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.

Cardiovascular Neurons Mediating Somatosympathetic Reflex in Rostral Ventrolateral Medulla

Goo,Yong-Sook,Kim,Sang-Jeong,Kim,Jun,Sung,Ho-Kyung 대한생리학회 1993 대한생리학회지 Vol.27 No.2

The rostral ventrolateral medulla (RVLM) includes vasopressor neurons, which transmit activation signals to the intermediolateral nucleus (IML) of the spinal cord, where the preganglionic sympathetic nucleus is located, to raise arterial blood pressure (BP). However, controversy exists as to the possible depressor area in the RVLM and the pathway involved. The present study persued evidence far the location of depressor neurons and the pathway by simultaneously observing changes in BP and the firing rate (FR) of cardiovascular neurons (CVNs) in the RVLM during the somatosympathetic reflex (SSR) elicited by peripheral nerve stimulation, since CVNs are known to contribute to the generation of the sympathetic nerve discharge. In 42 cats, anaesthetized with α-chloralose, single unit recording was performed, using carbon filament electrodes inserted into the RVLM, enabling estimation of the post R wave unit histogram (PR-UNlT) and the spike triggered average of sympathetic nerve discharge (STA-SND), allowing identification of CVNs. Antidromic stimulation of spinal T₂ segment was followed to determine whether the identified CVN projects axonal endings to the spinal cord (reticulospinal neuron). The sciatic nerve was electrically stimulated at AΔ-intensity (1 mA, 0.1 ms), 1 Hz and C-intensity (10 mA, 0.5 ms), 20 Hz to elicit the depressor, and pressor responses of the SSR, respectively. Simultaneous measurement of CVN firing rate was made. Experimental results are summarized as follows. 1) 20 out of 98 CVNs had axonal projections to the spinal cord and 17 out of 98 CVNs showed FR changes during SSR. 2) Response patterns of FR and BP during SSR were classified into 8 types. 3) These 8 different response patterns could be further classified into those from pressor and depressor neurons. These results demonstrate that some CVNs were identifiable as reticulospinal neurons responding to anti-dromic stimulation and that CVNs operating as depressor neurons as well as pressor neurons exist in the RVLM, both of which are involved with SSR mediation. Therefore, evidence was found that an independent depressor pathway might be involved in the mediation of SSR.

한국 천식아동의 기질특성

김승태,최성구,김상엽,정유숙,홍성도,김선우,이상일,이흥재 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

이 연구의 목적은 기관지 천식아동의 기질특성을 알아보기 위한 것이다. 저자중 일인의 예비연구에 의하면 천식아동집단은 습진이나 알러지성 비염 등의 만성질환을 가진 아동집단이나 정상아동과는 다른 기질특성을 갖는다. 세 살에서 일곱 살 사이의 정상아동과 기관지 천식을 앓는 아동 85명의 어머니들에게 한국판"부모기질설문(Parental Temperamental Questionnaire)"을 완성하도록 하여 기질을 측정하였다. 기질의 9가지 범주 및 요인 A점수를 비교하기 위하여 비모수적 통계법을 사용하였으며, 아동들의 기질진단을 비교하기 위하여 Chi-square통계법을 사용하였다. 그 결과 천식을 앓는 여아집단은 정상 여아집단에 비해 적응성과 반응의 역치 범주에서 통계적으로 유의하게 낮았다. 또 정상아동집단의 11%가 기질진단적으로 양육곤란형인 반면 천식아동집단은 22%를 차지했다. 두 집단은 기질진단면에서도 통계적으로 유의한 차이를 보였다. 이와 같은 결과는 천식아동에 특징적인 기질양상이 있음을 시사한다. 기질양상의 조기발견은 부모들에게 천식아동의 건강한 발달을 이해하고 행동장애 고위험집단인 만성질환을 앓는 소아들에게 적절한 양육을 제공하는데 도움을 줄 것이다. The objective of this study was to determine temperamental characteristics of children with bronchial asthma. An earlier preliminary study(Kim SP, Ferrara A, Chess 5, 1980) results show that the asthmatic children, as a group, are significantly different from two other control groups(1. children with eczema, allergic rhinitis, or both without asthma : Ⅱ. normal healthy children in their temperamental profile). The parents of 85 Korean children with bronchial asthma, ages 3 to 7 years, completed the Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess. The data collected were of ordinal type, ranked from 1 to 7 and the non-parametric Mann-whitney U Test was utilized. Any child with a suspected history or diagnosis of premature birth, organic brain syndrome, mental retardation, childhood psychosis, congenital physical anomaly, hereditary disease or any other medical or surgical conditions, other than asthma, requiring continuous physicians care was excluded from the study population. The results showed that asthmatic female children were characterized by lower adaptability and lower threshold of responsiveness. And 22% of asthmatic children were of the difficult type, compared to 11% of normal children. Both groups were statistically different in terms of temperamental constellation. The findings strongly suggest the existence of a distinct temperamental profile of asthmatic children. Early detection of the profile may be of great value for parents and child health care providers in understanding the asthmatic children's correct developmental needs and in determining appropriate parenting approaches for the chronically ill children at the risk of behavioral disorder.

