국내 5개 3차 병원의 β-lactam계 항생제 사용 실태 및 Klebsiella pneumoniae의 항생제 내성과의 상관 관계

정숙인,박경화,권기태,고관수,오원섭,정두련,백경란,염준섭,장현하,김신우,손준성,송재훈 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

Background : This study was performed to evaluate the prescribing pattern of β-lactam antibiotics and the relationship between antimicrobial resistance and antimicrobial use in 5 tertiary care hospitals in Korea. Materials and Methods : Data on annual patient-days and annual consumption (defined daily dose (DDD) per 100 patient-days) of β-lactam antibiotics from 2003 to 2005 in 5 tertiary hospitals were analyzed. To determine the antimicrobial resistance in K. pneumoniae, broth microdilution test and double disk synergy were performed according to the CLSI performance standards. Spearman's correlation coeffient was used to determine the relationship between antibiotic consumption and resistance. Results : The prescription of β-lactam antibiotics in 5 tertiary hospitals markedly varied. In two hospitals, increase in consumption of β-lactam antibiotics was more than 30% during recent 3 years. The higher consumption of β-lactam antibiotics significantly correlated with the higher rate of antibiotic-resistant K. pneumoniae in 5 tertiary care hospitals. Conclusion : Continuous surveillance of antibiotic use is needed to encourage appropriate prescribing of antibiotics and to reduce antibiotic resistance. 목적 : 항생제의 오남용으로 인한 내성균의 발현 및 급속한 확산이 전세계적으로 문제시 되고 있다. 특히 병원은 항생제 내성의 중심점에 있는 것으로 여겨진다. 본 연구에서는 최근 3년간 국내 5개 3차 병원의 β-lactam계 항생제의 사용량을 조사하고, 각 병원별 항생제 사용량과 K. pneumoniae의 항생제 내성률과의 상관관계를 알아보고자 하였다. 재료 및 방법 : 국내 5개 3차 병원에서 2003년 1월부터 2005년 12월까지 병원 입원 환자를 대상으로 연도별 재원연인원수와 각 β-lactam계 항생제의 총사용량을 수집하여 DDD (defined daily dose) per 100 patient-days로 환산하여 비교하였다. 2005년 6월부터 8월까지 각 병원의 임상검체에서 동정된 K. pneumoniae를 수집하여 액체배지미량희석법으로 항생제 감수성 검사를 시행하였고 ESBL(extended-spectrum β-lactamase) 생성 여부는 double disk synergy test를 시행하였다. 항생제 사용량과 내성의 상관관계는 Spearman 상관관계 분석을 시행하였다. 결과 : 5개 병원 중 3개 병원에서는 연도별 β-lactam계 항생제 사용량이 비슷하게 유지되었으나, 2개 병원에서는 2003년에 비해 2005년에 항생제 사용량이 30% 이상 증가하였다. β-lactam계 항생제 중 제제별 비율은 각 병원마다 차이가 있었으나, 3세대 cephaosporin의 사용이 가장 많았고 2세대 ceaphlosporin, β-lactam/β-lactamase inhibitor, 1세대 cephalosporin 순이었다. 경구용 β-1actam계 항생제의 사용량(r=0.900, P<0.037)과 2세대 cephalosporin의 사용량(r=0.900, P<0.037)은 각각 K. pneumoniae의 ESBL 생성과 양의 상관관계가 있었다. Ceftazidime의 사용량은 K. pneumoniae의 ceftazidime 내성률과 양의 상관관계가 있었다(r=0.900, P<0.037). 반면 imipenem의 사용량은 piperacillin/tazobactam 내성과 음의 상관관계가 있었다(r=-0.900, P<0.037). 결론 : 최근 3개년간 항생제 사용량은 병원별로 차이가 있으나 일부 병원에서는 증가하였다. β-lactam계 항생제의 사용량은 K. pneumoniae의 항생제 내성과 상관관계가 있었다. 항생제 사용을 줄임으로써 항생제 내성을 감소시킬 수 있을 것으로 기대되며, 병원별로 항생제 사용에 대한 지속적인 감시가 필요할 것이다.

