동일한 환자에서 조혈모세포이식 전후의 호중구감소 기간 중 감염양상에 대한 비교연구 : 중심정맥관 관련 패혈증을 중심으로 Based on Central Venous Catheter Related Septicemia

류재호,노규태,이영석,이영호,권혁찬,김재석,김효진,이영민,박혜원,박근희 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

연구배경: 동일한 환자를 대상으로 조혈모세포이식 전 일반 병실에서의 관해유도 항암제치료 및 강화요법으로 인한 호중구감소 기간의 감염양상과 고용량 항암제치료 후 무균실에서의 조혈모세포이식 시 호중구감소 기간의 감염양상을 중심정맥관 관련 패혈증을 중심으로 비교 연구함으로써 효율적인 감염관리지침을 마련하고자 하였다. 대상 및 방법: 1999년 1월부터 2001년 7월까지 2년 7개월간 동아대학교병원 일반병실에서 악성혈액질환으로 항암제 치료를 받다가 조혈모세포이식을 시행받았던 22명을 대상으로 중심정맥관 관련 패혈증의 형태를 비교분석하였다. 결과: 대상 환자들의 일반병실과 무균실에서의 입원기간은 각각 32±13일, 33±19일, 호중구 감소기간은 15±12일, 17±18일, 호중구 감소기간의 발열 횟수는 14회, 14회로서 입원병실의 종류에 따른 차이는 없었다. 환자들의 중심정맥관 사용일수는 일반병실에서 29일(7~545일), 무균실에서 100.5일(25~606일)이었으며, 총 사용일수는 각각 1,515일, 3,250일로서 무균실에서의 중심정맥관 사용일수가 의미 있게 길었다(P=0.001). 중심정맥관 사용 일수에 대한 감염률은 각각 5.28/1,000일, 3.08/1,000일로서 일반병실에서 그 빈도가 높았으나 통계적 유의성은 보이지 않았다(P=0.141). 결론: 중심정맥관 삽입 후 일반병실에서 항암제 치료를 받던 환자가 조혈모세포이식을 위하여 무균실에 입원하는 경우, 중심정맥관을 교체하는 것이 감염관리를 위하여 바람직할 것으로 생각된다. Background: We compared the incidence of central venous catheter (CVC) related septicemia during neutropenic period in the same patient, which developed following chemotherapy for remission induction and consolidation, or hematopoietic stem cell transplantation (HSCT). Methods: We retrospectively reviewed the medical records and laboratory data of 22 patients with hematologic malignancies who received anticancer chemotherapy followed by HSCT at Dong-A University Hospital between January, 1999 and July, 2001. We investigated the duration of hospitalization, duration of neutropenic period, duration of catheterization, microbiologically documented organisms and incidence of CVC related septicemia. Results: The data in general ward (before HSCT) and laminar air flow room (after HSCT) were as follows: duration of hospitalization was 32±13 days and 33±19 days, duration of neutropenic period was 15±12 days and 17±18 days, median duration of catheterization was 29 days (7~545 days) and 100.5 days (25~606 days) (P=0.001), and incidence of CVC related septicemia was 5.28/1000 days and 3.08/1000 days, respectively. In the CVC related septicemia, the most common etiologic organism was coagulase negative staphylococcus. Conclusion: We suggest that the exchange of CVC before admission to laminar air flow room could decrease the incidence of CVC related septicemia in HSCT recipients.

임부의 연령에 따른 보완대체요법에 관한 인식 태도 경험 비교 연구

김연진,김지연,노경민,신혜리,유예지,이지민,장희조,정아인,최소정,강숙정,이향연,민혜영 이화여자대학교 간호과학대학 2016 이화간호학회지 Vol.- No.50

