병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성

김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.

무애 양주동의 『삼국유사』 향가 인식

김성주 ( Seong Ju Kim ) 한국불교사학회 한국불교사연구소 2014 한국불교사연구 Vol.5 No.-

It was difficult to find the evidence about how Muhae(无涯) Yang Ju-dong(梁柱東) evaluate Samkukyusa in his books. We could indirectly understand it through how Yukdang(六堂) Choi Nam-seon(崔南善), who had, ideologically and culturally, a major influence on him, had evaluated Samkukyusa. He considered Hyanggas, national songs in Silla, as the oldest inheritance of this literature and the highest basis of our culture and ideology. And he also understood Samkukyusa as a literature which handed down such valuable Hyanggas, which were written by the borrowed characters from China. It was true that there was his interpretation of Hyanggas in his Kogayeongu(『古歌硏究』), which had not been corrected by the grammar of Seokdokgugyeol or Eonhae, the Korean annotation or translation of Chinese classics. Specially, because 音叱[ms] in Hyanggas was the same grammatical expression as □(ms) in Seokdokgugyeol which was a grammatical item expressing the speaker``s obligation, impropriety, ability or willness However, other scholars`` interpretations on Hyanggas after Muae were not better than that of Muae``s. Some of other scholars`` interpretations were very different from those of Muae``s. Therefore, if we take the circumstances at his time, his interpretation of Hyanggas, i.e. Kogayeongu, is an unequalled, immortal work, and also, if we correct something wrong in his interpretation of Hyanggas through the present grammar of Seokdokgugyeol and Enhae, his interpretation of Hyanggas is still an effective interpretation in this epoch of ours.

만성 간질환에 대한 DDB(Biphenyl Dimethyl Dicaboxylate)의 임상적 효과

이헌영,임의혁,김성걸,김진희,육은주,성자원,김병호,정형용,강대영,김영건 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

To investigate the effects of short-term administration of DDB(Biphenyl Dimethyl Dicarboxylate) for decreasing elevated serum aminotransferase levels in chronic liver diseases, authors applied 3 capsules of DDB per day at each meal time for 35 patients and compared with 35 patients treated with other conservative management. The following results were obtained. 1. Serum alanine aminotransferase (ALT) levels significantly decreased from 247.1± 180.0 IU/L of pretreatment level to 96.6±126.0 IU/L, 61.1±62.7 IU/L and 38.0±26.8 IU/L after 1, 3 and 6 months of treatment(p<0.05) and effective rates were observed in 60.0%, 71.4% and 88.6% of patients after 1, 3 and 6 months of treatment. 2. Serum aspartate aminotransferase (AST) levels decreased also significantly from 167.8±96.9 IU/L of pretreatment levels to 124.4±155.0 IU/L, 77.9±49.6 IU/L, 60.6± 46.9 IU/L after 1, 3 and 6 months of treatment(p<0.05), but decreasing pattern of serum AST was less significant than that of serum ALT. 3. No significant difference were observed in the serum ALT and AST changes according to the cause and duration of hepatitis. 4. No significant adverse effects were observed in whole patients treated with DDB. It is suggested that small dose administration of DDB is effective for decreasing serum aminotrans ferase levels in chronic liver disease in which other conservative management was not effective.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

하악골 골절에 대한 임상통계학적 연구

이성훈,김기영,조규승,소광섭,박홍주,조요기,오희균,유선열 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

광양만으로 유입하는 하천하구에서의 이화학적 특성 : 우수기 직후 유입하천에 따른 영향 effect of inputting rivers after rainy season in summer

김은영,정흥호,정호승,조환익,황주찬,최상원 한국환경과학회 2004 한국환경과학회지 Vol.13 No.9

Physicochemical characteristics of Kwangyang Bay, have been investigated on the effects of inputting rivers just after rainy season in summer 2003. The results ranged from 4.96~8.01 mg/L for DO, 1.16~3.09 mg/L for COD, 7.21~67.71 μM for DIN and 0.12~121.84 μM for phosphate. The COD of Yeosu Area was 1.19~3.09 mg/L, Kwangyang Area was 1.23 ~ 2.76 mg/L. The COD of Wallae cheon in Yeosu Area was 3.09 mg/L and Donghoan in Kwangyang Area was 2.76 mg/L. The reason of high COD might be industrial sewage of organic chemical plants and iron foundry. DIN of Yeosu Area and Kwangyang Area were 7.21--63.43 μM and 8.43 67.71 μM respectively. The average phosphate of Yeosu Area was 23.65 μM. The source of phosphate might be industrial sewages of fertilizer plant and phosphate gypsum stocked with high amounts. The metal concentrations were measured in the range of 1.01~175.10 ㎍/L for Cu, 0.13~1.78 ㎍/L for Cd, 1.13~5.21 ㎍/L for Pb, 1.58~13.57 ㎍/L for Cr and 1.07~20.68 ㎍/L for As. The average Cu concentration was 78.99 ㎍/L in Kwangyang Area. The source of Cu might be industrial sewage of iron foundry. The average Cr concentration of Yeosu Area was 9.07 ㎍/L. That is 2 times higher than Kwangyang Bay 5.74 gg/L, because of sewage of chemical plants.

