을 비교 관찰하였으며 피부 병변 3일 전부터 퇴원까지의 기간 동안 복통, 구토, 위장관 출혈, 설사 등의 증상을 기록하여 위장관 증상의 유무를 판단하였다. 결 과 : 위장관 내시경을 시행한 65명 중 위장관 증상이 있던 환아는 53명이었고, 증상이 없는 환아는 12명이었다. 6-10세 연령군이 많았고 위장관 증상은 남아에서 그리고 증상으로는 복통과 구토가 많았다. 위장관 내시경을 시행한 65명 중 십이지장 점막에 이상 병변의 빈도가 가장 높았으며, 병변의 양상에 따른 빈도는 십이지장염 12명, 위염과 십이지장염 9명, 십이지장미란 6명, 위염 5명, 십이지장궤양 5명, 위궤양 2명, 결장미란 1명의 순으로 관찰되었으며 정상소견은 25명이었다. 증상이 있던 환아 53명 중 38명에서 그리고 증상이 없던 환아 12명 중 2명에서 위장관 내시경 소견상 이상 소견을 보였다. 결 론: 위장관 증상이 있는 알레르기성 자반증 환아에서는 내시경 검사를 시행하는 것이 병변의 진단과 치료에 도움이 되었으나 더 많은 예에서 연구가 필요하리라 생각된다. Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

신생아에서 Vancomycin 내성 장구균 감염 1례

배수정,최귀전,김천수,이상락,김홍식,강진무,Bae, Soo Jung,Choi, Gui Jean,Kim, Chun Soo,Lee, Sang Lak,Kim, Heung Sik,Kang, Chin Moo 대한소아감염학회 1999 Pediatric Infection and Vaccine Vol.6 No.2

VRE 감염증은 항균제의 과다한 사용 후 출현하는 새로운 형태의 감염성 질환으로, 현재 심각한 임상 문제로 대두되고 있다. 최근 국내에서도 신경학적 장에나 당뇨병, 종양 등의 기저질환을 가진 성인 환자들에서 소수의 감염 예가 보고되고 있으나 소아기, 특히 신생아에서의 감염증은 잘 알려지지 않았다. 저자들은 생후 4일된 신생아에서 발생한 vancomycin 내성 E. faecalis 패혈증 l례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Vancomycin-resistant enterococcus(VRE) was first isolated from various specimens of patients with renal failure or leukemia in 1988. Thereafter VRE has been increasing gradually and became one of the clinically important palhogenic organisms currently. We experienced a case of E. faecalis sepsis in a 4 day old neonate. She was born at 39 weeks gestational age with 2,900gm weight by Cesarean section delivery due to breech presentation. She had had swelling and motion limitation of the left knee joint with fever for one day at age of 4 day and was transfered to our hospital. Ultrasonographic examination of her left knee joint showed some inflammatory change. E. faecalis was isolated from the blood. The organism showed resistance to vancomycin on drug susceptibility test using BHI agar screening test and disk diffusion method. After treatment with ampicillin-sulbactam for 3 weeks the baby was improved. Although VRE infection has been considered rare in Korea. considerable number of demonstrative studies about VRE isolation have been reported recently thus adequate countermeasures are needed to reduce the emergence and prevent nosocomial spreading of this organism.

재발한 급성 혼합형 백혈병에 동반된 골수괴사 1례의 MRI 소견

박주영,박억,박샛별,전동석,이희정,김흥식,강진무,Park, Joo Young,Park, Euk,Park, Seat Byeoul,Jeon, Dong Seok,Lee, Hee Jung,Kim, Heung Sik,Kang, Chin Moo 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.2

골수괴사는 골수를 침범하는 매우 드문 조직 소견으로 저자들은 급성 혼합형 백혈병 환아가 요통, 발열을 주소로 방문하여 세번째 재발하였을 때 골수 천자 도말 검사에서 골수괴사가 동반되고 혈청 LDH와 ferritin이 증가되었으며 자기공명영상에서 골수괴사의 특징적인 소견을 보인 1례를 경험하였기에 보고하는 바이다. Bone marrow necrosis is a rare complication of a variety of diseases affecting the marrow. The cause and incidence are unknown, and reports of treatment response are rare. We describe a case of relapsed acute mixed type leukemia with bone marrow necrosis. The patient was a 10 year old female diagnosed with acute mixed type leukemia four years ago. She had been on second remission state for 1 year, presented with severe back pain, tenderness in lower extremities, low-grade fever and general weakness. Her level of serum lactic dehydrogenase on admission was increased. Bone marrow aspiration from both posterior iliac crest showed marrow necrosis. Subsequent examination showed the same feature. Hip MRI showed heterogenous low signal intensity in both iliac bone on T-1 weighted image and heterogenous high signal intensity on T-2 wieghted image. Remission induction therapy was started but she expired on 59th hospital day due to the complication of sepsis.

