전문경영자의 특성과 유형

윤윤수 한국경영사학회 2000 經營史學 Vol.24 No.-

고등학생 변비의 위험요인에 관한 연구

윤윤수(Yoon-Soo Yoon),이석구(Sok-Goo Lee),김정연(Jeong-Yeon Kim) 한국농촌의학 지역보건학회 2005 농촌의학·지역보건 Vol.30 No.1

Vibrio Cholerae Serogroup Non - O1에 의한 패혈증 3예

윤윤수,박효순,배현주,이학중 대한감염학회 1997 감염 Vol.29 No.2

간경변을 가진 2명의 남자환자와 고령의 여자환자의 혈액배양에서 V.cholerae non-O1을 분리하였으며, doxycycline을 투여하여 두명의 환자는 완쾌 되었으나, 다른 한명은 결국사망하였다. V.cholerae non-O1은 여러가지 경로를 통하여 감염될 수 있으나, 오염된 해산물의 섭취에 의한 감염이 가장 가능성이 높으므로 여름철 해산물의 생식에 대한 주의를 요한다. 또한 간경변환자들에서 여름철에 생긴 패혈증의 경우 V.vulnificus 뿐만아니라, V.cholerae non-O1 감염의 가능성을 고려하여야 할 것으로 생각된다. Non-O1 V. cholerae usually causes endemic disease. common clinical manifestations of this infection involve gastroenteritis, sepsis, and wound infection. In Korea, six cases of infection with this pathogen have been reported. From 1995 to 1996, non-O1 V. cholerae was isolated from blood of three patients of sepsis in this hospital. Two of them had liver cirrhosis as a underlying disease. One patient died of progressive sepsis, and another two patients recovered. The isolates were identified by API 20E(API system, BioMerieux, France) and their biochemical properties were characterized. The serotypes of two isolates were determined to be o2 and O24. These cases, with the previous reports, suggest that non-O1 V. cholera should be considered as a pathogen causing septicemic a in patients who have underlying disease of liver cirrhosis during summer.

충청지역에서 발병한 쯔쯔가무시병의 임상적 관찰

배현주,손소희,윤윤수,윤성철,이학중 단국대학교 의과대학 1995 檀國醫大學術誌 Vol.1 No.1

위에서 발생한 원발성 편평세포암 1예

송일한,최정,전용,윤윤수,임창영,김정원,노임환,김흥태,김태훈,명나혜,정민 대한내과학회 1997 대한내과학회지 Vol.53 No.3S

저자등은 상복부 동통 및 체중감소를 주로로 내원한 55세 남자 환자에서 췌장미부, 비장피막, 위주위지방조직 및 림프절의 일부를 침범한 원발성 위내 순수편평세포암 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Primary squamous cell carcinoma of the stomach is a extremely rare tumor, described in only about 80cases in the literature since 1905. It occurs mostly in males, affects a slightly younger group as compared to adenocarcinoma, and has a predilection for the proximal stomach, especially along the lessor curvature side. The pathogenesis of this neoplasm is controversial, but squamous metaplasia resulting from any injury to the gastric mucosa appears to have a role in the pathogenesis of this cancer. The prognosis of squamous cell carcinoma of the stomach is probably less favorable than that of adenocarcinoma due to its higher frequency of lymphovascular invasion. We report a case of primary squamous cell carcinoma of the stomach in a 55-year-old male with a review of the literature,

루푸스신염에서 인터루킨 - 6 의 발현

윤성철(Sung Chul Yun),윤윤수(Yun Soo Yun),빈기태(Khi Tai Bhin),신영태(Young Tai Shin) 대한내과학회 1996 대한내과학회지 Vol.51 No.5

N/A Objectives: Interleukin-6 (IL-6) is a pleiotrophic cytokines which is related to immune system activation, acute phase reactants, hematopoietic regulatory function, and cell growth as well as the first cytokine that may be directly related to pathogenesis of autoimmune disease, as systemic lupus erythematosus. The production site of IL-6 has been confined to T cell, B cell, macrophage, fibroblast, myeloma cell, myxoma cell, endothelial cell, especially mesangial cell and other glomerular cell in the kidney until now. However, recently uroepithelial cell stimulated by the bacteria and renal tublar cell damaged by immunologic injury were reported to be a another possible production site of IL-6. Therefore, Authors chose cases of lupus nephritis that was confirmed by renal biopsy. Methods: We observed the expression of IL-6 by using the immunohistochemical staining and tried to estimate the role of IL-6. The patients classified as class 4, 5 that had a strong proliferative change histologically were mainly selected as specimens for a research. The specimens were studied immunohistologically and its clinical data were compared in various ways. Results: 1) Positive IL-6 expression was observed in 16 cases (80%) of total 20 cases. IL-6 positive cases of glomerulus were accompanied with the strong IL-6 expression of renal tubules all the time. 2) The stronger IL-6 expression more than (+ +) was confirmed in 7 cases of 12 class 4 cases (87.5%). 3) The incidence of nephrotic syndrome and the case of decreased complement (C3, C4) were more prevalent in the group of positive IL-6 when compared to the group of negative IL-6. Conclusions: IL-6 has a strong association with renal tubular cells and play an important role in cellular proliferation of glomerulus as well as in disease activity of lupus nephritis.

