Metallo-β-lactamase 생성 Pseudomonas aeruginosa 및 포도당 비발효그람음성간균의 검출방법에 관한 연구

신경섭,김원식,손재철,홍승복,최재운,형성민 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

연구목적: Metallo-β-lactamse (MBL)는 carbepenem를 포함하는 대부분의 β-lactam 항균제를 가수분해할 수 있으므로 MBL 생성균의 확산은 이들 균에 의한 감염의 치료에 큰 문제를 야기할 수 있다. 따라서 MBL 생성균에 의한 감염의 확산을 막기 위해 이들 균의 조기 검출이 필요하다. 저자들은 MBL 생성균을 검출할 수 있는 세 가지 방법을 PCR 방법과 비교하여 보았다. 재료 및 방법: Imipenem의 MIC가 8 μg/mL 이상인 50개의 포도당 비발효 그람음성 간균을 대상으로 EDTA-double disk synergy test (EDTA-DDS), Etest MBL, Hodge 변법을 시행하였으며 대조 검사로 IMP-1, VIM-1, VIM-2에 대한 PCR을 시행하였다. 결과: 총 50 균주 중 MBL 생성균은 Pseudomonas aeruginosa 1 균주, Alcaligenens xylosxidans 7 균주 등 8 균주(16%)가 검출되었다. 이들 균주는 모두 VIM-2 형이었으며, EDTA-DDS, Etest MBL은 PCR 방법과 100% 일치하였다. Hodge 변법은 8 MBL 생성균주 중 2 균주를 검출하지 못했다. 결론: 50 균주 중 8 균주가 MBL 생성균이었고 모두 VIM-2 형이었다. Etest MBL은 가격이 비싸 검사실에서는 EDTA-DDS가 적당할 것으로 사료된다. Purpose: Because metallo-β-lactamase (MBL) has activity to hydrolysls against most β-lactam drugs, dissemination of MBL producing bacteria may cause problems of treatment of infection by their microorganisms. Early detection or screening for MBLs will contribute to prevent further spread of resistance. Authors compared three MBL detection methods with PCR for MBLs. Materials and Methods: For 50 isolates of g1ucose nonfermentative gram negative bacilli with reduced susceptability against imipenem (MIC≥8 μg/mL), EDTA-double disk synergy (EDTA-DDS), Etest MBL and modified Hodge test were compared with PCR detection method for MBLs. Results: Among 50 isolates of glucose nonfermentative microorganisms, eight MBL producers including a Pseudomonas aeruginosa and 7 Alcaligenes xylosoxidans were detected. Those isolates were VIM-2 producer. The results of EDTA-DDS and Etest MBL completely agreed with PCR for MBL detection. Two isolates among eight MBL Producers were not detected in modified Hodge test. Conclusion: All of MBL producing bacteria were VIM-2 genotype. In conclusion, EDTA-DDS may be useful method for MBL detection in clinical laboratory due to high cost of Etest MBL strip.

韓國産 擔子菌類의 抗菌成分에 관한 硏究 (II) : 10種의 擔子菌에 대한 抗菌成分 檢索 A Screening Test for the Antibiotic Activities of Ten Basidiomycetous Fungi

鄭敬壽,申明哲,柳柄泰,金炳珏 충남대학교 약학대학 의약품개발연구소 1986 藥學論文集 Vol.2 No.-

The ether, methanol, and physiological saline extracts of the dried carpophores of ten basidiomycetous fungi, which were collected in the conifer woods of Chungnam National University at Taechon and Keyryoung Mountain Area in Chungcheungnamdo, were subjected to an antibiotic activity test by disc-plate method. Among them, the methanol extracts of Inocybe trechispora, Lactarius velumis, and Laccaria laccata and the ether extracts of I.trechispora showed antibiotic activities against Sarcina lutea; and the methanol extracts of I. trechispora and L. velumis and physiological saline extract of Coriolus versicolor showed antibiotic activities against Staphylococcus aureus; and the methanol extract of L. velumis showed antibiotic activity against Escherichia coli. None of the extracts, however, showed any activity against Serratia marcescens and Proteusvulgaris.

