고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

우리나라 상차림의 영양적 평가

김영순,이정희,오순덕,김수현,이정민,남택수,박태식,천유정 高麗大學校 倂設 保健大學 保健科學硏究所 2002 保健科學論集 Vol.28 No.1

This study was carried out to investigate the current nutritional problems owing to the increased consumption of westernized food in Korea and also was conducted to compare the nutritional characteristics of Korean traditional meal with those of the Western diet in similar serving size. The results obtained from nutritional evaluation are as follows: 1. The percentage of calories represented by carbohydrate: lipid: protein was 65:15:20 respectively for Korean traditional meal (Table setting of 3 Chop) therefore these ratios meet the dietary recommended allowances for Koreans. 2. Nutrient values of Korean traditional 3-Chop were shown to be better balanced than those of Western diet when the nutrients of the two types of diet were estimated by similar serving sizes and calories. 3. Compared to the Korean traditional meal, most fast foods were nutritionally imbalanced especially in that most of them showed higher amounts of fats. These results show that Korean traditional meals supply ideal nutrient intakes in contrasts to the westernized diet, therefore much work remains in developing a variety of menus and standard recipes for Korean traditional meals according to the changes in diet trends as well as emphasing the importance of Korean traditional meals as part of an ideal, well-banlanced diet.

정신분열병 환자에서 올란자핀과 연관된 체중 증가에 대한 니자티딘과 효과 : 예비 연구 A Pilot Study

배치운,정유경,이창옥,이수정,이철,백인호 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.1

본 연구는 올란자핀을 투여 후 체증 증가가 관찰된 정신분열병 환자들을 대상으로 nizatidine의 효과를 조사하고자 시도되었다. 올란자핀을 처으 투여 받은 환자들 중 체중 증가가 발생된 10명을 대상으로 하였다. 모든 환자에게 nizatidine을 300mg/day로 투여하였으며 임상 증상에 미치는 영향을 배제하기 위하여 PANSS와 BPRS를 기저 시점과 nizatidine 투여 후 4주 및 8주 시점에 측정하여 임상 증상의 변화를 평가하였다. 연구 시작 후 4주 및 8주 시점에서 체중 변화는 각각 1.1kg(1.5%)와 2.5kg(3.5%)이었으며 BMI의 경우 4주와 8주 시점에서 각각 0.4(1.6%)와0.9(3.7%)로 연구 기간동안 모두 유의한 감소를 보였다. 올란자핀을 복용하여 체중 증가가 관찰되었던 10명의 정신분열병 환자를 대상으로 하여 8주간 nizatidine을 투여한 결과, 연구 방법상의 제한점이 있으나 nizatidine은 올란자핀 관련 체중 증가의 치료에 효과적인 약물로 생각된다. Objectives:This pilot study was conducted to evaluate the effect of nizatidine on olanzapine-associated weight gain(OAWG) in schizophrenic patients in Korea. Methods:Ten subjects with OAWG from outpatients clinic who were diagnosed with schizophrenia and schizophreniform disorder in accordance with DSM-IV criteria. Positive and Negative Syndrome Scale(PANSS) and Brief Psychiatric Rating Scale(BPRS) were measured at baseline, week 4 and week 8 as were weight and Body Mass Index(BMI). A flexible dose of olanzapine plus fixed 150mg(b.i.d) dose of nizatidine was administered to all patients. Weight and BMI(kg/m^2) were recorded at each visit. Results:A combination of nazatidine resulted in significant reversal of OAWG without worsening the psychopathology. In the with studies of Western populations, an add-on therapy of nizatidine could be an effective option for the control of weight gain in olanzapine-treated patients in Korea. Conclusion:Our finding call for further evaluation of the effect of this drug on schizophrenics, with randomized placebo-controlled studies, in Asian populations.

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.

