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.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

응급실을 내원한 65세 이상 노인 환자의 분석

김진년,김태훈,강양욱,오명,김상철,김성훈,권계형,남홍우,이홍순,유형준 대한노인병학회 2001 대한노인병학회지 Vol.5 No.3

조갑진균증의 치료에서 터비나핀과 이트라코나졸의 이중맹검 비교연구 : 공동연구

김기홍,최종수,송준영,김상원,김수찬,안성구,성열오,서순봉 대한화학요법학회 1995 대한화학요법학회지 Vol.13 No.2

저자들은 새로 개발된 alyllamine계 항진균제인 터비나핀의 발톱의 조갑백서에서 치료 효과, 내약성 및 부작용 등을 평가하기 위해 triazole계의 이트라코나졸과 이중 맹검으로 비교 조사하였다. 치료방법은 터비나핀은 250㎎/days로 12주간, 이트라코나졸은 100㎎/day로 124주간 복용하고 양군 모두 치료 시작 후 36주까지 추적 관찰하였다. 조사방법은 조갑진균증 환자에 대해 치료에 대해 설명후 동의서를 받고 장기간 치료가 부적합한 경우를 제외한 149명(터비나핀군 74명, 이트라코나졸군 75명)이 치료를 받았으며 이중 25명이 탈락하고 13명이 부작용등으로 치료를 중지하여 111명(터비나핀군 51명, 이트라코나볼군 60명)이 치료를 완료하였다. 1. 임상적인 소견은 점진적으로 호전되었으며, 치료 시작후 36주에는 병변조갑의 감소 비율로 볼때 터비나핀군은 51명중 완전치료가 24(47.0%), 76%이상 호전이 18명(35.3%), 51%~75% 호전이 6명(11.8%), 26~50% 호전이 2명 (3.9%), 25% 이하의 호전을 보인 예는 1명(2.0%)였다. 이트라코나졸군은 60명중 완전치료가 27(45.0%), 76% 이상 호전이 14명(23.3%), 51%~75%호전이 9명(15.0%), 26~50% 호전이 2명(3.9%), 25% 이하의 호전을 보인 예는 1명(2.0%)였다. 이트라코나졸군은 60명중 완전치료가 27(45.0%), 76% 이상 호전이 14명(23.3%), 51%~75%호전이 9명(15.0%), 26~50% 호전이 7명 (11.7%), 25% 이하의 호전을 보인예는 3(5%)였다. 2. KOH도말 검사에서 음성 소견을 보인 비율은 터비나핀은 24주 후 50예(98.0%)였으며, 36주후에는 모두 음성을 나타내었고, 이트라코나졸은 치료 24주 후 51예(85.0%)였고, 36주후에는 59예(98.3%)에서 음성을 나타내었다. 진균배양 검사에서는 치료 12주 후에 터비나핀군은 51예중 44예에서 (86.3%), 이트라코나졸군은 60예중 52예에서 각각 음성이었으며(86.7%), 치료 36주 후에는 양군 모두에서 음성이었다. 3. 내약성은 양군 모두 시간이 지나면서 증가하였으며, 터비나핀은 moderate이상이 98~·00%였고, 이트라코나졸은 moderate이상이 96.7~100%였다. 4. 부작용은 위장관 증상이 가장 많았고 터비나핀은 23명, 이트라코나졸은 37명이었고, 2명, 3명에서 각각 일시적인 간효소치의 상승이 있었다. 이상의 결과로 보아 조갑진균증의 치료에 터비나핀 1일 250㎎씩 12주간의 경구투여는 치료율, 안정성 및 부작용에서, 추천할 만한 치료법이라 생각된다. In this randomized double-blind trial on multicenter study, the efficacy of the new antifungal agent, terbinafine(Lamlsil) was compared with the triazole antifungal agent, itraconazole, in the treatment of patients with onychomychosis. One hundred and forty nine patients(74 terbinafine, 75 itraconazole) with onychomlychosis were enrolled. Twenty five patients were lost to follow up and 13 reported adverse reaction with premature discontinuation of therapy. And 111 patients were eligible for follow-up until 36 weeks after starting the treatment. Fifty one patients received Lamisil(terbinafine) 250mg daily for twelve weeks (terbinafine group) and 50 received itraconazole 100mg daily for 24 weeks (itraconazole group). They were checked clinical symptoms(onycholysis, subungual hyperkeratosis, paronychyal inflammation, color change, brittleness, ridging, normal length of nails) and mycological improvement with KOH wet mount and culture during the study. Clinical improvements were slow but progressive. In terbinafine group of 5t patients, 24 patients(47.0%) were completely cleared and 18 patients(35.3%) were improved more than 76%, and 6 patients(11.8%) were improved in 53-75%. In itraconazole group of 60 patients, 27 patients(45.0% ) were completely cleared and 14 patients(23-3%) were improved more than 76%, and 9 patients(150%) were improved in 51-75% . In mycologic study, cure rate of the terbinafine group showed all negative at 36 week after the treatment while ittraconazole group showed all negative in culture but negative KOH in 98.3%. Adverse reactions and tolerability of both the drugs were good and net different significantly. All these findings suggest that the efficacy of Lamisil(terbinafine) 250mg daily for 12 weeks in the treatment of onychomycosis was similar to that of itraconazole 100mg daily for 24 weeks.

