• Archives of Pharmacal Research
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• 제18권2호
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• pp.84-89
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• 1995

The complexation and physical characteristics of egg phosphatidylcholine (PC) liposome containing amphotericin B(AmB) were investigated through circular dichrosim(CD) spectra, the size distribution, the turbidity change, and the calcein release. CD spectra of AmB-containing egg PC mxture exhibited a positive peak around 330 nm indicative of complexation of AmB and four negative peaks. The positive peak increased up to $2.2{\;}millidegree/{\mu}g$ AmB as AmB contents increased up to 12% (w/w), suggesting that AmB-phospholipid complexation was promoted by the antibiotics. The effective diameter of liposomesa by dynamic light scattering decreased from 450 nm to 220 nm as the amount of AmB in liposomes increased from o to 30% (w/w). The complexation may be responsible for the reduction in size. On the other hand, at around 1 mN deoxycholate (DOC), the reltive turbidities of 5 and 10% (w/w) AmB-containing liposome suspension were less than 1 probably due to the soblubilization of the complex, while those of pure PC liposome suspension were larger than 1 at the same concentration. Deoxycholate-induced release of liposomes, indicating the intercalation of the drug into the bilayers. Therefore, it is concluded that in AmB/eggPC/water system, AmB-phospholipid complexcoexists with AmB-containing liposomes.

• Mycobiology
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• 제31권2호
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• pp.95-98
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• 2003

Aantifungal agents were tested against 30 clinical isolates of Cryptococcus neoformans var. neoformans using the NCCLS method(M27-A2). Posaconazole, itraconazole and amphotericin B had lower MIC than the remaining four antifungal agents. The MIC result for posaconazole was over 220-fold lower active than fluconazole. Fluconazole MICs for most isolates fell within the dose-dependant range. The overall MIC ranges and $MIC_{50}s$ were amphotericin B(0.03-0.25; 0.25), fluconazole(0.5-64; 16), itraconazole(0.015-1; 0.125), terbinafine(0.06->2; 1), caspofungin(8-32; 32), voriconazole(0.015-0.5; 0.25), and posaconazole(0.015-0.25; 0.06 ${\mu}g/ml$), respectively. In conclusion, the $MIC_{50}s$ of these drugs did not exhibit any sign of an upward shift with the exception of fluconazole and tendency cross-resistance between the seven drugs was not observed. We conclude that in vitro resistance to antifungal agents has not significantly changed despite the recent wide-spread use of triazoles for long-term treatment of Cryptococcal meningitis.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.74-77
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• 2010

Rhino-orbital-cerebral (ROC) mucormycosis is an uncommon, acute and aggressive fungal infection. It remains a challenging problem to clinicians despite aggressive debridement surgery and antifungal therapy. The authors describe a case of ROC mucormycosis with pericranial abscess occurring in a female patient with uncontrolled diabetes mellitus. The infection initially developed in the right-sided nasal sinus and later progressed through the paranasal sinuses with the invasion of the peri-orbital and frontotemporal region, due to the delayed diagnosis and treatment. Numerous non-septate hyphae of the zygomycetes were identified by a punch biopsy from the nasal cavity and by an open biopsy of the involved dura. The patient was treated successfully with extensive debridement of her necrotic skull and surrounding tissues, drainage of her pericranial abscess and antifungal therapy, including intravenous amphotericin B for 61 days and oral posaconazole for the following 26 days. She returned to a normal life and has had no recurrence since the end of her treatment 15 months ago.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권1호
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• pp.69-73
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• 2004

뮤코르 진균증은 드물게 발생하지만 종종 치명적일 수 있으며, Phycomycetes종의 기회 감염에 의해 발생한다. 이 미생물은 부생의 호기성 진균(saprophytic aerobial fungus)이며 구강 점막, 부비동과 목에 통상적으로 존재하며 부패해 가는 식물, 거름, 고당 함유 음식 등에 나타난다. 뮤코르 진균증은 다양한 유형의 임상 형태로 면역결핍환자들에서 빠른 진행과 높은 치사율로 나타난다. 그러나 건강한 사람에서 두경부 영역에 감염된 예는 거의 없다. 본 교실에서는 58세 당뇨병이 있는 남자 환자에서 상악에 발생한 뮤코르 진균증의 증례에서 외과적 절제술과 ampotericin B의 정맥내 투여로 치료 되었으며, 현재까지 특별한 재발 소견 없이 양호한 결과를 얻었기에 이를 문헌 고찰과 함께 보고하는 바이다.

