성인 무균성 수막염 환자의 뇌척수액으로부터 Enteroviruses 의 분리

정희진(Hee Jin Cheong),김우주(Woo Joo Kim),김민자(Min Ja Kim),박승철(Seung Chull Park) 대한내과학회 1997 대한내과학회지 Vol.53 No.4

N/A Background: The enteroviruses are the most common etiologic agent of aseptic meningitis in adults and children. The incidence of enteroviral meningitis in childhood meningitis is up to 80%, but in adults is not known, worldwidely. In Korea, where tuberculosis is endemic, the rapid and accurate diagnostic method for enteroviral meningitis is required especially because early differential diagnosis of viral meningitis from tuberculous meningitis is very important. The aims of this study were the demonstration of enteroviruses from cerebrospinal fluid (CSF) of adult patients with aseptic meningitis by PCR/Southern hybridization and the verification of the usefulness of PCR/southern hybridization as a rapid diagnostic tool. Methods: From July 1992 to June 1995, total 34 CSF samples (10 from children, 24 from adults) of patients with aseptic meningitis were studied. As a control group, 15 patients with tuberculous meningitis and 15 patients with bacterial meningitis were studied. Viral RNA was extracted from CSF, reverse transcriptied into cDNA and amplified. The PCR products were Southern hybridizied with enteroviruses-specific digoxigenin-labelled probe. Results: 16/24(66.7%) samples of adult patients with aseptic meningitis were positive for enteroviruses, while in child patients with aseptic meningitis, 9/10(90%) samples were positive. And in one patient, PCR was positive from asymptomatic, onset-7th day CSF sample. Conclusion: Enteroviruses were the most common causative organisms of adult aseptic meningitis in Korea. And, this study showed the usefulness of PCR/Southern hybridization of enteroviruses from CSF for etiologic diagnosis of adult aseptic meningitis in subclinical, asymptomatic period.

데이터 모델을 활용한 정수장 착수공정의 자율운영 방안

정희진(Hee-jin Chung),김성훈(Sung-Hun Kim),이호현(Ho-Hyun Lee),임청조(Cheong-jo Lim) 한국정보통신학회 2023 한국정보통신학회 종합학술대회 논문집 Vol.27 No.1

증례 : 감염: 신병훈련소의 군인에서 발생한 아데노바이러스 55형 폐렴

윤진구 ( Jin Gu Yoon ),이샘나 ( Saem Na Lee ),이정민 ( Jung Min Lee ),노지윤 ( Ji Yun Noh ),송준영 ( Joon Young Song ),정희진 ( Hee Jin Cheong ),김우주 ( Woo Joo Kim ) 대한내과학회 2016 대한내과학회지 Vol.90 No.4

Adenoviral pneumonia is rare in healthy adults. However, several cases were recently reported in a military training center in South Korea. Adenovirus genotype 3, 6, and 7 are predominant in South Korea. More recently, genotype 55, which emerged sporadically in China, has been reported in South Korea. In this study, we present a case of adenoviral pneumonia caused by genotype 55 in a healthy soldier from an army recruit training center in South Korea. (Korean J Med 2016;90:365-368)

2009년 발생한 신종인플루엔자 대유행에 대한 정책적 대응 평가

최원석,김우주,정희진,Choi, Won-Suk,Kim, Woo-Joo,Cheong, Hee-Jin 대한예방의학회 2010 예방의학회지 Vol.43 No.2

Objectives: To evaluate the policies on 2009 influenza pandemic in Korea at the end of first wave. Methods: The main policies and the estimation of these were described according to the progress of 2009 influenza pandemic. Results: The public health measures for containment were estimated to be successful in the early stage. The preparedness of antiviral agents and vaccines before the pandemic, risk-communication on pandemic influenza and policies of government including vaccines, and the education of health care worker and support of health care institutions was not enough to respond to the pandemic. Conclusions: The additional evaluation should be performed at the end of the pandemic in various aspects including health and socioeconomic effects.

