우리나라 사람면역결핍바이러스(Human Immunodeficiency Virus) 감염환자에서 발병한 악성종양

최평균,송진수,조재현,김성한,박경화,방지환,박완범,김홍빈,김동완,김태유,허대석,오명돈,김남중,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background : Since highly active antiretroviral therapy has lengthened the life span of individuals infected with human immunodeficiency virus (HIV), the importance of malignancy associated with HIV has been increased. The relative frequencies of malignancies in HIV infected patients may vary in different race and region. The aim of this study is to determine the prevalence and characteristics of malignancies in patients with HIV infection in South Korea. Materials and Methods : To identify HIV patients with malignancy, we reviewed the electronic database of pathological reports for all HIV-infected patients seen from January 1986 to December 2005 at the Seoul National University Hospital. We retrospectively reviewed the medical records of them. Results : Among 850 patients infected with HIV, 33 episodes of malignant diseases were diagnosed in 32 patients (3.76%). Thirty were males, and median age was 46 years (range 29-70). At the time of the diagnosis of malignancy, median CD4^(+) lymphocytes count was 100/uL (range 5-620) and in 27 (82%) patients, CD4^(+) lymphocytes count were less than 200/uL. For 13 patients (40%), malignancy was initial presentation of HIV infection. Excluding patients initially diagnosed as malignancy, median follow-up duration from the first visit to diagnosis of malignancy was 36 months (range 3-96). Non-Hodgkin's lymphoma was the most frequent malignancy (13 patients), followed by Kaposi's sarcoma (7), Hodgkin‘s disease (3), acute myeloid leukemia (1), and other solid cancer (9) including one case of anal cancer associated with human papillomavirus. Among 13 patients with non- Hodgkin's lymphoma, 4(31%) achieved the complete remission after chemotherapy and/or radiation therapy, and had been followed without evidence of recurrence. Conclusion : Malignancy was diagnosed in 3.76% of patients infected with HIV. Non-Hodgkin‘s lymphoma is the most prevalent malignancy in HIV patients in South Korea. 목적 : 효과적인 항레트로바이러스 다제요법이 도입됨에 따라, HIV 감염환자들의 수명이 증가되었고, 이에 따라 HIV 감염환자에서 악성종양의 중요성 또한 증가하고 있다. 본 연구의 목적은 우리나라 HIV 감염환자에서 악성종양의 유병률과 호발하는 악성종양의 특성을 밝히는 것이다. 재료 및 방법 : 1986년부터 2005년까지 서울대학교병원에서 치료를 받은 HIV 감염환자의 의무기록을 후향적으로 분석하였고, 병리학적 검사 결과를 검토하여 악성종양이 진단된 환자들을 대상으로 연구를 시행하였다. 결과 : 총 850명의 환자 중, 32명(3.76%)에서 33예의 악성종양이 진단되어, 악성종양의 발병률은 1,000인년 당13.0명(95% 신뢰구간: 8.6∼17.4명)이었다. 그 중 남자는 30명이었고, 악성종양 진단 당시 연령의 중간값은 46 (29-70)세이었다. 악성종양 진단받을 당시, CD4 림프구 수의 중간값은 lOO/uL (5-620 uL) 이었고, CD4 림프구수가 200/ uL 미만인 환자가 27명(82%)이었다. 악성종양에 대한 검사 도중에 HIV 감염사실이 밝혀진 환자가 13명(40%)이었다. HIV를 진단 받은 후 악성종양이 발병한 환자들에서, HIV 진단 후 악성종양의 발병까지는 평균 36개월(3-96개월)이 걸렸다. 13명의 HIV 감염 환자에서 진단된 비호지킨림프종이 가장 흔한 악성종양이었고, 이외에 카포시육종이 7명, 호지킨병이 3명, HPV와 연관된 항문암이 1명의 HIV 환자에서 진단되었다. 그 밖에 급성백혈병, 방광암, 췌장장, 폐암, 진행성위암, 갑상선암, 간세포암, 후두암이 각각 1예씩 진단되었다. 비호지킨림프종이 진단된13명 환자 중, 4명(31%)은 항암치료 및 방사선치료를 받아 완전관해가 되었고, 현재 재발의 증거 없이 외래에서 경과 관찰 중이다. 결론 : 우리나라 HIV 감염환자에서 악성종양의 유병률은 3.76%이었고, 비호지킨림프종이 가장 흔한 악성종양이었다.

