신부전이 동반된 당뇨병 환자에서 발생된 침습성 모균증 : 수술과 Liposomal amphotericin B 및 GM-CSF 병합 요법에 의한 성공적인 치험 1예

이원영,오기원,임국희,장재혁,이동건,최정현,강무일,신완식,차봉연,이광우,손호영,강성구 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.4

저자들은 신부전이 동반된 당뇨병 환자에서 발생된 부비동형 모균증에 대하여 수술과 함께 liposomal amphotericin B 및 GM-CSF의 복합치료를 하여 성공적으로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Mucormycosis (zygomycosis) primarily affects diabetic or immunocompromised patients and typically progresses rapidly, necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are needed for cure, but it has the risk of causing significant renal toxicity. The recent development of liposomal amphotericin B allows antifungal therapy to be administered with potentially improved efficacy and reduced nephrotoxicity. We have experienced a case of paranasal mucormycosis successfully treated with surgery, liposomal amphotericin B and GM-CSF. A 59-year-old male suffering from diabetes mellitus for 6 years was admitted with pain at left maxillary area. He was diagnosed as mucormycosis after cytologic exam on the necrotic nasal mucosa, which showed typical hyphae. He have had diabetic nephropathy with macroproteinuria and had rapidly rising serum creatinine levels with the amphotericin B treatment: creatinine levels reverted to basal level with the use of liposomal amphotericin B. Despite surgical excision and continued antifungal therapy, his infection was not effectively controlled. Therefore, GM-CSF was administered additionally to improve phagocytic activity of leukocytes. He was finally cured after receiving a combination of aggressive surgery, liposomal amphotericin B and GM-CSF. To our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with liposomal amphotericin B in Korea.

"Tinidazole"(Fasigyn)에 依한 Giardia Lamblia의 驅蟲效果

崔源永,李玉蘭,李元求,이규면,朴定圭,李水月 中央醫學社 1973 中央醫學 Vol.25 No.4

"Tinidazole a new antiflagellate drug, was given orally for 3-7 days to 99 children infected with G.lamblia. Stool examination for detection and evaluation of therapeutic on giardiasis were made by formaline-ether concentration techniques. The children were grouped according to doses and the duration of administration of the drug. The results were summarized as follows; 1) Except 1 case out of 99 children, none of the children showed G. lamblia in the stool examination 2 weeks after administration of the drug, regardless of groups. 2) 4 weeks after administration of the drug, group A (10 mg per kg for 7 days) and group B (5 mg per kg for 7 days) children showed 100% of negative conversion, but group C (10 mg per kg for 5 days) children revealed 84.6% of negatives. 3) 6 months later, the negative conversion rates in groups A, B and C were reduced to 54.5%, 57. 1% and 50. 0% respectively. 4) Mild or transient side effects-nausea, abdominal pain, headache or fever and diarrhea were noted in 16 cases (27. 1%) out of 59 cases.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

조혈모세포이식술이 골수기질세포의 기원 및 조골세포로의 증식 및 분화에 미치는 효과

강무일,조성원,오은숙,백기현,이원영,오기원,김혜수,한제호,윤건호,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

근로자 건강증진전략을 위한 행동변화에 대한 요구도 평가

이강숙,임현우,구정완,홍현숙,이정민,이원철,박정일,맹광호,M, O'Donnel 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the stage of behavior change for health promotion strategy in workplace Methods : Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyong-in area from September to October 1998. Results : According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%, 0%, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0% in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%, 22.7%, 19.7%, 44.0% in female. In heavy smoker(p=0.017) and heavy drinker,(p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker. Conclusions : This study suggested that company support for health promotion in workplace was and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient health promotion strategy.

韓國産 진드기類의 分類學的 硏究 : Ⅱ. 털진드기및 中氣門진드기

李元求 全北大學校 基礎科學硏究所 1980 基礎科學 Vol.3 No.1

3 species of Cheyletid mites and 4 species of Mesostigmatid mites in house dusts and stored food materials as following list were investigated taxonomically from Korea. Suborder Trombidiformes Reuter, 1901 Family Cheyletidae Leach, 1814 1. Cheyletus malaccensis Oudemans, 1904 2. Cheyletus eruditus (Shrank, 1781) 3. Cheletomorpha lepidopterorum(Shaw, 1794) Suborder Mesostigmata Canestrini, 1819 Family Macrochelidae Vitzthum, 1930 4. Macrocheles muscaedomesticae(Scopoli, 1772) Family Dermanyssidae Kolenati, 1859 5. Dermanyssus gallinae(De Geer, 1778) 6. Ornithonyssus bacoti(Hirst, 1913) Family Laelaptidae Berlese, 1892 7. Haemolaelaps casalis Berlese, 1887

