당뇨식 잔반 감량을 위한 영양서비스 개선 활동의 효과

손정민,염혜선 대한지역사회영양학회 2008 대한지역사회영양학회지 Vol.13 No.5

Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get informat on about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian’s inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

성인 지역사회 폐렴의 원인 미생물에 대한 전향적 다기관 연구 : Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi

김민자,정희진,손장욱,심희선,박대원,박승철,우준희,강재명,김유겸,신완식,김양리,이환종,김지희 대한감염학회 2001 감염 Vol.33 No.1

Background : Despite rigorous investigations, the etiology of community-acquired pneumonia remains unknown in about 50% of hospitalized patients. The diagnosis of the etiological agent is becoming more challenging and more critical as number of newer pathogens have been recognized in recent years. In the 3-year period prospective study we investigated adult patients with community-acquired pneumonia for Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi as potential etiologic agents. Methods : A prospective multicenter study was performed from May 1997 to April 2000. A total of 431 patients with community-acquired pneumonia under the inclusion criteria were examined for specific microbial diagnosis; sputum culture and PCR, and serologic teats including indirect immunofluorescence antibody (IFA) test for Legionella, and hemagglutination tests for Leptosoira, Hantaan virus and O. tsutsugamushi. Etiologic diagnosis was determined on the basis of the review of case record forms and specific laboratory diagnostic criteria. Results : During the study period a total of 385 sputum and 283 serum samples were examined. Legionella pneumonia was diagnosed in 2.3% (10/431) of the cases examined : 1.4% cases with PCR-positive (5/367) and 2.1% with positive IFA test (6/283). Leptospirosis and scrub typhus were diagnosed in 0.4% (1/252) and 2.0% (5/252), respectively. All 5 cases with scrub typhus occurred in late fall, and rash or eschar was not found. None of cases was Hantaan virus infection. Conclusion : The results suggest that Legionella, Leptospira, and O. tsutsugamushi should be considered in the etiologic diagnosis and empirical antibiotic therapy of community-acquired pneumonia. (Korean J Infect Dis 32:24∼31, 2001)

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

Rotor 증후군

심찬섭(Chan Sup Sim),이성원(Sung Won Lee),손무영(Moo Young Sohn),김진숙(Jean Sook Kim),한명동(Myung Dong Han),백정민(Cheong Min Paik) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.2

Rotor syndrame is a familial disorder characterized by chronic, nonhemolytic, and predominantly conjugated hyperbilirubinemia with normal liver tissue without any pigment deposit in the liver cells. A 36-year-old Korean female was admitted due to intermittent jaundice, indigestion and general malaise. Physical examination revealed icteric sclera, but no hepatomegaly. Laboratory findings showed increased serum bilirubin with direct reacting bilirubin predominating and prolonged BSP retention (32% in 45 min.) Oral cholecystography revealed well-visualization but intravenous cholangiography did not reveal the gall bladder and the duct, Percutaneous needle biopsy specimen of liver showed no special abnormalities. Urinary total coproporphyrin excreation was increased. A brief review of the pertinent literature was made.

