다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

서울 강서지역 1개 대학병원에서 성인 급성 신우신염의 원인균과 항생제 감수성

황병연,이재갑,박대원,이연주,김성범,엄중식,손장욱,정희진,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 3년간 서울시 강서지역의 1개 대학병원에서 입원치료를 받은 성인 급성 신우신염 환자를 대상으로 원인균과 항생제 감수성을 조사하고, 향후 급성 신우신염의 초기 경험적 치료 항생제를 제안하고자 하였다. 방법 : 1999년 1월부터 2001년 12월까지 3년간 고려대학교 의과대학 구로병원에 상부요로감염으로 내원한 16세 이상 환자 229명의 의무 기록을 검토를 통하여, 인구학적 특성, 원인균, 항생제 감수성, 초기 항생제 사용 양상과 입원기간을 조사하였다. 결과 : 연구에 포함된 229명을 118명의 단순 신우신염군과 111명의 복잡 신우신염군으로 구분 하였다. 단수 신우신염의 평균 발생 연령은 38.2세와 복잡 신우신염 56.1세로 복잡 신우신염 환자의 연령이 유의하게 높았다(P<0.001). 양군 모두에서 원인균 중 E. coli의 분리율이 가장 높았으며 항생제 감수성 결과 ampicillin, trimethoprim-sulfame-thoxazole에는 높은 내성률을 보였고, ciprofloxacin, gentamicin, cefotaxime에 대한 감수성은 비교적 높았으나 복잡 신우신염의 경우 단순 신우신염에 비하여 ciprofloxacin, gentamicin에 대한 감수성이 다소 낮은 것을 확인할 수 있었다. 평균 입원 기간, 항생제 투여 기간에 있어서도 복잡 신우신염군에서 유의하게 길었다. 결과 : 본 연구의 결과 서울의 강서 지역에서 대학병원급에 치료 의뢰되는 단순 급성 신우신염의 치료에 있어 1차 항생제로 3세대 cephalosporin, aminoglycoside, quinolone 중 한가지를 초기 경험적 치료제로 사용을 고려하여야 할 것으로 사료된다. Background : The purpose of this study is to recommend the initial therapeutic regimen for adult patients with acute pyelonephritis (APN) according to the changes of antimicrobial susceptibility patterns of causative microorganisms isolated from patients with APN. Methods : We reviewed medical charts of 229 APN patients, who had been treated at Korea University Guro Hospital from 1st of January. 1999 to 31st of December, 2001. We investigated the demographic data, clinical findings, durations of hospital treatment, antimicrobial susceptibility patterns of the causative microorganisms and initial antibiotic regimens in patients with APN. Results : In this study, 229 adult patients with APN were classified into simple APN patients (118 patients, 51.5%) and complicated APN patients (111 patients, 48.4%). Mean age of patients with simple APN was 38.2±14.1 years old and that of patients with complicated APN was 56.1±14.9 years old. Mean age of patients with complicated APN was significantly higher than that of simple APN patients (P<0.0001). Escherichia coli was the most common microorganism both in simple APN (96.7%) group and in complicated APN (90.6%) group. Antimicrobial susceptibility of E. coli was at the low level of ampicillin (31%/20%) and trimethoprim-sulfamethoxazole (42.6%/34.2%) in each group. In contrast, ciprofloxacin (11.5%/22.7%), gentamicin (16.4%/22%) and cefotaxime (0%/8.2%) resistance remained at relatively lower level. In comparison of simple APN with complicated APN, ciprofloxacin and gentamicin resistances were higher in complicted APN group. Average duration of hospitalization (5.9±2.3 days/8.2±4.6 days) and duration of antibiotic use (12.1±3.9 days/15.3±10.0 days) were significantly longer in complicated APN. Conclusions: The results of this study suggests that 3rd cephalosporin, aminoglycoside or quinolone antibiotic would considered as one of the initial therapeutic regimen for patients with simple APN in southwestern Seoul.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

정맥로를 이용한 자가통증 조절기의 사용 시작 시점이 환자의 회복지수에 미치는 영향

김상태,배진호,김상범,임승운,신영덕,조광태,손호정 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

The Effect of the IV-PCA (Intravenous-Patient Controlled Analgesia) on the Recovery Index Gwang Tae Cho, M.D., Ho Jung Sohn, M.D., Sang Bum Kim, M.D. Young Deok Shin, M.D., Jin Ho Bae, M.D., Sang Tae Kim, M.D. and Seung Woon Lim, M.D. Department of Anesthesiology and Medical Research INstitute, College of Medicine, Chungbuk Nationa University, Cheongju, Korea Background: It is well known that intravenous patient controlled analgesia (IV-PCA) is an effective method to reduce the magnitude of postoperative pain. However, we do not know the appropriate time to start the IV-PCA. To determine the appropriate time to minimalize the sympathetic stimulation and shorten the awakening time after general anesthesia, experiments to indicate whether starting an infusion of the IV-PCA before the end of an operation has a minimal hemodynarmic change and similar recovery index compared with the control group were done. Methods: Seventy-eight patients scheduled for a total abdominal hysterectomy were randomly allocated to two groups. In the IV-PCA group (n = 37), we started the infusion of the IV-PCA before the end of the operation and in the control group (n = 41) which received no IV-PCA, we did not use the IV-PCA as a postoperative pain control method. We measured heart rate, blood pressure, postanesthesia recovery score every 10 minutes for 60 minutes and awakening time at the post-anesthesia care unit. Results: The postanesthesia recovery scores on arrival, 10, 20, 30, 40 and 50 minute after arrival at the post-anesthesia care unit were lower in the IV-PCA group than in the control group. In addition the awakening time after vaporizer-off and at the post-anesthesia care unit was longer in the IV-PCA group than in the control group. Conclusions: We conclude that starting the infusion of the IV-PCA before the end of the operation is not effective in early recovery and awakening. (Korean J Anesthesiol 2001; 41: 318~323)

