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      • 大邱地方 一部 大學生들의 吸煙實態

        姜福秀,芮旻海,李性寬 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

        1980년 10월 1일부터 1개월간 경북대학교 의과대학 남학생 303명과 대구시내 일반 대학생 255명을 대상으로 흡연에 관한 실태를 조사한 성적을 요약하면 다음과 같다. 1. 총대상자 558명중 흡연학생은 339명으로 흡연율은 60.7%로 나타났고, 의대생의 경우 62.4%, 일반 대학생의 경우는 58.8%의 흡연율을 나타내었다. 흡연 중단율은 전체 19.9%이며 의대생의 경우 16.5% 일반 대학생의 겅우 23.9%로 나타났다. 2. 흡연시작 연령은 대체로 20세 전후가 65.7%로 나타났으며 18세 이전의 고교시절부터 흡연을 경험한 학생이 23%로 나타났다. 3. 흡연기간은 과반수 이상인 56.2%가 5년미만인 것으로 나타났고 그중 2년 이상 3년 미만이 22.1%로 제일 높게 나타났다. 4. 흡연량은 하루 14개피 미만을 피우는 학생이 전체 63.1%로 제일 많았으며 25개피 이상 피우는 학생은 3.3%로 나타났다. 5. 흡연과 음주와의 관계에서 흡연하는 학생중 91.7%가 술을 마시는 것으로 나타났다. 6. 흡연동기로는 37.7%에 해당하는 학생이 호기심에 의해서 흡연을 시작했으며 17.7%의 학생은 선배 친구의 권유로 담배를 처음 시작한 것으로 나타났다. 7. 장차 흡연에 대한 태도는 계속 피우겠다는 학생이 45.7%, 감량 하겠다는 학생이 42.8%, 금연하겠다는 학생이 11.8%로 나타났으며, 의대생의 경우에서 60.3%가 금연 및 감량 하겠다는 것으로 나타나 일반대학생 46.7%보다 높은 율을 보였다. 8. 금연 및 감량의 이유조사에서 80%에 해당하는 대부분의 학생이 건강상 이유로 나타났고 경제적 이유도 8.5%나 되었다. 9. 흡연과 관계되는 증상조사에서 기침, 객담, 호흡곤란을 호소하는 빈도가 비흡연군에 비해 흡연군이 더 높게 나타났으며, 만성 폐쇄성 호흡기 질환에 이환되는 빈도도 흡연군이 비흡연군보다 높은 경향을 나타 내었다. The present study was conducted to investigate smoking status on 303 medical students and 255 non-medical students in Taegu, for 1 month from October 1, 1980. The results obtained are summarized as follows; 339 students of 558 subjects, 60.7 percent smoked. The percentage of medical students smoking showed 62.4 and the percentage of non-medical students was 58.8. Regarding the age started to smoke, 67.5 percent of total smokers commenced smoking around the age of 20 and 23 percent experienced smoking before the age of 18. In the regard to the average daily number of cigarettes smoking, 63.1 percent of total smokers consumed under 14 cigarettes, 3.3 percent smoked 25 or more cigarettes a day. Alcohol consumption was closely associated with smoking. 91.7 percent of total smokers revealed drinker. The commonest motives for starting the smoking habit were curiosity and the influence of friends who already smoked(55.4%). Considering attitude toward smoking habits in the future, 54.6 percent of students said they would stop or reduce smoking. The commonest reason for stopping and reducing the smoking habit was health hazard(80%). The complaints of cough with sputum and shortness of breath revealed higher rates among smokers than among non-smokers. Smokers were more likely to suffer from chronic bronchitis compared to non-smokers.

