서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

平肺湯이 Oleic acid로 誘發된 家犬의 急性 肺水腫에 미치는 영향

鄭在雨,韓相桓 圓光大學校 韓醫學硏究所 1992 원광한의학 Vol.2 No.1

Certain oriental medication have been shown to be effective in decreasing pulmonary vascular resistance and increasing cardiac output in primary pulmonary artery pressure secondary to pulmonary edema. So oleic acid was administered in 14 dogs in order to induce acute lung injury. And we studied the hemodynamecs and blood gas changes of Pyengpaetang(平肺湯) (50mg, 100mg) with continuous postive pressure was ventilation iv pulmonary edema. The pulmonary edema group, arterial oxygenation was improved after 5 and 10 cm H_2O PEEP (positive end expiratory pressure), but cardiovascular system was depressed. Blood pressure and cardiac output were decreased, and CVP, MPAP, PCWP were increased. In Pyengpaetang(50mg) group, mena aortic pressure was decreased and PCWP(pulmonary capillary wedge pressure)was decreased remarkably, while there was a significant increase in cardiac output. And there was improvement in PaO_2 and PaCO_2 without hemodynamic changes after applying 5 cm H_2O PEEP, but arterial blood gases (PaO_2, PaCO_2) were improved, while cardiovascular effects were depressed after 10cm H_2O PEEP. In Pyengpaetang (100mg) treated group, there was no significant hemodynamic change. But mena pulmonary arterial pressure was signifiacntly increased, and cardiac output was decreased signifiacntly after applying the more degree of PEEP. And blood gases were not changed significantly after applying the more degree of PEEP. The above results suggest that the effects of Pyengpaetang (50mg) group is superior to those of Pyengpaetang(100mg) group on the effects of himodynamics and gas exchanges in acute lung injury in dogs. So we can conclude that lower degree PEEP 5cm H_2O is more beneficial in Pyengpaetang (50mg) treated group.

