뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 ^(18)F-FDG Positron Emission Tomography의 유용성

김남돈,박연희,기승석,박용진,김형준,류백렬,김흥태,김성은,천기정,최창운,임상무 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절의 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로, 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다. Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose (^(18)FFDG)PET uptake diminished more rapidly following therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT. It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with ymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on ^(18)FFDGPET while CT showed persistent destructive bone lesion. Thus, ^(18)FFDGPET study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

방송을 통해 표출된 김건모 노래가사의 신화와 이데올로기

백선기(Seon-gi Baek),김남일(Nam-il Kim) 사이버커뮤니케이션학회 2006 사이버 커뮤니케이션 학보 Vol.18 No.1

본 논문은 1990년대 이후 한국 대중음악에서 큰 상업적 성공을 거두었으면서도 학문적으로는 소외되어 온 대중가수 김건모의 가요 가사 텍스트에서 ‘남성성’이 어떻게 재현되는지를 기호학적 분석 방법에 의해 검토한다. ‘김건모’는 1992년 방송을 통해 데뷔하여 대중성을 획득하였고, 이를 기반으로 해서 인터넷의 급격한 보급으로 인해 대중음악의 중요한 통로였던 방송의 영향력이 약화된 후에도 꾸준한 활동을 해 왔다. 연구결과 활동 초기의 텍스트에는 한국사회의 전통적인 가부장적 남성성이 다수 표출되고 있으나, 90년대 후반으로 들어서면서 사회문회적 변화를 반영한 ‘허여적 남성성’이 대폭 증가되어 표출되고 있다는 사실을 밝혀냈다. 또한 가사 텍스트는 주로 ‘남녀간의 사랑’을 주제로 하고 있고, ‘사랑’에서도 이별이나 그리움을 주로 다루고 있어 기존연구와 맥을 같이하고 있다. 그러나 이러한 ‘허여적 남성성’의 다수 표출 현상을 한국 사회의 전통적인 ‘가부장적 남성성’의 근본적인 변화로 보기는 어렵고, 단지 급변하는 현실에 적응 해가는 과정에서 성(gender) 정체성의 위기를 겪는 과정이자, 기존의 남성 정체성이 흔들려 현실에 적응하지 못하는 현상으로 볼 수 있다. 대중가요는 일반대중들의 삶에 편재되어 있으므로, 수용자들이 능동적으로 ‘즐기는’ 신체를 통해서 드러나고, 나아가 일상의 삶을 구성한다. 따라서 대중가요의 영향력은 매우 크며, 이를 통해 전달되는 ‘남성성’에 관한 신화와 이데올로기의 파급 효과는 사람들의 일상의 삶을 규정한다고 볼 수 있다. 현재 대중문화 영역 전반에 걸쳐 성 정체성과 관련된 담론의 다양한 표출 현상은 주목할 만한 변화로 볼 수 있다. 이러한 연구를 통하여 대중문화에서 성 평등 개념의 중요성과 인식의 전환에 대한 논의가 확장 될 것으로 본다. The goal of this paper is that figure and analysis the representing "Masculinity" among the Korean Popular Music on the tool of Semiotics. The author especially chooses, the Korean Pop Artist, Gun-Mo Kim who was the most famous at time of the mid and late 1990s. He had been almost success; however, he has never gotten the right estimation at the world of academic. He gained popularity since his first exposure on TV in 1992. He has been singing even after the rapid spread of the internet made the power of broadcasting weakened when the broadcasting was the important pathway of the popular music. At the result, Kim's early lyrics has a 'patriarch' masculinity, which is the something hegemonic icon of typical Korean costume, however, his late lyrics has a 'gift' masculinity. It could be more ex-plained possibly that the Korean Cultural Society has gradually changed since the late 1990s. In short, the text of Kim's lyrics which has the main issue is all about LOVE. That theme also consists of 'Do Affects' and 'Do Break-Ups'. This is the most common flow among the rest of Korean Popular Songs. Either, it could be hardly say that changed a 'gift and gift' masculinity instead of a 'patriarch' masculinity in the Korean Society. It does not mean that the BASIC has changed. That could be mere processing through of adjusting the present and fixing the gender issue. Nowadays, the world is so changing fast and ever than we think. So, that is too, the lyrics have shown the brake and waver of the image of masculine. The lyrics of songs are alive into the people's life. Sometimes, it could be touching and moving itself. The audiences surely enjoy that the moment through their body and soul. That must be remain and reinforce of them. The discourse which is related of the Gender Identity has shown every genre. It is the POINT. The author wants to discuss and debate more and more of it in the academic area. Of course, it is about the concepts of Gender Equality and Radical Paradigm. This is so important. And also it would hardly calculate that Music influence the people's life. They convey people a new thought, and a new issue so gently and naturally. It could be anything that something like Myth and Ideology about Masculinity and so on. Right now, it runs through of it.

