성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

Pigment Induction of Vitiligo with Fractional Laser: Preliminary Study

( Seung Hyun Cheong ),( Ji Yeon Byun ),( Yun Jeong ),( Kyu Kwang Whang ) 대한피부과학회 2008 초록집 Vol.46 No.10

Clinical and statistical review of 88 cases of stevens-johnson syndrome(SJS) and toxic epidermal necrolysis(TEN) experienced in 3 university hospitals in the last 10 years

( Jeong Yeon Hong ),( Kyu Uang Whang ),( Jong Suk Lee ),( Jung Eun Kim ),( Sul Hee Lee ),( Seung Min Lee ),( Tae Heum Park ),( Eun Ji Hong ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Because SJS and TEN occur very rarely, it is difficult to obtain well-organized epidemiological data. Therefore, we aimed to help early diagnosis and treatment by examining the characteristics, causative agents, and prognostic factors of SJS and TEN patients. Objectives: A retrospective analysis was performed on SJS and TEN patients who visited three medical institutions at Soonchunhyang University for 10 years from February 2009 to February 2019. Methods: Sex, age, past history, suspected drugs, blood test, other systemic symptoms, treatment, hospitalization period, and death were summarized, and the SCORTEN score of each patient was also measured for prognostic analysis. Results: As the causative agent, antibiotics were the most common with 29 cases (33.0%), NSAIDs in 20 cases (22.7%), antiepileptic drugs in 13 cases (14.7%), allopurinol in 10 cases (11.4%). In the antibiotic group, the frequency of penicillin and cephalosporin drugs was high. It was confirmed that there is a large correlation between the SCORTEN score and mortality. Conclusion: Early diagnosis of SCAR (Severe Cutaneous Adverse Reactions) and rapid discontinuation of the suspected drug is very important in the treatment of SCAR. Therefore, in order to prevent the occurrence of SCAR, it is necessary to block the re-administration of the suspected drug as possible, and for this, accurate management of the history of side effects is essential.

Rh(D) 부적합 수혈후 Rh(D) 항체생성 예방성공 1례

홍승호 ( Seung Ho Hong ),장연희 ( Yeon Hee Jang ),이상식 ( Sang Sik Lee ),황선보 ( Sun Bo Whang ),임문환 ( Moon Whan Im ),윤혜원 ( Hyeo Won Yoon ),심재철 ( Jae Cheol Sim ),김용탁 ( Yong Tak Kim ) 대한주산의학회 1993 Perinatology Vol.4 No.4

Effect of High-Dose Tamoxifen on Malignant Gliomas

Oh, Yeon Chul,Kim, Jung Hoon,Lee, Jung Kyo,Kim, Chang Jin,Kwon, Yang,Rhim, Seung Chul,Kwun, Byung Duck,Whang, C. Jin 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

