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.

전단자극 시 나트륨-칼슐 교환체 활성에 의한 횡방향 심방 근세포 Ca2+ 웨이브의 발생

김준철, 왕준, 손민정, 김경희, 우선희 충남대학교 약학대학 의약품개발연구소 2017 藥學論文集 Vol.32 No.-

In the present study, we investigated possible mechanism for the triggered global CaH wave from local Ca2+ wave in atrial myocytes under shear stress. Shear stress was applied onto single cells isolated from rat atria and two-dimensional confocal Ca2+ imaging was performed to measure Ca2+ signal. Shear stress of 16 dyn/cm2 induced local Ca2+ wave, which was followed by a rapid transverse global Ca2+ wave inhibition of Na + -ci+ exchange using KB-R7943 suppressed the occurrence of rapid transverse wave ob served under shear stress, but not the shear-induced local wave. in the presence of this chemical local wave was developed to global wave under shear stress which results in slower time to peak of peripheral and central CaH transients. As the preceding local Ca"+ wave signal was higher, the latency of the occurrence of transverse global wave was shorter, suggesting Ca2+ dependence of transverse Ca2+ wave. The results sug-gest that shear stress may activate Na+ -Ca2+ exchange via local CaZ+ wave, triggering the rapid global Ca2+ wave

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.

Identification of metabolites of MDR-1339, an inhibitor of β-amyloid protein aggregation, and kinetic characterization of the major metabolites in rats

Son, Jun-Hyeng,Jeong, Yoo-Seong,Lee, Jong-Hwa,Kim, Min-Soo,Lee, Kyeong-Ryoon,Shim, Chang-Koo,Kim, Young Ho,Chung, Suk-Jae Elsevier 2018 Journal of pharmaceutical and biomedical analysis Vol.151 No.-

<P><B>Abstract</B></P> <P>We previously reported that MDR-1339, an inhibitor of β-amyloid protein aggregation, was likely to be eliminated by biotransformation in rats. The objective of this study was to determine the chemical identity of metabolites derived from this aggregate inhibitor and to characterize the kinetics of formation of these metabolites in rats. Using high performance liquid chromatography coupled with mass spectrometry with a hybrid triple quadrupole-linear ion trap, 7 metabolites and 1 potential metabolic intermediate were identified in RLM incubations containing MDR-1339. In addition to these, 3 glucuronide metabolites were detected in urine samples from rats receiving a 10 mg/kg oral dose of MDR-1339. When the kinetics of the formation of two major metabolites, M1 and M2, were analyzed assuming simple Michaelis-Menten kinetics, the V<SUB>max</SUB> and K<SUB>m</SUB> values were found to be 0.459 ± 0.0196 nmol/min/mg protein and 28.3 ± 3.07 μM for M1, and 0.101 ± 0.00537 nmol/min/mg protein and 14.7 ± 2.37 μM for M2, respectively. When chemically synthesized M1 and M2 were individually administered to rats intravenously at the dose of 5 mg/kg respectively, the volume of distribution and elimination clearance were determined to be 4590 ± 709 mL/kg and 68.4 ± 5.60 mL/min/kg for M1 and 15300 ± 8110 mL/kg and 98.0 ± 19.5 mL/min/kg for M2, respectively. When MDR-1339 was intravenously administered to rats at a dose of 5 mg/kg, the parent drug and M1 were readily detected for periods of up to 6 h after the administration, but M2 was observed only from 2 to 4 h. A standard moment analysis indicates that the formation clearance of M1 is 6.01 mL/min/kg, suggesting that 19.7% of the MDR-1339 dose was eliminated in rats. These observations indicate that the hepatic biotransformation of MDR-1339 results in the formation of at least 10 metabolites and that M1 is the major metabolite derived from this aggregation inhibitor in rats.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Identification of ten metabolites (i.e., 7 Phase 1 + 3 Phase 2) of MDR-1339 in rats. </LI> <LI> Proposal for the major metabolic pathways to be CYP3A4, 2B6 and 2C9. </LI> <LI> Simultaneous quantification of MDR-1339 and its major metabolite M1 and M2. </LI> <LI> Formation of M1 accounted for ∼19.7% of the total MDR-1339 elimination in rats. </LI> </UL> </P>

Trends in hospital visits and healthcare costs of gout and seropositive rheumatoid arthritis in Korea from 2010 to 2017 using National Healthcare Claims

Kyeong Min Son,Ju-Ryoung Kim,Hang A Park,Hyun Ah Kim 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.3

