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.

MCR에 의한 혐기성 소화에 대한 암모니아의 영향

김양지,김춘미,김성일,김종수 선문대학교 ·중소기업기술지원연구소 2002 선문공대 연구/기술 논문집 Vol.7 No.1

혐기성 소화에서 미생물에 저해/독성 물질로 알려진 암모니아의 농도와 식종원에 따른 영향을 MCR(Master Culture Reactor)을 이용하여 회분식으로 분석하였다. 식종원은 축간농가 축산폐수 집수조의 침전슬러지 그리고 하수종말처리장 혐기성 소화조 잉여슬러지를 사용하였다. 식종원에 상관없이 암모니아는 1,500㎎NH_4-N/L에서 COD 제거율과 가스생성율로 측정된 혐기성 미생물의 활성에 저해영향을 주기 시작하여 2,500㎎NH_4-N/L에서 더욱 심하였다. 암모니아 저해 농도 범위에서 휘발성 유기산의 농도는 50㎎/L 범위로 유지되므로 메탄생성균 뿐만아니라 산생성균도 저해영향을 받는 것으로 나타났다. 축산폐수 집수조 침전슬러지로 식종된 경우 암모니아 2,500㎎NH_4-N/L 농도 범위 이상으로 운전하여도 COD 제거율과 가스생성율은 일정하게 나타났지만 하수종말처리장 혐기성 소화조 잉여슬러지로 식종된 경우 암모니아 농도가 증가할수록 COD 제거율과 가스생성율은 감소하였다. 결과적으로 암모니아에 장기간 순응된 축산폐수 집수조의 침전슬러지로 식종한 경우 암모니아의 저해 농도에 대하여 적응도 빨랐으며 저해영향도 적음을 알 수 있었다. The influence of ammonia and the sources of seeding on anaerobic digestion were investigated by batch operation of MCR(master culture reactor). The sources of seeding on anaerobic digestion were from swine wastewater collection pit and anaerobic digestion sludge of a municipal sewage treatment plant. The inhibition effects of ammonia on anaerobic microorganisms were initiated at ammonia concentration of 1,500 ㎎NH_4-N/L and the effects were increased by increasing ammonia concentration upto 2,500 ㎎NH_4-N/L regardless the sources of seeding as evidenced by decreases in COD removal efficiencies and biogas yields. The inhibition occurred to not only methanogens but also acidogens since the concentration of volatile fatty acids was maintained at 50 ㎎/L during the batch operations of MCR. The COD removal efficiency and biogas yield were maintained constantly while increasing ammonia concentration upto 2,500 ㎎NH_4-N/L when swine wastewater collection pit was used as seeding; however, those were decreased while increasing ammonia concentration when anaerobic digestion sludge was used as seeding. The results indicate that the seeding acclimated to high concentrations of ammonia for long time was easy in adaptation to high ammonia concentration and less subjective to ammonia inhibitory effects.

동종 골수이식 후 만성 이식편대숙주반응 환자에서 발생한 폐렴구균에 의한 수막뇌염 1예

신완식,김병욱,유진홍,김동집,김춘추,박종원,이종욱,김동욱,강문원,김양리 대한감염학회 1993 감염 Vol.25 No.3

Graft-versus-host disease (GVHD) is a frequent complication after bone marrow transplantation. Infectious complications are common in GVHD patients due to defect in cell-mediated immunity. A rare case of S. pneumoniae meningoencephalitis occured in a patient with extensive form of chronic GVHD after allogeneic bone marrow transplantation. He was immediately treated with full dosage of ceftriaxone and ampicillin. He suffered from various complications such as sepsis, acute renal failure, atelectasis, and seizure. Despite of aggressive treatment, he died probably due to renal shutdown and massive subacute cerebral infarction of left cerebral hemisphere. This report showed two unusual and rare features. First, the infection site was CNS rather than respiratory system. Second, the causative organism was S. pneumoniae, which is rare cause of CNS infection in immunocompromised patients.

