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      • KCI등재후보

        균혈증 및 패혈증의 임상 양상 및 예후 인자에 대한 고찰

        이수봉(Soo Bong Lee),이우철(Woo Chul Lee),정현철(Hyun Chul Jung),송상헌(Sang Heun Song),이동원(Dong Won Lee),김용범(Yong Bum Kim),정주섭(Joo Seop Chung),곽임수(Ihm Soo Kwak),조군제(Goon Jae Cho),나하연(Ha Youn Rha),장철훈(Chul Hun Ch 대한내과학회 1999 대한내과학회지 Vol.56 No.3

        Objectives : In spite of the improvement in therapeutic strategy, the mortality rate from sepsis is still high. The purpose of this study was to examine the clinical characteristics and prognostic factors of sepsis to get help in treatment and estimation of prognosis of sepsis. Methods : We analyzed the clinical and bacteriologic data of 313 admitted patients with bacteremia at Pusan National University Hospital from Jan., 1996 to Dec., 1997 retrospectively and all patients were categorized into 4 groups (bacteremia, sepsis, severe sepsis, septic shock) by the definition from American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, 1992. Results : 1) Male to female ratio was 1.22 : 1 and mean age was 52 years. 2) The overall mortality rate was 32.3% and the mortality rates of bacteremia, sepsis, severe sepsis and septic shock were 14.9%, 22.8%, 52.0%, and 95.2%, respectively. 3) Underlying diseases predisposing to bacteremia were diabetes mellitus(14.4%), solid cancer (13.1%), hematologic malignancy(10.2%) and liver cirrhosis(9.9%), but the most common was no underlying disease. 4) Among the total 80 species of isolated microorganisms, gram-positive organisms were responsible in 169 cases, gram-negative organisms in 218 cases. E. coli was isolated most frequently, followed by S. aureus, S. epidermidis, K. pneumoniae, Enterococcus spp., Enterobacter spp., Str. viridans group, CNS, P. aeruginosa and S. typhi. 5) Although the source of bacteremia could not be identified in 28.8% of the patients, the others had the primary site of infections ; skin(17.9%), gastrointestinal tract(16.9%), respiratory tract(12.5%), urinary tract(9.9%) and biliary tract(7.3%). 6) The mortality rate in patients with gram-positive bacteremia was 39.4%, with gram-negative bacteremia was 20.9% and with polymicrobial bacteremia was 33.3%. MRSA sepsis showed the highest mortality rate(58.8%), followed by Enterococcus spp.(50.0%), K. pneumoniae (35.0%), P. aeruginosa(27.3%) and E. coli(18.8%). 7) There was significant relation between etiologic organisms of bacteremia and the primary site of infections. 8) Using logistic regression analysis, mortality was predicted by disseminated intravascular coagulation, severity of sepsis and severity of underlying diseases. Conclusion : Sepsis occurred in 16 patients among 1,000 adult admitted patients and overall mortality rate was 32.3%, still high. The mortality rate had positive correlation with the severity of sepsis. Among 16 evaluated risk factors of mortality, mortality was predicted by disseminated intravascular coagulation, severity of sepsis and severity of underlying disease.

      • SCOPUSKCI등재

        실험연구 : Nicorandil이 Rocuronium의 약력학에 미치는 효과

        이수일 ( Soo Il Lee ),이종환 ( Jong Hwan Lee ),이승철 ( Seung Cheol Lee ),이정무 ( Jung Moo Lee ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5

