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Lidocaine, Thrombin, Epinephrine 의 항균효과
김진우,이동건,전혜선,김승준,김석찬,안중현,김치홍,권순석,김영균,김관형,문화식,신완식,송정섭,박성학 대한감염학회 2005 감염과 화학요법 Vol.37 No.6
목적 : 기관지내시경 검사에서 흔히 사용되는 국소마취제인 lidocaine과 내시경시 지혈목적으로 사용되는 thrombin과 epinephrine이 각종 균주에 미치는 항균효과에 대해 알아보고자 하였다. 재료 및 방법 : 균주는 가톨릭대학교 성모병원에서 2004년 3월부터 2004년 9월까지 임상검체 에서 동정된 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 각각 42, 42, 42, 43주를 대상으로 하였다. Lidocaine, thrombin, epinephrine 감수성 검사는 National Committee for Clinical Laboratory Standards (NCCLS, 2002)의 기준에 따랐다. 결과 : Lidocaine은 S. aureus, S. pneumoniae, P. aeruginosa에서 MIC_(50), MIC_(90) 모두 20,000 ㎍/mL 이었다. K. pneumoniae는 각각 10,000 ㎍/mL이었다. Thrombin은 S. aureus와 P. aeruginosa에서 MIC50 500 lU/mL 과 MIC_(90) 500 IU/mL 이상이었고, K. pneumoniae에서는 MIC_(50)과 MIC_(90)이 모두 500 lU/mL이상이었으나 S. pneumoniae에서는 MIC_(50)과 MIC_(90)은 125 IU/mL이었다. Epinephrine은 K. pneumoniae, S. pneumoniae에 대한 MIC_(50), MIC_(90)가 모두 >500 ㎍/mL이었고, S. aureus와 P. aeruginosa에 대한 MIC_(50), MIC_(90)가 모두 500 ㎍/mL이었다. 결론 : 기관지 내시경 검사에서 흔히 쓰이는 lidocaine, thrombin, epinephrine 등의 약제들이 호흡기 질환의 흔한 병원균인 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 균주들에 대해 항균 효과가 있을 수 있어 세균배양검사에 영향을 미칠 수 있겠다. Background : We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. Materials and Methods : The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. Result : MIC_(50) and MIC_(90) of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 ㎍/mL and that for K. pneumoniae were 10,000 ㎍/mL. MIC_(50) and MIC_(90) of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC_(50) and MIC_(90) of epinephrine for K. pneumoniae and S. pneumoniae were above 500 ㎍/mL; that for S. aureus and P. aeruginosa were 500 ㎍/mL. Conclusion : We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.
2002년 울산지역에서 유행한 무균성 뇌막염에 대한 임상적 고찰
김치관(Chi Kwan Kim),하태영(Tae Young Ha),이준화(Jun Hwa Lee),윤재득(Jae Deuk Yoon),김영돈(Young Don Kim),지영미(Young Mee Jee),박상규(Sang Kyu Park),정진영(Jin Young Jung) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.2
목 적 : 2002년 울산지역에서는 무균성 뇌막염이 급속히 유행하여 많은 소아들이 입원하여 치료하였다. 이에 저자들은 울산에서 유행한 무균성 뇌막염의 임상 양상과 검사소견 및 원인을 파악하고자 본 연구를 시행하였다. 방 법 : 2002년 5월부터 7월까지 울산대학교병원 소아과에 입원하여 무균성 뇌막염으로 진단받고 치료한 371명의 환자를 대상으로 성별, 나이, 임상증상에 대해 조사하였고 말초혈액 검사, 뇌척수액 검사를 시행하였으며 바이러스 배양검사는 뇌척수액, 분변을 채취하여 실시하였다. 결 과 : 1) 성별 분포는 남아 242례(65.2%), 여아 129례(34.8%)로 남녀비는 1.9:1로 남아에서 더 호발하였다. 2) 연령별 분포는 0-1세 미만군이 14례(3.8%), 1-5세군이 155례(41.8%), 6-10세군이 115례(31.0%), 11-15세군이 87례(23.5%)로 1-5세군에서 가장 많이 발생하였으며 평균 연령은 6.8±5.1세였다. 3) 임상증상은 발열 346례(93.3%), 두통 308례(83.0%), 구토 292례(78.7%), 복통 91례(24.5%) 순이었고 경부강직은 60례(16.2%)에서 보였으며 발열의 기간은 평균 3.2±1.8일이었다. 4) 말초혈액 검사상 백혈구 수는 평균 10,355±4,800/mm³였으며 CRP는 평균 0.96±1.67 mg/dL였다. 5) 뇌척수액 검사상 백혈수 수는 6-4,830/mm³으로 평균 212±385/mm³였으며 500/mm³ 미만이 88.4%로 대부분을 차지하였으며 다핵구가 평균 29.3±28.9%, 림프구가 평균 55.2±28.8%였다. 뇌척수액의 평균 단백은 37.0±18.9 mg/dL, 당은 68.3±17.6 mg/dL였다. 6) 장바이러스 배양 검사상 바이러스가 분리된 경우는 총 371례 중 67례(18.1%)였다. 이중 분변에서는 98례 중 39례(39.8%), 뇌척수액에서는 371례 중 34례(9.2%)에서 분리되었으며 배양 검사상 분리된 바이러스는 echovirus 6형이 10례, echovirus 9형이 15례, echovirus 11형이 4례, echovirus 13형이 18례, 분류되지 않은 enterovirus가 20례였다. 결 론 : 2002년 울산지역에서 유행한 무균성 뇌막염은 임상 양상이나 뇌척수액 검사소견 등이 지금까지 장바이러스에 의한 뇌막염에 대한 보고와 유사하였으며 원인 바이러스는 echovirus 6, echovirus 9, echovirus 11, echovirus 13, unclassified enterovirus 등이었다. Purpose : There occurred an explosive outbreak of aseptic meningitis in Ulsan, in the year of 2002. In this study, we report clinical manifestations, laboratory data and causative viruses of the outbreak. Methods : Were assessed 371 children with aseptic meningitis who were admitted to the Department of Pediatrics, Ulsan University Hospital in Ulsan between May and July, 2002. We reviewed the sex, age, clinical manifestations, peripheral blood examinations and CSF examinations of the patients. Virus isolation and serotype identification were performed by cell cultures of cerebrospinal fluid and stool. Results : The ratio of males to females was 1.9:1. The majority of aseptic meningitis occurred in children between 1 and 5 years of age with a mean age of 6.8±5.1 years. The clinical manifestations was fever, headache, vomiting, and abdominal pain and 16.2% of the patients developed neck stiffness. The mean duration of