성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

VRE 감염증의 임상상, 미생물학적 특성 분석 및 유전적 관련성 비교 : 전국 6개 병원에서 분리된 VRE를 중심으로

정희진,박정원,엄중식,하경임,신종희,김정미,이혜수,박영희,김우주,박승철 대한감염학회 2002 감염 Vol.34 No.5

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

만성정신질환자 가족의 부담감에 관한 연구

이경희,박청자 대한보건협회 2003 대한보건연구 Vol.29 No.2

The purpose of this study was to investigate the burden of the families with the chronic mentally ill to provide the basic data for nursing intervention program. The subjects of this study were 200 families with the chronic mentally ill registered in four community mental health centers at Daegu city. The data were collected during the period from May, 2002 to July, 2002. The instruments for the study were the burden scale used in Kim, Suji et. al.(1998).(a=.8812). The data were analyzed by descriptive statistics, t-test, Pearson correlation coefficient. ANOVA. and multiple stepwise regression. The results of analysis were as follows: 1. The mean score of burden is 2.95 and the mean score of quality of life is 2.93. 2. There is a negative correlation between the burden and the quality of life of families with the chronic mentally ill(r=-.31, p<.0l). 3. Burden showed the significant difference according to sex(t=-3.18, p<.05), marital status(F=4.12, p<.05).

금합금에서 납착되는 면의 간격이 파절저항에 미치는 영향

이청희 慶北大學校 齒科大學 1993 慶北齒大論文集 Vol.10 No.2

납착될 부위의 간격에 따른 파절하중을 비교하기 위하여 5㎝길이의 13개의 아크릴릭봉을 금합금(Au:70%, Pt:7%, Pd:2%)을 사용하여 주조한 후 1개는 대조군으로 두고, 12개를 중간점에서 장축에 수직되게 자르고 선반가공하였다. 0.13mm의 간격을 가진 Ⅰ군, 0.38mm간격의 Ⅱ군, 0.72mm 간격의 Ⅲ군, 1.13mm 간격의 Ⅳ군으로 각 군당 3개의 시편을 레진으로 고정시키고 납착용 합금을 만들어서 납착하였다. 인스트론 만능시험기에 4-점 테스트가 되도록 거상한 후 cross head speed 1mm/min으로 압축하중을 가하여 파절하중을 측정하였다. 주사전자미경으로 Ⅰ군과 Ⅱ군의 납착된 면 및 대조군을 관찰하여서 다음과 같은 결과를 얻었다. 1. 파절은 Ⅰ군과 Ⅱ군에서만 일어났으며, Ⅱ군에서 63.84kg으로 Ⅰ군의 31.63kg보다 높게 나타났고, Ⅲ군과 Ⅳ군의 대조군과 같이 파절이 되지 않고 bending만 일어났다. 2. 납착된 면의 주사전자현미경 관찰에서 대조군에서는 기포가 거의 없는 파절면을 관찰하였으며 Ⅰ군에서는 납착면의 중앙부가 납착되지 않은 상태이고 테두리만 납착된 상태로 나타났으며, Ⅱ군에서는 대조군보다 기포가 많은 것을 관찰하였다. In ordor to compare the fracture load according to the gap distance between the surface to be soldered. Thirteen samples were made with acrylic rods(length : about 5㎝, diameter 3.1mm) and casted with gold alloy(Au: 70%, Pt:7%, Pd:2%). One specimen was remained for the control group, and each of the twelve specimens was cut perpendicularly to the long axis inthe middle point, and then cut surface was lathed perpendicularly to the long axis. These specimens were divided into four groups as followings: Group Ⅰ was composed of 3 specimens and was held to 0.13mm gap distance. Group Ⅱ was composed of 3 specimens and was held to 0.38mm gap distance. Group Ⅲ was composed of 3 specimens and was held to 0.72mm gap distance. Group Ⅳ was composed of 3 specimens and was held to 1.13mm gap distance. Each specimen was fixed with Duraray resin and soldered with solder alloy according to each group. After mounting on Instron universal testing machine in order to accomplish 4-point test, the fracture load of the specimens was measured. Scanning electron microscophy was examined the fractured surface of group Ⅰ, group Ⅱ and control group. The results were as follows. 1. Fracture was only occur group Ⅰand Ⅱ and mean fracture load was 63.84kg in group Ⅱ and 31.63kg in group Ⅰ. And group Ⅲ,Ⅳ and control group were bent and were not fractured. 2. In examination by scanning electron microscopy, conterol group largely had no voids and group Ⅰ had unsoldered surface in the central part and group Ⅱ had soldered surface with scattered voids.

