BACKGROUNDS/AIMS: Recently, treatment failure with the third generation of cephalosporin was increasingly noted in patients with spontaneous bacterial peritonitis (SBP). We therefore were to evaluate the pattern of antibiotic resistance and its clinical significance. METHODS: We retrospectively analyzed 580 episodes of SBP occurring between 1995 and 1999. There were 87 episodes of SBP in 1995, 222 in 1998, and 271 in 1999. The pattern of isolated organisms and antibiotic resistance, and prognostic factors for survival, were analyzed. RESULTS: Microorganisms were isolated in 41% of total episodes. The three most frequently isolated organisms were E. coli (48%), K. pneumoniae (15%), and Aeromonas (8%). The percentage of resistant strains to cefotaxime (9%, 14%, 32%) and ciprofloxacin (13%, 21%, 32%) significantly increased. The proportion of E. coli producing extended spectrum beta-lactamase (ESBL) also increased significantly (0%, 16%, 33%). The need of secondary antibiotics such as imipenem due to treatment failure was significantly increased from 0% in 1995 to 33% in 1999. Overall in-hospital mortality, however, was not changed (20%, 20%, 24%, respectively). The factor affecting early mortality was renal failure at diagnosis. Prognostic factors for long-term survival were the presence of associated malignancy and ESBL-producing microorganisms. CONCLUSION: Microorgansims resistant to third generation cephalosporin and quinolone were increasingly isolated over the 5 years in patients with SBP. Measures to prevent in-hospital spread of resistant strains and indiscreet use of antibiotics should therefore be instituted.
4-Quinolones ; Adult ; Aged ; Anti-Infective Agents/pharmacology ; Bacterial Infections/complications/*drug therapy/*microbiology/mortality ; Cephalosporin Resistance ; Drug Resistance ; English Abstract ; Female ; Human ; Liver Cirrhosis/complications ; Male ; Middle Aged ; Peritonitis/complications/*drug therapy/microbiology/mortality ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVE: To determine the effect of rebamipide on the expression of Toll-like recepter 4 (TLR4) and TNF-alpha release in pulmonary epithelial cell line A549. METHODS: Lipopolysaccharide (LPS) was used to induce A549 in vitro, which was divided into 4 groups: a control group, a model group(LPS), and 2 intervention groups (10 mg/L rebamipide plus LPS; 30 mg/L rebamipide plus LPS). TNF-alpha release was detected with ELISA and expression of TLR4 was detected with RT-PCR and Western blot. RESULTS: A549 cells were stimulated with LPS and TNF-alpha release was increased compared with the control group (P<0.01), peaking at 6 h. Expression of TLR4 was also increased compared with the control group (P<0.01), but it was inhibited by rebamipide compared with the model group (P<0.05). There was no significant difference between the 2 intervention groups (P>0.05). CONCLUSION The antiinflammatory mechanism of rebamipide may be reducing cytokine release by inhibiting TLR4 expression. Rebamipide may be used as a supplementary anti-infection drug.
Alanine ; analogs & derivatives ; pharmacology ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Cell Line ; Epithelial Cells ; cytology ; Humans ; Lipopolysaccharides ; pharmacology ; Lung ; cytology ; metabolism ; Quinolones ; pharmacology ; Toll-Like Receptor 4 ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Oxolinic acid is a weak-organic acid which developed recently from Nalidixic acid. Author reports a clinical observation about the effect of oxolinic acid on patients of genito-urinary tract infection, who visited to our O.P.D. from May 1976 to Nov. 1976. Daily dose is 1.5gm per oral for 5-28 days. 1. Among 12 cases of nongonococcal urethritis, excellent and good effects are obtained in 10 cases. 2. Among 9 cases of Gonococcal urethritis, excellent effects are resulted in 7 cases. 3. Among 6 cases of acute cystitis, excellent in 4 cases and good result in 2 cases are noted. 4. Among 5 cases of chronic prostatitis, only 1 case excellent and good effects are noted in 2 cases. 5. Among 3 cases of epididymitis, good effects are seen in 2 cases. 6. On 2 cases of chronic cystitis, 1 case is excellent and no effect in 1 case is noted. 7. On 1 case of pyelonephritis, no effect is obtained. 8. Oxolinic acid has the antibacterial activity in 11 cases of 17 cases staphylococcus & streptococcus infections, 7 cases of 9 cases gonococcus infections, and 1 case of 2 cases proteus infections. No significant toxicity is seen through the course of therapy.
Cystitis ; Epididymitis ; Humans ; Male ; Nalidixic Acid ; Neisseria gonorrhoeae ; Oxolinic Acid* ; Prostatitis ; Proteus Infections ; Pyelonephritis ; Staphylococcus ; Streptococcus ; Urethritis

