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.

VRE 감염증의 임상상, 미생물학적 특성 분석 및 유전적 관련성 비교 : 전국 6개 병원에서 분리된 VRE를 중심으로

정희진,박정원,엄중식,하경임,신종희,김정미,이혜수,박영희,김우주,박승철 대한감염학회 2002 감염 Vol.34 No.5

水邊環境造成에 관한 硏究

李熙榮,丁仙吉 서울市立大學校 1994 論文集 Vol.28 No.-

The Water is very important resource to man. The riverain and view which are concern with water are important co-ownership resource to territory. We hold consciousness which is keep up and bring up water, and put in practice it. The plan which is make riverain-space, is realization of harmony between the use of water and closed water, detecte of riverain-space, a specific character of territory, which is base on the historical culture of territory with wholesome ecosystem, execute creativity. The improvement of riverain-environment is resuscitate natural sapce which is concern with water, inhabit variety microorganisms, animals and plants, play to conservative function of water quality, integrite and create beautiful riverain with natural disposition of consideration of ecology.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

만성정신질환자 가족의 부담감에 관한 연구

이경희,박청자 대한보건협회 2003 대한보건연구 Vol.29 No.2

The purpose of this study was to investigate the burden of the families with the chronic mentally ill to provide the basic data for nursing intervention program. The subjects of this study were 200 families with the chronic mentally ill registered in four community mental health centers at Daegu city. The data were collected during the period from May, 2002 to July, 2002. The instruments for the study were the burden scale used in Kim, Suji et. al.(1998).(a=.8812). The data were analyzed by descriptive statistics, t-test, Pearson correlation coefficient. ANOVA. and multiple stepwise regression. The results of analysis were as follows: 1. The mean score of burden is 2.95 and the mean score of quality of life is 2.93. 2. There is a negative correlation between the burden and the quality of life of families with the chronic mentally ill(r=-.31, p<.0l). 3. Burden showed the significant difference according to sex(t=-3.18, p<.05), marital status(F=4.12, p<.05).

고성능액체크로마토그래프법에 의한 원료 및 제제 중 메토트렉세이트 광학이성질체의 품질관리

홍정희,서은영,이은주,이관준,김경호,강종성 충남대학교 약학대학 의약품개발연구소 2011 藥學論文集 Vol.26 No.-

지역사회와 병원에서 페니실린 내성 폐렴구균 감염의 임상적 특징 및 분자유전학적 성상

정희진,황병연,박정원,김우주,김민자,박승철,이영희 대한감염학회 2001 감염 Vol.33 No.2

Background : During the last three decades, the resistance of S. pneumoniae to penicillin has been rapidly increasing in many parts of the world, especially in Korea. To characterize the clinical features and epidemiology of penicillin-resistant S. pneumoniae (PRSP) infections in the community -and hospital, as well as to investigate the possible spread of resistant clone, we performed the antimicrobial susceptibility tests, pulsed filed gel electrophoresis (PFGE) and penicillin-binding protein (PBP) profile analysis of PRSP isolates. Methods : A total 48 PRSP isolates from patients who visited or were admitted to Korea University Guro hospital during the period form July 1998 to June 1999 were studied. Anitimicrobial susceptibility tests for 48 isolates were performed with microbroth dilution method to determine the minimal inhibitory concentration of 11 antibiotics. 39 isolates and 35 isolates were subjected to PFGE and PBP profile analysis, respectively to investigate the genetic relatedness between PRSP isolates. Results : Pneumonia was most common site of infection in the community and the hospital as 50%. There were no significant differences of clinical fentures and prognosis between community and hospital isolates. But, patients with serious underlying diseases had poor prognosis despite of acquisition site. High level penicillin resistance were observed in 69%, multi-drug resistance were 64.6% of isolates. PFGE showed that 13 of 29 community acquired infection were identical PFGE pattern but not that of 23F Spanish clone. There were various PFGE patterns were observed from community and hospital acquired infection isolates. Some of them were existed in both. PBP profiles showed more diverse, even if in isolates of the same PFGE pattern. Conclusion : In our study, high level penicillin resistance and multi-drug resistance were observed in PRSP clinical isolates. No clinical and prognostic differences were observed between community and hospital acquired infections. Molecular epidemiology study were suggest the there were various genotypes of PRSP within our society. Some of them were observed of the hospital and community. Therefore, there was an evidence of communication of PRSP clones between the community and hospital. (Korean J Infect Dis 33:112~122, 2001)

