Slide Session : OS-IFD-07 ; Infectious Disease : In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus

( Myung Jin Lee ),( Kye Hyung Kim ),( Jong Youn Yi ),( Su Jin Choi ),( Chung Jong Kim ),( Nak Hyun Kim ),( Kyoung Ho Song ),( Pyoeng Gyun Choi ),( Ji Hwan Bang ),( Wan Beom Park ),( Eu Suk Kim ),( San 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus Myung Jin LEE1, Kye-Hyung KIM1, Jongyoun YI2, SuJin CHOI1, Chung-Jong KIM1, Nak- Hyun KIM1, Kyoung-Ho SONG1, Pyoeng Gyun CHOI1, Ji-Hwan BANG1, Wan Beom PARK1, Eu Suk KIM1, Sang-Won PARK1, Hong Bin KIM1, Nam Joong KIM1, Myoung- Don OH1 Seoul National University College of Medicine, Korea1, Pusan National University School of Medicine, Korea2 Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). No effective antiviral therapy is proven yet, but clinical use of ribavirin (RBV) has been tried. We investigated the antiviral effect of RBV against SFTSV in vitro. Methods: To test for cytotoxicity of RBV, Vero cells were treated with different concentrations of RBV (3.90 to 500 μg/mL, two-fold dilution) and analyzed by cell viability MTS assay 48h post-infection. To determine antiviral activity of RBV against SFTSV, Vero cells were infected with SFTSV strain Gangwon/Korea/2012 at 100 TCID50 (50% tissue culture infective dose) per well in a 96-well plate, and RBV was added at the concentrations showing no or minimal cytotoxicity. Viral RNAs were extracted from the culture supernatants and quantifi ed using one-step real-time reverse transcription- PCR to amplify the partial large segment of SFTSV. Statistical analysis was done by one-way ANOVA with Tukey`s post hoc test. Results: Cytotoxicity due to RBV was not observed at RBV concentration =31.3 μg/ mL. Viral RNAs at 24h post-RBV treatment were reduced with increasing RBV concentrations (1-32 μg/mL), compared with those of mock-treated cells (P <0.01, Figure). Half maximal inhibitory concentration (IC50) of RBV was 3.69 μg/mL at 24h post-RBV treatment. Conclusions: Our study shows that RBV has antiviral effect against SFTSV in a dose-dependent manner. Further studies are required to evaluate the effi cacy of RBV in SFTS.

저독성 난연제를 첨가한 에폭시 수지의 경화 동력학 및 유변학적 특성

박수진,송수완,이재락,민병각,신재섭 한국공업화학회 2004 공업화학 Vol.15 No.1

본 실험에서는 2관능성 에폭시 수지(EP)에 저독성 난연제인 tris (chloroisopropyl) phosphate (TCPP) 를 100:0~100:40 phr의 비율로 첨가한 후 이에 따른 경화 동력학과 유변학적 특성을 고찰하였다. 2EP/TCPP 시스템의 경화 활성화 에너지(E_(a))와 진화량(α)은 동적 DSC를 통하여 알아 보았으며, 유변학적 특성은 레오미터를 이용하여 등온 조건하에서 고찰하였다. 또한, 난연성 test인 UL94를 통하여 TCPP 함량에 따른 난연성의 변화를 살펴보았다. 실험 결과, E_(a)는 에폭시 수지 내에 TCPP의 함량이 증가할수록 증가하는 반면, 전화량(α)과 전환속도(d/dt)는 감소하는 경향을 나타내었다. 가교 활성화 에너지(E_(c)) 값은 구한 E_(a) 값과 유사한 경향을 나타내었으며, 이러한 결과는 TCPP의 증가로 인해 2EP 고유의 interpenetrating polymer network (IPN) 구조형성이 방해받기 때문이라 판단된다. 또한, TCPP의 함량이 30 phr 이상인 경우 난연성이 향상되었는데, 이는 TCPP 내의 난연성을 갖는 인과 염소의 영향으로 판단된다. In this work. the cure kinetics and rheological properties of difunctional epoxy (2EP) resins containing a low toxicity flame-retardant based on tris(chloroisopropyl) phosphate (TCPP) are investigated. The 2EP/TCPP content was varied within 100 : 0 ∼100 : 40 phr. The cure system are studied under the isothermal condition using a rheometer, Also, the flame resistance is determined by UL94 vertical test. From experimental results, the Ea of 2EP/TCPP system is higher than that of pure 2EP. While, the conversion (α1 and conversion rate (d/dt) are decreased with increasing of the TCPP content. The cross-linking activation energy (E_(e)) of the system is similar to (E_(a)). This is probably due to the increase of TCPP content. which obstructs the formation of interpenetrating polymer network (IPN) structure of the 2EP. Also, the improvement of flame resistance is achieved by addition of 30 phr TCPP in the 2EP/TCPP system. which can be attributed to the existence of incombustible phosphorous and chlorines in the TCPP.

