당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

교대로 운전되는 두 개의 UV/광촉매반응기로 구성된 폐가스 처리시스템에서의 광촉매의 비활성화 및 재생 특성

이은주 ( Eun Ju Lee ),정찬홍 ( Chan Hong Chung ),임광희 ( Kwang-hee Lim ) 한국화학공학회 2021 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.59 No.4

본 연구에서는 교대로 운전되는 두 개의 UV/광촉매 반응기로 구성된 폐가스 처리시스템의 운전단계와 단계별 광촉매의 비활성화의 상관관계를 사용된 광촉매에 대한 기기분석을 통하여 규명하였다. 선행연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]의 광촉매 반응기 시스템 운전에 사용되지 않은 광촉매를 담지한 다공성 SiO₂ 담체(A4), 1회 운전하는 동안 사용되고 재생을 경험하지 않은 광촉매를 담지한 다공성 SiO₂ 담체(A1), 2회 운전에 사용되고 1회 재생된 광촉매를 담지한 다공성 SiO₂ 담체(A2) 및 3회 운전에 사용되고 2회 재생된 광촉매를 담지한 다공성SiO₂ 담체(A3)와, 1차 재생(AD1) 또는 3차 재생(AD3)된 광촉매를 담지한 다공성 SiO₂ 담체에 대한 BET 분석, SEM, XPS, SEM-EDS 및 FTIR 분석 등을 수행하여, 광촉매를 담지한 다공성 SiO₂ 담체의 비활성화 및 재생 특성을 포함하는 특성 분석을 수행하였다. 그 결과로서, 3회 이상의 여러 번 재생을 수행하는 광촉매의 적정 재생 온도를 200℃ 미만으로 도출하였다. 이러한 광촉매의 적정 재생 온도는 BET 분석결과에서 도출된 기공에 흡착된 에탄올 산화분해 중간생성물의 대부분이 완전 분해가 되어 기공이 재생되는 재생 온도와 거의 일치하였다. 특히, XPS 분석 결과는, 선행 연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]에서 광촉매 반응기의 첫 번째 운전 후에 광촉매의 미세한 비활성화가 발생하였음을 나타내었다. 또한, XPS 분석 결과는, 선행연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]에서 광촉매 반응기의 두 번째 운전에서 비교적 큰 광촉매의 비활성화가 발생하여 첫번째 운전성능보다 약 5%만큼 못 미치는 에탄올과 황화수소 각각의 제거효율을 초래하였으나, 세 번째 운전에서의 에탄올과 황화수소의 제거효율은 두 번째 운전에서의 에탄올과 황화수소의 제거효율 실험 결과와 거의 비슷하였다는 연구 결과와 일치하였다. 한편, AD3를 사용하여 선행연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]에서와 같은 광촉매 반응기의 네 번째 운전을 수행할 것을 가정하면, 두 번째 운전에서보다 더 큰 광촉매의 비가역적 비활성화의 발생으로 인하여 에탄올과 황화수소 제거효율이 가장 크게 저하되리라 예상되었다. In this study, the correlation between operating stages of waste air-treating system composed of two alternatively-operating UV/photocatalytic reactors, and the deactivation of photocatalyst used in each operating stage, was investigated by instrumental analysis thereon. The repeated deactivation and subsequent re-generation of photocatalyst used in the waste air treating system of previous investigation performed by Lee and Lim (Korean Chem. Eng. Research, 59(4), 574-583(2021)), were characterized on virgin photocatalyst-carrying porous SiO₂ media (A4), used photocatalystcarrying porous SiO₂ media (A1, A2 and A3) collected from the corresponding photocatalytic reactor upon 1^st, 2^nd, and 3^rd run, respectively, regenerated photocatalyst-carrying porous SiO₂ media upon 1 time-run (AD1) and 3 times regenerated photocatalyst-carrying porous SiO₂ media upon 3 time-runs (AD3) by instrumental analysis including BET analysis, SEM, XPS, SEM-EDS and FT-IR. As a result, the proper regeneration-temperature for deactivated photocatalyst to be regenerated several times (more than 3 times), was suggested below 200℃. Such temperature of deactivated photocatalystregeneration was almost consistent to the one, according to BET analysis, at which tiny nano-pores blocked by adsorbed ethanol-oxidative and degraded intermediates (AEODI), were regenerated to be reopened through almost complete mineralization of AEODI. In particular, the results of XPS analysis indicated an incurrence of insignificant deactivation of photocatalysis upon 1^st run of UV/photocatalytic reactor (A or C) of the previous investigation. In addition, the results of XPS analysis were consistent with the experimental results of the previous investigation in that 1) deactivation of photocatalyst incurred during 2^nd run of the UV/photocatalytic reactor (A or C) resulted in decreased removal efficiency, by ca. 5% and 5%, of ethanol and hydrogen sulfide, respectively, compared with its 1^st run; 2) there was insignificant difference between the removal efficiencies of its 2^nd run and 3^rd run. Furthermore, the removal efficiencies of ethanol and hydrogen sulfide for hypothetical 4^th run of photocatalytic reactor in the previous investigation, using AD3, were expected to decrease, compared with its 3^rd run, by much more than those for 2^nd run in the previous investigation did, compared with its 1^st run.

