한국인 소아에서 분리한 Helicobacter pylori 균주의 항균제 내성률

김유미,이연주,오석희,성흥섭,김미나,김경모,Kim, Yoo-Mi,Lee, Yeoun-Joo,Oh, Seak-Hee,Sung, Heung-Sup,Kim, Mi-Na,Kim, Kyung-Mo 대한소아소화기영양학회 2011 Pediatric gastroenterology, hepatology & nutrition Vol.14 No.1

목 적: Helicobacter pylori (H. pylori) 제균 치료의 적절한 항균제 선택의 기반이 되기 위해 소아에서 H. pylori 항균제 내성률을 알아보고자 하였다. 방 법: 2003년 7월부터 2009년 4월까지 상복부 통증으로 본원을 방문한 환자 중 위 문부 생검 조직 배양에서 H. pylori 가 동정된 균주를 대상으로 항균제 감수성 검사를 시행하였다. 감수성 검사는 clarithromycin과 amoxicillin은 디스크 확산법으로, tetracycline과 metronidazole은 E-test를 시행하였다. 치료 원칙은 감수성 결과가 확인 된 환자는 감수성 결과에 따라 항균제를 선택 하였고, BAM (bismuth subsalicylate, amoxicillin, metronidazole) 또는 OAC (omeprazole, amoxicillin, clarithromycin)를 바탕으로 한 경험적 삼제요법을 택하였다. 치료 실패 시에는 bismuth (또는 bismuth subsalicylate)를 포함한 사제요법을 선택하였다. 결 과: 33명의 환자가 배양검사 양성을 보였고 28명의 환자에서 감수성 검사를 시행하였다. 이 중 항균제 내성을 보인 환아는 9명(32.1%)으로 그 중 7명(25%)이 clarithromycin 내성 균주를 보였고 5명(17.8%)이 metronidazole 내성 균주를 보였다. 대상이 적어 통계적인 분석을 하지 못하였으나 Clarithromycin과 metronidazole의 내성률이 시기적으로 감소하는 추세를 보였다. 결 론: 본 연구는 단일 병원에서 소수의 환아를 대상으로 이루어진 연구로 한계가 있으나, 간접적으로 국내소아 환아에서 분리된 H. pylori의 균주에서도 높은 항균제 내성과 시기적으로 내성률이 변하는 것을 알 수있었다. 따라서 소아 환자에서 적절한 항균제 선택을 제시하기 위한 보다 광범위한 연구가 필요한 것으로 생각한다. Purpose: The antimicrobial resistance of Helicobacter pylori is one of the critical factors in failure of eradication therapy. The purpose of this study was to evaluate antimicrobial resistance of H. pylori in Korean children. Methods: Gastric mucosal specimens for H. pylori were obtained from children with dyspepsia who were cared for at Asan Medical Center Children's Hospital in Seoul, Korea between 2003 and 2009. Antimicrobial resistance tests were performed using the disk diffusion method for clarithromycin and amoxicillin and the E-test for metronidazole and tetracycline. Most children with H. pylori infections were treated using triple therapies. Results: Thirty-three children had positive H. pylori cultures, although a resistance test was only performed in 28 patients. Resistant strains were found in 9 children (32.1%). The resistance rates to clarithromycin and metronidazole were 25% and 17.8%, respectively. There was no resistance to amoxicillin or tetracycline. The resistance rates decreased from 44.4% (2003~2006) to 26.3% (2006~2009) during the study period. Conclusion: Korean children demonstrated relatively high antimicrobial resistance to H. pylori in this study. However, there was a temporarily decreasing trend during the study period. A larger multi-regional study may be needed to determine the optimal antimicrobial treatment for pediatric patients infected with H. pylori.

GPS 서비스

김유미,Kim, Yu-Mi 한국통신학회 2003 정보와 통신 Vol.20 No.4

전라남도 나주시 동강면 일대 황토(풍화잔류토)의 토양학적 및 광물학적 특성 연구

김유미,배조리,김정빈,노열,Kim, Yumi,Bae, Jo-Ri,Kim, Cheong-Bin,Roh, Yul 대한자원환경지질학회 2014 자원환경지질 Vol.47 No.2

