• 제목/요약/키워드: Drug-resistance rate

검색결과 162건 처리시간 0.032초

Controlled Release Behavior of Bioactive Molecules from Photo-Reactive Hyaluronic Acid-Alginate Scaffolds

  • Nam, Hye-Sung;An, Jeong-Ho;Chung, Dong-June;Kim, Ji-Heung;Chung, Chong-Pyoung
    • Macromolecular Research
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    • 제14권5호
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    • pp.530-538
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    • 2006
  • There are three important components in tissue engineering: the cells, signaling factors (cytokines and growth factors), and scaffolds. To obtain finely engineered tissue, all three components should perform their individual functions and be fully integrated with each other. For the past few years, we have studied the characteristics of photodimerizable HA (CHA)/alginate (CA) composite materials. CHA/CA complex hydrogels, which were irradiated under UV light and, then treated with calcium ions, were found to have good biocompatibility, mechanical properties and water resistance for implantable tissue scaffolds. In this study, we introduced a cell growth factor (basic fibroblast growth factor; bFGF) into the CHA/CA scaffolds and studied its release behavior. We also introduced tetracycline hydrochloride and flurbiprofen into the same scaffolds as model activation factors and evaluated their release behaviors from the scaffolds. The drug release rate from the materials was influenced by various parameters, such as the degree of crosslinking, the cross linker type, the physico-chemical properties of the drug, and the amount of the drug in the polymer. The results indicated that the negatively charged CHA/CA composite materials showed sustained release behavior and that HA has a particularly strong negative charge, making it attractive toward tetracycline hydrochloride and bFGF, but repulsive toward flurbiprofen.

6개월 단기 항결핵 화학요법의 성적 (Results of 6 Month Short Course Chemotherpay for Pulmonary Tuberculosis with 2SHRZ/4HR)

  • 이향주;민철홍;이선우;박인원;최병휘;허성호
    • Tuberculosis and Respiratory Diseases
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    • 제38권2호
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    • pp.93-98
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    • 1991
  • A clinical trial was made on 76 patients with pulmonary tuberculosis to determine the effectiveness and acceptibility of 6 month 2SHRZ/4HR antituberculosis regimen. Out of 76 patients, 13 patients (17.1%) dropped out and 11 patients (14.5%) were excluded due to drug resistance. In 3 patients (3.9%), regimen was changed due to adverse effects. Treatment failure rate was 2.0% in 50 patients. One patient, who had far advanced lesion, was treated longer than 6 months due to failure of sputum conversion. The most common adverse effect was arthralgia, which was controlled by the administration of allopurinol and nonsteroidal anti-inflammatory drug. In conclusion, 2SHRZ/4HR for 6 months was effective regimen in treating the newly-diagnosed patients with tuberculosis, but change of the regimen and duration might be carefully considered by the severity of the lesion and adverse effect of the drug But further study will be needed to evaluate not only the efficacy and efficiency of 6 month chemotherapy but also relapse rates.

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Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching

  • Hongjo Choi;Dawoon Jeong;Young Ae Kang;Doosoo Jeon;Hee-Yeon Kang;Hee Jin Kim;Hee-Sun Kim;Jeongha Mok
    • Tuberculosis and Respiratory Diseases
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    • 제86권3호
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    • pp.234-244
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    • 2023
  • Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

Staphylococcus Species in the Dental and Medical Environment

  • Han, Seung-Ho;Kim, Shin-Moo;Jeong, Seung-Il;Kim, Kang-Ju
    • International Journal of Oral Biology
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    • 제38권1호
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    • pp.1-4
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    • 2013
  • Staphylococcus species are one of prevalent pathogens found in hospitals. Microbes that are a primary cause of nosocomial infection were isolated from a dental and medical environment it may assist the reader to explain what this is and how it differs from the 'dental health care providers and ward health care providers'. To investigate the distribution of staphylococcus species in this environment, we used vitek II to measure drug sensitivity, and further performed biochemical testing. The isolation rate of staphylococcus species from the dental and medical environment was 100% but from dental health care providers and ward health care providers were 44.4% and 33.3%, respectively. In the analyses, staphylococcus species showed resistance to diffusion of cefoxitin and oxacillin discs. These staphylococci may be sufficiently positive for the mecA gene. Our results suggest that staphylococci might be an important cause of nosocomial infection in the dental clinic.