• 한국환경보건학회지
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• 제20권2호
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• pp.80-89
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• 1994

The effects of amphotericin B (150 $\mu$g/ml) and cycloheximide (10 $\mu$g/ml) on the biosynthesis of phospholipid and their fatty acid composition in chloroplast isolated from Chlorella were analyzed to compare with control. The levels of total lipid, phosphatidylethanolamine (PE), and phosphatidylcholine (PC) in the group treated with antibiotics were decreased. However, the biosynthesis of phosphatidylinositol (PI) was not affected by antibiotics. The major fatty acid in chloroplast envelope was linolenic acid (27.71%) in control and stearic acid (21.59%) in the group treated with amphotericin B. It was showed that the group treated with cycloheximide contained more unsaturated fatty acid than the control.

• Journal of Oral Medicine and Pain
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• 제39권1호
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• pp.29-33
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• 2014

Mucormycosis is a rare but fatal fungal infection with low survival rate in immune-compromised patients. It is caused by a fungus belonging to the Mucoraceae family of the Zygomycetes class. Mucormycosis is classified as rhino-orbital-cerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and miscellaneous types according to its clinical manifestations. Early diagnosis and treatment along with correction of the underlying medical condition is important for favorable results. This case presentation describes mucormycosis involving the anterior maxillary region in a leukemic patient with prolonged neutropenia. The patient benefited from a timely biopsy and immediate treatment with amphotericin B, and was successfully managed with an interdisciplinary team approach consisting of dental and several medical specialists.

• 한국미생물·생명공학회지
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• 제25권3호
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• pp.335-337
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• 1997

In this study, we show a convenient MTT assay for detect the susceptibility of yeast-like form of Trichosporon beigelii against antifungal agents. This assay was developed based on mitocondrial respiration by determining reduction of 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) to formazan. Cells of T beigelii are seeded into 96-well microtiter plates, and antifungal agents, amphotericin B, magainin and CA-ME hybrid peptide were added with various concentrations. After 24 hr incubation, MTT was added, then incubations were continued for 4 hr. Formazan formation was quantified photometrically after extraction of the formazan with acid sodium dodesyl sulfate (SDS). From this assay, we could obtained MICs of antifungal agents against T. beigelii. The presented method can easily be used as an effective methods to assess the antiftingal action of various agents on yeasts with minimal amounts of antifungal agents.

• Tuberculosis and Respiratory Diseases
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• 제45권6호
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• pp.1199-1213
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• 1998

연구배경 : 최근 면역기능저하 환자들이 급증하고 있으며 이들에 있어서 새로 발생된 설명이 불가능한 폐침윤은 매우 흔하면서도 환자의 생명을 위협할 수 있는 상황으로 발전할 수 있다. 폐진균증은 이런 임상상에서 폐침윤의 중요한 원인으로 대두되고 있으나 이에 대한 연구가 많지 않아 본 연구를 시행하였다. 방 법 : 1996년 10월부터 1998년 4월까지 삼성서울병원에서 면역기능저하 환자 중 새로운 폐침윤이 있었던 환자로 조직학적으로 폐에서 진균이 증명되었거나 정상적으로 균이 자리지 않는 부위(sterile)에서 시행한 배양검사장 진균이 배양된 환자들을 대상으로 임상적 특정, 방사선학적 소견, 진단적 검사, 치료 및 그 결과에 대해 후향적인 조사를 시행하였다. 결 과 : 총 13명의 환자 (M : F=8 : 5, 연령 중앙값 47세)에서 14예의 폐진균증이 진단되었다. 진단은 asperogillosis가 12예였고 mucormycosis가 2예였다. 혈액암 환자 9명에서 10예, 장기이식 환자에서 4예의 폐진균증이 진단되었다. 3예에서는 진단당시 경험적 amphotericin B를 중앙값 9일(8-21일)간 투여받고 있었다. 혈액암군 10예 중 9예에서 폐침윤 발견당시 백혈구 감소증이 중앙값 16일동안 지속되었으며 발열(9/10), 기침(6/10), 가래(5/10), 호흡곤란(4/10), 흉통 (5/10), 악설음(4/10) 등의 증상과 징후가 흔하게 관찰되었다. 반면에 장기이식환자군에서는 증상 및 징후가 뚜렸하지 않은 경우가 많았다(p<0.05). 단순 흉부촬영상으로 새로운 폐침윤은 단일 혹은 다발성의 결절(6/14)이나 경결(consolidation)(8/14)의 형태로 나타났으며 흉부 단층촬영상에서는 간유리음영(14/14), 흉수(5/14), 동공형성(7/14) 등의 소견이 관찰되었다. 확진한 방법으로는 개흉술이 10예, 비디오 흉강경술이 2예, 경피적침흡인술이 1예, 농양의 농 배양검사가 1예였다. 모든 환자는 amphotericin B(591-2806mg) 투여를 받았으며 1예에서 liposomal amphotericin B, 1예에서 경구 itraconazole로 치료를 부분적으로 시행하였다. Amphotericin B 투여 후 12/14예에서 폐병변의 호전이 관찰되었으며 14예중 4예에서 사망하거나 회복이 불가능한 상태로 퇴원하였다. 결 론 : 혈액암의 치료로 과립구감소증이 있는 환자나 장기이식 환자에서 새로운 폐침윤이 결절이나 경결의 형태로 발현하면, 증상이 미미하거나 경험적 amphotericin B를 투여하고 있더라도 폐진균증을 의심을 해야하며 적극적인 진단과 치료로써 예후를 호전시킬 수 있을 것으로 기대된다.

