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급성담관염의 원인균주와 항생제감수성의 시간흐름에 따른 변화
권정석 ( Jeong Seok Kwon ),한지민 ( Ji Min Han ),김태원 ( Tae Won Kim ),오지혜 ( Ji Hye Oh ),권현희 ( Hyun Hee Kwon ),정진태 ( Jin Tae Jung ),권중구 ( Joong Goo Kwon ),김은영 ( Eun Young Kim ),김호각 ( Ho Gak Kim ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Background/Aims: We evaluated changes of causative pathogen in acute cholangitis and their antimicrobial susceptibility over six years and differences between community-acquired and hospital-acquired acute cholangitis at our institution. Methods: Medical records of 1,596 patients with acute cholangitis and biliary drainage between August 2006 and August 2012 were reviewed retrospectively. Cases were divided according to time: period 1 (August 2006-December 2008, n=645, 40.4%), period 2 (January 2009-August 2012, n=951, 59.6%). Cases were divided according to community-acquired cholangitis (n=1,397, 87.5%) and hospital-acquired cholangitis (n=199, 12.5%). Causative pathogens and antimicrobial susceptibility were investigated in each group. Results: Causative pathogen was isolated from bile culture in 1,520 out of 1,596 cases (95.2%). The three most frequently isolated Gram-negative bacteria were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n=485, 30.4%), E. coli (n=237, 13.2%), and Citrobacter freundii (n=110, 6.9%). Between periods 1 and 2, prevalence of ESBL-producing E. coli and Klebsiella pneumoniae did not show significant change (36.7% vs. 32.1%, p=0.073; 6.6% vs. 6.2%, p=0.732). C. freundii showed a significant increase from period 1 to period 2 (1.7% vs. 13.2%, p=0.000). In both time periods, imipenem was the antimicrobial agent showing the highest rate of susceptibility (93.3% vs. 93.9%, p=0.783). Higher prevalence of ESBL-producing E. coli and C. freundii was observed in the hospital-acquired cholangitis group (52.1% vs. 31.2%, p=0.000; 15.9% vs. 7.3%, p=0.001). Conclusions: The most common causative pathogen of acute cholangitis was ESBL-producing E. coli. Prevalence of C. freundii increased over the time period. Imipenem should be reserved as an alternative for resistant pathogens.
위부분절제술 후 발생하는 담도 확장 및 담석증의 임상적 의의
정석 ( Seok Jeong ),윤해리 ( Ha Rry Yoon ),권창일 ( Chang Il Kwon ),이태훈 ( Tae Hoon Lee ),한정호 ( Joung Ho Han ),송태준 ( Tae Jun Song ),황재철 ( Jae Chul Hwang ),김대중 ( Dae Jung Kim ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.1
Background/Aims: The well-organized study to support that increased cholelithiasis and bile duct dilatation can occur after gastrectomy has not been reported. The aim of this study was to determine the incidence of cholelithiasis and the degree of common bile duct (CBD) dilatation in patients undergoing subtotal gastrectomy, compared to those undergoing endoscopic treatment for gastric cancer. Methods: Patients who diagnosed with gastric cancer and received treatment at six academic referral centers were investigated for the incidence and time of cholelithiasis and the degree of CBD dilatation after treatment by analysis of 5-year follow-up CTs. The operation group underwent subtotal gastrectomy without vagotomy, while in the control group endoscopic treatmentwas administered for gastric cancer. Results: A total of 802 patients were enrolled in 5-year analysis (735 patients in the operation group and 67 patients in the control group). Cholelithiasis occurred in 47 patients (6.39%) in the operation group and 3 patients (4.48%) in the control group (p=0.7909). The incidences of cholelithiasis were 4.28% in Billoth-I and 7.89% in Billoth-II (p=0.0487). The diameter of proximal CBD and distal CBD increased by 1.11 mm and 1.41 mm, respectively, in the operation group, compared to 0.4 mm and 0.38 mm, respectively, in the control group (p<0.05). Patients with increased CBD dilatation more than 5 mm showed statistically significant increases in alkaline phosphatase and gamma-glutamyltransferase. Conclusions: The incidence of cholelithiasis was not increased due to subtotal gastrectomy without vagotomy, but the incidence was higher after Billoth-II compared to Billoth-I. In addition, significant change in the CBD diameter was observed after subtotal gastrectomy. (Korean J Gastroenterol 2015;66:33-40)
질산태 질소 정량을 위한 환원 증류법에서 Devarda’s Alloy의 입자크기 및 함량이 미치는 영향
정석호(Seok Ho Jung),권현재(Hyun Jae Kwon),정덕영(Doug Young Chung),한광현(Gwang Hyun Han) 韓國土壤肥料學會 2011 한국토양비료학회지 Vol.44 No.3
We analyzed the particle size distributions of three commercially available Devarda’s alloy (DA) products, tested the nitrate recoveries of each particle size category, and examined the amounts of DA required for 100% recovery by varying NO3−N concentration from 0.5 to 10 mg. We observed that use of DA coarser than 200 mesh resulted in poor analytical recovery (< 80%). While the tested alloys were considered to be fine enough (>90% of the particles were less than 100 mesh), the recovery dramatically declined from 80% to 10% in a high concentration range (4 to 10 mg N). Satisfactory recovery was obtained by increasing the amount of finer DA (less than 300 or 450 mesh). However, there was no quantitative relationship between the amount of fine DA and nitrate recovered. Generally, the amount of nitrate reduced per unit DA decreased as the recovery efficiency declined. These results suggest that a sufficient amount of DA must be determined based on particle size distribution, and that treatment of at least two levels of DA and comparison of the subsequent change in nitrate recovery is required for soils containing high levels of nitrate. In addition, further studies are encouraged to account for the observed stoichiometric dis-equivalence of recovered nitrate N per unit mass of DA.