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      • 녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

        장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

        목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.

      • 논에서 우분액비 시용이 총체보리 및 이탈리안 라이그라스의 생산성과 사료가치 및 환경오염에 미치는 영향

        최기춘,나상필,정민웅,임영철,박형수,김종근,김원호,김맹중,최기준,김명화,이상락,김다혜,육완방,Choi, Ki-Choon,Na, Sang-Pil,Jung, Min-Woong,Lim, Young-Chul,Park, Hyung-Su,Kim, Jong-Geun,Kim, Won-Ho,Kim, Maeng-Jung,Choi, Gi-Jun,Kim, Myeong-Hwa,L 한국축산환경학회 2012 축산시설환경학회지 Vol.18 No.2

        본 연구는 논에서 조사료 생산을 위한 작부형태별 우분액비의 시용효과를 규명하기 위하여 총체 벼 재배 후 우분액비 시용에 따른 총체보리 및 IRG의 생산성, 사료가치, 토양성분 및 용탈수중의 무기물 농도를 조사하였다. 본 연구는 2006년 5월부터 2009년 4월까지 3년 동안 전라북도 김제군 백산면 시험포장에서 완전임의배치 3반복으로 수행되었다. 총체보리의 2년간 평균수량은 7,520 kg/ha, 그리고 IRG는 평균 10,320 kg/ha으로 IRG가 총체보리 보다 현저하게 높은 수량을 보였다 (p<0.05). 이탈리안 라이그라스는 1번초가 2번초 보다 약 2배 이상의 수량을 보였다. IRG의 조단백질 함량은 총체보리보다 높았고 NDF, ADF 및 TDN 함량은 작물간에 큰 차이는 보이지 않았다. 경작형태별 우분액비 시용에 따른 토양내 pH, $P_2O_5$, T-N, OM 농도는 시험전에 비해 시험종료 후에 현저하게 증가하는 경향을 나타냈다 (p<0.05). 경작형태별 우분액비 시용에 따른 토양내 Ca, Na, Mg 및 K 농도는 시험전에 비해 시험종료 후에 현저하게 증가하는 경향을 나타냈다 (P<0.05). 경작형태별 우분액비 시용에 따른 용탈수중 $NH_4$-N, $NO_3$-N, $PO_4$-P, Cl, Ca, K, Mg, Na의 농도는 경작형태에 따른 확실한 차이를 보여주지 않았다. 따라서 논에서 우분액비를 이용하여 동계작물을 재배할 경우에는 수량도 중요하지만 환경적인 부분도 고려하여 우분액비를 이용해야 한다. This study was conducted to investigate the effects of cattle slurry on productivity of whole crop barley and Italian ryegrass and environmental pollution in paddy land. Cropping systems used in this study were consisted of two designs, such as whole crop barley applied with cattle slurry (WCB) and Italian ryegrass applied with cattle slurry (IRG). The field experiments were conducted on the clay loam at Backsanmyun, Kimje, Chunlabukdo province in Korea for three years (May 2006 to Apr. 2009). This study was arranged in completely randomized design with three replicates. The yields of WCB and IRG were 7,520 kg/ha and 10,320 kg/ha, respectively. The yields of IRG significantly increased as compared with that of WCB (p<0.05). The yield of Italian ryegrass in 1st cutting time was about 2-fold higher than that of 2nd cutting time. The contents of crude protein of IRG were higher than that of WCB. However, the contents of NDF, ADF and TDN were no difference between WCB and IRG treatments. The pH, and contents of T-N, $P_2O_5$ and organic matter (OM) in soil samples collected at the end of the experiment increased as compared with those at the beginning of the experiment (p<0.05). After the end of experiment, the concentrations of CEC (Ca, Na, Mg and K) in soil samples collected at the end of the experiment were remarkably higher than those at the beginning of the experiment (p<0.05). The concentrations of $NH_4$-N, $NO_3$-N, $PO_4$-P, Cl, Ca, K, Mg and Na in leaching water in paddy land cultivated with WCB and IRG were no difference between WCB and IRG treatments.

      • 담도에 국한되어 증상을 유발한 석회쓸개즙 2 예

        윤성우,이지영,하경호,이수경,한나,배효근,박선자 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

        Limy bile is a rare condition characterized by excessive precipitation of calcium carbonate in the gallbladder or bile duct. Recently we experienced two cases with obstructive jaundice in which limy bile in the common bile duct but not in the gallbladder for one case, and in the common bile duct and intra hepatic duct but not in the gallbladder for another case. The patients were treated by endoscopic sphincterotomy. Here, we report the cases and review the literature.

