• 생명과학회지
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• 제30권2호
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• pp.122-128
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• 2020

Candida albicans가 칸디다 혈증의 주요 원인 균으로 알려져 있지만, 최근에는 non-albicans Candida (NAC)에 의한 심각한 감염이 증가하고 있다. NAC 중에서 C. glabrata는 두 번째로 병원성을 나타내는 원인 균이지만 C. glabrata의 구조, 역학 등의 기본적인 연구는 거의 없는 실정이다. 따라서 본 연구에서는 다양한 유형의 임상 표본으로부터 분리된 총 102개의 C. glabrata균주로 multi-locus sequence typing (MLST)을 수행하였다. FKS, LEU2, NMT1, TRP1, UGP1 및 URA3을 포함한 6개의 하우스키핑 유전자를 증폭하여 염기서열을 분석하였다. 총 3,345개의 DNA 염기서열 중 49개의 가변 염기서열 부위가 발견되었으며, 그 결과 102개의 균주에서 총 12개의 상이한 서열 유형을 확인하였고, 알려지지 않은 서열 유형(USTs) 중 UST1이 가장 많이 나타났다. 이 연구의 결과는 국내 C. glabrata 항생제 처방에 도움이 될 것으로 사료되며, 한국에서 유행하는 C. glabrata에 대한 추가 연구를 위한 기본 역학자료로 사용될 것으로 기대한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.176-183
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• 2018

Purpose: Acute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon. Methods: We prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon. Results: Males had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032). Conclusion: Our findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.

• 대한핵의학회지
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• 제1권1호
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• pp.67-78
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• 1967

Over the past 6 years, from May 1960 to June 1966, 1,716 patients with various diseases of thyroid were examined and thyroid function tests with $^{131}I$ were done. Among them, 545 patients with hyperthyroidism were treated with $^{131}I$. A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ were presented and discussed. 1. The patients examined consisted of; 596 cases(34.7%) with toxic diffuse goiter, 412 cases(24.0%) with non-toxic nodular goiter, 278 cases(16.2%) with euthyroidism, 236 cases(13.8%) with non-toxic diffuse goiter, 89 cases(5.2%) with hypothyroidism, 53 cases(3.1%) with toxic nodular goiter, 32 cases(1.9%) with thyroiditis and 20 cases(1.2%) with dyshormonogenesis. 2. There were 218(12.7%) male patients and 1,498(87.3%) female patients, showing a ratio of 1:6.9. female predominantly. 3. The majority of patients(79.6%) were in the 3rd through 5th decades of their lives showing the peak in the 4th decades(35.9%). 4. The diagnostic values and normal ranges of $^{131}I$ uptake test, 48 hour serum activity, $T_3$ red blood cell uptake and $PB^{131}I$ conversion ratio were discussed. 5. An attention was given to dyshormonogenesis, a qualitative hypothyroidism, due to its characteristic findings of clinical and $^{131}I$ thyroid function tests, and its pathogenesis was briefly reviewed. 6. Among 545 patients with hyperthyroidism treated with $^{131}I$, 68.3% was cured after single. therapeutic dose and another 24.0% was cured after second dose. 7. The complications of $^{131}I$ therapy were discussed in some details and myxedema had developed. in 3.9% of our cases. No thyroid cancer was found after $^{131}I$ therapy.

• 대한임상검사과학회지
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• 제53권2호
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• pp.143-150
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• 2021

