조직학적 진단된 chronic necrotizing pulmonary aspergillosis 2예

김연숙,정숙인,기현균,김춘관,김신우,한정호,김성민,백경란,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

CNPA는 기존의 폐질환 및 폐절제술로 인해 국소방어기전에 저하가 있거나 비특이적 전신면역상태저하를 갖고 있는 환자들에게서 주로 발생하는 만성적인 공동성 폐질환이다. 현재까지 우리나라에서는 CNPA의 보고가 없는 상태이고, 저자들은 최근 조직학적으로 진단된 CNPA 2예를 경험하였기에 보고하는 바이다. 저자들이 경험한 CNPA 환자들은 만성알코올 중독 및 기관지확장증과 같은 기저질환과 폐절제술을 받은 병력이 있었다. Aspergillus가 폐실질을 침윤하고 있는 조직소견과 조직배양에서 Aspergillus가 검출되어 조직학적 진단이 가능하였고, amphotericin B의 정주요법 및 경구 itraconazole 투여와 폐절제술 등으로 성공적으로 치료되었다. 아직 많은 임상의들에게는 낯선 질환인 CNPA의 치료성적은 환자의 동반질환 및 CNPA 자체의 중증도, 진단과 치료 시작의 지연 등에 의해 크게 좌우되므로 만성적으로 진행하는 공동성 폐병변을 갖고 있는 환자에게서 CNPA를 감별하는 것이 중요하다. Chronic necrotizing pulmonary aspergillosis (CNPA) is a chronic cavitary form of pulmonary aspergillosis. Dozens of CNPA cases have been reported in patients with systemic immunologic dysfunction or altered local defense mechanism from preexisting pulmonary disease. Review of literatures revealed that no CNPA cases have been reported in Korea yet. We experienced two cases of CNPA proven by lung biopsy. A 53-year-old alcoholic male in poor nutritional state was admitted with generalized weakness and weight loss. Chest CT revealed a cavitary nodule surrounded with ground-glass attenuation. CT-guided fine needle aspiration and biopsy was done. The biopsy specimen demonstrated dichotomously branching septated hyphae consistent with those of Aspergillus sp. Another case was a 39-year-old man with bronchiectasis who was admitted with persistent hemoptysis. He had a past history of pulmonary tuberculosis. A parahilar lesion with intracavitary soft tissue mass was incidentally detected in high-resolution GT. Left lingular segmentectomy was done due to uncontrolled hemoptysis and CNPA was histologically diagnosed. Both patients were successfully treated with intravenous amphotericin B followed by oral itraconazole. Even though CNPA is unfamiliar to most clinicians, it should be included in differential diagnoses of chronic progressive cavitary pulmonary lesion, especially in patients with immunologic dysfunction.

정지형 자전거 운동 훈련이 건강한 여성의 체구성,심폐기능 및 유연성에 미치는 효과

김동옥,최정숙,안혜영,민혜숙,이경숙,박연환,송미령,최명애,최정안,김매자 서울대학교 간호대학 간호과학연구소 1999 간호학 논문집 Vol.13 No.1

The purpose of this study was to determine the changes in body composition, cardiopulmonary function, and flexibility following 8 weeks' bicycle ergometer exercise training. The subjects of this research consisted of healthy adult women between 30 and 40 years of age. Initial intensity of bicycle ergometer exercise was based on the target heart rate equivalent to 55% of maximal oxygen uptake, and intensity of the exercise increased by 5% every 2 weeks. Body composition, cardiopulmonary function at rest and during maximal exercise, as well as flexibility were determined before and after 8 weeks of bicycle ergometer exercise training. Masimal exercise was performed on the treadmill according to Bruce Protocol. The results obtained were as follows; 1. There were o changes in body weight, percent body fat, fat body weight, and lean body weight as well. The ventilation volume for 1 minute, respiratory quotient and expired CO₂ volume have not changed significantly after the training, either. 2. As a result of training, resting systolic and diastolic blood pressure decreased significantly(p<.05) 3. Maximal heart rate, maximal oxygen consumption and maximal running time increased significantly after the training(p<.05) 4. Pelvic flexibility increased slightly after the training, however, it did not reach the statistical significance. Trunk flexion forward increased significantly after the training(p<.05). From these results, it may be concluded that 8 weeks bicycle ergometr training improve the cardiopulmonary function and flexibility in healthy adult women between 30-40 years of age.

