• Title/Summary/Keyword: 항생제 치료

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Changes in C-Reactive Protein and Complete Blood Cell Count According to Procalcitonin Levels (프로칼시토닌의 수준에 따른 C-반응성단백과 혈구산정검사의 변화)

  • Kim, Jin-San;Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.15-22
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    • 2022
  • Procalcitonin (PCT) can provide an experimental rationale and a diagnostic lead to distinguish between bacterial and viral infections. This study sought to investigate the clinical characteristics and prognosis of patients with high PCT levels, to improve clinical diagnosis, and to determine whether PCT levels were associated with the subsequent development of sepsis in the general population. This was a retrospective observational study conducted on outpatients (N=127) over a year. The general data and laboratory parameters studied were PCT, C-reactive protein (CRP), and complete blood count (CBC). The positive rates of CRP and white blood cells (WBCs) in the elevated PCT group were higher than those of the normal group (P<0.05); the specificity and sensitivity of the PCT levels were obviously higher than those of the CRP and WBC levels at diagnosis (P<0.05). The mean PCT levels in the low group were significantly higher than those in the high or moderate group (P<0.001). There was a significant positive correlation with CRP, total WBCs, and neutrophils (P<.001). The main finding of this study was the significant association between an elevated PCT level and CRP and WBC levels, signifying a high diagnostic value. This has important implications for the diagnosis of bacterial infections and therapeutic implications for the use of antibiotic treatment in specific patients.

Green Synthesis of Nanoceria and the Mechanism Behind Their Antibacterial Activity (나노세리아의 친환경 합성과 항균 활성 메커니즘)

  • Maheshkumar Prakash Patil;Yong-Suk Lee;Mi Jeong Jo;Yong Bae Seo;Gun-Do Kim
    • Journal of Life Science
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    • v.34 no.9
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    • pp.647-655
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    • 2024
  • The synthesis of cerium oxide nanoparticles (nanoceria, CeO2) has received significant attention across scientific and technological disciplines in the last decade. This article explores an overview of the green synthesis method and the antibacterial activity of nanoceria. The utilization of biological materials, such as plants and microorganisms, in the synthesis of nanoceria, has gained attention as an ecofriendly approach. Plants are rich in phytochemicals, including alkaloids, flavonoids, phenols, proteins, and other nutritious components. Likewise, microorganisms generate bioactive metabolites, pigments, enzymes, proteins, acids, and antibiotics. The phytochemicals and metabolites are involved in the reduction of metal salt into nanoceria and provide stability to synthesized nanoparticles. Nanoceria synthesis using plants and microorganisms is facile and ecofriendly, and synthesized nanoceria are biocompatible. Many biomedical applications of nanoceria have been reported, including those that are anticancer, anti-inflammatory, larvicidal, enzyme inhibiting, antibiofilm, and antimicrobial. However, in this review, we focused on and described in detail the antibacterial potential of nanoceria. The antibacterial activity of nanoceria occurs due to excessive reactive oxygen species generation, the impairment of the cell membrane, and the inhibition of cellular mechanisms. Ultimately, this review's primary goal is to provide readers with a logical understanding of the significant achievements of nanoceria as a cutting-edge therapeutic agent for treating a range of microbial pathogens and combating other diseases.

Clinical Analysis of Ectopic Kidney in Children (소아 이소성 신장의 임상적 고찰)

  • Yook Jin-Won;Kim Ji-Hong;Kim Myung-Joon;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.196-202
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    • 1999
  • Purpose : When the mature kidney fails to reach its norml location in the renal fossa, the condition is known as ectopic kidney. Presenting symtoms can be various and it generally depend on the associated anomaly. Beside urologic anomalies such as hydronephrosis and vesicoureteral reflux, various anomalous vascular net work, skeletal anomaly or genital anomaly can be observed in this condition. Methods : Sixteen children with ectopic kidney was studied retrospectively to analyse initial presentation, accompanied anomaly and prognosis. Results : 56% of the children were accompanied with other urologic anomalies such as true incontinence and vesicoureteral reflux that required surgical treatment. 31% of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : Ectopic kidney can be often misdiagnosed as tumorous condition or as a surgical condition depend on the abnormal location of the kidney. Careful evaluation using abdominal sonogram, DMSA, VCUG and abdominal CT scan should be performed in order to search for associated anomalous condition and for proper management.