최근 SARS-CoV-2를 포함한 신종 및 변종 고병원성 바이러스의 확산과 이를 확진하기 위한 진단검사의 수요가 증가함에 따라 분자유전검사실 구축 시 필요한 공간별 기능을 조사하고 임상병리사의 안전성 확보를 위한 시설 지침을 마련하고자 하였다. 검사과정 중 검체 전처리 및 핵산 증폭 전실 및 후실 분리와 함께 음압설비가 필요하며, 핵산 증폭 전 공간을 분리해 단방향 작업 흐름을 고려해 공간 구성을 하여야 한다. 검사 진행과정 중 검체 전처리, 핵산 증폭 전 단계에서 실 분리와 함께 음압시설이 필요하며, 공간구성은 핵산증폭 전실 및 후실 공간을 분리하고 검사진행 방향을 단방향 검사흐름(unidirectional work flow)을 고려하여 계획하여야 한다. 안전관리 시설은 생물학적 안전 기준 2등급으로 지정하고 그에 따른 안전보호구를 배치하고, 위험물을 취급하는 경우 생물학적 안전상자 내부에서 진행해야 하며, 전염성 오염물의 폐기를 위한 멸균기가 필요하다. 국내 분자유전검사실 사례의 공통점은 검체 전처리공간을 -2.5 Pa 이하의 음압으로 유지하고 있으며, 검사과정상 전처리와 시약준비 공간에 대해서는 다른 공간에서 진행하고 있었다. 본 연구는 검사과정의 세부흐름과 공간별 기능을 분리하고 안전관리 기준 적용한 검사실 구축 방향을 제시하였고, 임시시설과 결핵검사실을 변경하여 사용하는 사례를 소개함으로써 더욱 효율적인 방향을 모색할 수 있는 자료로 의의가 있다고 하겠다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.178-184
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• 2013

Purpose: The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. Methods: The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. Results: The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. Conclusion: IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.364-369
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• 2021

Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.

• 대한임상검사과학회지
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• 제47권4호
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• pp.251-258
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• 2015

커큐민(curcumin)은 강황 내 주요 폴리페놀 화합물의 한 성분으로 비만과 관련된 비알코올성 지방간염을 막아 주는 것으로 잘 알려져 있다. 이 연구의 목적은 고지방 식이로 키운 비만 마우스에서 사염화탄소($CCl_4$)로 유발한 간섬유증에 미치는 커큐민의 보호효과를 조사하기 위해 시도하였다. 군간 비교를 위해, 정상 식이와 고지방 식이로 키운 마우스에 7주간 $CCl_4$를 투여하면서 동시에 커큐민을 투여한 것과 투여하지 않은 군으로 나누었으며, 체중이나 혈당과 같은 대사 프로파일이나 지방세포의 크기 및 간섬유증의 변화를 조사하기 위해 혈청 생화학적 검사, 조직학적 검사 및 면역조직화학적 검사를 수행하였다. 또한 간세포 내자멸세포의 관찰을 위해 TUNEL 법을 사용하였다. 그 결과 고지방식이+$CCl_4$ 마우스에 커큐민을 투여한 군에서는 투여하지 않은 군에 비해 체중, 공복혈당 수치, 혈청 AST, ALT 수치가 낮았고, 지방조직 내의 지방세포 크기와 대식세포 및 비만세포 수가 감소하였다. 이와 반대로 정상식이+$CCl_4$ 마우스에 커큐민을 투여한 경우에는 투여하지 않은 군에 비해 체중과 비만세포 수 이외에는 통계학적인 차이가 없었다. 더욱이 커큐민은 간조직의 간실질세포의 자멸세포 수는 줄인 반면 활성 간성상세포 모양의 비실질세포의 자멸세포 수를 증가시켰다. 이 결과를 종합해 볼 때 커큐민은 비만 마우스의 간질환 진행에서 효과적인 항섬유 치료제로서 사용할 수 있을 것으로 사료된다.

• 대한임상검사과학회지
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• 제36권1호
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• pp.27-32
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• 2004

Bone marrow transplantation(BMT) is widely used as curative means of various malignant and nonmalignant hematologic disorders, and early and accurate determination of engraftment is very important for critical management decisions. Reticulocyte counts performed by automated flow cytometric methods is a good indicator of erythropoietic activity and its evaluation has been proposed as an early predictor of bone marrow regeneration. Some reports highlighted the usefulness of the percentage of highly fluorescent reticulocytes and the sum of highly and medium fluorescent reticulocytes(immature reticulocyte fraction, IRF). In Asan Medical Center, the criteria for engraftment following BMT or PBSCT was defined as the first day of a 3-day trend of absolute neutrophil count(ANC)${\geq}500/uL$ and platelet count${\geq}30{\times}10^3/uL$. In 1999, Grotto et al proposed an indidator of bone marrow recovery as the first day on which the IRF was twice the minimum value after bone marrow transplantation. To compare the both criterias, we got consecutive datas of immature reticulocyte fraction, absolute neutrophil count(ANC), WBC count, platelet count and reticulocyte count by XE-2100 automated hematology analyzer(Sysmex Co. Japan) from 33 patients daily after BMT. When compared to standard neutrophil engraftment(10-30 days, $16.2{\pm}4.6days$), IRF engraftment (5-21 days, $11.0{\pm}3.9days$) occured significantly earlier in 87.9% of patients(P<0.05). The mean engraftment day for WBC count(11-29 days, $16.4{\pm}4.3days$) was similar to ANC, but platelet count and reticulocyte count revealed more delayed data (10-49 days, $19.1{\pm}7.4days$ vs 17-64 days, $31.4{\pm}14.1days$). In conclusion, our results confirm that an increase in the immature reticulocyte population is the earliest sign of the hematopoietic recovery after BMT and that automated reticulocyte quantification including immature fraction may be integrated into clinical protocols to evaluate bone marrow reconstitution.

