폐결핵치료 중인 환자에서 Rifampicin에 의해 유발된 위막성 대장염 2예

김봉진,권균홍,임창섭,김자영,홍정범,옥미선,배용목,김지연 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Pseudomembranous colitis (PMC) is a disease caused by Clostridium difficile proliferation. The causative drugs are clindamycin, third-generation cephalosporins, flouroquinolone and so on. Rifampicin has been reported as a cause of PMC in the 1980s, and the frequency of PMC is increasing because rifampicin is a first line drug for anti-tuberculosis therapy. Two patients were recently admitted to our hospital due to watery diarrhea for 1 month and they were diagnosed with PMC by sigmoidoscopy. Their onset age were 74, 72 years old and latent period of symptoms were 60, 129 days, respectively. In one case, the patient displayed coexisting hypertension and diabetes. The clinical symptoms improved after discontinuing the rifampicin and then administering oral metronidazole. We report here on two cases presumed to be rifampicin-induced PMC.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

Cisplatin과 Tobramycin이 白鼠 Corti器에 미치는 영향에 關한 電子 顯微鏡的 硏究 : Ultrastructural Study

김동환,신태균,김무강,김홍선,김원식 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.1

In order to study the morphological changes of Corti’s organ in the rat treated with cisplatin and tobramycin, thirty-three rats, weighing between 200∼250g, were used, and divided into 4 groups, i.e., 3 rats were used for control, and 30 rats were used for 3 experimental groups. Each experimental group was divided into cisplatin-treated, tobramycin-treated, and both cisplatin and tobramycin treated group with 10 rats. Rats were injected with a single dose of 7.7㎎/㎏ of cisplatin intraperitoneally and 50㎎/㎏/day of tobramycin for 2 days intramuscularly, respectively or both. Treated rats were sacrificed on the 3rd and 5th day after the first injection. Results were as follows; 1. Cisplatin-treated group: Outer hair cells of Corti’s organ were degenerated with the formation of vacuoles and appearance of lysosomes, however, inner hair cells showed mild vacuolization. 2. Tobramycin-treated group: NO pathological changes were found in Corti’s organ. 3. Combined cisplatin and tobramycin treated group: Outer and inner hair cells showed vacuolization, appearance of lysosomes, myelin figures and multivesicular body. There were also multivesicular body in the inner phalangeal cell and myelin figure in the Reissner’s membrance. 4. Degeneration of Corti’s organ in the combined treated group was more sever than those of the single cisplatin-treated or tobramycin-treated group. 5. NO pathological differences of Corti’s organ in duration of postinjection were manifested in any groups. It can be concluded that cisplatin induces toxicity to inner ear and cisplatin enhance toxicity more in continued treated with tobramycin.

요추 수술 예정 환자에서 실시한 선택적 신경근 차단술의 5년 추시 결과

심대무(Dae Moo Shim),김태균(Tae Kyun Kim),오성균(Sung Kyun Oh),최윤홍(Yun Hong Choi),이석중(Suk Jung Lee) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.1