서울 강서지역 1개 대학병원에서 성인 급성 신우신염의 원인균과 항생제 감수성

황병연,이재갑,박대원,이연주,김성범,엄중식,손장욱,정희진,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 3년간 서울시 강서지역의 1개 대학병원에서 입원치료를 받은 성인 급성 신우신염 환자를 대상으로 원인균과 항생제 감수성을 조사하고, 향후 급성 신우신염의 초기 경험적 치료 항생제를 제안하고자 하였다. 방법 : 1999년 1월부터 2001년 12월까지 3년간 고려대학교 의과대학 구로병원에 상부요로감염으로 내원한 16세 이상 환자 229명의 의무 기록을 검토를 통하여, 인구학적 특성, 원인균, 항생제 감수성, 초기 항생제 사용 양상과 입원기간을 조사하였다. 결과 : 연구에 포함된 229명을 118명의 단순 신우신염군과 111명의 복잡 신우신염군으로 구분 하였다. 단수 신우신염의 평균 발생 연령은 38.2세와 복잡 신우신염 56.1세로 복잡 신우신염 환자의 연령이 유의하게 높았다(P<0.001). 양군 모두에서 원인균 중 E. coli의 분리율이 가장 높았으며 항생제 감수성 결과 ampicillin, trimethoprim-sulfame-thoxazole에는 높은 내성률을 보였고, ciprofloxacin, gentamicin, cefotaxime에 대한 감수성은 비교적 높았으나 복잡 신우신염의 경우 단순 신우신염에 비하여 ciprofloxacin, gentamicin에 대한 감수성이 다소 낮은 것을 확인할 수 있었다. 평균 입원 기간, 항생제 투여 기간에 있어서도 복잡 신우신염군에서 유의하게 길었다. 결과 : 본 연구의 결과 서울의 강서 지역에서 대학병원급에 치료 의뢰되는 단순 급성 신우신염의 치료에 있어 1차 항생제로 3세대 cephalosporin, aminoglycoside, quinolone 중 한가지를 초기 경험적 치료제로 사용을 고려하여야 할 것으로 사료된다. Background : The purpose of this study is to recommend the initial therapeutic regimen for adult patients with acute pyelonephritis (APN) according to the changes of antimicrobial susceptibility patterns of causative microorganisms isolated from patients with APN. Methods : We reviewed medical charts of 229 APN patients, who had been treated at Korea University Guro Hospital from 1st of January. 1999 to 31st of December, 2001. We investigated the demographic data, clinical findings, durations of hospital treatment, antimicrobial susceptibility patterns of the causative microorganisms and initial antibiotic regimens in patients with APN. Results : In this study, 229 adult patients with APN were classified into simple APN patients (118 patients, 51.5%) and complicated APN patients (111 patients, 48.4%). Mean age of patients with simple APN was 38.2±14.1 years old and that of patients with complicated APN was 56.1±14.9 years old. Mean age of patients with complicated APN was significantly higher than that of simple APN patients (P<0.0001). Escherichia coli was the most common microorganism both in simple APN (96.7%) group and in complicated APN (90.6%) group. Antimicrobial susceptibility of E. coli was at the low level of ampicillin (31%/20%) and trimethoprim-sulfamethoxazole (42.6%/34.2%) in each group. In contrast, ciprofloxacin (11.5%/22.7%), gentamicin (16.4%/22%) and cefotaxime (0%/8.2%) resistance remained at relatively lower level. In comparison of simple APN with complicated APN, ciprofloxacin and gentamicin resistances were higher in complicted APN group. Average duration of hospitalization (5.9±2.3 days/8.2±4.6 days) and duration of antibiotic use (12.1±3.9 days/15.3±10.0 days) were significantly longer in complicated APN. Conclusions: The results of this study suggests that 3rd cephalosporin, aminoglycoside or quinolone antibiotic would considered as one of the initial therapeutic regimen for patients with simple APN in southwestern Seoul.

자료 : 영양사의 직무능력 향상을 위한 계속교육의 참여동기 분석

손정민 ( Cheong Min Sohn ),조영연 ( Young Yun Cho ),배미용 ( Mi Yong Bea ),도은경 ( Eun Kyoung Do ),나우리 ( Woo Ri Na ),김미성 ( Mi Sung Kim ) 대한영양사협회 2013 대한영양사협회 학술지 Vol.19 No.4

