임상강좌 : 감염 ; 국내 발생 브루셀라증

오원섭 대한내과학회 2005 대한내과학회 추계학술대회 Vol.69 No.20

당뇨병과 감염-감염증, 미리 알고 예방하자

오원섭,O, Won-Seop 사단법인 한국당뇨협회 2006 당뇨 Vol.199 No.-

당뇨환자는 정상인에 비하여 특정 감염증의 발생빈도가 높다. 또한 감염증으로 인한 합병증과 사망률이 높기때문에 조기에 진단하여 치료하는것이 매우 중요하다.

Antibiotic Treatment of Vertebral Osteomyelitis caused by Methicillin-Susceptible Staphylococcus aureus: A Focus on the Use of Oral β-lactams

오원섭,Chi Sook Moon,정진원,추은주,곽이경,김시현,류성열,박성연,김백남 대한감염학회 2019 Infection and Chemotherapy Vol.51 No.3

Background: Vertebral osteomyelitis (VO) is a rare but serious condition, and a potentially significant cause of morbidity. Methicillin-susceptible Staphylococcus aureus (MSSA) is the most common microorganism in native VO. Long-term administration of parenteral and oral antibiotics with good bioavailability and bone penetration is required for therapy. Use of oral β-lactams against staphylococcal bone and joint infections in adults is not generally recommended, but some experts recommend oral switching with β-lactams. This study aimed to describe the current status of antibiotic therapy and treatment outcomes of oral switching with β-lactams in patients with MSSA VO, and to assess risk factors for treatment failure. Materials and Methods: This retrospective study included adult patients with MSSA VO treated at nine university hospitals in Korea between 2005 and 2014. Treatment failure was defined as infection-related death, microbiological relapse, neurologic deficits, or unplanned surgical procedures. Clinical characteristics and antibiotic therapy in the treatment success and treatment failure groups were compared. Risk factors for treatment failure were identified using the Cox proportional hazards model. Results: A total of 100 patients with MSSA VO were included. All patients were treated, initially or during antibiotic therapy, with one or more parenteral antibiotics. Sixty-nine patients received one or more oral antibiotics. Antibiotic regimens were diverse and durations of parenteral and oral therapy differed, depending on the patient and the hospital. Forty-two patients were treated with parenteral and/or oral β-lactams for a total duration of more than 2 weeks. Compared with patients receiving parenteral β-lactams only, no significant difference in success rates was observed in patients who received oral β-lactams for a relatively long period. Sixteen patients had treatment failure. Old age (adjusted hazard ratio [HR] 5.600, 95% confidence interval [CI] 1.402 – 22.372, P = 0.015) and failure to improve C-reactive protein levels at follow-up (adjusted HR 3.388, 95% CI 1.168 – 9.829, P = 0.025) were independent risk factors for treatment failure. Conclusion: In the study hospitals, diverse combinations of antibiotics and differing durations of parenteral and oral therapy were used. Based on the findings of this study, we think that switching to oral β-lactams may be safe in certain adult patients with MSSA VO. Since limited data are available on the efficacy of oral antibiotics for treatment of staphylococcal VO in adults, further evaluation of the role of oral switch therapy with β-lactams is needed.

2018 러시아 월드컵 중계방송

오원섭 한국방송협회 2018 방송문화 Vol.- No.413

양수호르몬의 임상적 의의

오원섭,김철성 한림대학교의료원 1980 人間科學 Vol.4 No.4

Effect of Early Plasma Exchange on Survival in Patients with Severe Fever with Thrombocytopenia Syndrome: A Multicenter Study

오원섭,허상택,유정래,권기태,김혜인,이수진,전재범,류성열,김현아,허지안,위유미,임민희 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.4

Despite a high mortality rate, no specific treatment for severe fever with thrombocytopenia syndrome (SFTS) has been established. This study compared the clinical outcomes of SFTS patients treated with plasma exchange (PE group) with those who were not treated (non-PE group) at nine Korean hospitals between May 2013 and August 2015. A total of 53 SFTS patients were included: 24 (45.3%) PE cases and 29 (54.7%) non-PE cases. The overall in-hospital mortality rate was 32.1% (17/53). The in-hospital mortality rate of the PE group did not differ from that of the non-PE group (29.3% vs. 34.5%, p=0.680). Of the 24 PE cases, 16 (66.7%) were treated with PE within 7 days of symptom onset (early PE group). The early PE group survived longer than the non-PE group (mean 28.4 days vs. 22.6 days, p=0.044). Multivariate analysis showed an inverse association between early PE implementation and 30-day mortality (adjusted hazard ratio 0.052, 95% confidence interval 0.004–0.678, p=0.024). The results of this study suggest that early PE implementation may have a beneficial effect on the clinical outcome of SFTS patients.

