서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

뇌혈관질환을 동반한 당뇨병 환자에서 지속적 혈당측정의 유용성 평가

정성훈,강인구,박철영,류미숙,우정택,김성운,김진우,김영설 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

연구배경: 뇌혈관질환을 동반한 고령의 당뇨병환자는 이들의 신경학적 결손으로 경고 증상없이 심한 저혈당에 노출될 가능성이 크다. 실제로 하루 4번 정도의 자가 혈당 측정으로는 이를 감지하기 어려울 뿐 아니라 검사에 따른 고통으로 적극적인 혈당 조절에 제한이 따르게 된다. 이에 저자들은 Mini Med사의 지속적 혈당측정기(CGMS, continuous glucose monitoring system)를 이용하여 뇌혈관질환을 동반한 당뇨병 환자에서 24시간 혈당의 변동양상을 알아보고 각기 다른 인슐린 치료방침에 따른 혈당조절의 효율성을 비교하고자 하였다. 방법: 2001년 1월부터 6월까지 경희대학교 부속병원에 입원해 있는 10명의 뇌혈관질환을 동반한 제 2형 당뇨병환자를 대상으로 하였다. 이 들은 모두 튜브식이를 받고 있엇고 최소 1개월 이상 인슐린 치료를 시행 받았다. 지속적 혈당측정기를 착용하고 3일간의 연속적인 혈당을 측정하였고, 치료 첫 날은 NPH, 둘째 날은 속효성 인슐린과 NPH, 마지막 날은 혼합형 인슐린제제로 치료하여 그 효과를 비교하였다. 이들 각기 다른 인슐린 제재의 하루 총량에 차이는 없었다. 혈당치가 3.3mmol/L 미만이거나 7.8mmol/L를 초과하는 경우 그 차이값의 총합을 시간으로 나누어 이 값(△Glu)이 적을수록 치료효과가 우수한 것으로 판정하였다. 또한 당 수치가 3.3mmol/L 미만인 경우를 저혈당 event, 16.7mmol/L 초과한 경우를 고혈당 event로 임의로 정의하였고, 이를 통해 지속적 혈당측정의 유용성을 간접적으로 평가하고자 하였다. 결과: 평균 △Glu값은 첫째 날이 0.93 ± 0.43mmol/Lㆍmin?¹, 둘째날이 0.71 ± 0.29mmol/Lㆍmin?¹ 마지막 날이 0.58 ± 0.29mmol/Lㆍmin?¹로서 서로 다른 3가지 치료방침사이에 통계학적으로 유의한 차이는 없었다(p=0.115). 10명의 환자들 중 자가 혈당측정기로는 1명에서 저혈당 event, 2명에서 고혈당 event를 인지하였으나 지속적 혈당측정기로는 각각 9명에서 event를 확인하였다. 결론: 지속적 혈당측정기를 이용한 각각의 인슐린 치료방침에 따른 혈당조절 효율성의 차이는 없었으나, 자가혈당 측정기로는 알 수 없었던 일 중 혈당 변동사항을 정확하게 알 수 있어, 뇌혈관질환을 동반한 당뇨병 환자에서 보다 적극적인 인슐린 치료 및 관리를 할 수 있을 것으로 생각된다. Background: Diabetic stroke patients are susceptible to hypoglycemia. However, there are many limitations in detecting hypoglycemic events, even though glucoses levels are checked 3 to 4 times per day using the fingerstick method. Therefore, we investigated the glycemic excursions and pattern in diabetic stroke patients using the continuous glucose monitoring system (CGMS, MiniMed) and its clinical utility. The other objective was to compare the treatment dfficacy between insulin regimens. Methods: From jan 2001 to jun 2001, 10 adult type 2 diabetic stroke patients wore CGMS for consecutive 3 days, which continuously checked the glucose level. NPH insulin, multiple daily injection of regular insulin ± NPH and the mixed type(Novolet 30/70, Novo Nordisk) were used on the first, second and third days of the study, respectively. If the mean delta glucose(△Glu = A+B/time, A=∑(hlucose-7.8), glucose > 7.8 mmol/l, B=∑(3.3-glucose) if, glucose < 3.3 mmol/l) was calculated in order to recognize the degree of individual glycemic changes and to compare the efficacy of each treatment diverse insulin regimen. We arbitrarily defined a glucose level less than 3.3mmol/l, as a hypoglycemic event, and more than 16.7mmol/l as a hyperglycemic event. Results: Variable patterns of glycemic changes were observed among patients with the same dosage, but a different insulin regimen. The mean △Glu was 0.93±0.43 on the first day, 0.71±0.29 on the second day and 0.58±0.29 on the third. There was no significant difference in treatment efficacy between the 3 different insulin modalities(p=0.115). Of the 10 patients, a hypoglycemic event was detected in 1 with the fingerstick method, in contrast to 9 with CGMS, with hyperglycemic events being detedted in 2 and 9, respectively. Conclusion: Continuous glucose monitoring maybe useful in providing the information necessary for optimal glycemic control in the diabetic stroke patients.

