VRE 감염증의 임상상, 미생물학적 특성 분석 및 유전적 관련성 비교 : 전국 6개 병원에서 분리된 VRE를 중심으로

정희진,박정원,엄중식,하경임,신종희,김정미,이혜수,박영희,김우주,박승철 대한감염학회 2002 감염 Vol.34 No.5

성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

Vancomycin-Resistant Enterococci (VRE) 빈도, 검사법 및 감염관리 대책에 관한 전국 병원 설문조사

정희진,김우주,최선주,이경원,최강원,박승철 대한감염학회 2001 감염 Vol.33 No.2

Background : Vancomcyin-resistant enterococci (VRE) have been an important nosocomial pathogen in the 1990s. Recently, VRE have become an emerging nosocomial pathogen in Korea, but there have been no nationwide study about the status of VRE in Korea. This nationwide questionnaire survey was aimed to determine the prevalence of VRE, the appropriateness of detection method fur VRE, and to evaluate the infection control program in hospitals of various size in Korea. Methods : During 4 weeks (September 1 to October 1, 1999), a questionnaire surveillance study was conducted. We had sent the questionnaire to 200 large hospitals in Korea, which were distributed nationwide. Questionnaire included the prevalence of VRE within the hospital, the detection method for VRE, method of enterococci isolation, antibiotics-susceptibility test and infection control method of VRE. Results : The response rate to questionnaire was 42%. The species identification of enterococci was capable in 62.3% but the accurate enterococcal speciation were capable in 18%. Appropriate antibiotic-sus-ceptibility test were produced only in 6.5%. Total 746 VRE were detected in 42 hospitals during 1-year despite of low sensitivity of detection methods. VRE was noted in 54.4% of hospitals at least. The isolation programme of VRE infected patients was presented in 20.3%, regular surveillance of VRE in high-risk pop ulation was produced only in 16.5%. Conclusion : The prevalence of enterococci among microorganisms isolated from clinical specimens were increased up to 27.7% in Korea. VRE has been emerged in many big cities as well as in Seoul. The microbiological methods that include the speciation of enterococcal isolates, antimicrobial susceptibility test, and VRE detection appeared to be inappropriate in many hospitals. And, proper control and prevention methods were presented in a few hospitals. Education and training about accurate detection of VRE as well as proper infection control programs for VRE are urgently needed. (Korean J Infect Dis 33:78~87, 2001)

금합금에서 납착되는 면의 간격이 파절저항에 미치는 영향

이청희 慶北大學校 齒科大學 1993 慶北齒大論文集 Vol.10 No.2

납착될 부위의 간격에 따른 파절하중을 비교하기 위하여 5㎝길이의 13개의 아크릴릭봉을 금합금(Au:70%, Pt:7%, Pd:2%)을 사용하여 주조한 후 1개는 대조군으로 두고, 12개를 중간점에서 장축에 수직되게 자르고 선반가공하였다. 0.13mm의 간격을 가진 Ⅰ군, 0.38mm간격의 Ⅱ군, 0.72mm 간격의 Ⅲ군, 1.13mm 간격의 Ⅳ군으로 각 군당 3개의 시편을 레진으로 고정시키고 납착용 합금을 만들어서 납착하였다. 인스트론 만능시험기에 4-점 테스트가 되도록 거상한 후 cross head speed 1mm/min으로 압축하중을 가하여 파절하중을 측정하였다. 주사전자미경으로 Ⅰ군과 Ⅱ군의 납착된 면 및 대조군을 관찰하여서 다음과 같은 결과를 얻었다. 1. 파절은 Ⅰ군과 Ⅱ군에서만 일어났으며, Ⅱ군에서 63.84kg으로 Ⅰ군의 31.63kg보다 높게 나타났고, Ⅲ군과 Ⅳ군의 대조군과 같이 파절이 되지 않고 bending만 일어났다. 2. 납착된 면의 주사전자현미경 관찰에서 대조군에서는 기포가 거의 없는 파절면을 관찰하였으며 Ⅰ군에서는 납착면의 중앙부가 납착되지 않은 상태이고 테두리만 납착된 상태로 나타났으며, Ⅱ군에서는 대조군보다 기포가 많은 것을 관찰하였다. In ordor to compare the fracture load according to the gap distance between the surface to be soldered. Thirteen samples were made with acrylic rods(length : about 5㎝, diameter 3.1mm) and casted with gold alloy(Au: 70%, Pt:7%, Pd:2%). One specimen was remained for the control group, and each of the twelve specimens was cut perpendicularly to the long axis inthe middle point, and then cut surface was lathed perpendicularly to the long axis. These specimens were divided into four groups as followings: Group Ⅰ was composed of 3 specimens and was held to 0.13mm gap distance. Group Ⅱ was composed of 3 specimens and was held to 0.38mm gap distance. Group Ⅲ was composed of 3 specimens and was held to 0.72mm gap distance. Group Ⅳ was composed of 3 specimens and was held to 1.13mm gap distance. Each specimen was fixed with Duraray resin and soldered with solder alloy according to each group. After mounting on Instron universal testing machine in order to accomplish 4-point test, the fracture load of the specimens was measured. Scanning electron microscophy was examined the fractured surface of group Ⅰ, group Ⅱ and control group. The results were as follows. 1. Fracture was only occur group Ⅰand Ⅱ and mean fracture load was 63.84kg in group Ⅱ and 31.63kg in group Ⅰ. And group Ⅲ,Ⅳ and control group were bent and were not fractured. 2. In examination by scanning electron microscopy, conterol group largely had no voids and group Ⅰ had unsoldered surface in the central part and group Ⅱ had soldered surface with scattered voids.

