장티푸스 진단에 있어서 Vi-Indirect Fluorescent Antibody Test의 민감도 및 특이도

장경희,류동렬,박성하,박병규,이준구,염준섭,최영화,송영구,김현숙,정윤섭,김준명 대한감염학회 1998 감염 Vol.30 No.4

목 적 : 장티푸스는 체액의 세균배양검사에서 Salmonella typhi의 분리로 확진하지만 조기진단을 위해서는 혈청학적인 검사가 도움이 된다. 저자 등은 1989년 이후 장티푸스진단에 S. typhi의 Vi항원을 이용한 간접형광항체법 (Vi-indirect fluorescent antibody test : Vi-IFAT)을 도입하였다. 이에 지난 7년간의 검사결과를 토대로 Vi-IFAT의 민감도 및 특이도를 규명하고자 하였다. 방 법 : 1989년부터 1996년까지 연세대학교 의과대학 세브란스 병원에 발열을 주소로 내원하여 Vi-IFAT가 의뢰된 환자 중 발열의 원인이 확진된 744명의 환자를 대상으로 하였으며, Vi-IFAT에 있어서 양성반응은 1:64이상으로 하였다. 결 과 : 1) 세균배양검사에서 확진된 장티푸스 환자 178예 중 168예에서 양성반응을 보여 민감도는 94.4%이었다. 항체가는 1:64가 89예, 1:128이 36예, 1:256이 27예, 그리고 1:512가 16예이었다. 위음성이었던 10예의 항체가는 1:32가 7예, 1:16이하가 3예이었다. 2) 발열을 주소로 내원한 환자 중 장티푸스 이외의 다른 질환으로 확진된 566예 중 538예에서 음성반응을 보여 특이도는 95.1%이었다. 항체가는 1:32가 117예, 1:16이하가 421예이었다. 위양성이었던 28예의 항체가는 1:64가 23예, 1:128이 5예이었으며, 장티푸스 이외의 살모넬라증이 4예, 요로계감염이 10예, 소화기계감염이 6예, 호흡기 계감염이 5예, 악성 종양이 2예, 그리고 바이러스 감염이 1예이었다. 3) Vi-IFAT 양성인 196예 중에서 장티푸스는 168예로 양성예측율은 85.7%이었으며, Vi-IFAT 음성인 548예 중 장티푸스 이외의 발열질환은 538예로 음성예측율 98.2%이었다. 4) 배양검사와 Widal test 사이의 일치율 (Kappa value)는 0.28로 poor agreement를 보였으며 Vi-IFAT와 Widal test 사이의 Kappa value는 0.74로 good agreement를 보였다. 그러나 배양검사와 Vi-IFAT 사이의 Kappa value는 0.86으로 excellent agreement를 보여 일치율이 가장 높은 검사는 배양검사와 Vi-IFAT라 할 수 있겠다. 5) 장티푸스 환자에 있어서 Vi-IFAT의 양성율은 발열기간이 1중 미만인 환자에서는 68%, 1내지 2주인 환자에서는 89.5%, 2주이상인 환자에서는 100%이었다. 결 론 : Vi 항원을 이용한 간접형광항체법 (Vi-IFAT)은 장티푸스 진단에 높은 민감도 및 특이도를 가지며, 또한 조기진단에 있어서도 임상적으로 유용함을 확인할 수 있었다. Background : Typhoid fever is diagnosed by culture or serological study. The confirmative diagnosis of typhoid fever is made by culture of the causative organism usually from body fluids. Serological test is a supportive diagnositic tool, which is useful for early diagnosis. In Severance Hospital, Vi-indirect foluorescent antibidy test(Vi-IFAT) using the Vi-antigen of Salmonella typhi has been used in the diagnosis of typhoid fever since 1989. We investigated the test results from the past 7 years, in order to clarify the sensitivity and specificity of Vi-IFAT. Methods : A retrospective study was done on patients whose chief complaint was fever and who were tested using Vi-IFAT in the Severance Hospital from 1989 to 1996. The positive value for Vi-IFAT was defined as 1:64 or higher. Results : The sensitivity and specificity of Vi-IFAT for typhoid fever was 94.4% and 95.1%, respectively. The positive and negative predictive values were 85.7% and 98.2% respectively. Positive rates of Vi-IFAT after fever onset increased with time and 68% were positive before the first week. From the first to the second week, 89.5% were positive and after the second week, 100% were positive. Conclusion : Vi-IFAT is not only a valuable serologic test for the diagnosis of typhoid fever, but also useful in the early diagnosis of the disease.