      • 大邱地域社會에서의 精神醫學에 對한 態度의 變化

        尹錫夏 慶北大學校 醫科大學 1975 慶北醫大誌 Vol.16 No.1

        1970年부터 1975年까지 5年間 慶北醫大病院의 一般醫師 看護員 및 大邱市內에 居住하는 一般人을 對象으 로 이들의 精神疾患과 精神科에 對한 態度의 變化를 알아 보았다. 調査方法은 1) 精神病의 原因, 治療, 豫後 2) 精神病患者에 對한 偏見과 拒否 3) 神經症과 精神生理障碍 및 精神治療 4) 精神科, 精神科醫師, 精神科病棟 等 모두 20項目의 選多式으로 된 設問紙를 使用했다. 이 質問紙로 1970年 3月에 慶北醫大病院의 醫師 看護員 84名과 市內에 居住하는 一般人 143名에게 調査 를 實施하고, 같은 質問紙를 사용하여 1975年에 慶北醫大病院의 醫師 看護員 78名과 一般人 475名을 對 象으로 調査하였다. 一般人은 1970年의 調査對象者와 年齡, 敎育程度, 職業等의 條件이 같은 143名을 1975년의 應答者中에서 選擇하여 比較하였고 醫師 看護員은 年齡, 敎育程度가 거의 同一하다고 보고 그 대로 1970年 調査와 1975年 調査 成績을 統計的으로 比較하였던 바 아래와 같은 몇 가지의 事實을 發見 하였다. 1970년 조사와 1975년 조사를 비교할 때 1. 醫師 看護員群에서 1. 變化가 없는 것은 1) 精神疾患의 原因과 精神病의 精神科的 治療에 對해서는 80% 以上이 올바른 知識을 가지고 있고 2) 80% 以上이 如前히 精神病疾患을 앓았던 사람이면 가까운 關係를 맺기를 꺼려하고 있다. 3) 約 半數의 應答者들은 여전히 精神病患者는 대부분 위험하다고 믿고 있으며 精神科病棟의 開放을 찬 성하는 者들은 30% 程度에 不過하다. 4) 醫師 看護員의 半程度는 綜合病院에서 精神科病棟을 獨立된 建物에 分離시키길 바라고 있다. 2. 變化를 보인 것은 1) 精神科病棟의 全的 開放에는 反對者가 아직많으나 精神病患者에게 보다 人道的이고 自由로운 入院에 찬성하는 者가 增加했으며 2) 精神病을 앓았던 사람이라도 皮相的 關係에서는 그들을 社會的으로 받아드리려는 者가 많아졌고 3) 精神病의 豫後에 대해서는 悲觀的 態度를 나타낸 者가 增加하였고 4) 精經病의 治療는 精神科에서 精神治療를 받는것이라는데 찬성하는 者는 줄고 "수양"이 좋다는 應答者 가 增加하였다. 5) 精神科醫師들에 對한 好意的 態度가 적어지고 그들의 分析的 態度에 不快하다는 態度를 가진者가 增 加하였다. 2. 一般人가운데서 1. 變化가 없는 것은 1) 應答者의 約 1/2이 如前히 精神疾患의 原因과 治療에 대하여 잘 알고 있지못하며 2) 約 30%는 神經症의 治療에 관해서도 알고 있지 못하고 3) 精神病이 모두 위험할 것이라는 態度를 보인 者가 如前히 過半數를 차지하며 4) 70% 以上은 精神生理障碍의 槪念에 對하여 多少 알고 있다. 2. 有意한 變化는 醫師 看護員들과 마찬가지로 精神疾患者들에 대한 보다 人道的 入院方法을 支持하는 者와, 깊은 關係가 아니라면 精神病을 앓은 者라도 社會的으로 받아드리려는 者들이 많아졌다. 그러나 醫師看護員들과는 달리 1) 精神治療의 效果와 精神病의 회복 정도에 對한 期待에서 肯定的인 者가 많아졌고 2) 神經症의 原因에 關해 올바르게 알고 있는 者는 줄어든 反面 "精經의 病"으로 誤解하는 者가 많아졌 고 3) 精神病을 모두 위험시하는 者와 가까운 관계를 꺼려하는 者들이 增加하였다. (本硏究를 하는데 여러가지로 도와주신 高麗神經精神科醫院의 金政輝 先生과 慶北醫大病院 腦波檢査室의 林美淑孃에게 심심한 감사를 드린다.) In order to implement the better care for the mentally ill and to promote mental health in general at the given community, it is utmost important to understand the attitude of the general public as well as medical professionals toward psychiatry. In the recent years, it is vaguely believed that the attitude about psychiatry has been much accepted than ever before, however, no systematic research has been done to confirm on the subject. This study is done to compare how the attitude has been changed over the past five years, from 1970 to 1975. In the year of 1970, we had conducted the study to analyze the general attitude about psychiatry by using the the questionaire form of multiple choice. The data were obtained from the random sampling of the staff at Kyungpook University Hospital and the general public in Taegu city. In 1975, five years later, we conducted the same study to compare with the previous findings by using the same questionaire form. Though the samples were not the same as the previous one, we tried to match sex, age and education accordingly. The summary of the study is made as follows: A) Among the medical professionals 1) No significant changes in attitude were noted in the following items: a) More than 80% showed a positive view on the prospect of mental illness. b) More than 80% were still reluctant to have an intimate relation with the mentally ill. c) About half of the respondents saw the mentally ill unpredictable and dangerous, and only 30% favored on the open ward system. d) In the general hospital setting, half of them were in favor of separating the psychiatric ward. 2) Significant changes in attitude were noted in the following items: a) Though they were against opening the psychiatric ward, the increasing trend was exprssed that the mentally ill should be handled more humanistically. b) They became more acceptable toward the mental patients, however, at a superficial level though. c) They became more pessimistic about the prognosis of the psychotic patient. d) The increasing numbers had showed the "rest" would be a preferable treatment for the neurotics. e) Psychiatrists were viewed lesser humanistic and their assumed analytic eyes made the respondent quite uncomfortable. B) Among the general public No significant changes: a) About half of them were still poorly informed about the etiology and treatment of the mental illness. b) About 30% had still held a misconcept on the treatment of neurotics. c) More than half had still seen the mentally ill unpredicatble and dangerous. d) More than 70% were well informed about the psychosomatic concept. Significant changes: Likely with medical professionals a) The increasing trend was expressed that the mentally ill should be handled more humanistically. b) They become more socially acceptable toward the mental patient. Unlikely with the medical professionals, b) They were becoming more positive about psychotherapy as well as about the prospect of psychotics. c) Those who were well informed about neurosis were decreasing in number and they tent to see it caused by the inflammation of "nerve" d) The increasing trend was noted in viewing the mentally ill as dangerous and in relutance to have an intimate relation.