선택적 신동맥 색전술을 이용한 신절석술 후의 신출혈 치료 1례

이중화,이보배,윤능수,임승수,박청희 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

A patient with uncontrollable postoperative renal hemorrhage was successfully treated by selective injection of gelfoam into the anterior inferior segmental branch of right renal artery. Follow up arteriography was done 16 days later. It revealed persistent occlusion of the bleeding vessels. This method is a simple effective procedure in cases of renal hemorrhage to diverse etiology without responsive management.

Finite Element Analysis of Stress Distribution with Load Transfer Characteristics of the Implant/bone Interface

이종우,이청희,조광헌 대한치과이식학회 2003 대한치과이식학회지 Vol.22 No.1

만성정신질환자 가족의 부담감에 관한 연구

이경희,박청자 대한보건협회 2003 대한보건연구 Vol.29 No.2

The purpose of this study was to investigate the burden of the families with the chronic mentally ill to provide the basic data for nursing intervention program. The subjects of this study were 200 families with the chronic mentally ill registered in four community mental health centers at Daegu city. The data were collected during the period from May, 2002 to July, 2002. The instruments for the study were the burden scale used in Kim, Suji et. al.(1998).(a=.8812). The data were analyzed by descriptive statistics, t-test, Pearson correlation coefficient. ANOVA. and multiple stepwise regression. The results of analysis were as follows: 1. The mean score of burden is 2.95 and the mean score of quality of life is 2.93. 2. There is a negative correlation between the burden and the quality of life of families with the chronic mentally ill(r=-.31, p<.0l). 3. Burden showed the significant difference according to sex(t=-3.18, p<.05), marital status(F=4.12, p<.05).

지역사회와 병원에서 페니실린 내성 폐렴구균 감염의 임상적 특징 및 분자유전학적 성상

정희진,황병연,박정원,김우주,김민자,박승철,이영희 대한감염학회 2001 감염 Vol.33 No.2

Background : During the last three decades, the resistance of S. pneumoniae to penicillin has been rapidly increasing in many parts of the world, especially in Korea. To characterize the clinical features and epidemiology of penicillin-resistant S. pneumoniae (PRSP) infections in the community -and hospital, as well as to investigate the possible spread of resistant clone, we performed the antimicrobial susceptibility tests, pulsed filed gel electrophoresis (PFGE) and penicillin-binding protein (PBP) profile analysis of PRSP isolates. Methods : A total 48 PRSP isolates from patients who visited or were admitted to Korea University Guro hospital during the period form July 1998 to June 1999 were studied. Anitimicrobial susceptibility tests for 48 isolates were performed with microbroth dilution method to determine the minimal inhibitory concentration of 11 antibiotics. 39 isolates and 35 isolates were subjected to PFGE and PBP profile analysis, respectively to investigate the genetic relatedness between PRSP isolates. Results : Pneumonia was most common site of infection in the community and the hospital as 50%. There were no significant differences of clinical fentures and prognosis between community and hospital isolates. But, patients with serious underlying diseases had poor prognosis despite of acquisition site. High level penicillin resistance were observed in 69%, multi-drug resistance were 64.6% of isolates. PFGE showed that 13 of 29 community acquired infection were identical PFGE pattern but not that of 23F Spanish clone. There were various PFGE patterns were observed from community and hospital acquired infection isolates. Some of them were existed in both. PBP profiles showed more diverse, even if in isolates of the same PFGE pattern. Conclusion : In our study, high level penicillin resistance and multi-drug resistance were observed in PRSP clinical isolates. No clinical and prognostic differences were observed between community and hospital acquired infections. Molecular epidemiology study were suggest the there were various genotypes of PRSP within our society. Some of them were observed of the hospital and community. Therefore, there was an evidence of communication of PRSP clones between the community and hospital. (Korean J Infect Dis 33:112~122, 2001)

사용자 분석을 통한 대학기숙사 거주환경 개선에 관한 연구

이청웅,박행자,임경희 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.2

This study, as a case study of four university dormitories in Gwangiu, examined the situation of interior space and conducted a quantitative survey invesitgating importance about the interior space and assessment factors of residential environment on users. Then user satisfaction at the assessment factors of residential environment was analyzed to draw problems and explore improvement. The results showed the following problems that should be resolved: Bedrooms should increase the area of convex space; toilets and bathrooms should be changed into a cluster type at least in common use by floor; rest space should reinforce heating and cooling system; robby space should become mixed space for various user's behavior; private fitness rooms should be planned as group fitness space; private libraries should reinforce lighting facilities: and computer rooms should complement and improve HVAC.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5