• 한국산학기술학회논문지
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• 제19권1호
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• pp.121-126
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• 2018

중환자실에 입원한 환자들의 구강위생은 매우 중요한 문제이다. 중환자들은 기본적으로 면역이 저하된 환자들로 각종 병원성 세균들에 의한 감염의 기회가 높기 때문이다. 구강문제는 감염의 1차 방어선인 구강이 감염의 우선적인 부위로 작용될 뿐 아니라 전신감염을 초래하기도 한다. 본 연구에서는 중증환자의 구강청소를 용이하게 하는 마우스 피스 형태의 새로운 진공 구강 세정기 설계에 관한 연구를 수행하였다. 이중 구조 방식의 세정기와 표준 치아 모델로써 3D CAD 모델링 및 유동해석 모델을 수립하고 압력 및 유동특성을 분석하였다. 세정기 내부의 압력은 거의 일정한 분포를 보였으나, 속력분포의 경우 치아 안쪽과 바깥쪽에서 큰 차이를 보였다. 치아 안쪽에서도 가운데 부분의 속도가 가장 높고 가운데에서 멀어질수록 속력이 감소하는 특성을 보였다. 세정기의 흡입관과 배출관을 바꾸어 해석한 결과 치아 바깥쪽 가운데 부분의 속도가 가장 높게 나타났다. 세정기의 효과를 높이기 위해서 흡입-배출을 교대로 바꾸는 교번식을 제안하고, 어금니 부위의 속력을 높이는 설계 보완이 요구된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1177-1180
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• 2014

Background: Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. Objectives: To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. Materials and Methods: Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. Results: A total of 191 women were eligible, with a mean age of $27.0{\pm}8.9$ years; and a mean body mass index of $20.6{\pm}8.9kg/m^2$. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ${\geq}5$ was the only factor associated with LSIL+(aOR 2.65, 95%CI 1.11-6.29, p 0.027). Conclusions: LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

• Tuberculosis and Respiratory Diseases
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• 제67권2호
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• pp.135-139
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• 2009

Human metapneumovirus (hMPV) is a recently recognized human respiratory pathogen, which is known to be associated with upper and lower respiratory tract infections mainly in children, immunocompromised patients, and the elderly. The clinical manifestations of hMPV infections are similar to those of the human respiratory syncytial virus infection, which range from mild upper respiratory tract infection to severe bronchiolitis and pneumonia. Recently, hMPV has come to be thought of as the cause a similar spectrum of disease in adults as that seen in children; however, most of the reports of hMPV infections have focused on infection in children. We report a case of severe hMPV pneumonia requiring mechanical ventilation in an immunocompetent adult in Korea.

• 대한의생명과학회지
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• 제26권3호
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• pp.170-178
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• 2020

Mycobacterium tuberculosis (MTB) continues to be one of the main causative agents of tuberculosis (TB); moreover, the incidence of nontuberculous mycobacteria (NTM) infections has been rising gradually in both immunocompromised and immunocompetent patients. Precise and rapid detection and identification of MTB and NTM in respiratory specimens are thus important for MTB infection control. Molecular diagnostic methods based on the nucleic acid amplification test (NAAT) are known to be rapid, sensitive, and specific compared to the conventional acid-fast bacilli (AFB) smear and mycobacterial culture methods. In the present study, the clinical performances of three commercial molecular diagnostic assays, namely TB/NTM PCR (Biocore), MolecuTech Real MTB-ID^® (YD Diagnostics), and REBA Myco-ID^® (YD Diagnostics), were evaluated with a total of 92 respiratory specimens (22 AFB smear positives and 67 AFB smear negatives). The sensitivity and specificity of TB/NTM PCR were 100% and 75.81%, respectively. The corresponding values of MolecuTech Real MTB-ID^® and REBA Myco-ID^® were 56.52% and 90.32%, and 56.52% and 82.26%, respectively. TB/NTM PCR showed the highest sensitivity; however, the concordant rate was 10% compared with sequence analysis. Although MolecuTech Real MTB-ID^® showed lower sensitivity, its specificity was the highest among the three methods. REBA Myco-ID^® allowed accurate classification of NTM species; therefore, it was the most specific diagnostic method. Of the three PCR-based methods, MolecuTech Real MTB-ID^® showed the best performance. This method is expected to enable rapid and accurate identification of MTB and NTM.

• Pediatric Infection and Vaccine
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• 제27권2호
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• pp.83-89
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• 2020

목적: A군 사슬알균은 소아 환자들에 있어서 흔한 감염원으로 다양한 임상양상을 보인다. 급성편도염이나 피부 및 연조직 감염이 흔하며 상당한 이환율과 사망률을 동반하는 혈류감염 또한 발생할 수 있다. 본 연구는 국내 소아 A군 사슬알균 혈류감염 환자들의 임상양상과 치료 결과를 확인하고자 하였다. 방법: 이 연구는 단일기관의 후향적 연구로, 2000년 1월부터 2016년 12월까지 A군 사슬알균 혈류감염으로 입원치료 받은 18세 이하 소아 환자들을 대상으로 하였다. 균혈증 발생시 임상양상, 기저질환, 중환자실 치료 여부, 그리고 균주의 항생제 감수성을 조사하였다. 결과: 19명에서 A군 사슬알균 혈류감염이 확인되었다. 10명(53%)이 남자였으며 연령의 중앙값은 7.4세였다(범위, 0.3-17.4세). 14명(74%)의 환자들이 만성 기저질환을 가지고 있었다. 5명(26%)은 면역저하(백혈병 및 만성신질환) 환자였다. 8명(42%)이 림프낭종, 혈관종, 정맥 기형 등 림프관 및 혈관 기형이 있었으며 그 중 7명은 발열과 병변부 국소 염증소견이 있었다. 3명(16%)의 환자들에게 폐렴이 발생했고 이 중 2명은 인공호흡기 치료를 받았다. 환자들의 30일째 사망률은 6% (1/19)였으며 해당 환자는 균혈증을 동반한 폐렴으로 사망하였다. 모든 검출된 A군 사슬알균은 페니실린에 감수성을 보였다. 15균주(79%)는 에리스로마이신과 클린다마이신에 감수성을 보였다. 결론: 본 연구에서 A군 사슬알균 혈류감염이 발생한 소아 환자들의 임상양상을 분석하였다. A군 사슬알균은 소아에 있어 균혈증을 유발할 수 있는 심각한 감염의 원인균으로 고려가 필요하다.

