당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

Simvastatin이 골결손부 회복에 미치는 영향

강정호,김규태,최용석,이현우,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.3

Purpose : To observe and evaluate the effects of Simvastatin-induced osteogenesis on the wound healing of defective bone. Materials and Methods : 64 defective bones were created in the parietal bone of 32 New Zealand White rabbits. The defects were grafted with collagen matrix carriers mixed with Simvastatin solution in the experimental group of 16 rabbits and with collagen matrix carriers mixed with water in the controlled group. The rabbits were terminated at an interval of 3, 5, 7, and 9 days, 2, 4, 6, and 8 weeks after the formation of defective bone. The wound healing was evaluated by soft X-ray radiography. The tissues within defective bones were evaluated through the analysis of flow cytometry for the manifestation of Runx2 and Osteocalcin, and observed histopathologically by using H-E stain and Masson’s trichrome stain. Results : 1. In the experimental group, flow cytometry revealed more manifestation of Runx2 at 5, 7, and 9 days and Osteocalcin at 2 weeks than in the controlled groups, but there was few difference in comparison with the controlled group. 2. In the experimental group, flow cytometry revealed considerably more cells and erythrocytes at 5, 7, and 9 days in comparison with the controlled group. 3. In the experimental group, soft x-ray radiography revealed the extended formation of trabeculation at 2, 4, 6, and 8 weeks. 4. Histopathological features of the experimental group showed more fibroblasts and newly formed vessels at 5 and 7 days, and the formation of osteoid tissues at 9 days, and the newly formed trabeculations at 4 and 6 weeks. Conclusion : As the induced osteogenesis by Simvastatin, there was few contrast of the manifestation between Runx2 and Osteocalcin based on the differentiation of osteoblasts. But it was considered that the more formation of cells and erythrocytes depending on newly formed vessels in the experimental group obviously had an effect on the bone regeneration.

e-비즈니스 활동이 품질경영성과에 미치는 영향

강현석,서영호 한국경영과학회 2001 한국경영과학회 학술대회논문집 Vol.- No.1(1)

Although there are many factors that influence the managerial performance of organizations, many companies try to use electronic communication technology for customer satisfaction and process optimization these days. With the proliferation of telecommunication technologies, the traditional focus of information systems on the internal operation has shifted to external activities such as customer care and supplier/ partner relationships. In recent years, the Internet has come to revolutionize the way in which business is operated and is related with other businesses. Internet- oriented QM (Quality Management) activities have played a significant role in providing speedy, efficient, and accurate means of business transactions and business process reengineering especially in the areas of customer relationship management (CRM) and supplier/partner relationship management (SCM: supply chain management). The purpose of this study is to analyze the impact of e-quality management (e-QM) activities on business quality and performance. In order to analyze the impact of e-QM empirically, e-QM activities are further divided into two groups, e-CRM and e-SCM. Activities in each group together with related technologies are defined. This study investigates the degree to which company's use of Internet and questionnaires to collect data for statistical analysis. From the empirical analysis, it is shown that the degree of e-QM operations is positively related with operational performance. This indicates that companies with more e-CRM and e-SCM activities tend to perform operations more efficiently and more effectively with possibly brighter future financial performances.

온주밀감의 수체부위에 따른 질소 함량 및 집적량

강영길,유장걸,오현도,오상호 濟州大學校 亞熱帶農業硏究所 1998 亞熱帶農業硏究 Vol.15 No.-

온주밀감에 있어 질소 시비법 개선의 기초자료로 활용하고자 흑색화산회토에 재식된 8년생 궁천조생 16 그루를 대상으로 수체부위별 건물중, N 함량, N 축적량, 건물중 및 N 축적량의 수체부위별 분포비율 등을 조사·분석한 견과를 요약하면 다음과 같다. 1. 그루당 건물중은 7.2~12.6 kg의 범위에 있었고 평균이 10.3 kg, CV가 16.5%이었다. 수체부위별 평균 건물중 분포비율은 뿌리에 총건물중의 22.6%, 줄기에 38.8%, 잎에 14.9%, 과실에 23.7%가 분포되어 있었다. 그루간 수체부위별 건물중 분포비율의 CV는 잎에서 가장 적었고(7.8%) 근간 및 수간에서 매우 컸다(38.5 및 42.6%). 2. 나무 전체 평균 N 함량은 1.13%이었고 뿌리, 줄기, 잎, 과실의 평균 N 함량은 각각 0.96, 0.75. 2.58, 0.99%이였으며, 세근, 녹지의 N 함량은 각각 1.83, 1.18%로 비교적 많은 편이었다. 수체부위별 N 함량의 CV는 4.3~14.6%로 건물중에 비하여 현저히 낮았고 잎(6.8%), 과육(4.6%), 과피(5.5%)에서 적었으나 녹지에서는 14.6%로 컸다. 3. 그루당 N 축적량은 80~145 9의 범위에 있었고 평균이 116 g이었는데, 뿌리에 N 총축적량의 19.3%, 줄기에 25.9%, 잎에 34.0%, 과실에 20.8%가 분포되어 있었다. 뿌리내 N 축적량의 16.4, 32.6, 51.0%가 각각 근간(stock), 중·대근, 세근에, 줄기내 N 축적량의 12.2, 19.8, 26 2, 41.8%가 각각 수간, 대지, 중지, 녹지에, 과실 N 축적량의 68.5%가 과육에 집적되어 있었다. 그루간 수체부위별 N 축적량의 CV는 수체부위별 건물중 분포비율에서와 대체로 비슷한 경향이었다. Dry weight, N content and accumulation, and the distribution of dry weight and N accumulation in various plant parts of sixteen 8-year old Satsuma mandarin trees (Citrus unshiu Marc. Cv. Miyakawa Wase) grown in volcanic ash soil were determined in December 1997 to obtain some information for improving N fertilization. Dry weight per tree ranged from 7.2 to 12.6 kg and averaged 10.3 kg (CV 16.5%) Roots, stems, leaves and fruits had 22.6, 38.8, 14.9, and 23.7% of total dry weight, respectively. The coefficient of variability for leaf dry weight distribution among 16 trees was least (7.8%) while the CV for stock and trunk dry weights great (38.5 and 42.6%, respectively). Average N content for whole tree, roots, stems, leaves and fruits had 1.13, 0.96, 0.75, 2.58 and 0.99%, respectively. Fine roots and twigs also had higher N content with 1.83 and 1.18%, respectively. The coefficient of variability for N content in the various parts of trees ranged from 4.3 (fruits) to 14.6% (twigs) and was much smaller than the CV for dry weight and N accumulation. Nitrogen accumulation per tree ranged from 80 to 145 g and averaged 116 g. Whole roots, stems, leaves and fruits had 19.3, 25.9, 34.0, and 20.8% of total N accumulation of whole tree, respectively. Stock, medium-big roots, and fine roots had 16.4. 32.6, and 51.0% of total N accumulation in whole roots, respectively, while trunk, big and medium branches, and twigs 12.2, 19.8, 26.2 and 41.8% of N accumulated in whole stems, respectively, and pulp 68.5% of N accumulated in whole fruit. The coefficients of variability for N a cumulation distribution among 16 trees had similar trend with dry weight distribution.