      • 비외상성 소장천공

        신언성,유완식,황일우 慶北大學校 醫科大學 1986 慶北醫大誌 Vol.27 No.4

        저자들은 1976년부터 1985년까지 만 10년간 경북대학교 의과대학 외과학교실에서 경험한 비외상성 소장천공 환자 85예를 대상으로 발병원인, 진단방법, 치료결과에 대해서 분석한 결과를 요약하면 다음과 같다. 소장천공의 원인별로는 장티프스가 64예, 장결핵이 8예, 장폐쇄가 5예, 중피종이 1예, 원인불명이 7예 이었고 수술전 진단이 정확했던 경우는 장티프스가 93.8%, 장결핵이 37.5%, 장폐쇄가 60% 이었다. 장티프스의 경우에 Widal 반응의 양성율은 발열후 제 4주째가 제일 높았고, 혈액배양에서 Salmonella균의 양성율은 제 2주째가 제일 높았으며, 병리조직 검사에서는 거의 비슷한 양성율을 나타내었다. 합병증의 발생빈도는 장폐쇄의 경우 80%, 장티프스의 경우 48.4%, 장결핵의 경우 12.5%로 원인질환에 따라서 차이를 나타내었고, 복강내 오염이 심할때의 합병증 발생빈도는 63.2%, 중등도 일때는 54.8% 경할 때는 31.4%로 나타나서 유의한 차이를 나타내었다. 천공부위를 단순봉합 했을 경우 합병증은 44.9%에서 발생하였고 절제후 단단문합술을 실시했을 경우는 52.9%에서 발생하여 유의한 차이는 없었다. We had managed 85 cases of the nontraumatic small intestinal perforations during the 10 year period from 1976 through 1985 at the Department of Surgery, Kyungpook National University Hospital. There were 64 cases of typhoid fever, 8 cases of tuberculous enteritis, 5 cases of intestinal obstruction, and one case of mesothelioma as the underlying cause of the small intestinal perforation. The correct preoperative diagnosis of the underlying cause was established in 93.8% of typhoid fever, 60% of intestinal obstruction, and 37.5% of tuberculous enteritis. Of the patients with the typhoid fever, the highest positive rate of the Widal reaction was reported in the fourth week of the disease, and the blood culture for Salmonella typhi in the second week of the disease. The morbidity of the patients with intestinal obstruction was 80%, typhoid fever 48.4%, tuberculous enteritis 12.5%. The morbidity was 31.4% in patients with minimal peritoneal contamination, 54.8% with moderate contamination, 63.2% with severe contamination. This difference was statistically significant. The morbidity according to the types of the operation was not significantly different.