본 연구는 영양사 직무능력 향상을 위한 계속교육의 참여동기를 분석하여 향후 영양사의 계속교육 프로그램 개발을 위한 기초자료로 사용하기 위해 실시되었다. 영양사 622명을 대상으로 조사된 설문 분석 결과는 다음과 같다. 1. 본 연구에 참여한 영양사는 연령별, 최종학력별, 근무처별, 영양사 업무 근무경력별로 분류하여 조사하였다. 조사에 참여한 영양사의 연령대는 40대가 262명(42.1%)으로 가장 많았으며, 최종학력은 4년제 대학졸업이 322명(51.8%)으로 가장 많은 것으로 나타났다. 근무처는 학교 영양사가 251명(40.4%)으로 가장 많은 것으로 나타났으며, 근무 경력은 7∼10년 228명(36.7%)이 가장 많은 것으로 나타났다. 2. 전문영양사 계속교육 참여동기에 대한 타당성 및 신뢰도 검증을 위해 요인분석을 실시한 결과 총 4개의 요인이 도출되었다. 이는 각각 ‘전문역량 유지 및 개발’, ‘상호교류 및 전문가의 책임’, ‘직업의 안정성, 개인의 이익’, ‘고객에 대한 서비스’라 명명하였고, 이 중 ‘전문역량 유지 및 개발’의 설명분산이 29.343%로 가장 큰 것으로 나타났다. 참여요인의 Cronbach’s α값은 각각 0.967, 0.927, 0.878, 0.937로 분석되었다. 3. 본 설문에 참여한 영양사의 일반적 특성에 따른 계속교육 참여동기에 대한 분석결과 연령이 낮을 수록, 학력이 낮을수록, 유치원, 어린이집, 기타 근무자일 경우, 6년 이하의 경우에서 ‘직업의 안정성, 개인의 이익’에 대한 참여동기가 높은 것으로 분석되었다. 이상 결과를 종합하여 볼 때 영양사 계속교육 촉진 및 프로그램 개발을 위해 본 연구에서 분석된 연령, 학력, 근무처 및 경력 등을 고려하여 전문성을 증진시킬 수 있는 프로그램을 개발해야 할 것이며, 특히 연령이 적고, 경력이 길지 않은 영양사의 참여동기가 높은 것으로 보아 이들을 위해 전문성을 가진 프로그램 개발이 우선적으로 이루어져야 할 것으로 사료된다. This study analyzed the reasons for continuing education among dietitians. An internet-based survey of 622 dieticians was conducted from August 31, 2012 to September 12, 2012. Based on data from the Participation Reasons Scale (PRS) questionnaire, factor analysis was conducted by principle component analysis for the extraction of major factors. Subsequent reliability analysis was performed by assessing Cronbach`s α. The ANOVA-test was performed to compare the participation reason scores for each factors according to general characteristics. Statistical analysis was performed using SPSS ver.17.0, and P<0.05 was considered significant. Factor analysis for the participation reasons revealed four types of factors. These factors were “maintenance and development of professional competencies”, “interaction and responsibility of professionals”, “job stability and personal profits” and “services for customers” respectively. Among the participation reasons, “maintenance and development of professional competencies” was the first reason with a 29.34% variance. In addition, the participation reasons for continuing education differed according to age (P<0.05), the highest level of education (P<0.05), workplace (P<0.01), and work experience in dietetic area (P<0.001). In conclusion, continuing education programs for dietitians should focus on effectively developing and promoting professionalism.