Background/Aims: We examined temporal trends in the rate of gout and seropositive rheumatoid arthritis (RA) hospital visits and healthcare costs in Korea. Methods: We conducted a serial cross-sectional analysis of Korean national healthcare claims. We calculated the annual increase in hospital visits (emergency department [ED] visits, outpatient visits, and hospitalizations) and total healthcare costs per visit. Results: From 2010 to 2017, the annual rates of ED visits, outpatient visits, and hospitalizations for gout increased from 6.28 to 21, from 638.38 to 1059.55, and from 12.37 to 15.6 per 100,000 persons, respectively. Before 2013, ED visits for gout were most common in patients over 70 years old, but they were most common in those aged between 30 and 49 years after 2013. The number of patients with ED visits, outpatient visits, and hospitalizations for RA from 2010 to 2017 increased from 1.25 to 1.87, from 219.04 to 307.49 and from 8.44 to 12.32 per 100,000 persons, respectively. However, there was no increase in the prevalence of ED visits for RA in any age group except for those older than 70 years. The cost per ED visit for gout significantly decreased from 496.3 to 273.6 US dollar during the study period. There was no significant change in the cost per ED visit for RA between 2010 and 2017. Conclusions: There was a large increase in ED visits for gout during the study period. Further studies are needed to analyze the reason behind increased ED visits for gout and suggest ways on how to improve gout care.

Role of Methacholine PC20 in FEF25-75% for the Diagnosis of Bronchial Asthma

( Kyeong Min Son ),( Seung Hun Jang ),( Hye Ryun Kang ),( Bo Ram Han ),( Joo Hee Kim ),( Hyun Sung Kim ),( Sung Hoon Park ),( Yong Il Hwang ),( Dong Gyu Kim ),( Ki Suck Jung ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.4

Background: The methacholine bronchial provocation test is a useful tool for evaluating asthma in patients with normal or near normal baseline lung function. However, the sensitivity of this test is 82∼92% at most. The purpose of this study is to evaluate the clinical usefulness of FEF25-75% in identification of airway hyperresponsiveness in patients with suspected asthmatic symptoms. Methods: One hundred twenty-five patients who experienced cough and wheezing within one week prior to their visiting the clinic were enrolled. Results: Sixty-four subjects showed no significant reduction of FEV1 or FEF25-75% on the methacholine bronchial provocation test (Group I). In 24 patients, FEF25-75% fell more than 20% from baseline without a 20% fall of FEV1 during methacholine challenge (Group II). All patients who had more than 20% fall of FEV1 (n=37) also showed more than 20% of reduction in FEF25-75% (Group III). Baseline FEV1/FVC (%) and FEF25-75% (L) were higher in group II than group III (81.51±1.56% vs. 75.02±1.60%, p<0.001, 3.25±0.21 L vs. 2.45±0.21 L, p=0.013, respectively). Group II had greater reductions of both FEV1 and FEF25-75% than group I at 25 mg/mL of methacholine (p<0.001). The provocative concentration of methacholine causing a 20% fall in FEF25-75% in group II was about three-fold higher than that in group III. Conclusion: A 20% fall of FEF25-75% by methacholine provocation can be more sensitive indicator for detecting a milder form of airway hyperresponsiveness than FEV1 criteria.

Role of Methacholine PC20 in FEF_25-75% for the Diagnosis of Bronchial Asthma

Son, Kyeong Min,Jang, Seung Hun,Kang, Hye Ryun,Han, Bo Ram,Kim, Joo Hee,Kim, Hyun Sung,Park, Sung Hoon,Hwang, Yong Il,Kim, Dong Gyu,Jung, Ki Suck The Korean Academy of Tuberculosis and Respiratory 2009 Tuberculosis and Respiratory Diseases Vol.67 No.4

Background: The methacholine bronchial provocation test is a useful tool for evaluating asthma in patients with normal or near normal baseline lung function. However, the sensitivity of this test is 82~92% at most. The purpose of this study is to evaluate the clinical usefulness of $FEF_{25-75%}$ in identification of airway hyperresponsiveness in patients with suspected asthmatic symptoms. Methods: One hundred twenty-five patients who experienced cough and wheezing within one week prior to their visiting the clinic were enrolled. Results: Sixty-four subjects showed no significant reduction of $FEV_{1}$ or $FEF_{25-75%}$ on the methacholine bronchial provocation test (Group I). In 24 patients, $FEF_{25-75%}$ fell more than 20% from baseline without a 20% fall of $FEV_{1}$ during methacholine challenge (Group II). All patients who had more than 20% fall of $FEV_{1}$ (n=37) also showed more than 20% of reduction in $FEF_{25-75%}$ (Group III). Baseline $FEV_{1}$/FVC (%) and $FEF_{25-75%}$ (L) were higher in group II than group III (81.51${\pm}$1.56% vs. 75.02${\pm}$1.60%, p<0.001, 3.25${\pm}$0.21 L vs. 2.45${\pm}$0.21 L, p=0.013, respectively). Group II had greater reductions of both $FEV_{1}$ and $FEF_{25-75%}$ than group I at 25 mg/mL of methacholine (p<0.001). The provocative concentration of methacholine causing a 20% fall in $FEF_{25-75%}$ in group II was about three-fold higher than that in group III. Conclusion: A 20% fall of $FEF_{25-75%}$ by methacholine provocation can be more sensitive indicator for detecting a milder form of airway hyperresponsiveness than $FEV_{1}$ criteria.

