폐결핵의 조기진단에 있어서 이중중합효소연쇄반응법의 유용성

조성란,최영진,김용훈,이철세,김영창,김휘준 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Background: Pulmonary tuberculosis is a great public health problem in Korea. Early detection of Mycobacterium tuberculosis (M. tuberculosis) in clinical samples becomes more and more important in the control of tuberculosis. Recently, molecular methods have been applied to early detection of M. tuberculosis. Methods: To elucidate the effectiveness of nested polymerase chain reaction (PCR) in early diagnosis of pulmonary tuberculosis, we peformed Acid-fast bacilli (AFB) stain, AFB culture, and nested PCR on 84 sputa. Results: 8 (9.5%) specimens were positive by AFB stain, 17 (20.2%) by AFB culture, and 15 (17.9%) by nested PCR. Using AFB culture as standard method, the sensitivity of AFB stain and nested PCR was 47.1% and 82.4%, respectively. The specificity of AFB stain and nested PCR was 100% and 98.5%, respectively. Conclusions: Nested PCR was more sensitive than AFB stain and had shorter processing time(24-48hrs) than AFB culture. So it may be effective to use nested PCR in order to detect M. tuberculosis when AFB smear Is negative.

1998-1999년에 임상 검체로부터 분리된 주요 세균의 항생제 내성

김휘준,조성란 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

Surveillance of antimicrobial resistance can provide information needs for empirical therapy of antimicrobial agents and for control of resistance. To determine the trend of antimicrobial resistance in Soonchunhyang Chunan Hospital, we analyzed in vitro susceptibility and identification data in 1998 and 1999. The results showed that cefoxitin-resistant Escherichia coli and Klebsiella pneumoniae and 3rd-generation cephalosporin-resistant K. pneumoniae, Enterobacter cloacae, and Serratia marcescens were prevalent, that fluoroquinolone-resistant Acinetobacter baumannii had increased, and imipenem-resistant Pseudomonas aeruginosa were prevalent. Oxacillin-resistant Staphylococcus aureus and penicillin-resistant pneumococci were prevalent. An increase of imipenem-resistant P. aeruginosa and vancomycin-resistant Enterococcus faecium is a new obvious threat. To prevent the spread of multi-resistant bacteria and the emergence of new resistance, continuous monitoring of antimicrobial resistance, appropriate use of antibiotics, and control of nosocomial infection are necessary.

이중혈류유발 심폐소생술이 심정지를 유발한 개의 단기 생존율에 미치는 영향

황성오,조준휘,강구현,김성환,문중범,이강현,이승환,윤정한,최경훈,홍은석 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background and Objectives: We previously reported that, compared with standard cardiopulmonary resuscitation(S-CPR), better hemodynamic effects could be achieved by simultaneous sterno-thoracic cardiopulmonary resuscitation(SST-CPR) in which we compressed the sternum and constricted the thorax circumferentially during the systolic period by using a device. This study was designed to assess whether SST-CPR, compared with S-CPR, improve the survival rate of dogs with cardiac arrest. Subjects and methods: Twenty-five mongrel dogs(19∼31㎏) were enrolled in this study. After four minutes of ventricular fibrillation induced by an AC current, animals were randomized to resuscitate with either S-CPR(n=13) or SST-CPR(n=12). Epinephrine(1 ㎎) was injected into the right atrium every three minutes after the beginning of CPR. Defibrillation was attempted after 6 minutes of CPR. Standard advanced cardiac life support was started if defibrillation was not successful. Results: SST-CPR resulted in significantly(p<0.001) higher systolic arterial pressure(91±47 vs 47±24 ㎜ Hg), diastolic pressure(43±24 vs 17±10 ㎜ Hg), coronary perfusion pressure(35±25 vs 13±9㎜ Hg), and end tidal CO2 tension(9±4 vs 3±2 ㎜ Hg). Two of 13 animals(15 %) resuscitated with S-CPR and six of 12 animals(50%) resuscitated with SST-CPR survived until 12 hours after cardiac arrest(p<0.05). Donclusion: SST-CPR, compared with S-CPR, improves the short-term survival rate in canine cardiac arrest.

골반염증성 질환과 질염을 가진 환자의 진단과 추적관찰에서 Chlamydia trachomatis의 검출을 위한 이중 중합효소 연쇄반응의 적용

이진우,조현철,최규연,배동한,김휘준 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Objectives : PCR has generally been more sensitive than the conventional microbiological test for the detection of C.trachomatis which has been a leading cause of sexually transmitted disease. The purpose of this study was to evaluate the prevalence of C.trachomatis infection in the patients with pelvic imflammatory disease(PID) and the usefulness of nested PCR as a follow-up test in patiens with C. trachomatis infection after administration of antibiotics. Methods: Cervical swab specimens were obtained from 187 patients with PID and vaginitis attending the Soonchunhyang Chunan Hospital. From the C. trachomatis positive patients, cervical swab specimens were obtained once a week after treatment until PCR tested negative. We performed the nested PCR with Chlamydia-CR kit(Bioneer, Korea.) Results: From 6(5.8%) of 187 cervical swab specimen, C. Trachomatis was detected by nested PCR. These patients were treated with doxycycline and metronidazole for 7 to 14 days. All of 6 C. trachomatis positive patients revealed PCR-negative immediately after the completion of antibiotics treatment. Conclusions: With the above results, the nested PCR is a relatively simple, fast, and practical tool for the detection of C. trachmatis and may be a useful follow-up test for monitoring the treatment effect.

