정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

산지하천에서 빛과 초식에 의한 부착조류의 생체량변화

김현우,김현주,김진수,윤해순,주기재 東亞大學校附設基礎科學硏究所 1998 基礎科學硏究論文集 Vol.15 No.1

빛과 초식에 의한 부착조류의 생체량 변화에 대한 영향을 평가하기 위하여 자연기질과 인공기질(유약을 칠하지 않은 타일: 3.7×9.5×2cm)을 이용하여 부분적으로 음지화된 2차 산지하천에서 실험하였다. Open canopy(상대적 빛 투과율: 20∼50%, chl. a: 9.5±3.0㎎/㎡, n=25)에서는 closed canopy(<6% 상대적 빛 투과율, 3.2±0.9㎎/㎡, n=17)보다 높은 부착조류 생체량을 유지하였다. 하천 주변식생의 잎 성숙과 잦은 강우에 의해서 여름의 부착조류 생체량은 봄과 겨울에 비하여 낮았다. 봄에 인공기질에 부착조류가 부착하는 속도는 겨울보다 빨랐으며 겨울에는 자연기질 수준(8∼9㎎/㎡)에 이르기 까지 최소 5∼6주 정도 소요되었다. 초식자인 다슬기는 출입을 제한한 실험구에서는 출입이 허용된 대조구보다 약간 높은 생체량(AFDW, chl. a)을 보였다. 결론적으로 빛이 부착조류 생체량에 증가에 미치는 영향은 초식 보다는 더 큰 것으로 사료된다. Effects of light and grazing on the biomass development of periphyton were evaluated using natural and artificial substrata (unglazed tile: 3.7×9.5×2cm) in a partially shaded 2nd order mountain stream. In open canopy (relative light input 20∼50%), a relatively high biomass (chl. a: 9.5±3.0㎎/㎡, n=25) was maintained than that of closed canopy (<6% of light input, 3.2±0.9㎎/㎡, n=17). Due to shading and frequent rainfalls, biomass was lower during the summer than in the spring and winter. During the spring, colonization of periphyton on artificial substrata occurred faster than in winter and it took a minimum of 5∼6 weeks to reach the biomass of natural substrata (8∼9㎎/㎡). When snails were allowed to freely enter the chamber (mean density: 114 ind./㎡) with artificial substrata, biomass accumulation (chl. a, AFDW) was low compared to the snail excluded enclosure (50∼90% of ungrazed substrata). It was concluded that the light input on periphyton biomass in a partially shaded stream played a more important role than grazing.

가토의 하악골 연장시 Sodium fluoride 투여가 골형성에 미치는 영향

김용하,설정현,변우목,김정철,우상현,강무석 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.4

The purpose of this study was to improve bone formation and shorten the period involved in distraction osteogenesis using sodium fluoride (NaF). This has been used in managing osteoporosis for several decades. This study was carried out on 40 New Zealand white rabbits. Twenty animals were used for a control group (no medication) and 20 for the experimental group. NaF 1 mg/kg/day was administered to each experimental animal via drinking water beginning 4 weeks prior to surgery and continued until sacrifice for examination. A distraction device was applied to the left mandible along a plane perpendicular to the direction of osteotomy. After a 5-day latent period, the mandibles were lengthened at 1 mm per 24 hours for 10 days. Five rabbits from each group were sacrificed on the 1st day, 2nd week, 4th week and 8th week of the consolidation period. After lengthening, all the rabbits developed a severe cross-bite. By the 4th week, cortical continuity was seen. Bone densities at the site of bony lengthening were measured by quantitative computer tomography (QCT) and dual X-ray absorptiometry (DXA). The results were as follows: the measurements of the experimental group were significantly higher than of the control group by the 1st day of the consolidation period (p<0.05) and insignificantly higher after the 2nd week. Histologically, in the experimental group, there were more osteoblasts, increased and thickened trabeculae and more mature lamellar bones than in the control group. This study showed that osteogenesis of the experimental group was significantly higher during and immediately after distraction. Our study suggested that the use of NaF could improve bone formation and decrease the period of distraction osteogenesis if a safe dose and method of fluoride administration can be determined for growing humans.

