국내 말라리아 상황과 연구동향

고원규,정준용 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1S

Vivax malaria has re-emerged in the northern part of the Republic of Korea from 1993 after over 10 years absence. The number of cases has increased every year and reached to about 3000-4000 a year. Thanks to this epidemic researches and developments on malaria is activated in the country. Some important achievements produced by Institute of Malariology. Inje University are introduced. The geographical distributions of patients and antibody titers showed the characteristic of border malaria. Thus collaborative efforts with North Korea are necessary to control this epidemic successfully. In this epidemic, two different genotypes were found In the genes of CSP, DBP, MSP-1 (ICB 4-5), and AMA-1. The DNA structures of the genes were similar to them from East Asia. 58% of 80 patients' blood shows single genotype in each gene had a combination of genotypes (CSP SK-A:DBP SK-I:MSP-1), and 29% of them has another (CSP SK-B:DBP SK-Ⅱ:MSP-2). Thus it was concluded that genetically different two strains (KOR1 and KOR2) of P. vivax were mainly distributed in the endemic area. One-shot multiplex PCR was designed for differential diagnosis of two major species of Plasmodium by targeting the 18s rRNA gene. In an evaluation on 210 clinical samples the new PCR test showed very high feasibility, sensitivity (100%), and specificity (100%). Malaria is one of major infectious diseases in the world, causing 300-500 million clinical cases and more than one million deaths each year. The importance of vaccine and new drugs for malaria must be stressed.

Anisakis type I 幼蟲에 의한 人體感染 2例

손운목,고원규,설상영,정정명 인제대학교 1991 仁濟醫學 Vol.12 No.3

91년 5월 17일에 上腹部痛을 主訴로 本院을 내원한 2명의 患者에 대하여 胃 內視鏡檢査를 시행하였던 바, 胃 粘膜에 길이로 묻혀 있는 Anisakis 幼蟲을 1마리씩 檢出하였다. 胃 粘膜이 충체를 중심으로 肥厚되어 있었고 肉芽腫性 病巢가 형성되어 있었다. 검출된 충체는 둘다 Anisakis type I 幼蟲이었다. Two cases of gastric anisakiasis caused by Anisakis type I larva were reported. The patients, residing in Pusan, were 66-year-old male and 36-year-old female. They chiefly complained of epigastric pain and recalled they had eaten raw marine fish such as sea eel and bream. Two whitish round worms were found in the hypertrophic and granulomatous mucosa of stomach wall on gastroscopic examinations, and were classified as Anisakis type I larva.

Echinoparyphium recurvatum의 레디아, 유미유충 및 피낭유충의 표피미세구조

손운목,고원규 인제대학교 1993 仁濟醫學 Vol.14 No.4

투과전자현미경을 이용하여 Echinoparyphium recurvatum의 레디아, 유미유충 및 피낭유충의 표피미세구조를 관찰하고자 하였다. 자연감염된 물달팽이로부터 획득한 유충들을 통상적인 시료제작 과정을 거친 후 JEOL 1200EX-II 투과전자현미경으로 관찰하였다. 레디아의 바깥 표피면에는 원형질층에서 돌출한 미세융모들이 분포하였고, 원형질층의 아래에는 구불구불한 형태의 기저층이 위치하였으며, 실질층에는 막성지질과립, 화염세포 및 표피세포 등이 분포하였다. 레디아 내에서 발육 중인 유미유충의 원형질층에는 전자밀도가 낮은 과립과 길죽길죽한 사립체가 분포하였으며 발육함에 따라 바깥 표피면의 융기 및 굴곡이 심화되었다. 성숙 유미유충의 원형질층에서는 다양한 형태의 과립과 피극 및 감각유두 등이 관찰되었다. 피낭유충의 낭벽은 섬유성 물질로 이루어져 있었으며, 원형질층은 유미유충 시기에 비하여 훨씬 조밀한 구조를 나타내었다. E. recurvatum 유충의 표피미세구조가 기본적으로는 서로 유사하나 발육단계에 따라 그에 상응하는 독특한 구조로 변화하였다. An transmission electron microscopic study was performed to observe the tegumental ultrastructures of the redia, cercaria and metacercaria of Echinoparyphium recurvatum. Each stage of the larval worms were obtained from the naturally infected fresh water snail, Radix auricularia coreana. They were prepared for transmission electron microscopic observations and observed by a JEOL 1200EX-II transmission electron microscope. The findings were summarized as followed. 1.The entire surface of the redial tegument was covered with microvilli, 0.45×0.4 μm in average size, which were not branched usually. The highly convoluted basement layer was 0.2μm wide or so. One kind of electron-dense secretory granules, flame cells and tegumental cells were observed in the parenchymal layer. 2.The cytoplasmic layer of a developing cercaria in redia was about 1.3μm wide and contained numerous electron-luscent secretory granules and mitochondria. 3.The cytoplasmic layer of a mature cercaria was about 2.4μm wide and contained 4 types of secretory granules, tegumental spines and ciliated sensory vesicle in its matrix. 4.The cyst wall of a metacercaria was consisted of a fibrous chitin substance. Numerous polyribosomes and small elliptical secretory granules were observed in the parenchymal layer of metacercaria. From the above findings, it is concluded that some characteristic features by the layer stage of E. recurvatum are obtained and they are helpful in the ultrastructural studies of other larval trematodes.