Purpose: This study aims to test if the age of pregnant women affects the perception, experience, and attitude towards complementary alternative therapy (CAT), by investigating the perception, experience, and attitude of pregnant women under the age of 35, and above 35 (Advanced Maternal Age). The study will 1) find the general characteristics of pregnant women under and over the age of 35 2) compare the perception, behavior, and experience of pregnant women under and over the age of 35, and 3) find the comparison of the perception, behavior, and experience according to the general characteristics of pregnant women under and over the age of 35. Method: The subjects of this study are composed of 44 women under the age of 35 and 44 women above the age of 35, totaling 88 pregnant women visiting midwiferies, obstetrics and gynecology, and baby fairs in Seoul and Gyeong-Gi area. Data for this study was collected from November 28, 2015 to January 6, 2016 for 40 days. The collected data analyzed mean, standard deviation, t test, ANOVA, and chi-square by using SPSS 23.0. Result Results show that there is a significant difference in the perception, attitude, and experience of the two-sample groups in the use of CAT. The question of “what is most necessary when applying CAT in a hospital clinical environment” for the perception criteria came out with the results of t=9.980, p<.05. For the attitude, results showed that the answers of pregnant women under the age of 35 displayed a more positive attitude towards CAT. (t=2.421, p<.05) Lastly, in the experience section, pregnant women under the age of 35 showed more CAT use than the other sample group. Conclusion Results have shown that there is a difference in the perception, behavior, and experience between the two sample groups. Therefore further research on the efficacy and the adverse effects of CAT needs to be done.

당의 종류 및 첨가량을 달리한 깨다식의 품질특성

김진숙,한영실,유선미,김행란,전혜경 한국조리과학회 2003 한국식품조리과학회지 Vol.19 No.3

깨다식의 감미 및 물성 등의 개선을 위해 꿀보다 높은 점도와 hardness를 가지는 쌀엿과 조청 등을 첨가 혼합하여 품질을 조사한 결과를 요약하면 다음과 같다. 깨다식의 적정 재료 배합비는 깨가루 100 기준시, 꿀과 쌀엿의 동량 혼합액 50%(w/w)였으며, 이를 기준으로 제조한 깨다식의 이화학적 특성은 당도 17.44 brix˚, tnqns 12.16, 환원당 15.44, 단백질 12.88, 지방 32.02, 조회분 2.82 %이었고, 기계적 특성 중 TPA의 chewiness는 0.28~0.30, hardness는 27.22~27.44 g/㎠이고, 색도의 L값은 41.67, a값 4.58, 그리고 b값은 16.99였다. This study was carried out to investigate the effects of the addition of sweeteners to Sesame Dasiks. Sesame Dasiks were prepared by adding various sweeteners to sesame seeds powder, at 40, 50, 60 and 70%, and their quality characteristics were measured. In the chewiness and hardness analyses of Sesame Dasiks, the 50% group (the same ratio and mixture of honey and lire jelIy) gave the highest results. For the sweetness, taste and overall acceptability of the Sesame Dasiks, the 50% group was also the better The texture profile analyses found the optimal chewiness and hardness of the Sesame Dasik to be 0.28 ~ 0.30 and 27.22 ~ 27.44, respectively.

감마선 조사 육류, 가금류에서 저장전과 후의 조사선량에 따른 DNA fragmentation의 변화

이혜진,김상미,박유경,양재승,강명희 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.2

The changes in DNA damage were investigated during storage after irradiation. Beef, pork and chicken were irradiated at 1.0, 3.0 and 5.0 kGy and stored for 6 months at 20℃. The comet assay was applied to the sample muscles at the beginning of irradiation and at the end of storage. Muscles were isolated, sliced, and the suspended cells were embedded in an agarose layer. After lysis of the cells, they were electrophoresed for 2 min. and then stained. DNA fragmentation in tissues caused by irradiition was quantified as tail length and taii moment (tail length x % DNA in tail) by comet image analyzing system. Right after irradiation, the differences in tail length between unirradiated and irradiated muscles were significant(p<0.05) in beef, pork and chicken. With increasing the irradiation doses, statistically significant longer extension of the DNA from the nucleus toward anode was observed. Similarly even 6 months after irradiation, all the irradiated muscles significantly showed longer taii length than the unirradiated controls. The results represented as tail moment showed similar tendency to those of tail length, but the latter parameter was more sensitive than the former. These results indicate that the comet assay could be one of the simple methods of detecting irradiated muscles. Moreover, this method suggest that using comet assay, we were able to detect DNA damage differences even after 6 months after irradiation.

