Slide Session : OS-IFD-07 ; Infectious Disease : In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus

( Myung Jin Lee ),( Kye Hyung Kim ),( Jong Youn Yi ),( Su Jin Choi ),( Chung Jong Kim ),( Nak Hyun Kim ),( Kyoung Ho Song ),( Pyoeng Gyun Choi ),( Ji Hwan Bang ),( Wan Beom Park ),( Eu Suk Kim ),( San 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus Myung Jin LEE1, Kye-Hyung KIM1, Jongyoun YI2, SuJin CHOI1, Chung-Jong KIM1, Nak- Hyun KIM1, Kyoung-Ho SONG1, Pyoeng Gyun CHOI1, Ji-Hwan BANG1, Wan Beom PARK1, Eu Suk KIM1, Sang-Won PARK1, Hong Bin KIM1, Nam Joong KIM1, Myoung- Don OH1 Seoul National University College of Medicine, Korea1, Pusan National University School of Medicine, Korea2 Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). No effective antiviral therapy is proven yet, but clinical use of ribavirin (RBV) has been tried. We investigated the antiviral effect of RBV against SFTSV in vitro. Methods: To test for cytotoxicity of RBV, Vero cells were treated with different concentrations of RBV (3.90 to 500 μg/mL, two-fold dilution) and analyzed by cell viability MTS assay 48h post-infection. To determine antiviral activity of RBV against SFTSV, Vero cells were infected with SFTSV strain Gangwon/Korea/2012 at 100 TCID50 (50% tissue culture infective dose) per well in a 96-well plate, and RBV was added at the concentrations showing no or minimal cytotoxicity. Viral RNAs were extracted from the culture supernatants and quantifi ed using one-step real-time reverse transcription- PCR to amplify the partial large segment of SFTSV. Statistical analysis was done by one-way ANOVA with Tukey`s post hoc test. Results: Cytotoxicity due to RBV was not observed at RBV concentration =31.3 μg/ mL. Viral RNAs at 24h post-RBV treatment were reduced with increasing RBV concentrations (1-32 μg/mL), compared with those of mock-treated cells (P <0.01, Figure). Half maximal inhibitory concentration (IC50) of RBV was 3.69 μg/mL at 24h post-RBV treatment. Conclusions: Our study shows that RBV has antiviral effect against SFTSV in a dose-dependent manner. Further studies are required to evaluate the effi cacy of RBV in SFTS.

