서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

아스팔트 콘크리트의 고온변형저항 특성 측정방법 개발

김광우,이문섭,김중렬,이순제 강원대학교 부설 석재복합신소재 제품연구센터 2002 석재연 논문집 Vol.7 No.-

본 연구는 정하중하에서 아스팔트 혼합물의 소성변형 저항특성을 측정할 수 있는 새로운 시험방법을 개발하기 위하여 수행되었다. 2가지 골재(편마암, 화강암)와 6가지 아스팔트(일반아스팔트, 5가지 개질 아스팔트)를 사용하여 총 12개의 밀입도 혼합물을 제작하였다. 마샬 배합설계를 통해 최적아스팔트 함량을 구하고, 결정된 최적아스팔트 함량으로 마샬공시체(S=10 cm)와 자이레토리 공시체(S=15cm)를 제작하여 마샬안정도시험, 휠 트랙킹 시험, 개발된 김테스트(Kim -test)를 수행하였다. 김테스트는 공시체와 하중봉을 지지할 수 있는 김시험장치(Kim tester)를 이용하여 하단이 반경(r) 0.5 또는 1.0cm로 원형절삭한 직경(D) 3cm, 4cm의 하중봉을 사용한다. 또한 재하는 마샬 하중재하 장치를 사용하여 공시체를 60℃ 수조에 30분동안 수침시킨 후 실시되었다. 정하중은 공시체의 직경방향이 아닌 축 방향으로 50 mm/min가 가해졌고, 최대하중(P_max)과 수직변형(y)이 측정되었다. 마샬안정도시험과 간접인장강도시험에서 얻어지는 것과 유사한 곡선이 각각의 시험에서 얻어졌다. 강도값은 P_max, r, y 및 H(=D-2r)을 이용한 K_D=4P_max/π(H+2√(2ry-y^2))^2식을 통하여 계산하였고, 이를 변형강도(kgf/㎠)로 정의하였다. 실험결과, 공시체 직경이나 골재종류보다는 하중봉과 하중봉 하단의 원형처리 여부가 K_D와 P_max 값에 영향을 미치는 것으로 나타났다. 통계분석결과에서 K_D가 소성변형 깊이와 동적 안정도에 높은 상관성을 보였다. 향후 연구를 통해 K_D의 유효성이 검증된다면, Kim-test는 아스팔트 혼합물의 소성변형 저항성을 판단할 수 있는 시험방법으로 사용될 수 있을 것이다. This study dealt with developing a new approach for finding properties which might represent rut resistance characteristics of asphalt mixture under static loading. Two aggregates, a normal asphalt (pen 60-70) and 5 PMAs were used in preparation of 12 dense-grade mixtures. Marshall mix design was used in determination of the optimum asphalt content (OAC) and each mixture at the OAC was prepared for a newly-developed Kim test on Marshall specimen (S=10 cm) and gyratory specimen (S=15cm), and for wheel tracking test. Kim test used Marshall loading frame and the specimen was conditioned for 30min at 60℃ before loading through Kim tester, and apparatus consisting of a loading column and a specimen and column holder. Diameter (D) of column was 3cm and 4cm with each column having different radius (r) of round cut at the bottom. The static load was applied at 50mm/min in axial direction of the specimen, not in diameteral direction, and the maximum load (P_max) and vertical deformation (y) at the maximum load point were measured. A curve, similar to the one from a Marshall test or static indirect tensile strength test was obtained from each test. A strength value was calculated based on the P_max, H(=D-2r). r and y by using the equation K_D=4P_max/π(H+2√(2ry-y^2))^2 and is defined as deformation strength (kgf/㎠). The values of P_max/y and K_I=K-D/y were also calculated to see if these have any correlation with rutting. In general, D and r were significant factors affecting K_D, while specimen size was not. The statistical analyses results showed the K_D had the best correlation with rut depth and dynamic stability. The next best correlation was found from P_max which was followed by P_max/y and K_I in order. Therefore, K_D can be used for selecting the highly resistable asphalt mixture against permanent deformation.

7개 대학 병원에서 조사한 지역사회 폐렴의 원인균

정문현,김성민,강문원,최희정,정희진,이경원,한성우,송재훈,신형식,김의종,최강원,김민자,박승철,배현주,정윤섭,김준명,백경란,신완식,이규만,김양리 대한감염학회 1997 감염 Vol.29 No.5

