1.Anti-tumor effects of Toxoplasma gondii and antigen-pulsed dendritic cells in mice bearing breast cancer
Bong Kyun KIM ; Hei Gwon CHOI ; Jae-Hyung LEE ; In Wook CHOI ; Jae-Min YUK ; Guang-Ho CHA ; Young-Ha LEE
Parasites, Hosts and Diseases 2025;63(1):37-49
		                        		
		                        			
		                        			 Cancer immunotherapy is widely used to treat various cancers to augment the weakened host immune response against tumors. Dendritic cells (DCs) are specialized antigen-presenting cells that play dual roles in inducing innate and adaptive immunity. Toxoplasma gondii is a protozoan parasite that exhibits anti-tumor activity against certain types of cancers. However, little is known about the anti-tumor effects of T. gondii or tumor/parasite antigen-pulsed DCs (DC vaccines, DCV) in breast cancer. In this study, C57BL/6 mice were administered E0771 mouse breast cancer cells (Cancer-injected) subcutaneously, T. gondii Me49 cysts orally (TG-injected), or DCs pulsed with breast cancer cell lysate antigen and T. gondii lysate antigens (DCV-injected) intraperitoneally. Tumor size and immunological characteristics were subsequently evaluated. We also evaluated matrix metalloproteinase (MMP)-2 and MMP-9 levels in E0771 mouse breast cancer cells co-cultured with T. gondii or DCs by RT-PCR. The tumor volumes of mice injected with breast cancer cells and antigen-pulsed DCs (Cancer/DCV-injected mice) were similar to those of Cancer-injected mice; however, they were significantly reduced in T. gondii-infected tumor-bearing (TG/Cancer-injected) mice. Moreover, tumor volumes were significantly reduced by adding antigen-pulsed DCs (TG/Cancer/DCV-injected mice) compared to TG/Cancer-injected mice. The levels of IFN-γ, serum IgG2a levels, and CD8+ T cell populations were significantly higher in DCV- and TG-injected mice than in control mice, while no significant differences between Cancer- and Cancer/DCV-injected mice were observed. The levels of IFN-γ, the IgG2a levels, and the percentage of CD8+ T cells were significantly increased in TG/Cancer- and TG/Cancer/DCV-injected mice than in Cancer-injected mice. IFN-γ levels and serum IgG2a levels were further increased in TG/Cancer/DCV-injected mice than in TG/Cancer-injected mice. The MMP-2 and MMP-9 mRNA expressions were significantly decreased in mouse breast cancer cells co-cultured with live T. gondii, T. gondii lysate antigen, or antigen-pulsed DCs (DCV) but not in inactivated DCs. These results indicate that T. gondii induces anti-tumor effects in breast cancer-bearing mice through the induction of strong Th1 immune responses, but not in antigen-pulsed DCs alone. The addition of antigen-pulsed DCs further augments the anti-tumor effects of T. gondii. 
		                        		
		                        		
		                        		
		                        	
2.Anti-tumor effects of Toxoplasma gondii and antigen-pulsed dendritic cells in mice bearing breast cancer
Bong Kyun KIM ; Hei Gwon CHOI ; Jae-Hyung LEE ; In Wook CHOI ; Jae-Min YUK ; Guang-Ho CHA ; Young-Ha LEE
Parasites, Hosts and Diseases 2025;63(1):37-49
		                        		
