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      • 임상 검체에서 분리된 vancomycin 내성 장구균에 대한 Quinupristin/dalfopristin(Synercid®)을 포함한 10종 항균제의 시험관내 항균력

        정희진,박기호,김동림,김우주,김민자,박승철,신종희 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

        목적 : 본 연구에서는 고려대 병원과 전남대 병원에서 임상 검체로부터 분리된 VRE 16균주를 대상으로 하여 장구균 감염의 치료에 흔히 사용되는 항균제인 ampicillin, gentamicin, vancomycin, teicoplanin과 VRE에 대해서도 비교적 항균력이 있는 것으로 알려진 기존의 chloramphenicol, doxycycline, erythromycin, ciprofloxacin, rifampicin, 그리고 다제 내성 그람 양성균의 치료를 위하여 새로이 개발된 quinupristin/dalfopristin을 이용한 시험관내 항균력을 조사하고자 하였다. 방법 : 총 16균주의 VRE faecium을 대상으로 quinupristin/dalfopristin (Synercid^(R))를 포함한 10종 항균제에 대한 최소 발육 억제 농도(MIC)를 한천희석법을 이용하여 측정하였다. 각각의 항균제에 대한 감수성은 NCCLS에서 제시한 기준에 의거하여 해석하였다. 결과 : 1) 5균주의 vanB VRE에 대한 항균제의 MIC_(90)은 ampicillin, erythromycin, gentamicin, cipro- floxacin에서 각각 64㎍/㎖, 512㎍/㎖, 512㎍/㎖, 4㎍/㎖로서 100%에서 내성을 보였고, doxycycline, chloramphenicol의 경우 4㎍/㎖, 4㎍/㎖로서 100%에서 감수성을 보였다. Teicoplanin의 MIC_(90)은 1㎍/㎖로서 모두 감수성을 보였고 quinupristin/dalfopristin에 대해서도 MIC_(90) 0.25㎍/㎖로서 감수성을 보였다. 2) 11균주의 vanA VRE에 대한 항균제들의 MIC 범위는 vanB VRE보다는 다양하였다. MIC_(90)을 보면 amplicillin, erythromycin의 경우 256㎍/㎖, 512㎍/㎖으로 100%에서 내성을 보였응며, gentamicin은 MIC_(90) ≥500㎍/㎖의 고도내성을 보인 경우가 8 균주로서 73%에서 내성을 보였다. Ciprofloxacin은 vanB VRE에서와 마찬가지로 MIC≥32㎍/㎖의 100%의 내성을 보였다. Chloramphenicol의 경우는 MIC_(90)이 16㎍/㎖로서 vanA VRE faecium에 대해서도 감수성이 있는 약제로 남아 있었다. 반면에 doxycycline은 MIC_(90)이 4㎍/㎖로서 시험관내에서는 100% 감수성을 보였고, quinupristin/dalfopristin은 MIC_(90)이 2㎍/㎖로서 내성을 보인 균주는 한 균주도 없었다. 결론 : 국내 임상분리 VRE 16균주는 기존에 사용되어 오던 chloramphenicol, doxycyline등의 항균제에 대하여 시험관내에서 100% 감수성을 보였으며 quinupristin/dalfopristin과 같은 새로운 항균제에 대해서도 중등도 또는 완전 감수성을 보여 향후 VRE에 의한 감염증 치료에 있어 이들 약제의 병합요법등이 고려될 수 있을 것이라 사료된다. Background : Vancomcyin-resistant enterococci (VRE) have become a major nosocomial pathogen in the USA during 1990s. In Korea, VRE have recently emerged as a important nosocomial pathogen and posed therapeutic difficulty. We evaluated the antimicrobial susceptibility of clinical VRE isolates to the antimicrobial agents that are commonly used to treat enterococcal infections and to some alternative drugs and to a newer antibiotic such as quinupristin/dalfopristin(Synercid®). Methods : We evaluated 16 clinical VR-E. faecium (5 vanB VRE, 11 vanA VRE) strains that were isolated from Korea Universtiy and Chonnam University hospital during the last five years (1994-1998). The isolates were identified to the species level by using API 20system. The in vitro susceptibility testing was performed by the agar dilution methods, following the criteria described by the National Committee for Clinical Laboratory Standards (NCCLS). The VRE isolates were tested against antimicrobial agents commonly used to treat enterococcal infections (vancomycin, teicoplanin, ampicillin, gentamicin), potential alternative drugs (chloramphenicol, doxycycline, ciprofloxacin, erythromycin, rifampicin) and a newer antibiotic (quinupristin/dalfopristin). Results : 100% (5/5) of vanB VR-E. faecium were resistant to ampicillin, gentamicin and ciprofloxacm, but 100% (5/5) were susceptible to chloramphenicol, doxycycime, teicoplanin and quinupristin/dalfopristm. 100% (11/11) of vanA VR-E. faecium were resistant to ampicillin, ciprofloxacm, 73% were resistant to gentamicin, and 100% (11/11) were susceptible to chloramphenicol and doxycycline. Quinupristin/dalfopristm showed intermediate or high level susceptibility against all vanA VRE isolates. Rifampin is less susceptible (MIC: 4-16 ㎍/mL) against both vanA and vanB VR-E. faecium. Conclusion : The treatment options for infections caused by VRE seem to be very narrow since a small percentage of those isolates were susceptible to the other antmicrobial agents commonly used to treat these infections. And only a few of the alternative drugs including quinupristin/dalfopristm tested showed good in vitro activity. This study suggested that chloramphenicol, doxycycline and qumuprisitin/dalfopristin would be a good candidate to treat VRE infection, but further studies are necessary to demonstrate the clinical role of these antimicrobial agents.

