소비자 중심의 선택약가제도 연구 : 경구용 당뇨병 치료제를 중심으로

김남효,최경업,손현순,신현택 한국약료경영학회 2010 한국보건사회약료경영학회지 Vol.2 No.2

Extended-spectrum β-lactamase 생성균주에 의한 지역사회 획득 소아 요로 감염의 위험 인자

김남효,이택진,김지희 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.6

Background:Extended-spectrum β-lactamase (ESBL) producing bacteria have been increasingly recognized in the community. The aim of this study was to identify risk factors for community-onset urinary tract infections (UTIs) by ESBL producers in children. Materials and Methods:We analyzed 854 episodes of community-onset UTIs in children diagnosed at CHA Bundang Medical Center from January, 2004 to April, 2009. The presence of ESBL in Escherichia coli and Klebsiella spp. was screened and confirmed by VITEK®-2 ESBL test. Controls were matched in a 2:1 ratio to case patients by age and sex. The clinical characteristics, risk factors, antimicrobial resistance, and treatment efficacy were compared with controls. Results:The most common pathogen was Escherichia coli (681 isolates), followed by Klebsiella pneumoniae (60 isolates), Enterococcus faecalis (23 isolates), etc. The number of isolated ESBL producers among the pathogens E. coli and K. pneumoniae was 25 (3.7%) and 7 isolates (11.7%), respectively. No significant differences were noted as to the UTI history prior to the present treatment, underlying urogenital anomaly, and clinical characteristics. Use of any antibiotics within a month (P=0.012, Odds ratio, 6.341, 95% confidence interval, 1.492 to 26.955) was related to the increased risk of community-onset UTI by ESBL producers. Conclusions:ESBL-producing bacteria has been identified in pediatric community-onset UTI, and the use of any antibiotics within the previous month was related to the increased risk of UTI by ESBL producers. Therefore, careful selection and use of antibiotics should be recommended for community-onset UTI in children. Background:Extended-spectrum β-lactamase (ESBL) producing bacteria have been increasingly recognized in the community. The aim of this study was to identify risk factors for community-onset urinary tract infections (UTIs) by ESBL producers in children. Materials and Methods:We analyzed 854 episodes of community-onset UTIs in children diagnosed at CHA Bundang Medical Center from January, 2004 to April, 2009. The presence of ESBL in Escherichia coli and Klebsiella spp. was screened and confirmed by VITEK®-2 ESBL test. Controls were matched in a 2:1 ratio to case patients by age and sex. The clinical characteristics, risk factors, antimicrobial resistance, and treatment efficacy were compared with controls. Results:The most common pathogen was Escherichia coli (681 isolates), followed by Klebsiella pneumoniae (60 isolates), Enterococcus faecalis (23 isolates), etc. The number of isolated ESBL producers among the pathogens E. coli and K. pneumoniae was 25 (3.7%) and 7 isolates (11.7%), respectively. No significant differences were noted as to the UTI history prior to the present treatment, underlying urogenital anomaly, and clinical characteristics. Use of any antibiotics within a month (P=0.012, Odds ratio, 6.341, 95% confidence interval, 1.492 to 26.955) was related to the increased risk of community-onset UTI by ESBL producers. Conclusions:ESBL-producing bacteria has been identified in pediatric community-onset UTI, and the use of any antibiotics within the previous month was related to the increased risk of UTI by ESBL producers. Therefore, careful selection and use of antibiotics should be recommended for community-onset UTI in children.

