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.

세라믹-세라믹 관절면의 Bicontact^(�)형 인공 고관절 전치환술의 단기 추시 결과

김영민,김상림,유기형,김재광,유정준,김희중 대한고관절학회 2001 Hip and Pelvis Vol.13 No.1

응급실을 내원한 65세 이상 노인 환자의 분석

김진년,김태훈,강양욱,오명,김상철,김성훈,권계형,남홍우,이홍순,유형준 대한노인병학회 2001 대한노인병학회지 Vol.5 No.3

전침 자극에 의한 오디 괄약근 운동성 변화에 관한 연구

이성구,김명완,김홍자,서동환,이상수,김동일,유교상,주연호,민병일,김지훈 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

Background/Aims: This study was designed to evaluated the effects of electroacupuncture on the sphincter of Oddi (SO) motility in humans and to correlate the manometric findings with plasma cholecystokinin (CCK) levels. Methods: Eleven patients (M: F= 5: 6) who had various kinds of biliary disorders were enrolled. SO motility was monitored with a conventional low-compliant continuously perfused technique using ERCP (n=9) or percutaneous transhepatic cholangioscope (n=2). After baseline monitoring for phasic wave contractions of SO, electroacupuncture was applied at a specific acupoint, GB 34, in these 11 patients. A nonspecific acupoint 5 cm away from GB 34 was selected as a control. Manometric parameters of SO were also checked in 6 subjects during stimulation of the control acupoint. CCK plasma levels were measured during the time course of electroacupuncture stimulation. Result: All the manometric parameters including the basal pressure of SO, amplitude, frequency and duration of phasic wave contraction of SO were significantly decreased (p< 0.05) during electroacupuncture stimulation. The inhibition of SO contractility was accompanied by increased CCK plasma levels. After removal of electroacupuncture stimulation, restoration of amplitude and duration to basal condition were noted. A tendency towards the return of SO contractility was also observed in basal pressure and frequency. Stimulation of the control acupoint, however, did not affect the SO contractility and plasma CCK levels. Conclusions: Electroacupuncture stimulation of acupoint GB 34 showed reversible inhibition of SO contraction in humans. We speculate that the response of SO to electroacupuncture stimulation may be mediated by some neurohormonal mechanisms including CCK release. (Korean Journal of Gastrointestinal Motility 2000;6:44-41)

척수압박으로 발현된 급성 골수성 백혈병에 동반된 과립구성 육종 1 례

윤상준,김영곤,김희종,박유환,정춘해,김양수,김태균,박영진,전호종 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

저자들은 척수압박으로 하지마비를 보인 환자에서 수술 후에 급성 백혈병에 동반된 과립구성 육종으로 진단된 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Granulocytic sarcoma(GS) is an uncommon tumor composed of immature cells of the granulocytic series. Most case of GS occur in the course of acute leukemia and the blast crisis of chronic leukemia, Rarely, however, it may present before leukemia becomes clinically apparent. It may also occur in patients with myeloproliferative disoders. GS has been reported that it occurs in 3% to 9% of patients with acute myelogenous leukemia(AML) and the incidence of GS is reported to be higher in patients with t(8;21). GS occurs relatively commonly in africa and has been reported to affect 10-25% of black children presenting with AML. This is very rare case of granulocytic sarcoma with AML(FAB M5) presented with spinal cord compression which was supported by decompression laminectomy.

김영삼 정권기 한국 자본주의국가의 분열: 재벌개혁을 중심으로

김성수 ( Sung Soo Kim ),유신희 ( Sin Hui Yoo ) 한양대학교 제3섹터연구소 2013 시민사회와 NGO Vol.11 No.1