IgG avidity assay 를 이용한 급성 한탄바이러스 감염의 진단

김우주(Woo Joo Kim),정희진(Hee Jin Cheong),우흥정(Heung Jeong Woo),박승철(Seung Chull Park),김민자(Min Ja Kim),백락주(Luck Ju Baek) 대한내과학회 1999 대한내과학회지 Vol.56 No.5

N/A Objective : The golden standard of serodiagnosis of HFRS is IFA(indirect immunofluorescence antibody test). However, positive IFA for IgG antibody does not always correlate with current infection because IFA may be positive due to past exposure to Hantaan virus such as subclincal infection or due to vaccination in endemic area. So supplementary diagnostic method is needed to diagnosis of HFRS with more accuracy. Methods : In this study, the usefulness of IgG avidity assay with 8 mole/l urea in diagnosis of HFRS was investigated. Serum samples from 45 patients with acute phase HFRS and 79 residents of endemic area, who had HFRS antibody were tested for IgG avidity. Results : The distribution of IgG avidity index of HFRS antibody was different acute phase of HFRS patients from endemic area residents(p<0.001). Patients with acute phase HFRS exhibited lower avidity of Hantaan virus-specific IgG (mode of 64 of avidity index), in contrast endemic area resident had a higher avidity (mode of 4 of avidity index). Conclusion : The IgG avidity assay should assist in the diagnosis of acute phase HFRS and may be used to identify recent infection and past exposure to Hantaan virus.

B형 인플루엔자와 관련되어 발생한 혈구포식 림프조직구증식증

이샘나 ( Saem Na Lee ),윤진구 ( Jin Gu Yoon ),조치현 ( Chi Hyun Cho ),최철원 ( Chul Won Choi ),최정윤 ( Jung Yoon Choi ),정희진 ( Hee Jin Cheong ),김우주 ( Woo Joo Kim ) 대한내과학회 2016 대한내과학회지 Vol.91 No.1

혈구포식 림프조직구증식증(HLH)은 대식세포와 림프구의 증식과 활성화가 조절되지 않아 발생하게 되는 드문 과염증 증후군으로, 치명적인 예후를 초래하는 경우가 많다. 저자들은 기저 질환이 없는 환자에서 B형 인플루엔자 감염과 연관되어 발생한 혈구포식 림프조직구증식증으로 인하여 사망한 증례를 경험하여 이를 보고하는 바이다. Influenza infection may be complicated by various infectious or non-infectious diseases. Among them, hemophagocytic lymphohistiocytosis (HLH) is an uncommon hyperinflammatory syndrome caused by uncontrolled proliferation and activation of macrophages and lymphocytes, and it is often life threatening. A previously healthy male patient was suspected to have HLH after influenza B infection. The diagnosis was established based on clinical diagnostic criteria suggested in the HLH-2004 trial. Despite prompt antiviral therapy, the patient expired on day 19 of hospitalization. Influenza can thus be complicated by HLH. Due to the non-specific manifestations of HLH, clinical suspicion and early diagnosis are important. (Korean J Med 2016;91:88-91)

한국 훈련병에서 수막염균 보균에 대한 4가 수막염균 결합 백신의 영향

허중연 ( Jung Yeon Heo ),배송미 ( Song-mee Bae ),정희진 ( Hee Jin Cheong ),김우주 ( Woo Joo Kim ),김민영 ( Min Young Kim ),나원웅 ( Wonwoong Na ),최강원 ( Kang-won Choe ),천병철 ( Byung Chul Chun ) 국군의무사령부 2014 대한군진의학학술지 Vol.45 No.1