반코마이신 내성 장구균 감염에 대한 quinupristin-dalfopristin 치료 경험

추은주,최상호,조영환,정선미,김백남,김남중,김미나,김양수,우준희,류지소 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.1

VRE 감염이 중환자에서 급속히 증가하고 있으나 이에 대한 확실한 치료제가 없어 새로운 항생제에 대한 활발한 연구가 있는데 그 중 하나가 quinupristin/dalfopristin이고, 저자들은 중증 환자들의 VRE 감염에 대해 quinupristin/dalfopristin를 투여하여 치료한 임상적 경험을 하였기에 문헌고찰과 함께 보고하는 바이다. Vancomycin-resistant enterococci (VRE) was first recognized in 1992 in Korea. VRE infection have been increasingly reported in immunosuppressed patients over the past decade and have become one of major nosocomial pathogens. Clinicians carings for patients with VRE infections face severe constraints in the selection of treatment. Quinupristin/dalfopristin is active in vitro againt vancomycin-resistant E. faecium (VREF), with a MIC_(90) of 1.0㎍/mL. We studied the clinical efficacy and safety of this agent in the treatment of VREF infection. Patients were included if they had signs and symptoms of active infection including bacteremia, intra-abdominal infection, and wound infection. A total of 13 patients with VREF infection were enrolled. A favorable clinical response (cure or improvement) occured in 10 of 11 evaluable patients. The only adverse events related to quinupristin/dalfopristin were arthralgia and myalgia, which occurred in 2 of 13 patients. These results suggest that quinupristin/dalfopristin is effective and safe as treatment for VREF infections in critically ill patients with serious underlying conditions.

후천성 면역 결핍증에서의 폐렴구균 감염 부검 1예 : An Autopsy Report

이미숙,우준희,진소영,김종원,최창현,김양수,김은옥,김백남,이동화,류지소 대한감염학회 1996 감염 Vol.28 No.3

28세 남자의 후천성 면역 결핍증 환자에서 S. pneumoniae 폐렴이 합병되어 사망한 1예를 경험하여 부검소견과 함께 보고하는 바이다. Pulmonary infections such as Pneumocystis carinii, cytomegalovirus, and tuberculosis are a major cause of morbidity and mortality in patients with human immunodeficiency virus(HIV) infection. Patients with HIV infection are at increased risk for bacterial pneumonia in addition to opportunistic infection. Although in a primary defect, HIV infection is associated with substantial dysfunction of humoral immunity, which predisposes patients to bacterial infections, particularly with encapsulated organisms, such as Streptococcus pneumoniae. We report a case of 28 year-old Korean male with HIV infection who died of respiratory failure due to pneumococcal pneumonia with autopsy findings.

