현암 김종희 회장의 생애와 경영이념 연구

김성수(Sung Soo Kim) 한국경영사학회 2009 經營史學 Vol.52 No.-

이 논문은 한국 화약산업의 개척자 한화그룹의 창업주 현암 김종희 회장의 생애와 경영활동 연구를 통한 경영이념 및 신 기업가정신(New Entrepreneurship)을 발굴하는 데 목적을 두었다. 현암 김종희 회장은 1922년 11월에 출생하여 1981년 7월(59세)에 영면 하였다. 비교적 짧은 생을 살았지만, 현암 김종희 회장은 1952년 30세 때에 화약산업의 불모지인 한국에서 한국화약㈜을 창업하였다. 그는 ‘다이너마이트’ 생산의 성공으로 혁신적인 화약류 국산화의 꿈을 실현한 훌륭한 기업가이다. 그는 한화그룹의 창업주로서 화약, 석유화학, 기계, 호텔, 건설, 무역 등 생전에 17개의 대기업집단을 이룬 창업 CEO이다. 그는 신의와 혁신, 도전과 개척 정신 그리고 변혁적 리더십 소유의 기업가로, 한국의 화약산업 개척자로서 화약산업사의 역사적 인물로 부각되며, 우리나라 화약산업의 기업 가사 연구의 중요한 경영사학적 사례를 제공한 기업인으로 평가된다. 그는 생애 경영활동을 통하여 사업보국 이념을 중심으로 ‘신용과 의리 그리고 봉사’로서 인류사회에 공헌하고자 하는 경영이념을 실현한 기업가이다. 특히 사업보국을 이념으로 발굴된 그의 신 기업가정신은 이 연구에 큰 의미를 준다. 즉, (1) 신의정신, (2) 도전과 개척정신, (3) 책임정신, (4) 근검절약정신, (5) 합리주의 정신, (6) 창의와 혁신정신, (7) 인재육성정신 등 7개의 기업가정신으로 나타나고 있다. 그리고 그의 혁신적 기업인 상은 (1) 인간성 중시의 변혁적 리더십을 소유한 기업인으로 대표되며, (2) 정도경 영을 실천한 기업인 (3) 경영이념(사업보국주의)을 통한 생산성 향상 정신을 실천한 기업인, (4) 혁신경영과 기술개발 노력을 실천한 기업인, (5) 위기극복과 문제점 해결능력을 갖춘 기업인 등으로 평가된다. 특히 (6) 국익증대의 선봉에 선 민간 외교관, (7) 스포츠 강국을 꽃피운 체육계의 거목이라는 경영인 상을 가진 기업가로도 높이 평가된다. The purpose of this study is to explore the chairman Chong-Hee Kim’s life and Managerial ideology, founder of Hanwha group. This research was to Highlight the entrepreneurship of chairman Chong-Hee Kim of Korea explosive founded (currently Hanwha Corp. Explosive Division), who carries the management principle which focuses on the devotion to business patriotism of social responsibility by providing best products and services with talent and technology. Also it aimed to revisit the life and the management principle of chairman Chong-Hee Kim who, with the business patriotism of righteousness and sense of mission, tried to found korea’s first gunpowder corporation. This research was mainly divided into two parts:literature-history research method and managerial history research method, and it analyzed the managerial accomplishment chronically according to the literature history documents, and managerial history method. This study took 12 months in which the document collecting process, writing process, and 6 party joint research processes were completed. The content of the research divided and categorized chairman Chong-Hee Kim’s life and managerial principle in the following order:(1) Social back ground at time of his birth (2) Elementary, middle and high school education in his teenage period (3) Business career begins (age 20-30) in his adolescent (4) 30s (age 31-40):president inauguration of the korea explosive founded, (currently Hanwha corp.explosive division), and his management his managerial growth process in his early adult life, in case, oct, 1952 korea explosive founded (gunpowder corp), oct, 1955 Incheon explosive plant acquired, jan,1959 all domestics industrial explosive suppled by korea explosives (5) 40s (age 41-50):his managerial revolution process in his middle the prime of the life, in case, Jan, 1964 Shinhan bearing industrial acquired, Nov, 1969 Kyungin energy established (6) 50s (age 51-59):genius management and establishment of the leading corporation in the Korean defense industrial and diversified management in his latter the prime of the life. In case, dec,1972, Hankook plastics industrial established, sept, 1974, union polymer established (currently Hanwha polydreamer), may 1975, Cheon-an Bukil foundation established, may 1976, sundo securities acquired (currently Hanwha securities). Next, the entrepreneurship through chairman Chong-Hee Kim’s managerial creed and ideology was examined. The 7 elements of Chong-Hee Kim’s new entrepreneurship of business patriotism that were examined are as follows : (1) Spirit of faithfulness (2) Spirit of challenge and pioneer (3) Responsibility for the fulfillment of obligation (4) Spirit of diligence and frugality (5) Spirit of rationalism for management (6) Spirit of creative and Innovation (7) Spirit of corporative social responsibility and service to society His entrepreneurship is based on the transformational leadership of rich humanity and management of righteousness, he is pioneer of schumpeter’s (J.A), and the creative entrepreneur who seeks for Innovation. The management philosophy of Hanwha (chong-hee, kim) is embedded in the Hanwha TRI circle ; the three circles Represent Trust, Respect and Innovation, respectively. They are the three pillars of how it’s conduct our business. Vision of Hanwha (chong-hee, kim) is just as committed being trustworthy, respected and Innovative as a responsible member of society as the Hanwha be to becoming dynamic global enterprise. As symbolized in the Hanwha TRI Circle, Trust, Respect and Innovation are core value as its interact with customer, serve our community and improve the everyday lives of people in general.