배양된 신경교종에서 tomoxifen은 핵산의 합성 및 세포의 증식을 억제할 수 있음을 in vitro study상 알 수 있다. 이러한 성장 억제는 tamoxifen의 항에스트로겐 특성에 의존하지 않고, protein kinase C라는 효소의 억제를 통해서 이루어지는 듯 하다. 저자들은 1991년 2월부터 1993년 1월까지 본원 신경외과에 입원하여 수술 후 부가적 치료로써 고용량 tamoxifen을 병행한 28명의 악성 신경교종환자들에서 고용량 tamoxifen의 부가적 치료 효과 및 그 부작용을 알아보기 위하여 본 임상실험을 시행하였다. 고용량 tamoxifen의 부가적 치료효과는 통계학적으로 유의하게 증가된 생존기간 및 생존율로 정의하였다. Tamoxifen 치료군의 경우 처음에는 약제의 부작용을 알아보기 위하여 표준 항에 스트로겐 용량인 20㎎을 하루에 2회 경구 투여하였으며, 특별한 문제가 없으면 1달 이상에 걸쳐 매주 용량을 증가하여 100㎎을 하루 2회 경구 투여하였다. Tamoxifen 사용 후 역형성 성상세포종과 다형성 교아세포종간의 생존기간 및 생존율을 비교하여 보았을 때 역형성 성상세포종에서 다형성 교아세포종보다 중간 생존율이 약간 높았으나 통계학적 유의한 차이는 없었다. 또한 치료 방법(방사선 단독 치료군, 방사선 치료와 ACNU 화학요법을 병행한 치료군, 그리고 방사선 치료와 tamoxifen을 병행은 치료군)에 따른 생존기간 및 생존율을 비교하여 보았을 때, tamoxifen 치료군에서 다른 치료군들보다 생존기간 및 생존율이 약간 높았으나 역시 통계학적 의미는 없었다. 고용량 tamoxifen으로 치료하였던 대부분의 환자들에서 심한 부작용은 관찰할 수 없었다. Tamoxifen 용량을 증가시키는 동안 5명의 환자에서 식욕부진 증상이 발생하였으며, 다른 합병증들로서 무월경, 오심/구토, 그리고 변비 등을 관찰할 수 있었으나 혈액학적 변화는 관찰할 수 없었다 저자들은 고용량 tamoxifen을 악성 신경교종 환자에서 비교적 안전하게 사용할 수 있다고 생각한다. 본 임상실험 결과는 만족스럽지 못했으나 저자들은 제한된 본 연구결과로 악성 신경교종 환자들에서 고용량 tamoxifen의 치료 효과를 단정할 수 없다고 생각하며, 따라서 이 약제에 대한 보다 광범위한 연구가 이루어져야만 한다고 생각한다. In vitro studies have shown that the nonsteroidal antiestrogen tamoxifen can suppress deoxyribonucleic acid(DNA) synthesis and cell proliferation in cultured human gliomas. This frowth suppression is independent on its antiestrogenic properties. Tamoxifen may act through the inhibition of the enzyme protein kinase C(PKC), which transduces mitogenic signals from the cell surface to the nucleus. In order to evaluate the therapeutic response and side effect of high-dose tamoxifen, we performed a clinical study of 28 patients with malignant gliomas who were treated with high-dose tamoxifen in our hospital between Febrary 1991 and January 1993. An effect was defined as a statistically improved survival times/rates. In patients who were assigned to receive high-dose tamoxifen, it was first administered at standard antiestrogen doses(20㎎ orally bid/day) to observe for any side effect and if tolerated, the dose was increased weekly to achieve target doses(100㎎ orally bid/day) over a 1 month period. We compared the survival times/rates between anaplastic astrocytomas and glioblastoma multiformes. Although the median survival time was slightly longer in anaplastic astrocytomas and glioblastoma multiformes, there was no statistical difference of survival curves between two groups at the p=0.05 level. We also exmamined the survival times/rates of malignant gliomas according to treatment modalities(radiotherapy along, radiotherapy plus ACNU, and radiotherapy plus tamoxifen). Although the survival rate and time were slightly higher in radiotherapy plus tamoxifen group than those of another treatment groups, we could not find the statistical significance of survival curves between three treatment groups(p>0.05)). High-dose oral tamoxifen appeared to be well tolerated in most patients. Five patients developed anorexia following dose escalation of tamoxifen. Another complications were amenorrhea, nausea/vomiting, and constipation. There were no changes in hematological studies that could be attributed to tamoxifen. We think that high-dose tamoxifen can be administered safely to malignant glioma patients. Our results were not impressive. We conclude that the definition of the true efficacy of high-dose tamoxifen in patients harboring malignant gliomas is not possible from this limited study, and a further large scale, randomized trial of this agent is necessary.

Distributions of Minimum Inhibitory Concentration for Delpazolid and Linezolid in Drug-resistant Mycobacterium Tuberculosis in South Korea

( Jeong Seong Yang ),( Hyeonji Kim ),( Minji Kang ),( Seung Heon Lee ),( Dong Yeon Shin ),( Young Lag Cho ),( Nakwon Kwak ),( Jae-joon Yim ),( Jake Whang ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.0

