메티실린 내성 황색포도알균 주사부위 감염 후 발생한 척추추간판염 1예

김진용,김현옥,고광일,김영생,김길현,김수연,박윤수,서일혜,조용균 대한감염학회 2007 감염과 화학요법 Vol.39 No.6

본 증례는 약물남용자가 아닌 환자에서 MRSA에 의한 말초주사부위 감염 후 발생한 화농성 척추추간판염의 첫 보고이다. 최근 MRSA에 의한 원내감염이 증가하고 있는 현실에 비추어 볼 때 말초주사부위 감염 후 MRSA에 의한 화농성 척추추간판염의 발생을 고려하여야 한다. Infections of the intervertebral disc and adjacent vertebrae may present with spondylitis, discitis and spondylodiscitis and are hematogenous origin in most cases. Potential sources of hematogenous infection are skin and soft tissue infection, genitourinary tract infection, infective endocarditis, intravenous drug abuse, respiratory tract infection and infected intravenous injection site. We have experienced a case of pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with peripheral injection site infection. He was successfully treated with surgical debridement and antibiotics.

성인에서 발생한 폐렴을 동반한 출혈성 수두 1예

김현옥,김진용,고광일,김영생,김수연,박윤수,서일혜,조용균 대한감염학회 2007 감염과 화학요법 Vol.39 No.6

출혈성 수두는 심각한 합병증을 초래 할 수 있으며 사망률이 높은 질환으로 국내에서는 소아에서 발생한 2예 이외에는 성인에서 발생이 보고된 바가 없다. 본 증례에서와 같이 면역이 억제된 성인에서 출혈성 수포가 전신적으로 발생하면서 폐렴이 동반된 경우 치명적이므로 조기에 acyclovir 지속 정주요법 등의 적극적인 치료를 고려해야 한다. 저자들은 면역이 저하된 성인에서 폐렴이 동반된 출혈성 수두가 발생하여 조기에 acyclovir 지속적 정맥 주입요법 시행 후 치명적인 합병증 없이 호전을 보인 예를 경험했기 에 보고하는 바이다. Chickenpox is a common benign childhood disease caused by varicella-zoster virus, typically associated with fever and a characteristic exanthematous vesicular rash. The clinical manifestations in adults are more severe and more commonly complicated with varicella pneumonia. Hemorrhagic varicella, also called malignant chickenpox, is very rare and potentially fatal. Bleeding can occur in the form of hemorrhages within the rash and surrounding skin or within the mucous membrane. We report a case of hemorrhagic varicella complicated with pneumonia in a immunocompromised host. We emphasize on the successful treatment with continuous acyclovir infusion.

16S rRNA 유전자 염기서열 분석에 의해 확인된 Acinetobacter spp. 가성요로감염 유행

김수연,김진용,강지혜,박신영,이희승,박윤수,서일혜,조용균 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

목적 : 본 연구는 일개 대학병원의 한 병동에서 16SrRNA 유전자 염기서열 분석을 통해 확인된 Acinetobacter spp. 가성요로감염 집단 발생에 대한 조사이다. 재료 및 방법 : 일개 대학병원의 일반병동에서 2005년 9월 23일부터 26일까지 5명의 환자에서 Bordetelta bronchiseptica 세균뇨가 동시에 분리되었다. 해당 환자들에 대한 입원 진료 기록을 확인하고, 이학적 검사를 시행하였고, 의료진 면담 등의 역학적 조사와 의심되는 전파원의 환경 감시배양을 시행하였다. 또한 다섯 균주들의 상동성 확인을 위해 pulsed field gel electrophoresis (PFGE)를 하였고, 정확한 균 동정을 위해 16S rRNA 유전자 염기서열 분석을 하였다. 결과 : VITEK system에 의해 B. bronchiseptica로 보고된 다섯 균주들은 거의 유사한 항생제 감수성을 가지고 있었다. 유행조사에서 요로감염의 증상이나 균혈증을 보인 환자는 없었고, 환경 감시배양에서 공통의 전파원은 증명되지 않았다. 또한 PFGE와 16S rRNA 유전자 염기서열분석에서 상동성을 가진 동일 Acinetobacter spp.로 확인되어 이에 의한 가성요로감염의 유행으로 결론지었다. 결론 : 역학적 조사와 함께 PFGE와 16s rRNA 유전자염기서열 분석과 같은 분자생물학적인 조사를 시행하는 것은 희귀한 균에 의한 병원감염 유행조사에 도움이 될 것이다. Background : Acinetobacter spp. is increasingly implicated in hospital-acquired infections. We experienced a pseudooutbreak of Bordetella bronchiseptica bacteriuria identified with biochemical tests, that was later identified as Acinetobacter spp. by using 16S rRNA gene sequence analysis. Materials and Methods : Five in-ward patients were found to have B. bronchiseptica bacteriuria without symptoms of urinary tract infection between September 23 and 26 of 2005. We conducted pulsed field gel electrophoresis (PFGE) of the bacteria and epidemiological investigation of this pseudooutbreak. In addition, 16S rRNA gene sequence analysis was performed for the verification of the strains. Results : All 5 isolates were identified as B. bronchiseptica with similar antibiogram by VITEK system. There was no evidence of any symptom or sign of urinary tract infection. The source of this pseudooutbreak was not detected even after performing environmental culture and interviews with healthcare workers. We could not get the appropriate results from the first PFGE with XbaI restriction enzyme. B. bronchiseptica is an unusual organism in human so we conducted 16S rRNA gene sequence analysis for verification. The analysis of 16S rRNA gene sequence with 5 isolates demonstrated 99-100% similarity to a sequence of Acinetobacter spp. (AU1523). According to the results of 16S rRNA gene sequence analysis, we performed the second PFGE with SmaI restriction enzyme, which showed indistinguishable pattern among the all 5 isolates. Conclusion : This investigation suggests that the combined method of 16s rRNA gene sequence analysis and PFGE would be helpful for investigation of outbreak caused by unusual organisms.