시상하부-뇌하수체 질환에서 종합적 뇌하수체전엽 기능검사의 진단적 의의

김수동,김신우,김정국,하승우,김보완 慶北大學校 醫科大學 1993 慶北醫大誌 Vol.34 No.4

시상하부-뇌하수체질환의 기저질환에 따른 종합적 뇌하수체전엽 자극검사의 진단적 가치를 알아보고자 81례의 뇌하수체 기능부전증환자를 대상으로 시상하부질환군과 Sheehan증후군, 말단비대증과 프로랙틴종, 그리고 뇌하수체선종에서 시야장애가 동반된 군과 장애가 없는 군으로 나누고 기능검사의 결과를 비교하였다. 1. Sheehan증후군 15례 가운데 GH 및 cortisol결핍이 전례(각각 100%)에서 FSH, LH 및 TSH결핍이 11∼12례(73∼80%)에서 관찰되었고 13례(86%)에서는 TRH에 대한 PRL분비증가가 저하 또는 소실되었다. 두개인두종 10례를 포함한 시상하부질환 14례 가운데 12례(86%)는 PRL의 기저지가 비정상직으로 증가되어 있었으며 TRH자극에 대해 PRL분비 증가가 11례(79%)에서 둔화되어 있었다. GH분비능도 11례(79%)에서 저하되었으며 그 밖의 cortisol, LH, TSH, FSH의 순으로 분비능이 저하되어 있었으나 그 빈도는 Sheehan증후군에 비해 전반적으로 낮았다. 2. 말단비대증 18례 가운데 14례(78%)에서 GH기저치가 비정상적으로 증가되어 있었고 13례(72%)는 저혈당자극에 대해 정상적인 GH의 증가를 보였으며 8례(44%)에서 고프로랙틴 혈증이 동반되었다. 프로랙틴종 18례 가운데 전례(100%)에서 PRL기저치가 증가되었고 13례(72%)에서 TRH에 대한 PRL의 증가반응이 둔화되었다. LH, FSH, cortisol 및 TSH분비능의 장애는 말단비대증군에서 프로랙틴종에 비해 다소 높은 빈도를 보이는 경향이었다. 3. 뇌하수체선종 가운데 시야장애가 동반된 21례에서 시야장애가 없는 23례에 비해 GH, cortisol및 LH의 분비반응이 저하된 빈도가 다소 높은 경향이었다. 이상의 결과로 보아 종합적 뇌하수체전엽 기능검사는 시상하부-뇌하수체질환의 기저질환을 진단하는데 중요한 정보를 제공할 수 있다고 생각한다. The combined stimulation test using TRH, LHRH and insulin has allowed investigation of the reserve of all pituitary tropic hormones under physiological and pathological conditions. To evaluate the diagnostic efficacy of this test for differentiating the underlying causes of hypopituitarism, we analyzed retrospectively the results of these tests done in 81 patients with proven hypothalamo-pituitary disorders. 1. In 15 patients with Sheehan's syndrome as a typical type of primary hypopituitarism, responses of both GH and cortisol to insulin-induced hypoglycemia were decreased in 15 cases all (100% in both) and of FSH, LH and TSH in 11 to 12 cases(73-80%). Incremental response of prolactin(PRL) to TRH was diminished or absent in 13 cases(86%). In 14 patients with hypothalamic diseases, including 10 cases of craniopharyn-gioma, as a representative secondary hypopituitarism, the basal PRL levels were abnormally elevated in 12 cases (86%) and both responses of PRL to TRH and of GH to hypoglycemia were blunted in 11 cases (79% in both). The frequency of impaired cortisol secretion was 50%, followed by LH, TSH and FSH secretion : overall frequency much lower than in Sheehan's syndrome. 2. In 18 acromegalics with pituitary adenoma, basal GH levels were abnormally elevated in 14 cases(78%) and incremental responses of GH to hypoglycemia were found in 13(72%). Hyperprolactinemia was accompanied in 8 (44%). In 18 patients with prolactinoma, basal PRL levels were moderately to markedly elevated in all of them(100%) and responses of PRL to TRH were blunted in 13(72%). The frequency of impaired secretion of LH, FSH, cortisol and TSH was slightly higher in acromegalics than in patients with prolactinoma. 3. The frequency of impaired secretion of GH, cortisol and LH tended to be slightly higher in patients with pituitary adenoma associated with visual field defect than those without visual field defect. These results suggest that the combined pituitary stimulation test will give us some of reliable information for evaluating the underlying causes of hypopituitarism.

간호사들에서 월경전불쾌기분장애와 삶의 질, 사회직업기능 및 장애 간의 연관성

김선영,김재민,김웅장,양수진,김성완,신일선,윤진상 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : This study aimed to investigate the prospective associations of premenstrual dysphoric disorder (PMDD) with quality of life, socio-occupational function and disability. Methods : 170 nurses were recruited 6om two general hospitals. Interviews were made at baseline and at four follow-up points (two mid follicular phases and two late luteal phases ofthe two consecutive menstrual cycles). The baseline evaluation Consis-ted of sociodemographic characteristics and menstmal history. PMDD was diagnosed by DSM-IV criteria after observation of the two menstrual cycles. The follow-up evaluations were consisted ofthe World Health Organization Quality of Life-Brief form, the Social and Occupational Functioning Assessment Scale, and the World Health Organization Disability Assessment Scale-II. Results : PMDD was detected 15 (8.8%) of 170 participants. The PMDD group showed significantly worse quality of life and socio-occupational functioning than the none-PMDD group particularly at the late luteal phases. No significant differences were found in sociodemographic characteristics and menstrual history between those with and without PMDD. Conclusion : PMDD was prospectively associated with worse quality of life and socio-occupational functioning in this study group.

