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Regional Citrate Anticoagulatinln for Continuous Renal Replacement Therapy in Children (소아의 지속적 신대체요법에서 Citrate 항응고요법의 경험)

  • Hahn Hye-Won;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.76-82
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    • 2005
  • Purpose : Regional anticoagulation with trisodium citrate for continuous renal replacement therapy(CRRT) is an effective and safe method, with lower bleeding risk. However it is not widely used because of complex current protocols used to prevent anticipated metabolic derangements. We evaluated simplified regional anticoagulation protocols with ACD-A(R) solution and commercially available calcium-containing dialysis solution. Methods : The medical records of twenty-eight patients who underwent CRRT were reviewed. Hemofilter life span according to the anticoagulation method used was compared, and laboratory findings at Pre- and 48 hours post-CRRT initiation were compared in the citrate-based CRRT group. Results : Of the twenty-eight Patients, five patients underwent citrate-based CRRT Hemofilter life span was 1.60 $\pm$ 0.72 days, showing no significant differences with the hemofilter life span in the heparin based and LMWH based CRRT group. No patients experienced hemorrhagic complications. PT, aPTT, sodium, t$CO_{2}$, iCa levels showed no difference in pre- and post-CRRT. Total calcium levels were increased. At the recommended postfilter iCa level, j.e., 0.25-0.39 mmol/L, all five patients needed increased amount of citrate infusion, and Ca infusion requirement was decreased. Conclusion : Simplified regional citrate anticoagulation with calcium-containing dialysate is an effective and safe method, and is not associated with increased hemofilter clotting. However, increased postfilter iCa level is recommended.

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Scintigraphy with Indium-111-oxine Labeled Leukocytes for Localization of Abscesses (복부농양진단을 위한 Indium-111 표지백혈구스캔)

  • Kim, Byung-Tae;Lee, Dong-Soo;Lee, Kyung-Soo;Choi, Hyung-Shik;Kim, Myung-Joon;Yang, Seung-O;Lee, Jae-Hoon;Choi, Chang-Soon;Kim, Taek-Kyu;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.1
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    • pp.37-48
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    • 1990
  • Detection of deep-seated abscesses is sometimes difficult with ultrasonogrpahy or computed tome graphy alone. Indium-111-labeled leukocyte has widely used in the localization of abscesses after introduction by Segal and Thakur in 1976. But there are some difficulties in using indium-111-oxine in our country because of hardness to get the radiopharmaceutical timely and long time for labeling leukocytes. So we peformed the indium-111-labeled leukocyte scan for establishment of the labeling procedure and clinical application. We labeled the mixed leukocytes from 36 ml of patient's blood using 4 ml of ACD solution, 7 ml of 6% hydroxyethyl starch solution $(HESPAN^{(R)})$, 1 mCi of indium-111 oxine, 5 ml of normal saline and centrifuge. It took about 2 hours for the preparation of radiolabeled leukocytes and attention for contamination was needed. The average injected dose of labeled mixed leukocytes was 465 uCi. The average number of injected leukocytes was $2.5\times10^8$ and the labeling ratio was $57{\pm}13%$ (Table 2, Fig. 5). These number and ratio were sufficient for the localization of abscess. About twenty per cent of indium was labeled to red blood cells and platelets (Fig. 6) and the half-life of injected radiolabeled leukocytes was 8.3 hours. Scan was performed in 9 patients who were suspected to have abscesses clinically or radiologically. Three patients were positive, in one patient who had abscess close to lower lumbar vertebrae was surgically drained and another 2 positive cases did not show abscess clearly on computed tomography, so only antibiotics were administrated and treated successfully. The negative 6 patients were improved without specific treatment. In conclusion, the use of indium-111 oxine labeled leukocytes for localization of abscesses were very specific and helpful in the decision of treatment considering its relatively simple labeling method, and could be easily performed providing timely supply of the radiopharmaceutical.

