병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성

김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.

물질사용장애 환자의 색다른 것을 추구하는 기질

김미영,박제민,윤경일,유택규,권도훈,김성곤,김명정,장기용 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

In this study, the relationship between substance use and high-novelty seeking was tested using Cloninger et al's 240-items Temperament and Character Inventory(TCI) in 34 substance users(32 methamphetamine and 2 cocaine dependence disorders), 80 normal controls and 48 schizophrenics Demographic characteristics and substance use-related past history were taken by semi-structured interview. Subjects were aged 18-45 and general psychopathology was screened by Symptom Checklist 90 revised. The results were as follows. 1) Among temperament subdivisions in the TCI, novelty seeking(NS) was significantly higher in the substance users(22.1±4.9) than the normal controls(18.0±5.0) and the schizophrenics(15.6±3.3). There were no significant differences in other temperament subdivisions such as harm avoidance, reward dependence and persistence, neither character subdivisions such as self-directiveness, cooperativeness and self- transcendence. 2) A significant inverse correlation was found between NS and age both in the substance users(r=0.274) and the normal controls(r=0.468). This study suggested that the biogenetic temperament characteristics in substance use disorder were related with their high novelty seeking, not low harm avoidance.

CO_2 레이저빔을 이용한 TFT-LCD 도광판의 패턴 제작에 관한 연구

김경동,백창일,송철기,안성훈 경상대학교 생산기술연구소 2002 工學硏究院論文集 Vol.2 No.-

A light guide panel is an element of the LCD backlight module that is often used for the display of compact electronic devices. In this study, a laser marking system is proposed to fabricate light guide panel, which can replace other manufacturing methods such as silk printing, stamping, or v-cutting methods. The objective of this research is to evaluate the process parameters of the laser marking system. Light guide patterns were marked with a 50W CO_2 laser(CW) to understand the effects of average power and scanning speed on the geometry and quality of groove pattern. The width of the fabricated grooves increases with increasing laser power and decreasing scan speed. In order to analyze surface characteristics and optical properties(luminance, uniformity), SEM photography and BM7(luminance measuring system) were used. As a result, the optimal conditions of the process parameters that provide high luminance was obtained.

선반작업에서 절삭유 농도에 따른 표면 거칠기의 영향

김원일,이윤경,왕덕현,김경년,이상복 경남대학교 신소재연구소 1995 論文集 Vol.5 No.-

본 연구는 선번작업에서 표면거칠기 변화특성을 여러 가지 조건변화에 따라 규명한 것이며 이 결과를 생산현장에서 생산성 향상을 위한 기초자료로 이용하고자 한다. 피삭재는 기계 구조용 탄소강(SM45C)가 사용되었으며 절삭유 농도, 절삭속도, 이송, 절삭깊이의 작업조건이 변화되었다. 실험결과에 의하면, 표면거칠기는 경절삭의 경우 20:1의 수용성 절삭유가 사용되었을 때 양호하였으며 절삭유 사용으로 인하여 구성인선의 임계속도가 상승됨을 추측할 수 있었다. 또한 실제 표면거칠기는 이론값에 비하여 습식의 경우 4-20배, 건식의 경우 3배 정도 거칠었으며 중절삭을 할수록 이론과 실험값이 대채로 일치하고 있었다. This study is to evaluate characteristic of surface roughness in turning with respect to the change of working conditions, and this paper is to present principal data for safety design. Structural steel(SM45C) is used as the workpiece. the change of density of cutting fluid, cutting speed, feed and depth of cut are adapted From the results obtained by experiments, it is observed that the useage of cutting fluid(cutting:water = 1:20) had much influence on the surface roughness, suggested that cutting fluid are increasing the critical speed of BUE. Also, experimental surface roughness becomes consistant to the theoritical one at heavy cutting.

