최근 장티프스 진단에 있어서 Widal Test의 의의

이치국,이식,최정기,이수택 대한감염학회 2001 감염 Vol.33 No.3

Background : Typhoid can be diagnosed with certainly only by the isolation of Salmonella Typhi from the blood, urine, feces, or other body fluids. The Widal reaction has been one of the most important diagnostic tests for typhoid and is still widely used in many developing countries. Methods : The Widal test was done in 50 nontyphoidal febrile patients, and 50 patients with proven typhoid in Chonbuk area. we compare this result with that of last 10 years. Results : By rapid slide method S. typhi O titer of 1 : 160 or more was seen in 58% and S. typhi H titer of 1 : 320 or more was seen in 12% of patients with bacteriologically proven typhoid fever. Conclusion : O titer was similar to the result of past 10 years. A false positive test was found in 40% of patients with nontyphoidal febrile patients in whom Widal test must therefore be interpreted with caution. (Korean J Infect Dis 33:206∼209, 2001)

다제 내성 Psedomonas aeruginosa 감염에서 Carumonam의 효과

김신재,이치국,최광호,이흥범,이용철,정성후,이혜수,이양근 최신의학사 2000 最新醫學 Vol.43 No.3

다제 내성 Pseudomonas aeruginosa 감염에서 Carumonam의 효과

김신재,이치국,이식,최광호,이흥범,이용철,정성후,이혜수,이양근 의과학연구소 2000 全北醫大論文集 Vol.24 No.1

Carumonam is a newer monobactam antibiotics which possesses a broad spectrum of antimicrobial activity against Gram negative organism. In this study, we evaluate the clinical effectiveness of Carumonam in patient with infection due to multidrug resistant pseudomonas aeruginosa. Fifteen patients were enrolled in this non-controlled, monocenter study. Carumonam was given intravenously at the dose of 1.0 gram three times daily for 7 to 10 days. Isolated P. aeruginosa was resistant to beta lactam antibiotics, beta lactam/beta lactamase inhibitors, aminoglycoside, and fluoroquinolone. Satisfactory therapeutic responses were observed in eleven (73.3%) with serologically confirmed multidrug resistant P. aeruginosa organism. Two patients experienced persistent fever, chills and productive cough, one patient showed transient thrombocytopenia and two patients experienced transient elevation of AST/ALT. In conclusion, Carumonam proved to be an effective and safe antibiotics in the treatment of multi-drug resistant P. aeruginosa in gastrointestinal and lower respiratory tract infection.

표적세포의 Nitric oxide 합성이 LAK 세포의 세포독성에 대한 예민도에 미치는 영향

박성일,박주형,이치국,김신재,최보금,곽재용,임창열,Park, Sung Il,Park, Ju Hyung,Lee, Chi Kug,Kim, Shin Chae,Choi, Bo Geum,Kwak, Jae Yong,Yim, Chang Yeol 대한면역학회 2001 Immune Network Vol.1 No.2

Background: Nitric oxide (NO), a cytotoxic molecule is produced in various tissues including tumor cells during interleukin-2 (IL-2) therapy . Lymphokine-activated killer (LAK) cells are induced during IL-2 therapy, and have cytotoxic activity against tumor cells. The current study investigated the effects of NO synthesized in target cells or exposure of target cells to NO on the sensitivity of target cells to LAK cell cytotoxicity. Methods: Cytotoxicity was measured using 4 h chromium release assays. LAK cells which were induced by a 4 day incubation of BALB/c mouse splenocytes with IL-2 (6,000 IU/mL) were employed as effector cells. RD-995 skin tumor cells originated from a C3H/HeN mouse were employed as target cells. NO synthesis in target cells was induced by a 24 h incubation of RD-995 cells with $IFN{\gamma}$ (25 U/mL), TNF (50 U/mL) and IL-1 (20 U/mL). S-nitrosyl acetylpenicillamine (SNAP), an NO donor, was used to expose target cells to NO. $N^G$-monomethyl-L-arginine (MLA) and carboxy-PTIO were added during cytotoxicity assays to inhibit NO synthesis, and to scavenge NO produced by target cells, respectively. Results: Sensitivity of NO-producing RD-995 cells to LAK cell cytotoxicity was decreased by addition of MLA and carboxy-PTIO during cytotoxicity assays. However, the two reagents had no effect on the sensitivity of non-NO-producing RD-995 cells. Pretreatment of RD-995 target cells with SNAP increased the sensitivity in comparison with untreated cells. Conclusions: Sensitivity of target cells to LAK cell cytotoxicity is increased by target cell NO synthesis or exposure to NO. Further studies are needed to evaluate whether these in vitro results have relevance to in vivo phenomena.

급성 췌장염 치료 중 발생한 베르니케뇌병증 2예

안득수,이수택,최정기,이양덕,이치국,이성중 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4

The local and systemic complications of acute pancreatitis are protean. The systemic complications include pulmonary, cardiovascular, hematologic, renal, metabolic, and central nervous system abnormalities. Wernicke's encephalopathy is developed due to diencephalic and mesencehalic dysfunction of central gray structures surrounding the third and fourth ventricles by thiamine deficiency. Patients who are in fasting state, receiving parenteral nutrition, recovering from gastrointestinal surgery, being fed after a period of starvation, undergoing hemodialysis, or suffering from advanced cancer, are particularly susceptible to Wernicke's encephalopathy. Here, we report two cases of Wernicke's encephalopathy complicated during the management of acute pancreatitis.

