영구형 항서맥 심박조율기 환자의 장기추적관찰

최현석,이무용,최영진,최성준,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우,이명용 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

악성 질환에서의 고용량 화학요법과 자가말초혈액 조혈모세포이식술 : 단일기관 치료 경험

최정혜,안명주,오호석,이웅수,오석중,이영열,최일영,김인순 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.2

연구배경: 고용량 화학요법은 항암제의 투여 용량에 따라 항암효과가 비례하는 용량반응 관계가 있는 악성종양에서 효과를 기대할 수 있으며 현재 급성백혈병, 악성림프종, 다발성골수종 등의 혈액 종양과 유방암, 고환암, 난소암, 신경아세포종 등의 고형암 환자에서 시행되고 있다. 저자들은 고용량화학요법에 이어 자가조혈모세포이식을 시행 받은 악성 종양 환자를 대상으로 치료효과 및 부작용 등의 임상상을 알아보고자 하였다. 방법: 1997년부터 2003년까지 한양대학교 병원에서 자가조혈모세포이식을 시행 받은 악성 종양 환자 31예(남서 : 여성 15 : 16, 중앙연령: 50세, 다발성골수종 14예, 비호지킨림프종 9예, 유방암 4예, 호지킨림프종 3예, 급성골수성백혈병 1예)를 대상으로 후향적 분석을 시행하였다. 결과: 채집된 단핵구의 중앙값은 5.1×10^(8)/kg (범위 1.6~189.3)이었고 CD34양성세포수의 중앙값은 12.0×10^(6)/kg (범위 1.3~75.1)이었다. 말초혈액 과립구가 500/μL 에 도달하는 중앙값은 11일(범위 8~27)이었고 혈소판이 20,000/μL에 도달하는 중앙값은 11일(범위 0~32)이었다. 고용량 항암화학요법 후 21예가 완전관해, 5예가 부분관해에 도달하였다. 생존한 환자의 중앙추적기간은 29.5개월이었고 전체 환자의 2년 무병생존기간은 55.7%이었고 중앙값은 48.2개월이었다. 2년 생존기간은 62.9%이었으며 중앙값에는 도달하지 않았다. 10예의 사망환자 중 7예가 질병의 진행으로 사망하였고, 조기사망 3예(심부전과 신부전 1예, 장파열 1예, 패혈증 1예)가 있었다. 결론: 이 연구는 포함된 환자의 수가 적고 추적기간이 짧은 단점이 있으나, 다발성골수종, 악성림프종 등의 악성 질환에서 고용량 항암화학요법과 자가조혈모세포이식은 안전하고 효과적인 치료임을 추정할 수 있었다. Background: We performed the current study to evaluate the safety and efficacy of high-dose chemotherapy (HDC) with autologous peripheral blood stem cell transplantation (ASCT) in malignant diseases. Methods: Between January 1997 and March 2003, 31 patients (14 multiple myeloma, 9 Non-Hodgkin's lymphoma, 3 Hodgkin's disease, 4 breast cancer, and 1 acute myelogenous leukemia) underwent HDC with ASCT. Stem cells were collected by CS-3000 after mobilization treatment with chemotherapy and granulocyte colony-stimulating factor. The conditioning regimens included high-dose melphalan, BEAM (BCNU, etoposide, cytosine arabinoside, melphalan), BEAC (BCNU, etoposide, cytosine arabinoside, cyclophosphamide), CPB (cyclophosphamide, cisplatin, BCNU) and others. Results: There were 15 male and 16 female patients and median age was 50 years (range: 29~77). The median number of mononuclear and CD34+ cells was 5.1×10^(8)/kg (1.6~189.3) and 12.0×10^(6)/kg (1.3~75.1), respectively. The median time of neutrophil (>500/μL) and platelet (>20,000/μL) engraftment was 11 (8~27) and 11 (0~32) days after ASCT, respectively. Twenty-two patients experienced neutropenic fever. Twenty-one patients achieved complete remission and 5 patients achieved partial remission after HDC with ASCT. The median follow-up duration for surviving patients was 29.5 months. Causes of death included disease progression (7), sepsis (1), bowel perforation (1), and renal failure (1). Median progression free survival (PFS) was 48.2 months and median overall survival (OS) was not reached. Two-year PFS and OS was 55.7% and 62.9%, respectively. Conclusion: Our results suggest that HDC with ASCT was safe and effective modality in patients with various malignant diseases.

