• 제목/요약/키워드: multidrug

검색결과 554건 처리시간 0.031초

Early and Long-term Outcomes of Pneumonectomy for Treating Sequelae of Pulmonary Tuberculosis

  • Byun, Chun-Sung;Chung, Kyung-Young;Narm, Kyoung-Sik;Lee, Jin-Gu;Hong, Dae-Jin;Lee, Chang-Young
    • Journal of Chest Surgery
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    • 제45권2호
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    • pp.110-115
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    • 2012
  • Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (${\geq}50$ years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (< 1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

다양한 암세포주에서 Jaspine B의 함암활성 비교 (Differential Cytotoxic Effects of Jaspine B in Various Cancer Cells)

  • 이지훈;최광익;권미화;이동주;최민구;송임숙
    • 생명과학회지
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    • 제26권12호
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    • pp.1392-1399
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    • 2016
  • Jaspine B는 석회해면류에서 추출된 sphingosine유도체로 인간 암세포에서의 항암활성이 보고되었다. 그러므로 본 연구는 다양한 인간 암세포주에서 항암활성을 비교하고, 암세포주에서의 Jaspine B의 농도를 측정하여 항암 활성과의 연관성을 확인하고자 하였다. 항암활성은 MTT 방법을 이용하여 측정하였고, $EC_{50}$ 값으로 표현하였다. 암세포주내 Jaspine B의 농도는 LC-MS/MS를 이용하여 분석하였다. 항암활성은 세포주마다 다양하게 나타났는데, 유방암과 흑색종 세포주에서 항암활성이 높게 나타났으며($EC_{50}$ 각각 $2.3{\mu}M$$2.6{\mu}M$), 신장암세포주에서는 $EC_{50}$ 값이 $29.4{\mu}M$이었다. 암세포주에서의 $EC_{50}$ 값은 동일한 세포에서의 Jaspine B 농도와 높은 상관성을 나타내었으며(r=0.838), 암세포내 약물농도를 조절하는 것으로 잘 알려진 P-glycoprotein과 breast cancer resistance protein 등의 배출수송계와는 관련이 없음을 확인하였다. 이상의 결과는 세포내 약물농도를 높게 유지하는 것이 항암활성에 매우 중요하며, 세포내 약물농도가 암세포주에 따라 다른 약효를 보이는 원인으로 사료된다.

도축장의 소와 돼지 분변에서 분리한 살모넬라속의 약제내성 및 약제내성 유전자의 보유율 (Prevalence of the antimicrobial resistance and resistance associated gene in Salmonella spp. isolated from pigs and cattle in slaughterhouse)

  • 하도윤;지대해;조상래;박애라;정은희;박동엽;이국천;양정웅;김종수;김혜정;정종화;송익현;김애란;이지연;김용환
    • 한국동물위생학회지
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    • 제34권1호
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    • pp.45-54
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    • 2011
  • This study was conducted to investigate the distribution of Salmonella spp. from pigs and cattle in slaughterhouse, the antimicrobial resistance pattern and the prevalence of resistance genes of isolates. A total of 640 fecal samples from pigs and cattle in slaughterhouse were collected for isolation of Salmonella spp.. Isolation rate was revealed as 15% in pigs and 1.6% in cattle. As result of serotyping, group B (56.6%) were identified as most common in pigs and cattle isolates, in order of group C (24.5%) and group E (15.1%). S. Typhimurium (50.9%) was most common serotype. The major serotypes were in order of S. Rissen and S. London (11.3%) and S. Riggil (7.6%). In antimicrobial test, all isolates were demonstrates susceptibility to nitrofurantoin. But isolates were revealed resistance other antibiotics in order of tetracycline (64.6%), streptomycin (68.3%), ampicillin and amoxicillin (56.3%) and spectinomycin (47.9%). With polymerase chain reaction, antimicrobial resistance gene strA (75.0%) and aadA1 (3.1%) were detected in streptomycin resistance isolates and tetA (94.3%) and tetB (11.3%) gene were detected in tetracycline resistant isolates, but tetG was not detected. Class 1 integron gene was detected in all Salmonella isolates.

