Lidocaine, Thrombin, Epinephrine 의 항균효과

김진우,이동건,전혜선,김승준,김석찬,안중현,김치홍,권순석,김영균,김관형,문화식,신완식,송정섭,박성학 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 기관지내시경 검사에서 흔히 사용되는 국소마취제인 lidocaine과 내시경시 지혈목적으로 사용되는 thrombin과 epinephrine이 각종 균주에 미치는 항균효과에 대해 알아보고자 하였다. 재료 및 방법 : 균주는 가톨릭대학교 성모병원에서 2004년 3월부터 2004년 9월까지 임상검체 에서 동정된 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 각각 42, 42, 42, 43주를 대상으로 하였다. Lidocaine, thrombin, epinephrine 감수성 검사는 National Committee for Clinical Laboratory Standards (NCCLS, 2002)의 기준에 따랐다. 결과 : Lidocaine은 S. aureus, S. pneumoniae, P. aeruginosa에서 MIC_(50), MIC_(90) 모두 20,000 ㎍/mL 이었다. K. pneumoniae는 각각 10,000 ㎍/mL이었다. Thrombin은 S. aureus와 P. aeruginosa에서 MIC50 500 lU/mL 과 MIC_(90) 500 IU/mL 이상이었고, K. pneumoniae에서는 MIC_(50)과 MIC_(90)이 모두 500 lU/mL이상이었으나 S. pneumoniae에서는 MIC_(50)과 MIC_(90)은 125 IU/mL이었다. Epinephrine은 K. pneumoniae, S. pneumoniae에 대한 MIC_(50), MIC_(90)가 모두 >500 ㎍/mL이었고, S. aureus와 P. aeruginosa에 대한 MIC_(50), MIC_(90)가 모두 500 ㎍/mL이었다. 결론 : 기관지 내시경 검사에서 흔히 쓰이는 lidocaine, thrombin, epinephrine 등의 약제들이 호흡기 질환의 흔한 병원균인 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 균주들에 대해 항균 효과가 있을 수 있어 세균배양검사에 영향을 미칠 수 있겠다. Background : We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. Materials and Methods : The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. Result : MIC_(50) and MIC_(90) of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 ㎍/mL and that for K. pneumoniae were 10,000 ㎍/mL. MIC_(50) and MIC_(90) of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC_(50) and MIC_(90) of epinephrine for K. pneumoniae and S. pneumoniae were above 500 ㎍/mL; that for S. aureus and P. aeruginosa were 500 ㎍/mL. Conclusion : We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.

The Structure Renewal of the Korean church: With Special Analysis Through Paul Hievert's Set Theory

Kim, Hong-Kwan 한국기독교학회 2006 한국기독교신학논총 Vol.45 No.-

The Structure Renewal of the Korean Church: With Special Analysis through Paul Hieberts Set Theory Kim, Hong-Kwan (Mokwon Univ., Missiology) This study is an attempt to explpore the structural renewal of the Korean churches. In order to analyze the structure of Korean churches will be used Paul Hiebert set theory. On the basis of Hieberts theory, Korean churches can be judged to be affected by bounded set thinking. Although the world is changing more rapidly than ever before, most Korean churches seem to be stuck in time, clinging to tradition and structures at the expense of fulfilling the biblical mission. Korean churches are in trouble. Using bounded set theory, three structural characteristics of Korean churches will be delineated: local church centeredness, hierarchical structure and leadership, and institutionalization.Korean churches have had difficulty in communicating the gospel in an economically, politically and culturally changing society. Looking at this situation, it seems that Korean churches have not responded adequately to the changing culture. They have not sufficiently examined their effectiveness in ministry to people in a changing socio-cultural context. Consequently, Korean churches are experiencing a plateau in growth and some are even experiencing a stage of stagnation. One factor in Korean church decline is that the structure of church is more serious than others. The role and site of structe in mission and ministry is very important. In this paper, I would like to investigate an issue related to church renewal and structure in the missional perpectives. What is the effective church structure for evangelism of the unchurched in the Korean context?