목적: 하지 방사통을 호소하는 환자의 수술 준비 과정에서 선택적 척추 신경근 차단술을 실시하고, 그 효과가 얼마나 오래 유지되는지를 알아 보고자 5년 이상 추시된 환자를 대상으로 분석하여 그 결과를 보고 하고자 한다. 대상 및 방법: 2000년 1월에서 2000년 12월까지 하지 방사통으로 타 병원 혹은 본원에서 수술적 치료를 권유받은 환자 중 수술 준비 과정에서 진단 및 치료 목적으로 선택적 척추 신경근 차단술을 시행한 환자를 대상으로 하였으며, 이중 5년 이상 추시가 가능하였던 69예를 대상으로 하였다. 결과분석은 진료기록부와 전화 인터뷰를 통해 하였으며. 신경차단술 시행군과 수술을 시행한 군의 치료결과 분석은 Kim's criteria (김의 평가기준), VAS(Visual analog scale) score를 이용하였다. 결과: 연구 대상 환자 69예 중 37예에서는 차단술 후에 증상 호전이 없어 수술을 시행하였고, 32예에서는 신경차단술 만으로 증상호전 되었다. 젊은 사람(60세 미만)에서 보존적 요법보다는 수술을 하는 경향이 많았으며, 이환 기간이 길수록(6개월 이상) 신경근 차단술 보다는 수술하는 경우가 높았다. 차단술 만으로도 호전된 32예의 환자 추시 결과상 다른 치료 없이 증상 호전이 지속되었던 환자는 17예(24.6%)였고 증상이 재발하여 추가 치료를 필요로 한 환자는 15예이었다. 이중 4예는 수술적 치료를 시행하였다. 결론: 수술이 예정된 하지 방사통 환자를 대상으로 수술 준비 기간 동안에 신경근 차단술을 시행하여 그 중 일부에서는 장기 추시에서도 증상 호전이 지속 되었다. 따라서 신경차단술은 수술 전에 한번 시도해 볼 만한 방법 중의 하나로 사료된다. Purpose: To evaluate the effectiveness of a selective nerve root block (SNRB) in patients with sciatica before surgery through a more than 5 year follow up. Materials and Methods: Between January 2000 and December 2000, patients with sciatica, who were recommended to undergo surgery to diagnose and treat sciatica by other clinics or at our hospital, were selected to undergo SNRB before surgery. Among them, 69 patients were followed up for 5 years. The analysis was based on the patients' medical records and telephone interviews, and the treatment results in the SNRB group and operation group were analyzed using Kim's criteria and the Visual Analog Scale score. Results: Among the 69 patients, there was no improvement in symptoms in 37 patients after SNRB. Therefore, they underwent surgery. The symptoms of the remaining 32 patients were improved by SNRB. Overall, younger patients and those with a longer symptom duration required surgery. Conclusion: SNRB was performed on patients with sciatica who were scheduled to undergo surgery. Some patients showed improvement in their symptoms in the long term. Therefore, SNRB should be considered as a treatment option prior to surgery.

Nicotine이 발생중인 鷄胎의 體重 成長에 미치는 영향

金武剛,金弘善,柳時潤,申台均,李永浩,趙聲煥 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

The authors studies the effects of Nicotine on the Body weight growth of the developmental chick embryo. On the sixth day of incubation, 0.41mg, 0.82mg and 1.65mg of Nicotine were injected into the chorioallantoic sac of each egg of three groups and one group was injected physiological saline solution as a control, and the eggs were broken for weighting the body weight in every other day from the twelfth day to eighteenth day of incubation. In an attempt to analyze the growth of the body weights, growth formula of Zimmerman and relative growth formula of Huxley were applied. The following results were obtained. 1. The growth of chick embryo boby weight was affected as inhibiting by the Nicotine. The inhibiting effects were in proportion to the injected Nicotine dosage. 2. The growth quantity of the body weight injected 1.65mg was almost half weight of the control group body weight. 3. Growth rate was decreased continuously with tine until 18th day in the 1.65mg injected group but it was increased in 0.41mg and 0.82mg injected group with time lapse from 12th day to 18th day, and 0.41mg injected group was more increased than 0.82mg injected group. 4. Specific growth rate decreased in the all of 0.41mg, 0.82mg and 1.65mg injected group and in the decrease degree 1.65mg and 0.82mg injected group ware severe and 0.41mg injected group was slight. 5. Growth centers of growth gradient were 12th day in the 0.41mg injected group and 18th day in the 0.82mg and 1.65mg injected groups. 6. Relative growth rate was also decreased proportionally in related with injected Nicotine dosage.

부문별 환경세 도입이 경제에 미치는 효과분석 : 소비부문 VS 생산부문

김홍균 서강대학교 경제연구소 2003 시장경제연구 Vol.32 No.2

The purpose of this paper is to compare the effect of a production pollution tax vs and a consumption pollution tax on the economy. In doing so, the paper uses the dynamic general equilibrium model. The main findings are as follows. The production pollution tax have a negative effect on consumption, leisure and capital, while the consumption pollution tax have no influence on leisure, capital. In sum, the consumption pollution tax is more efficient than production pollution tax.

