아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

조기 천장골염의 자기공명영상 소견

김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),심승철 ( Seung Cheol Shim ),장대국 ( Dae Kook Chang ),고회관 ( Hee Kwan Koh ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),전의용 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.2

목적: 천장골염의 유무가 척추 관절염의 진단에 중요한데 단순 골반 검사에서 변화가 없는 환자를 대상으로 MRI를 이용하여 천장골염의 조기변화 소견 및 MRI방법에 따른 장점을 비교하고자 하였다. 대상 및 방법: 단순 골반 검사에서 천장골염 유무가 확실하게 구분되지 않은 혈청 음성 척추 관절염 환자 26명을 대상으로 MRI를 시행하고 염증의 주침범위치를 천측과 장측, 관절의 상하로 구분하고, MRI방법에 따른 변화를 비교하였다. 결과: 모든 예에서 조영 증강되는 판누스를 관찰할 수 있었고, Grade I 이하에서는 장골측과 관절하부, 인대성 관절보다 활막성 관절을 더 많이 침범하였다. Grade II 이상에서도 장골측과 관절 하부에 더 많았으나 인대성 관절을 Grade I이하에서보다 더 많이 침범하였다. 관절 주변 지방 침착역시 장골측과 관절 하부에 더 주로 침범하였고 Grade II 이상에서 약간 더 많았다. 관절 주변 골염은 Grade 0에서는 없었고, Grade I에서는 주로 장골측과 관절 하부에서 92%가 양성이었고, Grade II에서는 93%에서, Grade III에서는 64%에서 양성으로, 장골측을 주로 침범하였으나 관절 상하부의 구분은 없었다. 인대성 천장골 관절은 Grade I 이하에서 38%, II 이상에서는 94%에서 침범하였다. 관절 주변 골염과 지방 침착, 그리고 판누스의 관찰에는 MPGR보다 스핀에코 영상이 좋았고, 관절면의 불규칙성 또는 관절강의 확대와 관절 강직여부의 관찰에는 스핀에코에 비해 MPGR 영상이 좋았고, 연골하 경화는 비슷하였다. 천장골염의 정도와 ESR, CRP와의 연관성은 없었다. 걸론: 천장골 관절에서 염증의 시작은 주로 장골 측과 관절의 하부에서 먼저 시작되고, 관절이 진행될수록 장골측에서 천골측까지로 범위가 확대 되었다. MRI방법에 의한 차이로 초기단계에는 스핀에코 영상이 관절염을 확인하는데 도움이 되고 관절면이 불규칙하게 되고 경화가 되어 병이 진행된 상태에서는 MPGR영상이 진단에 더 도움이 되었다. 염증성 배부 동통이 있는 경우 단순 골반 검사에서 이상이 없는 환자인 경우에도 MRI 검사를 시행하여 천장골염의 유무를 확인하는 것이 중요하다. Objective: The early detection of sacroiliitis on X-ray is important to diagnose spondyloarthropathy(SpA). The conventional radiography, bone scan, and computer tomogram have the problems of sensitivity, specificity, and side effects. We examined sacroiliitis using MR imaging in patients who had inflammatory back pain, but no definite changes in conventional radiogrphy. Other radiologic techniques were compared in detection of early sacroillitis. Methods: Twenty six patients with SpA were examined. The MRI findings of both sacroiliac joints were evaluated in every patients, such as pannus, periarticular osteitis and fat accumulation, subchondral sclerosis, and joint space changes(irregularity, ankylosis). Also we analyzed the changes of sacroiliac joints in sacroiliitis. Results: The predominant sites of involvement were upper aspect and iliac surface of sacroiliac joint in subchondral sclerosis, lower and iliac in pannus, periarticular fat accumulation, and iliac in periarticular osteitis. The MPGR images were superior to spin echo images in evaluation of joint space changes(irregularity, and ankylosis). Conclusions: Sacroiliitis is initiated in iliac side and lower portion of sacroiliac joints. MRI can detect early changes of sacroiliitis in patients with no conventional radiographic changes. MRI seems to be needed in patients with inflammatory back pain.