본 연구는 전라남도 나주지역 황토의 토양학적 및 광물학적 특성을 확인하고 주변 모암과의 상관관계를 통해 그 기원 및 형성과정을 알아보고자 하였다. 연구지역은 전라남도 나주시 동강면 장동리이며, 토양단면(약 150 cm 깊이)의 황토를 깊이별로 상부, 중부, 하부층으로 나누어 토양학적 특성(색, pH, 입도분리)과 광물학적 특성(광물조성, 입자의 크기, 모양, 화학조성)을 연구하였다. 모암시료는 박편제작 및 현미경관찰을 통해 구성광물을 기재하고 황토의 구성광물과 연관성을 알아보았다. 연구 결과 황토는 pH 4.3~5.1 범위를 갖는 산성토이며 미사와 점토가 주로 구성된(약 95%) 미사질양토와 미사질식양토였다. 모래와 미사의 주 구성광물은 석영, 운모, 장석이며 점토는 침철석, 수산화층간 버미큘라이트, 일라이트, 카올리나이트, 할로이사이트, 질석과 소량의 석영이 포함되어 있었다. 모래와 미사의 SEM-EDX 분석을 통해 구성광물의 형태를 확인한 결과, 풍화작용으로 인해 부식되어 표면이 거칠고 산화철로 피복되어 있는 장석이 관찰되었고 하부층으로 갈수록 그 양은 증가했다. 점토는 TEM 분석을 통해 다양한 형태의 층상규산염광물이 확인되었으며, 상부에서 하부층으로 갈수록 침철석의 양이 증가했는데 이는 상부 층에서 용탈된 산화철이 하부층으로 이동되어 집적된 것으로 사료된다. 황토의 모암으로 사료되는 주변의 암석은 석영, 사장석, 흑운모, 녹니석 등으로 이루어진 화강반암이었다. 즉, 화강암류의 모암에서 장석과 운모 등이 풍화작용을 받아 일라이트, 질석, 수산화층간버미큘라이트 및 카올리나이트로 변하였으며 침철석은 흑운모 풍화에 의해 형성된 것으로서, 본 연구지역의 황토는 오랜 기간 풍화작용에 의해 형성된 풍화잔류토로 판단된다. The objectives of this study were to characterize the physicochemical properties and mineralogy of Hwangto (yellow residual soils) from the southwestern part of Korea and to understand the soil-forming processes of the residual soils from their parent rocks. Both the yellowish residual soils as well as the unweathered and weathered parent rocks were obtained from Jangdong-ri, Donggang-myun, Naju, Jeollanam-do, Korea. The soil samples were examined to analyze the said soil's physicochemical properties such as color, pH, and particle size distribution. A scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM) and X-ray diffraction (XRD) analysis were performed in order to understand the mineralogy, chemical composition, and morphology of the soils. Two thin sections of a parent rock were analyzed to study its mineral composition. A particle size analysis of the soils indicates that the residual soil consists of mainly silt and clay (approximately 95%) and that soil textures are silty clay or silt clay loam. The soil colors of the residual soil are dark brown (7.5YR 3/4) through yellowish red (5YR 4/6). The pH of the residual soil ranges from 4.3 to 5.1. The major minerals of the parent rocks were quartz, biotite, chlorite, and plagioclase. The mineralogy of the sand fraction of the residual soil was quartz, biotite, muscovite and sanidine. The mineralogy of the silt fraction of the residual soil was quartz, biotite, muscovite, Na-feldspar, K-feldspar, and sanidine. The clay mineralogy of the soil was goethite, kaolinite, ilite, hydroxy-interlayed vermiculite(HIV), vermiculite, mica, K-feldspar and quartz. The mineral composition of the residual soil and the parent rock indicates that feldspar and mica in the parent rock weathered into illite, vermiculite and hydroxy-interlayed vermiculite(HIV), and finally changed into kaolinite and halloysite in the yellowish residual soils.

고셔병 환자에서 효소대체치료의 장기적 효과와 한계

김유미,Kim, Yoo-Mi 대한유전성대사질환학회 2014 대한유전성대사질환학회지 Vol.14 No.1

Gaucher disease is a multisystemic disorder arising from a deficient activity of the lysosomal enzyme glucocerebrosidase, which leads to accumulation of glycosylceraide and other glycolipids in the regiculoendothelial system. The characteristics of Gaucher disease are anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. Enzyme replacement therapy (ERT) has been proven to prevent progressive manifestations of Gaucher disease and effective in improving anemia, thrombocytopenia, bone markers and biomarkers. However, some patient needs still remain unmet because of the inaccessibility of certain sites including brain, bone and various organs. ERT could not Improve the irreversible lesion such as liver fibrosis, hepatopulmonary syndrome, and necrosis or infarction of bone and other organs. Adult patients with Gaucher disease should be screened for longterm complication such as bone disease, pulmonary hypertension, gallstone, and cancer, especially in patients with splenectomy. Parkinsonism and polyneuropathy was also reported among patients with type 1 Gaucher disease, but ERT does not improve neurological function. We need to review the benefits and unmet needs of ERT in Gaucher disease.

