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오원섭,O, Won-Seop 사단법인 한국당뇨협회 2006 당뇨 Vol.199 No.-
당뇨환자는 정상인에 비하여 특정 감염증의 발생빈도가 높다. 또한 감염증으로 인한 합병증과 사망률이 높기때문에 조기에 진단하여 치료하는것이 매우 중요하다.
폐렴구균의 용혈능 변화와 pneumolysin 유전자의 변이 양상
오원섭,장현하,정숙인,김연숙,이혁,김신우,김성민,백경란,이남용,송재훈 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.3
목적 : 폐렴구균은 인체에서 폐렴, 수막염 및 패혈증 등을 일으키는 중요한 병원균으로 현재 전 세계적으로 항균제 내성이 큰 문제가 되고 있다. 하지만 폐렴구균의 항균제 내성에 따라 병독성이 어떻게 변화하는지에 대해서는 구체적으로 알려져 있지 않다. 이에 기능적 및 구조적 분석을 통하여 폐렴구균의 주요 병독성 인자인 pneumolysin의 병인론적 역할을 규명하고자 하였다. 방법 : 임상 검체에서 분리된 페니실링 감수성 균주 20주와 내성 균주 20주를 대상으로 하였다. Pneumolysin의 세포 독성의 변화를 관찰하기 위하여 각각의 균주들의 용혈능을 측정하였고, pneumolysin 유전자를 중합효소 연쇄반응으로 증폭한 후 증폭 산물의 유전자 구조를 분석하였다. 결과 : 페니실린 감수성 균주와 내성 균주간의 용혈능은 유의한 차이를 보이지 않았으나, 일부 용혈능이 매우 낮은 균주에서 Lys152→Thr, Thr-172→Ile, Lys-224→Arg와 같은 변이가 관찰되었다. 결론: pneumolysin의 세포 독성의 변화는 항균제 내성 정도와는 무관하였으나, 일부 용혈능이 저하된 균주에서 발견된 pneumolysin 유전자의 변이가 pneumolysin의 세포 독성에 영향을 주는 것으로 보인다. Background : Pnumolysin (Ply) is one of the most important virulence factors of Streptococcus pneumoniae. To investigate the functional and structural variation of Ply, hemolytic activity (HA) and gene sequences of pneumolvsin were determined. Methods : A total of 40 invasive pneumococcal isolated (20 penicillin-susceptible & 20-resistant strains) were analyzed. HA of each isolate was measured in crude extracts (1×10^8 CFU/mL) hourly from the time of inoculation to 9h. Crude extracts (50㎕) and DTT buffer (100㎕) were serially diluted in 96-well plate and mixed with 1% sheep blood (50㎕). HA was represented as the reciprocal of the greatest dilution, which resulted in the complete lysis. Two sets of oligonucleotide primers were used to amplify a 1,474-bp fragment containing the coding region and a 578-bp fragment of upstream region of ply gene, respectively. Amplified products were directly sequenced. Results : HA showed a wide variation from 0 to 87,480 regardiess of penicillin MICs, serotypes or specimen sources. Two bacteremic strains showed completely no hemolytic activity. No significant differences in HA between penicillin-susceptible (Mean± SE : 15,468± 4,693) and penicillin-resistant strains (21,384± 4,087) were found (p > 0.05).Sequencing of the coding region showed unique alterations in amino acids in strains with markedly reduced hemolytic activity (≤ 40): Thr-172-Ile and Lys-224-Arg. However, upstream region of ply gene was highly conserved. Conclusions : Ply activity was not related with antibiotic resistance. Absence of HA in some strains was associated with unique alterations in amino acid sequences in ply gene. Relationnship between genomic alteration and functional changes in pneumolysin should be further investigated.
오원섭,이승준,이창섭,허지안,허애정,박윤선,허상택,배인규,박상원,김의석,김홍빈,송경호,이꽃실,이상록,염준섭,이수진,김백남,곽이경,이재훈,김영근,김효열,김남중,오명돈 대한의학회 2011 Journal of Korean medical science Vol.26 No.4
The purpose of this study was to establish a prediction rule for severe illness in adult patients hospitalized with pandemic influenza A (H1N1) 2009. At the time of initial presentation, the baseline characteristics of those with severe illness (i.e. , admission to intensive care unit, mechanical ventilation, or death) were compared to those of patients with non-severe illnesses. A total of 709 adults hospitalized with pandemic influenza A (H1N1) 2009 were included: 75 severe and 634 non-severe cases. The multivariate analysis demonstrated that altered mental status, hypoxia (PaO2/FiO2≤ 250), bilateral lung infiltration, and old age (≥ 65 yr) were independent risk factors for severe cases (all P < 0.001). The area under the ROC curve (0.834 [95% CI, 0.778–0.890]) of the number of risk factors were not significantly different with that of APACHE II score (0.840 [95% CI, 0.790-0.891]) (P = 0.496). The presence of ≥ 2 risk factors had a higher sensitivity, specificity, positive predictive value and negative predictive value than an APACHE II score of ≥ 13. As a prediction rule, the presence of ≥ 2 these risk factors is a powerful and easy-to-use predictor of the severity in adult patients hospitalized with pandemic influenza A (H1N1) 2009.
오원섭 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.6
Intracranial mycotic aneurysm (IMA) is rare, but life-threatening cerebrovascular lesion, which arises from a variety of primary infection foci such as infective endocarditis, bacterial meningitis, cavernous sinus thrombophlebitis, etc. The diagnosis of IMA usually depends on the documentation of an intracranial aneurysm by vascular imaging in the presence of primary infection foci. As the gold standard for detecting IMA, high-tech computed tomography will eventually replace cerebral angiography. Because of the lack of prospective cohorts and randomized controlled trials, there is no widely accepted treatment guideline for IMA. With recent advances in surgical technique and the introduction of endovascular therapy, however, clinical outcome of patients with IMA tends to improve. This review will provide the state-ofthe-art knowledge on clinical aspect and treatment strategy of IMA.
오원섭,전성빈 대한의학회 2016 Journal of Korean medical science Vol.31 No.5
Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock. Although estimation of the residual blood volume is crucial, the standard measuring methods are impractical or unsafe. Vital signs, central venous or pulmonary artery pressures are inaccurate. We hypothesized that the residual blood volume for acute, nonongoing hemorrhage was calculable using serial hematocrit measurements and the volume of isotonic solution infused. Blood volume is the sum of volumes of red blood cells and plasma. For acute, non-ongoing hemorrhage, red blood cell volume would not change. A certain portion of the isotonic fluid would increase plasma volume. Mathematically, we suggest that the residual blood volume after acute, non-ongoing hemorrhage might be calculated as 0·25N/[(Hct1/Hct2)-1], where Hct1 and Hct2 are the initial and subsequent hematocrits, respectively, and N is the volume of isotonic solution infused. In vivo validation and modification is needed before clinical application of this model.