The Characteristics of Metallo-β-Lactamase-Producing Gram-Negative Bacilli Isolated from Sputum and Urine: A Single Center Experience in Korea

Bum Sik Chin,김준명,한상훈,최석훈,이한성,정수진,최희경,최준용,송영구,김창기,용동은,이경원 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.2

Metallo-β-lactamase (MBL) production usually results in high-level resistance to most β-lactams, and a rapid spread of MBL producing major gram-negative pathogens is a matter of particular concern worldwide. However, clinical data are scarce and most studies compared MBL producer (MP) with MBL non-producer (MNP) strains which included carbapenem susceptible isolates. Therefore, we collected clinical data of patients in whom imipenem-nonsusceptible Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) were isolated from sputum or urine, and investigated MBL production and the risk factors related with MBL acquisition. The antimicrobial susceptibility patterns were also compared between MPs and imipenem-nonsusceptible MNPs (INMNP). Among the 176 imipenem-nonsusceptible isolates, 12 MPs (6.8%) were identified. There was no identifiable risk factor that contributed to the acquisition of MPs when compared to INMNPs, and case-fatalities were not different between the two groups. The percentage of susceptible isolates was higher among MPs for piperacilin/tazobactam and fluoroquinolones while that of ceftazidime was higher in INMNPs (p < 0.05). As regards to aztreonam, which has been known to be a uniquely stable β-lactam against MBLs, susceptibility was preserved in only two isolates (16.7%) among MPs, and was not higher than that of INMNPs (23.2%). In conclusion, the contribution of MBLs to imipenem non-susceptibility in PA/ABs isolated from sputum and urine was relatively limited, and there was no significant risk factor associated with acquisition of MPs compared with INMNPs. However, limited susceptibility to aztreonam implies that MPs may hold additional resistance mechanisms, such as extended spectrum β-lactamases, AmpC β-lactamases, or other non-enzymatic mechanisms.

α-galactosidase A 유전자 분석으로 확인된 Fabry 병

진범식 ( Bum Sik Chin ),김지인 ( Jee In Kim ),이진성 ( Jin Sung Lee ),홍순원 ( Soon Won Hong ),정현주 ( Hyun Joo Chung ),김희만 ( Hee Man Kim ),김동기 ( Dong Ki Kim ),구영석 ( Young Suck Goo ),이호영 ( Ho Yung Lee ) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.6

Fabry disease is a X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A. This abnormality in enzyme results intracellular accumulation of globotriaosylceramide and leads to severe painful neuropathy with progressive renal cardiovascular, and cerebrovascular dysfunction and early death. We report a 35 year-old man who had been suffered from acroparesthesia aggravated by body temperature elevation and with asymptomatic renal function impairment, which were proven to be due to Fabry disease. We performed gene analysis by PCR direct sequencing and confirmed missense mutation of GLA gene. Recently enzyme replacement of α-galactosidase was introduced and we think that the importance of early diagnosis and treatment should be emphasized.

