Nutlin-3 induces HO-1 expression by activating JNK in a transcription-independent manner of p53

CHOE, YUN-JEONG,LEE, SUN-YOUNG,KO, KYUNG WON,SHIN, SEOK JOON,KIM, HO-SHIK Spandidos Publications 2014 International journal of oncology Vol.44 No.3

A recent study reported that p53 can induce HO-1 by directly binding to the putative p53 responsive element in the HO-1 promoter. In this study, we report that nutlin-3, a small molecule antagonist of HDM2, induces the transcription of HO-1 in a transcription-independent manner of p53. Nutlin-3 induced HO-1 expression at the level of transcription in human cancer cells such as U2OS and RKO cells. This induction of HO-1 did not occur in SAOS cells in which p53 was mutated and was prevented by knocking down the p53 protein using p53 siRNA transfection, but not by PFT-alpha, an inhibitor of the transcriptional activity of p53. Accompanying HO-1 expression, nutlin-3 stimulated the accumulation of ROS and the phosphorylation of MAPKs such as JNK, p38 MAPK and ERK1/2. Nutlin-3-induced HO-1 expression was suppressed by TEMPO, a ROS scavenger, and chemical inhibitors of JNK and p38 MAPK but not ERK1/2. In addition, nutlin-3-induced phosphorylation of JNK but not p38 MAPK was inhibited by TEMPO. Notably, the levels of nutlin-3-induced ROS were correlated with the mitochondrial translocation of p53 and this induction was prevented by PFT-beta, an inhibitor of the mitochondrial translocation of p53. Consistent with the effect of the ROS scavenger and MAPK inhibitors, PFT-beta reduced HO-1 expression and the phosphorylation of JNK induced by nutlin-3. In the experiments of analyzing cell death, the knockdown of HO-1 augmented nutlin-3-induced apoptosis. Collectively, these results suggest that nutlin-3 induces HO-1 expression via the activation of both JNK which is dependent on ROS generated by p53 translocated to the mitochondria and p38 MAPK which appears to be stimulated by a ROS-independent mechanism, and this HO-1 induction may inhibit nutlin-3-induced apoptosis, constituting a negative feedback loop of p53-induced apoptosis.

Combined Gene Therapy with Hypoxia-Inducible Factor-1α and Heme Oxygenase-1 for Therapeutic Angiogenesis

Bhang, Suk Ho,Kim, Ju Hee,Yang, Hee Seok,La, Wan-Geun,Lee, Tae-Jin,Kim, Ga Hee,Kim, Hyun Ah,Lee, Minhyung,Kim, Byung-Soo Mary Ann Liebert 2011 Tissue engineering. Part A Vol.17 No.7

<P>Transfection with either hypoxia-inducible factor-1α (HIF-1α) or heme oxygenase-1 (HO-1) gene can induce neovascularization in ischemic tissues. Although expression of transfected HIF-1α gene occurs rapidly, the expressed HIF-1α protein degrades quickly, limiting its therapeutic efficacy. Meanwhile, expressed HO-1 protein does not rapidly undergo degradation, but gene expression occurs a couple of days after transfection, resulting in apoptosis and a delay in angiogenesis in ischemic tissues at the incipient period of HO-1 gene transfection. We hypothesize that combined delivery of HIF-1α and HO-1 gene will enhance antiapoptosis and neovascularization in ischemic tissue compared with HIF-1α or HO-1 single-gene therapy. To test this hypothesis, ischemic mouse hindlimbs were treated with HIF-1α and/or HO-1 gene therapy. The combined gene therapy proved superior to both single-gene therapies, resulting in rapid expression of HIF-1α gene and long-term maintenance of expressed HO-1 protein. The apoptosis in the ischemic region was significantly less, and angiogenic growth factor secretion and angiogenesis were greater in the combined gene therapy than in either of the single-gene therapies. Our results suggest that a combined gene therapy of HIF-1α and HO-1 enhances the transfection of both genes and improves angiogenesis compared with either single-gene therapy.</P>

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

Upregulation of heme oxygenase-1 by ginsenoside Ro attenuates lipopolysaccharide-induced inflammation in macrophage cells

Kim, Sokho,Oh, Myung-Hoon,Kim, Bum-Seok,Kim, Won-Il,Cho, Ho-Seong,Park, Byoung-Yong,Park, Chul,Shin, Gee-Wook,Kwon, Jungkee The Korean Society of Ginseng 2015 Journal of Ginseng Research Vol.39 No.4