유명산의 식물상 및 산림군락분류에 관한 연구

김흥식,김인수,홍금희,김남영,박광서,김정유,박완근 江原大學校 森林科學硏究所 2003 Journal of Forest Science Vol.19 No.-

2002년 3월부터 2003년 10월까지 유명산 자연휴양림을 대상으로 식물상과 산림군락구조를 조사한 결과, 관속식물이 98과 331속 570종 1아종 81변종 4품종 2교잡종으로 총 658종류로 나타났으며, 한국특산식물은 10과 14속 13종 2변종 1교잡종 총 16종류. 희귀 및 멸종위기식물은 9과 10속 11종 총 11종류, 귀화식물은 12과 22속 28종 총 28종류로 나타났다. 산림군락은 신갈나무-철쭉군목, 신갈나무-생강나무군단, 소나무-산거울군락, 잣나무-주름조개풀군락, 물푸레나무-신갈나무군락, 층층나무-신갈나무군락, 굴참나무-신갈나무군락, 싸리-신갈나무군락으로 전체 1군목, 1군단, 6군락이 분포하는 것으로 나타났다. The study was carried out to investigate the flora and community classification of forest vegetation in Mt. Yumyeong from March, 2002 to October, 2003. As a result of that, the vascular plants were 98 families, 331 genera, 570 species. 1 subspecies, 81 varieties, 4 formae, 2 hybrid, 658 taxa in all. Korean endemic plants were 10 families, 14 genera, 13 species, 2 variaties, 1 hybrid. 16 taxa in all ;, rare and endangered plants were 9 families, 10 genera. 11 species, 11 taxa in all ; naturalized plants were 12 families, 22 genera, 28 species, 28 taxa in all. The forest vegetation was classified into 1 order, 1 alliance. 6 communities : Rhododendro - Quercetalia mongolicae (Kim, 1990) Lindero - Quercion mongolicae (Kim, 1990) A. Carex humilis var. nana - Pinus densiflora Community B. Oplismenus undulatifolius - Pinus koraiensis Community C. Fraxinius rhynchophylla - Quercus mongolica Community D. Cornus controversa - Quercus mongolica Community E. Quercus variabilis - Quercus mongolica Community F. Lespedeza bicolor - Quercus mongolica Community

급성 백혈병 환자에서 수두양 피부병변을 보인 파종성 Fusarium 감염 1예와 국내 파종성 Fusarium 감염증에 대한 고찰

오수진,정희선,김준성,김태석,조병식,최수미,김명신,이연수,이석,신완식 대한감염학회 2007 감염과 화학요법 Vol.39 No.5

최근 면역저하환자의 증가와 함에 국내에서도 점차 침습성, 파종성 Fusarium 감염증 보고가 증가하고 있다. Fusarium 감염은 아스페르길루스 감염과 유사한 임상양상을 보이지만 특징적인 피부병변을 동반하고 혈액배양에서 균이 분리되는 경우가 더 많다. 저자들은 급성 림프구성 백혈병으로 진단받고 치료중인 30세 남자 환자에서 중증의 호중구 감소 상태에서 비특이적인 피부병변을 동반한 파종성 Fusarium 혈류감염을 경험하였기에 국내 증례 고찰과 함께 보고하는 바이다. 환자의 초기 피부병변은 구진에서 시작하여 주로 소포성 병변과 일부 통증을 동반한 결절 등 여러 형태로 나타났고, Tzank 도말검사 양성으로 비정형 수두로 오인되었다. 이후 피부병변은 농포로 변하였고, 혈액배양 및 피부 조직검사에서 파종성 Fusarium 감염으로 진단받았다. 환자는 liposomal amphotericin B, voriconazole 병합요법과 G-CSF 투여, 과립구 수혈을 받았으나, 호중구 감소증에서 회복하지 못하고 급성 호흡곤란증후군과 다장기 기능부전으로 사망하였다. 본 증례는 파종성 Fusarium 감염의 경우에도 수두양 병변으로 비특이적인 양상으로 나타날 수 있으므로, 감별진단을 위해 적극적으로 혈액배양과 피부조직검사를 시행해야 함을 보여준다. Recently, we experienced a case of disseminated fusarial blood stream infection with varicelloid skin eruptions, who had suffered from persistent neutropenic fever after salvage chemotherapy for relapsed acute lymphocytic leukemia (ALL). Neutropenia continued in spite of G-CSF and granulocyte transfusion, and he failed to respond to conventional amphotericin B initially, and then liposomal amphotericin B and voriconazole combination therapy. Disseminated fusariosis can be diagnosed by blood cultures in 50% of patients and present skin lesions in more than 80% of patients. So, typical skin lesions are important clue to diagnose of the disseminated fusariosis. However, many skin lesions in immunocompromised hosts are due to various infectious and non-infectious causes. So, this case shows that it is important to obtain biopsy specimens of skin lesions for histopathologic examination, culture and staining. Here, we present our case with the review of the literatures reported in our country, so far.

