인공 판막 환자에서 발생한 Listeria monocytogenes 심내막염 1예

신상엽,손준성,김형훈,민태훈,윤종욱,장현하,정숙인,오원섭,김성민,백경란,송재훈 대한감염학회 2002 감염 Vol.34 No.5

전통마을 경관보전에 관한 정책대안 연구

신상섭,허준,노재현 한국정원학회 2002 한국전통조경학회지 Vol.20 No.2

The purpose of this research make a counter proposal on the conservation state and policy of traditional village(Asan Woeam:牙山 外岩村, Andong Hahoe:安東 下回村, Kyeongju Yangdong:慶州 良洞村, Soonchun Nakaneupsung:順天 樂安邑城村) landscape. Up until now, it is true that the value of traditional village landscape had been buried and the conservation of those places has been measured only on the basis of their basis of their economic value. In the future, we will try to recognize the value of traditional village as the history of villagers lives and to cherish their diversity, that the current interests of people persist and also provides the opportunity to recover the beautiful landscape of traditional village. The conservation policy of traditional village landscape in the Korea must have designation as landscape cultural assets, introduction technique of landscape impact assessment, consolidation of landscape state, land use system adjustment, participation of landscape specialist, toward sustainable tradition village, introduction of new community village idea. Also, there are necessary set up of traditional landscape design criteria and master plan, operation of landscape impact evaluation.

시화호에서 해수유입 전·후의 수환경 요인과 식물플랑크톤 동태

신재기,김동섭,조경제 한국환경과학회 2000 한국환경과학회지 Vol.9 No.2

The dynamics of water quality and phytoplankton population had examined by monthly sampling from the upper to the lower part of watergate in an artificial Shihwa Reservoir in which situated near newly cities and industrial complex on the west coast of Korea from January 1997 to December 1998. Among environmental factors, yearly average concentration of chl-a, TN and TP seemed to eutrophic or hypertrophic conditions that ranged 146.4∼245.8㎍/ℓ , 1.6∼2.7㎎ N/ℓ, 258∼448㎍ P/ℓ , 26.9∼80.7 ㎍/ℓ, 1.0∼2.4 ㎎ N/ℓ and 74∼239㎍ P/ℓ respectively. Water quality was extremely deteriorated to consistently accumulation into inner reservoir by load of pollutants from autochthonous and allochthonous until early July 1997 after embankment. Water pollution of Shihwa Reservoir was remarkble on the biological condition with largely persistent bloom of phytoplankton and increase rate of standing crops was 2.4/yr. The development trend of phytoplankton in water ecosystem were closely related to increse and decrease of physico-chemical factors and those scale seemed to control by nutrient contents. Inflow of seawater into reservoir to object of repair of water quality began on July 1997. This action was caused to variable of algal flora as well as improvement of water quality. As to see dominant species, composition of those composed to mostly freshwater algae before inflow of seawater such as Selenastrum capricornutum of green algae, Cyclotella atomus, C meneghiniana of diatom and Microcystis spp. of blue-green algae and the other hand brackish algae were dominated after inflow of seawater such as Chaetoceros dicipiens, Skeletonema costatum of diatom, Dinophysis acuminata, Gymnodinium mikimotoi, G. sanguineum, Gyrodinium spirale, Prorocentrum minimum of dinoflagellate and Eutreptiella gymnastics of euglenoid. Moreover, small flagellates including Chroomonas spp. of cryptomonad were abundant throughout the year. The cause of water deterioration during fill of the freshwater were complexly supported with extra and intra parameters. The variation pattern of phytoplankton were related to water temperature and salinity by inflow of seawater based to plentiful nutrients. The dynamics of phytoplankton were assessed to ecosystem that clearly condition of dominant by unique or a few algal species seasonally.

급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염 2예

신성철,백경란,정재홍,송봉근,김동희,전경만,채제욱,손준성,정숙인,오원섭,송재훈 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

