국내에서 분리된 Vancomycin 내성 장구균에 대한 분자역학적 연구

김수정,이남용,배직현,이경원,이위교,김의종,최명식,백경란,김성민,송재훈 대한감염학회 1998 감염 Vol.30 No.1

목 적 : 장구균은 병원 감염의 원인균으로서 최근 그 빈도와 중요성이 증가하고 있다. 특히 vancomycin에 내성을 보이는 장구균(VRE)은 효과적인 치료약제가 드물고, 그 내성 유전자가 vancomycin에 감수성을 보이는 다른 장구균이나 그람양성 구균에 전달될 수 있어 임상적인 중요도가 더욱 크다. 본 연구에서는 국내 5개 병원에서 분리된 VRE 균주의 표현형과 유전형을 결정하고, 분자역학적 방법을 이용하여 유전적 연관성 여부를 밝히고자 하였다. 방 법 : 각 병원에서 수집된 균주는 환자의 임상 검체에서 또는 VRE 집락화에 대한 선별검사에서 분리된 균주였다. 이들을 대상으로 vancomycin과 teicoplanin의 MIC를 측정하여 표현형을 결정하였으며, PCR로 vancomycin 내성 유전자를 증폭하여 유전형을 결정하였다. 또한 이들중 vanA와 vanB 유전자를 갖는 균주들을 대상으로 플라스미드 분석과 PFGE를 시행하였다. 결 과 : VRE로 최종 동정된 균주들은 42균주(E. faecium 21주, E. faecalis 6주, E. avium 2주, E. casseliflavus 13주)였으며, 항균제 감수성 양상으로 결정한 표현형은 VanA, VanB, VanC형이 각각 14주(33%), 7주(17%), 21주(50%)였다. PCR로 결정한 유전형은 vanA 12주(E. faecium), vanC 16주 였으며, 이중 VanA의 표현형을 보인 E. faecium 2주가 VanB의 유전형으로 판명된 것을 제외하면 표현형과 유전형은 모두 일치하였다. 플라스미드 분석과 PFGE 결과, 병원내 동일 균주의 전파 가능성이 5개 병원중 3병원에서 증명되었다. 결 론 : 국내 병원에서도 vancomycin 내성 유전자를 갖는 VRE가 다수 분리되고 있음을 확인할 수 있었으며, 연구 결과 일부 병원에서 내성균주의 병원내 전파 가능성을 시사하였다. 아직까지 국내에서 VRE로 인한 감여보고는 적지만 곧 임상적으로 문제가 될 것으로 판단되며, 따러서 내성균의 발생이나 확산을 억제하기 위한 노력과 감시가 필요할 것으로 생각된다. Background : Enterococci have emerged in recent years as a frequent cause of life-threatening nosocomial infections. The emergence of vancomycin-resistant enterococci(VRE) presents as an increasingly important problem particularly in the treatment and the potential dissemination of vancomycin-resistance. The purpose of this study is to determine the phenotypes and genotypes of VRE isolated from five hospitals and to study the genetic relatedness among them. Methods : Antimicrobial susceptibility patterns and amplification of vancomycin resistance genes were used for phenotyping and genotyping of 42 VRE isolates respectively. For 21 isolates with vanA or vanB gene, plasmid profiles and pulsed field gel electrophoresis(PFGE) patterns were analyzed for molecular epidemiologic study. Results : Out of 42 isolates, 21 were identified as E. faecium, 6 as E. faecalis, 2 as E. avium, and 13 as E. casseliflavus. Phenotyping showed 14 isolates as VanA(33%), 7 as VanB(17%) and 21 as VanC(50%). Genotyping resulted in 12 isolates as VanV(5 of E. faecalis and 7 of e. faecium) and 9 as VanB(all E. faecium). Genotyping results were concordant with phenotyping results except for the two E. faecium isolates of VanA which had VanB genotype. Intrahospital spread of the same strains was proven in three hospitals by plasmid profiles and PFGE analysis. Conclusion : The study demonstrated a considerable number of VRE isolates in Korea and intrahospital spread proven by molecular epidemiologic methods. Although VRE infection has been considered very are in Korea, practical guidelines including restriction of vancomycin usage and surveillance, are warranted to prevent infection and dissemination of VRE.