쯔쯔가무시병에서 가피의 위치와 복장과의 관계

김백남,곽이경,문치숙,김의석,박상원,이창섭 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 쯔쯔가무시병의 예방을 위하여 위험지역에서 긴소매 윗옷을 입고 바지 끝을 양말 속에 넣는 것이 권장되고 있다. 이러한 예방조치의 효용성을 알아보기 위하여 우리는 쯔쯔가무시병에서 가피의 위치와 신발과 복장과의 관계를 살펴보았다. 재료 및 방법 : 2005년 10-12월 사이 6개 병원에서 전형적인 임상양상, 가피의 존재, 혈청검사 결과로 쯔쯔가무시병이 의심되거나 확진된 159명의 성인을 대상으로 가피의 위치, 추정 감염일, 야외활동, 당시 착용한 신발과 복장 등 을 조사하였다. 결과 : 혈청검사는 5명에서 시행되지 않았고 99명이 양성이었으며, 가피는 142명에서 발견되었다. 몸의 두 군데에서 발견된 6명을 제외한 136명 중 82명(60.3%)에서 가피는 하반신(아랫배, 엉덩이, 서혜부, 생식기, 넓적다리, 종아리)에 있었다. 감염일이 추정가능하고 가피가 1개만 있는 44명을 대상으로 하였을 때, 가피가 하반신에서 발견된 17명에서 슬리퍼를 신거나 맨발인 경우는 5명이었으나 상반신에 있는 27명 중에는 아무도 없었다(P=0.006). 바지아랫단을 양말 속에 집어 넣은 4명 중 1명은 하반신에서 3명은 상반신에서 가피가 발견되었다. 42명이 긴 소매 윗옷을 입었는데, 이중 16명은 하반신에서 26명은 상반신에서 가피가 발견되었다(P=1.00). 결론 : 쯔쯔가무시병 환자에서 신발을 신지 않거나 발이 잘 보호되지 않았을 때 가피는 하반신에 더 잘 생겼다. 바지 아랫단의 처리방법이나 긴 소매 윗옷의 착용은 가피의 위치와 통계적으로 유의한 연관관계는 발견되지는 않았다. 그러나 표본수가 적고 유충의 침범경로에 영향을 줄수 있는 다른 요인이 있기 때문에 가피의 위치와 연관관계가 없다고 이 연구에서 단정할 수는 없다. 따라서 쯔쯔가무시병의 예방을 위한 실용적인 권고를 위해서는 더 많은 연구가 필요하다. Background:Wearing a long-sleeved shirt and tucking the pants legs into the socks is recommended to prevent scrub typhus. This study investigated associations between the location of eschar and the type of clothes and shoes to evaluate the efficacy of these protective measures. Materials and Methods:One-hundred and fifty nine patients in whom scrub typhus was confirmed or suspected based on the typical clinical manifestations, presence of eschar, or positive results of serologic tests at 6 Korean hospitals from October to December 2005 were included in this study. We collected the information on the location of eschar, presumed exposure date to chiggers, and the clothes and shoes which they had worn. Results:Serologic tests were positive in 99 patients. Eschars were observed in 142 patients and 6 of them exhibited more than 2 eschars. Eighty-two (60.3%) of 136 patients with a single eschar had an eschar on the lower half of the body. Of the 44 patients whose exposure date could be estimated, and who had only a single eschar, 5 of the 17 patients with eschars in the lower half of their bodies, and none of the 27 patients with eschars in the upper half of their bodies went barefoot or wore open footware (P=0.006). Only 4 patients tucked the pants into their socks, and an eschar was found in the lower half in one patient, and in the upper half of the body in the other 3 patients. Of 42 patients who wore long-sleeved shirts, eschars were found in their lower bodies in 16, and on their upper bodies in 26 (P=1.00). Conclusion:When the feet were not protected properly with shoes, eschars were found more frequently on the lower half of the body than on the upper half. Wearing a long-sleeved shirt or tucking the pants legs into the socks was not found to be significantly correlated to the location of eschars. Further studies involving larger samples are necessary for the development of practical guidelines of protective measures to prevent scrub typhus.

'계획에 없던 재수술'의 분석

김은경,조성현,김창엽,오병희 한국의료QA학회 1995 한국의료질향상학회지 Vol.2 No.1

Background: clinical indicators are objective measures of process or outcome of patient care in quantitative terms. This study aims to review the medical records of patients who 'return to operating room during the same admission', which is one of the critical clinical outcomes, and describe the result by unplanned reoperation rate. Methods: Computerized patient registry was used for selecting subject conditions. For medical records retrieved, two nurse evaluators identified the presence of explicit reoperation planning in medical records. Results: Overall reoperation rate was 2.8% and unplanned reoperation rate 1.3%, The main category of reoperation cause was the postoperative bleeding. Duration of stay from previous operation to reoperation of the unplanned group, 12.7 days, was shorter than that of the planned(p<.05). The differences did not reach statistical significance in age, sex and length of stay. Conclusion: Results suggested that unplanned reoperation rate was lower than 'threshold' level other institutions had established. However, this result could become comparable only after management of medical records would be improved and risk adjusted.