• 대한임상검사과학회지
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• 제54권1호
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• pp.15-22
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• 2022

프로칼시토닌(procalcitonin, PCT)은 세균성과 바이러스성의 감염을 구별하기 위한 과학적 근거와 진단상의 중요한 단서를 제공한다. 프로칼시토닌이 높은 환자의 임상적 특성과 예후를 조사하고 임상적 진단을 향상시키고자 한다. 프로칼시토닌이 일반적인 집단에서 패혈증의 유병률과 연관성이 있는지를 결정한다. 이에 본 연구는 1년 동안 프로칼시토닌을 검사한 외래 환자(127명)의 C-반응성단백과 혈구산정검사의 결과를 기반으로 후향적 조사연구이다. 분석에 사용된 데이터는 프로칼시토닌, C-반응 단백 그리고 혈구산정검사이다. PCT의 결과가 높은 군의 CRP와 WBC의 양성율은 정상군보다 높게 나타났다(P<0.05). 프로칼시토닌 수준의 특이성과 민감도는 C-반응단백과 백혈구 수준보다 높게 나타났다(P<0.05). 또한. 프로칼시토닌의 결과값을 삼분위한 그룹의 분석에서는 낮은 군과 중간군의 값에 비해 높은 군의 값이 평균보다 높은 것으로 나타났다(P<.001). 상관분석에서는 프로칼시토닌은 C-반응단백, 백혈구(호중구, 림프구 포함)에서 양의 상관성을 보였다(P<.001). 이 연구의 주된 발견은 높은 프로칼시토닌은 C-반응성단백, 백혈구들의 수준에서 높은 연관성을 보이며 진단적 가치를 확인하였다. 따라서 이러한 관련 인자들은 환자의 감염진단과 항생제 치료에 중요한 진단적 및 치료적 영향을 미칠 것으로 사료된다.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.132-141
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• 2006

Purpose : This study was aimed to determine the predictive risk factors for the treatment response and relapse rate in children diagnosed with idiopathic nephrotic syndrome. Methods : We analyzed the medical records of children who were diagnosed and treated for childhood idiopathic nephrotic syndrome from November 1991 to May 2005. Variables selected in this study were age at onset, sex, laboratory data, concomitant bacterial infections, days to remission, and interval to first relapse. Results : There were 46 males and 11 females, giving a male:female ratio of 4.2:1. The age($mean{\pm}SD$) of patients was $5.8{\pm}4.1$ years old. Of all patients who were initially given corticosteroids, complete remission(CR) was observed in 54(94.7%). Of the 54 patients who showed CR with initial treatment, 40(70.2%) showed CR within 2 weeks and 14(24.6%) showed CR after 2 weeks. The levels of serum IgG were lower in the latter group who showed CR after 2 weeks(P=0.036). Of the 54 patients who showed CR with initial treatment, 47(82.5%) relapsed. Of these patients, 35.1% were frequent relapsers and 43.9% were infrequent relapsers. There was no significant correlation between the frequency of relapse and the following variables : sex, days to remission, and laboratory data. However, age at onset and interval to first relapse had a negative correlation with the frequency of relapse(Pearson's coefficient=-0.337, -0.433, P<0.012, P<0.01). Conclusion : The age at onset and the interval to first relapse were found to be predictive clinical parameters for the relapse rate, while the levels of serum IgG at initial presentation were a predictive laboratory factor for treatment response in childhood idiopathic nephrotic syndrome.