Effect of C-reactive protein (CRP) on Pregnancy Outcome after Ultrasound-indicated Cerclage

( Young Ran Lee ),( Gong Ju Choi ),( Ji Eun Song ),( Su Ran Choi ),( Keun Young Lee ) 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Developing a Monitoring System for Toothbrushing

Ok Su Kim,Sang Woo Kim,Ji Sun Kim,Hong Ran Choi,Ok Joon Kim 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.2

Proper oral hygiene is required to maintain oral health and prevent oral disease. Toothbrushing is central to proper oral hygiene. Mechanical tooth cleaning is the mainstay of plaque control. A variety of toothbrushing techniques have been developed and evaluated for their efficacy. However, these evaluations are subjective. To adequately evaluate toothbrushing objectively, a novel toothbrushing monitoring system was developed. The system involves user-monitored brushing patterns including toothbrush motions using a 3-axis gyroscope, 3-axis accelerometer, 3-axis magnetic sensor, one load-cell and Bluetooth devices. To confirm the efficacy of this toothbrushing monitoring system, eight periodontist performed tooth brushing in a dental model, and their brushing motion was monitored and recorded, and evaluated by statistical means. The proposed monitoring system can be used to aid dental care personnel in toothbrushing instruction.

Progesterone receptor membrane component 1 in fetal membranes with preterm labor, preterm premature rupture of membrane, and chorioamnionitis

( Soo Ran Choi ),( Ji Young Seo ),( Hyung Eun Choi ),( Eunae Jo ),( Hwayeon Choi ),( Su Kyung Jung ),( Shina Jang ),( Sung Ook Hwang ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: Progesterone receptor membrane component 1(PGRMC1) is one of membrane progesterone receptors that to directly activates intracellular signaling cascades. Although PGRMC1 may have anti-inflammatory and anti-apoptotic actions, the role of PGMC1 in fetal membranes remains unclear. Preterm labor (PTL) and preterm premature rupture of membrane (PPROM) are association with inflammation in fetal membranes. The purpose of our study was to determine the expression of PGRMC1 in fetal membranes with PTL, PPROM, and acute histologic chorioamnionitis (HCA). Methods: Full thickness of fetal membranes were obtained from women with preterm birth (PTB), gestational age matched (32-34weeks of gestational age), combined PTL without HCA (PTL, n=10), PPROM without HCA (PPROM, n=10), and PTB with HCA (HCA, n=10) and from women undergoing term elective cesarean delivery without labor or HCA (T, n=9). The expression of PGRMC1 was assessed by Western blot and densitometric analysis. Because CD14 is a component of the innate immunity, CD14 was used for inflammatory indicator. Immunohistochemistry (IHC) with specific antibodies to PGRMC1 and CD14 was done. Nonparametric statistics was used for analysis. Results: All layers of fetal membrane, amnion, chorion, and deciduas had PGRMC1 expression. PGRMC1 expressions in PTB including PTL (mean 0.28±0.07, p=0.01), PPROM (mean 0.59±0.19, p=0.22), and HCA (mean 0.16±0.07, p=0.003) were decreased than in those of T (mean 0.87±0.48). Especially, in PTB with HCA PGRMC1 expression was significantly decreased compare to PTL and PPROM (p=0.006, p=0.001, respectively). CD 14 was inversely expressed proportional to PGMC1 (r = - 0.518, p =0.002). PGRMC1 expression in PPROM was higher than those of PTL (p=0.002), although there was no difference in expression level of CD 14 (p=0.458). IHC showed that PGRMC1 was predominantly in the cytoplasm of cells, and represented immunoreactivity consistent with immunoblotting results. Conclusion: PTB with PTL, PPROM, and especially HCA are associated with a decreased PGRMC1 in fetal membranes along with inversely increased of CD 14. PGRMC1 expression in PPROM was higher than those of PTL. Acknowledgements: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea goverment (No. 2017R1D1A1B03029882)

Effect of Lepidium spp. (Maca) Extract on the Improvement of Sexual Function in Rats Induced Erectile Dysfunction with Ethanol