신규간호사와 프리셉터가 인지하는 프리셉터의 교수효율성 비교

김지양,김영선,김춘실,박현숙,신미영,윤연숙,조유숙,박미미,유문숙 한국간호과학회 간호행정학회 2009 간호행정학회지 Vol.15 No.2

Objective: The purpose of this study was to compare preceptors and new graduate nurses on their perception of preceptor teaching effectiveness. Methods: The participants were 90 new nurses and 90 preceptors who worked in A medical center. The data were collected from July 1 to September 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaire. Results: New nurses' perception (4.07±.44) of the preceptor teaching effectiveness was significantly higher than perception of the preceptors (3.57±.37). Fifty five percent of new graduate nurses reported a lack of coherence in the preceptor's practice guidelines. For 5 causal factors classified on the teaching effectiveness, the factor of 'Professional knowledge and ability' showed the highest score, but 'Interpersonal and communication skill' got lowest score for both group. Preceptors responded that they did not have enough time to teach well because of their heavy workloads. Conclusions: These results suggest that the preceptors need appropriate compensation and education opportunities, and new graduate nurses need consistent education by the teaching professionals. Therefore, it is important to give preceptors full charge of the preceptorship. Also, it will be necessary to develop education programs to enhance interpersonal and communication skill for preceptors and new nurses.

토끼 수막염 모델을 이용한 다제내성 폐렴구균에 대한 Meropenem의 치료 효과

김신우,진정화,강수정,정숙인,김연숙,기현균,김춘관,이혁,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

목적 : 다제내성 폐렴구균에 의한 수막염은 기존과 단일 항생제로는 근치가 어려워 ceftriaxone과 vancomycin 혹은 rifampin의 병용요법이 권유되고 있다. 다제내성 폐렴구균에 사용할 수 있는 다른 약제 중 meropenem은 시험관내 폐렴구균에 대한 항균력이 좋고 경련 등의 중추신경계 부작용이 거의 없어 다제내성 폐렴구균에 의한 수막염의 치료에 이용할 수 있을 것으로 기대되나 이에 대한 자료가 매우 부족한 상태이다. 이에 연자 등은 meropenem과 meropenem+vancomycin의 병용요법이 다제내성 폐렴구균 수막염의 치료에 효과가 있는지를 토끼 수막염 동물 모델을 이용하여 검증하고자 하였다. 방법 : 인체에서 수막염을 일으킨 다제내성 폐렴구균 균주(penicillin MIC 2, ceftriaxone MIC 4, meropenem MIC 0.5㎍/㎖)를 토끼 척수강 내에 직접 주입하여 수막염을 유발한 후 ceftriaxone, vancomycin, rifampin, meropenem의 단일 항균요법, ceftriaxone+vancomycin, ceftriaxone+rifampin, meropenem+vancomycin의 병용요법 간에 치료 효과의 차이를 비교 하였다. 각 치료군은 6 마리의 토끼를 대상으로 하였다. 각각의 항생제는 5 시간 간격으로 2번 정주하였으며, ceftriaxone은 1회 투여하였다. 균주 주입 후 각 치료군이 토끼에서 치료 후 0, 5, 10, 24 시간에 척수액을 채취하여 균주의 수를 측정하여 24시간째의 살균 여부를 최종 치료 효과로 판정하였다. 결과 : meropenem 단독 요법은 10시간째에 모든 균주를 살균하였으나 24시간 째에 다시 균의 성장이 관찰되었으며, meropenem+vancomycin의 병용요법은 단독 약제보다 우수한 살균효과를 보였으나 상승작용은 없었다. 결론 : meropenem+vancomycin의 병용요법은 기존의 ceftriaxone+vancomycin보다 24시간째에 더 큰 균의 감소 경향을 보여(P=0.054) 임상에서 사용이 가능할 것으로 기대되며 향후 실제 수막염 환자에서의 임상효과를 증명하는 연구가 필요할 것으로 생각된다. Background : Because antimicrobial monotherapy for pneumococcal meningitis caused by penicillin-resistant strains is not satisfactory, ceftriaxone+vancomycin [C+V] or ceftriaxone+rifampin [C+R] regimens are recommended. Meropenern [M] is one of the monotherapy options for penicillin-resistant pneumococcal meningitis due to good in-vitro activity against pneumococci and rare adverse reactions in CNS. But there have been few reports in the efficacy of meropenern against pneumococcal meningitis. We evaluated therapeutic efficacy of the meropenern and meropenem+vancomycin in a rabbit model of meningitis caused by penicillin-resistant S. pneumoniae (PRSP). Methods : Meningitis was induced by intracistemal inoculation of a pneumococcal strain isolated from a patient with meningitis (MIC; penicillin 2, ceftriaxone 4, meropenem 0.5 g/㎖). Bacterial concentrations in the CSF were measured at 0, 5, 10, and 24 h after therapy was started. Therapeutic efficacy was evaluated by the final bacterial concentration in the CSF at 24 h. Results : C+V cleared the CSF at 10 h, but regrowth of bacteria was noted at 24 h. Meropenem monotherapy resulted in sterilization at 10 h but regrowth at 24 h. M+V was superior to M or V monotherapy but did not show synergism. Therapeutic efficacy of M+V was at least equal or superior to that of C+V (P = 0.054). Conclusion : Meropenem+vancomycin regimen could be one of the useful options in the treatment of PRSP meningitis. Clinical trials to evaluate the M or M +V are warranted in the future.

