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.

서울시 교직원의 고혈압 실태파악과 그 요인에 관한 연구

신선미,김종희,한규종,이희우 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.1

Purpose : To describe epidemiological characteristics and related factors in school personnel with hypertension. Method : 5,384 school personnel (2,638 males and 2,746 females) received physical examination at the Seoul School Health Center in 2002. blood pressure(BP) was classified by JNC 7th report. Normal BP is systolic BP <120 and diastolic BP<80, prehypertension BP is 120-139 or 80-89mmHg, stage 1 hypertension BP is 140-159 or 90-99, and stage 2 hypertension >=160 or >=l00 mmHg. each group was evaluated by gender. We used multiple regression and logistic regression. Results : Normotension was 20.13% in d e s and 48.65% in female, prehypertension 43.4% in males and 3.06% in females, stage 1 hypertension 26.38% in males and 10.99% in females, stage2 hypertension 9.59% in males and 3.2% in females. the older age group had higher distribution of stage 1 hypertension and stage 2 hypertension. The means and abnormal rates of BMI, blood sugar, total cholesterol, GOT, GPT, and GTP was higher when their blood pressure was higher. However, an alcohol habit among lifestyle factors had an inverse effect. Higher Bp was correlated to a &her BMI, FBS, and cholesterol-like dose response. In stage 1 hypertension, the related factors of hypertension for males were BMI, amount of cigarettes smoked, exercise, blood sugar, total cholesterol, and GTP. In stage 1 hypertension, age, BMI, exercise, blood sugar, total cholesterol were related factors in female. In stage 2 hypertension, age and smoking were related factors in male, and age, BMI, and cholesterol in female. Conclusions : It is possible to intervene in all related factors of hypertension except age through life-style modification and appropriate medical management. Active health promotion is needed in School personnel.

敗醬草가 癌細胞柱에 미치는 影響

申大澈,權貞南,金瑩均,韓宗鉉,김재석,김재섭 동의대학교 한의학연구소 1997 동의한의연구 Vol.1 No.-

The purpose of this study was to investigate effect of water extract of Patriniae Herba on the poliferation of human cancer cell-lines. The effects of Patriniae Herba on the poliferation of A43l, HeLa, MOLT-4, K562 cells, Balb/c 3T3 cells, mouse thymocytes, splenocytes and human lymphocytes were estimated by MTT colorimetric assay, The results were as follows; 1. Patriniae Herbs did not effect A43l, HeLa, MOLT-4, K562 cells. 2. The cytotoxicity of mitomycin C on MOLT-4 cells was increased by the combination of Patriniae Herba. 3. Patriniae Herba inhibited the proliferation of Balb/c 3T3 cells. 4. Patriniae Herba stimulated the proliferation of thymocytes. 5. Patriniae Herba stimulated the proliferation of splenocytes. 6. Patriniae Herba stimulated the proliferation of human lymphocytes.

