국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

유방암에서 PCNA, c-erbB-2 그리고 p53의 표출양상에 관한 연구

김득수,김의한,양승하 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Breast carcinoma is a common malignant tumor in korea. Various oncogenes have been found in malignant tumor cells. There were many reports for correlation betwee PCNA, c-erbB-2, and p53, and prognosis of breast carcinoma, but is controversial. We performed immunohistochemical stain for PCNA, c-erbB-2, and p53 for 27 cases of benign tumor and 49 cases of carcinoma of the breast and evaluated expression rate of each antigens, and we compared their correlation with prognosis of patients in breast carcinoma. The results were as follow; 1) PCNA LI of benign tumor and carcinoma of breast were 74.04±17.85 and 71.86±21.57. c-erbB-2 expression rates were 85.19% and 79.59%, and p53 were 0% and 51.02%. 2) PCNA LI showed no difference according to types of benign tumor and to types, histologic grade, and lymph node metastatic status of carcinoma. 3) c-erbB-2 showed higher expression rate in grade Ⅱ(87.5%) and grade Ⅲ(88.89%) than grade Ⅰ(62.50%) in breast carcinoma but it was not significant difference. 4) p53 showed significantly higher expression rate in left side and non-metastatic cases compared to right side and metastatic cases(each p<0.05), and it showed increasing expression rate according to highening of grade without significant differnece(p=0.069). 5) The expression of p53 in breast carcinoma showed significant correlation with proliferative activity of tumor cells(P<0.05). Above results showed that there was correlation the expression of p53 and poor prognosis of patients and proliferative activity of tumor cells in breast carcinoma. c-erbB-2 showed indistinctive correlation with prognosis and no correlation with proliferative activity of tumor cells. PCNA showed no relation to prognosis

국산 및 수입 Luncheon Meat의 품질비교에 관한 연구

김천제,최수일,한의수,이효진,고원식 건국대학교 동물자원연구센터 1991 動物資源硏究誌 Vol.16 No.-

본 연구는 국내에서 생산되고 있는 돈육 luncheon meat과 수입 luncheon meat의 성분조성 및 품질을 비교 평가하기 위하여 실시하였다. 그 결과를 요약하면 다음과 같다. 1) 국산돈육 luncheon meat의 수분함량은 57.2%로 수입품(53.1%)보다 높았으며 조지방 함량은 수입품(53.1%)보다 높았으며 조지방 함량은 수입품이 26.6%로 국산품(20.6%)보다 높았다. 그러나 조단백질 함량은 거의 같았다. 2) 국산돈육 luncheon meat와 수입품 모두 대장균이 검출되지 않으며, 타르색소(tar colors)도 사용하지 않은 것으로 나타났다. 3) 국산돈육 luncheon meat의 NO₂의 함량은 4 ∼ 35ppm으로 돈육수입 luncheon meat(1.7∼6ppm)보다 높았다. 4) 국산돈육 luncheon meat의 TBA가는 0.09∼0.13로 비교적 낮았으나, 유통기간이 긴 수입돈육 luncheon meat는 0.09∼0.39로 국내제품에 비하여 상대적으로 높은 값을 나타내었다. 5) 국산돈육 luncheon meat의 VBN(12.3∼18.4mg%)은 수입품(15.7∼18.2mg%)보다 낮았다. 6) 수입 luncheon meat는 국산 luncheon meat보다 jelly loss가 약2배 높았다. 7) 경도는 국산돈육 luncheon meat통조림이 수입품보다 높은 것으로 나타났으나, 탄력성과 응집성은 큰 차이가 나지 않았다. The aim of this study was to assay and compare the ingredient or composition and quality of imported pork luncheon meat with those of domestic's. The results obtained were as follows. 1. The amount of water in domestic pork luncheon meat products(57.2%0 was higher than that of imported products(52.2%0, and the content of crude fat in imported products(26.6%) was higher than that of domestic products(20.6%). The amount of crude protein, however, both domestic and imported products was approximately the same. 2. E.coli was not found in both domestic and imported products. No tar-colors were detected in both samples. 3. The amount of NO₂in domestic pork luncheon meat products(4 to 35ppm) was higher than that of imported products(1.7 to 6ppm). 4. The TBA-value of domestic pork luncheon meat products(0.09 to 0.13) was relatively low, whereas the value of imported products was higher than that of domestic products(0.09 to 0.39). 5. The VBN-value of domestic luncheon meat products(12.3∼18.4mg%) was lower than that of imported products(15.7∼18.2mg%). 6. The jelly loss of imported pork luncheon meat products was approximately 2 times higher than that domestic's . 7. The hardness of imported pork luncheon meat products was lower than that of domestic products. Elasticity and coheshiveness in both products were not significantly different.

