발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염 2예

신성철,백경란,정재홍,송봉근,김동희,전경만,채제욱,손준성,정숙인,오원섭,송재훈 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

국균은 호흡기를 통해 유입되며 심한 면역기능저하 환자에서 기회감염을 일으키는 진균이며 주로 혈관을 따라 폐를 침범하고 심장과 골침범은 매우 드문 것으로 알려져 있다. 저자들은 급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염을 2예을 경험하였다. 19세 남자환자로 동종 조혈모세포이식 후 발생한 고열과 요통의 원인으로 감염성 심내막염 진단하에 수술결과 국균에 의한 감염으로 확증되어 수술적 절제술과 liposomal amphotericin B로 치료하였으나 국균 심내막염의 재발과 국균 척추염의 악화, 뇌 출혈로 사망하였다. 23세 남자환자로 관해요법 후 발생한 고열과 요통의 원인으로 국균 심내막염과 국균 척추염 진단하에 수술적 절제술과 amphotericin B로 치료하여 1년 2개월 동안 국균 심내막염의 재발은 없었으나 지속적인 백혈병의 재발과 국균 척추염의 악화, 침습성 폐 국균증으로 사망하였다. Although Aspergillus endocarditis has rarely been reported, it can cause fatal complications in hematologic malignancy patients and allogeneic stem cell transplant recipients. We experienced two cases of aspergillus endocarditis developed in acute lymphoblastic leukemia patients. Case; A 19-year-old patient developed Aspergillus endocarditis after allogenic hemopoietic stem cell transplantation. He was treated with surgical intervention and liposomal amphotericin B. He died of recurred Aspergillus endocarditis and cerebral hemorrhage probably related with aspergillosis of central nervous system. Case 2; A 23-year-old patient developed invasive Aspergillus endocarditis after induction chemotherapy. Aspergillus endocarditis was successfully treated by surgical intervention and amphotericin B. He died of refractory neutropenic fever and sepsis after the third relapse of leukemia and repetitive chemotherapy. He probably had invasive pulmonary aspergillosis without evidence of endocarditis recurrence. Because the mortality of Aspergillus endocarditis is very high, early diagnosis and surgical intervention are very important for better outcome.

남자 알코올 의존 환자의 기질적 특성에 관한 연구

김성곤,민영기,이덕기,김미영,송영상,권도훈,고영훈,박제민,정병선 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.1

목 적: 본 연구의 목적은 한국인 남자 알코올 의존 환자의 기질적 특성을 Temperament and Character Inventory(TCI)를 이용하여 조사하는 것이다. 방 법: DSM-Ⅳ 진단 기준에 맞는 알코올 의존 환자 30명과 정상인 36명을 대상으로 연구학적 특성을 조사하고, 기질적 특성을 한글판 TCI를 이용하여 조사하였다. 모든 대상자의 나이는 30~60세였다. 결 과: 1) 두 군간 평균 나이는 유의한 차이가 없었으나, 교육 정도와 결혼을 유지하고 있는 비율 및 취업률은 알코올 의존군이 정상 대조군에 비해 유의하게 낮았다. 2) 알코올 의존군에서는 정상 대조군에 비해 Harm Avoidance(HA) 점수와 Self-transcendence(ST)점수는 유의하게 높았으며, Self-directiveness(SD)점수는 유의하게 낮았다. 3) 알코올 의존군 내에서의 각 척도들 간의 상관관계는, HA와 SD 점수, HA와 Persistence(PE) 점수, ST와 SD 점수는 각각 유의한 음의 상관관계, ST와 PE 점수, SD 점수와 Cooperativeness(CO) 점수, Reward Dependence(RD)와 CO 점수는 양의 상관관계를 보였다. 결 론: 이러한 본 연구의 결과는 한국인 남성에서 수줍음을 잘 타며, 걱정도 많고, 염세적이고 쉽게 피로해지는 기질적 특성이 알코올 의존과 연관성이 있음을 의미한다. Objectives : The purpose of this study was to assess the temperament of male parients with alcohol dependence. Methods : The subjects were 30 patients who met DSM-Ⅳ criteria for alcohol dependence and 36 normal controls. All subjects completed Temperament and Character Inventory(TCI) which was developed by Cloninger. Results : 1) The educational level, marital status, and occupation in alcohol dependence group were significantly lower than those of normal control group, but there was no difference in the age between two groups. 2) Among the scores of TCI, the score of harm avoidance(HA) and self-transcendence(ST) were significantly higher in the alcohol dependence group than in the normal control group. 3) In the alcohol dependence group, a significant negative correlation among the scores of TCI was between HA and SD, HA and Persistence(PE), ST and SD, and positive correlation between ST and PE, SD and Cooperativeness(CO), Reward Dependence(RD) and CO. Conclusion : These results suggest that shy, fearful, pessimistic and fatigable temperament are related to developing alcohol dependence in Korean males.