두가지 혈류 유발방법에 의한 새로운 심폐소생술(이중 혈류 유발 심폐소생술)장치의 개발

황성오,김현,조준휘,오범진,임종천,최경훈,윤정한,이승환,김영식,이강현,이윤선 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. Methods and results: we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To determine strap width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of strap in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the stemum was depressed to 5 cm. Cardiopulmonary resusciation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal study using two dogs. Conclusion: New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.

외상환자에서 전신성 염증 반응 증후군 (Systemic Inflammatory Response Syndrome)의 발생과 혈청 TNF-α와의 관계

김현,이강현,임종천,조준휘,오범진,황성오 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background and purpose: The systemic inflammatory response syndrome(SIRS), as defined recently by critical-care specialists, may result from various etiologies including infection, burn, or trauma. The purpose of this study was to determine whether TNF-αis associated with the development of systemic inflammatory response syndrome caused by multiple trauma. Methods: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study. Multiple blood samples were serially drawn to measure serum TNF-αlevel on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-αwas measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value for serum TNF-α. Results: Serum TNF-αlevels of SIRS group were persistently elevated above reference value until 3 days after on admission. Peak serum TNF-αlevel at 12 hours after admission was higher in SIRS group than non-SIRS group(p<0.05). There was no significant correlation between injury severity score and TNF-αlevels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. Conclusion: The result of this study suggests that persistent elevation of TNF-αand degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.

심초음파로 결정된 응급 심낭천자술의 천자부위

김성환,황성오,이강현,조준휘,강구현,문중범,이승환,윤정한,최경훈,김영식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. Methods: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital, Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0 cm was considered as the primary safety factor in determining the Puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. Results: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area In 11 patients(12%), and the right parastemal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31 ±21 mm in patients with the subcostal approach and 21±8 mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intraperical pressure among patient groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach.

인천 인현동 호프집 화재 피해자 분석

최정태,안무업,안희철,최영미,정재봉,서정열,유기철,이삼우,박석현,조준휘,김성환,김아진,송근정 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Purpose : This study was conducted to develop field triage, transportation, distribution, and prehospital care at a fire disaster by analyzing the victims of the fore that broke out at a bar in Incheon. Method : We analyzed the cases of the victims of a fire in Incheon in Oct. 1999. We determined the primary care hospital, the arrival time, the burn size, the outcome, and the injury type from the medical records, the concerned organ records, and interviews with concerned persons. Result : The total number of victims was 137: 56 prehospital deaths, 1 hospital death, and 80 survivals. The Pearson correlation coefficient between the burn size and the severity was -0.175. There were 121(89.6%) cases of inhalation injury, 59 (43.7%) cases of flame burns, 66 (48.9%) cases of hypoxic brain damage, and 16 (11.9%) cases involving other types of injury. Conclusion : The causes of death of the fire victims were inhalation injury and hypoxic brain damage due to CO poisoning and other toxic inhalants. We propose the use of a simple triage and rapid treatment(START) system and a reassessment the delayed category in fire disasters.

Reduced beta-catenin expression in the hippocampal CA1 region following transient cerebral ischemia in the gerbil.

Cho, Jeong-Hwi,Yan, Bing Chun,Lee, Young Joo,Park, Joon Ha,Ahn, Ji Hyeon,Kim, In Hye,Lee, Jae-Chul,Kim, Young-Myeong,Lee, Bonghee,Cho, Jun Hwi,Won, Moo-Ho Kluwer Academic/Plenum Publishers 2013 Neurochem Res Vol.38 No.5

<P>Beta-catenin, a transcription factor, plays a critical role in cell survival and degradation after stroke. In this study, we examined changes of expression in beta-catenin in the hippocampal CA1 region of the gerbil following 5 min of transient cerebral ischemia. We observed neuronal damage using cresyl violet staining, neuronal nuclei immunohistochemistry and Fluro-Jade B immunofluorescence. Four days after ischemia-reperfusion (I-R), most of pyramidal cells in the CA1 region were damaged. In addition, early damage in dendrites was detected 1 day after I-R by immunohistochemical staining for microtubule-associated protein 2 (MAP-2), and MAP-2 immunoreactivity was hardly detected in the CA1 region 4 days after I-R. We found that beta-catenin (a synapse-enriched cell adhesion molecule) was well expressed in dendrites before I-R. Its immunoreactivity was well colocalized with MAP-2. Chronological change of beta-catenin immunoreactivity was novelty in the present study. Twelve hours after I-R, its immunoreactivity was decreased in the stratum radiatum of the CA1 region, however, its immunoreactivity was increased 1 and 2 days after I-R, and decreased sharply 4 days after I-R. However, we did not find any change in beta-catenin immunoreactivity in the CA2 and CA3 region. In brief, we suggest that early change of beta-catenin expression in the stratum pyramidale of ischemic hippocampal CA1 region is associated with early dendrite damage following transient cerebral ischemia.</P>

Accelerated and Exacerbated Effects of High Dietary Fat on Neuronal Damage in the Gerbil Septum Induced by Transient Cerebral Ischemia

Jeong-Hwi Cho,Joon Ha Park,Ji Hyeon Ahn,In Hye Kim,Jae-Chul Lee,Bai Hui Chen,Hyunjin Tae,Ki-Yeon Yoo,Yun Lyul Lee,Moo-Ho Won,Jun Hwi Cho 한국실험동물학회 2014 한국실험동물학회 학술발표대회 논문집 Vol.2014 No.2