서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we 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 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

Lidocaine, Thrombin, Epinephrine 의 항균효과

김진우,이동건,전혜선,김승준,김석찬,안중현,김치홍,권순석,김영균,김관형,문화식,신완식,송정섭,박성학 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 기관지내시경 검사에서 흔히 사용되는 국소마취제인 lidocaine과 내시경시 지혈목적으로 사용되는 thrombin과 epinephrine이 각종 균주에 미치는 항균효과에 대해 알아보고자 하였다. 재료 및 방법 : 균주는 가톨릭대학교 성모병원에서 2004년 3월부터 2004년 9월까지 임상검체 에서 동정된 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 각각 42, 42, 42, 43주를 대상으로 하였다. Lidocaine, thrombin, epinephrine 감수성 검사는 National Committee for Clinical Laboratory Standards (NCCLS, 2002)의 기준에 따랐다. 결과 : Lidocaine은 S. aureus, S. pneumoniae, P. aeruginosa에서 MIC_(50), MIC_(90) 모두 20,000 ㎍/mL 이었다. K. pneumoniae는 각각 10,000 ㎍/mL이었다. Thrombin은 S. aureus와 P. aeruginosa에서 MIC50 500 lU/mL 과 MIC_(90) 500 IU/mL 이상이었고, K. pneumoniae에서는 MIC_(50)과 MIC_(90)이 모두 500 lU/mL이상이었으나 S. pneumoniae에서는 MIC_(50)과 MIC_(90)은 125 IU/mL이었다. Epinephrine은 K. pneumoniae, S. pneumoniae에 대한 MIC_(50), MIC_(90)가 모두 >500 ㎍/mL이었고, S. aureus와 P. aeruginosa에 대한 MIC_(50), MIC_(90)가 모두 500 ㎍/mL이었다. 결론 : 기관지 내시경 검사에서 흔히 쓰이는 lidocaine, thrombin, epinephrine 등의 약제들이 호흡기 질환의 흔한 병원균인 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 균주들에 대해 항균 효과가 있을 수 있어 세균배양검사에 영향을 미칠 수 있겠다. Background : We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. Materials and Methods : The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. Result : MIC_(50) and MIC_(90) of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 ㎍/mL and that for K. pneumoniae were 10,000 ㎍/mL. MIC_(50) and MIC_(90) of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC_(50) and MIC_(90) of epinephrine for K. pneumoniae and S. pneumoniae were above 500 ㎍/mL; that for S. aureus and P. aeruginosa were 500 ㎍/mL. Conclusion : We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.

우라늄 투여후 간조직에서의 효소활성도의 변화

김국찬,이강석,김진규,김인규,박효국,천기정,김상복 대한방사선 방어학회 1993 방사선방어학회지 Vol.18 No.2

우라늄 피폭후 효소활성도가 내부피폭의 biomarker로서의 가능성을 연구하기 위하여 수서생물인 잉어9Caprinus carpio)의 복강내 우라늄 투여시 간조직에서 일어나는 여러가지 효소계의 변화를 조사하였다. 이러한 효소활성도의 변화는 우라늄 내부피폭의 biomarker로서 가능성을 가지고 있으며 연구결과는 다음과 같다. 1) 6일째까지 우라늄을 주사하여 적출한 간에서의 전체단백질량은 계속 감소하고 있다. 2) 세포내의 lysosome내에 함유하고 있는 acid protease와 β-glucuronidase의 활성도는 6일째 투여후까지 활성도가 감소하고 있다. 3) Alkaline phosphatase의 경우 6일째 우라늄 투여후까지 증가하고 있으며 반대로 acid phosphatase의 경우 6일째 우라늄 투여후까지 활성도가 급격히 증가하였고 glutamate oxaloacetate transaminase의 활성도는 완만하게 증가하고 있다. 4) Creatine kinase의 활성도는 완만한 감소를 보이고 있으며 malate dehydrogenase는 첫번 우라늄 투여후에 활성도가 급격히 감소하였고 3일째 우라늄 투여후에는 활성도가 거의 나타나지 않았다. We examined various enzyme activity changes by intraperitioneal injection uranium in the carp liver. These enzyme activity changes can be used as biochemical indicators of internal exposure to uranium. The results were followings ; 1) Total protein concentration decreased by intraperitoneal injection in the carp liver. 2) Lysosomal acid protease and β-glucronidase activities increased in the liver until sixth intraperitoneal injection of uranium, but lysosomal acid phosphatase activities decreased in the liver until the sixth injection of uranium. 3) Alkaline phosphatase activities sharply increased and Glutamate oxaloacetate Transaminase activities steadily decreased in the liver until the sixth injection of uranium. 4) Creatine %kinase activities steadily decreased and malate dehydrogenase activities sharply decreased in the liver after the primary injection of uranium. Any malate dehydrogenase activities was not detected after sixth injection of uranium.