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Recommended Method for Radioisotope Red-Cell Survival Studies (방사성(放射性) 동위원소(同位元素)를 이용(利用)한 적혈구수명측정법(赤血球壽命測定法)(ICSH 추천))

  • Berlin, N.I.;Dudley, R.A.;Garby, L.;Heimpel, H.;Lee, M.;Lewis, S.M.;McIntyre, P.;Mollison, P.L.;Najean, Y.;Pettit, J.
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.1-9
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    • 1980
  • 혈액질환(血液疾患), 특히 용혈성빈혈(溶血性貧血)을 수반(隨伴)한 경우(境遇)에 적혈구(赤血球)의 생성(生成), 파괴과정(破壞過程)을 정확히 파악하는 것은 빈혈(貧血)의 발생기전(發生機轉) 및 병인(病因), 치료(治療), 예후(豫後) 결정(決定)에 매우 중요(重要)하다. 적혈수명측정법(赤血壽命測定法)은 최근(最近) 방사성(放射性)동위원소(同位元素)를 이용(利用)한 방법(方法)이 소개된 이래 널리 시행(施行)되어 왔다. 그러나 그 방법(方法) 및 결과(結果) 해석(解釋)에 표준화(標準化)가 되어 있지 않았던 중 1971년 ICSH (International Committee for Standardization in Hematology)에서 expert panel을 갖고 ICSH 추천 방법(方法)을 발표(發表)하였고, 본지(本誌)에서도 그 내용(內容)을 게재(揭載)한 바 있다. 1980년 ICSH는 전문기관 및 전문가의 협조(協調)를 얻어 다시 expert panal을 갖은 후 1971년에 추진한 적혈구수명측정법(赤血球壽命測定法)의 일부(一部)를 수정(修正)하여 ICSH의 표준방법(標準方法)으로 발표(發表)하였다. 개정(改正)된 표준방법(標準方法)과 1971년 ICSH추친 방법(方法)과의 차이(差異)는 다음과 같다. $^{51}Cr$표지방법중(標識方法中) 참고방법(參考方法)(Reference method)인 ACD법(法)에 수정(修正)을 가하여, ACD solution 구성성분(構成成分)이 차이(差異)가 있으며, 표지(標識)$^{51}Cr$의 양(量)을 체중당(體重當) $1.5{\mu}Ci$에서 $0.5{\mu}Ci$로 제한(制限)시켰다. 투여방법(投與方法)에 대한 언급 특히 투여하는 표지적혈구(標識赤血球)의 용적을 정확하게 측정 하기 위한 방법 4가지를 추가하였고, 검체준비(檢體準備) 과정중(過程中)의 pipet error를 방지(防止)하기위해 일정(一定)한 형태의 pipet을 사용(使用)하며, 1ml의 tuterculin syringe는 사용(使用)하지 않기로 하였다. 또한 결과분석시(結果分析時) 혈구용적(血球容積)의 항정성(恒定性)을 위해 Sodium pertectnetate($^{99m}Tc$)를 이용(利用)해 혈구용적(血球容積)을 반복(反復)해 측정(測定)하도록 하였으며 이때 사용(使用)하는 방사성동위원소(放射性同位元素)는 $^{32}P$ 대신 $^{99m}Tc$로 하였다. 결과해석시(結果解釋時) IgG 항체(抗體) 또는 IgM 항체(抗體)에 따른 차이점(差異點)에 대한 고려가 추가(追加)되었다. ICSH와 국제혈액학회(國際血液學會)에서 수정(修正)된 ICSH 표준방법(標準方法)에 의한 적혈수명측정법(赤血壽命測定法)을 널리 소개(紹介)하여 결과(結果)의 표준화(標準化)를 기하고자 연관잡지(聯관(關)雜誌)에 게재(揭載)할 것을 요청(要請)하였기에 전문(全文)을 본지(本誌)에 소개(紹介)하고자 한다.

