성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

대전시 노은 도매시장 채소류의 농약 잔류 실태 및 식이섭취량 추정

한국탁,이규승,이은경,이용재,고광용,원동준,이정원,권순덕 한국환경농학회 2003 한국환경농학회지 Vol.22 No.3

대전시 노은 도매시장에서 채취한 6종의 채소류 중 농약잔류량을 조사한 후 이에 대한 위해성 평가를 실시하였다. 전체 100건의 분석시료 중 농약이 검출된 시료의 비율은 46.0%이었고, 잔류허용기준 초과비율은 6.0% 이었다. 검출비율이 높은 시료는 상추(85.0%), 깻잎(80.0%), 오이(60.0%) 순이었고, 상추 3건, 깻잎 3건이 허용기준을 초과하였다. 살균제는 dicar-boximide계, 유기염소계, azole계 농약, 살충제는 유기인계, 합성 pyrethroid계 농약이 많이 검출되었다. 검출빈도가 높은 성분은 procymidone, chlorpyrifos, chlorothalonil, cypermethrin, EPN의 순이었다. 위해성을 평가하기 위해서 각 농작물에 대한 농약의 추정 섭취량과 ADI를 비교한 결과, 허용기준을 초과한 깻잎의 bitertanol, triflumizole, iprobenphos가 다른 성분에 비하여 높은 비율을 보였다. 그러나 각 농산물의 식이섭취량이 적어 ADI에 대한 추정섭취량의 비율이 0.46%이하로 나타나 그 영향이 매우 낮은 것으로 판단되었다. Pesticide residues in some vegetables collected at Noeun wholesale market in Daejeon were surveyed and assessed their risk In 100 samples, the detection rate of pesticide was 46.0% and the rate exceed MRL was 6.0%. Commodities showing high detection rate were lettuce(85.0%), perilla leaf(80.0%) and cucumber(60.0%). Dicarboximide, organochlorine, and azole fungicides and organophosphorus and pyrethroid insecticides were detected. Detection frequency of pesticide was in the order of procymidone, chlorpyrifos, chlerothalonil, cypermethrin and EPN. When the estimated intake amount of the pesticides were compared with ADI to assess their risk, bitertanol, triflumizole and iprobenphos in perilla leaf were higher rate than the other vegetables. However the total amounts of intake of pesticides were estimated to less than 0.46% of ADI.

부신피질 자극호르몬 단독결핍 1례

박경식,이승현,최석영,박태규,이동화,이찬우,정성복,이인규 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

부신피질 자극호르몬 단독결핍은 국내에서 7례만이 보고된 희귀 질환이며 병인 및 경과 등 아직 불분명한 측면이 많다. 이는 질환지체의 희귀성도 있지만 치료후 자연경과에 대한 장기적인 추적검사가 이루어진 경우가 드물기 때문이기도 하다. 저자들은 비특이적인 전신증상을 주소로 내원한 폐경기후의 56세 여자 환자에서 자가면역질환의 증거없이 고프로릭틴혈증을 보인 부신피질 자극호르몬 단독결핍 1례를 경험하고 1년간의 부신피질호르몬 대치요법후 추적검사를 실시하였기에 문헌 고찰과 함께 보고하는 바이다. Isolated ACTH deficiency is a rare disorder which shows secondary adrenal insufficiency with normal states of other pituitary hormones. A 56-year-old postmenopausal woman complaining general weakness and intermittent mental confusion presented negligible serum cortisol and ACTH level with hyperprolactinemia and mild hyponatremia. Rapid ACTH stimulation test did not show significant increase of serum cortisol level. Combined pituitary stimulation test showed negligible response of cortisol and ACTH, and slightly decreased response of prolactin and gonadotropin. But the responses of TSH and GH were normal. There was no evidence of organic pituitary of hypothalamic lesion in brain MRI and antithyroid autoantibody was not detected in serum. After receiving 12 months of glucocorticoid replacement therapy, she skipped the medicine for 3 weeks and we performed follow-up endocrinologic tests. Serum ACTH and cortisol level was also negligible and prolonged ACTH simulation test showed normal response of serum cortisol. CRF stimulation test showed no response of serum ACTH. Basal prolactin level was decreased to near normal and combined pituitary stimulation test showed normal response of prolactin with slightly blunted response of TSH and GH. We concluded that the case was nonautoimmune origined isolated ACTH deficiency which was accompanied by hyperprolactinemia and resultant deficiency of gonadotropin, so we report this case with review of literatures.

