리네졸리드와 반코마이신을 교대로 투여하여 치료한 지속성 메티실린 내성 황색포도알균 균혈증 1예

김낙현,김문석,장은선,강유민,김가연,장희창,박완범,김의종,김남중,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for ≥7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

唐·憲宗과 元和中興

金明姬 호남대학교 2003 호남대학교 학술논문집 Vol.24 No.1

Xianzong(□宗:806-820) was the last Tang imperial reformer and was counted as the strongest emperor in late Tang times. He won authority by personally leading successful campaigns against rebel provinces(fan-zhen:□□814-819), and his economic and administrative reforms gave the dynasty another half-century of efficient empire-wide administration. Murdered by two discontented eunuchs, Xianzong was succeeded by his son Muzong(□宗;7:820-824). Xianzong combined a strong sophisticated knowledge of the political forces within his own court and had relatively better relationship with his ministers than his predecessors in an appropriate way. The years between the aftermath of the An Lu-shan(安□山:755-763) rebellion and the accession of Xianzong in 805 saw no basic changes in the provincial structure, despite the major events which occurred. At that particular period, the essential task of recovery was to show the power of the central government on the battlefield. As Prof. Twitchett express the situation, "Xianzong had no illusions about the possibility of a rapid restoration of central power, and moved with caution and sought to exploit opportunities as they arose." Further, because he did not see the provincial problem purely in military terms, Xianzong set to work on the institutional reforms with his newly appointed ministers. It surely is apparent that the purpose of reforms were not purely for the welfare of the populace. However, due to the restoration of central power by the government, most of the provinces had kept relatively peaceful state. When we make an assessment on his achievement, there can be a few different opinions; relatively positive one or the opposite. More than anything else he inherited a replenished treasury and a strong central army from Dezong and his imperial position was essentially secure. Another major resource was the bureaucracy which, despite outbreaks of factionalism and signs of corruption, was in a relatively healthy state and contained many brilliant officials such as Li Ji-fu(李吉□), Li Jiang(李□), Pei Du(□□) and Yuan Zhen(元□). The court possessed, then, the resources needed for strong central action. He seems to have chosen his men well and in return to have inspired their confidence. Li Ao(李□) commented on the Xianzong's reign as follows; 'of all restoration monarchs since antiquity none have come up to this', and from this phrase we could glimpse at the confident sentiment of the times.

『唐會要』의 勅令 分析을 통해본 唐代의 賤民制度

金明姬 호남대학교 1988 호남대학교 학술논문집 Vol.9 No.-

The slavery system which played an important role in an agricultural-production throughout the Han dynasty, changed their role and we ight in society accordance with the decline of the dyrasty. During the six dynasties, the slave and the dependant were co-existed as dual-structure in society. when the T'any dyrasty established, the system had given place to the system of common-servile people and the system became fixed from then on. In this article, it focused on the inter-connection between the system and the economical changes, in particular, the land system. Among various historical materials, the edicts on the slaves from 「T'ang Hui-yao」 were chosen as main references. The contents of the edicts could be devided into three phases: first, the period of the restriction on the number of slaves which was allowed to be employed in one household; second, the prohibition on kidnapping of commoners and selling them as slaves; third, the prevention of employing foreign slaves inside the china proper. These three phenomena reflects the change of social circumstances; in order to prevent the commoner becoming the slave, the government had to issue the edicts in reducing the rumbers of slaves, and eventually the slave-status itself disappeared from society. At the same time, it reflects the variation of the ruling class on how they recognize the servile people. In other words the cognition for the servile class of the ruling-class such as royal-family and aristocrats had been undergo rapid changes. Despite the difficulties in its effectiveness, these succession of edicts on the servile class, influenced on the social understanding for the class, and on the whole, it contributed to the abolishment of the system from chinese society. Through various changes of social conditions, eventually the servile class which played an important role in chinese society, vanished altogether. From these aspects, the T'ang era was the transitional period which witnessed such changes.