포스트 및 코어 수복시 레진 세멘트가 파절 저항에 미치는 영향

이청희 慶北大學校 齒科大學 1993 慶北齒大論文集 Vol.10 No.2

손상이 심한 근관치료된 치아를 포스트 및 코어로 회복할 때에 포스트 세멘트의 기계적 및 화학적 성질이 치근 파절저항에 어떠한 영향을 주는지 알아보기 위해서, 발거된 소구치를 사용하여 법랑-백아질 경계선 상에서 치아장축에 수직되게 절단한 후 기성품인 평행한 Para-post를 샌드브라스팅하여 깊이 7mm로, Ⅰ군에는 Z,P,C., Ⅱ군에는 Panavia, Ⅲ군에는 All-bond로 세멘트한 후 복합레진 코어를 형성하고 치질 1mm 포함하는 금관을 니켈-크롬계 비귀금속으로 주조하여 각치아에 Z.P.C.로 세멘트 하였다. 인스트론 만능 시험기에 시편을 거상하고 치아 장축에 45˚가 되게 압축하중을 가하여 파단하중을 측정하고 치근내부를 주사전자현미경으로 관찰한 결과 다음과 같을 결과를 얻었다. 1. 파절저항이 Panavia 군에서는 175.8±54.5kg, Z.P.C.군에서는 146.8±36.8kg, 그리고 All-bond 군에서는 144.6±25.8kg의 순서로 나왔으나 통계적으로 유의성있는 차이를 나타내지 않았다.(P>0.05). 2. 파절 후의 주사전자현미경(SEM) 관찰에서 Panavia 군은 상아질 세관 내로 레진의 침투가 거의 관찰되지 않았으며, All-bond 군에서는 일부 관찰되었다. The purpose of this study was to evaluate root failure loads of teeth in which posts were cemented with various cements. Thirty-three recently extracted, intact premolars were used and stored in a physiologic saline solution from the time of extraction. The crown of each tooth was removed with a water-cooled diamond disk at the cemento-enamel junction. Then, the teeth were endodontically treated and post spaces were prepared to 7mm in depth with a Para-post drill(P-42-5). The teeth were divided into three groups of eleven teeth per each group. Prefabricated parallel Para-Posts(PD-K-5, Φ1.25mm) were sandblasted and used in each group. Group Ⅰ; Posts were cemented with zinc phosphate cement. Group Ⅱ; posts were cemented with Panavia cement. Group Ⅲ; Posts were cemented with All-Bond and Composite luting cement. A composite resin core was built to the height of 4.5mm above the tooth and sunk to the depth of 1mm and was involved the substance of the tooth because of the ferrule effect. Thereafter, a complete cast crown was made with nickel-chrome alloy and cemented with zinc phosphate cement on each tooth. The failure loads of the specimens were measured by an Instron Universal testing machine. The mean values of failure loads for the three groups were statistically compared by Duncan's multiple range test. There was an examination by scanning electron microscopy in order to evaluate the mechanical bonds of resin on the internal root surface in each teeth. The results were as follows; 1. There was not a statistically significant difference between the failure loads of each group(P>0.05). 2. In examination of SEM, there were no resin tags in dentinal tubules in group Ⅱ(Panavia). In group Ⅲ(ALL-Bond), there were resin tags in dentinal tubules, though sometimes, there were no resin tags.

