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.

양수천자를 받은 임신 및 출산아의 추종관찰

朱甲順,韓鍾卨,李在玄 慶熙大學校 1979 論文集 Vol.9 No.-

The follow-up studies on the outcome of pregnancy and infant having amniocentesis during midpregnancy were analized. Only 483 pregnant women gave the informations for the follow-up study among 1453 patients having amniocentesis during midpregnancy from Jan. 1976 to Dec. 1978 at the department of Obstetrics and Gynecology, Kyung Hee University Hospital. The results were as follows: 1. The 483 pregnant women having amniocentesis gave fullterm delivery in 457 (94.62%), premature delivery in 8 (1.86%), immature delivery in 2 (0.41%) missed abortion in 1 (0.21%), induced abortion in 3 (0.41%) and on pregnancy in 10 (2.07%). 2. Of 473 births, 4 still births, 9 neonatal deaths and 4 infant deaths were encountered. 3. Artificial inductions of the pregnancy were carried out in 3 cases such as a 47 XYY syndrome of the fetus, an anencephalus and a patients who had vaginal leakage of amniotic fluid after amniocentesis. 4. A total of 29 patients complained as follows: Abdominal pain in 15, amniotic leakage in 5, vaginal spotting in 4, amniotic fluid leakage with abdominal pain in 4 and vaginal spotting combined with vaginal leakage in 1. 5. The risks involved in amniocentesis for prenatal diagnosis are in our experience small, so that even the use of relative indication for sampling is justified. However, even if there are no increased statistical risk, there should be carried out by experienced obstetricians. 6. Of 278 term deliveries, 63 (22.66%) cases had permanent contraceptions such as tubal ligations or vasectomies and 100 (35.9%) cases are on temporary contraceptives after delivery.

Hamlet의 "TO BE, OR NOT TO BE" 독백

전갑종 동아대학교 인문과학대학 영어영문학과 1994 동아영어영문학 Vol.10 No.-

Discussions of Hamlet's "TO BE OR NOT TO BE" soliloquy are almost as varied and divergent as interpretations of the play itself. Among the various discussions three basic approaches to the soliloquy prevail : one of these explains the speech as a consideration of either acting against King Claudius : the second reads the speech as a contemplation of suicide : and the third is some kind of compromise between -or fusion of- the first two, explaining, for example, that Hamlet think first about his revenge against Claudius, then examines the idea of suicide, and finally rebukes himself for losing "the name of action' Comparison with Shakespeare's other soliloquies indicates that the "TO BE OR NOT TO BE" is not the usual confidential, informative soliloquy but an overheard soliloquy which has the function developing an important thread of the plot, the element of feigned madness. And I suggested has the first line of the soliloguy be read relation to the situation before and after the soliloguy rather to the lines following the first line, which will interpret the first line as "to be so(true) or not to be so" and as related to the theme of appearance versos reality rather than as "to exit or not to exit." It is a passage in which the young prince desperately and brilliaintly attempts to veil his true purposes behind an "antic disposition,'. The awareness of the reality of evil underneath the appearance of good, which Shakespeare makes so important a part of his conception of character and dramatic structure that it becomes essential to the action and is reflected everywhere in the language and imagery - that awareness is bound to result in a brooding en death as the filial reality of all. Here too, Shakespeare was using for his dramatic purpose a familiar tradition, and whorl he makes Hamlet think continually of death, he deepens the theme of the difference between appearance and reality itself.

球形 Shell에서 點熱源에 依한 溫度分布 : 第二報 非定常狀態일 때 Part 2. for unsteady state

李鍾鵬,劉甲鍾 경북대학교 공과대학 1979 工大硏究誌 Vol.8 No.-

The temperature distributions of a spherical shell due to a point heat source were studied by analytical approach and checked by experiment. The temperature of a point source varied with time as T=(τ)/(a+bτ). Physical properties of spherical shell and the heat transfer coefficient of outer surface were assumed to be uniform. The heat transfer equation for the system was solved by a finite difference method for the unsteady state condition. Temperature profiles of the spherical shell were measured by thermocouples and were compared with the calculated profiles. Agreement of the analytical and experimental results was good.

傾斜二重圓管內에서의 自然對流

劉甲鍾 慶北大學校 1982 論文集 Vol.34 No.-

This paper presents results of a numerical analysis and an experimental investigation of natural convective heat transfer in the annulus between inclined cylinders. The MAC method is employed as a numerical technique. The results provide the details of convective heat trausfer characteristics in inclined concentric cylinders. Agreement of the analytical and experimental results is good.