국균은 호흡기를 통해 유입되며 심한 면역기능저하 환자에서 기회감염을 일으키는 진균이며 주로 혈관을 따라 폐를 침범하고 심장과 골침범은 매우 드문 것으로 알려져 있다. 저자들은 급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염을 2예을 경험하였다. 19세 남자환자로 동종 조혈모세포이식 후 발생한 고열과 요통의 원인으로 감염성 심내막염 진단하에 수술결과 국균에 의한 감염으로 확증되어 수술적 절제술과 liposomal amphotericin B로 치료하였으나 국균 심내막염의 재발과 국균 척추염의 악화, 뇌 출혈로 사망하였다. 23세 남자환자로 관해요법 후 발생한 고열과 요통의 원인으로 국균 심내막염과 국균 척추염 진단하에 수술적 절제술과 amphotericin B로 치료하여 1년 2개월 동안 국균 심내막염의 재발은 없었으나 지속적인 백혈병의 재발과 국균 척추염의 악화, 침습성 폐 국균증으로 사망하였다. Although Aspergillus endocarditis has rarely been reported, it can cause fatal complications in hematologic malignancy patients and allogeneic stem cell transplant recipients. We experienced two cases of aspergillus endocarditis developed in acute lymphoblastic leukemia patients. Case; A 19-year-old patient developed Aspergillus endocarditis after allogenic hemopoietic stem cell transplantation. He was treated with surgical intervention and liposomal amphotericin B. He died of recurred Aspergillus endocarditis and cerebral hemorrhage probably related with aspergillosis of central nervous system. Case 2; A 23-year-old patient developed invasive Aspergillus endocarditis after induction chemotherapy. Aspergillus endocarditis was successfully treated by surgical intervention and amphotericin B. He died of refractory neutropenic fever and sepsis after the third relapse of leukemia and repetitive chemotherapy. He probably had invasive pulmonary aspergillosis without evidence of endocarditis recurrence. Because the mortality of Aspergillus endocarditis is very high, early diagnosis and surgical intervention are very important for better outcome.

국내 대학병원에서 정주용 Ciprofloxacin 사용의 적정성 평가

김신우,박효정,오원섭,김연숙,장현하,정숙인,정두련,이혁,염준섭,기현균,손준성,백경란,우건조,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 병원에서의 정주 ciprofloxacin 사용의 적정성을 평가하고자 하였다. 재료 및 방법 : 2003년 9월 25일부터 8개의 대학병원에서 정주 ciprofloxacin을 받았던 290명의 연속적으로 모집한 성인환자를 대상으로 약제사용 평가(DUE)를 전향적으로 수행하였다. 이 연구에 사용된 DUE 기준은 미국병원약사회의 기준을 국내 실정에 맡게 수정하여 사용하였으며 1) 사용의 정당성에 관한 항목, 2) 사용 시 준수되거나 시행되어야 할 사항에 대한 항목, 3) 부작용에 대한 항목, 4) 치료 효과에 대한 항목으로 나누어 조사하였다. 결과 : 환자의 평균 나이는 54세였다. 33예(26.9%)에서만 약제 사용의 적정성 측면에서 기준을 만족하였고 91예(73.1%)에서는 사용이 적절하지 않았다. 정주 cipro-floxacin의 부적절한 사용의 흔한 원인은 수술 전후의 예방약 사용, 비뇨기계 처치 전의 예방적 사용, 열성 질환에 대한 경험적 사용 등의 순이었다. 사용 시 준수사항 의 측면에서는 사용 전 배양검사(73.8%)와 사용 중 배양검사(68.6%)가 낮은 수행 정도를 보였으나 그 외는 비교적 높은 적정성(82.4-100%)을 보여주었다. 정주 ciprofloxacin사용의 합병증은 드물었다. 치료 효과의 면에서 치료반응은 93.3%였다. 결론 : 약제 사용의 정당성 기준에 따른 정주 cipro-floxacin의 부적절한 사용은 연구에 포함된 대학병원에서 매우 흔하였다(73.1%). 그러므로 적절한 항생제 사용에 대한 교육과 제도적 장치가 매우 필요한 것으로 판단되었다. Background : To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. Materials and Methods : We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. Results : Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. Conclusion : Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.

江湖歌辭文學에 나타난 先人들의 風流景觀相

노재현,신상섭,허준 한국정원학회 2002 한국전통조경학회지 Vol.20 No.2

The purpose of this study is to comprehensively understand the predecessor’s typical perspective and internal meaning based on Pung-Ryu(風流) in Gang-Ho Gasa(江湖歌辭) literatures. In addition, it seeks to understand more fundamental consciousness of traditional beauty by approaching in a different manner. Almost of in the first half(序詞) of poems, authors peaceful life in his hermitage is described. They residence were Jung(亭子) around mountain and river. On the Jung, they can take a rest to contemplate and to feel the natural features and the picturesque scene, and can give a meaning of the place to make a seasonal view. In the latter phrase(展開部) of poems, it is identified that everything is determined by its own way of natural being.And they showed that his thought about dwelling location may be determined by the way of Pung-Ryu. In the last half(結詞) of poems, it is identified that their pursued an utopia and transcended himself without time and space. That is closely related to their personal mind for the affinity with nature and pusuit of freedom. And their life of Pung-Ryu are understood as escaping activity to solve his mind stress appeared in real life. Therfore, the world of Pung-Ryu in their literatures is transcendental and immanent praiseworthy for nature. The chracteristics of Pung-Ryu in Gang-Ho Gasa literatures falled into the three class hierachy such as a natural prise(自然讚美), a convivialty-self complacency(自與自得) and a singing and dancing-drinking-fishing(彈絃一樂). First of all, in their life, nature is reconized as an item existing as an object as well as a subject which can be separated from human beings. An aspect of ‘Pung-Ryu’ in Gang-Ho Gasa literatures are one of the representative sense fo beauty.