Metagonimus Takahashii와 Heterophyes Nocens의 혼합인체감염 1례

손운목,고원규,조규일 인제대학교 1992 仁濟醫學 Vol.13 No.2

1991년 8원 16일 부산백병원 종합검진센타를 찾은 27세 남자의 대변에서 異形吸蟲類의 충란이 검출되었다. 한달후 parziquantel과 황산 마그네슘을 투여하여 치료하였던 바, 587 마리의 M. takahashii와 8 마리의 H. nocens가 검출되었다. 이에 생물학적, 역학적 性狀이 다른 두 이형흡충류의 혼합인체감염 1례를 보고함과 아울러 분류학적으로 이견이 많은 M. takahashii의 형태학적 특징을 재기술하였다. A case of natural human infection by Metagonimus takahashii and Heterophyes nocens was confirmed by collection of adult warms after praziquatel treatment on August, 1991, and in order to clarify the species identity, the morphological characteristics of M. takahashii were rediscribed. The patient was a 27-year old male residing in Hadong-gun, Kyungnam Province, Korea. He had the clinical complaints of fatigue, indigestion and arrhythmia, and said to have eaten raw flesh of several kinds of marine and/or freshwater fish. Praziquantel in single dose 10mg/kg was given followed by purgation with magnesium salt, and 587 M.takahashii and 8 H. nocens were collected from the diarrheal stools. M. takahashii were dorsoventrally flattened, 0.998×0.573mm in average size, and they had the following morphological characteristics : no posteriormost location of right testes ; separated left testis from the right one ; distribution of uterine tubules over the left testis and intertesticular junction ; distribution of the vitellaria passing through the posteriormost portion of the body ; larger size of the eggs. H. nocens were also dorsoventrally flattened, 0.924×0.543mm in average size, and they had a well-developed ventral sucker and a genital sucker bearing the 54 chitinous rodlets. From the above results, a case of human infection by M. takahashii and H. nocens was identified. This study may be the 32nd human case of H. nocens infection in the literature in Korea.

해외유입전염병관리 체계에 대한 의사들의 성향조사

이종수,이원자,고원규,전진호 한국건강관리협회 1998 건협 Report Vol.1 No.-

구충감염에 의한 철결핍성 빈혈 1예

이상봉,설상훈,강석우,조환진,조경임,이원식,주영돈,손창학,고원규 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1

Hookworm infection is one of the major parasitic diseases in warm moist climates, but its prevalence in Korea is very rare nowadays. Authors examined a case of iron deficiency anemia (IDA) associated with hookworm infection in a 46-year-old male. The peripheral blood examination showed markedly increased number of eosinophils, a low level of hemoglobin and decreased MCV. The iron study revealed that serum ferritin was 10.4 ng/ml, serum iron was 30㎍/dl. and total iron-binding capacity was 423㎍/dl. A large number of hookworm ova (7,925/g) were found in the stool sample. The G-I studies were all normal findings. We propose that we have to consider hookworm infection as one of the causes in a case of unknown IDA origin.

Two new genotypes of Plasmodium vivax circumsporozoite protein found in the Republic of Korea

Weon-Gyu KHO,Yeong-Hong PARK,Joon-Yong CHUNG,Jong-Pil KIM,Sung-Tae HONG,Won-Ja LEE,Tong-Soo KIM,Jong-Soo LEE 대한기생충학열대의학회 1999 The Korean Journal of Parasitology Vol.37 No.4

Epidemiology of Malaria and Genotypes of Plasmodium vivax in Korea

Weon-gyu Kho 대한수의학회 2003 대한수의학회 학술대회발표집 Vol.2003 No.-

Since 1993 the number of vivax malaria cases has increased every year in the northern part of Republic of Korea. This study was designed to characterize factors related to the reemergence of malaria in Korea. A total of 21 cases diagnosed in 1993 and 1994 were distributed sporadically in the narrow zone along DMZ. Of total 317 civilian inhabitant cases reported in 1994—|1997, a total of 287 cases were studied and 80.8% of them were resident within 10 km from the south border of DMZ. The frequency distribution of anti-Plasmodi urn vivax antibody titers using IFAT was compared in three villages in relation with distance from DMZ. The number of inhabitants with high antibody titer was larger in the village nearest to the border than that in more distant villages. Our results presented in this study suggested highly that the reemerging vivax malaria started in the border area most possibly caused by infected mosquitoes flown across the border. This pattern of transmission repeated year after year. In this epidemic, two different genotypes were found in the genes of CSP, DBP, MSP-1 (ICB 4-5), and AMA-1. The DNA structures of the genes were similar to them from East Asia. 58% of 80 patients’ blood shows single genotype in each gene had a combination of genotypes (CSP SK-AiDBP SK-I:MSP-1), and 29% of them has another (CSP SK-B:DBP SK-ILMSP-2). Thus it was concluded that genetically different two strains (KOR1 and KOR2) of P. vivax were mainly distributed in the endemic area.

Analysis of polymorphic region of GAM-1 gene in Plasmodium vivax Korean isolates

Weon-Gyu KHO,Joon-Yong CHUNG,Ui-Wook HWANG,Jin-Ho CHUN,Yeong-Hong PARK,Woo-Chul CHUNG 대한기생충학열대의학회 2001 The Korean Journal of Parasitology Vol.39 No.4

Analysis of polymorphic regions of Plasmodium vivax Duffy binding protein of Korean isolates

Weon-Gyu KHO,Joon-Yong CHUNG,Eun-Jeong SIM,Dong-Wook KIM,Woo-Chul CHUNG 대한기생충학열대의학회 2001 The Korean Journal of Parasitology Vol.39 No.2