서울지역 여대생들의 떡에 대한 인식 및 섭취 실태 조사

김영순,오순덕,김향미,신지홍,김현경,배유미,조규영,조성환 高麗大學校 倂設 保健大學 保健科學硏究所 2003 保健科學論集 Vol.29 No.1

This study conducted a survey of the improvement and popularization for Korea Rice Cakes, a Korean traditional food, on two hundred women students in five colleges in Seoul, Korea. It was investigated to get the information of the recognition, preference, and consumption patterns for the succession and improvement of Korean Rice Cakes. The results are as follows: 1. A portion of 41.5% among responders knows from three to six kinds of Korean Rice Cakes, and of 28% can make at least one among the kinds of Korean Rice Cakes. 2. A portion of 91% recognizes that Korean Rice Cakes are one of well-nourished food, but of 42% answers that Korean Rice Cakes cannot be replaced with the principle food. Also, there are no significant differences in the recognition of Korean Rice Cakes as the kinds of religions. 3. The frequency of purchase is about one or twice in a month (35.5%). Consumers (36.5%) intend to purchase Korean Rice Cakes for the commemoration of national holidays or anniversaries. 4. The reasons for the preference of other foods more than Korean Rice Cakes are the easiness of purchase (36.0%), the deliciousness (21.5%), the diverse kindness (17.5%), and the proper package (9.5%). It is important that constant and particular school / home education is need to improve and success Korean Rice Cakes.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

담도 및 췌장 악성종양에서의 CAl9-9의 진단적 가치에 대한 평가

명승재,최승목,김은옥,최호순,이성구,김명환,민영일,류진숙 大韓消化器病學會 1995 大韓消化器病學會誌 Vol.27 No.3

Lidocaine, Thrombin, Epinephrine 의 항균효과

김진우,이동건,전혜선,김승준,김석찬,안중현,김치홍,권순석,김영균,김관형,문화식,신완식,송정섭,박성학 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 기관지내시경 검사에서 흔히 사용되는 국소마취제인 lidocaine과 내시경시 지혈목적으로 사용되는 thrombin과 epinephrine이 각종 균주에 미치는 항균효과에 대해 알아보고자 하였다. 재료 및 방법 : 균주는 가톨릭대학교 성모병원에서 2004년 3월부터 2004년 9월까지 임상검체 에서 동정된 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 각각 42, 42, 42, 43주를 대상으로 하였다. Lidocaine, thrombin, epinephrine 감수성 검사는 National Committee for Clinical Laboratory Standards (NCCLS, 2002)의 기준에 따랐다. 결과 : Lidocaine은 S. aureus, S. pneumoniae, P. aeruginosa에서 MIC_(50), MIC_(90) 모두 20,000 ㎍/mL 이었다. K. pneumoniae는 각각 10,000 ㎍/mL이었다. Thrombin은 S. aureus와 P. aeruginosa에서 MIC50 500 lU/mL 과 MIC_(90) 500 IU/mL 이상이었고, K. pneumoniae에서는 MIC_(50)과 MIC_(90)이 모두 500 lU/mL이상이었으나 S. pneumoniae에서는 MIC_(50)과 MIC_(90)은 125 IU/mL이었다. Epinephrine은 K. pneumoniae, S. pneumoniae에 대한 MIC_(50), MIC_(90)가 모두 >500 ㎍/mL이었고, S. aureus와 P. aeruginosa에 대한 MIC_(50), MIC_(90)가 모두 500 ㎍/mL이었다. 결론 : 기관지 내시경 검사에서 흔히 쓰이는 lidocaine, thrombin, epinephrine 등의 약제들이 호흡기 질환의 흔한 병원균인 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 균주들에 대해 항균 효과가 있을 수 있어 세균배양검사에 영향을 미칠 수 있겠다. Background : We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. Materials and Methods : The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. Result : MIC_(50) and MIC_(90) of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 ㎍/mL and that for K. pneumoniae were 10,000 ㎍/mL. MIC_(50) and MIC_(90) of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC_(50) and MIC_(90) of epinephrine for K. pneumoniae and S. pneumoniae were above 500 ㎍/mL; that for S. aureus and P. aeruginosa were 500 ㎍/mL. Conclusion : We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.