대전시 노은 도매시장 채소류의 농약 잔류 실태 및 식이섭취량 추정

한국탁,이규승,이은경,이용재,고광용,원동준,이정원,권순덕 한국환경농학회 2003 한국환경농학회지 Vol.22 No.3

대전시 노은 도매시장에서 채취한 6종의 채소류 중 농약잔류량을 조사한 후 이에 대한 위해성 평가를 실시하였다. 전체 100건의 분석시료 중 농약이 검출된 시료의 비율은 46.0%이었고, 잔류허용기준 초과비율은 6.0% 이었다. 검출비율이 높은 시료는 상추(85.0%), 깻잎(80.0%), 오이(60.0%) 순이었고, 상추 3건, 깻잎 3건이 허용기준을 초과하였다. 살균제는 dicar-boximide계, 유기염소계, azole계 농약, 살충제는 유기인계, 합성 pyrethroid계 농약이 많이 검출되었다. 검출빈도가 높은 성분은 procymidone, chlorpyrifos, chlorothalonil, cypermethrin, EPN의 순이었다. 위해성을 평가하기 위해서 각 농작물에 대한 농약의 추정 섭취량과 ADI를 비교한 결과, 허용기준을 초과한 깻잎의 bitertanol, triflumizole, iprobenphos가 다른 성분에 비하여 높은 비율을 보였다. 그러나 각 농산물의 식이섭취량이 적어 ADI에 대한 추정섭취량의 비율이 0.46%이하로 나타나 그 영향이 매우 낮은 것으로 판단되었다. Pesticide residues in some vegetables collected at Noeun wholesale market in Daejeon were surveyed and assessed their risk In 100 samples, the detection rate of pesticide was 46.0% and the rate exceed MRL was 6.0%. Commodities showing high detection rate were lettuce(85.0%), perilla leaf(80.0%) and cucumber(60.0%). Dicarboximide, organochlorine, and azole fungicides and organophosphorus and pyrethroid insecticides were detected. Detection frequency of pesticide was in the order of procymidone, chlorpyrifos, chlerothalonil, cypermethrin and EPN. When the estimated intake amount of the pesticides were compared with ADI to assess their risk, bitertanol, triflumizole and iprobenphos in perilla leaf were higher rate than the other vegetables. However the total amounts of intake of pesticides were estimated to less than 0.46% of ADI.