Clonidine Patch제의 효능시험 : 혈압강하작용 (Antihypertensive Action of Clonidine Patch)

  • 정재훈;신찬영;류재련;박우일;고광호
    • Biomolecules & Therapeutics
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    • 제4권2호
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    • pp.205-207
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    • 1996
  • Clonidine, an antihypertensive drug, stimulates postsynaptic alpha-2 adrenergic receptors in the central nervous system and lowers arterial pressure through the effects on both cardiac output and peripheral resistance. However, many patients experience that sedation and xerostomia occur upon oral administration of clonidine. These side effects are due to high plasma peak concentration and can be avoided when clonidine is given transdermally. In this study, we tested the antihypertensive effects of trandermal administration of clonidine patch on spontaneously hypertensive rat (SHR) which is a model animal for human essential hypertension. Forty eight SHR (male) were divided into six groups according to the dose levels, respectively. After transdermal administration of clonidine patch of each dose, systolic blood pressure and heart rate were measured. Clonidine patch produced maximal antihypertensive and bradycardiac effects 48 hrs after administration and antihypertensive effects showed dose-dependency. We suggest that antihypertensive effects of clonidine patch are similar to those of orally given clonidine and clonidine patch can be used instead of clonidine tablet.

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병원녹농균(病院綠膿菌)의 동종균접합(同種菌接合)에 의한 다제내성(多劑耐性)의 전달(傳達) (Transmission of Multiple Drag-Resistance in Hospital Pseudomonas aeruginosa by Intraspecies Conjugation System)

  • 김정;한왕수;서인수
    • 대한미생물학회지
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    • 제14권1호
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    • pp.49-61
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    • 1979
  • Two hundred and ninety-five strains of Peudomonas aeruginosa isolated from clinical sources were tested for drug resistance and demonstration of R plasmids by intraspecies conjugation system. Sixty strains were found highly resistant to two or more of drugs. The rate of resistant strains were 38.9% to kanamycin(km), 33.2% to streptomydn(sm), 22.7% to sulfisomidine(Sa), 14.2% to chloramphenicol(Cp), 13.8% to tetracycline(Tc), 3.0% to carbenicillin(Cb), and to gentamicin(Gm), respectively. But no strains was resistant to nalidixic acid and colistine. They were resistant to per milliliter to more than $400{\mu}g$ per ml. of Tc, $800{\mu}g$ per ml of Cp and of Sm, $6,400{\mu}g$ per ml. of Sa, $200{\mu}g$ per ml. of Cb, $100{\mu}g$ per ml. of Gm, and $25{\mu}g$ per ml. of colistine. Forty-three strains of Pseudomonas aeruginosa could be transferred their resistance to Pseudomonas aeruginosa 2-70, 1005 rifampin resistant FP-auxotrophic mutant. Of sixty multiple resistant strains, forty-three(71.6%) demonstrated R plasmids; nineteen carried resistance to(Tc Cp Sm Sa), six to(Tc Cp Sm), three to(Tc Cp Sa), and Cp, five to(Tc Sm Sa), two to(Tc Sa), (Cp Sm) and Tc, and one to(Cp Sm Sa). Degree of resistance of recipients recieving R plasmids from donors were almost the same level of resistance as the donor in regardless of mating temperature at $25^{\circ}C$ and $37^{\circ}C$. Resistance to Tc, Sm, and Sa were transferred to a very few of recipient cells at five minutes after mating with donor and recipient cells but resistance to Cp were transferred to the majority of recipient cells. The transfer frequency of Tc, Cp, Sm, and Sa resistance from donors to recipients were from $1.0^{-1.4}\;to\;1.0^{-3.5}$ at $25^{\circ}C$ for 18 hours of incubation and were from $1.0^{-1.5}\;to\;1.0^{-3.5}$ at $37^{\circ}C$ for 18 hours of incubation.

