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      • KCI등재후보

        자발성 세균성 복막염을 일으킨 그람음성간균의 3세대 세팔로스포린 내성률 변화

        방지환,송경호,박주경,박완범,김성한,김홍빈,김남중,오명돈,김의종,이효석,최강원 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

        The third generation cephalosporin is widely used in treatment of spontaneous bacterial peritonitis (SBP). Resistance to the third generation cephalosporin was associated with poor outcome in patients with SBP. Thus it is necessary to know the changes in resistance rate. We planned to investigate retrospectively on resistance rate of the third generation cephalosporin of gram negative bacteria isolated in patients with SBP, who visited Seoul National University Hospital between 1998 and 2006. The Clinical and Laboratory Standards Institute guidelines were applied for antibiotic susceptibility test. A total of 269 consecutive episodes of clinically and microbiologically proven SBP was identified during the study period and 209 cases were caused by gram negative organisms. Among 209 isolates, 22 (10.5%) showed resistance to the third generation cephalosporin. The prevalence of resistance was decreasing during the study period (P=0.014).

      • KCI등재후보

        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.

      • KCI등재후보

        우리나라 사람면역결핍바이러스(Human Immunodeficiency Virus) 감염환자에서 발병한 악성종양

        최평균,송진수,조재현,김성한,박경화,방지환,박완범,김홍빈,김동완,김태유,허대석,오명돈,김남중,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

        Background : Since highly active antiretroviral therapy has lengthened the life span of individuals infected with human immunodeficiency virus (HIV), the importance of malignancy associated with HIV has been increased. The relative frequencies of malignancies in HIV infected patients may vary in different race and region. The aim of this study is to determine the prevalence and characteristics of malignancies in patients with HIV infection in South Korea. Materials and Methods : To identify HIV patients with malignancy, we reviewed the electronic database of pathological reports for all HIV-infected patients seen from January 1986 to December 2005 at the Seoul National University Hospital. We retrospectively reviewed the medical records of them. Results : Among 850 patients infected with HIV, 33 episodes of malignant diseases were diagnosed in 32 patients (3.76%). Thirty were males, and median age was 46 years (range 29-70). At the time of the diagnosis of malignancy, median CD4^(+) lymphocytes count was 100/uL (range 5-620) and in 27 (82%) patients, CD4^(+) lymphocytes count were less than 200/uL. For 13 patients (40%), malignancy was initial presentation of HIV infection. Excluding patients initially diagnosed as malignancy, median follow-up duration from the first visit to diagnosis of malignancy was 36 months (range 3-96). Non-Hodgkin's lymphoma was the most frequent malignancy (13 patients), followed by Kaposi's sarcoma (7), Hodgkin‘s disease (3), acute myeloid leukemia (1), and other solid cancer (9) including one case of anal cancer associated with human papillomavirus. Among 13 patients with non- Hodgkin's lymphoma, 4(31%) achieved the complete remission after chemotherapy and/or radiation therapy, and had been followed without evidence of recurrence. Conclusion : Malignancy was diagnosed in 3.76% of patients infected with HIV. Non-Hodgkin‘s lymphoma is the most prevalent malignancy in HIV patients in South Korea. 목적 : 효과적인 항레트로바이러스 다제요법이 도입됨에 따라, HIV 감염환자들의 수명이 증가되었고, 이에 따라 HIV 감염환자에서 악성종양의 중요성 또한 증가하고 있다. 본 연구의 목적은 우리나라 HIV 감염환자에서 악성종양의 유병률과 호발하는 악성종양의 특성을 밝히는 것이다. 재료 및 방법 : 1986년부터 2005년까지 서울대학교병원에서 치료를 받은 HIV 감염환자의 의무기록을 후향적으로 분석하였고, 병리학적 검사 결과를 검토하여 악성종양이 진단된 환자들을 대상으로 연구를 시행하였다. 결과 : 총 850명의 환자 중, 32명(3.76%)에서 33예의 악성종양이 진단되어, 악성종양의 발병률은 1,000인년 당13.0명(95% 신뢰구간: 8.6∼17.4명)이었다. 그 중 남자는 30명이었고, 악성종양 진단 당시 연령의 중간값은 46 (29-70)세이었다. 악성종양 진단받을 당시, CD4 림프구 수의 중간값은 lOO/uL (5-620 uL) 이었고, CD4 림프구수가 200/ uL 미만인 환자가 27명(82%)이었다. 악성종양에 대한 검사 도중에 HIV 감염사실이 밝혀진 환자가 13명(40%)이었다. HIV를 진단 받은 후 악성종양이 발병한 환자들에서, HIV 진단 후 악성종양의 발병까지는 평균 36개월(3-96개월)이 걸렸다. 13명의 HIV 감염 환자에서 진단된 비호지킨림프종이 가장 흔한 악성종양이었고, 이외에 카포시육종이 7명, 호지킨병이 3명, HPV와 연관된 항문암이 1명의 HIV 환자에서 진단되었다. 그 밖에 급성백혈병, 방광암, 췌장장, 폐암, 진행성위암, 갑상선암, 간세포암, 후두암이 각각 1예씩 진단되었다. 비호지킨림프종이 진단된13명 환자 중, 4명(31%)은 항암치료 및 방사선치료를 받아 완전관해가 되었고, 현재 재발의 증거 없이 외래에서 경과 관찰 중이다. 결론 : 우리나라 HIV 감염환자에서 악성종양의 유병률은 3.76%이었고, 비호지킨림프종이 가장 흔한 악성종양이었다.