Calculation of the Residual Blood Volume after Acute, Non- Ongoing Hemorrhage Using Serial Hematocrit Measurements and the Volume of Isotonic Fluid Infused: Theoretical Hypothesis Generating Study

오원섭,전성빈 대한의학회 2016 Journal of Korean medical science Vol.31 No.5

Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock. Although estimation of the residual blood volume is crucial, the standard measuring methods are impractical or unsafe. Vital signs, central venous or pulmonary artery pressures are inaccurate. We hypothesized that the residual blood volume for acute, nonongoing hemorrhage was calculable using serial hematocrit measurements and the volume of isotonic solution infused. Blood volume is the sum of volumes of red blood cells and plasma. For acute, non-ongoing hemorrhage, red blood cell volume would not change. A certain portion of the isotonic fluid would increase plasma volume. Mathematically, we suggest that the residual blood volume after acute, non-ongoing hemorrhage might be calculated as 0·25N/[(Hct1/Hct2)-1], where Hct1 and Hct2 are the initial and subsequent hematocrits, respectively, and N is the volume of isotonic solution infused. In vivo validation and modification is needed before clinical application of this model.

Nismutine(ACNU)에 의해 유발된 급성 폐손상 1례

오원섭,박현용,정효균,김현주,장태원,정만홍 대한결핵 및 호흡기학회 1996 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.83 No.0

폐렴구균의 용혈능 변화와 pneumolysin 유전자의 변이 양상

오원섭,장현하,정숙인,김연숙,이혁,김신우,김성민,백경란,이남용,송재훈 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.3

목적 : 폐렴구균은 인체에서 폐렴, 수막염 및 패혈증 등을 일으키는 중요한 병원균으로 현재 전 세계적으로 항균제 내성이 큰 문제가 되고 있다. 하지만 폐렴구균의 항균제 내성에 따라 병독성이 어떻게 변화하는지에 대해서는 구체적으로 알려져 있지 않다. 이에 기능적 및 구조적 분석을 통하여 폐렴구균의 주요 병독성 인자인 pneumolysin의 병인론적 역할을 규명하고자 하였다. 방법 : 임상 검체에서 분리된 페니실링 감수성 균주 20주와 내성 균주 20주를 대상으로 하였다. Pneumolysin의 세포 독성의 변화를 관찰하기 위하여 각각의 균주들의 용혈능을 측정하였고, pneumolysin 유전자를 중합효소 연쇄반응으로 증폭한 후 증폭 산물의 유전자 구조를 분석하였다. 결과 : 페니실린 감수성 균주와 내성 균주간의 용혈능은 유의한 차이를 보이지 않았으나, 일부 용혈능이 매우 낮은 균주에서 Lys152→Thr, Thr-172→Ile, Lys-224→Arg와 같은 변이가 관찰되었다. 결론: pneumolysin의 세포 독성의 변화는 항균제 내성 정도와는 무관하였으나, 일부 용혈능이 저하된 균주에서 발견된 pneumolysin 유전자의 변이가 pneumolysin의 세포 독성에 영향을 주는 것으로 보인다. Background : Pnumolysin (Ply) is one of the most important virulence factors of Streptococcus pneumoniae. To investigate the functional and structural variation of Ply, hemolytic activity (HA) and gene sequences of pneumolvsin were determined. Methods : A total of 40 invasive pneumococcal isolated (20 penicillin-susceptible & 20-resistant strains) were analyzed. HA of each isolate was measured in crude extracts (1×10^8 CFU/mL) hourly from the time of inoculation to 9h. Crude extracts (50㎕) and DTT buffer (100㎕) were serially diluted in 96-well plate and mixed with 1% sheep blood (50㎕). HA was represented as the reciprocal of the greatest dilution, which resulted in the complete lysis. Two sets of oligonucleotide primers were used to amplify a 1,474-bp fragment containing the coding region and a 578-bp fragment of upstream region of ply gene, respectively. Amplified products were directly sequenced. Results : HA showed a wide variation from 0 to 87,480 regardiess of penicillin MICs, serotypes or specimen sources. Two bacteremic strains showed completely no hemolytic activity. No significant differences in HA between penicillin-susceptible (Mean± SE : 15,468± 4,693) and penicillin-resistant strains (21,384± 4,087) were found (p > 0.05).Sequencing of the coding region showed unique alterations in amino acids in strains with markedly reduced hemolytic activity (≤ 40): Thr-172-Ile and Lys-224-Arg. However, upstream region of ply gene was highly conserved. Conclusions : Ply activity was not related with antibiotic resistance. Absence of HA in some strains was associated with unique alterations in amino acid sequences in ply gene. Relationnship between genomic alteration and functional changes in pneumolysin should be further investigated.

자궁내태아사망

오원섭 한림대학교의료원 1989 人間科學 Vol.13 No.9