병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성

김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.

24주간 추적하는 임상 연구에서 한국인 남자 알코올 의존 환자의 비재발률

강철중,김성곤,남궁기,조동환,이병욱,최인근,최용성,박성봉,제영묘,김현경,김성연 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objetives : In order to provide useful data tbr the further clinical studies with Korean alcohol-dependent patients, enrollment and non-relapse rates were investigated while alcohol-dependent patients wcre followed up for 24 weeks. Methods : The subjects of this study were alcohol-dependent male patients who, for the first time, visited a hospital among 3 groups of hospitals, University Hospital, General Hospital or Mental Hospital, or those who needed to be followed up after discharge from those hospitals. After assigning 12 subjects to each hospital, we investigated enrollment and non-relapse rates while cognitive-behavioral therapy and pharmacotherapy were provided. Results : 1) Forty-eight patients were enrolled and the rate of enrollment was 36.4%. The enrollment rate in the University Hospital group was 52.1%, in the General Hospital group 50.0%. and in the Mental Hospital group 10.4%. 2) In 48 patients, non-relapse rate was 27.1% at 12 week and 18.8% at 24 weeks after starting follow-up. It was 24.4% and 20.0% at 12 and 24 weeks, repectively, in the University Hospital group while the General Hospital group showed 33.3% and 16.7%, respectively, and the Mental Hospital Group showed 20.0% at both 12 and 24 weeks. Conclusion : These results provide important data for further clinical studies of Korean alcohol-dependent patients.

國內飼育 犬에 있어서 心臟絲狀蟲의 感染率에 관한 調査 硏究

Ji Hee Seong(成知禧),Hwa Joong Yoon(尹和重),Won Chang Lee(李元暢),Kwang Ho Kim(金光浩),Seung Won Kang(姜承遠) 한국예방수의학회 1996 예방수의학회지 Vol.20 No.2

The purpose of this study was carried out an epidemiological survey on the prevalence rate of the canine heartworms in Seoul City and the districts of Pa-Ju, Seong-Nam and Po-Chon in Kyonggi province of Korea from September 1994 to the end of September 1995. The blood samples from 292 male and 193 female dogs (pet, 363 ; fighting dogs, 60 ; working dogs, 62) were examined for the adult heartworms cuticle antibodies using the enzyme-linked immunosorbent assay (ELSA) kits. The test was designed to detect the antibodies of the host against the specific cuticle antigens produced with the adult heartworms.

압축 비디오에서 DCT 계수와 MB의 타입을 이용한 장면 전환 검출 연구

김종훈,이재승 동양대학교 산업기술연구소 2001 東洋大學校 産業技術硏究所 論文集 Vol.3 No.1

Vidio is an important and challenging media and requires sophisticated indexing schemes for efficient retrieval from visual databases. Generally, video streams are composed of video shots, which is consecutive video sequences recored during a record operation of camera. Scene change detection is a key issue in high-level video processing. In this paper, we propose a new scene change detection algorithms on compressed video using DCT coefficients and MB type.

國內飼育 犬에 있어서 心臟絲狀蟲의 感染率에 관한 調査 硏究

成知禧,尹和重,李元暢,金光浩,姜承遠 한국수의공중보건학회 1996 예방수의학회지 Vol.20 No.2

사망 진단서(시체 검안서) 작성의 문제점

김규석,임용수,이중의,서길준,윤여규,어은경,염석란,정연권,이윤성 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates Methods: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. Results: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital,101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). Conclusion: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.

CNC 절단기를 이용한 강판의 절단특성에 관한 연구(1)

김성일,이중희,김태영 한국공작기계학회 2002 한국공작기계학회 춘계학술대회논문집 Vol.2002 No.-

In the cutting of plate steel, the quality of the cut surfaces is strongly dependent on the cutting conditions such as cutting speed, kerf width, plate thickness, length of tip-specimen and oxygen pressure etc. the cutting tests of plate steel were carried out using CNC gas cutting machine. this paper deals with cutting characteristics of plate steel using CNC cutting machine. the width of cutting entrance and exit, the surface roughness of cutting surfaces and the cutting surface are examined at various cutting conditions.