최대 칩두께를 이용한 쏘블레이드에서 칩핑과정의 역학적 모델링

김경우,김우순,최현민,김동현 한국공작기계학회 2001 한국공작기계학회 춘계학술대회논문집 Vol.2001 No.-

In order to establish the optimum process parameters and diamond saw blade composition for machining natural stone, the chip formation process and the wear process must be understood. Diamond saw blade is one of the most effective, versatile, and extensively used methods of processing rock and other hard materials, such as granite, marble, concrete and asphalt. For many years, it has been known that chip thickness is one of the most significant in the understanding of the sawing process, and other variables such as force and power have been correlated with it. In this study, mathematical relations of a material chipped by a single grit of the saw blade will be undertaken. The material chipping geometries have been mathematically defined and derived as maximum chip thickness.

피질골 절제술을 응용한 견치 및 대구치의 후방 견인

김상철,김선영,김현숙,정혜승,김현태,조진우 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.2

빠르며 정확하고 안전한 치아이동을 목표로 삼고 있는 교정치료에서 최근 새로이 도입된 피질골 절제술과 견인 골형성술을 응용한 치아이동에 대하여 알아보았다. 특히 견치나 대구치의 후방이동은 기존의 치아 이동 양식으로는 조절이 어렵고, 장기적인 기간에 불가피한 치아이동이다. 피질골 절제술과 견인 골형성술을 동반하여 상당히 효과적인 원심이동을 기할 수 있었던 증례를 통하여 적용 술식, 견인 장치 등을 논하고 그효과를 파악하였다. 이런 술식을 통해 빠른 치아 이동과 이에 따른 전반적인 치료기간의 감소가 가능하였으며, 무리한 치아이동에서 발생할 수 있는 고정원 소실이나 치근흡수, 치주조직의 파괴 같은 부작용도 줄일 수 있었다. Tooth movement facilitated by corticotomy and distraction osteogenesis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed. Active bone deposition was then possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment, which lead to the reduction of the total treatment period. Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or periodontal breakdown.

공구형상이 칩유동에 미치는 영향에 관한 연구

김경우,김우순,윤주식,채왕석,김동현 한국공작기계학회 2000 한국공작기계학회 추계학술대회논문집 Vol.2000 No.-

A new methodology is presented to evaluate material properties at high strain rates and high temperatures based on orthogonal metal cutting experiments and FEM simulations. Average strain rate and average temperature found in the deformation zone are computed and flow stress data at these conditions are modified until cutting forces calculated in simulations match those determined in experiments. Material properties obtained from this method were verified by additional metal cutting simulations. Derivation from cutting forces measured in experiments was less than 10%. The feasibility of tool design using FEM simulations is also demonstrated.

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,

PCR을 이용한 국내시장에 유통중인 유전자재조합 콩 및 가공식품의 모니터링

김묘영,김재환,김현중,박선희,우건조,김해영 한국응용생명화학회 2003 Applied Biological Chemistry (Appl Biol Chem) Vol.46 No.4

본 연구에서는 PCR을 이용하여 국내시장에 유통중인 원료콩과 가공식품에 epsps 또는 pat 유전자가 삽입된 유전자재조합 콩(GMS)의 사용여부를 모니터링하였다. 이러한 GMS의 검출을 위해 3쌍의 primer set을 제작하였고, 각각의 primer들은 GMS에 삽입된 유전자와 특이적으로 반응하여 PCR산물을 생성하였다. 2001년 표시제가 시행되기 이전에 생산된 총 가공식품과 이후의 제품에 대해 각각 모니터링을 수행하였으며, 표시제 이전에 생산된 제품의 경우 대부분의 미국산 원료에서 esps가 삽입된 GMS가 검출되었으나, 표시제 이후에는 검출되지 않았다. A method using PCR was developed for the monitoring of genetically modified soybean (GMS) and GMS derived foods utilized in the market. We designed 3 pairs of specific oligonucleotide primers based on epsps and pat inserted in GMS and ferritin gene as internal standards. Template DNAs isolated from soybean and processed foods were used for multiplex PCR with 3 primer sets. PCR, used with specific primer sets for GMS detection, showed the amplified DNA fragments with GMS template DNA. In this study, GMS containing epsps was detected from soy processed foods manufactured before GM food labeling system, however, GMS containing epsps or pat was not detected from soy processed foods manufactured after GM food labeling system.