아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

현대소설에 나타난 만주체험

장현숙(Chang Hyun Sook) 가천대학교 아시아문화연구소 2008 아시아문화연구 Vol.14 No.-

The space of Manchuria in Korean modern novels engages with the Korean migration history and the modern history of western great powers that wanted to win vested rights in China, Japan, and Northeast Asia during the period of Japanese imperialism’s occupation of Korea. The writers who described the experience of Manchuria in the Korean modern literatures well are Choi Seo-Hae, Gang Gyeong-Ae, Kim Chang-Geol, and Ahn Soo-Gil. Especially, Ahn Soo-Gil, while living in Gando from 1932 to 1945, published「Dawn」,「Rice Plant」, and「Records of Stock Farming」, using the life in Gando in 1940s as the subject matters. And he published a collection of his works, 『Bukwon』, and a long novel, 『Booggando』, through which he was highlighted as a representative writer having the experience of Manchuria. In this paper, Ahn Soo-Gil's life and literary characteristics, and further, the characters, the writer’s national consciousness, and the description structure of 『Booggando』 will be focused.

묵논의 식생천이에 관한 연구

이창석,박현숙,유영한,홍선기 서울여자대학교 자연과학연구소 1998 자연과학연구논문집 Vol.10 No.-

폐경년도가 다른 묵논에서 식생요인과 환경요인의 변화를 분석하여 천이계열 및 천이의 추진 기작을 밝혔다. 조사지소는 경작 중인 논, 폐경 후 3년(초기 묵논), 7년(중기 묵논) 및 10년째의 묵논(후기 묵논) 및 묵논에 인접한 계곡림(극상림)의 5단계로 구분하였다. 경작 중인 논, 초기 묵논, 중기 묵논, 후기 묵논 및 계곡림에서 각 조사지소의 우점종으로 판단한 천이계열은 뚝새풀군락→사마귀풀군락→갯버들군락→오리나무군락의 순서로 나타났다. 천이단계별 우점종의 분포와 그것의 생활령을 분석하여 파악된 천이의 추진기작은 내성모델을 따르는 것으로 밝혀졌다. 천이단계에 따른 다양성지수의 변화에서 종품부도와 종다양성지수는 초기에 증가하고 중기에 감소하였다가 그 이후 다시 증가하는 경향을 보였으나 균등성지수는 큰 변화가 없었다. 직경급분포도에서 중기 묵논의 갯버들개체군은 정규분포형을, 후기 묵논의 것은 역 J자형을 보여 전자는 그들이 과거적 어느 한 시기에 동시적으로 출현하였음을 반영하고, 후자의 것은 그들이 현재 경쟁상태에 있음을 반영하였다. 후기 묵논에 성립된 오리나 무개체군의 직경급분포도는 역 J자형을 보여 그들이 침입단계에 있음을 반영하였고, 계곡립의 것은 정규분포형을 보여 그들이 안정상태에 있음을 반영하였다. 이러한 식생요인에 대한 분석 결과, 현재 논으로 이용되고 있는 지역의 잠재자연식생은 오리나무군락이 될 것으로 판단되었다. 천이의 진행에 따른 토양환경요인의 변화에서 수분한량은 초기 묵논에서 현저히 증가되었고, 중기 이후의 묵논에서 감소하였다. pH는 큰 변화를 나타때지 않았고, 유기물, N, P, K, Ca 및 Mg함량은 천이의 진행에 따라 증가하는 경향을 보였다. To clarify the vegetational sere and driving mechanism of succession, vegetation and soil environmental factors were investigated in the old paddy field with different in the lapsed years after abandonment, Study sites were divided into 5 stages of the paddy field under cultivation, the old paddy fields of the initial, middle and late stages, and the climax forest of the mountainous valley near to the abandoned paddy fields. Sere estimated from dominant species of above mentioned study sites was shown in the order of Alpecurus aequalis var. amurensis community, Aneilema keisak community, Juncus effusus var. decipiens community, Salix gracilityla community, and Alnus japonica communt. y. Driving mechanism of succession inferred from the distribution of dominant species in each successional stage and their life form was based on the tolerance model. Species richness and diversity indices steadily increased since the middle stage but evenness index did not show any distinct change. In frequency distribution diagrams of diameter classes, Salix gracilistyla population of the middle and the late stages showed normal and reverse J-shaped distribution patterns, respectively. Result of the former reflects that individuals composing of that poulation were invaded simultaneously in a given time of the past and that the latter suggests that they are in state of intraspecific competition. Distribution diagram of Alnus japonica population in the late stage showed reverse J-shaped distribution pattern reflects that those individulas are in the stages of invasion and that of the valley forest showed normal distribution pattern suggests that they are in stable stage. From the results of analyses on those vegetation data, it was interpreted that potential natural vegetation of the present paddy field might be Alnus japonica community. In changes of soil environmental factors with the progression of succession, soil moisture content rapidly increased in the initial stage and then decreased since the middle stage. Organic matter, N. P. K, Ca and Mg contents tended to increase with the succession stage but pH did not show any distinct change.