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Efficacy of Exemestane After Nonsteroidal Aromatase inhibitor Use in Metastatic Breast Cancer Patients

  • Kim, Sun-Hye;Park, In-Hae;Lee, Hye-Won;Lee, Keun-Seok;Nam, Byung-Ho;Ro, Jung-Sil
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.979-983
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    • 2012
  • Background : Previous studies have suggested a lack of complete cross-resistance between steroidal (exemestane) and non-steroidal aromatase inhibitors (nSAI). Methods : Eighty-eight metastatic breast cancer (MBC) patients who received 25 mg of exemestane orally once a day at the National Cancer Center, Korea, between 2003 and 2009, were reviewed retrospectively. All patients had received nSAI for metastatic disease prior to exemestane therapy. Results : The median age was 52 years (range, 33-79), and 13 (14.8%) patients were premenopausal who concomitantly received GnRH agonist. Exemestane was given as a second- (80.7%) or third-line (19.3%) hormone therapy. The clinical benefit (CB) rate (complete response + partial response + stable disease ${\geq}$ 24 weeks) was 30.7%, with a median CB duration of 10.0 months (range, 6.3-78.7). The median progression-free survival (PFS) was 3.0 months (95% confidence interval [CI], 1.99-4.01) and the overall survival (OS) 21.5 months (95% CI, 17.96-25.04), with a median followup of 50.3 months. Patients who achieved CB had longer OS than those patients who did not (29.6 vs 17.9 months; P=0.002). On univariate analysis of predictive factors, patients who had achieved CB from previous nSAI tended to show lower CB rate (24.6% vs 44.4%, respectively; P=0.063) and shorter PFS (2.8 vs 4.8 months, respectively; p=0.233) than patients who had not. Achieving CB from previous nSAI became independent predictive factor for CBR to exemestane on multivariable analysis (Odds ratio = 2.852, P = 0.040). Conclusions : Exemestane after nSAI failure was effective in prolonging CB duration. The drug's efficacy seemed to be inferior in patients who had benefit from previous nSAI use.

소아청소년에서의 항생제 사용량 변화에 따른 그람음성 균주의 항생제 내성률 변화 양상 (The Impact of Antibiotic Burden on the Selective Resistance of Gram Negative Bacteria in Children)

  • 박세라;이은택;소혜진;유리나;이진아
    • Pediatric Infection and Vaccine
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    • 제28권2호
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    • pp.82-91
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    • 2021
  • 목적: 본 연구에서는 소아환자의 혈액에서 분리된 주요 그람음성 균주의 항생제 내성 양상을 파악하고 항생제 사용량과의 관계를 알아보고자 하였다. 방법: 2014년 1월부터 2018년 6월까지 서울아산병원 어린이병원에 입원한 18세 이하의 소아청소년에서 발생한 그람음성 균주 균혈증 중 Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, 총 4가지 균주를 대상으로 항생제 내성 양상을 분석하였다. 또 원내에서 소아에게 주로 사용하는 정주용 항생제의 사용량과 항생제 내성률의 변화와의 관련성을 분석하였다. 결과: 본 연구 기간 동안 전체 혈액배양에서, K. pneumoniae (6.4%; 105/1,628), E. coli (5.6%; 91/1,628), P. aeruginosa (3.3%; 54/1,628) 및 A. baumannii (2.5%; 41/1,628)의 순으로 분리되었다. 2014-2018년에 분리된 E. coli와 K. pneumoniae의 광범위 cephalosporin 계열에 대한 내성률은 각각 49.3%와 54.4%였다. 2014년도에는 carbapenem에 내성을 보이는 E. coli 균종이 처음 출현하였고, 5년간의 내성률은 5.3%였다. 연구기간 동안 항생제 사용량과 항생제 내성률 사이의 상관관계를 분석하여, 3세대 cephalosporin 사용량과 A. baumannii의 내성률(r2=0.96, P=0.004) 그리고 carbapenem의 사용량과 K. pneumoniae의 내성률(r2=0.79, P=0.045) 간에 양의 상관관계를 확인하였다. 결론: 국내 소아에서 발생한 그람음성균 균혈증 분석 시 3세대 및 4세대 cephalosporin에 대한 높은 내성률이 확인되며, carbapenem에 대한 내성도 확인되고 있다. 일부 항생제 사용량과 해당 약제에 대한 내성률에 선형 상관관계가 있었으며, 이는 항생제 사용량이 내성률에 영향을 미칠 수 있음을 시사한다. 이에 지속적인 원내 항생제 사용량 및 내성률에 대한 감시가 필요하며, 적절한 항생제의 선택 및 관리는 내성균주 출현 예방 및 치료 성적 향상에 필수적이다.