Dissipation Pattern of Flubendiamide on Jujube Fruits for Establishment of Pre-Harvest Residue Limits

Seung Woo Eun,Joo Yeong Byeon,Min Hye Kim,Su Bum Heo,Ga Ram Yu,Sang Hyun Sohn 한국농약과학회 2017 한국농약과학회 학술발표대회 논문집 Vol.2017 No.4

Integrating Protein Production in the Gnome-scale Metabolic Model of Pichia pastoris

Seung Min YOO,Seung Bum SOHN,Tae Yong KIM,Sang Yup LEE 한국생물공학회 2011 한국생물공학회 학술대회 Vol.2011 No.4

Lithofacies and volcano-sedimentary evolution of the Paleocene-Eocene Sejong Formation, Barton Peninsula, King George Island, Antarctica

Seung Bum Kim,Young Kwan Sohn,Moon Young Choe 대한지질학회 2003 대한지질학회 학술대회 Vol.2003 No.

Biological Effects of Ceramic-coating on Titanium

Sohn, Sung-Hwa,Lee, Jae-Bum,Kim, Ki-Nam,Kim, Hye-Won,Kim, In-Kyoung,Lee, Seung-Ho,Seo, Sang-Hui,Kim, Yu-Ri,Lee, Seung-Min,Shin, Sang-Wan,Ryu, Jae-Jun,Kim, Meyoung-Kon The Korean Society of Toxicogenomics and Toxicopro 2006 Molecular & cellular toxicology Vol.2 No.2

Several features of the implant surface, such as roughness, topography, and composition play a relevant role in implant integration with bone. This study was conducted in order to determine the effects of ceramic-coatings on Ti surfaces on the biological responses of a human osteoblast-like cell line (MG63). MG63 cells were cultured on Zr (Zrconium-coated surface), Nb (Niobium-coated surface), and control (Uncoated Titanium) Ti. The morphology of these cells was assessed by SEM. The cDNAs prepared from the total RNAs of the MG63 were hybridized into a human cDNA microarray (1,152 elements). The appearances of the surfaces observed by SEM were different on each of the three dental substrate types. MG63 cells cultured on Zr, Nb and control exhibited cell-matrix interactions. In the expression of several genes were up-, and down-regulated on the different surfaces. The attachment and expression of key osteogenic regulatory genes were enhanced by the surface morphology of the dental materials used.

Integral Square Error를 이용한 재폐로 시 전압 위상차에 따른 과도 안정도 분석

손승현(Seung-Hyun Sohn),오윤식(Yun-Sik Oh),강성범(Sung-Bum Kang),김철환(Chul-Hwan Kim),양정재(Jung-Jae Yang),오화진(Hwa-Jin Oh) 대한전기학회 2012 대한전기학회 학술대회 논문집 Vol.2012 No.10

두 가지 항부정맥 약제를 병용 투여하여 성공적으로 치료한 심실빈맥이 동반된 부자중독 1례 보고

유승목 ( Seung Mok Ryoo ),손창환 ( Chang Hwan Sohn ),오범진 ( Bum Jin Oh ),김원 ( Won Kim ),임경수 ( Kyoung Soo Lim ) 대한임상독성학회 2011 대한임상독성학회지 Vol.9 No.2

Aconitine is an anti-inflammatory agent with therapeutic uses in oriental medicine as an analgesic and for treatment of stroke. Because of its sodium channel effect, aconitine can promote undesirable, wide complex tachyarrhythmia. If tachycardia develops during use of aconitine, class Ia and class III anti arrhythmic drugs can be utilized for treatment. However there are no single anti-arrhythmia agents which are uniformly effective. We report a case, characterized by wide complex tachyarrhythmia and severe hypotension, which was successfully treated by simultaneous injections of amiodarone and lidocaine. A 59-year-old woman exhibiting clinical signs of drowsiness as a result of ingesting 6 g of aconitine, was admitted to the emergency department. Initially, wide complex tachyarrhythmia (ventricular tachycardia and pulse rate of 180 beats/min) and severe hypotension (blood pressure of 53/26 mmHg) was observed. After simultaneous injection of amiodarone and lidocaine, the patient’s rhythm pattern changed to an accelerated junctional rhythm with ventricular premature complex. Two hours later, the patient’s heart pattern became a sinus rhythm. As demonstrated by this case, simultaneous injections of amiodarone and lidocaine can be useful in treating ventricular arrhythmia induced by aconitine.