발열이 있는 6개월 미만의 영아에서 세균성 감염에 대한 Procalcitonin의 진단적 가치

김남효,이택진,김지희 대한소아감염학회 2009 Pediatric Infection and Vaccine Vol.16 No.2

Purpose : The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants <6 months of age. Methods : A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/μL) and an increased CRP level (>1.06 mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis. Conclusion : Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source. 목 적: 6개월 미만의 열이 있는 영아에서 세균성 감염을 진단하는 데 있어서 C-반응 단백질(CRP), 전백혈구 수치 (WBC)와 비교하여 혈청 procalcitonin (PCT)가 진단적 가치 가 있는지 알아보고자 연구를 시행하였다. 방 법 : 전향적인 연구방법을 채택해 2008년 7월부터 9월 까지 분당차병원 소아청소년과에 발열을 주소로 내원한 6개 월 미만의 영아를 대상으로 하였다. 내원 당시 체온, 흉부방사 선 검사, 뇨분석검사 및 배양검사와 함께 말초 혈액에서 WBC 를 포함한 전혈구 검사, CRP, PCT, 혈액배양검사를 진행하였 고, 임상 증상과 이학적 검사에 따라서 대변검사와 복부방사 선 검사, 수막염 진단을 위한 뇌척수액 검사도 진행하였다. 결 과: 총 71명의 영아가 연구에 포함되었고 이 중에서 26 명(36.6%)이 요로감염을 진단받았으며, 22명(31.0%)이 바이 러스성 수막염을 진단받았다. 다른 질환으로는 급성 인두염과 포진성 구협염이 각각 1명씩 진단되었고, 상부 호흡기 감염증 7명, 급성 세기관지염 8명, 급성 위장관염 4명, 균혈증 2명이 진단되었다. 요로감염군과 바이러스성 수막염군을 비교했을 때, WBC와 CRP수치는 요로감염군에서 통계적으로 유의하게 더 높은 수치를 보였으나, PCT수치는 두 군 사이에서 통계적 으로 유의한 차이를 보이지 않았다. ROC 곡선 분석에 의해 산출한 곡선 아래 면적은 WBC 0.792 (95% CI, 0.65-0.896), CRP 0.77 (95% CI, 0.626-0.879), PCT 0.568 (95% CI, 0.417-0.710)로 측정되었으며, 다중 로지스틱 회귀분석에 의 해 WBC가 11,920/μL보다 큰 경우와 CRP가 1.06 mg/dL보다 큰 경우는 요로감염을 진단하는 데 있어서 진단적 가치가 있음 을 확인하였다. 결 론: 6개월 미만의 발열을 주소로 내원한 영아에서 세균 성 감염을 예측하기 위한 인자로서 혈청 PCT수치에 대한 연구 가 부족하고 진단적 기준 역시 명확하지 않으므로 단독으로 해석함에 있어서 주의를 기울여야 한다.

청소년 친화적인 공동주택 공간특성에 관한 연구 - 수원 A지역 현상설계안을 중심으로 -

김남효,방선주,Kim, Nam-Hyo,Bang, Seon-Joo 한국주거학회 2009 한국주거학회 논문집 Vol.20 No.3

For the young period, privacy is a crucial factor in establishing one's own identities, values and relationships. The capacity of residential environment to protect individual's privacy takes considerable part in influencing psychological and physiological development of adolescents. This study analyzed adolescents residential values and the elements of spatial plans for the passage and outdoor in Apartment Design Competition of Suwon A district in 2008. One hundred and ten middle and high school students living in Metropolitan area were selected and questionnaire was conducted during February 7 to February 15 in 2009. The data was analyzed by SPSS 11.0 program using one-way ANOVA and crosstab. The study results were summarized as follows; First, the adolescents valued 'safety' the most, regardless of their age and gender and the safety of adolescents commuting should be considered. Second, protecting their own private territories was next important element among other elements. Privacy can be protected by using movable walls, changing the doorway, dividing parents' and adolescents independent territory. Third, in terms of convenience, choosing location of children's room and walking way should be considered. Forth, from the survey, demand for indoors leisure activity was highly valued and required for aesthetic point of view. Considering the sculptures and facilities must satisfy the aesthetics and practicality. Fifth, in terms of social needs, 61.6% of people answered positively to the community facilities for social relationship. Residential environment affects enormous part of adolescents emotional and academic development. Therefore, designing residential areas for adolescents friendly should reflect the demands for safety, territory, convenience, aesthetic and social life.

