혈액암환자에서 조혈모세포 이식 후 따르는 헤르페스 바이러스 감영 양상

이호섭,탁희상,신성훈,김양수,남성진,김혜수,박진희,정수현,김성빈,김예나 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

배경 : 헤르페스바이러스과에는 단순포진 바이러스(HERPES SIMPLEX VIRUS, HSV), 수두대상포진 바이러스 (VARICELLA-ZOSTER VIRUS, VZV), 엡스타인-바 바이러스 (EPSTEIN-BARR VIRUS, EBV), 그리고 거대세포 바이러스 (CYTOMEGALOVIRUS, CMV) 등이 있다. 헤르페스바이러스 감염은 혈액암환자에서 조혈모세포 이식 환자에서 전파 (dissemination), 이차감염, 세균 중복 감염의 심각한 합병증을 일으킬 수 있다. 하지만 항암약물치료를 받는 림파종 환자에서 항 바이러스 약제의 사용 용량과 기간에 대한 concensus는 없다. 헤르페스바이러스 감염에 대한 발생율과 위험인자를 후향성으로 분석하였다. 방법 : 고신대학교 복음 병원에서 1995년 6월부터 2009 년 2월 사이에 새롭게 진단되어 조혈모세포 이식을 받은 전체 58명의 환자들이 후향적으로 현 연구에 등록했다. 헤르페스 바이러스 감염은 임상적 진단, 혈청학적 검사 또는 병리학적 진단에 기초하여 확진한다. 환자들의 특성은 다음과 같다: 평균 연령은 44세 (범위 19-62세)였고 남녀비는 30:28이었다. 등록된 질환은 백혈병 (n=9, 15.5%), 림프종 (n=30, 51.7%), 다발성 골수종 (n=12, 20.7%), 재생불량성 빈혈 (n=6, 10.3%) 그리고 골수이형성증후군 (n=1, 1.7%)이 포함되었다. 결과는 chi-squre test나 independent samples T test를 사용하여 분석되었다. Multivariate analysises에 대해 logistic regression test를 사용하였다. 결과 : 15명의 환자들 (25.9%)에서 조혈모세포 이식후 헤르페스 바이러스 감염이 발생하였다. 조혈모세포 이식 5년간 누적 발생율은 53.9%였다. Univariate analyses에서 헤르페스 바이러스 감염에 대한 유의한 위험 인자는 없었다. 하지만 조혈모세포 이식후 생존 기간(40.18 ± 30.14 months vs 20.06 ± 26.67 months, p=0.018)은 헤르페스 바이러스 감염의 낮은 발병율과 유의한 관련성이 있었다. 이식 편대 숙주질환 (GVHD)의 존재 (37.5% in developed GVHD vs 0% in no GVHD, p=0.200), 동종조혈 모세포 이식에서 면역억제요법의 기간 (15.98 ± 14.02 months vs 6.78 ± 3.67 months, p = 0.374)은 헤르페스 바이러스 감염에 대한 위험인자가 아니었다. 결론 : 조혈모세포 이식 후 생존 기간은 어사이클로비어 예방을 받은 혈액암 환자에서 헤르페스 바이러스 감염의 낮은 발병율과 연관성이 있는 것으로 보인다. 저용량의 어사이클로비어 예방은 헤르페스 바이러스 감염의 고위험군인 조혈모세포 이식을 받은 혈액암 환자에 필요하리라 생각된다. Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI. Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28. The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%), aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysis, we used logistic regression test. Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy (IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI. Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.

초음파속도법을 이용한 혼화재 및 섬유 사용 콘크리트의 압축강도 추정에 관한 연구

김정섭,신용석,노성열 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.1

This study aims to estimate strength approximate to actual concrete strength by presenting appropriate non-destructive strength estimation expression with admixtures such as fly ash, blast furnace slag and silica fume which are used as cement substitute and polypropylene fiber and steel fiber and owing to their s of cement owing to their equal conditions to blending characteristics of concrete used for domestic structures and their recyclable properties. In case of ultrasound velocity, equation by Japanese Architecture Society was estimated 4%~11% higher than destructive strength till 60 days of age, but as age progresses, i is estimated to 15% lower than destructive strength and remaining suggested equation was estimated 3%~27% lower than destructive strength in almost age. As a result of comparing error rates between conventional suggested equations and this estimation equations, there are a little differences by age, but error rate of this study was reduced to 0.6%~18.6% by ultrasound velocity method and it is judged that it is desirable to be used for concrete using admixture and fiber