      • 綜合病院에 入院한 結核性腦膜炎 患兒의 疫學的 觀察

        尹聖道,李性寬 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1

        大邱市內 三大綜合病院에 1975年부터 1980年까지 6年間 小兒科에 入院한 結核性腦膜炎 患兒 253名에 대한 疫學的調査分析 結果는 다음과 같다. 結核性腦膜炎의 發生率은 男兒가 女兒보다 높고, 3세以下의 年少兒에서 高率이었고, 年度別로는 1975年을 起點으로 했을때 漸次減少하였으며, 季節的으로는 春季가 가장높고 秋季가 낮았다. 地域別로는 大都市外廓地가 가장높고, 다음이 農村, 中都市, 大邱市中心都의 順位였다. 出生順位別로는 끝아이에서 높고, 中間아이에서 低率이었다. 結核家族에서 發生率이 높았고 BCG未接種者에서 높았다. 發病에서 入院까지의 期間은 中期以後가 많고 症狀으로는 末期인 意識混濁을 同伴하는 患兒가 많았다. 症狀別로는 熱, 嘔吐, 痙攣, 意識不明등이 높게 나타났으며 治療期間은 7日以後가 34%, 8日에서 20日까지가 31%, 20日이후가 24%였다. 退院時의 治療成積은 漸定的인 退院當時 狀態에서 症狀이나 腦脊髓膜液性狀의 狀況으로 判定하여 好轉한 것이 51.7%, 惡化가 36.9%, 死亡이 11.4%이었다. 好轉率은 男兒가 女兒보다 高率이었고 年齡的으로는 年少兒가 年長兒보다 높았으며, 年度別로는 1975年을 起點으로 했을때 年度가 經過함에 따라 好轉率이 높았고, 季節的으로는 夏節에서 높았고, 地域的으로는 都市의 中心地는 높으나 外廓地는 가장 低率이었다. 出生順位別로는 中間아이에서 높고 첫아이에서 가장 낮았다. 傳染源이 있는 患兒에서 높았고, BCG接種兒에서 높았다. BCG와 傳染源이 같이 있는 BCG 群에서 高率이었고, 傳染源은 있으나 BCG 接種이 없는兒에서 가장 낮았다. 症狀別로는 意識混濁群이 가장 낮았고 頭痛郡이 가장 높았다. 發病해서 入院까지의 期間이 짧을수록 그리고 入院期間이 길수록 好轉率이 높았다. 끝으로 적극 협조해주신 慶北大學敎醫科大學 부속병원 소아과교실원, 계명대의과대학 소아과 교실원 및 파티마병원 소아과원 제위에게 심심한 감사를 표시하는 바이다. During the last 6 years since 1975, epidemiological studies were done on 253 children with tuberculous meningitis admitted in 3 general hospitals in Daegu. The result were as follows; 1) The statistical studies indicated a gradual decrease in the incidence after 1975. Concerning the age difference, the highest incidence was noticed in the group of the children under 3 years old, rate of the group was 57.3% of the total patients. Concerning sex differences, the incidence of the male patients were slightly higher than that of the female patients. Concerning the seasonal differences, its incidence in spring was found to be the highest. Concerning the areas, the incidence in the suburban area was highest and rural, middle urban and central area in the large city were followed. Concerning the birth order, the incidence was higher in last child than in first and middle child. The source of the infection was mainly familial and inicidence of the group with infectious source accounted for 36.5%. The incidence of the group inoculated BCG accounted for 39.1% of the total patients. The main chief complaints were drowsiness, convulsion, vomiting, headache and fever. Main complications of the disease were miliary tuberculosis, 17.0%, pulmonary tuberculosis, 9.5%, other tuberculous lesion, 2.0% and other diseases, 6.0%, respectively. Concerning duration between initial onset and admission within 10 days, 11-20 days and after 20days were 36.8%, 40% and 20.6%, respectively. Concerning duration of treatment were within 5days, 6-10days, 11-20days and more than 30days were 31.0%, 15.0%, 42.0% and 12%, respectively. 2) The prognosis of the diseases was analysed by various factors. Concerning the age difference, the patients less than 3 years old showed low rate of improvement and the rate of improvement increased with increase of ages. Concerning sex difference, the rate of improvement was slightly higher were in male than female cases. Concerning calendar year, the rate of the improvement was increased year by year. Concerning seasonal difference, the rate of the improvement was the highest in summer and autumn, winter and spring in that order. Concerning birth order, the rate of the improvement was highest in middle child and last and first child were in that order. The rate of the improvement were higher in the patients with infectious source than in those without sources and in the group of BCG vaccination than in that of non-vaccination. Concerning relationship between the rate of improvement and the history of infectious source and BCG vaccination, it was found that its rate of the patient with infectious source and BCG vaccination was highest paradoxically and the patient with infectious source and non-vaccination was lowest. Concerning the duration between initial onset and admission, the rate of improvement was higher in shorter period than that of longer period. Concerning the duration of the treatment, the rate of improvement was higher in the patients received longer period than that of shorter period. The rate of improvement was 35.1% in the group of the patients who showed disturbance in the consciousness already on the admission, while the group with headache was the highest rate with 73.7%.

      • 超音波를 利用한 胎兒發育豫測

        許東殷,李台鎬 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1

        1980年 2月 1日부터 1年間 慶北大學校 醫科大學 附屬病院 産婦人科에서 産前管理를 위하여 來院한 患者中 最終月經이 正確한 189例의 姙婦의 兒頭大橫徑 測走値와 兒體重 및 胎兒年齡과의 相關關係, 82例의 兒頭前後徑 測定値와 胎兒年齡의 相關關係 및 64例의 兒頭前後徑 測定値와 兒體重의 相關關係를 硏究한 바 그 成績을 아래와 같이 要約한다. 兒頭大橫徑과 兒體重間에 가장 높은 相關關係를 觀察할 수 있었고 相關係數 r=0.95(p<0.001)이었다. 兒頭大橫徑과 胎兒年齡과의 相關關係는 매우 높았고 相關係數 r=0.92였고 p<0.001이었다. 兒頭前後徑과 兒體重間의 相關은 비교적 높았고 相關係數 r=0.79였고 p<0.005이었다. 兒頭前後徑과 胎兒年齡과의 相關關係는 r=0.73 으로 가장 낮았고 p<0.O05이었다. 兒頭大構徑의 超音波診斷 平均値와 實測平均値는 各各 9.06cm와 8.72cm로 그 差는 0.34cm로 매우 僅少하였다. 以上의 成績으로 超音波 兒頭徑線 測定, 特히 大橫徑測定은 正確하며 胎兒의 體重 및 年齡을 豫測하는데 큰 도움을 줄 것으로 생각되며 前後徑測定値도 補助診斷의 充分한 價値가 있을 것으로 생각된다. Studies were made whether or not correlation take place between biparietal sono-cephalometry and fetal weight and gestational age of 189 cases, antero-posterior sonocephalometry and fetal gestational age of 82 case and anteroposterior sono-cephalometry and fetal body weight, of 64 cases. All gravidas were randomly selected, having regular menstrual period who visited out patient clinic from Feb. 1 1980 to Jan. 31 1981 for prenatal care. Results summarized were as follows. The highest correlation observed was between fetal biparietal sono-cephalometry and fetal body weight, showed correlation coefficiency r=0.95(p<0.001), and mean standard deviation of 312.4gm. Correlation between biparietal cephalometry and gestational age revealed r=0.92(p<0.001), and mean standard deviation of fetal gestatational age, 1.8 week. Correlation between antero-posterior cephalometry of fetal head and fetal body weight indicated r=0.79 (p<0.005), and mean standard deviation of body weight was 497.9gm. The least correlation observed was between anteroposterior cephalometry and fetal gestational age, r=0.73(p<0.005) and mean standard deviation of 2.9 week. The difference between mean biparietal sonocephalometry, 9.06㎝ and that of actual measurement 8.72㎝ was only 0.34㎝. Judging from the results obtained, it was suggested that sono-cephalometry, particulary biparietal measurement will play a important role on estimation of fetal body weight and gesttional age. Measurement of antero-posterior sono-cephalometry also revealed as a adjunctive measure for prediction of fetal maturity.