2형 당뇨 환자에 있어서 C형 간염의 유병률에 관한 연구

김구영,서광섭,유광렬,임병욱,채선애,강남훈,김창훈,권영우,김희수,류성태,이정환,박성우,오웅식,김정한 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

Background: We have doubt about the truth that Type 2 DM is associated with chronic hepatitis C infection. The aim of our study was to prove a close relationship between chronic HCV infection and type 2 DM in korean patients. Methods: We reviewed the out-patient's medical records of 466 patients with type 2 DM who visit the Sung-ae hospital from March 2000 to August 2001. Diabetic patients were analyzed for the following variables: age, sex, waist circumference, weight, waist/hip ratio, using of self monitoring of blood glucose, method of therapy, duration of disease, experience of previous transfusion, major surgical procedure, accompanied disease, liver function tests (LFT), HbA1 c. We ruled out patients with liver cirrhosis. Results: Hepatitis C virus infection was observed more frequently in patient with Type 2 DM. Of 466 Type 2 DM patients, 13 patients were infected with Hepatitis C virus (2.79%). Compared with mean prevalence of Korean population (1.3~1.6%), it's value is very high. the other hand, 21 patients were infected with Hepatitis B virus (4.5%). Such results are similar to mean prevalence of the general public (4~5%). Conclusions: Prevalence of hepatitis C was closely associated in korean patients with type 2 DM. And an increased prevalence is independent of cirrhosis.

녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

노인 인구에서 신경인지기능저하와 혈청 지질농도와의 상관성

유영선,최석주,정성수,김지은,윤성욱,전동욱,백준형,박성우,이정구,추일한,김영훈 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.6

Objectives : In this study, the authors evaluated the correlation between eurocognitive impairments and serum lipids levels among Korean elderly over the age of 65. Methods : A total of 609 elderly individuals participated in this study. Screening for cognitive impairments were carried out using the Mini-Mental Status Examination-Korean version (MMSE-KC). There were 197 subjects above 1.5SD Of MMSE- KC and they were evaluated using the Korean versions of the Consortium to Establish a Registry for Alzheimer's Disease (AD) (CERAD-KC) and Geriatric Depression Scale (GDS-K). Results : There was a correlation between old age/low levels of education and AD (p<0.05, P<0.01). There was an inverse correlation between the serum level of total cholesterol and the word list recognition test scores. The serum levels of LDL cholesterol were inversely correlated with the scores on the constructional praxis test, word list recall test and word list recognition test. Inverse correlations between the serum level of triglyceride and scores on the word list recall test and word list recognition test were also observed. Conclusion : There were inverse correlations between the serum levels of lipids and language/memory function in subjects with AD.

