mecA 양성 메티실린 내성 포도구균의 mec 조절유전자에 대한 분자역학적 연구 및 다양성 분석

우희연,이남용,맹성호,한승훈,인경수,김상욱,성승용,김익상,최명식 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

목적 : 병원 감염과 지역 감염의 원인균으로서의 중요성이 증가되고 있는 MRSA와 MRCNS의 메티실린 내성 관련 유전자에 대해 분자역학적인 조사를 시행하고 mec 조절유전자의 다양성을 분석하여 분자유전학적 연구와 감염 관리에 기본적 자료를 제공하고자 연구를 시행하였다. 방법 : 본 연구에서는 국내 동일 대학병원에서 분리된 mecA 양성 MRSA 78균주와 MRCNS 36균주를 대상으로 항균제 감수성 검사와 중합효소연쇄반응을 시행하여 표현형과 유전형의 분포를 알아보고 내성 정도와 유전형의 상관성을 분석하였다. 결론 : 최소억제농도를 측정하여 oxacillin 감수성 양상을 알아본 결과 총 90개의 MRSA 임상검체 중 3균주에서 감수성을 보였고, MRCNS 36균주는 모두 내성을 보였으며, 고도 내성을 보이는 균주일수록 다제내성을 보이고 있었다. 중합효소연쇄반응으로 mecA 유전자 유무를 분석하여 mecA 양성을 보인 MRSA 78균주와 MSCNS 36균주 만을 대상으로 mec 조절유전자에 대한 중합효소연쇄반응을 시행하여 유전형의 분포를 조사하였다. 그 결과 MRSA와 MRCNS 모두에서 mecA-Pr-mecA-mecR1-mecI형, mecA-Pr-mecA-mecR1형과 mecA-Pr-mecA-mecR-1의 5′말단형의 3가지 유전형이 공통적으로 관찰되었는데, 이외에 MRSA에서는 mecA-mecR1형, mecA-mecR1의 5′말단형이, MRCNS에서는 mecA-Pr-mecA형과 mecA형이 추가로 분리되었다. 유전형의 분포를 연도별로 분석한 결과 연도별로 우세한 유전형이 서로 다른 것을 알 수 있었다. 유전형과 내성 정도의 상관성을 분석한 결과, mecA-Pr-mecA-mecR1을 보유한 MRSA의 경우 mecA 억제유전자로 생각되는 mecI 유전자 유무에 관계없이 모두 고도 내성을 나타내어 mecI의 유무는 내성 정도와는 일정한 관련이 없었으나, MRSA와 MRCNS 모두에서 mecI와 동시에 mecR1의 3′말단이 결혼된 유전형이 저도 및 중등도 내성을 보이는 균주에서 유의하게 많이 관찰되어 mecI가 결손된 균주에서는 mecR1의 3′말단부위의 유무가 내성 정도의 결정에 중요한 역할을 할 것으로 생각하였다. 결론 : 국내에서 분리되는 메티실린 내성 포도구균의 유전형의 분포가 국외 분리주와 차이를 보이는 것으로 관찰되었다. 또한 기존의 보고와는 달리 메티실린 내성 정도와 유전형 사이에 유의한 연관성이 있는 것으로 관찰되어 mec조절유전자가 내성 발현 뿐만 아니라 내성 정도의 결정에 중요한 역할을 하는 것으로 관찰되었다. MRSA가 중요한 감염균임에도 불구하고 아직까지 MRSA의 내성기전에 대해 확실하게 규명되지 않아 치료가 더욱 어려워지고 있는 실정이므로 이에 대한 더욱 종합적인 연구와 동시에 발생과 확산을 막기 위한 노력이 필요할 것으로 생각된다. Background : High prevalence of methicillin resistance has been noticed in staphylococci which also have been recognized as important nosocomial and multi-drug resistant pathogens. In this study, we investigated the distribution of mec regulator genes and the presence of the mutation in mecIgene to reveal the resistance mechanism at molecular level. Methods : The isolates included 90 clinical isolates of MRSA, 36 MRCNS of which methicillin resistance were determined by disk diffusion test and isolated in a single hospital during 1996-1999. We performed microdilution MIC test for oxacillin resistance and Kirby-Bauer test for other antibiotics. Genotypes of mecA positive (determined by PCR) isolates (78 MRSA, 36 MRCNS) were investigated by PCR amplification of mec regulator genes such as 3' end and 5' end of mecR1. mecI, and Pr-mecA. Results : In MIC assay, all MRSA strains except 3 strains and all MRCNS strains showed oxacillin resistance. The level of resistance correlated to the multi-drug resistance. Seven genotypes were observed in mecA positive MRSA and MRCNS. Differences of predominant genotypes among years isolated and among species were observed. Deletions of the 3' end of mecR1 and the mecI were more frequently observed in the low- and borderline-level resistant MRSA and MRCNS (P(0.05). So the important role of 3' end of mecRI in determining resistance level was suggested. Conclusion : This study demonstrated that genomic distribution of methicillin-resistant staphylococci isolated in Korea was different from that of strains isolated in other countries. And important role of mec regulator genes for expression of methicillin resistance was suggested.

