정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 as biomarkers of patients with established acute kidney injury

( Won Yong Cho ),( Sung Yoon Lim ),( Ji Hyun Yang ),( Se Won Oh ),( Myung-gyu Kim ),( Sang-kyung Jo ) 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.3

Background/Aims: Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been recently discovered and validated as sensitive biomarkers that can predict stage 2 or 3 acute kidney injury (AKI) development in high-risk patients. We aimed to assess whether these biomarkers could predict adverse outcomes and renal recovery in established AKI patients. Methods: This was a single-center study prospectively enrolling 124 patients diagnosed with AKI. TIMP-2, IGFBP7, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule 1 (KIM-1) levels were measured at the time of diagnosis and the predictive performance of short-term outcomes and renal recovery was assessed. Results: Patients were divided into 4 quartiles according to the initial urinary TIMP-2/IGFBP7 levels. Stage 3 AKI (odds ratio [OR], 17.86), classified by the Kidney Disease Improving Global Outcomes (KDIGO), as well as the third and fourth quartiles of TIMP-2/IGFBP7 (OR, 5.75 and 44.98, respectively), were found to be independent predictors of renal replacement therapy at the time of AKI diagnosis. In addition, KDIGO stage 3 AKI (OR, 2.468) or the third of fourth quartiles of urinary TIMP-2/IGFBP7 (OR, 1.896 and 3.622, respectively) were also found to be useful in predicting nonrecovery of renal function. In a separate analysis of patients with renal recovery at discharge, initial urinary TIMP-2/IGFBP7 or urinary IGFBP7 at discharge could also predict new-onset or progressive chronic kidney disease (CKD). Conclusions: In AKI patients, urine TIMP-2/IGFBP7 could serve as a biomarker for predicting adverse outcomes, renal recovery, or the development and progression of CKD.

한방 닭죽 개발 및 최적 배합비율 확립

김경연 ( Kyung Yeon Kim ),백무열 ( Moo Yeol Baik ),박천석 ( Cheon Seok Park ),최성원 ( Sung Won Choi ),김창남 ( Chang Nam Kim ),김병용 ( Byung Yong Kim ) 한국식품영양학회 2013 韓國食品營養學會誌 Vol.26 No.1

죽의 기능성 향상을 위하여 2:1:1:1의 배합으로 혼합한 한약재료(가시오가피, 숙지황, 산약, 백복령)와 닭가슴살 등의 재료를 사용해 한방 영양죽을 제조하였다. 한방 닭죽의 DPPH radical 소거능, SOD 유사활성, 맛의 선호도, cost는 수학적인 canonical model과 trace plot을 이용하여 분석한 결과, SOD 유사활성 이외에는 각 성분들이 독립적으로 작용하여 상호작용이 없는 선형 모델을 보여주었다. DPPH radical 소거능, SOD 유사활성, 맛의 선호도를 최대로, cost를 최소로 목적 범위를 설정하고, 각각의 canonical 계수를 이용하여 수적 최적화를 통하여 최적 배합비를 구한 결과, 한약 혼합물 101g, 닭가슴살 38.66g, 찹쌀 비율 41.34g의 최적 배합비를 구하였으며, 이 배합비에 따른 맛의 선호도는 6.39, DPPH radical 소거능은 17.25㎎VCE/ℓ, SOD 유사활성은 2.25%, cost는 1,382.39 won으로 나타났으며, 여러 결과들 사이에 최적화된 한 값에 수렴하는 desirability는 0.714로 나타났다. 이는 한약혼합물이 많을수록 기능성 면에서는 높게 나타나지만 맛의 선호도면에서는 낮게 나타냈고, 닭가슴살의 경우에도 그 함량이 많을수록 맛의 선호도는 올라갔지만 그에 반해 cost가 높게 올라간 것을 반영한 결과로 사료된다. The objectives of this study were to develop porridge with medicinal herbs and chicken breast meat and to find out the optimum mixing ratio. Several herb extracts such as Acanthopanacis senticosus, Rehmannia glutinosa, Disocorea japonica, and Poria cocos Wolf were used in the ratio of 2, 1, 1, and 1, respectively. The optimum processing condition for herbal chicken porridge was determined by a design expert program. Seventeen experimental points were selected, and herb extracts (82∼101g), chicken breast meat (30∼50g), and glutinous rice (40∼60g) were chosen as the independent variables. The measured responses were preference of taste, DPPH radical scavenging, SOD-like activity, and cost. The optimum formulation of herbal chicken porridge using the numerical analysis was set at herbal extracts (101g), chicken breast meat (38.66g), and glutinous rice (41.34g) with a 0.714 desirability value. DPPH radical scavenging effect, preference of taste and the cost showed a linear model, whereas SOD-like activity showed a quadratic model indicating a higher interaction among the mixture. As a result of proximate composition of optimized herbal chicken porridge, the contents of moisture, carbohydrate, crude protein, crude lipid, and ash contents were 76.4, 9.0, 1.4, 0.5, and 1.6%, the calories of the porridge was 46.1kcal/100g.