老化過程에서 흰쥐 滑車神經의 軸索의 數 및 直徑의 變化

최영수,엄창섭,서영석 최신의학사 1987 最新醫學 Vol.30 No.8

중환자실 병원감염에 대한 다기관 공동 조사연구

박은숙,박미라,진혜영,김정은,최정실,송영구,최영화,이위교,홍성관,허애정,양동규,김준명 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

미치광이풀 모상근 배양에서 Tropane Alkaloid 생산성 증진을 위한 최적 생물학적 엘리시터 선발

정희영,강승미,강영민,김용덕,양재경,정영관,최명석 Plant molecular biology and biotechnology research 2003 Plant molecular biology and biotechnology research Vol.2003 No.-

Scopolamine and hyoscyamine which belong to tropane alkaloids are the pharmaceutically valuable anticholinergic drugs. In order to increase the productivities, the effects of elicitation were investigated during hairy root cultures of Scopolia parviflora. Biotic elicitors originated from 3 fungi and 1 yeast were prepared as homogenate and supernatant and added to 3-week-old cultures. Both of homogenate and supernatant of Candida albicans elicitors increased the scopolamine production. The production of hyoscyamine was enhanced by homogenate of Fusarium solani and supematant of C. albicans. Most of the other fungal elicitors were also improved on the tropane alkaloid production compared to non-treatment. Among the elicitors tested, C. albicans was proved the optimal biotic elicitor on tropane alkaloids production. These results will be served mass production of tropane alkaloids by large-scale production.

김치에서 분리한 Lactobacillus sp. JC-7과 Lactobacillus acidophilus 88간의 Electrofusion 최적조건 설정

조영배,최현정,백형석,전홍기 부산대학교 유전공학연구소 1997 분자생물학 연구보 Vol.13 No.-

김치 발효 숙성기간을 연장하고 신선도를 오랫동안 유지 할 수 있는 김치발효 starter의 개발을 목적으로 최적숙성기에 있는 김치로부터 bacteriocin생성능이 없는 유산균을 분리하여 동정하였으며, bacteriocin생성능이 우수한 L.acidophilus 88을 융합시키기 위해 electrofusion에 대한 최적 조건을 검토하였다. 분리균주는 Lactobacillus속으로 동정되어 Lactobacillus sp. JC-7이라 명명하였다. Electrofusion에 의해 생성된 융합주를 식별하기 위해 streptomycin(2.5㎎/ml)에 내성을 나타내는 Lactobacillus sp. JC-7변이주와 kanamycin(600㎍/ml)에 내성을 나타내는 L.acidophilus 88변이주를 분리하였다. Electrofusion을 100V/㎝, 120msec(72ohms,1670 capacitance) 에서 수행했을 때 융합효율이 가장 양호하였으며 전기장의 세기와 시간이 중가할수록 융합 효율이 현저히 감소하였다. 2가 양이온은 농도가 중가할수록 대체적으로 융합효율을 감소시키는 경향을 나타내었으나 1mM MGCl_2에서는 대조군에 비해 융합효율이 약간 증가하였다. PEG매개에 의한 융합법의 융합효율을 비교한 결과, 융합효율은 chemical fusion<electrofusion<electrofusion+20% PEG순을 나타내었다. Evaluation of Optimum Conditions for the Electrofusion between Lactobacillus sp. JC-7 Isolated from Kimchi and Lactobacillus acidophilus 88. Young-Bae Jo, Hyun-Jung Choi, Hyung-Suk Baik and Hong-Ki Jun*. Department of Microbiology, Pusan National University, Pusan 609-735,Korea-A lactic acid bacterium was isolated from kimchi. The isolated strain was identified as the genus Lactobacillus thrugh its morphological characteristics and named as Lactobacillus sp. JC-7. The optimum conditions for the electrofusion between streptomycin(2.5㎎/ml)resistant mutant of Lactobacillus acidophilus 88 and kanamycin(600㎍/ml) resistant mutant Lactobacillus sp. JC-7 were evaluated. The highest number of fusants were obtained at a capacitance value of 120msec(1670㎌), a field strength of 100V/㎝,and a pulse controller setting of 72Ω. The potimum pH of elecroporation buffer was 7.5 and the concentration of divalent cation was 1mM MG^2+. Electrofusants were efficiently obtained by addition 20% polyethylene glycol to electroporation buffer. The yield of fusion was better than that of using polyethylene glycol mediated chemical induction.

