• Title/Summary/Keyword: 치료 저항성

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Implication of Quantitative Culture of Bronchoalveolar Lavage Fluid in the Diagnosis of Ventilator Associated Pneumonia in Patients with Antimicrobial Therapy (항생제 사용 중 발생한 기계 호흡기 관련 폐렴에서 기관지 세포 세척술의 진단적 의미)

  • Chang, Yoon-Soo;Ahn, Chul-Min;Chung, Byung-Chun;Kim, Hyung-Jung;Kim, Seong-Kyu;Lee, Won-Yong;Shin, Jeung-Su
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.72-81
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    • 2000
  • Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

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Breakthrough Urinary Tract Infection: A Clinical Study of Experience of a Single Center (예방적 항생제 사용중에 발생한 요로감염: 단일 병원에서 경험한 임상연구)

  • Bae, Sang-In;Cheon, Chong-Kun;Kim, Su-Young
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.203-209
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    • 2010
  • Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

Selection of fungicides to control leaf spot of jujube (Zizyphus jujuba) trees caused by Phoma sp. (Phoma sp.에 의한 대추나무 점무늬병 방제용 살균제 선발)

  • Lee, Bong-Hun;Lim, Tae-Heon;Cha, Byeong-Jin
    • The Korean Journal of Pesticide Science
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    • v.4 no.3
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    • pp.40-46
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    • 2000
  • To select the effective fungicides for the control of leaf spot disease of jujube tree (Zizyphus jujuba) caused by Phoma sp., inhibitory effects of 26 fungicides for mycelial growth were investigated at $250{\mu}g\;a.i./m{\ell}$. In the test, eight fungicides were selected and minimum inhibitory concentration (MIC) for mycelial growth and an inhibitory effect for spore germination were investigated. Among the fungicides, myclobutanil, hexaconazole, and triflumizole were excluded in control effect tests because of their relatively high MICs. MICs were ranged $10-50{\mu}g\;a.i./m{\ell}$ for benomyl, carbendazim + kasugamycin (CK), and thiophanate-methyl. triflumizole (TT), and $50-250{\mu}g\;a.i./m{\ell}$ for iprodione + propineb (IT) and iminoctadine-triacelate (IT). However, benomyl and IP showed very low inhibitory effect on conidial germination. When the fungicides were sprayed on the seedlings before the leaves were inoculated with conidial suspension of Phoma sp., the protective values of CK and TT were around 70% at 1,000 ppm and around 90% at 2,000 ppm. The protective values were around 70% at 2,000 ppm (benomyl), 4,000 ppm (IP), and 8,000 ppm (IT). When the fungicides were sprayed after inoculation, benomyl showed the highest curative values of over 90% at 1,000 ppm and the values of CK and TT ranged $70{\sim}80%$ at 1,000 ppm. However, IP and IT had little or no effect on therapy of the disease. IT caused necrotic phytotoxicity on the leaves of jujube seedlings. As results, the best fungicides for the protection of jujube trees from leaf spot disease were CK (2,000 ppm) and TT (2,000 ppm) and for the remedy of the tree, benomyl (1,000 ppm) was the best. Therefore, alternate application of benomyl and CK or TT will be effective in the disease control.

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Effects of Gastrodia Rhizoma Extracts on Global Coronary Circulation in Rats (천마 Extracts가 백서의 국소적 관상순환기능에 미치는 영향)

