• 제목/요약/키워드: Treatment resistant

검색결과 1,550건 처리시간 0.024초

Vaneomycin-Resistant Enteroeocci (VRE) 약물치료방법 (Vaneomycin-Resistant Enteroeocci (VRE) Treatment Options)

  • 김묘경
    • 한국임상약학회지
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    • 제9권1호
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    • pp.1-14
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    • 1999
  • Vancomycin-resistant Enterococci (VRE) have recently emerged in Korean hospitals, as well as in those of other countries. VRE have been partially attributed to the overuse and misuse of vancomycin. The mecbanisms of VRE resistance are related to VanA, VanB, and VanC. Both VanA and VanB produce abnormal ligase enzymes to form D-ala-D-lactate termini in E. faecium and E. faecalis, instead of D-ala-D-ala termini. Meanwhile, Van C produces D-ser-D-ala termini in E. gallinarum and E. casseliflavus. These abnormal termini have a low affinity to vancomycin. As a result, VRE avoid the activity of vancomycin by these mechanisms. Unfortunately, there is no approved therapy for the treatment of VRE. Thus, available but uncommonly prescribed antibiotics (due to their toxicity or unproven efficacy) may become possible options. They include chloramphenicol, novobiocin, fosfomycin, and bacitracin. The combination therapy of available agents may also be the other options. They include high doses of a penicillin- or ampicillin-aminoglycoside combination, high doses of an ampicillin/sulbactam and aminoglyoosidcs combination, an ampicillin and vancomycin combination, and a ciprofloxacin, aminoglycosides, and rifampin combination. With respect to the near future, many types of investigational agents will most likely expand their treatment options for VRE. Teicoplanin, a glycopeptide, can be used for VanB- and VanC-related VRE. LY333328, a new generation of glycopeptide, is effective in treating VanA as well as VanB and VanC. RP59500 (quinupristin/dalfopristin), a streptogramin, is effective in treating vancomycin-resistant E. faecium. New generation quinolones (especially clinatloxacin) are potential options for the treatment of VRE, even though they cannot work as effectively against VRE as they can against Staphylococci. Both glycylcyclines (a new generation of tetracyclines) and ketolides (a new generation of macrolides) show good activity against Enterococci, regardless of vancomycin susceptibility. Oxazolidinones (i. e. eperezolid and 1inezolid) and everninomicins (i. e. SCH27899) are new groups of antibiotics, which also demonstrate good activity against VRE. It is imperative that clinical pharmacists take the responsibility of investigating new treatment options for VRE in order to combat this growing problem throughout the world.

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Anti-cancer effects of fenbendazole on 5-fluorouracil-resistant colorectal cancer cells

  • Park, Deokbae;Lee, Jung-Hee;Yoon, Sang-Pil
    • The Korean Journal of Physiology and Pharmacology
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    • 제26권5호
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    • pp.377-387
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    • 2022
  • Benzimidazole anthelmintic agents have been recently repurposed to overcome cancers resistant to conventional therapies. To evaluate the anti-cancer effects of benzimidazole on resistant cells, various cell death pathways were investigated in 5-fluorouracil-resistant colorectal cancer cells. The viability of wild-type and 5-fluorouracil-resistant SNU-C5 colorectal cancer cells was assayed, followed by Western blotting. Flow cytometry assays for cell death and cell cycle was also performed to analyze the anti-cancer effects of benzimidazole. When compared with albendazole, fenbendazole showed higher susceptibility to 5-fluorouracil-resistant SNU-C5 cells and was used in subsequent experiments. Flow cytometry revealed that fenbendazole significantly induces apoptosis as well as cell cycle arrest at G2/M phase on both cells. When compared with wild-type SNU-C5 cells, 5-fluorouracil-resistant SNU-C5 cells showed reduced autophagy, increased ferroptosis and ferroptosis-augmented apoptosis, and less activation of caspase-8 and p53. These results suggest that fenbendazole may be a potential alternative treatment in 5-fluorouracil-resistant cancer cells, and the anticancer activity of fenbendazole does not require p53 in 5-fluorouracil-resistant SNU-C5 cells.