fever was 3.2 days. The mean value of peripheral blood leukocytes was 10,355±4,800/mm³ and the mean value of CRP was 0.96±1.67 mg/dL. Initial CSF findings revealed leukocytes 212±385/mm³, protein 37.0±18.9 mg/dL and glucose 68.3±17.6 mg/dL. Viruses were isolated 67(18.1%) out of 371 patients and the serotypes were echovirus 6 in 10 cases, echovirus 9 in 15 cases, echovirus 11 in 4 cases, echovirus 13 in 18 cases, and unclassified enterovirus in 20 cases. Conclusion : Aseptic meningitis was prevalent in Ulsan, in the year of 2002. The clinical manifestations and the laboratory findings of the patients were compatible with those of previous reports. The causative viruses were echovirus 6, echovirus 9, echovirus 11, echovirus 13 and unclassified enterovirus.
Kim, Chi,Ahn, Joong,Kim, Seung,Lee, Sook-Young,Kim, Young,Kim, Kwan,Moon, Hwa,Song, Jeong,Park, Sung,Kwon, Soon Taylor Francis 2006 The Journal of asthma Vol.43 No.5
<P>Therapeutic modalities of airway remodeling in asthma have proved to be unsuccessful regarding reversing the previously established chronic airway changes. Recently, the potential of plasmid DNA to inhibit the Th2 immune response has been demonstrated in animal models of asthma. Bacillus Calmette-Guerin (BCG) immunization also induced immunomodulation, which appeared to be reliant on the properties of the interferon-gamma that was produced. Mice were immunized with house dust mite extract (HDM). At the 3 week point, we injected BCG subcutaneously into mice on three successive weeks. One week after the BCG injection, we immunized mice with the DNA plasmid encoding for murine T-cell epitope on Dermatophagoide pteronyssinus 2 thrice weekly. At 9 weeks after immunization, we measured airway responsiveness. Twenty four hours later, we performed bronchoalveolar lavage and histological examinations. Co-administration of DNA vaccination and BCG resulted in a partial suppression of the overproduction of goblet cells and the thickness of the peribronchial smooth muscle in ongoing allergic responses. In the bronchoalveolar lavage fluid, the number of total cells and eosinophils was reduced, and regarding the change of cytokines, the concentration of IL-4 was also decreased, but interferon-gamma was increased in the co-administration group, opposed to the asthma group. These results suggest that co-administration of vaccination with the DNA encoding T-cell epitope and BCG are effective regarding ongoing allergic response and might constitute an ideal method for combating allergic disease in the future.</P>
하부 호흡기 감염에 대한 Cefodizime과 Ceftriaxone 1일 1회 투여의 임상 효과
김치홍,김양리,권순석,김영균,김관형,문화식,송정섭,강문원,박성학 대한화학요법학회 1993 대한화학요법학회지 Vol.11 No.2
Cefodizime is a parenteral bactericidal cephalosporin derivative of cefotaxime possenssing an extended antimicrobial spectrum including Streptococcus pneuminae, Haemophilus influenzae, methicillin susceptible Staphylococcus aureus and most members of the Enterbacteriaceae. The efficacy and safety of cefodizime and been proved by clinical studies of worldwide distribution in various kinds of infection. To evaluate the clinical and antimicrobial efficacy of a single dose of cefodizime versus ceftriaxone in the treatment of patients with lower respiratory infections, we performed open, controlled, randomized study in 45 patients with community acquired pneumonia at Kangnam St. Mary's hospital from June, 1992 to August, 1993. 1) Cefodizime was highly effective clinically in 28 out of 31 patients with lower respiratory infections(response rate; 90.3%), while ceftriaxone showed 78.6% of response rate. 2) 13 out of 14 patients, who sputum evaluable, showed bacterial elimination(bacteriological response rate: 92.9%) by cefodizime. 3) Any significant side effects were not observed during cefodizime treatment except transient skin rash in one patient. Above results showed that a single dose of cefodizime was highly effective antimicrobial regimen in the treatment of lower respiratory infections with negligible side effects.
지속적 양압공급치료로 임상적 호전을 보인 활동성 선단거대증에 동반된 폐쇄성 수면 무호흡증후군
문화식 ( Hwa Sik Moon ),최영미 ( Young Mee Choi ),안석주 ( Seong Ju Ahn ),김치홍 ( Chi Hong Kim ),권순석 ( Soon Seog Kwon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.4