  • Kim, Eun-Ji;Ji, Geun-Eog;Kang, Young-Hee
    • Korean Journal of Food Science and Technology
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    • v.26 no.3
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    • pp.213-220
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    • 1994
  • Gastrodia (G) Rhizoma has been used clinically as an oriental herbal medicine with sedative, anticonvulsive, and depressor effects. The present study tested effects of G. Rhizoma extracts on the coronary circulation and myocardial oxygen consumption in perfused rat hearts. Sprague Dawley rats (SD) and spontaneously hypertensive rats (SHR) were employed as experimental animals and nonworking Langendorff heart perfusion technique introduced for heart experiments. G. Rhizoma extracts were prepared from grinding G. Rhizoma into powder, extracting in water and 50% ethanol for 4 or 16 hr and diluting with Krebs-Henseleit bicarbonate perfusion buffer to be 70%. Hearts were perfused with bicarbonate buffer oxygenated with 95% $O_{2}:$ 5% $CO_{2}$ at constant coronary perfusion pressure of $90cmH_{2}O$. The diluted extracts were infused into coronary arteries in a concentration of $1{\sim}5\;{\mu}M$ for $7{\sim}8 min. While in SD water- or ethanol-extracts of G. Rhizoma extracted for 16 hr increased coronary perfusate flow (CPF) and decreased coronary vascular resistance (CVR), ethanol-extracts in SHR produced coronary vasoconstriction associated with enhanced CVR. G. Rhizoma extracts-induced increase in CPF reduced myocardial oxygen extraction, and thus myocardial oxygen consumption ($MVO_{2}$) remained at that observed prior to infusion of extracts. In SD and SHR 16 hr-water-extracts markedly altered coronary venous effluent pH and $Pco_{2}$ and evoked metabolic acidosis, which could be a coronary vasodilator mechanism decreasing CVR. In this study, the extracts decreasing CVR in SD and SHR did not augment the lactate production. Therefore, although the effects of the extracts on cardiac function and coronary circulation depended on solvents and duration for extraction, the 16hr-water-extracts, at least, exhibited coronary vasodilation in SD and SHR. Conversely, ethanol-extracts constricted coronary arteries in SHR. G. Rhizoma extracts-induced vasodilation might be due to the metabolic acidosis rather than due to the increased lactate production. The results indicate that G. Rhizoma extracts obtained from proper extracting procedures can be used as a safe and clinically applicable herbal medicine in the cardiovascular diseases such as coronary artery disease and hypertension for vasodilatory and antihypertensive actions.

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Effect of PS-K on nile tilapia, Oreochromis niloticus, as an adjuvant and prophylactic agent (나일 틸라피아에 대한 질병예방제 및 면역보조제로서의 PS-K 효과 분석)

  • Park, Kyun-Hyun;Ha, Jai-Yi;Huh, Min-Do;Huh, Sung-Hoi;Jeong, Hyun-Do
    • Journal of fish pathology
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    • v.10 no.1
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    • pp.45-52
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    • 1997
  • A protein-bound polysaccharide preparation, PS-K, isolated from Coriolus versicolor was evaluated for its ability to enhance resistance against Edwardsiella tarda, causal agent of classical edwardsiellosis in tilapia, Oreochromis niloticus. Fish treated with a dose rate of 0.1 mg PS-K $g^{-1}$ body weight were challenged by intraperitoneal injection of E. tarda with different concentrations. Against low burdens of injections($1.2{\times}10^7$ and $1.2{\times}10^8$ cfu/fish), PS-K treated fish did not show any mortality compared to 50% and 100% mortality of control groups, respectively. However there was no increase of resistance against challenge with high concentrations of E. tarda ($1.2{\times}10^9$ and $1.2{\times}10^{10}$cfu /fish) except few days delaying of death. Tilapia injected with PS-K one day after intraperitoneal inoculation of E tarda($1.2{\times}10^7$ cfu/fish) showed 100% survival rate compared to control group of 50% survival rate. The result indicates the potential of PS-K as a prophylactic agent in aquaculture. The increased antibody response in fish received PS-K one week prior to FKC administration suggested the influence of PS-K on the specific humoral immunity and increased resistance against bacterial infection.

