• 대한의용생체공학회:의공학회지
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• 제23권3호
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• pp.235-241
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• 2002

결핵을 진단하는 방법 중에서 신속하고 비교적 비용이 적게드는 방법은 객담을 통한 결핵균 도말 검사이다. 결핵균 도말 검사는 슬라이드에 도말한 환자의 객담을 가온 과정을 통해 고착시키고. acid-fast 염색방법을 통해 염색시킨 후 현미경으로 결핵균을 관찰하는 것이다. Acid-fast 염색방법은 크게 hot staining과 cold staining 방법 두 가지가 있으며, 우리나라에서는 염색 결과가 선명한 hot staining 방법인 Ziehl-Neelsen 방법을 주로 이용한다. 그러나, 기존의 결핵균 자동염색기는 가온 기능이 없어 환자의 객담을 슬라이드에 검사자가 고착을 시켜야 하고. 선명도도 낮은 문제점을 가지고 있다. 본 연구에서는 검사자의 인력 절감과 검사자 개인의 염색 능력에 따른 염색 정도의 변화를 줄이기 위해 가온이 가능한 결핵균 자동염색기를 개발하였다 개발된 염색기는 객담의 고착에서 염색 그리고 건조가지 전 과정이 자동으로 이루어진다. 염색 시간은 5개의 슬라이드를 고품질로 염색할 경우 21분이 소요되었다. 성능 평가를 위해 총 91개 객담을 대상으로 자동과 수동염색을 시행하여 일치율을 비교해 본 결과 75%로 통계적으로 유의한 차이를 보이지 않았다 (P>0.05).

• 한국식품과학회지
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• 제17권3호
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• pp.170-174
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• 1985

닭고기의 위생적이고 경제적인 저장법 개발을 위하여 0, 5, 8및 10kGy의 감마선(線)을 조사(照射)하고 $3{\sim}4^{\circ}C$에서 41일간 냉장하면서 오염된 미생물의 살균효과를 조사(調査)하였다. 닭고기의 일반세균의 오염은 중온균이 $7.8{\times}10^5/g$, 저온균이 $3.6{\times}10^5/g$, 고온균이 $1.1{\times}10^3/g$으로 나타났으며, 효모 및 곰팡이는 $3.0{\times}10^3/g$마리, 장내세균 중 대장균군은 $2.1{\times}10^3/g$, 또한 선택성이 감한 S S agar 배지에서 80마리의 시험구중 91%인 74마리가 분리되었고 8.0${\times}$10/g정도였다. 감마선 살균효과에서 일반세균은 5${\sim}$10kGy의 조사(照射)로 2${\sim}$4log cycles이상 멸균되었고, 또한 5kGy이상의 조사(照射)는 효모 및 곰팡이, 대장균군과 다른 장내세균의 살균(殺菌)에 매우 효과적이며, 미생물학적 측면에 있어서 2${\sim}$4주간 저장기간의 연장이 가능하였다.

• 미생물학회지
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• 제39권4호
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• pp.283-287
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• 2003

본 연구에서는 에어컨 내에서 서식하는 세균을 분리하여 동정하였고 이들 에어컨에 대한 위생 관리에 대하여 조사하였다. 20개의 에어컨 냉각기에서 8종의 세균이 분리, 동정되었는데 그것들은 가장 많이 분리 동정된 Pantoea sp.를 비롯하여 Bacillus circulans, Bacillus pumilus, Corynebacterium, Flavimonas oryzihabitans, Ochrobacterum anthropi, Micrococcus sp., non fermented bacilli (NFB)이었다. 한편 에어컨 사용자 1,322명을 대상으로 에어컨의 위생관리 상태에 대하여 조사하였는데 설문자의 1,138명(86%)이 에어컨 사용시 환기를 하는 것으로 나타났다. 에어컨 청소에 있어서 1,128명(85%)이 청소를 하는 것으로 나타났지만 에어컨의 오염원들이 되는 에어컨의 필터 청소는 864명(66%)이 하지 않는 것으로 나타났고 에어컨의 열교환기는 1089명(82%)이 하지 않는 것으로 나타났다. 이런 결과로 상기에서 언급된 세균들과 같은 에어컨 오염원이 증가하면 호흡기 질환과 같은 인간의 질병을 초래할 수 있다는 것을 알 수 있었고 따라서 에어컨 사용시 에어컨의 오염원제거와 위생관리는 에어컨내 세균으로부터 발생되는 인간의 질병을 예방할 수 있을 것이다.