관절경을 이용한 전방 십자인대 재건술: : Two Tunnel Method와 One Tunnel Method의 비교 Comparison of Two Tunnel Method with One Tunnel Method

김경순,신규철,김동헌 건국대학교 의과학연구소 1995 건국의과학학술지 Vol.5 No.-

저자들은 1988년 3월부터 1994년 9월까지 진구성 방전십자인대 손상에 대하여 관절경하에서 슬개골-건-골을 이용하여 재건술을 시행한 환자중 1년이상 추시가 가능했던 30례의 환자를 대상으로 결과를 분석하여 다음과 같은 결과를 얻었다. 1) 남자가 많았고 30대가 가장 많았다. 2) 가장 많은 손상 원인은 교통사고였으며 17명의 환자에서 동반손상이 있었다. 3) 수상후 수술까지의 기간은 평균 9개월이었고 3개월부터 18개월까지 고른 분포를 보였다. 4) 가장 많은 동반손상은 내측부 인대 파열이었고 다음은 내측부 반월판 손상이었다. 5) 환자의 임상적 평가는 Lysholm knee scoring scale을 사용하였다. Two tunnel군에서는 최종 평가시 79%에서 양호 이상의 소견을 보였고, One tunnel 군에서는 81%에서 양호 이상의 소견을 보였다. 6) 10명의 환자에서 추시관절경을 시행하였으며 관절경 소견상 이식거늬의 생착과정을 확인할 수 있었다. 저자들은 관절경하에서 슬개골-건-골을 이용한 선방 십자인대 재건술을 시행하여 양호한 결과를 얻었고 향후 장기 추시가 필요할 것으로 사료되며 두 가지 수술 방법에 따른 뚜렷한 차이는 없었다. 또한 추시 관절경 검사는 이식건의 성숙 과정을 관찰하고 환자의 재활치료에 방침을 정하기 위해 필요하리라고 사료된다. Recent Arthroscopic ACL reconstruction methods have been developed as a technical solution to achieve proper positioning of the graft. In this study, ACL tear were treated with BTB autograft using either arthroscopic two tunnel method or one tunnel method. We analyzed the 30 cases who had taken the reconstruction surgery of ACL from March 1988 to September 1994. The results were as follows. In the two tunnel group, 79%(15 patients) were estimated as exellent or good result and 81%(9 patients) in the One tunnel group. Follow-up arthroscopy was perfomed to observe the maturation process of the graft in 10 cases. There was no clinical differences between two groups.

연성 골수정을 이용한 장관골 개방성 골절의 치료

김동헌,신규철,김경순 건국대학교 의과학연구소 1995 건국의과학학술지 Vol.5 No.-

Multiple fractures of the long bone shaft are not uncommon. There has been much controversies concerning over the method of its treatments due to their frequent complication rate. A randomized, prospective study of Ender nailing for multiple fracture of the long bone shaft of thirty-five cases in twenty-five patients was undertaken at the department of orthopaedic surgery, from January 1989 to Febrary 1995. The results are follows: The average age of the patients was 36-year-old and 20 patients were male and the most common cause was traffic accident. Among 35 cases, comminuted fractures were 10 cases and segmental fractures were 4 and others are transverse, short oblique fractures. Average interval from injury to operation was 2 days. Average bone union time. 1) Humerus : 11 week. 2) Femur : 20 week. 3) Tibia : 18 week. The most common complications were nail migration and superficial infection. The non-union developted in one case. From the result, Ender nailing is one of good treatment modality in open long bone fracture of grade Ⅰ, Ⅱ and selected grade Ⅲa, which provides low risk of complication and allows early weight bearing and ambulation without periosteal stripping in the long bone shaft fracture.

