호중구 감소성 발열을 보인 고형암 환자의 임상양상 및 그람양성균 균혈증의 위험인자

구남수,김준형,최유경,정세진,오형중,윤기태,김연아,신소연,김명수,김영근,박윤선,최준용,송영구,이경원,김준명 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

목적 : 항암요법을 시행받고 호중구 감소성 발열이 발생한 고형암환자에서 임상양상을 분석하고 그람양성균균혈증의 위험인자를 알아보고자 하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 연세대학교 의과대학 세브란스 병원 종양내과에서 고형암으로 진단받고 항암요법을 시행받은 18세 이상의 암환자에서 호중구 감소성 발열이 있었던 288예를 대상으로 하였다. 결과 : 항암요법을 시행받은 고형암 환자 중 288예에서 호중구 감소성 발열이 발생하였다. 이중 원인을 찾을 수 있었던 경우는 130예로 전체 45.1% 이었으며 미생물학적 확인감염(microbiologically documented infection, MDI)은 53예(18.4%) 이었다. 균혈증이 동반된 호중구 감소성 발열의 원인균 분포를 보면 총 53예에서 그람양성균이 27예 분리되어 50.9%를 차지하였고 그람음성균이 25예(47.2%), 진균 1예(1.9%) 순이었다. 그람양성균 중에서 methicillin 내성 포도상구균의 비율은 35% 이었다. 호중구 감소성 발열 환자에서 그람양성균 균혈증의 독립적인 위험인자를 분석한 결과 중심정맥 카테터와 연관된 감염이 있는 경우, 구내 점막염이 발생한 경우, 그리고 피부 및 연조직 감염이 발생한 경우에서 그람양성균 균혈증의 위험이 높았다. 결론 : 호중구 감소성 발열이 발생한 고형암 환자에서그람양성균 균혈증이 가장 높은 빈도를 보였으며 특히 중심정맥 카테터와 연관된 감염이 있는 경우, 구내 점막염이 발생한 경우, 그리고 피부 및 연조직 감염이 발생한 경우에서 그람양성균 균혈증의 위험이 높음을 알 수 있었다. 따라서 호중구 감소성 발열이 발생한 고형암 환자에서 발열 당시에 위와 같은 위험인자가 있을 경우 glycopeptide의 조기 사용을 고려해야 할 것으로 사료되며 앞으로 더 많은 환자를 대상으로 하는 전향적 연구가 진행되어야 할 것으로 생각된다. Backgrounds : Recently, there has been a rise of prevalence of gram positive infection among cancer patients with febrile neutropenia. The proportion of antibiotic-resistant gram positive infection has been growing lately, especially in Korea, where the rate of MRSA infection was over 70%. It brings to careful consideration of early glycopeptide treatment in febrile neutropenic patients if gram positive infection is suspected. Also until now, most studies concerning febrile neutropenic patients were mainly related to hematologic malignancy rather than solid tumor. Materials and Methods : We evaluated clinical manifestations and risk factors for gram positive bacteremia in a cohort of 288 solid tumor patients who were more than 18 years old and had neutropenic fever after chemotherapy from January 2002 to December 2004 at the Department of Oncology, Yonsei Cancer Center, Seoul. Results : We identified the cause of fever in 130 (45.1%) cases, of which 53 (18.4%) cases were blood stream infection. Gram positive organism was isolated in 27 cases which comprises 50.9% of blood stream infections, followed by gram negative organism (47.2%) and fungus (1.9%). A logistic regression analysis revealed that gram positive bacteremia was associated independently with central venous catheter (CVC) infection, oropharyngeal mucositis, skin and soft tissue infection in febrile neutropenic patients with solid tumor. Conclusions : Gram positive bacteremia was common among febrile neutropenic patients in solid tumor and was associated with CVC infection, oropharyngeal mucositis, skin and soft tissue infection. The early use of glycopeptide must be taken into account in such conditions.

