국내 혈액질환 환자에서 침습성 아스페르길루스증의 구제치료로서 Voriconazole의 효과와 안전성

권재철,김시현,최수미,최재기,이동건,박선희,최정현,유진홍,신완식 대한감염학회 2010 감염과 화학요법 Vol.42 No.1

Background: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in patients with hematologic malignancies. We investigated the efficacy and safety of voriconazole (VCZ) when used as salvage therapy for IA in Korean adults with hematologic malignancies who had not responded to prior antifungal therapy. Materials and Methods: We retrospectively reviewed data, collected from January 2007 to October 2008, from patients with proven or probable cases of IA. All were probable IA cases, except for one proven case. All cases were refractory or intolerant to antifungal therapy prior to administration of VCZ. Efficacy and safety were assessed in patients treated with VCZ for more than 3 days and for more than one dose, respectively. A favorable response [complete (CR) or partial (PR)] was defined by significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results: Fifty patients who met the inclusion criteria were enrolled. There were 27 male and 23 female patients with mean age of 44.4 years (range, 15-65 years). Underlying diseases were acute leukemia (35 cases), chronic myelogenous leukemia (4 cases), myelodysplastic syndrome (3 cases), lymphoma (3 cases) and other hematologic diseases (5 cases). Twenty-two patients had received chemotherapy and 13 patients had undergone hematopoietic stem cell transplantation. The lung was the main infection site (94%) followed by the sinus (6%). Amphotericin B deoxycholate alone was the most frequent previous antifungal therapy. The mean duration of antifungal therapy prior to VCZ therapy was 13.9±8.8 days (2-44 days). The median duration of VCZ therapy was 19 days (interquartile range, 49 days). Sixteen patients (32.0%) showed favorable responses (CR:PR=8:8) at the end of VCZ therapy. The numbers of patients with stable disease, progression and death were, 6 (12%), 6 (12%) and 22 (44%) respectively. Most of those with unfavorable responses had relapsed underlying malignancies or refractory graft versus host diseases. Twelve patients developed drug-related adverse events but only one patient stopped VCZ treatment prematurely. Conclusions: VCZ demonstrated an acceptable level of toxicity in patients with hematologic malignancies but further studies are required to prove its efficacy as salvage therapy.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

原料의 種類와 形態에 따른 Aspergillus oryzae 麴의 生理活性 및 酵素力

최성현,정재홍,이상덕,손화영,성창근,오만진,김성렬 충남대학교 농업과학연구소 1997 농업과학연구 Vol.24 No.2

CNU O4-5 isolated from conventional Meju, which is used as raw material for making a soybean fermentation food, identified as an Aspergillus oryzae. To make koji, Aspergillus oryzae CNU O4-5 was cultured for 3-4 days at 30℃ with various grain materials such as flour, soybean powder, flour+soybean powder(1:1), soaked soybean and rice. The koji was evaluated for analyze the angiotesin converting enzyne(ACE) inhibition, antioxidative activity, superoxide dismutase(SOD) activity, amylase and protease activity, α-amylase and glucoamylase activities of flour koji wee higher than those of the koji soybean powder. However neutral and alkaline protease activities of flour koji were lower than those of flour+soybean powder and soybean koji. Amylase and protease activities of kojies of soaked soybean and rice showed very low level. The range of the ACE inhibition rate by hot water fraction of the kojies, which are cultured with various gain materials, were from 45% to 54%. The antioxidative activity of ethanol-fraction of koji, which is made by using the soybean powder or soaked soybean, prolonged for 6 days in lard at 60℃. The SOD activity of grinded fraction of koji, which is made by using the flour or soybean powder, was same as 2,000 units per g of each koji.

니켈담지촉매의 제조과정에서 액상산화의 효과

최재석,임태훈,홍성안,이호인 한국공업화학회 2004 응용화학 Vol.8 No.1

The deactivation of reforming catalyst in the DIR-MCFC was reported to be affected by dispersion, loading amounts, kind of support and so on. In this research, we checked the resistivities of catalysts prepared by the different methods, and examined the effect of liquid phase oxidation. The oxidized catalyst in a liquid phase showed the increased activity and dispersion even though the nickel species was supported by deposition-precipitation method. In order to investigate the role of the oxidation, TGA, TPR and XRD analyses were conducted. The increase in activity was ascribed to the strong metal-support interaction which was induced by liquidphase oxidation.

생검펀치를 이용한 점액낭종의 절제

홍은혜,최병재,이제호,최형준,손흥규,김성오 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

점액낭종은 소타액선 분비관의 폐쇄나 파열로 타액이 저류되어 발생하는 연조직 부종이고, 비교적 높은 빈도로 발생하는 구강내 가성 낭종으로 스스로 파열되어 치유되기도 하지만 대개는 만성적으로 진행되어 몇 주에서 몇 달간 지속되기 때문에 치료가 필요하다. 점액 낭종의 발생시, 주변에 이환된 소타액선을 포함하여 제거하는 완전절제술 외에 재발율을 낮추기 위한 스테로이드의 국소적 주입, 냉동동결요법(cryotherapy), 미세조대술(micromarsupialization) 등의 여러 가지 치료방법이 제시되고 있다. 완전절제술의 한 방법으로 생검펀치(biopsy punch)를 이용할 수 있는데, 조작이 간편하고 출혈이 적으며 술 후 처치가 거의 필요없다는 장점이 있다. 이 증례는 점액낭종이 있고 행동 조절이 힘든 소아에서 생검펀치를 사용하여 점액낭종을 완전히 제거한 경우로, 양호한 결과를 얻었다. Mucocele is a clinical term of the localized superficial mucosal swelling caused by salivary retention after the obstruction or the rupture of minor salivary ducts. Various treatment methods have been suggested to lower its recurrence rate, including complete excision of lesion Biopsy punch can be used easily and simply for complete excision of mucocele. It has several advantages, such as convenience in use, low bleeding tendency, and nearly no requirements for post-operative management. In this case, biopsy punch was used for the removal of mucocele in an uncooperative child, which enable fast, simple and safe procedure, with a good result.