      • KCI등재

        족삼리의 전기침 자극에 대한 개구반사 크기의 변화

        이상호,나창수,송형근,서영아 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.4

        The purpose of this study was to investigate the effect of various electroacupuncture duration induced by acupuncture point-Zusanli(S36) electrical stimulation on inhibition of amplitude of digastric electromyogram (dEMG)evoked by noxious electrical stimuli around the mental foramen. <Experiments were conducted on adult rats (SD) were anesthetizde with> intraperitoneal sodium pentobarbital in an initial dose of 50mg/kg and maintenance doses of 4.5mg/kg/h were given through a cannula in the femoral vein using a constant infusion pump. A pair of stimulating electrodes were inserted for noxious stimuli around the mental foramen. An irritant electronic stimuli pulse (0.2 Hz,0.1 ms duration) was produced with an intensity of about 1.5-2 times threshold for evoking the dEMG. The anterior belly of the digastric muscle was exposed and a pair of 0.1mm wire electrodes were inserted for dEMG recording. Acupuncture point stimulation on Zusanli (2 Hz, 250㎲, biphasic pulse. 2 V) was delivered by Dental Electronic Anesthesia (3M,U.S.A). For periods of electronic stimulation of 10, 20, and 30min, the amplitudes of dEMG were measured on the oscilloscope and on the monitor connected to the amplifier. The following results were obtained: The dEMG was decreased to 73.4% of that in the control set after 10 min electroacupunture stimulation (Group Ⅰ): The dEMG was decreased to 77.1%(10min), 54.0% (20min)of that in the control set after 20minutes of electroacurunture stimulation (Group Ⅱ). The dEMG was decreased to 73.7% (10min), 61.9%(20min), 76.2%(30min) of that in the control set after 30 min of electroacupunture stimulation (Group Ⅲ). From these results, it may be that in the electroacupuncture stimulation on the Zusnali resulted in a reduction of amplitude of daEMG and that the most effective electroacupuncutre stimulation period was 20min.

      • 단백질흡착을 막는 소프트콘택트렌즈에 관한 연구

        조종수,정영일,나재운,김성호 朝鮮大學校 1997 藥學硏究誌 Vol.18 No.2

        양말단에 이크릴레이트를 갖는 폴리에틸렌글리콜 미크로마(PEG macromer)와 또한 PEG macromer와 폴리하이드록시에칠메타아크릴레이트[P(HEMA)] 혹은 폴리(하이드록시에칠메타아크릴레이트-하이드록시프로메타아크릴레이트-비닐피롤리돈)[P(HEMA-co-HPMA-co-NVP)]와 상호침투된 망상구조의 시료가 소프트콘텍트렌즈의 알부민의 흡착을 막기위하여 제조되었다. PEG macromer의 중합으로 macromer의 다관능성기로 인하여 가교된 겔이 형성되었다. P(HEMA-co-HPMA-co-NVP)/PEG IPN계 콘텍트렌즈에서 PEG분자량이 중가할수록 알부민의 흡착량은 감소되었다. 또한 IPN제조시의 PEG의 농도가 짙을수록 알부민의 흡착량은 감소되었다. PEG macromer와 IPN하기전의 P(HEMA)계 및 P(HEMA-co-HPMA-co-NVP)계의 콘텍트렌즈에 비하여 PEG macromer와 IPN함으로서 렌즈의 착용감이 훨씬 상승되었다. Poly(ethylene glycol)(PEG) macromers terminated with diacrylate groups and interpenetrating polymer networks(IPN) composed of poly(hydrowyethyl methacrylate)(PHEMA) or poly(hydrowyethyl methacrylate-co-hydroxypropyl methacrylate-co-N-vinyl pyrrolidone)[P(HEMA-co-HPMA-co-NVP)]and PEG macromer were synthesized with the aim of abtaining protein adsorption resistant soft contact lens. Polymerization of PEG macromer. Crosslinked p(HEMA)or P(HEMA-co-HPMA-co-NVP) chains were interpenetrated into the cross-linked three-dimensional networks of PEG. It was found that albumin adsorption onto the contact lens prepared by P(HEMA-co-HPMA-co-NVP)/PEG IPN decreases with an increase of molecular weight of PEG. Also, it was found that albumin adsorption onto the both contact lens decreases with an increase of concentration of PEG macromer in the IPN preparation. There are also more adequate in the biointerness for the contact lens by P(HEMA)/PEG IPN or P(HEMA-co-HPMA-co-NVP)/PEG IPN than that by P(HEMA) or P(HEMA-co-HPMA-co-NVP).