당뇨병환자에서 수술 시 왜 혈당조절이 필요할까?

김유미,Kim, Yu-Mi 사단법인 한국당뇨협회 2005 당뇨 Vol.186 No.-

전파 분석 알고리즘 및 전파 간섭 분석 기준 연구를 통한 전파 관리 시스템 기능 강화 방안 도출

김유미,이일근,배석희,Kim, Yu-Mi,Rhee, Ill-Keun,Bae, Suk-Hee 한국전기전자학회 2003 전기전자학회논문지 Vol.7 No.2

본 연구에서는 전파관리시스템(RFMS)의 효율적 운용을 위하여 전파전파 분석 기능 개선 방안을 도출하였다. 즉, ITU-R에서 권고하는 파라미터별 전파전파 알고리즘, 간섭분석 알고리즘 및 공유기준들에 대한 체계적인 분석을 수행한 후, 사용자가 원하는 환경 및 조건에 적합한 전파간섭 분석 알고리즘과 보호기준을 자동으로 선택해 낼 수 있는 모델 선정 기준안을 도출하였다. 이 결과를 이용하여 RFMS에서 최적의 전파 간섭 분석 알고리즘을 자동 선택하여 효율적으로 분석을 수행하도록 해주는 프로그램 및 그 활용 예를 제시하였다. This paper proposed an improvement scheme for effective usage of radio-frequency management system(RFMS), which has been operated to facilitate national spectrum management and monitoring in Korea. Based on the wave propagation models, interference analysis algorithms, and sharing criteria recommended by ITU-R, we derived criteria for the automated selection of the channel interference analysis algorithms and sharing conditions adequate to the environment to be analysed. Then using the obtained criteria, computer and program has been made and shown to select the most appropriate propagation models, interference analysis algorithms, and sharing criteria from the ones provided in RFMS, with the illustrative example.

뇌성마비로 인한 양측성 첨내반족 변형의 수술적 치료 후 발생한 종외반족 변형의 치료(1예 보고)

김유미,이우천,정웅서,Kim, Yu-Mi,Lee, Woo-Chun,Chung, Ung-Seo 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.2

Calcaneal or calcaneovalgus deformity can occur after surgical treatment of equinus or eguinovarus deformity in cerebral palsy patient. It is a serious complication and the results of many conservative and operative treatments are reported unsatisfactory. We experienced one case of both calcaneovalgus deformity following operative treatment of diplegic equinovarus deformity in a spastic cerebral palsy patient and report about the result of the treatment.

간호대학생의 전공만족도, 진로결정 자기효능감과 진로성숙도에 관한 상관성 연구

김유미,강수찬,권기남,서유진,성승훈,손정림,손현아,신유라,김은희,Kim, You-Mi,Kang, Su-Chan,Kwon, Ki-Nam,Seo, Yoo-Jin,Sung, Seong-Hun,Son, Jeong-Lim,Son, Hyeon-Ah,Shin, Yu-Ra,Kim, Eun-Hee 한국임상보건과학회 2018 한국임상보건과학회지 Vol.6 No.1

Purpose: This study intends to understand the correlation between career satisfaction and career decision self - efficacy and career maturity of nursing students, and to examine whether career satisfaction and career decision-making self-efficacy affect career maturity. Methods: The data analyzed using IBM SPSS Statistics 20 were collected from April 1, 2016 to April 15, 2014 in 184 students at the four-year college of Nursing in J city. Results: The results of the analysis of the correlation between major satisfaction, career decision self-efficacy and career maturity of nursing college students indicate that there was a positive correlation with career maturity (r=.428, p<.001), career decision self-efficacy (R=.442, p<.001) and majors' satisfaction (r=.605, p<.001) either. likewise, career maturity and career maturity were positively correlated with career maturity and career satisfaction. Conclusions: Therefore, it is possible to enhance and improve adaptation to major through conversations in conjunction with counseling and career guidance from the entrance, and maintaining intimate and solid relationship between the students and professors, also, the students and senior of whom, leading to intensify positive implication to future career.