The Change of Understory Vegetation by Different Thinning Treatments in a Pinus koraiensis Plantation

( Dong June Yeom ),( Dong Young Kim ),( Hye Seon Lee ),( Ji Hong Kim ),( Hee Moon Yang ) 한국임학회 2009 한국임학회 학술발표논문집 Vol.2009 No.-

감염관련 혈구탐식증후군 (Infection-Associated Hemophagocytic Syndrome)으로 추정되는 2예 보고 및 국내 증례 분석

류동렬,염준섭,장경희,홍성관,박윤수,최영화,송영구,양우익,유내춘,한지숙,김준명 대한감염학회 1998 감염 Vol.30 No.5

목적: 혈구탐식증후군은 골수, 간, 림프절 및 비장에 조직구 증식과 침윤이 있으면서 이들에 의한 혈구탐식의 소견을 보이며, 임상적으로는 고열, 전신쇠약, 간비종대 및 림프절종대를 보이고, 말초혈액에서 범혈구 감소증, 혈액응고 이상 및 간기능 이상을 보이는 질환이며, 악성 질환의 증거없이 감염증과 관련되어 나타나는 경우를 infection-associated hemophagocytic syndrome이라 한다. 저자 등은 평소 건강하던 환자에서 감염증과 관련된 것으로 추정되는 혈구탐식증후군 2예를 경험하고 보고하고 현재까지 국내에서 보고된 IAHS에 대한 역학, 임상증상, 검사 소견, 관련 감염 질환, 기저 질환의 유무에 대해 고찰하고자 하였다. 방법: 1985년부터 국내에서 보고된 IAHS에 대한 31예의 증례보고를 고찰하고, 본원에서 경험한 증례 2예의 임상증상, 말초혈액 소견, 골수 천자 소견을 조사하였다. 결과: 총 33예의 IAHS 중 평균 연령은 20.8세 였고 남녀의 비율은 2:1로 남자에서 흔하였으며, 발열(100%), 간종대 (84.8%) 비종대 (81.8%), 범혈구감소증(51.5%), 혈액응고장애(69.7%), 간기능이상 (75.8%) 소견이 흔하게 관찰되었고, 바이러스 감염과 동반된 경우가 10예였으며 그 중에서 헤르페스 바이러스가 가장 흔하였고, 세균감염이 7예에서 동반되었다. 스테로이드 치료, 발기신부전, 간경변, 급성 골수성 백혈병 및 골수 이형성 증후군으로 화학요법을 시행 받은 후 면역 억제 상태에서 발생한 경우도 있었으나, 기저 질환을 찾을 수 없는 경우도 25예가 있었다. 결론: 감염증과 관련된 혈구탐식증후군은 비교적 드문 질환이나 현재까지 그 치료방법에 대해 정립된 바가 없어 치명적일 수 있다. 향후 본 질환에 대한 정확한 진단과 관련 감염질환을 찾기 위한 노력이 좀더 적극적으로 이루어져야 할 것이며, 적절한 치료법의 정립이 필요할 것으로 사료된다. The hemophagocytic syndrome is a disorder caused by systemic proliferation of benign histiocytes with avid phagocytosis of blood cells. Although this is an established disease entity, early clinical diagnosis is often difficult. The disease is known to be rare. The clinical and laboratory characteristics of 33 patients with the infection-associated hemophagocytic syndrome were reviewed which included previously reported 31 cases from the literature, and 2 recent cases presented in this study. The patients were 22 males and 11 females with a mean age of 20.8 years(range 1 to 69 years). Ten patients were associated with viral infection and seven with bacterial infection. The infection usually occurs in patients with preexisting immunological abnormalities, but in this study underlying illness was found in only 8 out of the 33 cases. The overall mortality rate was 63.6%, which is a higher percentage than in other countries. Since the clinical course can be fulminant, accurate diagnosis and effective treatment are needed.

