뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성

도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.

신경회로망에 의한 2차원초음파의 화상재구성

金應珪,權寧島 大田産業大學校 1994 한밭대학교 논문집 Vol.11 No.0201

Comparing with light, Utrasonic has so small degenerating characteristic in solid and liquid matters that the measurement to use ultrasonic is widely used in medicine and biology. In this paper, echo process of ultrasonic transducer which is replace in circle type is done in the neural network and the method for image reconstruction of two dimensional target is presened. The image reconstruction in the same target its learned pattern and in unlearned target is done in this experiment. In result, although image reconstruction in unlearned target was not enough obtained, in the case of the same target as learned pattern, most of target images are reconstructed by this method and it is possible that two dimensional image is also reconstructed. It is hinted that three dimensional image reconstruction is possible in some target by improving the neural network structure and increasing the kinds and the number of tearing patterns.

신경회로망과 k-NN법의 식별능력비교 : 모음 및 膝蓋骨亞脫臼CT화상인식에 있어서의 고찰 A Study in Vowel and Patellar Subluxation Image Recognitions

金應珪,權寧島 大田産業大學校 1994 한밭대학교 논문집 Vol.11 No.0201

In this paper, a comparison of classification ability between BPN( Back Propagation Neural Network) and k-NN (k-Nearest Neighbor) is made using the classification methods with patellar subluxation images and voice data. First, automatic diagnosis possibility of patellar subluxation symptoms, from CT images, is examined. Experimentally, BPN(a three-layered back propagation neural network) method is compared with k-NN(k nearest neighbor) method. A typical example of the conventional nonparametric recognition method is used, in the classification ability in order to evaluate the BPN method. Continuously, the same comparison in voice data is made as mentioned above. From the result of image recognition of patellar subluxation by using BPN method, Automatic diagnosis possibility is suggested in some degree. BPN method showed 9.2 percent higher than that of the k-NN classification method in the average recognition rate. Although k-NN classification is simple in theory, classification time was fairly long. Therefore, it seems that real time recognition is difficult. On the other hand, the BPN method is slow in learning time but is very fast in recognition time. If the number of dimensions of the samples is large, it can be said that BPN is better than k-NN in classification ability.

주사형 정전용량 현미경의 개발

金應珪,權寧島 大田産業大學校 1996 한밭대학교 논문집 Vol.13 No.0201

In this study, a scanning capacitance microscopy(SCaM) by stage driving is proposed and presented some of the experimental results. SCaM is a microscopy which scans a surface of materials mechanically in two or two point five dimensions by a capacitance probe with a few tenth ㎛ size tip, and display images of the surface shape or capacitive distribution. The present target of the SCaM is 0.1㎛ resolution power which exceeds that of optical microscopy. This will become a powerful tool for inspecting ULSI pattern etched by X-ray, biological data, etc. The experimental system is composed based on a VHD video disk which captures the capacitance changes of the video disk surface and converts it into video signal.

레이져스캐너 3차원계측에 있어서 다방향 데이터의 통합

金應珪,權寧島 大田産業大學校 1995 한밭대학교 논문집 Vol.12 No.0201

When objects are scanned satially by a laser-beam and mechanical mirror scanners, a technique is presentd for obtainment of three-dimensional data, and then measurement errors are often a significant problem. In this paper, first, a model of the systematic errors for a two-dimensional mirror scanner is developed based on the geometry of the laser scanning system. Parameter values are modified to reduce the different between measured and calculated values. This show that it is possible to measure three-dimensional data in a three-dimensional measurement system with enough precision for practical use. Futhermore, complete object data can be obtained without occlusion by combine scanner data from multiple directions.

웨이블릿 변환에 의한 정보 압축

김응규,권영도 한밭대학교 정보통신전문대학원 2005 정보통신전문대학원 논문집 Vol.3 No.1

본 연구에서는 웨이블릿 변환법에 기반한 정보압축을 제안한다. 신호와 화상의 압축 원리는 그 전력이 낮은 영역쪽으로 집중한다는 것을 이용한 비트의 할당, 즉 최적 양자화로, 주파수 분해방법으로써 이산코사인 변환법과 하부밴드 부호화 등이 실용화되고 있다. 본 연구에서 취급하는 웨이블릿 변환법도 그중의 한가지로 신호를 다중해상도로 분해해서 최적양자화를 행한다. 웨이블릿 변환은 주파수분할 방법 중의 하나로서 이산코사인 변환 또는 서브밴드 필터링 그리고 필터뱅크로 구현할 수 있다. 또한 공간적으로 국한(집중)되는 기저함수의 우수한 성질로부터 다른 방법에서 지적되어진 단점을 억제하는 효과가 있어, 다른 방법과 비교하면서 웨이블릿 변환의 장점에 대해서도 기술한다. In this study, on information compression based on the wavelet technique is described. The principle of signal or image compression is performed by optimization of quantization, that is the bit allocation taking advantage of their energy concentration in low frequency components. The wavelet transform is one of frequency decomposition, such as the discrete cosine transform or sub-band filtering, and it is also implemented as a filter bank. Wavelet transform with use of spatially localized basis function can reduce several drawbacks in conventional methods. The benefit of wavelet based compression method is described as comparing the transform method to another ones.