한국근대소설의 판소리서술양식 수용 : 채만식·김유정의 소설을 중심으로

辛宗漢 단국대학교 1993 論文集 Vol.27 No.-

This study aims to find out a link of literary tradition through the analysis of literary works in 1930s. By succession of lityerary tradition we mean the accommodation and reformation of conventional techniques of expression, not mere adoptation of subject matters alone as in the most preceding studies. Our concern is rightly given to how the narrative form of p'ansori(a narrative musical form unique to Korea) was accommodated in several works of Chae-mansik and Kim-youjeong. We have shown that conventional narrative techniques of p'ansori were accommodated and renovated in short stories of Chae-mansik and Kim-youjeong. We have considered their accommodation and reformation of conventional techniques of expression mainly from three viewpoints, centering on structural, aesthetic and stylistic ones. And we came to following conclusions. First, various scenes of long stories are made into unit elements, while short stories themselves unit elements, with the repetition of 'Chang and Aniri', 'tension and relaxation'. The consequence of this technical skill leads readers to aesthetic experiences. Secondly, they made secure aesthetic distance, adopting a narrator who not only interferes in the stories themselves, but also identifies himself with a character in the novel, causing eventual relaxation of tension. The reason Chae and Kim made full use of Satire and Humor, among all literary techniques, is due to the fact that they suffered from intellects' helplessness, agony and self-contradiction under the rule of Japanese colonialism. Thirdly, vividness and liveliness of vernacular language were obtained with the help of colloquialism in p'ansori. Frequent use of present inflexional suffixes and peculiar honorific suffixes briought about dramatic illusion for readers. This literary techique leads to the effects of simultaneity and reality. In sum, Chae-mansik largely preferred Satire, while Kim-youjeong Humor. The task of making exact distinctions between them remains to be settled by further studies. The necessity of understanding original ways of expression of our people is most urgent and rewarding. The contributions of this study will be those of making a fresh investigation of colloquialism of p'ansori from social and spiritual point of view.

스카라 로봇의 속도제어를 위한 지능제어 알고리즘 개발

한성현,신행봉,Le Xuan Thu,안종국 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

We propose a new technique to the development of Intelligent control algorithm based-on digital signal processors in order to improve the precision and robustness for system of industrial robot. Intelligent control has emerged as one of the most active and fruitful areas for research in the applications of fuzzy set theory, especially in the real of industrial processes. In this thesis, a self-organizing fuzzy controller for the industrial robot manipulator with a actuator located at the base is studied. A fuzzy logic composed of linguistic conditional statements is employed by defining the relations of input-output variable of the controller, In the synthesis, one of the most difficult problems is the determination of linguistic control rules from the human operators. To overcome this difficult, SOFC is proposed for a hierarchical control structure consisting of basic level and high level that modify control rules. The proposed scheme is simple in structure, fast in computation, and suitable for implementation of real-time control. Performance is illustrated by simulation and experimental results for SCARA robot.

강재 슬릿형 댐퍼를 부착한 철근콘크리트조 골조의 거동

신종익,이정한,송한범,강대언,오상훈,차승렬,이용재,김상대,이원호 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

This study investigates the performance of the reinforced concrete frame with the steel plate slit damper. The test was carried out to investigate the structural behavior between the reinforced concrete bare frame and the reinforced concrete frame with the steel plate slit damper. The test results showed that the energy absorption capacity of the damped-frame was several times larger than that of the bare frame. For the damage by the input energy is concentrated on the steel plate slit damper, the ductilities of the former structure were increased and the damaged frame can be reused after exchange the steel plate slit damper.

저압 증발하의 열교환 특성에 관한 연구

신유식,이윤환,서종수,전영흥,정효민,정한식 경상대학교 해양산업연구소 2002 해양산업연구소보 Vol.15 No.-

The purpose of this research is to obtain the characteristics of heat transfer or heat exchange under the vacuum pressure. The general heat transfer or heat exchange can be changed with the experimental environment. In this report, the exothermic calorie and endothermic calorie were measured under the vacuum chamber. These two kinds of calories show the evaporative and condensing sides, respectively, and these calories were measured by using the parameter with flow rate.

경계층 난류박리의 제어에 관한 연구 : 제1보;매끄러운 2차원 디퓨저 벽면에서의 난류박리특성 First Report;Turbulent Separation Characteristic on the Smooth 2-Dimensional Diffuser Wall Surface

신정관,박종일,이한영,김경훈 경희대학교 산학협력기술연구원 1995 산학협력기술연구논문집 Vol.1 No.-

The structure of the turbulent wall layer developing into flow separation was studied. The experiments were performed to find out the formation of turbulent separation lead to diverging of the diffuser wall in a two-dimensional asymmetric diffuser which was attached to a downstream end of a long straight channel to provide a fully-developed turbulent inlet condition. First report, this is to estimate how to develop the region of the separation in the smooth diffuser wall with diverging condition and then is the reference on the characteristics of rough diffuser wall being under discussion at second report. As a result, static pressure profile of the fixed wall are in accord with the static pressure profire of the movable wall. Separation has broken out at the diffuser open angle θ=7o, while the diffuser openingangle is increasing, the region of the separation is advanced at the upstream and separation appears at the diffuser open angle θ=12o in the fixed wall too.