천연자원의 Cytotoxicity와 Antioxidative activity 검색

김태희,양기숙,이수현 숙명여자대학교 약학연구소 1993 약학논문집-숙명여자대학교 Vol.9 No.-

A preliminary lab experiment was carried out on 29 species of medicinal plants known to be effective anti-cancer agents among the folk medicine. The cytotoxicity of P_(388), L_(1210) leukemia cells, the inhibition rate of its root meritism through the cress seedling assay and the lipid peroxidation test were performed. Potential cytotoxicity on the P_(388) leukemia cells in the Thalictrum aquilegifolium, Lindera obtusiloba and Artemisia annua and the control of cell proliferation in the caulis of Acathopanax chiisanensis against L1 2 I O leukemia cells were observed. In the cress seedling test, the plants such as Pharbitis nil, Artemisia iwayomogi, the caulis of Acanthopanax chiisanensis, Clematis mandshurica and Melandrium firmum showed activity in vincristine 200㎕/㎖ cisplatin 500㎕/㎖ concentration. On the system 1,2-lipid peroxidation, it was found that Artemisia iwayomogi and Artemisia annua exhibited strong antioxidative effect in the homogenate substance of rat liver injured by CC1₄.

임신 중 발견된 대망 종괴 1례

조인숙,김태의,김정식,이해혁,이권해,김희경,남계현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A case of omental mass during Pregnancy Omental cyst is a rare lesion and occur primarily during childhood and young adulthood. When encountered, most of them are benign and intraabdominal masses. It shows a large mass but not palpable and often asymptomatic. The precise diagnosis is made by most commonly at surgery or during pathologic examination. So, we report this case with brief review of literatures.

萬頃江流域에 있어서 井水中의 弗素含量에 관한 硏究

金完泰,安榮根,申和雨,張賢淑 원광대학교 식품약품안전성연구소 1987 食品藥品安全性硏究 Vol.1 No.-

This study is the survey about Fluorine contents in the well water of area of Mankyung River side and water of Mankyung River. The result of this survey is as followings: The water of well in this area contained 0.5∼1.3ppm and it's average value was about 0.8 ppm. The water from Mankyung River contained 0.8∼0.9ppm and it's average value is 0.87ppm. By the regionally sectional survey the well water of the area of Mankyung River side, the well water of Chun-Ju, Iri, Samye, and Kusan contained 0.5∼0.8ppm, but the well water of Baikku area contained 0.6∼1.3ppm. Especially in Baikku area 63% of well contained 0.6∼1.0ppm and 38% of well contained 1.1∼1.3ppm. From the above results one can conclude that the 38% of well water of the Baikku area is troubled one.

원발성 난소 소세포암 2례

조인숙,남계현,김태희,김정식,이해혁,이권해,권계원 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Two cases of primary small cell carcinoma of the ovary occurred. One was a case of 43-year-old woman associated with hypercalcemia and the other was a case of 40-year-old woman with pulmonary type. Ovarian small cell carcinoma of the hypercalcemic type have clinicopathological, immunohistochemical, ultrastructural, and flow cytometric features that from differ from those of small cell carcinomas of the pulmonary type. It is important for therapeutic reasons to distinguish these two types of ovarian tumors from each other and from a variety of malignant small cell tumors that ovary primarily or secondarily. So, we reported these cases with a brief review of the concerned literatures.

更年1號丸의 抗酸化活性에 對한 硏究

이현숙,남경수,이태균 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

To investigate the antioxidant effects of Gaengnyounilhohwan (GIH), we administrated acetaminophen (500mg/kg, i.P.) that induced hepatic lipid peroxidation to starved mice for 24hrs after pretreatment of GIH for 6 days. And the effects of GIH on the hepatic enzymes(glutathion-S-transferase, superoxide dismutase, glutathion peroxidase and catala se) which participate in lipid peroxidation and glutathion metabolism were investigated. The results were as follows 1. GST(glutathion-S-transferase) activity in the acetaminphen treated group was remarkably reduced compared with saline treated group (control group). However, in the pretreated group of GIH for 6 days GST activity was increased about 2.7 fold. 2. Compared with control group, SOD (superoxide dismutase) activity was decreased by 26.9% in the acetaminophen treated group. On the other hand, in the GIH pretreated group SOD activity was almost recovered to the level of control group. 3. In the acetaminophen treated group, GSH-Px(glutathion peroxidase) activity was decreased by 47.1 % compare with control group. And in the GIH pretreated group. GSH-Px activity was increased about 2 fold and recover to the control group. 4. Catalase activity was also decreased by 23.8% in actamlnophen treated group. However, in the GIH pretreated group, catalase activity was increased above 2 fold compared with control group. 5. In the acetaminophen treated group, malondialdehyde values of plasma and cytosolic fraction were significantly increased compared with control group. However, after the GIH treated group, lipid peroxide formation was decreased by 47% in plasma, and remarkably decreased 3.7 fold in cytosolic fraction. These results suggest that GIH plays a protective role in the formation of acetaminophen induced lipid peroxidation.