당뇨병성 다발성 신경병증에 대한 thioctic acid의 유효성 및 안정성에 관한 연구

황진수,염정필,조용근,김종화,이치국,최유진,김현각,류완희,박태선,백홍선 의과학연구소 1999 全北醫大論文集 Vol.23 No.2

Diabetic neuropathy is a major factor in determining the morbidity of diabetic patients and most common complication, so the majority of diabetic patients have diabetic polyneuropathy. The most common causes of amputation of lower extremities are diabetic neuropathy and vascular insufficiency, taken over 50% of all causes. Near-normoglycemia is now generally accepted as the primary goal in the prevention of diabetic neuropathy. However, relatively long periods of near normal glycemic control for several months or even years may be needed to retard the progression of nerve dysfunction in diabetic patients with advanced stages of peripheral neuropathy. Hence, additional pharmachological treatments of painful neuropathic symptoms are frequently required to maintain the quality of life in symptomatic diabetic neuropathy. Antioxidant treatment has been shown to prevent nerve dysfunction in experimental diabetes mellitus, thus providing a rationale of potential therapeutic value for diabetic patients. The effects of thioctic acid, anti-oxidant α-lipoic acid, were studied in a eight weeks schedule in 21 diabetes mellitus patients with symptomatic peripheral neuropathy. They were assigned to treatment with thioctic acid 600㎎ once daily before breakfast. Neuropathic symptoms(pain, burning, parethesia, and numbness) were scored at baseline and each visits(4th week and 8th week later). Biochemical status was checked via blood sampling at baseline and 8th week of treatment. As a result, the mean value of total symptom scores were 6.6±2.0, 6.1±2.2, and 4.5±1.7 at baseline, second, and third visit. Although there was no significant statistical change in total symptom scores of neuropathic symptoms between first and second visit, significant improvements were observed at third visit compared with second visit(p=0.03). But no specific unfavorable effects or biochemical changes were not noted during the treatment with thioctic acid. So, we observed the significant beneficial effects of thioctic acid 600㎎ once daily before the breakfast for eight weeks in controlling symptoms of diabetic neuropathy without specific adverse reaction.

슬관절 골관절염 환자에서 AVOCADO/SOYBEAN UNSAPONIFIABLES (ASU)의 효과: ASU 단독치료와 ASU-Nasproxen 병용치료의 효과 및 위장관 부작용의 비교

김종화 ( C H Kim ),이동민 ( D H Lee ),김용성 ( Y S Kim ),최보금 ( B G Choi ),박주형 ( J H Park ),김신재 ( S J Kim ),이치국 ( C K Lee ),전현순 ( H S Jeon ),류완희 ( W H Yoo ),곽재용 ( J Y Kwak ),백홍선 ( H S Baek ) 전북대학교 의과학연구소 2001 全北醫大論文集 Vol.25 No.1

ASU 치료는 증상을 갖고 있는 슬관절의 골관절염 환자의 통증 개선과 관절 기능을 호전시키고, 약물투여 중지 후에 지속효과를 갖는 증상개선 약제로서 안전하게 사용할 수 있을 것으로 보인다. 소염진통제인 naproxen과의 병용치료와의 비교에서는 병용치료 군에서 효과의 발현시기와 전반적인 평가에서는 우월하였으나, 부작용이 보다 많이 발생하였다. 따라서 ASU를 골관절염의 약물치료의 한 방법으로 사용될 수 있을 것으로 보이며, 단순진통제 및 소염진통제 등의 약물 등과 같이 단일요법으로서의 사용과 다른 약물과의 병용치료의 효과 및 안정성에 대해서는 보다 많은 연구가 필요할 것으로 보인다. Objective: To compare the efficacy and safety between avocado/soybean unsaponifiables (ASU) alone and ASU-naproxen combination in the treatment of symptomatic osteoarthritis (OA) of the knee and to determine persistent efficacy after stopping medication and gastrointestinal tolerability. Methods: One hundred twenty-five patients with symptomatic OA of the knee were included in 20-week trial with 12-week treatment period and 8-weeks post-treatment follow-up. Efficacy was evaluated by Lequesne`s index (LI), pain score (VAS; visual analong scale. 10cm) at 4-week interval during the study and physician`s and patient`s global assessment at 20th week. Gastrointestinal side effects were evaluated by questionnaire for gastrointestinal symptoms and number of the ingested antacids during the study. Results: Sixty-three patients were received ASU alone, while sixty-two patients were received ASU and naproxen. Mean±SD scores of pain VAS score were reased from baseline at 8th and 12th weeks after medication in the former groups and 4th, 8th and 12th weeks in the latter groups. Mean±SD scores of LI were decreased from baseline at 12th week after medication in the former groups and 4th, 8th, 12th week in the latter groups. Both scores of LI and pain VAS were maintained at 8th week after stopping medication. The scores of LI and pain VAS scale were significantly decreased in combination group than ASU alone group at 4th and 8th weeks, but tended to lower in combination group at 12th week and post-treatment period. The improvement of physician`s global assessment was seen in 65.4% of combination and 53.2% of ASU alone group. The patient`s global assessment was similar to it. Twenty-six patients (20.8%) could not complete the 20-week study and the causes are different in two groups: side effects are more common cause in combination group and low efficacy and non-compliance were more common in ASU alone group. Gastrointestinal side effects are the most common adverse effects of the both groups, and the frequencies are more common in patients received naproxen as a combination therapy. Conclusion: ASU showed immediate and persistent efficacy in the treatment of patients with symptomatic OA of the knee. The combination of ASU and naproxen was more effective than ASU alone during the treatment period, but similar at post-treatment period. Gastrointestinal side effects were more frequent in combination group than ASU alone.