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,

인체 대장암 및 자궁경부암에서 PCR-SSCP법을 이용한 Ki-ras 암유전자의 점돌연변이에 관한 연구

박영홍,백낙환,김현찬,김상효,홍관희,김기태,이기영 인제대학교 1994 仁濟醫學 Vol.15 No.2

인체 대장암 20례와 자궁경부암 10례의 암조직을 대상으로 c-Ki-ras 유전자 codon 12와 13에서의 점돌연변이를 알아보고자 polymerase chain reaction(PCR)과 single-strand conformation polymorphism(SSCP) 검사법을 시행하였다. 대장암의 경우 20례중 9례(45%)에서, 자궁경부암의 경우 10례중 1례(10%)에서 양성으로 나왔다. 대장암에서는 codon 12에서 GGT가 TGT로의 치환이 4례로서 가장 많았으며, AGT, CGT로의 치환이 각 1례였고 codon 13에서는 GGC가 GAC로의 치환이 2례, TGC로의 치환이 1례인 것으로 나타났다. 자궁경부암의 경우 codon 12에서 GGT가 AGT로의 치환이 1례인 것으로 나타났다. In an attempt to clarify the role of genetic alteration in the genesis of human colorectal and cervical cancers, tissue specimens from 20 patients with colorectal cancer and 10 patients with cervical cancer were examined for the presence of point mutation in K-ras2 exon 1 by single strand conformation polymorphism analysis of PCR product. Exon I of c-Ki-ras2 was amplified by polymerase chain reaction(PCR) and comparison was made between the normal and mutated genes by nondenaturing polyacrylamide gel electrophoresis(PAGE) of PCR product and nucleotide sequence analysis using asymmetric PCR with direct sequencing. Genomic DNA from white blood cells were used as normal control and those from A427 cell line were used as mutated control. 1.PCR product from A427 cell line showed a distinct migration shift pattern compared to the normal control in PAGE and the direct sequencing indicated that nucleotide sequence of codon 12 was mutated from GGT to GAT. In addition, there was a loss of normal allele in A427 cell line. 2.PCR product from 9 cases(45%) out of a 20 colon cancer patients showed migration shifts in PAGE, and all of these 9 patients invariably demonstrated mutation of ras gene, either in codon 12(6 cases:30%) or 13(3 cases:15%). The base substitutions in codon 12 were: from GGT to AGT(1), CGT(1), or TGT(4). Base changes in codon 13 were from GGC to TGC(1) or GAC(2). 3.PCR product from 1 cases(10%) out of a 10 cervical cancer patients showed migration shrifts in PAGE, Invariably demonstrated mutation of ras gene in codon 12. The base substitutions was from GGT to AGT(1) TQE incidence of point mutation of c-Ki-ras in colon cancer was high, however, it was low in cervical cancer, which showed the relation of ruts gene mutation with colon cancer. PCR -SSCP analysis is a simple, rapid and efficient method of detection of point mutation, especially when dealing with multiple samples.

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.

Complication of Intraoperative Radiation Therapy (IORT) in Gastric Cancer

김명세(Myung Se Kim),김성규(Sung Kyu Kim),송선교(Sung Kyo Song),김홍진(Hong Jin Kim),권굉보(Koing Bo Kwan),김흥대(Heung Dae Kim) 대한방사선종양학회 1992 Radiation Oncology Journal Vol.10 No.2

영남대학교 의료원 치료방사선과에서 1988년 6월 15일에 위함 환자의 수술중 방사선치료를 시작한 이래 1992년 8월 30일까지 총 58예에서 시도하여 그중 53예에서 IORT를 실시하였으며, 정기적인 추적검사에서 한명의 국소개발 환자도 보고되지 않고 있다. 출혈(3예), 장관폐쇄(3예), 폐혈증(2예), 골수기능저차(1예)를 포함한 총 9예(17%)의 합병증이 보고되었고, 이중 6예(13%)가 사망하였다. IORT(1500cGy), 외부 방사선치료 (-4500cGy)와 강한 항암제를 병합치료 하였음에도 불구하고 주등(수술과 항암제 치료)의 25.2%, 김등(수술 불가능한 환자에서 항암제 투여)의 18%, 리등(수술)의 18.5%, Kraming등(IORT 2800-3500cGy)의 35.3%에 비해 낮은 합병증을 보여 IORT가 위암의 치료에 공헌할 수 있음을 시사하였다. 그러나 비교적 높은 치사율(11.3%)은 더욱 세심한 수술수기 및 수술 후 환자의 치료가 필요하며 외부 방사선치료와 항암제치료의 적절한 시기 조절 및 치료선량의 가감이 필요할 것으로 생각된다. Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and increase distant metastasis free survival. IORT is the modality which could increase local control without increasing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988 and performed 53 IORT in patients with gastric cancer. No local failure had been reported including interstinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's 25.2% (chemotherapy + operation), Kim's 18% (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500cGy), external irradiation (--4500cGy) and extensive chemotherapy (FAM, 5FU + MMC, BACOP). Our data encouraged us to re-inforce further IORT in stomach cancer treatment.

멧돼지 생식후 발생한 선모충증의 가족 내 집단발생사례

김에스더,편래현,박지한,김강호,최일,박홍훈,이용희,용태순,홍성관 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

선모충증은 전 세계적으로 발생하는 기생충 인수공통감염의 한로 선모충의 유충에 감염된 육류를 덜 익혀 섭식시 발생하며 감염 초기에 설사, 복통의 증상이 나타나며 후기에 유충의 체내 이행으로 발열, 근염, 안검 부종 등이 동반된다. 확진은 근육 생검을 하여 피포 유충을 확인하는 것이고 최근에는 특이 항체를 측정하거나 유전자 검사와 같은 다양한 검사가 시도되고 있다. 저자 등은 4명의 한 가족이 야생 멧돼지를 생식한 후 선모충증의 전형적인 임상 증상 및 검사 소견을 보인 가족 내 집단발생사례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Trichinosis is a worldwide parasitic infection caused by ingesting an uncooked raw meat containing viable larvae of nematode Trichinella. Although most cases have been reported in Western countries, the incidence has decreased due to strict control of meat handlings and improved hygiene in these countries. In Korea, the first case of Trichinella spiralis was reported in a patient who ingested an uncooked badger. We have also experienced four cases of Trichinella spiralis infestation among family members who showed typical clinical manifestations and laboratory findings after ingesting raw wild swine meat, and herein report the finding.

