• 대한임상검사과학회지
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• 제48권4호
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• pp.327-334
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• 2016

최근 사람과 가축에 항균제의 과도한 사용으로 감염병을 일으키는 병원성 세균들의 항균제 내성이 증가하고 있다. 본 연구에서는 PCR과 염기서열분석법을 이용하여 충청지역 일개의 대학병원에 의뢰된 임상검체와 같은 지역에서 사육된 닭으로부터 분리된 P. mirabilis 균주를 대상으로 16S ribosomal RNA methyltransferase(RMTase) 유전자와 integron을 조사하였다. 또한 Repetitive extragenic palindromic sequence-based PCR (REP-PCR)을 이용하여 P. mirabilis 균주들의 역학적 연관성 조사하였다. 총 38균주의 P. mirabilis 중에서 임상검체로부터 분리된 7균주 (18.4%)만이 RMTases 유전자를 가지고 있었는데 이들은 모두 amikacin, tobramycin, 및 gentamicin에 내성을 나타냈다. 또한 대상균주 중 23균주(60.5%)가 class 1 integron을 가지고 있는 것으로 나타났으며 class 2 및 class 3 integron은 검출되지 않았다. 본 연구에서 확인된 integrons에는 aminoglycoside 내성유전자(aadA2, aadA5, aadA7, 및 aacCA5), ${\beta}$-lactmam 내성유전자($bla_{PSE}$), erythromycin 내성유전자(ereA), lincosamides 내성유전자(linF), 및 trimethoprim 내성유전자(dfrA12, dfrA17 및 dfrA32)등이 유전자 카세트로 포함되어 있었다. 본 연구결과 RMTase 유전자는 임상검체로부터 분리된 P. mirabilis 균주에만 확산되어 있었던 반면 class 1 integrons는 임상검체와 닭으로부터 분리된 P. mirabilis 균주에 광범위하게 확산되어 있음을 확인할 수 있었다. 게다가 닭으로부터 분리된 균주 중에는 동일한 REP-PCR 밴드패턴을 보인 균주들이 있었는데 이는 닭들 사이에서 P. mirabilis 균주가 수평확산 되었음을 의미한다. P. mirabilis 균주에서 항균제 내성유전자의 확산을 막기 위해서는 내성유전자 지속적인 모니터링과 감시가 필요할 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.49-60
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• 1988

1984년부터 1987년까지의 최근 4년간 영남대학교 의과대학 부속병원에서 시행한 혈액배양의 분석결과 다음과 같은 결론을 얻었다. 1) 4년간 8083검체의 혈액이 배양되어 582검체에서 균이 분리되어, 총 혈액배양 양성율은 7.2%이었고, 분리균주 중 다균성 감염증은 16예(2.8%)였다. 2) 분리균주의 분포는 그람 양성균이 189, 그람 음성균이 393이었고, 그람 양성균의 균종별 분리는 Staphylococcus aureus가 82, coagulase 음성 Staphylococcus가 73, 기타 Staphylococcus sp.가 20의 순이었다. 그람 음성균은 Escherichia coli가 75, Salmonella typhi가 80, Salmonella paratyphi A가 72이고, 그 외 Kldbsiella, Enterobacter의 순으로 분리되었다. 포도당 비발효 그람 음성균은 Pseudomonas cepacia가 46, Pseudomonas aeruginosa가 16, 그 외 Acinetobacter등이 소수 분리되었다. 3) Salmonella균종을 제외한 모든 균종에서 매년 증가되는 양상을 보이고, 병원내 감염균으로 간주되는 Serratia, Acinetobacter균종이 1984년의 6.35%에서 1987년에는 17.7%롤 증가되었다. 4) Aeromonas hydrophilia는 6~10월에 높은 분리율을 나타애고, Salmonella typhi는 1월과, 5월에서 8월사이, Salmonella paratyphi A는 1월과 6월에서 9월사이에서 높은 분리율을 나타냈다. 대개 모든 균종에서 여름철에 분리율이 높았다. 5) 분리균종의 항생제 감수성 검사에서는 Staphylococcus aureus와 장내세균에서는 기본 항생제에 대한 감수성을 나타낸 반면, 포도당 비발효 균종은 약 32%에서 기본 항생제에 대한 내성을 가진 것으로 나타났으며, 병원성 감염의 주요 원인균은 Serratia, Acinetobacter, Pseudomonas, Enterobacter균종에서는 항생제의 내성이 큰 문제점으로 대두되었다.

• Tuberculosis and Respiratory Diseases
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• 제67권3호
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• pp.199-204
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• 2009

Background: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. Methods: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. Results: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. Conclusion: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.