        Background: Some investigators have shown that nicorandil, a KATP channel opener, depresses the neuromuscular transmission contraction of the skeletal muscle. However, others have reported that it improves the recovery of vecuronium relaxation and the myotonic activity of muscle. This study investigated the effect of nicorandil on rocuronium relaxation. Methods: Hemidiaphragm-phrenic nerve preparations were obtained from male Sprague-Dawley rats (150-250 g). The preparations were bathed in Krebs` solution containing in (mM): NaCl 118, KCl 5, CaCl2 2.5, NaHCO3 30, KH2PO4 1, MgCl2 1 and glucose 11. The preparations were, then maintained at 32℃ and aerated with a mixture of 95% O2 and 5% CO2. Isometric forces that were generated in response to 0.1 Hz, and, 50 Hz for 1.9 seconds with supramaximal electrical stimulation (0.2 msec, rectangular) to the phrenic nerve were measured using a force transducer. The single twitch tension (ST) and peak tetanic tension (PTT) were calculated as % inhibition of the control, and the tetanic fade (TF), as % increase in the PTT. Each preparation was exposed to one of the 6 nicorandil concentrations (0.0, 0.625, 1.25, 2.5, 5, 10μM), and the adequate volume of the rocuronium solution was cumulatively added to the tissue bath for a desired rocuronium concentration until there was an 80-90% decrease in the ST. The effect of rocuronium at each concentration was allowed to reach a steady state before the tension parameters were measured. The EC5, EC25, EC50, EC75, and EC95 of rocuronium for the ST, PTT and TF were calculated using a probit model. The differences between the EC50 of rocuronium according to the nicorandil concentrations were tested using a t-test and a Bonferroni`s correction. Results: 1.25 and 2.5μM nicorandil shifted the cumulative concentration-response curves for the TF of rocuronium to the right. 5 and 10μM nicorandil shifted the cumulative concentration-response curves for the ST of rocuronium to the left. Conclusions: Lower concentration of nicorandil may help maintain the tetanic contraction during rocuronium relaxation. (Korean J Anesthesiol 2006; 50: 567~71)

      • SCOPUSKCI등재

        유연포장 필름의 종류 및 두께에 따른 화랑곡나방 침투율 연구

        이수현(Soo Hyun Lee),권상조(Sang-Jo Kwon),이상은(Sang Eun Lee),김정헌(Jeong-Heon Kim),이정수(Jung-Soo Lee),나자현(Ja Hyun Na),한재준(Jaejoon Han) 한국식품과학회 2014 한국식품과학회지 Vol.46 No.6

        이 연구에서는 식품포장분야에 사용되는 유연포장재들의 두께에 따른 방충효과를 규명하여 각각의 포장재에서 일정 수준의 방충효과를 나타내기 위한 필름의 최적의 조건을 연구하고자 하였다. 식품용 유연포장재들 중에서도 가장 널리 이용되고 있는 PE, PP, PS, AF, PET를 채택하여 실험을 진행한 결과, 각 포장재들의 두께에 따른 화랑곡나방 유충에 의한 침투율은 전반적으로 필름의 종류에 관계없이 두께가 얇을수록 포장재 내부로 빠르게 침투하는 경향을 보였다. 특히 PP와 PS의 경우 다른 필름들과는 다르게 각각 20 μm와 30 μm에서 72시간 이내에 100% 침투되는 결과값을 보여 방충포장소재로서의 상대적인 취약함을 보였다. 결과적으로 필름의 종류에 상관없이 두께가 증가할 수록 화랑곡나방 유충의 침투율이 낮아진다는 것을 보여 주었다. 따라서 식품 내 해충과 같은 동물성 이물의 혼입을 방지하기 위해서는 포장 소재의 종류에 따라 특정 두께 이상을 확보해야 한다고 판단된다. This study investigated the effect of perforation by the Indian meal moth (Plodia interpunctella) larvae on various flexible food-packaging films, in relation to their thickness and type. Among the various flexible packaging films, polyethylene (PE), aluminum foil (AF), polypropylene (PP), polystyrene (PS), and polyethylene terephthalate (PET) were selected for this study due to their wide usage in food packaging. Based on their thickness, film penetration by P. interpunctella larvae was measured as in following order: PP, 20 μm; AF, 9 μm; PET, 12 μm; PP, 30 μm; PS, 30 μm; PE, 40 μm; PE, 35 μm; PS, 60 μm; and PET, 16 μm. P. interpunctella larvae rapidly penetrated through the packaging films regardless of their thickness and type. In particular, it was observed that PP of 20 μm and PS of 30 μm were completely penetrated by P. interpunctella larvae within 72 h, rendering thin PP and PS films less valuable as anti-insect packaging films. Our results show that the perforations by P. interpunctella larvae were observed in the thin films. These results imply that each packaging film has a marginal thickness against the perforations by P. interpunctella larvae.

