조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

한국형 후각검사 KVSS Test의 개발

홍석찬,유영석,김은서,김석천,박수홍,김진국,강성호 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.7

Free Communications : P2 ; Cannabinoid Receptors : Its Impact in Epidermal Differentiation and Possible Role in Treatment of Psoriasis

( Ji Seok Kim ),( Chan Hee Nam ),( Ji Yeon Yoo1 ),( Hyun Jung Kim ),( Se Kyoo Jeong ),( Sung Ku Ahn ),( Seung Phil Hong ) 한국피부장벽학회 2014 한국피부장벽학회지 Vol.16 No.2

Purpose: There are researches indicating that in human skin, the cannabinoid receptors exist, which take a part of endocannabinoid system. Nonetheless, the possible association of cannabinoid receptors with the pathogenesis of psoriasis has not yet been fully elucidated. Through this research, we tried to document the association between cannabinoid system, epidermal differentiation and psoriasis. Methods: Using human keratinocyte (KC), the expression of cannabinoid receptor-1 (CB1R) and -2 (CB2R) was analyzed according to the degree of differentiation. Also we examined for changes in differentiation marker of KC after application of CBR agonist. In addition, murine model applied with imiquimod to induce psoriasis symptoms was used to evaluate the effect of topical CBR agonist on inflammation and skin barrier function. Results: Compared to normal human skin, CBR expression was reduced in epidermis of psoriasis skin. Western blotting revealed the expression of both CB1R and CB2R in undifferentiated KC. The expression level of CB1R increased as the differentiation progressed in KC as with involucrin, K1 and K10. On the other hand, there was no change of CB2R in the process of differentiation. Furthermore, CB1R agonist partly increased expression of proteins associated with epidermal differentiation. Through this we could speculate that the CB system may be associated with proteins related to epidermal differentiation. Moreover, inflammation and barrier function in murine models with psoriasis symptoms were improved after 3 days-application of topical CB1R agonist. Conclusion: Cannabinoid receptors in human skin might be related to the differentiation of KC, and since its activation could improve skin barrier condition in murine psoriasis model, it can be expected to be a new therapeutic target for treatment of psoriasis.

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.

가상가공기법을 이용한 볼엔드밀과 플랫엔드밀의 절삭력 해석 시스템 개발

유동일,김석일,윤태선 한국 항공대학교 항공산업기술연구소 1998 航空宇宙産業技術硏究所 硏究誌 Vol.8 No.-

본 연구에서는 볼엔드밀과 플랫앤드밀에 의해서 야기되는 절삭력을 가상적으로 평가할 수 있는 기반을 구축하기 위한 노력으로써 가상가공기법을 이용한 절삭력 해석 시스템을 구현하였다. 공구의 기하학적 제원과 공작기계(밀링머신, 머시닝센터)의 운전 조건에 의해서 변화되는 절삭력은 공작물과 공구의 접촉영역 내에 위치한 미소 절삭날에 적용하는 미소 절삭력들을 중첩시키는 방법을 통해서 해석하였다. 특히 구조변형을 고려한 절삭력은 절삭력과 구조변형의 평형조건을 이용해서 결정하였다. 아울러서 볼엔드밀과 플랫엔드밀의 절삭력에 대한 실험결과와 해석결과의 비교를 통해서 본 연구에서 개발한 절삭력 해석 시스템의 유용성을 입증하였다. In this study, a cutting force analysis system for ball and flat end-mills is realized based on the virtual manufacturing technologies. Cutting force which depends on the specification of cutting tool and operating conditions of machine tool(milling machine, machining center), is predicted by superposing the infinitesimal cutting forces on infinitesimal cutting edges existing in the contact area between cutting tool and workpiece. Especially, the equilibrium condition between cutting force and structural deformation of cutting mechanism is introduced to determine the cutting force considering the influence of structural deformation. And comparison between the predicted and measured cutting forces for ball and flat end-mills shows the effectiveness of the cutting force analysis system developed in this study.