백금 담지 카본블랙 촉매 제조 및 활성조사

김종범,이무성,이완진,양갑승,서곤,김종호 全南大學校 觸媒硏究所 2002 觸媒硏究 論文集 Vol.23 No.-

Platinum catalysts supported on carbon were prepared by using various method. The particle size distribution of loaded platinum was examined using transmission electron microscope, and that was discussed relatively to the oxidation treatment of carbon black and loading method of platinum. In addition, the relationship between its particle size distribution and catalytic activities in the deep oxidation reaction of carbon monoxide and the reduction removal of dissolved oxygen by hydrazine. The number of functional groups on carbon black largely increased by the oxidation treatment with nitric acid compared to that with air or hydrogen peroxide. The large number of functional groups were effective for homogeneous loading of platium, dispersing highly homogeneous platinum particles of 2∼3 nm in a diameter by the methanol reduction method. On the other hand, a large amount of platinum could be loaded on carbon balck using an impregnation method, but the particle size distribution of platinum was poor in homogeneity. Platinum could be dispersed with extremely small particles using on ion exchange method, but the loading amount of platinum was very small. The activities of Pt/VX catalysts in the oxidation reaction of carbon monoxide and the redution of dissolved oxygen strongly varied with the number of platinum atoms exposed, regardless of the particle size, indicating that the highest catalytic activity was obtained on the Pt/VX catalyst prepared using the methanol reduction method due to the high dispersion and large loading of platinum.

韓國人의 環境保護態度形成을 위한 行政的接近

朴鍾珠,辛京勳,鄭甲源 圓光大學校 1982 論文集 Vol.16 No.1

Many developing countries are faced today with serious problems emanating from environmental deterioration with limited resources and technologies, they face the need to increase industrial production and simultaneously to control environmental problems attendant on such expansion. They are in dilemma since environmental pollution is often a problem where solutions run counter the continued and uninterrupted industrial growth. Korea is a case in point. During the past two decades the country enjoyed one of the highest economic growth rates among the developing nations. But the rapid expansion of industries and the emergence of densely populated urban areas during the period have placed heavy strains on the quality of the country's environment. The Korean government, cognizant of the seriousness of the problem, began taking measures aimed at curbing environmental deterioration. The meaning of environment is differentiated in accordance with the disciplines which systematically deals with the environmental problems or with the practical positions and approaches, since the environmental problems appear to be important social and daily life problems. Broadly speaking, environment is the whole which influence each other in and out of a group of organisms. In these regards, the environment of which center is human beings can be called a human environment or a human ecosystem. Human environment is a complex one composed of the human beings and their environmental conditions, that is to say, man-society-biotic and abiotic beings and their conditions. The human environment is different from and more complex than any environments in terms of fact that the man, being quite a component of the system, is able to change the structure of the system by his intellectual activities. The purpose of the present study aims at gathering basic attitudinal data relating to the environment and preparing the usable policy alternatives in Korea. Data for the study were collected from sample survey (367 persons) conducted in Junrabukdo province, using a standardized interview schedule. Major findings of the research can be summarized as follows: (1) satisfaction with the existing quality of the daily environment was expressed by higher level, relatively. So it may be reasonably assumed that the satisfaction they expressed reflected more than the objective realities of their environment. (2) public knowledge of conservation or pollution control programmes was very low despite the concerted effort of both governmental and civilian conservation organizations to arouse public consciousness for environmental protection in conservation programmes was also very low. (3) considering that conservation movements had not been widely known and that partictpation had been very low, public support for environmental protection was very strong. Approximately two-thirds of the sample were found willing to pay an additional one percent of their current tax as a special environmental tax. Almost unanimously, respondents were in favor of establishing environmental education as part of the regular academic curricula from the elementary school up. (4) Environmental personality test shows that Koreans have a strong tendency to view their environment as an object to be developed and modified to suit his immediate needs and desires.