중증 고혈압증의 임상적 관찰

육동민(Dong Min Yook),곽시영(Si Young Kwak),김성식(Seong Sik Kim),이성숙(Seong Sook Lee),홍관표(Kwan Pyo Hong),최창필(Chang Pil Choi),이재우(Jae Woo Lee),이시래(Si Rhae Lee) 대한내과학회 1987 대한내과학회지 Vol.33 No.2

N/A Clinical studies were carried out in the 110 cases of severe hypertension who had been admitted from January 1979 to August 1985 and the following results were obtained: 1) Underlying diseases of severe hypertension were essential hypertension in 67 cases, renal parenchymal hypertension in 36 cases, and renovascular hypertension in 7 cases. 2) Plasma renin activity was the highest in the group of renovascular hypertension which was 22.07±9.20 ng/ ml/hr, and as a whole, the higher diastolic blood pressure, the higher plasma renin activity was. Plasma renin activity in the group of K-W grade IV retinopathy was higher than those of the other groups. 3) The incidence of ventricular hypertrophy fullfilling voltage criteria and with accompanying ST-T changes on electrocardiolgram was 81.5% in the group of essential hypertension and there was no difference in relation to the level of pressure or fundoscopic changes. 4) The serum creatinine level was the highest in the group of renal parenchymal hypertension (7.93±2.98 mg/dl), and in the group of K-W grade IV retinopathy (6.86±3.50mg/dl), but there was no significant difference in relation to the level of diastolic blood pressure, 5) There were no significant difference in cardiothoracic ratio on chest X-ray in relation to underlying diseases, diastolic blood pressure or fundoscopic changes. 6) The major complications were congestive heart failure (49.1%), hypertensive encephalopathy (17.3%), and cerebrovascular accident (8.2%). 7) In the group of essential hypertension blood pressure was controlled by conservative treatment in 81.0% but in 35.7% in the group of renal hypertension. The patients of chronic renal failure who were treated with dialysis blood pressure was controlled in 87.0%. In all 6 cases with renal transplantation, nephrectomy or renal angioplasty blood pressure was well controlled. 8) In cases refractory to triple antihypertensive regimen blood pressure was controlled by minoxidil in 66.7% and by captopril in 75.0%. 9) In 45 cases who were followed up for more than 6 months diastolic blood pressure was controlled under 100mmHg in 77.8% and there were improvement of renal function, fundoscopic findings and electrocardiographic findings in 20.0%, 33.3% and 16.7%, respectively.

한국인 A 형 간염 환자에서 A 형 간염 바이러스의 유전자형에 관한 연구

권오상,송기준,박상훈,송진원,김재선,김종헌,변관수,이창홍,연종은,백락주,박영태 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.3

$quot;목적: 한국에서 과거 A형 간염은 낙후된 개인위생 및 자연환경으로 유소아기에 불현성 감염으로 앓고 지나가게 되어 청소년 및 성인에서 HAV에 대한 항체 보유율이 매우 높고 성인에서의 급성 A형 간염은 매우 드물게 보고되었다. 그러나 고도의 경제성장과 더불어 식생활, 위생상태의 개선, 상하수도의 보급 등으로 유소아기의 A형 간염 이환율이 현격히 감소하면서 청소년 및 성인에서 HAV 항체가 없는 인구집단 즉 HAV에 감염되면 현증 간염이 발생할 수 있는 인구 집단이 증가되어 최근 수 년 사이에 현증 A형 간염이 폭발적으로 증가하게 되었다. 이에 저자는 HAV의 유전자형을 알아보고 이미 보고된 각국의 HAV와 연관성을 알아보고자 본 연구를 시행하였다. 대상과 방법: 1994년부터 1998년까지 한국에서 산발적으로 발생한 18예의 A형 간염 환자의 혈청에서 HAV RNA를 추출, 역전사-중화효소 연쇄반응법(RT-PCR)으로 증폭하여 직접 염기서열의 분석을 통해 국내 HAV 사이에 염기서열, 아미노산의 차이 등을 알아보고 세계 각국에서 보고되었던 HAV 분리주들과 비교하였다. 결과: HAV 게놈의 특정부위인 VP1/2A 연결부위 168 bp 길이에서 시행한 염기서열 분석 결과 한국에서 분리된 18예의 HA이러스는 최근 해외에서 유입된 바이러스일 가능성은 적으며 따라서 장기간 국내에서 토착화된 바이러스일 것으로 생각된다. $quot;Background/Aims: Studies of genotypes and changes in nucleotide and amino acid sequences of hepatitis A virus (HAV) may provide valuable information on the epidemiological aspects of a particular region. In Korea the prevalence of anti-HAV in the 1 - 20 year age group declined from 60% in 1980 to 9% in 1995. As a result this age group has a high risk of HAV infection. Actually over 1,500 cases of clinically overt hepatitis A occurred in 1998 while few cases of clinical hepatitis A had been reported until the early 1990s. The aims of this study are to determine the genotypes of HAV which have been circulating in Korea and to define the phylogenetic relationships of geographically defined isolates. Method: From 1994 - 1998 a total of 18 serum specimens was obtained from patients in Korea with sporadic form acute hepatitis A. The HAV nucleic acid from serum specimens was subjected to genomic sequence analysis following viral RNA extraction, reverse transcription and amplification of the cDNA by PCR. DNA sequencing was performed in both directions of each PCR product. Results: All isolates clustered within the subgenotype IA irrespective of the geographic locations and timing of the clinical hepatitis. Among 18 Korean isolates, 9 isolates had 2 amino acid sequence changes and 2 isolates had 1 amino acid sequence change. These changes in the amino acid sequences are unique and have never been reported in HAV subgenotype IA. Conclusions: All isolated HAV had genotype (IA). Eleven of 18 isolates had unique changes in amino acid sequences. These data indicate that the endemic HAV has been circulating in Korea over a long period of time.