흰쥐의 원위콩팥단위내 칼슘결합단백질 (calbindin-D28k)에 관한 면역세포화학적 연구

김영희,김완영,김인범,한승호,오수자,차정호,김진 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.6

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

전자구개도(EPG)를 이용한 한국어 치경마찰음 /ㅅ, ㅆ/의 조음운동적 특성

김지영(Ji-Yeong Kim),우승탁(Seong-Tak Woo),김미진(Mi-Jin Kim),오다희(Da-Hee Oh),김수진(Su-Jin Kim),하지완(Ji-Wan Ha) 한국언어청각임상학회 2021 Communication Sciences and Disorders Vol.26 No.2

배경 및 목적: 본 연구는 전자구개도를 사용하여 한국어의 치경마찰음인 /ㅅ/와 /ㅆ/를 조음운동적 측면에서 비교 분석해보고, 치경마찰음 조음 시 나타나는 혀-구개 접촉에 관한 정보를 제공하기 위한 목적으로 시행되었다. 방법: 한국어가 모국어이며 발음에 문제가 없는 정상 성인 5명이 전자구개도를 착용하여 치경마찰음을 분절음 차원에서뿐 아니라 단어 내 위치 및 모음문맥을 달리하여 녹음한 후 팰라토그램을 분석하였다. 결과: 그 결과, /ㅅ/와 /ㅆ/는 협착의 너비와 혀-구개 최대접촉구간에서 유의한 차이를 보였다. /ㅆ/에서 협착의 너비가 더 좁고 전체 혀-구개 접촉구간은 더 넓게 나타났다. 단어 내 위치에 따른 차이는 유의하지 않았지만, 고모음인 /ㅣ/ 문맥에서는 저모음인 /ㅏ/에 비해 협착의 위치가 후방화되었으며, 지속시간도 가장 긴 것으로 나타났다. 또한 혀-구개 접촉 구간도 가장 넓게 나타났다. 논의 및 결론: 본 연구는 전자구개도를 사용하여 한국어 치경마찰음의 혀와 구개 접촉에 관한 정보를 제공했다는 점에서 그 의의를 갖는다. 또한 본 연구의 결과는 한국형 전자구개도의 개발의 기초자료로써 그 의미가 있다. Objectives: The present study is aimed an electropalatographic investigation of Korean fricatives /s/ and /s*/. All data from this study is based on the production of 5- adult speakers who speak Korean as their first language. Methods: Electropalatography (EPG) is an instrumental technique for showing tongue and palate contact during speech. The participants recorded /s/ and /s*/ in CV (/si/, /sɑ/, /su/, /s*i/, /s*ɑ/, /s*u/) and VCV (/ɑsi/, /ɑsɑ/, /ɑsu/, /ɑs*i/, /ɑs*ɑ/, /ɑs*u/) context using EPG and then, four variables were analyzed: row of medial groove (RMG), medial groove width (MGW), medial groove length (MGL), and maximum contact frame (MCF). Results: There was significantly greater medial groove width and maximum contact frame for / s*/ compared to /s/. The difference between /si/ and /sɑ/ was also found in the row of medial groove, medial groove width and maximum contact frame. /si/ was produced further back, and had a longer medial groove length. Also, it showed more total tongue-palate contact than /sa/. Conclusion: A various range of palatal contact patterns were found between typical adults for perceptually normal /s/ and /s*/. The results provided the information about tongue–palate pattern of Korean fricatives /s/ and /s*/. These findings would be utilized to build the basic data and useful information for Korean EPG system.

ESD(Electrospray Deposition)를 이용한 SU8 바이오센서 개발

김준완,김범준,히구찌토시로우,야마가따유따까,이원희,김동수,Kim, Jun-Wan,Kim, Beom-Jun,HiGuChi, Toshirowu,YaMaGaTa, Yutaka,Lee, Won-Hui,Kim, Dong-Su 재료연구소 2005 機械와 材料 Vol.17 No.1