국내에서 분리된 Vancomycin 내성 장구균에 대한 분자역학적 연구

김수정,이남용,배직현,이경원,이위교,김의종,최명식,백경란,김성민,송재훈 대한감염학회 1998 감염 Vol.30 No.1

목 적 : 장구균은 병원 감염의 원인균으로서 최근 그 빈도와 중요성이 증가하고 있다. 특히 vancomycin에 내성을 보이는 장구균(VRE)은 효과적인 치료약제가 드물고, 그 내성 유전자가 vancomycin에 감수성을 보이는 다른 장구균이나 그람양성 구균에 전달될 수 있어 임상적인 중요도가 더욱 크다. 본 연구에서는 국내 5개 병원에서 분리된 VRE 균주의 표현형과 유전형을 결정하고, 분자역학적 방법을 이용하여 유전적 연관성 여부를 밝히고자 하였다. 방 법 : 각 병원에서 수집된 균주는 환자의 임상 검체에서 또는 VRE 집락화에 대한 선별검사에서 분리된 균주였다. 이들을 대상으로 vancomycin과 teicoplanin의 MIC를 측정하여 표현형을 결정하였으며, PCR로 vancomycin 내성 유전자를 증폭하여 유전형을 결정하였다. 또한 이들중 vanA와 vanB 유전자를 갖는 균주들을 대상으로 플라스미드 분석과 PFGE를 시행하였다. 결 과 : VRE로 최종 동정된 균주들은 42균주(E. faecium 21주, E. faecalis 6주, E. avium 2주, E. casseliflavus 13주)였으며, 항균제 감수성 양상으로 결정한 표현형은 VanA, VanB, VanC형이 각각 14주(33%), 7주(17%), 21주(50%)였다. PCR로 결정한 유전형은 vanA 12주(E. faecium), vanC 16주 였으며, 이중 VanA의 표현형을 보인 E. faecium 2주가 VanB의 유전형으로 판명된 것을 제외하면 표현형과 유전형은 모두 일치하였다. 플라스미드 분석과 PFGE 결과, 병원내 동일 균주의 전파 가능성이 5개 병원중 3병원에서 증명되었다. 결 론 : 국내 병원에서도 vancomycin 내성 유전자를 갖는 VRE가 다수 분리되고 있음을 확인할 수 있었으며, 연구 결과 일부 병원에서 내성균주의 병원내 전파 가능성을 시사하였다. 아직까지 국내에서 VRE로 인한 감여보고는 적지만 곧 임상적으로 문제가 될 것으로 판단되며, 따러서 내성균의 발생이나 확산을 억제하기 위한 노력과 감시가 필요할 것으로 생각된다. Background : Enterococci have emerged in recent years as a frequent cause of life-threatening nosocomial infections. The emergence of vancomycin-resistant enterococci(VRE) presents as an increasingly important problem particularly in the treatment and the potential dissemination of vancomycin-resistance. The purpose of this study is to determine the phenotypes and genotypes of VRE isolated from five hospitals and to study the genetic relatedness among them. Methods : Antimicrobial susceptibility patterns and amplification of vancomycin resistance genes were used for phenotyping and genotyping of 42 VRE isolates respectively. For 21 isolates with vanA or vanB gene, plasmid profiles and pulsed field gel electrophoresis(PFGE) patterns were analyzed for molecular epidemiologic study. Results : Out of 42 isolates, 21 were identified as E. faecium, 6 as E. faecalis, 2 as E. avium, and 13 as E. casseliflavus. Phenotyping showed 14 isolates as VanA(33%), 7 as VanB(17%) and 21 as VanC(50%). Genotyping resulted in 12 isolates as VanV(5 of E. faecalis and 7 of e. faecium) and 9 as VanB(all E. faecium). Genotyping results were concordant with phenotyping results except for the two E. faecium isolates of VanA which had VanB genotype. Intrahospital spread of the same strains was proven in three hospitals by plasmid profiles and PFGE analysis. Conclusion : The study demonstrated a considerable number of VRE isolates in Korea and intrahospital spread proven by molecular epidemiologic methods. Although VRE infection has been considered very are in Korea, practical guidelines including restriction of vancomycin usage and surveillance, are warranted to prevent infection and dissemination of VRE.

K형 강관접합부의 편심접합에 관한 실험적 연구

김갑순,신의균,김우범,정수영 충남대학교 산업기술연구소 2000 산업기술연구논문집 Vol.15 No.1

A finite element analysis and experimental study were performed to investigate the behavior and strength of a connection of tubular steel member considering slenderness ratio and eccentricity. Primary interest here are ultimate strength of connections having eccentricity. In comparison with the current design standard according to which the gravity axes of the main and branch pipes coincide with each other, the inner eccentric joint where the gravity axes of the branch pipes are shifted to the gusset plate side can reduce the gusset plate size. However, in the eccentric joint where the gravity axes do not coincide, the bending moment that acts on the main pipe due to eccentricity causes a problem. As a result, in cases where the slenderness ratio is 40 or less, the buckling strength of the inner eccentric joint was similar to that of a joint without eccentricity. Therefore the possibility of use of inner eccentricity connection to reduce the gusset plate size has been verified.