열전 반도체를 이용한 냉수기 개발에 관한 연구

이원희,정순원,구경완,이명섭 永同大學校 1997 硏究論叢 Vol.3 No.1

본 논문에서는 기존의 냉매 대신에 열전 소자를 사용하여 구성한 냉수기가 갖는 여러 가지 장점 및 냉수기의 중요 소자인 TEC 모듈(Thermo Electric Cooler Module)에 대한 최대 효율 구동 방법 등을 연구하였다. 또, 열교환기의 재질 및 모양, 방열판과 냉각팬의 크기 등을 변화시키면서 냉수기로서 최적의 효율을 가질 수 있도록 냉수기를 설계하였고, 그 설계를 바탕으로 실험을 하여 TEC 모듈(Thermo Electric Cooler Module)을 이용한 냉수기가 상품화 가능성이 있는지를 검토하였으며, 그 결과를 기술하였다. We developed a new cooling system which applies TEC module using peltier effect. Our cooling system has better effiency and make smaller pollution than conventional cooling system. We applies that cooling system to making cool water dispenser. We designed the cold water dispenser of optimum effiency varying material, shape, and size of heat sink and cooling fan. The possibility of a commodity on this designed cold water dispenser is investigated.

한국산 애응애과의 분류학적 연구

李定相,李元求 全北大學校 1987 論文集 Vol.29 No.-

A taxonomic investigation was carried out on the mites of the family Tenuipalpidae, plant feeders, which were collected in Cholla-Do Province from October, 1985 to September, 1986. We report the following 3 species belonging to 2 genera: Brevipalpus californicus(Banks, 1904) ; B obovatus Donnadieu, 1875; Tenuipalpus zhizhilashviliae Reck, 1953. Among them, Brevipalpus californicus (Banks, 1904) is recorded from Korea for the first time.

점박이응애(거미강:진드기목)의 행동에 관한 연구

이원구,이소영 全北大學校 1995 論文集 Vol.39 No.-

The two-spotted spider mites feed on various host plants, both wild and cultivated. This investigation was accomplished to understand behavior of two-spotted spider mites. Overwintering female mites were collected from apples from Jan. 5 to Feb. 11, 1993. Most apples (26 out of 33 apples) had two-spotted spider mites. The mean number of detected mites were 83.4 individuals per apple. After rearing several generations on bean leaves, the mites were used to test phototaxis. They showed slight positive phototaxis in adult stage, but no differences in their nymphal or larval stages. We put mites on leaf discs specially designed to test host preference and observed their movements. As a result, it appeared that the mites prefer pea or acacia than any other host, and avoid ginkgo or mint. Comparing microscopic surface structures of tested plant leaves, host preference of two-spotted spider mites seemed due to chemical factors rather than physical factors.

韓國産 Phytoseiidae科(거미綱:진드기目)의 分類學的 硏究

李元求,柳面玉 全北大學校 基礎科學硏究所 1991 基礎科學 Vol.14 No.1

본 연구는 捕食性 mite인 Phytoseiidae 科의 분류학적 검토를 목적으로 이루어졌다. 1998년 6월부터 1989년 6월 사이에 주로 호남지역에서 채집된 표본을 정리한 결과, 식물의 잎에서 발견된 것으로는 다음과 같이 5종이 동정되었다. 1) Amblyseius (Amblyseius) deleoni Muma et Denmark, 1971, 2) A. (A.) orientalis Ehara,. 1959, 3) A. (A.) longicornis(Evans, 1952), 4) Phytoseius (Phytoseius) nipponicus Ehara, 1967, 5) P. (P.) blakistoni Ehara. 1966. 그 중 deleoni, P. nipponicus, P. blakistoni의 3종은 한국 미기록종이었다. 본 연구에서의 우점종은 A. deleoni이었다. Three species of phytoseiid mites were previously known to occur in Korea. In these paper, descriptions and records are given of five species of the family as follows. *1. Amblyseius (Amblyseius) deleoni Muma et Denmark, 1971, 2. Amblyseius (Amblyseius) orientalis Ehara, 1959, 3. Amblyseius (Amblyseius) longisinosvs(Evans, 1952), *4. Phytoseius (Phytoseius) nipponicus Ehara, 1962, *5 Phytoseius (Phytoseius) blakistoni Ehara. 1966. Of which, three species with asterisk are new to Korea. Thus, a total of six species, including Typhlodromus vulgaris which is not treated in this paper, are known from Korea.