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.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

2-구획 인공 모세혈관 모델을 이용한 Pseudomonas aeruginosa 임상균주에 대한 Panipenem의 효과

이동건,전혜선,최수미,최정현,유진홍,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적 : Panipenem은 일본에서 개발된 카바페넴계 항생제로 광범위한 항균력을 나타낸다고 보고되고 있지만 P. aeruginosa에 대해서는 아직 논란이 있다. 본 연구에서는 임상에서 분리된 P. aeruginosa 균주를 대상으로 사람의 약역학을 모의할 수 있는 시험관내 역동 모델을 이용하여 panipenem (PAPM)과 imipenem (IMPM)의 효과를 비교하고 Muller-Hinton broth (MHB)와 basic amino acid 함량이 적은 배지(Minimum Broth Davis, MBD)에 효과의 차이가 있는지 확인하고자 하였다. 재료 및 방법 : 혈액에서 분리된 P. aeruginosa SGP14 균주를 대상으로 하였다. 사람의 약동학을 모의할 수 있는 2-구획 인공 모세혈관 모델(two-compartment model)을 제작하였고, 세균이 peripheral compartment에서 반감기에 따라 농도가 변하고 있는 항생제에 노출되고, 접종한 세균의 수는 희석되지 않게 하였다. PAPM과 IMPM의 용량은 500mg씩 하루 2회를 모의하도록 하였고 2일간 실험하였다. Panipenem, imipenem의 반감기는 사람의 약역학과 같이 10시간에 맞추었다. 항생제 투여 간격은 panipenem, imipenem 모두 12시간으로 하였고 각 항생제의 최고 및 최저농도는 사람에 투여했을 때의 혈중농도에 맞추었다(panipenem 각각 45.6, 0 ug/mL, imipenem 각각 33.0, 0 ug/mL). 배지는 MHB와 MBD를 사용하였고 4군으로 나누어 실험하였다. [PAPM (MHB), PAPM (MBD), IMPM (MHB), IMPM (MBD)] peripheral compartment에서 0, 1, 2, 4, 6, 8, 12, 24, 32, 48시간에 맞춰 샘플을 하였고 집락수 (cfu/mL)를 측정하였다. 결과 : SGP14에 대한 PMPM, IMPM의 MIC는 각각 64, 2 ug/mL이었다. PAPM (MHB)는 2시간이 지나면서 다시 자라기 시작하여 32시간째부터는 항생제를 사용하지 않은 대조군과 같은 곡선을 보였다. 12시간까지의 집락수 변화는 4가지 실험군에서 군간 의미있는 차이를 보이지 않았지만(P=0073) 군내의 PAPM (MHB)가 PAPM(MBD), IMPM (MBD)와 비교하여 집락수 변화가 유의하게 작았다. 또한 48시간까지의 집락수 변화는 PAPM(MBD)이 가장 많았고, 그 다음이 IMPM (MHB), IMPM(MBD)였으며, PAPM(MHB) 순이었다(P=000). 48시간까지 집락수 변화는 IMPM (MHB)와 IMPM (MBD)사이에 차이가 없었다. 결론 : 사람의 혈청내 basic amino acid 농도와 PAPM의 농도를 모의하도록 한 2-구획 인공 모세혈관 모델에서 PAPM은 IMPM과 비교하여 P. aeruginosa에 대해 비슷하거나(12시간째) 더 나은 살균력을 보였다(48시간째). 추후 본 실험의 결과와 실제 임상에서의 P. aeruginosa에 대한 panipenem의 효과를 비교해보는 것이 필요하겠다. Background : Panipenem (PAPM) is a new carbapenem which has an enhanced broad spectrum activity against both gram-positive and negative organisms. However, its activities in vitro against Pseudomonas aeruginosa are still under controversy. The aim of this study was to compare the activity of PAPM with those of imipenem (IMPM) against clinical isolates of P. aeruginosa using in vitro kinetic model and to evaluate the differences according to the quantity of basic amino acid in media. Materials and methods : Using a clinical isolate of P. aeruginosa (SGP14) from blood, an in vitro 2-compartment artificial capillary model based on a dialyzer unit was prepared. Antibiotics were given as a bolus q12 hrs for 48 hrs. Simulated doses and frequencies of PAPM and IMPM were 500 mg q12 hrs as approved by Korea Food and Drug Administration. Muller-Hinton broth (MHB) and minimal broth Davis (MBD) were used as culture media and we divided the experiments into 4 groups [PAPM (MHB), PAPM (MBD), IMPM (MHB), IMPM (MBD)]. At 0, 1, 2, 4, 6, 8, 12, 24, 32, and 48 h, samples were removed from peripheral compartment and viable bacterial counts were measured. Results : The susceptibility of PAPM and IMPM for SGP14 were 64 and 2 ug/mL in MHB and 4 and 2 ug/mL in MBD, respectively. Up until 12 hours, changes in bacterial colony counts were not significantly different (P=0.073) for each group. However among the four groups, PAPM (MHB) showed the least changes compared with PMPM (MBD), IMPM (MBD). The largest decrement of colony during 48 hours was observed with PMPM (MBD), followed by IMPM (MHB) or IMPM (MBD), and PAPM (MHB) in decreasing order (P=0.00). There were no differences between IMPM (MHB) and IMPM (MBD) as for the change in colony counts. Conclusions : The bactericidal activities of panipenem against the clinical isolate of P. aeruginosa was similar (at 12 h) or superior (at 48 h) to that of imipenem in an in vitro 2-compartment artificial capillary model using minimal broth to simulate human serum drug concentrations.

