서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

The fate of spinal schwannomas following subtotal resection: a retrospective multicenter study by the Korea spinal oncology research group.

Sohn, Seil,Chung, Chun Kee,Park, Sung-Hye,Kim, Eun-Sang,Kim, Ki-Jeong,Kim, Chi Heon M. Nijhoff ; Kluwer Academic Publishers 2013 Journal of neuro-oncology Vol.114 No.3

<P>The fate of residual spinal schwannomas needs to be estimated in order to plan further management after subtotal removal. Our aim was to evaluate the growth rate of residual spinal schwannomas and compare results in regrowth and no regrowth groups by using data collected from the Korea Spinal Oncology Research Group database. From January 1989 to August 2011, 27 patients with residual spinal schwannomas were selected. Patients with at least two follow-up magnetic resonance image (MRI) studies after subtotal resection were included. The mean period of MRI follow-up was 62.4 months. A tumor size increase of over 2 mm in the maximal diameter was considered indicative of regrowth. Age, sex, size at initial diagnosis, postoperative tumor size, and Ki-67 labeling index were compared between regrowth and no regrowth groups. Eight residual schwannomas regrew (29.6 %), and 19 (70.4 %) did not regrow. Average growth rate of the regrowing tumors was 1.0 4.4 mm/year. The mean percentage increase in tumor size during follow-up was 10.0 28.8 %. The Ki-67 labeling indices were significantly different between regrowth and no regrowth groups (P = 0.014). Two patients underwent a revision operation for significant tumor regrowth. Nineteen cases (70.4 %) among 27 residual spinal schwannomas did not regrow significantly, but further surgical treatments were necessary in 2 patients due to significant regrowth. The Ki-67 labeling index was higher in the regrowth group. Earlier follow-up MRI is recommended for patients whose tumors have higher Ki-67.</P>

우라늄 투여후 간조직에서의 효소활성도의 변화

김국찬,이강석,김진규,김인규,박효국,천기정,김상복 대한방사선 방어학회 1993 방사선방어학회지 Vol.18 No.2

우라늄 피폭후 효소활성도가 내부피폭의 biomarker로서의 가능성을 연구하기 위하여 수서생물인 잉어9Caprinus carpio)의 복강내 우라늄 투여시 간조직에서 일어나는 여러가지 효소계의 변화를 조사하였다. 이러한 효소활성도의 변화는 우라늄 내부피폭의 biomarker로서 가능성을 가지고 있으며 연구결과는 다음과 같다. 1) 6일째까지 우라늄을 주사하여 적출한 간에서의 전체단백질량은 계속 감소하고 있다. 2) 세포내의 lysosome내에 함유하고 있는 acid protease와 β-glucuronidase의 활성도는 6일째 투여후까지 활성도가 감소하고 있다. 3) Alkaline phosphatase의 경우 6일째 우라늄 투여후까지 증가하고 있으며 반대로 acid phosphatase의 경우 6일째 우라늄 투여후까지 활성도가 급격히 증가하였고 glutamate oxaloacetate transaminase의 활성도는 완만하게 증가하고 있다. 4) Creatine kinase의 활성도는 완만한 감소를 보이고 있으며 malate dehydrogenase는 첫번 우라늄 투여후에 활성도가 급격히 감소하였고 3일째 우라늄 투여후에는 활성도가 거의 나타나지 않았다. We examined various enzyme activity changes by intraperitioneal injection uranium in the carp liver. These enzyme activity changes can be used as biochemical indicators of internal exposure to uranium. The results were followings ; 1) Total protein concentration decreased by intraperitoneal injection in the carp liver. 2) Lysosomal acid protease and β-glucronidase activities increased in the liver until sixth intraperitoneal injection of uranium, but lysosomal acid phosphatase activities decreased in the liver until the sixth injection of uranium. 3) Alkaline phosphatase activities sharply increased and Glutamate oxaloacetate Transaminase activities steadily decreased in the liver until the sixth injection of uranium. 4) Creatine %kinase activities steadily decreased and malate dehydrogenase activities sharply decreased in the liver after the primary injection of uranium. Any malate dehydrogenase activities was not detected after sixth injection of uranium.