2009년 인플루엔자 대유행 중 인플루엔자 진료소 방문자의 연령 분포 변화

김백남,곽이경,문치숙,김연숙,김의석,배인규,염준섭,이창섭,허지안 대한감염학회 2010 감염과 화학요법 Vol.42 No.2

The pandemic influenza (H1N1 2009) virus, after being introduced in Korea in April, 2009, spread rapidly nationwide in mid-2009. This study was conducted to characterize trend in age distribution of visitors to Flu-clinics during the pandemic. Demographic, clinical and laboratory data of visitors to flu clinic from Week 36 to 52 (August 30 to December 26) of 2009 were retrieved and collected from electronic databases at 9 hospitals. Visitors 0-6, 7-12, 13-18, 19-29, 30-64, and 65 years or more of age were classified into group I to VI, respectively. A total of 107,467 visitors were seen at Flu-clinics for a 17-week study period. Of those, 32,485 were laboratory-confirmed. Antivirals were prescribed for 62,533 visitors. Numbers of visits, prescriptions of antivirals, and laboratory-confirmed cases of the pandemic influenza (H1N1 2009) peaked at Week 44. A large number of visits by group II and III were followed by those of group I and V, especially around the peak. Numbers of visits by group VI were lowest in all hospitals. In some hospitals, higher number of visits lasted longer in children than in adults while vice versa in other hospitals depending on the location. In summary, the pandemic influenza (H1N1 2009) was presumed to peak in late October and involved majorly children and students in Korea. Unique age distribution of visitors to flu clinic was observed in some hospitals.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

예비유아교사 임용직전 교육프로그램 개발 및 교사역량에 미치는 효과

김연희 ( Yeon Hee Kim ),신인숙 ( In Sook Shin ),최성열 ( Sung Yeol Choi ) 한국아동교육학회 2013 아동교육 Vol.22 No.3