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Analysis of whole genome sequencing and virulence factors of Vibrio vulnificus 1908-10 isolated from sea water at Gadeok island coast

  • Hee-kyung Oh;Nameun Kim;Do-Hyung Kim;Hye-Young Shin;Eun-Woo Lee;Sung-Hwan Eom;Young-Mog Kim
    • Fisheries and Aquatic Sciences
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    • v.26 no.9
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    • pp.558-568
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    • 2023
  • Vibrio vulnificus is an aquatic bacterium causing septicemia and wound infection in humans. To understand this pathogen at the genomic level, it was performed whole genome sequencing of a cefoxitin-resistant strain, V. vulnificus 1908-10 possessing virulence-related genes (vvhA, viuB, and vcgC) isolated from Gadeok island coastal seawater in South Korea. The genome of V. vulnificus 1908-10 consisted of two circular contigs and no plasmid. The total genome size was estimated to be 5,018,425 bp with a guanine-cytosine (GC) content of 46.9%. We found 119 tRNA and 34 rRNA genes respectively in the genome, along with 4,352 predicted protein sequences. Virulence factor (VF) analysis further revealed that V. vulnificus 1908-10 possess various virulence genes in classes of adherence, antiphagocytosis, chemotaxis and motility, iron uptake, quorum sensing, secretion system, and toxin. In the comparison of the presence/absence of virulence genes, V. vulnificus 1908-10 had fur, hlyU, luxS, ompU, pilA, pilF, rtxA, rtxC, and vvhA. Of the 30 V. vulnificus comparative strains, 80% of the C-genotype strains have all of these genes, whereas 40% of the E-genotype strains have all of them. In particular, pilA were identified in 80% of the C-type strains and 40% of the E-type strains, showing more difference than other genes. Therefore, V. vulnificus 1908-10 had similar VF characteristics to those of type C strains. Multifunctional-autoprocessing repeats-in-toxin (MARTX) toxin of V. vulnificus 1908-10 contained 8 A-type repeats (GXXGXXXXXG), 25 B.1-type repeats (TXVGXGXX), 18 B2-type repeats (GGXGXDXXX), and 7 C-type repeats (GGXGXDXXX). The National Center for Biotechnology Information (NCBI) Basic Local Alignment Search Tool (BLAST) showed that the RtxA protein of V. vulnificus 1908-10 had the effector domain in the order of cross-liking domain (ACD)-C58_PaToxP-like domain- α/β hydrolase-C58_PaToxP-like domain.

Radio-isotope Red Cell Survival Studies Recommended by ICSH (방사성동위원소(放射性同位元素)를 이용(利用)한 적혈구수명측정법(赤血球壽命測定法)(ICSH추천(推薦)))