Dietary fat increases solid tumor growth and metastasis of 4T1 murine mammary carcinoma cells and mortality in obesity-resistant BALB/c mice

Kim, Eun Ji,Choi, Mi-Ran,Park, Heesook,Kim, Minhee,Hong, Ji Eun,Lee, Jae-Yong,Chun, Hyang Sook,Lee, Ki Won,Yoon Park, Jung Han BioMed Central 2011 Breast cancer research Vol.13 No.4

<P><B>Introduction</B></P><P>High-fat diets (HFDs) are known to cause obesity and are associated with breast cancer progression and metastasis. Because obesity is associated with breast cancer progression, it is important to determine whether dietary fat <I>per se </I>stimulates breast cancer progression in the absence of obesity. This study investigated whether an HFD increases breast cancer growth and metastasis, as well as mortality, in obesity-resistant BALB/c mice.</P><P><B>Methods</B></P><P>The 4-week-old, female BALB/c mice were fed HFD (60% kcal fat) or control diet (CD, 10% kcal fat) for 16 weeks. Subsequently, 4T1 mammary carcinoma cells were injected into the inguinal mammary fat pads of mice fed continuously on their respective diets. Cell-cycle progression, angiogenesis, and immune cells in tumor tissues, proteases and adhesion molecules in the lungs, and serum cytokine levels were analyzed with immunohistochemistry, Western blotting, and enzyme-linked immunosorbent assay (ELISA). <I>In vitro </I>studies were also conducted to evaluate the effects of cytokines on 4T1 cell viability, migration, and adhesion.</P><P><B>Results</B></P><P>Spleen and gonadal fat-pad weights, tumor weight, the number and volume of tumor nodules in the lung and liver, and tumor-associated mortality were increased in the HFD group, with only slight increases in energy intake and body weight. HF feeding increased macrophage infiltration into adipose tissues, the number of lipid vacuoles and the expression of cyclin-dependent kinase (CDK)2, cyclin D1, cyclin A, Ki67, CD31, CD45, and CD68 in the tumor tissues, and elevated serum levels of complement fragment 5a (C5a), interleukin (IL)-16, macrophage colony-stimulating factor (M-CSF), soluble intercellular adhesion molecule (sICAM)-1, tissue inhibitors of metalloproteinase (TIMP)-1, leptin, and triggering receptor expressed on myeloid cells (TREM)-1. Protein levels of the urokinase-type plasminogen activator, ICAM-1, and vascular cell adhesion molecule-1 were increased, but plasminogen activator inhibitor-1 levels were decreased in the lungs of the HFD group. <I>In vitro </I>assays using 4T1 cells showed that sICAM-1 increased viability; TREM-1, TIMP-1, M-CSF, and sICAM-1 increased migration; and C5a, sICAM-1, IL-16, M-CSF, TIMP-1, and TREM-1 increased adhesion.</P><P><B>Conclusions</B></P><P>Dietary fat increases mammary tumor growth and metastasis, thereby increasing mortality in obesity-resistant mice.</P>

제왕절개술 환자에서 수술전 투여한 ketamine의 혈청 interleukin-6 및 수술후 통증에 대한 효과

김진수,김유재,안기량,김천숙,김일호,한찬수 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

The inflammatory reaction to tissue damage during surgery may induce central sensitization followed by hyperalgesia. Previous studies suggest that central sensitization is related to N-methyl-D-aspartate (NMDA) receptor activation, which can be blocked with NMDA antagonist, ketamine. Thus, we compared the effect of preoperative intravenous and epidural low doses of ketamine with placebo on serum interleukin-6 (IL-6) level and postoperative pain. ASA class I and II women scheduled for C-sections received intravenous ketamine 0.15mg/kg(group 2) or placebo(group 1), or epidural ketamine(0.15 mg/kg) before the operation. IL-6 levels were measured before and during the operation, and 8, 24, and 48 hrs after the operation. Visual Analogue Scales(VAS) and Verbal Ration Scales(VRS) were measured at 8, 24, and 48 hrs after the operation. Serum IL-6 levels at 8, 24, and 48 hrs after the operation were significantly lower in the intravenous ketamine and epidural ketamine groups than in the control group. VAS at 8 hrs and 48 hrs after the operation were significantly lower in the epidural ketamine group. VAS at 8 hrs and 48 hrs after the operation were significantly lower in the epidural ketamine group than in the control and intravenous ketamine groups. In conclusion, in the preoperative intravenous and epidural administration of low doses(0.15mg/kg) of ketamine, both are effective in reducing postoperative IL-6 levels. Epidural Ketamine is more effective than intravenous ketamine in postoperative pain control.

