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.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

상악동에 발생한 국균증 2례

조용석,김경원,박현진,강지연,이건국,신향미 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

국균증은 토양, 유기체 그리고 모든 형태의 유기물 잔사에 광범위하게 존재하는 국균 (Aspergillus) 속에 의하여 발병한다.이 균의 포자는 공기 중에서 전염될 수 있으므로 가장 흔한 감염 진균 중 하나이다.부비동에 발생한 국균증은 초기 임상 증상이 만성 부비동염과 유사하며, 방사선 사진 등을 이용한 검사상도 일반 세균성 감염과 구별하기가 매우 어렵다.대개는 병리조직학적 검사로 국균을 확인해서 확진을 내리게된다.국균증의 치료는 외과적으로 상악동내의 병소를 완전히 제거하고 비강에로 충분한 공기를 통기시키는 것이 가장 중요하며 보조적으로 전신적인 항진균제를 사용해야한다. 증례는 40세와 24세인 여자 환자들로서 전신적으로는 건강했으며 임상적 방사선적으로 만성 상악동 증세를 보였다.상악동 근치술을 시행하면서 국균종으로 여겨지는 암갈색 덩어리들이 관찰되었고 술 후 병리조직검사상 국균증으로 진단되었다.국균증으로 진단 후 보조적으로 전신적 항진균제를 투약하였으며 재발없이 치유되었다. Aspergillus is a fungus of the Acetomyces class that is most commonly encountered in the human environment.Aspergillosis of the maxillary sinus is not common and it requires special consideration to diagnose and eradicate. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. Generally the diagnosis of sinus aspergillosis can be confirmed by histologic examination, however, characteristic radiographic appearance such as coherene of radiodense sinus concretions can be found by careful examination of the radiograms. The choice of treatment of maxillary sinus aspergillosis is radical surgery with adjunctive systemic antifungal therapy. We experienced two cases of maxillary sinus aspergillosis, which initially diagnosed as chronic maxillary sinusitis and showed a necrotic mass intraoperatively and histologically diagnosed as aspergillosis.We reports theses cases with review of literature.

크랭크샤프트의 기상 계측 시스템 개발

조현용,이원재,조재완,김석일 한국공작기계학회 2008 한국공작기계학회 추계학술대회논문집 Vol.2008 No.-

On-machine measurement (OMM) is considered as an effective approach to increase productivity in small batch production. This paper presents a specialized OMM system based on a touch probe, which can be used to measure and estimate the accuracies of crankshaft machined by a 5-axis multitasking machines. Measurement paths were created based on the CAD model of crankshaft and probe radius compensation, and were verified by virtual measurements. An NC program was created by performing the postprocessing of measurement paths, and was transferred to the multitasking machine, directly via RS232C interface. And the accuracies of crankshaft were measured through the touch probe controlled by the NC program. Especially, this specialized OMM system is more effective in case of measuring a large crankshaft because of handling difficulty due to its huge size and heavy weight.

이중에너지 방사선 흡수계측법을 이용한 성인 남녀의 장골 및 경골의 골밀도에 관한 연구

조용석,김경원,이경호,박현진,서상수,오상엽 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Purpose : The aim of this study was to evaluate the bone mineral density of iliac and tibial bone which are frequently selected as autogenic bone graft donor sites, and to evaluate the efficiency of this method as a guideline for the selection of bone graft donor site. Materials and Methods : In this study 61 male and 70 female volunteers at Chungbuk National University Hospital were involved between Jan. 1998 to Sept. 1999. We measured bone mineral density of the iliac and the tibial bone using dual energy X-ray absorptiometry. We evaluated the data using the SAS system for Windows and bone mineral density of the lumbar was used for control. Results : Age showed the highest correlation in correlation matrix between physical and bone variables. Height and weight showed lower correlation of linear increment. In man, the change of bone density according to age demonstrated linear decrease irrespective of the lumbar, ilium, and tibia. In woman, the change of bone density according to age showed cubic form, which increased in the third and forth decade. So it had a peak bone mass on about 35 year-old, thereafter, the change of bone density slowly decreased until 50 year-old, but it rapidly decreased after 50 year-old and it slowly decreased again after 65 year-old. Both in all subjects and subject with osteoporosis, the change of bone mineral density according to age showed statistically significant decrease in lumbar and tibia, but ilium was irrespective. Conclusion : In patients of aged or with osteoporosis, ilium demonstrated less tendency of decrease in bone mineral density than tibla. So this preliminary study suggested that ilium seemed better donor site for autogenic bone graft than tibia.