건강인의 비인강에서 황색포도구균의 분리와 Methicillin 내성 Staphylococcus Aureus의 항균제 감수성

김신무,정수진,정재옥,신용섭 원광보건전문대 1995 원광보건전문대학논문집 Vol.18 No.-

폐렴구균의 용혈능 변화와 pneumolysin 유전자의 변이 양상

오원섭,장현하,정숙인,김연숙,이혁,김신우,김성민,백경란,이남용,송재훈 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.3

목적 : 폐렴구균은 인체에서 폐렴, 수막염 및 패혈증 등을 일으키는 중요한 병원균으로 현재 전 세계적으로 항균제 내성이 큰 문제가 되고 있다. 하지만 폐렴구균의 항균제 내성에 따라 병독성이 어떻게 변화하는지에 대해서는 구체적으로 알려져 있지 않다. 이에 기능적 및 구조적 분석을 통하여 폐렴구균의 주요 병독성 인자인 pneumolysin의 병인론적 역할을 규명하고자 하였다. 방법 : 임상 검체에서 분리된 페니실링 감수성 균주 20주와 내성 균주 20주를 대상으로 하였다. Pneumolysin의 세포 독성의 변화를 관찰하기 위하여 각각의 균주들의 용혈능을 측정하였고, pneumolysin 유전자를 중합효소 연쇄반응으로 증폭한 후 증폭 산물의 유전자 구조를 분석하였다. 결과 : 페니실린 감수성 균주와 내성 균주간의 용혈능은 유의한 차이를 보이지 않았으나, 일부 용혈능이 매우 낮은 균주에서 Lys152→Thr, Thr-172→Ile, Lys-224→Arg와 같은 변이가 관찰되었다. 결론: pneumolysin의 세포 독성의 변화는 항균제 내성 정도와는 무관하였으나, 일부 용혈능이 저하된 균주에서 발견된 pneumolysin 유전자의 변이가 pneumolysin의 세포 독성에 영향을 주는 것으로 보인다. Background : Pnumolysin (Ply) is one of the most important virulence factors of Streptococcus pneumoniae. To investigate the functional and structural variation of Ply, hemolytic activity (HA) and gene sequences of pneumolvsin were determined. Methods : A total of 40 invasive pneumococcal isolated (20 penicillin-susceptible & 20-resistant strains) were analyzed. HA of each isolate was measured in crude extracts (1×10^8 CFU/mL) hourly from the time of inoculation to 9h. Crude extracts (50㎕) and DTT buffer (100㎕) were serially diluted in 96-well plate and mixed with 1% sheep blood (50㎕). HA was represented as the reciprocal of the greatest dilution, which resulted in the complete lysis. Two sets of oligonucleotide primers were used to amplify a 1,474-bp fragment containing the coding region and a 578-bp fragment of upstream region of ply gene, respectively. Amplified products were directly sequenced. Results : HA showed a wide variation from 0 to 87,480 regardiess of penicillin MICs, serotypes or specimen sources. Two bacteremic strains showed completely no hemolytic activity. No significant differences in HA between penicillin-susceptible (Mean± SE : 15,468± 4,693) and penicillin-resistant strains (21,384± 4,087) were found (p > 0.05).Sequencing of the coding region showed unique alterations in amino acids in strains with markedly reduced hemolytic activity (≤ 40): Thr-172-Ile and Lys-224-Arg. However, upstream region of ply gene was highly conserved. Conclusions : Ply activity was not related with antibiotic resistance. Absence of HA in some strains was associated with unique alterations in amino acid sequences in ply gene. Relationnship between genomic alteration and functional changes in pneumolysin should be further investigated.

Pichia ohmeri에 의한 악성외이도염 1예

손준성,신상엽,민태훈,장현하,정숙인,오원섭,김성민,백경란,송재훈 대한감염학회 2002 감염 Vol.34 No.5

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.