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병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성
김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5
목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.
文永熙,高在鍾,金庚完 朝鮮大學校 1996 藥學硏究誌 Vol.18 No.1
Lindera obtusiloba has been used for the treatment of fever, abdominal distention and pain in traditional medicine. The anti-inflammatory activity of the extracts from Lindera obtusiloba was investigated utilizing carrageenin-induced edema, granuloma pouch in rats. The effects of this agent on capillary vascular permeability and acetic acid-induced writhing in mice were also examined. It showed to have significant analgesic activity on the writhing syndrome in mice induced by 0.7% acetic acid at Water extract of root(600㎎/㎏). It was also inhibites the increase in carpillary vascular permeability induced by acetic acid in mice. It showed anti-inflammatory activity in 1% carrageenin-induced edema with oral administeration in rats and exhibited significant preventive effect on edema at Water extract of root(600㎎/㎏). The water extract of root from Lindera obtusiloba showed significant inhibition on granuloma and exudate formation in rats. In the present study, the Water extract of root was indicated to have the analgesic and anti-inflammatory activity.
무증상 한국인에서 근위부 대장용종의 예측 인자로서 원위부 대장용종의 의미
김진호,최재원,주광로,민영일,김해경,김영민,박의련,홍원선,김도하,정성애,명승재,김석균,양석균,정훈용,조문경,심기남,김기락 대한소화기학회 2000 대한소화기학회지 Vol.36 No.5
Background/Aims: The aim of this study was to examine whether rectosigmoid polyps could be a marker for proximal lesions. Methods: A total of 367 asymptomatic patients with distal colonic polyps (314 adenomatous; 53 hyperplastic) noted on sigmoidoscopy and 134 asymptomatic controls without distal colonic polyps were evaluated with total colonoscopy. No one had risk factors of colorectal cancers or polyps. Results: Incidence of synchronous proximal adenomas was higher in the patients with distal adenomas than in the patients with distal hyperplastic polyps and the controls (30.3% vs 17.0% and 15.7%, p$lt;0.05). It was also higher in the patients with multiple distal adenomas than in the patients with single distal adenoma. Patients with distal adenomas bigger than 5 mm in diameter had a higher risk of synchronous proximal adenomas (42.4% vs 25.8%, p$lt;0.005). Patients with advanced distal adenomas had a higher prevalence of advanced adenomas in the proximal colon than those with non-advanced distal adenomas (9.1% vs 2.1%, p$lt;0.05). Conclusion: Rectosigmoid polyps detected on flexible sigmoidoscopy can be a predictor of proximal neoplasia according to their morphologic characteristics and pathology.
Kim, Bo Gyung,Kim, Deog Young,Kim, Seung Ki,Kim, Jung Min,Baek, Seung Hak,Moon, In Seok Informa Healthcare USA, Inc. 2014 Electromagnetic biology and medicine Vol.33 No.3
<P>Transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Repetitive TMS (rTMS) applied over the temporoparietal cortex has been reported to show therapeutic effects on tinnitus. We compared the effects of 1 Hz rTMS delivered either contralaterally or ipsilaterally to the symptomatic ear in patients with unilateral tinnitus. Forty patients with asymmetric hearing loss and non-pulsatile tinnitus localized to poorer ear of 6 months in duration or greater who were refractory to medication were enrolled in this study. Patients were assigned randomly to one of two treatment groups: with 1 Hz stimulation applied the temporoparietal junction either ipsilaterally (<I>n</I> = 21) or contralaterally (<I>n</I> = 19) to the symptomatic ear. The patients were given 600 pulses per session daily for 5 d. Changes in the tinnitus handicap inventory (THI) and self-rating visual analog scores (VAS) for loudness, awareness and annoyance were analyzed before, immediately after and 1 month after treatment. There was no significant difference in the rate of patients with marked improvement between ipsilateral and contralateral stimulation groups. In addition, there were no significant differences in the amount of decreases in THI scores and VAS between the two groups immediately or 1 month after rTMS. Finally, significant decreases in THI scores and most VAS were observed 1 month after rTMS in both groups compared to pretreatment. Daily treatment with 1 Hz rTMS ipsilaterally and contralaterally to the side of tinnitus both had significant beneficial effects. The laterality of stimulation with 1 Hz rTMS is not the decisive factor in relieving symptoms.</P>
Kim, Chungho,Seon Lee, Hyo,Lee, Deokjae,Lee, Sang Don,Cho, Eun-Gyung,Yang, Soo Jung,Kim, Sang Bum,Park, Dongeun,Kim, Moon Gyo American Society of Hematology 2011 Blood Vol.117 No.4
<B>Abstract</B><P>Epithin/PRSS14, a type II transmembrane serine protease, is involved in normal epithelial development and tumor progression. Here we report, as an interacting substrate of epithin, a receptor tyrosine kinase Tie2 that is well known for important roles in the vessel stability. Epithin interacts with and degrades the Tie2 extracellular portion that contains the ligand-binding domain. Epithin is located in the neighbor of Tie2-expressing vessels in normal tissue. Furthermore, epithin can cleave and degrade Tie2 not only in the same cell but also from neighboring cells nearby, resulting in the degradation of the Tie2 ectodomain. The remaining Tie2 fragment was highly phosphorylated and was able to recruit a downstream effector, phosphatidylinositol 3-kinase. Knocking down epithin expression using short hairpin RNA in thymoma cell severely impaired the migration through endothelial cells that show the actin rearrangement during the process. The diminution of epithin protein expression in 4T1 breast cancer cells caused the significant decrease in the number of transendothelial migrating cells in vitro as well as in those of metastasizing tumor nodules in vivo, Therefore, we propose that epithin, which regulates endothelial Tie2 functions, plays a critical role in the fine tuning of transendothelial migration for normal and cancer cells.</P>