매립가스 자원화 방법별 경제성 분석

김홍균 서강대학교 경제학연구원 2001 시장경제연구 Vol.30 No.2

This study assesses four methods for reuse of land-fill gas in terms of net-benefit. Main results from this study are as follows: ① Netbenefit has a postive value for all four methods. ② While the method to produce low quality gas among four methods has the highest netbenefit, the method to produce electricity by using steam turbine has lowest netbenefit. ③ As the sales price of electricity increases, the netbenefit of the method to electricity with gas engine increases the most rapidly.

생쥐 鼻中隔 各種 粘膜上皮 및 粘膜下腺의 分布樣狀과 그 表面積에 관한 硏究

金東煥,金武剛,申台均,金弘善,柳時潤,李永浩 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1

In order to set the distribution pattern and surface area of the mucosal epithelium and submucosal gland in the mice nasal septum. 3-month-old healthy 6 mice weighing 25gm approximately have been contributed for this research. For the mapping of the each nasal epithelium and submucosal gland in the submicroscopic level, the routine paraffin block of the mice nasal septum were cut as the 10㎛ thick at 110㎛ intervals. Consecutive 2 slides were stained with H-E and PAS and reconstructed in form of maps representing the structure in a sagittal plane. The results obtained from this research were summarized as follows. 1. The unilateral nasal surface epithelial area of the mice nasal cavity was 31.23㎟ 2. The areas of the stratified squamous epithelium, respiratory epithelium and olfactory epithelium which compose the unilateral nasal epithelium were 4.47㎟(14.3%), 12.7㎟(40.8%), and 14.02㎟(44.9%), respectively. 3. Submucosal glands in the mice nasal septum were divided into the PAS-positive, PAS-negative and Bowman's glands by the PAS staining. 4. The surface area of the PAS-positive glands in the nasal unilateral septum was 5.23㎟ which is located in the central area of the respiratory portion. 5. The surface area of the PAS-negative glands in the nasal unilateral septum was 5.05㎟ which is located above and below the PAS-positive gland. 6. The surface area of the Bowman's glands was 12.1 ㎟ which was located in the olfactory region. 7. In the vestibular region., 3 ducts of PAS-negative glands of the respiratory region are found, and below the nasal septum there is the infraseptal gland(PAS-negative).

내적 치유에 대한 목회 신학적 이해

김홍근 한세대학교 1998 敎授論叢 Vol.13 No.-

IT 職業訓練과 經濟的 成果

金鴻均,申一淳,張熙宗 한국국제경제학회 2002 국제경제연구 Vol.8 No.3

본 연구의 목적은 IT직업훈련의 경제적 성과를 측정하는데 있다. 경제적 성과의 측정은 두가지 측면 즉 고용과 임금의 관점에서 행해졌다. 사용된 자료는 1998~1999년의 한국노동패널조사 자료이며 대상은 1차 년도의 실업자 또는 실망실업자 1,877명이다. 본 연구의 주요 결과는 다음과 같다. 첫째, 취업효과에 있어 IT교육훈련의 질적인 측면의 중요성이 두드러지게 부각되었다. 단순히 IT직업훈련의 유무가 취업에 '음'의 효과를 가지는 것에 비해 6개월 이상 IT직업훈련을 사람은 그렇지 않은 사람에 비해 취업될 확률이 24%나 높게 나타났다. 둘째, 취업효과를 학력별로 살펴볼 경우, 고등학교 이하의 그룹에서는 6개월 이상 교육받은 사람은 그렇지 않은 사람에 비해 취업될 확률이 38% 높은 것으로 나타났는데, 이 수치는 고려된 다른 어떤 변수들보다 높다. 셋째, 취업효과에 비해 IT직업훈련이 임금에 미치는 효과는 뚜렷하게 나타나지 않았다. 넷째, 비 IT직업훈련도 마찬가지이지만 특히 IT직업훈련의 경우 공공기관보다 민간기관에서 직업훈련을 받는 것이 또한 타인(정부 혹은 회사)이 비용을 부담하는 것이 취업에 유리한 것으로 나타났다. In this paper, we examined that whether IT job-training affects employment and insures job to pay high salary. This paper reports that all job-training overall affect not only employment but wage premium. even though the effect on wage premium is somewhat weak. In particular, the effect of IT job-training on employment is obvious and get stronger as training period increases in the low-educated group. In the case of the persons to receive IT job-training more than 6 months, the probability to get job is found to be higher by 38% than persons without receiving any other job-training