• 호남수학학술지
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• 제31권1호
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• pp.109-124
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• 2009

Based on the observed data for Clarithromycin released, three commonly used inflow models: the power, the exponential, and the logarithmic models are considered. Among them, the power model is used most in practice for simplicity. Using the numerical parameter estimation techniques, the parameters appeared in the model equations are estimated. Through the numerical estimation results using the several experimental data sets, the exponential model turns out to be best among the three models. More specifically, the sum of squares of absolute errors and the sum of squares of relative errors for the exponential model are reduced by 80-95 % for the experimental data sets and 60-90 % for the noise added data sets compared with those for the power and logarithmic models. A typical experimental data set is used in this paper to show the estimation method and its numerical results. The proposed numerical method and its algorithm are designed for estimating the parameters appeared in the model differential equations for which the exact form of the solution is unknown in general. The methodology developed can be applied to more general cases such as the nonlinear ordinary differential equations or the partial differential equations.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9909-9913
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• 2014

Background: Helicobacter pylori (H. pylori) remains an important cause of gastric cancer and peptic ulcer disease worldwide. Treatment of H. pylori infection is one of the effective ways to prevent gastric cancer. However, standard triple therapy for H. pylori eradication is no longer effective in many countries, including Thailand. This study was designed to evaluate the efficacy of adding bismuth and probiotic to standard triple therapy for H. pylori eradication. Materials and Methods: In this prospective single center study, H. pylori infected gastritis patients were randomized to receive 7- or 14-day standard triple therapy plus bismuth with probiotic or placebo. Treatment regimen consisted of 30 mg lansoprazole twice daily, 1 g amoxicillin twice daily, 1 g clarithromycin MR once daily and 1,048mg bismuth subsalicylate twice daily. Probiotic bacteria composed of Bifidobacterium lactis, Lactobacillus acidophilus and Lactobacillus paracasei. Placebo was conventional drinking yogurt without probiotic. CYP2C19 genotyping and antibiotic susceptibility tests were also done. H pylori eradication was defined as a negative $^{13}C$-urea breath test at least 2 weeks after completion of treatment. Results: One hundred subjects were enrolled (25 each to 7- and 14-day regimens with probiotic or placebo). Antibiotic susceptibility tests showed 36.7% metronidazole and 1.1% clarithromycin resistance. CYP2C19 genotyping revealed 40.8%, 49% and 10.2% were rapid, intermediate and poor metabolizers, respectively. The eradication rates of 7- or 14 regimens with probiotics were 100%. Regarding adverse events, the incidence of bitter taste was significantly lower in the 7- day regimen with the probiotic group compared with 7- day regimen with placebo (40% vs. 64%; p=0.04). Conclusions: The 7-day standard triple therapy plus bismuth and probiotic can provide an excellent cure rate of H. pylori (100%) in areas with low clarithromycin resistance such as Thailand, regardless of CYP2C19 genotype. Adding a probiotic also reduced treatment-related adverse events.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 1996년도 정기총회 및 추계학술대회
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• pp.29-30
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• 1996

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
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• pp.127.1-127.1
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• 2003

The purpose of this study is to investigate the prevalence of resistance to macrolide, lincosamide, streptogramin and ketolide antibiotics in Korea. The antibiotic susceptibility test was performed to the macrolide erythromycin, clarithromycin, azithromycin, josamycin, the lincosamide clindamycin, the streptogramin synercid and the ketolide ABT -773 against 337 clinical Staphylococcus aureus(SAU). Coagulase-negative Staphylococci (CNS) and Enterococci isolates exhibited an average percentage of 64％, 56％, and 81 ％ of resistance to erythromycin, respectively.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.759-767
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• 2014