토양으로부터 分離한 Bacteriophage의 특성

박현균,김도경,박경진,전홍성,박종필,김종승,김성준 조선대학교 부설 유전생물공학연구소 1992 유전생물공학연구지 Vol.2 No.-

환경 미생물 분야와 산업미생물 분야 및 분자생물학 분야에서 주목을 받고 있고, 많은 연구가 된 새로운 E. coli의 bacteriophage를 토양으로 부터 분리해서, 그 물리적인 특성과 핵산을 밝혀내, phage상호간의 관련성을 검토하여 보았다. 그 결과를 요약하면 다음과 같다. 1. 토양으로 부터 분리한 phage는 숙주균에 따라 SJ-1, SJ-2, SJ-3, SJ-4, SJ-5, SJ-6, SJ-7이라 명명하였다. SJ phage들은 높은 숙주특이성을 나타내 phage SJ-2, SJ一7은 단일종 숙주균에만 감염이 되었고, SJ-1, SJ-3, SJ-4, SJ-5, SJ-6은 다중독성을 나타내었다. 2. 7종류의 SJ-phage는 본 실험조건하에서는 모두 virulent phage임이 밝혀졌다. 모든 용균반의 형태는 중앙이 투명한 둥근 모양이었으며 주변에 무리가 있는 것과 없는것 두가지 형태를 나타냈다. 용균반의 크기는 1-5mm이었으며, SJ-5phage의 용균반이 5mm로서 가장 컸고 SJ-7 phage가 가장 적었다. 숙주균은 OD_600 0.3-0.5상태에서 가장 감염되기가 좋았다. 그리고 상층배지의 한천 농도와 양은 0.5%와 3ml이 가장 좋은 조건이었다. 3. 일단 증식 실험의 결과를 보면 SJ-phage는 잠복기가 15-50분이었고 평균 phage방출수는 190-250이었다. SJ-6과 SJ-7이 잠복기가 15분으로 가장 짧았고 SJ-4가 50분으로 가장 길었다. 평균 방출수는 SJ-3과 SJ-5가 250정도로 많았으며 SJ-1과 SJ-2는 약 190정도였다. 4. SJ-phage는 PD buffer에서 안정하였고, magnesium ion 5×10^-3M의 첨가는 phage에게 큰 안정성을 주었다. SJ-phage는 pH6과 pH9사이에서 안정하였으며 그 pH는 숙주균의 최적 pH였다. SJ-phage의 온도 불활성화는 40 ℃이상에서 불활성화되기 시작하여 60 ℃이상에서는 완전히 불활성화 되었다. 자외선 조사에 의한 불활성화에서 SJ-phage는 120초 이후에 완전히 불활성화 되었다. All phages used in this experiment were isolated from soil of the surburbs of Chun-Nam, and they designated as phage SJ-1, SJ-2, SJ-3, SJ-4, SJ-5, SJ-6, SJ-7. The hosts were JM105, JM109, K802, LE392, MC1000, MV1184 and PSM CC, respectively. These phages were virulent under the experimental conditions. They produced plaques with dear and round without halo. The size of plaques was 1-5mm in diameter. SJ-phages were stable in 5×10^-3M Mg^2+. Thermostability experiments indicated that SJ-phages were stable at 37℃. Optimal pH of the phages were 6-9. Exposure of the phages to U.V. for 120 seconds resulted in complete inactivation. In one-step growth experiments, the latent period at 37 ℃ was about 15-50 min and the average burst see was 190-250. Agarose gel electrophoresis of the phage DNA showed single band of high molecular weight from SJ-1 to SJ-7 phages

보문 : Polyethylene Film포장이 포도 Sheridan의 저장력에 미치는 영향

남상영(Sang Young Nam),김경미(Kyoung Mi Kim),박종천(Jong Chun Park),주선종(Seon Jong Joo),정재현(Jai Hyun Jung) 한국식품저장유통학회(구 한국농산물저장유통학회) 1997 한국식품저장유통학회지 Vol.4 No.1