Background As a recommendation for the treatment of multidrug-resistant (MDR) / rifampicin-resistant tuberculosis (RR) in WHO guidelines, the use of linezolid is strongly recommended for longer MDR-TB regimens. However, there are many reports of side effects from using linezolid. Delpazolid is a new antibiotic of an Oxazolidinone family, same as linezolid. Delpazolid was reported to be safer compared to linezolid with lower adverse effects. In this study, minimum Inhibitory Concentration (MIC) of drug-resistant TB isolates was measured for linezolid and delpazolid, and the distribution was confirmed. Methods A total of 514 resistant-TB clinical isolates were randomly selected from the Korea Mycobacterium Resource Center at the Korean institute of tuberculosis; respectively, 1 isoniazid-resistant, 389 MDR, 100 RR, and 24 extensively-resistant TB. The MIC test of linezolid and delpazolid was performed using Middlebrook 7H9 broth with 10% oleic-albumin-dextrose-catalase and 2,3 diphenyl-5-(2-thienyl)-tetrazolium chloride by broth microdilution Method in 96-well microplate. Results The MIC90 of linezolid and delpazolid were 0.5 mg/L and 1 mg/L, respectively. Additionally, for the MIC distribution, tentative epidemiological cutoff (ECOFF) of linezolid and delpazolid were determined as 1 mg/L and 4 mg/L. According to the ECOFFs, the number of resistant strains was 16 (3.11 %) and 10 (1.95 %) isolates for linezolid and delpazolid. Furthermore, 9 isolates were confirmed to be resistant to both antibiotics. Conclusions In this study, we compared the MIC distributions of linezolid and delpazolid in drug resistant-TB isolates, and confirmed the MIC90 and ECOFF values, and we also identified resistant isolates of linezolid and delpazolid, respectively. In further studies, the detailed resistance mechanism will be investigated in 8 isolates which have different resistance to the same oxazolidinone antibiotics. Finally, it will be confirmed whether there is a new mechanism of resistance that is still unknown for 9 strains having common resistance.

Comparison of Minimum Inhibitory Concentration Distributions between Delpazolid and Linezolid Against Mycobacterium Avium, Mycobacterium Intracellulare in Korea

( Hyeonji Kim ),( Jeong Seong Yang ),( Minji Kang ),( Seung Heon Lee ),( Dong Yeon Shin ),( Young Lag Cho ),( Nakwon Kwak ),( Jae-joon Yim ),( Jake Whang ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.0

Background n South Korea, the major causative agents of nontuberculous mycobacteria (NTM) pulmonary disease (PD) are Mycobacterium avium complex (MAC), composed of M. avium and M. intracellular. Linezolid is a first-line drug for drug-resistant tuberculosis, but it is only used for refractory MAC or M. abscessus lung disease. Since, linezolid has a high minimum inhibitory concentration (MIC) distribution of MAC, with an ECOFF value of 64 ug/ml. Another problem is that linezolid has serious side effects in long-term requiring NTM treatment. Delpazolid, a same oxazolidinone family, showed slightly better MIC distributions for MAC, but the most notable difference is that the side effects are remarkably low. These advantages were sufficiently confirmed through animal experiments and phase 1 clinical trials. However, comparing the antimicrobial activity of linezolid and delpazolid in clinical strains of M. avium, M. intracellulare was not reported yet. Methods The MIC of delpazolid and linezolid were compared with the domestic clinical strains M. avium (n=101) and M. intracellulare (n=104) by broth microdilution Method. Results In the case of M. avium, the separation rate of resistant strains of delpazolid was 45 %, which was 3 % lower than that of linezolid applying the same resistance reference concentration as 16 ug/ml. M. intracellulare was similar with linezolid resistance rate 82.69 % (n = 86) and delpazolid resistance rate 83.65 % (n = 87). Conclusions In this study, we compared the MIC of two antibiotics against clinical isolate. In the M. avium strain, the resistance ratio of linezolid was 3 % higher than that of delpazolid resistance. M. intracellulare resistance rates were similar for linezolid and delpazolid. Since there are significantly fewer side effects, it is expected that delpazolid can replace linezolid in refractory MAC or M. abscessus PD treatment which requiring long-term antibiotic administration.

안검 모낭충 감염군과 안구건조증 환자 중 비감염군에서의 마이봄샘 소실 비교

윤영채(Young Chae Yoon),조수연(Soo Yeon Cho),박선경(Sun Kyoung Park),유영식(Young Sik Yoo),황웅주(Woong Joo Whang),나경선(Kyung Sun Na),김은철(Eun Chul Kim),김현승(Hyun Seung Kim),황호식(Ho Sik Hwang) 대한안과학회 2022 대한안과학회지 Vol.63 No.1