      • 무릎운동훈련들이 안쪽빗넓은근과 가쪽넓은근의 수축 개시시간에 미치는 효과

        김명진,김지원,이재온,박경희,신화경 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.2

        The purpose of this study was to investigate the effect of knee exercises on the onset times of vastus medialis oblique muscle (VMO) and vastus lateralis muscle (VL) and in healthy subjects. Fifteen subjects (7 men, 8 women) in a mean age of 25.4 years participated in the study. Electromyographic (EMG) signals were recorded from the VMO and VL under four exercises. Knee exercises consisted of open kinematic terminal knee extension, straight leg raising, isometric hip adduction exercise, and closed kinematic terminal knee extension. No significant differences were found in the onset times of EMG activities of VMO and VL in the four exercises. There were also no significant differences among the exercises. These results coincided with previous studies that found no difference between onset of VMO and VL. However, it is difficult to say that there is no difference between onset of VMO and VL in healthy subjects. To confirm this results, further researches that follow same onset determination metod and exercises are needed. Not only is the study of onset time of muscle needed, but also the studies of the amount of activation and the rate of increase of muscle activation are needed.

      • KCI등재

        항정신병 약물이 Cyclooxygenase-2 유전자 발현과 Prostaglandin E_2 농도에 미치는 영향

        김종우,조성욱,범재명,윤도준,장환일,송지영 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.2

        Objectives : Cyclooxygenase(COX) is the central enzyme in the biosynthetic pathway to prostaglandins from arachidonic acids. The action mechanism of nonsteroidal anti-inflammatory drugs is through inhibition of COX activity and prostanoid biosynthesis including prostaglandin E_2(PGE_2). The antipsychotic drugs are known having an analgesic effects, however its mechanisms of actions of action to pain control was not still clearly proved. In the present study, the effects of antipsychotic drugs(chlorpromazie and clozapine) on the production of PGE_2 and the expression of COX-2mRNA and protein in P815 cell line were studied. Methods : For that purpose, the methods of RT-PCR, western blot and prostagalndin E_2 enzymeimmunoassay were applied. Results : The results showed tha tin P815 cells treated with chlorpromazine, the level of COX2 mRNA was significantly decreased compared to the control cells. And total cellular PGE_2 levels were significantly decreased after treatment with chlorpromazine and clozapine. Conclusion : These results suggest that antipsychotic drugs have revealed their analgesic effect through the inhibition of COX-2 activity and PGE_2 production. And also, these results partly supports the excess theory of prostaglangdins in the pathogenesis of schizophrenia.

      • 취업주부의 직업만족도와 어머니역할만족도 분석

        김명자,지혜선 숙명여자대학교 2000 生活科學硏究誌 Vol.15 No.-

        Employed wive have a difficulty to play their many roles. Especially maternal role is most important to woman, thus this study attempt to explore employed wife's maternal satisfaction by job satisfaction and related variable. Maternal satisfaction is composed of three factors: spouse support, mother-child relationship, role performance. To show the above research questions, the self-reportd questionnaire were taken from the employed wife in seoul and chong-ju city. 424sample were finally selected as datum sources. The data were analyzed by the statistical methods such as frequency, percentile, mean, standard deviation, Cronbach's αcoefficient, hierar-chical regression analysis through spss/pc+. The major findings are summarized as follows: First, Employed wive were more satisfied with mother-child relationship than spouse support and role performance. Second, job satisfaction shows significant difference according to education level, wife's income, household helper presence, a kind of helper. Third, maternal satisfaction shows significant difference according to age, education level, income. Fourth, the most influential variables on maternal satisfaction is job satisfaction and age. job satisfaction affect maternal satisfaction positively, however flexibility of job affected maternal satisfaction adversely. In conclusion, in order to improve employed wive's maternal satisfaction, the education program for parent role should be prepared according to the characteristics of the family system.