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

Component Steady-State Availability 의 Bayes 추정

김종호,박춘일 동국대학교 자연과학연구소 1988 자연과학연구 논문집 Vol.8 No.-

Noninfromative prior density function과 Conjugate prior density function에 대하여 component steady-state avilability의 Bayse 추정을 두고, 두가지 추정을 수치예로서 비교하였다. This paper presents a class of Bayes estimation of component steady-state availability. Throughout this paper, we will denote the mean time between failure and the mean time between repaie by MTBF and MTBR respectively. In section 2, we investigate Bayes estimation of the steady-state availability for noninformative prior density function and in section 3, we compute Bayes estimation for conjugate prior density function. Finally, numerical example to compare two estimation will be given in section 4.

실리콘 겔에 활성화된 복강 대식세포의 interleukin-6 및 tumor necrosis factor-α에 의한 섬유모세포 중식 자극

김환묵,한상배,이백권,이종원,한기택,천지훈 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.5

Silicone gel breast implants may induce local(fibrous capsular contracture) or systemic(rheumatoid arthritis, systemic sclerosis, etc) complications. The exact mechanism of fibrous capsular contracture has not been fully understood. In the present study, we tried to find out the effect of silicone gel on the fibroblast proliferation which has been known as a major contributing factor in fibrous capsular contracture formation. In vitro, activated macrophages are known to secrete monokines which affect fibroblast proliferation and collagen synthesis. And tumour necrosis factor-α(TNF-α) and interleukin-6(IL-6), which were released by macrophages, were reported as potent stimulator of fibroblast proliferation. The goal of this study is to investigate the role of macrophages and tumour necrosis factor-αor interleukin-6 in the interaction of fibroblasts and silicone gel. We designed four groups, two experimental and two control, using Institute for Cancer Research(ICR) mouse peritioneal macrophage and silicone gel. For the preparation of the conditioned medium of macrophages, peritoneal macrophages were prepared and cultured for 24 hours on the silicone gel-coated and naked (not coated) surface [silicone gel-macrophage conditioned medium(SCM; experimental group) and normal polystyrene-macrophage conditioned medium(NCM; control group) respectively]. To correct the effect of 10% fetal bovine serum which was included in Rapid Prototyping and Manufacturing Institute (RPMI) 1640 medium and draw the effect only by macrophages, the RPMI 1640 medium with 10% fetal bovine serum was cultured by the same method on the silicone gel-coated and naked surface (silicone gel-macrophage free conditioned medium; SFM and normal polystyrene-macrophage free conditioned medium; NFM respectively). Each conditioned medium was added onto NIH 3T3 fibroblasts culture at a final 25% concentration of total culture medium and followed by the cultivation for 24 hours. For antibody neutralizing experiments, each conditioned medium was preincubated with polyclonal rabbit anti-mouse TNF-α antibody or polyclonal rat anti-mouse IL-6 antibody for 1 hour and then, conditioned medium with antibody was added to the culture medium of NIH 3T3 fibroblasts by the same method. After 24 hours cultivation, total number of viable fibroblast(cell growth), DNA synthesis and collagen synthesis of fibroblasts with each medium were measured by sulforhodamine B(SRB) assay, 3H-thymidine and 3H-proline incorporation respectively. The results were as follows: 1. In the experiment about the effect of the conditioned medium on the fibroblast activity, the experimental group(SCM), compared with the control group(NCM), showed a significant increase of the cell growth (p<0.01), a significant decrease of DNA synthesis(p<0.001), but no significant difference in the collagen synthesis. 2. In the experiment about the effect of polyclonal rabbit anti-mouse TNF-α antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.01), but no significant difference in the collagen syn thesis. 3. In the experiment about the effect of polyclonal rat anti-mouse IL-6 antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.0001), but no significant difference in the collagen synthesis. In conclusion, culture supernatants (conditioned medium) of peritoneal macrophages, activated by silicone gel, stimulate the NIH 3T3 fibroblast proliferation. TNF-α and IL-6, products of macrophage, are involved in the stimulation of NIH 3T3 fibroblast proliferation in an in vitro condition.