단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

근로자 건강증진전략을 위한 행동변화에 대한 요구도 평가

이강숙,임현우,구정완,홍현숙,이정민,이원철,박정일,맹광호,M, O'Donnel 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the stage of behavior change for health promotion strategy in workplace Methods : Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyong-in area from September to October 1998. Results : According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%, 0%, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0% in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%, 22.7%, 19.7%, 44.0% in female. In heavy smoker(p=0.017) and heavy drinker,(p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker. Conclusions : This study suggested that company support for health promotion in workplace was and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient health promotion strategy.

Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예

배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.

초등과학영재학급 학생의 학습양식과 과학탐구능력 간의 상관관계

최선영,송현정,강호감 한국초등과학교육학회 2005 초등과학교육 Vol.24 No.2

The purpose of this study was to investigate the relation between the learning styles and science process skills of students of the gifted class in elementary school. Subjects were forty-eight students of the gifted class who are in the fifth grade studying at the gifted class of S elementary school in Bucheon, M and Y elementary school in Incheon on learning styles and science process skills of students. Learning Style Profile (LSP) was used as instrument to survey learning style of students of the gifted class which was developed by NASSP, and consists of four categories (cognitive skills, perceptual response, orientation and learning preferences) and twenty-four subscales. The results of this study were as follows: 1. In the learning styles test, students of the gifted class have higher scores of spatial skill, sequential processing skill, persistence orientation, manipulative preference, temperature preference and after-noon preference than general class students, but they have lower scores of discrimination skill and lighting preference, and there were statistically significant difference. 2. In science process skills test, there were statistically significant difference between students of the gifted class and general students. 3. In the correlation between the learning styles and science process skills, there was positive correlation of observing skill with spatial skill and manipulate skill of cognitive skill domain. For classifying skill, there was positive correlation with visual perceptual response, but was negative correlations with auditory and emotive perceptual response of perceptual response domain and with evening preference and verbal risk orientation of study preference domain. For measuring skill, there was positive correlation with sequential processing skill of cognitive skill domain. For formulating hypotheses, there was positive correlation with persistence orientation of study preference domain. For controlling variables, there was positive correlation with sequential processing skill and simultaneous processing skill of cognitive skill domain, and with verbal-spatial preference and early morning study preference of study preference domain. When planning and man-aging the gifted class, it will be beneficial and effective to consider the meaningful relations between the elements of learning style and science process skills in order to improve science process skills.

재래종 참외 종자 및 생육초기 주요형질의 유전력과 상관관계 분석

이상우,박상현,강호종,안상열,채윤석,김주현 진주산업대학교 농업기술연구소 2000 農業技術硏究所報 Vol.13 No.-

This experiment was conducted to obtain some basic imformation for korean native oriental melon breeding. Genetic variability, heritability, and correlation on 13 characters were analyzed. The results are summarized as follows; 1. Among 13 characters, plant height and length of lateral shoot showed high level of GCV(110-362%) and ECV(89-101%). The rest characters showed low level of GCV(7-21%) and ECV(0.16-9%). 2. Heritabilities of 13 characters investigated were high as over 50%. Especially those of hypocotyl length, 100-seed weigth and seed width were very high (> 95%). 3. High level correlation values were observed among seed characters and seedling characters. 4. Plant characters of early growth stage, except leaf stalk length, were not related with characters of seed or seedling 5. In early plant growth stage, plant height and length of lateral shoot were correlated positively with number of node, number of lateral shoot, leaf length and leaf width.

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.