Lidocaine, Thrombin, Epinephrine 의 항균효과

김진우,이동건,전혜선,김승준,김석찬,안중현,김치홍,권순석,김영균,김관형,문화식,신완식,송정섭,박성학 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 기관지내시경 검사에서 흔히 사용되는 국소마취제인 lidocaine과 내시경시 지혈목적으로 사용되는 thrombin과 epinephrine이 각종 균주에 미치는 항균효과에 대해 알아보고자 하였다. 재료 및 방법 : 균주는 가톨릭대학교 성모병원에서 2004년 3월부터 2004년 9월까지 임상검체 에서 동정된 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 각각 42, 42, 42, 43주를 대상으로 하였다. Lidocaine, thrombin, epinephrine 감수성 검사는 National Committee for Clinical Laboratory Standards (NCCLS, 2002)의 기준에 따랐다. 결과 : Lidocaine은 S. aureus, S. pneumoniae, P. aeruginosa에서 MIC_(50), MIC_(90) 모두 20,000 ㎍/mL 이었다. K. pneumoniae는 각각 10,000 ㎍/mL이었다. Thrombin은 S. aureus와 P. aeruginosa에서 MIC50 500 lU/mL 과 MIC_(90) 500 IU/mL 이상이었고, K. pneumoniae에서는 MIC_(50)과 MIC_(90)이 모두 500 lU/mL이상이었으나 S. pneumoniae에서는 MIC_(50)과 MIC_(90)은 125 IU/mL이었다. Epinephrine은 K. pneumoniae, S. pneumoniae에 대한 MIC_(50), MIC_(90)가 모두 >500 ㎍/mL이었고, S. aureus와 P. aeruginosa에 대한 MIC_(50), MIC_(90)가 모두 500 ㎍/mL이었다. 결론 : 기관지 내시경 검사에서 흔히 쓰이는 lidocaine, thrombin, epinephrine 등의 약제들이 호흡기 질환의 흔한 병원균인 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 균주들에 대해 항균 효과가 있을 수 있어 세균배양검사에 영향을 미칠 수 있겠다. Background : We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. Materials and Methods : The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. Result : MIC_(50) and MIC_(90) of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 ㎍/mL and that for K. pneumoniae were 10,000 ㎍/mL. MIC_(50) and MIC_(90) of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC_(50) and MIC_(90) of epinephrine for K. pneumoniae and S. pneumoniae were above 500 ㎍/mL; that for S. aureus and P. aeruginosa were 500 ㎍/mL. Conclusion : We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

한약에 의해 유발된 급성 간질성 신염 2례

김덕윤,박동건,김응석,강영모,양창헌,이정호,이동철,이영현,김정란 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

간질성 신염은 신장의 간질을 선택적으로 침범하는 염증성 질환으로 여러가지 원인에 의해 유발되며, 이 중 약물에 의한 경우는 각종 항생제, 비스테로이드성 진통제, 항경련제, 이뇨제, 면역억제제등에 의한 증례들이 보고되고 있다. 현재 각종 질환-특히 만성질환-의 치료에서 한약이 차지하는 비중이 적지 않으나, 그 각각의 성분들이 유발할 수 있는 부작용들에 대한 연구는 거의 없는 실정이다. 저자들은 관절염 치료를 위해 중국산 한약을 복용한 후 복통, 피로감 및 육안적 혈뇨를 주소로 내원한 두 환자에서, 단백뇨와 신기능 장애를 보여 시행한 신조직 생검상 급성 간질성 신염에 합당한 병리학적 소견을 보이고, 한약 복용 중지 후 급속한 회복을 보여, 한약에 의해 유발된 것으로 사료되는 급성 간질성 신염 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Acute interstitial nephritis is a disease characterized by renal interstitial inflammatory cell infiltration and acute renal functional deterioration. This is caused mainly by antibiotics, NSAID and diuretics such as thiazide, but cases induced by herb medication are rare. We experienced two cases of acute interstitial nephritis after treatment with herb medication. One 71-year-old female patient and the other 60-year-old female were admitted to the hospital because of general weakness and gross hematuria. Microscopic hematuria, pyuria, and proteinuria were presented. After definitive diagnosis with a renal biopsy, we noted rapid recovery of renal function by drug withdrawal and steroid therapy. We report these cases with a review of the referenced literatures. Key Words : Herb medication, Acute Interstitial nephritis.