하악 무치악 인공치아매식술시 하치조신경 전위술

최의환,하정완,김수관,정태영,김수흥 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.3

Modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Five transpositions of the inferior alveolar nerve together with the installation of 10 implants were performed in four patients. The mean postoperative follow-up time was 17 months, with a range of 8 to 20 months. All implants with functioning pontics remained stable, with no mobility or symptoms of pain and infection during the follow-up period. Neurosensory evaluation was performed using the two-point discrimination test. Two patients had objective neurosensory dysfunction at postoperative, but all the nerve function were reported as normal by the patients 4 months postoperatively.

Aloe, Gelfoam, Plaster가 골격손부의 신생골 형성에 미치는 영향에 관한 실험적 연구

최의환,김수관 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.2

Purpose : This study was to evaluate the effects of Aloe, Gelfoam, and Plaster of Paris on bone healing. Materials and Methods : Four experimental defects were created for placement of the three materials in the right femur of dogs. One defect served as an empty control site. The evaluation was performed at 1-, 6-, and 12-weeks by light microscopy and radiographs. Results: Radiographic and histologic examinations showed new bone formation in the presence of Aloe, Gelfoam, and Plaster of Paris and similar bone healing reactions. Conclusion: On the basis of these findings, it was concluded that Aloe, Gelfoam, and Plaster of Paris may be adequate agents for use in bone procurement.(J Korean Oral Maxillofac Radiol 1999;29:493-506)

콩과 식물의 α-galactosidase에 대한 연구

全瓊姬,金義守 嶺南大學校附設 基礎科學硏究所 1984 基礎科學硏究 Vol.4 No.-

Enzyme extracts were made from the cotyledons of the bean sprouts (soybeans, red beans, and mung beans) and the α-galactosidase activity and its kinetics were studied. 1. Protein amounts were decreased in accordance with the germination and development and this was particular in red beans and mung beans. 2. α-galactosidase activity was highest at the early stage of germination (72hrs. in soy beans, 48hrs. in mung beans) but decreased thereafter. there appeared no signifcant difference in species. 3. The Km values by Lineweaver-Burk plot were 0.39 in soy beans, 0.32 in red beans and 0.71 in mung beans. These results suggest that α-galactosidase play an important role in carbohydrate metabolism in leguminosae.

편평세포암종과 병발한 치성점액종

이병도,황의환,이상래,김봉수 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.1

Squamous cell carcinoma is the most common type of oral cancer and odontogenic myxoma is relatively uncommon benign tumor of mesenchymal origin. There are, to our knowledge, no prior reports of simultaneously occurring squamous cell carcinoma and odontogenic myxoma of the jaw bones. In this case, at first, the plain films and computed tomograms revealed a large expansile multilocular radiolucent lesion on left mandible and marked expansion of cortical plate. In addition this radiograms revealed also infiltrative bony destruction of anterior and medial border of ascending ramus of left mandible and alveolar bone of left maxilla, floating teeth on left lower molar area and metastatic enlargement of left submandibular, jugular digastric and spinal accessory lymphnodes. Magnetic resonance imaging of this patient revealed infiltrative growth of tumor on alveolar bone of left maxilla, left retromolar fat pad, left masseter and left medial pterygoid muscle. Intraoral presurgical biopsy presented typical features of squamous cell carcinoma. After chemotherapy with radiation therapy during 6 months, this central lesion was diagnosed as odontogenic myxoma by the postsurgical biopsy. After 3 months, this patient presented multiple metastatic signs at lumbar spines, rib and liver. Consequently, our case is simultaneous occurrence of squamous cell carcinoma and odontogenic myxoma.(J Korean Oral Maxillofac Radiol 1999:29:339-353)

서울 시내 4년제 남자 대학생의 우울과 흡연량, 흡연기간, 니코틴 의존도와의 관계

박지영,박소영,이미숙,백수진,신의경,예혜련,오승진,장윤정,조혜진,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

Background: With reports on the relation between smoking and depression appearing since 1980, it has become clear that depression is one of the psychodynamics of smoking, though there has been little or no progress made in the study of whether or not there is indeed a relation between depression and nicotine dependence. Purpose: The purpose of the study was to investigate the effects of depression on the amount and period of smoking and nicotine dependence among university man student smokers. Method: In periodical examination between 14 and 21, May, 2003, using 170 university male. The CES-D(Center for Epidemiologic Studies Depression) Scale and the FTQ(Fagerstrom Tolerance Qustionnaire) were utilized to measure the level of depression and nicotine dependency. The amount of smoking was calculated based on the number of cigarette used. Result: Results indicated that depression had something to do with amount of smoking. Nicotine dependence also was related to depression but total value was relatively low. finally the period of smoking had nothing to do with depression. Conclusion: The results of this study revealed that the amount of smoking of university man student smokers was very high. Both the amount of smoking and nicotine dependence were affected by levels of depression. Accordingly psychiatric nursing access such as emotional support is needed to manage depression and decrease smoking.