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.

Development of a noninvasive KIM-1-based live-imaging technique in the context of a drug-induced kidney-injury mouse model

Tae-Jun Kwon,Da-Sol Lee,Md. Enamul Haque,Rang-Woon Park,Byungheon Lee,Dongkyu Kim,Yong-Hyun Jeon,Kil-Soo Kim,Sang Kyoon Kim 한국실험동물학회 2021 한국실험동물학회 학술발표대회 논문집 Vol.2021 No.7

The development of reliable methods to diagnose acute kidney injury is essential to allow the adoption of early therapeutic interventions and evaluate their effectiveness. Based on the fact that kidney injury molecule-1 (KIM-1) expression levels in kidneys are markedly upregulated early after a damage event, here we developed a noninvasive KIM- 1-based molecular imaging technique to detect kidney injury. First, we took advantage of a phage-display platform to select small peptides demonstrating a specific high binding affinity to KIM-1. The promising candidate was conjugated with fluorescent probes, and its imaging potential was validated in vitro and in vivo. This peptide, with the sequence CNRRRA, not only showed a high imaging potential in vitro, allowing a strong detection of KIM-1 expressing cells by microscopy and flow cytometry but also generated a strong kidney-specific signal in live-imaging in vivo experiments in the context of a drug-induced kidney-injury mouse model. Our data overall suggest that the CNRRRA peptide is a promising probe to use in the context of in vivo imaging for the detection of KIM-1 overexpression in damaged kidneys.

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.

진로장애감소 집단상담 프로그램 효과

김수현 ( Soo Hyun Kim ) 서강대학교 학생생활상담연구소 2010 人間理解 Vol.31 No.2

본 논문에서는 대학생들을 대상으로 김수현(2008)의 진로장애감소 집단상담 프로그램의 효과를 검증했다. 총 8회기로 구성된 이 프로그램은 지방 소재 대학생들이 많이 느끼는 취업준비에 방해가 되는 심리적/환경적 장애감을 낮추고 효율적인 문제해결능력을 증진시킴으로써 적극적인 취업준비에 나서도록 돕는 내용으로 구성되어 있다. 프로그램의 진행에서 자기솔선적 행동의 계획과 실천, 언어적설득, 대리학습, 모델링, 구체적지도, 격려, 칭찬, 인지적왜곡이나 잘못된 신념을 바꾸는 인지행동적 기법, 실질적인 대처 및 문제해결기술 증진 방법 등을 활용한다. 4개 실험집단(36명)(비교집단 59명, 통제집단 115명)을 대상으로 프로그램 실시 전 후에 진로장애검사, 진로결정수준 검사, 자기효능감검사, 사회문제해결양식 질문지를 실시하고 사전-사후 점수에 대해 공변량분석을 실시했다. 공변량분석 결과 진로장애검사의 9개 요인 중취업기반부족 요인을 제외한 모든 요인에서 실험 후에 실험집단의 장애점수가 프로그램 실시전보다 낮아지고, 자기효능감검사의 3개 요인 모두와 사회문제해결양식 질문지의 7개 요인 전부에서 평균점수가 프로그램 실시전보다 높아짐으로써 본 프로그램의 효과가 입증되었다. 진로결정수준 검사에서도 확신수준의 점수는 실험집단에서 가장 높았으며, 진로미결정 점수는 실험집단에서 가장 낮아짐으로써 집단상담을 통해 진로미결정이 줄어들고 확신이 높아졌음을 알 수 있다. 이러한 결과와 프로그램 진행시 유의점이 논의되었다. The present study was conducted to verify the effects of group career counseling program, which was proposed by Soo-hyun Kim (2008) in an attempt to reduce psychological/ environmental career barriers that regional college students perceive and further to improve their problem-solving skills. The program consisted of 8 sessions in total. The participants in each of the four experimental groups (N = 36) completed a battery of paper-and-pencil measures, including the Career Barriers Scale, the Career Decision- Making Scale, the Self-Efficacy Scale, and the Social Problem Solving Inventory before and after the program. Results from analyses of covariance showed that participants` level of perceived barriers significantly decreased, whereas their self-efficacy and social problem solving significantly increased. Implications for counseling college students and some guidelines for implementing the program are discussed.