• 대한임상검사과학회지
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• 제42권1호
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• pp.38-45
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• 2010

The aim of this study was to assess the Clinical Usefulness of Helicobacter pylori Stool Antigen (HpSA) immunochromatographic assay for the diagnosis of H. pylori infection. In this study, we had compared HpSA-immunochromatographic assay with CLO test and UBT test. From a total of 140 patients (M:F=88:52) with upper endoscopy, biopsy specimens were obtained for CLO test. Stool specimens was collected from all patients and tested using a HpSA-immunochromatic assay. H. pylori infection status was defined as infected if the results of both CLO test and UBT test were positive. CLO test and UBT test findings showed that 92 patients were H. pylori positive and 48 patients were H. pylori negative. According to this definition, the sensitivity, specificity, and positive or negative predictive value (PPV, NPV) of HpSA-immunochromatographic assay were 97.8%, 100%, 100%, and 96%, respectively. Cross reactivity test of HpSA-immunochromatographic assay were performed with 10 enteric bacteria strains in fecal habitat, and there were no false positive reaction. We evaluated the usefulness of HpSA assay for eradication therapy with 10 of 92 H. pylori positive patients, positive results of them at pre-eradication therapy were converted to negative at post-eradication. The HpSA-immunochromatographic assay is a highly sensitive and specific non-invasive diagnostic method for detection of H. pylori infection, a useful diagnostic method for H. pylori in post eradication stage.

• 대한임상검사과학회지
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• 제46권2호
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• pp.47-53
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• 2014

The purpose of this study was to evaluate the clinical utility of TB/NTM PCR by comparing the results of TB PCR to detect Mycobacterium tuberculous (MTB) and nontuberculous mycobacteria (NTM) from paraffin-embedded tissue specimens. A total of 60 cases were tested using TB PCR and TB/NTM PCR. The MTB and NTM rate of TB/NTM PCR was 84.2% (16/19), 10.5% (2/19) in TB positive of TB PCR. The NTM rate of TB/NTM PCR was 29.3% (12/41) in TB negative of TB PCR. Fourteen different species of NTM were identified, the common isolate was M. gordonae (21.4%), M. avium (14.3%), M. ulcerans (7.1%), M. interjectum (7.1%), M. gilvum (7.1%), M. fortuitum (7.1%), M. mucogenicum (7.1%). The rare species identified were M. farcinogenes (7.1%), M. tokaiense (7.1%). Therefore, TB/NTM PCR is useful to differentiate MTB and NTM from paraffin-embedded tissue specimens and it is more effective in detecting NTM with TB PCR.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.599-606
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• 2012

The characterization of the whole genome of human papillomavirus type 16 (HPV16) from cervical cancer specimens with multiple infections in comparison with single infection samples as the oncogenic potential of the virus may differ. Cervical carcinoma specimens positive for HPV16 by PCR and INNO-LiPA were randomly selected for whole genome characterization. Two HPV16 single infection and six HPV16 multiple infection specimens were subjected to whole genome analysis by using conserved primers and subsequent sequencing. All HPV16 whole genomes from single infection samples clustered in the European (E) lineage while all multiple infection specimens belonged to the non-European lineage. The variations in nucleotide sequences in E6, E7, E2, L1 and Long control region (LCR) were evaluated. In the E6 region, amino acid changes at L83V were related to increased cancer progression. An amino acid variation N29S within the E7 oncoprotein significantly associated with severity of lesion was also discovered. In all three domains of the E2 gene non synonymous mutations were found. The L1 region showed various mutations which may be related to conformation changes of viral epitopes. Some transcription factor binding sites in the LCR region correlated to virulence were shown on GRE/1, TEF-1, YY14 and Oct-1. HPV16 European variant prone to single infection may harbor a major variation at L83V which significantly increases the risk for developing cervical carcinoma. HPV16 non-European variants prone to multiple infections may require many polymorphisms to enhance the risk of cervical cancer development.