과일·채소 섭취량과 Pooled Cohort Equation 이용한 심혈관질환 10년 예측 위험도와의 관련성

강민재(Cheong-Min),손정민(Sohn, Cheong-Min) 한국생활과학회 2016 한국생활과학회지 Vol.25 No.4

The consumption of fruits and vegetables is recognized as one of the contributing factors for preventing heart disease. However, recommendations of fruits and vegetables for preventing cardiovascular disease (CVD) have not yet been investigated in Korea. We conducted this study to determine the amounts of fruits and vegetables which would lower the risk of cardiovascular disease in Koreans. This study used cross-sectional data from the Fifth Korea National Health and Nutrition Examination Survey in 2010-2011. Subjects were community-dwelling, 2,639 men and 3,720 women aged 40-79 years. The estimated 10-year risk of CVD was calculated by the Pooled Cohort Equation (PCE). The amount and diversity of fruits and vegetables consumed were obtained by using 24-hour dietary recall data. Fruit and vegetable consumption is expressed as an odds ratio (OR) of individuals in the highest tertile compared with those in the lowest tertile. Men having a high consumption of fruits (OR : 0.772 ; 95 % confidence interval (CI) 0.597-0.997), vegetables (OR : 0.672 ; 95% CI 0.512-0.883) and vegetables plus fruits (OR : 0.604 ; 95% CI 0.452-0.807) showed a lower risk of CVD. Similarly for women, those having a high consumption of fruits (OR : 0.340 ; 95% CI 0.259-0.445), vegetables (OR : 0.628 ; 95% CI 0.496-0.796) and fruits and vegetables (OR : 0.395 ; 95% CI 0.306-0.510) demonstrated a lower risk of CVD. Dietary diversity of fruits, vegetables and both vegetables and fruits was associated with a significantly reduced risk of CVD in men (P for trend <0.05, P for trend <0.001, P for trend <0.001, respectively) and women (P for trend <0.001, P for trend <0.001, P for trend <0.001, respectively). There is a clear association between the estimated 10-year CVD risk and consumption of fruits and vegetables with regard to the total amount and variety consumed by healthy Korean adults.

웹기반 영양섭취 분석 프로그램의 개발 및 타당도 검증

손정민 ( Cheong Min Sohn ),정은순 ( Eun Sun Jung ),이예송 ( Ye Song Lee ),이은선 ( Eun Seon Lee ) 대한지역사회영양학회 2008 대한지역사회영양학회 춘-추계학술대회지 Vol.2008 No.2

Association of <i>RANBP1</i> haplotype with smooth pursuit eye movement abnormality

Cheong, Hyun Sub,Park, Byung Lae,Kim, Eun Mi,Park, Chul Soo,Sohn, Jin‐,Wook,Kim, Bong‐,Jo,Kim, Jae Won,Kim, Ki‐,Hoon,Shin, Tae‐,Min,Choi, Ihn‐,Geun,Han, Sang‐,Woo,H Wiley Subscription Services, Inc., A Wiley Company 2011 American Journal of Medical Genetics Part B: Neuro Vol. No.

<P><B>Abstract</B></P><P>Schizophrenia is a multifactorial disorder and smooth pursuit eye movement (SPEM) disturbance is proposed as one of the most consistent neurophysiological endophenotype in schizophrenia. The aim of this study was to examine the genetic association of <I>RANBP1</I> polymorphisms with the risk of schizophrenia and with the risk of SPEM abnormality in schizophrenia patients in a Korean population. Two SNPs of <I>RANBP1</I> were genotyped by TaqMan assay. Their genetic effect of single/haplotype polymorphisms on the risk of schizophrenia and SPEM abnormality from 354 patients and 396 controls were performed using <I>χ</I><SUP>2</SUP> and multiple regression analyses. Although no <I>RANBP1</I> polymorphisms were associated with the risk of schizophrenia, a common haplotype, <I>RANBP1‐ht2</I> (<I>rs2238798G–rs175162T</I>), showed significant association with the risk of SPEM abnormality among schizophrenia patients after multiple correction (<I>P</I><SUP>corr</SUP> = 0.002–0.0003). The results of present study provide the evidence that <I>RANBP1</I> on 22q11.21 locus might be causally related to the SPEM abnormality rather than the development of schizophrenia. © 2010 Wiley‐Liss, Inc.</P>

Development of Job Standards for Clinical Nutrition Therapy for Dyslipidemia Patients

( Min-jae Kang ),( Jung-sook Seo ),( Eun-mi Kim ),( Mi-sun Park ),( Mi-hye Woo ),( Dal-lae Ju ),( Gyung-ah Wie ),( Song-mi Lee ),( Jin-a Cha ),( Cheong-min Sohn ) 한국임상영양학회 2015 Clinical Nutrition Research Vol.4 No.2

Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.