경주지역 여고생의 초경과 체성장간의 관계

김준섭,권오구,박진석,오종수,박정현,박제식,안세한,이용환,서정호,신태섭,최영배,김덕수,이관,박수경 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

본 연구는 경주지역 1개 고등학교 3학년 여고생을 대상으로 초경 시작 전인 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레 수치와 초경 연령을 파악하여 여성의 초경이 빠를수록 체성장 속도의 변화가 있을 것이라는 가설을 기초로 두 요인간의 관련성을 파악하고자 시행되었다. 경주시 1개 여자고등학교 3학년생 총 317명에 대해 ㅊ경 나이, 초경시 심리 상태, 초경이 시작되었을 때의 상담 여부와 상담하였던 사람, 부모 신장과 초경전후의 식사 규칙성, 다이어트 경험, 수면시간, 스트레스, 음주/흡연 여부, 질병력 등에 대한 설문 조사를 시행하였고, 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레에 대한 정보는 건강기록부에서 확보하였다. 상기 대상자 중 건강기록부가 분실된 39명, 초경나이에 대해 응답하지 않았던 29명 및 결석 등으로 조사를 하지 못하였던 42명을 제외한 조사 대상자는 206명으로 선정하였다. 대상자들의 초경연령 평균값(Mean±SD)은 13.0±1.11이었고, 초등학교 4학년부터 고등학교 2학년까지의 초경 이후 신장 성장률은 감소하였으며, 초경연령이 빠른 군이 초등학교 때는 신장에 있어서 우위를 차지하나 고등학교에 오면서 신장은 비슷한 수준이 되었다. 초경후 1-2년 사이에 체중과 흉위의 증가율은 감소하였고, 초경연령이 빠른 군이 초등학교와 고등학교 사이에 체중과 흉위에서 모두 우위를 차지하였다. 본 연구의 결과는, 흔히 이차 성징의 시작 시점 혹은 사춘기의 시작 시점으로 보고있는 초경 연령이 청소년기의 성장과 밀접한 관련성이 있고, 특히 체중과 흉위의 성장 속도와 밀접한 관련성이 있음을 시사한다. To understand the onset of menarche in relation to changes in physical growth that take place during female adolescence, especially the changes in height and weight velocity. The 207 senior in one women high school of Kyongju were investigated in April 3 to 8, 2001. We collected the information, relation in the age at menarche, height & weight of parents, regularity of eating, and obesity diet, duration of sleeping, sickness & stress near age at menarche, by self-recording. The status of height, weight & chest circumference between the 4th grade of primary school and the junior of high school was collected by individual Health Record. The results were followed; The average age at menarche was 12.95±1.11 years old and the most frequent age of menarche is 13 years. After menarche, the velocity of height, weight and chest circumference were decreased. The most rapid group of menarche hold dominant position in height during elementary school. As time passed, they dont hold dominant position in height. The most rapid group of menarche get an advantage in the weight and the girth of chest after elementary school. The height of subjects is directly proportional to the height of their parents. These results suggest that the starting age at menestuation can be closely associated with physical growth and development.

지역사회획득 메티실린 내성 황색포도알균에 의한 급성 신우신염 1예

김수연,김진용,이희승,박철민,박윤수,서일혜,조용균 대한감염학회 2007 감염과 화학요법 Vol.39 No.2

전세계적으로 지역사회획득 메티실린 내성 황색포도알균에 의한 감염 질환이 증가하고 있으나 아직까지 국내외에서 이로 인한 요로감염의 보고는 없었다. 저자들은 지역사회획득 메티실린 내성 황색포도알균에 의한 신우신염을 진단하고 ciprofloxacin 투여로 성공적으로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. In the past decade, methicillin-resistant staphylococcus aureus (MRSA) have emerged in the community, causing serious infection in young and healthy persons without established risk factors for MRSA acquisition. This community acquired methicillin- resistant S. aureus (CA-MRSA) has been usually reported to cause the skin and soft tissue infection and necrotizing pneumonia. We have experienced a case of acute pyelonephritis caused by CA-MRSA without health care-associated risk factors. The staphylococcal cassette chromosome mec (SCCmec) typing and multilocus sequence typing (MLST) revealed the ST5- MRSA-IV clone, which showed SCCmec type IV and MLST allelic profile of ST5 (1-4-1-4-12-1-10).