홍삼류의 섭취가 비만과 혈중 지질의 상호관계에 미치는 영향

박화진,이정희,이소진,함혜선,조현정,임창률,유영빈,박기현 대한의생명과학회 2000 Journal of biomedical laboratory sciences Vol.6 No.4

비만은 동맥경화의 위험인자로서 혈중에 triglyceride의 농도를 종가시키고, 상대적으로 HDL-Cholesterol의 농도를 감소시킴과 동시에 수축기 혈압을 상승시킨다. 본 연구에서 홍삼제품류를 4년 또는 5년 동안 복용해 온 건강한 사람 (ginseng군)과 홍삼제품을 복용하지 않은 건강한 사람 (control군)을 대상으로 하여 신체 계측치로부터 비만지수를 구하고 이것과 혈중의 triglyceride (TG)농도, TG/HDL-Cholesterol ratio 및 수축기 혈압과의 상호관계를 연구한 바, ginseng군에서는 대조군에 비해 혈중의 TG 농도가 일정하게 유지되었고, TG/HDL-Cholesterol ratio 및 수축기 혈압도 일정하게 유지되었다. 이러한 현상은 ginseng군에서 기호품으로 alcohol을 섭취하거나, 흡연을 한 경우에도 상관없이 일정하게 유지 되었다. 이 결과는 홍삼제품류를 장기 복용하면 비만의 저하 및 고혈압 또는 동맥경화의 위험인자가 억제될 수 있고, 결론적으로 비만, 고혈압 및 동맥경화를 예방할 수 있을 것으로 추정한다. Obesity is the risk fcactor of atherosclerosis and not only increases triglyceride concentration in blood but also decreases relatively the ratio of TG to HDL-Cholesterol in blood. In case of obesity, systolic blood pressure is also increased in responding the increase of TG in blood. Index of obesity in red ginseng-taking group (ginseng group) was lower as compared with non-red ginseng-taking group (control group). The TG concentration, the ratio of triglyceride to HDL-cholesterol in blood and systolic blood pressure were decreased in the subjects of ginseng group compared with that in control group. It is inferred that long-term intake of ginseng products may help to prevent the risk of atherosclerosis and obesity.

대퇴부 슬관절 테이핑 적용이 등속성 근력 및 근지구력의 변화에 미치는 영향

김유섭,이혜진 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.1

Isokinetic muscle strength and endurance of 10 male athletes randomly sampled out of the undergraduates of W University were measured by using BiodexⅢ, an isokinetic measuring instrument, for the two periods, one with taping and another with no taping applied. From the outcomes of the measurement, following conclusion could be drawn: First, there was a significant difference(p<.05) in isokinetic muscle strength measured at the angular speed of 120°/sec as follows: 82.75±17.43Nm when taping was not employed at the extension muscle strength of peak torque; and 93.41±17.55Nm when taping was employed. Second, there was also a significant difference(p<.05) in isokinetic muscle strength at the angular speed of 60°/sec as follows: 154.53±49.47Jeuls when taping was not attached at the flexion muscle strength of total work; and 132.41±38.88Jeuls when taping was attached. Third, a significant difference(p<.05) was revealed in isokinetic muscle strength at the angular speed of 60°/sec as follows: 175.93±48.24watt when taping was not applied at the flexion muscle strength of average power; and 192.16±48.91watt when taping was applied. Fourth, a significant difference(p<.05) was also found in isokinetic endurance at the angular speed of 180°/sec as follows: 251.50±53.01watt when taping was not used at the flexion muscle strength of average power; and 264.75±50.04watt when taping was used. From the above findings, it becomes evident that taping bonded around femoral knee joints can be seen as an effective aid to improve muscle strength and endurance of athletes by instantly coping with their worries about repeated injuries and decreasing physical strength during the lengthy span of games.