자기구성 퍼지제어에 의한 8축 로봇의 강인제어

신행봉,김종수,김홍래,한성현 한국공작기계학회 2004 한국공작기계학회 추계학술대회논문집 Vol.2004 No.-

In this paper, it is presented a new technique to the design and real-time implementation of fuzzy control system based-on digital signal processors in order to improve the precision and robustness for system of industrial robot. Fuzzy control has emerged as one of the most active and fruitful areas for research in the applications of fuzzy set theory, especially in the real of industrial processes. In this thesis, a self-organizing fuzzy controller for the industrial robot manipulator with a actuator located at the base is studied. A fuzzy logic composed of linguistic conditional statements is employed by defining the relations of input-output variable of the controller, In the synthesis of a FLC, one of the most difficult problems is the determination of linguistic control rules from the human operators. To overcome this difficult, SOFC is proposed for a hierarchical control structure consisting of basic level and high level that modify control rules. The proposed SOFC scheme is simple in structure, fast in computation, and suitable for implementation of real-time control. Performance of the SOFC is illustrated by simulation and experimental results for robot with eight joints.

볼리비아 로즈목에 의한 다형홍반 양상을 보인 직업성 알레르기 접촉피부염 증례

신주연,홍윤철,임종한,박신구,이지나,김환철 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

배경 : 로즈목(rosewoods) 중 볼리비아 로즈목(Machaerium Scleroxyon)은 강력한 감작물질을 함유하고 있어서 외국에서는 이로 인한 자극 또는 알레르기 접촉피부염의 발생이 증가하고 있음에도 불구하고 지금까지 우리나라에서는 볼리비아 로즈목을 비롯한 수입목재에 의한 직업성 피부질환의 보고가 부족하였고, 이에 저자들이 볼리비아 로즈목에 의한 다형홍반 양상을 보인 직업성 알레르기 접촉피부염의 증례를 경험하였기에 보고하고자 한다. 증례 : 49세 남자로서 여러 가지 수입목재를 절단하고, 다듬는 작업을 하다가 소양감을 동반한 홍반성의 피부 증상이 발현되었고, 전신으로 증상부위가 확대되어 2주 동안 병원 입원 치료를 하게 되었으며, 이후 본원 산업의학과에서 피부첩포 검사 후 최종적으로 볼리비아 로즈목에 의한 알레르기 접촉피부염으로 확진되었다. 결론 : 수입목재들로 인한 직업성 피부질환 발생에 대한 광범위한 실테 조사가 필요하며, 이를 토대로 작업장에서의 직업성 피부질환의 발생을 감소시키기 위한 다각적인 예방, 관리 대책의 수립이 필요하다. Background: Woods are capable of causing allergic or irritant contact dermatitis which typically occurs on exposed areas. Because Bolivian rosewood exclusively contains the strong sensitizer R-3,4-dimethoxdalbergione, an increasing number of cases of initant and allergic contact dermatitis has been reported. Case report: A 49-year-old, male, wood worker, who handled a variety of woods, developed allergic contact dermatitis. A patch test confirmed a positive reaction to one of the exotic woods, Bolivian rosewood. Allergens found in Bolivian rosewood caused this patient's dermatitis, which cleared when he avoided &is wood. Conclusion: Exotic woods such as Bolivian rosewood can induce occupaiional contact dermatitis. Measures to lower the incidence of work-related dermatitis are needed in the workplace. Especially, when cutting or sanding woods, workers should wear proper personal protection.