환경영향을 고려한 정유공정의 일정계획

송제훈(Je Hoon Song),이동엽(Dong Yup Lee),박형진(Hyung Jin Park),박선원(Sun Won Park) 한국전과정평가학회 2001 한국전과정평가학회 정기총회 연구논문집 Vol.2001 No.0

핸드제스처를 이용한 원격미팅 자료 인터페이스

송제훈(Je-Hoon Song),최기호(KiHo Choi),김종원(JongWon Kim),이용구(Yong-Gu Lee) (사)한국CDE학회 2007 한국CDE학회 논문집 Vol.12 No.2

WebGL을 이용한 안내 시스템

박제훈(Je-Hoon Park),송주호(Joo-Ho Song),김은주(Eun-Ju Kim),고영웅(Young-Woong Ko),김선정(Sun-Jeong Kim),송창근(Chang-Geun Song) 한국정보과학회 2010 한국정보과학회 학술발표논문집 Vol.37 No.2B

최근 웹브라우저에서 3D 그래픽을 사용하기 위한 표준으로 웹 기반 3D 가속 기술인 WebGL(Web Graphic Library)[1]이 화제[2]가 되고 있다. WebGL은 Flash, Silverlight와 달리 Plug-in이 필요하지 않기 때문에 비교적 접근성이 쉬워 하드웨어 가속을 지원하는 3D 컨텐츠에 유용하다. 본 논문은 단편적으로 제공되던 웹에서 사용되던 기존의 길 안내 시스템을 WebGL을 이용한 3D 컨텐츠로 확장하여 사실감있는 정보를 구현하고자 한다.

FC 2-3 : The comprehensive analysis of recurred non-melanoma skin cancers after mohs micrographic surgery

( Hoon Soo Kim ),( Hyang Suk You ),( Won Jeong Kim ),( Hyun Ho Cho ),( Je Ho Mun ),( Marg Aret Song ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Mohs micrographic surgery(MMS) is the most widely used treatment option for non-melanoma skin cancer(NMSC) because of very high success rate of complete excision. However, even MMS cannot guarantee a 100% chance of cure and there is risk of recurrence after MMS. Objectives: To analyze clinical and histologic data of cases of recurred NMSC after MMS and to understand characteristic features of recurred cases. Methods: Total of 17 patients, including 9 with basal cell carcinoma(BCC) and 8 with squamous cell carcinoma(SCC), recurred after MMS during 15 year period at Pusan National University Hospital. Previous treatment history, location of lesion, clinical and histologic subtype and data related to MMS were investigated. Results: Five patients with BCC and 4 with SCC had previous treatment history such as laser ablation and incomplete excision. In BCC group, 4 were located on periorbital area and 6 had aggressive histologic type. The average number of MMS stage, tumor size and length of surgical margin in study groups was more larger than that of total patient group treated with MMS at our hospital. The mean interval between operation and recurrence was 52 months in BCC group and 9 months in SCC groups. Conclusion: Based on our study, particular attention should be drawn to NMSC patients with previous treatment history, specific anatomical location such as periorbital area, and large tumor size to reduce the risk of recurrence after MMS.

Antimicrobial and Anti-inflammatory Effect of Chitosan and Oligo-chitosan against Acne-related Bacteria

Song-Hee Kim,Bo-Geum Kim,Eun-Hye Kang,Jae-Young Je,Tae-Hoon Kim,Young-Mog Kim 한국수산과학회 양식분과 2016 한국수산과학회 양식분과 학술대회 Vol.2016 No.10

Antimicrobial and Anti-inflammatory Effect of Chitosan and Oligo-chitosan against Acne-related Bacteria

Song-Hee Kim,Bo-Geum Kim,Eun-Hye Kang,Jae-Young Je,Tae-Hoon Kim,Young-Mog Kim 한국수산해양기술학회(구 한국어업기술학회) 2016 한국수산해양기술학회 학술발표대회 Vol.2016 No.10

FC 2-6 : Clinical and dermoscopic characteristics of extramammary paget``s disease

( Je Ho Mun ),( Sung Min Park ),( Hyun Ho Cho ),( Won Jeong Kim ),( Mar Garet Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Extramammary Paget`s disease (EMPD) is a rare cutaneous, intraepithelial adenocarcinoma. Diagnosis is often delayed because of the various clinical presentations and the rarity of the disease. Dermoscopy improves diagnostic accuracy of pigmented and non-pigmented skin tumors. However, dermoscopic features of EMPD had not been thoroughly investigated. Objectives: To evaluate the clinical and dermoscopic characteristics of EMPD. Methods: Clinical and dermoscopic images of 32 histopathologically confirmed EMPD were analyzed. Results: EMPDs were clinically characterized by erythematous patches (100%), scales (62.5%), ulcer (37.5%), nodules (12.5%), focal hyperpigmentation (18.8%), and hypopigmentation (9.4%). Dermoscopically, the following features were detected: erythematous background coloration (100%), surface scales (96.9%), vascular patterns (90.6%), ulcers (43.8%), structureless white areas (12.5%), shiny white lines (12.5%), and pigmentary structures (34.4%). Among vascular patterns, dotted vessels were frequently observed (53.1%), followed by glomerular vessels (21.9%), and polymorphous vessels (12.5%). Conclusion: The results of our study suggest that there are distinctive clinical and dermoscopic features of EMPD. Recognition of the characteristic features of EMPD can facilitate accurate diagnosis of EMPD, and may reduce misdiagnosis.