생활체육참여자의 여가활동 유형이 생활만족에 미치는 영향

김의영,김의영,김영숙,윤대중,이병기 龍仁大學校 體育科學硏究所 2002 體育科學硏究論叢 Vol.12 No.1

This research is designed to make a comparative analysis of the types of leisure activities and the degree of and life satisfaction by demographic background variable and to present basic materials necessary for the development of programs for local policies on leisure in accordance with the local autonomous system with a view to determining the relationship between life satisfaction by type of leisure activity. The following are the findings. First, the survey failed to test a statistically significant difference between family member's mutual satisfaction, or the subordinate variable of age, job and health and general life satisfaction, or the subordinate variable of income. But there was a statistically significant difference in life satisfaction by gender, age, education, job, income and health at a level of 1 percent. Second, the survey on the influences of the types of leisure activities on leisure satisfaction and life satisfaction revealed that there was a statistically significant influences in all the subordinate variables of and life satisfaction.

리네졸리드와 반코마이신을 교대로 투여하여 치료한 지속성 메티실린 내성 황색포도알균 균혈증 1예

김낙현,김문석,장은선,강유민,김가연,장희창,박완범,김의종,김남중,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for ≥7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

항생제 사용과 관련된 Clostridium difficile 감염증

김홍빈,김남중,최희정,오명돈,김의종,최강원 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

목적 : Clostridium difficile 감염증은 중요한 원내 감염중의 하나로 최근 들어 항균제 사용의 증가와 함께 그 빈도가 늘어나고 있어 Clostridium difficile 감염의 빈도 및 임상양상을 알기 위해 본 연구를 시행하였다. 방법 : 102명의 정상 성인으로부터 대변에서 Clostridium difficile 배양을 시행하였으며, 92년 3월부터 93년 9월까지 서울대학교 병원에 입원한 환자중 대변배양 검사에서 Clostridium difficile이 배양된 61명의 환자를 대상으로 병록지를 토대로 조사하였다. 결과 : 정상 성인 중 3%에서 Clostridium difficile이 분리되었다. 대상환자의 기저 질환은 악성고형종양(29%), 혈액종양(6.5%), 뇌혈관 질환(6.5%), 간경변(4.9%) 등의 순이었으며, 대상 환자의 75%에서 균이 분리되기 6주 이내에 항균제가 사용되었다. 사용된 항균제는 aminoglycoside(60.8%), 1세대 cephalosporin(56.5%), 3 세대 cephalosporin(43.4%), ampicillin(15.2%), metronidazole(15.2%), clindamycin(8.6%)의 순이었다. 흔한 증상은 설사(77%), 복통(53.8%), 오심(37%), 빈맥(25%) 등이었며, 혈액 검사상 백혈구증가증은 21.6%, 저알부민혈증은 3.03%에서 관찰되었다. 44명의 환자중 24명의 환자가 대증적 치료 후 호전되었고, vancomycin이나 metronidazole을 투여받은 17명의 환자중 15명의 환자가 증상의 호전을 보였다. 4예가 사망하였으며, 3예(4.9%)는 재발하였다. 결론 : Clostridium difficile 장염은 항균제 사용시 흔히 발생하는 질환이다. 정상 성인의 3%에서 Clostridium difficile이 분리되었다. Objective : Clostridium difficile gastrointestinal disease is an important nosocomial infection and is associated with antibiotic use. This study evaluated the incidence and clinical characteristics of Clostridium difficile infections. Methods : Stool specimens from 102 normal adults were cultured for Clostridium difficile. Sixty-one patients with Clostridium difficile isolated from stool specimens were reviewed retrospectively. The patients were seen at the Seoul National University Hospital during the period from Mar., 1592 to Sep., 1993. Results : Clostridium difficile was isolated in 3% (3/102) of normal adult Population. Underlying diseases of the patients included solid tumor(29%), hematologic malignancy(6.5%), corebrovascular disease(6.5%), and liver cirrhosis(4.9%). Antibiotics associated with Clostridium difficile infections included aminoglycosides (60.8%), first generation cephalosporin(56.5%), third generation cephalosporin(43.4%), ampicillin(15.2%), metronidazole(15.2%), and clindamycin(8.6%). In 3/4 of the cases, these antibiotics had beer) administered within 6 weeks before Clostridium difficile isolated. Associated symptoms included diarrhea(77%), abdominal pain(53.8%), nausea(37%), fever(37.7%), and tachycardia(25%). Leukocytosis and hypealbuminemia were observed in 21.6% and 30.3%. Out of 44 cases received symptomatic treatment, 54% (24/44) improved. Of 17 cases treated with metronidazole or vancomycin, 88% (15/17) improved. Four cases expired and 3 cases(4.9%)were relapsed. Conclusion : Clostridium difficile gastroenteritis is frequently associated with antibiotic treatment. Three percent of normal adult population had Clostridium difficile.