Lactobacillus plantarumCLP-1이 돼지바이러스에 미치는 효과

이건희(Gun-Hee Lee),김영희(Young-Hee Kim),조현아(Hyeon-A Cho),강성기(Sung-Gi Kang),김동건(Dong-Gun Kim) 한국생물공학회 2011 KSBB Journal Vol.26 No.1

To isolate Lactic acid bacteria for animals, we have screened from Kim-chi, swine intestine, swine feces, and dairy products by random selection and anti-viral, antipathogenic bacteria test. Among them, CLP-1 shown that inhibitory effect against rotavirus, porcine epidemic diarrhea (PED) virus, Salmonella sp, and E.coli. By examining biological property, API-ZYM and identified Lactobacillus plantarum by 16S rDNAgene sequence. CLP-1 determined resistance to low pH and bile salt. Futhermore, the cell body of CLP-1 adhered to the intestinal epithelium tissue of swine and Caco-2 cell. CLP-1 was examined on cell immune system modulating activity in vitro. The whole cell and cell culture supernatant was increasing of interferon-β activity. And then, CLP-1 increased prevention effect by Salmonella enteritidis infection in SPF chickens. And we determined similar result in pigs.

동종 조혈모세포이식 후 발생한 크립토콕쿠스 척추염 1예

고윤호,임동준,이성수,조유경,이동건,최정현,김유진,민창기,김동욱,박정미,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

Skeletal cryptococcosis is an uncommon infection. Cryptococcus is a common cause of meningitis and infects 7∼10% of patients with AIDS. As well as AIDS, the infection may be seen in association with leukemia, lymphoma, Hodgkin's disease, sarcoidosis, tuberculosis and diabetes, also in patients on steroid medication. But there is no case report of skeletal cryptococcosis following allogeneic hematopoietic stem cell transplantation. A 40-year-old woman was admitted to the hospital because of low back pain. She had chronic myelogenous leukemia for 2 years and underwent allogeneic hematopoietic stem cell transplantation 8 months ago. She have been treated with steroid and cyclosporine orally because of chronic graft versus host disease. On examination she was afebrile and had posterior lower lumbar tenderness. But, she had no reduced strength of low extremities. Open biopsy was underwent. Histology demonstrated budding, round-to-oval, refractile yeast-like organisms within debris. The results of a lumbar puncture were unremarkable and cerebrospinal fluid culture failed to grow bacteria and yeast. The patient was treated with amphotericin B (1 gram) and AmBisome□ (2.8 gram) over 6 weeks. Three months after cessation of therapy, the patient was doing well.(Korean J Infect Dis 33:298∼301, 2001)

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

Staphylococcus aureus와 Coagulase-Negative Staphylococcus Species에 대한 Arbekacin의 시험관내 항균력

