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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.
Kyeong Woon Choi,Seong Woo Hong,Yeo Goo Chang,Woo Yong Lee,Byungmo Lee,In Wook Paik,Hyucksang Lee 대한외과학회 2014 Annals of Surgical Treatment and Research(ASRT) Vol.86 No.6
Purpose: This study was conducted to evaluate the systemic inflammatory response in colorectal cancer patients, and to estimate the usefulness of the Glasgow prognostic score (GPS) as a prognostic factor. Methods: Patients with biopsy-proven colorectal adenocarcinoma who were operated between April 2005 and December 2008 were enrolled in this study. The GPS was estimated based on the measurement of CRP and serum albumin level. The GPS was compared with other clinicopathological factors. Univariate and multivariate analyses were performed to evaluate the factors affecting cancer-specific survival. Results: GPS was significantly higher in patients with anemia, thrombocytosis, a high neutrophil to lymphocyte ratio, tumor of the colon, and large tumor. Patient age, gender, serum CEA level, tumor gross appearance, TNM stage, and tumor differentiation were not related with the GPS. In univariate analysis, hemoglobin, CEA, gross appearance of tumor, TNM stage, tumor differentiation, and GPS were associated with cancer-specific survival. In multivariate analysis, TNM stage (III or IV : I or II; hazard ratio [HR], 12.322; P = 0.015), tumor differentiation (poorly differentiated : well or moderately differentiated; HR, 3.112; P = 0.021), and GPS (GPS 2 : GPS 0 or 1; HR, 5.168; P = 0.003) were identified as independent prognostic factors in colorectal cancer. Conclusion: Our study showed that the GPS was an independent variable from tumor stage and a good and convenient prognostic factor in colorectal cancer patients.
Choi, Se Yeon,Choi, Byoung Geol,Rha, Seung-Woon,Byun, Jae Kyeong,Shim, Min suk,Li, Hu,Mashaly, Ahmed,Choi, Cheol Ung,Park, Chang Gyu,Seo, Hong Seog,Oh, Dong Joo,Jeong, Myung Ho Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.249 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES).</P> <P><B>Methods</B></P> <P>A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n=2691) and angiotensin receptor blockers (ARB) group (n=1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2years.</P> <P><B>Results</B></P> <P>After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2years,</P> <P><B>Conclusion</B></P> <P>In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2years.</P>
Carcinosarcoma of the Stomach: A Case Report
Choi, Kyeong Woon,Lee, Woo Yong,Hong, Seong Woo,Chang, Yeo Goo,Lee, Byungmo,Lee, Hye Kyung The Korean Gastric Cancer Association 2013 Journal of gastric cancer Vol.13 No.1
Carcinosarcoma is a rare malignant, biphasic tumor comprised of carcinoma and sarcoma components. In the gastrointestinal tract, carcinosarcoma is most frequently seen in the esophagus and rarely in the stomach. We report a 51-year-old female patient with 2-month-history of epigastric pain and dyspepsia. Endoscopic finding revealed a huge ulcerative lesion that infiltrated from the antrum to the mid-body. An endoscopically taken biopsy revealed poorly differentiated malignant round cell neoplasm. After the palliative subtotal gastrectomy, immunohistochemical studies showed two positive reactions for the epithelial marker and mesenchymal marker. Based on the above findings, the patient was diagnosed with gastric carcinosarcoma. The immunohistochemical analysis is a critical method in making an accurate diagnosis of carcinosarcoma.
Impact of Cigarette Smoking: a 3-Year Clinical Outcome of Vasospastic Angina Patients
Byoung Geol Choi,Seung-Woon Rha,Taeshik Park,Se Yeon Choi,Jae Kyeong Byun,Min Suk Shim,Shaopeng Xu,Hu Li,Sang-Ho Park,Ji Young Park,Woong Gil Choi,Yun-Hyeong Cho,이선기,Jin Oh Na,Cheol Ung Choi,Hong Euy 대한심장학회 2016 Korean Circulation Journal Vol.46 No.5
However, it is largely unknown whether smoking adds to any long-term clinical risk in VSA patients. Subjects and Methods: A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395). All CAS patients were prescribed with anti-anginal medications for at least 6 months. The incidence of major clinical outcomes and recurrent angina of these groups were compared up to 3 years. Results: There were considerable differences in the baseline clinical and angiographic characteristics among the three groups, but there was no difference in the endpoints among the three groups (including individual and composite hard endpoints) such as death, myocardial infarction, de novo percutaneous coronary intervention, cerebrovascular accident, and major adverse cardiac events. However, there was a higher incidence of recurrent angina in both the non-smoking CAS group and smoking CAS group, as compared to the nonCAS group. In multivariable adjusted Cox-proportional hazards regression analysis, smoking CAS group exhibited a higher incidence of recurrent angina compared with the non-CAS group (hazard ratio [HR]; 2.46, 95% confidence interval [CI]; 1.46-4.14, p=0.001) and nonsmoking CAS group (HR; 1.76, 95% CI; 1.08-2.87, p=0.021). Conclusion: Cigarette smoking CAS group exhibited higher incidence of recurrent angina during the 3-year clinical follow-up compared with both the non-CAS group and non-smoking CAS group. Quitting of smoking, paired with intensive medical therapy and close clinical follow-up, can help to prevent recurrent angina.
Rha, Seung-Woon,Choi, Byoung Geol,Baek, Man Jong,Ryu, Yang gi,Li, Hu,Choi, Se Yeon,Byun, Jae Kyeong,Mashaly, Ahmed,Park, Yoonjee,Jang, Won Young,Kim, Woohyeun,Choi, Jah Yeon,Park, Eun Jin,Na, Jin Oh,C Yonsei University, College of Medicine 2018 Yonsei medical journal Vol.59 No.5
<P><B>Purpose</B></P><P>Many recent studies have reported that successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO) has more beneficial effects than failed CTO-PCI; however, there are only limited data available from comparisons of successful CTO-PCI with medical therapy (MT) in the Korean population.</P><P><B>Materials and Methods</B></P><P>A total of 840 consecutive CTO patients who underwent diagnostic coronary angiography, receiving either PCI with DESs or MT, were enrolled. Patients were divided into two groups according to the treatment assigned. To adjust for potential confounders, propensity score matching (PSM) analysis was performed using logistic regression. Individual major clinical outcomes and major adverse cardiac events, a composite of total death, myocardial infarction (MI), stroke, and revascularization, were compared between the two groups up to 5 years.</P><P><B>Results</B></P><P>After PSM, two propensity-matched groups (265 pairs, n=530) were generated, and the baseline characteristics were balanced. Although the PCI group showed a higher incidence of target lesion and vessel revascularization on CTO, the incidence of MI tended to be lower [hazard ratio (HR): 0.339, 95% confidence interval (CI): 0.110 to 1.043, <I>p</I>=0.059] and the composite of total death or MI was lower (HR: 0.454, 95% CI: 0.224 to 0.919, <I>p</I>=0.028), compared with the MT group up to 5 years.</P><P><B>Conclusion</B></P><P>In this study, successful CTO PCI with DESs was associated with a higher risk of repeat PCI for the target vessel, but showed a reduced incidence of death or MI.</P>