아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

폐렴구균 감염증에서 항생제 내성의 임상적 의미 : Asian Network for Surveillance of Resistant Pathogens(ANSORP) Study

정숙인,기현균,손준성,고관수,김나영,장현하,오원섭,백경란,이남용,김신우,이혁,--,송재훈 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 전 세계적으로 폐렴구균의 페니실린을 포함한 β-lactam과 마크로라이드 및 퀴놀론 계열의 항생제에 대한 내성이 급격히 증가하여 임상적으로 문제가 되고 있으나, 시험관내 내성이 실제 임상적 예후에 미치는 영향에 대해서는 아직까지 논란이 되고 있다. 본 연구는 폐렴구균의 항생제 내성률이 높은 아시아 지역에서 항생제 내성이 폐렴구균 감염증의 임상경과에 미치는 영향을 평가하기 위하여 시행되었다. 방법 : ANSORP에서 주관한 전향적 임상 연구로서 1999년 11월부터 2001년 8월까지 아시아 지역 11개국의 14개 기관에서 진단된 침습성 폐럼구균 감염증 환자를 대상으로 내성 균주 감염의 위험요인, 임상양상, 예후 등의 임상적 분석을 시행하였다. 결과 : 총 646명 환자의 평균연령은 30.1세(6일-89세)였고, 이전 3개월 내에 항생제 사용력이 있는 환자는 159명(32.4%)이었다. 질환별로는 폐렴이 377예(58.4%)로 가장 많았고, 중이염 67예, 뇌수막염 66예(10.2%), 일차성 균혈증 65예(10.1%)였다. 총 646균주 중 347균주(53.7%)가 페니실린 비감수성(중등도 내성 23.1%, 고도 내성 23.1%)이었고, 페니실린에 대한 MIC_(90)은 0.03㎍/mL에서 4㎍/mL까지의 분포를 보였다. 페니실린 비감수성 균주에 의한 감염증과 차이가 없었다. 페니실린 내성 폐렴구균 폐렴에 의한 사망률은 페니실린 감수성 폐렴구균 폐렴에 의한 사망률과 차이가 없었다(p=0.846). Erythromycin에 대한 고도 내성을 보이는 균주의 비율이 매우 높았으나, 실제 임상상이나 치사율에는 영향을 미치지 않았다(p=0.092). 페니실린 비감수성 폐렴구균에 의한 뇌수막염의 치사률도 감수성 균주에 의한 사망률과 차이가 없었다(p=0.059). 결론 : 본 연구의 결과 페니실린 및 베타 락탐 제제에 대한 시험관 내성은 폐렴구균 폐렴이나 뇌수막염의 임상상이나 치사율에 영향을 미치지 않는 것으로 확인되었다. 이는 내성의 정도와 연관될 것으로 생각되므로, 향후 고도 내성 균주가 증가할 때 추가 검증을 요한다. 아울러 macrolide 및 퀴놀론계 항생제 내성의 임상적 의미에 대한 후속 연구가 필요할 것으로 사료된다. Background : Despite the widespread emergence of antimicrobial resistance among pneumococcal strains worldwide, clinical implications of in vitro resistance still remain an open question. To evaluate the clinical impact of pneumococcal resistance in Asian countries where the prevalence of pneumococcal resistance was reported to be highest in the world, ANSORP has performed a prospective, multinational surveillance study with cases with invasive pneumococcal diseases in Asian countries. Methods : In vitro susceptibility of pneumococcal isolates was determined by broth microdilution tests with 16 antimicrobial agents. All enrolled cases of pneumococcal infections were analyzed with regard to demographic data, clinical features, risk factors and mortality. Results : A total of 646 patients with pneumococcal infections were enrolled from 14 centers in 12 countries between the period from November 1999 to August 2001. Pneumonia (58.4%) was the most common clinical disease followed by bacteremia (33.4%), otitis media (10.4%), and meningitis (10.2%). Among 646 isolates, 347 (53.7%) were penicillin non-susceptible (intermediate 23.1%, resistant 30.7%). MIG_(90)s for penicillin ranged from 0.03 (India) to 4.0 ㎍/mL (Korea, Taiwan, Vietnam, and Hong Kong). Overall mortality from pneumococcal diseases by penicillin non-susceptible strains was not different from that by susceptible strains. Pneumococcal pneumonia caused by penicillin- or erythromycin-resistant strains showed similar mortality, severity of illness, or complications to that by susceptible strains. Mortality from pneumococcal meningitis caused by penicillin non-susceptible strains was also similar to that by susceptible strains. Conclusion : Data suggest that current situation of in vitro resistance to penicillin or macrolides may not affect the mortality from pneumococal pneumonia or meningitis caused by antibiotic-resistant strains.