Current trends of HIV/AIDS

진범식 ( Bum Sik Chin ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

HIV의 발견. 후천성면역결핍증(AIDS): 1981년 미국 대도시의 건강 성인에서 주폐포자충 폐렴(PCP)과 카포시 육종의 집단 발병을 계기로 명명. 병원체의 발견: 1984년 프랑스 Montagnier 박사가 인간면역결핍바이러스-1(HIV-1)을 분리. 진단법의 개발: 1985년 혈청검사법(ELISA)의 개발 . HIV의 유행현황. 전세계적으로 사하라사막 이남 아프리카에 가장 많은 환자가 존재하나 2000년대 초반 이후 폭발적인 환자 증가는 진정되는 추세. 예방사업 및 항레트로바이러스제 치료의 보급으로 신규진단 HIV감염자수 및 HIV관련 사망은 감소추세에 있으나 누적생존감염인수는 증가추세임.. 우리나라는 최근 신규진단 감염인수가 증가하여 2013년 이후 매년 1000명 이상의 새로운 HIV감염인이 진단되고 있음.. HIV의 자연사. 감염 후 약 2-4주의 잠복기 후 발열, 발진, 임파선비대, 인후통, 설사 등이 일정기간 지속되는 급성감염증상이 나타나지만 약 50%는 무증상임.. 이후 특별히 치료하지 않아도 무증상 잠복기로 이행되어 8-10년간 지속되지만 이 시기에도 면역기능은 점진적으로 감소하여 CD4 림프구수가 200 cells/ul 이하로 감소하면 기회감염이나 기회암이 발생하게 됨.. 에이즈 관련 증상·칸디다증 (구강, 식도, 기관지, 폐 등)·주폐포자충 폐렴·카포시 육종 (HHV-8 관련)·결핵 ( Mycobacterium tuberculosis)·거대세포바이러스 망막염. HIV 감염의 치료·항레트로바이러스제 투여·기회감염의 발생을 막기 위한 예방적 약제 투여·발생한 기회감염과 기회암을 치료하기 위한 약제 투여. 항레트로바이러스제 투여시점·현재 모든 HIV감염인에게 면역기능 저하와 관련 없이 치료를 권고·면역기능 저하가 명확하지 않더라도 치료를 일찍 시작할 경우 합병증 발생 감소·항레트로바이러스제 복용으로 바이러스 증식이 억제되면 타인으로의 전파력 감소. 권고되는 항레트로바이러스제의 종류·2NRTI (Nucleoside analogue Reverse Transcriptase Inhibitor) + PI (Protease Inhibitor)·2NRTI + NNRTI (Non-nucleoside Reverse Transcriptase Inhibitor)·2NRTI + INSTI (Integrase Strand Transfer Inhibitor) . 국내에서 사용 가능한 1차 치료제 조합약제 계열 약 종류 상품명 2NRTI+INSTI ABC/3TC/DTG 트리멕 TDF/ETC+DTG 트루바다+티비케이 TDF/ETC/EVG/c 스트리빌드 TDF/ETC+RAL 트루바다+이센트레스 2NRTI+PI/r TDF/ETC+DRV/r 트루바다+프레지스타/노비르 3TC, lamivudine; ABC, abacavir; COBI or c, cobicistat; DRV/r, darunavir/ritonavir; DTG, dolutegravir; TDF, tenofovir disoproxil fumarate; RAL, raltegravir; ETR , etravirine. INSTI계열 약제가 선호되는 이유 ·대부분의 환자에서 INSTI기반 치료는 효과가 우수하고 부작용이 적다. ·RAL 및 DTG 는 CYP 3A4-관련 약물 상호작용이 없다. . INSTI와 관련된 약물 상호작용 (http://www.hiv-druginteractions.org/) ·Rifampin, Al++, Mg++, Ca++등이 포함된 제산제나 변비약 등과의 병용은 피하는 것이 좋다. ·EVG/c의 경우 diazepam의 병용을 피하는 것이 좋고 triazolam이나 경구 midazolam사용은 금기이다. 또한 dexamethasone 전신투여 시 항레트로바이러스제의 효과가 저하될 수 있고 methylprednisolone, prednisolone, triamcinolone등은 쿠싱증후군을 유발할 수 있으므로 주의가 필요하다. ·DTG는 혈중 metformin의 농도를 증가시키므로 주의가 필요하다.

Utility of QuantiFERON-TB In-Tube Test for Differentiating Active Tuberculosis from Latent Tuberculosis Infection in an Intermediate Burden Country

최석훈,Bum Sik Chin,Sang Hoon Han,Han Sung Lee,Chang Oh Kim,Su Jin Jeong,Hee Kyung Choi,Myung Soo Kim,Jun Yong Choi,Young Goo Song,June Myung Kim 대한감염학회 2008 Infection and Chemotherapy Vol.40 No.6

Background : The aim of the present study was to assess the contribution of a QuantiFERON-TB Gold In-Tube test (QFT-IT) in differentiating active tuberculosis (TB) from latent tuberculosis infection (LTBI) by quantifying interferon-γ levels. Materials and Methods : We retrospectively reviewed clinical records of 314 patients older than 15 years who had performed QFT-IT between July 2006 and August 2007 at a tertiary care teaching hospital. Results : Subjects with active TB (n=81, culture confirmed active TB in 40 subjects) and LTBI (n=76) were included. Mean±SD IFN-γ levels were 4.96±3.98 IU/mL (range -0.08-10) for all subjects with active TB, 4.54±4.05 IU/mL (range -0.08-10) for culture confirmed active TB, and 4.11±3.57 IU/mL (range 0.35-10) for subjects with LTBI. The quantitative results of QFT-IT on IFN-γ levels between all the subjects with active TB and those with LTBI were not statistically significant (P=0.16). The result was similar when compared between those with culture confirmed active TB and those with LTBI, showing little statistical significance (P=0.554). Conclusion : The production of IFN-γ measured by QFT-IT showed no correlation between its level and the activity of Mycobacterium tuberculosis infection. These results suggest that measuring IFN-γ using QFT-IT might not be useful for distinguishing active TB from LTBI. Background : The aim of the present study was to assess the contribution of a QuantiFERON-TB Gold In-Tube test (QFT-IT) in differentiating active tuberculosis (TB) from latent tuberculosis infection (LTBI) by quantifying interferon-γ levels. Materials and Methods : We retrospectively reviewed clinical records of 314 patients older than 15 years who had performed QFT-IT between July 2006 and August 2007 at a tertiary care teaching hospital. Results : Subjects with active TB (n=81, culture confirmed active TB in 40 subjects) and LTBI (n=76) were included. Mean±SD IFN-γ levels were 4.96±3.98 IU/mL (range -0.08-10) for all subjects with active TB, 4.54±4.05 IU/mL (range -0.08-10) for culture confirmed active TB, and 4.11±3.57 IU/mL (range 0.35-10) for subjects with LTBI. The quantitative results of QFT-IT on IFN-γ levels between all the subjects with active TB and those with LTBI were not statistically significant (P=0.16). The result was similar when compared between those with culture confirmed active TB and those with LTBI, showing little statistical significance (P=0.554). Conclusion : The production of IFN-γ measured by QFT-IT showed no correlation between its level and the activity of Mycobacterium tuberculosis infection. These results suggest that measuring IFN-γ using QFT-IT might not be useful for distinguishing active TB from LTBI.