溫經湯에 關한 文獻的 考察

김연도,김철원,유심근,박병렬 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

Through the study of successive literatures form the Han-dynasty(漢代) when 《Keumjweyeuliak(금궤요략)》 was written to modern age, we inspected many types of Onkyungtang(溫經湯) and prescriptions including the term of ' Onkyung(溫經)' or Chokyung(調經)', and look into their composition and symptoms respond to administration of this medicine. The results of this study were as follows; 1. The medicine which makes up Onkyungtang was 38 kinds from the Han-dynasty to the Chung-dynasty(淸代), and up to the present it summed into 43 kinds. 2. Onkyungtang which was composed of different kinds of medicine was 10 types from the Han-dynasty to the Chung-dynasty and added 11 types in modern days. Therefore it sumed up into 21 types. 3. No Onkyungtang is seen more common than that of the same composition as in 《Keumjweyeuliak》 in successive literature. The next is the same constituents as in 《Buinyangbangdaejeon(婦人良方大全)》. Others were rare. 4. Onkyungtang in《Keumjweyeuliak》was used to treat cold syndrome of the penetration and conception vessles or uterus of deficiency type and that in 《Buinyangbangdaejeun》was for cold syndrome of the penetration and conception vessels or uterus of excess type. 5. Other names of Onkyungtang in《Keumjweyeuliak》were Daeonkyungtang(大溫經湯), Chokyungsan(調經散), Chokyungtang(調經湯), Chunkeumchokyungtang(千金調經湯), Chunkeumchokyungsan(千金調經散) and Soonkyungtang(小溫經湯). And the prescription in the same constitution was also called Chungkyungonkyungtang(仲景溫經湯), Keumkweonkyungtang(금궤온경탕) and Sibbionkunghwan(十二溫經丸). 6. Onkyungtang in 《Buinyangbangdaejeon》was called Soonkyungtang(小溫經湯) and the very prescription was also called in the name of Yangbangonkyungtang(良方溫經湯), Jinmionkyungtang(指迷溫經湯), Kungkwiinkyungtang and Jinssionkyungtang(陳氏溫經湯).

임부의 연령에 따른 보완대체요법에 관한 인식 태도 경험 비교 연구

김연진,김지연,노경민,신혜리,유예지,이지민,장희조,정아인,최소정,강숙정,이향연,민혜영 이화여자대학교 간호과학대학 2016 이화간호학회지 Vol.- No.50

Purpose: This study aims to test if the age of pregnant women affects the perception, experience, and attitude towards complementary alternative therapy (CAT), by investigating the perception, experience, and attitude of pregnant women under the age of 35, and above 35 (Advanced Maternal Age). The study will 1) find the general characteristics of pregnant women under and over the age of 35 2) compare the perception, behavior, and experience of pregnant women under and over the age of 35, and 3) find the comparison of the perception, behavior, and experience according to the general characteristics of pregnant women under and over the age of 35. Method: The subjects of this study are composed of 44 women under the age of 35 and 44 women above the age of 35, totaling 88 pregnant women visiting midwiferies, obstetrics and gynecology, and baby fairs in Seoul and Gyeong-Gi area. Data for this study was collected from November 28, 2015 to January 6, 2016 for 40 days. The collected data analyzed mean, standard deviation, t test, ANOVA, and chi-square by using SPSS 23.0. Result Results show that there is a significant difference in the perception, attitude, and experience of the two-sample groups in the use of CAT. The question of “what is most necessary when applying CAT in a hospital clinical environment” for the perception criteria came out with the results of t=9.980, p<.05. For the attitude, results showed that the answers of pregnant women under the age of 35 displayed a more positive attitude towards CAT. (t=2.421, p<.05) Lastly, in the experience section, pregnant women under the age of 35 showed more CAT use than the other sample group. Conclusion Results have shown that there is a difference in the perception, behavior, and experience between the two sample groups. Therefore further research on the efficacy and the adverse effects of CAT needs to be done.