RNAi에 의한 담배가루이(Bemisia tabaci, 가루이과, 노린재목)의 개체군 밀도변화

고나연(Na-Yeon Ko),윤영남(Young-Nam Youn) 충남대학교 농업과학연구소 2015 농업과학연구 Vol.42 No.1

Ninety genes randomly selected from tobacco whitefly (Bemisia tabaci) cDNA library was studied for selecting target gene in order to control of tobacco whitefly using TRV-VIGS vector (tobacco rattle virus-virus induced gene silencing vector) with RNAi. First of all, the occurrence of B. tabaci adult according to agro-infiltration of TRV was no significant difference. And that of TRV inserted tobacco whitefly cDNA showed a significant difference in each sample. P CV and N CV sample were more than 80% could be confirmed in 5 samples, for example, wh11, wh36, wh46, wh50 and wh71. Lastly, the occurrence of nymph and egg also showed a significant difference in each sample. That could be confirmed in 11 samples, for example, wh01, wh09, wh10, wh15, wh16, wh23, wh24, wh48, wh64 and wh66. In case of wh46, wh50 and wh71 sample could be confirmed that occurrence of B. tabaci adult was many, but occurrence of B. tabaci nymph and egg was a little. So sample showed a physioecological good effect to control of whitefly need to be investigated variation of gene expression in whitefly body using qRT-PCR through individual test.

mtDNA D-loop 변이로 확인된 한국재래닭의 다양한 모계기원

조창연(Chang-Yeon Cho),이풍연(Pung-Yeon Lee),고응규(Yeoung-Gyu Ko),김학규(Hak Kyu Kim),박미나(Mi-Na Park),연성흠(Seung-Hum Yeon) 韓國家禽學會 2011 韓國家禽學會誌 Vol.38 No.1

우리나라 재래닭의 기원을 구명하기 위해서 mtDNA Dloop 영역을 분석한 결과, 1,231~1,232개의 염기구성되어 있으며, 35개소에서 변이가 관찰되었다. 변이 부위를 이용하여 Haplotype을 분류한 결과, 21종으로 분류되었으며 이중 9개인 GenBank에 미등록된 것으로 밝혀졌다. Hplotype 다양성으로 추정한 한국 재래닭의 유전적 변이성은 중국의 재래닭과 유사한 것으로 추정되었다. Haplotype에 대한 Network 분석 결과, 재래닭은 5개의 Clade로 분류되었다. 이들 Clade에 대한 각 집단의 분포 현황으로 한국 재래닭은 운남성 및 중국 재래닭이 보인 결과와 유사하나, 일본의 재래닭과는 약간 상이한 것으로 밝혀졌다. 이상의 결과로 우리나라 재래닭은 공통선조가 다른 5개 이상의 모계가 중국을 통하여 유래되었으며, 일본에도 전파된 것이 확인되었다. 한편, 일본은 한반도를 유래하지 않은 닭의 유입이 있었던 것으로 추정된다. In this study, we analyzed the mitochondrial DNA D-loop region of Korean native chicken to clarify their phylogenetic relationships, possible maternal origin and routes of introduction into Korea. A 1231-1232 bp DNA fragment from the mtDNA D-loop region was sequenced in 315 chickens from 11 populations, Thirty-five variable sites that defined 21 haplotyes were observed. In Korean native chicken, diversity accounted for 90% of the variation, little differentiation among the strains. The 21 haplotypes clustered into 5 clades which were A, B, C, D and E. These results indicate that Korean chickens were derived from China with multiple origins.