		                        			
		                        			 Cancer immunotherapy is widely used to treat various cancers to augment the weakened host immune response against tumors. Dendritic cells (DCs) are specialized antigen-presenting cells that play dual roles in inducing innate and adaptive immunity. Toxoplasma gondii is a protozoan parasite that exhibits anti-tumor activity against certain types of cancers. However, little is known about the anti-tumor effects of T. gondii or tumor/parasite antigen-pulsed DCs (DC vaccines, DCV) in breast cancer. In this study, C57BL/6 mice were administered E0771 mouse breast cancer cells (Cancer-injected) subcutaneously, T. gondii Me49 cysts orally (TG-injected), or DCs pulsed with breast cancer cell lysate antigen and T. gondii lysate antigens (DCV-injected) intraperitoneally. Tumor size and immunological characteristics were subsequently evaluated. We also evaluated matrix metalloproteinase (MMP)-2 and MMP-9 levels in E0771 mouse breast cancer cells co-cultured with T. gondii or DCs by RT-PCR. The tumor volumes of mice injected with breast cancer cells and antigen-pulsed DCs (Cancer/DCV-injected mice) were similar to those of Cancer-injected mice; however, they were significantly reduced in T. gondii-infected tumor-bearing (TG/Cancer-injected) mice. Moreover, tumor volumes were significantly reduced by adding antigen-pulsed DCs (TG/Cancer/DCV-injected mice) compared to TG/Cancer-injected mice. The levels of IFN-γ, serum IgG2a levels, and CD8+ T cell populations were significantly higher in DCV- and TG-injected mice than in control mice, while no significant differences between Cancer- and Cancer/DCV-injected mice were observed. The levels of IFN-γ, the IgG2a levels, and the percentage of CD8+ T cells were significantly increased in TG/Cancer- and TG/Cancer/DCV-injected mice than in Cancer-injected mice. IFN-γ levels and serum IgG2a levels were further increased in TG/Cancer/DCV-injected mice than in TG/Cancer-injected mice. The MMP-2 and MMP-9 mRNA expressions were significantly decreased in mouse breast cancer cells co-cultured with live T. gondii, T. gondii lysate antigen, or antigen-pulsed DCs (DCV) but not in inactivated DCs. These results indicate that T. gondii induces anti-tumor effects in breast cancer-bearing mice through the induction of strong Th1 immune responses, but not in antigen-pulsed DCs alone. The addition of antigen-pulsed DCs further augments the anti-tumor effects of T. gondii. 
		                        		
		                        		
		                        		
		                        	
3.Anti-tumor effects of Toxoplasma gondii and antigen-pulsed dendritic cells in mice bearing breast cancer
Bong Kyun KIM ; Hei Gwon CHOI ; Jae-Hyung LEE ; In Wook CHOI ; Jae-Min YUK ; Guang-Ho CHA ; Young-Ha LEE
Parasites, Hosts and Diseases 2025;63(1):37-49
		                        		
		                        			
		                        			 Cancer immunotherapy is widely used to treat various cancers to augment the weakened host immune response against tumors. Dendritic cells (DCs) are specialized antigen-presenting cells that play dual roles in inducing innate and adaptive immunity. Toxoplasma gondii is a protozoan parasite that exhibits anti-tumor activity against certain types of cancers. However, little is known about the anti-tumor effects of T. gondii or tumor/parasite antigen-pulsed DCs (DC vaccines, DCV) in breast cancer. In this study, C57BL/6 mice were administered E0771 mouse breast cancer cells (Cancer-injected) subcutaneously, T. gondii Me49 cysts orally (TG-injected), or DCs pulsed with breast cancer cell lysate antigen and T. gondii lysate antigens (DCV-injected) intraperitoneally. Tumor size and immunological characteristics were subsequently evaluated. We also evaluated matrix metalloproteinase (MMP)-2 and MMP-9 levels in E0771 mouse breast cancer cells co-cultured with T. gondii or DCs by RT-PCR. The tumor volumes of mice injected with breast cancer cells and antigen-pulsed DCs (Cancer/DCV-injected mice) were similar to those of Cancer-injected mice; however, they were significantly reduced in T. gondii-infected tumor-bearing (TG/Cancer-injected) mice. Moreover, tumor volumes were significantly reduced by adding antigen-pulsed DCs (TG/Cancer/DCV-injected mice) compared to TG/Cancer-injected mice. The levels of IFN-γ, serum IgG2a levels, and CD8+ T cell populations were significantly higher in DCV- and TG-injected mice than in control mice, while no significant differences between Cancer- and Cancer/DCV-injected mice were observed. The levels of IFN-γ, the IgG2a levels, and the percentage of CD8+ T cells were significantly increased in TG/Cancer- and TG/Cancer/DCV-injected mice than in Cancer-injected mice. IFN-γ levels and serum IgG2a levels were further increased in TG/Cancer/DCV-injected mice than in TG/Cancer-injected mice. The MMP-2 and MMP-9 mRNA expressions were significantly decreased in mouse breast cancer cells co-cultured with live T. gondii, T. gondii lysate antigen, or antigen-pulsed DCs (DCV) but not in inactivated DCs. These results indicate that T. gondii induces anti-tumor effects in breast cancer-bearing mice through the induction of strong Th1 immune responses, but not in antigen-pulsed DCs alone. The addition of antigen-pulsed DCs further augments the anti-tumor effects of T. gondii. 
		                        		