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Studies on Development of Breeding Technique to Increase Hanwoo (Bos taurus coreanae) III. Hormonal Treatment of Reproductive Disorders and Effect of Intraovarian $\textrm{PGF}_{2a}$ Administration in Hanwoo (한우의 신속한 증식을 위한 번식기술 개발에 관한 연구 - III. 한우에서 번식장애 처치 및 $\textrm{PGF}_{2a}$의 난소실질내 투여효과에 관한 연구)

  • 손창호;오병철;임원호;백종환;오명환;이강남;정근기;강성근;김대영
    • Journal of Embryo Transfer
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    • v.17 no.2
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    • pp.153-162
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    • 2002
  • In order to develop the breeding techniques to increase Hanwoo (Bos taurus coreanae) population, the present study was performed 1) to establish the treatment protocol on reproductive disorders with GnRH or PGF/sub 2$\alpha$/, 2) to improve intraovarian PG $F_{2}$$\alpha$/ administration for reducing open period. Among total of 43 diagnosed, high percentage of cows (41.9%, 18 cows) were diagnosed as silent heat, followed by inactive ovaries (32.6%, 14 cows), ovarian cysts (9.3%, 4 cows), persistent corpus luteum (7.0%, 3 cows), endometriosis (4.7%, 2 cows), pyometra (2.3%, 1 cow) and luteal cysts (2.3%, 1 cow). To treat silent heat, 18 cows were administrated with 25 mg PGF/sub 2$\alpha$/, heat-detected, artificially inseminated and monitored pregnancy. All treated cows were heat-detected and 16 cows (88%) were successfully pregnant. With 200 $\mu\textrm{g}$ GnRH treatment, 7 cows (70%) with inactive ovaries and 3 cows (75%) with ovarian cysts were successfully pregnant. Administration with 25mg PGF/sub 2$\alpha$/, successfully treated 3 cows (100%) with persistent corpus luteum and 1 cow (100%) with luteal cysts, followed by 100% pregnancy rate. With the combined treatment of 25 mg PG $F_{2}$$\alpha$/and antibiotics, 2 cows (100%) with endometriosis were effectively treated and got pregnant after. artificial insemination (AI). In order to reduce open period, 5 mg PGF/sub 2$\alpha$/ was administrated intraovarian to 20 days cows after delivery, heat-detected, artificially inseminated and monitored pregnancy. In the first experiment, in order to recover uterus, 5mg PGF/sub 2$\alpha$/were administrated, followed by administration of 5mg PGF/sub 2$\alpha$/ at the interval of 14 days. As results, 74% (17/23 cows) of pregnancy rate after AI. In order to further reduce the open period, 5 mg PGF/sub 2$\alpha$/was administrated at the interval of 11 days without the period of uterus recovery, resulted in 94% (16/17 cows) pregnancy rate. In conclusion, these results showed that PGF/sub 2$\alpha$/ and GnRH treatment were effective hormonal treatment resume in Hanwoo with various reproductive disorders. In addition, modified protocol of intraovarian PGF/sub 2$\alpha$/ administration could be the effective method for reducing the open period.

A Clinical and Radiologic Study of Acute Focal Bacterial Nephritis in Children (소아에서의 급성 국소성 세균성 신장염의 임상 및 방사선학적 고찰)

  • Song, Kum Ho;Huh, Kwon Hoe;Cho, Ok Yeon;Sim, Jae Hoon;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang;Lee, Kwan Seop
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.351-357
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    • 2003
  • Purpose : To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies. Methods : From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a control group, 22 UTI patients with no radiologic abnormalities were selected and matched by age and sex. Results : The incidence of AFBN was more common in boys than in girls. Since both groups had similar symptoms, it was difficult to diagnose AFBN by clinical presentations alone. ESR and CRP were significantly higher in AFBN patients. The most common causative organism was E. coli in both groups. On the sonographic findings, the most lesions were seen on the upper lobe of the kidney; more frequently, on left kidney. The lesions showed globular or wedge-shaped increased echogenecity. $^{99m}Tc-DMSA$ scan showed the complete coincidence of the location, size and shape in all cases compared to the findings of renal sonography. Conclusion : The roles of renal sonography and DMSA scan were very important, and ultrasonography was an excellent initial tool in diagnosing AFBN. Since the degree of infection in AFBN is more severe than other urinary tract infections and evollution into a renal abscess is possible, early diagnosis and appropriate antibiotics therapy is essential.

