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소아 암 환자에서 발생한 Bacillus cereus 균혈증의 분자역학 분석에 관한 연구
김종민 ( Jong Min Kim ),박기섭 ( Ki-sup Park ),이병기 ( Byung-kee Lee ),김수진 ( Soo Jin Kim ),강지만 ( Ji-man Kang ),김양현 ( Yanghyun Kim ),유건희 ( Keon Hee Yoo ),성기웅 ( Ki Woong Sung ),구홍회 ( Hong Hoe Koo ),이남용 ( Nam Yo 대한소아감염학회 2016 Pediatric Infection and Vaccine Vol.23 No.3
목적: Bacillus cereus 는 암환자들에서 기회감염을 일으킬 수 있다. 2013년에서 2014년 기간 동안 삼 성서울병원 소아 암 병동에서 B. cereus 균혈증의 급격한 증가가 관찰되었다. 이에 증가된 B. cereus 균혈증에 대해 분자역학적 연구를 시행하였다. 방법: 2001년 1월부터 2014년 6월까지의 기간 동안 B. cereus 균혈증이 발생한 소아 암 환자들을 확 인하였다. 이번 연구에서 B. cereus 균혈증은, 오염여부와는 상관없이, 혈액배양검사에서 적어도 한 번 이상 B. cereus 가 확인된 경우로 정의하였다. 획득 가능한 균주들에 대해 multilocus sequence typing (MLST) 분석을 시행하였고, 후향적 챠트 리뷰를 실시하였다. 결과: 연구 기간 동안 총 19명의 B. cereus 균혈증 환자가 확인되었다. 그러나, 2013년도에는 B. cereus 균혈증 환자가 급격하게 증가하였다. 또한, 응급실 공사 중이던 2013년 7월의 1주, 2013년 10월의 한 주 동안 각각 3명의 환자가 발생하였다. 그러나 MLST 분석상 일정한 패턴이 없는, 다양한 sequence types (STs)들로 확인되었다. 2013년 이전의 5개의 균주들의 ST는 ST18, ST26, ST177, ST147-like type, ST219-like type이었고, 2013년도의 균주들의 ST는 ST18, ST73, ST90, ST427, ST784, ST34-like type, ST130-like type으로 확인되었다. 고찰: MLST 분석상 B. cereus 균주들의 다양한 ST 분포가 확인되었다. 이번 연구에서 단일 ST의 B. cereus 에 의한 균혈증 발생의 가능성은 낮아보인다. Purpose: Bacillus cereus has been reported as the cause of nosocomial infections in cancer patients. In our pediatric cancer ward, a sudden rise in the number of patients with B. cereus bacteremia was observed in 2013 to 2014. This study was performed to investigate the molecular epidemiology of increased B. cereus bacteremia cases in our center. Methods: Pediatric cancer patients who developed B. cereus bacteremia were identified from January 2001 to June 2014. The B. cereus bacteremia in this study was defined as a case in which at least one B. cereus identified in blood cultures, regardless of true bacteremia. Available isolates were further tested by multilocus sequence typing (MLST) analysis. A retrospective chart review was performed. Results: Nineteen patients developed B. cereus bacteremia during the study period. However, in 2013, a sudden increase in the number of patients with B. cereus bacteremia was observed. In addition, three patients developed B. cereus bacteremia within 1 week in July and the other three patients within 1 week in October, respectively, during emergency room renovation. However, MLST analysis revealed different sequence types without consistent patterns. Before 2013, five tested isolates were ST18, ST26, ST177, and ST147-like type, and ST219-like type. Isolates from 2013 were ST18, ST73, ST90, ST427, ST784, ST34-like type, and ST130-like type. Conclusions: MLST analyses showed variable ST distribution of B. cereus isolates. Based on this study, there was no significant evidence suggesting a true outbreak caused by a single ST among patients who developed B. cereus bacteremia.