흰쥐의 방사선 피폭후 생물학적 지표로서의 혈액효소

김진규,김상복,김국찬,천기정,김인규,박효국,이강석 대한방사선 방어학회 1993 방사선방어학회지 Vol.18 No.2

생물학적 선량평가를 위한 생화학적 지표 연구로서 흰쥐 혈액내 효소활성도의 변화를 조사한 결과는 다음과 같다. 1) Alkaline phosphatase 활성도는 0.1, 0.25, 0.5, 2, 4 Gy의 방사선 조사후 24시간까지 혈액내 활성도가 증가하였고 72시간 경과시에는 대조군과 비슷한 활성도를 보였다. Creatine kinase는 2, 4 Gy 방사선 조사후 혈액내에서 활성도에서 활성도가 72시간까지 증가하였으나 0.1, 0.25Gy, 0.5 Gy 방사선 조사시에는 커다란 변화를 보이지 않았다. 2) Malate dehydrogenase 활성도는 0.1, 0.25, 0.5 Gy 방사선 조사시에는 커다란 변화가 없었으며 lactate dehydrogenase는 방사선 조사후 활성도가 감소하였다. 3) GOT의 활성도는 선량률 0.1Gy/min.로 0.1, 0.25, 0.5, 2, 4 Gy 조사후에는 어떠한 변화도 없었으며 선량률 0.5 Gy/sec.로 0.5, 1, 1.5, 2, 3, 5, 7 Gy로 조사후에는 증가현상을 보이고 있다. Acid phosphatase 활성도는 상기의 어떠한 선량에서도 나타나지 않고 있다. 잠재적으로 이러한 효소들은 방사선 피폭의 지표물질로 사용될 수 있으며 생화학적 지식과 기술을 이용한 좀더 나은 지표물질을 찾기 위하여 계속적인 조사가 필요하다. Enzyme activity changes in rat blood as biochemical indicator useful for evaluating exposure dose were experimentally studied. The experimental results obtained are as follows: 1) Alkaline phosphatase activities increased in the blood serum until 24 hours after 0.1, 0.25, 0.5, 2 and 4 Gy irradiation and its activities returned mormal condition after 72 hours of post-irradiation. Creatine kinase activities increased in the blood serum until 72 hours after 2 and 4 Gy irradiation but any significant activity changes were not detected after 0.1, 0.25 Gy irradiation. 2) Malate dehydrogenase activities did not reveal available changes changes after 0.1, 0.25, 0.5 Gy irradiation and lactate dehydrogenase activities decreased in the blood serum after 0.1, 0.25, 0.5 Gy irradiation. 3) Glutamate oxaloacetate transaminase activity changes were detected in the blood serum after 0.1, 0.25, 0.5, 2, 4 Gy(0.1 Gy/min.) and GOT activities increased after 0.5, 1, 1.5, 2, 3, 5, 7 Gy(0.5 Gy/sec.). Any acid phosphatase activities were detected in the blood serum after 0.1, 0.25, 0.5, 2, 4 Gy(0.1 Gy/min.) and 0.5, 1, 1.5, 2, 3, 5, 7 Gy(0.5 Gy/sec.) irradiation. Potentially some of these enzymes can be used as indicator protein for radiation injury. Futher investigation is needed to find better biochemical indicatiors utilizing recent knowledge and techniques of biochemistry.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection

