척추주위 농양을 동반한 크립토콕쿠스 골수염 1예

오련,송은희,박기호,조오현,김탁,윤귀준,손병석,성흥섭,김미나,김양수,우준희 대한감염학회 2008 감염과 화학요법 Vol.40 No.5

Cryptococcosis is a disseminated infection caused by Cryptococcus neoformans. It usually causes pulmonary infection and meningitis in immunocompromised patients. However, osteomyelitis due to C. neoformans is extremely rare. It is generally known that cryptococcal osteomyelitis is a complication of disseminated cryptococcosis, appearing in 5-10%. We experienced a case of cryptococcal osteomyelitis with paraspinal abscess in a liver transplant patient.

벗나무속 수종간의 핵 리보솜 DNA의 ITS Ⅰ 염기서열 비교

오유성,김기옥,정용환,오문유,한상현,고미희 제주대학교 생명과학연구소 1998 제주생명과학연구 Vol.1 No.-

Comparison of four species (Prunus yedoensis, P. sargentii, P. pendula for. ascendens, P. serrulata var. quelpaertensis) and one cultivar of P. yedoensis were carried out by comparing their nucleotide sequences from the internal transcribed spacers (ITS) I of nuclear ribosomal DNA (rDNA). The length of the ITS I region was ranged from 229 to 236 base pairs (bp). The G+C contents of ITS I ranged from 58.5 to 60.2%. The value of nucleotide divergence across for four Prunus species and one cultivar ranged from 0.4 to 6%. The pairwise distance between P. pendula for. ascendens and P. yedoensis was 0.004 showing the lowest value among any other pairs. On the other hand, the pairwise distance betwen P. yedoensis and cultivated P. yedoensis was 0.026. The nucleotide analysis based on ITS I sequence was considerably similar to previous studies on the basis of random amplified polymorphic DNA (RAPD).

대구지역 거주자의 식생활 습관과 위장질환과의 관계

오미정,김수월,양희면,현재식,허천식,이명화 한국건강관리협회 2000 건협 Report Vol.3 No.-

간호학과 학생들의 노인에 대한 지식 및 태도

양경미,오현이,김진선,백영주 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Objectives: The purposes of this study were to investigate nursing students' knowledge and attitudes toward the elderly, to examine the correlation between knowledge and attitudes, and to identify predictors of nursing students' attitudes toward the elderly. Method: Study participants were 195 nursing students who enrolled in a university located in Gwangju. Data were collected using structured questionnaires. Results: The average FAQ Ⅰ score for nursing students in this study was 50.2%. The level of nursing students' knowledge was relatively low compared to knowledge of Western nursing students in previous studies. Moreover, the average scores of psychological dimension and family/sociological dimension were lower than those of physical/physiological dimension. Negative biases were prevalent when the biased scores were computed. Nursing students also reported a little preference for working with older patients after graduation. Although the average attitude score was in a neutral range, the number of items in a negative attitude score range were more than those in a positive attitude score range. Contrary to expectation, the correlation between knowledge and attitude was not statistically significant. Nursing students who have clinical experiences with the elderly reported higher scores on FAQ Ⅰ than their counterparts. A current relationship with elderly living in their household was a significant predictor of nursing students' attitudes toward the elderly. Conclusion: Results from this study suggest that nursing education should be directed to increase the nursing students' knowledge and positive attitudes toward the elderly. Exposure to well elderly as clients before they are hospitalized or institutionalized may be helpful to increase nursing students' positive attitudes toward the elderly.

Mycobacteria Growth indicator Tube(MGIT)와 Ogawa 배지를 이용한 결핵균의 신속검출

권오건,조현미,장인호,어영,윤갑준 대한임상미샐물학회 2000 Annals of clinical microbiology Vol.3 No.2

Non-typhi Salmonella 균혈증의 임상양상과 항균제 내성빈도

이상오,이미숙,양성연,조용균,김은옥,김양수,우준희,류지소,배직현 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