• Pediatric Infection and Vaccine
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• 제3권2호
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• pp.163-167
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• 1996

Aseptic meningitis, the most common infection of the central nervous system, is an acute illness mostly caused by enteroviruses. Cerebrospinal fluid(CSF) has been used for the detection of enteroviral RNA but the detection has been mostly performed in a single CSF specimen obtained during the illness. A major objective was to evaluate the relation of sampling time to the recovery of enteroviral RNA in CSF. Thirty seven CSF specimens were obtained from 24 patients between May and August 1993, when an outbreak of asceptic meningitis by echovirus type 9 occurred. Enteroviral RNA in CSF was detected by polymerase chain reaction(PCR). Data about onset of symptom development were obtained by review of medical records. Enteroviral RNA was detected by PCR in 29 of 37 CSF specimens. PCR yielded positive results in 4 of 5 CSF specimens obtained on day 1 to 3, 10 of 11 on day 4 to 6, 8 of 10 on day 7 to 9, 6 of 8 on day 10 to 12, 1 of 3 on day 13 to 15 postonset. Of 11 patients from each of whom more than one CSF were obtained on different day postonset, PCR yielded positive resutls in 2 of 3 cases in whom enteroviral RNA detection was negative in the first CSF. These results indicate that two or more CSF specimens obtained within 12 days postonset are required for improving the accuracy of the diagnosis of enteroviral meningitis.

• Childhood Kidney Diseases
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• 제21권1호
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• pp.8-14
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• 2017

Purpose: To classify the results of renal biopsy in pediatric patients and to compare pathological findings with clinical features. Methods: This study included data of 318 children who underwent renal biopsy at our hospital between December 1987 and November 2014. Biopsy specimens were examined histopathologically using light, immunofluorescence, and electron microscopy. Results: Asymptomatic urinary abnormalities was the most common clinical diagnosis (35.9%), followed by nephrotic syndrome (29.3%), and acute glomerulonephritis (18.0%). Glomerular disease was identified in 98.1% of the renal biopsy specimens. The most common primary cause of glomerulonephritis was IgA nephropathy, with gross hematuria in 61.9% of the patients, hypertension in 14.2%, proteinuria >1.0 gm/24-hr in 33.3%, and impaired renal function in 3.6% patients. Conclusion: The most common clinical diagnosis was asymptomatic urinary abnormalities, with primary glomerular disease being the most common renal biopsy finding, and IgA nephropathy the most common histopathological lesion. This study provides a 27-year overview of pediatric renal disease at our center and underlines the importance of renal biopsy for accurate diagnosis and proper management.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10809-10812
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• 2015

Background: Human papillomavirus (HPV) DNA testing is an effective method to screen for precancerous changes in the cervix. Samples from self-collection rather than Pap smear can potentially be used to test for HPV as they are more acceptable and preferred for use in certain settings. The objective of this study was to compare HPV DNA testing from self-collected vaginal swabs and physician-collected cervical swabs. Materials and Methods: A total of 101 self-collected vaginal and physician-collected cervical swabs of known cytology from Thai women were tested by electrochemical DNA chip assay. The specimens were divided into 4 groups: 29 with normal cytology, 14 with atypical squamous cells of undetermined significance (ASCUS), 48 with low-grade squamous intraepithelial lesion (LSIL), and 10 with high-grade squamous intraepithelial lesion (HSIL). Results: Positive detection rates of HPV from self-collected swabs were similar to those from physician-collected swabs. Among specimens with abnormal cytology, HPV was found in 50% of self-collected swabs and 47.2% of physician-collected swabs. In specimens with normal cytology, 17.2% of self-collected swabs and 24.1% of physician-collected swabs were positive for HPV. Concordance was relatively high between results from self-collected and physician-collected samples. The most common HPV genotype detected was HPV 51. Conclusions: HPV DNA testing using self-collected swabs is a feasible alternative to encourage and increase screening for cervical cancer in a population who might otherwise avoid this important preventive examination due to embarrassment, discomfort, and anxiety.

• 대한임상검사과학회지
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• 제56권1호
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• pp.89-98
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• 2024

육안검사는 정확한 병리조직학적 진단을 위해 수술, 내시경 검사에서 채취된 검체를 육안검사를 통해 암의 육안정보를 기록하고 병변은 현미경 표본을 만들기 위해 절편을 채취하는 행위이다. 육안검사의 기술은 간결하고 정확한 표현, 적절한 구조화, 충분한 절제, 중요정보에 대한 오류가 없는 표준화, 복잡한 검체의 사진 도표화가 이루어져야 한다. 병리학적 판독의 만족도를 높이기 위해서는 육안검사에 대한 이해가 충분한 이론적 실무적 바탕에서 신뢰를 얻기 위한 정확하고 신중히 수행해야 하는 업무이다. 육안검사 분야에서 임상병리사들의 경험을 바탕으로, 추가 표본 유형이 실행 가능한 후보로 식별되고 치료 측면에서 요구와 우려 사항을 신중하게 고려해야 한다. 또한, 각 기관의 부서에서는 임상과의 파트너쉽, 지속적인 전문인력 양성, 진단오류 및 가치 기반의 의료제공에 대한 국가적 초점 측면에서 검토해야 할 것이다.