이상의 글쓰기 방식 수용 양상 연구

장현숙(Hyun Sook Chang) 한국현대소설학회 2014 현대소설연구 Vol.- No.57

This study examined the writing methods of Lee Sang, who is representative of modernism in the 1930s, and how his methods have been adopted by writers such as Hwang Sun-Won, Kim Seung-Ok and Choi In-Ho; Particularly, this study found that the writing methods seen in Lee Sang’s writing such as juxtaposition of the accelerator effect and contrast using repetition and climax, poetic ellipsis and a modernist sensibility, induction of numbers and deconstruction, directly and indirectly influenced Hwang Sun-Won, Kim Seung-Ok and Choi In-Ho based on a comparative analysis on their writings. Lee Sang and Hwang Sun-Won were members of a coterie who wrote for magazines including 『Samsa Literature』 and ≪Tokyo Student Art Group≫ which continued the modernist tradition. Considering the time they spent in Tokyo and their acquaintance with artist Jeong Hyun-Woong, this study has examined the direct and indirect effect of Lee Sang’s writing on Hwang Sun-Won’s writing through a comparative analysis of their writings and their similarities. Kim Seung-Ok, one of the leading writers of the 1960s, also adopted Lee Sang’s writing techniques by examining aspects of the public or social realm that had become disconnected and excluded in the process of modernization and rapid urbanization through devices such as story fragmentation, repetition of silence and severance, poetic ellipsis and by invoking a modernist sensibility. In this study, it was confirmed that Choi In-Ho, who restarted his literary career with 『Modern Literature』 upon the recommendation of Hwang Sun-Won, was also affected by Lee Sang’s writing as he described big city life and the irrational and unreasonable aspects of modern life through a modernist sensibility, wit, humor and illusion. That is, Lee Sang’s writing - which represents modernism in the 1930s - directly and indirectly influenced Hwang Sun-Won who was the member of a coterie who wrote for 『Samsa Literature』 and ≪Tokyo Student Art Group≫ and considerable elements of their writing were rhetorically adopted and expanded by Kim Seung-Ok and Choi In-Ho.

주거공간의 지속가능성 계획 사례 분석

이현창(Hyun-chang Lee),남경숙(Kyung-sook Nam) 한국생활환경학회 2008 한국생활환경학회지 Vol.15 No.3

As pursuit of eco friendly housing, it was came out a requirement to develop sustainable design in housing. Sustainable development is a eco friendly development which meets the needs of the present without compromising the ability of future generations to meet their own needs. This study is to set up the sustainable development in housing which is a countermeasure in the long term of a environmental changing. The purpose of the study is to offer information about sustainable design in housing to residents which is related with solving the problems in housing and considering the future housing. A study would like to contribute to design development for sustainable development in housing. To study sustainable development in housing, we researched and analyzed of brand apartments model which will be completed in 2010 through model house, documents, catalog and internet sites. We knew that the progress are doing consistently to increase energy efficiency design as applying ecological design and make a design for decreasing environment pollution. But convenience design and universal design are not enough in housing. So there need to supply convenience, universal space design with equipment design for sustainable development in housing. Environment-friendly design of housing for health is a obligation and fundamental element in the world. As pursuit of convenience, we also want to request of convenience system which is based on the convenience and development of the machine civilization supports the equipment system development. So interior design and equipment system need of convenience as considering the changing lifestyle and applying the culture, trend.