西海岸地域 水産業發展을 위한 公開講座프로그램의 開發에 관한 硏究

金秀寬,金在璇,李禹昌,房基俊 군산대학교 1991 群山水産專門大學 硏究報告 Vol.25 No.1

The purpose of this study is to develop the extension program for the improvement of fisheries industry in the western coastal area by making the workers in fisheries understand its environment and obtain the knowledge and the skill about it. To attain the above purpose, theoretical and empirical approaches are used in this study. The extention program developed by this study will be a useful source material to the institutes which plan social education for the workers in fisheries. Suggestions for the activation and settlement of the social education are as follows. First, the frequency of the social education about fisheries will have to be increased. Second, the main institutes of social education will have to be diversed to specialize the education line and method. Third, the required subjects in pratical field will have to be selected and educated for improving the effect of social education.

남자 대학 세단뛰기 선수들의 도움닫기 마지막 3스트라이드의 유형과 접지와 이지 순간의 운동학적 분석

류재균,장재관,김상도 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

The purposes of this study were to examine the characteristics of the kinematic factors of the final three strides before takeoff of a triple jump and to collect the fundamental quantities of motion in order to improve the triple jump performance. The subjects were the 5 Finalists For an actual 16.70m over in the triple jump at the 2003 World Student Games. The last three strides were analysed using three cameras, The x, y, z coordinates of 20 points defining a Fourteen segment model of the human body were used For Further analysis, After smoothing the raw data with a fourth order Butterworth Filter, the centres of gravity of the subjects were calculated. After analyzing the kinematic data during the final three strides, the following findings were obtained: The last three stride Length changes in triple jump did not have a consistent pattern and showed the varieties in jumpers' technical preference. The height of center gravity was different in each event of the last three strides but the lowest center of gravity was the time of touchdown on the board. The maximum horizontal velocity was shown at the second-last and third-last stride takeoff instances.

요골동맥과 복재정맥을 이용한 관상동맥우회술의 조기성적

김관창,원태희,한재진,최수승,안재호 이화여자대학교 의과학연구소 2008 EMJ (Ewha medical journal) Vol.31 No.2

Background:Increasing interest and use of arterial conduits is based on the better patency of left internal thoracic artery(LITA) than that of saphenous vein(SV) graft. We compared the early result of coronary artery bypass grafting(CABG) using LITA and radial artery(RA group) with CABG using LITA and SV only(SV group). Material and Method:We compared the early operative results of 6 cases in RA group with 18 cases in SV group selected from 24 cases that had CABG between January 2006 and December 2006. We analyzed each group on the preoperative risk factors and operative results. Results:We can’t find significant differences in clinical and hemodynamic characteristics before surgery. There were no statically significant difference between two groups in operative mortality and each morbidities(postoperative intraaortic balloon pump insertion, bleeding, stroke, perioperative myocardial infarction, wound dehiscence), respectively. However, the overall incidence of conventional CABG using cardiopulmonary bypass was higher in RA group compared to SV group(p=0.016). Accordingly, RA group had longer duration of ventilation time(p=0.004) and ICU stay(p=0.003) than SV group with statically significant difference between two groups in hospital stay. The graft patency on postoperative coronary angiography or computerized tomographic angiography at 7-14 days after operation in both group patients were 100%(includeing LITA, RA and SV). Conclusion:We had early good operative results in RA group and SV group. 관상동맥우회술에서 내흉동맥의 장기개통률이 복재정맥보다 우수하다는 것이 알려짐과 더불어 두 개의 내흉동맥을 이용한 군에서의 장기 임상 성적이 하나의 내흉동맥만을 이용한 군에서의 성적보다 우월하다 것이 알려지면서 최근에는 동맥이식편의 사용이 증가하고 있다1)2). 좌내흉동맥이 동맥이식편중 가장 많이 그리고 오래 전부터 사용되어왔고 그 장기 개통률이 매우 우수한 것으로 증명되면서, 이식편으로 사용 가능한 다른 동맥이식편에 대한 사용이 늘어나고 있는 추세이다. 좌내흉동맥 이외에 사용될 수 있는 동맥이식편으로는 요골동맥, 우내흉동맥, 우위망막동맥 등이 있다. 이 중 우내흉동맥은 좌내흉동맥과 같이 사용한 경우 장기 생존율이 높다는 보고도 있지만 가용길이가 짧아 이용에 한계가 있고 수술시간이 길어지며 상처 합병증과 기술적인 문제 등이 있다2). 요골동맥은 Carpentier 등3)에 의해 1970년대 초 처음 이식편으로 소개되었으나 추적 관상동맥조영술상 높은 이식편 부전으로 인해 사용이 중단되었다가 1989년 다시 소개되어 주목을 받게 되었고4), 요골동맥박리술의 기술적인 변형과 항연축제의 사용으로 요골동맥의 연축을 최소화하여 사용하면서 많은 저자들에 의해 좋은 임상 성적과 높은 개통률을 보이고 있다5-7). 본 이화여자대학교 목동병원 흉부외과에서도 요골동맥을 좌내흉동맥에 이은 두 번째 동맥이식편으로 사용하고 있는데 본 연구에서는 본원에서 경험한 요골동맥을 사용하여 시행한 관상동맥우회술의 임상 성적과 수술 후 관상동맥조영술 혹은 컴퓨터 단층 혈관조영술 결과를 분석해 보고 아울러 이를 요골동맥을 사용하지 않고 내흉동맥과 복재정맥만을 이용한 군의 성적과 비교 분석해 보았다.