랫드에서 신우황청심원의 급성 및 아급성독성시험

오승민,남혜윤,김준수,연제덕,신대희,이진영,박대규,조명행,정규혁 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

The acute and subacute toxicity of New Woohwangchungsimwon(NWCH) which was used l-muscone as substitutive material of musk were investigated in S.D. rats. In intraperitoneal acute toxicity test, rats(Sprague-Dawley, SPF) were injected intraperitoneally with dosages of 0, 540, 750, 1,070, 1,500 and 3,000 ㎎/㎏. Body weights were significantly decreased at 540 ㎎/㎏ dose group in both sexes and abnormal autopsy findings were founded in both sexes at all treated groups. Intraperitoneal LD_50 of NWCH was 812.3 ㎎/㎏ in male and 872.3 ㎎/㎏ in female rats. In the subacute toxicity study, NWCH was administrated orally to both sexes of rats for 4 weeks as several doses(0, 320, 800 and 2,000 ㎎/㎏). There were neither dead animals nor significant changes of body weights during the experimental period. In addition, no differences were found between control and treated groups in clinical signs, urinalysis, hematology, serum biochemical analysis, and other findings. Above data strongly suggest that no observed adverse effect level of NWCH might be over 2,000 ㎎/㎏/day in this study.

랫드에서 l-muscone의 급성독성 및 아급성독성시험 연구

오승민,연제덕,남혜운,박대규,조명행,정규혁 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

l-Muscone is synthesized for use as substitutive material of musk which is the active ingredient of woohwangchungsimwon. The objective of this investigation was to evaluate the acute and subacute toxicity of l-muscone in rats. In oral acute toxicity test, SPF Sprague-Dawley male and female rats were gavaged with l-muscone of two doses(0, 5.0g/㎏). No dead animal and abnormal autopsy findings were found in control and treated group. Body weights were slightly decreased in both sexes of rats treated with 5.0g/㎏. Therefore, oral LD_50 of l-muscone was consider to be higher than 5.0g/㎏ in male and female rats. In intraperitoneal acute toxicity test, rats were injected intraperitoneally with dosages of 0, 1,000, 1,316, 1,732, 2,279 and 3,000 ㎎/㎏. Decreased body weights and motor activities were observed at high dose group. Intraperitoneal LD_50 of l-muscone were 1,920 ㎎/㎏ in male and female rats. In the subacute study. l-muscone was administrated orally to both sexes of rats for 4 weeks as several doses(0, 10, 100 and 1,000 ㎎/㎏). There were neither dead animals nor significant changes of body weights during the experimental period. In addition, no differences were found between control and treated groups in clinical signs, urinalysis, hematology, serum biochemical analysis, and other findings. Above data suggest that no observed adverse effect level of l-muscone in rats might be over 1,000 ㎎/㎏/day in this study.

