급성뇨로감염증에 대한 임상적 고찰

최일생 ( Il Saing Choi ),이대연 ( Dae Yon Lee ),이원영 ( Won Young Lee ),이해선 ( Hae Sun Lee ),이삼열 ( Sam Yuel Lee ) 대한내과학회 1971 대한내과학회지 Vol.14 No.4

For centuries urinary tract infection bas been a common disease. Howerver, it has been generally appreciated that urinary tract infection has become one of the foremost problems in medicine only within recent years. A clinical study` was done on 1, 126 cas

Rifampicin에 대한 Shigella의 감수성

정윤섭,이귀녕,이삼열 대한감염학회 1980 감염 Vol.12 No.1

Shigella remains to be the most frequently isolated enteric pathogen in Korea. Most of the recent shigellosis are known to be due to ampicillin - or co-trimoxazole-resistant strains. Rifampicin has been reported effective to cure the infection and to erradicate the organism from intestine. However, there has been no reported studies of rifampicin susceptibility on the recently isolated strains of Shigella in Korea. Poor correlations of a rifampicin disc diffusion test and an agar dilution test were reported. However, most of such studies were done with organisms other than Shigella. This study was conducted to see firstly, if the recent local strains of Shigella were susceptible to rifampicin and secondly if a disc diffusion test would correlated with an agar dilution method in Shgella. The following results were obtained. 1. A total of 193 Shigella strains isolated during 1978-80 were tested. The minimum inhibitory concentraion (MIC) of rifampicin in 175 strains(90.7%) was 16μg/ml or less. In 3 strains (1.6%), it was greater than 128μg/ml. 2. Cross resistance of rifamicin with ampicillin or with co-trimoxazole did not seem to exist. 3. The correlation between a disc diffusion test and an agar dilution test was poor. 4. Highly resistant strains, such as those with MIC of over 128μg/ml showed no inhibitory zone even to a 30μg disc. It is concluded that when rifampicin is used for the treatment of shigellosis one should understand the presence of rifampicin resistant strains. Disc diffusion test could only be used to screen those highly resistant strains.

1974-1983년 연세의료원에서의 혈액배양 결과

김현옥,강창기,정윤섭,이삼열 대한감염학회 1985 감염 Vol.17 No.1

Blood culture is a very important procedure in the diagnostic bacteriology to determine the etiologic agent, and the antimicrobial susceptibility test is also and essential part of the work to guide the therapy. It has been known that both the bacterial species isolated from blood and their antimicrobial susceptibility may change their patterns as time goes. In this study an analysis is made on the results of both blood cultures and the susceptibility of the isolates done at Yonsei Medical Center during 1974 to 1983. The following results were obtained. A total of 78,732 blood specimens were cultured and 12,963 positive results (8,012 patients) were obtained. During this period of time, the number of positive patients per 1,000 admissions increased from 15.3 in 1974 to 24.7 in 1983. Among the isolates, 96.4% were aerobic or facultative bacteria, 2.7% anaerobes and 0.9% fungi. The most commonly isolated pathogens were S. aureus, α-hemolytic Streptococcus, S. typhi, E. coli and P.aeruginosa. The proportion of S. typhi to total positive cultures decreased from 52% in 1974 to 19% in 1983, while the proportion of other species of Enterobacteriaceae increased. Species of Enterobacteriaceae were frequently isolated from both pediatric and senile patients. S. typhi was most frequently isolated from the age group of 20-49 years. Seasonal isolation rate of S. typhi showed two peaks, one in June-July and the other in December-January. Most of the other bacteria were somewhat more frequently isolated during summer months. Polymicrobial bacteremia were found in 4.2% of patients with positive blood cultures. Most of the organism involved were E. coli, K.pneumoniae, P. aeruginosa and S. aureus. An increase of antimicrobial resistant strains of S. aureus, Enterobacteriaceae with the exception of S. typhi, and P. aeruginosa were noted during the study period. Many of the currently isolated strain of S. aureus, Enterobacteriaceae and glucose non-fermenting gram-negative bacilli were resistant to commonly used antimicrobial agents. It is concluded from this study that S. aureus remains to be a frequently isolated pathogen, the proportion of S. typhi has been decreasing, the bacteremia due to gram-negative bacilli has been increasing, V. vulnificus is an important new pathogen recognized during this period and the increase of resistant strains of bacteria poses problem in the selection of therapeutic agents.