두경부 편평세포암종세포주에서 retinoic acid가 linear-quadratic 모델을 적용한 방사선감수성과 apoptosis 유발에 미치는 영향

이은숙,강범현,허민석,이삼선,최현배,최순철,박태원 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.3

Purpose : To evaluate the effect of all-trans-retinoic acid on radiosensitivity and radiation-induced apoptosis in NHOK, HEp-2 and FaDu cell lines. Material and Methods : We measured the changes in survival fraction at 2 Gy (SF2), α and β after treatment of retinoic acid (1μM) prior to irradiation with doses of 2,4,6 and 10 Gy and correlated the radiosensitizing effect of retinoic acid with them. Also, apoptosis induction was assayed with the flow cytometry on days 1, 2, 3, 4 and 5 after irradiation (2,10 and 20 Gy) combined with retinoic acid. Results and Conclusion : SF2 values for NHOK, HEp-2 and FaDu cell lines were 0.54, 0.64 and 0.41, respectively and the cell line of FaDu was the most radiosensitive, For cell lines of NHOK and HEp-2, pretreatment of cells with retinoic acid resulted in a significant decrease of the SF2 values. The α/β ratios of x-ray survival curve were 8.714(NHOK), 4.098(HEp-2) and 11.79(FaDu). The α/β ratio for NHOK decreased on pretreatment with retinoic acid, whereas those for HEp-2 and FaDu increased. Radiation induced apoptosis in all cell lines but, retinoic acid did not affect the apoptosis. (Korean J Oral Maxillofac Radiol 2001; 31 : 135-43)

사무직 근로자들의 직무 스트레스와 피로

차경태,김일희,고상백,현숙정,박준호,박종구,차봉석,장세진 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.3

목적: 이 연구는 전국 규모의 조사 연구에서 수집된 자료 중 사무직 근로자들을 대상으로,사회인구학적 특성,직업 특성,건강행태,직무 스트레스와 피로수준 간의 관련성을 분석하는 데 있다. 방법:‘한국인 직무스트레스 측정도구의 표준화 전국 조사연구National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002∼2004)’를 위해 2002년 5월 1일부터 2003년 5윌 30일 까지 수행되었으며,전국의 사업장에 근무하는 근로자 30,146명(남자: 84%,여자: 16%) 중 사무직 근로자 4,457명(남자: 68.9%,여자 31.1%)을 연구 대상으로 하였다. 자료수집방법은 사업장을 방문하여 보건 및 안전관리자 등에게 연구의 취지를 알린 후 설문조사에 대한 협조를 구하고 응답자 직접 기입법을 이용 하였으며,사회인구학적 특성,직업적 특성,건강관련 요인,KOSS-SF를 이용한 7개의 직무 스트레스 요인,그리고 MFS를 이용하여 피로 수준에 영향을 주는 요인에 대해 분석하였다. 결과: 일반적 특성,작업관련 특성,건강행태관련 특성 및 직무 스트레스 요인이 근로자들의 피로와 강한 관련성이 있음이 입증되었으며,특히 직무 스트레스의 하부 요인 중에서도 피로와 관련성을 보이는 요인이 남녀별로 다소 상이 하게 관련된다는 것을 발견할 수 있었다. 남자의 경우는 직무 스트레스의 하부 영역 중 직무 요구도,직무 불안정성,보상부적절 등이 영향력이 높은 주요 직무 스트레스 요인이었던 반면,여자는 직무 요구도,보상부적절,직장문화가 주요한 직무 스트레스 요인이었다. 결론: 직장인 피로가 갖는 보건학적 의학적 경제학적 중요성을 감안할 때,조직의 생산성 향상과 근로자 개개인의 삶의 질 향상 및 건강증진을 위해선 직무 스트레스 관리 프로그램이 절실히 요청된다고 볼 수 있다. Background & Objectives: A growing body of research has documented that occupational stress is closely associated with increased risk of fatigue. This study was conducted in an effort to assess the relationship of occupational stress to self-perceived fatigue among Korean white collar employees. Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002-2004). Among them, a total of 4,502 white collar employees were recruited. A structured questionnaire was employed to evaluate the participants' sociodemographics, job-related factors, health-related behaviors, occupational stress, and self-perceived fatigue. Occupational stress and self-perceived fatigue were assessed using the Korean Occupational Stress ScaleShort form (KOSS-SF) and the Multidimensional Fatigue Scale (MFS), respectively. Results: In logistic regression analyses, occupational stress was associated with an increased risk of fatigue, and some domains of occupational stress had different effects on fatigue by gender (job demand, job insecurity, and lack of reward for men, job demand, lack of reward, and discomfort in occupational climate for women), which indicates that occupational stress may perform a slightly different role in increasing the risk of fatigue by gender. Conclusion: The results of this study suggest that occupational stress is a determinant predictor of self-perceived fatigue. Thus, a stress management program for the reduction of occupational stress, and the promotion of white collar worker's health and quality of life is strongly recommended. Some limitations of this study and considerations for future studies were also discussed.