Two Stage Surgical Treatment of Acute Traumatic Knee Dislocation
Jong-Min Kim(김종민),Dong-Man Joo(주동만),Tae-Seok Nam(남태석),Hyung-Sun Ahn(안형선),Ji-Hyun Ahn(안지현),Dong-Wook Kim(김동욱),Seong-Il Bin(빈성일) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.5
목적: 외상성 슬관절 탈구의 치료에서 2단계로 나누어진 새로운 수술원칙의 유용성을 보고하고자 한다. 대상 및 방법: 1997년 10월부터 2001년 11월까지 슬관절 탈구로 내원한 14명, 15예를 대상으로 하였다. 평균 추시 기간은 24개월이었다. 측부인대 복합체는 수상 2주 내에 수술하였고, 이후 불안정성을 보이는 십자인대에 대하여 재건술을 시행하였다. 결과는 스트레스 방사선 사진, 관절 운동 범위, Lysholm 점수를 이용하여 평가하였다. 결과: 모든 예에서 전방, 후방십자인대가 파열되었으며, 내측측부인대는 10예, 외측측부인대는 8예에서 파열되었다. 모든 측부인대 복합체 손상에 대하여 수술 시행하였다. 3예에서 전방십자인대, 7예에서 후방십자인대 재건술을 시행하였으며, 5예에서는 재건술이 필요하지 않았다. 최종 스트레스 방사선 검사에서 내측측부인대는 모든 예에서 0-1도, 외측측부인대는 14예에서 0-1도, 전방십자인대는 모든 예에서 0-1도였으며, 후방십자인대는 11예에서 0-1도, 4예에서 2도였다. Lysholm 점수는 평균 87.6점이었다. 결론: 외상성 슬관절 탈구의 치료시, 첫 단계로 측부인대의 수술을 시행하고, 이후 선택적으로 십자인대 재건술을 시행하는 2단계 치료로 좋은 결과를 얻을 수 있었다. Purpose: The purpose of this study was to determine the effectiveness of a new two stage surgical treatment for acute traumatic knee dislocation. Materials and Methods: The study involved 15 knees in 14 patients treated between October 1997 and November 2001. The mean follow-up period was 24 months. In the first surgical stage, medial and/or lateral ligament complexes were repaired or reconstructed within two weeks of the injury. In the second surgical stage, once full range of motion was obtained 3-6 months later, anterior or posterior cruciate ligaments (ACL or PCL) were reconstructed if significant laxity was present. The final outcomes were assessed using stress X-rays, range of motion and Lysholm score. Results: There were ten cases of MCL tear and eight cases of LCL tear. All MCL and LCL injuries were either repaired or reconstructed. All cases had both ACL and PCL tears. Following the first stage of MCL/LCL surgery, the second stage surgery of ACL or PCL reconstructions was deemed to be necessary in three and seven cases, respectively. Five cases did not require ACL or PCL reconstruction. In stress X-rays at the last follow up examination, MCL, LCL, ACL and PCL instability was graded as 0 or 1 in 15, 14, 15 and 11 cases, respectively. PCL instability was graded as 2 in four cases. The mean postoperative Lysholm score was 87.6 points. Conclusion: The two stage surgical approach described here resulted in good outcomes for patients suffering from acute knee dislocation patients in terms of range of motion and stability.
소아에서 성공한 isoniazid와 rifampin에 대한 신속 탈감작요법 1예
이혜림 ( Heirim Lee ),김민선 ( Min-sun Kim ),양혜경 ( Hea-kyoung Yang ),김민지 ( Minji Kim ),이지영 ( Ji Young Lee ),김종민 ( Jong-min Kim ),강지만 ( Ji-man Kang ),김예진 ( Yae-jean Kim ),안강모 ( Kangmo Ahn ),김지현 ( Jihyun Kim 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.3
Hypersensitivity reactions to antituberculosis medicine are obstacles to the treatment of tuberculosis. However, rapid drug desensitization can secure successful treatment with essential antituberculosis medicines in pediatric patients. A 17-year-old boy with active pulmonary tuberculosis complained of generalized erythematous rashes, pruritus on the 11th day of tuberculosis treatment. He was diagnosed with hypersensitivity reactions to isoniazid and rifampin by the oral provocation test. After desensitization, the patient continued to take antituberculosis treatment with isoniazid, rifampin, pyrazinamide, and ethambutol. We report here a case of successful desensitization in an adolescent with hypersensitivity to isoniazid and rifampin. (Allergy Asthma Respir Dis 2016;4:212-216)
손소희,강지만,김종민,성세인,김이슬,이해정,김빛아름,이연경,고선영,신손문,김예진,Son, Sohee,Kang, Ji-Man,Kim, Jong Min,Sung, Sein,Kim, Yi-Seoul,Lee, Haejeong,Kim, BitA Reum,Lee, Yeon Kyoung,Ko, Sun Young,Shin, Son Moon,Kim, Yae-Jean The Korean Society of Pediatric Infectious Disease 2017 Pediatric Infection and Vaccine Vol.24 No.3
Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.
Urea-SCR 후처리장치의 NO<SUB>x</SUB> 저감에 대한 해석적 연구
윤병규(Byoungkyu Yun),김종민(Chongmin Kim),김종훈(Jong Hun Kim),김만영(Man Young Kim),최현하(Hyunha Choi),조규백(Gyubaek Cho),김홍석(Hongsuk Kim),정용일(Youngil Jeong) 한국자동차공학회 2008 한국자동차공학회 춘 추계 학술대회 논문집 Vol.- No.-
During the past few years emission regulations have become more stringent as a result of increased environmental issue and energy saving. To meet stringent emission regulations, an diesel exhaust gas after-treatment system was developed such as DOC, DPF, and SCR. Various reduction devices of NOx in exhaust gas existed, such as LNT (Lean NOx Trap), HC-SCR and Urea-SCR. Especially, it is well known that the Urea-SCR system for diesel engine after-treatment is very effective device for reduction of NOx in exhaust gas among others. However, the Urea-SCR has disadvantage of low NOx reduction efficiency, especially in low temperature exhaust gas condition. Furthermore, this device have many issues associated with the Ammonia slip phenomenon, layout optimization for NOx reduction, etc. This study presents an optimized property of Urea-SCR system for NOx reduction by changing such various parameters as space velocity and length of the DOC with the numerical experiments.