Photonic Bandgap Structures with Arrays of Spiral metal Patches

Jho, Won-June,Yeom, Dong-Hyuk,Yoon, Chang-Joon,Cho, Kyoung-Ah,Kim, Sang-Sig Institute of Korean Electrical and Electronics Eng 2007 전기전자학회논문지 Vol.11 No.4

A new type of photonic bandgap(PBG) structures that consist of arrays of spiral metal patches is proposed in this paper. Reflection phases and radiation of these PBG structures are simulated by high frequency structure simulator(HFSS) to characterize their performance. The simulation results show that the resonant frequency of the proposed PBG structures gets significantly lower than those of the PBG structures with square metal patches, but that the radiation is nearly the same for both of the PBG structures. Analysis on reflection phases reveals that the lowering of the resonant frequency is associated with the increase in capacitance.

In vivo Imaging of HIF-1 Activated Cancer Cells using Luciferase and Sodium/Iodide Symporter Genes

Chan Joo Yeom(염찬주),Joo Hyun Kang,Keon Wook Kang,Hyewon Youn,Dong Soo Lee,June-Key Chung 한국실험동물학회 2009 한국실험동물학회 학술발표대회 논문집 Vol.2009 No.2

Iodin-131I OIH와 99mTc - MAG3의 약물동력학 및 체내 분포에 관한 비교 연구

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),조보연(Bo Youn Cho),이동수(Dong Soo Lee),이범우(Bum Woo Lee),정재민(Jae Min Jeong),염미경(Mi Kyoung Yeom),김문혜(Mun Hye Kim),박경호(Kyung Ho Park),송세흠(Sae Heum 대한핵의학회 1990 핵의학 분자영상 Vol.24 No.1

N/A 99mTc-MAG, was synthesized, and biodistribution and blood clearance rate were compared with those of 131I-OIH in mice and rats respective]y. Finally renal image was obtained from a normal male volunteer before and after prescription of probenecid. The results obtained were as follows: 1) The uptalce of Tc-MAG, by kindey was higher than that of 131I-OIH in mice 10 mins after injection (n=6, p<0.05), but slightly lower uptakes were found in all organs (kindney, blood, stomach, mtestinge and liver) 2 hrs after injection. 2) For ' Tc-MAG, t1/2 a=2.4-+0.0 min, t1/2B=44.3+7.4 min, and blood clearance=3.4+0.5ml/min, and for 131I-OIH t1/2=1.8=0.2 min, t1/2=69.1+9.5 min, and blood clearance=1.3+O.l min were found in rats. 3) From the renogram of normal male volunteer, we could find that tmax=130 sec and t1/2=430sec before probenecid prescriptiori, and tmax 150-170sec and t1/2=810-1,170sec after probenecid prescriprion. From these results we concluded that Tc-MAG, can be used instead of 131I-OIH for obtaining renal irnage.

A Study of the Adjustment and Treatment Depending on the Change of Prostate Location Using DIPS in Proton Beam Therapy for Prostate Gland in which a Fiducial Gold Marker was Inserted

박준기,김선영,김태윤,최계숙,염두석,강동윤,최승오,박지연,Park, June-Ki,Kim, Sun-Young,Kim, Tae-Yoon,Choi, Kye-Sook,Yeom, Doo-Suk,Kang, Dong-Yoon,Choi, Seung-O,Park, Ji-Youn Korean Society for Radiation Therapy 2008 대한방사선치료학회지 Vol.20 No.1

Purpose: To monitor the changes of location of prostate gland using DIPS and to examine the adjustment and proton beam therapy depending on the movement of prostate gland in proton beam therapy for prostate gland in which a fiducial gold marker was inserted. Materials and Methods: This study was conducted in ten patients with prostate cancer who received proton beam therapy since April of 2008. To monitor the change of prostate location, three fiducial gold markers were inserted prior to the treatment. To minimize the movement of prostate gland, patients were recommended to urinate prior to the treatment, to intake a certain amount of water and to concomitantly undergo rectal balloon. In these patients, the set-up position was identical to that for a CT-simulation. The PA (posterior-anterior) and lateral images were obtained using both DIPS (digital image positioning system) and a plain radiography, and they were compared between the two imaging modalities. Thus, the changes of the location of fiducial gold marker were assessed based on three coordinates (x, y, z) and then adjusted. This was followed by proton beam therapy. Results: Images which were taken using a plain radiography were compared with those which were taken using DIPS. In ten patients, according to a reference bony marker, the mean changes of the location of fiducial gold marker based on an iso-center were X-axis: $\pm$0.116 cm, Y-axis: $\pm$0.19 cm and Z-axis: $\pm$0.176 cm. These ten patients showed a difference in the changes of location of prostate gland and it ranged between RT: 0.04 cm and RT: 0.24 cm on the X-axis; between Inf: 0.03 cm and Sup: 0.42 cm on the Y-axis; and Post: 0.05 cm and Ant: 0.35 cm on the Z-axis. Conclusion: To minimize the movement of prostate gland, as the pre-treatment prior to the treatment. In all the patients, however, three fiducial gold markers showed a daily variation which were inserted in the prostate gland. Based on the above data, Thus, the requirement of gold marker matching system depending on the daily variation in the proton beam therapy for which more accurate establishment of target was confirmed. It is assumed that an accurate effect of proton beam therapy would be enhanced by adjusting the target-center depending on the location change of prostate gland using DIPS which was used in the current study.