		                        		
		                        		
		                        	
4.Anti-tumor effects of Toxoplasma gondii and antigen-pulsed dendritic cells in mice bearing breast cancer
Bong Kyun KIM ; Hei Gwon CHOI ; Jae-Hyung LEE ; In Wook CHOI ; Jae-Min YUK ; Guang-Ho CHA ; Young-Ha LEE
Parasites, Hosts and Diseases 2025;63(1):37-49
		                        		
		                        			
		                        			 Cancer immunotherapy is widely used to treat various cancers to augment the weakened host immune response against tumors. Dendritic cells (DCs) are specialized antigen-presenting cells that play dual roles in inducing innate and adaptive immunity. Toxoplasma gondii is a protozoan parasite that exhibits anti-tumor activity against certain types of cancers. However, little is known about the anti-tumor effects of T. gondii or tumor/parasite antigen-pulsed DCs (DC vaccines, DCV) in breast cancer. In this study, C57BL/6 mice were administered E0771 mouse breast cancer cells (Cancer-injected) subcutaneously, T. gondii Me49 cysts orally (TG-injected), or DCs pulsed with breast cancer cell lysate antigen and T. gondii lysate antigens (DCV-injected) intraperitoneally. Tumor size and immunological characteristics were subsequently evaluated. We also evaluated matrix metalloproteinase (MMP)-2 and MMP-9 levels in E0771 mouse breast cancer cells co-cultured with T. gondii or DCs by RT-PCR. The tumor volumes of mice injected with breast cancer cells and antigen-pulsed DCs (Cancer/DCV-injected mice) were similar to those of Cancer-injected mice; however, they were significantly reduced in T. gondii-infected tumor-bearing (TG/Cancer-injected) mice. Moreover, tumor volumes were significantly reduced by adding antigen-pulsed DCs (TG/Cancer/DCV-injected mice) compared to TG/Cancer-injected mice. The levels of IFN-γ, serum IgG2a levels, and CD8+ T cell populations were significantly higher in DCV- and TG-injected mice than in control mice, while no significant differences between Cancer- and Cancer/DCV-injected mice were observed. The levels of IFN-γ, the IgG2a levels, and the percentage of CD8+ T cells were significantly increased in TG/Cancer- and TG/Cancer/DCV-injected mice than in Cancer-injected mice. IFN-γ levels and serum IgG2a levels were further increased in TG/Cancer/DCV-injected mice than in TG/Cancer-injected mice. The MMP-2 and MMP-9 mRNA expressions were significantly decreased in mouse breast cancer cells co-cultured with live T. gondii, T. gondii lysate antigen, or antigen-pulsed DCs (DCV) but not in inactivated DCs. These results indicate that T. gondii induces anti-tumor effects in breast cancer-bearing mice through the induction of strong Th1 immune responses, but not in antigen-pulsed DCs alone. The addition of antigen-pulsed DCs further augments the anti-tumor effects of T. gondii. 
		                        		