포러스 콘크리트를 利用한 보도용 콘크리트판 적용에 關한 實驗的 硏究

김재은,윤상혁,김우재,김성식,이영도,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

Although porous concrete is recently used as a pavement at a parking lot, a public square and a bicycle road, we use without enough examining. Most the maintenance of quality for porous concrete is only dealt with strength and color tone. Also, there is not yet enough fundamental data about dynamical properties for strength, rate of void and water permeability, even when it is applied to at the scene, it is been a matter. Accordingly in this study analyzed influences through the dynamical properties, combination, and time to vibration. After the analyzation, they investigated peculiar dynamics which are strength of porous concrete, rate of void, and water permeability follow the rate of increase on an admixture making pozzolan reaction. This is purpose to improve capacity of the sidewalk permeable concrete and development of the economical technique for pavement.

H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

양식산 터봇, Scophthalmus maximus에서의 Irido-like virus 감염

김위식,김기홍,김춘섭,김영진,정성주,정태성,신이치, 키타무라,마모루, 요시미즈,오명주 한국어병학회 2003 한국어병학회지 Vol.16 No.3

본 연구는 병리조직학적 및 전자현미경적 방법을 통해 양식산 turbot에서 발생하는 irido-like virus의 감염증을 소개하고자 한 것이다. 2003년 6월 전북 고창 소재 육상수조에서 양식중인 turbot치어에서 50∼70%의 대량폐사가 발생하였다. 병어는 사료섭취가 저하되고 힘없이 유영하다 폐사되었으며, 죽기 직전의 어류는 복부가 팽만되고 안구가 돌출되며 체색이 옅어지는 증상을 보였다. 해부학적 조사 결과, 아가미 빈혈과 간이 퇴색되어 있었으며, 특히 비장조직이 심하게 비대되어 있었다. 병어에 대한 조직학적 검사에서 비대 세포를 특징으로 하는 특이 병변이 주로 신장과 비장의 조혈조직에서 관찰되었으며, 아가미, 심장, 위, 장, 간, 췌장, 지방 조직에서도 관찰되었다. 그리고 전자현미경적 관찰 결과, 비대 세포의 세포질내에서 육각형의 지름이 136∼159 ㎚인 Irido-like virus를 관찰할 수 있었다. The high mortality of cultured juvenile turbot, Scophthalmus maximus occurred in Gochang on June, 2003. The diseased fish was lethargic with reduced feed intake. Grossly, these fish showed pale body, abdominal extension and exophthalmia. The dominant internal gross features of diseased fish were severely enlarged spleen, pale gills and or liver. Diseased fish histologically showed basophilic enlarged cells in the kidney, spleen, gill, heart, stomach, intestine, liver, pancreas and adipose tissue. Transmission electron microscopy (TEM) reveled hexagonal virions in the cytoplasm of necrotic cells. The viral particles lead a central electron-dense core and an electron translucent zone, and were 136-159 nm in diameter. These results suggest that the virus belonging to the iridoviridae was responsible for the mortality of cultured juvenile turbot.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.