  • The Korea Society of Nuclear Medicine The Korea Society of Nuclear Medicine
    • The Korean Journal of Nuclear Medicine
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    • v.5 no.1
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    • pp.1-10
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    • 1971
  • 혈액질환(血液疾患), 특히 용혈성빈혈(溶血性貧血)을 수반(隨伴)한 경우(境遇)에 적혈구(赤血球)의 생성(生成) 및 파괴과정(破壞過程)을 정확(正確)히 파악(把握)하는 것은 중요(重要)하여 특히 적혈구수명측정(赤血球壽命測定)은 빈혈(貧血)의 본능(本能) 및 발생기전(發生機轉)을 이해(理解)하는데는 물론 병인적(病因的) 치료(治療) 및 예후(豫後)를 결정(決定)하는데 대단(犬端)히 유용(有用)하다. 적혈구수명측정(赤血球壽命測定)에는 1919년(年) Ashby가 개발(開發)한 differential agglutination법(法)이 이용(利用)되어 왔으나 수혈(輸血)에 따른 위험(危險)이 있고 방법(方法)이 복잡(複雜)하다는 단점(短點)을 가져 새로운 적혈구수명측정법(赤血球壽命測定法)이 연구(硏究)되어 왔다. 최근(最近)에 $^{51}Cr$이나, $^{32}DFP$같은 방사성동위원소(放射性同位元素)를 이용(利用)한 방법(方法)이 도입(導入)된 이래(以來) 임상적(臨床的)으로 적혈구수명측정(赤血球壽命測定)이 많이 시행(施行)되고 있지만 아직까지도 그 방법(方法)이나 결과(結果)의 해석(解釋)에 표준화(標準化)가 안되어 있다. 현재(現在) 임상영역(臨床領域)에서 가장 널리 이용(利用)되고 있는 적혈구수명측정법(赤血球壽命測定法)은 방사성(放射性) chromium($^{51}Cr$)법(法)으로 1950년(年) Gray와 Sterling에 의(依)해 창안(創案)된 이래(以來) 많은 학자(學者)들에 의(依)해 여러 가지 변법(變法)이 고안(考案)되어 왔는데, 이의 가장 큰 이유(理由)는 $^{51}Cr$이 적혈구표지(赤血球標識)에 가장 이상적(理想的)인 것만은 아니고 그 결과(結果)에 많은 요인(要因)들이 영향(影響)을 미치기 때문이다. 또 이런 변법(變法)의 사용(使用)은 각(各) 검사(檢査)에서 계산(計算)된 측정치(測定値)에 차이(差異)가 있어 그 결과(結果)의 해석(解釋) 및 비교(比較) 검토(檢討)에 적지않은 난점(難點)이 생겨 표준화(標準化)된 공통적(共通的)인 방법(方法)의 사용(使用)이 중요(重要)하다는 사실(事實)이 인식(認識)되게 되었다. 1966년(年) 호주(濠洲)의 Sydney에서 개최(開催)되었든 제11차(第11次) 국제혈액학회(國際血學會)때 열린 제4차(第4次) International Committee for Standardization in Haematology(ICSH)에서 Diagnostic Applications of Radioisotopes in Haematology에 관(關)한 expert panel을 갖을것을 의결(議決)하여 다음과 같은 12명(名)의 위원(委員)이 결정(決定)되었으며 위원회(委員會)의 의장(議長)에 Dr. Szur, 총무(總務)에 Dr. Glass가 각각(各各) 선임(選任)되었다. 그간(間) 1967년(年) 영경(英京) London에서 첫 회합(會合)이 있은후(後) New York, Vienna(IAEA후원(後援)) Brthesda(NIH후원(後援))에서 전문위원회(專門委員會)를 갖고 적혈구수명측정법(赤血球壽命測定法)에 관(關)한 의견(意見)의 일치(一致)를 보았다. ICSH와 국제혈액학회(國際血學會)에서는 이번에 결정(決定)된 적혈구수명측정법(赤血球壽命測定法)을 널리 소개(紹介)하며, 측정법(測定法)과 얻어진 결과(結果)의 해석(解釋)에 표준화(標準化)를 기(期)할 목적(目的)으로 이에 연관성(聯關性)있는 전문지(專門誌)에 게재(揭載)할 것을 요청(要請) 받었기에 이에 전문(全文)을 소개(紹介)하는 바이다. 이들은 방사성(放射性) chromium 법(法)의 모든 세부적(細部的)인 면(面)을 표준화(標準化)하고 있으며 그간(間) 가장 논란(論難)의 대상(對象)이 되었던, $^{51}Cr$-표지방법(標識方法)에 있어서의 세가지 변법(變法), 즉 ACD법(法), Citrate-wash법(法), ACD/ascorbic acid법(法)을 모두 인정(認定)하고 있다. 또한, DFP($DF^{32}P$ 또는 $^3H-DFP$) 표지법(標識法)의 표준방법(標準方法)도 기술(記述)하고 있으며, 더욱 중요(重要)한 것은 적혈구수명측정법(赤血球壽命測定法)으로서 현재(現在)까지 대부분(大部分)의 학자(學者)가 사용(使用)하여 왔던 지표(指標)인 $T_{50}Cr$ 대신(代身)에 mean red cell life span을 사용(使用)할 것을 권(勸)하고 있다.

