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인간 면역부전바이러스 ( Human Immunodeficiency Virus ) 에 감염된 우리 나라 환자 35 명의 기회 감염증
최강원(Kang Won Choe),오명돈(Myoung Don Oh),김성민(Seong Min Kim),김남중(Nam Joong Kim) 대한내과학회 1995 대한내과학회지 Vol.48 No.5
N/A Objectives: The first AIDS case in Korea was reported in 1985. Since then the number of HIV/AIDS patients has increased steadly, As of end of 1993, a total of 323 HIV patients was reported. Incidence of several opportunistic infections(OI's) associated with HIV/AIDS appears to vary from country to country. To assess which are common OI's associated HIU/AIDS patients in Korea, we reviewed OI's in Korean HIV/AIDS patients. Methods: We reviewed retrospectively OI's in 35 HIV/AIDS patients who had been admitted or followed up for at least 6 months at the Seoul National University Hospital during the period of 1987 to June 1994. The diagnoses of OI's were made according to the CDC guidelines(MMWR 1992). CD4(+) lymphocytes count was calculated from total lymphocytes counts by percents of CD4(+) lymphocytes, which were measured by using immunofluorescent monoclonal antibody. Results: Tuberculosis(Tb) developed in 34%(12/35) of the patients. Of 12 patients with Tb, 5 had pulmonary Tb, 4 had pulmonary Tb with mediastinal lymph node involvement, 1 had cervical lymph node Tb, and 2 had miliary Tb. Candidoses developed in 23 % (8/35), pneumocystis carinii pneumonia in 20% (7/35), herpes zoster in 17% (6/35), CMV retinitis in 9% (3/35), and cryptococcal meningitis in 6% (2/35) of the patients. One of the patients had high antibody titer against toxoplasma. Median number of CD4(+) lymphocyte counts/mm3 at the time of the diagnoses of OI's was as follows: herpes zoster 242, Tb 137, cryptococcal meningitis 27, candidoses 23, P. carinii pneumonia 19, and CMV retinitis 11. OI's were clues to diagnoses of HIV infections in 20% (7/35) of the patients. OI's providing diagnostic clues to HIV infections were: P. carinii pneumonia in 2, Tb in 1, herpes zoster in 1, cryptococcal meningitis in 1, candidiasis in 1, and fever of unknown origin in l. Half(5/9) fatal cases died of pulmonary complications; 22% (2/9) of central nervous system infections; One patient committed suicide. Responses to treatment of Tb were good, and no patient died of tuberculosis. Conclusion: Tb was the most common OI in patients with HIV/AIDS. Considering very high prevalence of IgG CMV antibody in Korean population, CMV retinitis appears to be relatively uncommon. Toxoplasmosis was rare. Other OI's appear to be similar to that in other countries.
급성백혈병의 관해수도시 trimethoprim sulfamethoxazole 의 간염예방효과에 관한 연구
최강원(Kang Won Choe),우준희(Jun Hee Woo),방영주(Yung Jue Bang),배현주(Hyun Joo Bae),서철원(Cheol Won Suh),김시영(Si Young Kim),박선양(Seon Yang Park),김병국(Byoung Kook Kim),김노경(Noe Kyeong Kim),김승택(Seung Taik Kim) 대한내과학회 1988 대한내과학회지 Vol.35 No.1
N/A Fifty patients with acute leukemia were studied during remission induction treatment in a prospectively radnomized trial to assess the effect of prophylactic trimethoprim/sulfamethoxazole on infection and fever rate. Twenty-three patients randomly received two single-strength trimethoprim/sulfamethoxazole tablets twice daily and twenty-seven patients did not receive any drugs. There were no significant differences in the duration of granulocytopenia, number of febrile days, or use of parenteral antibiotics. But trimethorpim/sulfamefhoxazole prophylaxis resulted in a reduced incidence of microbiologically documented infections (8 versus eighteen; p<0.05). This was mainly the result of a reduction in the episodes of bacteremia in the treatment group as compared with the contirol group. The number of patients without fever in the treatment group was eight compared to only 2 in the control group (p<0.05). Thus, trimethoprim/sulfamethoxazole prophylaxis during granulocytopenia reduced the incidence of microbiologically docummented infection and had more patients afebrile.
이성우,정태화,최강원,임정기,이덕형,Lee, Sung-Woo,Chung, Tae-Wha,Choe, Kang-Won,Lim, Jung-Ki,Lee, Duk-Hyoung 대한예방의학회 1989 예방의학회지 Vol.22 No.4
In a small island community with a population of less than 100 residents, nine persons died and five experienced severe illnesses during the period from November 1986 to May 1988. Their initial symptoms were sore throat and fever. Renal failure and hepatitis developed within one week after the onset. Oral mucosal ulcer developed in some cases. After one week, progressive respiratory failure and dyspnea developed evidently and severe respiratory distress and hypoxia preceded those fatal cases. Chest X-ray findings revealed bilateral diffuse multiple cystic lesion with occasional multiple large emphysematous bullae. Based on these features paraquat poisoning was diagnosed and route of poisoning was investigated. In three sources of drinking water, trace amount of paraquat was detected in November 1988, six months after the incidence of recent fatal case. In November 1988, soybean sauces and soybean pastes from 12 households were found contaminated with high concentration of paraquat, the cause could not be identified. The possibility of the contamination of drinking water as the cause of this mass poisoning has been suggested.
황응수,조명제,차창룡,최강원,이승훈,장우현,Hwang, Eung-Soo,Cho, Myung-Je,Cha, Chang-Yong,Choe, Kang-Won,Lee, Seung-Hoon,Chang, Woo-Hyun The Korea Society for Microbiology 1986 大韓微生物學會誌 Vol.21 No.3
Serum samples from 51 patients with clinically suspected typhoid fever were tested for immunoglobulin G (IgG), IgM and IgA antibodies against the whole bacteria antigen of Salmonella typhi by an enzyme-linked immunosorbent assay. The levels of IgG and IgA antibody to-whole bacteria antigen were higher in the culture-proven patients than in controls. The levels of IgM antibody to- whole bacteria antigen showed better discrimination between culture negative patients and controls than those of IgG or IgA antibody to-whole bacteria antigen. The enzyme-linked immunosorbent assay was much more sensitive than the Widal test. It would be a useful tool for the diagnosis of typhoid fever with a single serum sample. 장티푸스가 의심되는 51명의 환자 혈청내에서 Salmonella typhi의 균체항원에 대한 IgG, IgM과 IgA 항체률 효소면역측정법으로 측정하였다. 균체항원에 대한 IgG와 IgA 항체가는 세균이 분리되어 장티푸스로 확진된 환자에서 건강대조군보다 높았다. 반면 세균을 분리하지는 못하였지만 임상증상 등으로 장티프스를 의심하는 환자에서는 IgM항체가는 건강대조군보다 높았다. 균체항원에 대한 항체를 효소면역 측정법으로 측정하는 것이 Widal 검사보다 민감도가 높았다. 장티푸스를 진단하는데 균체항원을 부착시켜 효소면역측정법을 사용하는 것이 유용할 것이다.