췌십이지장절제술 후 발생한 지속적인 구토증과 Wernicke 뇌병증

박우영,김성완,이삼연,신일선,김재민,박기형,양수진,윤진상 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.3

Wernicke encephalopathy is an acute neurologic disorder attributable to thiamine (vitamin B1) deficiency. We report the case of a 61-year-old female patient who presented Wernicke encephalopathy after surgery for pancreatic head cancer. From the ninth postoperative day, she had suffered from nausea and vomiting and had difficulties ingesting food, she was given total parenteral nutrition (TPN), but lacked adequate vitamin (thiamine) supplementation. After 28 days, she developed ataxia, ophthalmoplegia, and mental confusion. The magnetic resonance image showed pathologic changes in the medial thalamus,periaqueductal gray matter, medulla and mamillary bodies. The blood level of thiamine was very low. After intravenous and oral supplementation of thiamine (200 mg/day), consciousness was soon normalized and neurologic symptoms have gradually been improving. Nausea and vomiting disappeared after administration of a low dose of mirtazapine (7.5 mg/day). We emphasize the importance of thiamine supplementation to the patients who suffer from vomiting which hinders them from taking food and who require prolonged TPN.

타리비드 정(오플록사신 100㎎)에 대한 파비드 정의 생물학적동등성

박완수,조성희,이헌우,임호택,홍성제,서성훈,류재환,이경태 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.1

The purpose of the present study was designed to evaluate the bioequivalence of two ofloxacin tablets, Tarivid (Jell Pharm. Co., Ltd.) and Favid (ILHWA Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Twenty-four normal male volunteers, 23.67±3.12 year in age and 68.50±7.23 kg in body weight, were divided into two groups and a randomized 2x2 cross-over study was employed. After four tablets containing 100 mg of ofloxacin were orally administered, blood was taken at predetermined time intervals and concentrations of ofloxacin in plasma were deter mined using HPLC. Pharmacokinetic parameters such as AUC_(t) and T_(max) were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed AUC_(t), and C_(max) and untransformed T_(max). There were no sequence effects between two formulations in these parameters. The 90% confidence intervals for the log transformed data were acceptance range of log 0.8 to log 1.25 (e.g., log 0.94-log 1.04 and log 0.90-log 1.07 for AUC_(t) and C_(max) respectively). The major parameters. AUC_(t) and C_(max) met the criteria of KDFA for bioequivalence indicating that Favid tablet is bioequivalent to Tarivid tablet.

급성 파라쿼트 중독에서 혈중 파라쿼트 농도

박승민,김세현,최수진,김현,이완구,김영남,이광영,이영희,신성혜 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Paraquat is a bipyridyl compound, and when ingested, concentrated paraquat can cause either rapid death from multisystem failure and cardiovascular shock or delayed death from progressive pulmonary fibrosis. Paraquat is poorly absorbed by inhalation, but when ingested orally, severe illness can occur. Death usually occurs within 2 days if more than 50 ㎎/㎏ of paraquat is ingested . The most important prognostic indicator is the quantity of paraquat absorbed, as shown by the plasma paraquat concentration, and the prognostic indication depends mostly on the description given by the patients and their families about the amount of paraquat ingested, which is often underestimated or overestimagted. For these reasons, we tried to compare the plasma paraquat concentrations with amount of paraquat described by patients or their families. Methods: We reviewed the medical records of 59 patients with acute paraquat poisoning from February 1998 through February 1999, the paraquat concentrations in plasma were measured at Presbyterian Medical Center by using high performance liquid chromatography. Results: There was a striking discrepancy between the plasma paraquat concentration and the ingested amount described by the patients or their families. Conclusion: We recommend that the plasma paraquat concentration be measured in patients being treated for acute paraquat poisoning.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