飼料作物 Alfalfa(Medicago sativa L.)品種別 生育狀에 대하여

김무성,노영덕,김세영,백남인,정우진 경희대학교 부설 식량자원개발연구소 1996 硏究論文集 Vol.17 No.-

서로 특성이 다양한 32개의 도입한 Alfalfa품종을 우리나라 중부지역인 충청남도에 재배하여 초장과 건물중 등의 생육상태를 비교, 검토한 결과는 다음과 같다. 1. 평균초장이 큰 상위 10개 품종들은 Dekalb brand 135 > Diamond > Pioneer brand 581 > Raidor > Pioneer brand532 > Pierce> Nitro > Sparta ) Florida 77 > Sapphire의 품종순 이 며, 초장이 작은 10개 품종을 최하위 순으로 열거하여 보면 Salute < Spredor 2 < LS-1920 < Arrow < Challenger < Milkmaker < Armor < Pioneer brand 545 < Pioneer brand 5262 < Saranac의 품종 순이였다. 2. 총건물 수량이 많은 상위 10개 품종들은 Diamond > Nitro > Dekalb brand 120 > Dekalb brand 135 > Drummer > Saranac > Sapphire > Raider > Magnum > Dekalb brand 167의 품종 순이며, 건물수량이 적은 최하위 순으로 10개 품종은 Milkmaker < Pioneer brand 526 < Pioneer brand 5262 < Salute < Pioneer brand 555 < Decathlon < Pioneer brand 5929 < LS-1920 < Pioneer brand 581 < Husky의 품종들이였다. 3 평균초장과 총건물 수량의 결과를 비교하여 보면 대체로 초장이 우세하였거나, 열세하였던 품 종들이 다소간 건물수량이 우세하거나 열세하였으며, 정비례한 결과는 보이지 아니하였다. 4. 생육상태 및 건물수량이 모두 좋은 품종들은 Diamond, Nitro, Dekalb brand 135, Sapphire, Raidor품종들이며, 우리나라 중서부지역의 재배환경에 적합한 품종으로 사료된다 This study was conducted to select the best adapted alfalfa cultivars among the 32 introduced alfalfa cultivars with different characteristics in Chung-Chong Nam Do, Korea, environmental condition. Mean of plant height and total dry matter yields per cultivar from May to August in 1996 were determined. On the point of mean of plant height, ten high ranked cultivars among the 32 alfalfa cultivars in high order were Dekalb brand 135>Diamond>Pioneer brand 581>Raidor>Pioneer brand 532>Pierce>Nitro>Sparta>Florida 77>Sapphire and ten low ranked cultivars in low order were Salute<Spredor 2<LS-1920<Arrow<Challenger<Milkmaker<Armor<Pioneer brand 545<Pioneer brand 5262<Saranac. Ten high ranked cultivars from 32 alfalfa cultivars on the total dry matter yields in high order were Diamond>Nitro>Dekalb brand 120>Dekalb brand 135>Drummor>Saranac>Sapphire>Raidor>Magnum>Dekalb brand 167 and ten low ranked cultivars in low order were Milkmaker<Pioneer brand 526<Pioneer brand 5262<Salute<Pioneer brand 555<Decathlon<Pioneer brand 5929<LS-1920<Pioneer brand 581<Husky. Total dry matter yields of per cultivar was also slightly greater but It was not appeared direct proportion when alfalfa cultivar was appeared higher mean of plant height compared with those which were lower mean of plant height. Leading alfalfa cultivars for plant growth and dry matter yields were Diamond, Nitro, Dekalb brand 135, Sapphire, Raidor cultivar which can be well grown under moderate temperatures zone of midwest in Korea.