Chun, Yoon-Keun,Ha, Joo-hun,Hong-Jung-Woo,Oh, Soo-Myung,Kim, Sung-Soo 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Yoon-Keun Chun¹,Joohun Ha□Hong-Jung Woo□, Soo Myung Oh□,Sung Soo Kim□ ¹Department of Molecular Biology, College of Medicine,²Department of Surgery, college of Medicine,³Department of Internal Medicine, College of Oriental Medicine,and ⁴East-Weat Medical Reserch Institute,Kyung Hee University, Seoul, Korea. The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection. Proceedings of International Symposium on East-West Medicine, Seoul. 212-230, 1999. -Hepatitis B is caused by hepadnavirus. Hepatitis B virus replicates through 3.5kb pregenomic RNA intermediate which is regulated by core promoter. Pathogenesis of hepatitis B virus has been bilieved the result of host immune response. But recently many studies have reported that high level of viral replication caused by mutation in core promoter might result in severs hepatitis. But these studies were performed in vitro, not in vivo. So there is yet debate about which factor, viral of host factor, is more important in pathogenesis of hepatitis B virus. So we measured real viral replication level in 204 chronic hepatitis B patients by quantifying HBV DNA from sera by our novel PCR-based more sensitive method, and compared these results with ALT level measured from same sera, which indicates liver cell damage. Surprisingly there are no significant correlation between HBV DNA quantity and ALT level. Then we cloned core promoter region. In SSCP, we found that many viral mutants coexist in one patient. Base on SSCP result, we chose main viral core promoter type in each patients, which is thought to determine overall viral replication level in this patient. Main type of core promoter region of each 41 patients were directly sequenced. And with these we measured promoter activity by luciferase assay system and compared promoter activity with on another. We found tha there were some differences in promoter activity according to core promoter sequences. And we constructed replication-competent viral constructs with core promoter from 41 patients and Transfected these into HepG2 cell and measured HBV DNA by southern blot. There were also differences in HBV DNA quantity according to core promoter sequences. On these all results we investigated correlation between the effect of HBV core promoter on viral replication in vitro and HBN DNA quantity, ALT level from sera of each patients. We found there is no significant correlation among them. As a result, we concluded that in determining severity chronic hepatitis B patients, host factors of each patient is more important rather than replicative activity of virus itself.

Caffeine이 지구성 운동 수행능력에 미치는 영향과 억제성 아미노산에 의하여 활성화되는 이온통로의 조절작용

김은경,김영표,천병옥,이계영,김연정,임백빈,조영욱,김창주,김성수 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

To investigate the effect and mechanism of caffeine on endurance exercise, two experiments were performed. First, to test caffeine effect on aerobic exercise, 200-300g Sprague-Dawley rats were used and three groups, control group, low caffeine injection group and high caffeine injection group, were divided. Blood smpling by heart puncture were done at rest, after 30 min treadmill exercise, and after maximal exercise. Blood glucose, free fatty acid concentration were detected and following results were obtained. Glucose concentration showed significant difference between groups(p=0.0305) and also significant changes were exhibited between time(p=0.0004). Free fatty acid concentration had no difference between groups. but had significance between times(p=0.00065). Exercise endurance performance time showed significant difference(p=0.02350 in high caffeine injection group compared to control group. In this experiments, endurance exercise capacity was increased by caffeine injection. Therefore, second experiment was performed to investigate the effect of caffeine on ion current induced inhibitory amino acid neurotransmitter. GABA and glycine. Single periaqueductal gray neuron was acutely dissociated and nystatin perforated patch clamp was performed under voltage clamping condition. Caffeine evoked outward current in PAG neuron dose dependent manner. 1mM of caffeine application had no response. but 3mM caffeine evoked about 32.5±8.539pA outward ion current and 10mM caffeine evoked about 215.46±19.4pA outward current. 10^-2mM GABA activated Cl￣current and recorded by inward current. Caffeine inhibited GABA activated Cl￣ current concentration dependent manner. 10^-2mM of caffeine had no effect on 1-^-2mM of GABA response. but 10^-1mM caffeine inhibited GABA activated Cl￣ current about 5.74±2.13%, 1mM caffeine inhibited about 17.25±2.70%, 10mM caffeine inhibited GABA response about 45.31±7.71%. 10^-1mM of glycine activated Cl￣ current and also recorded by inward current. Caffeine inhibited glycine activated Cl￣ current concentration dependent manner. 10^-2mM caffeine decreased glycine activated Cl￣ current about 4.61±1.650%, 10^-1mM caffeine decreased about 6.49±2.24%, 1mM caffeine decreased about 26.82±4.27%, and 10mM caffeine decreased glycine response about 94.47±1.39%. These results suggest that caffeine inhibite inhibitory amino acid, GABA and glycine, this response causes excitation of CNS and this seems to be the basic mechanism of increasing effect to aerobic exercise performance by caffeine.