국내 Epstein-Barr 바이러스 일차감염의 임상적 특성

김백남,곽이경,문치숙,김의석,박상원,이창섭 대한감염학회 2007 감염과 화학요법 Vol.39 No.6

In this study, the clinical features of 264 patients of primary Epstein-Barr virus (EBV) infection between the years of 2002-2006 were evaluated retrospectively. The median age of the patients was 6 years old (0-69), and the hospitalization rate was 78.0%. Fever (83.3%) and sore throat (50.4%) were the most common symptoms. Cervical lymphadenopathy (71.2%), tonsillitis (51.1%), splenomegaly (26.1 %), hepatomegaly (25.8%), rash (10.2%) and jaundice (1.5%) were observed. Cervical lymphadenopathy was less frequent in older age groups. The annual number of primary EBV infections according to the age group during the study period did not change significantly in this study.

韓國 開創 新興宗數 儀禮服飾에 관한 硏究

김현경,임상임 대한가정학회 2003 Family and Environment Research Vol.41 No.2

This study examines the charactenstics of 45 sects of seven new aborginal religious groups in Korea including Jeungsan sect, Tangun sect, Soowoon sect, Won Buddhism, Bongnam sect, Gahksedo sect, Shamanism sect through field study and various documents. The purpose of the study is to elucidate how their religious ideas are reflected in their ceremonial costumes and what characteristics and underlying meanings these costumes have, and I reached the following conclusions 1. The new religious groups in Korea modified or mixed the designs or names of existing outfits to convey their idas or beliefs in their costumes. 2. The comtumes of new religious groups turned out to have certain characteristics in cornmon: they all reflected the times, Korean tradition, ancestor worship. 3. I looked at the symbolicity, names, and types of the outfit, and their color scheme to establish their structual characteristics, and it turned out that they all symbolized the creeds and ideas of each religion. The names of the costumes such as Way-Robe, Law-Robe, and Ceremony-Robe, for instance, had to do with Buddhism Taoism, and Confucianism. The most cornmon type of costume consisted of traditional hanbook top, pants, robe, and some type of headpiece for men, and hanbok top and, skirt for women, and it women were to wear a robe, it usually meant the sect believed in sexual equality. There was also a tendency to simplify or mintmiize the dress code, which seems to indicate that the sect was trying to adapt itself to the times. The most commontype of the outer garment for men was a robe with narrow sleeves, straight lapel, and no slits, and a robe with wide sleeves, straight lapel, and slits for women. The color scheme of the costumes included blue, white, yellow, red, and black, reflection the influence of the Yin-Yang and Five Elements idea and traditional preference for white of Koreans. 4. Thesse religious costumes were wom at various ceremonies, ritual,m and various anniversary services for the master and other dignitaries of the sect to render greater piety to those gatherings, to distinguish the sect from other religious groups, to clarify the meaning of the cermony, and to heighten the devout fellings of the participants. Thus, the structure (the symbolicity, names, and types of th outfit, and their color scheme) and religious background of the costumes of the new aboriginal religious groups in Korea turned out to have ingerited and mixed various elements of traditional Korean outfits and those of existing religions to symbolize their religious ideas. Many religions rise and fall, and each has its own dress codes, and I hope this study provides a framework and data for other researchers and leaders of new religious groups that will emerge inthe frture.

류머티스 관절염과 골관절염 환자에서 Transforming grwoth factor β의 발현 양상

김채기,윤원찬,송용호,김상경,최정윤 Official Journal of the Korean society for immunol 2001 Immune Network Vol.1 No.3

재생잔골재의 건축용 건조모르타르 적용에 관한 기초연구

김경덕,강석표,홍성윤 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

The natural aggregate will be used up within 10 years due to the great amount of consumption in making of construction materials. Regarding reservation of natural aggregate, the construction waste has to be recycled as one of important constituents of construction materials, typically, concrete. In mortar industry, the demand of fine aggregate is much heavier as industry developed. It is highly essential to think of application study using recycled fine aggregate. In this study, we investigated the effect on basic properties of screeding mortar when recycled fine aggregate is replaced. This study presents document in order to give an applicable guideline for the best use of recycled fine aggregate together with checking properties. We could find that screeding mortar properties is not much influenced by the existence of recycled fine aggregate because particle size distribution is well classified through manufacturing process. As a result, it is considered that application of recycled fine aggregate in dry mortar system is sufficient.