Outbreaks of Imipenem-Resistant Acinetobacter baumannii Producing Carbapenemases in Korea

  • Jeong Seok-Hoon;Bae Il-Kwon;Park Kwang-Ok;An Young-Jun;Sohn Seung-Ghyu;Jang Seon-Ju;Sung Kwang-Hoon;Yang Ki-Suk;Lee Kyung-Won;Young Dong-Eun;Lee Sang-Hee
    • Journal of Microbiology
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    • 제44권4호
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    • pp.423-431
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    • 2006
  • Among 53 Acinetobacter baumannii isolates collected in 2004, nine imipenem-resistant isolates were obtained from clinical specimens taken from patients hospitalized in Busan, Korea. Nine carbapenemase-producing isolates were further investigated in order to determine the mechanisms underlying resistance. These isolates were then analyzed via antibiotic susceptibility testing, microbiological tests of carbapenemase activity, pI determination, transconjugation test, enterobacterial repetitive consensus (ERIC)-PCR, and DNA sequencing. One outbreak involved seven cases of infection by A. baumannii producing OXA-23 ${\beta}-lactamase$, and was found to have been caused by a single ERIC-PCR clone. During the study period, the other outbreak involved two cases of infection by A. baumannii producing IMP-1 ${\beta}-lactamase$. The two clones, one from each of the outbreaks, were characterized via a modified cloverleaf synergy test and an EDTA-disk synergy test. The isoelectric focusing of the crude bacterial extracts detected nitrocefin-positive bands with pI values of 6.65 (OXA-23) and 9.0 (IMP-1). The PCR amplification and characterization of the amplicons via direct sequencing showed that the clonal isolates harbored $bla_{IMP-1}$ or $bla_{oxA-23}$ determinants. The two clones were characterized by a multidrug resistance phenotype that remained unaltered throughout the outbreak. This resistance encompassed penicillins, extended-spectrum cephalosporins, carbapenems, monobactams, and aminoglycosides. These results appear to show that the imipenem resistance observed among nine Korean A. baumannii isolates could be attributed to the spread of an IMP-lor OXA-23-producing clone. Our microbiological test of carbapenemase activity is a simple method for the screening of clinical isolates producing class D carbapenemase and/or class B $metallo-{\beta}-lactamase$, in order both to determine their clinical impact and to prevent further spread.

A New Paradigm to Mitigate Osteosarcoma by Regulation of MicroRNAs and Suppression of the NF-${\kappa}B$ Signaling Cascade

  • Mongre, Raj Kumar;Sodhi, Simrinder Singh;Ghosh, Mrinmoy;Kim, Jeong Hyun;Kim, Nameun;Sharma, Neelesh;Jeong, Dong Kee
    • 한국발생생물학회지:발생과생식
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    • 제18권4호
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    • pp.197-212
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    • 2014
  • Osteosarcoma (OS) is one of the most common malignant primary bone tumors and NF-${\kappa}B$ appears to play a causative role, but the mechanisms are poorly understood. OS is one of the pleomorphic, highly metastasized and invasive neoplasm which is capable to generate osteoid, osteoclast and osteoblast matrix. Its high incidence has been reported in adolescent and children. Cell signal cascade is the pivotal functional mechanism acquired during the differentiation, proliferation, growth and survival of the cells in neoplasm including OS. The major limitation to the success of chemotherapy in OS is the development of multidrug resistance (MDR). Answers to all such queries might come from the knock-in experiments in which the combined approach of miRNAs with NF-${\kappa}B$ pathway is put into use. Abnormal miRNAs can modulate several epigenetical switching as a hallmark of number of diseases via different cell signaling. Studies on miRNAs have opened up the new avenues for both the diagnosis and treatment of cancers including OS. Collectively, through the present study an attempt has been made to establish a new systematic approach for the investigation of microRNAs, bio-physiological factors and their target pairs with NF-${\kappa}B$ to ameliorate oncogenesis with the "bridge between miRNAs and NF-${\kappa}B$". The application of NF-${\kappa}B$ inhibitors in combination with miRNAs is expected to result in a more efficient killing of the cancer stem cells and a slower or less likely recurrence of cancer.

선천성 면역조절자인 항생펩타이드 분류 (Classification of Antimicrobial Peptides among the Innate Immune Modulators)

  • 이종환
    • 생명과학회지
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    • 제25권7호
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    • pp.833-838
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    • 2015
  • 다제약제 내성을 가지는 슈퍼 박테리아, 곰팡이, 바이러스, 기생충 감염은 주요한 건강위협인자들이다. 하지만, 건강위협 상황을 극복하기위해 현재 약제의 대안들중 항생펩타이드를 들 수 있다. 항생펩타이드는 자연계 다양한 종에서 생산된다. 항생펩타이드는 작은 단백질로 어류, 양서류, 파충류, 식물 그리고 동물의 감염으로부터 다세포생명체를 보호하는 선천성 면역에 관여하고 있다. 1980년대 이후로 매년 항생펩타이드의 수가 증가하고 있다. 박테리아, 원생생물, 곰팡이, 식물, 동물로부터 동정된 2,000가지 이상의 항생펩타이드가 항생펩타이드 데이터베이스에 등록되어 있다. 이러한 항생펩타이드의 대부분은 11-50개의 아미노산으로 구성되어 있고 하전상태는 0에서 +7까지이며 소수성은 31-70%를 차지하고 있다. 본 보고는 항생펩타이드를 생물학적 원천, 생물학적 기능, 펩타이드 성질, 공유결합패턴, 3차구조등에 의해 분류하였다. 항생펩타이드의 기능은 항균작용외에 세포주화성과 같은 세포생물학적 활성에도 기능성을 가지고 있다. 더욱이 림프절 스트로마로부터 기원한 fibroblastic reticular cell (FRC)에 염증상황 유도시 항생펩타이드가 발현되는 것을 확인하였다. FRC로부터 유도된 항생펩타이드는 whey acidic protein (WAP) 도메인을 포함하고 있었다. 이것은 단백질 도메인에 의해서도 항생펩타이드를 분류 할 수 있다는 것을 제시한다.