토양환경지도 자료를 이용한 콩밭 토양의 화학성 비교

박지숙,이민진,정재원,김미혜,이서연,지윤미,한준호,김유학,공명석,한광현,노희명 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

It is important to interpret the soil chemical properties in order to effectively manage the farmland. This study was conducted to investigate the soil chemical properties of upland soybean field according to the soil series at 32 upland fields located in the parts of Gangwon-do. Soil sampling sites were selected by using the National Statistics DB and KSIS DB that is a soil environment information system provided by the Rural Development Administration. Soil samples were collected from 0~15 cm of top soil before seeding or transplanting, air-dried, passed through a 2 mm sieve, and analyzed for soil pH, EC, organic matter, available phosphorus (P2O5), exchangeable potassium, exchangeable calcium and exchangeable magnesium. The average chemical properties have exceeded the each nutrient optimum range level of RDA, except the organic matter in experimental soil 2015. And despite application of conventional fertilization, each soil series nutrient contents were change respectively. The results of this study suggest that conventional fertilization should be applied based on the analysis about the amount of accumulated nutrient contents in the soil.

위선암에서 p53 단백의 과발현과 임상 및 병리학적 예후인자와의 상관관계

서병조,유항종,이주호,주미,이혜경,김진복 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2

Objective: Mutations in the p53 gene, one of the most common genetic alterations in human cancer, are implicated in tumorigenesis and tumor progression. Wild-type p53 negatively regulates the cell cycle; a loss of function by mutation might be expected to result in enhanced proliferating activity and tumor progression. A large number of immunohistochemical studies have confirmed p53 accumulation to be a very common feature of human malignancy. The aim of the present study was to determine whether p53 status in gastric cancer is correlated statistically with various histopathological indicators or not. Methods and Materials: A total of 197 surgically resected gastric adenocarcinomas were examined to determine whether a correlation exited between immunohistochemical expressions of the p53 protein and other histopathological factors. Results: p53 overexpression was observed in 46.2% of the gastric cancers. Overexpression of p53 was correlated with vascular invasion of gastric cancer(p=0.004). In early gastric cancer, the p53 overexpression rate was 42.3%, and of them, a correlation was found between the intestinal type of the Lauren classifcation(p=0.013) and histologically differentiated gastric cancer(p=0.014). Conclusion: p53 overexpression was significantly correlated with vascular invasion of gastric cancer. In cases of early gastric cancer, p53 overexpression was correlated with Lauren classification and differentiation. These results suggest that p53 mutation plays an important role in carcinogenesis in gastric adenocarcinomas. Further study in needed to determine the correlation between p53 overexpression and the prognosis for the gastric cancer patient.

시험관내 심내막염 모델에서 Methicillin 내성 포도구균에 대한 Vancomycin, Arbekacin, Gentamicin 단독 혹은 병합효과

이동건,전혜선,임동석,최수미,최정현,유진홍,신완식,강문원 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