Psychopharmacology has developed over approximately the past five decades. The remarkable proliferation of information in this area has made it difficult for clinicians to understand the characteristics of various psychotropic agents. Atypical antipsychotics including amisulpride, asenapine, aripiprazole, blonanserin, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone, and zotepine cause fewer extrapyramidal problems and have many clinical applications, but they can cause metabolic disturbances. Mood stabilizers and lamotrigine are widely used for bipolar disorder. Other novel anticonvulsants such as topiramate, oxcarbazepine, gabapentin, tiagabine, pregabalin, vigabatrin, levetiracetam, and riulzole have also been tested with diverging or inconclusive results. Antidepressants are commonly used in the clinical treatment of depression and anxiety disorder. However, the mechanism of action of medications used in the treatment of psychiatric disorders remains unclear. Understanding the mechanisms of action and clarifying the diagnosis may enhance the treatment outcome in psychiatry. In this review, we analyzed clinical pharmacology data for each drug within a class and discussed clinical strategies for administering currently available antipsychotics, mood stabilizer/anticonvulsants, and antidepressants widely used for various psychiatric indications.
Aripiprazole ; Amines ; Anticonvulsants ; Antidepressive Agents ; Antipsychotic Agents ; Anxiety Disorders ; Benzodiazepines ; Bipolar Disorder ; Carbamazepine ; Clozapine ; Cyclohexanecarboxylic Acids ; Depression ; Dibenzothiazepines ; Dibenzothiepins ; Fructose ; gamma-Aminobutyric Acid ; Heterocyclic Compounds with 4 or More Rings ; Lurasidone Hydrochloride ; Isoindoles ; Isoxazoles ; Nipecotic Acids ; Quetiapine Fumarate ; Pharmacology, Clinical ; Pregabalin ; Piperazines ; Piperidines ; Piracetam ; Psychopharmacology ; Pyrimidines ; Quinolones ; Risperidone ; Sulpiride ; Thiazoles ; Treatment Outcome ; Triazines ; Vigabatrin

OBJECTIVE: We have carried out a bibliometric study on the scientific publications in relation to atypical or second-generation antipsychotic drugs (SGAs) in South Korea. METHODS: With the EMBASE and MEDLINE databases, we selected those publications made in South Korea whose title included the descriptors atypic* (atypical*) antipsychotic*, second-generation antipsychotic*, clozapine, risperidone, olanzapine, ziprasidone, quetiapine, sertindole, aripiprazole, paliperidone, amisulpride, zotepine, asenapine, iloperidone, lurasidone, perospirone and blonanserin. We applied some bibliometric indicators of paper production and dispersion with Price's law and Bradford's law, respectively. We also calculated the participation index (PI) of the different countries, and correlated the bibliometric data with some social and health data from Korea (such as total per capita expenditure on health and gross domestic expenditure on research and development). RESULTS: We collected 326 original papers published between 1993 and 2011. Our results state fulfilment of fulfilled Price's law, with scientific production on SGAs showing exponential growth (correlation coefficient r=0.8978, as against an r=0.8149 after linear adjustment). The most widely studied drugs were risperidone (91 papers), aripiprazole (77), olanzapine (53), and clozapine (43). Division into Bradford zones yielded a nucleus occupied by the Progress in Neuro-Psychopharmacology and Biological Psychiatry (36 articles). A total of 86 different journals were published, with 4 of the first 10 used journals having an impact factor being greater than 4. CONCLUSION: The publications on SGAs in South Korea have undergone exponential growth over the studied period, without evidence of reaching a saturation point.
Antipsychotic Agents ; Benzodiazepines ; Biological Psychiatry ; Bipolar Disorder ; Clozapine ; Complement Factor B ; Dibenzothiazepines ; Dibenzothiepins ; Health Expenditures ; Heterocyclic Compounds with 4 or More Rings ; Imidazoles ; Indoles ; Isoindoles ; Isoxazoles ; Jurisprudence ; Korea ; Piperazines ; Piperidines ; Pyrimidines ; Quinolones ; Republic of Korea ; Risperidone ; Schizophrenia ; Subject Headings ; Sulpiride ; Thiazoles ; Quetiapine Fumarate ; Aripiprazole ; Lurasidone Hydrochloride

To develop a live vaccine strain against fowl typhoid and paratyphoid caused by Salmonella serovar Gallinarum biovar Gallinarum (Salmonella Gallinarum) and Salmonella serovar Enteritidis (Salmonella Enteritidis), respectively, several nalidixic acid resistant mutants were selected from lipopolysaccharide (LPS) rough strains of Salmonella Gallinarum that escaped from fatal infection of a LPS-binding lytic bacteriophage. A non-virulent and immunogenic vaccine strain of Salmonella Gallinarum, SR2-N6, was established through in vivo pathogenicity and protection efficacy tests. SR2-N6 was highly protective against Salmonella Gallinarum and Salmonella Enteritidis and safer than Salmonella Gallinarum vaccine strain SG 9R in the condition of protein-energy malnutrition. Thus, SR2-N6 may be a safe and efficacious vaccine strain to prevent both fowl typhoid and paratyphoid.
Bacteriophages ; Nalidixic Acid ; Protein-Energy Malnutrition ; Salmonella ; Salmonella enteritidis ; Typhoid Fever* ; United Nations ; Virulence