약물의 in vitro 투과 실험을 위한 사람의 비강점막상피세포 단층막의 일차배양

유진욱,김유선,이민기,노환중,이치호,김대덕 한국약제학회 2002 Journal of Pharmaceutical Investigation Vol.32 No.1

The primary culture of human nasal epithelial cell monolayer was performed on a Transwell. The effect of various factors on the tight junction formation was observed in order to develop an in vitro experimental system for nasal transport studies. Human nasal epithelial cells, collected from human normal inferior turbinates, were plated onto diverse inserts. After 4 days, media of the apical surface was removed for air-liquid interface (ALI) culture. Morphological characteristics was observed by transmission electron microscopy (TEM). A polyester membrane of 0.4 μm pore size was determined as the most effective insert based on the change in the transepithelial electric resistance (TEER) value as well as the ^14C-mannitol transport study. The ALI method was effective in developing the tight junction as observed in the further increase in the TEER value and reduction in the permeability coefficient (P_app) of ^14C-mannitol transport. Results of the transport study of a model drug, budesonide, showed that the primary culture system developed in this study could be further developed and applied for in vitro nasal transport studies.

Panipenem을 포함한 Carbapenem 계열 항생제의 몇 가지 임상균주에 대한 시험관내 항균력

이동건,김명신,강진한,전혜선,최수미,위성헌,김상일,최정현,유진홍,신완식,강문원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

