정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

癸酉靖難에 關한 考察

김용원 ; 김종언 김천대학교 1988 김천대학교 논문집 Vol.9 No.-

When King Dan jong, too young to rule the nation. succeed to the throne from king Mun jong, the power of the officials grew greater and greater than that of the king, which consequently put the Yi dynasty in a serious danger to existence. To save such a fragile dynasty, one of king Dan jong's uncles prince suyang who was the eldest, the most intelligent and determined, raised a successful coup detat Kae you- Jungran. Though there were a few rebellions against him after he took over the throne by means of violence, we should not neglect his achievements and efforts, which have been kept under the dark shadow until now, in order to save and secure the throne as well as the nation.

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

만성골반통의 동서의학적 고찰 : 부인과 질환으로 중심으로

김순열 ( Soon Yeol Kim ),윤종원 ( Jong Won Yoon ) 동국대학교 한의학연구소 1996 東國韓醫學硏究所論文集 Vol.5 No.-

The purpose of this study was to generalize the conception of chronic pelvic pain(CPP)through the literature of oriental medicine and occidental medicine. The results are obtained as follows. First, chronic pelvic pain(pain of more than 6 months' duration) may include pain of gynecologic, gastroenterologic, urologic neurologic, and musculoskejetal origin. In this study, the etiologic of chronic pelvic pain may remain obscure and the relationship between certain types of pathologic, such as endometriosis or adhesions, and the pain response may be inconsistent and often inexplicable. Second, the causes of CPP through the literature of oriental medicine were reviewed as pains due to a wind-pathogen, a cold, disorder of Qi, disorder of blood stasis, a improper diet, disorder of fluid, and deficiency type etc... And the charateristic pains were concerned with a aching pain, a heavy pain, a distending pain, a pain due to mass in the abdoman, a pain likes pulling etc... The degree an4 classification of charateristic pains in current of time were dependent on subjective factors. Third, in oriental medicine, it wasn`t to be suggested concretely recognition of etiological factor in pain, But they recognised that facters were influenced by pain. For example, diretic peripheral demages were concerned with a blood stasis, a phlegm, a damp phlegm, heart, and the pains that were occurrenced by sevn emotions were concerned with a stagnancy of Qi or a stagnancy of liver-Qi.

용혈성 요독 증후군이 합병된 출혈성 장염 1예

김능수,이원길,김기연,이종명,윤종수,김성한,전정훈 대한감염학회 1997 감염 Vol.29 No.3

저자들은 쇠고기에 의해 매개된 것으로 추정되는 출혈성 장염 및 이에 합병된 용혈성 요독 증후군 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report case of hemolytic uremic syndrome(HUS) associated with hemorrhagic colitis. A 35-year0old man was admitted to a local hospital because of abdominal pain and watery diarrhea which had developed about 6 hours after taking roast beef. He was treated with intravenous fluids and antibiotics, but watery diarrhea changed to bloody in nature from the next day. He was transferred to our hospital due to progressive ascites and jaundice on his 8th day of illness. Examinations revealed ascites, jaundice, microangiopathic hemolytic anemia, thrombocytopenia and uremia. Sorbitol-negative Escherichia coli was isolated from his stool, which proved as Shiga-like toxin-negative E. coli, serotype O25. His conditions improved markedly after three times of plasmapheresis and intravenous fluids therapy, and the organism was not isolated from the follow-up stool culture.

면양에서 개량된 제1위 누관 형성술 1례

김명철,김종만,김용국,김덕환,이영원 충남대학교 수의과대학 동물의과학연구소 1999 動物醫科學硏究誌 Vol.7 No.-

We performed rumen fistula operation in a sheep. In sheep, the procedure for a rumen fistula is quite successful, but choice of an appropriate cannula is of prime importance. The sheep was anesthetized by xylazine(0.1 ㎎/㎏ IM) administration 5 minutes after administration of atropine sulfate(0.1 ㎎/㎏ IM). We inserted rubber cannula in rumen incised and put rubber ring after employing purse-string suture in rumen. We marked the area for the puncture incision in the body wall through which the cannula is drawn. We drew the cannula as near the transverse process of the lumbar vertebrae as possible to minimize leakage. We isolated the cannula by fixing the stainless washer which has small holes. The sheep was given postoperative penicillin(20,000 IU/㎏ IM) to prevent secondary infection for 3 days. There were not observed the leakage of rumen contents, the entering of rubber cannula into abdominal cavity, and necrosis on incision site and skin, over months after surgery.