Extended-spectrum β-lactamase (ESBL) 생성 Klebsiella pneumoniae에 대한 여러 항균제의 최소억제농도의 분포

이문숙,권영미,김정민,윤윤수,유선미,배현주 대한감염학회 1997 감염 Vol.29 No.2

목적:국내에서 분리된 ESBL 생성 K.pneumoniae 57균주를 대상으로 여러 항생제의 MIC 값을 측정하여 MIC의 분포를 파악하고 cefotaxime, ceftazidime 및 aztreonam의 내성 수준을 분석하여 ESBL 생성 균주를 검출하기에 가장 적절한 항생제 및 break point 값을 제시하며, ESBL 생성 균주의 Non-β-lactam 항생제에 대한 내성을 측정하여 다제 내성을 확인하고자 하였다. 방법:단국대학교병원, 서울대학교병원 및 연세대학교병원에서 분리된 ESBL 생성 K. pneumoniae 균주와 Non-ESBL 생성 균주 63주를 대상으로 평판해석법으로 여러 항균제의 최소억제농도를 측정하였고 double-disk synergy test로 ESBL생성 균주를 확인하였다. 결과:ESBL 생성 K.pneumoriae의 β-lactam항생제에 대한 MIC값은 다양한 정도의 내성 수준을 나타내었다(Table 1 참조). Cefotaxime, ceftazidime, aztreonam의 MIC 중등도(Intermediate) 감수성 판정의 값은 ESBL 생성 측정도에서 각각 80.7%, 86%, 68.4%의 민감도(sensitivity)를 보여 ceftazidime이 가장 민감하였고, 92.0%,100%,95.2의 정확도(specificity)를 보여 ceftazidime이 가장 정확하였다. 또한 ESBL 생성 K. pneumoniae 에서 gentamicin. amikacin, ciprofloxacin의 ??은 Non-ESBL 생성 균주에 비해 통계적으로 유의하게 높아 ESBL 생성 균주들은 다약제에 내성임을 시사하였다(p<0.001). 결론:국내 분리 ESBL 생성 K. pneumoniae의 여러 항생제에 대한 MIC 값의 분포를 관찰한 결과 ESBL 생성 균주는 β-lactam 항생제에 다양한 내성을 보였으며 aminoglycosied나 quinolone 등을 포함한 다약제에 내성을 보였다. ESBL 생성 균주를 검출 하는 데 있어 ceftazidime이 가장 높은 민감도와 정확도를 나타내어 가장 적절한 항생제 임을 알 수 있었다. Background: Extended-spectrum β-lactamases (ESBLs) confer resistance to extended-spectrum cephalosporin (e.g., cefotaxime, ceftazidime) and aztreonam. But the diversity of ESBLs results in various susceptibility profiles with different β-lactams. To study the relative in vitro activities of various β-lactams and non-β-lactam antibiotics against the clinical isolates of ESBL-producing K. pneumoniae, we determined the MIC(minimum inhibitory concentration) of various antimicrobials. Methods: Fifty-seven isolates of K. pneumoniae which procuced ESBL and 63 isolates which did not produce ESBL from 3 university hospitals in Korea were tested. The MIC values of antimicrobials were determined by agar dilution method and detection of ESBL production was performed by double disk synergy test. Results: The MIC values of β-lactams against K. pneumoniae which produced ESBLs exhibited heterogenous susceptability profiles. In differenciation of ESBL production, MIC value of 8㎍/mL(breakpoint of intermediate resistance) of ceftazidime was more sensitive and more specific than that of cefotaxime or aztreonam. ??values of gentamicin, amikacin and ciprofloxacin against K. pneumoniae which produced ESBL were significantly higher than those against Non-ESBL producing isolates(P<0.001), suggesting that ESBL producing isolates are multi-drug resistant. Conclusion: The level of resistance to various β-lactams of K. pneumoniae which produced ESBL was heterogenous. ESBL-producing K. pneumoniae showed higher resistance to aminoglycoside and quinolone antibiotics. Ceftazidime was the most appropriate antibiotic to differentiate ESBL production.

간외담관 담석증에서의 초음파내시경의 진단적 유용성

김정원,임창영,송일한,김정택,노임환,윤윤수 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.1

Backgroud/Aims: Ultrasonography is the easiest, fastest procedure for the diagnosis of choledocholithiasis, but the diagnostic failure are mostly because of the intrapancreatic level of this condition and the absence of bile duct dillatation. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy in the digestive gas interposition. The aim of this study was to prospectively compare the diagnostic accuracy of endoscopie ultrasonography with abdominal ultrasonography and endoscopic retrograde cholangiography in 66 patients with suspected choledocholithiasis. Methods: All of the patients had abdominal ultrasonography, endoscopic ultrasonography ~and endoscopie retrograde cholangiography within 72 hours and final diagnosis was determined by endoseopic retrograde cholangiography with sphincterotomy. Results: (l) Choledocholithiasis was confirmed in 45 patients: Thirteen patients had nondilated common bile ducts and 20 patients had stones with diamerer $lt; 1 cm. (2) Endoscopic ultrasonography was more sensitive(95.5%) than abdominal ultrasonography (44.4%: P$lt;0.0001) and similar to endoscopic retrograde cholangiography (97.8%). Specificity was same as 100% in 3 diagnostic tools. (3) Endoscopic ultrasonography was superior to abdommal ultrasonography for the diagnosis of choledocholithiasis with nondilated common bile duct(100% vs 15.3%, P$lt;0.0001) and with less than 1cm sized small stone(100% vs 10.0%, P$lt;0.0001). Endoscopic ultrasonography results did not depend on stone diameter or common bile duct dilatation. Conclusions: Endoscopic ultrasonography could be an accurate and safe diagnostic tool for the diagnosis of choledocholithiasis and could be promising especially in the cases with difficult cannulation of bile duct and gal1 stone pancreatitis.