Background: Monovalent meningococcal conjugate vaccines against serogroup A or C had resulted in significant reduction of pharyngeal carriage rates against respective vaccine serogroup. However, the effect of quadrivalent meningococcal conjugate vaccine on meningococcal carriage has not been evaluated. We assessed on changing pharyngeal carriage rate of Neisseria meningitidis after the introduction of quadrivalent meningococcal conjugate vaccine in Korean military trainees. Methods: Twice oropharyngeal swabs were conducted at the beginning and end of army training period in Korean military trainees. First oropharyngeal swabs were undertaken prior to vaccination. Second round of swabbing was done 5 weeks later. Results: In 2013, overall carriage rate of N. meningitidis was higher at the end of training period (13.8%, 60 of 434 participants) than on entry of military service (8.9%, 39 of 434 participants). Although carriage rate of nongroupable and serogroup X isolates were increased over 5-week interval, carriage strains of vaccine serogroup, which were included serogroups in quadrivalent meningococcal vaccine, were relatively reduced from 7 to 2 isolates following vaccination. However, in 2014, overall carriage rate of N. meningitidis was significantly lower at the end of training period (5.2%, 23 of 443 participants) than on entry of military service (12.6%, 56 of 443 participants) (p=0.028). Carriage isolates of vaccine serogroups were significantly decreased with that of non-vaccine serogroup B over 5-week interval (p=0.006). Conclusion: Meningococcal vaccination in Korean military trainees resulted in reduction of pharyngeal carriage rates of not only vaccine serogroup meningococci but non-vaccine serogroup B. Quadrivalent meningococcal conjugate vaccine is likely to preventing carriage acquisition of meningococci in a closed population.

증례 : 야생 멧돼지 생식으로 인한 선모충증(Trichinellosis) 집단 발병 1예

허규영 ( Gyu Young Hur ),황병연 ( Byung Yoen Hwang ),이재갑 ( Jae Gap Lee ),이명구 ( Myung Goo Lee ),정희진 ( Hee Jin Cheong ),조성원 ( Sung Weon Cho ),주경환 ( Kyoung Hwan Joo ) 대한내과학회 2004 대한내과학회지 Vol.67 No.-

류마티스관절염과 전신홍반루푸스 환자에서의 대유행 H1N1 인플루엔자 백신 접종 반응

김지헌 ( Ji Hun Kim ),최한나 ( Han Na Choi ),김시혜 ( Si Hye Kim ),이화정 ( Hwa Jeong Lee ),박성훈 ( Sung Hoon Park ),김성규 ( Seong Kyu Kim ),최정윤 ( Jung Yoon Choe ),권현희 ( Hyun Hee Kwon ),정희진 ( Hee Jin Cheong ) 대한류마티스학회 2013 대한류마티스학회지 Vol.20 No.2

Objective. We investigated the efficacy and safety of pandemic H1N1 vaccine in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients, and evaluated its correlation with serum cytokine level. Methods. A total of 43 RA patients and 31 SLE patients were enrolled in the study and were compared with age, sex-matched 40 healthy controls (HC). The blood samples drawn from selected patients before vaccination and in post-vaccination at week 4 were assayed in one session to measure the titers of antibodies against haemagglutinin specific for influenza virus strains: A/California/7/2009 NYMC X-179A (H1N1). Serum IL17 and CXCL13 levels were measured in the same session by enzyme-linked immunosorbent assay. The association of serum cytokine level with anti-influenza antibody titer and mean fold increase (MFI) was investigated. Each specific side effect after vaccination was monitored in both the patients and control groups. Results. The geometric mean antibody titer (GMT) for preand post-vaccination at week 4 was not significantly different between RA and HC, SLE and HC. The seroconversion rate in HC and RA was not significantly different, whereas the seroprotection rate is significantly higher in HC (82.5%) than RA (55.8%) (p<0.05). MFI in HC, RA, SLE were 19.65, 6.00 and 6.06, which were significantly higher in HC. Serum IL17 level was 6.28±2.89 pg/mL and 7.56±3.34 pg/mL in pre-, post-vaccination SLE patients, 33.85±15.62 pg/mL and 38.04±18.60 pg/mL in RA patients and was significantly lower in SLE patients. Serum CXCL13 level was 518.73± 720.29 pg/mL and 431.53±601.23 pg/mL in pre-, post-vaccination SLE patients, which was significantly higher than HC (149.64±248.81 pg/mL and 147.36±213.92 pg/mL in each pre-, post-vaccination) and was not significantly different with the level of RA patients. In SLE patients, significant correlations were detected between cytokine level and post-vaccination antibody titer (r=0.22 p=0.026 between IL 17 and GMT; r=0.44, p<0.05 between CXCL13 and GMT). Conclusion. The increase in post-vaccination antibody titer is weaker in both RA and SLE patients group than the HC group. Post-vaccination antibody titer was positively correlated with B lymphocyte chemoattractant and CXCL13 in SLE patients, but not in RA patients.