흰쥐의 방사선 피폭후 생물학적 지표로서의 혈액효소

김진규,김상복,김국찬,천기정,김인규,박효국,이강석 대한방사선 방어학회 1993 방사선방어학회지 Vol.18 No.2

생물학적 선량평가를 위한 생화학적 지표 연구로서 흰쥐 혈액내 효소활성도의 변화를 조사한 결과는 다음과 같다. 1) Alkaline phosphatase 활성도는 0.1, 0.25, 0.5, 2, 4 Gy의 방사선 조사후 24시간까지 혈액내 활성도가 증가하였고 72시간 경과시에는 대조군과 비슷한 활성도를 보였다. Creatine kinase는 2, 4 Gy 방사선 조사후 혈액내에서 활성도에서 활성도가 72시간까지 증가하였으나 0.1, 0.25Gy, 0.5 Gy 방사선 조사시에는 커다란 변화를 보이지 않았다. 2) Malate dehydrogenase 활성도는 0.1, 0.25, 0.5 Gy 방사선 조사시에는 커다란 변화가 없었으며 lactate dehydrogenase는 방사선 조사후 활성도가 감소하였다. 3) GOT의 활성도는 선량률 0.1Gy/min.로 0.1, 0.25, 0.5, 2, 4 Gy 조사후에는 어떠한 변화도 없었으며 선량률 0.5 Gy/sec.로 0.5, 1, 1.5, 2, 3, 5, 7 Gy로 조사후에는 증가현상을 보이고 있다. Acid phosphatase 활성도는 상기의 어떠한 선량에서도 나타나지 않고 있다. 잠재적으로 이러한 효소들은 방사선 피폭의 지표물질로 사용될 수 있으며 생화학적 지식과 기술을 이용한 좀더 나은 지표물질을 찾기 위하여 계속적인 조사가 필요하다. Enzyme activity changes in rat blood as biochemical indicator useful for evaluating exposure dose were experimentally studied. The experimental results obtained are as follows: 1) Alkaline phosphatase activities increased in the blood serum until 24 hours after 0.1, 0.25, 0.5, 2 and 4 Gy irradiation and its activities returned mormal condition after 72 hours of post-irradiation. Creatine kinase activities increased in the blood serum until 72 hours after 2 and 4 Gy irradiation but any significant activity changes were not detected after 0.1, 0.25 Gy irradiation. 2) Malate dehydrogenase activities did not reveal available changes changes after 0.1, 0.25, 0.5 Gy irradiation and lactate dehydrogenase activities decreased in the blood serum after 0.1, 0.25, 0.5 Gy irradiation. 3) Glutamate oxaloacetate transaminase activity changes were detected in the blood serum after 0.1, 0.25, 0.5, 2, 4 Gy(0.1 Gy/min.) and GOT activities increased after 0.5, 1, 1.5, 2, 3, 5, 7 Gy(0.5 Gy/sec.). Any acid phosphatase activities were detected in the blood serum after 0.1, 0.25, 0.5, 2, 4 Gy(0.1 Gy/min.) and 0.5, 1, 1.5, 2, 3, 5, 7 Gy(0.5 Gy/sec.) irradiation. Potentially some of these enzymes can be used as indicator protein for radiation injury. Futher investigation is needed to find better biochemical indicatiors utilizing recent knowledge and techniques of biochemistry.

Systemic administration of low dosage of tetanus toxin decreases cell proliferation and neuroblast differentiation in the mouse hippocampal dentate gyrus

Bing Chun Yan,In Hye Kim,Joon Ha Park,Ji Hyeon Ahn,Jeong-Hwi Cho,Bai Hui Chen,Jae-Chul Lee,Jung Hoon Choi,Ki-Yeon Yoo,Choong Hyun Lee,Jun Hwi Cho,Jong-Dai Kim,Moo-Ho Won 한국실험동물학회 2013 Laboratory Animal Research Vol.29 No.3