1866∼7년 데이 드레스(day dress)의 설계 및 디자인 분석

김문숙,이서희,오현남,한성지,김현주 서울여자대학교 자연과학연구소 1996 자연과학연구논문집 Vol.7 No.-

As the current stage of the fashion begins to follow the styles of the past, the study on the past costume is getting more important, and as the methodology of the study accurately approached study through the rehabilitation of the past costume is more needed than the simple rearrangement of the historical documents. By this methodology, this study can be positioned as a recreation activity. The results of the study are as follows. 1) Style : The general silhouetts is the late crinoline style which is the period from 1860s to just before bustle. The dress is one-piece composed of fitted bodice, and skirt which the front is flat, side and back is triangular shape to the skirts. 2) Color and Material : the main color is pale stone and the sub-color is ivory and blue. The dress is made of a silk surface and cotton back and partly satin and velvet. 3) Pattern and sewing : the dress is together sewing comnined with lining and fabric. The skirt is gored skirt, the number of patterns is plenty because of the plenty of width of skirt. The double piping has various effect not only to decorate but also to conceal the seam, support the silhouette. 4) Detail : The general detail is double piping which are repeatedly used to decorate stand collar, bands of sleeve, froint bodice and gored panel seam of skirt. And the fringe and velvet ribbon are used to decorate the dress. 5) Structural characteristics : The double piping, velvet ribbon and twilled cotton are used to emphasize structural characteristics of crinoline style. And the waistband which is backed with a webbing band to reinforce it is also the structural characteristics. Synthetically, the 1886~7 day dress has the characteristics of transitional stage in which the chararcteristics of the costume of 1860s and the remnants of the characteristics of the previous costume style, and shows the characteristics of day dress well in terms of the style, color and fabrics, pattern and sewing, detail, and structural characteristics.

일부 만성질환에 징후발현과 위험요인에 관한 코호트 연구

김성봉,이명주,김순덕 고려대학교 의과대학 1996 고려대 의대 잡지 Vol.33 No.1

The incidence and risk factors for the manifestations of some chronic diseases were determined in 956 healthy employees of a hospital who had no diseases in a cohort study conducted between 1984 and 1994. The body measurements, laboratory, chest X-ray and questionnaire survey were performed in order to estimate the exposures or risk factor that was study entry age, sex, body mass index, systolic and diastolic blood pressure, fasting blood sugar, serum total cholesterol, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, hepatitis B surface antigen(HBsAg), family history smoking history, alcohol history, salty food intake, meat intake, exercise, and weight gain. And then they were followed up through the health examinations and questionnaire survey annually, and ascertained whether they had the manifestations of chronic diseases or not. The incidence rates were calculated by the concept of the incidence density because each of the study subjects had different follow-up periods. The results were as follows. 1. The study subjects were 324 males(33.9%) and 632 females (66.1%). The distribution of study entry age is 680 persons(71.1%) below 29 years of age, 165 persons(17.3%) between 30-39% years of age and 111 persons(11.6%) over 40 years of age. The observational person-years of study subjects were all 4,193 person-years. 2. Manifestation of chronic diseases newly diagnosed were 129 cases. There were 53 cases (41.4%) of hypercholosterolemia, 37 cases (28.7%) of liver disease, 24 cases (18.6%) of hypertension, 6 cases (4.7%) of diabetes mellitus, 6 cases (4.7%) of pulmonary tuberculosis, and 3 cases (2.2%) of urine abnormality. 3. The incidence density of manifestations of chronic diseases were 30.8 per 1,000 person-years, Age-standardized incidence density were 48.5 per l, 000 person-years for male and 21.1 per 1,000 person-years for female, and the relative risk were 2.3(95% confidence interval 1.4-3.8). The incidence densities were increased with the study entry age. There were 17.9 per 1,000 person-years below 29 years of age, 51.9 per 1,000 person-years between 30-39 years of age and 53.3 per 1,000 person-years over 40 years of age. The incidence density was highest as 71.3 per 1,000 person-years between 30-39 years of age for male and 65.2 per 1,000 person-years over 40 years of age for female. 4. The incidence density of hypercholesterolemia was 12.6 per 1,000 person-years, liver disease 8.8 per 1,000 person-years, hypertension 5.7 per 1,000 person-years, diabetes mellitus 1.4 per 1,000 person-years, pulmonary tuberculosis 1.4 per 1,000 person-years and urine abnormality 0.7 per 1,000 person-years. 5. The significant independent risk factors to be identified from the stepwise logistic regression analysis were body mass index and study entry age for hyperchole-sterolemia, male sex, HBsAg and weight gain for liver disease, and male sex and study entry age for hypertension. For the prevention of chronic diseases, it was very important to control the body mass index, weight gain and HBsAg that are reversible factors among the risk factors affecting to manifestations of some chronic diseases, whereas sex and age are irreversible factors.

사동사 '보내다'

김성주 동국대학교 국어교육과 1997 동국어문학 Vol.9 No.-

이와 같이 사동을 표현하는 문장은 모두 동등한 정도로 사동을 표현하는 것이 아니다.‘보내다’의 경우도 사동 형식이 없다는 이유로 사동사에서배제하기보다는 사동을 표현하는 특정한 형식은 없지만 사동사에서 배제하기보다는 사동을 표현하는 특정한 형식은 없지만 사동의 의미를 가지고 있는 사동사로 규정하고, ‘보내다’와 같이 특정한 형식이 없이 사동의 의미를 가지고 있는 동사를 사동법의 영역에 포함시킴으로써 언어 현상을 보다 잘 이해하고 적절하게 기술하는 문법 연구의 목적을 이룰 수 있다.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).