동물유래(動物由來) 병원세균(病源細菌)의 각종(各種) 항생물질(抗生物質)에 대한 감수성조사(感受性調査) (Antmicrobial Drug Susceptibility of Pathogenic Bacteria Isolated from Animals in Korea)

  • 김봉환;이재진;김기석;한태우
    • 대한수의학회지
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    • 제20권2호
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    • pp.85-92
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    • 1980
  • The antimicrobial drug susceptibility of 439 isolates of animal pathogens recovered from various clinical cases during 1978-79 has been investigated by the use of disk diffusion technique. The majority of 308 strains of Eschericihia coli were highly resistant to bacitracin, erythromycin, penicillin, streptomycin and tetracyclinon while only 0.3 per cent of them were resistant to gentamicin and 3.2 per cent to colistin. The percentages of strains resistant to ampicillin, carbenicillin, cephalothin, chloramphenicol and neomycin were 30.5%, 24.7%, 11:4%, 28.2% and 26.2% and repectively. However, none of E. coli cultures of ovine origin were resistant to ampicillin, carbenicillin, chloramphenicol, colistin, gentamicin, kanamycin, and neomycin. A total of 39 patterns of multipe drug1 resistance of 308 strains E. coli against 9 drugs in general use such as ampicillin, cephalothin, chloramphenicol, colistin, gentamicin, kanamycin, neomycin, streptomycin and tetracycline were observed and the most common multiple resistance patterns were SM, TC pattern (20.5%) and AM, CP, KM, NM, SM, TC pattern (9.7%). None of the 43 cultures of salmonella organism from pigs and chickens were resistant to ampicillin, carbenicillin, cephalothin, colistin, gentamicin and kanamycin; and the majority of the cultures were susceptible to chloramphenicol (90.0%), neomycin (97.7%) and tetracycline (93.0%). All the cultures were found to be resistant to bacitracin and penicillin and the rate of resistant strains to erythromycin and s treptomycin being 79.1% and 41.9% respectively. It was found that the majority of 63 cultures of staphylococcal isolates were resistant to lincomycin, penicillin, streptomycin and tetracycline. The percentages of 63 staphylococcal isolates susceptible to gentamicin, nitrofurantoin, cephalothin, ampicillin, methicillin, bacitracin and chloramphenicol were 98.4%, 98.4%, 95.2%, 93.7%, 93.7%, 92.1% and 92.1% respectively. The 25 cultures of streptococcal isolates were resistant in order of prevalence to streptomycin(88.0%), kanamycin(68.0%), gentamicin (44.0%), tetracycline (44.0%) and methicillin (40.0%) wihle the majority of them were sensitive to ampicillin, bacitracin, chloramphenicol and penicillin.

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다제내성 폐결핵 치료실패의 위험인자 분석 (The Analysis of Risk Factors of Treatment Failure in MDR-TB)

  • 김형수;최광민
    • Tuberculosis and Respiratory Diseases
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    • 제50권6호
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    • pp.686-692
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    • 2001
  • 배 경 : 다제내성 폐결핵의 발생은 약제선택의 제한성과장기간의 항결핵제의 복용으로 인한 부작용 등으로 인하여 치료 성공율을 감소시킨다. 본 연구는 치료 실패인자들을 알아내어 다제내성 폐결핵의 치료 성공율을 향상시키는데 기초자료로 삼고자 하였다. 대상 및 방법 : 1996년 1월부터 1998년 12월까지 입원치료를 시행한 다제내성 폐결핵 환자 111명을 대상으로 하였다. 다제내성 폐결핵 치료의 실패에 관계되는 인자들을 분석하기 위하여 치료에 성공한 군(I군)과 실패한 군(II군)으로 나누어 각 인자들을 독립표본 T-검정, $X^2$ 검정 그리고 Fisher의 정확확률 검정으로 비교 분석하였다. 결 과 : I군과 II군을 비교한 결과, 폐결핵 과거력의 유무, 흉부방사선 검사상 공동이 있는 경우와 과거의 치료 횟수, 내성 약제의 개수 그리고 치료약제의 개수에서 통계적 유의성을 관찰할 수 있었다(p<0.05). 결 론 : 다제내성 폐결핵 치료 실패의 위험인자는 과거의 치료력, 흉부방사선상 공동이 있는 경우, 내성약제의 개수가 많은 것임을 알 수 있었다. 따라서 다제내성 폐결핵의 치료 효과를 향상시키기 위하여 초치료 폐결핵관리를 보다 철저히 하여 항결핵제에 대한 약제 내성발생을 억제하는데 노력을 하여야 할 것으로 생각된다.

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