페니실린 내성 폐렴구균 균혈증의 임상적 특성

정두련,송재훈,김은옥,류지소,이남용,이혁,백경란,김성민,배직현,우준희,김양수 대한감염학회 1997 감염 Vol.29 No.4

목적: 지역사회 획득 감염의 매우 흔한 원인균인 폐렴구균의 페니실린 및 다른 항균제에 대한 내성의 증가는 세계적으로 문제가 될 뿐 아니라 국내에서 더욱 큰 문제로 대두되고 있다. 본 연구는 항균제 내성 여부에 따른 폐렴구균 균혈증의 임상적 특성 및 위험 요인를 분석하여 항균제 내성의 임상적 의미를 조사하고자 시행되었다. 방법:1989년부터 1994년까지의 폐렴구균 균혈증 41례를 대상으로 하여 의무기록지를 조사하였다. 균주의 항균제 감수성 검사는 oxacillin 디스크 확산법으로 페니실린 내성 여부를 거사한 후, 한천 희석법을 이용하여 페니실린을 비롯한 11개의 항균제의 MIC (minimal inhibitory concentration)를 구하고 감수성 여부를 판정하였다. 결과: 41균주 중 68.3%가 페니실린에 대하여 내성(중등도 12.2%, 고도 56.1%)을 보였으며 다제내성률은 61%였다. 특히 소아에서는 100%(고도 88.2%)의 내성률을 보여 성인보다 내성률이 더 높았다. 페니실린 내성 균주는 대부분 다른 β-lactam 항균제에도 내성을 보였으며 특히 페니실린 고도 내성 균주는 cefotaxime, ceftriaxone에 대하여 100% 내성을 보였고 imipenem에 대해서도 95.5%의 중등도 내성률을 보였다. 혈청형은 19와 23이 많았고 그 외에 6이 있었다. 임상적 특성의 분석상 환자들의 연령분포는 3개월부터 82세까지였으며 기저질환을 가지고 있는 환자가 56%이었으며 지역사회 획득 감염이 71%였다. 균혈증의 일차감염원은 폐렴(22례, 54%)과 수막염(5례, 12%)이 가장 많았다. 페니실린 내성의 위험요인으로는 소아 연령만이 유의한 요인으로 분석되었다. 항균요법에 대한 반응을 볼 때 실패한 경우는 고도 내성 군의 20%에서만 있었으며 병원내 총사망률은 페니실린 감수성 군이 30%, 중등도 내성 군이 20%, 고도 내성 군이 13.6%로서 유의한 차이는 없었다. 결론: 페니실린 내성 폐렴구균은 국내에 만연하고 있으며 높은 다제내성률을 보였다. 이들은 대개 지역 사회 획득 감염을 일으키는데 균혈증의 경우 그 사망률은 내성 여부에 따른 차이를 보이지 않았다. 소아연령만이 페니실린 내성의 위험요인으로 분석되었다. Background: The emergence of penicillin-resistant Streptococcus pneumoniae (PRSP) poses serious therapeutic problem in clinical practice, especially in cases with bacteremia or meningitis. Methods: To investigate clinical characteristics of bacteremic pneumococcal diseases due to PRSP, we retrospectively analyzed 41 cases with cocumented bacteremic diseases seen in a tertiary care hospital between 1989 and 1994. Results: Agar dilution test of 41 strains isolated showed that 68.3% of S. pneumoniae were PRSP [high-level resistance(R) 56.1%, intermediate resistance(I) 12.2%]. High-level resistant strains were not susceptible to other β-lactam agents, whereas isolates of penicillin-susceptible S. pneumoniae(PSSP) were uniformly susceptible to all β-lactam agents. Predominant serogroups of PRSP were 19, 23, and 6. Bacteremic diseases caused by PRSP included pneumonia (22), meningitis (5), peritonitis (3), acute otitis media (2), acute tonsillitis (2), endocarditis (1), pyelonephritis(1), and primary bacteremia(5). Children were more likely to be infected with PRSP with high-level or intermediately resistant strains than were adults(P=0.0001), but no differences were seen between PRSP and PSSP regarding sex. previous antibiotic history, previous hospitalization, and underlying immunocompromised conditions. Most cases were community-acquired (R 78.3%, I 60%, S 61.5%). Fatality rates of patients infected with PRSP were not different significantly from PSSP (22.6% vs. 30%). However, most fatal cases had underlying immunocompromised conditions. Conclusion: PRSP is widely prevalent in Korea and shows resistance to most antibiotics. It causes community-acquired bacteremic diseases with poor outcomes, but there was no difference in mortality between patients infected with PRSP and PSSP. Pediatric age was the only risk factor for penicillin resistance.

기초군사훈련이 체력과 신체구성에 미치는 영향

정영수,우재홍,박익렬,박성태,김연수 서울대학교 체육연구소 2000 서울大學校 體育硏究所論集 Vol.21 No.2

The purpose of this study was to investigate the effects of basic military training on the physical fitness and body composition of midshipmen. The test on the twenty subjects were done twice at the beginning and end of their 5-week's basic training with same variables and order in both tests in Naval Academy, Jin-Hae. The source variables of physical fitness in the test were muscle strength, muscle endurance, muscle power, agility, balance, flexibility and so on. The source variable of body composition were body weight, fat-free mass, percentage of body fat and so on. The sum of abdomen, triceps, and suprailium skinfold thickness were measured in order to assess alterations in fat-free mass and percentage of body fat. Paired sample t-test was used for data analysis and the significance level was set at the 0.05. The results of this study were as follow: 1.muscle endurance, balance, flexibility, endurance time(p〈0.01) and muscle power(p〈0.05) were increased after training programme. 2.muscle strength and agility showed tendency to increase. 3.Body weight and free-fat mass were increased but % body fat were decreased after training programme(p〈0.01). It might be concluded from the test that basic military training in Korean Naval Academy is effective for the increase physical fitness, cardiopulmonary function, fat-free mass and for the reduce of body fat percentage.