이질균 세포 단백의 분석에 있어서의 은 염색의 이용

김재석,이유철,조동택 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.3

To study the mechanism of virulence of Shigella, sodium dodecyl sulfate-polyacrylamide gel electro-phresis was conducted on membrane fractions from 2 strains of HeLa cell invasive Shigella flexneri. After electrophresis gel slab was stained first with Coomasie brilliant blue R-250 staining then followed by silver staining, more than tenfold increase in sensitivity was achieved over Coomasie brilliant blue R-250 stain. The total membrane fraction from Shigella flexneri 85DH38 stained with silver showed 12 protein bands; 180 kilodalton(K), 127K, 100K, 78K, 64K, 55K, 47K, 45K, 43K, 39K, 38K and 12.8K, but stained with Coomassie brilliant blue R-250 showed only 5 bands. The sodium lauryl sarcosinate (SLS) soluble membrane fraction showed prominent 100K band and less prominent 5 bands; 180K, 78K, 64K, 55K and 45K. The SLS insoluble membrane fraction showed prominent 47k, 39K, and 38K bands of porin proteins and less prominent 43K and 12.8K band. The total membrane fraction from Shigella flexneri 78B-1 showed 7 protein bands which also appeared in the fractions from Shigella flexneri 85DH38. There were 5 bands of low molecular weight proteins (10K to 20K) in gel run at 20 ㎃ but not appeared at 35 ㎃.

다운증후군유아의 운동발달과 트레드밀트레이닝 및 걸음 보조기의 중재효

김석진,강유석,김영덕 서울대학교 스포츠과학연구소 2009 스포츠과학리뷰 Vol.3 No.1

Down Syndrome is a representative hereditary disability which accompanies mental retardation, communication difficulties and motor development delay. In particular, the motor development delay that begins in infancy brings forth negative effects in various developmental domains such as emotional, social and cognitive areas as well as interfering with various aspects in everyday life. Therefore many researchers have tried to minimize such development delay in Down Syndrome by developing various early intervention programs and shown continuous attempts to prove its positive effects. The treadmill or foot orthoses intervention methods introduced in this study are being applied in America or Europe to infants with Down Syndrome in order to minimize their motor development delay. It is reported that treadmill training helps infants with Down Syndrome in movements related to balance such as standing or walking, and foot orthoses improves balance in ankles and motor skills when walking, as well as increase steady posture. For future studies, there is a need for researchers to discover the cause of motor development delay and abnormal development patterns in infants with Down Syndrome and to study the effects of such motor development delay on other developmental areas. Also, currently in Korea there is relatively insufficient development and supply of early intervention programs for infants with disabilities as well as studies regarding its effects. Therefore we need to develop early intervention programs according to the characteristics of each disability and evaluate the effects through experience. For this, we need to make the parents of infants with disabilities aware of the need for early intervention programs related to physical activity and its effects. 다운증후군은 정신지체와 의사소통의 곤란, 그리고 운동발달 지연이 동반되는 대표적인 유전적 장애영역 중 하나이다. 특히, 영유아기에서 시작되는 운동발달 지연은 이후의 다양한 발달영역 즉, 심동적, 사회적, 인지적 영역에 부정적인 영향을 미쳐 일상생활을 비롯한 다양한 영역에서의 수행에 곤란을 초래하게 된다. 따라서 많은 연구자들은 이러한 다운증후군의 발달 지체를 최소화하기 위해 다양한 조기중재 프로그램을 개발하고 그 효과를 증명하는 시도를 진행해 왔다. 본 연구에서 소개하고 있는 트레드밀이나 걸음보조기 중재방법은 미국이나 유럽에서 다운증후군유아의 운동발달지체를 최소화하기 위해 유아기부터 적용되는 방법이다. 트레드밀 트레이닝은 다운증후군유아의 서기와 걷기 등 주로 균형 및 보행에 도움을 주는 것으로 나타났으며, 걸음보조기는 보행 시 발목의 균형과 운동 기능을 향상시키고, 자세의 안정성을 높이는 것으로 보고되고 있다. 향후 연구자들에게는 다운증후군유아의 운동발달 지연과 비정상적인 발달 패턴을 유발하는 요인이나 그러한 운동발달 지연이 다른 발달 영역에 미치는 영향에 대해 알아보는 좀 더 포괄적인 연구가 요구된다. 또한 국내에서는 현재 장애유아를 위한 조기 중재프로그램의 개발과 보급, 그리고 효과 규명에 상대적으로 소홀한 실정이다. 따라서 장애유형별 특징을 고려한 조기 중재프로그램을 개발하고, 효과를 경험적으로 검토해 보는 시도가 필요하다. 이를 위해, 장애유아의 부모들에게 신체활동 관련 조기 중재프로그램의 필요성과 효과에 대한 올바른 인식을 전파하는 작업이 요구된다고 하겠다.