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

골수구성 백혈병 환자에게 발생한 결핵성 림프절염

이창섭,송진수,최평균,조재현,방지환,박경화,박완범,김홍빈,김남중,윤성수,박선양,김병국,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

혈액질환 가운데 결핵 발생이 증가한다고 알려진 것은 호지킨 림프종을 포함한 림프증식성질환 그리고 모양세포성 백혈병 등이 있다. 또한 동종 골수이식을 받은 환자에서도 결핵은 증가한다고 알려져있다. Kaplan 등은 골수구성 백혈병 환자에서 결핵 발생이 증가한다고 보고하였다. 그러나 골수구성 백혈병 환자에서 결핵의 발생이 증가하는 이유에 대해서는 아직까지 정확하게 밝혀지지 않았다. 저자들이 2년 동안 후향적으로 조사한 180명의 성인 골수구성 백혈병 환자들 가운데 결핵이 발생한 환자는 4명이었고, 발생 부위는 모두 림프절이었다. 결핵은 골수구성 백혈병의 특정 아형에만 국한되어 발생하지 않았지만, 50%에서 FAB 분류에 의한 M4였다. 림프절이 종대된 골수구성 백혈병 환자에서 특히, 결핵의 유병율이 높은 나라에서는 결핵성 림프절염도 감별진단에 포함시켜야 한다. During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.

STZ 유발 당뇨쥐에서 시간에 따른 생리적 항산화계의 변화

이순재,양정아,김성옥,최정화,신주영,채영미,차복경 대구효성가톨릭대학교 응용과학연구소 1997 응용과학연구논문집 Vol.5 No.-

The purpose of this study was to investigate change of physiological antioxidative system according to the time in streptozotocin-induced diabetic rats. Sprague-Dawley male rats weighing 150±10gm were randomly assigned to one normal and five STZ-induced diabetic groups. Diabetic groups were classified to experimental period. Diabetes was experimentally induced by intravenous injection of 55 mg/kg of body weight of STZ in citrate buffer(PH 4.3) after 6 weeks feeding of three experimental diets. Animals were sacrificed at 0, 3, 6, 12, 18th days of diabetic states. 1. Activity of superoxide dismutase(SOD) in liver was increased in that of diabetic mellitus(DM) groups at 3th day but that of DM groups was not significant from 6th day according to period. Glutathion peroxidase(GPX) was significantly decreased in DM groups from 6th day 2. Reduced glutathione(GSH) contents in liver significantly decreased in diabetic groups from 3rd day compared with those of DM groups according to the period. Oxidized glutathione(GSSG) was higher from 6th day. GSH/GSSG ratio was significantly lower than that of normal group from 3rd day to all experimental period 3. Contents of vitamin E in liver of DM groups were significantly decreased compared with that of normal group from 6th day. 4. Lipid peroxide(LPO) contents in liver of DM groups were significantly increased compared with that of normal group from 3rd day. The present results indicate that STZ-induced diabetic rats were reduced by antioxidative defense system and taken by peroxidate damage in tissue compared with normal group from 3rd day or 6rd day after injection STZ. It lended to acceleration all diabetic groups but no significance according to the experimental time.