Background Infection caused by nontuberculous mycobacteria (NTM) has been increasing. Awareness of this infection is crucial yet problematic. Delayed management may lead to destructive results. We empirically treated a series of patients with clinical suspicion of NTM infection prior to the identification of the pathogen. Methods A total of 12 patients who developed surgical site infections between January 2011 and February 2014 were reviewed. Patients with a skin and subcutaneous infection resistant to standard management over two weeks, and previous history of aesthetic procedures within three months were regarded as highly suspected of having an NTM infection. A variety of diagnostic modalities were examined simultaneously, along with starting empirical treatment including a combination of clarithromycin and moxifloxacin, and surgical debridement. Results All wounds healed completely within 4 weeks. The mean follow-up duration was 7.2 months, and none of the patients developed relapse. Specific NTM pathogens were identified in six patients. Eight patients showed caseating granuloma implying an NTM infection. One patient showed an uncommon Stenotrophomonas infection, which was successfully treated. Three patients had no evidence of a pathogen despite repeated microbial tests. Complications such as scarring, pigmentation, and disfigurement were common in all the patients. Conclusions NTM should be considered in the differential diagnosis of an unusual skin and soft-tissue infection. We propose an empirical regimen of clarithromycin and moxifloxacin as an efficient treatment option for an NTM infection.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.201-206
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• 2010

Nontuberculous mycobacterial (NTM) diseases are increasing worldwide. However NTM lung disease in organ transplant recipients has been rarely reported. Here, we report 2 cases of NTM lung disease in heart transplant recipients. A 37-year-old man, who had undergone a heart transplant one year previous, was admitted to hospital due to a cough. Chest CT scan showed multiple centrilobular nodules in both lower lungs. In his sputum, M. abscessus was repeatedly identified by rpoB gene analysis. The patient improved after treatment with clarithromycin, imipenem, and amikacin. An additional patient, a 53-year-old woman who had undergone a heart transplant 4 years prior and who suffered from bronchiectasis, was admitted because of purulent sputum. The patient's chest CT scan revealed aggravated bronchiectasis; M. intracellulare was isolated repeatedly in her sputum. Treatment was successfully completed with clarithromycin, ethambutol, and ciprofloxacin. NTM lung disease should be considered as a potential opportunistic infection in organ transplant recipients.

• Clinical and Experimental Pediatrics
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• 제52권7호
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• pp.832-836
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• 2009

증식성 기관지염(plastic bronchitis)는 기관지 내부에 폐쇄성 원주(cast)를 만드는 드문 질환으로 천식이나 선천성 심장병의 폰탄 수술 후 합병증으로 생길 수 있다. 증식성 기관지염의 치료는 원주를 스스로 뱉거나 기관지경으로 제거해주는 고식적인 치료와 새로 개발된 약제를 사용하는 단기 및 장기 치료로 나눌 수 있다. 저자들은 기저 질환이 없이 갑작스런 호흡 부전과 왼쪽 폐 전체의 무기폐를 보인 8세 남아와 폰탄 수술 병력이 있고 반복되는 오른쪽 중엽과 하엽의 무기폐를 보인 5세 여아에서 기관지 내시경을 통해 기관지내 원주를 확인하였고, 조직학적 검사에서 호산구, 호중구, 임파구와 같은 염증 세포를 포함한 점액질과 섬유질로 구성되어 있어 증식성 기관지염으로 진단후 재발 방지를 위해 흡입용 스테로이드와 저용량 경구용 clarithromycin을 사용한 경험을 문헌고찰과 함께 보고하는 바이다.

• Gut and Liver
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• 제12권6호
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• pp.648-654
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• 2018

Background/Aims: Dual priming oligonucleotide-based multiplex polymerase chain reaction (DPO-based PCR) can detect the presence of clarithromycin resistance without culture. The aim of this study was to investigate the cost-effectiveness of DPO-based PCR for Helicobacter pylori eradication. Methods: From 2015 to 2016, medical records of patients who received H. pylori eradication therapy were analyzed. Patients were divided into two groups: tailored group patients who were treated based on DPO-based PCR and empirical group patients. Eradication rate and medical cost, including diagnostic tests, eradication regimens, and $^{13}C$-urea breath tests, were compared between the two groups. Cost for one successful eradication was calculated in each group. The expected cost of eradication for empirical treatment was investigated by varying the treatment duration and eradication rate. Results: A total of 527 patients were analyzed (tailored group 208, empirical group 319). The eradication success rate of the first-line therapy was higher in the tailored group compared to that in the empirical group (91.8% vs 72.1%, p<0.01). The total medical cost for each group was $114.8{\pm}14.1U.S.$ dollars (USD) and $85.8{\pm}24.4USD$, respectively (p<0.01). The total medical costs for each ultimately successful eradication in the tailored group and in the empirical group were 120.0 USD and 92.4 USD, respectively. The economic modeling expected cost of a successful eradication after a 7- or 14-day empirical treatment was 93.8 to 111.4 USD and 126.3 to 149.9 USD, respectively. Conclusions: Based on economic modeling, the cost for a successful eradication using DPO-based PCR would be similar or superior to the expected cost of a successful eradication with a 14-day empirical treatment when the first-line eradication rate is ${\leq}80%$.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제1권1호
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• pp.37-44
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• 1998