본 연구는 예비유아교사가 정교사로 임용되기 직전 교사로서의 역량을 강화하지 위한 교육프로그램을 개발하고 이 프로그램이 예비유아교사의 교사역량에 미치는 효과를 살펴보고자 하는 데 그 목적이 있다 이러한 목적을 달성하기 위하여 설정한 연구문제는 다음과 같다. 첫째, 예비유아교사 임용직전 교육프로그램 구성은 어떠한가? 둘째, 예비유아교사 임용직전 교육프로그램이 교육신념, 전문적 자질, 교사효능감에 미치는 효과는 어떠한가? 교사역량을 갖춘 유야교사가 되기 위한 예비유아교사 임용직전교육프로그램의 개발은 문헌고찰, 예비유아교사와 현직유아교사의 인식 조사, 전문가 의견 조사를 거쳐 프로그램의 목표 및 교육내용, 교수-학습 방법을 구성하였다. 예비유아교사 대상 임용직전 교육프로그램의 효과를 살펴보기 위하여 대구시내에 소재한 B 전문대학 유아교육과 3학년 재학생 30명을 실험집단, 30명을 비교집단으로 구분하였다. 실험집단을 대상으로 주 3회, 총 12회기에 걸쳐 실험을 진행하였다. 수집된 자료는 SPSS 18.0 프로그램을 이용하여 실험집단과 비교집단의 사전검사, 사후검사, 추후검사의 평균과 표준편차를 산출하고 시기별 점수 차이가 있는지 알아보기 위하여 집단과 시기를 독립변인으로 한 반복측정 분산분석(repeated measures ANOVA)을 실시하였다. 본 연구의 결과는 다음과 같다. 첫째, 예비유아교사의 교사역량을 향상시키기 위한 임용직전 교육프로그램은 교육신념, 전문적 자질, 개인적 자질, 교사효능감 증진을 위한 12회기 프로그램으로 개발되었다. 교수-학습 내용 및 방법은 교사역할에 대한 자신감 및 구체적 기술을 다양한 활동과 반성적 과정을 통해 학습할 수 있도록 구성하였다. 둘째, 예비유아교사 임용직전 교육프로그램은 교육신념, 전문적 자질, 개인적 자질, 교사효능감 증진에 긍정적인 효과가 있다. 본 연구를 통하여 예비유아교사에게 필요한 현장적응 역량 강화교육의 중요성이 강조된다. The purpose of this study was to develop an educational program for pre-service early childhood teachers and to investigate the program`s effects on the teachers` teaching competence. The research questions were as follows. First, what is the purpose, contents, teaching-learning methods, and the assessment of the educational program for pre-service early childhood teachers? Second, what are the effects of the program on teaching beliefs, professional disposition, and teaching efficacy of the pre-service early childhood teachers? The educational program for pre-service early childhood teachers was constructed through literature reviews, surveys on the perceptions of in-service and pre-service teachers, and interviews of early childhood professionals to develop the purpose, the contents, the teaching-learning methods, and the assessment of the educational program. The effects of the programs were investigated by carrying out an experLn1ental study. A total of 30 pre-service early childhood teachers were assigned to the experimental group and 30 pre-service early childhood teachers were assigned to the comparative group. The experimental group participated in 3 sessions per week for a total of 12 sessions. The teaching beliefs was examined by Moon`s (1993) scale, the personal and the professional disposition by Ki`s (2008) scale, and the leaching efficacy by Kim`s (2000) scale. The collected data were analyzed using SPSS 18.0. A pre-test, a post-test, and an afterward-test were carried out to compare the means of the experimental and the comparative groups using a repeated measures ANDV A. The results of this study were as follows. First, the teaching competence of pre-service early childhood teachers were composed of the teaching beliefs, the personal and the professional disposition, and the teaching efficacy. The educational program for pre-service early childhood teachers was developed for 12 sessions to promote the teaching competence through reflective and hands-on activities. Second, the experimental group`s teaching beliefs, personal and professional disposition and disposition and teaching efficacy improved by participating in the educational program developed by this study. The results of this study emphasize the importance of educating the early childhood pre-service teachers to promote their practical knowledge applicable to their teaching profession.

Astromicin sulfate의 약동학 및 안전성 평가

정숙인,김연숙,오원섭,복혜숙,김명민,최경업,김연화,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3

목적 : Astromicin은 aminoglycoside계 항생제와 유사한 화학구조와 특성을 지니고, 기존의 aminoglycoside와 유사하거나 향상된 임상효과 및 부작용을 지닌 것으로 알려져 있다. 저자들은 astromicin의 약동학적 특성을 분석하고, astromicin 투여 환자를 대상으로 한국인에서 그 임상적 및 세균학적 효과와 안전성을 평가하고자 하였다. 대상 및 방법 : 약동학적 지표는 정상성인 남자를 대상으로 astromicin 200㎎을 30분간 정주한 후 24시간까지 혈장 및 뇨 검체를 수집하여 one-compartment open model에 따라 분석하였다. 중증으 세균감염이 있는 18세 이상의 환자를 대상으로 병용 또는 단독 투여한 후 임상적 효과와 세균학적 효과를 판정하였고, 치료전과 후의 순음청력검사와 혈청 크레아티닌으로 이독성과 신독성을 평가하였다. 결과 : 정상 성인 남자 12명을 대상으로 약동학적 지표를 평가하였고, 최고혈장농도는 투여 종료시점(C_(0))에서 16.87±1.68㎍/mL였으며, 반감기는 1.86±0.43 시간 이었고, AUC_(0-12h)은 38.12±10.57㎍ㆍhr/mL, Vd는 0.18±0.02L/㎏, CL은 5.25±2.07L/hr였다. 이러한 약동학적 지표는 다른 aminoglycoside와 유사한 결과를 보였다. 59명의 환자를 대상으로 시행한 임상적 효과 분석에서는 단독요법을 시행한 50명 중 임상적 치유율 94%, 세균학적 치유율 100%를 보였고, 순음청력검사를 시행한 48례의 환자중 의미있는 청력감소 소견은 관찰되지 않았으며, 신독성 또한 전혀 나타나지 않았다. 결론 : Astromicin의 약동학적 지표는 다른 aminoglycoside의 약동학적 지표와 비슷한 양상을 보이므로 향후 astromicin의 약물농도 감시에 있어서 다른 aminoglycoside의 치료적 약물 농도 감시 방법과 유사한 방법을 적용할 수 있으리라 기대된다. 또한 임상적 치유율이 우수하면서 신독성이나 이독성이 적어 세균 감염 환자의 치료에 있어서 단독 또는 병합 요법으로 비교적 안전하게 사용할 수 있으리라 생각된다. Astromicin(Fortimicin®) has some characteristics in common with other aminioglycoside antibiotics, although it has a unique chemical structure, which is different from them. This study was performed to elucidate the pharmacokinetic (PK) parameters of astromicin following single-dose intravenous infusion of 200 mg and to evaluate clinical efficacy and safety of astromicin in Korean populations. PK parameters of astromicin were determined in 12 healthy volunteers (65.5±5.2㎏). The plasma and urine samples were collected up to 24hrs. PK variables were calculated by fitting individual concentration-time curves to a one-compartment open model. Plasma level at the end of infusion was 16.87?1.68 ㎍/mL and declined to 1.05±0.35 (㎍/mL 8hr later. The half-life was 1.86±0.43 hr. Apparent volume of distribution was 0.18±0.02 L/㎏g, and total body clearance was 5.25±2.07 L/hr. These values were similar to those of other aminioglycosides. Clinical efficacy and safety were eviuated in 59 patients with moderate to severe bacterial infections who needed parenteral antibiotics. Among 50 patients who recieved astromicin monotherapy, 49 (98%) had favorable clinical reponse and 28 (100%) had favorable bacteriological response. Serial audiograms revealed no change in all of 48 patients. No nephrotoxicity was observed in all patients. Conclusively, our data suggest that therapeutic drug monitoring of astromicin can be conducted in a similar fashion as other aminioglycosides and astromicin is a useful and safe antibiotic in the treatment of severe bacterial infections.