요추천골부 수막척수류가 동반된 전두간형 뇌류 1례

김동석 ( Dong Seok Kim ),이상락 ( Sang Lak Lee ),강진무 ( Chin Moo Kang ),김동원 ( Dong Won Kim ) 대한주산의학회 1994 Perinatology Vol.5 No.2

Changing patterns of Clonorchis sinensis infection in Kyongbuk, Korea

Chong-Yoon JOO(주종윤),Myung-Sook CHUNG(정명숙),Sun-Jin KIM(김선진),Chin-Moo KANG(강진무) 대한기생충학열대의학회 1997 The Korean Journal of Parasitology Vol.35 No.3

상부 위장관 이물에 대한 임상적 고찰 : 내시경적 진단과 적출

안성훈(Sung Hoon Ahn),허정욱(Jung Wook Hur),강영우(Young Woo Kang),이준호(Jun Ho Lee),박승국(Seoung Kook Park),박태원(Tae Won Park),강진무(Chin Moo Kang) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

N/A Today upper gastrointestinal (UGI) endoscopy is widely used in diagnosis and management of foreign bodies. A clinical study of 76 cases with the foreign bodies in the upper gastrointestinal tract diagnosed by flexible UGI endoscopy in Dangsan Hospital from January 1982 to December 1992 was performed. Foreign bodies were common in male (rate 1,6: 1) and in 6th decade (28 cases, 36.8%). Bezoar was the most common foreign body (57 cases, 75.0%) and foreign bodies were mostly lodged in stomach (50 cases, 65.8%). Endosopic removal or destruction was successful in 31 cases (35.4%) including all 19 cases other than bezoar. 52 cases (68.4%) hacl combined diseases, 17 cases (22.4%) had past history of operation and 9 cases (11.8%) had history nf ingestion of foreign bodies. In conclusion, UGI endoscopy and endoscopic removal is required to diagnose and manage foreign bodies in UGI tract

Doxorubicin에 의한 심근증 1례

강진무,황종문,권태찬,권치한 啓明大學校 醫科大學 1990 계명의대학술지 Vol.9 No.2

Doxorubicin is effective chemotherapeutic agent in the treatment of various solid tumor and hematologic malignancies. Because of its cardiotoxicity, however, early inappropriate discontinuation of doxorubicin therapy in unavoidable and may minimize its therapeutic efficacy in may patients. Doxorubicin cardoptpxicity is dose related and the cardiomyopathy is fatal in over half the cases. Authers have experienced a case of doxorubicin induced cardiomyopathy in a 4 years old girl who diagnosed dose is 345mg/M?. She also had right nephrectomy and irradiation to the right kidney area. Brief review of the literature was made.

Alobar형 Holoprosencephaly 1례

강진무,서은숙,허상명,백태원 啓明大學校 醫科大學 1990 계명의대학술지 Vol.9 No.4

We experienced a case of alobar type holoprosencephaly without extracranial abnormalities except microcephaly in a 8 months old male infant. The diagnosis was made by brain CT scan, which showed the findings compatible to alobar type of holoprosencephaly. The patient is living up to the age 18 months with severe mental retardation. A brief review of literature was made.

제대 및 신생아 혈중 cytokine(IL₁β, IL6, TNF) 수치의 변화

강진무,김홍식,박인식,이형종 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

분만방법에 따른 제대혈과 양수 그리고 감염 및 stress가 있는 신생아혈중과 세포성분을 배양한 상청액의 cytokine치를 ELISA법으로 측정하여 다음과 같은 성적을 얻었다. 제대혈중 IL₁β치는 질식 유도분만때가 질식 자연 분만, 응급 제왕절개 및 계획 제왕절개때보다 유의하게 높았다(p<0.001). 신생아 혈중 IL₁β치는 감염이 동반된 경우와 stress가 동반된 경우에 높았으며, 감염이 동반되었을 때가 stress보다 더 높게 나타났고, 저체중 출생아에서 높았다. 계획 제왕절개시의 제대혈 IL₁β치는 양수보다 낮았다. 질식자연 분만시 제대혈 세포상청액의 IL₁β 혈장치보다 높았고, 양자간에 유의한 상관관계를 보였다(r=0.92, p<0.05). 감염이 동반된 신생아에서 IL₁β치는 혈장치가 높은 경우 세포 상청액치는 낮고, 혈장치가 낮은 경우 세포 상청액치는 높았다. IL6는 감염이 있는 신생아 혈장과 세포 상청액, 양수 등에서 검출되었다. TNF는 감염이 있는 신생아 세포 상청액 8례중 3례에서 측정되었다 The cytokines, interleukin-1β(IL₁β), interleukin-6(IL6) and tumor necrosis factor(TNF) are important mediators of host response to stress and infection. Impaired immune reaction and febrile responses to the infection in newborn period may result from abnormal cytokine regulation and there were difference in the responses between newborn and adult due to the different cytokine regulation system. To investigate the cytokine regulation in different circumstances of the delivery and newborn conditions, the measurement of the levels of IL₁β,IL6 and TNF in cord blood, amniotic fluid and the blood of the newborn were performed, using enzyme linked immunosorbent assay(ELISA,R&D Co.). Cytokines of the supernatant of incubated cellular pellet were also measured. Cord blood IL₁β level was significantly higher in induced vaginal delivery than that of the normal vaginal, emergency, and elective cesarian section delivery(p<0.001). Plasma IL₁β level of the newborn with infection or stress was elevated and the level was higher in infection than that of the newborn with stress during delivery. Premature baby had higher level than normal newborn. Cord blood IL₁βlevel was lower than that of amniotic fluid in elective cesarian section delivery. In normal vaginal delivery, IL₁βlevel of the cellular supernatant was higher than that of the plasma and showed good correlation(r=0.92, p<0.05). In newborn with infection, plasma IL₁βlevel was high in the cases with low supernatant level and the plasma level was low in the cases with high supernatant IL₁β. IL6 was detcted from the plasma and cellular supernatant of the newborn with infection and the amniotic fluid. TNF was detected in cellular supernatant of 3 among 8 newborn with infection.