인지도 조사에 의한 건국의대 의학과 교육목적 및 교육목표의 평가

박수경,김진국,김소정,김형수,이건세,장성훈 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

This study was conducted to survey the recognition and accuracy for educational goal and objectives of College of Medicine, Konkuk University on students and professors with using 18 items of questionnaire from May 15 through June 30, 2004. The recognition for educational goal of College of Medicine, Konkuk University in participating students and professors were 93-95%. And recognition for 3 objectives of College of Medicine, Konkuk University on participating students and professors were 84-87%, 95% respectively. However the accuracy for detail educational objectives using other college of medicine were 46-59% in first student survey, 44-67% in second student survey and 58-72% in professor survey. Therefore it is need to advertize 3 objectives to students and professors. And it is also necessary to refine the contents of educational objectives to more suggesting directions than broad goal of ideal.

석회유담즙증 1예

이지아,김도영,정혜경,문일환,신수연,곽재진 梨花女子大學校 醫科大學 醫科學硏究所 2003 EMJ (Ewha medical journal) Vol.26 No.1

Milk of calcium bile or limy bile is a rare disorder in which the gallbladder lumen is filled with a thick, paste-like, radio-opaque material. Churchman first reported a case of curious deposition of calcium salts within the gallbladder in 1911. Volkmann first used the term Kalkmilchgalle or "milk of calcium bile" in 1926. The radio-opaque material is almost entirely composed of calcium carbonate by weight. The mechanisms by which bile turns limy and radio-opaque or the time required for this biochemical alteration to occur are not well understood. The limy bile is found mostly in a gallbladder complicated by cholecystitis. Recently, we experienced a 33 year old woman who had a milk of calcium bile in the gallbladder lumen. We report this case with a review of literature.

Streptococcus anginosus 균혈증에 동반된 상완 골수염 및 주변부 연조직 농양 1예

한우진,조문숙,이정현,안홍대,윤규현,서종구,김진용,김수연,박윤수,서일혜,조용균 대한감염학회 2008 감염과 화학요법 Vol.40 No.5

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group, It has often been associated with pyogenic infection, such as periodontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-o1d man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed, Streptococcus anginosus grew in blood culture, He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

간호사의 이미지에 따른 간호전공만족도

가미정,김수미,김영경,남수진,오루미,육지수,이혜인,최미나,최혜민,허다은 이화여자대학교 간호과학대학 2010 이화간호학회지 Vol.- No.44

Purpose: The purpose of this descriptive study is to examine the correlation between nursing students’ perception of nurses and the level of their satisfaction with the major. Method: The survey was done with the total number of 192 nursing students from 10 different universities in S city selected by a convenience samplingmethod. In order to measure the perception of nurses, the measurement which was invented by Lee(1992) and revised by Jang(1998) was used. Also, the measurement designed by Shim, and modified by Kim(2007) was used for measuring of the students’ satisfaction in their major. The collected data was analyzed by SPSS 17.0. Results: 1.The most decisive factor of the conceptualization of the image of nurses for the nursing college students is their experience of meeting nurses as a patient. 2. Students reconsider the role of nurses by experiencing immediate relationships with nurses in field training. 3. Other factors of the survey such as the students’academic year, religion, the field training situation (individual experience, type of the hospital where they experienced the training, and a relationship with the nurse in charge of the training) or the existence of nurses among their family members do not affect the students’ satisfaction. 4. There is a positive correlation between the image of nurses of nursing college students and their satisfaction with the major(0.66). Conclusion: The positive image of nurses is directly related to the students’ satisfaction in the nursing major, which hugely affects on their academic achievements and decisions of career path. Therefore, there should be more efforts to increase the positive perception of nurses among nursing students.

私立大學生의 成長發育 및 營養狀態에 關한 硏究 : 中學校 入試有無過程을 通한 比較

朴淳永,具燾書,朴良元,金振浩,南炳執,朴昌植,朴喆斌 慶熙大學校 1980 論文集 Vol.10 No.-

In order to ascertain any possible changes in the physical and the nutritional status of Korean high school students before and after the abolishment of college entrance examination system, an intensive survey was conducted on the physical conditions of the incoming freshmen students (9532 males and 3428 females) of Kyung Hee University from 1972 to 1980. The finding are as below. 1. Physical growth conditions In each of the average physical dimensions of body height, body weight, chest girth and sitting height, a remarkable improvement was recorded for all age groups after the matriculation was abolished. 2. Physical and nutritional indices Relative body weight showed constant values of 35.0 in male and 32.0 in female. Relative chest girth showed the normal chest girth style in all age groups of both sexes. Relative sitting height showed a constant value of 54 for both sexes. The values of vervaeck index of th nutritional status were shown to be between 86-87 in male and 83-94 in female, Pelidisi index 91 and 92-93, Rohrer index of physical status 121-125 and 130-132, and Kaup index 206-211 and 202-210, respectively.