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.

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

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연구개 및 구개수에 발생한 편평세포암종

이승호,이성훈,김기영,김창룡,박문성,류선열,조규승 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Carcinoma of the mouth accounts for approximately 5% of all carcinomas occurring in man. Carcinoma of the oral cavity develops as a result of invasion of malignant epithelial cells through the normally intact basal cell layer into subcutaneous and submucosal tissuse. The sofe palate and uvula may be involved in oral cancer but are not common sites. Early lesions of soft palate carcinoma appear as red, white, or mixed changes in the mucosa. The earliest symptom is mild sore throat. Advanced lesions interfer with swallowing and may cause a voice change. Although surgical method of soft palate carcinoma is successful, prognosis is relatively poor to swallowing and speech problem. Occasionally marginal recurrence may be developed. This article reports a case of squamous cell carcinoma occurred unusually in the soft palate and uvula. The case was treated with neoadjuvant chemotherapy, local radicalexcision and postoperative irradiation. Patient was followed up for 2 years. There was no tumor recurrence. The overall result including function was satisfactory.

肥肉豚의 血液化學値에 關한 硏究

李政吉,康炳奎,魏聖河,朴承柱,朴來生 全南大學校 農漁村開發硏究所 1981 農業科學技術硏究 Vol.16 No.1

全羅南道 順天地方을 中心으로 한 養豚場에서 出荷된 肥肉豚을 對象으로 血液化學値를 調査했다. 돼지의 年齡은 7個月부터 13個月이었으며, 總 276頭(♀ 181,♂ 95)를 對象으로 屠畜場에서 採血했는데 Landrace와 Berkshire의 一代難種이 大部分이었다. 한편 本 實驗에서 使用한 무??豚은 모두가 去勢한 것이었다. 1. 測定한 血液化學値는 血淸?萄糖量, 血淸總蛋白量, ablumin量, globulin量, 血淸尿素?素量, 血淸 cholesterol量, calcium量, 無機燐量, 血淸 transaminase(SGOT와 SGPT)等이었다. 2. 本 調査에서 나타난 각종 血液化學値의 範圍 및 平均値는 이미 報告된 結果와 거의 一致하였다. 3. 血淸cholesterol量은 性別差가 없었고 겨울에 높은値를 보인 反面, 여름과 가을에는 낮은 치를 보였다. 4. 血淸總蛋白量의 季節的變動은 globulin量의 變動에 起因한 것이었고, globulin量은 全般的으로 높게 나타났는데 特히 여름철의 增加가 뚜렷했다. Samples of blood were taken from 276 fattening pigs(181 intact females and 95 castrated males) at slaughter and serum chemical values were determined. The pigs were from Suncheone area, Chonnam Province; their age ranged 7 to 13 months; most of them were crossbreds of Landrace and Berkshire. 1. Determined blood chemical values in the prestent study were glucose, total protein, albumin, globulin, serum urea nitrogen, cholesterol, calcuim, phosphorus, serum glutamin oxalacetic transaminase and serum glutamic pyruvic transaminase. 2. The ranges and means of the chemical values in the present study were reconcilable with the normal values previously reported. 3. Sex differences between castrated males and intact prepubertal females were not observed in serum cholesteol levels. There were significant differences between the means of seasons, with the higher cholesterol values being observed during the winter as compared with summer and fall. 4. Seasonal changes of total protein cantent were due to the seasonal changes of globulin values. The globulin values in the present study were higher than those reported previously by others; the values were highest during summer season.