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.

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.

김재철 회장의 생애와 기업가정신 연구

김성수(Sung soo Kim) 한국경영사학회 2009 經營史學 Vol.50 No.-

이 논문의 목적은 “성실한 기업활동으로 사회정의 실현”과 “도전과 정도경영”에 바탕을 둔 동원그룹의 창업자 김재철 회장의 생애와 경영활동을 통한 기업가 정신(Entrepreneurship)을 발굴하는 데 있다. 김재철 회장은 1969년 34세때 동원산업(주)를 창업한 현재(2009년 4월)까지 40여년간 한국수산업계를 선도해온 창업자이면서 전문경영자(CEO)이며, 식품산업으로 시작하여 1차산업에서 2차산업으로 그리고 3차산업의 금융 및 서비스산업까지 사업다각화로 동원그룹을 세계적(Global)기업으로 발전시킨 창조적, 혁신주의 기업가이다. 이러한 동원그룹의 김재철 회장의 연구는 다음과 같은 네 가지의 중요성을 가지고 있다. 첫째, 동원그룹 창업자 김재철 회장의 생애와 경영이념을 고찰하여, 동원창업자의 Entrepreneurship을 발굴하여, 한국기업가사 연구의 체계적 정립을 마련하는 데 있다. 둘째, 동원 김재철 회장은 슘페터(J. A, Schumpeter)가 지적한 혁신적(Innovation) 경영활동을 적용해서 “동원경영학”의 정립을 체계화시키는 데 노력하고 있다는 점이다. 셋째, 대표적 수산업의 CEO 김재철 회장 경영활동을 통하여 “동원수산경영”의 발전과정을 경영사학계에 보급시키고자 하는 기초자료 제공에 있다. 넷째는 앞으로 해양수산업의 관리자 및 CEO가 되고자하는 청소년 및 대학생들에게 기업가 정신(Entrepreneurship)의 중요성을 인식케 하는 기초자료를 제공하는 데 있다. 본 논문은 경영사연구방법론을 채택하였다. 경영사의 개척자인 미국하버드 경영대학원(Harvard University, Graduate School of Business Administration=HBS) 경영사 교수인 그라스(Norman Scott Brien gras)와 챈들러(Alfred, D. Chandler)박사 등이 개발하고 활용하여 전 세계 학계에 보급한 ‘경영사연구방법론’을 도입하여 활용하였다. 이에 따라 동원의 김재철 회장이 추구하는 가치와 정신은 고객/주주 제일주의, 1등주의, 현금흐름주의 등이며, 21세기 그의 정신은 (1) 창조정신, (2) 열성정신, (3) 도전정신 등 ‘Candoism’으로 요약된다. 또한 그의 기본사상은 (1) from the basic(기본의 철저한 준수) (2) fact finding(현장주의 업무수행 자세) (3) global standard(국제수준의 업무품질) 등으로 나타났다. 그리고 성실한 기업 활동으로 사회정의 실현을 선도하는 가치는 (1)생활문화의 New Leader로서 위상을 향상시키는 사업가치 (2) 고객을 존중하고 만족시키며, 동원그룹을 창조기업으로 승화시키는 고객가치 (3) 1등주의 인재육성과 성과조직을 인적자원관리의 최우선으로 하는 인재가치 등을 확인할 수 있었다. This study was to highlight the entrepreneurship of chairman Jae-Chul Kim the founder of Dongwon Industries Co., Ltd, who carries the management principle which focuses on the devotion to under the realization of social justice, the function of the enterprise will be done in honesty and loyalty. Dongwon creates fresh and new experiences into the customers’ lives. it will be the prime company that leads the lifestyle culture in the 21st century. Also it aimed to revisit the life and the management principle of chairman Jae-Chul Kim who, with the new management, tried to found world’s first human corporation social responsibility. This study was mainly divided into two parts:literature-history research method and managerial history research method, and it analyzed the managerial accomplishment chronically according to the literature history documents, and managerial history method. this research took 8 months in which the document collecting process, writing process, and 7 party joint research processes were complete. The content of the research divided and categorized chairman Jae-Chul Kim’s life stages and managerial principles in the following