7개 대학 병원에서 조사한 지역사회 폐렴의 원인균

정문현,김성민,강문원,최희정,정희진,이경원,한성우,송재훈,신형식,김의종,최강원,김민자,박승철,배현주,정윤섭,김준명,백경란,신완식,이규만,김양리 대한감염학회 1997 감염 Vol.29 No.5

목 적 : 폐렴은 많이 발생하면서 사망률이 크게 줄지 않는 질환이며, 이를 적절히 치료하기 위해서는 원인균의 상대적 빈도, 기저 질환에 따른 변화, 항균제 내성률, 사망에 관련된 인자들을 알아야 한다. 원인균의 빈도는 지역마다 차이가 있고 국내에서는 항균제 내성률이 높아 지역사회에서 발생한 폐렴을 치료하기 위한 경험적 항균제 선택에 도움이 되기 위해 서울 소재 6개 대학 병원과 천안의 1개 대학 병원이 참여하여 위의 사항들에 대해 조사를 하였다. 방 법 : 1995년에 내과에 입원했던 16세 이상 환자를 대상으로 했다. 퇴원 진단명이 폐렴 또는 폐결핵인 병록지을 찾았고, 이중에서 병원 감염을 제외하였다. 특이도를 높이기 위해, 이들 중에서 호흡기 증상이 있고 발열이나 저체온이 있으면서 흉부 X-선에서 이상 음영이 있는 환자만을 대상으로 했다. 폐결핵은 위의 기준에 입원 초기에 항균제 치료를 하고 입원 7일 이후에야 항결핵제가 투여된 경우만을 폐렴의 원인균으로 하였다. 혈액 배양에서 양성, 객담에서 항상균이나 M. tuberculosis가 증명된 경우, 혈청학적으로 항체가가 4배 이상 증가된 경우, 조직에서 원인균이 진단된 경우는 확정(definitive) 원인균으로 하였고, 객담에서 배양된 균이 그람 도말과 일치할때, 항결액제에 대한 반응으로 진단한 폐결핵, 단일 항체가 양성이고 이에 대해 항균제를 사용했을 때는 가능(probable) 원인균으로 정의하였다. 다세균 감염균은 각각 다 른 원인균으로 처리하였다. 임상 조사와 함께 임상병리과에서 S. pneumoniae, H. influenzae, M. catarrhalis, mycoplasma, 항상균에 대해 검사 의뢰 건수, 배양 양성수, 항균제 감수성 결과를 조사하였다. 결 과 : 폐렴의 증례 정의에 부합하지 않은 135명과 폐결핵의 정의에 해당하지 않는 230명을 제외하고 남은 246명의 평균 나이는 58.2세이고 남성이 142명(58.2%) 이었고, 71%의 환자에서 기저 질환이 있었다. 진단 방법의 시행 횟수는 혈액 배양 77.6%, 혈청 검사 18.3%, 기관지경 검사는 4.1%였고, 세균의 항원 검사를 한 예는 없었다. 원인균이 밝혀진 예는 77명(31.3%)이었다. 다세균 감염이 4명에서 있었고, 원인균의 상대적 빈도는 결핵 20명(확정 17, 가능 3: 6개 병원 자료), 폐렴구균 18(확정8 가능 10)명과 폐렴구균이 아닌 Streptococcus 3명 (모두 확정), H. influenzae 11명(모두 가능), 그람음성간균 11명(확정 7, 가능 4) (K. pneumoniae 8건), Mycoplasma 5명(확정 1, 가능 4), S. aureus 4명(확정 2, 가능 2), mucormycosis 1명(확정)이었다. 평균 입원 기간은 19일이고, 중환자실 입원률과 인공 호흡기 사용율은 각각 18%와 9.3%였다. 사망률은 13.8%였고 사망까지 평균 기간은 14.6일 이었다. 다변량 분석에서 사망을 예측할 수 있는 인자는 저체온과 빈호흡이었다. 임상병리과에서 배양되었던 모든 폐렴구균의 Penicillin 내성률은 서울 3개 병원에서 82-88%, 천안에서 72%였다. 폐렴 환자의 혈액에서 배양된 7주는 모두 Penicillin에 감수성이 있었다. K. pneumoniae 8주 모두 cefotaxime과 gentamicin에 감수성을 보였다. 결 론 : 후향적 조사이고 병원마다 원인균 진단에 차이가 있지만, 원인이 밝혀진 경우에는 결핵과 폐렴균이 흔하였고, 무균 부위에서 배양된 폐렴구균의 항균제 내성률은 낮았다. 원인이 밝혀지지 않은 경우가 많고, 혈청검사로 진단되는 원인균이 드물며, 분리균주가 적어 항균제 내성 정도를 추정하기 어려워, 이를 밝히기 위한 전향적 조사가 필요하다. Background : Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitation of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. Methods : medical records of adults (>15 years of age) hospitalized for CAP or pulmonary tuberculosis between April 1995 and March 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer of antibodies to “atypical”pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum withcompatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinucal response to anti- tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and Mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of resiratory pathogens from all body sites, and their clinical significance were evaluated. Results: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria,246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171(71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44(18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable: E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae and A. baumannii and K. pneumonias), S. aureus (2 definite and 2 probable) , and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8isolates). therates of admission to the intensive care unitand of using assisted ventilation were 18% and 9.3%, respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but seven isolated from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolated of k> pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. Conclusion: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which well be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.