가옥 및 실험실내 라돈평형인자, 비 흡착 라돈자손 비율의 일일 변동 특성

이승찬,김창규,이동명,강희동 대한방사선 방어학회 2001 방사선방어학회지 Vol.26 No.4

일반가옥 및 실험실에서 라돈농도, 평형등가농도 및 평형인자의 농도 변화를 검토하였으며, 환기조건에 따른 평형인자, 비흡착 라돈자손 비율의 변동 특성을 검토하였다. 가옥 7개 지점에서의 평균 라돈농도, 평형등가농도 및 평형인자는 각각 30 Bq m^-3, 19.6 Bq m^-3 0.65였다. 한편, 실험실 3개 지점에서의 평균 라돈농도, 평형등가농도 및 평형인자는 55.0 Bq m^-3, 31.9 Bq m^-3 , 0.58였다. 실내에서의 라돈농도, 평형등가농도 및 평형인자는 새벽 및 아침시간에 높고 오후 4시부터 밤 10시 사이에 낮아지는 주기적인 특성을 나타내었다. 환기상태가 좋은 경우가 환기상태가 나쁜 경우에 비해 평형인자는 낮아지는 반면, 비 흡착 라돈자손 비율이 증가하는 경향을 나타내었으며, 평형인자는 기압, 습도에 비례하는 반면, 온도에는 반비례하는 관계를 나타내었다. The variation characteristics of radon concentration, equilibrium equivalent concentration and equilibrium factor in some houses and laboratory buildings have been studied. The variation of equilibrium factor and the unattached fraction of radon progeny with ventilation condition have been also estimated. The averages of radon concentration, equilibrium equivalent concentration and equilibrium factor were 30 Bq m^-3, 19.6 Bq m^-3 and 0.65 in seven houses, while 55.0 Bq m^-3, 31.9 Bq m^-3 and 0.58 in three laboratory buildings, respectively. The diurnal variation of radon concentration, equilibrium equivalent concentration and equilibrium factor in indoor showed a typical pattern that the radon concentration, equilibrium equivalent concentration and equilibrium factor increased at dawn and morning, while decreased at midday and evening. While the equilibrium factor rate deceased in the indoor environment which was well ventilated, the unattached fraction of radon progeny increased. The equilibrium factor was in proportion to air pressure and humidity of indoor, whereas in inverse proportion to temperature.

낭종 적출후 악골 결손부 치유에 관한 동종골 이식 효과에 관한 연구

이동근,박화규,권경환,강문정,신기영,민승기,성헌모 大韓顎顔面成形再建外科學會 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.4

This study was aimed to suggest to better treatment method of jaw cyst that the maximum diameter was wider than 3cm, using different treatment and clinical and radiographic result. We divided the 60 patients into three groups, group A(20 patients) were treated with cyst enucleation and Decalcified Freeze-Dried Allogeneic Bone(DFDB) graft, group B(20 patients) were treated with cyst enucleation and autogenous bone graft, group C(20 patients) were treated with only cyst enucleation. Each group was evaluated with panramic radiograph and clinical sign & symptom at pre-op and post-op(immediate, 6, 12, 24, 36 month). Bone density was evaluated with disital densitometer. The result was as follows : 1. Post-Op infection was higher in group C(4 pts.) than in group A(1 pt.) and B(1 pt.) 2. Post-Op gingival recession was higher in group C(3 Pts.) than in group A(1 pt.) and B(1 pt.) 3. Anatomic distortion was higher in group C(3 Pt.) than in group A(1 Pt.), and B(1 pt.) 4. reoperation was done in two patients who were in group C 5. There were donor site morbidity in two patients 6. there was no significant difference between group A and B in their bony density in their follow up period(p>0.05). 7. There were significant differences between group A, B and group C in their bony density until post-op 24 months but a little differences at post-op 36 months(P<0.01)