CHILLING SENSITIVITY OF CUCUMBER PLANTS MONITORED IN TERMS OF CHLOROPHYLL FLUORESCENCE

LEE, CHIN BUM,KANG, IN-SOON,CHUN, HYUN SIK,SEO, KYE HONG,MOON, BYOUNG YONG 동의대학교 기초과학연구소 1997 基礎科學硏究論文集 Vol.7 No.1

For three cultivars of chilling-sensitive cucumber plants, chilling sensitivity was evaluated in terms of photosynthetic activity using Chl fluorescence techniques. Low-temperature treatment caused a decrease in photosynthetic activities of cucumber leaves, measured as CO₂exchange, as well as the decrease in the stomatal conductance. F_R of the three cultivars decreased after chilling for 24 h in light and the extent of decline of F_R of was the greatest in 'Chosaeng' cultivar. When these plants were recovered from light-chilling, 'Chosaeng' and 'Samchuk' cultivars did not fully restore the original value of F_R after 24 h of recovery, in contrast to 'Ilmi' cultivar which showed a rather efficient recovery. The results of F_R study showed that 'Chosaeng' was most susceptible, whereas Ilmi was most resistant, to chilling among the three cultivars of cucumber plants. When quenching coefficients for chlorophyll fluorescence was analyzed after chilling the cucumber plants for 24 h in light, 'Chosaeng' elicited more rapid declines in the coefficient for photochemical quenching (qQ), non-photochemical quenching (qNP) and energy-dependent quenching (qE) than 'Ilmi'and 'Samchuk' . The implications of these observations are discussed in relation to the growth habits of the respective cultivars in the field. The results showed that measurement of chlorophyll fluorescence was an effective means of screening chilling tolerance of cucumber plants. Furthermore, the study on the chlorophyll fluorescence induction and fluorescence quenching charactersitics showed that low temperature could accelerate inhibition of photosynthesis in chilling-sensitive plants, by limiting Calvin cycle activity and disrupting, in part, the energy dissipation mechanisms of the photosystem Ⅱ.

Developmental Changes in Photosynthetic Pigments and Chlorophyll Fluorescence in Etiolated Rice Seedlings During Greening

Chun, Hyun Sik,Moon, Byoung Yong,Suh, Kye Hong,Lee, Chin Bum 한국식물학회 1996 Journal of Plant Biology Vol.39 No.4

Decursinol 처리에 따른 보리 유식물의 전자전달 활성과 엽록소 - 단백질 복합체의 변화에 대하여

전현식(Hyun Sik Chun),이진범(Chin Bum Lee) 한국식물학회 1988 Journal of Plant Biology Vol.31 No.2

The effects of decursinol and decursin on chloroplast-mediated electron transport and phosphorylation in barley seedlings were investigated in comparison with coumarin in the dark or light. The changes of CP-complexes were also studied. Decursinol, decursin and coumarin caused marked inhibitory effects on germination of seed and electron transport and phosphorylation activity of seedling. The following order of inhibitory effectiveness was exhibited; decursinol>coumarin>decursin. Loss of chlorophyll and decrease of electron transport activity were retarded in the dark, but were reversely accelerated in the light by these three chemicals. The changes of CP-complex patterns were also similar to effects on chlorophyll content and the electron transport activity. These opposite effects in the dark and light suggest that these three chemicals act as natural growth retardants rather than cytokinins or growth inhibitors.

