어린 아동을 둔 취업모의 양육부담감 경험에 대한 현상학적 연구

김나현 ( Na Hyun Kim ),이은주 ( Eun Joo Lee ),곽수영 ( Su Young Kwak ),박미라 ( Mee Ra Park ) 여성건강간호학회 2013 여성건강간호학회지 Vol.19 No.3

본 연구는 취업모가 경험하는 양육부담감의 본질을 탐색하기 위해 시도된 현상학적 연구로 양육부담감의 7가지 주제모음을 도출하였으며, 이를 중심으로 논의해 보고자 한다. 첫 번째 주제모음은 ‘끊임없이 갈등하는 삶’으로, 참여자들은 일과 양육을 병행하며 힘겨운 시간을 보내지만 아무도 그들의 고충을 이해하고 지지해주는 사람이 없어 힘들어 하였다. 성공중심의 사회속에서 자녀를 잘 기르기 위한 궁극적 목표를 가지면서도 자기계발에 대한 부담과 아이들에게 충분한 시간을 할애하지 못하는 양육 현실 간의 상충되는 상황으로 인하여(Yang, 2011) 갈등하였다. 이러한 결과는 취업모가 가정에서 ‘엄마’로서의 책임을 다해야 하고, 직장 내에서도 여성으로서 특별한 배려의 대상이 되지 않기 위해 노력하기 때문에 두 역할사이에서 힘들어 한다는 Kim, Kim과 Lee (2011)의 연구결과를 뒷받침해 주었다. 이러한 고민과 갈등은 양육 스트레스를 더욱 가중시켜 자녀를 둔 젊은 취업 여성들뿐만 아니라 미혼여성들에게도 자녀 출산을 고민하게 하는 요인으로 이어지고 있으므로(Kim et al.,), 출산을 장려하고 양육부담감을 감소시키기 위한 실질적이고 효과적인 일, 가정 양립 지원책이 마련되어야할 것이다. 두 번째 주제모음은 ‘죄책감’으로, 참여자들은 전업주부처럼 온종일 아이를 잘 보살펴주지 못하여 미안해하고 죄책감을 느꼈다. 이는 특히 우리나라 여성들은 전통적으로 자녀를 위한 희생정신과 책임감이 강하여 돌봄이 부족하거나 양육이 충분하지 못할 경우 죄책감을 많이 느끼기 때문으로(Sung & Park, 2011), Yang과 Shin (2011)의 연구에서도 유사한 결과를 보고한 바 있다. 미안함과 죄책감 때문에 참여자들은 의도적인 스킨십으로 사랑을 각인시키고, 자녀가 원하는 물건을 갖게 함으로써 부족한 엄마 역할을 만회하고자 하였다. 그러나 일하는 어머니와 집에 있는 어머니 간 영유아 자녀의 발달위험 정도에 차이가 없다는 연구결과(Korea Institute of Child Care and Education, 2011)에서도 알 수 있듯이 어머니의 취업이 아이 발달에 부정적인 영향을 미치는 것은 아니기때문에 취업모들은 자녀에게 갖는 과도한 죄책감에서 벗어나 현명하고 일관적인 양육태도를 취하도록 노력해야 할 것이다. 또한 참여자들은 아이에게 미안해하면서도 일, 가사, 육아를 동시에 감당해야 하는 과중한 부담과 피로로 인해 쉽게 짜증을 내는 것으로 드러났는데, 이것은 직장에서의 스트레스와 피로가 가시기도 전 또 다른 노동을 시작해야 하는 이중의 긴장 속에서 육체적, 정신적 소진을 경험하기 때문일 것이다. 스스로 감정조절에 실패한 취업모는 미안한 마음과 죄의식을 느끼고 이를 만회하고자 최대한 행복한 모습을 보여주고 질적으로 더욱 집중해야 한다는 부담을 더 가지게 된다(Kim & Chang, 2008). 이러한 현상은 육체적 피로뿐만 아니라 해결 되지 않은 스트레스로 인해 모아관계에 부정적 영향을 미치게 되고, 자녀의 성장에도 나쁜 영향을 줄 수 있으므로(Yoon, Hwang, & Cho, 2009) 적절한 휴식과 스트레스 해결을 위한 시간을 가져야 할 필요가 있다. 세 번째 주제모음은 ‘아이교육에 관한 정보와 시간부족으로 불안함’으로, 참여자들은 자신은 일을 하고 있어서 절대시간이 부족함에도 자녀교육에 임하는 자신의 처지를 전업주부와 끊임없이 비교하면서 조급하고 불안해(Mishina, Takayama, Aizawa, Tsuchida, & Sugama, 2012; Yang & Shin, 2011) 하였다. 특히 우리나라는 자녀교육열이 매우 높고 자녀의 성공 여부에 따라 능력있는 어머니로 평가되기 때문에 취업모에게 자녀교육은 이중적 부담으로 작용하고 있다(Lee, 2007). 게다가 참여자들은 늦은 퇴근 시간과 피로함으로 자녀의 학습 조력자로서의 역할을 제대로 하지 못함으로 인해 현재 자녀의 학업뿐만 아니라 앞으로의 장래까지도 염려하였다. 이와 같은 현상은 자녀양육에서 교육이 큰 비중을 차지하는 우리나라의 사회적 분위기 때문에 주어진 여건 속에서 나름대로 최선을 다하지만 교육 문제에서만큼은 늘 부족하다고 느끼며, 이로 인해 받는 양육 스트레스도 매우 큰 것으로 보인다. 네 번째 주제모음은 ‘부족한 엄마로 낙인찍힘’으로, 참여자들은 고된 삶을 누구에게든 편하게 털어놓고 위로 받고 싶었지만 오히려 전업주부보다 육아에 더 엄격한 기준이 적용되었고, 부족한 엄마라는 낙인이 늘 따라다녔다. Yang과 Shin (2011)의 연구에서도 취업모는 ‘가정을 포기한 여자’라는 인식과 여성의 역할을 가족 중심에 두는 사회적 분위기 속에서 힘들어 하였다. 하지만 실제 취업모와 비취업모를 비교하였을 때 가정에서의 안전사고나 입원 경험 등에 차이가 없으며 양육태도 측면에서도 더 긍정적인 것으로 보고되었다(Bang, 2004). 즉 육아의 책임을 여성에게 떠넘기는 우리 사회의 불공평한 편견과 오해 속에서도 취업모는 최대한 아이에게 소홀 하지 않기 위해 부단하게 노력하고 있다고 볼 수 있을 것이다. 