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김천숙,박은정,강규식,김지은,안기량,권진형,유시현,주영철,권순정 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1
Background: The OR(operating room) should provide an optimum environment that is safe for the patient and the working personnel. The air ventilation system of OR has been studied to decrease the contamination of air. We investigated the flow and contamination of the air in OR at our hospital. Method: Cultures in OR were made and the number of bacteria and fungi were calculated. A two-dimensional model for the cross-section of an operation room is developed for the CFD (computational fluid dynamics) analysis. The characteristics of air flow in the empty operation room and in the occupied operation room are calculated by using a CFD program. Results: The current air ventilation system of our hospital does not deliver the clean air to the operating site efficiently in occupied OR. Conclusions: We suggested a new location of air ventilation system which improves air venting with little increase of the cost of equipment.
Park, Joon,Shin, Jong-Hee,Song, Jeong-Won,Park, Mi-Ra,Kee, Seung-Jung,Jang, Sook-Jin,Park, Young-Kyu,Suh, Soon-Pal,Ryang, Dong-Wook The Microbiological Society of Korea 2004 The journal of microbiology Vol.42 No.2
Pulsed-field gel electrophoresis (PFGE) typing was applied to the epidemiological investigation of 21 Candida tropicalis isolates collected from urine specimens of 11 patients and one healthcare worker, in an intensive care unit (ICU) over a 4-month period. Seventeen epidemiologically unrelated strains from 14 patients were also tested to determine the discriminatory power of PFGE. PFGE typing consisted of electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA (REAG), using two restriction enzymes (BssHII and SfiI). The EK pattern was the same in all 38 isolates, while REAG using SfiI separated the isolates into nine types. However, 16 different PFGE types were iden-tified by REAG with BssHII, and the same results were obtained when the results of both REAG tests were combined. In serial urinary isolates from 10 patients, all strains from each patient had the same PFGE pattern. While the epidemiologically unrelated strains from 14 patients consisted of 13 different PFGE types, the 20 isolates from the 11 ICU patients fell into only two PFGE types (types Cl and C2), and these apparently originated from the two different outbreaks. All strains of type Cl (n = 12) were isolated from six patients, between November 1999 and January 2000, and all of the type C2 strains (n=8) were isolated from five patients, during January and February 2000. This study shows two con-secutive clusters of C. tropicalis candiduria in an ICU, defined by PFGE typing, and also demonstrates that a PFGE typing method using BssHII is perhaps the most useful method for investigating C. tropi-calis candiduria.
누두흉환자에서 Nuss 방법에 의한 수술 중 환기방법에 따른 호기 일회호흡량, 흡기 최대압력 및 활력징후의 변화
조수현,이선학,안기량,박욱,박형주,곽수달,백남순,김천숙 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.2
Changes of Vital Signs, Expired Volume and Maximal Pressure by Mode of Ventilation during a Nuss Operation in Patients with Pectus Excavatum Soo Dal Kwak, M.D., Nam Soon Baek, M.D., Su Hyun Cho, M.D. Ki Ryang Ahn, M.D., Sun Hak Lee, M.D., Chun Suk Kim, M.D. Wook Park, M.D., and Hyung Joo Park, M.D. Departments of Anesthesiology, ??Chest Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea Background: This study was undertaken in order to investigate any cardiopulmonary changes caused by the surgical procedure during a Nuss operation in patients with pectus excavatum. Methods: Thirty patients undergoing the Nuss operation were divided into two groups. The patients were randomly assigned to either Group-V (n = 15) which volume controlled ventilation was applied, or to Group-p (n = 15) where pressure controlled ventilation was applied. Mechanical ventilation provided a tidal volume to be set at approximately 10 ml/kg and a frequency set to keep ETCO_2 in range, between 32 mmHg and 38 mmHg. During the surgical procedure, we recorded expired volume (V_E) and inspired maximal pressure (Pmax) changes according to the ventilator mode, and then also recorded changes in vital signs. Results: Heart rate and blood pressure had no significant changes in either groups. In Group-V, during rotation of the metal bar, there was a significant decrease in expired volume (P < 0.001), changes of inspired maximal pressure gradually increased with the operation (P < 0.001). In Group-P, rotation of the metal bar caused a significant decrease in expired volume (P < 0.001). Conclusions: During the Nuss operation, there should be careful observation of changes in the vital signs, expired volume and maximal pressure during insertion and rotation of the metal bar. (Korean J Anesthesiol 2001; 41: 178~183)
