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( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.
김지환,오세윤,김웅철,유진호,김태석,이준석,이원철 高麗大學校 倂設 保健大學 保健科學硏究所 2001 保健科學論集 Vol.27 No.2
This study was carried out to investigate psychiatric stress symptoms and stress- inducing factors, such as role overload, work demand, work procedure and so forth in korean dental laboratory technicians. Questionnaires were mailed to randomly selected 1000 dental technicians who were systematically selected. Among them, 786 dental technicians completed the questionnaires and returned them. Validity test and reliability test on the questionnaires were done prior to the main survey, using the SCL-90-R as a standard. Stress-inducing factors were identified with a multiple regression analysis on the continuous variables. To investigate stress-inducing factors on stress symptoms, analysis on distribution of characteristics was performed, and then correlation analysis and multiple regression analysis was carried out. The results of the study were as follows: According to multiple regression analysis, there was a statistical correlation between stress symptoms and role overload, work procedure, occupation conflict, interpersonal relationship, social support, personality traits in stress symptom(GSID). The stress symptoms in korean dental laboratory technicians seemed to be mostly job related ones, and considering the results obtained from the study, it is suggested that reducing work load and proper health promotion programs for dental technicians be necessary.
치과 기공사들에게서 나타나는 호흡기 증상과 이의 관련 요인
김웅철,오세윤,김지환,김진완,이준석,이가영,이세훈,유진호,김태석 高麗大學校 倂設 保健大學 保健科學硏究所 2001 保健科學論集 Vol.27 No.1
This study was carried out to investigate subjective respiratory symptoms and their attributable factors in Korean dental laboratory technicians. A questionnaire was mailed to randomly selected 1,900 dental laboratory technicians. Among them, 1,344 dental technicians completed the questionnaires and returmned them. Validity and reliability tests on the questionnaires were carried out before the main survey. To investigate risk factors on respiratory subjective symptoms, we performed analysis on distribution of characteristics, and then investigated univariate analysis and multiple logistic regression analysis. The prevalence rate of wheezing, cough and phlegm, and dyspnea was 4.8%, 33.9%, 54.9%, respectively. Statistically significant factors inducing subjective respiratory symptoms by multiple logistic regression analysis were sex, smoking, exercise, health examination, work hours a day, investment gas, investment dust, metal fume, resin vapor, and asbestos dust. Considering the results above, it seems that most subjective respiratory symptoms are related with health habits and occupational environmental-related factors. The result, consideration in mind, suggest that health promotion programs for smoking cessation, regular health examination, and physical exercise in health habit, and improvement on casting and resin work in dental technological environment be necessary.
그람양성구균에 대한 Teicoplanin과 Vancomycin의 시험관내 항균력
최태열,김경숙,전용관,서일혜,김정욱,이웅수,안정열,김홍석,정재용,최효선,김덕언,유진우 대한감염학회 1994 감염 Vol.26 No.1
An increasing frequency of methicillin resistant S. aureus(MRSA), methicillin resistant coagulase negative staphylococci(MRCNS) and Enterococcal infection have been observed in recent years. Teicoplanin is a new glycopeptide antibiotic obstained from the Actinoplanes teicomycetius. The molecular structure and spectrum of antimicrobial activity of teicoplanin is simillar to those of vancomycin, and has been reported to have an excellent in vitro and in vivo effect against various gram-positive infections. Therefore, we evaluated the in vitor susceptibility of gram positive cocci, such as, S. aureus, coagulase negative Staphylococci(CNS), and Enterococci to teicoplanin and vancomycin. The total 253 strains consisted of MSSA(40), MRSA(53), MSCNS(47), MRCNS(48), and Enterococci(65). They were assayed by disc diffusion and agar dilution. During the study, 57% of S. aureus and 49% of CNS showed resistance to methicillin. The inhibitory diameter of teicoplanin was 15-20mm in MSSA, 12-19mm in MRSA, 13-24mm in MSCNS, 11-23mm in MRCNS, and 15-22mm in Enterococci respectively, and showed sensitivity in all but 8 strains(3.2%). The range of the minimum inhibitory concentration (MIC) of teicoplanin to MSSA, MRSA, MSCNS, MRCNS and Enterococci were 9.12-2.0㎍/ml, 0.25-2.0㎍/ml, & 0.25-32㎍/ml, 0.12-1.0㎍/ml respectively. One case of S. haemolyticus was resistant to teicoplanin (32㎍/ml) by the agar dilution method. Eight minor (3.2%) and one major(0.4%) error was observed when the MIC and disk diffusion data were correlated with teicoplanin. As for vancomycin the inhibitory diameter was 17-21mm in MSSA, 15-21mm in MRSA, 18-26mm in MSCNS, 18-25mm in MRCNS, and 16-22mm in Enterococci respectively. The range of the MIC of vancomycin to MSSA, MRSA, MSCNS, MRCNS, and Enterococci were 0.25-1.0㎍/ml, 0.25-4.0㎍/ml, 0.5-2.0㎍/ml and 0.5-2.0㎍/ml respectively. One minor error (0.4%) was seen with the vancomycin disk. The MIC90 of MSSA and MRSA exhibited the same results in teicoplanin (1.0㎍/ml, 1.0㎍/ml), and vancomycin(2.0㎍/ml, 2.0㎍/ml). MSCNS and MRCNS exhibited greater MIC90 with teicoplanin(4.0㎍/ml, 8.0㎍/ml) than vancomycin(2.0㎍/ml, 2.0㎍/ml). Incontrase Enterococci were more susceptible to teicoplanin(0.5㎍/ml) than to vancomucin (2.0㎍/ml). Results from this analysis indicated that both teicoplanin and vancomycin were very excellent for gram positive infections, especially those resistant to methicillin.