뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성

도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.

대구시 하수도 설계를 위한 기본 조사연구

조병하,이상렵,이순탁,함능수,나인엽,오창언,김자홍 경북대학교 1971 生産技術 Vol.5 No.-

This study is a "reconnaissance" of "preliminary" grade survery with the objectives of compiling and analyzing drainage systems, river pollution, hydraulic and hydrologic characteristics of sewage, and conservation of public water supplies for design of sewer systems in Taegu. In addition, it contains basis information for design of new sanitary sewage and drainage systems for Taegu. The results are shown as follows;1) Before attempting to design a sewage system, it was necessary to set up reliable standards for estinating sewage amounts. 2) The results of analysis and examination of Taegu's drainage systems. 3) The investigation of "sewage quality and river pollution in Taegu. 4) In order to maintain the B.O.D. value of the Kumho River below 8 ppm, a sewage treatment plant will be necessary. The basic information necessary in planning a treatment plant is given. This study is a summary of reseach that was conducted jointly by Kyung-Pook National Univ ersity's Insttute of Industrial Sciences and Young-Nam Universty's Institute of Industrial Sciences and Young-Nam University's Department of Civil Engineering. The study was begun on Novemver 4,1969 and completed on November 3,1970. By an agreement between the United States Agency for International Development and the Ministry of Science and Technology of the Republic of Korea, the work was financial out of the MO ST/USAID Trust Fnnd.

메티실린 내성 황색 포도알균에 의한 연조직 및 골 감염에 대한 전환요법으로서의 경구 Rifampin의 유용성

손종원,김신우,하상우,이응갑,정덕원,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 메티실린 내성 황색 포도알균에 의한 연조직및 골 감염의 치료 시 glycopeptide약물의 정주 요법에 이은 경구 항생제로의 처방 전환이 요구되는 경우가 많으나 마땅한 경구 약제의 선택이 어려운 실정이다. 이에 경구 rifampin을 메티실린 내성 황색 포도알균에 의한 연조직 및 골 감염에 사용하여 치료한 경우를 분석하여 그 유용성 정도와 실패한 경우 실패의 위험인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월부터 2004년 9월까지 메티실린 내성 황색 포도알균에 의한 연조직 및 골 감염 환자를 대상으로 rifampin을 그 치료 목적으로 사용한 44명의 환자를 의무 기록과 X선 사진을 통해 후향적으로 분석하였다. 기초 자료를 분석하였고 감염이 재발하여 치료 실패로 판정된 환자들에 대해 치료 실패의 원인이 될 만한 주요 변수에 대한 Chi-square 검증과 로지스틱 회귀분석을 시행하였다. 결과 : 치료 후 재발은 20.5% (8/39)였으며 재발 예와 사망에 대한 위험요소에 대한 단변량 분석에서 고관절 보형물이 있는 경우 흔하였으나 통계적 차이에는 미치지 못하였다(P=0.065). 고관절 보형물 외에 동반된 질환들, 쇼크의 동반, 균혈증의 동반, 경구 시 ciprofloxacin과 rifampin의 병합 복용 기간 등을 혼란 변수로 사용한 다변량 로지스틱 회귀분석에서는 고관절 보형물 만이 통계적으로 유의하였다(P=0.044). 결론 : 메티실린 내성 황색 포도알균에 의한 연조직및 골 감염에 rifampin과 다른 약제를 병합하여 치료하는 경우 재발은 적었다. 치료 실패의 경우는 고관절 부위 감염과 같이 보형물을 쉽게 제거하기 어려운 상황과 관계되는 것을 보여준다. Background : Rifampin is sometimes used in combination with other anti-staphylococcal agents to treat methicillin-resistant Staphylococcus aureus (MRSA) infections but few reports are available about the usefulness of rifampin against MRSA infections, especially in soft tissue and bone infections. Thus, we evaluated the efficacy of rifampin as switch therapy for soft tissue and bone infections caused by MRSA and assessed the risk factors for treatment failure. Materials and Methods : We retrospectively studied 44 patients who had soft tissue and bone infections caused by MRSA and were treated with rifampin in combination or as monotherapy as switch therapy from January 2001 to September 2004. Results : The mean age of the subjects was 50.2 years and the number of male and female were 34 and 10, respectively. Median duration of rifampin use was 32 days and 25% of the patients had artificial prostheses. Thirty one patients (79.5%, 31/39) were cured with parenteral glycopeptide followed by rifampin in combination or as monotherapy. Eight patients (8/39) recurred after the completion of treatment. The presence of hip prosthesis was the only significant risk factor (P= 0.027) in multivariate logistic regression test. Rifampin was tolerable in all cases. Conclusion : Rifampin as switch therapy for soft tissue and bone infection caused by MRSA was effective in 79.5% (31/39) of sujects. The treatment failure seems to be associated with unremovable infected prosthesis.