      • 臨床材料에서 分離된 細菌의 抗生劑에 대한 感受性의 推移

        李斗鎭,金重明,金材植 慶北大學校 醫科大學 1984 慶北醫大誌 Vol.25 No.3

        慶北大學校 醫科大學 附屬病院 臨床病理科에서 1981年 1月부터 1984年 9月까지 臨床材料로부터 分離된 S. aureus 1999株, E. Coli 200株, Ser. macesens 109株, Salm. typhi 100株 및 Sh. flexneri 100株, Ps. aeruginosa 120株 都合 1028株를 임의로 選擇하여 disk diffusion method와 plate dilution method로 Pc-G, Ap, Cb, Ce, Cm, Tc, Ak, Gm 및 Tb에 對한 感受性과 그의 年次的 推移를 보았고, 그 耐性菌株에 있어서는 檢體別 分布, 年次別 增減 및 多劑耐性과 그 檢體別 分布를 보아 다음과 같이 요약할 수가 있었다. S. aureus의 Pc-G, Ce, Cm 및 Tc에 對한 感受性에 있어 가장 높은 것은 Ce에서였고, 가장 낮은 것은 Pc-G에서였으며, 이의 年次的 推移는 모두 낮아지는 傾向이었다. E. coli의 Ap, Ce, Cm, Tc, Ak, Gm 및 Tb에 對한 感受性에 있어서는, Gm에 가장 높았고, Tc에 가장 낮았으며 連次的 增減은 增加하는 것도 있었으나 大體로 減少하는 趨勢였다. K. pneumoniae의 前記 7種의 抗生劑에 對한 感受性은 Ak에 가장 높았고, Ap에 가장 낮았으며 이의 年次的 推移는 Cm, Ap 및 Tc에서는 增加되어 Tr, 其他에서는 減少되었다. Ser. marcescens의 前記 抗生劑에 對한 感受性은 Ak에서 가장 높았고, Ap와 Ce에 가장 낮았으며, 이의 年次的 增減에 있어서는, Ak가 증가되었고, 其他는 增減이 없든가 또는 減少되었는데 大體的으로 減少하는 傾向이었다. Salm. typhi의 感受性은 Ce에 가장 높았고 Tc에 가장 낮았는데, 가장 낮은 Tc에서도 80%以上이 感受性菌株였으며, 이의 年次적 增減推移는 若干 減少하는 쪽이었다. Sh. Flexneri의 感受性은 Gm. Tb 및 Ce에 가장 높았고, Ap와 Tc에 가장 낮았으며 이의 年次的 增減推移는 一律的으로 減少되었다. Ps. aeruginasa의 感受性은 Gm과 Cb에 가장 높았고 Tb에 가장 낮았는데 가장 높은 Gm와 Cb라 하더라도 그 感受性菌株는 40∼80%였으며, 이의 年次的 增減에서는 全般的으로 減少하는 傾向이었다. 菌株의 材料別 分布를 보면 S. aureus는 主로 膿에 많았고, 그 出現率은 喀痰과 氣管支分泌物, 咽頭分泌物에 높았고 多劑耐性은 1劑에서 4劑에 걸쳐 있었다. E. coli, K. pnenmoniae 및 Ser. marcescens의 耐性菌株의 材料別 分布는 主로 血液, 尿, 農, 喀痰과 氣管支分泌物, 咽頭分泌物에 많았고 그出現率도 그 材料에 높았으며 多劑耐性은 1劑에서 7劑에 걸쳐있었다. Salm. typhi와 Sh.flexneri의 耐性菌株의 材料別 分布를 보면, 前者는 血液, 尿, 對便 및 農에서 候者는 大使에서만 볼 수 있었고, 前者의 出現率은 尿와 大便에서 높았으며 多劑耐性은 1劑에서 7劑에 걸쳐 있었다. Ps. aeruginosa의 藥劑耐性菌株의 材料別 分布는 主로 尿와 膿에 많았고, 그 出現率은 咽頭分泌物에서 가장 높았으며 多劑耐性은 1劑에서 4劑까지 걸쳐 있었다. The bacteria tested were totally 1028 strains which composed of 199 strains of Staphylococcus aureus (S. aureus), 200 strains of Escherichia coli (E. coli), 200 strains of Klebsiella pneumoniae (K. Penumoniae), 109 strains of Serratia marcescens (S. marcescens), 100 strains of Salmonella typhi (Salm. typhi), 100 strains of shigella flexneri (Sh. flexneri), and 120 strains of Pseudomonas aeruginosa (Ps. aeruginosa), and all strains were isolated in clinical laboratory from Jan. 1981 to Sept. 1984. The antimicrobial susceptility against 9 antimicrobial agents were performed by means of a single high disk potency disk diffusion and a plate dilution test. S. aureus showed the highest sensitivity to cephalothin as 82-98% by disk-diffusion method and 88-94% by plate dilution method and the lowest sensitivity to penicillin G as 10-14% by disk diffusion and 12-18% by plate dilution method and in annual transition the susceptible strains of S. aureus decreased by year. E. coli showed the highest sensitivity to gentamycin as 68-90% by disk diffusion method and 76-90% by plate dilution method and the lowest sensitivity to tetracycline as 12-18% by disk diffusion and to ampicillin as 8-24% by plate dilution method and the susceptible strains of E. coli decreased by year. K. pneumoniae showed the highest sensitivity to amikacin as 20-96% by disk diffusion and 50-90% by plate dilution method and the lowest sensitivity to ampicillin as 6-12% by disk diffusion and 8-20% by plate dilution method. In the bacterial susceptibility, the susceptible strains of K. pneumoniae increased against ampicillin, chloramphenicol and tetracycline and decreased against cephalothin, amikacin, gentamicin and tobramycin by year. Salm. marcescens showed the highest sensitivity to amikacin as 63-72% by disk diffusion and 59-76% by plate dilution method and the lowest sensitivity to ampicillin 3-4% by disk diffusion method and to cephalothin 3% only by plate dilution method. The susceptible strains of S. marcescens increased against amikacin but decreased against the others by year. S. typhi showed the highest sensitivity to cephalothin as 96-100% by disk diffusion and 100% by plate dilution method and the lowest sensitivity to tetracycline 72-96% and 68-92% by plate dilution method. The sensitive strains of Salm. typhi generally decreased by year. Sh. flexneri showed the highest sensitivity to gentamicin and tobramycin as 92-100% by disk diffusion and to cephalothin 100% by plate dilution method. The sensitive strains of S. flexneri decreased by year. Ps. aeruginosa showed the highest sensitivity to gentamicin as 33-83% by disk diffusion and to carbenicillin 40-53% by plate dilution method and the lowest sensitivity to tobramycin as 23-53% by disk diffusion method and 23-46% by plate dilution method, and the sensitive strains of Ps. aeruginosa decreased by year. In the distribution of resistant strains by specimen, S. aureus were isolated from puses, and isolation rate were high in the sputum, bronchial secrete and throat secrete, and the susceptibility for multiple druge resistance of S. aureus were related up to four drugs. The resistant strains of E. coli, K. pneumoniae, and S. marcescens were distributed mainly in the blood, urine, pus, sputum, bronchial secrete and throat secrete, and the rates of appearance were all high in above specimens, and the multiple drugs resistance of E. coli, K. pneumoniae, and S. marcescens were related up to seven drugs. The resistant strains of Salm. typhi and Sh. flexneri were distributed mainly in the blood, urine, stool and pus, and the rates were high in the urine and stool, and the susceptibility for the multiple drugs of Salm. typhi and Sh. flexneri were also related up to seven drugs. The drug-fast strains of Ps. aeruginosa were distributed largely in the urine and pus and the rates were high in the throat secrete, and the susceptibility for the multiple drugs of Ps. aeruginosa were related up to four drugs.