사용자 분석을 통한 대학기숙사 거주환경 개선에 관한 연구

이청웅,박행자,임경희 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.2

This study, as a case study of four university dormitories in Gwangiu, examined the situation of interior space and conducted a quantitative survey invesitgating importance about the interior space and assessment factors of residential environment on users. Then user satisfaction at the assessment factors of residential environment was analyzed to draw problems and explore improvement. The results showed the following problems that should be resolved: Bedrooms should increase the area of convex space; toilets and bathrooms should be changed into a cluster type at least in common use by floor; rest space should reinforce heating and cooling system; robby space should become mixed space for various user's behavior; private fitness rooms should be planned as group fitness space; private libraries should reinforce lighting facilities: and computer rooms should complement and improve HVAC.

고성능액체크로마토그래프법에 의한 원료 및 제제 중 메토트렉세이트 광학이성질체의 품질관리

홍정희,서은영,이은주,이관준,김경호,강종성 충남대학교 약학대학 의약품개발연구소 2011 藥學論文集 Vol.26 No.-

水邊環境造成에 관한 硏究

李熙榮,丁仙吉 서울市立大學校 1994 論文集 Vol.28 No.-

The Water is very important resource to man. The riverain and view which are concern with water are important co-ownership resource to territory. We hold consciousness which is keep up and bring up water, and put in practice it. The plan which is make riverain-space, is realization of harmony between the use of water and closed water, detecte of riverain-space, a specific character of territory, which is base on the historical culture of territory with wholesome ecosystem, execute creativity. The improvement of riverain-environment is resuscitate natural sapce which is concern with water, inhabit variety microorganisms, animals and plants, play to conservative function of water quality, integrite and create beautiful riverain with natural disposition of consideration of ecology.

Vancomycin-Resistant Enterococci (VRE) 빈도, 검사법 및 감염관리 대책에 관한 전국 병원 설문조사

정희진,김우주,최선주,이경원,최강원,박승철 대한감염학회 2001 감염 Vol.33 No.2

Background : Vancomcyin-resistant enterococci (VRE) have been an important nosocomial pathogen in the 1990s. Recently, VRE have become an emerging nosocomial pathogen in Korea, but there have been no nationwide study about the status of VRE in Korea. This nationwide questionnaire survey was aimed to determine the prevalence of VRE, the appropriateness of detection method fur VRE, and to evaluate the infection control program in hospitals of various size in Korea. Methods : During 4 weeks (September 1 to October 1, 1999), a questionnaire surveillance study was conducted. We had sent the questionnaire to 200 large hospitals in Korea, which were distributed nationwide. Questionnaire included the prevalence of VRE within the hospital, the detection method for VRE, method of enterococci isolation, antibiotics-susceptibility test and infection control method of VRE. Results : The response rate to questionnaire was 42%. The species identification of enterococci was capable in 62.3% but the accurate enterococcal speciation were capable in 18%. Appropriate antibiotic-sus-ceptibility test were produced only in 6.5%. Total 746 VRE were detected in 42 hospitals during 1-year despite of low sensitivity of detection methods. VRE was noted in 54.4% of hospitals at least. The isolation programme of VRE infected patients was presented in 20.3%, regular surveillance of VRE in high-risk pop ulation was produced only in 16.5%. Conclusion : The prevalence of enterococci among microorganisms isolated from clinical specimens were increased up to 27.7% in Korea. VRE has been emerged in many big cities as well as in Seoul. The microbiological methods that include the speciation of enterococcal isolates, antimicrobial susceptibility test, and VRE detection appeared to be inappropriate in many hospitals. And, proper control and prevention methods were presented in a few hospitals. Education and training about accurate detection of VRE as well as proper infection control programs for VRE are urgently needed. (Korean J Infect Dis 33:78~87, 2001)