구동용 3상 3중 쵸퍼방식

정연택,한경희,이승환,김성남 明知大學校 産業技術硏究所 1987 産業技術硏究所論文集 Vol.6 No.2

This paper, in case of chopper controlling D.C. Motors, suggested three phase chopper system in order to reduce a source current and amature current ripple, and it's characteristic proves study on the theory and experiment. As a result of consideration, it was found that chopper system had reduced current ripple compare with two phase chopper system and impressed voltage of motor could be continuously controlled from 0 to the source voltage by adjusting chopper's time ratio α from 0 to 1.

거대적아구성빈혈의 임상적 고찰

곽승근,천재민,박남숙,박상은,박수진,윤환중,김삼용,조덕연 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Megaloblastic anemias are disorders caused by impaired DNA synthesis and chara-cterized by the presence of megaloblastic cells. Clinical data on these disorders in Korea are limited. The aim of this study was to analyze clinical characteristics of megaloblastic anemias caused by vitamin B12 deficiency. We identified 40 cases who were diagnosed as megaloblastic anemia from January 1993 to December 2002 in a retrospective study on the basis of chart review. We investigated the annual distribution of diagnosed patients, clinical manifestations and response to treatment. 19 cases were complicated with a previous total gastrectomy(gastrectomy group) and 21 cases had no history of surgical operation(non-gastrectomy group). The most common presenting complaint was generalized weakness. The median age at diagnosis was 7(range: 38-79) years in non-gastrectomy group. The mean pos-toperative duration was 7(range: 4-25)years in group of total gastrectomy and mean level of serum vitamin B12 was lower than 100 pg/mL in both group. Peripheral blood revealed thrombocy-topenia, macrocytic anemia and hypersegmented neutrophil in all cases. After treatment of pareliteral vitamin B12, Their clinical symptoms and hematologic findings improved except two patients who had bone marrow with lower cellularity. Cobalamin replacement after total gastrectomy is still missing. Diagnoses are made too late in a population of patients, resulting in irreversible neurological sequale, and we suggest that Pernicious anemia seems not to be very rare in Korea.

Ziprasidone의 자연적 임상경험에 대한 후향적 조사 연구 : 3개 대학병원의 경험

이승재,강도형,홍경수,주연호,김남식,권준수 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.3

Objectives : This naturalistic retrospective study investigated the effectiveness of ziprasidone measured by mean improve-ments of the Cltnical Global Impression (CGI-I). Secondary objectives included prescribing patterns, tolerability and safety. Methods : From May to July 2006, 98 psychiatric patients who have been taking ziprasidone for at least 2 weeks were selected. Their current clinical statuses were assessed by the interview and laboratory tests including electrocardiogram (ECG). Data on DSM-IV diagnoses, dosing, concomitant psychotropic medications, clinical changes, adverse effects, and laboratory findings were collected retrospectively. Results : Ziprasidone was mostly prescribed for a switch from another antipsychotics for the treatment of schizophrenia. Two main reasons for a switch were unsatisfactory efficacy and poor tolerance, especially weight gain, of the preceding anti-psychotic medication, Participants as a whole showed mean 2.7±1.0 of the CGI-Improvement. Significant weight reduction after switching to ziprasidone occurred, which was related to the clinical improvement. No significant increase of the QTc interval except one case was observed. Conclusion : The present study confirmed previous tolerability and safety data of ziprasidone as well as the results of its effectiveness.