Poster Session : PS 0697 ; Rheumatology ; Comparison of the Disease Activity Score Using Erythrocyte Sedimentation Rate and C-Reactive Protein in Koreans with Rheumatoid Arthritis

( Kyeong Min Son ),( Young Il Seo ),( Suk Yeon Kim ),( Hyun Ah Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The disease activity scored based on 28 joints (DAS28) has been widely used in clinical practice and research studies of rheumatoid arthritis (RA). Also, Korean National Health Insurance reimbursement criteria for biologic treatment of RA was recently revised based on disease activity measured with DAS28. The objective of this study was to evaluate discordance between DAS28 based on erythrocyte sedimentation rate (ESR) versus C-reactive protein (CRP) in patients with RA. Methods: From August to December 2011, 201 RA patients who visited 2 rheumatology clinics affi liated to Hallym University and had at least one DAS28 evaluation were examined. Results: The mean age of the included patients was 52 years, and 84% were female. The mean durations of disease was 32±46 months and the mean duration from fi rst treatment to measurement of DAS28 was 15 months. The mean swollen and tender joint counts for the 28 joints at the time were 1. 2±2. 6 (range 0-18) and 5. 4±6. 3 (range 0-26). The mean DAS28-ESR was higher than DAS28-CRP (3. 59 vs 3. 28; p<0. 000). The number of patients who satisfi ed the criteria of remission was 50(24. 9%) in DAS28- ESR versus 68 (33. 8%) in DAS28-CRP and the number of patients with high disease activity was 33(16. 4%) versus 14(7%) for DAS28-ESR and DAS28-CRP, respectively. There was a signifi cantdifference in the rate of patients reaching remission and low disease activity between the two measures (p<0. 001). Conclusions: There was discordance between the ESR based and CRP based DAS28, a situation that could affect clinical treatment decisions for Korean RA patients.

Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

Son, Kyeong Min,Cho, Nam H.,Lim, Seung Hun,Kim, Hyun Ah The Korean Academy of Medical Sciences 2013 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.28 No.5

<P>Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact.</P>

Association of body composition with disease activity and disability in rheumatoid arthritis

( Kyeong Min Son ),( Seong Hun Kang ),( Young Il Seo ),( Hyun Ah Kim ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1

Background/Aims: To explore the associations between body composition and pain, disease activity, and disability in rheumatoid arthritis (RA). Methods: The study enrolled 335 patients with RA and underwent body composition measurement with an InBody analyzer. The associations of body mass index (BMI), body fat mass, and skeletal muscle mass with disease activity score in 28 joints (DAS28), an index derived to measure the subjective component of DAS28 (DAS28-P), a pain visual analogue scale (VAS), and disability measured with the health assessment questionnaire (HAQ) were explored. Obesity was defined as BMI ≥ 25 kg/㎡. Results: The median (interquartile range) disease duration was 6 years (3.5 to 9) and the mean DAS28 score was 3.6 ± 1.1. The mean BMI was 23.6 ± 3.6 kg/㎡ and 109 patients (32.5%) were obese. Compared with non-obese patients, obese patients had a higher C-reactive protein (1.68 mg/dL vs. < 0.1 mg/dL, p = 0.013), higher pain VAS score (40 vs. 35, p = 0.031), and higher DAS28-erythrocyte sedimentation rate score (3.75 ± 1.18 vs. 3.46 ± 1.11, p = 0.031). In multivariate regression analysis, the DAS28 score in females was positively associated with the current steroid dose, body fat mass, and HAQ score, while the HAQ score in females was associated with older age, DAS28, lower skeletal muscle mass, and higher body fat/skeletal muscle ratio. In the multivariate regression analysis, the DAS28-P score in females was positively associated with body fat/skeletal muscle ratio and HAQ. Conclusions: Body composition, such as the body fat mass and body fat/skeletal muscle ratio, is significantly associated with disease activity and disability in female RA patients.