서울시내 공중전화기 위생검사

최영실(Choi Young Sill),서광석(Seo Kwang Suk) 한국환경관리학회 1997 環境管理學會誌 Vol.3 No.1

소 도축 관련 종사자에서 브루셀라증의 혈청유병률 및 위험요인

유석주,최영실,임현술,이관,박미연,주재신,강영아,Yoo, Seok-Ju,Choi, Young-Sill,Lim, Hyun-Sul,Lee, Kwan,Park, Mi-Yeoun,Chu, Chae-Shin,Kang, Young-A 대한예방의학회 2009 예방의학회지 Vol.42 No.4

Objectives : The incidence of zoonoses in Korea has increased recently. However, the study of high risk groups for zoonoses has not been conducted to date in Korea. Thus, we did this study to obtain data on brucellosis among slaughterhouse workers in Korea. Methods : We evaluated the structure of slaughterhouses and the process of slaughtering by reviewing the relevant literature and doing field studies. We visited 73 slaughterhouses and 62 residual products handle houses across the country. In addition, we conducted a questionnaire survey of the work activities, and obtained blood samples in order to determine the seroprevalence and risk factors of brucellosis. The titers of brucellosis antibodies were measured using the standard tube agglutination test SAT). We diagnosed subjects as seropositive for Brucellosis if the titers were more than 1:160. The data collected was evaluated using SPSS ver. 17.0. Results : We included 1,503 subjects and obtained 1,482 blood samples among them: 849 workers involved in slaughtering, 351 handlers of residual products, 190 inspectors and their assistants, and 92 grading testers and their assistants. The seroprevalence of brucellosis among the slaughterhouse workers was 0.8% (95% CI=0.4-1.5). Broken down, the seroprevalence of brucellosis among the workers involved in slaughtering was 0.7% (95% CI=0.3-1.6), the handlers of residual products was 1.7% (95% CI=0.7-3.9) respectively. Risk factors for contracting brucellosis among slaughterhouse workers were being splashed with cattle blood around the mouth, cattle secretions around the body and not putting on protective apron while at work. Conclusions : An educational program is needed for high risk groups on zoonoses about the prevention of infection. Thus, effective working guidelines for workers who participate in the slaughter of animals must be developed in order to protect them from zoonoses.

2,3,7,8-TCDD의 세포형질전환 및 내성획득에 관여하는 세포내 인자에 관한 연구

염태경(Tai Kyung Ryeom),최영실(Young Sill Choi),김옥희(Ok Hee Kim),강호일(Hoil Kang) 한국환경성돌연변이발암원학회 2006 한국환경성돌연변이·발암원학회지 Vol.26 No.1

To enhance our understanding of toxicity mediated through the pathway by which TCDD stimulates gene expression, we have investigated genes whose expressions are changed after treatment with TCDD and/or MNNG in human Chang liver cell. First, we treated with MNNG and TCDD for two weeks to transform human Chang liver cell. We obtained cell looks like to be transformed and compared the differential gene expression by using cDNA chip (Macrogen) which carrys genes related with signal transduction pathways, oncogenes and tumor suppressor genes, etc. We found that TCDD up- or down-regulated 203 and 111 genes including oncogenes and tumor suppressor genes in human Chang liver cell two fold or more, respectively. Second, we compared the differential gene expression after treatment with TCDD only by using cDNA chip (Superarray) which carrys genes related with cell cycle regulations, and found that TCDD up regulated genes related with cell proliferation as well as cell growth inhibition in human Chang liver cell two fold or more, respectively. These results suggest that toxicity induced by TCDD may reflect sustained alterations in the expression of many genes and that the changes reflect both direct and indirect effects of TCDD.