음악적 재능과 성격적 특징

정진우,박제경,염택구 최신의학사 1973 最新醫學 Vol.16 No.1

태권도 품새 수련이 아동의 심박수, 심근산소소비량, 에너지 대사에 미치는 영향

정성태,전태원,박익렬,정덕조,우재홍,이광희,이동기,강현주 서울대학교 체육연구소 2000 서울大學校 體育硏究所論集 Vol.21 No.1

The Taegeuk Poomse 1 through 8 of Taekwondo are based upon eight major branches of philosophical theories. The propose of this study was to investigate the nfluence of Taekwondo poomse trainning on heart rate, MVO2, energy metabolism in primary school students. Subjects for this study were eight male the fifth∼sixth grades students who participated in exercise program consist of Taekwondo poomse trainning in dojang which is located in Shinlim-2dong, Kwanak-Gu, Seoul(12.7± 0.5years, 150.8 ±4.6cm, 45.1 ± 9.4kg, 24.9 ± 9trainning length). The results of thet this study are as follows: 1) The average of heart rate was Taegeuk Poomse 1 through 8 of Taekwondo 90.57± 4.gbeats/min in rest and 139.7 ± 17.5beats/min in exercise. The minimum heart rate was 89.0±2.8, peak heart rate was 167.1 ±6.4 in exercise. It was ranged from 42% to 80% 2) of the max heart rate and ranged 42 to 65%HRmax. Taegeuk 1 Jang was differenced with others Jangs significantly(p<0.05), 2) The time of the Taegeuk 1 through 8 Jang of Taekwondo was 5minutes 12seconds. Heart rate was ranged from 90.6 ± 7.85beats/min to 171.8 ±8.Ibeats/min and increased linearly. 3) The average of the MVO2 was 11.1 ±0.78mmHg · bpm-3 in rest and 19.1 ± 1.2mmHg ㆍbpm-3 in exercise. MVO2 was ranged from 10.5mmHg · bpm-3 to 20.3mmHg · bpm-3. There were not difference between Taegeuk Poomses(p<0.05). 4) The energy metabolism was as follows: Mean VO2 Respiratory exchange ratio, energy consumption were 0.51(V02L/min),0.71(RQ),2.32Ckca1/min) in rest respectively. but In exercise Mean VO2 Respiratory exchange ratio, energy consumption were 0.89 ± 0.18( V 02L/min), 0.79±0.08(RQ), 4.26±0.51(kcal/min) respectively . The difference was only between Taegeuk 1 Jang and Taegeuk 3 Jang(p<0.05). This study showed that the Taekwondo Poomse trainning was proper exercise for fitness, body composition and weight control in normal, abnormal(obese) children because the Taekwondo trainning are dynamic and exciting sport.