순환골재를 사용한 콘크리트 보의 구조적 특성에 관한 연구

김정섭,신용석,노성열 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.1

This study identified materials and dynamic characteristics of reclaimed aggregates affecting reinforced concrete through materials and supplementary tests to use broken red bricks and waste concrete as substitutes of concrete and obtained the following results. As a result of the bending specimen test according to types of reclaimed aggregates, it was found that when normal concrete was compared with reclaimed concrete. RBA 30% specimen showed 99-104% of yield load and RCA 30% specimen showed 102-104% of yield load, which were the yield load and the largest yield load of normal concrete. Therefore, it is believed that RBA 30% and RCA 30% specimens has almost similar bending strength to ormal concrete. To sum up the results of material and supplementary tests, the mixed aggregates showed almost the same compressive strength and bending strength compared to that of normal concrete when 30% of broken red bricks and waste concrete were mixed. So this study suggests that they can be applied as thick aggregates.

반발경도법에 의한 혼화재 및 섬유사용 콘크리트의 압축강도 추정

김정섭,신용석,노성열,김정훈 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.2

This study aims to estimate strength approximate to actual concrete strength by presenting appropriate rebound method strength estimation expression with admixtures (fly ash, blast furnace slag, silica fume) which are used as cement substitute and polypropylene fiber and steel fiber and owing to their s of cement owing to their equal conditions to blending characteristics of concrete used for domestic structures and their recyclable properties. In case of rebound hammering, equation by Japanese Architecture Society was estimated 26~40% higher than destructive strength and remaining suggested equation was estimated 2%~18% lower. In case of ultrasound velocity, equation by Japanese Architecture Society was estimated 4%~11% higher than destructive strength till 60 days of age, but as age progresses, is estimated to 15% lower than destructive strength and remaining suggested equation was estimated 3%~27% lower than destructive strength in almost age. In case of complex methods, all suggested equations were estimated to 24%~94% higher than destructive strength. Since application of existing expression of normal concrete against concrete using admixtures and fiber causes error rate, this study suggests the following estimation expression depending on the kind of admixtures and fiber of concrete using them and position of non-destructive experiment. C-N f_(cu)=1.6R-25.43(R²=0.90), C-FA f_(cu) = 1.07R-8.76 (R²=0.82), C-BF f_(cu)=1.46R-23.09(R²=0.92) C-SF f_(cu) = 1.55R-22.96(R²=0.89), C-PP f_(cu) = 1.16R-12.24(R²=0.73), C-S f_(cu)=0.99R-8.07(R²=0.86)

UV-TiO_2 광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정혜광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경연구소 1998 環境硏究 Vol.14 No.1

UV-TiO_2 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_2는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7×10^7 cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0×10^2 cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 3.4×10 cells/㎖으로, 자외선 조사와 함께 TiO_2가 석영관에 박막증착된 경우에는 7.6×10^2 cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입수 11분 동안 자외선을 조사시킨 경우에는 1.3×10^2 cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 1×102 cells/㎖으로, 자외선 조사와 함께 TiO_2가 박막증착된 경우에는 7.9×10 cells/㎖을 나타내었다. 결국 UV-TiO_2 반응기에 사용되는 TiO_2가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_2 photocatalytic system on the Escherichia coli DH5-α and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 ㎚ was set on the center of pyrex round glass tube. Two types of TiO_2, one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7×10^5 cells/㎖ of E. coli for 11 min, the living cell number decreased to 4.0×10^0 cells/㎖. The effect of UV system together with slurried TiO_2 was less than 1 cells/㎖, whereas that of UV-coated TiO_2 system decreased to 7.1×10^3 cells/㎖. To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7×10^5 cells/㎖ were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3×10^2 cells/㎖. In the same condition except the addition of slurried TiO_2, the living cells were 1×10^2 cells/㎖. However, more cells could be killed by the system which consists of UV, coated TiO_2, and air bubble (7.9×10^1 cells/㎖). From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_2 system.