엽록체의 전자전달과 광음향 신호에 미치는 Simetryne 의 영향

전현식(Hyun Sik Chun),이혜주(Hae Joo Lee),선우양일(Yangil Sunwoo),박인호(In Ho Park),이진범(Chin Bum Lee) 한국식물학회 1988 Journal of Plant Biology Vol.31 No.3

The effects of simetryne on light induced electron transport and phosphorylation in isolated spinach (Spinacia oleracea L.) chloroplasts were investigated in comparison with sencor and DCMU. Simetryne, like sencor and DCMU, completely, inhibited PSⅡ electron transport and phosphorylation with 10^-6 M treatment but did not inhibit PSⅠ electron transport. Interference with the electron transport pathway was evidenced by the greater sensitivity of oxygen evolution and uptake than phosphorylation. The following order of decreasing inhibitory effectiveness was exhibited; DCMU>simetryne>sencor. The photoacoustic technique was also used to monitor the relative photosynthetic activity in the leaves treated with the herbicides (simetryne, sencor or DCMU) in viva and in vitro. Photoacoustic measurements on intact leaves provide quantitative information on two related aspects of the photosynthetic process, namely, photochemical energy storage and oxygen evolution. The relative photoacoustic signal of leaves treated with the herbicides showed low level in 21 Hz, but high level in 380 Hz and on isolated chloroplasts (both 21 Hz and 380 Hz) in comparison with that of the untreated leaves. These results suggest that some of photochemical energy is converted into the heat owing to the inhibition of electron transport pathway by the herbicides.

저온처리한 오이의 자엽에서 광합성 활성의 광의존성 저해

전현식(Hyun Sik Chun),문병용(Byoung Yong Moon),이춘환(Choon Hwan Lee),정익교(Ik Kyo Chung),박인호(In Ho Park),이진범(Chin Bum Lee) 한국식물학회 1993 Journal of Plant Biology Vol.36 No.2

The photosynthetic activities in relation to oxygen evolution rates, quantum yield, Co_2 uptake rates and room temperature chlorophyll fluorescence were investigated in cotyledons of cucumber seedlings exposed to low temperature(at 4℃) for 24 h. Light-chilling caused more inhibition on light-saturated maximum oxygen evolution rates, quantum yield, and Co_2 uptake rates that dark-chilling did in the cucumber plant. Light-chilling induced more marked increase in Fo and decrease in (Fv)m/Fm than dark-chilling did in the room temperature chlorophyll induction kinetics. The above results affected by chilling in the light are considered to be associated with the partial damage of the reaction center of PS Ⅱ and the decreased photosynthetic activities. There occurred a large decrease in qQ with little change in qNP in the light-chilling plant. When light- and dark- chilled plants were recovered at room temperature for 24 h and their chlorophyll fluorescences were induced with light doubling technique, light-chilled plants showed more smaller magnitude and rate of fluorescence relaxation than dark-chilled plants. These suggest that light-chilling might cause some alterations in transthylakoid ΔpH formation, and that photosynthetic apparatus of cucumber cotyledons is more susceptible to light-chilling. In the fast fluorescence induction kinetics, F_R was decreased by 60% in the light-chilled plants with reference to 25℃ light-grown plants, while the dark-chilled plants showed a decreased rate of only 20% with reference to 25℃ dark-treated plants for 24h, indicating that cucumber seedling is very sensitive to chilling stress. So, it is certain that chilling injury to the photosynthetic apparatus is strongly dependent on the presence of light in cucumber seedlings.

보리 엽록체의 광계 2에서 수은 , 구리 및 아연의 저해효과 비교

전현식(Hyun Sik Chun),권영명(Young Myung Kwon),이진범(Chin Bum Lee) 한국식물학회 1993 Journal of Plant Biology Vol.36 No.3

The room temperature fluorescence induction of chloroplasts was utilized as a probe to locate the site of inhibition by mercury, copper and zinc on PS Ⅱ by mercury. Inhibitory effect of Hg^2+ on electron transport activity was notable as compared with Cu^2+ and Zn^2+. At concentrations of HgCl_2 over 50 ㎛, activities of PS Ⅱ and whole-chain electron transport decreased more than 70%, while that of PS Ⅰ decreased about 10∼30%. This suggestsa that PS Ⅱ is more susceptible to Hg^2+ than PS Ⅰ is. In the presence of diphenylcarbazide (DPC), 50 ㎛ HgCl_2 inhibited the reduction of dichlorophenolindophenol (DCPIP) about 50%. Addition of heavy metals induced marked decrease in maximal variable fluorescence/initial fluorescene [(Fv)m/Fo], but no changes in Fo. With various concentrations of heavy metals, changes of chlorophyll a fluorescence emitted by PS Ⅱ showed gradual decrease in photochemical quenching (qQ), which indicates an increase in reduced state of electron acceptor, Q_A. Especially, the addition of HgCl_2 caused a notable decrease of qQ. In the presence of 50 ㎛ HgCl_2, energy-dependent quenching (qE) was completely reduced, whereas in the presence of 50 ㎛ CuCl_2 and ZnCl_2 it was still remained. The above results are discussed on the effects of mecury in relation to water-splitting system and plastoquinone (PQ) shuttle system.