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한국인에서 Human T - cell Lymphotropic Virus Type 1 ( HTLV - 1 ) 에 대한 항체보유
김준명(June Myung Kim),오영철(Young Chul Oho),박형천(Hyeong Cheon Park),권건호(Kun Ho Kwon),김응(Eung Kim),이선호(Seon Ho Lee),김기홍(Ki Hong Kim) 대한내과학회 1996 대한내과학회지 Vol.51 No.1
N/A Objectives: HTLV-I infections are newly recognized disease entity which are common in some tropical and subtropical areas including southwestern district of Japan. Inspite of geographical adjacency and frequent cultural exchanges between Korea and Japan, it has been known that Korea is not an endemic area and HTLV-I associated illnesses are very rare in Korea. Our study was designed to reevaluate the prevalence of anti-HTLV-I antibodies in Korea and its regional distributions. Methods: Sera were obtained from blood donors from various districts of Korea. Anti-HTLV-I anti- bodies were detected using microtiter particle agglutination test kit( Fujirebio Inc. Japan) employing an indirect agglutination technique. Results: The results were as follows 1) Total 9,281 donors were tested and 12 donors were anti-HTLV-I positive(positive rate = 0.13%) 2) Positive rate was 0.11% in male and 0.46% in female, with relative female sex predominence. 3) Frequency of seropositive donors had tendency to increase gradually with age. 4) Relatively high incidence of anti-HTLV-I positive donors were observed in Jonnam(0.15%), Kyung-nam(0.31%), and Chejue(0.80%) which showed increasing incidence as the district got closer to Japan. Conclusion : In conclusion the prevalence rate of anti-HTLV-I seemed to be very low in Korea. But districts close to endemic areas of Japan showed relatively high incidence of anti-HTLV-I positive donors. Surprisingly high incidence of of anti- HTLV-I positive donors were noticed in Chejue warranting further research on HTLV-I associated illnesses and prevention programs.
국내 Human Immunodeficiency Virus 감염의 감염 경로: 한국 HIV/AIDS 코호트 연구
김준명 ( June Myung Kim ),최준용 ( Jun Yong Choi ),정우용 ( Woo Yong Jeong ),성혜 ( Hye Seong ),김신우 ( Shin Woo Kim ),김우주 ( Woo Joo Kim ),최희정 ( Hee Jung Choi ),김민자 ( Min Ja Kim ),우준희 ( Jun Hee Woo ),김윤정 ( Youn Je 대한내과학회 2018 대한내과학회지 Vol.93 No.4
목적: 전 세계적으로 매년 신규 HIV 감염의 발생은 서서히 감소하는 추세를 보이고 있다. 그러나 국내 신규 HIV 감염의 발생은 도리어 급격히 증가하는 양상을 보이고 있으며, 젊은 층에서의 급격한 증가가 원인으로 알려졌다. 이에 국내에서 HIV 감염의 감염 경로를 분석하고 규명함은 국내에서의 급격한 증가 원인을 밝히고, 그에 대한 예방 및 관리 대책을 수립함에 있어서 중요한 근거가 되겠다. 방법: 2006년 12월부터 2018년 1월 까지 ‘한국 HIV/AIDS 코호트’에 등록된 HIV 감염인을 조사하여 분석하였다. 전국21개 참여 병원에서 진료를 받고 있는 18세 이상의 HIV 감염인으로서 등록 시에 주치의의 역학 관련 문진에 이어 훈련된 전문 상담 간호사가 제시하는 표준화된 설문지를 통해서 역학 조사를 실시하였다. 수집된 자료를 분석하여 전체 대상 및 연령군에 따른 감염 경로를 규명하였고, 특히 젊은 층에서는 좀 더 세부적으로 연령을 구분하여 감염 경로를 조사하고 비교하였다. 결과: 조사 대상은 1,474명이었으며, 남자는 1,377명, 여자는 97명이었다. 조사 대상의 평균 연령값은 41.4 ± 12.6세였으며, 남녀 성비는 14.2:1이었다. 전체 대상 HIV 감염인의 감염 경로를 분석해 보면 동성 및 양성 간 성접촉이 886명 (60.1%), 이성 간 성접촉이 508명(34.6%), 수혈 및 혈액제제에 의한 감염이 5명(0.3%), 마약주사 공동사용에 의한 감염이 1명(0.0%)이었다. 연령군에 따른 감염 경로를 비교해 보면 젊은 연령군으로 갈수록 동성 및 양성 간 성접촉에 의한 비율이 증가하였다. 다시 말해서, 18-29세의 젊은 연령군에 있어서는 동성 및 양성 간 성접촉이 71.5%로 크게 증가하였다. 또한, 18-29세의 젊은 연령군을 좀 더 세분화해서 조사해보면 젊을수록 동성 및 양성 간 성접촉에 의한 감염이 크게 증가하여 18-19세의 10대에서는 92.9%가 동성 및 양성 간 성접촉에 의해서 감염되었다. 결론: 국내 HIV 감염의 가장 주된 감염 경로는 동성 및 양성 간 성접촉이며, 이러한 경향은 연령이 젊어질수록 더욱 뚜렷이 나타났다. 특히, 10대의 경우에는 대부분이 동성 및 양성 간 성접촉에 의하여 감염되었다. 