간암 환자에 합병된 Citrobacter braakii 패혈증 1례 보고

이해미,배성하,이수남,이정우,신아영,류시영,이수연,윤문희,한선영,한남익,이영석,유진홍 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Citrobacter species is a gram-negative bacilli that can cause opportunistic infections in immunocompromised hosts. Citrobacter braakii refers to the genomospecies 6 of the Citrobacter freundii complex. There are no detailed studies on infections caused by this newly identified specific genetic species in Korea. We herein report a case of a patient with hepatocellular carcinoma who, after undergoing transcatheter arterial chemoembolization, developed biloma which later progressed to C.braakii sepsis and did not respond to treatment. To our knowledge, this is the first reported case in Korea on C. braakii infection resulting in septic shock in a patient with malignancy in Korea.

UV-TiO_2 광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정혜광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경연구소 1998 環境硏究 Vol.14 No.1

UV-TiO_2 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_2는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7×10^7 cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0×10^2 cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 3.4×10 cells/㎖으로, 자외선 조사와 함께 TiO_2가 석영관에 박막증착된 경우에는 7.6×10^2 cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입수 11분 동안 자외선을 조사시킨 경우에는 1.3×10^2 cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_2를 첨가하였을 경우에는 1×102 cells/㎖으로, 자외선 조사와 함께 TiO_2가 박막증착된 경우에는 7.9×10 cells/㎖을 나타내었다. 결국 UV-TiO_2 반응기에 사용되는 TiO_2가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_2 photocatalytic system on the Escherichia coli DH5-α and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 ㎚ was set on the center of pyrex round glass tube. Two types of TiO_2, one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7×10^5 cells/㎖ of E. coli for 11 min, the living cell number decreased to 4.0×10^0 cells/㎖. The effect of UV system together with slurried TiO_2 was less than 1 cells/㎖, whereas that of UV-coated TiO_2 system decreased to 7.1×10^3 cells/㎖. To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7×10^5 cells/㎖ were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3×10^2 cells/㎖. In the same condition except the addition of slurried TiO_2, the living cells were 1×10^2 cells/㎖. However, more cells could be killed by the system which consists of UV, coated TiO_2, and air bubble (7.9×10^1 cells/㎖). From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_2 system.

UV-TiO₂광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정해광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경공해연구소 1998 環境公害硏究 Vol.14 No.-

UV-TiO_(2) 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254 ㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_(2)는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7× 10^(7) cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0× 10^(2) cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_(2)를 첨가하였을 경우에는 3.4× 10 cells/㎖으로, 자외선 조사와 함께 TiO_(2)가 석영관에 박막증착된 경우에는 7.6× 10^(2) cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입후 11분 동안 자외선을 조사시킨 경우에는 1.3× 10^(2) cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_(2)를 첨가하였을 경우에는 1× 100 cells/㎖으로, 자외선 조사와 함께 TiO_(2)가 박막증착된 경우에는 7.9× 10 cells/㎖을 나타내었다. 결국 UV-TiO_(2) 반응기에 사용되는 TiO_(2)가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_(2) photocatalytic system on the Escherichia coli DH5-慣 and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 nm was set on the center of pyrex round glass tube. Two types of TiO_(2), one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7 * 10^(5) cells/??of E. coli for 11 min, the living cell number decreased to 4.0 * 1.0^(0) cells/?? The effect of UV system together with slurried TiO_(2) was less than 1 cells/?? whereas that of UV-coated TiO_(2) system decreased to 7.1 * 10^(3) cells/?? To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7 * 10^(5) cells/??were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3 x 10^(2) cells/?? In the same condition except the addition of slurried TiO_(2), the living cells were 1 * 10^(2) cells/?? However, more cells could be killed by the system which consists of UV, coated TiO_(2), and air bubble (7.9 * 10^(1) cells/??. From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_(2) system.

Purge & Trap-GC를 이용한 의약품 필름코팅 정제 중 잔류용제에 관한 연구

장준식,이명자,소유섭,문춘선,이주헌,박희라,김진숙,강경모,이선옥,방성연,유미자,유문균,금오성,이병욱 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

의약품은 약물을 생체에 적풋하기 위하여 유효성분의 효과가 언제나 일정하게 확보되고 사응에 편리하도록 만들어지는 것이므로 유효썽분 이외에 약효에 영향을 주지 않는 성분이 첨가되는 경운가 많다. 이 때 사용되는 용매들은 제피의 광택 및 건쪼시간의 단축 등을 위하여 휘발점이 낮을 용매들이 주로 사용되어진다. 본 연구는 의약품 필름코팅정제 중 잔류용매 4종(chlorofonr benzen, trichloro ethylen, 1,4-dioxane)에 대한 변형된 pirge & trap-GC 장치를 이용한 동시분석방법을 개발하였으며, 각 표준품의 RSD 값은 chloroform 3.03%, benzen 3.17%, trichloroethylen 3.69% and 1,4-dioxane 3.41%였다. 또한 시중 유통중인 의약품 50종에 대하여 잔류웅매 양을 측정하였으며, 검출되는 잔류용매는 한 건도 없었다. This study nras carried out to develope the analytical method for the mixture of chlorefonn, benzen, trichloroethylen and 1,4-dioxane simultaneously and determine the remainingorgauic solvents in coating tablets by Purge & Trap-GC. The results were as follouFs ; 1. Chloroform, benzen, trio:tloroethylen and 1,4-dioxane separated by tenax #5 trap by HP-624GC column by terrlperature programming. The peaks were separated completely at retentiontime of 6.88min for chloroform, 8.21min for benzen, 10.38miu for trichloroethylen and 11.95minfor 1,4-dioxane. 2. Standard RSD were individually chloroform 3.03%, benzen 3.17%, trichloroethylen 3.69%and 1,4-diorane 3.41%. 3. 60 samples were not detrcted chloroform, benzen, trichloroethylen and 1,4-dioxane.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

경막 내 colistimethate 투여로 치료한 다제 내성 cinetobacter baumannii 뇌실염

홍유아,유진홍,김진진,모은영,안건희,정희경,김진석,이현정,정미향,윤승배 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Acinetobacter species is a non-fermentative aerobic gram-negative coccobacillus that is an important pathogen found in nosocomial infections. Recently, multi-drug resistant Acinetobacter baumannii (MDR-AB) infections have been increasing and pose a serious problem. Most such infections present as bacteremia, pneumonia, or a wound infection; however, CNS infections are very rare. We herein present a case of ventriculitis caused by MDR-AB in a 37-year old man after a neurosurgical intervention. The patient was successfully treated with intrathecal colistimethate.

[환경] 음용 원수의 염소소독에 의한 소독부산물 생성패턴에 관한 연구 Ⅱ

이강진(Kang Jin Lee1),홍지은(Jee Eun Hong),표희수(Heesoo Pyo),박송자(Song-Ja Park),유제강(Je Kang Yoo),이대운(Dae Woon Lee) 한국분석과학회 2004 분석과학 Vol.17 No.1

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

[환경] 음용 원수의 염소소독에 의한 소독부산물 생성패턴에 관한 연구

이강진(Kang Jin Lee),홍지은(Jee Eun Hong),표희수(Heesoo Pyo),박송자(Song-Ja Park),유제강(Je Kang Yoo1),이대운(Dae Woon Lee) 한국분석과학회 2003 분석과학 Vol.16 No.3