      • 국내 Fabry disease 환자의 a-Galatosidase A 유전자 돌연변이 검색

        박기범,최지혜,강윤성,김선미,정향민,문영준,이광호 中央大學校 基礎科學硏究所 2001 基礎科學硏究所 論文集 Vol.15 No.-

        Fabry disease(FD) is an X-linked recessive lysosomal disorder caused by a deficiency of a-galactosidase A(a-Gal A), localized at Xq22. Besides onset of pain and paresthesias in the extremities, FD was diagnosed by absence of a-Gal A activity. In this experiment the a-Gal A activity of Korean FD patients was spectrometrically analysed using an artificial substate, 4-Mrthylumbellifery1-a-D-galactoside. As expected, no a-Gal A activity was detected in lymphocytes and lymphoblastoid cells from FD patients. To screen the mutation in their a-Gal A genes, we performed single strand conformation polymorphism(SSCP) and PCR-direct sequencing form seven a-Gal A exons. The nonsense mutation was identified both in classically affected hemyzygotes and a heterozygote. They showed the C to T transition at nucleotide number 11,002, resulting in a arginine-to-stop(R342X). This result will be applicable for pre- and neonatal detection of FD and to define the genotype/phenotype correlation.

      • 대기확산 모형의 민감도 분석에 관한 연구

        정장표,박명호,이기호 慶星大學校 1990 論文集 Vol.11 No.3

        Air quality dispersion models(AQM) are widely used to control air pollutants and to predict the distributions of air pollutants. But A. Q. M have many problems and limitations, therefore it is necessary to validate models before use. So in this study, to improve the model accuracy, the sensitivity analysis of three short-term models(TEM, RAM, PTMTP) is performed. The conclusions obtained from this study were as follows. 1) TEM model shows generally lower concentration than other two models, and the concentration values of RAM and PTMTP models are almost same over than 1km of downwind distance. 2) It appears that the sensitivities of stack height stack inner diameter, gas exit velocity and wind speed, are significant. And their Sensitivity coefficient of maximum concentration is consider ably high. 3) The gas exit velocity, stack inner diameter, gas temperature and air temperature which affect the plume rise, have some effect on the concentration values of each model within the downwind distance where final plume rise is determined. 4) The sensitivity coefficient of there models with downwind distance show larger value in the near distance from source.