만성 신부전증 환자의 중중 고혈당에 따른 의식 변화 결정에 대한 연구

위형중,이창범,박성광,강성귀,임천규,박은주,윤경택,한상웅,안유헌,김호중· 대한신장학회 2000 대한신장학회잡지 Vol.19 No.6

Prostaglandin F_2 alpha가 흰쥐의 적출심방 자율수축에 미치는 효과

李光潤,朱永恩 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1

Postaglandin F_2 alpha(PGF_2α)의 심근에 대한 직접적인 효과를 측정하기 위하여, 체중 22O∼250의 건강한 흰쥐의 심방을 적출하여 99.5%의 산소로 포화시킨 38℃의 Locke씨 영양액 내에서 myography하였다. PGF_2α 첨가하지 않은 군에서는(대조군, 13례) Magnus조에 현수한후 50분부터 70분까지 20분 동안 일정한 수축력과 수축빈도를 유지하였다. PGF_2α를 2.82×10 exp(-7)M의 농도로 첨가한 A군(8례)에서는 약물 첨가후 2분부터 수축력의 유의한 증가를, 8분부터는 수축빈도의 유의한 증가를 볼 수 있었다. PGF_2α를 2.82×10 exp(-8)M의 농로로 첨가한 B군(8례에서는 수축력의 변화는 A군과 유사하나 수축빈도는 약물 첨가후 20분에 유의한 증가를 보였다. A, B양군에서 심근의 수축기와 이완기의 시간적 관계를 조사해 본 결과, A군과 B군 모두에서 수축기는 약 0.03초로서 수축빈도에 상관없이 일정하며, 이는 대조군의 경우와 같다. 이완기는 그 시간이 A군과 B군에서 모두 수축빈도와 높은 역상관관계를 나타내었으며, 이는 대조군의 경우와 차이가 없다. 이상의 결과를 종합하면 PGF_2α는 본 실험의 조건하에서는 흰쥐의 적출심방근에 직접 작용하여 양성(positive)의 변력성작용(inotropic action)을 나타내는 동시에 이완기 시간을 단축시킴으로써 양성의 변시성작용(chronotropic action)을 나타내었다. The direct effects of prostaglandin F_2 alpha (PGF_2α) on the contractile activity of the isolated rat atria were investigated. The isolated rat atria were suspended in the Magnus bath which contained 70 ㎖ of Locke's solution perfused with 99.5% of oxygen at 38℃. Observing that the control group showed highly stabilized contractility and contraction rate from 50 min to 70 min after the preparation, PGF_2α in two different concentrations, i.e; 2.82×10 exp(-7)M (group A) and 2.82×10 exp(-8)M(group B) was added to the medium. Group A showed a significant increase in contractility in 2 min, and in contraction rate in 8 min. Group B showed a significant increase in contractility in 2 min, and in contraction rate in 20 min. The duration of the contraction phase showed no significant difference in each group, which however showed different frequencies of the contractions per min. But the decrease in the duration of the relaxation phase in each group was highly correlated with the increase of the contraction rate. In conclusion, under the experimental conditions of the present study, PGF_2α seems to have a direct positive inotropic action, and a positive chronotropic action with shortening of the duration of the relaxation phase in the isolated rat atrium.

우측 대장에 발생한 연소성 용종 1예

이준식,박성한,홍현진,안광순,김지연,배용목,이은영,박선자 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Juvenile polyp, also known as a retention polyp because they contain mucin cysts, is a relatively common hamartomatous lesion in chlidhood. It occurs in 1-2% of children and young adults; however it is uncommon in adulthood. Juvenile polyp is rare in the first year of life and is thus presumed to be acquired and not congenital. It is pedunculated, 2-3 cm in size, red-tan in colour, smooth and always shows fluid filled cystic spaces on cut surface. Histologically, Juvenile polyps are hamartomatous with distended, mucus-filled glands, often with cystic dilatation and edematous lamina propria containing abundant vasculature. The most common manifestation is rectal bleeding produced by auto-amputation of the polyp. Juvenile polyp has been considered not to be at increased risk of developing carcinoma. However, atypical epithelium is observed in some lesions, especially in larger polyps, which may give rise to adenoma and subsequent malignant transformation. Therefore the diagnosis of solitary juvenile polyp should not be made only with colonoscopy and biopsy, but should be totally resected endoscopically for pathologic evaluation. About 90% of the lesions are solitary and localized within 20cm from anal verge. In Korea, there are some reports of juvenile polyps located in the rectosigmoid colon. We report one case of juvenile polyp in adolescent that presented as a hematochezia & abdominal pain, which is located at right colon.

영아의 혀에 발생한 유아조직 1례

이희정,윤은실,최준혁,최광해 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out Sometimes, tongue lesions are present with dyspnea, dysphagia, dyarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination After excision of tongue mass, she had no problem with swallowing and breathing.

