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광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과
강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2
목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.
정신분열병 환자에서 세가지 청각 자극 "Oddball" 모형에 의한 사건관련전위 P3a와 P3b
진용탁,박이진,남지민,한상익,전양환 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5
Objectives : Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions Simultaneously, we examined patients with schizophrenia. Methods : fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). Results : P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). Conclusion : These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.
한강 하구역에 출현하는 황강달이(Collichthys lucidus)의 섭식생태
정수환 ( Su Whan Chung ),김병기 ( Byung Gi Kim ),김지혜 ( Ji Hye Kim ),김민규 ( Min Gyu Kim ),한경남 ( Kyung Nam Han ) 한국어류학회 2014 韓國魚類學會誌 Vol.26 No.4
황강달이의 섭식생태를 연구하기 위해 총 926개체를 한강하구역에서 채집하였으며, 전장 범위는 3.5~18.5 cm였으며, 산란기는 5~7월 경이었다. 먹이선호도를 조사한 결과, 이들종은 능동적인 저서포식자이며, 특히 절지동물문 중 십각류인 중국젓새우와 밀새우를 주로 먹는 것으로 조사되었다. 이들 종의 공복률은 총 23.8%였으며, 성장 및 계절에 따른 공복률의 변화가 있었으며 먹이생물 역시 각 특성에 따라 변하였다. 섭식행동 및 먹이생물 종은 계절에 따른 생식소지수의 변화에 따라 변하였다. 한강 하구역의 황강달이 위내용물에서는 넒은 범위의 먹이생물 종이 확인되어 비선택적 포식자로 볼 수 있다. Feeding ecology of Collichthys lucidus was determined by analysis of stomach contents of 926 specimens ranged from 3.5 to 18.5 cm in the Han River estuary. This fish actively fed on benthic crustaceans, mainly decapods, Palaemon carinicauda and Acetes chinensis, and they can be defined as the benthivorous predator. The percentage of empty stomachs was 23.8%. The vacuity index (VI)did not vary with the size classes, but showed significant monthly variations. Monthly variation of feeding activity appears to be related to the reproduction cycle of the fish, and to the temporal abundance of the prey organisms. Collichthys lucidus in Han River estuary fed on a wide array of prey items and could be considered as a non-selective predator.
Relationship between Gender Roles and Job Satisfaction among Neurological Physical Therapists
( Ji-whan Park ),( Seul-ki Han ),( Dae-hee Lee ) 대한물리의학회 2016 대한물리의학회지 Vol.11 No.3
PURPOSE: This study was aimed at investigating the types of gender roles and the relationship between gender roles and job satisfaction among neurological physical therapists. METHODS: The study subjects were 169 (male 74, female 95) neurological physical therapists working at general hospitals or rehabilitation centers in the Daejeon Metropolitan City area, South Korea. To identify job satisfaction scores, the subjects completed a questionnaire, and a vernier caliper was used by a trained examiner to measure the lengths of the subjects’ index and ring fingers (i.e., digitus secundus manus and digitus annularis, respectively) to examine gender roles. The index to ring finger length ratio (i.e., 2D:4D ratio) was calculated using a personal computer. An independent t-test was performed to compare the finger length ratio and job satisfaction of male group with that of the female group and a correlation analysis was performed to examine job satisfaction by gender roles. RESULTS: Finger length ratio is lower in males than in females. However, there was no significant difference statistically (p>.05). Regarding job satisfaction by gender, males were more satisfied with their jobs than females (p<.05). However, there were no significant correlations between job satisfaction and gender roles (p>.05). CONCLUSION: It cannot be concluded that bias against gender roles is a contributing factor for neurological physical therapists being satisfied with their job, and thus bias against gender roles among neurological physical therapists should be removed.