다섯 번째 주제모음은 ‘소원해진 가족관계’로, 육아에 대한 가치관의 차이나 비협조는 가족 간 갈등을 초래하였으며, 이로 인해 가족관계가 소원해지고 사이가 멀어졌다. 본 연구에서 참여자의 양육방식과 차이를 보이는 대리양육자는 대부분 할머니였으며, 대리양육자와의 육아갈등은 Kim과 Seo (2007)의 연구에서도 보고된 바 있다. 한편, 취업여성의 경우 배우자와의 불평등한 역할분담과 자녀교육방식에 불만을 갖는 경우가 많으며, 이는 심리적 부담을 가중시키게 되는데(Lee, 2008) 본 연구에서도 참여자들의 양육부담감은 남편의 무관심이나 비협조적인 태도로 인해 더욱 가중되는 것으로 나타났다. 예전과 달리 남성들이 여성의 취업을 지지하고 가사를 분담하는 등 도움을 주고 있지만 여전히 역할분담이 공평하게 이루어지지 못하고 있는 것으로(Yang & Shin, 2011) 보인다. 외국의 경우 법적으로 자녀 양육의 책임을 부모에게 공동으로 부여하고 있기 때문에(Kim & Seo, 2004) 양육을 인식하는 무게 정도가 우리와 다른 것으로 알려져 있다. 따라서 우리나라에서도 자녀양육의 책임을 개인이나 가족내의 문제로 남겨두기보다는 좀 더 제도적인 차원에서 접근한다면 취업모가 경험하는 역할 부담을 덜어줄 수 있을 것이다. 여섯 번째 주제모음은 ‘지쳐가는 삶’으로, 평상시에는 물론 특히, 급한 일이 생겼을 때 도움 받을 곳이 없어 어떠하든 혼자서 해결해야 하는 상황에 매우 힘들어 하였다. 이럴 때마다 취업모는 더욱 극심한 갈등을 겪음과 동시에 심신이 지쳐가는 경험을 반복하는 것으로 나타났다. Kim 등(2011)도 부부가 함께 일하기 때문에 육아를 분담해야 한다고 생각하지만 막상 긴급한 상황이 발생하면 ‘자연스럽게’ 여성의 책임으로 여기게 된다고 하였다. 이는 남편이 육아에 협력하기는 하지만 도와주는 정도의 수준으로, 여전히 우리 사회에서 남편의 가치관과 태도는 전통적인 성역할에 머물러 있는 것으로(Yang & Shin, 2011) 해석할 수 있다. 마지막 주제모음은 ‘하루하루 버텨나감’으로, 참여자들은 지금은 힘들지만 아이가 자라면 엄마의 부재를 이해하고, 자랑스러워 할 것이라 생각하였다. 즉, 현재 자신이 양육에 매진 하지 못하는 상황을 애써 긍정적으로 합리화하면서 버텨나가기 위해 노력하였다. 실제로 사춘기 딸의 경우 엄마의 사회적 성공을 긍정적으로 받아들여 성공한 엄마를 자신의 역할 모델로 삼고 있어(Jeong, 2005) 취업모의 이러한 합리화는 현재의 양육부담감을 이겨나가는 긍정적인 방어기제로 보인다. 주목할 점은 취업모의 삶이 힘겹고 지쳐가지만 본 연구참여자들은 전업주부로 돌아가기를 원하지는 않았다. 그 이유는 전업 주부로서 감당해야 할 양육과 가사일이 두렵기도 하지만(Kim et al., 2011) 사회로부터의 단절과 고립을 원하지 않으며 (Kim & Seo, 2012) 일을 하면서 얻는 성취감도 큰 것으로 설명할 수 있을 것이다. 이상의 연구결과에서 취업모들은 육아와 일 사이에서 갈등함, 육아에 대한 죄의식, 충분한 사랑과 보살핌을 주지 못한 미안함, 남편의 방관자적 태도에 불만을 가짐, 슈퍼우먼을 바라는 주변의 요구, 신체적 피로로 인한 잘못된 양육태도, 아이 교육을 걱정함, 전업주부와 교류가 없고 소외됨, 아이들이 자라면 엄마를 자랑스러워 할 것이라 생각함 등은 취업모의 양육 경험에 관한 선행연구(Kim et al., 2011; Kim & Chang, 2008; Yang & Shin, 2011)의 결과와 유사하게 도출되었다. 그러나 가족 관계가 소원해짐, 지쳐가는 삶, 하루하루 버텨나감 등의 새로운 주제모음이 도출되었다. 즉, 양육방식에 있어서의 가족간 의견 차이로 가족관계 마저 소원해진 채로 힘든 나날을 보내고 있었으며, 이러한 갈등과 부담감으로 삶은 지쳐가지만 자녀들의 미래와 자녀들이 자신의 노고를 알아줄 것이라는 희망으로 힘겨운 시간을 보내고 있음을 알 수 있었다. 취업모의 이러한 부정적인 양육경험은 둘째, 혹은 셋째 아이의 출산을 포기하게 만들어 저출산의 문제를 더욱 가중시키는 것으로 짐작된다. 따라서 어린 아동을 둔 취업모의 양육부담감을 줄이기 위하여 양육부담감에 대한 이해를 토대로 저출산의 문제를 해결하는 실질적이면서도 다차원적인 접근이 이루어져야 할 것이다. 더불어 취업모에 대한 편견과 고정관념을 깨뜨리고 그들의 미안한 마음을 위로해야 하며, 취업모 역시 잘못된 모성애적 믿음에서 비롯된 죄의식에서 벗어나도록 노력해야 할 것이다. Purpose: The purpose of this study was to describe the essential structure of the lived experience of working mothers` parenting burden in Korea. Methods: Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. Results: Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. Conclusion: These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.