Hye Ran Choi,Min Jung Lee,Su Jung Lee,Hee Jeon Park,Ji-Young Song,Il Su Kim,Daekeun Shin 한국식품영양학회 2018 한국식품영양학회 학술대회논문집(학술심포지움) Vol.2018 No.06

Health-related Quality of Life Outcomes of Adalimumab for Patients With Rheumatoid Arthritis in Korea

( Myeung-su Lee ),( Chang Hoon Lee ),( Hye Soon Lee ),( Yoon-kyoung Sung ),( Jung Ran Choi ),( Kyungsu Park ),( Mi-kyoung Lim ),( Byoong Yong Choi ),( Hyoun-ah Kim ),( Seung Won Choi ),( Yusun Lee ),( 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.2

Objective. Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disorder that impairs patients’ overall health-related quality of life (HRQOL). In this study, we evaluated the effect of adalimumab in Korean patients with active RA on HRQOL. Methods. Patients included in the study had moderate to severe active RA that did not respond to conventional drugs with a Disease Activity Score of 28 joints >3.2 and were biologics-naïve. All patients received adalimumab 40 mg subcutaneously every other week and were followed for 24 weeks. The primary endpoint was the change in baseline Health Assessment Questionnaire Disability Index (HAQ-DI) score at week 24. Secondary endpoints were changes in the EuroQol 5-dimension 3-Level (EQ-5D-3L) baseline score and Short Form 36-Item Health Survey (SF-36) domain scores at weeks 12 and 24 and change in baseline HAQ-DI score at week 12. Results. In total, 91 Korean patients were included. Ninety-three percent of patients were in high disease activity with a baseline mean DAS28 value of 6.1 within all patients. The mean change from baseline in HAQ-DI scores were -0.46 at week 12 and∼0.67 at week 24 (p<0.0001). Additionally, EQ-5D-3L score at weeks 12 and 24 had significantly improved (p<0.0001) compared to baseline. SF-36 at weeks 12 and 24 had significantly improved (p<0.0001, p=0.0001) compared to baseline. Conclusion. Treatment with adalimumab resulted in significant improvement in HAQ-DI, EQ-5D-3L, and SF-36 scores at 12 and 24 weeks in Korean RA patient. (J Rheum Dis 2021;28:68-75)

40세 이후 고령 산모의 임신과 출산의 임상적 고찰

최수란 ( Su Ran Choi ),김광준 ( Gwang Jun Kim ),이순표 ( Soon Pyo Lee ),김석영 ( Suk Young Kim ),윤성준 ( Seung Jun Yoon ),이의돈 ( Eui Don Lee ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3

목적 : 40세 이상 고령산모의 임신과 출산의 임상 양상을 파악하여 향후 고령산모의 임신과 출산에 도움을 주고자 한다. 연구 방법 : 1999년 1월부터 2001년 6월까지 가천의과대학교 산부인과에서 분만한 7,882명의 산모중 임신 20주 이후에 분만한 40세 이상의 산모 95명을 연구군으로 하였고, 이 기간 동안 무작위로 추출한 20세 이상 40세 미만의 산모 94명을 대조군으로 하여 통계학적으로 비교 분석하였다. 결과 : 출산율은 40세 이상 고령 Objective : To access the pregnancy tendency and delivery in women aged 40 years and older. Methods : From January 1999 to June 2001, 7882 deliveries were in Gacheon Medical School. Among them we compared 95 cases of pregnant women aged 40 years and older

기계학습 기반 사람 검출 및 위험 감지 기술

김성현 ( Seonghyun Kim ),이원재 ( Wonjae Lee ),박영수 ( Young-su Park ),이용태 ( Yong-tae Lee ) 한국정보처리학회 2017 한국정보처리학회 학술대회논문집 Vol.24 No.1

재난관리 및 대응 분야에서는 무인기의 낮은 운영비용과 자유로운 이동능력의 장점을 토대로, 무인기를 활용한 다양한 재난대응 방안이 연구되고 있다. 본 논문은 무인기를 통해 획득한 항공영상에 대하여, 기계학습 기반의 영상분석을 통한 사람 검출 및 사람 위험 감지 기술을 제안한다. 제안하는 기법은 사람 검출을 위한 딥러닝 네트워크와 범람지역 검출을 위한 딥러닝 네트워크로 구성된다. 제안하는 기법에서 사용하는 두 개의 딥러닝 네트워크를 통해, 사람의 단순 검출뿐만 아니라, 범람지역과 같은 위험지역 검출을 통해, 사람의 위험도를 판단할 수 있다.

