당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

이재복(李在福) 시의 정신차원 -법열의 자아와 절대에의 의지

이은봉 ( Eun Bong Lee ) 한국현대문예비평학회 2009 한국문예비평연구 Vol.- No.30

사후분해 시체에 대한 법의학적 접근

최영식,이상용,김유훈,조갑래,이봉우,양경무,정낙은,서중석,이한영,이원태,강현욱 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.

구강점막 부착용 케토프로펜 고분자 필름의 제조 및 평가

박진석,이상은,강봉석,이경록,이은주,박정숙 충남대학교 약학대학 의약품개발연구소 2014 藥學論文集 Vol.29 No.-

Abstract – The objective of this study was to prepare ketoprofen-loaded buccal adhesive patch. The adhesive patch was formulated by casting method using aqueous soluble polymer povidone K17 (PVP 17PF) as film-forming agent and hydroxypropylmethylcellulose (HPMC) as adhesive agent. To compare the effect of HPMC type, different molecular weight of K4M and K15M HPMC was used. The physicochemical properties of patches such as appearance, thickness, in vitro release, and adhesiveness were investigated. The concentration of ketoprofen was determined spectrophotometrically at a wavelength of 233 nm. The appearance of prepared patches was semi-transparent, light-yellow or almost colorless, and odorless. Thickness of each patches (n=6) was 0.895 ± 0.033 mm for K4M patch and 0.727 ± 0.036 mm for K15M patch. In vitro release test, both K4M and K15M patches showed over 20% release within 30 min. At 120 min, K4M and K15M patches demonstrated 95% and 67.5% release of ketoprofen, respectively, and up to 240 min, both patches released drug completely. Maximum adhesive force of K4M and K15M patches was 6.571 ± 2.703 gf and 2.735 ± 1.151 gf, respectively. Moreover, it took 28.29 ± 0.38 sec and 28.30 ± 0.34 sec for K4M and K15M patch to peel off them after adhesion, showing no significant difference. In conclusion, thickness, in vitro release, and maximum adhesive force could be modulated by alteration of polymer types.

마우스 대장암 모델 구축 및 항암제 활성 평가를 위한 예비 연구

김예솔,강봉석,이상은,이은주,이경록,정상헌,박정숙 충남대학교 약학대학 의약품개발연구소 2014 藥學論文集 Vol.29 No.-

Abstract – Aberrant crypt foci (ACF) are early imorphological changes observed in rodents after administration of colon-specific carcinogen such as azoxymethane (AOM). ACF are considered to be putative preneoplastic lesions and are widely used as a surrogate biomarker to rapidly evaluate chemopreventive potential of compounds. The size of colorectal cancer was evaluated after administration of three anticancer drugs, 1 parent drug and 2 prodrugs. The body weights of mice were measured daily and considered as a surrogate for evaluation of general wellbeing. Colons were removed, cut along the longitudinal axis and flushed with phosphate-buffered saline. Each colon was cut into three equal lengths and fixed flat between filter papers. The fixed colon sections were stained with methylene blue. The number of ACF per colon, the number of aberrant crypts observed in each focus and the location of each focus were recorded. After single administration of AOM and multiple doses of anticancer drugs, no significant changes in the body weights of the mice was observed which was recorded for 52 days. However, an expected ACF was not observed in any treated groups. These findings suggest the induction of ACF in mice requires the promotion by dextran sulfate sodium as well as the initiation by AOM.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

Phenazine Methosulfate의 Superoxide Radical 生成作用

李民化,安鳳煥,李起榮,朴昞柱,梁誠烈,薛鍾銀 全南大醫大 1984 전남의대학술지 Vol.21 No.2

화학 첨가제와 밀가루의 열처리가 제빵 특성에 미치는 효과

이지은,고봉경 한국조리과학회 2004 한국식품조리과학회지 Vol.20 No.2

Effects of various chemical additives and heat treatments were investigated on the wheat flour doughs and breads. Ammonium ferric citrate, Ca-citrate, CaCl_(2), FeSO_(4), MgCl_(2) and ZnO were mixed respectively to the flour up to 0.1% of flour dry weight basis. Ammonium ferric citrate and ferric sulfate showed no significant effects on the dough properties and magnesium sulfate, calcium chloride and zinc oxide increased elastic properties and optimum dough mixing time. However, calcium citrate and magnesium chloride showed no significant effects on the dough mixing properties. Most of chemicals were detrimental on the bread volume except MgSO_(4) and CaCl_(2). Breads with MgSO_(4) and CaCl_(2) retained the equal or slightly higher volume compared to control bread. Crumb and crust colors of breads with addition of chemicals were changed to lighter than that of control bread. L values both of crumb and crust increased with addition of chemicals except Ca-citrate. To inactivate the endogenous enzymes of flour, flour was roasted under electric oven, exposed to UV and microwave. Those heat treatments of flour increased dough stability and produced no dough breakdown after optimum mixing time. However, bread volume of heat-treated flour decreased.

경남지역의 사무직 노동자와 육체적 노동자의 요통특성에 관한 조사 연구

이한기,구봉오,문상은,김경,조희선 마산대학 보건과학연구소 2002 保健科學論集 Vol.3 No.-

This study has been attempted to be helpful for the back rehabilitation of Korean workers by analyzing the general, occupational, social aspects of low back pain and to identify possible risk factors for back pain in White and Blue collar workers. The primary data collected from 339 workers in Kyungnam by means of a questionnaire with random which was distributed from January 10 to 18, 2001. For the test of statistical significance, chisquare analysis was used to compare the back pain characteristics between the two groups. The results were as follows: 1.The incidence of low back pain in all workers studied was 81.1 %. The incidence of Blue collar with low back pain(88.2%) was higher than that of White collars(74.1%) (p<0.01) 2.With regard to the relationship of back pain to the occupational characteristics, statistically significant differences were observed between workers with and without back pain concerning the job factors on work-time, mental stress, work posture, trunk rotation, weight lifting, vibration, and heavy noise(p <0.05). 3.With regard to the relationship of back pain to the social characteristics, there were no differences with respect to traffic time. However, significant differences were showed between no pain and pain groups for the using bed, sleeping posture, walking amount, body type, health state, and physical exercise(p<0.05). 4.The comparative analysis of back pain related to work factors showed significant differences with respect to mental stress, work posture, trunk rotation in White collar group(p<0.05); and mental stress, trunk rotation, work posture, monotonus repetitive work, weight lifting, exposure to vibration in blue collar group(p<O.05). 5.The comparative analysis of social factors in two groups showed differences with respect to the using bed, walking amount, health state, physical exercise in White collar group(p<0.05); and walking amount, physical exercise in Blue collar group (p<0.05). Especially, Blue collar group showed high differences with respect to the health state(p<0.01). 6.In regard to the general aspects of back pain between two groups, there were differences concerning etiolgy of back pain, pain duration, counselling partners, treatment types, and sick-leaves(p<0.05), except awareness of back pain.