자궁경부암에서 p53과 human papillomavirus의 분포에 관한 연구

김영식,김대중,김의한,강상균,양승하 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Uterine cervical carcinoma is the most common malignant tumor of woman in Korea. Cervical lesions are associated with various subtypes of human papillomavirus(HPV), and recently there is many reports for interrelationship between p53 gene and HPV in development of cervical carcinoma. HPV is associated with condyloma acuminatum, flat condyloma, cervical intraepithelial neoplasm(CIN), and invasive carcinoma in uterine cervix. Among the subtypes of HPV, type 6b and 11 are reported as low risk group and type 16 and 18 are high risk group. p53 is an one of oncogene which control the cellular proliferation. The loss of p53 function by mutation and complex binding with HPV E6 could act an important role in developmental mechanism of cervical carcinoma. To observe the relationship between expression of p53 and HPV in CIN and invasive carcinoma, we analysed CIN 26 cases and invasive squamous cell carcinoma(SCC) 62 cases processed for immunohistochemical stain using monoclonal mouse anti-p53 and polyclonal anti-bovine papillomavirus. Then positivity of p53 and HPV was compared. The results are as followings: 1) The p53 in CIN showed positive reaction in twelve cases(46.2%) of twenty-six cases. Positive rates of CIN Ⅰ, CIN Ⅱ, and CIN Ⅲ are 33.3%, 42.9%, and 50% respectively. 2) The p53 in invasive squamous cell carcinoma showed positive reaction forty-four cases(71.0%) of sixty-two cases. Positive rates of microinvasive and invasive SCC are 53.8% and 75.5%, respectively. According to cell type, keratinizing type were eighteen cases(81.2%) of twenty-two cases and nonkeratinizing type were ninteen(70.4%) of twenty-seven cases. 3) Papillomavirus revealed low expression rate in CIN(26.9%) and invasive SCC (16.1%). 4) The p53 showed positive reaction in fourteen(82.4%) of papillomavirus-positive seventeen cases. Above results revealed higher positive rate of p53 according to progression of CIN and SCC, and in keratinizing type than in nonkeratinizing type of SCC. Positive rate of papillomavirus was very low, but high positive rate in p53 positive cases which suggest that p53 and HPV corelate in development of cervical carcinoma.

평행 평판 도파관내 수평 전기 쌍극자의 단순함수 형태 그린함수의 유도

김의중,이영순 金烏工科大學校 1996 論文集 Vol.17 No.-

Some discussions on the problematic aspects of the previous complex image method for the derivation of the vector and scalar potential Green's functions of a horizontal electric dipole in a PPW, are given. In particular, difficulties of the conventional 1-level approach in approximating the spectral Green's function in terms of complex exponential series over wide frequency range are pointed out. In order to resolve the problematic aspects and reduce the difficulties, and improved complex image method with 2-level approach is considered.

방사선조사와 저칼슘식이가 치아형성시 Interleukin-1의 분포에 미치는 영향에 관한 연구

김일중,황의환,이상래 대한구강악안면방사선학회 2000 Imaging Science in Dentistry Vol.30 No.3

Purpose : To elucidate the effects of the irradiation and calcium-deficient diet on expression of interleukin (IL)-1 during tooth formation of rat molar Materials and Methods : The pregnant three-week-old Spague-Dawley rats were used for the study. The control group was non-irradiation/normal diet group, and the experimental groups were irradiation/normal diet group and irradiation/calcium-deficient diet group . The abdomen of the rats on the 9th day of pregnancy were irradiated with single dose of 350 cGy. The rat pups were sacrificed on the 14th day after delivery and the maxillae tooth germs were taken. The specimen were prepared to make sections for light microscopy, and some of tissue sections were stained immunohistochemically with anti-IL-1 antibody. Results : In the irradiation/normal diet group, dental follicle showed fewer blood vessels, mononuclear cells, and fusions of mononuclear cells than in non-irradiation/normal diet group. Alveolar bone showed a few osteoblasts and osteoclasts. Periodontal ligament showed collagen fibers and fibroblasts with irregularity. Weak immunoreactivity for IL-1 was shown in dental follicle, alveolar bone, and periodontal ligament, In the irradiation/calcium-deficient diet group, dental follicle showed sparse cellularity. Alveolar bone showed diminished number of osteoblasts. Periodontal ligament showed irregular collagen fibers and atrophy of cementoblasts and fibroblasts. No immunore-activity for IL-1 was shown in dental follicle, alveolar bone, and periodontal ligament. Conclusion : Irradiation and calcium-deficient diet seems to cause disturbance of the expression of interleukin-1 during tooth formation of rat molar. (Korean J Oral Maxillofac Radiol 2000; 30: 159-168)