발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

월경전 기분 변화와 출산후 불안-우울 증상간의 상관성

한창수,김용구,이낙우,김 탁,김해중,김 현,조숙행 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

To investigate the relationship between premenstrual mood changes and anxiety, and mood symptoms in the perinatal period , questionaire survey was carried out. There was no significant correlation between premenstrual symptom scale value and Edinburgh postpartum depression scale value. And theme was no relationship between premenstrual symptom scale value and state anxiety inventory scale value in the perinatal period. This findings suggest that premenstrual mood changes are not directly correlated with mood changes in the perinatal period.

Reconstruction of Anterior Chest Wall Defect Induced by Sterile Costochondritis: A Case Report of Non-radiographic Axial Spondyloarthritis

Park Sang Hyun,Jeong Sang Hyun,민경현,Chang Lan Sook 대한창상학회 2023 Journal of Wound Management and Research Vol.19 No.2

Non-radiographic axial spondyloarthritis (axSpA) is a subtype of axSpA characterized by chronic low back pain and stiffness but without radiographic evidence of sacroiliitis or spinal changes. As is the case with axSpA, early initiation of nonsteroidal anti-inflammatory drugs, tumor necrosis factor inhibitor agents, or physical therapy are often recommended for patients with non-radiographic axSpA. While the clinical course of non-radiographic axSpA is less well-known than axSpA, we present a case of a patient with non-radiographic axSpA manifesting as a sterile abscess in the sternum and costal cartilage. In this case report, we describe the diagnostic process for this rare manifestation and reconstruction of the large chest wall defect using a pedicled transverse rectus abdominis musculocutaneous flap.

기니픽 기관지 말초신경에 대한 캡사이신의 탈감작 효과

정이숙(Yi Sook Jung),조태순(Tai Soon Cho),문창현(Chang Hyun Moon),신화섭(Hwa Sup Shin) 대한약학회 1997 약학회지 Vol.41 No.1

In the present study, capsaicin-induced desensitization of peripheral sensory nerves were investigated by using guinea pig bronchi, in which these nerves are stimulated with capsaicin to produce a contractile response via the release of sensory neuropeptides such as substance P and neurokinin A. The contractile response to capsaicin was inhibited by the combination of CP96345 and SR 48968 suggesting that the excitatory effect of capsaicin is mediated via both the tachykinin NK-1 and NK-2 receptor. Capsaicin produced in vitro-desensitization in dose-dependent manner, but after this in vitro-desensitization the response to NK-1 and NK-2 receptor agonist did not change. Systemic administration (s.c.) of capsaicin also desensitized significantly bronchial tissues but could not produce any change in the contractile response to the selective agonists of NK-1 and NK-2 receptor. Therefore, the present results suggest that functional desensitization to capsaicin-induced contractile response in guinea pig bronchi does not involve NK-1 and NK-2 receptor, while excitatory effect of capsaicin is mediated via both NK-1 and NK-2 receptor. In conclusion, it is suggested that capsaicin- induced excitation and desensitization involves somewhat different pathways.

반하후박탕(半夏厚朴湯) 추출물이 생쥐에 유발된 심리적 스트레스에 미치는 영향

임세현 ( Se Hyun Lim ),정현윤 ( Hyun Yun Jeong ),원호영 ( Ho Young Won ),김형우 ( Hyung Woo Kim ),최창원 ( Chang Won Choi ),정향숙 ( Hyang Sook Jeong ),김영균 ( Young Gyun Kim ),조수인 ( Su In Cho4 ) 대한본초학회 2012 大韓本草學會誌 Vol.27 No.4

Objective : Banhahubak-tang is indicated for globus hystericus, marked by a subjective sensation as if something stuffed in the throat, chest distress, cough or vomiting, greasy whitish, taut and smooth pulse. In this study, the effects of Banhahubak-Tang extract (BHTe) were tested for anti-stress action. Methods : BHTe was extracted by pure water using electronic extractor and then fed to ICR male mice (20±2g) orally with the dose of 100㎎/㎏/day for five days. Mice were exposed to sociopsychological stress by restraining and seeing foot shock stressed mice for one hour for five days. Results : BHTe administered group showed a tendency of decreasing of serum corticosterone secretion when compared with control group, and BHTe administration also significantly up-regulated noradrenaline secretions in the dorsal cortex of brain. Lipid peroxidation of the brain tissues of mice were tested by measuring malondialdehyde, but BHTe showed no significant change. The elevated plus-maze test was designed to detect the effect of anxiolytic drugs, and BHTe administered group showed a significant increase of latency time. Conclusions : These results suggest that BHTe can effectively rid the psychological stress and it`s related diseases.