江地開發이 地域社會發展에 미친 影響에 關한 比較硏究 : 테네시江 事例와 4大江 流域 開發計劃을 中心으로

金裕赫,琴東信,石琮顯 단국대학교 법정대학 지역개발학과 1982 地域開發論叢 Vol.3-4 No.-

인체 연부조직 육종에서 Cyclin D1, CDK4,p16 및 Rb 단백의 발현

유진영,이아원,강석진,김병기 대한병리학회 2001 Journal of Pathology and Translational Medicine Vol.35 No.3

산업장 근로자들의 건강증진 프로그램에 대한 수요

유중선,김석범,강복수 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

산업장 근로자들의 건강과 관련된 변수 및 행태를 조사하고, 그들이 원하는 건강증진 내용을 각 근로자의 특성별로 조사하여 비용-효과적인 근로자 건강 증진 프로그램을 개발하기 위해 1995년 12월부터 1996년 1월 사이에 실시된 40개의 근로자 일반 건강검진 및 특수검진 사업장에 근무하는 근로자 500명을 무작위로 추출하여 검진 실시와 병행하여 이 연구를 위해 개발된 설문지를 이용하여 자기기입식 방법에 의해 자료를 수집하였다. 현재 직장에서 실시하고 있는 건강증진 활동으로는 야외운동이 14.8%로 가장 많았으며, 정기적 건강검진, 실내운동 및 맨손체조 순이었다. 남자에서는 야외운동이 가장 많이 수행하는 건강증진 활동이었으며, 여자에서는 정기적 건강검진이 가장 많았다. 전체적으로 여자에 비해 남자의 건강증진 활동률이 더 높았다. 앞으로 현재근무하는 직장에서 실시되기를 희망하는 건강증진 활동은 정기적 건강검진이 26.2%로 가장 많았으며, 건강상담, 실내운동 및 야외운동 순이었다. 남자에서는 정기적 건강검진이 33.7%로 가장 많았으며, 그 외에도 건강상담, 실내운동, 야외운동 순으로 희망하였다. 여자에서는 체중관리 프로그램이 21.4%로 가장 많았고, 정기적 건강검진, 건강상담 등의 순이었다. 근무부서별 희망 건강증진 활동은 생산직의 경우 남녀근로자 모두 정기적 건강검진을 가장 선호하였고, 사무직의 경우 남자는 정기적 건강검진을, 여자는 체중관리 프로그램을 가장 많이 희망하였다. BMI 지수별 희망 건강증진 활동은 저체중 근로자 중 남자는 영양교육을, 여자는 체중관리 프로그램을 가장 선호하였다. 정상체중에 속하는 여자 근로자들도 체중관리 프로그램을 가장 선호하였다. 규칙적인 운동 및 식사를 하는 근로자는 남녀 모두 정기적 건강검진을 가장 선호하였으며, 규칙적인 운동 및 식사를 하지 않는 근로자 중 여자는 체중관리 프로그램을 가장 선호하였다. 남자 근로자는 음주 및 흡연 여부에 관계없이 정기적 건강검진, 건강상담 및 실내운동 순으로 선호하였다. 이상의 결과로 앞으로 가장 우선적으로 실시해야 할 건강증진프로그램은 정기적 건강검진이며 현대 실시중인 근로자 정기신체검사에 대한 만족도가 낮아 검진의 내용과 방법에 대한 개선이 요구되며 여성근로자들에 대한 체중 및 영양에 대한 올바른 지식 및 태도를 갖도록 하는 교육프로그램과 흡연근로자들을 대상으로 하는 금연프로그램의 필요성을 고취시켜야 하겠다. This study was conducted to identify the demand of work-site health promotion program of employees. A self-administered questionnaire method was used to collect data from 492 employees from 40 work-sites in Taegu City and Kyungpook Provincial area. The work-site health screening programs conducted for several years were placed low value by employees. The out-door exercise was the most popular health promotion activity implemented at work-site as a whole. The employees expressed that periodic health check-up, the health counseling, indoor exercise would be implemented as a health promotion program in the future. The male employees regarded that the periodic health check-up program should be established preferentially at work-site. However, the female employees gave priority to fitness program. The health related behavioral patterns slightly influenced the preference of health promotion program. The health screening program for employees should be improved and the health education of nutrition and diet for female employees should be implemented.