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서대홍,임홍섭,김충기,이겸철,조용구,정승수,심영웅,송갑영 대한감염학회 1998 감염 Vol.30 No.2
우상복부 동통, 발열과 오한 그리고 의식 둔화를 주소로 내원한 당뇨 환자에서 Klebsiella pneumoniae에 의한 가스형성 간농양을 균배양 검사를 통하여 진단하고 항생제 투여와 경피적 농양 배액술을 통해 증상의 호전을 보인 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Gas-forming pyogenic liver abscess is an uncommon, life-threatening, necrotizing infection that is usually found in poorly-controlled diabetic patients. Herein, we report a case of gas-forming liver abscess caused by Klebsiella pneumoniae, as proven by aspirated pus culture, in a 70-year old woman with diabetes mellitus. The patient was successfully managed with broadspectrum antibiotics and transhepatic percutaneous drainage and was discharged after 3 weeks of hospitalization. In conclusion, strict control of diabetes mellitus is the most important factor in the prevention of gas-forming pyogenic liver abscess.
이재동,송갑영,강창일,정정명,최하진 인제대학교 1981 仁濟醫學 Vol.2 No.2
개원 이래 1년 1개월간 본원에 내원하였던 급성 약물 중독 환자 240례를 임상적으로 관찰하였다. We did clinical evaluation with the 240 acute drug intoxication cases which occurred from June 1979. to Jull 1980 (13 months) in Busan with her surrounding rural area and following results were obtained. 1) Acute drug intoxication was 3.4% of total emergency visits and incidence leas highest in July, Summer season and 3rd. decade age group. 2) The motive of intoxication was suicidal attempt 78.3%, and the remainder was accidental poisoning. Male to Female ratio was 1: 1.2. The order of causative agent frequency was pesticides which was predominantly in rural area, various kinds of drugs, hyponotics & rodenticides which was predominantly in inner city area. 3) Overall fatality rate was 9.6%, most of them was pesticidal case and 77. 1% close was completely recovered.
호흡기질환 환자로부터 분리된 Mycoplasma pneumoniae의 tetracycline과 erythromycin에 대한 저항성 변이
장명웅,박인달,김광혁,송갑영,김성원,Chang Myung-Woong,Park In-Dal,Kim Kwang-Hyuk,Song Gap-Young,Kim Sung-Won 한국생명과학회 2005 생명과학회지 Vol.15 No.6
2002년 2월부터 2005년 4월까지 호흡기질환 환자로부터 분리된 M. pneumeniae 123 균주의 tetracycline과 erythromycin에 대한 MIC 범위는 각각 $0.5\~1.0$, and $0.5\~512{\mu}/ml$ 이었다. 분리된 M. pneumoniae 123 균주에서 plasmid DNA는 확인되지 않았다. 분리된 M. pneumoniae 123 균주 중에서 57($46.3\%$) 균주가 tetracycline에 저항성인 tetM유전자를 가지고 있었으며, 235 rRNA domain V에 erythromycin에 저항성 변이를 일으킨 균주가 60($48.8\%$)이었다. erythromycin에 저항성 변이를 일으키지 않은 63균주 중에서 tetM 유전자를 가지고 있는 균주는 36($57.1\%$)이었으며, erythromycin에 저항성 변이를 일으킨 60균주 중에서 21($35.0\%$ 균주가 tetM 유전자를 가지고 있었다. 본 연구로써 국내에서 tetracycline과 erythromycin에 대한 저항성 M. pneumoniae 균주의 분리율이 외국에 비하여 높으며, M. pneumoniae 감염의 치료에 erythromycin이 일차 선택제가 될 수 없으므로 이에 대한 범국가적 조사가 필요하다고 생각된다. One hundred and twenty three strains of Mycoplasma pneumoniae were isolated from patients with respiratory diseases from February 2002 to April 2005 in Busan, Korea. The MICs of tetracycline and erythromycin up to $90\%$ of the 123 M. pneumoniae isolates tested were $0.5\~1.0$, and $0.5\~512{\mu}/ml$, respectively. Plasmid DNA was not isolated from all of the M. pneumoniae isolates. Out of 323 strains of M. pneumoniae, 57 ($46.3\%$) stains contain tetM gene on their chromosomal DNA, and 60 ($48.8\%$) strains were mutated in domain V of 23S rRNA for erythromycin resistance. Out of 63 strains of M. pneumoniae which were not mutated in domain V of 235 rRNA for erythromycin resistance, 36 ($57.1\%$) strains contained tetM gene, and out of 60 strains of M. pneumoniae which were mutated in domain V of 23S rRNA for erythromycin resistance, 21 ($35.0\%$) strains contained tetM gene. These results suggest that the isolation rate of erythromycin and tetracycline resistant M. pneumoniae is higher than those of other countries, and erythromycin and tetracycline are not first choice drug for M. pneumoniae infection in Korea, and it need confirm by a nationwide surveilance of antimicrobial resistance.
