Bloodstream Infections and Clinical Significance of Healthcare-associated Bacteremia: A Multicenter Surveillance Study in Korean Hospitals

Son, Jun Seong,Song, Jae-Hoon,Ko, Kwan Soo,Yeom, Joon Sup,Ki, Hyun Kyun,Kim, Shin-Woo,Chang, Hyun-Ha,Ryu, Seong Yeol,Kim, Yeon-Sook,Jung, Sook-In,Shin, Sang Yop,Oh, Hee Bok,Lee, Yeong Seon,Chung, Doo The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.7

<P>Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. <I>Escherichia coli</I> was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, <I>Staphylococcus aureus</I> (15.2%), coagulase-negative <I>Staphylococcus</I> (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.</P>

분포형 토양침식지도를 이용한 한강상류지역 토양유실 위험성 평가

박찬원(Chan-Won Park),손연규(Yeon-Kyu Sonn),장용선(Yong-Seon Zhang),홍석영(S. Young Hong),현병근(Byung-Keun Hyun),송관철(Kwan-Cheol Song),하상건(Sang-Keun Ha),문용희(Young-Hee Moon) 한국토양비료학회 2010 한국토양비료학회지 Vol.43 No.6

본 연구에서는 1:25,000 정밀토양도 등 가용한 공간자료를 이용하여 작성된 토양유실도를 이용하여 한강 상류지역 10개 중권역 108 소유역에 대하여 토양유실량 평가하고 토지이용별 토양유실 위험지역을 분석하였다. 대상유역 총 토양유실량은 895만 Mg yr<SUP>-1</SUP>으로 예측되었으며, 면적당 평균 토양유실량은 6.1 Mg ha<SUP>-1</SUP>yr<SUP>-1</SUP>이었다. 중소유역 단위로 살펴보면 남한강지역이 북한강지역의 유실량 뿐만 아니라 면적당 유실량이 더 많았다. 이는 북한강 권역의 경우 화강암 및 화강편마암이 주요 모재인 반면에 남한강 권역의 경우 토양모재가 퇴적암지대를 많이 포함있어 토양침식성 인자 (K factor)와 경사 인자 (LS factor)가 상대적으로 높고, 남한강 지역의 경우 농경지 토양이 상대적으로 많이 분포하고 있기 때문으로 판단된다. 대상유역의 토지이용별 연평균 토양유실량을 분석한 결과 산림/초지 > 밭 >> 도심/대지 >> 논 > 과수의 순로 분석 대상유역 중 10.7%를 차지하고 있는 농경지에서 유실되는 토양의 추정량은 41.3%이였으며, 이중 6.2%면적을 차지하는 밭이 40.6%으로 44.2%의 산림/초지와 비슷한 수준이었다. 한강상류지역 토양유실 위험성 평가시 분포형 토양침식지도와 항공사진을 비교한 결과 토양유실에 대한 공간인 정보를 확실하게 보여주고 있으며, 토양침식위험성은 남한강권역의 남한강 상류 (1001), 평창강 (1002), 충주댐 (1003) 권역에서 각각 토양침식위험성이 “보통”이상으로 높은 지역이 각각 8.7%, 7.9%, 7.8%로 평균인 5.9%보다 높았으며, 이에 대한 보전방안이 강구될 필요가 있고 판단된다. This study was conducted to evaluate soil erosion risk with a standard unit watershed in the upper Han river basin using the spatial soil erosion map according to the change of landuse. The study area is 14,577 ㎢, which consists of 10 subbasins, 107 standard unit watersheds. Total annual soil loss and soil loss per area estimated were 895 × 10<SUP>4</SUP> Mg yr<SUP>-1</SUP> and 6.1 Mg ha<SUP>-1</SUP> yr<SUP>-1</SUP>, respectively. A result of analysis with a subbasin as a unit showed that annual soil losses and soil loss per area in Namhan river basins was more than in Bukhan river ones. Predicted annual soil loss according to the landuse ranked as Forest & Grassland > Upland >> Urban & Fallow area > Paddy field > Orchard. Upland area covered 6.2% of the study area, but the contribution of total annul soil loss was 40.6% and that of Forest & Grassland was 44.2%. As a evaluation of soil erosion risk using the spatial soil erosion map, we could precisely conformed the potential hazardous region of soil erosion in each unit watersheds. The ratio of regions, graded as higher “Moderate” for annual soil loss, were respectively 8.7%, 7.9% and 7.8% in 1001, 1002 and 1003 subbasins in Namhan river basin. Most landuse of these area was upland, and these area is necessary to establish soil conservation practices to reduce soil erosion based on the field observation.

