식도 정맥류 출혈을 동반한 간경변 환자에서 Ciprofloxacin의 예방적 투여는 세균성 감염 예방에 효과적인가?

홍성노,김범진,이선영,이춘영,류민규,최문석,이준혁,이풍렬,고광철,김재준,백승운,이종철,최규완 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.3

목적: 식도 정맥류 출혈을 동반한 간경변증 환자 에서 세균성 감염은 비교적 흔한 합병증으로 불량한 예후와 연관되어 있다. 이러한 환자에서 경구용 항생제를 예방적으로 투여하면 세균성 감염의 위험을 낮출 수 있는 것으로 보고 되어 왔으나, 세균성 감염이 흔히 발생하는 출혈 초기에는 경구로 항생제를 투여하는 것이 상당수에서 비효율적이며, 투여 자체가 어려운 경우가 많다. 저자 등은 식도 정맥류 출혈을 동반한 간경변증 환자에서 ciprofloxacin의 정맥 투여가 세균성 감염 예방에 효과적인지 알아보고자 연구를 시행하였다. 방법: 식도 정맥류 출 혈로 내시경적 식도 정맥류 결찰술을 시행 받은 Child-Pugh 분류 B군 이상의 간경변증 환자 40명 (남:여=33:7, 연령:30∼78세)을 일련적으로 등록하여 치료군(20명)과 대조군(20명)으로 무작위 배정하였다. 치료군에게는 ciprofloxacin 200mg을 12시간 간격으로 72시간 동안 정맥 주사하였고, 대조군에게는 항생제를 투여하지 않았다. 이들을 7일간 추적 관찰 하며 혈액 배양 검사, 소변 검사, 흉부 방사선 촬영 과 복수 천자 등의 검사를 시행하여 세균성 감염 여부를 양군간에 비교하였고, 각 군의 임상 경과와 병 원 재원 일수 및 의료비를 비교하였다. 결과: 20명 의 대조군 중 9명(45%)에서 세균성 감염이 발생하였으나, 20명의 치료군 중에서는 2명(10%)에서만 세균성 감염이 발생하여 치료군에서 대조군보다 세균성 감염의 발생이 유의하게 적었다(p<0.05). 임상 경과와 사망률은 양군간에 차이가 없었으나, 재원 기간은 치료군에서는 13.4± 9.6일, 대조군에서는 20.4± 23.7일로 대조군에서 더 긴 재원 기간을 보였고(p<0.001), 의료비도 치료군보다 대조군에서 의료비가 더 많았다(p<0.001). 결론: 식도 정맥류 출혈을 동반한 Child-Pugh 분류 B군 이상의 간경변증 환자에서 출혈 초기 정맥 주사용 ciprofloxacin을 사용하는 것은 세균성 감염의 발생 빈도를 낮추며, 병원 재원 일수 및 의료비를 감소시키는 효과가 있다. Background/Aims: In cirrhotic patients with esophageal variceal bleeding, bacterial infections are a frequent complication. Oral antibiotic prophylaxis decreases the incidence of bacterial infections. The administration of oral antibiotics, however, may be difficult in some cirrhotic patients with active bleeding.The purpose of this study was to assess the efficacy of prophylactic intravenous antibiotics for the prevention of bacterial infections in cirrhotic patients with esophageal variceal bleeding. Methods: From December 1998 to September 2001, a total of 40 consecutive cirrhotic patients with Child-Pugh class B or C were enrolled after emergent endoscopic esophageal variceal ligation (EVL) was taken because of esophageal variceal bleeding. Enrolled patients were randomized into a treatment group and a control group. The treatment group (n=20) received the intravenous ciprofloxacin 200mg IV q 12 hours for 3 days while the control group(n=20) didn,t. Results: Bacterial infection developed in nine patients (45%) of the control group and only two patients (10%) in the treatment group. The incidence of bacterial infections was significantly lower in the treatment group than the control group (p<0.005). The hospital cost and length of hospital stay decreased in the treatment group compared with the control group (p<0.001). There were no differences in the hospital course and mortality within 30 days between the two groups. Conclusions: In cirrhotic patients with variceal bleeding and with Child-Pugh class B or C, the use of intravenous ciprofloxacin for 3 days after EVL was not only effective in the prevention of bacterial infections but also cost-effective. (Korean J Hepatol 2002;8:288-296)