牛·李黨爭의 성격과 그 의미

金明姬 湖南大學校 1997 호남대학교 학술논문집 Vol.18 No.1

The 'Nui-Li factional strife(牛李黨爭)' which started with a personal conflict between Niu Seng-ju(牛僧孺 : ?-847) and Li Te-yu(李德裕 : 787-850), is known as one cause of T'ang dynasty's final fall. During the 820s the personal conflict became open political struggle within the Ch'ang-an(長安) bureaucracy and each party had been drawing people into political involvement and finally formed two 'factions(tang : 黨)'. A tang did not solicit members on grounds of policy differences, as a political party might do today; it did not have a strong cellular structure; and its membership was not fixed. One man was likely to be linked to the next, in a never-ending chain of accusations, for quite personal reasons. These included family connections, common origins, patronage relationships either in the examinations or in the course of an official career, colleague relationships, and simple instances of friendship and enmity. The factionalism in mid - T'ang dynasty actually involves only a few leaders on both sides -, what they did, with whom they were allied, and with whom they were at odds. The poor quality of the evidence concerning Niu-Li controversy prevents us to discuss the historical meaning of the mid - T'ang factionalism any deeper. It especially undercuts the various attempts to identify ideological positions or sociological differentiation as causes of the formation of the factions. The faction leaders were in pursuit of political power, and they attracted followers who hoped to share in the spoils. This should be evident from the story of the disputed examination of 821. The examination system was still at an early stage of development under the T'ang. It is only under the Ming and Ch'ing dynasty that the standards of objectivity associated with the examination system. While the Niu-Li controversy lasted, factionalism transformed the examination itself into a political event. The overtones of moral decay in the word tang were so strong that accuser, as well as accused, might find himself on the road to exile. A very different situation took shape under the weaker emperors of the 820s and 830s. The one determined attempt to put an end to factionalism before it had run its course - the so-called Sweet Dew plot of 835 - was an utter disaster. Another reason for the unusual intensity, and subsequent notoriety, of the Niu-Li controversy was the participation of eunuchs(宦官) in factional politics. The growth of eunuch power and the creation of the various offices that were their special preserve, had on the whole been resisted by literati officials in the latter half of the eighth century. But after the failure of the Wangs to undermine the eunuchs in 805, a number of the shrewder bureaucrats must have realized that eunuchs were part of the political world of Ch'ang-an. The participants in court intrigue criss-crossed the line between the inner and outer courts, in search of the strongest allies they could find. By the mid-820, then the eunuchs were fully integrated into the highest T'ang political circles, and the entire court had become the arena for factional struggle. From that time until the end of the dynasty, it was virtually impossible for any politician wishing to be effective in government affairs to avoid extensive contact with eunuchs. The 'Nui-Li factional strife(牛李黨爭)' which started with a personal conflict between Niu Seng-ju(牛僧孺) and Li Te-yu(李德裕) changed into political dispute(政見의 爭) and again, in the end, it transformed into party's "emotional conflict(意氣의 爭)" which involves all the Ch'ang-an(長安) bureaucracy. I have tried to emphasize the political aspect of the controversy in this paper, and the result was not satisfactory mainly because of the poor materials on the event. Yet I hope to continue this theme to probe the political features of the mid-T'ang factionalism.

가시적 모델링을 위한 GFN(Graphical Function Net)의 설계에 관한 연구

김명희 梨花女子大學校 韓國生活科學硏究院 1991 韓國生活科學硏究院 論叢 Vol.48 No.-

As the more general and higher abstracted level graphical modeling tool, the GFN(Graphical Function Net) is designed and also the possibility of visual modeling by GFN is presented. A model is specified by selection process of displayed icons which represent the elements of GFN and the created model can be automatically interpreted into SMPL or GPSS―Fortran simulation language. Visual interface manages the process which contains from the definition of system to the automatic translation. The system which can be defined by GFN is discrete queueing ststem.