      • 자궁경부 선암 및 선편평상피암의 임상적 고찰

        김광수,김삼식,김대한,황진석,심재철,이민석,이윤순,박일수 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

        목적 : 자궁경부의 선편평상피암은 원발성 자궁경부암의 약 2∼3%를 차지하며, 최근 편평상피암에 비해 그 상대적 빈도가 증가하는 추세이다. 그러나 우리나라에서는 자궁경부선암에 대한 몇 번의 통계적 조사외엔 구체적 임상적 연구가 드물다. 이에 선암 및 선편평상피암 환자들의 임상적 양상에 대한 분석을 시도하였다. 대상 및 방법 : 대상은 경북대학교 병원 및 동국대학교 경주병원 산부인과에서 자궁경부선암 및 선편평상피암으로 진단받은 환자들의 임상기록지를 통하여 연령별 분포, 임상병기별분포 및 이에 따른 치료, 증상 등의 임상적 양상을 분석하였다. 결과 : 1. 환자의 평균 연령은 49.5세로, 선암은 51.9세, 선편평상피암은 45세이다. 2. 임상병기별 분포는 1기가 22예(52.3%)로 가장 많았고, 2기 17예(40.5%), 3기 1예(2.4%), 4기 1예(2.4%)였다. 3. 분만 횟수는 1∼4회가 26예(61.9%)로 가장 많았다. 4. 가장 흔한 임상증상은 자궁출혈(비정기 출혈, 성교후 출혈, 폐경후 출혈)로 42예중 27예(64.3%)였으며, 그외 대하, 요통, 복통 등을 호소하였다. 5. 조직분화정도에 따른 분포는 well differentiated type이 15예(35.7%)로 가장 많았고, moderate differentiated type이 13예(30.9%), poorly differentiated type이 7예 (16.7%)였다. 6. class Ⅲ 이상의 비정형 질세포진 검사예는 20예(47.6%)였다. 7. 조직분화정도에 따른 임파절전이는 well differentiated type이 1예(14.3%), moderate differentiated type이 3예(27.3%), poorly differentiated type이 1예(33.3%)였다. 결론 : 임상적으로 잘 알려진 자궁경부 편평상피암과 선암의 임상적 고찰에는 별 특이한 차이가 없었으며, 자궁경부 선암의 치료에 있어서 병기에 따른 분류, 종양의 크기, 골반내 임파절 전이상태를 고려하여 치료 계획을 수립하여야 한다. There is increasing evidence that the prevalence of adenocarcinoma of the cervix has risen over the past two decades. Clinicopathological analysis was performed on 42 cases of adenocarcinoma and adenosqamous carcinoma of the uterine cervix. The adenosquamous patients were analysed on the basis of age, parity, stage, clinical symptom, histologic grading and pelvic lymph node metastasis. The mean age of the patient was 49.5 years old. The distribution by stage included FIGO stage Ⅰ, 22(52.3%); stage Ⅱ, 17(40.5%); stage Ⅲ, 1(2.4%); stage Ⅳ, 1(2.4%). The most frequent clinical symptom was uterine bleeding (intermenstrual, postcoital, postmenopausal) in 27 cases (64.3%). The histologic gradings were classified as follows: well differentiated type 15 cases(35.7%), moderate differentiated type 13 cases (30.9%) and poorly differentiated type 7 cases(16.7%). The rate of abnormal papanicolaou smear which obtained from patient were 40.7%. The frequency of lymph node metastasis was 14.3% in well differentiated type, 27.3% in moderate differentiated type and 33.3% in poorly differentiated type. There is no significant difference about clinicopathologic analysis between adenocarcinoma, adenosquamous carcinoma and squamous carcinoma of uterine cervix. There is considerable controversy about the most appropriate treatment of adenocarcinoma of the cervix. Treatment strategies should be based on the stage of disease, tumor size, lymph node metastasis status and recurrency.

      • 勤勞者에 대한 特殊健康診斷 所見

        金斗熙,金明漢 慶北大學校 醫科大學 1979 慶北醫大誌 Vol.20 No.1

        勤勞保健의 向上을 目的으로 先究者의 失敗한 地域 내에서의 새로운 기틀을 잡고 生産醫學 硏究에 이바지 하기 위하여 1976年에 탐색작전으로 시작하여 1977年 78年은 漸進的 勤勞者 健康管理事業을 推進한 결과 多少의 成績을 얻었기에 發表하는 바이다. 본 調査事業은 大韓産業保健協會와 慶北大學校 醫科大學 豫防醫學科와의 協同으로 이루어 졌다. 總對象 企業體중 5% 내외에서만이 特殊檢診을 의뢰하고 있으며 對象 企業體의 全勤勞者중 約 40∼40%가 有害部署에 勤務하는 것으로 되어 啓蒙不足을 意味하며 그중에서도 受診率이 약 45%(35∼55%) 내외임은 많은 問題를 던져 주고 있다. 受診者중 약 1/3 (30∼34%)에서 어떠한 身體的 所見을 찾아 볼 수 있었다. 注意를 요하는 자는 21∼27%로서 연연이 증가되고 있으며 職業과 深刻하게 有關되는 例는 5∼9%로 역시 增加 趨勢를 보이고 있다. 一般的인 病은 해마다 減少되고 있음은 좋은 現狀으로 일단 받아드려야겠다. 