TNF-α 억제제 사용 후 비장 결핵이 발생한 류마티스관절염 환자의 Rituximab 치료

김진수 ( Jin Su Kim ),최정란 ( Jung Ran Choi ),송정수 ( Jung Soo Song ),김경준 ( Kyung Joon Kim ),박윤수 ( Youn Su Park ),조준환 ( Jun Hwan Cho ),한민지 ( Min Jee Han ),최상태 ( Sang Tae Choi ) 대한류마티스학회 2013 대한류마티스학회지 Vol.20 No.2

저자들은 류마티스관절염에서 TNF-α 억제제 치료 후에 비장 결핵이 발생한 64세 여자 환자를 진단하고 치료하였으며, 결핵 치료 도중 악화된 류마티스관절염에 대하여 결핵의 악화 없이 rituximab으로 치료한 경험을 하였기에 이에 보고하는 바이다. One of the most important adverse effects of a tumor necrosis factor (TNF)-α inhibitor is the reactivation of tuberculosis. Most of them occur in the lung, but sometimes they can be found in other organs. Moreover, the proper management of active rheumatoid arthritis (RA) in patients with anti-TNF-α associated tuberculosis is still in debate. We present the case of a seropositive RA patient who showed good response with rituximab, an anti-CD20 monoclonal antibody, after developing splenic tuberuculosis, following treatment with TNF-α inhibitor. Confirming a diagnosis of splenic tuberculosis is difficult and can be delayed due to its nonspecific symptoms and rare occurrence. This case suggests that splenic tuberculosis should be doubted in RA patients treated with TNF-α inhibitor, and that rituximab may be considered as an alternative treatment option in RA patients with anti-TNF-α associated tuberculosis.

Species Identification of Nontuberculous Mycobacteria (NTM) by PCR-Restriction Fragment Length Polymorphism (PRA) of the rpoB Gene from Three Hospitals of Busan-Kyeongnam Area

Choi, Sung-Ran,Kang, Min-Jung,Park, Gyu-Hwan,Kim, Da-Hye,Jeong, Da-Woon,Seo, Eun-Hye,Lee, Hyang-Min,Park, Hyun-Kyung,Jeong, Jin-Yee,Lee, Jung-Min,Jeong, Soo-Young,Lee, Jun-Young,Cho, Eun-Jin,Jekal, Su 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.2

Recently, the isolation rate of nontuberculous mycobacteria (NTM) in clinical laboratories and the incidence of NTM infections are on the increase in Korea, but there have been only a few studies that reveal the general aspect of NTM isolation or species distribution. Therefore, this study was performed to examine the species identification by PCR-restriction fragment length polymorphism analysis (PRA, PCR-RFLP), and the clinical significance of mycobacterial cultures. PRA was used during the novel region of the rpoB gene and was developed for rapid and precise identification of mycobacteria to the species level. From January 2012 to April 2012, we examined pre-identified nontuberculous mycobacteria (60 species in 3 hospital of Busan-Kyeongnam area). We confirmed 4 (6.6%) Mycobacterium tuberculosis (MTB) and 56 (93.4%) NTM from 60 pre-identified NTM species by multiplex PCR (MolecuTech $MTB-ID^R$ V3, YD Diagnostics, Korea) and PRA (Myco-ID, YD Diagnostics, Korea). The distribution of 56 NTM species were M. intracellulare type I 15 (26.7%), M. avium 14 (25%), M. abscessus 11 (19.5%), M. kansasii type I 3 (5.4%), M. pulveris 2 (3.6%), M. intracellulare type, M. chelonae, M. kansasii type V, M. gallinarum, M. wolinskyi. Respectively, 1 (1.8%) and 6 (10.7%) species were not identified.