아미노글리코사이드 사용제한에 따른 병원성 균혈증 유발 그람음성간균의 내성변화 및 임상적 의의

오종택,김신우,손종원,도병훈,한승우,신병철,박지현,이종명,김능수 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 항균제 오남용으로 인한 내성균의 출현, 약물부작용의 발생 및 약제 비용의 증가는 환자 개인뿐만 아니라 사회적으로 문제가 되고 있다. 본 연구는 항생제의 오남용을 막기 위한 제도의 일환으로 시행한 아미노글리코사이드 사용 제한정책의 비용 효과적인 측면을 조사하고 그람음성간균에 의해 병원성 균혈증이 발생한 환자들을 대상으로 이 정책이 항생제 내성률과 환자 사망률에 미치는 영향을 연구하였다. 방법 : 930병상 규모의 3차 병원인 일개 대학병원에서 아미노글리코사이드 사용제한정책이 시행된 직후인 2002년 3월에서 9월 사이에 그람음성간균(Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Stenotrophomonas maltophilia, Burkholderia cepacia)에 의해 발생한 병원성 균혈증 환자 60명(실험군)과, 이 정책이 시행되기 전에 입원한 환자들 중 균주별로 같은 수만큼 선별한 병원성 균혈증 환자 60명(대조군)의 의무기록을 후향적으로 조사하였다. 결과 : 아미노글리코사이드 사용제한정책이 시행된 시기인 2002년 3월에서 9월 사이에 처방된 아미노글리코사이드 사용량 및 비용을 이 정책이 시행되기 전인 2001년 3월에서 9월 사이와 비교한 결과, 아미노글리코사이드의 사용량(antimicrobial utilization density)은 사용제한 후 225.2에서 130.3으로 42% 감소하였고 약제 비용은 44% 감소하였다. 아미노글리코사이드 사용제한 후 병원성 균혈증을 유발한 그람 음성간균의 이 항생제에 대한 내성률은 유의한 변화를 보이지 않았으며 균혈증과 직접 연관된 사망률도 환자의 나이, 성별, 기저질환 및 원발병소 등을 보정할 경우 유의한 차이를 보이지 않았다(40.4% vs. 24.1%, P=0.11). 결론 : 아미노글리코사이드를 5일을 초과한 사용 시 감염전문가의 사전 승인을 필요로 하는 사용제한정책은 아미노글리코사이드의 사용량과 비용을 유의하게 감소시켰다. 또한 이 정책 시행 후 그람음성간균에 의한 균혈증 환자에서 균혈증으로 인한 사망률과 아미노글리코사이드에 대한 내성률은 유의한 차이가 없었다. Objective : To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). Methods : Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gramnegative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. Results : During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225,2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. Conclusion : Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.

Dehydrocoupling of Bis(1-sila-3-butyl)benzene and 2-Phenyl-1,3-disilapropane to Polymers Using Zirconocene Combination Catalysts

Jun Lee, Jong-Hyun Kim, Soo-Yong Mo, Hee-Gweon Woo1, Do-Heyoung Kim, Jin Jun 조선대학교 기초과학연구원 2011 조선자연과학논문집 Vol.4 No.3

The catalytic dehydrocoupling of bis(1-sila-3-butyl)benzene 1 and 2-phenyl-1,3-disilapropane 2 by Cp2ZrCl2/Red-Al and Cp2ZrCl2/n-BuLi was reported to compare their catalytic efficiency. The dehydrocoupling of monomeric silanes 1 with the Cp2ZrC12/Red-Al and Cp2ZrCl2/n-BuLi combination catalysts produced two phases of polymers: one is a highly crosslinked insoluble solid, and the other is noncross-linked or slightly cross-linked soluble oil and could be a precursor for the solid polymer. The dehydrocoupling of 2 with the Cp2ZrCl2/n-BuLi combination catalyst similarly produced two phases of polymers. By contrast, the catalytic reaction of 2 with the Cp2ZrCl2/Red-Al combination catalyst produced a soluble polymer via redistribution/dehydrocoupling process.

뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성

도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.