In the present study, we investigated the effect of Tetaus toxin (TeT) on cell proliferation and neuroblast differentiation using specific markers: 5-bromo-2-deoxyuridine (BrdU) as an exogenous marker for cell proliferation, Ki-67 as an endogenous marker for cell proliferation and doublecortin (DCX) as a marker for neuroblasts in the mouse hippocampal dentate gyrus (DG) after TeT treatment. Mice were intraperitoneally administered 2.5 and 10 ng/kg TeT and sacrificed 15 days after the treatment. In both the TeT-treated groups, no neuronal death occurred in any layers of the DG using neuronal nuclei (NeuN, a neuron nuclei maker) and Fluoro-Jade B (F-J B, a high-affinity fluorescent marker for the localization of neuronal degeneration). In addition, no significant change in glial activation in both the 2.5 and 10 ng/kg TeT-treated-groups was found by GFAP (a marker for astrocytes) and Iba-1 (a marker for microglia) immunohistochemistry. However, in the 2.5 ng/kg TeT-treated-group, the mean number of BrdU, Ki-67 and DCX immunoreactive cells, respectively, were apparently decreased compared to the control group, and the mean number of each in the 10 ng/kg TeT-treated-group was much more decreased. In addition, processes of DCX-immunoreactive cells, which projected into the molecular layer, were short compared to those in the control group. In brief, our present results show that low dosage (10 ng/kg) TeT treatment apparently decreased cell proliferation and neuroblast differentiation in the mouse hippocampal DG without distinct gliosis as well as any loss of adult neurons.

원발성 피부 CD30 양성/ALK 음성 퇴형성 대세포 림프종 1예

이은주,김협,서영준,서기범,이증훈,박장규,김유찬,김춘옥 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.5

Primary cutaneous CD3O(Ki-1) Positive anaplastic large cell Iymphoma(ALCL) is a rare subset of cutaneous Iymphoma. with a much better prognosis. ALCL is a heterogeneous process that may have a T-cell, B-cell, or indeterminant(null) phenotype and which may or may not express the anaplastic Iymphoma kinase(ALK) oncoprotein. We report a case of ALCL in a 72 year old man. About 4 months ago, multiple erythematous firm ulcerative mass and satellite nodules developed on the right lower leg. The skin lesions rapidly increased in number and size. Some lesions became painful and centrally ulcered. The histologic findings showed a diffuse infiltrate of large Iymphocytes with large nuclei, prominent and multiple nucleoli, and ample cytoplasm. Immunohistochemical stainings for CD3O, CD5 were positive but stainings for LCA, CD3, CD45RO, CD2O, cytokeratin, EMA, and ALK were negative. Therefore, we diagnosed our case as CD+/30ALK- ALCL (Korean J Dermatol 2003;41(5) : 666~669)

기도이물에 관한 임상적 고찰

한찬수,김태정,김일호,김유재,김천숙,안기량 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Aspiration of a foreign body in the airway is common cause of sudden obstructive breathing, crouping cough, hoarseness, and wheezing. Especially that caused serious problem in case of the young children. A past history of foreign body aspiration is itself an indication for bronchoscopic examination of the airway, because some children with aspirated foreign bodies are without symptoms and chest X-ray films may not show abnormalities. So the anesthesiologist should take a notice of removing foreign body in the anesthetic procedure. The author have experienced 36 cases removal of foreign bodies in the airway under general anesthesia from July, 1982 to January, 1996 in Chunan Hospital, College of Medicine, Soonchunhyang University. The results were as follows 1) Among the 36 cases, 25 cases(69.7%) were under the age of 5. The ratio of male and female was 1.8 : 1. 2) In duration of lodgement, there was most frequent within one day in 15 cases(41.7%) and the longest duration was 20 days. 3) The most common symptom, sign and auscultation finding were cough 19 cases(52.8%). chest retractions 7 cases(19.4%) and decreased breathing sound 20 cases(55.6%) 4) Abnormalities in the chest X-ray were found in 15 cases(41.7%) among 36 cases. 5) Vegetable foreign bodies, expecially peanut were the most common airway foreign body(28.7%), followed by plastic foreign body(14.4%) and mucous plug(11.3%). 6) The foreign body involved the right bronchus 16 cases(45.7), left bronchus 10 cases(28.6%), trachea 5 cases(14.3%), and larynx 4 cases(11.4%). 7) Foreign body induced complications occurred in 9 cases(25.0%); pneumonia 8 cases and pneumomediastinum 1 case, and all of postoperative complication was pneumonia(25.0%). 8) 34 foreign objects(94.4%) were removed by endoscopy but tracheostomy was required in two patients.