• 제목/요약/키워드: Antibiotic therapy

검색결과 408건 처리시간 0.026초

급성 호흡곤란증후군과 수막뇌염을 동반한 쭈쭈가무시병 1예 (A Case of Scrub Typhus with Acute Respiratory Distress Syndrome and Meningoencephalitis)

  • 한혜원;최영기;박만원;박호성;손동균;노대근;김승준;이숙영;김영균;박성학
    • Tuberculosis and Respiratory Diseases
    • /
    • 제52권3호
    • /
    • pp.283-287
    • /
    • 2002
  • Scrub typhus is an acute, febrile disease of humans that is caused by Orientia Tsutsugamushi. It is transmitted through the bite of chiggers. The spectrum of the clinical severity for scrub typhus ranges from mild to severe with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. Severe pulmonary involvement e.g. acute respiratory distress syndrome(ARDS) and meningoencephalitis have rarely been observed since the introduction of specific antibiotic therapy. We experienced a case of scrub typhus manifested with ARDS and meningoencephalitis. The patient was treated with doxycycline, anticonvulsant and mechanical ventilator therapy.

인간 단클론 항체 생산용 Humanized Xenomouse 제작의 기초 소재인 생쥐 Ig 중사슬 및 경사슬 Genomic DNA 클론의 확보 및 유전자 적중 벡터의 제작 (Isolation of Mouse Ig Heavy and Light Chain Genomic DNA Clones, and Construction of Gene Knockout Vector for the Generation of Humanized Xenomouse)

  • 이희경;차상훈
    • IMMUNE NETWORK
    • /
    • 제2권4호
    • /
    • pp.233-241
    • /
    • 2002
  • Background: Monoclonal antibodies (mAb) of rodent origin are produced with ease by hybridoma fusion technique, and have been successfully used as therapeutic reagents for humans after humanization by genetic engineering. However, utilization of these antibodies for therapeutic purpose has been limited by the fact that they act as immunogens in human body causing undesired side effects. So far, there have been several attempts to produce human mAbs for effective in vivo diagnostic or therapeutic reagents including the use of humanized xenomouse that is generated by mating knockout mice which lost Ig heavy and light chain genes by homologous recombination and transgenic mice having both human Ig heavy and light gene loci in their genome. Methods: Genomic DNA fragments of mouse Ig heavy and light chain were obtained from a mouse brain ${\lambda}$ genomic library by PCR screening and cloned into a targeting vector with ultimate goal of generating Ig knockout mouse. Results: Through PCR screening of the genomic library, three heavy chain and three light chain Ig gene fragments were identified, and restriction map of one of the heavy chain gene fragments was determined. Then heavy chain Ig gene fragments were subcloned into a targeting vector. The resulting construct was introduced into embryonic stem cells. Antibiotic selection of transfected cells is under the progress. Conclusion: Generation of xenomouse is particularly important in medical biotechnology. However, this goal is not easily achieved due to the technical difficulties as well as huge financial expenses. Although we are in the early stage of a long-term project, our results, at least, partially contribute the successful generation of humanized xenomouse in Korea.

쯔쯔가무시병의 주요 임상적 특성 및 간호중재 분석 (Clinical Characteristics and Nursing Cares of Tsutsugamushi Disease Occurred in Gyongsangbuk-do Community)

  • 한희자;박종남;엄희경;홍현숙;백설향
    • Journal of Korean Biological Nursing Science
    • /
    • 제5권1호
    • /
    • pp.35-44
    • /
    • 2003
  • Objectives : Though Tsutsugamushi disease has been reported with increasing frequencies in rural communities in Korea, it is not easy to find the nursing investigations. Methods : We have conducted a survey on 30 cases who had the fever as a chief complaint, then clinically ruled out the Tsutsugamushi disease in autumn of $2000{\sim}2001$. Data were collected retrospectively by investigation of the general characteristics, clinical and laboratory findings, their nursing care. Findings: Of 30 cases, 46.7% were farmers, and 60.0% had chances of exposure to fields or mountains. The characteristic symptoms and signs were febrile sense and chill(100.0%), headache(80.0%), and eschar(66.7%). Abnormal laboratory findings were anemia (23.3%), elevated AST(60.6%), ALT(63.3%), and abnormal urinalysis findings(50.0%). 53.3% were serologically confirmed as Tsutsugamushi disease. Therapeutic nursing cares were composed with warm up by blancket(50.0%), Ice bag(50.0%) and doxycycline antibiotic therapy(100.0%). Other nursing care for them included fluid therapy(100.0%) and nutritional support with regular(56.7%) or soft diet(43.3%). Conclusion: The above results indicate nurses who take care of acute febrile clients should make her responsible for the fever and pain management as well as give education for infection control for the community inhabitants.