UV-TiO₂광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정해광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경공해연구소 1998 環境公害硏究 Vol.14 No.-

UV-TiO_(2) 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254 ㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_(2)는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7× 10^(7) cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0× 10^(2) cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_(2)를 첨가하였을 경우에는 3.4× 10 cells/㎖으로, 자외선 조사와 함께 TiO_(2)가 석영관에 박막증착된 경우에는 7.6× 10^(2) cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입후 11분 동안 자외선을 조사시킨 경우에는 1.3× 10^(2) cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_(2)를 첨가하였을 경우에는 1× 100 cells/㎖으로, 자외선 조사와 함께 TiO_(2)가 박막증착된 경우에는 7.9× 10 cells/㎖을 나타내었다. 결국 UV-TiO_(2) 반응기에 사용되는 TiO_(2)가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_(2) photocatalytic system on the Escherichia coli DH5-慣 and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 nm was set on the center of pyrex round glass tube. Two types of TiO_(2), one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7 * 10^(5) cells/??of E. coli for 11 min, the living cell number decreased to 4.0 * 1.0^(0) cells/?? The effect of UV system together with slurried TiO_(2) was less than 1 cells/?? whereas that of UV-coated TiO_(2) system decreased to 7.1 * 10^(3) cells/?? To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7 * 10^(5) cells/??were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3 x 10^(2) cells/?? In the same condition except the addition of slurried TiO_(2), the living cells were 1 * 10^(2) cells/?? However, more cells could be killed by the system which consists of UV, coated TiO_(2), and air bubble (7.9 * 10^(1) cells/??. From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_(2) system.

연쇄알구균 감염에 의한 급성 인후염 후 반응성 관절염 1예

박은하,도연실,양정채,강미라,서현주,정숙인,손준성,기현균,오원섭,백경란,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

연쇄알구균에 의한 급성 인후염 후 발생한 반응성 관절염은 급성 류마티스열의 개정된 진단기준을 충족하지 못하면서, 지속적 혹은 재발성의 비이동성 관절염과 발열, 홍반성 결절, 일시적 간기능 이상 등을 보이면서 심장염과 무도증을 드물게 동반하는 질환이다. 따라서, 발열을 동반한 급성 관절염 환자에서 감별해야 할 질환 중의 하나이며, 심근염 예방을 위한 페니실린 요법의 적응증 및 기간에 대해서는 아직 이론이 많은 상황으로, 보다 광범위한 연구가 필요하다. 저자들은 연쇄알구균에 의한 급성 인후염 1주 후에 발생한 하지의 다발성 비이동성 관절염과 함께 결절홍반 및 일시적 간기능 이상을 보인 환자에서 PSRA로 진단하고 비스테로이드성 항염증제 및 스테로이드로 성공적인 치료를 하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A β-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.

Bortezomib과 Dexamthasone으로 치료한 골수외 형질세포종 4예

백종현,이은영,장리라,손창배,신은경,서정아,이지숙,이호섭,이상민,신성훈,김양수 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Despite the use of aggressive local and systemic treatment including autologous stem cell transplantation in multiple myeloma, extramedullary recurrences are common and the prognosis of these patients is poor. Many novel drugs such as thalidomide, lenalidomide and bortezomib improve the response of treatment of multiple myeloma, but some reports failed to describe thalidomide has effect in extramedullary plasmacytoma. Recent data report on the successful treatment plasmacytomas with bortezomib in patients with advanced multiple myeloma. We treated 4 relapsed or refractory extramedullary plasmacytomas with bortezomib at our institution. We recognized all these extramedullary plasmacytomas decreased and showed more than partial response. This report lends support to the efficacy of bortezomib in the treatment of plasmacytoma and describes the safe use of bortezomib. Responses may, however, be of short duration. Therefore, despite our limited experience, we propose that bortezomib may be considered a therapeutic option for such patients who have risk of radiation therapy