미용사의 요통 경험에 영향을 미치는 요인

백승룡,남철현,배성욱,김성우,권현숙,이정옥,전연숙 慶山大學校 保健福祉硏究所 2002 保健福祉硏究 Vol.7 No.-

The purpose of this study is to analyze and grasp the actual lumbaginous condition and relevant factors of 1,182 beauty artists of beauty shops in 5 metropolitan cities, small-to-medium cities, and fishing or agrarian villages for 3 months from June 20 to September 25, 2000 through questionnaires. 1) They showed 61.0 percents in her twenties, 66.4 percents of unmarried women from all the female objects, 70 percents in high school graduates as educational background, 52.4 percents in metropolitan city as service place, 25.4 percents in smoking rate, 71.6 percents in drinking rate, 48.1 percents in general bed as condition of bedroom, 17.9 percents in exercising rate, 53.6 percents in 'little eating', 39.6 percents in two or three centimeters of heel, and 89.5 percents in hair as beauty-related professional field. 2) The rate of lumgaginous experience of beauty artists was 83.5 percents. They showed higher rate of 91 percents in the thirties and forties, 92 percents of the married, 93.9 percents in junior college graduates, 97.2 percents in higher economic classes, 88.7 percents in smokers, 85 percents in general bed, 89.3 percents in sleeping on one's face, 85 percents in swimming, 92 percents in stretch, 86.7 percents in 56 to 60 kilograms of weight, 89.7 percents in group O blood, 90.5 percents in experienced women of abortion, 97 percents in heel over 8 centimeters, 58.3 percents in 'feel much fatigue', 93.6 percents in inconvenient chair of beauty shop, and 89.4 percents in a lack of recess than other group. 3) The more women who have been experienced in lumbago, the higher their social treatment(p<0.01), income(p<0.001), working time(p<0.05), job potentiality(p<0.05), inner affinity(p<0.05), and job satisfaction of environment(p<0.001) were. Women who suffered much stress related to job environment(p<0.001), client(p<0.01), and their duty(p<0.01) showed high rate of lumbaginous experience. 4) In degree of lumbago by characteristic, there was the significant difference in age over 50-years-old, unmarried women, college graduates, service of small-medium cities, higher economic classes, smokers or drinkers, hot-floored room, sleeping with ransack, stretch or swimming, group A blood, fat body, experience of abortion, 6 to 7 centimeters of heel, convenient chair of beauty shop, insufficient recess, lumbago continued for one to the three months in comparison of other group. 5) There were variables of posture such as to place materials under one foot(p<0.001), to lay arm on armrest and desk(p<0.001), to pull materials near body while lifting them (p<0.05), to sometimes use anodyne(p<0.01), not to lift also light materials(p<0.001), to be inconvenient in sleeping(p<0.001), to be absent at job for two or three days(p<0.01). The degree of depression(p<0.001), had the significant effect on the degree of lumbago(32.7%). The results are as follows : Beauty artists have faced upon dangerous job environment to cause lumbago. The more the industrial society will be developed, the more their burden of service will be increased. In addition, the occupational stress and posture of beauty artists who showed high job satisfaction and high economical level became major factors which have had an effect on their lumbago. In conclusion, it is desirable for beauty-related organizations and professionals to positively develop program of health education with much concern as well as to lessen stress of beauty artists through education of job posture and rightful life in order to prevent lumbago of those beaut.