냉동 제대혈 세포의 체외 증폭

김삼용,김철희,배광봉,김현수,박상준,김종숙,윤환중,조덕연 충남대학교 암연구소 1998 癌共同硏究所 硏究誌 Vol.2 No.1

Background : Cord blood(CB), which has no HLA restriction, is an alternative to bone marrow for hematopoietic stem cell transplantation. The use of cord blood, however, is limited by the number of progenitor/stem cells necessary to reconstitute the older child or adult. Therefore, ex vivo expansion of CB could have tremendous impact on diverse clinical settings. We studied the ex vivo expansion of isolated population of CD34_(+) cells from cryopreserved CB cells. Methods : CD34 cells were isolated from cryopreserved CB mononuclear cells. Purified cells were cultured with various combinations of hematopoietic growth factors including erythropoietin(EPO), stem cell factor(SCF), granulocyte-colony-stimulating factor(G-CSF), gra-nulocyte, macrophage-colony-stimulating factor(GM-CSF), interleukin-1β(IL-1β), 1L-3, and IL-6. After 7, 10 or 14 days of culture, the fold increases of colony-forming unit- granu-locyte, macrophage(CFU-GM), burst-forming unit-erythroid(BFU-E), colony-forming unit-mix (CFU-Mix), and high proliferative potential colony-forming cell(HPP-CFC) were evaluated. Results : Ten-day culture with the combination of EPO, SCF, G-CSF, IL-1β, and IL-3 resulted in a median of 60-fold increase of CFU-GM, which was greater than those with the combinations of less than 5 growth factors. The addition of IL-6 or GM-CSF to this combination did not enhance CFU-GM expansion. Ten-day culture was significantly superior to 7-day culture for CFU-GM expansion. Prolongation of culture to 14 days, however, revealed decreased expansion of CFU-GM compared to 10 days. BFU-E and CFU-Mix were expanded to 2~5 folds in 7-day culture with the combination of EPO, SCF, and G-CSF. Further expansion was not achieved in 10-day culture and colonies disappeared in 14-day culture. HPP-CFC was expanded to a median of 7.5 folds in 7-day culture with the combination of EPO, SCF, G-CSF, IL-1β, IL-3, and IL-6. Neither 10-day or 14 day-culture enhanced expansion of HPP-CFU. Conclusion : Cryopreserved cord blood cells maintain ex vivo expansion potential. In our system, 10-day culture with the combination consisting of EPO, SCF, G-CSF, IL-1β, and IL-3 seems to be adequate for hematopoietic progenitor/stem cell expansion from cryopreserved cord blood cells.

게우젓 製造에 關한 硏究(II) : 熱成중 呈味成分 및 組織學的 變化 Changes in Teste Compunds and Histological Properties during Fermentation

金成洙,河璡桓,姜永周,金洙賢,金永東,宋大鎭 제주대학교 1990 논문집 Vol.30 No.-

To evaluate the composition of Gae-Woo Jeot which is one of important traditional salted and fermented sea foods in Cheju Do, changes of nucleotides and their related compounds, free amino acids, TMAO(trimethylamine oxide), TMA(trimethylamine) contents and histological properties during fermentation was examined. AMP was as high as 3.6?mole/?? in raw small abalone but IMP content was only trace while hypoxanthine and IMP was dominant in raw topshell-4.5 mole/?? and 4.3??mole/?? respectively. Hypoxanthine was predominant in 65 days fermented Gae-Woo Jeot. Main amino acid in Gae-Woo Jeot were glycine, arginine, glutamic acid, alanine, valine and histidine in order. These were consisted 50~60% of the total free amino acid while phenylalanine, tyrosine, methionine and isoleucine were poor in content. During fermentation TMAO decreased slowly and eventually disappeard within 85 days while TMA was increased until 65 days and started to decrease down to 6~9mg%. Muscle texture showed the disappearance of elasticity soon after the adding of 10% salt while no change of texture was oberved until 50 days of fermentation in 20% salt group.

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

산지하천에서 빛과 초식에 의한 부착조류의 생체량변화

김현우,김현주,김진수,윤해순,주기재 東亞大學校附設基礎科學硏究所 1998 基礎科學硏究論文集 Vol.15 No.1

빛과 초식에 의한 부착조류의 생체량 변화에 대한 영향을 평가하기 위하여 자연기질과 인공기질(유약을 칠하지 않은 타일: 3.7×9.5×2cm)을 이용하여 부분적으로 음지화된 2차 산지하천에서 실험하였다. Open canopy(상대적 빛 투과율: 20∼50%, chl. a: 9.5±3.0㎎/㎡, n=25)에서는 closed canopy(<6% 상대적 빛 투과율, 3.2±0.9㎎/㎡, n=17)보다 높은 부착조류 생체량을 유지하였다. 하천 주변식생의 잎 성숙과 잦은 강우에 의해서 여름의 부착조류 생체량은 봄과 겨울에 비하여 낮았다. 봄에 인공기질에 부착조류가 부착하는 속도는 겨울보다 빨랐으며 겨울에는 자연기질 수준(8∼9㎎/㎡)에 이르기 까지 최소 5∼6주 정도 소요되었다. 초식자인 다슬기는 출입을 제한한 실험구에서는 출입이 허용된 대조구보다 약간 높은 생체량(AFDW, chl. a)을 보였다. 결론적으로 빛이 부착조류 생체량에 증가에 미치는 영향은 초식 보다는 더 큰 것으로 사료된다. Effects of light and grazing on the biomass development of periphyton were evaluated using natural and artificial substrata (unglazed tile: 3.7×9.5×2cm) in a partially shaded 2nd order mountain stream. In open canopy (relative light input 20∼50%), a relatively high biomass (chl. a: 9.5±3.0㎎/㎡, n=25) was maintained than that of closed canopy (<6% of light input, 3.2±0.9㎎/㎡, n=17). Due to shading and frequent rainfalls, biomass was lower during the summer than in the spring and winter. During the spring, colonization of periphyton on artificial substrata occurred faster than in winter and it took a minimum of 5∼6 weeks to reach the biomass of natural substrata (8∼9㎎/㎡). When snails were allowed to freely enter the chamber (mean density: 114 ind./㎡) with artificial substrata, biomass accumulation (chl. a, AFDW) was low compared to the snail excluded enclosure (50∼90% of ungrazed substrata). It was concluded that the light input on periphyton biomass in a partially shaded stream played a more important role than grazing.