2007년 대한감염학회 권장 성인 예방접종 권장안

강진한,김홍빈,손장욱,이상오,정문현,정희진,최영화,최정현,최준용,최희정 대한감염학회 2008 감염과 화학요법 Vol.40 No.1

In 2007, the Korean Society of Infectious Diseases recommended an immunization schedule for adults residing in Korea. This recommendation includes four categories: standard immunization for healthy persons, supplementary immunization for persons with underlying illnesses, recommendations for health-care personnel and for international travelers. The Standard Immunization Schedule consists of universal vaccination (tetanus-diphtheria/tetanus-diphtheria-pertussis (Td/Tdap); hepatitis A vaccine for persons aged 20s; human papilloma virus vaccine for women under 26 years old; meningococcal vaccine for military recruits and college students in dormitories; influenza vaccination for persons aged 50 years or more and pregnant women; and pneumococcal vaccination for persons aged 65 years or more) and catch-up vaccination (hepatitis A vaccine for persons aged 30s; hepatitis B vaccine, varicella and MMR vaccines for persons who have uncertain specific immunities). The Supplementary Immunization Schedule recommends 4 vaccines, i.e., pneumococcal, influenza, meningococcal, and Haemophilus influenzae type b, appropriate to the underlying illnesses, and confirmation of the presence of antibodies to hepatitis A and hepatitis B. The Recommendation for Health-Care Personnel includes universal vaccination (influenza and pertussis) and catch-up vaccination (hepatitis B, measles-mumps-rubella and varicella for seronegative health-care personnel). The Recommended Immunization for International Travelers focuses reinforcement of vaccinations for healthy persons and includes certain immunizations necessary for international travel (yellow fever, meningococcal, plaque, tick-borne encephalitis, and cholera). These guidelines can be seen at www.ksid.or.kr.

Review : Signal-Transduction Pathways toward the Regulation of Brassinosteroid Biosynthesis

( Sung Hwa Choe ) 한국식물학회 2007 Journal of Plant Biology Vol.50 No.3

Symposium 8 : Plant Biochemistry ; Brassinosteroid Biosynthesis and Signaling

( Sung Hwa Choe ) 한국생화학분자생물학회 (구 한국생화학회) 2002 생화학분자생물학회 춘계학술발표논문집 Vol.2002 No.-

서혜부 탈장을 동반한 완전 고환성 여성화 증후군

최화영 ( Hwa Young Choe ),주성홍 ( Sung Hong Joo ),김예진 ( Ye Jin Kim ),조성진 ( Sung Jin Cho ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.1

Complete testicular feminization syndrome (androgen insensitivity syndrome) is the most common form of male pseudohermaphroditism, transmitted by means of maternal X-linked recessive gene. This syndrome is marked by unique combination; Normal female pheno

Increasing mumps incidence rates among children and adolescents in the Republic of Korea: age–period–cohort analysis

Choe, Young-June,Lee, Young Hwa,Cho, Sung-Il Elsevier 2017 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.57 No.-

<P><B>Summary</B></P> <P><B>Background</B></P> <P>To characterize the temporal dynamics of mumps epidemiology according to the different vaccine strains used, sex-specific trends were decomposed in an age–period–cohort (APC) analysis for mumps cases reported in South Korea.</P> <P><B>Methods</B></P> <P>National surveillance data were used to describe the epidemiology of mumps cases from 2001 to 2015. An APC model was used to break down the reported mumps cases into the effects of age, period, and birth cohort.</P> <P><B>Results</B></P> <P>From 2001 to 2015, the incidence started to increase from fewer than 10 cases to more than 100 cases per 100 000. The incidence rate was highest among males aged 15–17 years during 2013–2015, reaching 508.7 per 100 000 persons. There was an increased incidence during the late teenage years in the 1998–2000 cohort. An age shift towards the earlier teenage years was observed across the 2001–2003 and 2004–2006 cohorts. The risk of mumps increased according to the birth cohort; the net drift from 2001 to 2015 was 27.67 (95% confidence interval 27.5.47–29.90) for males and 27.25 (95% confidence interval 24.91–29.65) for females.</P> <P><B>Conclusions</B></P> <P>The increase in mumps seen in Korea may have been affected by the birth cohort exposed to the Rubini strain; however other factors may have contributed to the increase in non-exposed cohorts.</P> <P><B>Highlights</B></P> <P> <UL> <LI> From 2001 to 2015, mumps incidence increased from 10 to >100 cases per 100 000/year. </LI> <LI> The incidence rate was highest among males aged 15–17 years in 2013–2015. </LI> <LI> There were statistically significant cohort and period relative risks and net drifts. </LI> </UL> </P>

Highly sensitive and selective electrochemical cortisol sensor using bifunctional protein interlayer-modified graphene electrodes

Sung Ryeol Lim,Kwang Su Kim,Jun Young Lee,Chan-Hwa Chung,Woo-Seok Choe,Pil J. Yoo 한국고분자학회 2016 한국고분자학회 학술대회 연구논문 초록집 Vol.41 No.2