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Effect of Organic Materials and the Removal of Apical Shoot on Controlling Cucumber Downy Mildew (유기농업자재와 순지르기를 이용한 오이 노균병 방제)

  • Park, Jong-Won;Kim, Yong-Ki;Park, So-Hyang;Hong, Sung-Jun;Shim, Chang-Ki;Kim, Min-Jeong;Park, Jong-Ho;Han, Eun-Jung;So, Hyun-Gyu;Kim, Seok-Cheol
    • Korean Journal of Organic Agriculture
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    • v.24 no.4
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    • pp.919-929
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    • 2016
  • This study investigated the effect of organic materials (Bordeaux, Loess-sulfur) and the removal of apical shoot against downy mildew disease on cucumber cultivated in greenhouse. Five kinds of Bordeaux were made by adjusting mixing ratio of lime and copper sulfate in order to elucidate the optimal combination. The 4-6type Bordeaux was selected as the most effective combination for controlling cucumber downy mildew. Loess-sulfur showed inhibitory activity against cucumber downey mildew, but it was less effective than Bordeaux. It was confirmed that apical shoot cutting could reduce the incidence of cucumber downy mildew disease by 56.3%. When apical shoots of susceptible cucumber variety were cut at different leaf stages, disease incidence by early apical shoot cutting treatment was lower than that of late apical shoot cutting treatment. However in a resistant variety, 'Heukryungsamcheok', disease incidences of all cucumber apical shoot cutting treatments were lower than that of non-cutting treatment, but there was no differences between apical shoot cutting treatments due to low disease incidences. In addition, when organic materials and apical shoot cutting treatment were carried out in parallel, the combined treatments of organic materials and apical shoot cutting showed low disease incidence of cucumber downy mildew compared to untreated control. The lowest disease incidence of cucumber downy mildew was recorded in the combined treatment of 4-6type Bordeaux and apical shoot cutting. This study confirmed that apical shoot cutting can reduce the disease incidence of cucumber downy mildew and the combined treatment of apical shoot cutting and organic materials showed higher suppressive effect against cucumber downy mildew.

Ethics for Cloned Human Beings: (<네버렛미고>를 통해본 복제 인간 윤리)

  • Kim, Mihye
    • The Journal of the Korea Contents Association
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    • v.17 no.8
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    • pp.121-129
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    • 2017
  • The evolution of biotechnology is no longer strange to the hypothetical scenario of cloning human genes to make cloned human beings. The characters of are cloned humans made in the laboratory by the 100-year-old life planning. They are cohabited in a school called Hailsham, where they are secretly reared. The purpose of this project is to provide healthy organs to real human patients with incurable diseases. The main characters Cathy, Tommy, and Ruth experience the growth of body and consciousness here during adolescence, and they also know the secret of identity as a clone. As adults, they move to a second residence, Cottage and are ready to begin organ donation. The second stage is also part of a program to provide more genuine-like organs to real patients. Even though they know all the plans that humans have built, they do not resist them and fatefully accept their situation. However, their non-responsiveness is not a declaration of renunciation of life, but a self-sacrificing life extension for another future that is the extension of life through their organ donation. The film emphasizes the fraternity and sacrificial attitudes of the cloned human beings and shows that it is necessary to continue the discussions on cloned human beings from a bio-ethical point of view supported by philosophical reasons.

Identification and antimicrobial susceptibility of bacteria from the uterus of bitches with pyometra (개 자궁축농증에서의 원인균 분리 및 항생제 감수성 검사)

  • Lee, So-hyun;Cho, Jong-ki;Shin, Na-ri;Kim, Hye-soo;Yong, Hwan-yul;Yoo, Han-sang;Lee, Kang-nam;Lee, Byeong-chun;Hwang, Woo-suk
    • Korean Journal of Veterinary Research
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    • v.40 no.4
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    • pp.763-767
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    • 2000
  • This study was performed to isolate and identify bacteria from uterus with pyometra and examine their susceptibility to antimicrobial agents. Uterus of 16 bitches with pyometra were surgically removed by ovariohysteroctomy and then bacteria were isolated and identified. Also, susceptibility test to 15 antimicrobial agents was performed. Out of 16 bitches, 11 strains of Escherichia coli, 2 strains of Serratia marcescens, and 1 strain of Staphylococcus aureus and Salmonella spp. were identified. In antimicrobial susceptibility test, the majority of isolates were susceptible to enrofloxacin, norfloxacin, chloramphenicol, nalidixic acid, gentamicin, trimethprim-sulfamethazole, tetracycline, and moderately susceptible to carbenicillin, amikacin, ampicillin, neomycin, but resistant to vancomycin, streptomycin, bacitracin and colistin. In conclusion, E coli was the most common bacteria isolated from bitches with pyometra and those susceptible antimicrobial agents could be recommended to medical therapy of pyometra.