cDNA Library Construction of Aphis gossypii Using Gateway Cloning System

Hye-Ri Kwon,Jung-Kyu Kim,Na-Yeon Ko,Yu-Bin Jung,Chan-yeong Kang,Tae-Hee Ryu,Mi-Ja Seo,Hyoun-Sub Lim,Yong-Man Yu,Young-Nam Youn 한국응용곤충학회 2014 한국응용곤충학회 학술대회논문집 Vol.2014 No.10

Aphis gossypii was widely distributed throughout the tropical, subtropical and temperate zone. The chemical control of A. gossypii is becoming problem because it was rapidly appeared resistance expression to chemicals. We will attempt to resolve the this problem using RNAi technique. Besides, RNAi technology can be helpful to study the target genes of A. gossypii. In this study we produce cDNA library construction using gateway cloning system for selecting target gene in order to control of A. gossypii using RNAi. As a result, the 100-400bp of insert size, which is appropriate for RNAi was confirmed. Most of insert gene is associated with A. gossypii, after that insert sequence was compared with DNA databases and EST databases using NCBI blast search. Consequentially, A. gossypii of cDNA library with the titer of 3.15x105 clones were completed. And we will perform the LR recombination to transfer cDNA library into TRV2 (tobacco rattle virus) vector with att site. Then, after performing transformation using Agrobacterium tumefaciens (GV 2260), we inoculated to cucumber with A. tumefaciens. An insecticidal effect or a repellent activity against A. gossypii by changing behavior in transgenic cucumber plants were conformed. Also, the selecting target gene in order to control A. gossypii using RNAi may be provided.

Effects of soil and foliar applied herbicides on the evening primrose (Oenothera biennis )

Ko Jeung Woo,Kim Yu Na,Park Seon Min,Park Chang Wook,Park Hee Soon,Park Yeon Gyeong,Lee In Jung 한국잡초학회 2018 한국잡초학회 별책(학술대회 초록집) Vol.38 No.2

An Herbal Medicine, Yukgunja-Tang is more Effective in a Type of Functional Dyspepsia Categorized by Facial Shape Diagnosis: A Placebo-Controlled, Double-Blind, Randomized Trial

Ko, Seok-Jae,Park, Jae-Woo,Lee, Jae-hyung,Lee, Jung-eun,Ha, Na-yeon,Nam, Seong-uk,Lee, Jae-hong,Jeon, Soo-Hyung,Kim, Jong-Won,Kang, Changwan,Yeo, Inkwon,Kim, Jinsung Hindawi 2018 Evidence-based Complementary and Alternative Medic Vol.2018 No.-

<P><B>Introduction</B></P><P> Functional dyspepsia (FD) is a functional gastrointestinal disorder characterized by persistent upper dyspeptic symptoms without organic lesions. There is no standard therapy for FD. Yukgunja-tang (YGJT) is an herbal medicine used for treating upper gastrointestinal symptoms in Asia. Studies on the effect of YGJT on FD have been conducted. However, the results were inconsistent. In<I> Hyungsang</I> medicine, traditional Korean medicine, FD patients are classified into bladder body (BB) or gallbladder body (GB) subtypes by the shape and angle of their faces. Each subtype may have different characteristics, physiology, and pathology of the same disease. YGJT is more effective for patients with BB subtype. The three-dimensional facial shape diagnostic system (3-FSDS) was shown to be effective in diagnosing BB or GB subtypes. This study aimed to investigate the effect of YGJT on FD patients classified using the 3-FSDS.</P><P><B> Materials and Methods</B></P><P> The current study was a placebo-controlled, double-blinded, randomized, two-center trial. Eligible patients were diagnosed with either BB or GB FD subtype using the 3-FSDS. Ninety-six participants (48 BB and 48 GB subtypes) were randomly allocated to treatment or control groups in a 2:1 ratio. YGJT or placebo was administered for eight weeks. The primary outcome was assessed using the total dyspepsia symptom scale (TDS), while the secondary outcomes were assessed using the single dyspepsia symptom scale (SDS), proportion of responders, visual analog scale, Nepean dyspepsia index, functional dyspepsia-related quality of life, and spleen qi deficiency questionnaire.</P><P><B> Results and Discussion</B></P><P> The result of TDS showed the superior effect of YGJT on BB over GB subtype. The subgroup analysis of TDS and SDS scores showed the superior effect of YGJT over placebo. Other outcome variables did not show any significant differences between groups.</P><P><B> Conclusion</B></P><P> YGJT may be considered for FD patients diagnosed with BB subtype using 3-FSDS.</P>