증례 : 감염 ; 골수 및 림프절생검에서 섬유소 고리 육아종 소견을 보인 급성 Q열 1예

조오현 ( Oh Hyun Cho ),최영실 ( Young Sill Choi ),김탁 ( Tark Kim ),박기호 ( Ki Ho Park ),오련 ( Ryan Oh ),지현숙 ( Hyun Sook Chi ),김양수 ( Yang Soo Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1S

감염 ; 대구 지역 급성 Q열의 임상적 특징

이경숙 ( Kyoung Suk Lee ),최영실 ( Young Sill Choi ),권기태 ( Ki Tae Kwon ),이미정 ( Mi Jung Lee ),서아영 ( A Young Seo ),이신원 ( Shin Won Lee ),한승우 ( Seoung Woo Han ),김건우 ( Gun Woo Kim ),김현수 ( Hyun Soo Kim ),박창근 ( Ch 대한내과학회 2010 대한내과학회지 Vol.79 No.4

목적: 저자들은 Q열 환자 13명을 진단하고 치료하였으며, 국내에서 아직까지 증례 보고 이외에 Q열의 임상양상에 대한 연구는 없는 실정으로 저자들이 경험한 증례들의 임상적 특징을 분석해 보았다. 방법: 2006년 1월부터 2008년 8월까지 대구광역시지역 3개 종합병원에서 진단하고 치료한 급성 Q열 환자 13명을 대상으로 임상적 특성에 대한 후향적 조사를 환자들의 의무기록을 바탕으로 시행하였다. 미세간접면역형광항체법(indirect micro-immunofluorescence assay)에서 anti-phase II IgM 항체가가 1:50 이상이고, anti-phase II IgG 항체가가 1:200 이상인 경우 급성 Q열로 진단하였으며, 추가적으로 C. burnetii의 27-kDa 외막단백(outer membrane protein, OMP) com1유전자(438 bp)에 대한 중합효소 연쇄반응(polymerase chain reaction, PCR)을 시행하였다. 결과: 연구기간 동안에 급성 Q열로 진단된 환자는 총 13명이었다. 11명(84.6%)이 남성이었고, 2명(16.4%)이 여성이었으며, 환자들의 평균 나이는 49세(24~76)였다. 감염 경로를 추정해 볼 수 있는 환자는 모두 7명(53.8%)으로, 개 또는 고양이와 접촉한 환자가 3명(23%), 소와 접촉한 경우가 2명(15.3%), 사슴피를 섭취한 경우가 1명(7.7%), 낙동강 둑에서 쓰레기 줍기를 한 경우가 1명(7.7%)이었다. 모든 환자에서 발열이 있었으며, 두 번째로 흔한 임상증상인 근육통이 11명(84.6%)이었고, 두통, 식욕감퇴, 오한이 각각 8명(61.5%)씩 있었으며, 쇠약감과 복통이 각각 7명(53.8%)씩 있었다. 흉부X-선 검사에서 폐렴이 의심되는 환자는 없었다. 발열을 동반하는 간염이 주요 임상소견이었다. 특히 총 빌리루빈이 8mg/dL이 넘는 심한 고빌리루빈혈증을 나타낸 환자가 3명(23%)이 있었다. 모든 환자에서 위의 진단기준을 만족하고, 중합효소 연쇄반응에서 양성이었다. 3명(23%)에서 간 조직검사를 시행하였으며, 섬유고리 육아종(fibrin-ring granuloma)이 관찰되었다. 7명(53.8%)에서는 항균제 투여 전에 해열이 되었다. 투여된 항균제로는 doxycycline이 11명(84.6%), azithromycin이 1명(7.6%)이었으며, 1명(7.6%)은 항균제가 투여되지 않았다. 결론: 대구광역시지역에서 원인 불명의 발열과 간염을 동반한 환자에서는 Q열에 대한 혈청학적인 검사를 시행하고, 환자의 상태가 위중한 경우에는 경험적으로 doxycycline을 투여하는 것을 고려하여야 하겠다. Background/Aims: Although only a few sporadic cases of Q fever have been reported in Korea, a total of 13 cases have been seen in our area. We performed this study to evaluate the clinical characteristics of these cases of acute Q fever. Methods: Demographic features, clinical manifestations, laboratory and radiologic findings, and therapeutic outcomes of all cases were evaluated. Q fever was diagnosed using an indirect micro-immunofluorescence assay (MIFA) and polymerase chain reaction (PCR). Results: A total of 13 patients with acute Q fever seen from January 2006 to August 2008 at three teaching hospitals in the Daegu Metropolitan City area were enrolled. The mean age was 49 years old (range, 24~76), and the male to female ratio was 11:2. Six (46.2%) cases had a history of animal contact. Fever (100%) was the most common manifestation, followed by myalgia (84.6%), headache (61.5%), anorexia (61.5%), and chills (61.5%). All cases were diagnosed with high titers of anti-phase II antibody (IgM≥1:50, IgG≥1:200) and positive nested PCR for the 27-kDa OMP com-1 gene of Coxiella burnettii in the blood. In three cases, liver biopsies revealed the presence of compact fibrin-ring granulomas. No characteristics of pneumonia were diagnosed on chest X-rays. The predominant presentation was acute febrile illness with hepatitis, including three cases (27.3%) of severe cholestatic hepatitis. The most frequently used antimicrobial agent was doxycycline (84.6%), followed by azithromycin (7.7%). Conclusions: Acute Q fever may be added to the list of differential diagnosis of patients with acute febrile illness and hepatitis in the Daegu Metropolitan City area. (Korean J Med 79:404-411, 2010)