목적 : Non-typhi Salmonella는 대부분 발열과 설사를 동반한 급성 위장관염을 일으키며 수일에서 수주후 자연 치유된 다. 그러나 때로는 항균제 치료를 요하는 균혈증을 일으키기도 한다. 이에 저자들은 non-typhi Salmonella 균혈증이 혈액 배양에서 증명된 환자들에서 연령 및 기저질환의 유무에 따른 임상양상의 차이와 내성균 발생빈도에 대해 고찰하고자 한다. 방법 : 1989년 6월 1일부터 1996년 5월 31일까지 서울중앙병원에 입원했던 non-typhi Salmonella 균혈증 환자 66예를 대상으로 후향적으로 조사하였다. 임상미생물 기록을 조사하여 연도별 각 혈청군의 분포와 항균제 내성빈도를 분석하였다. 이들 중 56예의 의무기록을 검토하여 소아와 성인, 기저질환의 유무에 따른 임상양상의 차이와 치명율을 비교하였다. 결과 : 대상 환자 56예중 남자가 30예, 여자가 26예이었고, 소아가 16예(평균 20±1.9세, 범위 21일-7세), 성인이 40예(평균 45.7±19.1세, 범위 18세-19세)이었다. 소아에서는 4예(25.0%)에서만 기저질환이 있었고 사망환자는 한 예도 없었으나 성인에서는 27예(67.5%)에서 다양한 기저질환이 있었고(p<0.01) 4예의 환자가 패혈성 쇽으로 사망하였다. 이는 성인군에서는 10%, 성인 기저질환군에서는 14.8%(p=0.06)의 치명율을 나타내는 것이었다. 균혈증의 원발부위에 따라 분류하여 보면 위장관염 기원이 총 56예 중 31예(55.4%)로 가장 많았고 소아군에서는 기저질환이 없는 12예 중 11예(91.7%), 성인군에서는 13예 중 10예(76.9%)였으며 이들 중 사망은 한 예도 없었다. 원발성 균혈증으로 나타났던 성인 19예(47.5%) 중 18예(94.7%)에서 기저질환이 있어서(p<0.01) 기저질환이 있는 성인 환자에서 주로 원발성 균혈증이 발생함을 알 수 있었다. 국소형 감염에서 기원한 균혈증은 2예(3.6%)로 각각 담도염과 담낭염에서 발현하였다. 각 혈청군별 분포는 총 66예 중 A군 11예(16.7%), B군 25예(37.9%), C₁군 3예(4.5%), C₂군 2예(3.0%), D군 24예(36.4%), E군 1예(1.5%)이었다. 1993년 이전에는 B군이 전체의 51.6%로 다수를 차지하였으나 1994년 이후로는 D군이 57.1%로 주종을 이루었다. 한 개 이상의 항균제에 내성을 보인 내성균 발생빈도는 66예 중 18예로 27.3%를 보였다. 혈청군별로는 B군이 D군에 비해 더 높은 내성율을 보였다(44.0% ; 8.3%, p<0.01). 항균제별 내성율은 ampicillin, piperacillin이 각각 15.1%, ampicillin/sulbactam, trimethoprim/sulfamethoxazole이 각각 6.0%, tetracycline, aztreonam이 각각 3.0%, ticarcillin, gentamicin이 각각 1.5%를 보였다. 그러나 3세대 cephalosporin계와 quinolone계에는 내성을 보인 예가 없었다. 결론 : Non-typhi Salmonella 균혈증은 지저질환이 없는 소아나 성인에서는 급성 위장관염의 합병증으로 일시적인 균혈증을 보일 수 있으나 양호한 예후를 보인다. 그러나 면역기능 저하를 동반하는 기저질환을 가지고 있는 환자에서는 주로 원발성 균혈증으로 나타나며 중증의 임상 경과와 사망을 초래 할 수 있다. 항균제 내성율은 전체적으로 27.%였고 3세대 cephalosporin계와 quinolone계에는 내성을 보인 예가 없었다. Objectives :Non-typhi Salmonella causes acute gastroenteritis accompanied with fever and diarrhea, but it's usually cured spontaneously several days or weeks later. Sometimes, however, it can result in bacteremia which requires antibiotic treatment. In this paper, we're going to discuss differences in clinical manifestation depending on the age and existence of the underlying diseases and incidence of the resistant strains in the patients who suffer from bacteremia with non-typhi Salmonella proved in the blood culture. Methods : We retrospectively studied 66 cases of bacteremia with nontyphi Salmonella treated at Asan Medical Center from June 1, 1989 to May 31, 1996. The clinical microbiology records were examined and the yearly distribution of each scrogroup and the rate of resistance of antibiotics were analysed. We reviewed the medical records of 56 cases and compared the differences in clinical manifestation and fatality rate among children and adults, and the existence of the underlying diseases. Results : Of 56 ones for this study, there were 30 males, 26 females, and 16 children (mean age:2.0±1.9, range:21days-7years old) and 40 adults(mean age:45.7±9.1, range:18-91years old) were involved. Only 4 cases(25.0%) of children had underlying diseases with no dead cases, however, in adults, 27 cases(67.5%) had various underlying diseases(p<0.01), and 4 cases died of softie shock. In result, the fatality rate was 10% in adults group and 14.8%(p=0.06) in adults with underlying diseases. The origin of bacteremia of 31 cases(55.4 %) was gastroenteritis. Eleven cases(92.7%) of 12 children and ten(76.9%) of 13 adults without underlying diseases were from gastroenteritis and there were no dead cases. Of the cases of aults, the primary bacteremia were 19 cases(49.5%) and 18 cases(94.7%) of them had various underlying diseases(p<0.01). So we found that the bacteremia with non-typhi Salmonella occurred mainly as the primary bacteremia in adult cases with underlying diseases. Only two cases of bacteremia were originated from localized infection and each of them manifested at cholangitis and cholecystitis. Related to the serogroup distribution of total 66 cases, there were 11 cases(16.7%) in A group, 25 cases(37.9%) in B, 3 cases(4.5%) in C₁, 2 cases(3.0%) in C₂, 24 cases(36.4%) in D, and one case(1.5%) in E group. Until 1993, B group was a majority(51.6%), but D group became a majority(57.1%) since 1994. The rate of resistance of one or more antibiotics was 27.3%(18 cases of 66 cases). B group showed higher rate of resistance than D group(44.0% vs. 8.3%, p<0.01). Related to the respective rates of resistance of antibiotics, ampicillin and piperacillin showed 15.1%, ampicillin/sulbactam and trimethoprim/sulfamethoxazole were 6.0%, tetracyclin and aztreonam were 3.0%, and ticarcillin and gentamicin were 1.5%. The third generation cephalosporins and quinotones, however, had no cases showing resistance. Conclustion : Non-typhi Salmonella can show a transient bacteremia as the complication of acute gastroenteritis to the children as well as adults without underlying diseases. In general, it can be easily cured. To the patients with underlying diseases causing immunocompromised state, however, it can be manifested to the primary bacteremia and can cause fetal disease or death. General rate of resistance of antibiotics reaches at 27.3%, but the third generation cephalosporins and quinolones had no cases showing resistance.