전치 태반의 임상적 고찰

홍관표,이성동,김왕수,정종일,장하종,정혁,한세준 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

This study was undertaken for the clinical evaluation and statistical analysis on the 38 cases of placenta previa who were admitted and treated from March 1, 1988 to Feb. 28, 1991. The results were as follows : 1. The incidence of placenta previa was one per 53 deliveries or 1.90% 2. There were 57.9 % total placenta previa, 21.1 % partial placenta previa, 13.1 % low-lying placenta previa and 7.9% marginal placenta previa. 3. Placenta previa has occured more often in multipara (63.2%) than primigravida 4. More than one-third (38.8%) cases of placenta previa had delayed admission until labor occured for some time following vaginal spotting has first time been noticed. More instructive prenatal education should be emphasized 5. Lower segment transverse section rate was 63.2%, classical cesarean section rate was 15.8% and cesarean hysterectomy was 9.8%. The rest of them were treated by vaginal deliveries of 5 cases(13.2%) 6. The perinatal loss associated with placenta previa was considered still higher : the premature death was 15.8% and term death was 2.6%. The problem of prevention of prematurity still remains to be studied. 7. There was no maternal mortality in our study

아질산 노출이 이스라엘잉어 혈장내 아질산 농도 및 간장 약물대사효소에 미치는 영향

박관하,최상훈,김영길,김용호,최선남,김종배 한국환경독성학회 2003 환경독성보건학회지 Vol.18 No.2

Effects of ambient nitrite, N0₂^(-), at 1, 3, 10 and 30 mg/l, on the changes of plasma nitrite/nitrate and on hepatic drug-metabolizing enzyme activity were examined in the juvenile Israeli carp, Cyprinus carpio. When the fish were exposed to 1 and 3 mg/l N0₂^(-), there was an exposure duration-dependent increase in plasma N0₂- over the 96-hr period reaching 6~7 fold excess the ambient concentration, In the fish exposed to 10 mg/l, a plateau concentration of less than 2-fold of the environment was attained in 12 hr. With 30 mg/l, however, the maximal plasma NOf was 41.25 mg/1 at 12 hr followed by a gradual decline. There was a concentration increase in methemoglobin (metHb) level in all N02^(-)-exposed groups and a significant decrease in hematocrit value in 30 mg/l group after 96-hr exposure. Apart from the blunted increase in plasma N0₂^(-) with higher N0₂^(-)(10 and 30 mg/1) exposure, the ratio of plasma N0₃^(-) to N0₂^(-) was significantly higher in these groups compared to 1 and 3 mg/l. The imbalance in the plasma N0₃^(-)/N0₂^(-) at higher N0₂^(-) exposure suggests a possible accelerated conversion of N0₂^(-) to N0₃^(-). Nitrite exposure did not affect the hepatic drug-metabolic activities in juvenile Israeli carp. All these data indicate that disposition of N0₂- differ depending upon exposed concentration and that metHb production may not be the exclusive toxic mechanism in carp

Polyethylene glycol 용액(Colyte^(R))을 복용한 후 발생한 Boerhaave 증후군 1예

이관행,기승석,김인숙,김민정,박인호,장세중,하지수,김응수 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Spontaneous esophageal rupture (Boerhaave's syndrome) is a rare case that require early diagnosis and treatment because of its high mortality. The oral administration of osmotically balanced polyethylene-glycol-based electrolyte preparation is a commonly prescribed preparation for cleansing in patients undergoing colonoscopy. Nausea, vomiting and abdominal pain are frequently seen, but serious adverse reactions are rare. Esophageal rupture secondary to severe vomiting, which occurred during colonoscopy preparation using polyethylene gIycoI(PEG) electrolyte solution is extremely rare and only few cases have been published in the literature. We report a case of spontaneous esophageal rupture after routine administration of the PEG before colonoscopy. 대장 정결을목적으로 PEG 사용 후 아주 드물게 발생하는 Boerhaave 증후군 1예를 경험하였기에 보고하는 바이다.

현초로부터 분리한 항알러지물질

임융호,박관하,고동수 건국대학교 농업자원개발연구소 2000 農資源開發論集 Vol.22 No.-

Although there have been several pharmacologically distinct categories of anti-allergic agents, almost all of them are known to be limited in their clinical utility due primarily to side effects and weak efficacy. This fact is encouraging many investigators to screen novel anti-allergic agents structurally different from existing compounds. In a project to search anti-allergics from natural projects, we examined a wide range of higher plants to discover that acetone-water crude extract of Geranium thunbergii is effective in suppressing the passive cutaneous anaphylaxis ( PCA) responses of rats, a standard in vivo model for anti-allergy testing, The fraction underwent four steps further in an activity-guided manner finally to separate an active principle, GT2-3. With the aid of NMR spectroscopy, COSY, HMQC and DEPT techniques, the chemical structure of GT2-3 was determined to be quercetin, a known compound. The result indicates that quercetin is not potent enough for immediate clinical application, however, quercetin can be a promising lead compound for chemical modification for anti-allergic agent.