Q열로 진단된 불명열 3예

허상택 ( Sang Taek Heo ),박미연 ( Mi Yeoun Park ),최영실 ( Young Sill Choi ),오원섭 ( Won Sup Oh ),고관수 ( Kwan Soo Ko ),백경란 ( Kyong Ran Peck ),송재훈 ( Jae Hoon Song ) 대한내과학회 2008 대한내과학회지 Vol.74 No.1

Q열은 국내에서도 드물지 않은 질환으로 생각되며, 조기에 진단하지 못하는 경우에 심내막염이나 혈관염 등의 만성 Q열로 진행하여 사망에 이를 수 있다. 물론 급성 Q열은 비특이적 증상에서 폐렴이나 간염 소견으로 내원하는 환자가 대부분이나 발열의 원인이 확실한 경우 원인균이 밝혀지지 않아도 Q열의 혈청학적 의뢰를 요하는 경우는 흔하지 않다. 하지만 발열을 주소로 내원한 환자들에 대하여 상기 증례들처럼 불명열의 경우 가축이나 이들의 부산물에 접촉력이 있는 경우 뿐만 아니라 특별한 접촉력이나 직업력이 없더라도 불명열로 내원한 환자들의 감별진단에서 Q열의 가능성을 고려하여 혈청학적 검사 및 핵형 분석을 시행해야 하겠다. 향후 국내에서도 사람뿐만 아니라 가축에서의 대규모의 역학적 조사가 추가적으로 필요할 것으로 생각된다. Q fever is an orthozoonotic infection caused by Coxiella burnetii, which was recently reclassified from the order Rickettsials to the order Legionellales. Although Q fever is usually mild and self-limiting, it may be manifested as a serious disease, such as pneumonia, endocarditis, or meningoencephalitis. We describe three separate cases of acute Q fever, which were diagnosed by an indirect micro-immunofluorescence assay (MIFA) test and DNA amplification (PCR). Three adult patients were admitted between December 2004 and August 2006 because of a fever of greater than three weeks duration. Only one patient had contact history with a dog. Of the three patients, two patients had myalgia, headache, skin rash, lymphadenopathy, and hepatosplenomegaly. Although all sets of blood cultures were negative, anti-phase II antibody titers by using an indirect MIFA (IgG 1:512-1,024 and IgM 1:320) were markedly increased in sera from all of three patients. Concomitant PCR assays also demonstrated the presence of OMP com1 for C. burnetii in blood from all of the three patients. Two patients had complete resolution of symptoms and signs with a two-week course of doxycycline, while one patient had spontaneous defervescence. Although the incidence of Q fever is not well known yet in Korea, it should be considered in the differential diagnosis of patients with fever of unknown origin. (Korean J Med 74:100-105, 2008)