• Journal of Chest Surgery
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• 제30권3호
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• pp.330-335
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• 1997

아스페르길루스 감염증은 드물기는 하지만 면역 억제된 상황에서는 비교적 잘 발생하며 치사율도 높은 것으로 알려져 있다. 경구 또는 정맥내 치료제가 있기는 하지만 합병증이 많고 장기간 사용해야 하기 때문에 치료효과는 크게 기대할 수 없는 경우가 많다. 따라서 환자에 따라서는 외과적 요법을 병행하여 치료효과를 높이는 방법도 사용하고 있다. 세종병원에서는 지금까지 실시한 15례의 심장이식환자중 2 례의 폐 아스페르길루스증을 경 험하였기 에 보고하는 바이다. 두 환자 모두 나이와 수술시기가 비슷하였 으며 수술후 약 3주후 외래에서 흉부 X-선상 폐병변을 발견하였다 경피적 천자생검상 Aspergillus fumigatus로 확인되어 정맥내 Amphotericin B와 경구용 Itraconazole을 병용한 항진균제요법을 실시하 였으며 두번째 환자는 병변이 우하엽에 국한되어 외과적 절제술을 병용하였다. 첫번째 환자는 이식후 14개월째 양호한 상태로 추적중이며 두번째 환자는 치료 완료후 3개월째 비세포성 거부반응으로 사망하였다.

• Journal of Microbiology and Biotechnology
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• 제21권1호
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• pp.28-36
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• 2011

Diblock copolymers composed of poly(${\varepsilon}$-caprolactone) (PCL) and poly(N,N-dimethylamino-2-ethyl methacrylate) (PDMAEMA), or methoxy polyethylene glycol(PEG), were synthesized via a combination of ring-opening polymerization and atom-transfer radical polymerization in order to prepare polymeric nanoparticles as an antifungal drug carrier. Amphotericin B (AmB), a natural antibiotic, was incorporated into the polymeric nanoparticles. The physical properties of AmB-incorporated polymeric nanoparticles with PCL-b-PDMAEMA and PCL-b-PEG were studied in relation to morphology and particle size. In the aggregation state study, AmB-incorporated PCL-b- PDMAEMA nanoparticles exhibited a monomeric state pattern of free AmB, whereas AmB-incorporated PCL-b- PEG nanoparticles displayed an aggregated pattern. In in vitro hemolysis tests with human red blood cells, AmBincorporated PCL-b-PDMAEMA nanoparticles were seen to be 10 times less cytotoxic than free AmB (5 ${\mu}g$/ml). In addition, an improved antifungal activity of AmBincorporated polymeric nanoparticles was observed through antifungal activity tests using Candida albicans, whereas polymeric nanoparticles themselves were seen not to affect activity. Finally, in vitro AmB release studies were conducted, proving the potential of AmB-incorporated PCL-b-PDMAEMA nanoparticles as a new formulation candidate for AmB.