Solar urticaria in Korean patients

( Sung Min Kim ),( Young Ah Cho ),( Ji Su Lee ),( Ji Youn Hong ),( Jin Hee Kim ),( Joo Ran Hong ),( Hye In Cheon ),( Yang Won Lee ),( Yong Beom Choe ),( Kyu Joong Ahn ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Solar urticaria (SU) is an uncommon type of photodermatoses characterized by erythematous wheal with pruritus after sunlight exposure, which shows a female predominance. Only a few studies to analyze the clinical features of SU were reported in Asia. Objectives: We aimed to analyze the clinical and photobiological characteristics of SU in Korea. Methods: We retrospectively investigated the medical records of patients with SU who visited the department of dermatology, Konkuk university medical center from January 2005 to January 2020. Results: Of a total of 44 patients, 36 (81.8%) were male and 8 (18.2%) were female. The mean age at onset was 17.6 years (range, 5-47) and the mean threshold time was 19.7 minutes. Among 32 patients who underwent phototesting, the action spectrum most commonly implicated was ultraviolet (UV) A only in 12 (37.5%), and then visible light (415nm) only was responsible for SU in 8 (25.0%). Three patients (9.4%) were induced by both UVA and visible light (415nm). Even 4 patients (12.5%) were triggered by only natural sunlight. Serum immunoglobulin E levels were measured in 33 patients, and 17 (51.5%) showed values higher than normal. The treatment most widely used were oral antihistamine (43.2%), followed by phototherapy (13.6%). Conclusion: SU is a rare photodermatosis in Korea, which shows a male preponderance. In this study, UVA and visible light (415nm) were predominant action spectrum of SU.