• 대한수의학회지
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• 제39권6호
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• pp.1119-1125
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• 1999

Since Robert Koch found tubercle bacilli in 1882, the studies on tubercle bacilli of human and animal had been carried out. Being old tuberculin(OT) introduced in 1890, the specificity of the diagnosis of tuberculosis has been improved by continual uses of heat concentrated synthetic medium(HCSM) and purified protein derivatives(PPD) tuberculin. Now, two types of tuberculin test are used worldwidly ; the single intradermal test(SIT) using bovine tuberculin and the single intradermal comparative tuberculin test(SICTT) using avian and bovine tuberculins. In the SICTT, each countries have used with different combination of both avian and bovine tuberculins' titers. However, this kinds of studies have not reported in Korea. Therefore, the studies on the combination of their tuberculins' titers were performed through intradermal test of guinea pigs sensitized with either Mycobacterium bovis or M avium and were examined in 10 cattles of SIT positive reactors. Also, IFN-${\gamma}$ assay, the latest diagnostic method of bovine tuberculosis, was experimentally applied to SIT positive reactors. For determining the optimal titers, sensitized guinea pigs with M bovis and M avium were intradermally injected avian and bovine tuberculin. In guinea pigs sensitized with M bovis, bovine tuberculin 50 T.U. showed significant difference from all tested concentrations of avian tuberculin(p < 0.05). In guinea pigs sensitized with M avium, there is significantly different between bovine tuberculin and avian tuberculin by 25 T.U.(p < 0.01). Therefore, optimal titers of bovine and avian PPD tuberculins' titers for the SICTT in Korea were 5,000 and 2,500 tuberculin units, respectively, and the swelling diffences between bovine and avian site in SIT positive reactors were above 3mm. Also, in IFN-${\gamma}$ assay, the 9 SIT positive reactors were showed all the positive reactions.

• 한국의료질향상학회지
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• 제27권2호
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

• 대한영상의학회지
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• 제82권6호
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• pp.1524-1533
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• 2021

목적 인터페론-감마 분비 검사(interferon-gamma release assay; 이하 IGRA) 결과가 양성인 의료종사자의 흉부 X선(chest X-ray; 이하 CXR) 및 CT 결과를 기반으로 결핵의 발생률을 조사하고, 결핵 진단에서 진단 영상의 추가적인 역할을 알아보고자 하였다. 대상과 방법 IGRA를 시행 받은 1976명의 의료 종사자 중에서 IGRA 양성자를 후향적으로 조사하였다. 상부 폐야의 군집 결절 또는 선형 음영을 흉부 X선 양성으로 간주하였고, CT 결핵소견은 활성, 활동성미정, 비활동성, 정상으로 분류하였다. 활성 또는 활동성미정을 CT 양성으로 정의하였다. 결과 IGRA 검사 결과 255명(12.9%)에서 양성이었다. CXR과 CT는 각각 249명(99.2%)과 113명(45.0%)에서 시행되었다. CXR 양성 소견은 249명 중 7명(2.8%), CT 양성 소견은 113명 중 9명(8.0%)에서 각각 나왔다. 9명의 CT 양성 대상자 중 활성 또는 활동성미정 결핵 소견은 각각 6명(5.3%)과 3명(2.7%)에서 발견되었다. Acid-fast bacilli 염색, 배양 및 결핵에 대한 polymerase chain reaction을 포함한 미생물적 검사는 9명의 CT 양성 피험자 모두에서 음성이었다. CT 양성 피험자 9명은 경험적 항결핵약물 치료를 받았고, 이 9명 중 3명은 CXR 음성 소견이었다. 결론 IGRA 양성 의료 종사자에서 CT 검사는 무증상 결핵을 진단하는 데 도움을 주었다.

• Journal of Chest Surgery
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• 제13권3호
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• pp.285-291
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• 1980