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.

우수선수의 Bioelectrical Impedance (생체전기저항) 방법에 의한 신체구성 추정

이미숙,박기현,오재근 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.1

The purpose of this study was to estimate body composition of elite players using bioelectrical impedance method (BI). The BI data acquisition system (Art Haven 9, Kyoto, Japan) was used to determine the BI of the upper and lower limbs. BI of the forearm, upper arm, lower leg, and thigh on the right and left side were determined in 50 healthy elite sport players using a specially designed BI acquisition system. The BI is a rapid, noninvasive, and relatively inexpensive method for assessing body composition in field settings. Some sophisticated methods of BI can also be utilized in laboratory settings. To use BI methods appropriately in either setting, testers need to understand the basic assumption and principles, as the potential sources of measurement error, for this method. The present study indicate that BI analysis may be useful to predict the muscle volume.

발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

학령전기 장애아 어머니의 부담감과 사회적지지

양경미,백영주,오현이 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background and Objective : The purpose of this study is to identify the level of burden and social support of mothers who have handicapped children of preschool age, and is to determine whether providing social support is an effective strategy to relieve the burden of those mothers. Materials and Method : From August 17, to September 28, 1999, the data was collected from 83 mothers caring handicapped children of preschool age, who are being treated and educated at two welfare centers for the handicapped, two early training and treating centers for them in Kwangju, and one center in Seoul. Two instruments used in this study were the burden scale developed by Suh and Oh, and the Personal Resource Questionnaire(PRQ, Part Ⅱ) developed by Brandt and Weinert. The data was analyzed with t-test, ANOVA, Scheffe’s test, Pearson’s Correlation Coefficient, and Stepwise Multiple Regression analysis. Results : 1. The correlation between the burden and the social support was statistically significant. 2. Sorts of handicap of children was the most important predictor to burden of mothers caring handicapped children of preschool age(R2=.20). In addition to, this social support and brother’s precedence accounted for 32% of burden of those mothers. Conclusion : There was significant negative correlation between social support and burden.