불순물 첨가 BGO 섬광체 단결정의 육성과 열형광 특성

김성철,김중환,김종일,정중현,도시홍,김기동,이대원 동의대학교 기초과학연구소 1996 基礎科學硏究論文集 Vol.6 No.1

Eu or Fe doped BGO scintillation crystals were grown by Czochralski method. In order to get information about traps in the grown BGO crystals, we measured trap parameters including activation energy, frequency factor and the kinetic order of thermoluminescence, and compared such parameters with thermoluminescent characteristics of pure BGO scintillation crystals. In addition, optical transmittance of the grown BGO crystals was measured.

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.

CD34+ 조혈 모세포 이식 2례

김정아,정현식,김원석,윤성수,이홍기,박찬형,박성규,김동욱,이종욱,한치화,민우성,김춘추,김동집 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

Background: In most solid tumors, the CD34 antigen has not been detected, so positive selection of CD34+ cells may reduce tumor cell contamination and the CD34+ cells are capable of reconstituting hematopoiesis. We tried CD34+ cell transplantation in two patients. Method: CD34+ cells from chemotherapy + G-CSF mobilized PBPCs or bone marrow were positively selected with an avidin-biotin immunoadsorption column (CEPRATE SC system). Case 1. One course of chemotherapy using cyclophosphamide(200㎎/㎡) and etoposide (4.2g/㎡), combined with G-CSF(5㎍/㎏) S.C. was used in a relapsed lymphoma patient. This patient responded to the induction chemotherapy. CD34+ cells from harvested bone marrow were selected by the CellPro immunoadsorption column. The total number of mononuclear cells loaded onto the CellPro was 2.4×10^(8)/㎏, with 1.1% CD34+ cells. After column separation, the total number of positively selected cells was 5.16×10^(6)/㎏. The number of CFU-GM was 76.8×10⁴/㎏. This patient was treated with melphalan (140㎎/㎡) and TBI (1200cGy) and the positively selected CD34+ cells were infused. The time to neutrophil recovery greater than 0.5×10^(9)/L was 19 days and the time to platelet recovery greater than 50×10^(9)/L was 21 days. Case 2. Two courses of mobilizing chemotherapy were given 4 weeks apart using taxol(210㎎/m2) and adriamycin(60㎎/m2), combined with G-CSF(5㎍/㎏) S.C. in a breast cancer patients with 7 axillary node metastasis. CD34+ cells from each single leukapheresis product were selected by the CellPro immunoadsorption column. In the first collection, the total number of nucleated cells was 4.4×10^(8)/kg, with 0.42% CD34+ cells. In the second collection, the total number of nucleated cell was 2.8× 10^(8)/㎏ with 0.43% CD34+ cells. After colum separation, the total numbers of collected cells were 4.0×106/kg and 4.8×10^(6)/kg, the total number of CD34+ cells were 1.2×10^(6)/㎏ and 0.82×10^(6)/㎏. Colonogenic assays of positively selected CD34+ cells gave rise to myeloid erythroid, and multilineage colonies, with a median of 190 CFU-GM, 190 BFU-E, and 164 CFU-GEMM per 1×10³ adsorbed cells, respectively. High-dose chemotherapy with cumulative doses of 40mg/㎡ mitoxantrone, 750mg/㎡ thioptepa, and 1000mg/㎡ carboplatin was administered. Positively selected CD34+ cells were rapidly infused 24 hours after the end of high-dose chemotherapy. The time to neutrophil recovery greater than 0.5×10^(9)/L was 16 days and the time to platelet recovery greater than 50×10^(9)/L was 20 days.

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2