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배수정,최귀전,김천수,이상락,김홍식,강진무,Bae, Soo Jung,Choi, Gui Jean,Kim, Chun Soo,Lee, Sang Lak,Kim, Heung Sik,Kang, Chin Moo 대한소아감염학회 1999 Pediatric Infection and Vaccine Vol.6 No.2
VRE 감염증은 항균제의 과다한 사용 후 출현하는 새로운 형태의 감염성 질환으로, 현재 심각한 임상 문제로 대두되고 있다. 최근 국내에서도 신경학적 장에나 당뇨병, 종양 등의 기저질환을 가진 성인 환자들에서 소수의 감염 예가 보고되고 있으나 소아기, 특히 신생아에서의 감염증은 잘 알려지지 않았다. 저자들은 생후 4일된 신생아에서 발생한 vancomycin 내성 E. faecalis 패혈증 l례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Vancomycin-resistant enterococcus(VRE) was first isolated from various specimens of patients with renal failure or leukemia in 1988. Thereafter VRE has been increasing gradually and became one of the clinically important palhogenic organisms currently. We experienced a case of E. faecalis sepsis in a 4 day old neonate. She was born at 39 weeks gestational age with 2,900gm weight by Cesarean section delivery due to breech presentation. She had had swelling and motion limitation of the left knee joint with fever for one day at age of 4 day and was transfered to our hospital. Ultrasonographic examination of her left knee joint showed some inflammatory change. E. faecalis was isolated from the blood. The organism showed resistance to vancomycin on drug susceptibility test using BHI agar screening test and disk diffusion method. After treatment with ampicillin-sulbactam for 3 weeks the baby was improved. Although VRE infection has been considered rare in Korea. considerable number of demonstrative studies about VRE isolation have been reported recently thus adequate countermeasures are needed to reduce the emergence and prevent nosocomial spreading of this organism.
제대 및 신생아 혈중 cytokine(IL₁β, IL6, TNF) 수치의 변화
강진무,김홍식,박인식,이형종 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3
분만방법에 따른 제대혈과 양수 그리고 감염 및 stress가 있는 신생아혈중과 세포성분을 배양한 상청액의 cytokine치를 ELISA법으로 측정하여 다음과 같은 성적을 얻었다. 제대혈중 IL₁β치는 질식 유도분만때가 질식 자연 분만, 응급 제왕절개 및 계획 제왕절개때보다 유의하게 높았다(p<0.001). 신생아 혈중 IL₁β치는 감염이 동반된 경우와 stress가 동반된 경우에 높았으며, 감염이 동반되었을 때가 stress보다 더 높게 나타났고, 저체중 출생아에서 높았다. 계획 제왕절개시의 제대혈 IL₁β치는 양수보다 낮았다. 질식자연 분만시 제대혈 세포상청액의 IL₁β 혈장치보다 높았고, 양자간에 유의한 상관관계를 보였다(r=0.92, p<0.05). 감염이 동반된 신생아에서 IL₁β치는 혈장치가 높은 경우 세포 상청액치는 낮고, 혈장치가 낮은 경우 세포 상청액치는 높았다. IL6는 감염이 있는 신생아 혈장과 세포 상청액, 양수 등에서 검출되었다. TNF는 감염이 있는 신생아 세포 상청액 8례중 3례에서 측정되었다 The cytokines, interleukin-1β(IL₁β), interleukin-6(IL6) and tumor necrosis factor(TNF) are important mediators of host response to stress and infection. Impaired immune reaction and febrile responses to the infection in newborn period may result from abnormal cytokine regulation and there were difference in the responses between newborn and adult due to the different cytokine regulation system. To investigate the cytokine regulation in different circumstances of the delivery and newborn conditions, the measurement of the levels of IL₁β,IL6 and TNF in cord blood, amniotic fluid and the blood of the newborn were performed, using enzyme linked immunosorbent assay(ELISA,R&D Co.). Cytokines of the supernatant of incubated cellular pellet were also measured. Cord blood IL₁β level was significantly higher in induced vaginal delivery than that of the normal vaginal, emergency, and elective cesarian section delivery(p<0.001). Plasma IL₁β level of the newborn with infection or stress was elevated and the level was higher in infection than that of the newborn with stress during delivery. Premature baby had higher level than normal newborn. Cord blood IL₁βlevel was lower than that of amniotic fluid in elective cesarian section delivery. In normal vaginal delivery, IL₁βlevel of the cellular supernatant was higher than that of the plasma and showed good correlation(r=0.92, p<0.05). In newborn with infection, plasma IL₁βlevel was high in the cases with low supernatant level and the plasma level was low in the cases with high supernatant IL₁β. IL6 was detcted from the plasma and cellular supernatant of the newborn with infection and the amniotic fluid. TNF was detected in cellular supernatant of 3 among 8 newborn with infection.
Austenitic Steel의 Dendrite 組織에 관한 연구
김홍식,김영홍,김명호 울산대학교 1976 연구논문집 Vol.7 No.1
본 실험에서는 dendrite 조직에 미치는 응고속도의 영향과 이들 조직에 따른 기계적 성질의 변화관계 및 그 이유를 austenitic steel인 AISI 304 stainless steel 에 대하여 조사하였다. 그 결과 다음의 결론을 구하였다. 1.dendrite arm spacing은 냉각속도가 감소할수록 커진다. 2.dendrite arm spacing이 작을수록 硬度(hardness)는 증가하며, 이는 탄화물[CrㆍFe)₄ C]의 interdendritic region 분포에 기인하는 것으로 보인다. The cooling rate dependence of the development of the dendrite structure in austenitic steel and the dffect of the dendrite structure on the mechanical properties of the austenitic steel have been investigated. And the following conclusions were obtained from the experimental results; 1.The dendrite arm spacing increases with decreasing cooling rate. 2.The hardness increases with decreasing dendrite arm spacing and this phenomena could be explained on the basis that carbide [CrㆍFe)₄C] is distributed in the interdendritic region.