다제내성 결핵의 치료 성적 (Treatment Results of Multidrug Resistant Tuberculosis in a University Hospital in Korea)

  • 염호기;송영수;최수전;이봉춘;김동순
    • Tuberculosis and Respiratory Diseases
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    • 제43권6호
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    • pp.862-870
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    • 1996
  • Background : Multidrug-resistant tuberculosis(MDR-Tb) has been increased not only in Asia but also in Western society, which may cause public health problems and reduce the efficacy of treatment of tuberculosis. In Western society HIV infection is believed to do a central role in increasing incidence of MDR tuberculosis, but MDR-Tb in Korea may be somewhat different about clinical features, underlying disorders, and prognosis. Goble et al reponed that overall treatment failure rate in MDR-Tb including resistance to isoniazid(INH) and rifampin (RFP) was 44 %. The aim of this study is to find the treatment result in Korea and the factors determining the prognosis. Methods: A retrospective study of pulmonary tuberculosis cultured M. tuberculosis from sputum or bronchial washing fluid between 1986 through 1992 was conducted in the Seoul Paik Hospital, Inje University. We reviewed clinical courses of 141 patients, who had a tuberculosis with resistance to 2 or more drugs including isoniazid(INH) and rifampin(RFP). One hundred and 4 patients of 141 patients had completed treatment and followed up for more than one year. Results: Of 104 (mean age $43.6{\pm}16.7$, M: F=63 : 41) patients with sufficient follow-up data, 73(84.6%) patients responded which is defined as negative Sputum cultures for at least 3 consecutive months. Seven patients(6.7%) had a failure in negative conversion and 9(8.7%) of the patients who initially responded relapsed. Overall treatment failure rate was 15.4%, Patients who were treated for less than 12 months had a higher relapse rate(12.3%) than 18 months(4.9%). And there was a statistically significant correlation between the relapse rate and the number of drugs to which isolates wera resistant(p<0.05). Conclusion : The treatment failure rate of MDR-Tb in Korea was lower than previous studies in western Country and the major determining factor of prognosis was the number of resistant drugs to M. tuberculosis at drug sensitivity test. For reducing the relapse rate, we recommend more than 12 months of treatment for MDR tuberculosis.

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Comparison of TNF-Mediated Glucose Catabolism between the TNF-Sensitive and -Resistant Cell Lines

  • Kim, Yeon-Hyang;Park, Bok-Ryun;Cheong, Hee-Sun;Kwon, Oh-Hwan;Kim, Dae-Que;Kim, Soung-Soo
    • BMB Reports
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    • 제32권2호
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    • pp.140-146
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    • 1999
  • When murine fibrosarcoma L929 cells, a TNF-sensitive cell line, were treated with recombinant human tumor necrosis factor-$\alpha$ (rhTNF-$\alpha$), the activities of glycolytic regulatory enzymes and lactate dehydrogenase increased up to 100-150% compared to the control L929 cells after TNF treatment. By using various metabolic inhibitors and activators, it was found that cAMP-dependent protein kinase is responsible for the increase of activities of the glycolytic enzymes. The activities of glycolytic regulatory enzymes and lactate dehydrogenase of TNF-resistant A549 cells, a human lung carcinoma cell line, did not increase significantly compared to TNF-sensitive L929 cells upon TNF treatment. In contrast, the pyruvate carboxylase activities of A549 cells, but not L929 cells, increased up to 30~40% after TNF treatment. The data suggest that pyruvate carboxylase activity may contribute to the compensation of energy loss mediated by TNF treatment in TNF-resistant A549 cells.