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Enhanced Extraction of Bioactive Compounds from Bee Pollen by Wet-grinding Technology (벌 화분에서 습식 나노화 공정에 의한 유효성분의 추출)

  • Choi, Yun-Sik;Suh, Hwa-Jin;Chung, Il Kyung
    • Journal of Life Science
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    • v.26 no.6
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    • pp.651-656
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    • 2016
  • Bee pollen is produced by honeybees and is considered one of the most balanced and nourishing nutritional supplements available. Historically, bee pollen has been prescribed for its healing properties and consumed for its high-energy supply. Recent research has provided evidence that bee pollen has diverse biological activities, such as anti-oxidant, anti-inflammatory, anti-bacterial, and even anti-cancer effects. However, the outer membrane of the pollen grain, exine, is highly resistant to most acidic solutions, high pressure, and even digestive enzymes, and the resulting low bioavailability limits its nutritional and clinical applications. This study applied a wet-grinding method to destroy the exine effectively, and it then examined the pollen's enhanced biological activity. First, microscopic observations provided strong evidence that wet grinding destroyed the exine time-dependently. In addition, the content of polyphenols, well-known ingredients of bee pollen and used as internal standards for the quality control of commercial pollen preparations, increased up to 11-fold with wet grinding. Further, the anti-oxidant activity demonstrated on the ABTS anti-oxidant assay, as well as the DPPH radical scavenging assay, was also dramatically increased. Together, the results presented here support a new technology by which bee pollen can be used as a resource for medical, nutritional, and cosmetic applications.

An Experimental Study on the Effect of Combined X-ray and Microwave Hyperthermia on the Rectum and Urinary Bladder of Rats (흰쥐의 직장과 방광에 X-선 조사와 마이크로파 온열요법의 효과에 관한 실험적 연구)

  • Lee, Kyung-Ja;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.4 no.2
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    • pp.115-128
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    • 1986
  • Hyperthermia can enhance the radiation effect as a synergistic reaction in combined X-ray irradiation and hyperthermia; hyperthermia sensitize radioresistant S-phase cells and inhibit cellular recovery from sublethal damage. We fabricated 100 watts, 2450 MHz microwave applicator for hyperthermia and planned the method and condition of heating and measured the temperature by using Agar phantom as a preliminary test. For biological examination, 102 rats were divided into 4 groups as hyperthermia, X-ray irradiation (6Gy-15Gy), combined X-ray and hyperthermia, and normal control groups. Microscopic examination of the rectum and bladder was done and the results were as followings: 1. The microwave generator with 100 watts, 2450MHz magnetron could be heating up to $40^{\circ}{\sim}50^{\circ}C$ for one hour in living tissue. 2. The thermal distribution in tissue equivalent phantom with microwave can be maintained at $40^{\circ}{\sim}44^{\circ}C$ in area of 3cm in depth and 2-10cm in diameter. 3. In Hyperthermia alone group, there was submucosal edema of the rectum but no histologic change in the urinary bladder was seen. 4. The minimal necrosis of the mucosa was appeared in the rectum and bladder after 15 days of 6 Gy and 8 Gy irradiation respectively. The minimal necrosis of the muscle layer of rectum and bladder was appeared after 15 days of 8Gy and 60days of 10Gy irradiation respectively. 5. In combined group of radiation and hyperthermia, thermal enhancement ratio (calculated at necrosis of mucosa and muscle layer) of rectum and bladder was 1.0, and it suggest that there is no change of tolerance dose of normal rectum and bladder.

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