First Detection of $bla_{IMP-1}$ in Clinical Isolate Multiresistant Acinetobacter baumannii from Korea

  • Jeong Seok-Hoon;Bae Il-Kwon;Sohn Seung-Ghyu;Park Kwang-Ok;An Young-Jun;Sung Kwang-Hoon;Jang Seon-Ju;Heo Myong-Jin;Yang Ki-Suk;Lee Sang-Hee
    • Journal of Microbiology and Biotechnology
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    • 제16권9호
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    • pp.1377-1383
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    • 2006
  • Among 46 Acinetobacter baumannii isolates collected in 2004, two imipenem-resistant isolates were obtained from clinical specimens taken from patients hospitalized in Busan, Republic of Korea. Two carbapenemase-producing isolates were further investigated to determine the mechanism of resistance. These isolates were analyzed by antibiotic susceptibility testing, microbiological tests of carbapenemase activity, determination of pI, transconjugation test, enterobacterial repetitive consensus (ERIC)-PCR, and DNA sequencing. Two cases of infection by A. baumannii producing the IMP-1 ${\beta}$-lactamase were detected. The isolates were characterized by a modified cloverleaf synergy test and EDTA-disk synergy test. Isoelectric focusing of crude bacterial extracts revealed nitrocefin-positive bands with a pI value of 9.0. PCR amplification and characterization of the amplicons by direct sequencing indicated that the isolates carried a $bla_{IMP-l}$ determinant. The isolates were characterized by a multidrug resistance phenotype, including penicillins, extended-spectrum cephalosporins, carbapenems, and aminoglycosides. These results indicate that the observed imipenem resistance of two Korean A. baumannii isolates was due to the spread of an IMP-1-producing clone. Our microbiological test of carbapenemase activity is simple to screen class B metallo-${\beta}$-lactamase-producing clinical isolates to determine their clinical impact and to prevent further spread. This study shows that the $bla_{IMP-l}$ resistance determinant, which is emerging in Korea, may become an emerging therapeutic problem, since clinicians are advised not to use extended-spectrum cephalosporins, imipenem, and aminoglycosides. This observation emphasizes the importance of having effective control measures in Asian hospitals, such as early detection of colonized patients, isolation procedures, and a judicious use of antibiotics.

결핵 진단을 위한 검사 방법간의 효율성에 관한 비교 분석 (A Comparative Analysis on The Efficiency of Various Clinical Methods for Diagnosis of Tuberculosis)

  • 최석철;정천환;성희경;김태운;이원재
    • 대한의생명과학회지
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    • 제5권2호
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    • pp.191-200
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    • 1999
  • 최근 다약제 내성균주의 출현과 후천성 면역결핍증으로 인한 결핵발병률의 증가는 전세계적으로 중요한 보건문제가 되었다. 따라서 보다 빠르고 신뢰할 만한 진단법은 결핵 박멸을 위한 가장 중요한 필요조건 중의 하나일 것이다. 본 연구는 171명의 환자를 대상으로 폐결핵 진단의 전통적 방법들 (X-선, 항산성 염색, 배양)과 PCR법간의 진단적 가치와 효율성을 비교 검토하기 위해 시행하였다. 흉부 X-선 소견 및 검사 결과 그리고 다른 임상 소견들을 통해 결핵으로 확진된 예는 전체 171건의 검체 중 39예 (22.8%)였다. 이러한 확진을 근거로 할 때 각 검사별 민감도, 특이도, 효율성, 위양성률, 위음성률을 살펴보면 흉부 X-선의 경우 각각 69.2%, 87.1%, 83.0%, 12.9%, 30.8%; 항산성 염색의 경우 79.9%,95.5%,91.8%,4.6%, 20.5%; 배양의 경우 56.4%,99.2%,89.5%,0.8%,43.6%; PCR의 경우 82.1%, 96.2%, 93.0%,3.8%, 17.9%였다. PCR의 경우 가장 높은 민감도 및 효율성과 가장 낮은 위음성률을 보였다. 배양법은 가장 높은 특이도와 가장 낮은 위양성률을 보였다. 결론적으로 PCR은 결핵 진단을 위한 신속하고 효율적인 우수한 검사 방법이므로 일상적 임상 검사로의 활용가치가 매우 높다고 하겠다. 그러나 전통적인 여러 방법들 역시 임상상황에 따라 그 나름대로의 특별한 가치를 지니고 있으므로 철저한 정도관리를 통해 PCR과 병행 한다면 결핵균 검출율을 보다 높일 수 있으리라 판단된다.

