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이규만,박민정,김현태,이계숙 대한감염학회 1997 감염 Vol.29 No.3
목적: 최근의 전세계적인 결핵환자의 증가 추세는 주로 HIV 감염환자에서의 M. tuberculosis에 의한 기회감염에 기인하며, 특히 rifampin과 여러 종류의 항결핵치료제에 내성인 다약제 내성균에 의한 감염이 중요한 문제로 대두되고 있어, 이에 저자는 결핵균의 조기 검출과 이들 균주에서의 다약제 내성유무의 조기 판별을 위하여 PCR-역보합법의 유용성을 검토하고자 본 연구를 실시하였다. 방법: 임상 검체에서 분리된 분리주 37주와 표준 균주 3주를 대상으로 하여 결핵균을 동정하고, 다약제 내성의 대표 약제인 rifampin에 대한 내성의 유무를 결핵균 특이 probe와 내성 유발 유전자인 rpoB 유전자의 63bp 지역의 DNA를 PCR로 증폭하고 그 산물을 nitrocellulose 스트립에 고정된 probe들과 역보합 반응시키는 line probe assay를 시행하여, 그 결과를 통상적인 약제 감수성 검사 결과와 비교분석하였다. 결과 : 분리주 37주는 모두 M. tuberculosis로 동정되었다. Rifampin 내성을 보인 29균주는 모두 두개 이상의 약제에 내성을 보였으며, 28균주에서 isoniazid 내성을 동반하였다. Line probe assay로 얻은 분리주의 변이형의 빈도는 R5(531, TCG→TTG)가 11주(37.9%), R4(526, CAC→TAC, GAC)가 8주(27.6%), R2(516, GAC→GTC)가 4주(13.8), S2와 S4의 소실이 1주(3.4%), S1과 S2의 소실이 1주(3.4%), S 소실없이 R5 양성이 1주(3.4%), S4의 소실이 1주(3.4%) 및 야생형이 2주(6.9%)로 나타났다. 내성을 일으킨 약제의 수와 변이형의 유형간에는 특별한 상관관계가 없었다. 분리주 37주의 약제 감수성 검사 결과와 line probe assay의 결과간의 일치율은 95%였다. 결론: Line probe assay는 결핵균의 동정과 rifampin 내성 검출에 있어 통상적인 방법과 높은 일치도를 보였으며, 검사방법이 간단하고 검사소요시간이 짧아(48시간 이내) 통상적인 감수성 검사에 걸리는 약 4주의 시간을 단축시킬 수 있어 결핵의 조기 진단 및 치료에 유용하게 이용될 수 있음을 나타내었다. 그러나, 스트립에 제한된 수의 probe를 사용하기 때문에 새로운 변이나 다른 위치에서의 변이에 의한 감수성 검사를 병행해야 하며, 더 나아가서는 유전자 염기서열 분석을 통한 추가적 변이의 확인이 바람직할 것으로 사료된다. Background: Recent worldwide increase of tuberculosis has been mainly caused by opportunistic infections in the patients with AIDS. Emergence of multidrug-resistant Mycobacterium tuberculosis has been also posing serious problems on the treatment of tuberculosis. The purpose of this study was to evaluate the usefulness of the PCR-reverse hybridization method(line probe assay, INNO-LIPA; Innogenetics, Belgium) for the identification of M. tuberculosis and detection of rifampin-resistant M. tuberculosis. Method: Identification of 37 isolates was performed by both conventional method and line probe assay. Detection of rifampin resistance by line probe assay was based on the reaction amplified gene products of isolates with either wild type probes(S1, S2, S3, S4, and S5) specific for rpoB gene of mutant type probes(R2, R4a, R4b, and R5) specific for the mutation sequence in the rpoB region, and the results were compared with those by the absolute concentration method. Results: All of the 37 isolates were identified as M. tuberculosis by both line probe assay and conventional method. Eight isolates susceptible to rifampin by absolute concentration method showed no mutation by line probe assay. Twenty seven of 29 isolates resistant to rifampin by absolute concentration method showed the following mutations in rpoB gene: 11, S5-R5+(loss of S5 with R5); 7, S4-R4a; 1, S4-R4b+; 4, S2-R2+; 1, S1-S2+: 1; S2-S4-;1, S4-; and 1, R5+. The sensitivity of rifampin resistance by line probe assay was 95%. Conclusion: Line probe assay is a useful tool for the early identification of M. tuberculosis as well as determination of its rifampin resistance, especially in cases of emergent need for rapid treatment for tuberculosis before getting the final results of conventional antituberculous drug susceptibility test.
李季淑,金春元 한양대학교 의과대학 1983 한양의대 학술지 Vol.3 No.1
Nowadays, human prolactin is well estabished as a separate entity from pituitary growth hormone by a variety of biologic, chemical, immunologic and clinical characteristics. Specific and sensitive radioimmunoassay have been developed by several laboratories and this development has afforded an opportunity to study the prolactin under the physiologic and pathologic events. Author was determined the serum prolactin in 185 healthy Korean males and females according to age and sex differences by radioimmunoassay. The results were as follows: 1. The normal value (mean±1 SD) of serum prolactin was 10.8±5.3 ng/mL. 2. The normal values (mean±1 SD) in males and females were 10.0±4.8 ng/mL and 11.7±5.7 ng/mL, respectively. The difference of normal values of serum prolactin between males and females were significantly higher in females than in males. 3. The normal values of serun prolactin in females were in decreasing order to froth, first, third, fifth and second decades.
李雄烈,李季淑,朴承咸 한양대학교 의과대학 1983 한양의대 학술지 Vol.3 No.1
The study was made in order to investigate the present status of the superficial and the deep mycosis in Korea. The incidence and the organism by the mycological observations were reviewed. The study was made by the previously reported articles by many authors in Korea and and the results are as follows: 1. Dermatomycosis shows male predominace and the second decade shows peak incidence in age group. Trichophyton ferrugineum was markedly decreased and Trichophyton rubrum was increased. Thinea capitis was decreased and Tinea pedis was increased. 2. Otomycosis shows male predominance and the most important causative organism was Aspergillus species. 3. 87 cases of deep mycosis were reviewed and Aspergillosis and Cryptococcosis shows most high incidence. 4. 80 cases of Sporotrichosis was reported and shows peak incidence in third decade, male patient in Chon-nam area.