앱시스산 의존적 전사조절 신호 전달 구성 유전자

김남효,김범기 한국육종학회 2014 한국육종학회지 Vol.46 No.1

Abscisic acid (ABA) is a stress hormone that functions in abiotic stress adaptation in plants. Thus many efforts have been made to identify the molecular mechanisms of ABA signal transduction pathways. Recently there were big advances in understanding molecular mechanisms of ABA dependent expression. From the ABA receptors to the transcription factors, signaling components were discovered and the biological networks among the components were identified. In this review, we describe the ABA signaling components and the rice orthologues identified. These show that signaling network systems of ABA are highly conserved in dicot and monocot plants and we are able to manipulate the ABA signaling components to develop the abiotic stress tolerant crops.

미숙아 망막병증을 가진 극소 저체중 출생아에서 수술의 위험인자

김남효,이순민,은호선,박민수,박국인,남궁란,이철 대한신생아학회 2012 Neonatal medicine Vol.19 No.2

Purpose: The main postnatal risk factors of retinopathy of prematurity (ROP) were described as prolonged oxygen therapy and lower gestational age. Recent data suggest poor early weight gain during the first weeks of life, which can be an additional predictor of severe ROP. We aimed to analyze the risk factors associated with requiring operation for ROP in preterm infants with very low birth weight (VLBW). Methods: In a retrospective case control study, from January 2004 to June 2010, 140 VLBW infants diagnosed as ROP by the International classification of ROP were recruited. There were 14% of infants with stage 1 disease, 65.7% stage 2, and 20% stage 3or more. A group requiring a laser surgery for ROP was 66 infants, and a group not requiring surgery was 74 infants. Results: By a univariate analysis, antenatal steroid, chorioamnionitis, gestational age, birth weight, days on oxygen, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalasia and sepsis were significantly associated with ROP requiring surgery. Weight differences between birth and each from 4 to 12 weeks were significantly lower in the infants requiring surgery (P<0.05). However, after adjustment for gestational age in logistic regression, weight difference between birth and 8th week was a significant predictive factor for the requirement of surgery in infants with ROP (OR, 0.998; 95% CI, 0.996-0.999,P=0.013). Conclusion: We suggest that careful monitoring of weight change and aggresive nutritional support for poorly growing infants, during the first 8 weeks of life, may possibly prevent laser surgery of ROP in preterm VLBW infants. 목적: 미숙아 망막병증의 주요한 위험인자는 낮은 재태주령과 저체중출생, 장기간의 산소 사용 등으로 보고되었는데, 최근 출생 후첫 수 주 동안 적은 체중증가가 미숙아 망막병증을 일으키는 원인인자로 제시되어 이에 미숙아 망막병증을 진단받은 극소 저체중 출생아에서 레이저 광응고수술의 위험인자를 알아보고자 하였다. 방법: 2004년 1월부터 2010년 6월까지 세브란스 어린이병원 신생아중환자실에 입원한 1,500 g 미만의 미숙아 중 미숙아 망막병증을진단받았던 140명의 환아를 대상으로 후향적으로 분석하였다. 국제분류법에 의해 stage 1은 20명(14.3%), stage 2는 101명(72.1%), stage 3 이상은 19명(13.6%)이 진단받았다. 이 중 레이저 광응고수술을 진행한 군은 66명, 수술을 진행하지 않은 군은 74명이었다. 결과: 수술군이 대조군보다 재태주령과 출생 체중, 1분 아프가 점수는 더 낮았고 재원일수와 산소 사용 일수, 수혈 횟수는 더 많았으며, 기관지폐이형성증, 뇌실내 출혈, 뇌실 주변 백질연화증, 패혈증이더 많았다. 산모의 융모양막염은 수술군에서 더 빈번하였으며, 산전스테로이드 투여는 더 적었다. 또한, 출생체중 대비 매주 체중증가는수술군에서 생후 4주에서 12주 사이에 통계적으로 유의하게 더 적었으나 재태주령을 보정한 다중회귀분석에서 생후 8주때 체중증가가 미숙아 망막병증에서 수술로 진행될 수 있는 위험인자로 통계적으로 유의하였다 (OR, 0.998; 95% CI, 0.996-0.999, P=0.013). 결론: 미숙아 망막병증이 있는 극소 저체중 출생아에서 생후 첫 8주간의 체중증가가 적으면 레이저 광응고수술을 진행할 가능성이높아지므로, 적극적인 영양관리를 통한 체중 증가가 필요할 것으로사료된다.