Background: The beneficial effects of ginsenoside species have been well demonstrated in a number of studies. However, the function of ginsenoside Ro (GRo), an oleanane-type saponin, has not been sufficiently investigated. Thus, the aim of the present study was to investigate the anti-inflammatory effects of GRo in vitro using the Raw 264.7 mouse macrophage cell line treated with lipopolysaccharide (LPS), and to clarify the possible mechanism of GRo involving heme oxygenase-1 (HO-1), which itself plays a critical role in self-defense in the presence of inflammatory stress. Methods: Raw 264.7 cells were pretreated with GRo (up to $200{\mu}M$) for 1 h before treatment with 1 mg/mL LPS, and both cell viability and inflammatory markers involving HO-1 were evaluated. Results: GRo significantly increased cell viability in a dose dependent manner following treatment with LPS, and decreased levels of reactive oxygen species and nitric oxide. GRo decreased inflammatory cytokines such as nitric oxide synthase and cyclooxygenase-2 induced by LPS. Moreover, GRo increased the expression of HO-1 in a dose dependent manner. Cotreatment of GRo with tin protoporphyrin IX, a selective inhibitor of HO-1, not only inhibited upregulation of HO-1 induced by GRo, but also reversed the anti-inflammatory effect of GRo in LPS treated Raw 264.7 cells. Conclusion: GRo induces anti-inflammatory effects following treatment with LPS via upregulation of HO-1.

Upregulation of heme oxygenase-1 by ginsenoside Ro attenuates lipopolysaccharide-induced inflammation in macrophage cells

Sokho Kim,Myung-Hoon Oh,Bum-Seok Kim,Won-Il Kim,Ho-Seong Cho,Byoung-Yong Park,Chul Park,Gee-Wook Shin,Jungkee Kwon 고려인삼학회 2015 Journal of Ginseng Research Vol.39 No.4

Background: The beneficial effects of ginsenoside species have been well demonstrated in a number of studies. However, the function of ginsenoside Ro (GRo), an oleanane-type saponin, has not been suffi- ciently investigated. Thus, the aim of the present study was to investigate the anti-inflammatory effects of GRo in vitro using the Raw 264.7 mouse macrophage cell line treated with lipopolysaccharide (LPS), and to clarify the possible mechanism of GRo involving heme oxygenase-1 (HO-1), which itself plays a critical role in self-defense in the presence of inflammatory stress. Methods: Raw 264.7 cells were pretreated with GRo (up to 200mM) for 1 h before treatment with 1 mg/ mL LPS, and both cell viability and inflammatory markers involving HO-1 were evaluated. Results: GRo significantly increased cell viability in a dose dependent manner following treatment with LPS, and decreased levels of reactive oxygen species and nitric oxide. GRo decreased inflammatory cytokines such as nitric oxide synthase and cyclooxygenase-2 induced by LPS. Moreover, GRo increased the expression of HO-1 in a dose dependent manner. Cotreatment of GRo with tin protoporphyrin IX, a selective inhibitor of HO-1, not only inhibited upregulation of HO-1 induced by GRo, but also reversed the anti-inflammatory effect of GRo in LPS treated Raw 264.7 cells. Conclusion: GRo induces anti-inflammatory effects following treatment with LPS via upregulation of HO-1.