      • KCI등재후보
      • SCOPUSKCI등재

        신기능 저하 환자에서 99mTc - DMSA 신장 스캔을 이용한 신 섭취율과 사구체 여과율의 상관성

        이수봉(Soo Bong Lee),정현철(Hyun Chul Jung),곽임수(Ihm Soo Kwak),나하연(Ha Yeon Rha),안승재(Seoung Jae An),정유석(Yoo Suck Jung) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.4

        배 경 : 신기능 저하 환자에서 신기능을 정확히 평가하는 것은 중요하고, 다양한 방법으로 사구체 여과율(GFR)을 구하고 있다. 임상에서 흔히 ^99mTc-DTPA 신장 스캔과 99mTc-DMSA 신장 스캔이 개별 신기능의 평가에 많이 이용되고 있다. 본 연구에서는 99mTc-DMSA 신장 스캔을 이용하여 신피질 영상을 위한 1시간 상대적 신 섭취율과 사구체 여과율 사이의 상관성을 검토하고자 하였다. 방 법: 1998년 1월부터 2001년 3월까지 부산대학교병원 신장내과에 내원한 환자들 중 ^99mTc-DMSA 신장 스캔, ^99mTc-DTPA 신장 스캔, 혈청 크레아티닌, 24시간 요 중 크레아티닌을 검사한 65명의 환자들 중에서, 중증 및 중등도 신기능 저하 환자 42명을 대상으로 하였다. ^99mTc-DTPA 신장 스캔을 이용한 사구체 여과율(DTPA-GFR)에 따라 중증 신기능 저하군(A)과 중 등도 신기능 저하군(B)으로 나누었다(A군 : ≤20 mL/min/1.73㎡, n=20명, B군 : 20-50 mL/min/1.73㎡, n=22명). 99mTc-DMSA 신장 스캔을 이용하여 1시간 상대적 신 섭취율(DMSA-%uptake, TRUR)을 구하고, 이것을 99mTc-DTPA 신장 스캔을 이용한 사구체 여과율(DTPAGFR), 내인성 크레아티닌 청소율(Ccr), Cockcroft와 Gault가 고안한 추정 크레아티닌 청소율(C & G Ccr)과 Spearman rank correlation test를 이용하여 상관성을 비교하였다. 결 과 : 전체 42명의 대상 환자들 중에서 15명은 남자였고, 27명은 여자였다. 평균 나이는 54 세(28-80세)였다. 두 군에서 평균 DTPA-GFR과 평균 TRUR은 각각 통계적으로 유의한 차이 를 보였다(14.8±4.7 vs 34.9±8.4 mL/min/1.73㎡, p<0.05; 8.9±3.7 vs 16.3±7.4%, p< 0.05). 그러나 TRUR의 DTPA-GFR에 대한 상관성을 보았을 때, A군에서는 유의한 상관관계는 없었으나, B군에서는 유의한 상관관계를 보였다(0.263, p>0.05 vs 0.731, p<0.01). 또한 TRUR의 혈청 크레아티닌, Ccr, C & G Ccr에 대한 상관성을 보았을 때, 두 군 모두에서 통계적으로 유의한 상관관계를 보였다. 결 론 : ^99mTc-DMSA 신장 스캔에서 신피질 영상으로 사용되는 1시간 상대적 신 섭취율은 실제 사구체 여과율을 정확하게 측정할 수는 없지만, 신기능이 중증이하로 감소되지 않은 경우에는 사구체 여과율을 간접적으로 반영하였다. Background : Glomerular filtration rate(GFR) is an important parameter for the evaluation and monitoring of renal function. The aim of this study was to investigate the correlation between the relative 1 hour uptake of 99mTc-DMSA renal scan(DMSA-%uptake, TRUR) and GFR which was estimated by 99mTc-DTPA, serum creatinine and 24 hour-urinary creatinine excretion. Methods : Between January 1998 and March 2001, 65 patients had undergone ^99mTc-DMSA renal scan, ^99mTc-DTPA renal scan, serum creatinine and 24 hour-urinary creatinine excretion. Of them, 42 patients had moderately or severely reduced renal function(DTPA-GFR ≤50 mL/min/1.73㎡). According to the DTPA-GFR level, patients were divided into two groups : Group A(n=20) with DTPA-GFR ≤20 mL/min/1.73㎡(mean±S.D. 14.8±4.7), Group B(n=22) with DTPA-GFR 20-50 mL/min/1.73㎡(mean±S.D. 34.9±8.4). Between the TRUR and other methods to estimate renal function such as DTPA-GFR, 24 hour-urinary creatinine clearance(Ccr) and Cockcroft & Gault`s formula(C & G Ccr), the correlation coefficient was measured by Spearman rank correlation test. Results : Of 42 patients, 15 were men and 27 were women(mean age 54 years; range 28-80 years). there were significant differences between mean DTPA-GFR and mean TRUR in both groups(14.8±4.7 vs 34.9±8.4 mL/min/1.73㎡, p<0.05; 8.9±3.7 vs 16.3±7.4%, p<0.05). In group A, TRUR(mean±S.D. 8.9±3.7%) was not significantly correlated with DTPA-GFR(r=0.263, p>0.05). In group B, TRUR (mean±S.D. 16.3±7.4%) was significantly correlated with DTPA-GFR(r=0.731, p<0.01). In both group, serum creatinine, Ccr and C & G Ccr were significantly correlated with TRUR. Conclusion : Although the relative 1 hour uptake of the ^99mTc-DMSA renal scan, as a method of renal cortical image could not estimate the true GFR, it showed a good correlation with GFR in patients with moderately reduced renal function. 99mTc-DMSA renal scan seems to be helpful to evaluate the renal function in patients with moderately reduced renal function.

