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심근경색과 Chlamydophila pneumoniae 감염의 관련성
은상진,허운보,김유경,이난영,이원길,채성철 대한임상미생물학회 2005 Annals of clinical microbiology Vol.8 No.1
Background: Although there are growing evidences linking Chlamydophila pneumoniae infection to myocardial infarction, it remains controversial. The authors intended to assess whether C. pneumoniaeinfection is associated with myocardial infarction. Methods: Sera and peripheral mononuclear cells (PMNCs) were collected from 54 cases of acute myocardial infarction (MI), 33 cases of old MI, and 60 normal controls. Anti- C. pneumoniaeIgG and IgM antibodies were measured using a microimmunofluorescence (mIF) method, and C. pneumoniae DNA was detected using polymerase chain reaction (PCR). Results: Seropositivity of anti- C. pneumoniae IgM antibody by mIF was shown 5.0% in control group, 29.6% (OR=8.00) in the acute MI and 6.1% (OR=1.23) in old MI group. Seropositivity of anti-C. pneumoniae IgG antibody were 60.0 % in control group, 92.6% (OR=8.33) in the acute MI and 87.9% (OR= 4.83) in old MI group. The antibody titers in the acute MI and old MI group tended to be higher compared to those in control group. No C. pneumoniae DNA was detected in any case by PCR. Conclusion: The seropositivity and antibody titers were significantly higher in the acute MI and old MI group than in control group, suggesting that C. pneumoniae infection may be a risk factor for myocardial infarction.
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서상철,은상진,김한길,송경은,서장수,최성만,이원길,김재식,김중명 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.1
목적 : 결핵균 동정을 위한 중합효소 연쇄반응을 임상병리검사로서 적용하기 위한 기초 실험으로 분석학적 예민도와 특이도를 알아보고 검토된 조건에 의한 중합효소 연쇄반응을 실제 임상 가검물에 적용하기 위함이다. 재료 및 방법 : Ziehl-Neelsen염색 양성인 객담, 뢰벤스타인-젠센(Loewenstein-Jensen) 배지에서 분리된 결핵균 및 M. tuberculosis H37Rv를 비롯한 항산균 표준균주 11주와 비항산균 10주를 사용하여 2가지 DNA의 분리법, 3set 프라이머, 3종류 중합효소, 2가지 미량 원심시험관 및 Easy-Cycler^R(Ericomp사, 미국)와 수조형으로 검사를 시행하여 DNA 증폭 산물을 비교하였다. 또한 이미 지일-닐슨 염색법에 의한 선별검사에서 음성을 나타낸 객담 53예, 소변 101예, 삼출액 128예, 뇌척수액 54예 등 총 370예의 임상가검물을 대상으로 하여 위에서 검토된 중합효소 연쇄반응 조건으로 검사한 성적과 지일-닐슨 염색법, 배양법 성적과 비교하였다. 결과 : DNA분리방법 2가지와 3가지 중합효소는 분석학적 예민도와 5fg로 나타나 차이를 발견할 수 없었으며, 프라이머 P1, P2쌍은 예민도가 5fg, 프라이머 INS1, INS2쌍과 프라이머 Pt3, Pt6쌍의 예민도는 0.5fg이었다. Easy-Cycler^R가 수조형에 비해 높고, 미량 원심시험관은 Robbins사 제품이 Sarstedt사 제품에 비해 높은 분석학적 예민도를 나타냈다. 프라이머 P1, P2쌍과 프라이머 INS1, INS2와 Pt3, Pt6 2쌍의 프라이머의 특이도에 있어서는 항산균 표준균주 중 M. tuberculosis H37Rv, M. tuberculosis ATCC 27294, M. bovis ATCC 29312의 3주에서 특이 증폭 띠를 관찰할 수 있었다. 그러나 비결핵성 항산균 8주에는 특이 증폭 띠를 나타내지 않았다. 또 비항산균 10주에도 특이 증폭 띠가 관찰되지 않았다. 따라서 Robbins사의 미량 원심시험관과 proteinase-K법에 의한 DNA분리방법에 Easy-Cycler^R를 사용하여 프라이머 INS1, INS2쌍으로 일차 중합효소 연쇄반응을 시행한 후 프라이머 Pt3, Pt6쌍으로 이차중합효소 연쇄반응을 시행하는 방법을 370예의 임상가검물에 시행하였고 지일-닐슨 염색법과 결핵균배양검사도 동시에 시행한 결과 중합효소 연쇄반응 양성은 106예(28.6%), 배양 양성은 27예(7.3%) 및 염색 양성은 18예(4.9%)였으며, 결핵환자는 141명(38.1%)였다. 370예의 임상 가검물로 시행한 중합효소 연쇄반응의 진단학적 예민도와 특이도, 양성결과 예측치 및 음성결과 예측치는 68.8%, 96.1%, 91.5% 및 83.3%로 각각 나타났다. 결론 : 결핵균 동정을 위한 중합효소 연쇄반응은 배양검사에 비해 신속하며, 분석학적인 예민도와 특이도가 뛰어나므로 결핵 진단을 위한 임상병리검사로서 유용하다고 사료됨. In this study, We investigated the optimal conditions of polymerase chain reaction(PCR) assay for the rapid identification of Mycobacterium tuberculosis in clinical specimens as routine laboratory test. So we have compared two DNA isolation methods, 3 polymerases, 2 set of primer, 2 kinds of thermocycler and 2 microtubes. We evaluated two DNA isolation methods, bead-beating method and proteinase-K method, the latter was more sensitive than the former. In comparision of two sets of primers, P1 and P2 primers detecting 123-base pair fragment of IS6110 made from Biosnthesis(U. S. A.) and INS1 and INS2 primers detecting 245-base pair fragment of IS986 showed equally sensitive results ie. 5fg. Specificity of primers were tested and INS1 and INS2 primers gave 245-base pair product from M. tuberculosis H37Rv, M. tuberculosis