곰팡이에서 분리한 Helicobacter pylori 항균물질의 분리 및 구조규명

남궁준,연승우,백남수,김태한,김영호,김창진,김기원 충남대학교 약학대학 의약품개발연구소 1998 藥學論文集 Vol.14 No.-

Helicobacter pylori is a Gram-negative bacterium which causes chronic gastritis and is associated with gastric ulcer, duodenal ulcer and gastric carcinoma. In the process of screening of antibacterial activities against H. pylori from soil microorgani는, fungus No. 60686 was isolated. After fementaion of No. 60686, the antibacterial compound was isolated, purified and followed by extraction of mycelium with orgainic solvents, acetone and ethyl acetate, through silica gel chromatography, LH-20 gel chromatography and HPLC. As a result of the structural analyses of the compound by IR, ^1H- and ^13C-NMR, FAB/Mass spectrophotomer, the compound having the antimicrobial activity was idenfitied as chaetoglobosin A (C_32H_36N_2O_5), a cytochalasan derivative. The antimicrobial activity of chaetoglobosin A was tested against Gram-positive and negative bacteria by paper disk method. Among the test strains of 9 Gram-positive bacteria and 18 Gram-negative bacteria containing 4 H. pylori strains, the growth of 4 H. pylori strains and 3 S. aureus strains (SG 511, 285 and 503) was only inhibited by chaetoglobosin A. Also it was shown that its growth inhibition against H. pylori strains was stronger than that against S. aureus strains at the treatment of the same concentration. Therefore it was concluded that chaetoglobosin A has a specific growth inhibition against H. pylori of the tested bacteria.

통풍성 관절염의 임상적 고찰

윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.

동일한 국제예후지표(International Prognostic Index)를 나타내는 미만성 대형 B-세포 림프종에서 Bcl-2와 p16의 임상적 중요성

박상은,박수진,곽승근,박남숙,천재민,윤환중,조덕연,김삼용,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

In Korea, malignant lymphoma is a common cancer, comprising about 2.7% of all malignant neoplasm. Diffuse large B cell lymphoma is the most common lymphoma, representing about 50% of all Non-Hodgkin's lymphoma. Diffuse large B-cell lymphoma is usually considered as heterogeneous group of neoplasms rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embrace patients with heterogeneous prognoses. But International Prognostic Index scoring system is not sufficiently predict the prognosis. It is likely that the prognostic assessment of patients with diffuse large B-cell lymphomamight be improved by using biological features. Bcl-2 protein and p16 protein expression is recognized as useful biologic markers predicting the prognosis of patients with diffuse large B-cell lymphoma. To determine the clinical significance and prognostic value of bcl-2 and p16 proteins expression patterns, we studied 18 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for bcl-2, p16. The results are as follows; 1) The median age was 54(rage : 37-69). There were 12 male patients(66.7%) and 6 female patients(33.3%) The 'B' symptom was abscentin all patients. The stages were as follows : Ⅰ, 2 patient(11.1%), Ⅱ, 10 patient(55.6%), Ⅲ, 4patient(22.2%) and Ⅳ, 2patient(11.1%). 3 patients(16.8%) had the elevated LDH level, 14 patients(77.8%) had the normal LDH level and 1 patients(5.6%) was not identified the LDH level. 2 patients(11.1%) had the bulky disease and 16 patients(88.7%) had no bulky diease. The distribution of ECOG status were O, 2 patients(11.1%c), 1, 14patients(77.8%) and 2, 2patients(11.1%). 2) Theimmunohistochemistry results are as follows bcl-2:+,10 patients(55.6%), bcl-2:-, 8patinets(44.4%), p16:+,3 patients(16.7%), p16:-, 15patients(83.3%) 3) After a median follow UP durations of 67 months, the median survival time was 57 months with a rage of 7-100+ months. 5-years overall survival rates was 44% by Kaplan-Meier method. 4) Reduced overall survival was demonstrated in the patients who expressed bcl-2 protein(P=0.0174). 5-year overall survivial rate was 12%(bcl-2 expression) versus 88%(no bcl-2 expression) 5) Among diffuse large B-cell lymphoma patients with IPI score 0-1, reduced overall survival was demonstrated with bcl-2 expression(P=0.023). 5-year overall survival rate was 18%(bcl-2 expression group) versus 100%(no bcl-2 expressiongroup) 6) Median survival durtation of diffuse large B-cell lymphoma patients negative for p16 expression was 57 months whereas p16 postive patients' median survival duration was not reached(P=0.4478). In diffuse large B-cell lymphoma patients with identical IPI scores, bcl-2 expression had additional prognostic value.