Medicinal Chemistry : EVALUATION OF CADMIUM-INDUCED NEPHROTOXICITY USING URINARY METABOLOMIC PROFILES IN SPRAGUE-DAWLEY MALE RATS

( Yu Kyung Lee ),( Eun Young Park ),( Shi Won Kim ),( Ji Yeon Son ),( Tae Hyung Kim ),( Won Gu Kang ),( Tae Chun Jeong ),( Kyu Bong Kim ),( Seung Jun Kwack ),( Jae Won Lee ),( Suh Mann Kim ),( Byung M 영남대학교 약품개발연구소 2015 영남대학교 약품개발연구소 연구업적집 Vol.25 No.-

The aim of this study was to investigate urinary metabolomics profiles associated with cadmium (Cd)-induced nephrotoxicity and their potential mechanisms. Metabolomic profiles were measured by high-resolution 1H-nuclear magnetic resonance (NMR) spectroscopy in the urine of rats after oral exposure to CdCl2 (1, 5, or 25 mg/kg) for 6 wk. The spectral data were further analyzed by a multivariate analysis to identify specific urinary metabolites. Urinary excretion levels of protein biomarkers were also measured and CdCl2 accumulated dose-dependently in the kidney. High-dose (25 mg/kg) CdCl2 exposure significantly increased serum blood urea nitrogen (BUN), but serum creatinine (sCr) levels were unchanged. High-dose CdCl2 (25 mg/kg) exposure also significantly elevated protein-based urinary biomarkers including osteopontin, monocyte chemoattractant protein-1 (MCP-1), kidney injury molecules-1 (Kim-1), and selenium-bingding protein 1 (SBP1) in rat urine. Under these conditions, six urinary metabolites (citarate, serine, 3-hydroxyisovalerate, 4-hydroxyphentllactate, dimethylamine, and betaine) were involved in mitochondrial energy metabolism. In addition, a few number of amino acids such as glycine, glutamate, tyrosine, proline, or phentlalanine and carbohydrate (glucose) were altered in urine afrer CdCl2 exposure. In particular, the metabolites involved in the glutathione biosynthesis pathway, including cysteine, serine, methionine, and glutamate, were markedly decreased compared to the control. Thus, these metabolites are potential biomarkers for detection of Cd-induced nephrotoxicity. Our results further indicate that redox metabolomics pathways may be associated with Cd-mediated chronic kidney injury. These findings provide a biochemical pathway for better understanding of cellulat mechanism underlying Cd-induced renal injury in hunmans.

십이경근(十二經筋)과 근육(筋肉)과의 관계(關係)에 대한 연구

심원보 ( Won Bo Sim ),김용득 ( Yong Deuk Kim ),안영남 ( Young Nam An ),김경식 ( Kyung Sik Kim ),손인철 ( In Chul Sohn ) 대한경락경혈학회 2004 Korean Journal of Acupuncture Vol.20 No.2

The Oriental Medicine is described with so many terms of its own theory causing misunderstand of the concept which is expressed with same term used in modern medicine. Muscular system is also used in the both medicines, the Oriental Medicine and modern medicine. For the purpose of resolving the misunderstand of using the medical terms, we referred to a large number of literature for the muscular system in both medicine. Although there are few references concerning about systematic components in the Oriental Medicine, among the concepts of the Oriental Medicine, there are comparatively many approaches to the Meridian muscular system, a muscular system related with the Meridian, Therefore, there are many similarities and differences in the interrelation between the muscular system which was stated at the time of the concept of the Meridian system was developed and anatomical muscular system in the modern medicine. As a result of survey the references, we found out that anatomical muscular system is limited to visual compartments, whereas the Meridian muscular system is covering not only visual components but also the relation with internal organs. We conclude that there are conceptual differences in the kyung-keun system in the past and anatomical muscular system in the present.

일반논문(一般論文) : 『황제내경(黃帝內經)』에 나타난 부인과(婦人科)에 관(關)한 문헌고찰(文獻考察)

김혜원 ( Hye Won Kim ),조정훈 ( Jung Hoon Cho ),장준복 ( Jun Bock Jang ),이경섭 ( Kyung Sub Lee ) 대한한의학원전학회 ( 구 대한원전의사학회 ) 2005 대한한의학원전학회지 Vol.18 No.1

Poster Session:PS 0545 ; Nephrology : A Case Report of Capd Peritonitis with the Pathogen of O. Anthropi