건강한 사람에서 발병한 수두와 동반된 수두폐렴 1 예

박원종,유성근,신경철,정진홍,이관호 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

Varicella is a contagious infection in childhood disease typically affecting children aged 2-8 years and usually follows benign outcome. In the adult, clinical presentation is more severe and more commonly associated with complications. Varicella pneumonia, although rare, is a potentially life-threatening complication that should be suspected in any adult with varicella and respiratory symptoms. We report a case of varicella pneumonia in immunocompetent patient. The characteristics radiographic findings consisted of diffuse scattered coarse nodular infiltrations, less than 1cm sized, with ground glass opacity and consolidation in both lung fields. The patients was started on intravenous acyclovir. The chest radiograph performed 2 weeks later showed complete resolution of the pulmonary lesions.

Effects of TNF-α and Leptin on Weight Loss in Patients with Stable Chronic Obstructive Pulmonary Disease

( Kyeong Cheol Shin ),( Jin Hong Chung ),( Kwan Ho Lee ) 대한내과학회 2007 The Korean Journal of Internal Medicine Vol.22 No.4

Background: Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Methods: Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum tumor necrosis factor-alpha (TNF-α) were measured in all the study participants. The difference and correlation of these parameters were investigated between the two groups. Results: Emphysematous patients were characterized by a lower body mass index (BMI) and fat-mass (FM) compared with the chronic bronchitis patients (p<0.001). The plasma leptin levels, as corrected for the FM, were not different between the COPD patients and healthy controls (78.3±30.9 pg/mL/kg vs. 70.9±17.3 pg/mL/kg, respectively), and the plasma leptin levels, as adjusted for the FM, were also not different between the two groups of COPD patients. In the chronic bronchitis patients, the plasma leptin concentration was correlated with the BMI (r=0.866, p<0.001) but it was not correlated with the BMI in the emphysema patients. The serum TNF-α levels were higher in the stable COPD patients than those in the controls, but there was no statistical difference (10.7±18.6 pg/mL vs. 7.2×3.5 pg/mL, respectively, p0.05). The leptin concentration was well correlated with the BMI and %FM in the patients with chronic bronchitis and the leptin concentration was only correlated with the %FM (r=0.450, p=0.027) in emphysema patients. There was no correlation between the plasma leptin concentration, as adjusted for the fat mass, and the activity of the TNF-α system. Conclusion: The interaction of leptin and the activity of the TNF-α system in the pathogenesis of tissue depletion may not play an important role in chronic stable COPD patients.

Physical activity in chronic obstructive pulmonary disease: clinical impact and risk factors

( Kyeong-cheol Shin ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1

Experience of Treating Critically Ill COVID-19 Patients in Daegu, South Korea

( Kyeong-cheol Shin ) 대한결핵 및 호흡기학회 2021 Tuberculosis and Respiratory Diseases Vol.84 No.3

At the beginning of February 2020, Daegu faced a serious situation due to the rapid outbreak of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2. The healthcare system in Daegu Metropolitan City was ill-prepared for this sudden disaster situation. The COVID-19 pandemic is still ongoing in South Korea. Daegu has limited medical resources compared to the Seoul Metropolitan Area, and it is hypothesized that a review of the outbreak therein could provide information that will be valuable for dealing with future outbreaks. The likelihood of death due to COVID-19 depends on the capacity of the area for the treatment of critically ill patients. This report reviews the overall treatment process followed for critically ill patients in Daegu.

호흡기내과 의사를 위한 COPD 리뷰

신경철 ( Kyeong Cheol Shin ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.1

Many findings suggest that chronic obstructive pulmonary disease (COPD) imposes an enormous burden on pa-tients, health-care professionals and society. COPD contributes to morbidity and mortality and to a significant use of health-care resources. In spite of a higher prevalence of COPD in Korea, the result of COPD treatment is not effective. The purpose of this article was to review recent advances in the study of COPD in Korea with the aim of improving effective management. This review highlights articles pertaining to the following topics; prevalence, assessment of COPD, risk factors for hospitalization, co-morbid diseases, phenotypes, and treatment issues.

한국인의 흡연습관에 따른 폐암발생의 비교위험도

신경철 ( Kyeong Cheol Shin ),류헌모 ( Hun Mo Ryoo ),박혜정 ( Hye Jung Park ),문영철 ( Yeung Chul Mun ),정진홍 ( Jin Hong Chung ),이관호 ( Kwan Ho Lee ) 대한결핵 및 호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.48 No.3