만성 요통 환자의 심리사회적 특성

김용민,원중희,최의성,서중배,이호승,허윤무 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 만성 요통 환자의 많은 수가 직업 등 주변 환경과 심리 상태의 영향을 받는 것으로 추정되나 그 연관성은 아직 논란이 많다. 본 연구에서는 설문 조사를 통하여 만성 요통 환자의 심리사회적 특성을 알아보고자 하였다. 대상 및 방법. 1997년 7월부터 1998년 12월까지 6주 이상 지속된 만성 요통으로 본원 정형외과 외래를 내원한 환자들 중 기질적 원인이 불명확한 62명의 환자들에서 직업, 유발요인, 치료 등 요통 관련 요소 설문과 Minnesota Multiphasic Personal Inventory (MMPI)를 실시하였다. 요통 관련 사항에는 통증의 기간, 정도, 통증이 유발 또는 심해지는 자세, 그리고 본인이 생각하는 요통의 원인 등을 포함하였다. MMPI는 전체 평균을 이용한 방법과 two-code 방법을 이용하여 평가하였다. 결과: 만성 요통환자의 직업 상 실내에서 앉아 일하는 직업이 가장 맡았으며 일정한 자세를 오래 유지하며 앉거나 서 있는 경우 증상이 악화되는 것으로 기술되었다. MMPI에서는 건강 염려증, 우울증, 히스테리의 세 척도의 평균이 55이상으로 상승되어 있었다. Two-code 방법에서는 92% (46/50)의 환자에서 위 세 척도 중 적어도 하나 이상 상승되어 있었다. 결론: 만성 요통 환자들에서 일상 생활의 자세와 직업이 요통의 발생 및 악화에 영향이 있을 것으로 보여졌다. MMPI를 통한 심리 인성 검사 상 건강 염려증, 우울증, 히스테리의 성향이 증가되어 있어 요통의 발생과 만성화에 심리적 요소가 영향을 미치는 것으로 보여졌다. 사회경제학적, 정신심리학적 요인이 만성 요통에 미치는 영향의 규명을 위한 다양하고 심도 있는 연구가 필요하다고 생각된다. Purpose : Socioeconomic and psychologic factors seem to affect incidence, severity, and chronicity of low back pain. Purpose of this study is to survey socioeconomic factors and document psychoneurotic traits via MMPI in chronic low back pain patients. Materials and Methods : From July 1997 to December 1998, questionnaire about low back pain-related factors such as duration, severity, posture, occupation etc. and MMPI were given to patients who visited our department for chronic low back pain()6weeks). 62 patients completed, and 50 of them completed MMPI. The answers were analyzed. MMPI scores were evaluated in mean±SD method and two-code method. Results : Sedentary workers were the most common. And symptoms were told to be elicited by long sitting or standing posture(job) . Hs, D, Hy scales of MMPI, which are know as "neurotic triad by two-code method was observed in 92% (46/50) . Conclusion : It seemed that job and posture had Important role in chronic low back pain. And, it seemed that chronic low back pain patients had some psychoneurotic traits especially in hypochondriasis, depression, and hysteria. More investigations to document the influences of socioeconomic and psychoneurotic factors in chronic low back pain seems to be necessary.

마이크로스트립 구조에 대한 공간영역 그린함수의 값을 구하기 위한 효율적인 수치해석 적분기법

김의중,이영순 國立金烏工科大學校附設生産技術硏究所 1997 産業技術開發硏究 Vol.13 No.-

An efficient numerical integration technique of the Sommerfeld integral, which used to evaluate the spatial-domain Green's function for the microstrip structure, is condidered. The error caused by the singular integral and slow convergence in the infinite integration interval, are improved using the folding around method and the average algorithm respectively. In order to check the validity of the present method, the results evaluated by the numerical integration of a vector potential Green's function are compared with those evaluated by the quasi-static terms in near field and the surface waves in the far field. Good agreements between them are observed.