  • PDF

저용량 독시싸이클린 투여가 당뇨환자 마치 성인성 치주염 환자의 치은열구액내 효소 활성도에 미치는 영향에 관한 비교연구 (The effects of low dose doxycycline regimen on gingival crevicular fluid enzyme actmty of diabetic patients with periodontitis and adult periodontitis patients)

  • 정성념;한수부
    • Journal of Periodontal and Implant Science
    • /
    • 제27권4호
    • /
    • pp.701-722
    • /
    • 1997
  • It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

  • PDF

하악골 골절후 이차감염으로 인한 골수염시 유리 장골 이식술과 고압산소 요법을 이용한 재건 치험례 (RECONSTRUCTION COMBINED WITH HBO THERAPY AND ILIAC BONE GRAFT IN MANDIBULAR FRCTURE SITE OSTEOMYELITIS)

  • 김수남;이동근;임창준;윤성필
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제13권1호
    • /
    • pp.110-116
    • /
    • 1991
  • 하악골 골절시 감염으로 인한 합병증에는 비유합, 부정유합, 감염에 의한 골수염, 치아 및 지지골 상실, 국소부위로부터 인접부위로 감염확장 등이 있다. 그 원인으로는 크게 국소요인과 전신요인으로 분류되는데 국소요인으로는 부적절한 고정과 수복, 감염 및 개조된 혈액공급을 들 수 있고 전신 요인으로는 부적절한 고정과 수복, 감염 및 개조된 혈액 공급을 들 수 있는 전신요인으로는 환자의 나이 및 대상장애 질환이나 primary bone disease, 영양결핍을 들 수 있다. 악골골절과 관련된 골수염은 조기에 적절한 고정 및 치료, 항생제 요법, 골절선상의 치아에 대한 치료, 전신적 저항성을 항진 시킴으로서 예방할 수 있다. 본 저자들은 하악골 골절수 이차감염으로 인한 골수염에서 골 이식의 일반적인 원칙인 감염이 없는 부위가 아닌 염증이 존재한 부위에 유리장골 이식술과 고압산소 요법을 병행하여 양호한 결과를 얻었기에 이에 보고하는 바이다.

  • PDF

투여 항생제군과 Clostridium Difficile-Associated Diarrhea의 위험인자 분석 (Risk Factor Analysis of Clostridium Difficile Associated Diarrhea and Antibiotics Administration)

  • 오경선;이숙향
    • 한국임상약학회지
    • /
    • 제20권1호
    • /
    • pp.78-84
    • /
    • 2010
  • Background: Clostridium difficile is the primary reason of the nosocomial diarrhea. The antimicrobial therapy plays a central role in the pathogenesis of Clostridium difficile associated diarrhea (CDAD). Although nearly all classes of antimicrobial agents have been associated with CDAD, clindamycin and the third-generation cephalosporins have traditionally been considered to the greatest risk factor. Recent studies have also implicated fluoroquinolones as high-risk agents due to increasing use of the agents. This study was to determine the incidence and the risk factors of CDAD related to the administered antibiotics and to assess the therapeutic regimen of metronidazole or vancomycin based on the C. difficile toxin assay Methods: A retrospective study was performed in patients with Clostridium difficile toxin assay at I Hospital (Incheon, South Korea) during the period from January 2007 through December 2007. Administrative, laboratory, and pharmacy data were collected from Electronic Medical Databases. Results: The analysis included 129 reported C.difficile toxin assay results, with 42 positive cases and 87 negative cases. Significant antibiotic risk factors for CDAD included the use of the fourth-generation cephalosporinse (OR=5.97, 95% CI 1.37-25.98, P=0.017). Administration of metronidazole was protective against CDAD (OR=0.30, 95% CI 0.12-0.74, P=0.009). Prolonged antimicrobial therapy has been associated with an increased risk of CDAD. The third-generation cephalosporins (OR=3.81, 95% CI 1.08-13.41, P=0.037) and aminoglycoside (OR=5.50, 95% CI 1.43-21.10, P=0.013) demonstrated greater risk for CDAD over 15 days than 8days or less days of treatment duration. Conclusions: The fourth and third generation cephalosporin, aminglycoside were the significant risk factors compared with other antibiotics, whereas metronidazole appears to be protective. The longer duration of antiobiotic use increased CDAD.

마우스 림프구증식과 GM-CSF생성에 미치는 Berberine의 효과 (Effects of Berberine on Lymphocyte Proliferation and GM-CSF Production in Mice.)

  • 김은영;노민희;정양숙;김형수;김광혁
    • 생명과학회지
    • /
    • 제17권5호
    • /
    • pp.694-698
    • /
    • 2007
  • 본 연구에서는 berberine이 세포성 면역에 미치는 효과를 보기위하여 림프구증식과 GM-CSF생성을 보고자 하였다. 마우스 비장세포에 berberine을 작용시켰을 때 저농도에서 세포성장을 촉진함으로서 림프구증식에 자극제로서의 역할을 담당할 것으로 보인다. GM-CSF의 생성은 berberine 단독처리에 의해서 증가됨으로서 GM-CSF생성의 증가로 인한 세포성 면역반응의 상승이 예상되고 LPS나 Con A에 의한 GM-CSF의 생성을 저해함으로서 과도한 GM-CSF생성을 중간에서 차단할 것으로 보인다. 따라서 이러한 결과들은 앞으로의 추가적인 연구결과들이 있게 되면 임상에서의 면역요법과 항염증작용에 berberine이 이용될 가능성을 시사한다 하겠다.