특히 貧血의 減少와 糖尿의 增加는 勤勞者 榮養問題와 關聯되는 것으로서 食生活의 보다 向上을 뜻하는 것으로 생각된다. 結核과 高血壓의 減少는 事後措置의 結果로 볼 때 産業保健上 좋게 받아들여야 할 것이나 그 以後의 待遇問題가 어떤지 궁금하다. 呼吸器, 眼 등의 有病率의 結果로 有機溶劑와 酸·알카리 取扱者에 대한 作業環境의 改善을 意味한다고도 볼 수 있겠다. (筆에 앞서 본 硏究에 協助해 주신 大韓産業保健協會 會長 崔 永泰 博士님과 大邱地方 動勞廳事務所의 關係職員 여러분께 感謝드립니다.) This paper presents the result of the preceeding of industrial health work and some physical findings from travelling clinic of The Gyongbug Industrial Health Center for three years duration since 1976. The center mentioned was founded by making a letter of agreement to promote the industrial health in our arounding society between President of The Korea Association of Industrial Health and Dean of Medical School of Kyungpook National university at February 26, 1976. And then I had an oppotunity to participate directly for industrial health survey. The converage area was illustrated in Fig. 1--shaded part in cluding of Daegu city and nine adjacent counties (Gun). Gyeongbug province was divided into four subareas-textile, electric, iron and mining. These subareas were same as the Govermental supervising area by Areal Labour Offices in this prooince. The appropriate registrated industries in Daegu Labour Office of which had five or more emplo yees were 1,707 at the early of 1976, but incressed to 3,173 at the end of 1978, And about 80% of them were located in Daegu city and about 50% were textile. The population worked in the registrated industries were estimated as 19,041 in 1976, but 32,043 in 1978. The mobile team was constituted with three part-time medical Drs. specialized by preventive medicine, two technicians-one for clincial pathology and another for radiology, a nurse and a clerk. And the Laboratory facilities of the Medical School of KNU were used to befor this task. By the way, the availables consulted to visit for health survey only about five percent of all industries every year. About 40-50% of all employees were exposed to somewhat harmful environment. Among them, about 35-55% were only examined for occupational diseases by this progress in spite of that they had to be examined by any authorized medical organizations, at least once a year-it was prescribed by Government in Labour Law. Among the examined employees, about one third, 30-34% of them were something recognized with abnomal physical findings- C_5-dip, pulmonary tuberculosis, hypertension and anemia, respiratory or eyes and ENT symptoms and signs, and sugar and alvumin in urinalysis. There were included of thoese who needed somewhat careful attentions- about 21-27% of the examinees. The cases of that closely related to their occupations, the complaints of occupational physical symptom and signs were five to nine per cent, but there were a trand of increasing gradually in every year. In otherwise, non-occupational physical problems were gradually decreased in the same duration. Particularly, it was supposed that the slight decrease of anemia and the slight increase of diabetic cases by the years mean favourable supplies of their nutrients than before time, and that also the decrease of pulmonary tuberculosis and hypertension may be suggested the more well control of the industrial health, even if these data were too coarse and feeble to say definitly.