청소년의 여가와 리조트 공간디자인에 관한 연구 - 'H' 리조트 증설 현상설계안을 중심으로 -

김남효,박은정 한국청소년시설환경학회 2009 청소년시설환경 Vol.7 No.1

미술장식품의 유형과 가로경관과의 상관성에 관한 연구 : 서울시 테헤란로 가로경관을 중심으로 Focused on the Seoul Teheran streetscape

김남효,송준호,이현재,이상호,송성진 대한건축학회 2001 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.21 No.2

The problems with the environmental sculptures outside building did not make the characteristics of the specific environment and did not form a big flow in the urban contextualism. The purpose of this study is to provide a practical guide for the present conditions and the preference of environmental sculptures in streetscape. The data are collected through questionnaire surveys from passengers on the Seoul Teheran Street and college students majoring in architecture. 15 samples of sculptures are preferences, and analyzed by the statistics. As a result, the present conditions of artistic environmental sculpture are mostly dissatisfied on ornamental, spatial and cultural contextualism for the better streetscape. Also the sculpture should be constituted with Che principles of form, size, color, materials, location, harmony, and given the identity of streetscape.

Extended-spectrum β-lactamase 생성균주에 의한 지역사회 획득 소아 요로 감염의 위험 인자

김남효,김지희,이택진 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Background : Extended-spectrum β-lactamase (ESBL) producing bacteria have been increasingly recognized in the community. The aim of this study was to identify risk factors for community-onset urinary tract infections (UTIs) by ESBL producers in children. Materials and Methods : We analyzed 854 episodes of community-onset UTIs in children diagnosed at CHA Bundang Medical Center from January, 2004 to April, 2009. The presence of ESBL in Escherichia coli and Klebsiella spp. was screened and confirmed by VITEK??-2 ESBL test. Controls were matched in a 2:1 ratio to case patients by age and sex. The clinical characteristics, risk factors, antimicrobial resistance, and treatment efficacy were compared with controls. Results : The most common pathogen was Escherichia coli (681 isolates), followed by Klebsiella pneumoniae (60 isolates), Enterococcus faecalis (23 isolates), etc. The number of isolated ESBL producers among the pathogens E. coli and K. pneumoniae was 25 (3.7%) and 7 isolates (11.7%), respectively. No significant differences were noted as to the UTI history prior to the present treatment, underlying urogenital anomaly, and clinical characteristics. Use of any antibiotics within a month (P=0.012, Odds ratio, 6.341, 95% confidence interval, 1.492 to 26.955) was related to the increased risk of community-onset UTI by ESBL producers. Conclusions : ESBL-producing bacteria has been identified in pediatric community-onset UTI, and the use of any antibiotics within the previous month was related to the increased risk of UTI by ESBL producers. Therefore, careful selection and use of antibiotics should be recommended for community-onset UTI in children.

선택약가제도가 건강보험 약품비 지출에 미치는 영향 : 경구용 당뇨병 치료제를 대상으로 한 시나리오 분석

김남효,최경업,손현순,신인철,신현택 한국임상약학회 2014 한국임상약학회지 Vol.24 No.2