세포질내 정자주입법(ICSI)에 있어서 정자흡입 및 난자내 주입방법에 관한 연구

이택후,김항진,송건호,김대근,전상식,박윤규,서태광,전병균,류은경,이은숙,문진수,김광철 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1

Study on Method of Sperm Aspiration and Injection into an Oocyte in Intracytoplasmic Sperm Injection(ICSI) Immobilization of spermatozoa prior to intracytoplasmic sperm iniection(ICSI) sometimes results in crooked tail and this makes it difficult to aspirate sperm into an injection pipette tail first. Head-first sperm aspiration into an injection pipette avoid this problem due to the bigger size of the sperm head. The effect of head or tail-first sperm injection into an oocyte on fertilization cleavage, percentage of grade I embryos and development to blastocyst stage in ICSI program has been studied. A single living immobilized spermatozoa from oligoasthenozoospermic patient was injected into an oocyte head-first or tail-first according to the treatment. Eighteen hours after microinjection, oocytes ware inspected for survival and fertilization Fertilized oocytes with two pronuclei were cultured in 30μl drop of mHTF supplemented with 10% heat-inactivated follicular fluid(FF) at 37℃. On day 2. embryo transfer was performed with cleaved embryos. The remaining 2-8 cell stage embryos were co-cultured with BRL cells in mHTF + 10% FF for 72 hours and the developmental stage was observed. The data were analyzed by Analysis of Variance. A total of 164 oocytes from 36 cycles were assigned to earth treatment and ICSI was performed(88 head-first, tail-first). The rates of normal fertilization were 81.8% and 76.3% for head-first and tail-first, respectively. Of the fertilized oocytes, the percentage of cleaved embryos and the percentage of grade 1 embryo among cleaved embryos were 88.9% and 68.8%, 93.1% and 74.1% for head-first and tail-first, respectively. Of the 2-8 cell embryos cultured, 44.4%(16/36) and 50.0%(10/20) for head first and tail first, respectively developed to blastocyst stage. There were no differences in fertilization, cleavage, rates of grade 1 embryos, and development to blastocyst stage. In conclusion, head-first or tail-first sperm injection into an oocyte in ICSI program does not affect fertilization and subsequent embryo development to blastocyst stage in vitro.

인체 B 림프구 활성화의 신호전달과정에서 IL-4 수용체와 CD40 분자간의 상호작용

이충은,윤석란,변광호 大韓免疫學會 1995 大韓免疫學會誌 Vol.17 No.3

Stimulation of B cells through CD40 antigen has been reported to agument the interleukin-4(IL-4)induced B cell proliferation and differentiation. In order to elucidate mechanisms underlying the synergistic action, we examined the effect of CD40-mediated signal on the IL-4-induced B cell activation. Treatment of dense, resting tonsillar B cells with agonistic anti-CD40 mAb caused a noticeable induction of IL-4 receptor(IL-4R) mRNA expression within hours, which was followed by a significant enhancement of the IL-4-induced surface IL-4R and CD23 expression, suggesting a role of CD40 in amplifying the IL-4-induced signal. Signal interplay between the IL-4 and the CD40 system was further supported by the observation that, in tonsillar B cells, IL-4 plus anti-IgM induced CD40 expression and tyrosine phosphorylation of IL-4R, and that anti-CD40 co-immunoprecipitated the IL-4R and the IL-4R associated tyrosine kinase activity, which implies a possible molecular interaction between IL-4R and CD40. Together these results suggest that there is a cross-talk between CD40-and the IL-4R-mediated signal transduction system during the T cell-dependent B cell activation.

Bacillus thuringiensis subsp. darmstadiensis 73E10-2의 σ-endotoxin 생산 및 용해조건

殷鍾克,李光培 대구보건대학 1992 대구보건대학 論文集 Vol.13 No.-

For the limition on the utility of chemical insecticides, numerous investigation have been focused on biological control of insect pests. Among many biological agents for insect pest control, Bacillus thuringiensis is considered to be one of most promising agents. In general, Bacillus thuringiensis subsp. darmstadiensis 73E10-2 produces α-endotoxin which is mosquitocidal toxin during sporulation. In the strain was produced a lot of α-endotoxin after cultivation at 28℃ for 8 days in T.Y.G. medium α-endotoxin in was highly toxic activity to mosquito larvae after dissociation of α-endotoxin in 50mM NaOH containing 10mM EDTA at 27℃ for 30 min.