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Insertion Sequence 6110의 Mixed-Linker 중합효소 연쇄반응을 이용한 Mycobacterium tuberculosis의 Molecular Typing
김재삼,김계영,허완재,임채호,정희진,박승철,성낙현,김우주,김민자 대한감염학회 1996 감염 Vol.28 No.1
목적 : M. tuberculosis에서 mixed-linker를 이용한 IS6110의 PCR을 시행하여 그 RFLP를 분석하고, 이를 기존의 RFLP법에 의한 결과와 비교 분석하여 신속하고 효과적인 molecular typing법으로서의 유용성을 검토하였다. 방법 : Mixed-linker PCR법을 이용하여 다양한 약제 감수성을 보이는 13명의 환자에서 분리된 14결핵 균주들의 임상 분리균을 대상으로 IS6110과 이에 인접된 염기서열을 포함하는 다양한 절편들을 증폭시켜 얻어진 mixed-linker RFLP를 conventional RFLP와 비교하였다. 결과 : 13명의 환자에서 분리된 13균주들의 mixed-linker RFLP 결과 모든 다른 RFLP양상을 보였으며, 이는 conventional RFLP의 결과와 일치하였다. Mixed-linker PCR법으로 증폭된 절편들은 기본적으로 150-600 bp 사이에 존재하였으며, IS6110의 한절편인 소식자로 Southern hybridization하여 IS6110에 특이함을 증명하였다. Mixed-linker RFLP는 conventional RFLP보다 더 많은 수의 절편들을 보여 주었다. Mixed-linker와 conventional RFLP 양상들은 약제 내성과 무관하였다. 결론 : Mixed-linker PCR법은 기존의 conventional RFLP법보다 더욱 간편한 방법으로 결핵균의 신속한 동정 및 molecular typing을 가능하게 하여 결핵의 역학조사에 효과적인 방법임을 알 수 있다. Background : Various classic typing methods including phage typing, antibiotic resistance typing and multilocus enzyme electrophoresis have been proven inefficient because of the phenotypic and genotypic homogeneities of the Mycobacterium tuberculosis(M.tuberculosis) species. Thus, DNA restriction fragment length polymorphism(RFLP) analysis using the repetitive element insertion sequence 6110(IS6110) of the M. tuberculosis genome has been proposed to be a powerful epidemiologic tool. However, this method requires large amount of genomic DNA and Southern hybridization procedures. The aim of this study was to evaluate DNA RFLP analysis by mixed-linker polymerase chain reaction(mixed-linker PCR) for a rapid, simple typing method, which specifically amplified genomic RFLP fragments containing IS6110 with using one primer specific for IS6110 and a second primer complementary to a linker ligated to the restricted genomic DNA. Methods : Fourteen clinical isolates of M. tuberculosis with various drug susceptibilities including 2 strains isolated from a patient were used for the study. Their RFLP patterns by mixed linker-PCR(mixed liker RFLP) were analyzed and compard with those by the conventional RFLP method. Results : Mixed-linker RFLP obtained from 13 isolates of 13 patients showed all different reproducible patterns and 2 isolates from the same patient showed almost the same RFLP patterns which had different drug susceptibility. mixed-linker RFLP patterns were correlated to the results by the conventional RFLP. And mixed-linker RFLP showed a higher number of fragments containing IS6110 than those by the conventional RFLP. However, both mixed-linker and conventional RFLP were independent of drug resistance patterns. Conclusion : Mixed linker-RFLP is a rapid, simple typing method with high discrimination and reproducibility, and seems to be useful for epidemiologic study of M. tuberculosis.
식도와 십이지장에 병발한 중복암 1예 : 십이지장 선암과 식도 편평상피 세포암
김영완,임채호,양해주,허완재,김재삼,성낙현,박경식,최종범,정석인 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.4
The occurrence of double primary cancer of the esopbagus and duodenum is considered very rare. Moreover, it is difficult to manage this type of double cancer because esophageal cancer has a biologic tendency to early metastasis. We report a case of double primary cancer, which we have synchronously confirmed esophageal squamous cell carcinoma and duodenal adenocarcinoma with gastrofiberscopic biopsy, and then treated them by gastrojejunostomy and systemic chemotherapy.
유세포분석기로 확진한 남매에서 발생된 혈소판 무력증 2 예
김동진,박경식,김재삼,이숙경,성낙현,백석기,허완재,임채호,현정례,박훈기,남이현,김춘섭 대한내과학회 1996 대한내과학회지 Vol.51 No.2
Glanzmann's thrombasthenia is a rare autosomal recessive genetic disorder of platelet function. It is caused by the deficiency or abnormality of the major platelets glycoprotein(GP)IIb-IIIa complex. Glanzmann's thrombasthenic platelets show no aggregation in response to the stimulation of ADP and platelet agonist(epinephrine, collagen), but it show aggregation in response to ristocetin. The platelet membrane glycoprotein IIb-IIIa complex is involved in cell to cell interaction and cell to matrix fibronectin interaction. Because the binding of fibrinogen allows platelets to aggregate, the binding of platelets on the subendothelium. The absence of defect of this receptor cause the platelet bleeding disorder called Glanzmann's Thrombasthenia. We experienced two cases of Glanzmann's thrombasthenia in 16-year-old female and 15-year-old male. They are from the same family, but they parents and older sister had no history of bleeding tendency. The 16-year-old female showed frequent epistaxis, showed frequent gum bleeding for the past 5 years, and she was prone to bruise since she was 11-year-old. Her 15-year-old brother showed similar symptom. On platelet aggregation test, mother showed normal response, but her two child showed no response to ADP, epinephrine and collagen, but showed normal response to ristocetin. They were diagnosed as Glannnann's Thrombasthenia by the analysis of Glycoprotein on platelet membrane by Flow-cytometry. The review of the literature was made briefly.