서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

노치 형상 및 냉각속도에 따른 Zr-2.5Nb 압력관의 DHC거동

김상재,김영석,임경수,김성수,정용무 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.1

The objective of this study is to investigate the delayed hydride cracking (DHC) velocity and the incubation time for the water-quenched and furnace-cooled Zr-2.5Nb tube with the different radius of a notch tip. DHC tests were carried out at constant K_1 of 20 MPa√m and 250℃ on the cantilever beam (CB) specimens subjected to furnace cooling or water quenching after electrolytic charging with 57 or 72 ppm hydrogen, respectively. An acoustic emission sensor was attached to the CB specimens to detect the incubation time before the start of DHC. The shape of the notch tip changed from the fatigue crack to the dull crack with its radius ranging from 0.1 to 0.15 mm. The DHC incubation time increased remarkably with the increasing radius of the notch tip, which appeared more strikingly on the furnace-cooled CB specimens than on the water-quenched ones. However, both furnace-cooled and water-quenched CB specimens indicated little change in the DHC velocity with the radius of the notch tip unless their notch tip exceeded 0.125mm. These results demonstrate that the uncleation rate of hydrides at the notch tip determines the incubation time and the DHC velocity becomes constant after the concentration of hydrogen at the notch tip reaches the terminal solid solubility for dissolution (TSSD). This observation agrees well with Kim's DHC model. A difference in the incubation time and the DHC velocity between the furnace-cooled and water-quenched specimens is discussed in terms of the uncleation rate of hydrides at the notch tip and the hysteresis of hydrogen solubility.

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.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

2003년도 해양스포츠 체험활동을 통한 소아건강교실 사례 발표

김현준,이상엽,이가영,곽현,이남수,김혜선,김윤진,김인주,김용기,대한비만학회 부산분과학회 일동 대한비만학회 2003 The Korean journal of obesity Vol.13 No.4

부산에 소재한 3개 초등학교 청소년단체 소속의 초등하교 3학년부터 6학년까지 구성된 172명을 대상으로 청소년단체 지도자, 초등학교교사, 자원봉사자, 의사와 영양사가 1박 2일간의 해양스포츠 체험활동 을 통한 건강교실을 시행하였다. 대상자의 체질량지수, 체지방량을 측정하여 비만정도를 평가하였으며, 칼로리 섭취에 대한 강의를 시행하였고, 설문지 조사를 통해 대상자의 식이 섭취 습관에 대한 조사를 시행하였고, 본 건강교실에 대한 만족도를 측정하였다. 대상자중 남자에서는 40%, 여자에서는 25.69%에서 비만 경향을 보였다. 대상자의 대부분에서 시행된 건강교실에 긍정적 반응을 보였으며, 향후 체계적인 구성과 철저한 사전계획이 병행되어 본 증례 보고와 같은 건강교실을 시행한다면, 비만아동에서 거부감 없이 비만에 대한 교육을 실시할 수 있으며, 정상 체중 아동군에서도 비만에 대한 예방교육을 시행할 수 있는 프로그램이 될 것이다. 172 elementary school students involved this health program. This subjects were learened about obesity that affect health problem, ideal eating habits, calories that contained in the children's favorite foods by doctors and nutritionist. And this stubjects were checked heights, weight, body fat percent. Obesity is 40% in the boys and 25.69% in the girls. Most subjects were satisfactory with this health program. So we will effectively educate obese children without resistance and prevent normal weight children from obesity through structured and well-designed health program that similar to this program.

C 의과대학에서 문제강의에 대한 학생들의 직접평가가 강의개선에 미친 영향

김석용, 이상진, 최재운, 김승렬, 김용대, 배성은, 김영규 충북대학교 의과대학 충북대학교 의학연구소 2012 忠北醫大學術誌 Vol.22 No.1