( Hyung Oh Kim ),( Chun Gyoo Ihm ),( Tae Won Lee ),( Kyung Hwan Jeong ),( Seul Ki Kim ),( Ji Yun Park ),( Jin Sug Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: We report a rare case of CAPD peritonitis caused by Ochrobacterium anthropi. Introductions: Among the continuous ambulatory peritoneal dialysis(CAPD) patients, peritonitis is one of the most commonly taken complications, and also the general cause of dialytic modality exchange to hemodialysis. Usual pathogens of CAPD peritonitis may be bacteria, fungi, mycobacteria. Coagulase negative staphylococci, S. aureus, campylobacter, pseudomonas are common reported pathogens among the bacteria, of CAPD peritonitis cases, meanwhile candida is among fungi. Ochrobacterium anthropi is one species of Brucellaceae, which is rare pathogen of human disease. Case (Methods and results): 73 years old female, who was on CAPD due to diabetic end stage renal disease visited Kyung-Hee University hospital with intermittent abdominal pain. Body fi uid analysis showed increased white blood cell(WBC) count of 26,750/mm3 with her peritoneal fi uid. Culture study with peritoneal fi uid suggested O. anthropi, and DNA sequencing with PCR was consistent with O. anthropi. Intraperitoneal ceftazidime and cefazolin were administrated as empirical antibiotics. Ceftazidime resistance was noted with the result of antibiotics sensitivity test at 7th day of hospitalization, and antibiotics were changed into intraperitoneal gentamicin, which showed sensitivity to the pathogen. CAPD catheter removal and antibiotics re-exchange into imipenem and cefazolin, which were other sensitive antibiotics by the sensitivity test, were done since clinical manifestation and peritoneal fi uid WBC count was repeatedly improved and aggravated. The patient discharged with improved lab test results and resolving clinical symptoms afterward. Conclusions: We presentators report rare case of CAPD peritonitis with pathogen of O. anthropi. The pathogen of the case confi rmed by classical microbiologic, and molecular biologic Methods: The patient was unable to treat only with antibiotics, thus CAPD catheter, which might be act as colonizing source, was removed, and the disease resolved.

Lunar Sodium Observations at the Kyung-Hee Observatory

Dong-Wook Lee,Kyung-Won Chun,Sang-Joon Kim 한국천문학회 2010 天文學會報 Vol.35 No.1

신이식후 발생하는 감염에 대한 고찰

김재필(Jae Phil Kim),조대옥(Dae Ok Cho),고경식(Kyung Sik Ko),안재형(Jai Hyung Ahn),이태원(Tae Won Lee),임천규(Chun Gyoo Ihm),김명재(Myung Jae Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: Renal transplantation is a major therapeutic advance for patients with chronic renal failure. But recipients of renal transplantation are prone to infection with both common and unusual organisms. And infectious diseases remain a major cause of morbidity and mortality in renal transplant recipients. This study was to analyze the infections in renal transplant recipients; its occurrence according to sites and organisms; comparison among immunosuppressive agents; prognostic differences of urinary tract infections(UTI) between those developed during 1 month after transplantation and those not developed; graft outcome; and patients mortality. Mothods: 181 renal transplant recipients were examined. They received renal transplantion between january 1979 and December 1992 at the Kyung-Hee University Hospital. 158 of them received transplantation from living-related donors, 22 from living-unrelated donors, and 1 from cadaver donor. Their age at the time of transplantation ranged from 14 to 66 years(mean 35.6 years), and the male to female ratio was 2.3: 1. The observation period ranged from 1 to 144 months(41.26±31.71, mean±S. D.). Results: 1) 110 recipients(60.7% of total) had 232 episodes of infectious complications whereas 71(39.3% of total) had no infectious episodes. About half of infectious episodes(128 episodes, 55.2% ) occurred during 1 month after transplantation. 2) The most common site of infection was urinary tract(138 episodes, 59.2%) whth the next sites coming in this order, bacteremia(32 episodes, 13.8%), pulmonary(21 episodes, 9.1%), and skin(21 episodes, 9.1%). 3) The causative organisms of UTI ranked in this order E. coli 21.7%, staphylococcus spp 14.5%, and pseudomonas spp 13.0%. 4) The causative organisms of bacteremia ranked in this order E. coli 34.4% salmonella spp 18.8%, pseudomonas spp 12.5 %, and staphylococcus spp 12.5%. 5) There was no significant differences of infectious episodes among immunosuppressive regimens. 6) Early UTI group(UTI occurred during 1 month after transplantation) recorded significantly higher incidence of urinary tract infections after 1 month that followed than non-UTI group. But there was no differences between two groups on graft and patients outcome. 7) The major cause of death was life-threatening infections(63.2 %). Conclusion: Most infections due to various organisms may occur during 1 month after transplantation. And still they constitute a major cause of death in renal transplant recipients.

제왕절개 분만율의 지역간 변이와 관련요인에 대한 연구

김혜경,이정운,박강원,문옥륜,Kim, Hye-Kyung,Lee, Jeon-Un,Park, Kang-Won,Moon, Ok-Ryun 대한예방의학회 1992 Journal of Preventive Medicine and Public Health Vol.25 No.3

The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows : It was found that. cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible($15{\sim}49$ years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates : In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three deplendent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the valiance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has veen found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.