      • 잔류 담석

        이영하 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.1

        1976년 6월부터 1980년 5월까지 경북대학교 의과대학 외과학교실에 입원가료한 잔류담석 18예에 대한 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 이기간중 본병원에서 발견된 잔류담석은 5예로 모든 담낭절제술의 4%, 총수담관담석제거술의 5%이었다. 2) 18예잔류담석증 환자가 과거에 받았던 일차수술은 총담관을 절개하여 탐색하였던 경우가 15예로 83%였다. 3) 일차수술후 잔류담석의 증상이 나타났는 기간은 50%에서 1년이내, 50%에서는 1년에서 긴 경우는 26년까지 다양하였다. 4) 잔류담석의 원인으로 술자의 경험과 올바른 판단의 부족 및 불충분한 시설하에 수술을 시행한 경우가 55%이었다. 5) 수술전 잔류담석의 확인은 5예서 T-tube담관조용술, 13예에서는 P.T.C.로 담석을 확인하였다. 6) 이차수술식은 9예서 총담관절개술 및 총담관 십이지장문합술을, 괄약근성형술 3예 및 4예서는 잔류담석제거와 T-tube drainage를 실시하였다. 7) 재수술후 잔류담석이 2예서 발견되어 그 발생빈도는 13%이었다. 사망예는 없었다. Despite the use of operative cholangiography and meticulous technique in exploring the common bile duct, the retained stone which is still occaisonally found during the post-operative period, is one of the problems that haunts the surgeon. A series of eighteen cases of retained stone was analyzed in order to investigate the clinical characteristics and to find out the way to decrease the incidence of retained stone. Following results were obtained. The occurrence of retained stone was more frequently encountered after previous choledocholithotomy. The best way of preoperative confirmation of retained stone was P. T. C. and T-tube cholangiography. To reduce the incidence of retained stone, the surgeon in charge of an operation on the gall stone must try to detect and remove all stones in the bile duct through palpation, operative cholangiography and duodenostomy according to individual cases. Also he must combine biliary drainage procedure (sphincteroplasty or choledochoduodenostomy) with primary operation under some circumstances.

      • API 20C Auxanogram^�에 의한 효모 동정 가치

        이원길,김중명,김재식,김경숙 慶北大學校 醫科大學 1988 慶北醫大誌 Vol.29 No.1

        1987년 1월부터 동년 12월까지 경북대학교 의과대학 임상병리과에 의뢰된 검체 중에서 분리되었던 효모는 총 184주이었으며, API 20C Auxanogram을 이용하여 동정한 결과 아래와 같이 요약할 수 있었다. 효모가 많이 분리된 검체는 객담 78(42.5%), 요 54(29.2%), 늑막액 12(6.5%) 순이었으며, 많이 분리된 효모로는 C. albicans 80주 (43.6%), C. parapsilosis 44주 (23.9%), C. tropicalis 31주 (16.8%) 등이었으며, C. albicna와 C. tropicalis가 가장 많이 분리된 검체는 객담이었고, C. parapsilosis가 가장 많이 분리된 검체는 늑막액이었으며, T. beigelli와 T. glabrata가 가장 많이 분리된 검체는 요이었다. Yeast infections are commonest fungal infection of human. Their incidence become to be increased, as the frequency of altered host immune system is increased. Since antifungal agent within a selective or narrow range of activity are available, it is important that speciation of yeast in routine clinical microbiolgy practive should be effected rapidly and reliably We isolated 184 strains of yeast and that were identified by API 20C Auxanogram. Sputum(42.5%), urine(29.2%) and peritoneal fluid(6.5%) were the most frequnt specimen in which yeast isolated in order Candida albicans(43.6%), Candida parapsilosis(23.9%) and Candida tropicalis(16.8%) were the most frequently identified Species in order Candida albicans and Candida tropicalis were most frequenly isolated species in sputum among various specimens. Candida parapsilosis was in pieural fluid, and Torulopsis glabrata and Trichosporon beigelli were in urine.

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