Application of Embryo Transfer Technology to Proliferate Population Size of Jeiu Black Cattle

Young-Hoon Kim,Weon-Ho Chang,Hyun-Joo Kim,Chang-Nung Kim,Byung-Hak Kim,Eun-Young Kim,Chang-Eon Oh,Sang-Rae Cho,Yun-Ho Choy,Se-Pill Park 한국동물생명공학회(구 한국동물번식학회) 2012 발생공학 국제심포지엄 및 학술대회 Vol.2012 No.1

小兒 腸重疊症의 臨床的 分析

鄭能秀(Nung Soo Chung),張秀一(Soo Il Chang) 대한외과학회 1986 Annals of Surgical Treatment and Research Vol.30 No.4

血淸 Gamma-Globulin의 2-Mercapto-Ethanol 感受性에 關한 觀察

李能姬,朴英淑,獨孤英昌,金世坤 現代醫學社 1968 現代醫學 Vol.9 No.2

The effect of 2-Mercapto-Ethanol(2ME) on serum gamma globulin of 2months to 15months o age was experimented by hemagglutination-inhibition (H-I) antibody titration against Japanese . encephalitis virus(J.E.V). Gamma globulin is divided to 19 S & 7 S gamma globulin by their molecular weight (19 S: 900, 000^-1, 000, 000, 7S: 150, 000)- Immunologically, 7 S gamma globulin is more significant which has permanent antibody than 19 S gamma globulin which has temporal antibody only. Right after vaccination or infection, 19 S gamma globulin aFFears for 1-x-3 weeks followed by 7`S gamma globulin or Permanent antibody appearance. 2 ME irzctivates 19 S gamma globulin dropping the antibody titer. The serum gammaglobulin which contains higher 7S gamma globulin was less inactivated by 2 ME. This, we may call 2 ME resistant, on the contrary the serum contains higher 19 S gamma globulin was more inactivated and we may call as ISME sensitive. From the experiment the transmission from 2ME resistant to 2ME sensitive, seemed to be 5months of age. In other words, maternal serum gamma globulin, especially 7 S gamma globulin which is 2ME resistant and immunologically significant starts to drop the antibody titer at 5 months of age.

자궁경부종양에서 Proliferating Cell Nuclear Antigen(PCNA)을 이용한 세포증식능에 관한 연구

김수녕,박찬규,송건창,김호곤 대한부인종양 콜포스코피학회 1994 Journal of Gynecologic Oncology Vol.5 No.2

Proliferating cell nuclear antigen (FCNA) is a nuclear protein that is syntheaimd in late Gl and S phases of cell cycle and is correlated with the cell proliferative stale. The recent study demonstrated that FCNA functions in 13NA replication. The present study evaluated proliferetive indices (PI) for the assessment of tumor proliferation and for investigating prognostic significancx, in cervical tumors. lmmunohiatoehemical PCNA staining was perfurmed in formalin-fixed paraffin-embedded cervical tissues via the avidin-biotin-complex immunoperoxidase methad. Mean PI was 36.03+-5.14% in normaI controls, as compared to 66.19+-1l.36% in cerviml intraepithelial neoplasia. and 63.19+10.94% in invasive cervical cancer. Our results showed no significant correlation between Pll and histological type. Among invasive cervical cancer (24 cases), PI was 64.43 +-10.94% in squamoua cell carcinoma and 59.00+4.10% in adenocarcinoma. There was no eipiifiant relationship between Fl and clinical etage, and between PI and lesion size. This study suggeste that Pl may not serve as a new prognostie factor in cervical tumors.

Degranulation and Cytokine Expression in Human Cord Blood-derived Mast Cells Cultured in Serum-free Medium with Recombinant Human Stem Cell Factor

Hyeun Wook Chang,Tae Chul Moon,Eunkyung Lee,백석환,Makoto Murakami,Ichiro Kudo,Nung Soo Kim,Jong Myung Lee,Hae-Ki Min,Naotomo Kambe 한국분자세포생물학회 2003 Molecules and cells Vol.16 No.2

Detection and Characterization of Novel Extracellular Phospholipase A2 in Urine of Patients with Acute Pyelonephritis

Lee, Jong Myung,Baek, Suk Hwan,Chang, Hyeun Wook,Nam, Kyung Soo,Lee, Jee Hye,Moon, Tae Chul,Park, Jae Hyeun,Kim, Nung Soo 생화학분자생물학회 1982 BMB Reports Vol.30 No.2

Extracellular phospholipase A₂ activity has been detected in urine of patients with acute pyelonephritis (APN). This enzyme required micromolar Ca^(2+) ion for its maximum activity and showed a broad range of pH (4.5∼10) optimum. Urine enzyme hydrolyzed phosphatidylethanolamine (PE) and phosphatidylserine (PS) more effectively than phosphatidylcholine (PC). PLA₂ activity in the urine of patients with APN was about 5-fold higher than that of healthy individuals. When urine was subjected to heparin-Sepharose column chromatography, phospholipase A₂ activity was detected in both heparin-non-binding and binding fractions. Both phospholipase A₂ activities were sensitive less than a micromolar calcium concentration and did not react with anti-human 14-kDa group II phospholipase A₂ monoclonal antibody, HP-1. These findings suggest that two kinds of novel extracellular phospholipase A₂, which may not belong to the 14-kDa group II phospholipase A₂ family, exist in the urine of patients with APN.

STSAT-3 Main Payload, MIRIS Flight Model Developments

Wonyong Han,Dae-Hee Lee,Youngsik Park,Woong-Seob Jeong,Chang Hee Ree,Bong kon Moon,Sung-Joon Park,Sang-Mok Cha,Uk-Won Nam,Jang-Hyun Park,Duk-Hang Lee,Nung Hyun Ka,Kwang-Il Seon,Sun Choel Yang,Jong-Oh 한국천문학회 2010 天文學會報 Vol.35 No.1