목 적 : 폐렴은 많이 발생하면서 사망률이 크게 줄지 않는 질환이며, 이를 적절히 치료하기 위해서는 원인균의 상대적 빈도, 기저 질환에 따른 변화, 항균제 내성률, 사망에 관련된 인자들을 알아야 한다. 원인균의 빈도는 지역마다 차이가 있고 국내에서는 항균제 내성률이 높아 지역사회에서 발생한 폐렴을 치료하기 위한 경험적 항균제 선택에 도움이 되기 위해 서울 소재 6개 대학 병원과 천안의 1개 대학 병원이 참여하여 위의 사항들에 대해 조사를 하였다. 방 법 : 1995년에 내과에 입원했던 16세 이상 환자를 대상으로 했다. 퇴원 진단명이 폐렴 또는 폐결핵인 병록지을 찾았고, 이중에서 병원 감염을 제외하였다. 특이도를 높이기 위해, 이들 중에서 호흡기 증상이 있고 발열이나 저체온이 있으면서 흉부 X-선에서 이상 음영이 있는 환자만을 대상으로 했다. 폐결핵은 위의 기준에 입원 초기에 항균제 치료를 하고 입원 7일 이후에야 항결핵제가 투여된 경우만을 폐렴의 원인균으로 하였다. 혈액 배양에서 양성, 객담에서 항상균이나 M. tuberculosis가 증명된 경우, 혈청학적으로 항체가가 4배 이상 증가된 경우, 조직에서 원인균이 진단된 경우는 확정(definitive) 원인균으로 하였고, 객담에서 배양된 균이 그람 도말과 일치할때, 항결액제에 대한 반응으로 진단한 폐결핵, 단일 항체가 양성이고 이에 대해 항균제를 사용했을 때는 가능(probable) 원인균으로 정의하였다. 다세균 감염균은 각각 다 른 원인균으로 처리하였다. 임상 조사와 함께 임상병리과에서 S. pneumoniae, H. influenzae, M. catarrhalis, mycoplasma, 항상균에 대해 검사 의뢰 건수, 배양 양성수, 항균제 감수성 결과를 조사하였다. 결 과 : 폐렴의 증례 정의에 부합하지 않은 135명과 폐결핵의 정의에 해당하지 않는 230명을 제외하고 남은 246명의 평균 나이는 58.2세이고 남성이 142명(58.2%) 이었고, 71%의 환자에서 기저 질환이 있었다. 진단 방법의 시행 횟수는 혈액 배양 77.6%, 혈청 검사 18.3%, 기관지경 검사는 4.1%였고, 세균의 항원 검사를 한 예는 없었다. 원인균이 밝혀진 예는 77명(31.3%)이었다. 다세균 감염이 4명에서 있었고, 원인균의 상대적 빈도는 결핵 20명(확정 17, 가능 3: 6개 병원 자료), 폐렴구균 18(확정8 가능 10)명과 폐렴구균이 아닌 Streptococcus 3명 (모두 확정), H. influenzae 11명(모두 가능), 그람음성간균 11명(확정 7, 가능 4) (K. pneumoniae 8건), Mycoplasma 5명(확정 1, 가능 4), S. aureus 4명(확정 2, 가능 2), mucormycosis 1명(확정)이었다. 평균 입원 기간은 19일이고, 중환자실 입원률과 인공 호흡기 사용율은 각각 18%와 9.3%였다. 사망률은 13.8%였고 사망까지 평균 기간은 14.6일 이었다. 다변량 분석에서 사망을 예측할 수 있는 인자는 저체온과 빈호흡이었다. 임상병리과에서 배양되었던 모든 폐렴구균의 Penicillin 내성률은 서울 3개 병원에서 82-88%, 천안에서 72%였다. 폐렴 환자의 혈액에서 배양된 7주는 모두 Penicillin에 감수성이 있었다. K. pneumoniae 8주 모두 cefotaxime과 gentamicin에 감수성을 보였다. 결 론 : 후향적 조사이고 병원마다 원인균 진단에 차이가 있지만, 원인이 밝혀진 경우에는 결핵과 폐렴균이 흔하였고, 무균 부위에서 배양된 폐렴구균의 항균제 내성률은 낮았다. 원인이 밝혀지지 않은 경우가 많고, 혈청검사로 진단되는 원인균이 드물며, 분리균주가 적어 항균제 내성 정도를 추정하기 어려워, 이를 밝히기 위한 전향적 조사가 필요하다. Background : Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitation of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. Methods : medical records of adults (>15 years of age) hospitalized for CAP or pulmonary tuberculosis between April 1995 and March 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer of antibodies to “atypical”pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum withcompatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinucal response to anti- tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and Mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of resiratory pathogens from all body sites, and their clinical significance were evaluated. Results: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria,246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171(71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44(18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable: E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae and A. baumannii and K. pneumonias), S. aureus (2 definite and 2 probable) , and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8isolates). therates of admission to the intensive care unitand of using assisted ventilation were 18% and 9.3%, respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but seven isolated from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolated of k> pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. Conclusion: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which well be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.