비만 여성을 대상으로 한 해조류 추출물의 국부처치와 운동 병행을 통한 지방분해 효과의 임상적 검정

서태수,이인숙,변재철,김규호,박승한,김유영,김상국,김현정,김상기,신동철,성미영,박종석,김종기,박언휘 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.3

This study was carried out to test the body fat breakdown during topical seaweed extract treatment and in combination with the aerobic exercise. Of 20 female obesity subjects, ten treated a cream types of seaweed extract(control group) and ten treated a placebo cream(placebo group). Topical treatment of each sample was designed for 4 weeks, and treated with 2 times a day about 10ml on the abdomen and the thigh, respectively. All subjects were participated aerobic dance half hour a day and four times a week. After 4 weeks of topical treatment and exercise, they were measured body fat, skinfold thickness, body circumference. Then venous blood samples were taken and analyzed blood cells, serum enzymes, and serum lipids. There were reduction of body weight, % of body fat, antebrachium, brachium, chest, waist, thigh circumference and abdomen thickness between pre and post treatment in both group. Especially, body weight and % of body fat significantly reduced in the subjects treating the seaweed extract than those treating the placebo. There were significant decrement in total cholesterol and LDL whereas increment in HDL and TBIL in the control group, but no significant difference in the placebo group. In conclusion, there were 7.6% of body fat reduction during 4 weeks of aerobic exercise and 21% of body fat reducement in combination of topical seaweed treatment and exercise, respectively. These results suggest that the topical treatment of seaweed extract should be very effective for fat breakdown. Especially, the body fat breakdown maximized in the combination with the topical seaweed extracts treatment and the aerobic exercise.

초등학교 교사들의 직무스트레스와 건강 수준

조현숙,이종태,손혜숙,박진국 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : The purpose of this study was to assess the effect of job strain on stress and health status among elementary school teachers. Methods and Material : The subjects in this study were 300 teachers who were selected from among 588 teachers in 13 out of 42 elementary schools in the city of Gimhae. Through the questionnaire, demographic characteristics, Karasek's Job Content Questionnaire(JCQ) and the Psychosocial Well-being Index (PWI) to assess their occupational characteristics and psychosocial stress level were surveyed. Medical checkup results of them were adopted to measure their Health status. Results : 24.9 percent of the general teachers were low strain group, and 16.3 percent of them were high strain group. In the senior teachers, 19.7 percent belonged to a low strain group and 21.3 percent belonged to a high strain group. In regard to health status, more senior teachers than junior teachers suffered from obesity(24.6%) and diabetes(11.5%) (p<0.O5), and they also were higher in DBP(p<0.057), total cholesterol(p=0.039) and blood sugar level(p=0.000), the low strain group perceived more social support(p=0.000), and the high strain group felt bigger physical overload(p=0.000). Concerning psychosocial stress, the low strain group was more aware of teacher social role and put more confidence in themselves(p=0.004). The high strain group was more depressed(p=0.001), but no difference was detected in health status. The health status difference between the high strain and low strain groups was significant in depression of psychosocial stress(OR=3.823, 95%CI=1.584-9.224). Conclusion : The senior teachers group was more morbid to obesity, diabetes and hyperlipidemia, which implies that some measure should be studied to help senior teachers manage those diseases properly. The high strain group suffered more from physical overload and was high 'Social support'. Therefore it's required for high strain group to be given more support from colleagues and supervisors, and a stress management program should be implemented to reduce their psychosocial stress.