지역 스포츠집단에 활동 특성에 관한 연구

이종갑,하헌태 공주영상정보대학 2000 논문집 Vol.7 No.-

본 연구에서는 D시에 있는 지역스포츠집단의 활동 특성을 정리하면 결과에 나타난 <그림7>과 같으며 결론은 다음과 같다. 1) A군의 특성은 남성 주도의 팀이 많다. 특히 중년, 고령자는 창립연수가 오래된 팀에 적극적으로 참가하고 있다. 참가 동기에 관해서는 중년, 고령자는 친목·교류지향이 강하고 건강관리지향도 약간 강하다. 그러나 기능향상 승리지향의 의식이 비교적 낮다. 그래서 B, C보다 수동적으로 스포츠에 참가하는 것으로 나타냈다. 2) B군의 특성은 우선 여성 중심으로 한 팀이 많다. 그래서 B군의 팀은 연령 구성 면에서 다음에 진술한 것처럼 크게 둘로 나눠진다. 하나는, 젊은 층 사람은 창립연수가 짧은 신설 팀으로 또한 기능향상, 승리지향이 강하게 나타나고 있다. 또 하나는 중년·고령층의 사람은 창립연수가 오래된 팀으로 또한 건강 관리지향이 강하다고 하는 2가지다. 전체적으로 젊은 층 주도의 팀이 많이 존재하고 기능향상, 승리지향이 비교적 강하고 이기는 것에 즐거움을 찾는 경향으로 나타났다. ◁표 삽입▷(원문을 참조하세요) 3) C군의 특성은 남녀 혼합, 또한 개인적 스포츠이다. C군은 신설 팀이 많이 존재하고 있다. 스포츠 참가 동기에 관해서는 친목·교류지향과 기능향상, 승리지향이 A, B군의 중간으로 나타나있지만 친목·교류지향이 A, B군보다 낮게 나타났다. 그러나 수동적 참가는 A. B보다 낮은 것은 다시 말해 C군이 능동적으로 스포츠에 참가한다는 특성이 있다. 지역스포츠는 사라져 가는 지역의 전통적인 인간관계를 부활시키고 새로운 구성원이 지역으로 사회적 통합을 촉진하는 강력한 매개체로서의 기능을 갖는 것으로 나타나고 있다. 결론적으로 이웃사람들은 그 장소를 빌려 교류하거나, 친목을 도모하거나 혹은 스포츠의 참된 의미를 추구하기도 하는 밝은 지역사회 형성에 기여하는 것이다. 그러나 현실을 보면 시민의 지역스포츠 참가가 희망하고 원하는 것이 채워지지 않는 경우도 있다. 그 예로 기술·승리지향이 비교적 강한 사람은 수준이 높은 팀에 가입하고 싶어하고 실제 이웃의 팀은 그와 같은 팀이 아주 적기 때문이다. 여러 사람들과 교류하고 싶은 사람들은 집단 의식이 강한 팀에 가입하고 싶지만, 그 지역에 그와 같은 팀은 많지 않다. 하여튼 자신의 기호에 맞는 팀에 참가하는 것은 당연한 것이나 다양한 동기를 갖고 있는 사람들에 대한 팀의 취향선택은 왜 어려운 일이라고 생각된다. 그러므로 독일에서 보여지는 지역스포츠클럽을 도입 모방하는 것이 앞으로 바람직하다. 독일의 스포츠클럽에서는 각각의 종목에 있어서 수준이 다른 팀이 몇 개인가 존재하고 있다. 또 연령, 성별로 나누지 않고 어린이, 주분 사회인 그리고 다양한 동기를 갖고있는 사람은 누구나 자유로이 참가할 수 있다. 규모가 대단히 큰 클럽도 있고 매우 적은 클럽도 있다. D시의 경우 지역에 의해 그와 같은 스포츠클럽을 고려하면 시민의 지역스포츠에 참가는 무엇보다도 지역스포츠가 활발해지는 것이 아닐까 라고 느껴진다. 따라서 지역스포츠활동에 참가하는 사람들의 활동욕구를 충족시켜가기 위해서는 클럽의 조직구성이나 운영방법, 혹은 시설관리에 이르기까지 사소한일에서 커다란 일까지 어떻게 충족시켜 줄까가 결국 지역스포츠 활동의 활성화를 위한 재편성이 앞으로 지역스포츠에 던져진 중요한 문제라고 생각된다.

컨테이너 터미널의 효율적 운영을 위한 의사결정지원시스템

김갑환,김홍배,윤원영,김종훈,권봉재,조지운 釜山大學校生産技術硏究所 1998 生産技術硏究所論文集 Vol.55 No.-

A decision support system is introduced for the efficient operation of port container terminals. It consists of ship planning subsystem, yard planning subsystem, resource management subsystem, real-time control subsystem, and simulation subsystem. The system is intended to support the planning process of the planners and the operation process of the administrators in the container terminals. It is assumed that the transfer crances and the yard tractor/trailers are used to handle containers in the marshaling yard. The system is explained in terms of the functions of each subsystem and the data flows among various subsystems.

球形 Shell에서 移動熱源에 依한 溫度分布

劉甲鍾 慶北大學校 1980 論文集 Vol.29 No.-

The temperature distributions of a spherical shell due to a moving point heat source were studied by analytical approach and checked by experiment. A spherical shell had two point heat sinks and physical properties of spherical shell were assumed to be uniform and the heat transfer coefficients were assumed to be zero. The heat transfer equation for the systems was solved by a finite difference method for the quasi-steady state condition. Temperature profiles of the spherical shell were measured by thermocouples and were compared with the calculated profiles. Agreement of the analytical and experimental results was good.