Slide Session : OS-IFD-07 ; Infectious Disease : In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus

( Myung Jin Lee ),( Kye Hyung Kim ),( Jong Youn Yi ),( Su Jin Choi ),( Chung Jong Kim ),( Nak Hyun Kim ),( Kyoung Ho Song ),( Pyoeng Gyun Choi ),( Ji Hwan Bang ),( Wan Beom Park ),( Eu Suk Kim ),( San 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus Myung Jin LEE1, Kye-Hyung KIM1, Jongyoun YI2, SuJin CHOI1, Chung-Jong KIM1, Nak- Hyun KIM1, Kyoung-Ho SONG1, Pyoeng Gyun CHOI1, Ji-Hwan BANG1, Wan Beom PARK1, Eu Suk KIM1, Sang-Won PARK1, Hong Bin KIM1, Nam Joong KIM1, Myoung- Don OH1 Seoul National University College of Medicine, Korea1, Pusan National University School of Medicine, Korea2 Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). No effective antiviral therapy is proven yet, but clinical use of ribavirin (RBV) has been tried. We investigated the antiviral effect of RBV against SFTSV in vitro. Methods: To test for cytotoxicity of RBV, Vero cells were treated with different concentrations of RBV (3.90 to 500 μg/mL, two-fold dilution) and analyzed by cell viability MTS assay 48h post-infection. To determine antiviral activity of RBV against SFTSV, Vero cells were infected with SFTSV strain Gangwon/Korea/2012 at 100 TCID50 (50% tissue culture infective dose) per well in a 96-well plate, and RBV was added at the concentrations showing no or minimal cytotoxicity. Viral RNAs were extracted from the culture supernatants and quantifi ed using one-step real-time reverse transcription- PCR to amplify the partial large segment of SFTSV. Statistical analysis was done by one-way ANOVA with Tukey`s post hoc test. Results: Cytotoxicity due to RBV was not observed at RBV concentration =31.3 μg/ mL. Viral RNAs at 24h post-RBV treatment were reduced with increasing RBV concentrations (1-32 μg/mL), compared with those of mock-treated cells (P <0.01, Figure). Half maximal inhibitory concentration (IC50) of RBV was 3.69 μg/mL at 24h post-RBV treatment. Conclusions: Our study shows that RBV has antiviral effect against SFTSV in a dose-dependent manner. Further studies are required to evaluate the effi cacy of RBV in SFTS.

Lithographically-featured photonic microparticles of colloidal assemblies

Lee, Su Yeon,Kim, Shin-Hyun,Heo, Chul-Joon,Hwang, Hyerim,Yang, Seung-Man Royal Society of Chemistry 2010 Physical Chemistry Chemical Physics Vol.12 No.38

<P>We have described a new and promising strategy for the fabrication of composite and porous photonic crystal microparticles that combines the self-assembly of colloidal particles with photolithography techniques. We fabricated silica/SU-8 composite microparticles with photonic bandgaps <I>via</I> four steps: (1) deposition of the silica colloidal crystals on the photoresist, (2) embedding of the colloidal crystals in the photoresist, (3) UV exposure through a photomask and subsequent development, and (4) release of the microparticles from the substrate. Embedding was performed above the glass transition temperature (<I>T</I><SUB>g</SUB>) of uncrosslinked SU-8. At such temperatures, capillary forces on the silica particles facilitate the migration of colloidal crystals in the SU-8 matrix. Particle migration ceased when the top colloidal crystal layer was trapped at the interface between air and SU-8. In addition, we also prepared porous microparticles with an inverse opaline structure by dissolving the embedded silica particles from the composite structures. The porous microparticles showed enhanced reflectivity at the bandgap position due to the large refractive index contrast. The bandgap position of the microparticles was controlled by the size of the silica particles, which determined the lattice constant. Bilayered composite and porous microparticles with two distinct photonic bandgaps were also prepared by sequential deposition of colloidal crystals composed of two differently sized silica particles.</P> <P>Graphic Abstract</P><P>A new and promising fabrication strategy of photonic crystal microparticles was demonstrated by combining colloidal self-assembly with photolithography. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c0cp00134a'> </P>

BEZ235 (PIK3/mTOR inhibitor) Overcomes Pazopanib Resistance in Patient-Derived Refractory Soft Tissue Sarcoma Cells

