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Escherichia coli O157:H7 감염의 신속한 분자생물학적 진단
신형식,오태근,신종성,지정훈,손보라,신경섭 대한감염학회 2001 감염 Vol.33 No.2
Background : Sorbitol fermenting Escherichia coli O157 were reported. And E. coli O157 : H7 produce various Shiga toxin (Stx) such as Stx1, Stx2, or variants of Stx2. In this study, we tried to establish laboratory methods that detect E. coli O157 : H7 quickly and precisely by analyzing sensitivity of colony hybridization test and PCR technique. Methods : Stx1-producing E. coli ATCC 43890, Stx2-producing E. coli ATCC 43889, and Stx2vha- producing E. coli ATCC 51435 were tested. Three strains of E. coli were diluted with 0.1 g of diarrheal stools from 107 CFU to 101 CFU respectively. The stool samples were incubated overnight in MacConkey agar plates. A mean of 63 colonies were hybridized by stx1- and stx2-specific oligonucleotide probes. PCR for stx1 gene and stx2 gene was done after overnight-incubation of stool samples in the LB broth with vancomycin (6 ug/mL). Positive colonies by colony hybridization were confirmed by PCR for stx1 gene and stx2 gene. Results : Colony hybridization test could detect Stx1-producing E. coli at 103 CFU per 0.1 g of stool, Stx2-producing E. coli at 105 CFU per 0.1 g of stool, and Stx2vha-producing E, coli at 104 CFU per 0.1 g of stool. PCR technique after enrichment in LB broth with vancomycin (6 ug/mL) could detect stx1-, stx2-, and stx2vha-containing E. coli at 10 CFU per 0.1 g of stool respectively. Conclusion : A combination of colony hybridization and PCR after enrichment in broth with van-comycin (6 ug/mL) is usefu1 for the rapid and precise diagnosis of infections of Shiga toxin-producing E. coli O157 : H7.(Korean J Infect Dis 33:97∼103,2001)
외상성 뇌부종 환자에서 감압적 두개절제술의 임상적 의의
신형식,김태홍,황용순,박상근 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objectives: Mortality and morbidity rates of malignant posttraumatic brain swelling remain high depite advances in treatment of increased intracranial pressure. If conventional therapy fails in patients suffering from intracranial hypertension, there is only small number of second-tier option left including decompressive craniectomy. The role of decompressive craniectomy in posttraumatic brain swelling remains controversial. We assessed the efficacy and indications of decompressive craniectomy. Methods: The authors performed decompressive bifrontotemporal craniectomy and dural expansion in 24 patients with malignant posttraumatic brain swelling between January 1997 and March 2000. Epidural pressure monotoring was performed in all patients. The clnical data and surgical outcomes were reviewed retrospectively. Results: The favorable outcome(GOS score 4-5) was 58%(14 of 24 patients), whereas the mortality rate was 29%(7 of 24 patients). Three patients(12%) remained in severely disabled state. Increased rate of favorable outcome was seen in the patients who had 8 or more of GCS score at admission and exhibited B wave in ICP monitoring and who showed steady state or slow deterioration in clinical course. Conclusion: If conservative therapy fails, decompressive bifrontotemporal craniectomy should be considered in the management of malignant posttraumatic brain swelling before irreversible ischemic brain damage occurs.
Empirical Treatment and Prevention of COVID-19
신형식 대한감염학회 2020 Infection and Chemotherapy Vol.52 No.2
The rapid spread of severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2) in the population and throughout the cells within our body has been developing. Another major cycle of coronavirus disease 2019 (COVID-19), which is expected in the coming fall, could be even more severe than the current one. Therefore, effective countermeasures should be developed based on the already obtained clinical and research information about SARS-CoV-2. The aim of this review was to summarize the data on the empirical treatment of COVID-19 acquired during this SARS-CoV-2 infection cycle; this would aid the establishment of an appropriate healthcare policy to meet the challenges in the future. The infectious disease caused by SARS-CoV-2 is characterized by common cold along with hypersensitivity reaction. Thus, in addition to treating common cold, it is essential to minimize the exposure of cells to the virus and to mitigate the uncontrolled immune response. A proper combination of antiviral agents, immune modulators such as prednisolone, and anticoagulants such as heparin and anti-C5a antagonists could be employed to minimize lung damage and prevent systemic involvements. Finally, strategies to achieve population immunity against SARS-CoV-2 should be developed through understanding of the interaction between the immune system and the virus.