수종의 수복재의 불소 적용법에 따른 불소 유리에 관한 비교 연구

김종수,이연호,유승훈 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.1

불소는 구강내에서 치아 우식의 예방 및 초기 우식의 재광화를 유도하기 위한 목적으로 널리 사용되고 있으며, 불소가 유리되는 수복물을 이용하게 되면, 수복물 주위의 이차 우식 및 구강내의 우식 감수성을 감소시킬 수 있다. 현재 소아치과 영역에서 주로 사용되고 있는 불소유리 수복재로는, 전통적인 글라스 아이오노머와 레진 강화형 글라스 아이오노머, 컴포머 등이 있는데, 본 연구에서는 현재 소아치과 영역에서 많이 사용되고 있는 불소를 유리하는 수복재의 불소 유리량 및 불소 적용방법에 따른 불소유리량의 변화를 비교하여 확인하고자 한다. 복합레진으로 Z-250™(Group Ⅰ)과 컴포머로 Dyract^(®) AP(GroupⅡ), 레진 강화형 글라스 아이오노머로 Fuji Ⅱ LC^(®)(Group Ⅲ), 자가중합형 글라스 아이오노머로 Fuji ⅨGP Fast^(®)(Group Ⅳ)를 실험대상으로 선정하였다. 각 재료별로 동일한 크기의 디스크를 제작하여, 31일 동안 매일 새로운 용액으로 교환하면서 불소 유리량을 측정하였다(실험 Ⅰ), 이후 수복 재료별로 불소 적용 방법에 따라 4군으로 나누는데, A군은 대조군(No treatment)으로, B군은 불소가 함유된 치약(500ppm, Stages, Oral-B^(®),Holland)을 3분간 3회 적용하고, C군은 1.23% APF Foam(1000ppm, Sultan Topex,#31150,Canada)을 1회 적용하며, D군은 B군과 동일한 치약을 3회 적용하고, 1.23% APF Foam을 1회 적용하였다. 불소 적용 후 7일 동안 불소 유리량을 측정하였다(실험Ⅱ). 실험 Ⅰ에서, 실험 개시일부터 7일까지 불소 유리량이 급속히 감소하고, 이후 일정한 불소 유리량을 보였다. Ⅲ군 (Fuji Ⅱ-LC^(®))과 Ⅳ군 (Fuji ⅨGP Fast^(®))이 다른 군에 비해 높은 불소 유리량을 보였으며,Ⅲ군과Ⅳ군 사이에서는 유의한 차이를 보이지 않았다. 실험 Ⅱ에서, 불소 적용 후 Ⅱ,Ⅲ,Ⅳ군에서 불소 유리량이 증가한 양상을 보이는데,Ⅱ군에서는 불소 적용 후 2일, Ⅲ군에서는 5일,Ⅳ군에서는 4일부터 초기 불소 유리량 수준으로 돌아갔다. Fluoride released from dental restorative materials effectively declines the incidence and activity of dental caries and inhibits tooth demineralization. This study investigated the fluoride release and uptake characteristics of one composite resin (Z-250™)three glass ionomer-based restorative material (Dyract AP, Fuji Ⅱ LC^(®),Fuji Ⅸ GP Fast^(®)),Forty discs(6 mm diameter and 1 mm height) were prepared for each material. Each disc was immersed in 5ml of distilled water within polyethylene vial and stored at 37℃. The distilled water was changed every 24 hours and the release of fluoride was measured for 31 days. At the end of this period. each specimen was subjected to one of four treatments : (A) no fluoride treatment (control) : (B) application of a fluoride dentifrice (500ppm) for three minutes three times : (C) application of the 1.23% acidulated phosphate fluoride(APF) foam for one minute once: (D) the same regimen as (B), plus application of the APF foam for one minute once. Then, all samples were reassessed for an additional 7 days. For all samples, the greatest fluoride release was observed after the first day of the study but diminished with time. On the 7th day of the study. fluoride release level was stabilized. Fuji ⅡLC^(®) and fuji ⅨGP Fast^(®) released higher amount of fluoride than other materials: however no statistically significant difference was found from Fuji Ⅱ LC^(®) and Fuji Ⅸ GP Fast^(®). The amount of fluoride of Dyract^(®) AP Fuji ⅡLC^(®) and Fuji ⅨGP Fast^(®) was increased after fluoride treatment, and diminished with time.