		                        		
		                        		
		                        	
5.Anti-tumor effects of Toxoplasma gondii and antigen-pulsed dendritic cells in mice bearing breast cancer
Bong Kyun KIM ; Hei Gwon CHOI ; Jae-Hyung LEE ; In Wook CHOI ; Jae-Min YUK ; Guang-Ho CHA ; Young-Ha LEE
Parasites, Hosts and Diseases 2025;63(1):37-49
		                        		
		                        			
		                        			 Cancer immunotherapy is widely used to treat various cancers to augment the weakened host immune response against tumors. Dendritic cells (DCs) are specialized antigen-presenting cells that play dual roles in inducing innate and adaptive immunity. Toxoplasma gondii is a protozoan parasite that exhibits anti-tumor activity against certain types of cancers. However, little is known about the anti-tumor effects of T. gondii or tumor/parasite antigen-pulsed DCs (DC vaccines, DCV) in breast cancer. In this study, C57BL/6 mice were administered E0771 mouse breast cancer cells (Cancer-injected) subcutaneously, T. gondii Me49 cysts orally (TG-injected), or DCs pulsed with breast cancer cell lysate antigen and T. gondii lysate antigens (DCV-injected) intraperitoneally. Tumor size and immunological characteristics were subsequently evaluated. We also evaluated matrix metalloproteinase (MMP)-2 and MMP-9 levels in E0771 mouse breast cancer cells co-cultured with T. gondii or DCs by RT-PCR. The tumor volumes of mice injected with breast cancer cells and antigen-pulsed DCs (Cancer/DCV-injected mice) were similar to those of Cancer-injected mice; however, they were significantly reduced in T. gondii-infected tumor-bearing (TG/Cancer-injected) mice. Moreover, tumor volumes were significantly reduced by adding antigen-pulsed DCs (TG/Cancer/DCV-injected mice) compared to TG/Cancer-injected mice. The levels of IFN-γ, serum IgG2a levels, and CD8+ T cell populations were significantly higher in DCV- and TG-injected mice than in control mice, while no significant differences between Cancer- and Cancer/DCV-injected mice were observed. The levels of IFN-γ, the IgG2a levels, and the percentage of CD8+ T cells were significantly increased in TG/Cancer- and TG/Cancer/DCV-injected mice than in Cancer-injected mice. IFN-γ levels and serum IgG2a levels were further increased in TG/Cancer/DCV-injected mice than in TG/Cancer-injected mice. The MMP-2 and MMP-9 mRNA expressions were significantly decreased in mouse breast cancer cells co-cultured with live T. gondii, T. gondii lysate antigen, or antigen-pulsed DCs (DCV) but not in inactivated DCs. These results indicate that T. gondii induces anti-tumor effects in breast cancer-bearing mice through the induction of strong Th1 immune responses, but not in antigen-pulsed DCs alone. The addition of antigen-pulsed DCs further augments the anti-tumor effects of T. gondii. 
		                        		
		                        		
		                        		
		                        	
6.A Comparative Cross-sectional Study of the Development of Hepatocellular Carcinoma in Patients with Liver Cirrhosis Caused by Hepatitis B Virus, Alcohol, or Combination of Hepatitis B Virus and Alcohol.
Nak So CHUNG ; Oh Sang KWON ; Cheul Hee PARK ; Young Nam KIM ; Gwon Hyun CHO ; Jong Jun LEE ; Gil Hyun KIM ; Hyun Ok KIM ; Kwang Il KO ; Sang Kyun YU ; Kwang An KWON ; Yun Soo KIM ; Duck Ju CHOI ; Ju Hyun KIM
The Korean Journal of Gastroenterology 2007;49(6):369-375
		                        		