성인기에 진단된 당원병 제 Ia형의 다양한 임상 양상

김유미,전종근,김구환,유한욱,Kim, Yoo-Mi,Cheon, Chong Kun,Kim, Gu-Hwan,Yoo, Han-Wook 대한유전성대사질환학회 2015 대한유전성대사질환학회지 Vol.15 No.1

당원병 Ia형은 glucose-6-phosphatase 효소의 결핍으로 인해 발생되는 상염색체열성 질환으로 특징적인 임상양상으로 대부분 영아기에 진단되나 증상의 경중에 따라 진단 연령이 늦어지기도 한다. 또한 환자 진단 시 유전 양식을 고려한 올바른 유전 상담과 더불어 형제, 자매에 대한 스크리닝이 중요하겠다. 본 연구는 성인기에 진단된 GSD Ia 자매에서의 임상양상의 차이를 기술하고 성인기 합병증에 대한 문헌을 고찰하여, 특히 간질환, 신부전 또는 대사성 질환으로 진료 받는 성인 환자들에서 당원병에 대한 감별과 당원병 진단 시 합병증에 대한 검사와 관리에 대해 필요성을 보고하는 바이다. 저혈당, 고지혈증, 고요산증, 젖산혈증, 대사성 산증, 기관 내 당원 축척에 대한 적절한 검사 및 약물 요법을 통해 급성 및 만성 합병증 예방과 적절한 치료를 위해 의료진의 체계적인 접근 및 노력이 필요하겠다. Glycogen storage disease (GSD) type Ia is rare inborn metabolic disorder, caused by glucose-6-phosphatase deficiency. It characterized by hepatomegaly, hypoglycemia, lactic acidosis, hypertriglyceridemia, and hyperuricemia and it is usually manifested in the infantile period. In addition, it is also associated with growth failure, pubertal delay, anemia, platelet dysfunction, osteopenia, and pulmonary hypertension. Hepatocellular adenoma and renal dysfunction are frequent late complications. Delayed diagnosis and inappropriate therapy lead to many complications such as growth failure, osteoporosis, refractory gout, renal failure, hepatocellular carcinoma (HCC), and pulmonary hypertension. Here, two Korean sisters diagnosed with GSD Ia, aged 33 and 36 respectively, were described and compared to recent articles about four adults with late diagnosis of GSD Ia. One sister had typical manifestations of GSD Ia including short stature (height, 145 cm), multiple hepatic adenoma, chronic kidney disease stage IV, and severe osteoporosis, whereas the older sister had normal stature (162 cm), one tiny hepatic nodule, and normal renal function. Direct sequencing of G6PC in two sisters identified a homozygous splicing mutation, c.645G>T, which is a prevalent mutation in Korea. Interestingly, our cases and four adults from recent reports had asymptomatic mild hypoglycemia and various manifestations including renal failure, HCC, fatty liver, or uncontrolled hyperlipidemia. These adult cases represent not only heterogenous phenotype to genotype within family members with GSD Ia but also long-term complications such as gouty arthritis, renal failure, and osteoporosis in untreated adult GSD Ia patients. In addition, lactic academia and hypertriglyceridemia are good markers of GSD Ia to distinguish from metabolic disease.

한국에서 시판되는 가정간편식 제품의 당류 함량 평가

김유미,최미경,Kim, Yu-Mi,Choi, Mi-Kyeong 대한영양사협회 2020 대한영양사협회 학술지 Vol.26 No.2

The purpose of this study was to assess the sugars contents of home meal replacement (HMR) products currently sold in Korea. This study surveyed and examined the sugars contents in 835 popular HMRs (294 ready-to-eat foods; RTE, 499 ready-to-cook foods; RTC, 42 fresh-cut vegetables; FCV) through the nutrition labels. The average price, weight and energy content of 835 HMR products were 3,917.5 Korean won, 336.0 g, and 522.7 kcal, respectively. The sugars content per product was significantly higher in the RTCs (13.4 g) and RTEs (10.3 g) than that in the FCVs (4.2 g) (P<0.001), and the percentage of energy from sugars was 9.7% for the RTEs, 10.2% for the RTCs, and 8.7% for the FCVs without any significant difference. The sugars contents of 9 RTE types were in the order of side dishes (34.3 g), sunsik (22.5 g) and hamburgers (12.1 g) per package. The percentage of energy from sugars was highest in side dishes (28.1%), followed by kimchi (24.9%), sunsik (17.2%), and hamburgers (10.6%). Among 14 RTC types, the sugars contents were in the order of hot dogs (52.9 g), tteokbokki (30.4 g) and noodles (21.2 g) per package. The percentage of energy from sugars was the highest at 22.9% for sauces, followed by side dishes (17.3%), porridges (14.4%), instant stews (14.3%), and hot dogs (13.1%). Strategies and practices are needed to reduce the sugars contents of HMR producers and the sugars intakes of HMR consumers.