국제물류 환경변화에 따른 경제자유구역 물류거점기능 강화방안

서수완,박영태 한국물류학회 2005 물류학회지 Vol.15 No.1

본 연구는 중국 물류시장의 급속한 성장에 대응하고 한국내 글로벌 물류기업 유치 및 물류산업 육성을 위한 대안의 일환으로 경제자유구역의 물류거점기능 강화방안을 분석하였다. 본 연구에서 검토한 바에 따르면 경제자유구역의 성공가능성은 투자대상국의 발전가능성과 시장규모, 배후연계수송능력, 물류비수준과 물류기반시설 및 화물처리시설 확보수준 및 국가지원 등의 변수에 의해 결정될 수 있으며, 아울러 한국 물류기업의 경쟁성 향상 또한 매우 중요한 변수로 간주되고 있다. 이러한 사실로부터 경제자유구역에 대한 외국기업을 비롯한 관련 물류기업의 투자를 이끌어내기 위해서는 비용요인 보다는 시장요인 개선전략을 통해 경제자유구역의 물류거점기능 강화전략이 추진되어야 한다는 결론을 도출할 수 있었다. 이는 한국 자체시장 규모를 확대시킬 수 있는 전략의 추진이 선행되어야 함을 의미하는 것이며, 이를 위해서는 국내 물류기업의 경제자유구역 참여를 확보할 수 있는 정책적 보완이 요구된다. 아울러 한국의 주요 거점지역과 외국 주요 거점간에 보다 많은 물류네트워크 관계를 형성할 수 있는 방안을 모색하는 것이 순차적인 전략이라고 판단할 수 있다. This paper investigated strengthening the function of logistics hub in free economic zone(FTZ) in order to attract investments from global logistics companies and to raise logistics industry. The successfully probability of FTZ will be decide by potential growth of host country and market size, transportability connected with hinterland, logistics cost level, logistics infrastructure, level of cargo handling facility, government support, competitiveness of Korean logistics companies, etc. Therefore, to attract investment from the foreign companies and related logistics companies, the strategy to strengthen the function of logistics hub in FTZ have to performed through improvement of market factors rather than cost factors was deduced. It is mean that the procurement strategy to expand market size in Korea is pre-performed, and political supplementation, the investment on FTZ is guaranteed by domestic logistics companies, should be needed. Also, it is that the more and more logistics network inter major logistics hub in domestic and foreign is build will be successively strategy.

소아에서의 급성 파종성 뇌척수염의 임상적 고찰

조수진,박은애,유은선,김혜순,손세정,서정완,이승주,한후재 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

목적: 급성 파종성 뇌척수염은 감염이나 예방 접종 후 발생하는 중추 신경계의 급성 자가 면역 염증성 질환으로 탈수초를 일으킨다. 신경학적인 증상으로 발현되고 대부분 환전히 회복되지만 신경학적 후유증을 남기거나 사망 할 수도 있다. 이에 저자들은 본원에서 발생 한 14명을 분석하여 조기 진단과 치료에 도움을 주고자 하였다. 대상과 방법: 1998년 3월부터 2003년 8월까지 이대목동병원에서 급성 파종성 뇌척수염으로 진단 받은 14명의 의무기록을 후향적으로 조사하였다. 결과: 환자들의 평균 발생 연령은 5±7.8개월이였고, 특정계절이나 연도에 집중되어서 나타나지는 않았다. 선행질환은 주로 비특이적인 상기도 감염이 가장 많았고, 초기증상으로는 경련이 가장 많았다. 그 외에 의식저하나 운동장애도 있었다. 뇌척수액 검사에서 백혈구 증가증이 발견된 경우는 있었으나 단백이 증가된 경우는 없었다. 뇌 자기공명 촬영에서 T2 증강시 뇌백질과 기저핵에 고음영의 다발성 병소가 발견되었고 추적 촬영에서 대부분에서 소실되었다. 뇌파 검사가 시행되었던 경우 전반적인 서파가 가장 많았고 국소적인 극파가 나온 경우도 한 명 있었다. 환자들은 정맥 면역 글로블린과 메틸프레드니졸론으로 치료하였고 치료 시작 후 3~7일내 증상이 호전되었다. 모든 환자를 2달 이상 추적 관찰하였고 항경련제가 지속적으로 필요한 정도의 경련성 질환이 두 명, 신경아교증이 남아잇는 경우가 한 명, 외래에서 다발성 경화증이 의심되는 경우가 한 명 있었다. 결론: 급성 파종성 뇌척수염은 침범 부위에 따라서 다양한 임상 상으로 나타나며 면역 글로블린과 메틸프레드니졸론이 치료에 효과적이였다. 본 연구에서는 대상 환자수가 적어 신경학적 후유증의 위험요소는 밝힐 수는 없으나, 예후는 검사소견과 연관되어 있지는 않았고, 대부분에서 양호하여 완전히 회복되었으나, 신경학적 후유증이 남은 경우도 있었다. Objective:Acute disseminated encephalomyelitis(ADEM) is an acute demyelinating autoimmune inflammatory disease of the central nervous system which develops after infection of vaccination. It may be fatal, and produce a permanent residual static disability or fully recover. We retrospec-tively studied 14 cases to investigate the clinical findings and outcome of ADEM. Methods : 14cases of ADEM diagnosed at Ewha Womans University Mokdong Hospital from 1998 to 2003 were retrospectively reviewed. Results : The age of onset was 5years±7.8 months and no seasonal clustering was found. The time of onset of symptoms was between 3 to 30 days. The preceding events were nonspecific upper respiratory infections in 9 cases, aseptic meningitis in 4 cases, and gastroenteritis in one case..The initial symptoms were seizure, altered consciousness, hemiparesis, fever, headache, and vomiting. Brain MRI showed multifocal high signal intensity lesions on T2 weighted image mainly in the cerebral whith matter, basal ganglia and periventricular white matter. EEG was performed in some cases and showed generalized or focal slow waves and only one case showed focal spikes. Patients were treated with IV globulin and methylprednisolone and the symptoms improved within 3-7 days after treatment. All patients were followed up for more than 2 months and most of them fully recovered except two. Conclusion : ADEM presents in various clinical manifestations depending on its involvement of the brain lesions. Most cases recovered fully but in some cases, residual permanent neurologic sequelae remained.

