• Tuberculosis and Respiratory Diseases
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• 제49권6호
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• pp.676-683
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• 2000

배경 : 다제 내성 폐결핵은 적극적인 내과적 치료에도 불구하고 높은 치료 실패율을 보이므로 최근 보조적 치료 수단으로 폐절제술이 다시 등장하여 시행되고 있다. 그러나, 폐절제술에 대한 적응증이 아직 확립되지 않은 상태이므로 본원에서 폐절제술을 시행 받은 다제 내성 폐결핵 환자들의 치료 효과를 비교 분석하여 적응증의 정립에 지표를 제시하고자 본 연구를 시행하였다. 방법 : 1996년 5월부터 2000년 2월까지 INH와 RFP에 동시 내성을 보이는 다제 내성 폐결핵 환자 중 폐결핵 자체에 대한 보조적 치료로써 폐절제술을 시행한 환자 13명을 대상으로 하여 진료 기록을 중심으로 후향적 으로 조사하였다. 결과 : 남자 5명, 여자 8명으로 연령은 $37.5{\pm}12.4$세 (24~63세)였다. $2.4{\pm}0.8$ 회의 화학치료 과거력을 가지고 있었으며, 수술 전에 내성 약제수는 $5.2{\pm}1.9$제, 감수성 약제수는 $5.4{\pm}1.5$제였다. 다제 내성 결핵을 진단 받고 수술까지의 기간은 $109.7{\pm}132.0$개월이 본원에서 재치료 받은 후 $10.5{\pm}8.8$ 개월이었다. 대부분의 환자 (92.3%)에서 주병변에 공동을 동반하고 있었으며, 수술 전 $FEV_1$은 $2.37{\pm}0.83$ ml 였다. 늑막폐정제술은 2명에서, 폐엽절제술은 분엽절제술이나 설상절제를 포함하여 11명에서 시행 받았다. 수술 후 한 환자 (7.7%)에서 폐렴이 발생하였고, 사망은 없었다. 균음전은 수술 후 $41.5{\pm}58.9$ 일만에 되었다. 모든 환자에서 수술 후 $5.1{\pm}0.8$ 제의 약제를 약 24개월까지 투여 받았는데, 한 환자(7.7%)에서 수술 32개월 만에 재발 하였다. 결론 : 주병변이 국한되어 있는 다제 내성 폐결핵 환자는 내과적 재치료에 실패하는 경우에는 보조적인 치료로써의 폐절제술을 적극적으로 고려해야 할 것이다.

• Journal of Microbiology and Biotechnology
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• 제26권1호
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• pp.151-159
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• 2016

Nanoparticles have wide-scale applications in various areas, including medicine, chemistry, electronics, and energy generation. Several physical, biological, and chemical methods have been used for synthesis of silver nanoparticles. Green synthesis of silver nanoparticles using plants provide advantages over other methods as it is easy, efficient, and eco-friendly. Nanoparticles have been extensively studied as potential antimicrobials to target pathogenic and multidrug-resistant microorganisms. Their applications recently extended to development of antivirals to inhibit viral infections. In this study, we synthesized silver nanoparticles using Cinnamomum cassia (Cinnamon) and evaluated their activity against highly pathogenic avian influenza virus subtype H7N3. The synthesized nanoparticles were characterized using UVVis absorption spectroscopy, scanning electron microscopy, and Fourier transform infrared spectroscopy. Cinnamon bark extract and its nanoparticles were tested against H7N3 influenza A virus in Vero cells and the viability of cells was determined by tetrazolium dye (MTT) assay. The silver nanoparticles derived from Cinnamon extract enhanced the antiviral activity and were found to be effective in both treatments, when incubated with the virus prior to infection and introduced to cells after infection. In order to establish the safety profile, Cinnamon and its corresponding nanoparticles were tested for their cytotoxic effects in Vero cells. The tested concentrations of extract and nanoparticles (up to 500 μg/ml) were found non-toxic to Vero cells. The biosynthesized nanoparticles may, hence, be a promising approach to provide treatment against influenza virus infections.