미디어 스포츠의 政治的 性向에 關한 考察 : 批判的 硏究의 立場 From a standpoint of critical study

金相九,李康雨 江原大學校附設 體育科學硏究所 1991 江原大學校附設體育科學硏究所論文集 Vol.- No.16

So far in any country, sport has been developed in accordance with the progress of its nation. Meanwhile, the governing bodies of nations have employed various means in order to secure justice for their control and one of the means is to trade on sport for political purpose and to carry it more effectively into execution is to exploit mass media. Accordingly, the relationship among sport, politics and mass media can not be overlooked in terms of the present situation of some nations. The establishment of such relation cloes not mean that sport has political inclination with it but that it become possible when sport is undersood as playing a role of messenger of an ideological assertion that affect on politics as symbolic system of mass media that convey message. In this respect, media sport come to infuse the political ideology into the product of media not only by the attribute of political economics of media itself, but also in the ruling process of men of political powers. Also, it points up the fact that sport is being exploited by mass media for the ruling group to continue their control by diffusing the consciousness of the ruling group (men of political powers or proprietors of media) through ideological organization like mass media and by adapting the consciousness of the ruled group (the masses) to the rationalization of the existing systems. It enable the ruling group to secure justice for their ruling by making the masses de-political, de-social and de-community through the international distortion of contants of. mass media to the masses. The funtions of media sport as a messenger of political ideology drawn from the study are;First, media sport funtions as giver of justice for control to the men of political powers, Second, it functions to sustain and continue the present system rather than to bring about radical changes to the existing social orders. But, notwithstanding that the ideological effect of media sport should be analyzed on the basis of the positive method of study, most studies have only the probability to analyze the reality in which media sport cannot but containing ideology. Another point to be considered is that the producers of contents of media sport should not merely accept and manifest blindly such ideology but at the same time, they should combine it with an effort to examine the true meaning of sport and to reflect on the problems.

Heidegger, Benjamin, Deleuze의 차이관에 의한 후기산업사회 문화현상 해석(Ⅰ)

김상구 신한영미어문학회 1997 새한영어영문학 Vol.37 No.-

The idea of "difference" has played an important role in modern and postmodern thought, especially Martin Heidegger, Walter Benjamin, and Gilles Deleuze'. It is why this idea can be applied to the interpretation of the cultural phenomena in post-industrial society. It can be also applied to any other genre. It is not too much to say that the background of Heidegger's philosophy lies in the idea of "difference". It can be described as the primal principle of existence in Heidegger's philosophy. The ontological difference, as he called it, is the difference between Being and beings. The relation of Being to beings is always affected by the surrounding conditions in the practical history. This relation cannot be fixed and cannot be taken a specific form, so it has always appeared as a formless thing. It is always changeable and mutable. It is also said that Benjamin's restoration of pure language is for achieving "difference" in his allegorical criticism and view of the translation. In this point, the "difference" means transformation. This is similar to Heidegger's. Deleuze, in Difference and Repetition, said the eternal reversion is the return of not "being" and "the same" but "becoming" and "difference". This comment of his is related with Heidegger's and Benjamin's remarks. Meanwhile, their views of difference connect with the anthropological approaches by Michael Thompson, Mary Douglas, and Michael Riffaterre on the interpretation of the post-industrial society. It is why the ontological validity op 'rubbish', 'dirt', and 'cliches' in their theories can be replaced with the idea of "difference".

Isonitrosoethylacetoacetate Imine 리간드의 니켈(II) 착물 합성 및 구조 특성

김인환,구본창,최강열,김상태,이만호 大邱大學校附設 基礎科學硏究所 1993 基礎科學硏究 Vol.10 No.-

Nickel(lI) Complexes of the type Ni(IEAA-NH)(IEAA-NR) (R = H₁, CH₃, C₂H_(5), n-C₃H_(7), n-C₄H_(9), or CH₂C_(6)H_(5)), where IEAA-NH and IEAA-NR represents isonitrosoethylacetoacetate imine and its N-alkyl derivative, respectively, have been prepared. And the structure of the complexes have been studied by elemental analyses, electronic, infrared,1H and 13C-NMR spectra. It has been determined that IEAA-NH ligand coordinates to nickel through the nitrogen of imine group and the oxygen of isonitroso group to form 6-membered chelate ring and IEAA-NR coordinates to nickel through the nitrogens of imino group and isonitroso group to form 5-membered chelate ring in the square-planar Ni(IEAA-NH)(IEAA-NR) complexes.