황해도 탈춤음악의 전승과 선율구조

김호석 ( Ho Seok Kim ) 한국음악사학회 2009 한국음악사학보 Vol.43 No.-

한국의 탈춤은 춤·대사·음악의 3요소로 구성되는데, 그중에서도 음악은 춤의 반주로 사용되는 반주음악과 대사 중에 나오는 노래로 구분할 수 있다. 탈춤의 춤과 대사는 일찍이 관심있는 학자들의 연구와 채록활동을 통해 그동안 많은 연구논문과 저서들이 발표되었지만, 음악에 관하여는 최근에 임혜정과 이진원이 발표한 논문 외에 필자가 출간한 『탈춤음악본총서 1·2·3』권이 고작이다. 따라서 본고는 탈춤음악 중 필자가 직접 전승 및 연주활동에 참여하고 있는 황해도탈춤을 중심으로 반주음악의 전승실태와 선율구조의 특징 및 연주기법에 대하여 알아보고, 대사 중에 연희자들이 부르는 노래의 선율구조에 대하여 살펴보고자 한다. 먼저 반주음악의 전승실태에 관해서는, 6.25전쟁 후 월남한 예술인을 통해 명맥을 이어온 황해도피리가락이 오선보를 활용한 그룹지도를 통해 현재 봉산탈춤·강령탈춤·은율탈춤 등 황해도탈춤의 반주음악악사들에게 전승되어 연주되고 있을 뿐만 아니라, 2000년부터는 한국예술종합학교 전통예술원을 비롯한 서울지역 주요대학 국악과의 피리전공자들을 대상으로 열린 하계강습을 통해 서도풍류라는 연주곡목으로 전승되어 연주회장에서 수회 발표되기도 하였다. 이러한 황해도탈춤의 반주음악은 피리2·대금1·해금1·장고1·북1·징1 등 모두 6명으로 구성된 삼현육각편성으로 연주되고 있지만, 편의상 쌍피리와 타악기의 편성으로 연주하기도 하며, 놀이의 흥을 돋우기 위해 길놀이 및 몇몇 과장에서는 태평소와 타악기만으로 연주하기도 한다. 현재 연주되고 있는 황해도탈춤의 반주음악에는 해주가락·재령가락·은율가락 등이 있는데, 해주가락과 재령가락은 봉산탈춤과 강령탈춤의 전 과장에서 반주음악으로 연주되고 있으며, 특히 해주가락 중 타령은 은율탈춤공연에서도 연주되고 있다. 반면 은율가락인 긴염불은 은율탈춤공연에서만 제한적으로 연주되고 있는 실정이다. 또한 연주기법에 있어서 해주가락의 경우 서도소리의 창법이 묻어있지만, 재령가락과 은율가락의 경우에는 연주기법은 해주가락의 특징을 적용하되 선율구조는 「솔-라-도-레-미」로 되어있다. 다음으로 황해도탈춤에서 연희자들이 부르는 노래의 선율구조를 살펴보면, 강령탈춤에 나오는 물레타령이 유일하게 수심가토리이고 경토리가 가장 많으며, 육자백이토리와 메나리토리의 곡이 골고루 분포되어 있다. 또한 경토리로 되어있는 곡의 일부는 창법에 있어서 서도소리의 창법을 적용하기도 한다. Hwanghaedo Mask Dance Music could be preserved till today because of devotional endeavors of Pak Tong-sin, Kim Yong-t`aek, and Yang So-un. Hwanghaedo mask dance music is divided into the instrumental accompaniment music and songs that are sung by performers. The accompaniment music is divided into Pak Tong-sin`s Hwanghaedo p`iri Tunes that are performed in Pongsan t`alch`um, Kangryong t`alch`um, and Unyul t`alch`um, and Kim Yong-t`aek`s Unyul Tunes and t`aep`yongso Tunes that are played in Unyul t`alch`um. Songs were transmitted from Yang So-un to all of three organizations preserving Hwanghaedo mask dance and 68 songs survive. Hwanghaedo p`iri Tunes consists of Haeju tunes - yombul, t`aryong, and kukkori - that were transmitted to from Chong Mok-tong and Yi Ho-yun and Chaeryong tune - t`aryon sinawi - that Pak adopted from Chaeryong p`iri players. These pieces are played throughout the entire acts in Pongsan t`alch`um and Kangryong t`alch`um and t`aryong is played in Unyul t`alch`um. Among Kim Yong-t`aek`s Unyul Tunes and t`aep`yongso Tunes, kin yombul, chajin tomburi, tol changdan, and unyul kut changdan are played as accompaniment music of Unyul t`alch`um. Hwanghaedo p`iri Tunes, that were transmitted to the writer from Pak Tong-sin, are still in the process of transmission to the next generation throughout courses in the Korean National University of Arts and special summer courses in every other year. Besides, it became an independent instrumental genre to be performed on the stage being recognized as sodo p`ungnyu. The accompaniment music of Hwanghaedo mask dance are divided into three categories according to it musical frames. The first is Haeju karak that consist of sol-(la)-re -mi; yombul, t`aryong, and kukkori are haeju karak. Second, the scale is formed with sol-la-do-re-mi including t`aryong karak, t`aryong sinawi, unyul karak, kin yombul, and t`aep`yongso karak, chajin tomburi, tol changdan, and unyul kut changdan. Third, the scale is formed with la-do-re-mi-sol. The instrumentation of the accompaniment music of Hwanghaedo mask dance should be samhyon yukkak; however, only Pongsan t`alch`um is accompanied with Samhyon yukkak; Kangroong t`alch`um only with two piri and one taegum; Unyul t`alch`um with two p`iri and one t`aepyongso. Performing techniques of p`iri, witch is the main instrument of the accompaniment music, can be discussed with the three main techniques. The first technique is the throat technique which is expressing a little lower tone than re as a staccato on the first hole. The second technique is expressing re by holding the reed deeply vibrating the pitch deeply on the second hole. The third technique is expressing the pitch of the back hole with the long sustentation and vibration at the end. These techniques not only appear in Hwanghae-do piri Tunes but also Unyul Tunes. Songs that are sung in Hwanghaedo mask dances are divided according to dances and categorized according to their tori, regional styles. If the scale of a song is the same as sol-la-do-re-mi or la-do-re-mi-sol, it is kyong t`ori. If the scale of a song is the same as mi-la-ti-do-re with the characteristic ti, it is yukchabaegi t`ori. Mi-sol-la-do-re is known as menari t`ori, and re-la-do or la-mi-sol, which is perfect fifth above re-la-do, is susimga t`ori. Some of non-harmonic tones - for example, passing tones, neighboring tones, and escape tones - may appear. Among sixty-eight pieces that are sung in Hwanghaedo mask dance, thirty-five pieces are kyong t`ori. which is more than a half, twenty one pieces are yukchabaegi t`ori, which is 1/3 of the entire, ten pieces are in menari t`ori, one is susimga t`ori, and one is p`yong sijo. As utilizing the staff notation instead of the oral transmission, the system of transmission became more efficient and it made the group lecture possible; and thus, Hwanghaedo p`iri Tunes, which were in danger to be lost, have been popularized in the traditional music society. In addition, it became rigid not only as the accompaniment music of Hwanghaedo mask dance but also as an instrumental genre known as sodo p`ungnyu.