		                        			
		                        			BACKGROUND/AIMS: Alcohol may be a cocarcinogen in patients with chronic viral hepatitis. We investigated the effect of alcohol on the development of hepatocellular carcinoma (HCC) in liver cirrhosis (LC) caused by hepatitis B virus (HBV). METHODS: All patients with LC or HCC associated with HBV or alcohol, admitted between March 2001 and June 2005, were included. Patients were divided into three groups according to the etiology of LC: Alcohol (AL), HBV, or HBV+alcohol (HBV+AL). Age and laboratory data at the enrollment of study were analyzed. The logistic regression coefficiency for the prevalence of HCC was calculated by using variables such as age, gender, serologic markers, and etiology of LC. RESULTS: In LC patients (n=342), the proportions of AL, HBV, and HBV+AL groups were 44%, 39%, and 17%, respectively. The proportions of HCC in AL, HBV and HBV+AL groups were 17%, 55%, and 76%, respectively. Age at the diagnosis of HCC was younger in HBV+AL than in AL group (p=0.036). In logistic regression analysis for the risk factor of HCC, odds ratio of age was 1.056 (p<0.001). Odds ratios of HBV and HBV+AL group comparing AL were 8.449 (p<0.001) and 17.609 (p<0.001), respectively. Therefore, old age and chronic alcohol intake in patients with HBsAg were the risk factors of HCC. CONCLUSIONS: Chronic alcohol intake may be an additive factor for the development of HCC in patient with LC caused by HBV. However, a prospective cohort study is needed to confirm these findings.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Carcinoma, Hepatocellular/*epidemiology/etiology
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hepatitis B, Chronic/*complications/epidemiology
		                        			;
		                        		
		                        			Hepatitis, Alcoholic/complications/epidemiology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Liver Cirrhosis/*complications/virology
		                        			;
		                        		
		                        			Liver Cirrhosis, Alcoholic/*complications/epidemiology/virology
		                        			;
		                        		
		                        			Liver Neoplasms/*epidemiology/etiology
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Regression Analysis
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
7.CA Case of Non-traumatic Hemobilia due to Pseudoaneurysm of the Hepatic Artery.
Gwon Hyun CHO ; Jong Jun LEE ; Sang Kyun YU ; Kwang An KWON ; Dong Kyun PARK ; Yeon Suk KIM ; Yang Suh KU ; Yu Kyung KIM ; Ju Hyun KIM
Korean Journal of Gastrointestinal Endoscopy 2006;33(3):173-177
		                        		
		                        			
		                        			Hemobilia is a cause of obscure gastrointestinal hemorrhage. Most cases have an iatrogenic or traumatic origin but cases of hemobilia with non-traumatic causes are rare. The non-traumatic causes of hemobilia are inflammation, gallstones, neoplasm and vascular lesions. Currently, various therapeutic options are available for hemobilia, and transarterial embolization is now the first line of intervention used to stop the bleeding of hemobilia, which shows a high success rate of approximately 80% to 100% with a lower morbidity and mortality rate than with surgery. We report a rare case of non-traumatic hemobilia caused by a pseudoaneurysm of the hepatic artery that was successfully treated with transarterial embolization.
		                        		
		                        		
		                        		
		                        			Aneurysm, False*
		                        			;
		                        		
		                        			Gallstones
		                        			;
		                        		
		                        			Gastrointestinal Hemorrhage
		                        			;
		                        		
		                        			Hemobilia*
		                        			;
		                        		
		                        			Hemorrhage
		                        			;
		                        		
		                        			Hepatic Artery*
		                        			;
		                        		
		                        			Inflammation
		                        			;
		                        		
		                        			Mortality
		                        			
		                        		
		                        	
8.The Usefulness of Colonoscopic Biopsy in the Diagnosis of Intestinal Tuberculosis and Pattern of Concomitant Extra-intestinal Tuberculosis.
Yun Jung LEE ; Suk Kyun YANG ; Seung Jae MYUNG ; Jeong Sik BYEON ; Il Gwon PARK ; Jung Sun KIM ; Gin Hyug LEE ; Hwoon Yong JUNG ; Weon Seon HONG ; Jin Ho KIM ; Young Il MIN
The Korean Journal of Gastroenterology 2004;44(3):153-159
		                        		