      • SCIESCOPUSKCI등재

        Gintonin facilitates catecholamine secretion from the perfused adrenal medulla

        Seung-Yeol Na,Ki-Hwan Kim,Mi-Sung Choi,Kang-Su Ha,Dong-Yoon Lim 대한생리학회-대한약리학회 2016 The Korean Journal of Physiology & Pharmacology Vol.20 No.6

        The present study was designed to investigate the characteristics of gintonin, one of components isolated from Korean Ginseng on secretion of catecholamines (CA) from the isolated perfused model of rat adrenal gland and to clarify its mechanism of action. Gintonin (1 to 30 μg/ml), perfused into an adrenal vein, markedly increased the CA secretion from the perfused rat adrenal medulla in a dose-dependent fashion. The gintonin-evoked CA secretion was greatly inhibited in the presence of chlorisondamine (1 μM, an autonomic ganglionic bloker), pirenzepine (2 μM, a muscarinic M<sub>1</sub> receptor antagonist), Ki14625 (10 μM, an LPA<sub>1/3</sub> receptor antagonist), amiloride (1 mM, an inhibitor of Na<sup>+</sup>/Ca<sup>2+</sup> exchanger), a nicardipine (1 μM, a voltage-dependent Ca<sup>2+</sup> channel blocker), TMB-8 (1 μM, an intracellular Ca<sup>2+ </sup>antagonist), and perfusion of Ca<sup>2+</sup>-free Krebs solution with 5mM EGTA (a Ca<sup>2+</sup>chelater), while was not affected by sodium nitroprusside (100 μM, a nitrosovasodialtor). Interestingly, LPA (0.3~3 μM, an LPA receptor agonist) also dose-dependently enhanced the CA secretion from the adrenal medulla, but this facilitatory effect of LPA was greatly inhibited in the presence of Ki 14625 (10 μM). Moreover, acetylcholine (AC)-evoked CA secretion was greatly potentiated during the perfusion of gintonin (3 μg/ml). Taken together, these results demonstrate the first evidence that gintonin increases the CA secretion from the perfused rat adrenal medulla in a dose-dependent fashion. This facilitatory effect of gintonin seems to be associated with activation of LPA- and cholinergic-receptors, which are relevant to the cytoplasmic Ca<sup>2+</sup> increase by stimulation of the Ca<sup>2+</sup> influx as well as by the inhibition of Ca<sup>2+</sup> uptake into the cytoplasmic Ca<sup>2+</sup> stores, without the increased nitric oxide (NO). Based on these results, it is thought that gintonin, one of ginseng components, can elevate the CA secretion from adrenal medulla by regulating the Ca<sup>2+</sup> mobilization for exocytosis, suggesting facilitation of cardiovascular system. Also, these findings show that gintonin might be at least one of ginseng-induced hypertensive components.

      • KCI등재

        혈액암환자에서 조혈모세포 이식 후 따르는 헤르페스 바이러스 감영 양상

        이호섭,탁희상,신성훈,김양수,남성진,김혜수,박진희,정수현,김성빈,김예나 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