• Tuberculosis and Respiratory Diseases
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• 제80권2호
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• pp.143-152
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• 2017

Background: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. Methods: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. Results: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-$na{\ddot{i}}ve$ groups (78.3% vs. 78.4%, respectively). Conclusion: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.

• Tuberculosis and Respiratory Diseases
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• 제63권4호
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• pp.368-371
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• 2007

Pulmonary cavities are caused by bacterial pneumonia, fungal diseases, lung cancer, and tuberculosis (TB). However, in Korea, patients with cavitary lung lesions are generally considered to have pulmonary TB, where the incidence of TB is approximately 70/100,000 per year. We report a case of chronic necrotizing pulmonary aspergillosis that was obscured by multidrug-resistant pulmonary TB.

• Journal of Microbiology and Biotechnology
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• 제28권5호
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• pp.671-678
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• 2018

Papiliocin, isolated from the swallowtail butterfly (Papilio xuthus), is an antimicrobial peptide with high selectivity against gram-negative bacteria. We previously showed that the N-terminal helix of papiliocin (PapN) plays a key role in the antibacterial and anti-inflammatory activity of papiliocin. In this study, we measured the selectivity of PapN against multidrug-resistant gram-negative bacteria, as well as its anti-inflammatory activity. Interactions between Trp2 of PapN and lipopolysaccharide (LPS), which is a major component of the outer membrane of gram-negative bacteria, were studied using the Trp fluorescence blue shift and quenching in LPS micelles. Furthermore, using circular dichroism, we investigated the interactions between PapN and LPS, showing that LPS plays critical roles in peptide folding. Our results demonstrated that Trp2 in PapN was buried deep in the negatively charged LPS, and Trp2 induced the ${\alpha}$-helical structure of PapN. Importantly, docking studies determined that predominant electrostatic interactions of positively charged arginine residues in PapN with phosphate head groups of LPS were key factors for binding. Similarly, hydrophobic interactions by aromatic residues of PapN with fatty acid chains in LPS were also significant for binding. These results may facilitate the development of peptide antibiotics with anti-inflammatory activity.

• 한국미생물·생명공학회지
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• 제46권2호
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• pp.162-170
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• 2018

Non-typhoidal Salmonella is one of the main pathogens causing food-borne illness in humans, with up to 20% of cases resulting from consumption of pork products. Over the gastroenteritis signs, multidrug resistant Salmonella has arisen. In this study, pan-susceptible phenotypic strains of Salmonella enterica serotype Weltevreden recovered from pig production chain in Chiang Mai, Thailand during 2012-2014 were chosen for analysis. The aim of this study was to use whole genome sequencing (WGS) data with an emphasis on antimicrobial resistance gene investigation to assess their pathogenic potential and genetic diversity determination based on whole genome Multilocus Sequence Typing (wgMLST) to expand epidemiological knowledge and to provide additional guidance for disease control. Analyis using ResFinder 3.0 for WGS database tracing found that one of pan-susceptible phenotypic strain carried five classes of resistance genes: aminoglycoside, beta-lactam, phenicol, sulfonamide, and tetracycline associated genes. Twenty four and 36 loci differences were detected by core genome Multilocus Sequence Typing (cgMLST) and pan genome Multilocus Sequence Typing (pgMLST), respectively, in two matching strains (44/13 vs A543057 and A543056 vs 204/13) initially assigned by conventional MLST and Pulsed-field Gel Electrophoresis (PFGE). One hundread percent discriminant ability can be achieved using the wgMLST technique. WGS is currently the ultimate molecular technique for various in-depth studies. As the findings stated above, a new of "gold standard typing method era" for routine works in genome study is being set.