• Pediatric Infection and Vaccine
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• 제13권2호
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• pp.180-185
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• 2006

침습적 Pseudomonas 감염은 대개 면역 저하 환자들에서 발생하며, 이는 높은 사망률과 관련이 있다. 그러나 드물게는 면역력이 정상인 숙주에서도 발생할 수 있다. 첫 번째 증례는 괴저성 농창과 Pseudomonas 패혈증이 발생한 5개월 여아이며, 두번째 증례는 9개월 남아에서 지역사회 감염으로 발생한 폐렴과 Pseudomonas 패혈증이다. 두 환아 모두에서 녹농균이 배양검사로 증명되어 감수성 있는 항생제를 사용하였으며, T 림프구, B 림프구, 보체, 식세포 등 면역력에 대한 검사는 모두 정상이었다. 저자들은 이전에 건강했던 영아들에서 발생한 침습성 녹농균 감염증 2례를 경험하였기에 이를 보고하는 바이다.

• 대한미생물학회지
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• 제35권4호
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• pp.289-297
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• 2000

Background: Staphylococcus aureus (s. aureus) and Escherichia coli (E. coli) are major pathogens in community and hospital. And they sometimes cause the outbreak in hospital in the immunocompromised patients. Pulsed-field gel electrophoresis (PFGE) has been regarded as a standard method for genotyping in epidemiologic studies, but it is laborious and time-consuming. Infrequent restriction site-polymerase chain reaction (IRS-PCR), a new genotyping methods, was performed to compare the applicability with PFGE. Methods: We performed PFGE and IRS-PCR on S. aurues (n=120) and E. coli (n=117) which were collected clinically in 4 different hospitals. We assessed each method in terms of discriminatory power, quality, and efficiency. Results: In E. coli, the discriminatory power of IRS-PCR was $46.7{\sim}86.7%$, and that of PFGE was $88.9{\sim}96.7%$ according to hospital. But in S. aurues, the discriminatory power of IRS-PCR was $20{\sim}56.7%$, and that of PFGE was $40{\sim}90%$ according to hospital. The typablity and reproducibility of IRS-PCR were 100% of each. PFGE needed four days to complete the procedure, but IRS-PCR could be performed within one day, IRS-PCR showed better resolution than PFGE. Conclusion: In case of gram negative bacteria (like E. coli), IRS-PCR could be a reliable alternative for epidemiologic typing due to better efficiency and comparable discriminatory power. But in the case of gram positive bacteria (like S. aureus), IRS-PCR does not seem to be suitable for the strain-to-strain differentiation. More trials and changes of restriction enzymes or primers could reveal the efficacy of IRS-PCR in the field of molecular typing.

• 한국미생물생명공학회:학술대회논문집
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• 한국미생물생명공학회 2000년도 Proceedings of 2000 KSAM International Symposium and Spring Meeting
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• pp.3-6
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• 2000

Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

• 생명과학회지
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• 제24권1호
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• pp.61-66
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• 2014

본 연구는 면역억제 마우스에서 양강 에탄올 추출물이 면역증강에 미치는 영향을 평가해보았다. 마우스에 cyclophosphamide를 2회 복강 주사한 후 양강 추출물을 30, 100, 300 mg/kg 용량으로 4주간 경구투여 한 후, 체중 및 면역장기 무게, 비장세포수, 혈청 사이토카인 농도 및 혈청 면역글로불린의 농도를 측정하였다. 실험 결과 체중과 비장세포수는 양강 추출물 투여 시 대조군과 비교하여 유의한 차이를 보이지 않았다. 혈청의 IL-2, TGF-${\beta}$ 및 IFN-${\gamma}$ 농도는 AO 100군에서 대조군에 비해 유의적인 증가를 보였고(p<0.05) IL-4 농도는 실험군에서 유의한 차이를 보이지 않았다. 혈청 내 IgM의 농도는 대조군에 비해 양강 추출물 투여군 모두에서 유의적으로 증가하였고 (p<0.05), IgA의 농도는 양강 추출물 투여군에서 증가하는 경향을 보였는데 특히 AO100군에서 유의성 있게 증가하였다(p<0.05). 본 연구 결과는 양강 에탄올 추출물은 혈청 내 사이토카인 농도와 면역글로불린 농도를 증가시켜 면역력 증강에 기여할 것으로 보이며 특히 100 mg/kg을 투여하였을 때 효과가 가장 큰 것으로 나타났다.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.452-456
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• 2012

Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.