목 적: H. pylori 감염증에 대한 치료요법은 성인의 경우 여러가지 방법이 알려져 있으나 국내에서 소아를 대상으로 한 H. pylori 치료결과에 대한 연구보고는 미미하다. 이에 저자들은 소아에서의 H. pylori 감염증에 대한 치료결과 및 재발률을 조사하고, 아울러 효과적이고 경제적인 치료방법을 찾아보고자 하였다. 대상 및 방법: 1993년 11월부터 1997년 8월까지 복통 또는 상부위장관 출혈을 주소로 연세의대 세브란스병원 소아과에 내원하여 상부위장관 내시경검사와 Warthin-Starry 은염색, CLO검사 결과 H. pylori 감염증으로 진단된 환아 120례 중 치료 후 추적관찰이 가능하였던 75례를 대상으로 하였다. 대상환아는 남아가 39례, 여아가 36례였으며, 평균연령은 $11.4{\pm}2.5$세였다. 대상환아들은 초기약제로 DA($Denol^{(R)}$과 amoxycillin), OA(omeprazole과 amoxycillin) 또는 DC($Denol^{(R)}$과 clarithromycin) 등 세가지 요법중 한가지를 투여하였고, 제균에 실패한 환아에 대해서는 DAM($Denol^{(R)}$과 amoxycillin, metronidazole), DC, OA, OC(omeprazole과 clarithromycin) 중 한가지를 2~4주간 투여하였으며, 치료종결 4주 후 H. pylori 제균 여부를 진단시와 동일한 방법으로 판정하였다. 결 과: 대상환아의 상부위장관질환은 만성 결절성위염 46례, 위궤양 9례, 십이지장궤양 6례, 표재성위염 6례 및 정상 8례 등이었다. DA는 69례에서 투여되어 이중 63례(91%)에서 H. pylori가 제균되었고, DAM은 DA에 실패한 2례중 1례, DC는 초기 치료한 4례중 3례(75%)와 DA에 실패한 2례중 1례(50%)에서, OA는 초기치료한 2례에서, OC는 DA에 실패한 1례에서 모두 제균되였다. 치료 후 H. pylori 제균에 실패한 환아는 7례(DA 6례, DC 1례) 였으며, 이중 3례는 2차 치료(DAM, DA 및 DC 각 각 1례)로 제균되었고, 나머지 4례(DAM 2차요법 1례, 추적 불능 3례)에서는 제균되지 않았다. 치료 후 H. pylori가 제균되었으나 수 개월이 지나 재발된 환아는 4례(5.3%)로 치료 종결 후 3개월에서 3년 사이에 재발되었다. 재발된 4례중 2례는 2차 요법(OC, DA 각각 1례)으로 제균되었고, 나머지 2례(DC 2차요법 1례, 추적불능 1례)에서는 제균되지 않았다. 결 론: bismuth subcitrate와 amoxycillin의 두약제 요법은 H. pylori의 제균율이 91%로 높고 재발률도 5.3%로 낮으며, 또한 경제적이기 때문에 소아의 H. pylori 감염증에 대한 초기 치료제로 선택되어 질 수 있는 유용한 치료방법중의 하나로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.173-176
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• 2012

We report a rare case of lung disease caused by Mycobacterium terrae in a previously healthy woman. A 45-year-old woman was referred to our hospital due to a chronic cough with sputum. A computed tomography scan of the chest revealed bronchiolitis in conjuction with bronchiectasis in both lungs. Nontuberculous mycobacteria were identified and isolated from the bronchoalveolar lavage fluid collected from each lung. All isolates were identified as M. terrae by various molecular methods that characterized the rpoB and hsp65 gene sequences. Antibiotic therapy using clarithromycin, rifampin, and ethambutol improved the patient's condition and successfully resulted in sputum conversion.