• Journal of Microbiology and Biotechnology
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• 제24권10호
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• pp.1354-1367
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• 2014

In the present work, we describe a simple, cheap, and unexplored method for "green" synthesis of silver nanoparticles using cell extracts of the cyanobacterium Anabaena doliolum. An attempt was also made to test the antimicrobial and antitumor activities of the synthesized nanoparticles. Analytical techniques, namely UV-vis spectroscopy, X-ray diffraction, Fourier transform infrared (FTIR) spectroscopy, transmission electron microscopy (TEM), and TEM-selected area electron diffraction, were used to elucidate the formation and characterization of silver-cyanobacterial nanoparticles (Ag-CNPs). Results showed that the original color of the cell extract changed from reddish blue to dark brown after addition of silver nitrate solution (1 mM) within 1 h, suggesting the synthesis of Ag-CNPs. That the formation Ag-CNPs indeed occurred was also evident from the spectroscopic analysis of the reaction mixture, wherein a prominent peak at 420 nm was noted. TEM images revealed well-dispersed, spherical Ag-CNPs with a particle size in the range of 10-50 nm. The X-ray diffraction spectrum suggested a crystalline nature of the Ag-CNPs. FTIR analysis indicated the utilization of a hydroxyl (-OH) group in the formation of Ag-CNPs. Ag-CNPs exhibited strong antibacterial activity against three multidrug-resistant bacteria. Additionally, Ag-CNPs strongly affected the survival of Dalton's lymphoma and human carcinoma colo205 cells at a very low concentration. The Ag-CNPs-induced loss of survival of both cell types may be due to the induction of reactive oxygen species generation and DNA fragmentation, resulting in apoptosis. Properties exhibited by the Ag-CNP suggest that it may be used as a potential antibacterial and antitumor agent.

• Tuberculosis and Respiratory Diseases
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• 제51권1호
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• pp.53-58
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• 2001

기관지 동맥 색전술에도 불구하고 반복되는 대량 객혈을 보이는 동공성 폐결핵 환자에서 나선형 CT를 이용하여 Rassmusen 동맥류의 위치 및 크기를 비교적 정확히 진단하여 coil 이용한 경도관 폐동맥 색전술로 성공적으로 지혈 시킨 사례를 경험하였기에 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제23권3호
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• pp.223-228
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• 2016

국내 Shigella 감염은 대부분 Shigella sonnei 에 의해 발생하나 드물게 Shigella flexneri 에 의한 집단 감염이 보고되고 있다. 항생제 사용률이 높은 국내에서 extended-spectrum ${\beta}-lactamase$ (ESBL) 생성 S. sonnei 감염에 대한 보고는 있었으나 ESBL을 생성하는 S. flexneri 에 대한 예는 지금까지 없었다. 저자들은 국내 한 어린이집에 다니는 소아 2명에게서 CTX-M-14 유형 ESBL 생성 S. flexneri type 2a 감염 증례를 경험하였으며 이는 국내에서 ESBL을 생성하는 S. flexneri 감염의 첫 증례이다. 앞으로 국내에서도 Shigella 감염 시 ESBL 균주의 가능성을 고려하고 적극적인 역학조사와 경험적 항생제 투여에 대한 신중한 선택이 필요할 수 있을 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제60권7호
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• pp.221-226
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• 2017

Purpose: Escherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections. Methods: We examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University Hospital between 2011 and 2014. Bacterial strains were classified into STs by partial sequencing of seven housekeeping genes (adk, fumC, gyrB, icd, mdh, purA, and recA). Clinical characteristics and antimicrobial susceptibility were compared between ST131 and non-ST131 UPEC isolates. Results: Sixteen UPEC isolates (14.0%) were extended-spectrum ${\beta}-lactamase$ (ESBL)-producers; 50.0% of ESBL-producers were ST131 isolates. Of all the isolates tested, 13.2% (15 of 114) were classified as ST131. There were no statistically significant associations between ST131 and age, sex, or clinical characteristics, including fever, white blood cell counts in urine and serum, C-reactive protein, radiologic abnormalities, and clinical outcome. However, ST131 isolates showed significantly lower rates of susceptibility to cefazolin (26.7%), cefotaxime (40.0%), cefepime (40.0%), and ciprofloxacin (53.3%) than non-ST131 isolates (65.7%, 91.9%, 92.9%, and 87.9%, respectively; P<0.001 for all). ESBL was more frequently produced in ST131 (53.3%) than in non-ST131 (8.1%) isolates (P<0.01). Conclusion: ST131 E. coli isolates were prevalent uropathogens in children at a single medical center in Korea between 2011 and 2014. Although ST131 isolates showed higher rates of antimicrobial resistance, clinical presentation and outcomes of patients were similar to those of patients infected with non-ST131 isolates.