연구목적: 팀티칭에 근거한 통합강의는 최근 대부분의 의과대학에서 시행되는 강의형태이다. 그러나 기 존에 사용되고 있는 온라인 강의평가 방식은 이러한 강의 특성에서 나타나는 문제점을 파악하기 힘든 점이 있다. 본 대학에서는 팀티칭에 의한 통합강의에서 문제강의를 직접적으로 파악하는 ‘문제강의 직 접평가지’를 개발하였다. 본 연구의 목적은 새로이 개발된 문제강의 직접평가지가 강의개선에 끼친 영 향력을 알아보고자 하는 것이었다. 연구방법: 2007년 2학기부터 2009년 2학기까지 충북대학교 의과대학 1, 2학년을 대상으로 문제강의 직접평가지에 의한 강의평가를 실시하였다. 평가지 질문 중에서 두 가지 객관식 질문에 대한 답변을 분 석대상으로 선택하였다. 질문은 첫째, ‘가장 유익하고 도움이 많이 되었던 강의들은 무엇입니까?’와 둘 째, ‘가장 어렵거나 이해하기 힘들었던 강의들은 무엇입니까?’였다. 강의평가를 실시한 강좌들 중에서 2 년 이상 연속적으로 강좌구조와 평가지의 객관식 질문 형식이 변하지 않은 14개의 강좌를 분석대상으로 하였다. 각각 연도의 평균 긍정비율을 다른 연도의 것과 카이제곱 검정 방법을 사용하여 비교하였다. 결과: 14개의 강좌 중에서 시작연도와 마침 연도 간에 긍정비율이 증가된 경우는 13개 강좌였다. 그 러나 통계적으로 의미가 있는 경우는 5개 강좌에서 나타났다. 결론: 문제강의 직접평가지에 의한 문제강의를 판별해 내는 방법은 단기간에 통합강좌의 개선에 효과 적이다.

Investigation of Weld Corrosion Eff ects on the Stress Behavior of a Welded Joint Pipe Using Numerical Simulations

Yong‑Sang Kim,Jung‑Gu Kim 대한금속·재료학회 2019 METALS AND MATERIALS International Vol.25 No.4

In this paper, the infl uence of weld corrosion on the mechanical behavior of a welded joint pipeline was investigated usingcorrosion and mechanical simulations simultaneously. In the corrosion simulation, the modeling results (i.e., the corrosionpotential and current density) revealed that the welded joint is preferentially corroded and the corrosion rate is higher in theoutside environment due to the severe corrosion factors. The increase in corrosion degradation according to the operationtime increases the stress concentration on the welded joint, indicating that the failure risk of the welded joint is increasedwith increasing corrosion degradation. These results can be used to evaluate the lifetime of welded joints exposed to corrosionand suggest guidelines for the maintenance of structures.

A Study of the Yang-gyeong-gyu-il-ui (兩景揆日儀) in the Joseon Dynasty

Yong Sam Lee,Sang Hyuk Kim,Byeong-Hee Mihn 한국우주과학회 2015 Journal of Astronomy and Space Sciences Vol.32 No.1

The Yang-gyeong-gyu-il-ui (兩景揆日儀) is a kind of elevation sundial using three wooden plates. Sang-hyeok Lee (李尙爀, 1810~?) and Byeong-cheol Nam (南秉哲, 1817~1863) gave descriptions of this sundial and explained how to use it in their Gyu-il-go (揆日考) and Ui-gi-jip-seol (儀器輯說), respectively. According to Gyu-il-go (揆日考) there are two horizontal plates and two vertical plates that have lines of season and time. Subseasonal (節候) lines are engraved between seasonal (節氣) lines, subdividing the interval into three equal lines of Cho-hu (初候, early subseason), Jung-hu (中候, mid subseason) and Mal-hu (末候, late subseason); there are 13 seasonal lines for a year, thus resulting in 37 subseasonal lines; also, there are 12 double-hour (時辰) lines for a day engraved on these plates. The only remaining artifact of Yang-gyeong-gyu-il-ui was made in 1849 (the 15th year of Heon-jong) and is kept at the Korea University Museum. We have compared and analyzed Yanggyeong- gyu-il-ui and similar western sundials. Also, we have reviewed the scientific aspect of this artifact and built a replica. Yang-gyeong-gyu-il-ui is a new model enhanced from the miniaturization development in the early Joseon Dynasty and can be applied to the southern part of the tropic line through a structure change.