老齡者의 建康을 위한 生活習慣 實態調査

申東敏,長鳳愚,李揆文,金賢俊,金昌範,崔宗洙,崔鍾晥,李鍾珏,金圭碩,趙庚旭,金鍾聲,朴鍾振 平生體育硏究所 論文集 1987 平生體育硏究所 論文集 Vol.2 No.-

With a view to examining the habit and method in which old people maintain and improve their health, we consulted 551 men and 444 women who were over 65 years old, and concluded as follows: 1. Habit of eating It's been revealed that most of the old people keep a regular eating hour, control the quantity of meal or eat a little food, and prefer vegetables to meat. 2. Mental health Old people feel the necessity for mental health and most of them (about 80%) keep good mental health without becoming pessimistic. Their chief concenrs have turned out to be about their sons and daughters and their own health and finance. 3. Managing Good Health It has been revelaed that old people do not possess any special kind of secret to keep good health but taking plenty of rest, regular meal, and proper exercise, and many of them (about 60%) have been shown to eat invigorant food that they can easily get around their living area. 4. Physical Functions It has been revealed that many old people are conscious of some symptoms about their parts of body and about to percent of them suffers from neuralgia. Some measures like medical aid especially for old people need to be taken as soon as possible. As we have found that the health-keeping method of old people consists plenty of rest, proper exercise, and appropriate nutrition, we can conclude that the recreatonal and culture facilities and programs for keeping old people in good health should be developed. It is also necessary to study food that contribute to their health and develop ways to get rid of the stresses to which they are exposed in their daily life. Presides, it is natural that government found an administrative department to deal with these matters effectively.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

지속가능한 산림경영을 위한 기준 및 지표의 산림기능구분에 대한 적용성 연구

우종춘,장재영,신현지 江原大學校 森林科學硏究所 2005 Journal of Forest Science Vol.21 No.-

지속가능한 산림경영을 위하여 우리나라는 여러 가지 프로세스 중에 몬트리올 프로세스를 채택하고 있다. 본 연구에서는 우리나라에 적용 가능한 7개 기준. 27개 지표를 산림의 6가지 기능에 적용하였다. 산림기능에 대표성, 적합성, 가능성 기준과 지표를 각각의 산림 상태와 목표로 하는 방향을 고려하여 가장 비중 있게 적용되는 기준과 지표를 선정하였다. 그리고 각각 다른 산림에 모두 같은 기준과 지표를 가지고 산림을 평가할 수는 없으며 이를 적용하기 위해서는 산림에 대한 정확한 데이터와 지식이 필요 하다고 사료된다. To be a sustainable forest management, Korea took a Montreal process in many proccsses. This study applied seven criterias. twenty-seven indicators that are applicable indicators to the forest function type. Forest function type choose representation. suitability, possibility criterias and indicators that forest conditions are thought a great deal of wegit on th forest by a goal. And we can't estimate many forest with same criteria and indicators every time, to apply them need correct data and knowledge about forest.

草鳥中毒에 關한 綠豆의 解毒效果

禹元洪,韓宗鉉,辛民敎 圓光大學校 醫科學硏究所 1985 圓光醫科學 Vol.1 No.2

This study was carried out to elucidate the effectiveness of Testa mungo counteracting the poisonous effect of Aconiti Radix and difference in effectiveness between Testa mungo extract and Testa mungo juice. First, Lethal dose 50 of Aconiti Radix for mouse, since then, the difference in effectiveness between Testa mungo extract and Testa mungo juice was observed. Mice were pretreated by dosing half LD 50 of Aconiti Radix in oral administration for histological examination for 7 days and the damage of liver was induced. Among 1 group dosed with Testa mungo extract, Ⅱ group dosed with Testa mungo juice and control group, the difference of counteracting effects of the toxicity of Aconiti Radix were observed histologically. The results were as follows : 1. Lethal dose 50 of Aconiti Radix was 49.8㎎/20g. (confidence limits ; 22.7∼86.2㎎/20g) 2. The counteracting effects for the toxicity of Aconiti Radix LD 50 were seen above 13.3 ㎎/20g in group dosed with Testa mungo extract and above 0.4cc/20g in group dosed with Testa mungo juice. 3. In the histological exainination, the counteracting effects of Testa mungo for the toxicity of Aconiti Radix was seen from 3 days on the liver-damaged mice by the result of being pretreated with Aconiti Radix extract for 7 days. 4. Testa mungo juice was more effective than Teata mungo extract in the counteracting effects for the toxicity of Aconiti Radix.

갈륨액체금속 이온원과 인듐액체금속 이온원의 빔 특성에 대한 연구

현정우,임연찬,정강원,정원희,박철우,이종향,강승언 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

본 연구에서는 인듐 액체금속이온원을 제작하여 빔 특성에 대해 연구를 하였으며, 기존에 연구를 하였던 갈륨 액체금속이온원의 빔특성과 비교 분석 하였다. 빔특성 분석을 위해 빔 안정도, 전류-전압특성곡선, 에너지 퍼짐을 측정하였다. 액체금속이온원에 사용되는 액체금속 저장소 및 바늘전극(tip)은 500μm의 직경을 갖는 텅스텐을 사용하였으며, 국내에서 제작된 제품을 사용하였다. 액체금속 저장소의 구조는 이전에 구상하여 연구가 이루어진 6개의 pre-etching된 텅스텐와이어(wire)가 묶여진 형태를 사용하였다.