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Growth Performance and Field Evaluation of Herbicide-Resistant Transgenic Creeping Bentgrass

  • Lee, Ki-Won;Lee, Byung-Hyun;Seo, Bo-Ram;Kim, Jin-Seog;Lee, Sang-Hoon
    • 한국초지조사료학회지
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    • 제33권3호
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    • pp.167-170
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    • 2013
  • This study examined the growth performance and field evaluation of the dual herbicide-resistant transgenic creeping bentgrass plants. The effect of glyphosate treatment on the herbicide resistance of the transgenic creeping bentgrass plants was determined, and the non-transgenic control plant withered at the concentration $11{\mu}g/mL$ or higher whereas the transgenic creeping bentgrass plants survived the treatment at the concentration of $3,000{\mu}g/mL$, and the increase of the plant length was repressed as the glyphosate treatment concentration was increased. At field evaluation, glufosinate-ammonium and glyphosate were simultaneously treated to investigate the weed control effect. The results showed that more than 90% of the weeds withered four week after herbicide treatment, while the transgenic creeping bentgrass plants continued to grow normally. Therefore, the dual herbicide-resistant creeping bentgrass plants may be able to greatly contribute to the efficiency of weed control and to the economic feasibility of mowing in places such as golf courses.

Disruption of Established Bacterial and Fungal Biofilms by a Blend of Enzymes and Botanical Extracts

  • Gitte S. Jensen;Dina Cruickshank;Debby E. Hamilton
    • Journal of Microbiology and Biotechnology
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    • 제33권6호
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    • pp.715-723
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    • 2023
  • Microbial biofilms are resilient, immune-evasive, often antibiotic-resistant health challenges, and increasingly the target for research into novel therapeutic strategies. We evaluated the effects of a nutraceutical enzyme and botanical blend (NEBB) on established biofilm. Five microbial strains with known implications in chronic human illnesses were tested: Candida albicans, Staphylococcus aureus, Staphylococcus simulans (coagulase-negative, penicillin-resistant), Borrelia burgdorferi, and Pseudomonas aeruginosa. The strains were allowed to form biofilm in vitro. Biofilm cultures were treated with NEBB containing enzymes targeted at lipids, proteins, and sugars, also containing the mucolytic compound N-acetyl cysteine, along with antimicrobial extracts from cranberry, berberine, rosemary, and peppermint. The post-treatment biofilm mass was evaluated by crystal-violet staining, and metabolic activity was measured using the MTT assay. Average biofilm mass and metabolic activity for NEBB-treated biofilms were compared to the average of untreated control cultures. Treatment of established biofilm with NEBB resulted in biofilm-disruption, involving significant reductions in biofilm mass and metabolic activity for Candida and both Staphylococcus species. For B. burgdorferi, we observed reduced biofilm mass, but the remaining residual biofilm showed a mild increase in metabolic activity, suggesting a shift from metabolically quiescent, treatment-resistant persister forms of B. burgdorferi to a more active form, potentially more recognizable by the host immune system. For P. aeruginosa, low doses of NEBB significantly reduced biofilm mass and metabolic activity while higher doses of NEBB increased biofilm mass and metabolic activity. The results suggest that targeted nutraceutical support may help disrupt biofilm communities, offering new facets for integrative combinational treatment strategies.

시스플라틴 내성세포주에서 열충격에 의한 세포사멸에 관한 연구 (Heat Shock Induces Necrosis in Cisplatin-resistant Gastric Cancer Cells through Suppressing JNK1/2 Activation and HSP27 Induction)

  • 임성철;최철희;한송이
    • 생명과학회지
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    • 제19권12호
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    • pp.1705-1711
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    • 2009
  • 항암제 내성을 획득한 암세포는 많은 경우 다양한 세포 독성 물질에 대해 교차 내성을 나타낸다. 그러나 온열 치료가 내성 획득 종양에 적용 될 때의 종양 세포의 사멸 효과는 알려져 있지 않다. 본 연구는 시스플라틴에 내성을 갖는 위암 세포 주, SNU601/Cis2이 열충격에 반응하는 민감도와 세포 사멸 방식을 조사함으로써 약물 내성 종양의 온열 치료 효과를 예측하고자 하였다. 정상 위암 세포 주 SNU601/WT은 열충격에 매우 민감하게 반응하며 apoptosis로 사멸하지만, 내성 위암 세포 주 SNU601/Cis2는 미열충격에 내성을 나타내었으며 고열충격에 노출되자 necrosis로 사멸하였다. 또한 SNU601/Cis2에서 necrosis의 발생은 열충격에 의한 JNK1/2의 활성화와 HSP27의 발현저하 현상과 관련되어 있었다. Necrosis의 유도는 세포막 파괴에 의해 세포 내부 물질의 방출로 인한 주변 조직의 염증반응을 수반하는데, 이러한 염증 반응은 암의 성장을 촉진하고 암의 성상을 심화시키는 것으로 보고되고 있다. 이러한 관점에서, 온열 치료가 약물 치료와 병행 될 경우에는 교차 내성과 necrosis로 인한 역효과를 방지하기 위하여, 그 적용이 주의 깊게 이루어져야 할 것으로 판단된다.

