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.

RADIANCE 프로그램과 인터넷 환경을 이용한 조명시뮬레이션 시스템 개발

송규동,김지현,최안섭 대한건축학회 2003 대한건축학회논문집 Vol.19 No.4

The prediction of illuminances from daylight and artificial lighting has been an important issue in the field of architecture. Architects traditionally have used scale models or various computer programs as tools for predicting the available illuminance in a building and for visualizing the overall lighting quality of the environment. The program requires accurate modeling of the geometric and photometric properties of a designed environment. RADIANCE is a program developed to aid lighting designers and architects by predicting the lighting levels and appearance of a space prior to construction of a building. The modeling of geometric property is usually conducted by commercially available CAD softwares. The modeling of photometric properties includes material color, texture and/or transmittance, daylight availability, and luminous intensity distribution of artificial light sources. The simulation itself uses backward ray-tracing technique to compute radiance values, which are typically arranged to form a photographic quality image. The purpose of this study is to develop a Radiance rendering system that operates automatically on the WWW environment.

건강보험에서 5인 미만 사업장의 직장보험 편입 효과 평가와 정책 방향

송명섭,김창보,고수경,임정수,박지연 한국사회보장학회 2002 사회보장연구 Vol.18 No.2

본 논문은 건강보험공단이 2001년 「월 이후 추진하고 있는 5인 미만 사려장의 직장보험 편입을 평가하고 향후 정책방향을 제시하는데 목적을 두고 있다. 5인 미만 사업장의 직장보험 편입은 보험 가입자의 보험료 부과의 형평성을 제고하고, 영세사업장 노동자들의 보험료 부담을 경감시키며 건강보험재정 안정 효과를 위한 것이다. 2001년 7월 이후 12월 31일까지 직장보험으로 신규편입한 대상자는 모두 약 64만명이었으나 편입이전지역보험 대상자는 약 53만명, 직장보험 대상자는 약 10만명이었다. 또한 동일 기간동안 직장보험으로 편입된 사업장은 모두 88,751개였다. 편입 전후 개인별 보험료 수준 변화를 살펴보면 보험료 부과대상 중 77.6%는 본인이 부담해야 할 보험료가 감소하였다. 대신 사업주의 보험료 부담은 상대적으로 늘어났다. 한편 2001년 7월 이후 12월까지 직장보험 편입으로 건강보험의 재정은 약 19,530백만원의 재정절감효과가 있었다. 직장보험은 7,331백만원의 보험료 수입 증가가 발생하였으며, 지역보험은 12,199백만원의 재정절감 효과가 있었다. 향후 5인 미만 사업장의 직장보험 편입이 원만히 추진되기 위해서는 피부양자 인정기준의 개선과 영세사업장 사업주의 보험료 부담을 경감시켜주기 위한 방안을 강구해야 하며, 사회적으로는 비정규직 노동자에 대한 사회보장 적용 확대를 위한 노력이 동시에 추구되어야 할 것이다. This study was conducted for the purpose of evaluating coverage of small companies with less than 5 persons by Corporate Insurance since July 2001 and of suggesting policy implication. This coverage expansion by Corporate Insurance was intended for improving equity level of contribution imposition, alleviating financial burden of employees and achieving financial stability of health insurance. While, from July 2001 to December, the number of newly covered beneficiaries was about 642 thousand persons, the number of Regional beneficiaries before the new coverage expansion by Corporate Insurance was 533 thousand persons. And the number of Corporate Insurance beneficiaries before the coverage expansion was 101 thousand persons. For the same period, the number of companies by the new coverage expansion of Corporate Insurance was 88,751. Before and after the expansion, taking into account changes of individual contribution levels, payment share levels of contribution were reduced to the 77.6% of the beneficiaries newly covered by Corporate Insurance. Instead, payment share level of contribution of employers was increased more than before. And 19,530 million won was increased in National Health Insurance Expenditure. 7,331million won was increased in Corporate Insurance revenue. Expenditure reduction effect of 12,199 million won was able to be obtained in Regional Insurance. In order to implement successfully the coverage expansion by Corporate Insurance in times ahead, employers' contribution share should be reduced, when considering low profitability levels of small companies.

이트라코나졸의 경구용 액제 처방화

정기섭,홍지웅,최기송,지상철,박은석 한국약제학회 2002 Journal of Pharmaceutical Investigation Vol.32 No.4

The oral bioavailability of itraconazole is variable and low in fasting state. This is mainly due to the low solubility of this drug. Bioavailability can be improved by changing the formulation and it is general that the liquid preparations show greater bioavailability than the solid dosage forms such as tablets and capsules do. Benzyl alcohol-water binary mixture showed the excellent solubilizing capacity for itraconazole but the release of the drug from the preparation needs to be enhanced. In this study, various nonionic surfactants and hydrophilic polymers, poloxamers, were screened to investigate their effects on the release of itraconazole from the liquid preparations. Poloxamer 407 showed the most enhancing effect on the drug release and the release rate was proportional to the amount of poloxamer 407 added. A liquid preparation of itraconazole, consisting of benzyl alcohol/water/poloxamer 407 ternary solvent system, released more than 80% of the total drug amount at 5 min and showed the possibility of a new formulation development.

