서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1994)

김재홍,안진균,정성재,김영태,김중환,김시영,이석종,이홍렬,서호석,김경훈,권혁진,정우권,고우석,이용석,안필수,오준규,오용섭 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.1

Background : In recent years gonorrhoea has been panendemic and remains one of the most common Sexually Transmitted Diseases in the world, especially in developing countries. Objective & Method : For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria Gonorrhoeae(PPNG), Ive have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1994, 168 strains of N. gonorrhoeae were isolated, among which 109 (64,9% ) were PPNG. Conclustion : Our results suggests that the prevalence of PPNG in Seoul is still increasing.

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

Rifampicin 에 의한 급성 신부전 1예

김홍범,김장섭,김명준,박근수,나하연 대한감염학회 1982 감염 Vol.14 No.1

We have experienced of a case of acute renal failure after the administration of rifampicin. The patient was a 23 years old male and had suffered from pulmonary tuberculosis since Aug. 1979 and had been treated with rifampicin, isoniazid and streptomycin for 1 year. When the second dose of rifampicin was given to the patient because of recurrence of Feb. 1981, headache, nausea and high fever developed, and it was discontinud. On Jun. 1981, 4 days before admission, rifampicin was tried again, but 20 minutes after ingestion, headache, nausea and vomiting developed, then oliguria followed. Physical examination and laboratory findings showed the pictures of acute renal failure. Peritoneal dialysis was performed for 3 times. After 10 days of oliguric phase, urinary output increased and general condition improved. He was discharged at 27th HD with complete recovery.

폐경후 여성에서 정량적 전산화 단층 촬영을 이용한 요추부의 골밀도 측정

김준현,김홍배,김동호,허민 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.4

성대마비환자를 대상으로 시행한 후두근전도검사의 임상적 유용성

최홍식,최영준,문상우,김태만,최홍식,최영준,문상우,김태만 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.2

ImmunoDot법에 의한 전신성 류마티스 질환의 자가항체 검사

박성환,김선준,김성일,민준기,이상헌,홍연식,조철수,김호연 최신의학사 1997 最新醫學 Vol.40 No.7

급성 백혈병 환자에서 감염증의 양상 및 예후인자에 관한 연구 : 1988년∼1995년까지

정희진,김병수,신상원,김열홍,김우주,김민자,김준석,박승철,김권범 대한감염학회 1998 감염 Vol.30 No.3

목적 : 급성 백혈병의 경우 골수기능이 억제되고 항암화학요법에 따른 골수기능 저하로 감염의 위험이 증가하며 감염의 치료가 환자의 생존에 큰 영향을 미치게 된다. 이에 저자들은 1988년부터 1995년까지 고대 구로병원에 급성 백혈병으로 입원했던 환자들 중 입원 기간 내 감염이 있었던 경우를 대상으로 하여 감염의 위험인자 및 감염증의 예후를 후향적으로 분석함으로써 향후 급성 백혈병환자의 감염의 치료에 대한 지침을 얻고자 하였다. 방법 : 급성 백혈병으로 확진된 환자들 중 감염병에 이환된 경우를 대상으로 하여 각각을 미생물학적 확인감염, 임상적 확인감염, 그리고 설명 불가열로 구분하였다. 각각의 경우에서 감염 당시의 호중구 수, 호중구 감소 기간, 항암화학요법과의 연관성, 감염 병소, 배양된 검체 및 원인균, 선택적 소화관 살균법의 사용여부 및 골수회복 여부 등을 조사한 후 환자의 예후와 어떤 관계가 있는 지 조사하였다. 결과 : 연구 대상은 총 113예로 남녀비는 46:67 이었고 평균연령은 34±13세, 진단은 급성 골수성 백혈병 (AML)이 84예, 급성 림프구성 백혈병(ALL)이 29예였으며, 감염시 평균 호중구수는 663±1678/㎣이었고, 호중구 감소 기간은 평균 18±13일이었다. 감염양상은 항암화학요법과 연관된 감염이 84예로 대부분이었고 미생물학적 확인 감염이 40예로서 35%였으며, 폐렴과 원발성 패혈증이 각각 20예와 19예로 가장 많았고, 카테터 연관 감염이 7예로 나타났다. 배양된 균주는 E. coli가 10예(25%)로서 가장 많았으며, 전체적으로 E. coli, P. aeruginosa, K. pneumoniae 등의 그람음성균이 63%로 대부분을 차지하였으나 최근 그람양성구군 및 진균의 분리율이 증가하는 양상을 보였다. 감염증의 예후를 분석한 결과 진균 감염인 경우나 호중구 감소 기간이 긴 경우 사망률이 높았으며 그 중에서도 골수 기능이 회복 여부가 환자들의 생존과 통계적으로 유의한 연관이 있었다.(P=0.01). 결론 : 급성 백혈병 환자들에서의 감염은 관해유도화학요법 후 초래되는 호중구 감소와 유의한 관계가 있으며, 폐렴 및 패혈증의 임상양상을 보이는 경우가 흔하고, 원인균별로는 그람 음성균이 주류를 이루나 최근 그람 양성균 감염이 증가하는 추세를 보였다. 감염의 예후 인자로는 진균 감염인 경우나 호중구 감소 기간이 긴 경우 사망률이 높았으나 골수 기능의 회복여부가 결정적인 역할을 하는 것으로 나타나, 향후 급성 백혈병 환자의 치료에 있어 감염 빈도의 감소와 감염에서의 조속한 회복을 위해서는 골수 기능의 회복에 중점을 두어야 할 것으로 사료된다. Background : Infection is one of the most important and fatal complications in patients with acute leukemia. The characteristics of infection in acute leukemic patients are different from those in other diseases by the lack of normal inflammatory responses or distinct clinical evidence except fever. To improve the outcome of acute leukemia, it is very important to recognize the risk factors, patterns and prognostic factors of acute leukemia. Methods : We analyzed retrospectively the patterns of infection from 113 febrile patients with acute leukemia from January, 1988 to December, 1995. To determine the prognostic factors and the outcome of infection, the following variables were analyzed: the presence of neutropenia, use of chemotherapeutic agents, type and site of infections, isolated organisms, gastrointestinal decontamination, duration of neutropenia, and bone marrow recovery. Results : Out of 113 febrile patients with acute leukemia, 84 infection episodes(74%) occurred after chemotherapy. The mean duration of neutropenia was 18±13 days. The incidence of microbiologically-documented infection(MDI) was 35%(40/113). Pneumonia was the most common infection(26%), followed by primary sepsis(24%), catheter-related infection(9%). In cases of MDI, 63% were caused by gram-negative bacteria, followed by gram-positive bacteria(28%), and fungi(10%). Escherichia coli(25%) was the most common isolated in MDI. Regarding the prognostic factors in cases with infections, the recovery of bone marrow function was the only statistically significant factor(P=0.01). Conclusion : Infection has been a major cause of morbidity and mortality in acute in acute leukemic patients. To prevent infection and thereby improve the prognosis of acute leukemia, restoration of bone marrow function at early stage is important.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.