        배경 : 헤르페스바이러스과에는 단순포진 바이러스(HERPES SIMPLEX VIRUS, HSV), 수두대상포진 바이러스 (VARICELLA-ZOSTER VIRUS, VZV), 엡스타인-바 바이러스 (EPSTEIN-BARR VIRUS, EBV), 그리고 거대세포 바이러스 (CYTOMEGALOVIRUS, CMV) 등이 있다. 헤르페스바이러스 감염은 혈액암환자에서 조혈모세포 이식 환자에서 전파 (dissemination), 이차감염, 세균 중복 감염의 심각한 합병증을 일으킬 수 있다. 하지만 항암약물치료를 받는 림파종 환자에서 항 바이러스 약제의 사용 용량과 기간에 대한 concensus는 없다. 헤르페스바이러스 감염에 대한 발생율과 위험인자를 후향성으로 분석하였다. 방법 : 고신대학교 복음 병원에서 1995년 6월부터 2009 년 2월 사이에 새롭게 진단되어 조혈모세포 이식을 받은 전체 58명의 환자들이 후향적으로 현 연구에 등록했다. 헤르페스 바이러스 감염은 임상적 진단, 혈청학적 검사 또는 병리학적 진단에 기초하여 확진한다. 환자들의 특성은 다음과 같다: 평균 연령은 44세 (범위 19-62세)였고 남녀비는 30:28이었다. 등록된 질환은 백혈병 (n=9, 15.5%), 림프종 (n=30, 51.7%), 다발성 골수종 (n=12, 20.7%), 재생불량성 빈혈 (n=6, 10.3%) 그리고 골수이형성증후군 (n=1, 1.7%)이 포함되었다. 결과는 chi-squre test나 independent samples T test를 사용하여 분석되었다. Multivariate analysises에 대해 logistic regression test를 사용하였다. 결과 : 15명의 환자들 (25.9%)에서 조혈모세포 이식후 헤르페스 바이러스 감염이 발생하였다. 조혈모세포 이식 5년간 누적 발생율은 53.9%였다. Univariate analyses에서 헤르페스 바이러스 감염에 대한 유의한 위험 인자는 없었다. 하지만 조혈모세포 이식후 생존 기간(40.18 ± 30.14 months vs 20.06 ± 26.67 months, p=0.018)은 헤르페스 바이러스 감염의 낮은 발병율과 유의한 관련성이 있었다. 이식 편대 숙주질환 (GVHD)의 존재 (37.5% in developed GVHD vs 0% in no GVHD, p=0.200), 동종조혈 모세포 이식에서 면역억제요법의 기간 (15.98 ± 14.02 months vs 6.78 ± 3.67 months, p = 0.374)은 헤르페스 바이러스 감염에 대한 위험인자가 아니었다. 결론 : 조혈모세포 이식 후 생존 기간은 어사이클로비어 예방을 받은 혈액암 환자에서 헤르페스 바이러스 감염의 낮은 발병율과 연관성이 있는 것으로 보인다. 저용량의 어사이클로비어 예방은 헤르페스 바이러스 감염의 고위험군인 조혈모세포 이식을 받은 혈액암 환자에 필요하리라 생각된다. Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI. Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28. The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%), aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysis, we used logistic regression test. Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy (IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI. Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.

      • KCI등재후보

        임상 검체에서 분리된 nontyphoid Salmonella에서의 integron의 빈도와 특징

        이정은,박수진,김성한,김미나,이남용,이복권,이상오,김양수,우준희,최상호 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

        Background : Nontyphoid Salmonella (NTS) is a leading cause of human food-borne enteritis, It has been known that integron, a naturally occurring gene capture and expression element, Plays an important role in the development and dissemination of multidrug-resistance. In this study, we investigated the prevalences and molecular characteristics of integrons in NTS clinical strains. Materials and Methods : Between 1995-96 and 2000-03, a total 261 NTS clinical strains comprising 39 serotypes were collected from clinical specimens. All strains were serotyped, and the MICs of ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, tetracycline, and trimethoprim were determined by agar dilution method. Integrons were detected by PCR amplification of integrase genes, and gene cassettes were determined by PCR and sequencing, Conjugation experiments were performed using E. coli J53 as a recipient. The clonal relationship was analyzed by pulsed-field gel electrophoresls (PFGE). Results : Of the 261 strains tested, class 1 integrons were present in 21 strains (8.0%). Class 2 and class 3 integrons were not found. The integron-positive rate was higher in S. Typhimurium (24.2% [8/33]) than in S. Enteritidis (2.0% [3/153]). Overall rates of antimicrobial resistance were higher in integron-positive strains. dhfr12-orfF-aadA2gene cassette was detected in 5 strains, aadA2in 4 strains, dhfr17-orfF-aadA5 in 2 strains, and addA1 in 1 strain. Ten integron-positive transconjugants were successfully selected. Among 8 integron-positive strains of S. Typhimurium, 7 had similar PFGE patterns. Conclusion: This study suggests that integrons are already playing a significant role in antimicrobial resistance in NTS. Continuous monitoring is needed to detect the emergence and spread of integron-mediated antimicrobial resistance.