고립성 폐결절의 감별진단에서 결핵균에 대한 Nested PCR 의 유용성

심재정(Jae Jeong Shim),이소라(So Ra Lee),이상엽(Sang Youb Lee),이상화(Sang Hwa Lee),서정경(Jung Kyung Suh),정희진(Hee Jin Cheong),조재연(Jae Yun Cho),김우주(Woo Joo Kim),강은영(Eun Young Kang),인광호(Kwang Ho In),유세화(Se Hwa Yoo),강 대한내과학회 1997 대한내과학회지 Vol.52 No.6

N/A Objectives: The evaluation and management of a patient with solitary pulmonary nodule(SPN) are guided by principles that were derived from earlier surgical studies. SPN has a relatively good prognosis even if it is a malignant lesion. In Korea, where there is a high incidence of pulmonary tuberculosis, approximately 40% to 70% of clinically encountered solitary pulmonary nodules are tuberculous lesions. SPNs can be diagnosed by clinical findings and chest imaging techniques, but confirmed only by pathologic or cytologic studies. Transthoracic needle aspiration biopsy(TNAB) or cytology will be diagnostic in 80% to 95% of malignant nodules, but will identify the benign nature in 50% to 90% of benign nodules; such results imply lower accuracy of TNBA or cytology in diagnosing benign nodules. Differential diagnosis of SPNs can be difficult in tuberculosis endemic areas, such as in Korea, Nested polymerase chain reaction(PCB) is the widely used method to test very small amount of pathogene and to detect M, tuberculosis in fine needle aspirates. Methods: 33 patients with SPN found on chest radiographs were evaluated by chest CT, mycobacteriologic and cytologic studies from sputum, bronchial washing fluids, and transthoracic fine needle aspirates, 17 cases were malignant SPNs(51.5%), consisting af 14 primary lung cancers and 3 metastatic SPNs, 18 cases were benign SPNs(48.5%), consisting of 8 tuberculous, 4 localized pneumonia, 1 pulmonary sequestration, and 3 radiologically suspected tuberculous lesions without response to anti-TB drugs. Nested PCR for detecting M. tuberculosis using TB-1, TB-2, TB-28, and TB-29C was carried out on fine needle aspirates from 33 patients with SPN. Results: Among the pathologically proven 17 malignant SFNs, 15(88.5%) cases were detected as cancer on chest CT. 15(88.5%) cases were confirmed by transthoracic needle aspiration cytology, among which 3(17.7%) cases showed positive on sputum cytology, and other 3(17.7%) cases yielded positive on bronchial washing cytology as well. Two cases of malignant nodules were confirmed by open resection. In 8 tuberculous SPNs, Neither AFB stain of sputum, bronchial washings, nor transthoracic needle aspirates showed positive. However, mycobacterium was cultured in 1 (9.l%) case from sputum, in 3 (27.3%) cases from bronchial washing fluids, and in 2 (18.2%) cases from transthoracic needle aspirates. Thus, five cases were confirmed bacteriologically; one case had positive culture results on both bronchial washing and transthoracic needle aspirates. Three out of 8 tuberculous cases were radiologically suspected and showed response to anti-TB drugs, but were not bacteriologically confirmed. Chest CT could detect 72.7% of tuberculous nodules. Aspirates from malignancy, pneumonia, and sequestration were negative on nested PCR for tuberculosis, One of the 3 radiologically suspected tuberculous nadules with- out response to anti-TB drugs yielded positive results on nested PCR for M, tuberculosis. In contrast, 7 out of 8(87.5%) aspirates from proven tuberculous nodules showed positive results on nested PCR for M. tuberculous, which included 4 bacteriologically proven tuberculous nodules and 3 radiologically suspected tuberculous nodules with response to anti-TB drugs. Conclusion: Nested PCR could be used to detect M. tuberculosis in fine needle aspirates from tuberculous SPN with good sensitivity (87.5%) and specificity(96.0%). Therefore, nested PCR for detecting M. tuberculosis in fine needle aspirates may be useful in the differential diagnosis of solitary pulmonary nodules.