Post pneumonectomy empyema either with bronchopleural fistula or without bronchopleural fistula is an infrequent postoperative complication, but very serious and critical problem. But it is of some interest that the development of a postoperative empyema following resection for carcinoma of the lung might have a favorable effect on the survival of patients in recent speculation of the literature. We have experienced 4 cases of postoperative empyema following pneumonectomy for carcinoma of the lung at department of chest surgery, Yon Sei University, medical college during 11 years from Jan. 1968 to June 1980. Histologically, 3 cases were demonstrated squamous cell carcinoma except one oat cell carcinoma. Onset of postoperative empyema occurred over a wide range of time, from as early as the 5th postoperative day to insidious onset 6 months after pneumonectomy. The most common organisms isolated from the empyema cavities were staphylococcus aureus, pseudomonas aeruginosa and gram negative bacilli. All cases had a large number of organisms and more infections but not single infection. 2 out of 4 cases are treated with open pleural window drainage and irrigation with antibiotic`s solution 2 or 3 times per week by this time and postoperative general course is not eventful. One is alive to 2 years 3 months, another is alive to 8 years 11 months until now. And 2 out of 4 patients is survived over 4 years 10 months. Analysis of postoperative empyema complicating pneumonectomy for bronchogenic carcinoma revealed an increase in 4 year 10 months survival [50%].

• 대한미생물학회지
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• 제20권1호
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• pp.73-77
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• 1985

Haemophilus aphrophilus is a fastidious gram-negative bacillus found in mouth of normal individuals. Though H. aphrophilus infection is quite rate, it includes such serious ones as endocarditis and brain abscess. The authors isolated H. aphrophilus from five patients with the diagnosis of lung abscess, conjunctivitis, brain abscess and facial masticator space abscess. Two of the patients died. Three of the patients also yielded other species of bacteria from the same specimens. One of the isolate was intermediately susceptible to amikacin and resistant to tobramycin, indicating the necessity of a routine susceptibility test in order to select the proper antimicrobial agents. Since H. aphrophilus can be differentiated from other similar organisms by morphological and biochemical characteristics, one should determie the possibility of this organism when fastidious gram-negative bacilli are isolated from blood or from sites adjacent to upper respiratory tract.

• 대한의생명과학회지
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• 제19권2호
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• pp.132-141
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• 2013

Mycobacterium isolates were retrospectively identified, antibiotics susceptibility test results and basic clinical data were analyzed for the 715, excepted 308 in 1,023 specimens, from a mycobacterial laboratory at a tertiary care hospital from September 2002 to December 2008. Their male to female ratio was 1.12 to 1 (379 male, 336 female). The median age of study population was 47 years (range from 10 to 93 years). Distribution of Mycobacterium species was 90.1% of total were isolates Mycobacterium tuberculosis, and 9.9% of the total non-tuberculosis Mycobacterium isolated, and Among nontuberculosis Mycobacterium isolates, 60.6% were Mycobacterium avium complex, 14.1% were isolates Mycobacterium abscessus, and 12.7% were isolates Mycobacterium intracellulare. Among 526 Mycobacterium tuberculosis isolates, 81.7% isolates were susceptible to first line antibiotics, 18.3% were resistant to one or more antibiotics. Non-tuberculosis Mycobacterium isolates, all were resistant to two or more antibiotics. Multi-antibiotic resistant tuberculosis rate was show 10.2% of total specimens. Isolated Mycobacterium species, 19.2% were multi-antibiotic resistant tuberculosis, and the rate of nontuberculosis Mycobacterium resistant to isoniazid and rifampin was very highly 84.5%. Thus among acid fast bacilli culture positive cases, Mycobacterium tuberculosis and non-tuberculosis Mycobacterium were must exactly identification and antibiotic sensitivity test. It was considered to help to select of the antibiotic in preventive medicine.

• 대한의생명과학회지
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• 제23권2호
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• pp.96-103
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• 2017

Nocardia species (spp.) are opportunistic pathogen in immunocompromised hosts. The genus Nocardia contains more than 70 species. Nocardia takedensis has been recently reported as a new species of the genus Nocardia. In this study, we describes the first clinical isolate of N. takedensis from the skin lesion in Busan, Korea. For the identification of clinical isolate to the species level as N. takedensis, classical methods (colony morphology, biochemical characteristics, and antimicrobial susceptibility), molecular method (16S rRNA gene sequencing), and MS (mass spectrometry) analysis were conducted. Clinical isolates grew slowly on the culture media (5% sheep blood agar and chocolate agar) under 5% $CO_2$ condition. Especially, carotene pigmentation was detected well on the media. Using mass spectrometry, Nocardia isolate was not identified to the species level. However, molecular method based on 16S rRNA sequencing confirmed the isolate as N. takedensis correctly. N. takedensis isolate was partial positive for acid-fast bacilli on the Ziehl-Neelsen method. And it was observed to be resistance to amoxicillin/clavulanic acid and ciprofloxacin. Our results provide useful information to develop optimal identification protocol of N. takedensis in clinical diagnostic laboratories.