科學 探究能力 評價 問題 類型 變化에 關한 縱斷的 硏究

우종옥,이항로,구창현 한국교원대학교 과학교육연구소 1996 청람과학교육연구논총 Vol.6 No.1

This study investigated the literature about science process skills' evaluation to analyse transition of evaluation objectives before and after a Scholastic Ability Test for College Entrance. In the literature survey the researcher established a 3 dimensional science assessment framework with X axis as science concept, Y axis as science process skills and Z axis as problem context. In order to analysis and compare each items the researcher selected 210 items from the 1st to the 7th trials and 138 items from the 1st to 4th Scholastic Ability Test for College Entrance and sampled 2873 science achievement test items from 10 high schools. In accordance with this taxonomy the researcher analysed and compared science process skills item forms. The following results were drawn: The items were evenly distributed in all the four areas(Earth Science, Biology, Physics and Chemistry) of the science concept domain, but they were heavily concentrated on data analysis and drawing a conclusion in science process domain. In the domain of problem context school context was the majority. In spite of distribution like this the ratio on science process skills measurement items and science achievement test items was increased after the Scholastic Ability Test for College Entrance was given. Also the ratio on item expression type was increased. Item form was almost 5 options selection type in the national level test. Although there were 4 options selection type, 5 options selection type, short answer type, essay type in school level test, rising from 33.1% to 65.5% on 5 options selection type is exhibited. This study showed that the school level item form was better various than the nation level. This point like this is the evidence for the improvement toward the science process skills test and influenced by Scholastic Ability Test for College Entrance. The ratio on the item which joined with the 3 axes had a mean of 99.3% in nation level test and mean 44.9% in school achievement test level. But the ratio in the school achievement test level increased after the Scholastic Ability Test for College Entrance was given. In view of this study we must furthermore study the item types which can evaluate validately science process skill's five stage each and evaluation method by the high school students' problem solving patterns and features in scientific inquiry on all science process skills elements.

서양산 고추냉이 추출물이 함유된 세치제의 효능에 대한 임상적 실험연구

서현우,박호원,김종수,이시영,신일식 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

The purpose of this study was to find out the effect of dentifrice containing Horseradish (Armoracia rustica) root extracts on improvement of oral hygiene. The clinical evaluation was done participated by 80 adults volunteers who provided a informed consent for their participation. The participants were divided into two groups ; control group (using toothpaste without Horseradish extracts) and experimental group (using toothpaste containing Horseradish extracts). The checklist of the experiment includes the plaque index, gingival index and anti-caries activity. The anti-caries activity was measured by cultivating Streptococcus mutans for 48 hours then estimating the number of increased bacteria using Dentocult SM. The double-blind method was used in this study. The results of this study can be summarized as follows; 1. The plaque formation decreased 28% in control group, 58% in experimental group using dentifrice with Horseradish extracts compared to baseline data. 2. For gingival index, control group and experimental group showed 26% and 40% decrease compared to baseline data, respectively. 3. The score of caries activity test decreased by 4% for control group and 69% for experimental group compared to baseline data. According to the results, a dentifrice containing Horseradish extracts can improve oral hygiene. 식물성 자연추출물 중 하나인 고추냉이 추출물을 배합한 세치제의 구강환경 개선 효과를 알아보기위해 총72명을 대상으로 교차실험 및 이중맹검법을 실시하여 치면세균막지수, 치은염지수 및 우식활성도검사 등을 비교 검토한 결과 다음과 같은 결 론을 얻었다. 1. 치면세균막지수는 초기값에 비해 대조군은 28%, 고추냉이 추출물 배합세치군은 58%의 억제효과를 나타내었다. 2. 치은염지수는 초기값에 비해 대조군은 26%, 고추냉이 추출물 배합세치군은 40%의 억제효과를 나타내었다. 3. Dentocult-SM을 이용한 우식활성도 평가에서는 초기값에 비해 대조군은 4%, 고추냉이 추출물 배합세치군은 69%의 억제효과를 나타내어 고추냉이 추출물 배합세치군이 대조군에 비해 유의할만한 Streptococcus mutans 억제효과를 나 타내었다. 이상의 결과들로 보아 고추냉이 추출물을 배합한 세치제는 치면세균막 억제와 치은염의 감소 그리고 우식활성도 억제에 중 요한 역할을 하여 구강환경 개선에 뛰어난 효과를 보이는 것으로 사료된다.