개질아스팔트 콘크리트의 변형강도와 소성변형특성 연구

김광우,최선주,이문섭,홍상기,안경애,이순제 강원대학교 부설 석재복합신소재 제품연구센터 2003 석재연 논문집 Vol.8 No.-

본 연구는 정하중하에서 최대하중과 변형을 이용하여 구한 변형강도(K_(D))로부터 아스팔트 콘크리트의 소성변형 계수의 추정 가능성을 보여준다. 이 논문은 새로운 강도특성치인 K_(D)를 개발하는 김테스트 연구의 일부로 최근 2, 3단계의 연구결과이다. 19mm 편마암과 화강암 2가지 골재와 3가지 폴리머로 제조한 7가지 바인더로 같은 입도에서 소성변형 저항성이 다른 14가지 혼합물을 만들었다. 3단계에선 슬래브 공시체(30cm x 30cm x 6cm)를 제조후 반으로 나누어 한쪽 공시체에선 두 개의 김테스트 공시체 코어를 뜨고 다른 한쪽으로는 60℃ 반복주행(WT)시험을 수행하였다. 한편 2단계에선 슬래브 공시체의 가운데에서 WT 시험을 수행하고 그 양옆에서 김테스트 공시체 코어를 채취하였다. 4가지 하중봉을 사용하여 60℃에서 김 테스트를 수행하였다. 침하깊이-반복회수 곡선으로부터 최종 침하 깊이와 동적안정도 두 가지 소성변형 계수를 각 혼합물별로 구했다. 각 하중봉과 골재 별로 K_(D)와 소성변형 계수간의 통계적 상관관계 분석을 수행한 결과 K_(D)와 소성변형 계수와의 결정계수가 매우 높게(R² > 0.9) 나타났다. 그러므로 K_(D)는 소성변형 계수를 추정하는데 있어 매우 적합한 특성치이며 4cm 직경에 1cm 반경으로 원형절삭한 하중봉이 R² 가장 높게 나타나는 하중봉임을 알 수 있었다. 따라서 김테스트는 향후 소성변형을 추정하기 위한 표준화된 특성치로 사용할 수 있도록 더 연구 개발을 할 수 있을 것으로 판단되었다. This study shows predictability of rut parameters of asphalt concrete based on the deformation strength (K_(D)) which is obtained from the maximum load, deformation and size variables of loading head under simple static loading. This paper is the result of latest studies, phases 2 and 3, which are parts of Kim Test study for developing a new strength property, K_(D), for asphalt concrete. Two aggregates, gneiss and granite, with maximum size of 19mm and seven binders using three polymers(LDPE, SBS, SBR) were used to produce 14 different natures of rut resistance mixtures using the same gradation. A slab(30m x 30cm x 6m) was cut into two pieces and 2 cores for Kim test were taken from a half piece and the other piece was used for wheel tracking (WT) test at 60℃ in phase 3. In phase 2, WT test had been carried out in the middle of a whole slab and cores were taken from both sides of the wheel path along the center line. Kim test was performed using four loading heads at 60℃. Two rut parameters, depth of rut and dynamic stability, from the rut depth-cycle curve from a WT test were obtained for each mixture. Statistical analysis were performed for each loading head and aggregate to find out correlation between K_(D) values and each rut parameter. The analysis result showed that K_(D) had very high coefficient of determination (R² > 0.9) on the average with rut parameters. It was found that K_(D) is a good property that has excellent predictability for rut parameter of asphalt concretes, and the 4cm diameter loading head with 1cm curvature radius gave the best result in R². Therefore, Kim test can be further developed as a standard property for use in rut performance estimation of asphalt concretes.

Azithromycin으로 치료한 임신 중 쓰쓰가무시병 1예

김광석,최진욱,서호종,김기훈,박성호,서광섭,고성만,김순혜,김호정 대한감염학회 2001 감염 Vol.33 No.5

We report a case of tsutsugamushi disease in a 26 year-old pregnant woman who was treated with azithromycin. Her gestation period was 27 weeks and she admitted with fever, rash, and eschar on the right shoulder. Currently recommended medications for the treatment of scrub typhus are doxycycline or chloramphenicol. But, these drugs are class D drugs according to the U.S. Food and Drug Administration (FDA) Fetal Risk Summary, so they couldn't be used to treat pregnant women. Recently, a few case reports suggested that azithromycin, a relatively new macrolide antibiotic, was effective and safe for the treatment of scrub typhus in pregnant women. And, there is no evidence that azithromycin causes harmful effects to the developing fetus or to children. On the basis of current in vivo test that confirms the effectiveness of azithromycin, it may be the drug of choice for the treatment of scrub typhus in pregnant women and children. (Korean J Infect Dis 33:380-382, 2001)