부재료 첨가에 따른 갓김치의 항산화성

최영숙,황정희,김재이,전영수,최홍식 부산대학교 김치연구소 2000 김치의 과학과 기술 Vol.6 No.-

Antioxidative activities (AA) of mustard leaf kimchi (MLK) by the addition of optional ingredients among selected minor materials were studied. In order to determine AA of MLK with different spices, the model systems of ground cooked beef with green onion, garlic, and red pepper powder were prepared and stored for 4 weeks at 4℃. AA of red pepper added group was stronger than those of others. AA of red MLK was relatively higher than that of (green) MLK. For the enhancement of AA of MLK, another model systems were prepared with the selected antioxidative optional ingredients, which were bonnet bellflower root, leek, burdock, sea tangle, sea mustard, seastaghorn at the level of 2% or 4%. The extracts of water, 75% methanol and hexane of MLK, bonnet bellflower root added MLK, and seastaghorn added MLK had a considerable AA with the inhibition of peroxide formation during the autioxidation of linoleic acid mixtures in aqueous model systems at 37℃. Therefore, AA was more effective in MLK containing specific optional ingredients than that of MLK alone significantly.

금속수은 폭로 근로자의 일시뇨를 이용한 생물학적 모니터링 평가

홍두루미,김순덕,염용태,최재욱 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.1

Biological monitoring for exposure permits estimation of organ doses or body burdens from exposures through all relevant portals of entry. Biological monitoring data may be used to estimate environmental concentrations when the latter cannot be measured directly. Biological indices are usually concentration of a chemical of its metabolites or its effect at the true receptors. Mercury concentration in urine has been most commonly recommended as a biological exposure index of mercury. for data based on urine analysis, variation in urine volume is the most significant. The urinary concentration related to excretion of the solute provides some correction for fluctuation of urine output. Sampling time must be carefully observed because distribution and elimination of a chemical are kinetic events. This study has evaluated mercury concentration in spot urine compared to the results of 24 hour collected urine by the adjustment methods(specific gravity, creatinine) and sampling time. The subjects were 43 workers who had been exposed to the metallic mercury. The results were as follows: 1. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0.639-0.715 and were not different by adjustment methods. 2. In the high exposure group who were over 100ug/l of urinary mercury, the correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0.687-0.824 and were not different by adjustment methods. 3. Mercury concentration in spot urine were very variable by sampling time or exposure time. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were most highest as 0.85-0.91 at first voiding urine in the morning, and were 0.77-0.86 at urine collected within four hours before end of shift. In the biological monitoring to exposure of mercury, sampling of spot urine were most proper at first voiding urine in the morning, and then at urine collected within four hours before end of shift. But the adjustment methods of specific gravity and creatinine were no difference of the results.

매복된 중절치의 재식

최수미,이긍호,최영철,박재홍 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.4

매복치는 인접치의 이동 및 치근흡수, 악궁의 공간상실, 치성낭종 형성, 부분맹출에 의한 감염, 전위맹출 등 여러 가지 합병증을 유발할 수 있다. 이를 방지하기 위해 매복치의 발육상태,모양,매복된 위치나 각도에 따라 발치, 외과적 노출 및 교정적 견인, 재위치 및 치아이식 등을 시행할 수 있다. 본 증례는 상악 좌측 중절치의 맹출장애를 주소로 본과에 내원한 환아로, 내원 당시 상악 좌측 중절치는 치조골 내에서 정상적인 맹출 경로를 이탈하여 역위 매복되어 있었다. 역위된 정도를 고려했을 때 외과적 견인 및 노출을 이용한 교정적 처치를 수행하기 보다는 재식시키는 것이 바람직할 것으로 판단하였다. 치아를 발거하여 치근 부위의 치낭이 건점함을 확인하고 정상적인 치조와 내로 재식한 후 resin-wire splint로 1주일간 고정하였다. 치아의 생활력이 건전하고 치근형성이 미약하여 치수에 대한 처치는 하지 않았으며 그 후 일년 동안 주기적인 관찰을 시행하여 치근의 성장이 양호함을 확인하였다. 매복된 영구치의 매복된 위치나 각도가 정사 범주에서 지나치게 벗어나 예후가 불확실하더라도 무조건 발치하기보다는 환자와 보호자의 심리적인 면, 저작기능, 심미성 등을 고려하여 더욱 보존적인 시술을 하는 것이 바람직할 것이다. Delayed eruption of a maxillary incisor results in midline shift, the space occupied by adjacent teeth and different levels of alveolar height. Extraction or surgical/orthodontic therapy is the most common treatment for a impacted maxillary incisor. Surgical repositioning provides another option for treatment of this problem. The advantages of this approach include immediate esthetic improvement, use of a single and simplified surgical procedure, simple and short orthodontic therapy, a normal gingival margin and the possibility of the developing root adapting to the new position. Autotransplantation of an immature tooth provides for possible adaptation of the developing root apex to the new position. A root whith an open apex has good chance of pulp revascularization after transplantation.

급박 하지 허혈증에 대한 비수술적 치료의 장기 추적 결과

최재영,손민수,이길연,이상목,고석환,홍성화,윤층,오수명,박호철 대한혈관외과학회 2003 Vascular Specialist International Vol.19 No.1