Pion-Nucleon Scattering in Phase Shift Analysis below 400 MeV/c

李應頀,金成度 서울교육대학교 과학교육연구소 1995 科學과 數學敎育 論文集 Vol.21 No.-

본 연구는 400 MeV/c 이하의 에너지 영역에서 위상이동분석(S-, P-, D-파)을 소개하고 그 물리적 의미 및 위상이동에 의한 파이온-핵자 산란단면적을 연구하였다. 이들 에너지 영역에서 π^+p 반응은 이용가능한 실험치와 좋은 일치를 보여 주고 있으나, π^-p 반응은 │p│?? 150 MeV/c보다 낮은 에너지에서 다소 차이를 보여 주었다. 본 연구의 결과로부터 π^-p 반응에서 나타나는 I=1/2에 대한 위상이동은 낮은 에너지 영역에서 더욱 정확한 분석을 요구한다. We have introduced pion-nucleon phase shifts(S-, P-, and D-wave), to study its physical properies, and to provide the cross sections of pion-nucleon scattering calculated using fitted phase shifts for energies below 400 MeV/c. In this energy region, we have found that the agreement is quite respectable for π^+p at all energies, but less good for π^-p below |q| ?? 150 MeV/c.

캡슐내시경과 단일풍선 소장내시경으로 진단된 공장의 간질종양 1예

송도경,심기남,태정현,김경진,송명은,송하응,윤혜원,정가영,정정화 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.2

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4×2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.

빌베리 추출물이 함유된 눈 영양제 개발 추진전략 연구

박선미, 이영성, 김응도 충북대학교 국가미래기술경영연구소 2016 기술경영 Vol.1 No.1

미국 국립안연구소가 주도로 한 황반변성의 예방과 진행 완화에 관련한 대규모 임상 연구로 황반에 고밀도로 존재하는 루테인과지아잔틴, 망막의 주요 성분인 오메가-3, 항산화 물질인 빌베리 추출물을 추가하여 황반변성 예방에 도움을 주는 것에 그 초점을 맞추고 있다. AREDS2 포뮬러를 적용한 제품으로 망막 주변의 황반색소 변성을 방지하지만 인체에서 합성이 불가능한 루테인 및 지아잔틴 및 빌베리 추출물을 함유하여 더욱 강화해 만든 항산화 작용의 프리미엄급 눈 건강기능제품 이다. 기존 눈 영양제와는 다른 미국 국립안연구소의 대규모 임상결과와 학술 데이터를 바탕으로 출시되는 제품인 만큼 노화로 감소하는 황반 색소밀도를 유지하는데 커다란 역할을 경험하게 될 것으로 기대한다.

Statistical Parametric Mapping 분석을 이용한 알쯔하이머병과 혈관성 치매의 Tc-99m HMPAO SPECT 영상 소견

박경원,강도영,김응규,김상호,김재우 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.1

Background:Functional neuroimaging of single photon emission computed tomography (SPECT) has been used to diagnose or to define the pathophysiological mechanisms of dementias. The purpose of this study was to assess the specific patterns and the differences of regional cerebral blood flow (rCBF) in the patients with Alzhermer's disease (AD) and vascular dementia (VD) using Tc-99m HMPAO SPECT. Methods:Fifty five AD, 34 VD, and 30 normal control subjects participated in this study. Patients with VD and AD were matched for age and clinical dementia rating scores. Three groups were evaluated with Tc-99m HMPAO SPECT for measuring rCBF. Statistical parametric mapping (SPM) software was used for analysis of SPECT image data. The SPECT data in the patients with AD and VD were compared with the normal control subjects and then compared with each other. Results:SPM analysis of the SPECT image showed significant perfusion deficits in the bilateral frontotemporal regions in the patients with AD and in the bilateral frontotemporoparietal regions in the patients with VD compared with normal control subjects (uncorrected p<0.001). AD patients, compared to VD patients, revealed significant hypoperfusion in the bilateral frontal areas, left middle temporal gyrus, right fusiform gyrus, right precuneus and right postcentral gyrus (uncorrected p<0.01). VD patients, compared to AD patients, revealed significant hypoperfusion in the bilateral thalami, left insula, bilateral postcentral gyri, right cuneus, right cingulate gyrus and bilateral frontal subcortical regions (uncorrected p<0.01). Conclusions:Our study shows the characterisitcs and patterns of perfusion deficits in AD and VD patients, and defines the specific areas of hypoperfusion in these two dementias.