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Protoplast Formation and Regeneration of Bacillus strains producing biopolymer (Biopolymer 생산성 Bacillus속 균주의 원형질체 형성과 재생)

  • Yim, Moo-Hyun;Kim, Seong-Ho
    • Applied Biological Chemistry
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    • v.42 no.1
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    • pp.20-28
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    • 1999
  • To improve Bacillus strains producing biopolymer, conditions for protoplast formation and regeneration were investigated in biopolymer producing Bacillus subtilis K-1 and lactose utilizing Bacillus coagulans. Bacillus subtilis K-1 mutant (SM-2) and Bacillus coagulans mutants (CM-12) were marked auxotrophic and antibiotics-resistant (SM-2) and an antibiotics-resistant mutants, respectively. To formate protoplasts derived from the mutants, conditions were established as follows. For B. subtilis mutant SM-2, its culture in mid-logarithmic phase was added with penicillin G (1.0 unit/ml) and further reacted for 1.5 hr. Cells were collected and then treated in lysis fluid (pH 7.0) containing 0.4 M sucrose and lysozyme $25\;{\mu}g/ml$ for 40 min at $37^{\circ}$. Protoplast formation was very successful (99.6%) and the ratio of cell wall regeneration was 2.4%. For Bacillus coagulans mutant CM-12, its mid-logarithmic phase culture was treated with penicillin G (0.3 unit/ml) and glycine (0.5%) for 1hr. Cells were collected and then resuspended in lysis buffer (pH 7.0) containing 0.6 M lactose and lysozyme $(300\;{\mu}g/ml)$ for 30 min at $37^{\circ}$. Protoplast formation was also successful (90.8%) and cell wall regeneration ratio was similar to SM-2 (2.2%). To improve regeneration frequency, regeneration medium was obtained as followed condition,. Cell wall regeneration was improved 2-4 folds with 5.1% for B. subtilis SM-2 and 10.3% for B. coagulans CM-12 when protoplasts mixed with soft top agar(0.4%) was overlaid onto trypticase soy broth medium containing 0.4 M sucrose, 0.7% casamino acid, 1% PVP, 25 mM $MgCl_2,\;25\;mM\;CaCl_₂$ and 1.5% agar.

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Distribution of foodborne pathogens in red pepper and environment (고추와 재배환경의 식품매개 병원균 분포)

  • Jung, Jieun;Seo, Seung-Mi;Yang, SuIn;Jin, Hyeon-Suk;Jung, Kyu-Seok;Roh, Eunjung;Jeong, Myeong-In;Ryu, Jae-Gee;Ryu, Kyoung-Yul;Oh, Kwang Kyo
    • Korean Journal of Food Science and Technology
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    • v.53 no.6
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    • pp.799-808
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    • 2021
  • This study was performed to investigate the extent of microbial contamination, the presence of enterotoxin genes, and the antibiotic susceptibility of Bacillus cereus in 58 red pepper plants and 43 environmental samples (soil, irrigation water, and gloves) associated with the plant cultivation. The detected counts of total aerobic bacteria, coliform bacteria, Escherichia coli, Bacillus cereus, and Staphylococcus aureus were lower in these samples, as compared to the regulations of standards for foods; moreover, pathogens, such as E. coli, E. coli O157:H7, Listeria monocytogenes, and Salmonella spp., were not detected. Genes encoding hemolysin BL enterotoxins (hblA, hblC, and hblD) as well as non-hemolytic enterotoxins (nheA, nheB, and nheC) were detected in 23 B. cereus specimens that were isolated from the test samples and had β-hemolytic activity. Interestingly, B. cereus is resistant to β-lactam and susceptible to non-β-lactam antibiotics. However, in this case, the isolated B. cereus specimens exhibited a shift from resistant to intermediate in response to cefotaxime and from susceptible to intermediate in case of rifampin, trimethoprim-sulfamethoxazole, vancomycin, clindamycin, and erythromycin. Therefore, the levels of B. cereus should be monitored to detect changes in antibiotic susceptibility and guarantee their safety.