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이길호,조용현,심봉석,이상돈 대한의학회 2010 Journal of Korean medical science Vol.25 No.8
We investigated the risk factors for resistance to ciprofloxacin, cefazolin, ampicillin and cotrimoxazole in Escherichia coli isolates from urine of Korean female patients with acute uncomplicated cystitis (AUC). A total of 225 patients and their E. coli isolates were prospectively and nationwidely enrolled between May and October, 2006. All the antimicrobials did not show any differences according to the age group. A higher rate of ciprofloxacin resistance was observed in the south (OR: 3.04, 95% CI: 1.19-7.80 for Chungcheong-do & Jeolla-do; OR: 3.04, 95% CI: 1.22-7.58 for Gyeongsang-do) compared to Gyeonggi-do. Two recurrences of AUC in the past year was an important risk factor for antimicrobial resistance (ciprofloxacin; OR: 6.71, 95% CI: 1.86-24.11 and cefazolin; OR: 5.72,95% CI: 1.20-27.25). However, the resistance to co-trimoxazole and ampicillin was not associated with any of the risk factors. This study also revealed the pattern of multi-drugs resistance in ciprofloxacin resistant E. coli strains. In conclusion, for Korean patients with two more recurrences of AUC in the past year, it is strongly recommended to perform an antimicrobial sensitivity test with a urine sample before empirical treatment.
Uroplakins in the Lower Urinary Tract
이길호 대한배뇨장애요실금학회 2011 International Neurourology Journal Vol.15 No.1
The apical surface of mammalian urinary epithelium is covered by numerous scallop-shaped membrane plaques. This plaque consists of four different uroplakins (UPs) and integral membrane proteins. UPs, which are a member of the tetraspanin superfamily,are assembled into plaques that act as an exceptional barrier to water and toxic materials in urine. Within the plaques, the four UPs are organized into two heterodimers consisting of UP Ia/UP II and UP Ib/UP III in the endoplasmic reticulum. The two heterodimers bind to a heterotetramer, and then assemble into 16-nm particles in the Golgi apparatus. The aggregated UP complex ultimately covers almost all the mature fusiform vesicles in cytoplasm. These organelles migrate towards the apical urothelial cells, where they can fuse with the apical plasma membrane. As a result, the UPs are synthesized in large quantities only by terminally differentiated urothelial cells. For this reason, the UPs can be regarded as a major urothelial differentiation marker. In UP knockout (KO) mice, the incorporation of fully assembled UP plaques in cytoplasm into the apical surface is not functional. The mice with UP III-deficient urothelium show a significantly reduced number of UPs, whereas those with UP II-deficient urothelium have nearly undetectable levels of UPs. This finding strongly suggests that UP II ablation completely abolishes plaque formation. In addition, UP II KO mice contain abnormal epithelial polyps or complete epithelial occlusion in their ureters. UP IIIa KO mice are also associated with impairment of the urothelial permeability barrier and development of vesicoureteral reflux as well as a decrease in urothelial plaque size. In this review, I summarize recently published studies about UPs and attempt to explain the clinical significance of our laboratory results.
An Unusual Presentation of Diabetic Ketoacidosis in Familial Hajdu-Cheney Syndrome: A Case Report
이길호,안소연,손영배,정선용,정윤석 대한의학회 2013 Journal of Korean medical science Vol.28 No.11
A 21-year-old man with diabetic ketoacidosis (DKA) displayed short and clubbed fingers and marked eyebrow, which are typical of Hajdu-Cheney Syndrome (HCS). Laboratory findings confirmed type 1 diabetes mellitus (DM). After conservative care with hydration and insulin supply, metabolic impairment was improved. Examinations of bone and metabolism revealed osteoporosis and craniofacial abnormalities. The mutation (c.6443T>G) of the NOTCH2 gene was found. The patient was diagnosed with HCS and DM. There may be a relationship between HCS and DM, with development of pancreatic symptoms related to the NOTCH2 gene mutation.
이길호,김흥국 中央醫學社 1992 中央醫學 Vol.57 No.8
Now the ESWL is the treatment of first choice in the urinary tract stone, but it was difficult to localize the mid ureteral stone by ultrasonography. Therefore, the mid ureteral stone was treated with push back or fluoroscopic localization. The complication of the push back, such as ascending infection or ureteral penetration, were developed ocassionally, Then ultrasonic localization was co isidered, and insitu ESWL in 21 patients with mid ureteral stone was performed. The results were as follows; 1. 20 (95.2 %) out of 21 patients with mid ureteral stone by ultrasonic localization was treated successfully. 2. The size of stones was 0.5 0.9 cm in 11 (52.4 %) patients, 1.0 1.4 cm in 7 (33.3 %) patients and 1.5 1.9 cm in 3 (14.3 %) patients. 3. The average sessions and shock waves of ESWL according to the stone size was 2 sessions and 2190 waves in 0.5 0.9 cm, 1.83 sessions and 2133 waves in 1.0 1.4 cm and 3 sessions and 3667 waves in 1.5 1.9 cm, respectively. 4. Transient gross hematuria (21 cases, 100 `%), colic pain (2 cases, 9.5 %), nausea and vomiting (2 cases, 9.5 %) and steinstrasse (3 cases, 14.3 %) was developed and recovered spontaneously without specific management. The author believes that the further technical improvement of sonography made possible to successful disintegration of the mid ureteral stone.