국내 시판 항생제의 허가 용량 및 용법의 적정성에 대한 고찰 : 국내 약제사용설명서(package insert)와 미국 Physicians' Desk Reference의 비교 Comparison of Domestic Package Inserts with Physicians' Desk Reference

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

목적 : 국내 시판중인 항생제의 1일 투여량과 투여간격의 적정성을 확인하고 적응증 및 중증도에 따른 항생제 용량 제시 여부를 확인하기 위하여 항생제 시판시 KFDA의 허가사항을 담은 약제사용설명서을 미국 FDA 공인 약제에 대한 사용지침으로 쓰이고 있는 PDR(Physicians' Desk Peference)과 비교하였다. 방법 : PDR에 등재되어 있는 항생제 중에서 시럽 및 도포용 항생제를 제외한 총 61종에서, 국내에 시판되어 있는 51종 항생제의 약제사용설명서를 대상으로 1일 투여량, 투약횟수, 적응증 및 중증도에 따른 설명 정도를 비교하였다. 결과 : 1) 1일 투여량 비교 : 비교 가능한 전체 항생제에서, 약제사용설명서가 PDR보다 적은 용량을 제시한 경우는 경구용 8종, 주사용 11종으로 총 19종(37%)였으며, 많은 용량을 제시한 경우는 경구용만 2(4%)종이었고, 동일하거나 비슷한 용량을 제시한 경우는 경구용 15종, 주사용 15종으로 총 30(59%)종이었다. 약제사용설명서에서 적은 용량이 제시된 항생제 중 경구용인 cefdnir, cefixime, cefpodoxime, ofloxacin, levofloxacin, norfloxacin(6종), 주사용인 cefazolin, cefotetan, ceftizoxime, meropenem (4종) 등 반수이상의 약제가 일본제약회사로부터 국내에 수입된 약들이었으며 일본의 약제 사용설명서와 동일한 용량을 제시한 것을 알 수 있다. 2) 투여간격 비교 : 비교가능한 항생제 51종 중에서 국내약제사용설명서가 PDR과 동일한 투약횟수, 투여간격을 제시한 항생제는 30종(59%)이었다. 국내 약제사용설명서가 PDR보다 적은 투약횟수, 긴 투여간격을 제시한 항생제는 9종(17%)이었다. 오히려 많은 투약횟수, 짧은 투여간격을 제시한 항생제가 12종(24%)이나 되었다. 경구용만 비교하였을 경우 국내 약제사용설명서가 PDR보다 적은 투약횟수를 제시한 항생제는 없었으며, 동일하세 제시한 경우는 15종, 빈번한 투약횟수를 제시한 경우는 10종이었다. 주사용 항생제에서 국내 약제사용설명서가 PDR보다 긴 투여간격을 제시한 항생제는 9종, 동일한 경우는 15종, 짧은 투여간격을 제시한 경우는 2종이었다. 3) 적응증 및 중증도에 따른 비교 : 약제사용설명서에서 적응증 또는 중증도에 따른 용량에 대한 설명이 부족한 경우는 경구용 13종, 주사용 7종으로 총 20종(39%)이었으며, PDR에서는 경구용 1종, 주사용 2종으로 총 3종(6%)이었다. 결론 : 항생제에 첨부되는 약제사용설명서 및 약제사용설명서를 바탕으로 편집되는 의약품집이 항생제를 처방하는 의사들이 용법과 용량을 결정함에 있어 참고 역할을 하고 있으나, 국내의 시판 허가사항을 담은 약제사용설명서가 많은 수에서 적응증 또는 중증도에 따른 1일 투여량과 투여간격에 대한 정확한 정보를 제공하고 있지 못하고 있다. Background : The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. Materials and Methods : Package inserts about antibiotics, only oral or parenteral agent, wereperused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. Results : Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases: 15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases: 8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases : 10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases: 13 oral and 7 parenteral agents) revealed no information for dose adjustment commons to indications or the severity of infection. Conclusion : This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.

사용자 분석을 통한 대학기숙사 거주환경 개선에 관한 연구

이청웅,박행자,임경희 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.2

This study, as a case study of four university dormitories in Gwangiu, examined the situation of interior space and conducted a quantitative survey invesitgating importance about the interior space and assessment factors of residential environment on users. Then user satisfaction at the assessment factors of residential environment was analyzed to draw problems and explore improvement. The results showed the following problems that should be resolved: Bedrooms should increase the area of convex space; toilets and bathrooms should be changed into a cluster type at least in common use by floor; rest space should reinforce heating and cooling system; robby space should become mixed space for various user's behavior; private fitness rooms should be planned as group fitness space; private libraries should reinforce lighting facilities: and computer rooms should complement and improve HVAC.