통계적 품질 관리도 기법을 활용한 혈액수급관리

고찬규 ( Chan Kyu Ko ),김민경 ( Min Kyung Kim ),양원모 ( Won Mo Yang ),정문영 ( Mun Yeong Jeong ),황형태 ( Hyung Tae Hwang ),이성임 ( Sung Im Lee ),강주형 ( Ju Hyeong Kang ),오진아 ( Jin A Oh ),최영실 ( Young Sill Choi ) 한국보건정보통계학회(구 한국보건통계학회) 2015 보건정보통계학회지 Vol.40 No.1

Objectives: The purpose of this report is to monitor the status of blood management based on blood supply, usage, and wastage data provided by Korea Blood Inventory Monitoring System (KBIMs). Methods: KBIMs is the ongoing national surveillance system for blood management. The current report includes data from 25 sentinel hospitals during 2009-2012 years. In this sample, the data collected in each hospital were summed and defined on the weekly basis for the use of the control chart. Results: Since the amount of blood usage covers over 99 percent of the supply, they appear to have similar control chart patterns. Blood type A, B and O show obvious shifts in mean supply and usage which occur beyond the center line in 2012. Blood wastage is out of control in 2010 and 2012. Interestingly, this does not occur in the winter season and the pattern of blood wastage has significant seasonal difference (p=0.001). Conclusions: Findings suggest that the blood usage has an increasing tendency in all blood types except AB in 2012, while blood wastage has seasonal variations. Even though such state may not stay the same, this analysis provides enough warrants for further study.

사람 子宮筋에서 分離한 mitochondria 分劃내 Adenosinetriphosphatase 活性度에 미치는 Mg^(++),Ca^(++),Na^(+),K^(+), 및 Creatinephosphate의 影響

崔英實 부산의대 1972 부산의대잡지 - 부산대학교 의과대학 Vol.12 No.1

羊水의 Creatinine, Sodium, Postassium 및 Chloride 濃度의 動態

崔英實,鄭泰朝,辛東穆 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.1

제주도에서 브루셀라에 의해 발생한 특발성 세균성 복막염

허상택,조유경,김영리,이근화,윤지완,고관수,박미연,최영실 대한감염학회 2007 감염과 화학요법 Vol.39 No.1

Spontaneous bacterial peritonitis is the common infectious disease in liver cirrhosis patients with a fever. Brucellosis is a rare cause of bacterial peritonitis. A case indigenous to a citizen of Jeju, he ate a raw veal of cow four times in last 2 months prior to admission. The gram-negative bacilli were isolated from blood and peritoneal fluid cultures. He was confirmed brucellosis by serologic work- ups. This isolate was confirmed as Brucella abortus by using PCR amplification of 16S ribosomal RNA (rRNA) and omp2. This is the first case of bruellosis that was diagnosed spontaneous bacterial peritonitis in liver cirrhosis patient among native korean citizens. Successful treatment was obtained by using a regimen of doxycycline and gentamicin. Brucella should be suspected as a cause of spontaneous bacterial peritonitis in cirrhotic patients with no response to standard spontaneous bacterial peritonitis treatments. 브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중의 하나로, 국내에서도 해마다 환자가 증가하고 있는 상황이다. 본 증례는 간경화 환자에서 환자의 잘못된 지식을 바탕으로 소 태아 육회를 섭취한 이후 복수와 발열을 주소로 내원한 환자이다. 상기 과거력이 환자의 질환과의 직접적인 연관성을 밝히기는 어려우나 환자의 진단을 추정하는데 도움이 되었으며, 이러한 가능성을 배제하기 위해서라도 국내 유통에 있어서 좀더 적극적인 대체가 필요하다 하겠다. 상기 환자는 브루셀라에 의해 발생한 특발성 세균성 복막염 환자로 제주도에서 발생한 내국인의 첫 증례이기에 문헌 고찰과 함께 보고하는 바이다.