A Clinical Study of Children Who Showed Benign Hemophagocytic Histiocytes in Bone Marrow Examination (골수 검사상 양성 혈구 탐식 조직구가 나타난 소아의 임상적 고찰)

  • Park, Jin A;Park, Joo Young;Park, Ji Min;Park, Seat Byoul;Kim, Heung Sik;Jeon, Dong Seok
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1007-1015
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    • 2002
  • Purpose : The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination. Methods : We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells. Results : The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes. Conclusion : Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.

The Effect of Low-dose Longterm Erythromycin on Bronchiectasis (기관지확장증에서 Erythromycin의 소량 장기투여 효과)

  • Kim, Young-Whan;Oh, Yeon-Mok;Jung, Man-Pyo;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.390-394
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    • 1993
  • Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.

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Prognostic Factors after Arthroscopic Treatment of Infectious Knee Arthritis (감염성 슬관절염의 관절경적 치료 이후 예후 인자에 대한 분석)

  • Kang, Sang-Woo;Choi, Eui-Sung;Kim, Dong-Soo;Jung, Ho-Seung;Hong, Seok-Hyun;Go, Ban-Suk
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.30-36
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    • 2019
  • Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

Clinical Study on Thoracic Actinomycosis (흉부 방선균종의 임상적 고찰)

  • Hong, Sang-Bum;Kim, Woo-Sung;Lee, Jae-Hwan;Bang, Sung-Jo;Shim, Tae-Son;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Lee, In-Chul;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1058-1066
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    • 1998
  • Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

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Dosage Adjustment before and after Warfarin - Rifampin Combination Therapy (와파린-리팜핀 병용 시 용량 조절)

  • Kim, Dong-Hyun;Kim, Kyung-Hwan;Choi, Kyung-Hee;Lee, Kwang-Ja;Lee, Hye-Suk;Son, In-Ja;Kim, Ki-Bong;Lee, Jae-Woong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.354-359
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    • 2008
  • Background: Warfarin is used as an anticoagulant and it is mainly excreted by the liver metabolism (the R-form is mainly metabolized by cytochrome p450 3A4, and the S form by cytochrome p450 2C9). Rifampin is usually used for tuberculosis or endocarditis, and it is a representative drug that induces the CYP families, including 3A4 and 2C9. The anticoagulation effect of warfarin decreases through the increased metabolism that's due to the induction of enzymes, and this iscaused by rifampin when patients take these two medicines together. No one has suggested appropriate guidelines regarding this drug interaction even though an appropriate adjustment of warfarin's dosage is needed. We examined the drug interaction in patients who received warfarin-rifampin combination therapy according to the time interval, and the factors affecting drug interaction were analyzed. Based on the data, we tried to determine the clinically available warfarin dosage guidelines before and after taking this drug combination. Material and Method: We reviewed the OO University Hospital anticoagulation service team's follow up sheets that were filled out from Jan '1998 to Sep 2006 for the patient who took warfarin - rifampin combination therapy (n=15). Result: The average INR of all the patient before rifampin administration was $2.25{\pm}0.52$ $(mean{\pm}SD)$, and that value for the first 100 days after rifampin administration was $1.98{\pm}0.28$. The p value for these two sets of data showed no correlation (paired t-test, p>0.05). The average INR of all the patient before rifampin cessation was $2.19{\pm}0.34$, and the value after rifampin cessation was $2.49{\pm}0.43$. The p value of these two showed correlation (paired t-test, p<0.05) but the average INR falls between the therapeutic INR range. Conclusion: The warfarin dose adjustment equation of before and after warfarin-rifampin combination therapy was derived based on this study's results because the warfarin dosage adjustment of the anticoagulation service team was considered appropriate.