목적 : Panipenem은 일본에서 개발된 카바페넴계 항생제로 그람양성균, 그람음성균, 혐기균에 이르기까지 광범위한 항균력을 나타낸다고 보고되고 있지만 국내에서 분리되는 균주에 대한 감수성 검사결과는 아직 없다. 본 연구에서는 임상에서 분리된 E. coli, K. pneumoniae, P. aeruginosa, S. pneumoniae 균주를 대상으로 carbapenem 계열 및 몇 가지 항생제와 감수성을 비교하고, 특히 P. aeruginosa의 경우 carbapenem의 효과를 Muller-Hinton agar (MHA)가 반감시킬 수 있는 특성을 고려하여 감수성에 변화가 있는지 확인하고자 하였다. 방법 : 2002년 3월부터 6월까지 가톨릭대학교 성모병원, 강남성모병원, 성가병원, 성모자애병원, 성빈센트병원에서 분리된 임상균주 E. coli, K. pneumoniae, P. aeruginosa, S. pneumoniae를 대상으로 하였다. 항생제 감수성 검사는 NCCLS 기준에 따랐고 P. aeruginosa의 경우 MHA 이외에 minimal agar Davis (MAD)를 추가로 사용하였다. 감수성 결과 해석시 panipenem은 imipenem과 같은 기준을 적용하였다. 결과 : E. coli, K. pneumoniae, P. aeruginosa는 각각 100균주였고, S. penumoniae는 134균주였다(PSSP 41, PNSP 93균주). E. coli, K. pneumoniae는 모든 균주가 imipenem, meropenem, panipenem에 대해 감수성을 보였다. P. aeruginosa의 경우 imipenem, meropenem, panipenem, ceftazidime의 MIC_(90)은 각각 16, 8, 32, 64㎍/mL이었다. MHA와 MAD 배지를 이용하여 P. aeruginosa에 대한 항생제 감수성을 비교해 본 결과 imipenem, panipenem의 MIC_(90)가 각각 16, 32㎍/mL에서 8㎍/mL로 감소하였고, imipenem에 비해 panipenem이 더 많이 감소하였다. S. pneumoniae의 경우 PSSP는 imipenem, meropenem, panipenem에 대해 모두 내성이 없었고 PNSP는 imipenem, meropenem, panipenem에 대한 MIC_(90)가 각각 1, 2, 0.25㎍/mL이었다. 결론 : 결론적으로 panipenem은 E. coli, K. pneumoniae에 대해 기존의 카바페넴계 항생제와 유사한 우수한 항균력을 보였다. P. aeruginosa의 경우 ceftazidime, imipenem과 비슷한 항균력을 보였고 아미노산 함량이 적은 배지를 사용함에 따라 MIC가 낮아졌으며 imipenem보다 더 많은 영향을 받았다. S. pneumoniae의 경우 특히 PNSP에서 기존의 카바페넴계 항생제보다 우수한 항균력을 보였다. Panipenem은 주요 그람음성균 및 폐렴연쇄구균 감염에 유용할 것으로 기대된다. Background : Panipenern (PAPM) is a new carbapenern which has an enhanced broad spectrum against both gram-positive and negative organisms. The aim of study was to compare the activities of PAPM with those of imipenern (IMPM), meropenern (MRPM) against several clinical isolates in Korea. Methods : We tested the in vitro antimicrobial activities of PAPM, IMPM, and MRPM against total 300 clinical isolates of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa and 134 Streptococcus pneumoniae collected from 5 different university hospitals. Using NCCLS guidelines, MICs of PAPM, IMPM, MRPM, and/or ceftazidime were determined. Results : All isolates of E. coli and K. pneumoniae were susceptible to PAPM, IMPM and MRPM. MIG_(90) of PAPM, IMPM, and MRPM against P. aeruginosa were 32, 16, and 8 ㎍/mL, respectively. Comparing Mueller-Hinton agar (MHA) and minimal agar Davis (MAD), the MIG_(go) of PAPM and IMPM were reduced from 16 and 32 ㎍/mL to 8 and 8 ㎍/mL, respectively. PAPM was more influenced by MAD than IMPM. All isolates of penicillin susceptible S. pneumoniae showed 0% of resistance to the carbapenems tested. MIC_(90) of PAPM, IMPM and PRPM against penicillin non-susceptible S. pneumoniae were 0.25, 1 and 2 ㎍/mL, respectively. Conclusion : Panipenern could be one of the potentially useful drugs for the treatment of infections caused by E. coli, K. pneumoniae, and S. pneumoniae. We also showed that PAPM had good anti-pseudomonal activity when examined in MAD, the amino acid-limited media. Therefore, it could be useful for the treatment of infections caused by P. aeruginosa.

Modified 9Cr-1Mo 강의 항온변태처리에 따른 미세조직 및 경도변화

유정훈,주성욱,허성강,신기삼,이수,정연길 국립7개대학공동논문집간행위원회 2003 공업기술연구 Vol.3 No.-

Evolution of microstructure and its relation with hardness in the modified 9%Cr-1%Mo steel which was isothermally heat-treated has been investigated in various heat-treatment temperatures and time of duration. For microstructural and crystallographic analyses, optical microscope, scanning and transmission electron microscopes, energy dispersive spectrometer, and X-ray diffractometer were used. Vickers microhardness tester were used for the measurement of hardness. Precipitates of the complex M23C6, M(C,N) formed at grain boundaries and interiors of grains had led to the secondary hardening. Normalized specimen and all of the isothermally heat-treated ones showed no evidence of retained austenite.