위성헌,강진한,허동호,이동건,김상일,김양리,최정현,김종현,유진흥,허재균,신완식,강문원 대한감염학회 2001 감염 Vol.33 No.4

Background : Most strains of methicillin-resistant Staphylococcus aureus (MRSA) now exhibit high-level resistance to various antibiotics, such as β -lactam antibiotics, aminoglycosides, macrolides, tetracyclines and quinolones. Recent reports describing the therapeutic failure of vancomycin for MRSA infections have arisen considerable concerns regarding the emergence of MRSA strains, which will require new therapeutic agents. Arbekacin, an aminoglycoside antibiotic, has antibacterial activity against both gram-positive and gram-negative bacteria and is stable in the presence of aminoglycoside inactivating enzymes produced by S. aureus. In this study, we compared the antibacterial activity of arbekacin with those of vancomycin, gentamicin, and amikacin against Staphylococcus aureus (S. aureus) and coagulase-negative staphylococci (CNS). Methods : For a collection of 549 S. aureus and 251 CNS isolates from three Catholic University Hospitals in Korea, minimum inhibitory concentrations (MICs) of arbekacin, vancomycin, amikacin and gentamicin were determined by agar dilution method using Mueller-Hinton agar according to NCCLS (National Committee for Clinical Laboratory Standards, USA)criteria. Results : Among 549 S. aureus isolates, 278 isolates were MRSA and 271 isolates were methicil sensitive S. aureus (MSSA). MIC50 & MIC90 of arbekacin against 549 S. aureus were 0.5 & 1 ㎍/mL, and MIC50 & MIC90 of vancomycin were 1 & 1 ㎍/mL. MIC of arbekacin against 549 S. aureus isolates ranges from 0.03 to 4 ㎍/mL, and MIC of vancomycin against 549 S. aureus ranges from 0.25 to 2 ㎍/mL. MIC90 of amikacin against 549 S. aureus was 32㎍/mL, and that of gentamicin was 128 ㎍/mL. MICs of amikacin and gentamicin were variable, ranging from 0.125 to 256, and otherwise arbekacin and vancomycin revealed relatively narrow range of MICs. MIC90 of arbekacin against 278 MRSA isolates & 271 MSSA were 1 & 0.5 ㎍/mL, and those of vancomycin against MRSA & MSSA were 1 & 1 ㎍/mL. MIC90 of amikacin against 278 MRSA & 271 MSSA isolates were 32 & 4 ㎍/mL, and that of gentamicin against MRSA & MSSA isolates were 128 & 32 ㎍/mL respectively. Among 251 CNS isolates, 122 isolates were MRCNS and 129 were MSCNS. MICSO & MIC90 of arbekacin against 251 CNS isolates were 0.25 & 2 ㎍/mL, and those of vancomycin were 1 & 2 ㎍/mL. MIC of arbekacin against 251 CNS isolates ranges from 0.015 to 32 ㎍/mL, and that of vancomycin isolates ranges from 0.25 to 2 ㎍/mL, MIC90 of arbekacin against 122 MRCNS & 129 MSCNS isolates were 2&0.3 ㎍/ML, and those of vancomycin were 2&s ㎍/ML. MIC90 of amikacin against 251 CNS isolates was 32 ㎍/ML, and that of gentamicin was 128 ㎍/ML for CNS. MIC90 of amikacin against 122 MRCNS & 129 MSCNS isolates were 128 & 8㎍/mL, and those of gentamicin ere 256 & 32 ㎍/mL. Conclusion : Considering above results, arbekacin can be useful agent against most strains of MRSA and MRCMS, which exhibit high-level resistance to amikacin and gentamicin. (Korea J Infect Dis 33:254~260, 2001)

다결정 실리콘 태양전지의 상부 전극용 금속 박막 적용

김상수,임동건,이준신,심경석,김홍우,이만근 성균관대학교 1997 학술회의지원논문목록집 Vol.1997 No.-

We investigated grain boundary effect for terrestrial applications of solar cells with low cost, large area, and high efficiency. Grain boundaries are known as potential barriers and recombination centers for the photo generated charge carriers, which make it difficult to achieve a high efficiency cell. To reduce these effects of grain boundarues, we investigated various influencing factors such as thermal treatments various grid patterns selective wet etchings for grain boundarues, buried contact metallizations along grain boundaries, and use of metallic thin films. From the various grid patterns we learned that the series resistance of solar cell reduced open circuit voltage and consequently decreased the cell efficiency. This paper describes the effect of various grid patterns and the employment of metallic thin films for a top electrode.

난소에서 발생한 내배엽동 종양 1예

김종수,최승도,선우재근,배동한 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The endodermal sinus tumor(EST) of ovary is originated from the undifferentiated primitive germ cell of the embryonal stage. This tumor is the third most frequent malignant germ cell tumors of the ovary and highly malignant. About one-third of patients are premenarcheal at the time of diagnosis. Acute abdominal or pelvic pain is the most initial symptom. The treatment of the EST consists of surgical exploration, unilateral salpingo-oophorectomy and a frozen section for diagnosis. All patients with ESTs are treated with either adjuvant or therapeutic chemotherapy. We experienced one case of the endodermal sinus tumor of the ovary in 21 years old women, who had complaint with abdominal distension and pain. So we report the case with brief review of literatures.