국내 혈액질환 환자에서 침습성 진균 감염의 구제치료로서 Caspofungin의 효과와 안전성

최수미,박선희,이동건,최정현,유진홍,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.5

목적 : 본 연구에서는 국내 혈액질환 환자들에서 일차 항진균제를 부작용으로 인해 투여할 수 없거나, 일차 항진균제에 반응이 없는 침습성 진균 감염증의 구제치료로서 caspofungin의 효과와 이상반응에 대한 임상 경험을 소개하고, 예후인자를 분석해 보았다. 재료 및 방법 : Caspofungin은 첫날 70 mg, 이틀째 부터 50 mg을 하루 일회 투여하였고, caspofungin 종료시 그리고 종료 4주 후 반응을 평가하였다. 결과 : 총 55명의 환자가 분석에 포함되었고, 남자 32명, 여자 23명, 평균 나이는 38.2세(16-65세)였다. 기저 질환은 급성 백혈병 33명, 골수이형성 증후군 12명, 만성 백혈병 3명, 기타 7명이었다. 진균 감염은 확진 1명, 가능 5명, 추정 47명, 불확실 2명이었고, 감염 장소는 폐를 침범한 경우가 49명, 파종감염 6명이었다. 전체적으로 41.8% 환자에서 양호한 반응을 보였으며, 치료군, 치료후 기저질환의 상태, 침습성 진균 감염 진단시 호중구 감소증 여부, 스테로이드 등 면역억제제 사용 여부가 유의한 예후인자였다. 약제관련 이상반응은 14.5%에서 관찰되었고, 발열, 피부 발진, 간기능 저하 등으로 나타났다. 이중 4명에서 이상반응과 관련하여 투약을 중지하였고, 약제 중단 후 증상은 모두 호전되었다. Caspofungin 관련 신독성은 관찰되지 않았다. 결론 : Caspofungin은 국내 혈액질환 환자에서 침습성 진균 감염증의 구제치료에 효과적으로 안전하게 사용될 수 있겠다. 최근 여러 항진균제들이 개발되어 임상에 도입되고 있는 바, 항진균 작용 범위, 독성, 약역동학적 특성, 비용-효과면 등을 고려하여 환자별로 직절한 항진균제를 선택하도록 해야 할 것이다. Background : Invasive fungal infection (IFI) is an important cause of morbidity and mortality in patients with hematologic malignancy. Patients with IFI who fail to standard therapy have poor prognoses. We investigated the efficacy and safety of caspofungin (CAS) in Korean adults with hematologic diseases and IFI who did not respond to the conventional antifungal therapy. Materials and Methods : Patients with IFI refractory or intolerant to standard antifungal therapy received CAS 50 mg IV daily after 70 mg loading dose on day 1. Efficacy and safety of CAS were assessed in patients who received more than one dose. Favorable response [complete (CR) or partial (PR)] was defined as significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results : From Feb. 2004 to Feb. 2005, 55 patients who met the inclusion criteria were enrolled. There were 32 male and 23 female patients with mean age of 38.2 years (range, 16-65). Underlying diseases were acute leukemia (33 cases), myelodysplastic syndrome (12 cases), chronic myelogenous leukemia (3 cases), and other hematologic diseases (7 cases). Thirty-six patients were receiving chemotherapy and 13 patients were under hematopoietic stem cell transplantation (HSCT). The number of proven, probable, possible, and indeterminate IFI cases was 1, 5, 47, and 2, respectively. Conventional amphotericin B, intravenous itraconazole, and liposomal amphotericin B were administered for average of 14.9 days prior to administering CAS. Mean duration of CAS therapy was 12.8 days (range, 1-45). Twenty-three patients (41.8%) showed favorable responses (CR : PR=8 : 15) at the end of CAS therapy. Chemotherapy group, neutropenic state, remitted state of underlying disease, and no steroid therapy were significant prognostic factors for favorable response. Eight (14.5%) patients developed drug-related adverse events such as fever, skin eruption, and hepatic dysfunction which were reversible after discontinuation of CAS. Drug-related nephrotoxicity was not observed. Conclusion : On the basis of our investigation, CAS was effective and safe as a salvage therapy of refractory IFI or as an alternative for patients intolerant to standard antifungal agents.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.