Kim, Hee Kyung,Kim, Sun Young,Lee, Su Jin,Kang, Mihyeon,Kim, Seung Tae,Jang, Jiryeon,Rath, Oliver,Schueler, Julia,Lee, Dong Woo,Park, Woong Yang,Kim, Sung Joo,Park, Se Hoon,Lee, Jeeyun Neoplasia Press 2016 Translational oncology Vol.9 No.3

<P><I>BACKGROUND:</I> Although pazopanib treatment has become the standard chemotherapy in salvage setting for metastatic sarcoma patients, most patients progress after pazopanib treatment in 4 to 6 months. After failure to pazopanib, patients have limited options for treatment. Therefore, subsequent therapy in patients who failed to pazopanib is urgently needed and the use of patient derived cells or patient derived tumors for accompanying testing with various pharmacological inhibitors could offer additional treatment options for these patients. <I>METHODS:</I> Patient derived tumor cells were collected from ascites at the time of progression to pazopanib and a 13-drug panel was tested for drug sensitivity. We confirmed the results using <I>in vitro</I> cell viability assay and immunoblot assay. We also performed the genomic profiling of PDX model. <I>RESULTS:</I> The growth of patient derived tumor cells was significantly reduced by exposure to 1.0 μM AZD2014 compared with control (control versus AZD2014, mean growth = 100.0% vs 16.04%, difference = 83.96%, 95% CI = 70.01% to 97.92%, <I>P</I> = .0435). Similarly, 1.0 μM BEZ235 profoundly inhibited tumor cell growth <I>in vitro</I> when compared to control (control versus BEZ235, mean growth = 100.0% vs 7.308%, difference = 92.69%, 95% CI = 78.87% to 106.5%, <I>P</I> < .0001). Despite the presence of CDK4 amplification in the patient-derived tumor cells, LEE011 did not considerably inhibit cell proliferation when compared with control (control vs LEE011, mean growth = 100.0% vs 80.23%, difference = 19.77%, 95% CI = 1.828% to 37.72%, <I>P</I> = .0377). The immunoblot analysis showed that BEZ235 treatment decreased pAKT, pmTOR and pERK whereas AZD2014 decreased only pmTOR. <I>CONCLUSION:</I> Taken together, upregulation of mTOR/AKT pathway in sarcoma patient derived cells was considerably inhibited by the treatment of AZD2014 and BEZ235 with downregulation of AKT pathway (greater extent for BEZ235). These molecules may be considered as treatment option in STS patient who have failed to pazopanib in the context of clinical trials.</P>

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

연쇄상구균의 약제내성과 전이성 R-plasmid의 특성

김종훈,임대환,이창훈,이수정,이월라,황미혜,김은희 한국어병학회 2003 한국어병학회지 Vol.16 No.1

본 연구는 넙치 병어에서 분리된 연쇄상구균들의 항균제 내성 경향을 파악하고, 약제내성의 전이에 관여하는 R plasmid를 검출하여, 분리 균들 내에서 이들 plasmid의 분포를 알아보기 위하여 실시하였다. 넙치 병어에서 분리된 연쇄상구균 40 균주의 대부분은 ampicillin, doxycycilne (DOXY), erythromycin, florfenicol, flumequine, norfloxacin, osolinic acid, oxytetracycline (OTC)의 2~5약제에 동시내성을 나타내었다. 이들 내성균으로부터 내성 전이에 관여하는 R plasmid (pST9)가 검출되었으며, OTC와 DOXY내성이 R plasmid에 의하여 수용균인 Streptococcus sp.로 전이가 이루어졌다. 전이성 R plasmid의 분포를 알아보기 위하여 colony 혼성화 반응을 실시한 결과, 40 분리 균주 중 6 균주에 동일한 DNA 구조의 R plasmid가 존재하는 것으로 나타났다. 그러므로 이들과 DNA 구조가 다른 R plasmid도 넙치병어에서 분리되는 연쇄상구균의 약제내성에 관여하고 있음을 시사하였다. MICs of 8 chemotherapeutic agents against forty streptococcal isolates were determined. These strains were isolated from diseased olive flounder, Paralichthys olivaceus, and showed 2~5 multiple drug resistance against different antibacterial agents including ampicillin, doxycycline (DOXY), erythromycin, florfenicol, flumequine, norfloxacin, oxolinic acid, and oxytetracycilne (OTC). In conjugation experiment, we found transferable R plasmids carrying OTC and DOXY resistance determinant in 3 drug resistance strains analyzed. Six out of 40 isolates showed positive signal in colony hybridization with the R plasmid DNA (pST9) as a probe. It suggests that other types R plasmid different from pST9 is also involving in multiple drug resistance of streptococci isolated from olive flounder.