Clostridium difficile 의 독소생성주 분리 2예 보고

고윤웅,이삼열,정윤섭,김정호,윤진우 대한감염학회 1984 감염 Vol.16 No.2

Clostridium difficile was isolated from stool specimens of two patients. A 28-year-old woman with acute myelocytic leukemia developed diarrhea during cotrimoxazole and cephalexin therapy. The other patient a 64-year-old woman with chronic myelocytic leukemia developed diarrhea with melena while receiving ampicillin, gentamicin and cotrimoxazole. Stool culture of one patient yielded moderate number of the organism by a qualitative culture and the other patient yielded ?? of the organism by a quantitative culture. Both of the isolates were toxin positive by a latex agglutination test. Stool specimen from one patient, which was diluted upto 1:64, was also tested for toxin and gave positive results.

한국인 Graves씨병에 있어서의 HLA항원 분포에 관한 연구

허갑범,이혜리,이상용,박기일,김춘규,김윤정,송경순,이삼열 인제대학교 1982 仁濟醫學 Vol.3 No.1

Graves씨병은 자가면역성 갑상선 질환의 하나로 유전적인 요소가 중요한 역활을 한다. Graves씨병에 대한 감수성과 HLA항원 분포와의 연관성을 극명하기 위해 한국인 Graves씨병 52예를 대상으로 HLA항원 분포를 검사하고 정상대조군 72예와 비교 분석하여, 외국과는 달리 Graves씨병 환자에서 HLA-All 증가되는 반면 HLA-B locus 항원에서는 유의한 차이가 없음을 관찰하였다. Graves' disease is one of the autommune thyroid diseases and genetic factors seem to play an important role in the pathogenesis of Craves' disease. Lymphocytes of 52 Korean patients with Graves' disease and 72 normal unrelated controls were examined for HLA antigens by the microcytotoxicity test. Also antithyroglobulin and antimicrosomal autoantibody tests were performed on 43 patients with Graves' disease The following results were obtained: 1.The frequency of the HLA-A11 antigen in patients with Graves' desease was increased to 30.8% compared to 12.5% incontrols (p<0.025). 2.There's no consistent association between Graves' disease and HLA-B locus antigens including B8 and Bw35 which were significantly increased in Caucasians and Japaneses, respectively. 3.No significant differences of HLA antigens were present at the HLA-C locus. 4.No significant correlation was observed between the frequency of thyroid autoantibodies and HLA antigens in Korean patients with Graves' discase. In summary, these results showed close association between Graves' disease and HLA-A locus antigen(A11) but no significant correlation with HLA-B locus antigens in Korean patients with Graves' disease. These findings might suggest racial difference.

Campylobacter fetus subsp. jejuni에 의한 장염 4예

정윤섭,김경숙,유영해,이삼열,고창준,고윤웅,문영명,한동관 대한감염학회 1981 감염 Vol.13 No.1

Campylobacter was isolated from stool specimens taken from 2 pediatric and 2 adult patients with enteritis. All of the 4 isolates showed typical characteristics of C. fetus subsp. jejuni in morphology, gram reaction, cultural and biochemical tests. Two isolates were resistant to cephalothin only, while the third one was resistant to co-trimoxazole, as well. The last isolate was different from others being resistant to amikacin, gentamicin, kanamyin and tobramyin. During this study period of time, a total of 871 stool specimens were cultured, and 12.1% of them yielded shigella while only 0.5% yielded campylobacter.