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

사상체질론의 정신의학적 타당성에 대한 연구

민성길,김동기,박진균,전세일 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 건간한 의대상 312명과 신경증적 장애를 가진 환자 288명을 대상으로 하였다. 사상체질의 구별은 노정우 및 김달래 두 전문가에 의한 판정, 그리고 경희의대 사상체질 설문지(QSCC Ⅱ)에 의한 판정 등 3가지 방법에 의하였다. 연구 대상에게 정신과적 증상척도(SCL-90), 체질특성척도 및 성격척도를 사용하여 자가 평가하게 하였다. 각종 척도들의 타당도와 신뢰도는 입증되었다. 이 척도들을 통계적으로 분석하고 고전적 설명과 어느 정도 일치하는 지를 검토하였다. 연구결과 : 1) 3가지 분류방법간에 차이가 컸었다. 그 중 전문가의 직접적 면담에 의한 감별보다 QSCCⅡ 설문지형이 비교적 감별력이 컸다. 3) QSCCⅡ가 감별력이 비교적 크다고 하더라도 그 결과가 소음군의 대인공포-강박증, 불면-식용상실, 무력-예민-소화기-한기-피부증후군 그리고 정력부족등 신경증적 증상과 소극-비사교적, 내향형 성격 및 이성적 성격특징 등 몇가지 특징을 감별하는 데에만 비교적 유의하였고, 태음군의 특정인 독특한 신념, 온기, 활달-사교적 성격에 대해서는 부분적으로 그 특징을 감별하였다. 또한 소양군의 활달-사교형 성격과 감정형 성격의 특징 등은 극히 부분적으로 감별하였다. 결 론 : 이러한 결과는 현존하는 사상체질 구분방법에 일치점이 결여되어 있다는 것, 각종척도를 사용한 결과는 사상체질에 관한 고전적 설명을 부분적으로만 입증하고 있다는 것, 따라서 사상체질구분에 대한 향후보다 객관적인 연구가 필요하다는 것을 시사한다. Object : This study is to examine the validity of constitutional classification of Sa-sang medical theory. This theory classifies the human constitution to 4 types according to classical oriental philosophy on yin and yang. Subjects and Method : Subjects were 312 medical students and 288 neurotic patients with diagnosis of neurotic, stress related and somatoform disorders and minor depressive episodes according to ICD-10. Medical students were classified to 4 Sa-sang Constitution Classification(QSCCⅡ). For assessmnent of symptoms and signs, Korean version of SCL-90, a constitution scale and personality scale which were designed for this study were used. These instruments were found to be reliable and valid through statistical analysis. Subjects were asked to rate these scales. The data were analysed with factor analysis and factor scores were compared among 4 Sa-sang constitutions by ANOVA and t-test. The data from patient group were analysed with factor analysis and the results were compared with the Sa-sang medical theory. Results : Results of classification by 3 ways were inconsistent showing a significant difference among them. Among them, QSCCⅡ was most reliable. In QSCC Ⅱ, only the factor scores of factors of homophobia-obsession, weakness-sensitiveness-indigestion-chillness-skin syndrome, sexual weakness, passive-unsociable personality, introverted personality and rational, personality, were significantly high in So-um (small yin) group of medical students. A factor of warmnes and active-sociable personality were significantly high in Tae-um(big yin)group. Also active-sociable and effective pesonality was partly related with So-yang(small yang)group. Conclusion : These results suggest that those present classification methods inconsistent, that these methods are proving only parts of Sa-sang medical theory, and that objective and scientific studies are needed for reliability and validity of Sa-sang medical theory.

소아 확장성 심근증의 임상적 고찰

이성환,김준식,박근수,김명성,권태찬,김천수,이상락 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.1

A Clinical assessment of the 25 patients with dilated cardiomyopathy who were admitted to the Department of Pediatrics, Keimyung University Dong San Hospital from January, 1982 to June, 1993 was performed. The result were as follows: 1) Among 25 patients with dilated cardiomyopathy. 8(32%) were younger than 1 year of age at the time of admission. 2) Adriamycin toxicity was the only encountered etiologic factor in 1 patient. 3) On admission, hepatomegaly and tachycardia were noted in almost all patients. 4) The Chest X-rays showed cardiomegalies in all 25 patients, pulmonary vein congestions in 15(60%) and pleural effusion in 2(8%). 5) The electrocardiography showed left ventricular hypertrophy in 72% and supraventricular tachycardia in 32%. 6) The echocardiographic examination showed left ventricular dilatations in all patients and left atrial dilatations in 20(80%). 7) Of 18 patients who had followed mean period of 2.9 years, 10 patients died within 9 months after the diagnosis.