      • 십이지장과 대장을 동시에 침범한 결핵 1예

        이만재,박치영,곽재정,유보열,기장도,박찬국,김만우,김정용 조선대학교 1995 The Medical Journal of Chosun University Vol.20 No.1

        Tuberculosis of duodenum is so rare and is usually secondary to pulmonary or intestinal tuberculosis . It is difficult to diagnose duodenal tuberculosis in clinical and radiologic findings due to its non-specific symptoms and inconsistent lesion. The diagnosis was made on the basis of the histological study of the endoscopic biopsy and resected surgical specimen. so we report a case of tuberculosis of duodenal bulb and of ascending colon with, the brief review of the literatures.

      • 한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

        최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

        The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

      • 뇌자도 측정을 위한 저잡음 Nb SQUID 센서의 설계 및 제작

        이용호,권혁찬,김진목,이상길,임청무,박용기,박종철 경북대학교 센서기술연구소 1998 센서技術學術大會論文集 Vol.9 No.1

        We report on the design, fabrication and performances of a low-noise Nb SQUID sensor for neuromagnetic measurements. The main features of the developed sensor are i) large flux-to-voltage transfer, making the SQUID readout electronics simple, and ii) use of the integrated planar pickup coil to eliminate the environmental magnetic field noises. The magnetic field noise of the developed SQUID sensor is below 5 fT/√Hz at 100 Hz, which is low enough to be used in neuromagnetic measurements.

      • 서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

        김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

        In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

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        Comparison of the effectiveness of sirolimus- and paclitaxel-eluting stents for small coronary artery lesions

        Park, Kyoung-Ha,Park, Seong-Wook,Hong, Myeong-Ki,Kim, Young-Hak,Lee, Bong-Ki,Park, Duk-Woo,Choi, Bong-Ryong,Kim, Mi-Jeong,Park, Kyoung-Min,Lee, Cheol Whan,Cheong, Sang-Sig,Kim, Jae-Joong,Park, Seung-J WILEY-LISS 2006 Catheterization and Cardiovascular Interventions Vol. No.

        <P>Background: The sirolimus-eluting stent (SES) and the paclitaxel-eluting stent (PES) reduce restenosis in small coronary artery lesions. However, it is not clear which of these stents is superior in terms of clinical outcomes. Methods: The authors retrospectively examined 197 patients with 245 de novo small coronary artery lesions (≤≤2.75 mm) that were treated with either the SES (156 lesions) or the PES (89 lesions). Six-month angiographic restenosis rates and the 9-month target lesion revascularization (TLR) rates were compared between the two groups. Results: In terms of baseline clinical and angiographic parameters, the two groups well matched together. Six-month angiographic follow-up was performed on 170 patients (86.3%), comprising 135 SES lesions (86.5%) and 76 PES lesions (85.4%). At 6-month angiographic follow-up, the late lumen loss was less in the SES group than in the PES group (0.29 ± 0.42 vs. 0.69 ± 0.63 mm, P < 0.01). Therefore, the SES group showed a lower rate of angiographic restenosis than the PES group (6.7% vs. 27.7%, P < 0.01). At 9 months there were no deaths or myocardial infarctions in either group. The 9-month TLR rate was lower in the SES group than in the PES group (3.3% vs. 14.4%, P < 0.01). The Kaplan-Meier estimate of freedom from TLR at 9 months was 96.7% for the SES patients and 86.5% for the PES patients (P < 0.01). Conclusions: The SES treatment may be superior to the PES treatment in terms of long-term clinical and angiographic outcomes in patients with small coronary artery lesions. © 2006 Wiley-Liss, Inc.</P>

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