ATCC 27294 and Mycobacterium bovis ATCC 29312 but not from 8 nontuberculous mycobacterial strains such as M. kansasii ATCC 12478, M. terrae ATCC 15755, M. intracellurae ATCC 13950, M. avium ATCC 25281, M. gordonae ATCC 14470, M. fortuitum ATCC 6841, M. smegmatis ATCC 19420, M. scrofulaceum ATCC 19981. Coagulase-positive staphylococcus, coagulase-negative staphylococcus, streptococcus, Esccherichia coli, Serra-tia marcescens, Klebsiella pneumoniae, Enlerobacter aerogenes, Enterobacter cloacae, Acinetobacter calcoaceticus, Pseudomonas aerugonosa showed no 245-base pair amplification product. PCR by the P1 and P2 primers showed 123-base pair amplification product from M. tuberculosis H37Rv, M. tuberculosis ATCC 27294 and Mycobacterium bovis ATCC 29312 but not from 8 nontuberculous mycobacterial strains such as M. kansasii ATCC 12478, M. terrae ATCC 15755, M. intracellularae ATCC 13950, M. avium ATCC 25281, M. gordonae ATCC 14470, M. fortuitum ATCC 6841, M. smegmatis ATCC 19420, M. scrofulaceum ATCC 19981. Coagulase-postive staphylococcus, coagulase-negative staphylococcus, streptococcus, Escherichia coli, Serratia marcescens, Klebsiella pneumoniae, Enlerobacter aerogenes, Enterobacter cloacae, Acinelobacler calcoaceticus, Pseudomonas aeruginosa showed no 123-base pair amplification product. In comparision of polymerase, Taq DNA polymerase^R(Promega Co., U. S. A.) was more cost effective than Ampli Tag^R(Perkin-Elmer Cetus, U. S. A.), but these two were equally sensitive and specific in the detection of M. tuberculosis-specific DNA. Tac polymerase (Korea'Biotech, Korea) showed many nonspecific bands. In comparision of thermocycler, Easy-Cycler^R(Ericomp, U. S. A.) was more sensitive than water-bath type and in that of microtubes Robbin's were more sensitive than Sarstedt's PCR results were compared with results of culture for M. tuberculosis and Ziehl-Neelsen stain in 370 clinical specimens that were negative by initial Ziehl-Neelsen stain. There were 27 specimens(7.3%) that were positive for M. tuberculosis by culture, 18(4.9%) specimens that were positive by Ziehl-Neelsen stain, and 106 specimens(28.6%) that were positive for PCR and 141 cases that were positive for tuberculosis. Overall sensitivity, specificity, positive predictive value and negative predictive value were 68.8, 96.1, 91.5 and 83.3% respectively, for PCR; 19.1, 100, 100, and 66.8%, respectively for culture; and 12.8, 100, 100, and 59.0% respectively for Ziehl-Neelsen stain.
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심근경색과 Chlamydophila pneumoniae, Cytomegalovirus, Helicobacter pylori 및 HIV 감염의 관련성
허운보,김유경,은상진,류재기,이원길 대한임상미생물학회 2005 Annals of clinical microbiology Vol.8 No.1
Background: There is some evidence linking the infections with common organisms such as Chlamydophila pneumoniae, cytomegalovirus (CMV), Helicobacter pylori and HIV to myocardial infarction (MI). We had performed a serologic study to assess whether C. pneumoniae, CMV, H. pyloriand HIV infections are associated with MI. Methods: Serum samples were obtained from 54 cases of acute MI, 33 cases of old MI, and 60 normal controls. C-reactive protein (CRP) as an inflammation marker was measured and antibodies to C. pneumoniae, CMV, H. pyloriand HIV were assayed by ELISA. Odds ratios (OR) were calculated against control group. Results: CRP was significantly higher in the acute MI and old MI group. ORs of C. pneumoniae infection increased considerably in the acute MI (IgM 1.57, IgG 4.80) and old MI group (IgM 2.42, IgG 5.18). ORs of CMV infection were 3.30 in the acute MI and 5.12 in old MI group. ORs of H. pylori infection showed below 1 in the acute MI and old MI. Anti-HIV antibody showed all negative result in three groups, so OR could not be calculated. Conclusion: C. pneumoniaeand CMV infections appear to be risk factors for MI.
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