뇌스캔용 99mTc - HM - PAO의 방사성 동위원소표지에 영향을 미치는 인자에 대한 연구

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),김상은(Sang Eun Kim),염미경(Mi Kyoung Yeom) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A Technetium-99 m-hexamethylpropyleneamine oxime (99mTc-HMPAO) is a neutral-lipophilic chelate which is used for scanning cerebral blood flow. The labeling efftciencies of 99mTc-HM-PAO is known to be sensitive to the amount of pertechnetate added and the quality of the pertechnetate. Because of these factors, the manufacture recornmends that HM-PAO kits be reconstituted with a maximum of 30 mCi pertee.hnetate which was eluted <4 hr earlier from a generator which had been eluted <24 hr previously. So we measured the labelling efficiencies and the decomposition rate constant according to the amount of pertechnetate added, the volume of pertechnette added, and generator in-growth time. We used the 3-system chromatagraphic rnethods (paper & ITLC-SG chrornatography) which analyzed the labelling efficiencies of the 99mTc-HM-PAO. There was no significant difference in labelling efficiencies between variable pertechnetate acitvities added. (39.9 +- 4.9mCi: 87.8 +- 5.1 (%), 60.8 +- 5.0mCi: 90.7 +- 2.2(%), 79.0 +- 6.0mCi: 86.8 +- 3.9 (%), 106.6 +- 11.6mCi: 87.7 +- 1.2 (%), p>0.05) No significant difference in labelling efficiencies were found between pertechnetate of 4 ml and 5 ml. (4 ml: 89.1+3.2 (%), 5 ml: 87.3+4.0 (%), p> 0.05) There was no difference between 1-6 and 10 +-48 hr of generator in-growth time. (1-6 hr: 87 8+ 4.0 (%), 10 +- 48 hr: 89.6+1.6 (%), p>0.05) The mean value of decompositian rate constant was 0.196+ 0.097 (hr-1), and there were no differerce according to the amount of pertecnetate added and the volume of pertecnetate added, (39.9+4.9 mCi: 0.208+0.059 (hr-1), 60.8 +- 5.0 mCi: 0.191 +- 0.100 (hr-1) 79.06.0mCi: 0.192 +- 0.118 (hr-1 ), 106.6 +- 11.6mCi: 0.212 +- 0.030 (hr-1), p>0.05, 4ml: 0.200+0.074 (hr-1), 5mi: 0.193 +- 0.115 (hr-1), p>0.05) In the case of using the first eluate, the labeliing efficiency of 99mTc-HM-PAO was 82.1%.. These data suggest that there were no significant aiteration in labelling efficiency of 99m Tc-HM- PAO aecording to the considerable range of pertechnetate activities and volume added, and generator in-growth time. Also, it was shown that one vial of HM-PAO kit supplied the Tc-HM-PAO which was used for 3-4 patients.

The Evaluation of Ecological Attributes in a Natural Deciduous Forest Using Point-centered Quarter Method

( Tie Feng Piao ),( Sang Hoon Chung ),( Sung Kee Kang ),( Dong Young Kim ),( Hye Seon Lee ),( Dong June Yeom ),( Ji Hong Kim ) 한국임학회 2009 Forest Science And Technology Vol.5 No.1

Mixture toxicity of metal oxide nanoparticles and silver ions on Daphnia magna

Park, Chang-Beom,Jung, Jae-Woong,Baek, Minjeong,Sung, Baeckkyoung,Park, Jin-Woo,Seol, Yohan,Yeom, Dong-Hyuk,Park, June-Woo,Kim, Young Jun Springer-Verlag 2019 Journal of nanoparticle research Vol.21 No.8