칸디다혈증 환자에서 분리된 Candida albicans 균주의 중합효소연쇄반응 및 Southern 교잡법을 이용한 형별 분석
박주열,신종희,양성진,오봉준,조덕,기승정,신명근,서순팔,양동욱 대한감염학회 2004 감염과 화학요법 Vol.36 No.6
목적 : 최근 Candida albiocans에 의한 감염의 분자역학을 이해하기 위해 다양한 균 형별 검사가 시도되고 있으나, 가장 적합한 방법은 아직 정립되어있지 않다. 본 연구는 칸디다혈증 환자의 임상검체에서 분리된 C. albicans 균주들을 대상으로 두 가지 DNA fingerprinting법을 이용하여 균 분류를 시도하고 그 성적을 비교하여 보았다. 재료 및 방법 : C. albicans 칸디다혈증으로 진단된 환자 14명의 각종 임상검체(혈액 14주, 카테터 7주, 요 4주 및 호흡기 4주)에서 분리된 C. albicans 29주를 대상으로 하였다. Interrepeat (IR) PCR을 이용한 분석에는 primer 1245 및 1246의 두 가지를 이용하였고, Cl fingerprinting법은 염색체 DNA를 EcoRI으로 분해한 후 Ca3의 C1 단편을 probe로 이용하여 Southern 교잡법으로 실시하였다. 결과 : 14명에서 분리된 총 29주는 IR PCR를 이용한 분석 결과, primer 1245에 의해 9가지 형, primer 1246에 의해서는 7가지 형, 두 primer를 조합할 경우 13가지 형으로 구분된 반면, C1 fingerprinting법에 의해 16가지 형으로 구분되었다. 두 가지 방법의 결과를 조합할 때 29주는 총 16가지 형으로 구분되어 C1 fingerprinting법을 단독으로 시행한 성적과 일치하였다. 두 가지 방법 모두에 의해 10명의 혈액과 기타 검체에서 분리된 균주는 환자별로 동일한 유형으로 구분된 반면, 1명에서 분리된 균주는 서로 다른 유형이었다. 반면, 3명에서 분리된 균주는 환자별로 모두 동일한 IR PCR 유형을 보였으나, C1 fingerprinting법에 의해서는 다르거나(1명), 유사한(2명)유형을 보였다. 두 가지 방법을 조합하여 판정할 때 각 환자의 혈액에서 분리된 균주는 대부분 카테터(7명중 6명), 뇨(4명 중 4명) 혹은 호흡기(4명 중 3명)에서 분리된 균주와 유사하거나 동일한 유형이었다. 결론 : C. albicans 균주의 형별 분석에는 IR PCR법에 비해 C1 fingerprinting법이 분별력이 더 우수한 방법으로 생각되었으며, 칸디다혈증 환자의 카테터, 요 혹은 호흡기검체에서 분리되는 균주는 대부분 혈액에서 분리된 균주와 동일하거나 유사한 유형을 보임을 알 수 있었다. Background : Although several molecular typing methods have been used to investigate C. albicans infections, there remains no "gold standard" method by which relatedness of C. albicans strains is determined. In this study, two DNA fingerprinting methods were compared for genotyping of clinical strains of C. albicans isolated from candidemic patients. Materials and Methods : Twenty-nine strains of C. albicans isolated from various clinical specimens (14 from blood, 7 from catheter, 4 from respiratory tract secretion, and 4 from urine) of 14 candidemic patients were analyzed. Primer 1245 and 1246 were employed for IR PCR and Southern blot hybridization method was used for C2 fingerprinting, with Ca3 and C1 as primers, after the fragmentation of DNA with EcoR1 Results : IR PCR method separated 29 isolates into 9 (1245 primer), 7 (1246 primer) and 14 (combination of two primers) types, whereas C1 fingerprinting identified 16 different types. By combining the IR PCR and C1 fingerprinting methods, total of 16 different genotypes were identified among 29 isolates from 14 patients, which is the same result obtained by the C1 fingerprinting only. Using both methods, blood and non-blood isolates from each patient produced identical genotypes for 10 patients and different genotypes for 1 patient. In three patients, isolates from blood and other site of each patient showed identical patterns by IR PCR fingerprinting, but appeared different (n=1) or similar (n=2) by C1 fingerprinting. Overall, for 87% (13/15) of patients, isolates collected from catheter (6 of 7 patients), urine (4 of 4 patients), or respiratory (3 of 4 patients) were identical or similar to the corresponding blood isolates. Conclusion : Our study shows that C1 fingerprinting method is more discriminatory than IR PCR for the molecular typing of C. albicans isolates. For the majority of patients, blood and other site isolates had identical or similar genotypes.
두가지 근이완상태를 동시에 비교평가하기 위한 양측 상지혈류차단법의 유익성
김순임,황경호,김선종,김성열,박욱,옥시영,안기량 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.3
This technique in the conscious volunteers to study the neuromuscular blockade was described in which two different muscle relaxants of ED95×10(-1) in 20ml 0.9% saline were injected simultaneously into one arm and the contralateral arm below the occlusion site of circulation with tourniquet, and then two different neuromuscular blockades were compared following tourniquet released after 80% twitch depression. The benefits of this technique were obtained as following; 1) Simplicity, saving and safety from easily to set up and using low dose of muscle relaxant. 2) Expected results from pure effects of muscle relaxant without any drug interactions. 3) Time shortening of experimental study. 4) Saving time and experiments from simultaneously comparison of control with study group in one experiment. 5) The study of pure receptor binding with muscle relaxant, since a presumed plasma concentration of muscle relaxants is near or actually zero after release of the tourniquet when fresh blood had flushed the limb. Concusively bilateral isolated forearm technique is elegant method to study the biophase binding interacted of relaxants and cholinerceptor.