갑상선 기능항진증의 $^{131}I$ 치료시 갑상선 조사량에 관한 연구 (A Study on the Radiation Dose of $^{131}I$ in the Thyroid Gland during the Treatment of Hyperthyroidism)

  • 서환조;고창순;이문호
    • 대한핵의학회지
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    • 제9권1호
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    • pp.59-71
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    • 1975
  • 53 patients with hyperthyroidism have been analyzed with special reference to therapeutic response to radioactive iodine ($^{131}I$) treatment. Mean effective half-life, 24 hour uptake rate and radiation dose of $^{131}I$ in hyperthyroid patients included in this study were respectively. 1. Mean effective half-life of $^{131}I\;was\;4.7{\pm}1.5$ days in the tracer dose and $5.0{\pm}1.5$ days in the therapeutic dose. 2. Mean 24 hour uptake rate of $^{131}I\;was\;72.7{\pm}11.1%$ in the tracer dose and $73.4{\pm}12.3%$ in the theapeutic dose. 3. Mean radiation dose of $^{131}I\;was\;5,319{\pm}2,648$ RAD as predicted and $5,692{\pm}2,843$ RAD as actual. A single dose of radioactive iodine treatment was satisfactory in 34 patients (radioiodine sensitive) and multiple doses of radioactive iodine treatments were required in 19 patients (radioiodine resistant). A radioiodine resistant group of patients with hyperthyroidism was distinctively characteristic in the following aspects. 1. Mean thyroid weight calculated in the resistant group ($63.9{\pm}14.0gm$) was significantly (p<0.01) greater than that of the sensitive group ($46.6{\pm}13.3gm$). 2. Mean 24 hour uptake rate of the tracer dose in the resistant group ($67.3{\pm}10.7%$) was significantly (p<0.01) lower than that of the sensitive group ($75.7{\pm}10.5%$). 3. Mean 24 hour uptake rate of the therapeutic dose in the resistant group ($68.5{\pm}13.7%$) was significantly (p<0.05) lower than that of the sensitive group ($76.1{\pm}10.9%$). 4. Mean predicted radiation dose, of $^{131}I$ in the resistant group ($3,684{\pm}1,745$ RAD) was significantly (p<0.01) lower than that of the sensitive group ($6,232{\pm}2,683$ RAD). 5. Mean actual radiation dose of $^{131}I$ in the resistant group ($4,100{\pm}1,691$ RAD) was significantly (p<0.01) lower than that of the sensitive group ($6,582{\pm}3,024$ RAD). 6. No significant difference was detected in terms of effective half-life of $^{131}I$ among the groups (p>0.05). 7. The average mean % difference of effective half-life, uptake rate and radiation dose measured following the tracer and therapeutic dose of $^{131}I$ were not statistically significant (p>0.05). Therefore effective half-life, uptake rate and radiation dose of the therapeutic dose of $^{131}I$ were readily predictable following the tracer dose of $^{131}I$. 8. It is concluded that the possibility of resistance to radioactive iodine treatment may be anticipated in patients with thyroid gland large in size and compromised $^{131}I$ uptake rate.

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치료저항성 조현병: 정의와 임상양상 (Treatment-Resistant Schizophrenia: Terminology and Clinical Features)

  • 이건석
    • 대한조현병학회지
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    • 제23권2호
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    • pp.45-50
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    • 2020
  • Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.