따라서 그에 따른 합리적인 예방 및 관리 정책을 수립하는 것이 절실히 요구된다 하겠다. Background/Aims: Global efforts to prevent human immunodeficiency virus (HIV) infection and strengthen treatment programs have reduced the annual incidence of HIV infection. However, the incidence recently increased unexpectedly in Korea. Therefore, to understand the cause of the increase in HIV infection incidence in Korea, it is important to identify the mode of HIV transmission. Methods: We included HIV-infected individuals enrolled in the Korea HIV/AIDS (acquired immune deficiency syndrome) Cohort from December 2006 to January 2018. The subjects were older than 18 years and were receiving care at 21 participating hospitals. They were interviewed by their physician at enrollment, and an epidemiological survey was conducted using a stand ardized questionnaire provided by a professional counseling nurse. Results: There were 1,474 subjects: 1,377 men and 97 women. Their mean age was 41.4 ± 12.6 years, and the male-to-female ratio was 14.2. The transmission modes were as follows: homosexual and bisexual contacts in 885 (60.1%), heterosexual contacts in 508 (34.6%), blood transfusion and blood products in 5 (0.3%), and injected drug use in 1 (0.0%). Regarding age, the proportion infected by homosexual and bisexual contacts was higher in the younger age groups: 71.5% in subjects aged 18-29 years. When this age group was further subdivided, 92.9% of those aged 18-19 years were determined to be infected via homosexual and bisexual contacts. Conclusions: In Korea, HIV is transmitted predominantly via homosexual and bisexual contacts, which is more common among younger age groups and the cause of infections in most teenagers. (Korean J Med 2018;93:379-386)
국내 HIV 감염 / AIDS 의 역학적 및 임상적 양상
김준명(June Myung Kim),조군제(Goon Je Cho),홍성관(Sung Kwan Hong),정주섭(Ju Seub Chung),장경희(Kyung Hee Jang),김창오(Chang Oh Kim),박윤수(Yoon Soo Park),조정호(Jung Ho Cho),김효열(Hyo Yeoul Kim),최영화(Young Hwa Choi),송영구(Young G 대한내과학회 2001 대한내과학회지 Vol.61 No.4
N/A Background: The epidemiologic and clinical features of HIV infection/AIDS are different among various races, regions, and countries. To determine the epidemiologic and clinical characteristics of HIV infection in Korea, we analyzed and compared with that of other populations. Methods: Medical records of 176 HIV-infected per sons in Severance Hospital of Yonsei University College of Medicine and Hospital of Pusan University College of Medicine from year 1985 to 2000 were reviewed retrospectively. Results: One hundred and seventy six patients were analyzed among which 156 (88.6%) were male and 20 (11.4%) were female with a male to female ratio of 7.8:1. At the time of diagnosis, the age distribution was 78 cases (44.3%) in the thirties, 44 cases (25.0%) in the twenties, and 35 cases (19.9%) in the forties, and the mean age was 35.9±9.3. Heterosexual contact was the most frequent transmission route (92 cases, 52.3%), and 42 cases (23.9%) were transmitted by homosexual contact. At initial visit , asymptomatic HIV infection constituted 75 cases (42.6%), and AIDS 72 cases (40.9%). At initial visit, mean value of CD4+ lymphocyte counts was 252/mm3 and HIV RNA 226,035 copies/mm3. One hundred and twenty one of 176 patients developed 317 cases of opportunistic diseases. At the diagnosis of HIV-related opportunistic diseases, mean CD4+ lymphocyte count was 140/mm3 and mean HIV RNA 347,403 copies/mm3. Candidiasis (50 cases, 28.4%) was the most frequent opportunistic disease followed by pneumocystis carinii pneumonia (PCP) (37 cases, 21.0%), tuberculosis (29 cases, 16.5%), cytomegalovirus (CMV) infection (21 cases, 11.9%), HIV encephalopathy (9 cases, 5.1%), and herpes zoster (9 cases, 5.1%). There were 3 cases (1.7%) of malignant lymphoma and 2 cases (1.1%) of Kaposi's sarcoma. At the diagnosis of opportunistic diseases, mean CD4+ lymphocyte counts of patients with candidiasis was 71/mm3, PCP 63/mm3, and tuberculosis 142/mm3, and the mean HIV RNA level was 338,474 copies/mm3, 281,967 copies/mm3, and 817,012 copies/mm3 respectively. Among the 317 opportunistic diseases, AIDS-defining diseases were 150 cases (47.3%), of which PCP was 37 cases (24.7%), tuberculosis 29 cases (19.3%), CMV infection 21 cases (14.0%), HIV wasting syndrome 15 cases (10.0%), and esophageal candidiasis 14 cases (9.3%). The earliest AIDS-defining diseases to manifest in AIDS patients were tuberculosis (25 cases, 33.3%), followed by PCP (17 cases, 22.6%), esophageal candidiasis (14 cases, 18.7%), CMV infection (5 cases, 6.6%), and HIV wasting syndrome (4 cases, 5.3%). Thirty-five (19.9%) of 176 patients were died. The common causes of death were tuberculosis (9 cases, 25.7%), PCP (9 cases, 25.7%), bacterial pneumonia (7 cases, 20.0%) and HIV encephalopathy (3 cases, 8.5%). Conclusion: The epidemiologic and clinical features of HIV infection/AIDS in Korea are different from that of developing countries such as Southeast Asia and Africa as well as from that of developed countries. (Korean J Med 61:355-364, 2001)
칸디다뇨증 환자에 있어서 칸디다혈증 동반과 관련된 위험인자 분석
김창오(Chang Oh Kim),김명환(Myoung Hwan Kim),심대근(Dae Keun Shim),조정호(Jung Ho Cho),김병극(Byoung Keuk Kim),김창년(Chang Nyun Kim),송영구(Young Goo Song),김준명(June Myung Kim) 대한내과학회 2001 대한내과학회지 Vol.60 No.5
N/A Background : The early diagnosis of candidemia is critical for the management. The candidemia is known to be associated with 10% of candiduria. But the risk factors in patients with candiduria who are associated with candidemia are not known. We analyzed the risk factors in patients with candiduria who are associated with candidemia. Methods : We retrospectively reviewed 164 patients with candiduria in Yonsei Medical Center from January 1998 to December 1998. Candiduria patients were divided into two groups. Candiduria patients without candidemia (Group 1 , 147 patients) and candiduria patients with candidemia (Group 2 , 17 patients). Results : 1) The mean age of the patients were 57.5 years in group 1 and 62.5 years in group 2. There were no significant differences in the sex ratio between the two groups. 2) Central venous catheter insertion (53%, 100% in group 1 , 2 ), hypotension (14%, 59% in group 1, 2), other associated infections (64%, 100% in group 1, 2), intensive care (41, 76% in group 1, 2) and fever (46%, 82% in group 1, 2) were the very significant risk factors in patients with candiduria who were associated with candidemia. 3) Urinary tract procedure (11%, 88% in group 1, 2), urinary catheter insertion (63%, 94% in group 1, 2), thrombocytopenia (17%, 41% in group 1, 2) and DM (8%, 24% in group 1, 2) were the significant risk factors of candidemia. 4) Candida colony count (cfu/mL) of urine culture was not a significant risk factor 5 ) Mortality rate (27%, 59% in group 1, 2) was significantly high in patients with candidemia. Conclusion : Central venous catheter insertion , hypotension , other associated infections , intensive care and fever were the very significant risk factors of candidemia in patients with candiduria. (Korean J Med 60:479-484 , 2001)