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.

황색포도구균의 균혈증에서 초기 항생제 치료가 예후에 미치는 영향

김성한,박완범,이기덕,강철인,최영주,김홍빈,박상원,김의석,오명돈,김의종,최강원 대한감염학회 2002 감염 Vol.34 No.5

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

Mycobacterium mageritense에 의한 당뇨병성 족부 감염증 1예

김충종,김낙현,김문석,김계형,전재현,박문석,박경운,박완범,박상원,김홍빈,김남중,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Diabetic foot infection is one of the important complications in patients with advanced diabetes mellitus. Limb threatening infections such as osteomyelitis, abscess, and necrotizing fasciitis are frequently accompanied by the disease. Non-tuberculous mycobacterium (NTM) is a rare causative organism of diabetic foot infection. Thus, if one is not suspicious or meticulous, infection due to NTM will be easily overlooked and this will result in delayed diagnose and treat. Therefore, it is necessary to consider NTM as the causative organism if the wound does not respond to the conventional antibiotic treatment and the culture from the adequately obtained specimen reveals atypical acid-fast bacilli. We present a case of diabetic foot infection with osteomyelitis and abscess due to Mycobacterium mageritense, one of the rapid growing mycobacteria, that was successfully treated with surgical debridement and appropriate antibiotic treatment.

중추신경계 합병증을 동반한 삼일열 말라리아 1례

김문석,김가연,강유민,김낙현,전재현,박완범,김홍빈,김남중,박상원,홍윤호,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Plasmodium vivax malaria is an endemic disease in Korea, which rarely causes severe complications including those occurring in the cerebrum. There are limited numbers of complicated cases that have been reported around the world. We experienced a case of vivax malaria with cerebral complication: cognitive impairment and ataxia. A 55-year-old female with diabetes mellitus presented to the emergency department with acute fever of two days’ duration. She did not have any history of travelling abroad or receiving blood transfusions. Peripheral blood smear revealed vivax malaria with parasitemia density of 0.53 percent. She demonstrated loss of orientation, especially regarding time and place, and ataxia. Although the initial hydroxychloroquine treatment for malaria was successful, cognitive impairment and ataxia persisted and were not recovered. Brain MRI showed no structural abnormality. Brain PET showed diffuse hypometabolism in right parieto-temporal lobe of the brain.

일렬 자가조혈모세포이식을 받은 다발성 골수종 환자에서 발생한 뇌 톡소포자충증 1례

김계형,송경호,전재현,박완범,박상원,김홍빈,김남중,김인호,오명돈 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant recipients, usually associated with allogeneic hematopoietic stem cell transplantation (HSCT). We report a case of cerebral toxoplasmosis in a patient with multiple myeloma, following tandem autologous stem cell transplantation. A 55-year-old Korean male presented with weakness in both legs that had progressed to both arms. A magnetic resonance imaging scan of the brain revealed multiple, variablesized ring-enhancing lesions with surrounding edema in the cerebral hemispheres and brain stem. Stereotactic biopsy revealed bradyzoites of Toxoplasma gondii in the brain tissue. The patient received trimethoprim-sulfamethoxazole, followed by pyrimethamine and sulfadiazine, accompanying treatment for progressive multiple myeloma. Cerebral toxoplasmosis should be considered as one of the differential diagnoses in patients with neurologic signs following autologous HSCT.

결핵치료제인 시판 리팜피신제제의 생체내 이용율

김종두,안기완,서영환,조경상,김철,김상도,홍순표 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.1

This study was attempted to investigate the dissolution rate and the bioavailability of commercially available rifampicin preparations after oral administration in nine normal volunteers. Cross-over design was used for the analysis. The dissolution test was conducted in artificial gastric juice and artificial intestinal juice using basket method with four rifampicin preparations (A, B, C, and D) which were pharmaceutically equivalent. The results were as follows; The dissolution rate was higher in the order of A>C>B>D in artificial gastric juice, and A>B>C>D in artificial intestinal juice. Area under the blood concentration time curve (AUC) was larger in order of A>C>B>D. Relative bioavailability(%) of rifampicin preparations were 93.6% for B, 97% for C, 84.4% for D preparation compared with standard A preparation. Peak blood concentration (Cmax) was higer in order of A>B>C>D. Peak time (Tmax) was larger in order of D>C>A>B. Absorption rate constant (Ka) was larger in order of B>A>D>C. there was little difference in elimination rate constant and biological half-life. The correlation of the dissolution rate in artificial gastric juice and area under the blood concentration time curve as well as correlation of the dissolution rate in artifical intestinal juice and peak time showed significant linear relationship. From the result of the this experiments, it can be concluded that for the choice of preparations, bioavailability must be performed in man because the bioavailability of rifampicin preparations showed big differences among commercial preparations which were abvertised as pharmaceutically equivalent, and that the bioavailability of rifampicin preparations in man partially could be predicted from the results of dissolution rate.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