목적: 비접촉 마이봄샘촬영술을 이용하여 눈꺼풀 모낭충 감염 여부에 따른 마이봄샘 소실 정도를 비교하고자 하였다. 대상과 방법: 저자들은 눈꺼풀 모낭충에 감염된 24명의 성인 환자와 감염되지 않은 40명의 환자를 대상으로 적외선 디지털 카메라를 사용하여 비접촉 마이봄샘촬영술을 시행하였다. 마이봄샘의 소실을 기준으로 오른쪽 눈의 위눈꺼풀과 아래눈꺼풀의 마이봄점수를 합하여 각 피험자에 대한 전체 마이봄점수를 구했다. 각 그룹의 눈꺼풀 모낭충 감염 여부 및 성별에 따라 마이봄점수를 평가하였다. 결과: 64명 64안이 연구에 등록되었으며, 평균 나이는 67.9세(40-79세, 남자 65.2세, 여자 69.1세)였다. 눈꺼풀 모낭충 감염과 총 마이봄점수, 위 및 아래눈꺼풀 마이봄점수 사이에 유의한 연관성이 있었다(각각, p=0.000, p=0.002, p=0.004). 마이봄점수는 남자와 여자 사이에 유의한 차이가 없었다. 연령과 마이봄점수 사이에 양의 상관 관계가 시사되었으나, 본 연구에서는 집중된 연령 분포로 인해 R2 값이 낮았다. 결론: 비접촉 마이봄샘촬영술을 이용한 검사에서 눈꺼풀 모낭충 감염이 마이봄샘 변화와 유의한 관련이 있었다. Purpose: To compare the degree of meibomian gland drop-out associated with Demodex infestation using non-contact meibography. Methods: We performed noncontact meibography using an infrared digital camera on 24 adult subjects infested by Demodex and 40 without infestation. The right upper and lower lids were scored based on the loss of meibomian glands, and the scores of the upper and lower eyelids were summed to obtain the total meiboscore for each subject. Meiboscores were evaluated according to Demodex infestation and gender in each group. Results: Sixty-four eyes of 64 people were enrolled in this study. The study subjects had an average age of 67.9 years (range, 40-79 years; men, 65.2 years; women, 69.1 years). There was a significant association between Demodex infestation and total meiboscore and upper and lower eyelid meiboscores (p = 0.000, p = 0.002, p = 0.004, respectively). There was no significant difference in the meiboscores between men and women. Age and meiboscore suggested a weak positive correlation; however, the R2 value was low, due to the concentrated age distribution of the study population. Conclusions: Based on noncontact meibography, the authors concluded that the prevalence of changes in the meibomian glands was significantly related to Demodex infestation; however, there was no significant difference between men and women.

분산처리 제어 시스템간의 정보 전송 방식에 관한 연구

신기명(Gi-Myung SHIN),이재연(Jae-Yeon YI),황승구(Seung-Ku WHANG),김용득(Yong-Deak KIM) 대한전기학회 1988 대한전기학회 학술대회 논문집 Vol.1988 No.7

<i>Roseomonas aerophila</i> sp. nov., isolated from air

Kim, Soo-Jin,Weon, Hang-Yeon,Ahn, Jae-Hyung,Hong, Seung-Beom,Seok, Soon-Ja,Whang, Kyung-Sook,Kwon, Soon-Wo International Union of Microbiological Societies 2013 International journal of systematic and evolutiona Vol.63 No.6

<P>An aerobic, Gram-stain-negative, motile, mesophilic bacterium, designated strain 7515T-07<SUP>T</SUP>, was isolated from an air sample in the Taean region, Republic of Korea. The strain grew at 4–40 °C (optimum, 30 °C) and pH 5.0–9.0 (optimum, pH 7.0). Phylogenetic analysis based on 16S rRNA gene sequences showed that strain 7515T-07<SUP>T</SUP> was related to members of the genus <I>Roseomonas</I> and had highest 16S rRNA gene sequence similarity with <I>Roseomonas ludipueritiae</I> 170/96<SUP>T</SUP> (96.7 %). 16S RNA gene sequence similarity between strain 7515T-07<SUP>T</SUP> and <I>Roseomonas gilardii</I> ATCC 49956<SUP>T</SUP> (the type species of the genus <I>Roseomonas</I>) was 93.4 %. Strain 7515T-07<SUP>T</SUP> contained Q-10 as the ubiquinone and C<SUB>18 : 1</SUB>ω7<I>c</I> and C<SUB>19 : 0</SUB> cyclo ω8<I>c</I> as the dominant fatty acids (>10 %). The polar lipid profile contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine and two unidentified aminolipids. The DNA G+C content was 73.0 mol%. Combined data from phenotypic, phylogenetic and chemotaxonomic studies demonstrated that strain 7515T-07<SUP>T</SUP> is a representative of a novel species of the genus <I>Roseomonas</I>, for which the name <I>Roseomonas aerophila</I> sp. nov. is proposed. The type strain is 7515T-07<SUP>T</SUP> ( = KACC 16529<SUP>T</SUP> = NBRC 108923<SUP>T</SUP>).</P>