만성 요통 환자의 심리사회적 특성

김용민,원중희,최의성,서중배,이호승,허윤무 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 만성 요통 환자의 많은 수가 직업 등 주변 환경과 심리 상태의 영향을 받는 것으로 추정되나 그 연관성은 아직 논란이 많다. 본 연구에서는 설문 조사를 통하여 만성 요통 환자의 심리사회적 특성을 알아보고자 하였다. 대상 및 방법. 1997년 7월부터 1998년 12월까지 6주 이상 지속된 만성 요통으로 본원 정형외과 외래를 내원한 환자들 중 기질적 원인이 불명확한 62명의 환자들에서 직업, 유발요인, 치료 등 요통 관련 요소 설문과 Minnesota Multiphasic Personal Inventory (MMPI)를 실시하였다. 요통 관련 사항에는 통증의 기간, 정도, 통증이 유발 또는 심해지는 자세, 그리고 본인이 생각하는 요통의 원인 등을 포함하였다. MMPI는 전체 평균을 이용한 방법과 two-code 방법을 이용하여 평가하였다. 결과: 만성 요통환자의 직업 상 실내에서 앉아 일하는 직업이 가장 맡았으며 일정한 자세를 오래 유지하며 앉거나 서 있는 경우 증상이 악화되는 것으로 기술되었다. MMPI에서는 건강 염려증, 우울증, 히스테리의 세 척도의 평균이 55이상으로 상승되어 있었다. Two-code 방법에서는 92% (46/50)의 환자에서 위 세 척도 중 적어도 하나 이상 상승되어 있었다. 결론: 만성 요통 환자들에서 일상 생활의 자세와 직업이 요통의 발생 및 악화에 영향이 있을 것으로 보여졌다. MMPI를 통한 심리 인성 검사 상 건강 염려증, 우울증, 히스테리의 성향이 증가되어 있어 요통의 발생과 만성화에 심리적 요소가 영향을 미치는 것으로 보여졌다. 사회경제학적, 정신심리학적 요인이 만성 요통에 미치는 영향의 규명을 위한 다양하고 심도 있는 연구가 필요하다고 생각된다. Purpose : Socioeconomic and psychologic factors seem to affect incidence, severity, and chronicity of low back pain. Purpose of this study is to survey socioeconomic factors and document psychoneurotic traits via MMPI in chronic low back pain patients. Materials and Methods : From July 1997 to December 1998, questionnaire about low back pain-related factors such as duration, severity, posture, occupation etc. and MMPI were given to patients who visited our department for chronic low back pain()6weeks). 62 patients completed, and 50 of them completed MMPI. The answers were analyzed. MMPI scores were evaluated in mean±SD method and two-code method. Results : Sedentary workers were the most common. And symptoms were told to be elicited by long sitting or standing posture(job) . Hs, D, Hy scales of MMPI, which are know as "neurotic triad by two-code method was observed in 92% (46/50) . Conclusion : It seemed that job and posture had Important role in chronic low back pain. And, it seemed that chronic low back pain patients had some psychoneurotic traits especially in hypochondriasis, depression, and hysteria. More investigations to document the influences of socioeconomic and psychoneurotic factors in chronic low back pain seems to be necessary.

찻물에서의 Cd과 Pb 이온 제거에 관한 차입자의 효과

김중만,백승화,박성수 한국식품영양학회 1998 韓國食品營養學會誌 Vol.11 No.5

차재료를 찻물에 담근 후 차건데기를 건저내고 마시는 차류의 중금속 제거력을 조사하기 위하여 Cd과 Pb 용액에서 보리차, 옥수수차, 쟈스민차, 현미녹차, 홍차, 결명자차, 감껍질차, 귤껍질차, 누룽지의 입자별, 농도별, 온도별 제거 정도를 조사한 결과는 다음과 같다. 입자의 크기가 작아질수록 모든 차에 있어서 중금속 제거력은 증가되었고, 금속별 제거량은 Cd는 결명자차(3.253∼6.136㎎/g)가, Pb은 쟈스민차(6.784∼7.557㎎/g)가 높았다. 농도별 중금속 제거량은 중금속의 농도가 증가할수록 증가하였는데 Cd와 Pb는 쟈스민차(1.209∼4.815㎎/g, 0.642∼7.004㎎/g)가 제거력이 높았다. 농도별 중금속의 제거작용은 모든 차류에서 증가되었으나 옥수수차는 Pb에서 0.497∼0.647㎎/g로 제일 낮았다. 온도별 중금속 제거량은 온도가 높아질수록 증가하여 Cd은 결명자차가 4.080∼7.799㎎/g, Pb는 쟈스민차가 7.003∼7.763㎎/g으로 증가하는 경향을 보였다. Removabilities of heavy metals(Cd and Pb) by the tea materials (barley-tea, corn-tea, jasmin-tea, brown rice-green tea, cassia tora-tea, persimmon peel-tea, orange peel-tea and rice-tea) in the tea-water were studied in the various conditions ; particle size of tea(20, 40, 70 mesh), concentration of heavy metal(25, 50, 100 ppm) and extraction temperature(20, 30, 50, 100℃). The removabilities by the tea solids were increased as the particle size decreased, concentration of heavy metal increased, and extracting temperature increased. Of the nine kinds of tea, Cd and Pb removability by jasmin-tea was highest. In addition, heavy metal removability by cassia tora tea was better than that of other tea as extraction temperature was increased.

좌심방 석회화와 관련된 반복된 좌심방 혈전 1예

김성훈,우성용,오유경,정우백,임철현,신재원,박철수,윤호중,정욱성,홍순조 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.3