The Risk of Colorectal Neoplasia in Patients with Gallbladder Diseases

홍성노,이태윤,윤성철 대한의학회 2015 Journal of Korean medical science Vol.30 No.9

Cholecystectomy is associated with an increased risk of colorectal cancer, but little is known about the relationship between gallbladder disease and colorectal adenoma. Gallbladder polyps and colorectal neoplasia (CRN) share several risk factors such as obesity, diabetes and metabolic syndrome, which might account for their association. In this study, we investigated whether asymptomatic patients with gallbladder disease are at increased risk of CRN and identified the factors to their association. The study population consisted of 4,626 consecutive, asymptomatic individuals drawn from a prospective health check-up cohort who underwent both ultrasonography and colonoscopy screening. The prevalence of CRNs in patients with gallbladder polyps or gallstones was significantly higher than that in the control group (32.1% vs. 26.8%; P = 0.032, 35.8% vs. 26.9%; P = 0.020). A multivariate regression analysis showed that gallbladder polyps were an independent risk factor for CRN [adjusted odds ratio (OR): 1.29; 95% confidence interval (CI); 1.03-1.62] whereas gallstones were not (adjusted OR: 1.14; 95% CI: 0.79-1.63). The adjusted OR for the risk of CRN was 1.12 for gallbladder polyps < 5 mm (95% CI, 0.85-1.46) and 1.79 for gallbladder polyps ≥ 5 mm (95% CI, 1.15-2.77). The prevalence of CRN increased with increasing polyp size (P trend = 0.022). Our results suggest that colorectal neoplasia is significantly related to gallbladder polyps, especially those ≥ 5 mm.

한국산 고양이(Felis cattus)에서 한탄바이러스의 이환률

홍성노,이연태,조규봉 檀國大學校 基礎科學硏究所 1995 論文集 Vol.6 No.-

양수에서 Ureaplasma urealyticum 분리율에 관한 연구

홍성노 동남보건대학 2004 論文集-東南保健大學 Vol.22 No.1

In order to evaluate the effect of Ureaplasma urealyticum and Mycoplasma hominis infection on the outcome of pregnancy, 600 terms pregnant women and 368 of vaginally delivered newborns were investigated at some Department of Obstetrics and Gynecology Clinics situated in Suwon city during the period of Sep. 2003 to April 2004. The endocervical culture of the 600 pregnant women and the nasopharyngeal culture of 157 neonates were performed, and the results were obtained as follows: l. Among 600 term pregnant women, 164 cases (27.3%) were positive for only U.urealyticum, 13 cases(2.2%)were positive for only M.hominis, and 102 cases(17%) were positive for both U.urealyticum and M.hominis. So total 248 cases were positive for U.urealyticum(44.3%) and total 115 cases were positive for M.hominis(19.2%). 2. Among 157 neonates, 34 cases (21.6%) were positive for U.urealyticum, 6 cases (3.8%) were positive for M.hominis and 23 cases(14.6%) were positive for both U.urealyticum and M.hominis. So total 57 cases were positive for U.urealyticum (36.3%). and total 29 cases were positive for M.hominis(18.4%). 3. In this in vitro culture study, U.urealyticum has been found to be susceptible to antibiotic Tetracycline, Doxycycline, Erythromycin, Spectinomycin, Gentatmycin, Kanamycin, Josamycin.

혈액내 세균의 신속검출을 위한 혈액배양용 검체의 보존액 제조에 관한 연구

홍성노 동남보건대학 2003 論文集-東南保健大學 Vol.21 No.1

In diagnosing and treating the suspected patients of septicaemia or bacteriemia, it is very important to detect bacteria in the patients' blood. To detect infectious bacteria in the patients' blood quickly and exactly, blood from patients must be cultivated in culture medium quickly. Not cultivating bacteria soon after gathering patients' blood, infectious bacteria in the patient's blood may die out and cannot be detected. In this case patients infected with bacteria can be diagnosed erroneously as non-infected. In order to develop immersion keeping infectious bacteria alive for the exact detection in spite of some delay, this study was conducted from September 1, 2002 to April 30, 2003.