최환주,심영웅,서대홍,김춘섭,송갑영,임홍섭,김충기,이겸철 대한내과학회 1997 대한내과학회지 Vol.53 No.2
Hepatoma is one of the most common malignant disease among cancers that occur in Korea. Recently, according ta developing imaging diagnostic technology and non surgical treatment the hepatoma is easily detected in early diagnosis and appropriate treatment. From this point of view, the histologic pattern of hepatoma is markedly important. This is the first reported case of sclerosing hepatocellular carcinoma, which is characterized by intense fibrosis, in which the tubular neoplastic structures are embedded. The incidence of sclerosing hepatocellular carcinoma is very rare. Therefore the rare histologic pattern of hepatoma might be introduced by many studies and reports. We recently experienced a case of sclerosing hepatocellular carcinoma.
Mycoplasma pneumoniae의 분리 및 항생제 감수성 검사(III)
장명웅,김광혁,박인달,송갑영,김성원,이은영,김문찬,조명훈,김규언,최충언,박선영,조현장,Chang Myung-Woong,Kim Kwang-Hyuk,Park In-Dal,Song Gap-Young,Kim Sung-Won,Lee Eun-young,Kim Moon-Chan,Cho Myung-Hoon,Kim Kyu-Earn,Choi Choong-Eon,Park Se 한국생명과학회 2005 생명과학회지 Vol.15 No.3
2002년 2월부터 2005년 2월까지 성인 및 소아 호홉기질환자 994명의 상기도 도말물에서 M. pneumoniae 균주를 분리하고, 분리 균주의 ciprofloxacin, ofloxacin, minecline, tetracycline, sparfloxacin, josamycin, erythromycin에 대한 감수성 검사를 실시하였으며, 분리된 균주의 235 rRNA domain II와 V에서 erythromycin저항성 변이가 일어났는가를 PCR과 유전자 염기서열분석으로 erythromycin에 감수성인 M. pneumonine균주의 염기서열과 비교분석하여 확인하였다. 호흡기질환자에서 M. pneumoniae의 분리율은 123/994$(12.4\%)$이었으며, 분리된 M. pneumoniae 균주의 minocycline, sparfloxacin, tetracycline, ciprofloxacin, ofloxacin, josamycin, erythromycin MIC 범위는 각각 $0.015\~0.25,\;0.06\~0.5,\;0.06\~0.5,\;0.25\~0.5,\;0.25\~0.5,\;0.015\~8.0,\;0.015\~8.0{\mu}m$이었다. 분리 동정된 M. pneumoniae 균주 중에서 erythromycin에 저항성인 균주가 60주$(48.8\%)$였으며, 모두가 ribosomal protein L4 영역과 23S rRNA domain V에 내성변이가 일어났으며, 이 중 2균주는 23S rRNA domain II에도 변이가 일어난 균주도 있었다. 국내에서 분리되는 M. pneumoniae균주의 $48\%$가 erytomycin에 저항성인 균주이므로 앞으로 이 균에 의한 폐렴의 치료에 주의가 요구된다. The 994 throat swabs obtained from 688 adults and 306 children patients with respiratory diseases were examined for Mycoplasma pneumoniae infection by culture method. Antimicrobial susceptibilities of the resulting 123 M. pneumoniae isolates were evaluated by testing minimum inhibitory concentrations (MICs) of erythromycin, minocycline, tetracycline, josamycin, sparfloxacin, ofloxacin, and ciprofloxacin by a broth micro-dilution method. The erythromycin resistant strains of M. pneumoniae was determined above $1.0{\mu}g/ml$ of MIC for erythromycin. The erythromycin resistant strains of M. pneumoniae was confirmed resistant gene mutation of the portions of genes 23S rRNA (domain II and V), and ribosomal protein 14 and L22 by PCR amplified and their nucleotide sequenses were compared to those of the susceptible strain M129. The isolation rate of M. pneumoniae was $12.9\%$ (89/688) for the adults and $11.1\%$ (34/306) for the children. The $MICs_{90}$ of the M. pneumoniae isolates were $0.12{\mu}g/ml$ for minocycline, $0.25{\mu}g/ml$ for sparfloxacin, $0.5{\mu}g/ml$ for ciprofloxacin, ofloxacin, and tetracycline, respectively, and $2.0{\mu}g/ml$ for josamycin and erythromycin, respectively. The isolation rate of erythromycin resistant M. pneumoniae from patients was $49.4\%\;(44/89)$ for the adults, $47.1\%\;(16/34)$ for children, and $48.8\%\;(60/123)$ for the total. No mutation could be detected in the ribosomal protein L22 region, but all strains were mutated in the ribosomal protein L4 as two point mutation M144V. Two point mutations in domain V of 23S rRNA were selected in the presense of erythromycin resistant M. pneumoniae isolates, such as one strain was G2057C mutant, two strains were A2059C mutants, three strains were C2611G mutants, four strains were A2058C mutants, five strains were A2058T mutants, twenty strains were A2059G mutants, and twenty-five strains were A2058G mutants, respectively. These results show that erythromycin was not the most active compound against M. pneumoniae infection in Korea and clinical studies of macrolides in human patients are demanded.