		                        			
		                        			BACKGROUND/AIMS: Intestinal tuberculosis can be difficult to diagnose because it may mimic many other intestinal diseases. The aim of this study was to evaluate the diagnostic yield of colonoscopic biopsy and frequency of concomittent extra-intestinal tuberculosis in intestinal tuberculosis. METHODS: The medical records of 225 consecutive patients with intestinal tuberculosis (81 men, 144 women; mean age 40.6 yrs) were analyzed retrospectively. RESULTS: Histological examination of colonoscopic biopsy specimens revealed granulomas in 163 (72.4%) of the 225 patients. However, caseous necrosis was found in only 25 (11.1%) patients, and acid-fast bacilli (AFB) were noted in 39 (17.3%) of the 225 patients. Mycobacterium tuberculosis was isolated from the culture of biopsy specimens in 52 (29.3%) of 177 patients. Eighty-four patients (37.3%) had concomitant extra-intestinal tuberculosis and 67 (29.8%) showed active pulmonary tuberculosis. Histological examination of the biopsy specimens enabled the diagnosis of intestinal tuberculosis by the presence of either caseating granulomas or AFB in 52 (23.1%) patients. Combination of histological examination and Mycobacterium culture established the diagnosis in 87 (38.7%) patients. Before getting the result of Mycobacterium culture, the diagnosis could be made, by either histological examination or the presence of extra-intestinal tuberculosis in 107 (47.6%) patients. Combination of caseating granulomas, AFB staining, Mycobacterium culture, and the presence of extra-intestinal tuberculosis resulted in the diagnosis in 126 (56.0%) patients. CONCLUSIONS: To increase the diagnostic yield, AFB staining and Mycobacterium culture should be routinely performed on biopsy specimens in addition to routine histological examination for caseating granulomas.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			*Biopsy, Needle
		                        			;
		                        		
		                        			*Colonoscopy
		                        			;
		                        		
		                        			English Abstract
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intestinal Diseases/*diagnosis
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Mycobacterium tuberculosis/isolation & purification
		                        			;
		                        		
		                        			Tuberculosis, Gastrointestinal/complications/*diagnosis
		                        			;
		                        		
		                        			Tuberculosis, Pulmonary/complications
		                        			
		                        		
		                        	
9.Diagnosis of Cowden's Disease Based on Gastrointestinal Manifestations.
Il Gwon PARK ; Seung Jae MYUNG ; Suk Kyun YANG ; Hye Sook CHANG ; Tae Hun KIM ; Gin Hyug LEE ; Hwoon Yong JUNG ; Weon Seon HONG ; Sung Ae JUNG ; Jin Ho KIM ; Young Il MIN
Korean Journal of Gastrointestinal Endoscopy 2003;26(4):183-191
		                        		
		                        			
		                        			BACKGROUND/AIMS: Cowden's disease is an autosomal dominant hereditary disease characterized by the various hamartomatous and neoplastic lesions of multiple organs. We analyzed gastrointestinal manifestations of 5 cases of Cowden's disease and suggest several findings which are helpful to gastroenterologists for the early diagnosis. METHODS: The clinical characteristics of 5 unrelated patients with Cowden's disease were evaluated. Four patients were male, one patient was female, and their ages at the time diagnosis ranged from 17 to 49 years. All patients had the pathognomonic mucocutaneous lesions and thyroid nodules. RESULTS: In all patients, the esophagus was affected by acanthosis. In 4 patients, the stomach was affected by numerous variable sized polyps. In 4 patients, the duodenum was involved by several polyps. In 4 patients, the entire small bowel and in one patients, only the terminal ileum was affected by numerous polyps. In all patients, the colon, especially the sigmoid colon and rectum, showed numerous variable sized polyps. Family history was positive for stomach cancer in two patients. CONCLUSIONS: Cowden's disease should be considered in patients with esophageal acanthosis among patients with colonic polyposis, although the mucocutaneous lesions, unfamiliar to gastroenterolgists, are pathognomonic criteria for the diagnosis.
		                        		