민들레 추출액 농도에 따른 민들레 코팅쌀밥의 품질에 관한 연구

유경미,이연경,김세희,황인경,이부용,김성수,홍희도,김영찬 한국조리과학회 2005 한국식품조리과학회지 Vol.21 No.1

Washed rice was coated by spraying aqueous dandelion (Taraxacum officinale) extracts at 20, 30, 40 'Brix and dried at room temperature. The coating procedure was conducted 5 mL/min for 10min. Property changes in the dandelion coated rice and un-coated cooked rice were observed during 2 days of storage. Increasing the coating concentration was associated with lower color values (L, a value) and moisture contents. Sensory and texture properties generally decreased in the cooked rice coated with dandelion more than the control (non-coated rice). But, D-20(20 °Brix of the dandelion concentration) resulted in better textural properties and s ensnry scores for hardness and overall acceptability in cooked rice. Compared to the control, the washed rice roated with 20 °Brix for 0 and 2 days showed better quality in sensory activities, a lower gel consistency and better textural activities. It was concluded that the optimum coating ration of rice and added dandelion extract for cooking were 20 °Brix and 5% respectively, in proportion to the total weight of raw rice.

일 대학 부속병원 간호사들의 연구장애 요인

유연희,배수정,김진선 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.1

Background and Objectives: Evidence based practice is a hallmark of professional nursing. However, low levels of research utilization are problematic in nursing. The purposes of this study were to identify the facilitators and barriers to research utilization and to identify factors associated with research utilization among nurses. Methods: A descriptive study was conducted with a sample of 227 nurses in a university hospital located in a metropolitan city. The questionnaire included the Barriers Scale and questions about research activities, research related educational needs, and resources used to obtain information for clinical decision making. Results: The main barriers to research utilization identified by the respondents were: the fact that most research is published in a foreign language; implications for practice are not made clear; the research has not been replicated. The greatest mean score of each of the sub-scales was the communication factor followed by the organization, research, and nurse factors. Nurses who had received education for research methods, statistics, and reference search and who had participated research activities reported lower barrier score than those who did not. Conclusions: Although the nurses perceived the importance of research utilization in their practice, there was a poor application in their work. Decreasing known barriers would facilitate research-based practice. The implications for nursing to decrease the barriers to research utilization are discussed.

스타이렌 아이오노머의 기계적인 성질에 미치는 혼합 양이온의 영향

김희석,나연화,이용혁,이법원,유지강,박기주,김준섭 조선대학교 생산기술연구소 1998 生産技術硏究 Vol.20 No.1

The styrene-co-methacrylate ionomers neutralized with Na +, Ba2 +, and mixed cation of both were prepared. The dynamic mechanical properties of two cation-containing ionomers were measured and compared to those of the ionomers neutralized with only one type of cations. We found that in the ionomers with one type of cations the difference in the type of cation does not change the glass transition temperatures. It was found, however, that the cluster Tg of the mixed cation ionomer is lower than that of the single cation ionomers. Thus it was postulated that in the two-cation system the two cations in a solution have sufficient dynamics to form new type of multiplet containing both cations, which may be slightly bigger than that found in the single cation multiplet. The mechanical properties also imply that the strength of ion interactions in the multiplets of the two cation ionomer is thought to be weaker than that of the one cation ionomers. These two effects are believed to contribute the lower in the cluster glass transition of mixed cation system.