The level of urinary aflatoxin M1 in Korean adults

Yong-Dae Kim1, Hyojin Kwon, Sun-In Moon, Sang-Yong Eom, Jung-Duk Park, Byung-Sun Choi, Seok-Joon Sohn, Young-Seoub Hong, Ho Kim, Ho-Jang Kwon, Ji-Ae Lim, Hae-Jung Yoon, Gwang-Jin Kim, Heon Kim 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.3

Competitive ELISA methods were used to measure the level of aflatoxin M1 (AFM1) from urine in 1008 Korean adults. Subjects were selected by random sampling in all areas of Korea, except Cheju-do. The recovery rate of AFM1 using this method was 105% (73-124%). The geometric mean of urinary AFM1 in all subjects was 3.43 pg/mL (3.67 ng/g creatinine). The level of AFM1 in males was statistically higher, compared with female subjects. However, the levels of AFM1 did not differ according to age. Subjects in Chungbuk-do showed the highest urinary AFM1 concentration, whereas subjects in Kyeongnam-do showed the lowest concentration. Assuming an excretion rate of 5%, this AFM1 excretion corresponds to approximately 0.1 microgram/day in Korean adults.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

크론병에 대한 CoPPLX의 방어효과에 대한 연구

이호학,김유림,문창기,이재일,양병윤,김종수,이정민,정재혁,안석진,박상준,김윤권,김소연,김영중,조민구,최영자,장성조 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

수입 외국산 모발세정용 화장품의 중금속 농도에 관한 연구

문정아,문덕환,박명희,안진홍,김종은,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : For the purpose of preparing the fundamental data and preventing the health impairment due yo heavy metals in hair cleaner. Methods and Material : The author determined the concentration of heavy metals(Fb, fn, Cr, Ni and Cu) in hair cleaner with flameless atomic absorption spectrophotometer. Results : The results were as follows : 1. The mean concentration of heavy metals in total hair cleaner were 0.046㎍/g for Pt, 0.O67㎍/g for Mn, 0.069㎍/g for Cr, 0.046㎍/g for Ni, and 0.022㎍/g for Cu, respectively. 2. There was not statistically significant difference to mean concentrations of each heavy metal in hair cleaner by producing nation. 3. The highest mean concentration of each heavy metal in hair cleaner by type of use were 0.140㎍/g for Mn in sensitive hair cleaner(p<0.05), 0.053㎍/g for Cu in others products(p<0.01). 4. The mean concentration of heavy metals in hair cleaner by type of hair cleaner were high at 0.O54㎍/g for Pb in shampoo products(p<0.O5), 0.120㎍/g for Cr and 0.06㎍/g for Cu in combination products(p<0.01). 5. The mean concentration of heavy metals in hair cleaner by acidity were high at 0.056㎍/g for Pb, 0.124㎍/g for Cr, and 0.032㎍/g for Cu in alkali products (p<0.05). 6. Correlation coefficient of heavy metal concentration in hair cleaner were 0.175 for Pb and Cr, 0.165 for Pb and Mn, 0.824 for Cr, and Mn, 0.189 for Cr, and Ni, 0.406 for Cr, and Cu, 0.197 for Mn and Ni, and 0.375 for Mn and Cu(p<0.05). 7. Exposure amount of heavy metals per when we used lOg of hair cleaner (onetime using amount) were 0.46㎍ for Pb, 0.67㎍ for Mn, 0.69㎍ for Cr, 0.46㎍ for Ni, and 0.22㎍ for Cu, respectively. Conclusion : As above results, there was very low level concentration of heavy metal in hair cleaner but we are using the hair cleaner everyday, therefore we can exposed to heavy metals as cronic exposure so the author suggest to prepare the program of preventing the health impairment due to heavy metals.

반복적인 급성 신부전을 유발한 호산구성 장염 1 예

정혜진;김현태;김유선;정현걸;강윤경;문정섭 인제대학교 2011 仁濟醫學 Vol.32 No.-

Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by presence of gastrointestinal symptoms, eosinophilic infiltratio n of one or more parts of gastrointestinal tract without involvement of other organs and absence of parasitic infestation. The clinical presentation depends on the extents and depths of eosinophilic infiltration. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. We report a case of eosinophilic enterocolitis in a 55-year-old female presented with abdominal pain and watery diarrhea resulting in recurrent acute renal failure.

하악골에 발생한 골막 골육종

김태우,김승범,권혁찬,문선재,윤정훈,김형준,차인호,육종인,김진 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Periosteal osteosarcoma is a distinct entity of malignant bone tumor with characteristic clinical, morphological, and histological features within the group of juxtacortical osteosarcoma. Periosteal osteosarcoma is predominantly located in the tubular long bones, and extremely rarely involving the jaws. A case of periosteal osteosarcoma of the right mandible is presented. A 27-year-old woman complained of the gingival swelling and bleeding tendency of the right posterior mandible. Clinical examination revealed a reddish brown strawberry-like swelling on the affected mucosa, which measured 1.5㎝×1.5㎝. The tumor was located on the lingual cortex of the mandible and extended into the surrounding soft tissues. Microscopically, the tumor consisted exclusively of atypical chondroblastic cells with a small osteoblastic area. A minimal bone marrow involvement was noted and the adjacent cortex was free of tumor. These findings suggested that the tumor originated from the periosteal cambium layer, which lies between the periosteal fibrous layer and the cortex of mandible.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.