      • KCI등재

        한국인 직무 스트레스 측정도구의 개발 및 표준화

        장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

        Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

      • KCI등재후보

        임상검체에서 분리된 그람 음성 세균들에 대한 Isepamicin의 시험관내 항균력

        권현희,박수진,소민욱,박현구,최성호,김미나,최상호,정진용,우준희,김양수 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

        Background : The increasing incidence of multidrug-resistant gram-negative bacteria causing nosocomial infections is an important clinical problem. Isepamicin is a recently developed aminoglycoside which has been known to have potent activity against gram-negative organisms. We evaluated the in vitro activities of isepamicin and other aminoglycosides against a large number of gram-negative organisms. Materials and Methods : We tested the in vitro antimicrobial activities of isepamicin, amikacin, gentamicin, and tobramycin against 566 gram-negative organisms collected between January 2006 and June 2006 in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined and interpreted according to the recommendations of Clinical and Laboratory Standard Institute (CLSI). The breakpoint MIC used for interpretation of isepamicin was MIC≤16 ㎍/mL as susceptible, 32 ㎍/mL as intermediate, and 64 ㎍/mL as resistant. Results : The MIC_(50)/MIC_(90) of isepamicln for Escherichia coli, Klebsiella pneumon/ae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae were 1/2, 0.5/>128, 4/16, 16/>128, and 1/2 ㎍/mL, respectively. The susceptibilities for E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, and E. cloacae were 100%, 86.4%, 89.7%, 50.0%, and 96.6%, respectively. For E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae, isepamicln had better in vitro activities than gentamicin and tobromycin, and had similar activities with amlkacin. For A. baumanii, all four tested aminoglycosides had similar in vitro activities. Conclusion : Isepamicin had excellent in vitro activities against gram-negative organisms, except A. baumanii. The overall in vitro activities were similar with amikacin. 목적 : 그람 음성 세균은 다양한 지역사회 및 병원 획득 감염의 원인균이다. 최근에는 병원 감염을 일으키는 그람 음성 세균에서 항균제 내성균의 출현과 확산이 큰 문제가 되고 있다. Isepamicin은 최근에 소개된 gentamicin B의 유도체로 외국에서의 연구에 의하면 그람 음성 세균들에 대한 항균력이 우수함이 보고 된 바 있다. 본 연구에서는 우리나라의 임상 균주들을 대상으로 그람 음성세균에서 isepamicin의 시험관내 항균력을 기존의 아미노배당체 제재들과 비교하여 평가하고자 하였다. 재료 및 방법 : 2006년 1월에서 6월 사이에 서울아산병원 환자에서 분리된 Escherichia coli 113 균주, Klebsiella pneumoniae 110 균주, Pseudomonas aeruginosa 117 균주, Acinetobacter baumannii 108 균주, 그리고 Enterobacter cloacae 118 균주를 대상으로 isepaimcin, amikacin, gentamicin, tobramycin에 대한 최소억제농도(minimal inhibitory concentration, MIC)를 한천 희석법(Mueller-Hinton Agar)을 이용하여 측정하였다. 감수성여부는 CLSI 기준에 따랐으며, isepamicin은 MIC≤16㎍/mL를 감수성, MIC=32 ㎍/mL를 중등도 내성, MIC≥64 ㎍/mL를 내성으로 판정하였다. 결과 : Isepamicm의 E. coli, K. pneumoniae, P. aeruginosa, A baumannii, E. cloacae에 대한 MIC_(50)/MIC_(90)은 각각 1/2, 0.5/>128, 4/16, 16/>128, 1/2 ㎍/mL였고, 항균제 감수성률은 차례대로 100%, 86.4%, 89.7%, 50.0%, 96.6%였다. 기존 아미노배당체 제재들과 비교하면 E. coli, K. pneumoniae, P. aeruginosa, E. cloacae에서는 amikacin과 비슷한 감수성률을 보였고, gentamicin과 tobramycin보다 높은 감수성률을 보였다. A baumannii의 경우 isepamicin의 감수성률이 50.0%로 비교적 낮았지만 amikacin, gentamicin, tobramycin도 각각 50.0%, 46.3%, 47.2%의 감수성률을 나타내어 4가지 항균제가 모두 비슷한 항균력을 보였다. 결론 : Isepamicin은 그람 음성 세균들에 있어 기존의 아미노배당체 제재들과 비교했을 때 amikacin과는 동등한 시험관내 항균력을 보이고 gentamicin, tobramycin보다 뛰어난 시험관내 항균력을 보여 사용이 유망한 아미노배당체 중 하나라 생각된다.

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