이 글에서는 한국 사회의 다양한 갈등이 급격하게 분출되었던 김영삼 정권기를 자본주의국가론의 관점에서, 특히 풀란차스의 국가론을 적용하여 분석한다. 민주화를 통해 권위주의 국가가 붕괴되면서 재벌 독점자본의 한국 사회에 대한 헤게모니가 위협받게 된다. 이 상황에서 집권한 김영삼 및 민주계는 중소자본가계급을 위시로 하여 도시중산층 등을 대표하는 세력으로서, 비록 3당합당을 통해 권위주의 세력과 제휴 했지만 계급대표성에 있어서 독점자본을 대표하는 권위주의 세력과는 본질적인 차이를 지닌다. 따라서 김영삼 정권기의 재벌개혁을 중소자본과 독점자본의 계급투쟁이라는 관점에 입각하여 분석할 수 있다. 이에 따라 본고에서는 김영삼 정권기의 정치적·경제적·이데올로기적 층위의 구조와 실천을 파악한 뒤, 이와 같은 정치사회와 시민사회에서의 계급실천이 국가기구 내에 어떻게 반영되었는가를 살펴보도록 한다. This paper will provide a theoretical framework of emerging class struggle of Korean society during the Kim Young-Sam regime by using capitalist state theory of Greek philosopher Nicos Poulantzas. Having democratization the hegemony of Chaebol was exposed to popular resist. In return, Kim`s government tried to reconfigure a fundamental economic structure through so-called Chaebol reform. Although Min-ja party was formed, there still remained three different factions. Elected president Kim as his supporting partisans, the Min-chu faction(of democratic liberal party) which were advocates of small and medium sized capitalist classes, were in essential antagonism with another faction of their party, Min-chung, representing the monopolistic capitalist classes. Thus the reform of Chaebul could be construed as class struggle between small and medium sized business and monopolistic capital. Consequently, the state apparatus reflected the class struggle which exists simultaneously in political and civil society.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

난소절제후 Estrogen을 투여한 흰쥐 대동맥에서 Protein Kinase C-α와 Fas 발현의 변화

이왕수,이상엽,안지현,송영빈,김학진,이광재,유재격,김상욱,김태호,김치정,류왕성 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3

Estrogen is believed to decrease coronary artery disease. Protein kinase C-α(PKCα)appear to be important in signal conduction pathways. Estrogen treatment increases catalytic activity of PKCα,and activation of PKCαcan modulate estrogen receptor levels and responsiveness. And it was reported that activation of PKC can protect cells from apoptosis induced by Fas ligation. But the beneficial effect of estrogen on PKCαwas not clearly demonstrated. The objective of this study was to evaluate the role of PKCαafter ovariectomy and estrogen therapy in rat aorta. The results were summarized as below: 1. The significant pathological changes were not observed in the rat aorta irrelevant to ovariectomy and estrogen therapy. 2. The expression of Fas was decreased in the aorta of estrogen-treated rats than that of ovariectomized rats without estrogen therapy. 3. Increased expression of PKCαwas more marked in the aprta of estrogen-treated rats than that of ovariectomized rat without estrogen therapy. In conclusion,PKCαmay be important in signal conduation pathway on the effect of estrogen. Activation of PKCαby estrogen reduced Fas expression, suggesting that PKCαactivation may play a role in protection against atherasclerosis. Further studies are needed to elucidate the role of PKCαafter estrogen therapy.

안근성 중증근무력증이 동반된 갑상선 기능항진증의 임상상 : Report of Six Cases

서지영,김두만,김현규,최철수,임성희,유재명,최문기,유형준,박성우,김형철,송홍기,김덕환 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

圓光醫大 附屬 第2病院 神經精神科 患者에 對한 統計的 考察(Ⅱ)

박민철,장광철,김상원,김한주,유미경,김훈,유용진,김현정,박남진,오상우,이귀행,노승호,백영석 圓光大學校 醫科大學 神經精神科學敎室 1992 圓光精神醫學 Vol.8 No.1