Bowen’s disease on nail associated with HPV type 56 in young SLE patient

( Na Young Kim ),( Ki Yeon Kim ),( Dong Seok Shin ),( Jeong Eun Kim ),( Joo Yeon Ko ),( Young Suck Ro ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.72 No.2

The Association Between Tachycardia and Mortality in Septic Shock Patients According to Serum Lactate Level: A Nationwide Multicenter Cohort Study

Na Soo Jin,Oh Dong Kyu,Park Sunghoon,Lee Yeon Joo,Hong Sang-Bum,Park Mi Hyeon,Ko Ryoung-Eun,Lim Chae-Man,Jeon Kyeongman 대한의학회 2023 Journal of Korean medical science Vol.38 No.40

Background: This study aimed to evaluate whether the effect of tachycardia varies according to the degree of tissue perfusion in septic shock. Methods: Patients with septic shock admitted to the intensive care units were categorized into the tachycardia (heart rate > 100 beats/min) and non-tachycardia (≤ 100 beats/min) groups. The association of tachycardia with hospital mortality was evaluated in each subgroup with low and high lactate levels, which were identified through a subpopulation treatment effect pattern plot analysis. Results: In overall patients, hospital mortality did not differ between the two groups (44.6% vs. 41.8%, P = 0.441), however, tachycardia was associated with reduced hospital mortality rates in patients with a lactate level ≥ 5.3 mmol/L (48.7% vs. 60.3%, P = 0.030; adjusted odds ratio [OR], 0.59, 95% confidence interval [CI], 0.35–0.99, P = 0.045), not in patients with a lactate level < 5.3 mmol/L (36.5% vs. 29.7%, P = 0.156; adjusted OR, 1.39, 95% CI, 0.82–2.35, P = 0.227). Conclusion: In septic shock patients, the effect of tachycardia on hospital mortality differed by serum lactate level. Tachycardia was associated with better survival in patients with significantly elevated lactate levels.

Deep convolutional neural network for the diagnosis of thyroid nodules on ultrasound

Ko, Su Yeon,Lee, Ji Hye,Yoon, Jung Hyun,Na, Hyesun,Hong, Eunhye,Han, Kyunghwa,Jung, Inkyung,Kim, Eun‐,Kyung,Moon, Hee Jung,Park, Vivian Y.,Lee, Eunjung,Kwak, Jin Young John Wiley Sons, Inc. 2019 Head & neck Vol.41 No.4

<P><B>Abstract</B></P><P><B>Background</B></P><P>We designed a deep convolutional neural network (CNN) to diagnose thyroid malignancy on ultrasound (US) and compared the diagnostic performance of CNN with that of experienced radiologists.</P><P><B>Methods</B></P><P>Between May 2012 and February 2015, 589 thyroid nodules in 519 patients were diagnosed as benign or malignant by surgical excision. Experienced radiologists retrospectively reviewed the US of the thyroid nodules in a test set. CNNs were trained and tested using retrospective data of 439 and 150 US images, respectively. Diagnostic performances were compared between the two groups.</P><P><B>Results</B></P><P>Of the 589 thyroid nodules, 396 were malignant and 193 were benign. The area under the curve (AUC) for diagnosing thyroid malignancy was 0.805‐0.860 for radiologists. The AUCs for diagnosing thyroid malignancy for the three CNNs were 0.845, 0.835, and 0.850. There was no significant difference in AUC between radiologists and CNNs.</P><P><B>Conclusions</B></P><P>CNNs showed comparable diagnostic performance compared to experienced radiologists in differentiating thyroid malignancy on US.</P>