사례보고 : 하수오 복용 후 발생한 재발성 독성 간염 1예

배상훈 ( Sang Hoon Bae ),김동현 ( Dong Hyun Kim ),배영석 ( Young Seok Bae ),이광재 ( Kwang Jae Lee ),김동완 ( Dong Wan Kim ),윤정빈 ( Jeoung Bin Yoon ),홍준호 ( Joon Ho Hong ),김상현 ( Sang Hyun Kim ) 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.2

Toxic hepatitis has been reported as a major cause of acute hepatitis, but its potential induction by herbal remedies and/or health foods is usually neglected. We experienced a case of toxic hepatitis associated with Polygoni multiflori, a Chinese herb commonly known as Ho-Shou-Wu. A 54-year-old woman consumed Ho-Shou-Wu for 1 month, after which she experienced fatigue and overall weakness. A diagnosis of toxic hepatitis was made based on her clinical history, the findings for viral markers and other laboratory data, and ultrasonography. Her condition improved considerably after she stopped taking Ho-Shou-Wu. However, she resumed taking Ho-Shou-Wu immediately after discharge from hospital, which aggravated her symptoms and liver function. She was immediately readmitted and stopped taking Ho-Shou-Wu. Her relapse into hepatitis immediate after resuming consumption of the herb is strongly indicative of the validity of Koch`s postulate in this case.

대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

Azithromycin으로 치료한 임신 중 쓰쓰가무시병 1예

김광석,최진욱,서호종,김기훈,박성호,서광섭,고성만,김순혜,김호정 대한감염학회 2001 감염 Vol.33 No.5

We report a case of tsutsugamushi disease in a 26 year-old pregnant woman who was treated with azithromycin. Her gestation period was 27 weeks and she admitted with fever, rash, and eschar on the right shoulder. Currently recommended medications for the treatment of scrub typhus are doxycycline or chloramphenicol. But, these drugs are class D drugs according to the U.S. Food and Drug Administration (FDA) Fetal Risk Summary, so they couldn't be used to treat pregnant women. Recently, a few case reports suggested that azithromycin, a relatively new macrolide antibiotic, was effective and safe for the treatment of scrub typhus in pregnant women. And, there is no evidence that azithromycin causes harmful effects to the developing fetus or to children. On the basis of current in vivo test that confirms the effectiveness of azithromycin, it may be the drug of choice for the treatment of scrub typhus in pregnant women and children. (Korean J Infect Dis 33:380-382, 2001)