목적 : Methicillin 내성 포도구균(methicillin resistant Staphylococcus aureus, MRSA)은 병원감염의 중요한 원인균으로 vancomycin이 선택약제이다. 그러나 심내막염 등의 중증감염에서는 vancomycin의 치료실패와 함께 최근 내성균도 증가하고 있어 vancomycin을 대체할 수 있는 항균제와 보다 효과적인 항균요법의 개발이 필요하다. 본 연구에서는 사람의 환경과 유사한 시험관내 감염 모델을 적용하여 MRSA 치료를 위한 vancomycin, arbekacin, gentamicin의 단독 및 병합효과를 비교하였다. 방법 : 임상에서 분리된 MRSA 2균주(GRI 53, gentamicin 내성 : GS171, gentamicin 감수성)로 fibrin clot을 제작하여 시험관내 심내막염 모델을 만들어 vancomycin, arbekacin, gentamicin을 단독 혹은 병합주입하였다. 반감기와 최고 및 최저농도는 사람의 약동학을 기준으로 하였다. Vancomycin은 6, 12, 24시간마다 주입하거나 24시간 연속주입하였고 arbekacin은 12, 24시간마다, gentamicin은 8, 24시간마다 주입하였다. 병합주입의 경우 vancomycin은 12시간마다, gentamicin, arbekacin은 24시간마다 투여하였다. 각 투여군의 살균효과는 0, 8, 24, 32, 48, 72시간째의 fibrin clot내 집락수로 측정하였다. 결과 : GRI153에 gentamicin을 주입한 군 이외의 모든 실험군에서 대조군에 비해 의미있게 fibrin clot내 집락수가 감소하였다(P<0.001). Vancomycin과 arbekacin 단독주입군내서 8시간째의 집락수는 GRI153보다 GS171에서 의미있게 낮았고(P=0.02), GS171에 arbekacin 12시간마다 투여한 군의 집락수가 가장 낮았다(P=0.01). 72시간째 집락수는 균주의 종류나 vancomycin 혹은 arbekacin의 투여간격에 따른 차이가 없었다. GRI153에서 vancomycin과 arbekacin의 병합주입군은 24시간까지 상가작용이 있었으나 vancomycin과 gentamicin 병합주입에서는 무관작용이었고 GS171에서도 72시간 동안 무관작용을 보였다. 또한 전 실험기간 동안 내성균은 발현되지 않았다. 결론 : 시험관내 심내막염 모델에서 MRSA에 대한 arbekacin의 항균력은 vancomycin과 유사하여 단독주입이 가능함을 시사한다. Gentamicin 내성균주의 경우 두가지 항균제의 병합주입으로 24시간까지 상가작용을 보이고 있으나 임상에 적용하기 위해서는 추가연구가 필요할 것으로 생각된다. Background : Glycopeptide has been used for the one-and-only treatment of choice in methicillin resistant Staphylococcus aureus (MRSA) infection, but its exclusive use for the MRSA infection has led to the increased risk of glycopeptide-resistance. To find an alternative (s), we employed an in vitro infective endocarditis model (IVIEM) to compare the efficacy of vancomycin (VCM). arbekacin (ABK), and gentamicin (GM) alone or in combination. Methods : Using two strains of clinically isolated MRSA, one GM susceptible (GS171) and the other GM resistant (GR153), fibrin clots were prepared and suspended in IVIEM. Antibiotics were added as a bolus to simulate human pharmacokinetics of regimens, including q 6 h, q 12 h, q 24 h, or continuous infusion with VCM, q 12h or q 24 h with ABK, and q 8 h or q 24 h with GM. In cases of combination, regimens were VCM q 12 h plus ABK q 24 h, and VCM q 12 h plus GM q 24 h. Fibrin clots were removed from each model at 0, 8, 24, 32, 48. and 72 h, and the bacterial densities (in CFU/g) were determined. Results : At 8 hour, the colony counts of GS171 were lower than those of GR153 (P=0.02), and the lowest with the ABK q12h against GS171 (P=0.01). At 72 hour, monotherapy with ABK or VCM produced same degree of bacterial reductions in IVIEM, regardless of dosing frequency or GM-resistance. In the case of GM-resistance, combination of VCM and ABK did show additive effect until 24 hours, although VCM and GM showed no indifference during all the experiments. Development of resistance during experiment was not observed with any regimens. Conclusions : Our data suggest that ABK monotherapy could be used as an alternative to VCM even in the treatment of GM-resistant staphylococcal endocarditis. Further studies will clinical trials are warranted to evaluate the additive effect of VCM and ABK.