		                        		
		                        		
		                        			Colon
		                        			;
		                        		
		                        			Colon, Sigmoid
		                        			;
		                        		
		                        			Diagnosis*
		                        			;
		                        		
		                        			Duodenum
		                        			;
		                        		
		                        			Early Diagnosis
		                        			;
		                        		
		                        			Esophagus
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genetic Diseases, Inborn
		                        			;
		                        		
		                        			Hamartoma Syndrome, Multiple*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Ileum
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Polyps
		                        			;
		                        		
		                        			Rectum
		                        			;
		                        		
		                        			Stomach
		                        			;
		                        		
		                        			Stomach Neoplasms
		                        			;
		                        		
		                        			Thyroid Nodule
		                        			
		                        		
		                        	
10.Isolation Trend of Enterobacter, Citrobacter, and Serratia for the Recent Five Years and Antimicrobial Susceptibility of Derepressed AmpC beta-lactamase Producing Strains.
Jong Ha RYU ; Hong Seok PARK ; Dong Eun YONG ; Eung Chil CHOI ; Kyun Gwon LEE ; Yun Sop CHONG
Korean Journal of Infectious Diseases 2002;34(1):26-33
		                        		
		                        			
		                        			BACKGROUND: Derepressed AmpC beta-lactamase producing Enterobacter cloacae, Citrobacter f reundii, and Serratia marcescens are important nosocomial pathogens and the infections are difficult to treat, because they are multi-drug resistant. The aim of this study was to determine the isolation rate and trend, and antimicrobial susceptibility of derepressed strains isolated from clinical specimens. METHODS: E. cloacae, S. marcescens, and C. f reundii isolated from 1996 through 2000 were enrolled in the study. Antimicrobial susceptibility was tested by NCCLS disk diffusion method. Derepressed strain was defined as strain non-susceptible to third generation cephalosporin. The isolation patterns of important gram-negative bacilli with the derepressed strains were analyzed with respect to years, patient's locations and specimens. RESULTS: Among the clinical isolates, the derepressed strains of E. cloacae, S. marcescens, and C. f reundii were 65%, 70%, and 56%. The proportion of the derepressed strains : E. cloacae increased from 68% in 1996 to 71% in 1998, however, decreased to 59% in 2000, S. marcescens increased from 68% in 1996 to 73% in 2000, C. f reundii decreased from 69% in 1996 to 41% in 2000. The proportion of the derepressed strains were high among the isolates from blood and respiratory specimens of inpatient and intensive care patient. The resistance rates of the depressed strains were 47~62% to third generation cephalosporin and aztreonam, 15~85% to aminoglycoside, 68% to cotrimoxazole, and 31% to levofloxacin. CONCLUSION: Among the clinical isolates of E. cloacae, S. marcescens, and C. f reundii, the derepressed strains were as high as 56~70%, and they were commonly isolated from blood and sputum specimens of inpatient and intensive care patient, and showed high resistance rates to the most antimicrobial agents.
		                        		
		                        		
		                        		
		                        			Anti-Infective Agents
		                        			;
		                        		
		                        			Aztreonam
		                        			;
		                        		
		                        			beta-Lactamases*
		                        			;
		                        		
		                        			Citrobacter freundii
		                        			;
		                        		
		                        			Citrobacter*
		                        			;
		                        		
		                        			Cloaca
		                        			;
		                        		
		                        			Diffusion
		                        			;
		                        		
		                        			Enterobacter cloacae
		                        			;
		                        		
		                        			Enterobacter*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Inpatients
		                        			;
		                        		
		                        			Critical Care
		                        			;
		                        		
		                        			Levofloxacin
		                        			;
		                        		
		                        			Serratia marcescens
		                        			;
		                        		
		                        			Serratia*
		                        			;
		                        		
		                        			Sputum
		                        			;
		                        		
		                        			Trimethoprim, Sulfamethoxazole Drug Combination
		                        			
		                        		
		                        	
            
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