괴테 문학에서의 사징 개념

장희창 문예미학회 1996 문예미학 Vol.2 No.1

Inappropriateness of Quinolone in Scrub Typhus Treatment Due to gyrA Mutation in Orientia tsutsugamushi Boryong Strain

장희창,최수미,장미옥,안준환,김의진,강승지,신종희,최현일,정숙인,박경화 대한의학회 2013 Journal of Korean medical science Vol.28 No.5

The use of quinolone for treatment of rickettsial diseases remains controversial. Recent clinical studies suggest that quinolone is not as effective as others in patients with rickettsial diseases including scrub typhus, although the mechanism is not well understood. In this study, we evaluated the mutation in gyrA associated with quinolone resistance. We prospectively enrolled scrub typhus patients, collected blood samples and clinical data from October, 2010 to November, 2011. Among the 21 patients enrolled, one initially received ciprofloxacin for 3 days but was switched to doxycycline due to clinical deterioration. We obtained the gyrA gene of Orientia tsutsugamushi from 21 samples (20 Boryong strain, 1Kato strain) and sequenced the quinolone resistance-determining region. All of 21 samples had the Ser83Leu mutation in the gyrA gene, which is known to be associated with quinolone resistance. This suggests that quinolones may be avoided for the treatment of serious scrub typhus.

Gentamicin 고도내성 장구균의 임상양상과 치료결과

장희창,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한내과학회 2004 대한내과학회 추계학술대회 Vol.2004 No.1

생태적 관점에서 본 괴테 문학

장희창 (사)민족미학연구소/이론과실천 2003 민족미학 Vol.2 No.-

괴테 「 색채론 」 의 구조와 그 현대적 의미

장희창 한국괴테학회 1999 괴테연구 Vol.11 No.-

Goethe wehrt sich von Anbeginn gegen Newtons Definition der Farbe als objektiven Bestandteils des Lichts, denn die auf das MeBbare und Quantitative gerichtete Erkla¨rung la¨ßt gerade das fu¨r ihn Wesentliche außer acht: der Farbe spezifische Qualita¨t, wie sie uns in Gelb. Rot und Blau entgegentritt. Erst durch die Verwandlung des Lichts im Auge des Sehenden entsteht Farbe von bestimmter Pra¨gung. Goethe will weder das Auge noch das Licht untersuchen; er setzt sie als bekannt voraus. Ihn bescha¨ftigt vielmehr die lebendige Beziehung beider, wie sie sich in den Farben manifestiert. Er experimentiert zwar, aber seine Versuche unterscheiden sich von denen der Naturwissenschaft darin, daß sie ihren Gegenstand weder aus dem Zusammenhang mit den u¨brigen Erscheinungen noch aus der Verbindung mit dem Beobachter lo¨sen, wobei weitgehend der Erlebnischarakter gewahrt wird. Gerade dieser Charakter, diese lebedige Beziehung erscheint in den Werken Goethes als Urpha¨nomen. Die Urpha¨nomene erachtet Goethe als dem Menschen ada¨quate Formen der Erkenntnis und Anschauung. In ihnen werden die gestaltenden Kra¨fte der Natur im Bild faßbar. Wa¨hrend es urspru¨nglich das Ziel jeder Naturforschung war, die Natur mo¨glichst so zu beschreiben, wie sie an sich, d. h. ohne unseren Eingriff und ohne unsere Beobachtung wa¨re, so erkennen wir, daß eben dieses Ziel unerreichbar. Eben deswegen richten einige Physiker der Moderne auf Goethes Denkweise. Goethe hat vorausgeahnt, daß die fortschreitende Umgestaltung der Welt durch die Verbindung von Technik und Naturwissenschaft sehr gefa¨rlich sei. Also wird vor allem hervorgehoben, daß Goethes Naturbetrachtung vom Menschen ausgehe, daß in ihr der Mensch und sein unmittelbares Naturerlebnis den Mittelpunkt bilde, von dem aus sich die Erscheinung in eine sinnvolle Ordnung fu¨gen. Eben darin ko¨nnten wir sogar den Ansatzpunkt der modernen o¨kologischen Denkweise sehen.

Clinical Features, Risk Factors and Outcomes of Bacteremia due to Enterococci with High-Level Gentamicin Resistance: Comparison with Bacteremia due to Enterococci without High-Level Gentamicin Resistance

장희창,이신원,송경호,전재현,박완범,박상원,김홍빈,김남중,김의종,오명돈,최강원 대한의학회 2010 Journal of Korean medical science Vol.25 No.1

High-level gentamicin resistance (HLGR) in enterococci has increased since the 1980s, but the clinical significance of the resistance and its impact on outcome have not been established. One hundred and thirty-six patients with bacteremia caused by enterococci with HLGR (HLGR group) were compared with 79 patients with bacteremia caused by enterococci without HLGR (non-HLGR group). Hematologic malignancy,neutropenia, Enterococcus faecium infection, nosocomial infection and monomicrobial bacteremia were more common in the HLGR group than the non-HLGR group, and APACHE II scores were also higher (P<0.05, in each case). Neutropenia,monomicrobial infection, stay in intensive care at culture, and use of 3rd generation cephalosporin, were independent risk factors for acquisition of HLGR enterococcal bacteremia. Fourteen-day and 30-day mortalities were higher in the HLGR group than the non-HLGR group in univariate analysis (37% vs. 15%, P=0.001; 50%vs. 22%, P<0.001). However, HLGR was not an independent risk factor for mortality due to enterococcal bacteremia in multivariate analysis. Therefore, HLGR enterococcal bacteremia is associated with more severe comorbid conditions and higher mortality than non-HLGR enterococcal bacteremia but the HLGR itself does not contribute significantly to mortality.

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서 보다 10.9배 높았다. 결론 : 2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background : This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods : A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results : In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion : The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 Infection and Chemotherapy Vol.36 No.6

목 적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결 과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이 기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서보다 10.9배 높았다. 결 론:2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background:This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods:A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results:In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion:The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

괴테 문학-그 저항과 순응의 역사적 기록

장희창 새얼문화재단 1999 황해문화 Vol.24 No.-

First Imported Case of Zika Virus Infection into Korea

장희창,박완범,김우진,전준영,최수진,최평균,정숙인,지영미,김남중,최은화,오명돈 대한의학회 2016 Journal of Korean medical science Vol.31 No.7

Since Zika virus has been spreading rapidly in the Americas from 2015, the outbreak of Zika virus infection becomes a global health emergency because it can cause neurological complications and adverse fetal outcome including microcephaly. Here, we report clinical manifestations and virus isolation findings from a case of Zika virus infection imported from Brazil. The patient, 43-year-old Korean man, developed fever, myalgia, eyeball pain, and maculopapular rash, but not neurological manifestations. Zika virus was isolated from his semen, and reverse-transcriptase PCR was positive for the virus in the blood, urine, and saliva on the 7th day of the illness but was negative on the 21st day. He recovered spontaneously without any neurological complications. He is the first case of Zika virus infection in Korea imported from Brazil.