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

일개 대학병원에서 경험한 방선균증의 임상상

정숙인,김연숙,기현균,김춘관,김신우,이혁,김성민,백경란,송재훈 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.3

배경 : 방선균증은 혐기성의 그람양성 간균에 의한 만성 화농성 감염으로, 경안면부, 흉부, 복부, 골반부 등을 주로 침범한다. 최근 구강 위생의 향상과 항생제의 사용으로 인해 방선균증의 빈도의 감소와 함께 그 임상양상 또한 크게 변화하였다. 저자들은 국내에서의 방선균증의 임상상을 분석하기 위해 본 연구를 시행하였다. 방법 : 1995년 5월부터 1998년 9월까지 삼성서울병원에서 방선균증으로 진단받은 환자를 대상으로 임상기록지를 토대로 감염병소와 임상경과 등을 후향적으로 조사하였다. 결과 : 방선균증 환자는 모두 12명으로 경안면부 1례, 흉부 3례, 복부 3례, 골반부 5례였다. 임상양상은 주로 종괴의 형태로 나타나 진단을 내리기까지 종양과의 감별에 어려웠으며 진단은 모두 조직검사나 흡인액에서 유황과립을 확인함으로써 이루어졌다. 방선균증으로 진단된 환자는 모두 호전소견을 보였다. 결론 : 국내에서도 방선균증이 드물지 않게 발생하고 있으며 임상양상이 다양하여 가장 많이 오진되는 질환 중의 하나이다. 방선균증은 조직검사나 균배양검사를 통해 진단하고 항생제를 통해 완치될 수 있는 질환이므로 환자 진단에 관심을 가지면 불필요한 수술을 피할 수 있을 것으로 생각된다. Background: Actinomycosis is an indolent, slowly progressive bacterial infection, caused by Actinomyces. a gram-positive, non-spore-forming anaerobic or microaerophilic rod. Actinomycosis affects nearly every organ and body site. The disease is classically divided into four types, depending on the anatomic sites involved: cervicofacial, thoracic, abdominal, and pelvic. It has been considered as a rare disease, and only several cases have been reported in Korea. We performed this study to analyse the clinical manifestations of actinomycosis in Korea. Method: We retrospectively reviewed the medical records of patients with actinomycosis at the Samsung Medical Center from May 1995 to December 1998. Results: During the study period, actinomycosis was diagnosed in 12 patients: 1 patient had cervicofacial lesion, 3 thoracic, 3 abdominal, and 5 pelvic. The male and female ratio was 1 : 2 and the mean age was 47.2 years. Sulfur granule was observed in the pathologic specimens from all cases, but organism did not grow at all. It was very difficult to differentiate actinomycosis from tumorous conditions without pathologic diagnosis. All patients were clinically improved with antibiotics or surgical procedures. Conclusion: Actinomycosis is not a rare disease nowadays and has various clinical manifestations. It can be diagnosed by pathologic examination or culture and cured by antibiotics without surgical management.