Aloe-Emodin-Mediated Photodynamic Therapy Attenuates Sepsis-Associated Toxins in Selected Gram-Positive Bacteria In Vitro

  • Otieno, Woodvine;Liu, Chengcheng;Ji, Yanhong
    • Journal of Microbiology and Biotechnology
    • /
    • 제31권9호
    • /
    • pp.1200-1209
    • /
    • 2021
  • Sepsis is an acute inflammatory response that leads to life-threatening complications if not quickly and adequately treated. Cytolysin, hemolysin, and pneumolysin are toxins produced by gram-positive bacteria and are responsible for resistance to antimicrobial drugs, cause virulence and lead to sepsis. This work assessed the effects of aloe-emodin (AE) and photodynamic therapy (PDT) on sepsis-associated gram-positive bacterial toxins. Standard and antibiotic-resistant Enterococcus faecalis, Staphylococcus aureus, and Streptococcus pneumonia bacterial strains were cultured in the dark with varying AE concentrations and later irradiated with 72 J/cm-2 light. Colony and biofilm formation was determined. CCK-8, Griess reagent reaction, and ELISA assays were done on bacteria-infected RAW264.7 cells to determine the cell viability, NO, and IL-1β and IL-6 pro-inflammatory cytokines responses, respectively. Hemolysis and western blot assays were done to determine the effect of treatment on hemolysis activity and sepsis-associated toxins expressions. AE-mediated PDT reduced bacterial survival in a dose-dependent manner with 32 ㎍/ml of AE almost eliminating their survival. Cell proliferation, NO, IL-1β, and IL-6 cytokines production were also significantly downregulated. Further, the hemolytic activities and expressions of cytolysin, hemolysin, and pneumolysin were significantly reduced following AE-mediated PDT. In conclusion, combined use of AE and light (435 ± 10 nm) inactivates MRSA, S. aureus (ATCC 29213), S. pneumoniae (ATCC 49619), MDR-S. pneumoniae, E. faecalis (ATCC 29212), and VRE (ATCC 51299) in an AE-dose dependent manner. AE and light are also effective in reducing biofilm formations, suppressing pro-inflammatory cytokines, hemolytic activities, and inhibiting the expressions of toxins that cause sepsis.

생물막 분산기작을 이용한 만성창상의 치료전략 (Therapeutic strategies to manage chronic wounds by using biofilm dispersal mechanisms)

  • 김재수;김민호
    • 미생물학회지
    • /
    • 제55권2호
    • /
    • pp.87-102
    • /
    • 2019
  • 대부분의 만성창상(chronic wounds)은 생물막으로 인해 상처 치유시 염증단계를 지속시킨다. 생물막은 항생제(antibiotics)에 대한 저항성을 가지며 침투력을 저하시키고 살균제(biocides)에 대한 내성을 지니며 국소면역반응을 약화시킨다. 또한 생물막은 주변의 조직에 단단히 붙어 있어 제거하는 작업이 매우 어렵다. 그러므로 주변 조직을 손상시키지 않으면서 단단한 생물막을 제거하는 전략은 매우 중요하다. 그 중에 하나가 분산기작을 이용한 생물막의 해체이며 지금까지 많은 연구가 수행되어 왔다. 본 고찰논문에서는 특별히 화학주성, 파지요법, 다당류, 다양한 효소(당분해효소, 단백질분해효소, DNA 분해효소), 계면활성제, 분산신호, 자기유도인자, 조절인자, 억제제 등이 소개되었으며 더 나아가 항생제 치료 및 다른 치료와의 병행을 통한 병합요법도 소개되었다. 앞으로 본 논문에서 제시된 생물막의 분산기작의 지식을 이용하여 만성 창상 감염치료의 가능성이 더 높아지길 기대한다.

Failure of Ciprofloxacin Therapy in the Treatment of Community-Acquired Acute Pyelonephritis caused by In-Vitro Susceptible Escherichia coli Strain Producing CTX-Type Extended-Spectrum β-Lactamase

  • Seok, Hyeri;Cha, Min Kyeong;Kang, Cheol-In;Cho, Sun Young;Kim, So Hyun;Ha, Young Eun;Chung, Doo Ryeon;Peck, Kyong Ran;Song, Jae-Hoon
    • Infection and chemotherapy
    • /
    • 제50권4호
    • /
    • pp.357-361
    • /
    • 2018
  • While carbapenems are the drug of choice to treat extended-spectrum-${\beta}$-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient's clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.