건조 수산가공식품의 방사능 및 중금속 오염도 조사

이지연,정진아,전종섭,이성봉,권혜정,김정은,이병훈,모아라,최옥경,Lee, Ji-Yeon,Jeong, Jin-A,Jeon, Jong-Sup,Lee, Seong-Bong,Kwon, Hye-Jung,Kim, Jeong-Eun,Lee, Byoung-Hoon,Mo, A-Ra,Choi, Ok-Kyung 한국식품위생안전성학회 2021 한국식품위생안전성학회지 Vol.36 No.3

건조 수산가공식품의 안전성 확보를 위해 2020년 경기도 내 유통 중인 건조 수산가공식품 12품목 120건을 수거하여 방사능(¹³¹I, ¹³⁴Cs, ¹³⁷Cs) 및 중금속(납, 카드뮴, 비소, 수은) 함량을 분석하였다. 모든 시료에서 자연 방사성 핵종 중 하나인 ⁴⁰K만 검출되었으며, 인공 방사성 물질인 ¹³¹I, ¹³⁴Cs, ¹³⁷Cs는 최소검출가능농도(MDA) 이하의 값을 나타내었다. 중금속의 평균 함량[평균±표준편차(최소값-최대값)]은 생물로 환산하였을 때 납 0.066±0.065(N.D.-0.332) mg/kg, 카드뮴 0.200±0.406(N.D.-2.941) mg/kg, 비소 3.630±3.170(0.371-15.007) mg/kg, 수은 0.009±0.011(0.0005-0.0621) mg/kg 이었으며, 수산물에서 중금속 기준이 있는 제품의 경우 모두 기준 규격 이내로 나타났다. 국내산 제품과 수입산 제품의 중금속 함량은, 조개의 카드뮴과 새우의 수은 함량에서만 유의적인 차이를 나타내었다(P<0.05). 본 연구 결과, 유통 중인 건조 수산가공식품에서 방사능 및 중금속은 안전한 수준인 것으로 판단되나, 식품 중 특히 수산물에서 방사능 오염에 대한 국민의 우려가 크기 때문에 국민들의 불안감 해소를 위해 방사능 검사는 지속적으로 필요할 것으로 생각된다. 또 향후 건조 수산가공식품 중에서도 건조된 형태로 직접 섭취 가능한 제품의 중금속 관리 기준 설정을 위한 기초 자료로 활용할 수 있을 것이다. A total of 120 samples corresponding to 12 categories of dried processed fishery products distributed in Gyeonggi-do were examined for radioactivity contamination (¹³¹I, ¹³⁴Cs, ¹³⁷Cs) and heavy metals (lead, cadmium, arsenic, and mercury). One natural radioactive material, ⁴⁰K, was detected in all products, while the artificial radioactive materials ¹³¹I, ¹³⁴Cs and ¹³⁷Cs were not detected at above MDA (minimum detectable activity) values. The detection ranges of heavy metals converted by biological basis were found as follows: Pb (N.D.-0.332 mg/kg), Cd (N.D.-2.941 mg/kg), As (0.371-15.007 mg/kg), Hg (0.0005-0.0621 mg/kg). Heavy metals were detected within standard levels when there was an acceptable standard, but the arsenic content was high in most products, although none of the products had a permitted level of arsenic. In the case of dried processed fishery products, there are products that are consumed by restoring moisture to its original state, but there are also many products that are consumed directly in the dry state, so it will be necessary to set permitted levels for heavy metals considering this situation in the future. In addition, Japan has decided to release contaminated water from the Fukushima nuclear power plant into the ocean, so there is high public concern about radioactivity contamination of food, including fishery products. Therefore, continuous monitoring of various food items will be necessary to ease consumers' anxiety.

기관폐쇄를 일으킨 모균병(Tracheal Mucormycosis)1례

이성원 ( Seong Won Lee ),안중현 ( Joong Hyun Ahn ),손성현 ( Seong Hyun Son ),김민정 ( Min Jeong Kim ),문화식 ( Hwa Sik Moon ),박성학 ( Sung Hak Park ),송정섭 ( Jeong Sup Song ) 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.5