2-구획 인공 모세혈관 모델을 이용한 Pseudomonas aeruginosa 임상균주에 대한 Panipenem의 효과

이동건,전혜선,최수미,최정현,유진홍,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적 : Panipenem은 일본에서 개발된 카바페넴계 항생제로 광범위한 항균력을 나타낸다고 보고되고 있지만 P. aeruginosa에 대해서는 아직 논란이 있다. 본 연구에서는 임상에서 분리된 P. aeruginosa 균주를 대상으로 사람의 약역학을 모의할 수 있는 시험관내 역동 모델을 이용하여 panipenem (PAPM)과 imipenem (IMPM)의 효과를 비교하고 Muller-Hinton broth (MHB)와 basic amino acid 함량이 적은 배지(Minimum Broth Davis, MBD)에 효과의 차이가 있는지 확인하고자 하였다. 재료 및 방법 : 혈액에서 분리된 P. aeruginosa SGP14 균주를 대상으로 하였다. 사람의 약동학을 모의할 수 있는 2-구획 인공 모세혈관 모델(two-compartment model)을 제작하였고, 세균이 peripheral compartment에서 반감기에 따라 농도가 변하고 있는 항생제에 노출되고, 접종한 세균의 수는 희석되지 않게 하였다. PAPM과 IMPM의 용량은 500mg씩 하루 2회를 모의하도록 하였고 2일간 실험하였다. Panipenem, imipenem의 반감기는 사람의 약역학과 같이 10시간에 맞추었다. 항생제 투여 간격은 panipenem, imipenem 모두 12시간으로 하였고 각 항생제의 최고 및 최저농도는 사람에 투여했을 때의 혈중농도에 맞추었다(panipenem 각각 45.6, 0 ug/mL, imipenem 각각 33.0, 0 ug/mL). 배지는 MHB와 MBD를 사용하였고 4군으로 나누어 실험하였다. [PAPM (MHB), PAPM (MBD), IMPM (MHB), IMPM (MBD)] peripheral compartment에서 0, 1, 2, 4, 6, 8, 12, 24, 32, 48시간에 맞춰 샘플을 하였고 집락수 (cfu/mL)를 측정하였다. 결과 : SGP14에 대한 PMPM, IMPM의 MIC는 각각 64, 2 ug/mL이었다. PAPM (MHB)는 2시간이 지나면서 다시 자라기 시작하여 32시간째부터는 항생제를 사용하지 않은 대조군과 같은 곡선을 보였다. 12시간까지의 집락수 변화는 4가지 실험군에서 군간 의미있는 차이를 보이지 않았지만(P=0073) 군내의 PAPM (MHB)가 PAPM(MBD), IMPM (MBD)와 비교하여 집락수 변화가 유의하게 작았다. 또한 48시간까지의 집락수 변화는 PAPM(MBD)이 가장 많았고, 그 다음이 IMPM (MHB), IMPM(MBD)였으며, PAPM(MHB) 순이었다(P=000). 48시간까지 집락수 변화는 IMPM (MHB)와 IMPM (MBD)사이에 차이가 없었다. 결론 : 사람의 혈청내 basic amino acid 농도와 PAPM의 농도를 모의하도록 한 2-구획 인공 모세혈관 모델에서 PAPM은 IMPM과 비교하여 P. aeruginosa에 대해 비슷하거나(12시간째) 더 나은 살균력을 보였다(48시간째). 추후 본 실험의 결과와 실제 임상에서의 P. aeruginosa에 대한 panipenem의 효과를 비교해보는 것이 필요하겠다. Background : Panipenem (PAPM) is a new carbapenem which has an enhanced broad spectrum activity against both gram-positive and negative organisms. However, its activities in vitro against Pseudomonas aeruginosa are still under controversy. The aim of this study was to compare the activity of PAPM with those of imipenem (IMPM) against clinical isolates of P. aeruginosa using in vitro kinetic model and to evaluate the differences according to the quantity of basic amino acid in media. Materials and methods : Using a clinical isolate of P. aeruginosa (SGP14) from blood, an in vitro 2-compartment artificial capillary model based on a dialyzer unit was prepared. Antibiotics were given as a bolus q12 hrs for 48 hrs. Simulated doses and frequencies of PAPM and IMPM were 500 mg q12 hrs as approved by Korea Food and Drug Administration. Muller-Hinton broth (MHB) and minimal broth Davis (MBD) were used as culture media and we divided the experiments into 4 groups [PAPM (MHB), PAPM (MBD), IMPM (MHB), IMPM (MBD)]. At 0, 1, 2, 4, 6, 8, 12, 24, 32, and 48 h, samples were removed from peripheral compartment and viable bacterial counts were measured. Results : The susceptibility of PAPM and IMPM for SGP14 were 64 and 2 ug/mL in MHB and 4 and 2 ug/mL in MBD, respectively. Up until 12 hours, changes in bacterial colony counts were not significantly different (P=0.073) for each group. However among the four groups, PAPM (MHB) showed the least changes compared with PMPM (MBD), IMPM (MBD). The largest decrement of colony during 48 hours was observed with PMPM (MBD), followed by IMPM (MHB) or IMPM (MBD), and PAPM (MHB) in decreasing order (P=0.00). There were no differences between IMPM (MHB) and IMPM (MBD) as for the change in colony counts. Conclusions : The bactericidal activities of panipenem against the clinical isolate of P. aeruginosa was similar (at 12 h) or superior (at 48 h) to that of imipenem in an in vitro 2-compartment artificial capillary model using minimal broth to simulate human serum drug concentrations.