간호사들에서 월경전불쾌기분장애와 삶의 질, 사회직업기능 및 장애 간의 연관성

김선영,김재민,김웅장,양수진,김성완,신일선,윤진상 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : This study aimed to investigate the prospective associations of premenstrual dysphoric disorder (PMDD) with quality of life, socio-occupational function and disability. Methods : 170 nurses were recruited 6om two general hospitals. Interviews were made at baseline and at four follow-up points (two mid follicular phases and two late luteal phases ofthe two consecutive menstrual cycles). The baseline evaluation Consis-ted of sociodemographic characteristics and menstmal history. PMDD was diagnosed by DSM-IV criteria after observation of the two menstrual cycles. The follow-up evaluations were consisted ofthe World Health Organization Quality of Life-Brief form, the Social and Occupational Functioning Assessment Scale, and the World Health Organization Disability Assessment Scale-II. Results : PMDD was detected 15 (8.8%) of 170 participants. The PMDD group showed significantly worse quality of life and socio-occupational functioning than the none-PMDD group particularly at the late luteal phases. No significant differences were found in sociodemographic characteristics and menstrual history between those with and without PMDD. Conclusion : PMDD was prospectively associated with worse quality of life and socio-occupational functioning in this study group.

Effect of Developmental Lead Exposure on the Expression of Hippocampal NMDA Receptor Subunit mRNA

Kim, Tae-Wan,Chung, In-Sung,Bae, Jae-Hoon,Shin, Dong-Hoon,Lee, Mi-Young,Kim, Joon-Sik 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

목적: in vivo 및 vitro에서 해마 신경세포의 발생단계별 NMDA 수용체 아단위 mRNA 발현에 대한 연 폭로 영향을 알아보고자 하였다. 방법: 흰쥐 해마 신경세포의 발생단계별 NMDA 수용체 NR2A, NR2B 아단위 mRNA 발현에 대한 연의 영향은 정상군과 연 폭로군의 출생 후 7일, 14일, 22일 흰쥐의 해마에서 in situ hybridization으로 mRNA 발현 정도를 densitometer로 측정하여 비교하였고, 연과 NMDA 의 세포독성은 해마 신경세포 일차배양 후 도립현미경을 이용한 형태학적인 관찰과 LDH 활성도를 이용하여 측정하였다. 결과: 연 과 NMDA 에 의한 세포독성에 대한 in vitro 실험에서 형태학적 소견과 LDH 활성도에서 해마 미성숙 신경세포와 성숙 신경세포사이의 차이가 있었으므로, 연과 NMDA 독성효과는 해마 신경세포의 발달 단계에 따라 차이가 있다. 정상군의 해마에서의 NR2A mRNA 발현은 출생 후 연령이 증가함에 따라 점진적으로 증가하였으나, NR2B mRNA 발현은 출생 후 연령이 증가함에 따라 점진적으로 증가하였으나 NR2B mRNA 발현은 연령의 증가에 따른 변화가 없었다. 연 폭로에 희한 NR2A mRNA 발현은 유의하게 감소하였으나(p<0.05), NR2B mRNA 발현은 변화가 나타나지 않았다. 만성적 연 폭로는 NR2A를 포함하는 NMDA 수용체를 감소시킬 수 있음을 알 수 있다. 결론: 연은 해마신경세포의 발생단계에서 NMDA 수용체 아단위 특히 NR2A mRNA 발현의 변화를 야기하여 시냅스 신호 전달에 영향을 나타냄을 알 수 있었다. Hippocampus