자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

골수구성 백혈병 환자에게 발생한 결핵성 림프절염

이창섭,송진수,최평균,조재현,방지환,박경화,박완범,김홍빈,김남중,윤성수,박선양,김병국,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

혈액질환 가운데 결핵 발생이 증가한다고 알려진 것은 호지킨 림프종을 포함한 림프증식성질환 그리고 모양세포성 백혈병 등이 있다. 또한 동종 골수이식을 받은 환자에서도 결핵은 증가한다고 알려져있다. Kaplan 등은 골수구성 백혈병 환자에서 결핵 발생이 증가한다고 보고하였다. 그러나 골수구성 백혈병 환자에서 결핵의 발생이 증가하는 이유에 대해서는 아직까지 정확하게 밝혀지지 않았다. 저자들이 2년 동안 후향적으로 조사한 180명의 성인 골수구성 백혈병 환자들 가운데 결핵이 발생한 환자는 4명이었고, 발생 부위는 모두 림프절이었다. 결핵은 골수구성 백혈병의 특정 아형에만 국한되어 발생하지 않았지만, 50%에서 FAB 분류에 의한 M4였다. 림프절이 종대된 골수구성 백혈병 환자에서 특히, 결핵의 유병율이 높은 나라에서는 결핵성 림프절염도 감별진단에 포함시켜야 한다. During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.

Cone beam형 전산화단층촬영법을 이용한 하악과두의 골변화에 관한 연구

이지운,김형섭,송주섭,김경아,고광준 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.37 No.3

Purpose : To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibular disorder (TMD) Patients. Materials and Methods : 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co.,Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra-and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Results : Osteophyte (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior and medial surfaces of the mandibular condyle. The intraobserver agreement was good to excellent(k=0.78-0.84), but interobserver agreement was fair(k=0.45). Conclusion : CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

A High Speed and Low Power 4:1 Multiplexer Architecture for Graphic Memory Interface

Ji-Seop Song,Sang-Hyuk Yang,Eung-ju Kim,Shin-Il Lim,Suki Kim 대한전자공학회 2010 ICEIC:International Conference on Electronics, Inf Vol.1 No.1

This paper proposes the new 4:1 MUX architecture for high speed and low power graphic memory interface. The proposed architecture consists of one 4:2 MUX and one optimized 2:1 MUX. The 4:2 MUX is based on double 2:1 MUX. This proposed 4:1 MUX architecture eliminates the flip-flops in the conventional tree topology and also achieves 33% reduction of power consumption compared to the conventional tree topology, while this new 4:1 MUX shows 2X speed improvement compared to the conventional one stage architecture. The merits of both conventional architectures are simultaneously achieved with this optimized architecture. The simulation results show that 10Gb/s 4:1 MUX in proposed architecture consumes 10㎃ current at 1.8V supply voltage and has over 200㎷ eye opening. All simulations are performed with 0.18㎛ CMOS technology.

Cross contamination associated with the wiping method during the sanitation of the food-contact surfaces

Ji Seop Song,Ki Won Lee,Young Hoon Lee,Tae Jin Cho 한국식품영양과학회 2021 한국식품영양과학회 학술대회발표집 Vol.2021 No.10

Major purposes of using wet wipes by consumers are not only to clean the food-contact surfaces but also to remove the microbial contaminants. However, the evaluation on the decontamination efficacy of domestic commercial wet wipes has been limited to the preservation test without considering the wiping effects. In this study, we modified the 4-field test method designed for investigating the biocidal effects of wet wipes (EN 16615) to identify the major determinant factors on the removal of bacteria on the surface by the simulation of consumers’ actual use of wipes. We analyzed the surface removal and residual level of bacteria after wiping according to the weight and wiping method as key factors of decontamination efficacy. The differences in the weight and wiping method represented as the direction and the repetition of the wiping affected the surface residual number of bacteria and the level of cross-contamination. Thus, the comprehensive examination on the interaction of bacteria and wipe during their contact by wiping is expected to be the basic information to establish the guideline for the proper use of wipe with the perspectives to the microbial risk management.

Implication from the risk assessment of cross-contamination associated with wiping patterns by consumers with the perspective to the decontamination of the food contact surfaces

Ji Seop Song,Yoon Oh,Tae Jin Cho 한국식품영양과학회 2022 한국식품영양과학회 학술대회발표집 Vol.2022 No.10