국내 시판 항생제의 허가 용량 및 용법의 적정성에 대한 고찰 : 국내 약제사용설명서(package insert)와 미국 Physicians' Desk Reference의 비교 Comparison of Domestic Package Inserts with Physicians' Desk Reference

이재갑,이연주,황병연,정혜원,정성주,김성범,정희진,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 국내 시판중인 항생제의 1일 투여량과 투여간격의 적정성을 확인하고 적응증 및 중증도에 따른 항생제 용량 제시 여부를 확인하기 위하여 항생제 시판시 KFDA의 허가사항을 담은 약제사용설명서을 미국 FDA 공인 약제에 대한 사용지침으로 쓰이고 있는 PDR(Physicians' Desk Peference)과 비교하였다. 방법 : PDR에 등재되어 있는 항생제 중에서 시럽 및 도포용 항생제를 제외한 총 61종에서, 국내에 시판되어 있는 51종 항생제의 약제사용설명서를 대상으로 1일 투여량, 투약횟수, 적응증 및 중증도에 따른 설명 정도를 비교하였다. 결과 : 1) 1일 투여량 비교 : 비교 가능한 전체 항생제에서, 약제사용설명서가 PDR보다 적은 용량을 제시한 경우는 경구용 8종, 주사용 11종으로 총 19종(37%)였으며, 많은 용량을 제시한 경우는 경구용만 2(4%)종이었고, 동일하거나 비슷한 용량을 제시한 경우는 경구용 15종, 주사용 15종으로 총 30(59%)종이었다. 약제사용설명서에서 적은 용량이 제시된 항생제 중 경구용인 cefdnir, cefixime, cefpodoxime, ofloxacin, levofloxacin, norfloxacin(6종), 주사용인 cefazolin, cefotetan, ceftizoxime, meropenem (4종) 등 반수이상의 약제가 일본제약회사로부터 국내에 수입된 약들이었으며 일본의 약제 사용설명서와 동일한 용량을 제시한 것을 알 수 있다. 2) 투여간격 비교 : 비교가능한 항생제 51종 중에서 국내약제사용설명서가 PDR과 동일한 투약횟수, 투여간격을 제시한 항생제는 30종(59%)이었다. 국내 약제사용설명서가 PDR보다 적은 투약횟수, 긴 투여간격을 제시한 항생제는 9종(17%)이었다. 오히려 많은 투약횟수, 짧은 투여간격을 제시한 항생제가 12종(24%)이나 되었다. 경구용만 비교하였을 경우 국내 약제사용설명서가 PDR보다 적은 투약횟수를 제시한 항생제는 없었으며, 동일하세 제시한 경우는 15종, 빈번한 투약횟수를 제시한 경우는 10종이었다. 주사용 항생제에서 국내 약제사용설명서가 PDR보다 긴 투여간격을 제시한 항생제는 9종, 동일한 경우는 15종, 짧은 투여간격을 제시한 경우는 2종이었다. 3) 적응증 및 중증도에 따른 비교 : 약제사용설명서에서 적응증 또는 중증도에 따른 용량에 대한 설명이 부족한 경우는 경구용 13종, 주사용 7종으로 총 20종(39%)이었으며, PDR에서는 경구용 1종, 주사용 2종으로 총 3종(6%)이었다. 결론 : 항생제에 첨부되는 약제사용설명서 및 약제사용설명서를 바탕으로 편집되는 의약품집이 항생제를 처방하는 의사들이 용법과 용량을 결정함에 있어 참고 역할을 하고 있으나, 국내의 시판 허가사항을 담은 약제사용설명서가 많은 수에서 적응증 또는 중증도에 따른 1일 투여량과 투여간격에 대한 정확한 정보를 제공하고 있지 못하고 있다. Background : The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. Materials and Methods : Package inserts about antibiotics, only oral or parenteral agent, wereperused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. Results : Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases: 15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases: 8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases : 10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases: 13 oral and 7 parenteral agents) revealed no information for dose adjustment commons to indications or the severity of infection. Conclusion : This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.