      • KCI등재

        아무도 보지 못한 새

        이수덕(Lee, Soo-Duck) 부산경남사학회 2013 역사와 경계 Vol.89 No.-

        이 글은 漢代봉황의 출현과 그 출현에 따른 서상의 위상과 성격 변화를 다룬다. 고대 중국의 서상 중에 봉황이 차지하는 의미와 변화를 언급한다. 봉황은 태양의 사자이자 성왕에 부응하는 존재였으며, 漢代에 들어와 점차 황제의 권위를 상징하는 위상을 가지게 된다. 주로 前漢중후기에 집중적으로 나타났으며 그 출현에는 民爵사여나 세금 감면과 같은 은사가 수반되었다. 출현의 특징으로는 일정한 시기에 집중하고, 특히 일정한 지역 즉 齊魯지역에 집중되었다가 차츰 경사 지역으로 옮겨가고 있음을 확인하였다. 後漢대에는 전한과 같은 위상을 보이지는 않았으며 은사도 줄어든다. 그것은 상징으로서의 위상에 변화가 생겼기 때문이다. This article is to discern the change of quality and position for auspicious sign, especially with the appearance of sacred phoenix. This paper contents treated and investigated the origin and quality in ancient china"s good omen, especially sacred phoenix. The sacred bird is a very important being, doing the envoy from the sun and compliant being for the sacred king. In Han(漢) china, the sacred bird, phoenix, gradually takes the position of representative for HwangDi (皇帝). It is reported that the phoenix appeared mostly in Former Han"s middle and post period. Its advents is accompanied with the mercy from HwangDi (皇帝), including tax reduction and title of nobility. And it is certificated that its advents have regular feature, mostly focused on spring time and QiRu(齊魯) area, gradually transferred to central area. In Former Han, the phoenix do not take the same positioning of Former Han. The mercy and frequency is decreased. It is understood with the change of quality of the sacred phoenix.

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