우수여자 유도선수들의 연간 트레이닝과 디트레이닝에 따른 무산소성 역치의 변화

홍관이,정정진,김학렬,김기진,조현철,손태열,노성규 龍仁大學校 體育科學硏究所 1992 體育科學硏究論叢 Vol.2 No.1

The seasonal variance for estimate of exercise intensity, energy expenditure, maximal oxygen uptake and anaerobic threshold of elite women judo players(Group Ⅰ:4,Group Ⅱ: 4) was measured during 3,5,7,9,10month. The results of this study is as follows. 1. Exercise intensity by %HRmax during seasonal training was shown range of 56.45-73.62, 65.56-82.15, 80.03-86.62, 62.06-68.83%HRmax, respectiveley, from 3 to 9month in the warm up, additional exercise, main exercise and cooling down. 2. Energy expenditure per min during seasonal training was shown range of 4.09-7.96, 5.41-8.66, 8.95-9.90 and 5.05-6.41Kcal/min, respectiveley, from 3 to 9month in the warn up, additional exercise, main exercise, main exercsie and cooling down. 3. Changes of maximal oxygen uptake(VO₂max)during seasonal training and detraining not significant difference between both group, and in the seasonal variance. However, maximal heart rate during detraining expressed significant difference(p<0.05) between both group. 4. Anaerobic threshold levels during seasonal training and detraining not significant difference between both group, and in the seasonal variance. However, AT-VE(1/min) and AT- work time(min) of group Ⅱ expressed significant difference(p<0.01) in the seasonal variance.

自然膣式 分娩한 滿朔兒의 臍帶血 酸一鹽基値 平衡 및 가스 分壓의 正常 役値 設定

김영미,홍관표,정혁 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

The increasing interest in the use of umbilical cord acid-base determinations to assess intraparturn events makes it important to define more precisely the normal values of these parameters. Therefore this study was performed to obtain normal values of pH, PCO_(2), PO_(2), and bicarbonate in umbilical artery and vein. Cord blood acid-base values were determined from normal infants born after uncomplicated labor and vaginal deliveries at 38 to 41 weeks' gestation and infants had normal base fetal heart rate and Apgar score≥7 at 1 minute. The results were summarized as follow, 1) Mean umbilical arterial values ± SD for the parameters studied were : pH 7.25±0.09, PCO_(2) 52.5±9.7 mmHg, PO_(2) 17.0±5.1 mmHg and bicarbonate 22.9±2.8mmol/L, 2) Mean umbilical venous values were : pH 7.29±0.08, PCO_(2) 46.0±8.9mmHg, PO_(2) 22.6±6.7mmHg and bicarbonate 22.1±2.6 mmol/L. We anticipate that increasing attention will be focused on the acid-base status of the newbom infant. This biochemical status will then be retrospectively correlated with obstetric management and anterospectively correlated with short-and long-term neonatal outcome. Normal mean values and standard deviations for umbilical artery and vein pH, PCO_(2), PO_(2) and bicarbonate have been provided 39 selected vaginal deliveries.

자전거 에르고미터운동시 유ㆍ무산소성 역치수준의 근전도 변화

김기진,조현철,홍관이,정정진,손태열 龍仁大學校 體育科學硏究所 1991 體育科學硏究論叢 Vol.1 No.1

The aim of present study is investigate the change of IEMG and PEMG in the aerobic, anaerobic threshold by ventilation an blood locate concentration. Subjects of this study is adult sedentary men of age 32.18±4.28yrs. Subjects performed an incremental test on the bicycle ergometer from an initial work load of 0.5KP(60 rpm) to exhaustion by 3-min steps of 0.5KP. The results of this study was as follows: 1. The levels of relative exercises load in the ventilation, lactate, PEMG and IEMG by aerobic threshold were appeared 39.88±15.62%, 39.66±13.05%, 34.31±13.74% and 36.69±13.05%, respectively. It was not significant difference between variables. 2. The levels of relative exercise load in the ventilation, lactate, PEMG and IEMG by aerobic threshold were appeared 70.02±7.72%, 65.69±8.82%, 64.61±8.65% and 69.64±9.76%, respectively. It was not significant difference between variables. In this results above, It is considered that analysis methods by non-linear increase point of PEMG and IEMG related to both respiratory gas variables, blood lactate accumulation type and muscle function, muscle fiber recruitment type for determination of aerobic and anaerobic threshold.