일부 의료서비스업 VDT작업자의 상지 근골격계 증상의 정도와 관련된 요인

김형렬,원종욱,송재석,김현수,김치년,노재훈 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.2

목적: 본 연구는 상지 근골격계 질환의 유병율이 높은 집단으로 알려진 VDT작업자를 대상으로 이들의 근골격계 통증을 정량화하고, 정량화된 통증점수를 종속변수로 하여, 이와 관련성을 갖는 작업요인, 사회심리적 요인을 파악하고자 하였다. 방법: 서울지역에 위치한 1500병상 규모의 대학병원에 근무하고 단말기 작업을 주로 수행한다고 알려진 부서에 대해 병원내 안전관리과와 협의를 거쳐 163명을 연구대상으로 선정하였다. 이중 138명이 설문에 참가하였고, 이들을 최종 연구대상으로 하였다. 설문지를 가지고 연구변수를 측정하여, 나이, 근무연수, 가사노동의 정도 등의 인구학적 변수와 직무스트레스 및 사회적지지, 근골격계 증상, 통증의 양상 등을 조사하였다. 분석방법은 일반적 특성 및 작업특성, 통증의 양상을 성별에 따라 파악하였고, 통증점수의 타당성을 검정하기 위해, 통증점수의 구성요소와 통증점수를 시각적 상사척도와 상관성 검정을 시행하였다. 통증점수를 종속변수로 하고 직무요구도, 직무재량도, 동료의지지, 상사의지지, 여러작업환경특성, 인구학적 특징 등을 독립변수로 하여 다중회귀분석을 시행하였다. 결과: 첫째 통증의 정량화를 위해 사용한 통증평정지수는 시각적 상사척도와의 상관관계가 높은 것으로 나타나, 어느 정도의 타당성을 지닌 방법으로 해석할 수 있었다. 둘째, 이 통증 점수를 종속변수로 하여, 관련요인 분석한 다중회귀분석에서 직무요구도가 높을수록 통증의 정도가 높고(p<0.01), 여성일수록 남성에 비해 높은 통증점수를 보였다(p<0.01). 결론: 근골격계 질환의 높은 유병율을 보이는 집단의 경우, 이들의 증상 유무만을 가지고 관련요인을 분석하는 방법을 사용하기 어렵다. 따라서 이런 경우, 통증을 정량화하여, 다양한 관련요인을 찾으려는 노력이 필요하며, 본 연구에서 사용한 통증평정지수는 타당성을 지닌 정량화 방법이라고 여겨진다. 또한 본 연구에서는 직무요구도가 높을수록, 여성일수록 높은 통증점수를 보였다. Objectives: This study was designed to quantify symptoms in the upper extremities and to identify the pain related factors among hospital workers using video display terminals. Methods: The subject-group consisted of 138 employees working at a hospital using video display terminals. A structured questionnaire was used to estimate the participants' general characteristics, and job contents. Job stress was measured using Karaseks JCQ(Job Content Questionnaire). Pain in the upper extremities was identified according to the NIOSH symptoms survey criteria. Quantification was measured using Kim Chul's method. Pearson's Correlation analysis was used to identify validity in quantification. VAS(visual analog scale) was used to compare with this method. Multiple regression analyses elucidated the relationship between quantified pain and various work factors, such as job stress. Data were analysed with SAS 6.12 program. Results: First, in quantification using Kim Chul's method, the correlation between modified PRS(pain rating score) and VAS was extremely high by 0.60(P<0.01), indicating the high validity of PRS. Second, the groups of high job demand, high job control, and females were related to an increased pain level. Conclusions: These results suggest that the self pain assessment method, PRS, is valuable and useful in analyzing occupational musculoskeletal symptoms. High demand, job control and gender may influence the levels of pain. Prospective studies about musculoskeletal disorder are required.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.