2009년 인플루엔자 대유행 중 인플루엔자 진료소 방문자의 연령 분포 변화

김백남,곽이경,문치숙,김연숙,김의석,배인규,염준섭,이창섭,허지안 대한감염학회 2010 감염과 화학요법 Vol.42 No.2

The pandemic influenza (H1N1 2009) virus, after being introduced in Korea in April, 2009, spread rapidly nationwide in mid-2009. This study was conducted to characterize trend in age distribution of visitors to Flu-clinics during the pandemic. Demographic, clinical and laboratory data of visitors to flu clinic from Week 36 to 52 (August 30 to December 26) of 2009 were retrieved and collected from electronic databases at 9 hospitals. Visitors 0-6, 7-12, 13-18, 19-29, 30-64, and 65 years or more of age were classified into group I to VI, respectively. A total of 107,467 visitors were seen at Flu-clinics for a 17-week study period. Of those, 32,485 were laboratory-confirmed. Antivirals were prescribed for 62,533 visitors. Numbers of visits, prescriptions of antivirals, and laboratory-confirmed cases of the pandemic influenza (H1N1 2009) peaked at Week 44. A large number of visits by group II and III were followed by those of group I and V, especially around the peak. Numbers of visits by group VI were lowest in all hospitals. In some hospitals, higher number of visits lasted longer in children than in adults while vice versa in other hospitals depending on the location. In summary, the pandemic influenza (H1N1 2009) was presumed to peak in late October and involved majorly children and students in Korea. Unique age distribution of visitors to flu clinic was observed in some hospitals.

항균제 사용에 대한 감염내과의사의 의견에 대한 담당의사의 순응도와 단기효과

김백남,진규복,홍윤석 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

crobial utilization density로 환산하여 분기별로 비교하였다. 결과 : 부적절한 처방사례는 전체의 85.6%이었으며, 치료적 사용인 경우 73.7%가 부적절하였으며, 예방적 사용인 경우는 모두 부적절하였다. 감염내과의사의 의견에 대한 담당의사의 순응도는 46.5%이었으며, 외과계에 비해 내과계 지료과에서(64.2% vs. 43.1%, P=0.005), 예방적 사용에 비해 치료적 사용인 경우(54.7% vs. 36.5%, P=0.001) 순응도가 높았다. Aminoglycoside계열 향균제는 2002년 1사분기 때 269.1 AUD에서 2003년 2사분기 때 171.8 AUD로, antipseudomonal cephalosporin계열 항균제는 112.1 AUD에서 64.5 AUD로 감소하였으며, 입원환자 전체에서 정주용 항균제의 사용은 2002년 1사분기 때 770.8 AUD에서 2003년 2사분기 때는 626.8 AUD로 감소하였다(모두, P<0.01). 결론 : 순응도가 비교적 낮은데도 이와 같은 방법으로 항균제 사용량의 감소가 관찰되었지만, 적절한 항균제 사용을 유도하기 위해서는 더 효과적이고 효율적인 항균제 관리 체제의 개발과 수용이 필요하다. Background : Many strategies have been developed to guide more appropriate and cost-effective antibiotic use in hospitals. This study was done to evaluate compliance and short-term impact of targeted antibiotic advisory consult implemented in our hospital since October 2002. Materials and methods : A total of 339 prescriptions in 187 patients were retrospectively reviewed and antimicrobial utilization density was compared quarterly from January 2002 through June 2003. Results : Overall, 85.6% of prescriptions were inappropriate, with 73.7% being inappropriate for therapeutic regimens and 100% for prophylactic regimens. Overall compliance was 46.5%. The compliance was higher in the medical services than in the surgical services (64.2% vs. 43.1%, P=0.005) and for therapeutic use than for prophylactic use (54.7% vs. 36.5%, P=0.001). From 1Q 2002 to 2Q 2003, use of aminoglycosides was reduced from 269.1 AUD to 171.8 AUD, and that for antipseudomonal cephalosporins from 112.1 AUD to 64.5 AUD (both, P<0.01). Overall, inpatient use of parenteral antibiotics was decreased from 770.8 AUD to 626.8 AUD (P<0.01). Conclusion : Targeted antibiotic advisory consult resulted in substantial reduction in antibiotic use despite relatively poor compliance. This type of antibiotic control program can be an alternative for hospitals with limited human resources trying to implement an antibiotic policy.

혈액배양검사의 원리와 실제

김백남 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

Blood cultures are the gold standard for diagnosing bloodstream infections and identifying causative organisms. Every effort should be made to improve diagnostic yield, and obtained results should be interpreted cautiously in the context of clinical findings. In this review, several issues of clinical relevance with regard to blood culturing are addressed; these issues include indications, skin antisepsis, timing and number of blood cultures, volume of obtained, and interpretation of positive blood culture results.

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.