본 연구는 1986년 7월 11일부터 1991년 7월 10일까지 원광의대 부속 제2병원 신경정신과에서 의래 및 입원치료를 받았던 6,072명의 환자를 대상으로 병원 역학조사를 실시하고 그 결과를 1차조사 (박민철 등1986)와 비교했다. 1.전체 환자 중 남자가 54.4%로 여자보다 많았고, 이리와 이리 인접지역이 84.0%로 대부분의 지역을 나타났다. 의료보장상태는 보험환자가 57.1%, 의료보호환자21.8%, 일반환자 21.1%였으며 연령별로는 20대 24.6%, 30대 22.8%로 20대 30대가 절반정도를 차지했다. 2.외래환자에서는 신경중성장애가 46.0%로 가장 많고 정동장애, 경련성장애 순이며, 입원환자에서는 정신분열증이 30.5%로 가장 많고 기질성정신장애, 정동장애의 순이었다. 3.남자는 신경증성쟝애(23.4%), 정신분열증, 기질성정신장애 순이고 여자는 신경증성장애(39.9%), 정동장애, 정신분열증의 순이었다. 남자가 여자보다 많은 진단은 알코올정신장애(94.6%), 기질성정신장애, 소아정신장애 순이고, 여자가 남자보다 많은 진단은 정동장애(64.5%), 신경증성장애였다. 4.진단별 연령분포에서 신경증성장에는 30대(25.3%), 20대, 40대 순이고, 정신분열증은 20대(40.5%), 30대, 40대 순이며, 정동장애는 20대, 30대, 50대 순이나 비교적 비슷한 융이었다. 5.진단별 발병연령에서 신경증성장에는 20대, 30대가 절반이고,정신분열증은 20대(51.3%), 10대, 30대 순이며 정동장애는 20대(30.7%), 30대, 50대 순이었다. 진단별 평균 발병연령은 신경증성장애 32.7세, 정동장애 36.1세, 정신분열증 23.6세였다. 6.진단별 이병기간은 2년이상이 신경증성장에 28.3%, 정신분열증 68.5% 정동장애 43.9%인데 전체적으로 41.0%였다. 진단별 평균 이병기간은 정신분열증 73.2개월, 정동장애 45.5개월, 신경증성장애 29.5개월이었다. We examined epidemiologic study of 6,072 patients who visited Wonkwang Neuropsychiatric hospital since July 11 of 1986 until July 10 of 1991 and compared this results with previous study(Park et al 1986). The study revealed as follows:1. Of total patients males visited this hosptial more than females as 57.1%, Most of them(84.0%) resided Iri and neighbouring Iri. In the point of insurance, insured patients, medicaid patients and uninsured patients were 57.1%, 21.8% and 21.1% respectively. On the distribution of age, the twenties, the thirties were 24.6%, 22.8% respectively and twenties and thirties were about half of total patients. 2. Of outpatients neurotic disorder was the most as 46.0%, secondly mood disorder and thirdly convulsive disorder, but of inpatients schizophrenia was the most as 30.5%, secondly organic mental disorder and thirdly mood disorder. 3. Of males neurotic disorder was the most as 23.4%, secondly schizophrenia, and thirdly organic mental disorder, but of females neurotic disorder was the most as 39.9%, secondly mood disorder and thirdly schizophrenia. alcoholic mental disorder(94.6%), organic mental disorder, child mental disorder were mostly found in males,but mood disorder(64.5%) and neurotic disorder were mostly found in females. 4. On the distribution of age neurotic disorder was found the most in the thirties(25.3%), next in the twenties and in the forties, and schizophrenia was found the most in the twenties(40.5%), next in the thirties and in the forties, but mood disorder was found the most in the twenties, next in the thirties and in the forties but revealed similar rates relatively. 5. On the distribution of age of onset neurotic disorder developed nearly half during the twrnties and the thirties, schizophrenia developed mostly during the twenties (51.3%), secondly the teens and thirdly the thirties, but mood disorder developed firstly the twenties(30.7%), secondly the thirties and thirdly the fifties. on the average age of onset of illness neurotic disorder, mood disorder and schizophrenia were 32.7 years, 36.1 years and 23.6 years respectively. 6. On the duration of illness more than two years was 28.3% in neurotic disorder, 68.5% in schizophrenia and 3.9% in mood disorder and on the average duration of illness schizophrenia, mood disorder and neurotic disorder were 73.2 months, 45.5 months and 29.5 months respectively.