Helicobacter pylori와 대장균의 Shuttle Vector 개발

조명제,이우곤,이상룡,김경희,안영숙,김성희,김현주,류복덕,최여정,윤영혜,백승철,전영석,이광호 경상대학교 유전공학연구소 1997 遺傳工學硏究所報 Vol.16 No.-

In this study, a vehicle vector using cryptic plasmids was constructed for gene transfer in Helicobacter pylori. pHP51(3.9 kb) and pHP489(1.2 kb) were selected for constructing vectors from cryptic plasmid of H. pylori isolates in Korea. The HindⅢ-digestedDNA fragment(1.2kb) of pHP489 and 1.6kb DNA fragment of pHP51 were ligated with a kanamycin resistance gene(aph3'-Ⅲ) from C. jejuni to produce the recombinant plasmids pHP489K and pHP51K, respectively. Transformation frequency of pHP51K by electroporation was low. But pHP489K could be effectively transformed into various H. pylori strains. In order to design an intermdiate vehicle vector for gene transfer into H. pylori, pBlueHP489K was prepared by recloning pHP489K DNA into pBluescript and pTZ19R vector. This vector permitted the DNA fragment containing pHP489 sequence, aph3'-Ⅲ, and cloned DNA to be cut and self-ligated in the SacⅠ site after cloning. ureA and ureB gene were inserted into pBlueHP489K, resulting in pBlueHP489K/AB. The DNA fragment containing pHP489, kanamycin resistance gene(aph3'-Ⅲ), and urease structural gene was cut away from pBlueHP489K/AB and self-ligated to generate pBlueHP489K/AB. pBlueHP489K/AB made urease-negative H. pylori strains restore their urease activity. By this experiment, pBlueHP489K was confirmed to be the vehicle system for transferring H. pylori genes.

WinC : EiC를 이용한 주체적 C 프로그래밍 언어 학습시스템 설계 및 구현

조상,현정식,이석희 청주대학교 산업과학연구소 2001 産業科學硏究 Vol.19 No.1

In this paper, we design and implement the Windows C language teaming system(WinC) using EiC(Extensible Interactive C). WinC provide visual programming environment for students in introductory C language, help students identify the problems when the program does not run correctly WinC provide debug environment which show the control flow of program and the values of all the variable Using this powerful tool, students can cultivate the ability to find the problems and correct them

전파조정기를 이용한 마이크로파 소자용 Calibration

석은영,조현광,서영석,한교용 영남대학교 공업기술연구소 2000 工業技術硏究所論文集 Vol.28 No.1

A microwave device measurement tool kit using the TRL method for microwave tuner was developed. Teflon substrate was used for easy manufacturing. An adapter from CDI was used for the junction transition between microstrip and coaxial line. Mask production procedure which have the 3:1 reduction ratio was developed for microstrip transmission line manufacturing. Using these procedure the Cal Kit which can have Thru, Reflect, and Line was manufactured. TRL error correction method can be applied to the Kit. We tested the Cal kit and the error due to the microstrip line could be corrected. It can be applicable to the accurate measurement of microwave transistors.

안면경련의 침구치료에 대한 문헌적 고찰

조현석,장준혁,김경호,윤종화,김갑성 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.7 No.2

편측 안면경련은 편측 안면근의 불수의적, 간헐적 수축으로서 심할 경우 안면 근력 약화 및 강직현상등이 나타나기도 하는 질환이다. 서양의학에서 편측 안면경련의 병태생리에 대한 가설은 크게 두가지로 대별되는데, 첫째는 중추성 가설(핵가설)이고, 둘째는 말초성가설이다. 치료방법은 대별하여 내과적 치료와 외과적 치료의 나눌 수 있는데, 외과적 치료가 다양하게 시행되어 왔으며, 근래에는 두개강내 미세혈관 감압술이 시행되고 있다. 韓醫學에서는 眼瞼痙攣울 眼胞振跳, 胞輪振跳라고 하고, 眼眉跳라고도 하며, 그 외 目瞬, 目跳, 眼皮跳 등의 이름으로도 불리운다. 外因으로는 風邪가 經絡에 侵入하는 것이며, 內因으로는 肝血虛한 中의 風邪가 兼하기 때문이다 따라서, 국부경혈 자침과 함께 장부변증에 따라 肝, 膽經 경혈의 사용과 합께 耳鍼T의 시술이 유용할 것으로 사료된다. Hemifacial spasm including blepharospasm is characterized by spontaneous clonic and tonic muscle spasm on one side of the face with synkinesis. Though the etiology of hemifacial spasm is not entirely understood, generally there are two. One is nuclear hypothesis and the other is peripheral hypothesis. There are two ways of treatment of hemifacial spasm. One is internal medicine and the other is operative method. In oriental medicine, hemifacial spasm is very similar to diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), or Anmido(眼眉跳) in symptoms. The diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), Anmido(眼眉跳) is related to the function of liver(肝) and risk factors are regarded as Pung(風). The acupuncture therapy of hemifacial spasm is based on Liver meridian(LV), Gallbladder meridian(GB), And ear-acupuncture is recommended as a good method for hemifacial spasm.

역행성 유도선을 이용한 굴곡성 기관지경을 통한 이중관 기관내관 삽관한 경험

조현석,김문철 인제대학교 2008 仁濟醫學 Vol.29 No.-

The use of a retrograde guidewire technique to assist in the management of the difficult airway was first reported in 1981. Since then, modifications of this technique have included the use of the fiberoptic bronchoscope (FOB) to permit tracheal intubation under direct visual control. We report here on the case of a 54-year-old female who was scheduled for an operation for esophageal diverticulectomy and she could not be intubated with double-lumen endotracheal tube. The cause was an esophageal bougie at the oral cavity, which made visualization of the glottis impossible. We perfomed alternative technique by passing a guidewire in a retrograde manner from the trachea to the mouth and then passing a fiberoptic bronchoscope within an endotracheal tube over the wire. No further complication occurred and surgery was finished satisfactory.