K 강선 및 긴장대 강선을 이용한 원위 쇄골 제 2형 골절의 치료

정환용,이우석,전택수,김대환,김광균,임재우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 윈위부 제 Ⅱ형 골절의 치료에 있어 견봉 쇄골 관절을 통과하지 않고 직접 골편을 고정시키는 K 강선 및 긴장대 강선을 이용한 고정술로 치료한 환자에서 임상 결과를 후향적으로 분석하여 보고하고자 한다. 대상 및 방법: 2000년 5월부터 2001년 5월까지 쇄골 원위부 제 Ⅱ형 골절로 관혈적 정복술 및 K 강선 및 긴장대 강선을 이용한 고정술을 실시한 12례 중 최소 1년 이상 추시가 가능한 11례를 대상으로 하였다. 임상적 평가를 위해 최종 추시에서 변형된 견관절 기능 평가법을 사용하여 결과를 분석하였고 골유합 상태, 합병증, 견관절 운동범위를 측정하였다. 결 과: 전례에서 골유합을 얻었으며, 수술 후 골 유합까지의 기간은 평균 10주 (8~12주)였다. 최종 추시 상 견관절의 운동범위는 모두 정상 소견이었고, 변형된 견관절 기능 평가상 우수 9례, 양호 2례였다. 결 론: 쇄골 원위부 제 Ⅱ형 골절에서 K 강선 및 긴장대 강선을 이용한 고정술은 좋은 치료 방법 중 하나로 사료된다. Purpose: This is retrospective study to analyze the clinical results of the usefulness of K-wires and tension band wiring that fix the fracture fragment directly without passing the acromioclavicular joint in distal clacivle type Ⅱ fractures. Materials and Methods: From May 2000 to May 2001, eleven patients with distal clavicle type Ⅱ fracture were treated by open reduction and internal fixation with K-wires and tension band wiring. The clinical results were analyzed according to modified shoulder rating scale for distal clavicle freacture. Radiological union, complication, and range of motion of the shoulder were assessed. Results: All fractures were united at 10 weeks (8~12 weeks) in average. Finally, full range of motion of the shoulder joint was achieved in all patients. No complication was found and the modified shoulder rating scale for distal clavicle fracture were as follows: excellent 9 and good 2. Conclusion: K-wires and tension band wiring can be a good treatment method for distal clavicle type Ⅱ fractures.

磁束 制御型 PWM INVERTER에 의한 誘導 電動機의 可變速 制御

禹靖仁,文在星 동아대학교 공과대학 부설 한국자원개발연구소 1987 硏究報告 Vol.11 No.1

This paper attempts driving for minimized riffle torque of three phase Induction motor with optimized switching pattern of Pulsewidth-modulated Inverter by a microcomputer, this pattern is obtained by a new founded 1-m axis on the vector of instantaneous linkage flux locus and dispersive constant of riffle torque that is made from harmonic output currents of PWM Inverter. In this paper, Althogh the actual linkage flux locus is demanded high frequency switching for obeying a ideal limkage flux locus in the PWM Inverter, we find out smoothed variable-speed controlling by the optimized switching pattern on the software of microcomputer(Z-80).

Metallurgical Process for Total Recovery of All Constituent Metals from Copper Anode Slimes: A Review of Established Technologies and Current Progress

Jae‑chun Lee,Kurniawan Kurniawan,Kyeong Woo Chung,Sookyung Kim 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.7

Copper anode slimes, the by-product of the copper electrorefining process, have been the subject of extensive investigationfor recovering precious metals viz., Au, Ag, Pt and Pd, in addition to being the main source of rare/energy-critical elementssuch as Se and Te. There have been various approaches aiming at the development of extraction processes involving thermaland aqueous approaches and their combination. In this paper, the literature relating to the treatments of copper anode slimeis compiled to present the underlying concept for the total recovery of all valuable metals from anode slimes. The industrialand proposed scenarios gathered from various sources show that the basis of applying different streams essentially dependson the concentration of copper and selenium in the slimes. Copper anode slime processing has a history of being in a developmentperiod, though at times showing overlaps. The discussion of each metallurgical process is basically explained bythermodynamic analysis using suitable software as well as fundamentals of the chemistry. Recent progress is highlightedand compared to the established technologies with regard to environmental impact and economic consideration/feasibility. This discussion is followed by the construction of a conceptual flowsheet on the progress currently made. It is expected thatfurther work regarding metal recovery from copper anode slimes would objectively shorten the number of stages for thepretreatment as well as metal separation from leach solutions.