As many Koreans now travel abroad, they are at increased risk for a variety of infectious diseases that are endemic to developing countries in the tropics and subtropics. We report two cases of co-infection with Giardia lamblia and Salmonella species not susceptible to nalidixic acid, after travel abroad.
Coinfection ; Communicable Diseases ; Developing Countries ; Giardia ; Giardia lamblia ; Nalidixic Acid ; Salmonella

Turtle-borne Salmonella enterica owns significance as a leading cause in human salmonellosis. The current study aimed to determine the quinolone susceptibility and the genetic characteristics of 21 strains of S. enterica subsp. enterica isolated from pet turtles. Susceptibility of four antimicrobials including nalidixic acid, ciprofloxacin, ofloxacin, and levofloxacin was examined in disk diffusion and MIC tests where the majority of the isolates were susceptible to all tested quinolones. In genetic characterization, none of the isolates were positive for qnr or aac(6')-Ib genes and no any target site mutations could be detected in gyrA, gyrB, and parC quinolone resistance determining regions (QRDR). In addition, neighbor-joining phylogenetic tree derived using gyrA gene sequences exhibited two distinct clads comprising; first, current study isolates, and second, quinolone-resistant isolates of human and animal origin. All results suggest that studied strains of S. enterica subsp. enterica isolated from pet turtles are susceptible to quinolones and genetically more conserved with regards to gyrA gene region.
Animals ; Ciprofloxacin ; Diffusion ; Humans ; Levofloxacin ; Nalidixic Acid ; Ofloxacin ; Quinolones ; Salmonella enterica* ; Salmonella Infections ; Salmonella* ; Trees ; Turtles*

Experiments were conducted to define the optimal constituents of culture medium and atmospheric condition for growth of Campylobacter pylori. Two clinical isolates were streaked onto various media, incubated in two different atmospheric conditions (microaerophilic condition and carbon dioxide incubator), and growth was assessed semiquantitatively according to relative colony size and extent of growth through the streak. The growth obtained on Campy media, composed of GC agar base plus 1% hemoglobin, 0.2% activated charcoal, 1% IsoVitaleX, vancomycin 6mg /L nalidixic acid 20mg/L and amphotercin 2 mg/L, was used as reference. Our conclusions were as follows: Tryptic soy agar base was not acceptable for the growth of C. pylori. The organism grew in both atmospheric conditions, but generally showed a scantier growth in the carbon dioxide incubator than under the microaerophilic condition, however GC agar containing 1% hemoglobin and 0.2% activated charcoal supported well the growth of C. pylori in the carbon dioxide incubator. The authors have found that the GC agar base supplemented with 1% hemoglobin and 0.2% charcoal was the most satisfactory medium and a microaerophilic condition was optimal atmospheric condition for the growth of Campylobacter pylori in this study.
Agar ; Biopsy* ; Campylobacter* ; Carbon Dioxide ; Charcoal ; Helicobacter pylori* ; Incubators ; Nalidixic Acid ; Vancomycin

This study was performed for the assessing the distribution, drug resistance and its transferability, and cell agglutinating ability of Enterobacteriaceae isolated from urine of patients with urinary tract infection. Total 164 strains of Strains of Enterobacteriaceae including, 91 strains of E. coli, 35 strains of klebsiella, 23 strains of Proteus, 6 strains of Serratia, 6 strains of Citrobacter, 3 strains of Enterobacteriaceae were isolated from urine. In the cell agglutinating test, most organisms, except Proteus, showed mannose resistant agglutination. Among organisms tested more than 20 strains, E. coli showed highest frequency of cell agglutination. In the comparison of cell agglutinating characteristics of E. coli and Klebsiella isolated from urine and other sources urinary isolates of E. coli showed higher frequency of agglutination and greater agglutinating potency than isolates from other sources, but Klebsiella showed little difference between isolates of urine and other sources. Urinary isolates usually showed high frequency of resistance to penicillin(90%), ampicillin(89%). sulfamethoxazole(69%), tetracycline(66%), chloramphenicol(53%), but showed low frequency of resistance to moxalactam(1%), amikacin(2%), and nalidixic acid (9%), and these resistance were highly transferable resistance mediated by R plasmid.
Agglutination ; Citrobacter ; Drug Resistance* ; Enterobacteriaceae ; Humans ; Klebsiella ; Mannose ; Nalidixic Acid ; Plasmids ; Proteus ; Serratia ; Urinary Tract Infections