충청남도 서북부지역 고교생들의 유치방안에 관한 연구

문재우,장호순,이영관,이덕희 순천향대학교 사회과학연구소 2001 순천향 사회과학연구 Vol.7 No.1

Students applying for Soonchunhyang University are mainly from Seoul City, Kyeonggi Province, and Choongnam Province. Attracting high school students from Seoul and Kyeonggi areas getting more competitive among colleges, and thus require more time and money. Meanwhile, recruiting high school students form local area become more economic and effective for Soonchunhyang University due to its location. This study is to find out the factors that influence students and their parents in the northwestern Choongnam Provice in applying for university admission. The survey of students and their parents in Chonan, Asan, Yesan, Dangjin, Seosan, Taean and Hongsung reveals that they prefer colleges located in Seoul and Daejeon to those in Asan and Chonan. They responded that notoriety, facilities and student welfare service as important factors in selecting colleges. They also showed high interest in whether the colleges offer new field of major, cultural environments, atmosphere for hard study, employment opportunity after graduation, and scholarship and financial aid. They obtained information of prospective colleges less from mass media such as newspapers and TV than internet, admission guidebooks by colleges, and publications from private institutions for college admission.

요추간판탈출증에서 현미경 수술과 경피적 자동수핵제거술에 대한 비교연구

신원한,장재칠,주교성,김범태,최순관,변박장 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

A retrospective study of operative results were carried out in a series of 164 patients who were performed microdiscectomy and 57 patients performed automated percutaneous lumbar discectomy (APLD) for herniated lumbar discs between January 1, 1990 and June 30, 1996 at the Department of Neurosurgery, Soonchunhyang University Hospital. The operative results were analysed, and the correlation between preoperative clinicoradiological factors and postoperative clinical results were statistically assessed. The major results were as follows : 1. Of 164 microdiscectomy cases, 102 were males and 62 were females, mean age was 42.4 years and incidence was the highest in the 5th decade, and of 57 APLD cases, 43 were male and 14 female, mean age was 32.2 years and incidence was the highest in the 3rd decade. 2. The preoperative symptoms and signs were lumbago(98.2%), radiating pain(96.3%), positive straight leg raising test(77.4%), motor weakness(27.4%), claudication(13.4%) & voiding difficulty(2.4%) in microdiscectomy cases, and lumbago(98.2%), radiating pain(98.2%), positive straight leg raising test(70.2%) & motor weakness(17.5%) in APLD cases. 3. Number of operated levels were performed 226 in microdiscectomy and 74 in APLD. The most commonly operated levels of two groups were L4-5 level. 4. Operative results 1) The overall success rates by Prolo's scale were 87.1% in microdiscectomy and 80.7% in APLD, respectively. 2) In younger age group (below 30 years) and in non-compensatory group, success rates were significantly higher in microdiscectomy. 3) As to protrusion and degeneration on MRI, clinical results of moderate protrusion and degeneration of discs in microdiscectomy were statistically significant, and those of mild protrusion and degeneration of discs in APLD were also statistically significant. 4) The most common cause of failure was inappropriate removal of disc material in microdiscectomy and sequestered discs in APLD. According to the above results, there were no differance in overall success rates between microdiscectomy and APLD. But clinical results seem to be influenced by the age, existence of compensation, and by the degree of protrusion and degeneration of discs as prognostic factors. If the selection of operative procedure between microdiscectomy and APLD for herniated lumbar disc is carefully done with clinical and radiologic findings of patients, good outcome might be achieved.