중합효소연쇄 반응법에 의한 인형거대세포바이러스(human cytomegalovirus)의 신속한 검출

김의종,오명돈,박기호,신형식,이환종,김남중,최강원 대한감염학회 1996 감염 Vol.28 No.4

목 적 : 인형거대세포바이러스(HCMV)는 면역 저하 환자에서 폐렴, 망막염, 간염 등 치명적인 감염증의 원인이다. 전통적인 세포 배양법으로 HCMV를 분리하기까지는 1주에서 4주가 걸리므로 이 바이러스에 의한 질환이 의심되는 경우 신속한 진단법을 이용한 진단이 바람직하다. 저자들은 한국에서 분리되는 야생주 HCMV를 검출하는데 중합효소 연쇄 반응법을 이용할 경우의 진단적 유용성을 알기 위하여, 전통적인 세포배양법으로 HCMV가 분리된 검체를 이용하여 중합효소 연쇄 반응법의 특이도와 민감도를 평가하였다. 방 법 : 국내 야생주 HCMV 15주, 그리고 전통적인 바이러스 배양법으로 HCMV가 분리된 소변 15검체를 대상으로 중합효소 연쇄 반응을 실시하였다. 중합효소 연쇄 반응은 Towne주의 immediate early antigen의 유전자에서 유리된 primer MIE와 AD169주의 immediate early antigen의 유전자에서 유리된 primer IE를 이용하였다. 증폭 산물은 겔 전기영동 후 EtBR으로 염색하여 자외선 하에서 관찰하였다. Primer IE에 의한 증폭산물은 또한, DNA blot hybridization 방법으로 확인하였다. 결 과 : 1) 국내 HCMV 야생주 15주를 대상으로 중합효소 연쇄 반응을 한 결과 primer IE를 이용한 경우에는 100%(15/15)에서 177bp의 증폭 산물이 관찰되었고, 이들 증폭 산물은 모두 probe IE와 보합 결합되었다. primer MIE를 이용한 경우에는 93%(14/15)에서 435bp의 증폭 산물이 관찰되었다. 2) 세포 배양법으로 HCMV가 분리된 소변 15검체를 대상으로 primer IE를 이용하여 중합효소 연쇄 반응을 한 결과 direct gel analysis 법으로는 73%(11/15)에서, 보합 결합법으로는 87%(13/15)에서 관찰되었다. Primer MIE를 이용한 경우에는 direct gel analysis법으로 87%(13/15)에서 435bp의 증폭 산물이 검출되었다. 결 론 : Primer IE와 MIE를 이용한 중합효소 연쇄 반응법은 국내 야생주 HCMV를 신속히 검출하는데 유용한 검사법이다. Background : Human cytomegalovirus(HCMV) can cause pneumonitis, hepatitis, retinitis and other serious diseases in the immunocompromised patients. It takes 1 to 4 weeks to diagnose HCMV infection by conventional virus culture. Therefore, when HCMV diseases are suspected, a rapid diagnostic method such as polymerase chain reaction(PCR), antigen assay or shell vial culture is desirable. We evaluate the sensitivity and specificity of a PCR for the rapid detection of HCMV wild strains in Korea. Methods : We used 2 sets of primers ; primer IE and primer MIE derived from the sequence for immediate early gene of AD169 strain and Towne strain, respectively. Fifteen clinical isolates of HCMV, suspended in MRC-5 cells, were amplified by PCR. Fifteen urine specimens which were positive for HCMV by conventional virus culture were also amplified. Amplification products were analyzed by polyacrylamide gel electrophoresis. The products from PCR with primer IE were also identified by DNA blot hybridization. Results : PCR using primer IE gave the PCR products in all of the 15 HCMV wild strains. All of these were hybridized with probe IE. When primer MIE were used, 93%(14/15) of the wild strains showed amplified bands by direct gel analysis. When the urine specimens were amplified by PCR with primer IE, amplified bands were seen in 73%(11/15) by direct gel analysis ; 87%(13/15) by hybridization method. When primer MIE were used, 87%(13/15) of the urine specimens showed the PCR products by direct gel analysis. Conclusion : Polymerase chain reaction with primer IE and MIE may be a specific and sensitive diagnostic method for rapid detection of HCMV wild strains in Korea.