Plenary Session 2 : PS-2-1 ; Outcomes of hepatitis B virus recurrence after liver transplantation: a multicenter analysis in Korea

( Hee Yeon Kim ),( Jong Young Choi ),( Dong Goo Kim ),( Myoung Soo Kim ),( Soon Il Kim ),( Shin Hwang ),( Sung Gyu Lee ),( Kwang Woong Lee ),( Kyung Suk Suh ),( Young Seok Han ),( Dong Lak Choi ),( Se 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: The outcome of hepatitis B virus (HBV) infection after liver transplantation (LT) was improved by hepatitis B immunoglobulin (HBIG) and nucles(t)ide analogue (NUA). However, HBV recurrence after LT is critical because the recurrence is occasionally accompanied by a progressive destruction of graft and poor survival. The aims of this study were to investigate the significance HBV recurrence and identity factors associated with HBV recurrence. Methods: From October 1999 to February 2011, a total of 2684 consecutive LT recipients who underwent HBV-associated LT were retrospectively enrolled from 7 transplantation centers in Korea. Results: Prophylaxis regimens were HBIG monotherapy (67.7%) or a combination of HBIG with NUA (22.3%). The recurrence rate of HBV was 6.1% (164 recipients) during mean follow-up duration of 10.9 years. The median time from transplantation to recurrence was 2.1 years (0.1-7.9 years). Of the 1,071 patients with hepatocellular carcinoma (HCC) prior to LT, 155 patients (14.5%) had HCC recurrence after transplantation, and 48 patients (31.0%) had HBV recurrence. Of the 48 patients with recurrence of both HBV and HCC, 25 patients (52.1%) experienced HBV recurrence after HCC recurrence. In the multivariate analysis, pretransplant HCC, pretransplant HBV DNA above 5.5 log copies/mL was independent clinical factors influencing HBV recurrence after LT. The mortality rate among the recipients with HBV recurrence was 34.1% (56 recipients). Mean overall survival was 6.4 years in the HBV-recurrence group and 9.9 years in the HBV-nonrecurrence group (p<0.001). HBV recurrence was not an independent prognostic factor for overall survival. HCC recurrence was the most important factor for overall survival. Conclusions: The overall outcome of LT in HBV-related liver disease was excellent with the current prophylaxis regimen Choon Hyuck David Kwon,8 Suk-Koo Lee8 Pretransplant HBV DNA and HCC were important factors for HBV recurrence. HBV recurrence after LT did not significantly influence on the overall survival without combining of HCC recurrence.

Ehlers - Danlos 증후군

주용진,최성문,최영자,성호석 ( Yoing Jin Joo,Sung Moon Choi,Young Ja Choi,Ho Suk Sung ) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.5

A Case of Ehlers-Danlos syndrome Yoing Jin Joo, M.D., Sung Moon Choi, M.D., Young Ja Choi*, M.D., Ho Suk Sung, M.D. Department of Dermatology, Clooego of Medicine, Inje University, Pusan, Korea We presented a case of Ehlers-Danlos syndrome in a 25-year old female, who had hyperextensibility of skin, skin fragility, cigarette paper-like atrophic scar, joint hyperextensibility and skeletal abnormality of scoliosis since birth. There was no family history. Microscopic and electron microscopic examinations of the skin biopsy specimens from normal appearing skin on the forearm and the site of subcutaneous nodule was compatible with finding of Ehlers-Danlos syndrome. Although the manifestations of this case including marked extensibility of skin, joint, skin fraility and atrophic scar might be in accord with type Ⅰ(gravis) Ehlers-Danlos syndrome, skeletal abnormality of scoliosis did not correspond to this type, but to type Ⅳ(hydroxylysine deficient) Ehlers-Danlos syndrome. We consider this case as a type Ⅳ Ehlers-Danlos syndrome.

Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

안면부에 발생한 고정형 스포로트리쿰증 3례

최윤애,류영욱,정재봉,송준영,이규석 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

We experienced 3 cases of fixed type cutaneous sporotrichosis confined to the face. Case 1 was a 32-month old child, affected over the nose. Case 2 was a 25-year old man, affected over the left cheek. Case 3 was a 71-year old man, affected over the nose. Histopathologically, chronic granulomatous inflammation with pseudoepitheliomatous hyperplasia was observed. Mycologically, typical dark brown to black colored colonines with moist, wrinkled and membranous surfaces were cultured. All patients were completely cured by oral administration of saturated KI and itraconazole combined therapy in a short period(40-90 days).