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Genetic Relationship between SCCmec Types and Virulence Factors of Methicillin-Resistant Staphylococcus aureus Clinical Isolates in Korea

  • Lim, Kwan-Hun;Lee, Gyu-Sang;Park, Min;Lee, Jin-Hee;Suh, In-Bum;Ryu, Sook-Won;Eom, Yong-Bin;Kim, Jong-Bae
    • 대한의생명과학회지
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    • 제16권2호
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    • pp.75-82
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    • 2010
  • The molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates have demonstrated their genetic diversity and evolution. A total of 137 strains of MRSA clinical isolates was collected from Korean healthcare facility in 2007. The MRSA clinical isolates were analyzed by molecular typings (SCCmec element and agr locus typing), virule nce factor gene detections {(Panton-Valentine leukocidin (PVL), enterotoxin, exfoliative toxin and toxic shock syndrome toxin-1), and amplified fragment length polymorphism (AFLP)}. The MRSA clinical isolates were classified as SCCmec type II-agr type 1 (2 strains), type II-agr type 2 (79 strains), type III-agr type 1 (24 strains), type III-agr type 2 (2 strains), type IV-agr type 1 (27 strains), type IV-agr type 2 (2 strains), and non-typable (1 strain, agr type 3). Based on SCCmec types, SCCmec type II (95.1%) and III (88.5%) indicated higher multidrug resistance rate than SCCmec type IV (10.3%) (P<0.001). The most common enterotoxin genes were seg (83.8%), sei (83.1%), and sec (80.2%). The tst gene was present in 86 out of 137 (62.8%) MRSA isolates. All MRSA isolates were negative for PVL and exfoliative toxin genes. The combinations of toxin genes were observed in particular SCCmec types; 97.6% of SCCmec type II strains carried sec, seg, sei and tst genes, 73.0% of SCCmec type III strains carried sea gene, and 89.7% of SCCmec type IV strains carried sec, seg and sei genes. Each of the SCCmec types of MRSA isolates had distinct AFLP profile. In conclusion, SCCmec type II, agr type 1 and 2 have demonstrated to be the most common types in Korea, and the results indicated that the virulence factors are closely associated with their molecular types (SCCmec and agr types).

임상에서 분리한 메치실린 내성 황색포도상구균에 대한 녹나무잎 추출물의 항균활성 (Synergistic Effects of Cinnamomum camphora Leaves Extract against Clinical Isolated Methicillin-resistant Staphylococcus aureus)

  • 차정단;최미래;고은실;황승미;강제란;오좌섭;박영진;정용환;전아림;최경민
    • 한국자원식물학회지
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    • 제28권1호
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    • pp.9-15
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    • 2015
  • 메치실린내성 황색포도상구균(MRSA)은 가장 중요한 지역 사회 병원성 균주의 하나로서 항생제 내성 문제가 세계적으로 대두되고 있다. 감염 치료에 대한 부작용과 내성이 적은 새로운 항생제의 개발에 많은 관심과 연구가 필요하다. Cinnamomum camphora는 제주도에서 자생하는 녹나무과의 식물이다. 민간에서는 신경 쇠약, 간질, 방광염, 신우 신염, 당뇨, 암과 당뇨병 치료제로 이용되고 있다. 본 연구에서는 80% 에탄올을 이용하여 녹나무잎을 추출물하여 임상에서 분리한 메치실린 내성 균주에 대한 항균활성을 연구하였다. 그 결과 녹나무잎 추출물에서 높은 항균활성을 관찰 할 수 있었고, 항생제와의 병용처리 녹나무잎 추출물의 MIC와 MBC의 범위는 $156-313{\mu}g/ml$$313-625{\mu}g/ml$로 판독되었고, oxacillin의 병용처리의 범위는 $1288-256{\mu}g/ml$$128-512{\mu}g/ml$, 그리고 ampicillin의 병용처리 범위는 ${\mu}g/ml$$8-128{\mu}g/ml$로 판독되었다. 녹나무잎 추출물과 항생제의 병용처리는 MRSA 항균활성에 대한 상승효과가 높게 나타났다.