마우스 난소에서 초기 난포 발달 과정동안 weel kinase의 역할에 관한 연구

홍성노 동남보건대학 2004 論文集-東南保健大學 Vol.22 No.2

Recruitment of primordial follicles(PMF) is crucial for female fertility. however. factors and mechanisms that regulate this process are poorly understood.

Filling the Technical Gap between Standard Endoscopic Mucosal Resection and Full Endoscopic Submucosal Dissection for 20–35 mm Sized Colorectal Neoplasms

홍성노 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.4

COMMENTARY

Endoscopic Therapeutic Approach for Dysplasia in Inflammatory Bowel Disease

홍성노 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.5

Long-standing intestinal inflammation in patients with inflammatory bowel disease (IBD) induces dysplastic change in the intestinal mucosa and increases the risk of subsequent colorectal cancer. The evolving endoscopic techniques and technologies, including dye spraying methods and high-definition images, have been replacing random biopsies and have been revealed as more practical and efficient for detection of dysplasia in IBD patients. In addition, they have potential usefulness in detailed characterization of lesions and in the assessment of endoscopic resectability. Most dysplastic lesions without an unclear margin, definite ulceration, non-lifting sign, and high index of malignant change with suspicion for lymph node or distant metastases can be removed endoscopically. However, endoscopic resection of dysplasia in chronic IBD patients is usually difficult because it is often complicated by submucosal fibrosis. In patients with dysplasias that demonstrate submucosa fibrosis or a large size (≥20 mm), endoscopic submucosal dissection (ESD) or ESD with snaring (simplified or hybrid ESD) is an alternative option and may avoid a colectomy. However, a standardized endoscopic therapeutic approach for dysplasia in IBD has not been established yet, and dedicated specialized endoscopists with interest in IBD are needed to fully investigate recent emerging techniques and technologies.

구연 : 소화기 ; 수술 하지 않은 증상담석증 환자에서 증상 재발에 담낭 기능이 미치는 영향

홍성노,이종균,이규택,이풍렬,고광철,김재준,백승운,유병철,이종철 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-

The Effect of the Bowel Preparation Status on the Risk of Missing Polyp and Adenoma during Screening Colonoscopy: A Tandem Colonoscopic Study

홍성노,성인경,김정환,최원혁,Byung Kook Kim,고순영,Jung Hyun Lee,Dong Choon Seol,Su Young Ahn,이선영,박형석,심찬섭 대한소화기내시경학회 2012 Clinical Endoscopy Vol.45 No.4

Background/Aims: Although a small amount of fecal material can obscure significant colorectal lesions, it has not been well documented whether bowel preparation status affects the missing risk of colorectal polyps and adenomas during a colonoscopy. Methods: We prospectively enrolled patients with one to nine colorectal polyps and at least one adenoma of >5 mm in size at the screening colonoscopy. Tandem colonoscopy with polypectomy was carried out within 3 months. Results: A total of 277 patients with 942 polyps and 714 adenomas completed index and tandem examinations. At the index colonoscopy,187 polyps (19.9%) and 127 adenomas (17.8%) were missed. The per-patient miss rate of polyps and adenomas increased significantly as the bowel cleansing rate declined from excellent to poor/inadequate on the Aronchick scale (polyps, p=0.024; adenomas,p=0.040). The patients with poor/inadequate bowel preparation were independently associated with an increased risk of having missed polyps (odds ratio [OR], 3.21; 95% confidence interval [CI], 1.13 to 9.15) or missed adenomas (OR, 3.04; 95% CI, 1.04 to 8.88) compared to the patients with excellent bowel preparation. Conclusions: The risk of missing polyps and adenomas during screening colonoscopy is significantly affected by bowel preparation status. It seems appropriate to shorten the colonoscopy follow-up interval for patients with suboptimal bowel preparation.