唐ㆍ中葉의 政治思想

金明姬 호남대학교 2001 호남대학교 학술논문집 Vol.22 No.1

Chang Chiu-ling(張九齡), prominent statesman and poet of the Kai-yuan(開元) Period was an advocated Confucian Scholarship and Li Lin-fu(李林甫) was a renowned Legalist at least in his practice of politics. Whether or not Ching Chih-ling and Li Lin-fu were enemies before 734, their ministry soon developed into a bitter personal struggle. rheir colleague Pei Yao-ch'ing(裵耀卿) sometimes supported one and sometimes the other, but was in any case much preoccupied with the complex reform of the grain transport system. Both Chang Chiu-ling and Li Lin-fu enjoyed the emperor's highest regard; Chang as the successor to Chang Yueh in the role of moral counsellor and source of orthodox ritual and political wisdom, Li as a skilled administrator and institutional expert. Li was an adept political manipulator, skilled in intrigue and in handling people; Chang was a notoriously difficult colleague, unyielding, intransigent, obstructive, obsessed with minor points of principle, narrow-minded and violent in his prejudices. In particular he was passionately committed to the idea that literary values and scholarship were essential for a high office, and openly despised those who did not share his own literary background. His most bitter scorn was reserved for the military. With two such disparate chief ministers trouble was inevitable, and their opposition was made the more severe since it epitomized the protracted struggle which had been intensifying since the early 720s between the literary elite recruited through the examinations and the older aristocratic elite elements and technical specialists in the bureaucracy. As Chang had already predicted, after the An-Shih Rebellion the political disorder in T'ang imperial court became more complicated, and at the same time North-Eastern part of China was in revolt against the T'ang government. In 782 four local commanders set up independent administrations and took the title of 'king'. Later, the bureaucrats in the court were divided in their views regarding the policies of the central government toward the military power in outlying districts. Factions at court, divided politically and by social origin, became so strong that the entire administration was threatened. The struggle for political power between these two factions, intensified by personal feuds among the party leaders, continued for almost fifty years, and weakened the bureaucratic structure upon which the empire rested and strengthened further the power of the eunuchs who had entrenched themselves in the central administration and armies.

시대와 문학 -게오르크 뷔히너의 경우-

김명희 한국독일언어문학회 2003 독일언어문학 Vol.0 No.21

In dieser Arht wird versucht, die Beziehung von Literatur und Zeit bei Georg Biichner aufzuzeigen. Buchner hat sich trotz seiner Tatigkeit in verschiedenen Bereichen bis zu seinem Tod mit der sozio-historischen Real& seiner Zeit auseinandergesetzt. In seiner Zeit, dem Vorm&z, gab es scharfe Konflikte zwischen dem Feudaladel und dem liberalen Biirgertum. Biichner ist sowohl gegen den Feudahsmus als auch gegen die biirgerliche Klasse aufgetreten. Er ist fur das Interesse des Volkes gewesen. Er war uberzeugt, da8 die wichtigsten Widerspriiche seiner Zeit auf wirtschaftliche Ungleichheit zuriickzufiihren waren. Mit dieser Ansicht ist Buchner als Revolution& und Dichter Mtig gewesen. Die literarische Arbeit Biichners geht aus seiner politisch-revolutioniiren Praxis hervor. In den literarischen Texten Biichners spiegelt sich sein Zeitbedtsein wider. Seine zentralen Themen sind folgende: F roblematik von Reichtum und hut, veralkte moderne Gesellschaft , Kritik am falschen Bedtsein der herrschenden Klassen, Machtlosigkeit der Menschen in der Geschichte, Nihilismus, Langeweile, Entfremdung und Schizophrenie. Biichner hat festgestellt, dal3 die rein materiel1 orientierte Zeit mit den Mitteln und den Prinzipien der klassisch-romantischen Kunst nicht mehr beschreiben werden kann. Das heifit, man braucht neue Formen, urn die Wirklichkeit der veriinderten Zeit darzustellen. Die wichtigsten strukturellen Merkmale von Biichners Texten sind Diskontinuitlit und Parataktik in Szenenreihen, Handlungsablauf, Personencharakter und Sprachstil. Bese liickenhafte Stmktur fiihrt zur Differenziang von Personen und Situationen, was dem Publikum und dem Leser die Moglichkeit verschiedener Interpretationen bietet. Es ist gerade dieses Merkmal, dal3 Biichners Dichtung lebendig erhalten hat. Biichners Literatur geht nicht von der Idee oder dern Begriff seiner Zeit aus, sondern von der Realitlit und von den Menschen, so wie sie waren. Die ein bestimmtes Zeitalter beherrschende Idee verwdmt sich mit der &it. Aber das Wesen der Menschen und ihrer GesellschaftJichkeit iindert sich nur wenig. Biichner setzt sich in seiner Dichtung mit seiner historischen Lebenswelt auseinander. Trotz dieser Gebundenheit an die Zeit fihren sein Interesse fiir das Leben der Menschen und die neue poetische Struktur seiner Dichtung mit ihrer realistischen Darstellungsweise dazu, da13 seine Dichtung ncch heute lebendig ist und ihre Wirkung entfaltet.