교통사고 발생요인에 따른 인적 피해정도 분석

양관철,이태용,류기하 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

To know the severity and frequency of motor vehicle injuries by the attributing risk fators, the auther analyzed the automobile injury risk factors by human factor, motor vehile factor and physical/social environmetal foctors. The 541, cases were randomly sampled from motor vehicle accidents in Taejon Area during one year through 1990. The results were summarized as follows : 1. Of the total 541 injuries 37.5% belonged severe case and 62.5% were slightly injured case. 2. The high risk factors of severe motor vehicle injuries were as follows Human factors : 20s' -30s' age groups, over 6 years driving carriers, careless of passer by, overspeed, drunken driving. Motor vehicle factors : Cab, driving speed of over 60Km/hr, the accident of car vs human. Road factors : Straight road, cross work, the road of residential and rural area Environmental factors : Winter time, cloudy, raniny and snowy weather around midnight hours.

소나무(Pinus densiflora) 목질을 이용한 수용액 중의 Cu(II)흡착

김하나,박세근,양경민,김영관 강원대학교 산업기술연구소 2007 産業技術硏究 Vol.27 No.A

Milled Korean pine (Pinus densiflora) wood was used to evaluate its adsorption capacity of Cu(Ⅱ) ions from aqueous solution by running a series of batch experiments. Prior to the tests, the milled woods were pretreated with 1N NaOH, 1N HNO_(3), and distilled water, respectively, to examine the effect of pretreatment. Within the tested pH range between 3 and 6, copper adsorption efficiency of NaOH-treated wood(96~99%) was superior to the HNO_(3)-treated wood(19~31%) and distilled water-treated wood(18~35%). The efficiency of copper removal by wood enhanced with increasing solution pH and reached a maximum copper ion uptake at pH 5~6. Adsorption behavior of copper onto both raw and HNO_(3)-treated woods was mainly attributed to interaction with carboxylic acid group. For NaOH-treated wood, carboxylate ion produced by hydrolysis or saponification was a major functional group responsible for Cu sorption. NaOH treatment of wood changed the ester and carboxylic acid groups into carboxylate group, whereas HNO_(3) treatment did not affect the production of functional groups which could bind copper. A pseudo second-order kinetic model fitted well for the sorption of copper ion onto NaOH-treated wood. A batch isotherm test using NaOH-treated wood showed that equilibrium sorption data were better represented by the Langmuir model than the Freundlich model.

대체 경로를 이용한 개선된 AODV 알고리즘

이관표,서주하 강원대학교 정보통신연구소 2003 정보통신논문지 Vol.7 No.-

An ad hoc network is a collection of wireless mobile nodes without the support of a stationary infrastructure. In ad hoc networks, each node acts as a router to support multiple hops to overcome limited range of packet radios. Recently, a variety of routing protocols have been developed. AODV is one of the various routing protocols on ad-hoc networks, and transmits data using a single route that is obtained with route discovery procedure. In AODV, whenever a link is failed, the source node runs the route re-discovery procedure again, obtain a new route, and transmits data through it. In this paper, we propose a new alternative route composition protocol based on AODV to reduce delay and loss of data packet during the path re-discovery procedure time. When a link fail occurs and data to transmit are still on source node and networks, we use the potential alternative route which is composed locally through previous discovery procedure instead of full re-discovery procedure in AODV.

천연자원을 이용한 간기능 증진제 개발 연구 : Benzo(a)pyrene에 의해 유도된 간기능 장해에 미치는 천궁 추출액의 영향 The Effect of Cnidii Rhizoma on Benzo(a) Pyrene Induced Hepatotoxicity

尹水弘,이송애,하헌,박은주,오관현 대구효성가톨릭대학교 1993 연구논문집 Vol.46 No.1

The present study was undertaken to compare the pharmacological activity of crude Cnidii Rhizoma reported with the clinical uses in the oriental medicine. Crude Cnidii Rhizoma used for the treatment of anemia, body chill, menstural irregularity and menstural pain as hematic tonic effector, sedative, adodyne and clear extravasated blood. Therefore we tested the effects of Cnidii Rhizoma water extract on the liverprotective activities in the rats. The results obtained form liver microsomal enzyme assay, measurement of serum and liver alanine, aspartate aminotransferase and lipid accumulation indicated that Cnidii Rhizoma extract showed significant liver-protective activities against benzo(a)pyrene poisoning.