제 2형 당뇨병 환자에서 혈중 Metalliproteinase-9의 농도

김상용,김희중,주유철,최동현,배학연 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Purpose : Diabetic nephropathy is a serious complication of diabetes and accounts for much of its morbidity and mortality. It is well known that the overt clinical phase of diabetic nephropathy is preceded for many years by the presence of microalbuminuria. Microalbuminuria is thought to be a marker of widespread vascular damage and may underlie the propensity toward severe extrarenal vascular disease in microalbuminuric patients. Metalloproteinase-9 has a broad substrate specificity for native collagens as well as proteoglycan and elastin. One study reported that an increased plasma metalloproteinase-9 concentration precedes the development of microalbuminuria in type 2 diabetic patients. Another study reported that a high glucose concentration cause a abnormality on the activity of metalloproteinase by the mesangeal cell. The purpose of the present study was to examine whether palsma metalloproteinase-9 concentrations are altered at various complications in type 2 diabetic patients. Methods : Sixty patients with type 2 diabetes and thirty healthy control were recruited for the present study. No patient had any malignancy or history of heart disease, liver disease, collagen disease. We recorded age, duration of diabetes, and blood pressure. After an overnight fast, blood was drawn from an antecubita1 vein of measurement of glucose, metalloproteinase-9, HbA1C, and serum creatinine. To measure plasma concentration of metalloproteinase-9, a one step sandwich enzyme immunoassay using two monoclonal antibodies was used. Patients were divided into two group according to the presence or abscence of microalbuminuria. The groups were then compared with regard to clinical and laboratory characteristics and serum concentration of metalloproteinase-9. Results : The mean serum levels of metalloproteinase-9 in diabetic patients (62.32±25.83ng/㎖) were significantly higher than in healthy controls(12.92±4.97ng/㎖) (p<01). The mean serum levels of metalloproteinase-9 in diabetic patients with microalbuminuria(81.16±41.43ng/㎖) were significantly higher than in those with normoalbuminuria(31.48±7.34ng/㎖) (p<01) and much more than in healthy control(12.92±4.97ng/㎖) (p<05). Furthermore, the severity of nephropathy were closely associated with the serum metalloproteinase-9 level and the serum metalloproteinase-9 level was significantly correlated with microalbuminuria. The mean serum level of metalloproteinase-9 in diabetic patients with retinopathy(61.74±39.07ng/㎖) was significantly higher than in those with no retinopathy(34.98±9.02ng/㎖) (p<05). But, in diabetic patients with normoalbuminuria, there is no difference between the groups with retinopathy versus no retinopathy. Conclusion : In summary, a sustained increase in serum metalloproteinase-9 in patients with type 2 diabetes is associated with a high risk for the development of microalbuminuria. The results of this study suggest that the serum rnetalloproteinase-9 was a useful and noninvasive marker for the development of diabetic nephropathy. It could be also used to predict the development of diabetic complications and to assess therapeutics or the prognosis of diabetes. The usefulness of this model will be clarified by a larger scale and serial study.

신규간호사와 프리셉터가 인지하는 프리셉터의 교수효율성 비교

김지양,김영선,김춘실,박현숙,신미영,윤연숙,조유숙,박미미,유문숙 한국간호과학회 간호행정학회 2009 간호행정학회지 Vol.15 No.2

Objective: The purpose of this study was to compare preceptors and new graduate nurses on their perception of preceptor teaching effectiveness. Methods: The participants were 90 new nurses and 90 preceptors who worked in A medical center. The data were collected from July 1 to September 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaire. Results: New nurses' perception (4.07±.44) of the preceptor teaching effectiveness was significantly higher than perception of the preceptors (3.57±.37). Fifty five percent of new graduate nurses reported a lack of coherence in the preceptor's practice guidelines. For 5 causal factors classified on the teaching effectiveness, the factor of 'Professional knowledge and ability' showed the highest score, but 'Interpersonal and communication skill' got lowest score for both group. Preceptors responded that they did not have enough time to teach well because of their heavy workloads. Conclusions: These results suggest that the preceptors need appropriate compensation and education opportunities, and new graduate nurses need consistent education by the teaching professionals. Therefore, it is important to give preceptors full charge of the preceptorship. Also, it will be necessary to develop education programs to enhance interpersonal and communication skill for preceptors and new nurses.

SMAS 거상술 및 Malar Fat Pad의 수지박리를 이용한 안면거상술

강연웅,유원민,김지명,박병윤 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.5