      • 소나무로부터 배출되는 모노테르펜 구성비의 수령별 특성 연구

        김조천,홍지형,주명칠,전진,김기준 동신대학교 환경연구소 2002 환경연구 Vol.7 No.1

        소나무로부터 직접 배출되는 주요한 모노테르펜 물질로 α-pinene, camphene, myrcene, β -pinene, α-phellandrene, α-terpinene, d-limonene, p-cymene, β-phellandrene 등이 확인되었다. 7년생 소나무에서 직접 배출되는 모노테르펜 물질의 구성비를 분석한 결과 β-pinene이 67.0%로 가장 높았고, 22년생 소나무 경우에 β-phellanone이 37.4%로 가장 높았으며, 32년생 소나무는 α-pinene 구성비가 약 42.9%로 가장 높았다. 소나무는 수령에 따라서 구성비에 큰 차이를 보였으며, 소나무 수령이 높을수록 α-pinene이 구성비가 높았다. 소나무의 수령별 α-pinene과 β-pinene의 비율(α-pinene/β-pinene)을 비교한 결과, 7년생 소나무의 경우 0.16~l.15 범위로 나타났고, 22년생 소나무의 경우 0.64~2.47로 나타났으며, 32년생 소나무의 경우 0.50~18.47 범위로 나타났다. α-pinene과 β-pinene의 비는 수령이 높아질수록 좀 더 높은 값을 보였고, 동일한 수령일지라도 나무에 따라서 차이를 보였다. The major monoterpenes emitted from the Pinus densiflora were α-pinene, camphene, myrcene, β-pinene, α-phellandrene, α-terpinene, d-limonene, p-cymene and β-phellandrene. As a result of comparison of monoterpene composition by tree age for P. densiflora, it was found that β-pinene was a dominant monoterpene for 7-year-old pine(67%). β-Phellandrene(37.4%) and α-pinene(46.1%) were most abound for 22-year-old pine and 32-year-old pine respectively. The ratio of monoterpene composition varied considerably with tree age for the pine, and the percentage of α-pinene composition increased with tree age. The ratio of α-pinene and β-pinene(α-pinene/β-pinene) increased with tree age, and varied tree to tree.

      • KCI등재
      • 지도부딘 투여력이 없는 Human Immunodeficiency Virus Type 1 감염환자에서 지도부딘 내성 발현율

        김남중,최은숙,김의석,이대호,최영주,방지환,오명돈,최강원 대한감염학회 2001 감염 Vol.33 No.1

        Backgroud : Drug resistant virus has been seen with all effective antiretroviral drugs in current practice. The isolation of resistant virus from subjects is associated with more rapid clinical outcome. The presence of resistance-conferring mutations in a patient in whom therapy is foiling indicates that other antiretroviral drugs should be considered. So, the identification of drug resistant Human Immunodeficiency Virus (HIV-1) mutations is of increasing importance. Zidovudine monotherapy for HIV-1 infection has been widely used in Korea since 1990. So, the prevalence of zidovudine resistant virus has been expected to be high. The purpose of the present study is to determine the prevalence of zidovudine resistant HIV-1 among zidovudine-naive Korean patients. Methods : We tested drug susceptibility of HIV-1 isolated from 19 zidovudine-naive Korean patients. We amplified a portion of gene reverse transcriptase of HIV-1 by RT nested PCR method. The susceptibility of HIV-1 to zidovudine was determined by sequencing the DNA base pairs of gene reverse transciptase. Results : Two (10.5%) of 19 HIV-1 isolates from zidovudine naive patients showed resistance conferring mutations to zidovudine. Two (2.1%) of 95 codons analysed from zidovudine naive patients showed mutations conferring resistance to zidovudine. Conclusion : The prevalence of zidovudine resistant HIV-1 was 10.5% among zidovudine-naive Korean patients. (Korean J Infect Dis 33:40~45, 2001)

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