order:(1) social back ground at the time of his birth (2) elementary, middle and high school education in his teenage period (3) university and establishment of oneself in life, one’s youth period is the time of adventure and daring (4) president inauguration and the foundation of the Dongwon Industries Co., Ltd and his management and his managerial growth process in his early adult life, (5) genius management and new experience creator-Dongwon group of the leading enterprise in the world in his latter adult life Next, the entrepreneurship through chairman Jae-Chul Kim’s managerial principle was examined. The 10 element of Jae-Chul Kim’s new the Entrepreneurship that were examined are as follows : (1) Spirit of a Sincerity and Credit (2) spirit of creativity and Innovation (3) spirit of earnestness (4) spirit of challenge and cultivation(development). (5) spirit of customer satisfaction (6) spirit of human respect (7) spirit of Justice (right) management (8) spirit of responsibility and autonomous(self-control) (9) spirit of stage management or artistic management (10) spirit of corporate social responsibilities. Dongwon corporation’s chairman Jae-Chul Kim carries the entrepreneurship principles such as (1) management that gives happiness to the customers (2) management that respects people (3) management that creates new value (4) living up to the fundamental principle (5) applying significance to even a small matter (6) challenging any new tasks, etc. His entrepreneurship is based on the righteous managerial spirit, known as “I need to be the challenge and innovation”, which aims to reflect the past and analyze today’s critical situation. especially his righteous managerial spirit is leading the Dongwon Group as the global corporation through Business ethics, humanity, innovation, etc. therefore, he is pioneer of Schumpeter’s(J.A), and the creative entrepreneur who seeks for innovation. He is reviewed as one of the greatest 21st century manager who carries these 6 characteristics:(1) artistic mind of stage management (2) positive mind (3) emphasis on self-changing (4) faith and trust (5) keeping endurance and rule (6) having courage not to be afraid of failure (7) emphasis on social contribution.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

족부백선의 치료에서 터비나핀과 이트라코나졸의 이중맹검 비교연구

김기홍,최종수,박의수,김상원,김수찬,안성구,서무규,서순봉 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.2

터비니핀(terbinafine)의 족부백선에 대한 치료효과를 판정하기 위해 6개 병원의 피부과에서 공동연구로 족부백선환자90명에 대하여 치료완료하였으며 2군으로 나누어 터비나핀 1일 250㎎씩 2주간 경구치료와 이트라코나졸 1일 100㎎씩 4주간 치료를 이중맹검으로 실시하여 임상적 및 진균학적인 검사로 치료효과와 약제의 내약성을 평가하였다. 완치율은 터비나핀군은 치료 1주후 6.5%, 2주후 23.9%, 4주후 69.6%, 6주후 89.1%였으며, 이트라코나졸군은 치료 1주후 0%, 2주후 22.7%4주후 59.1%, 6주후 77.3%이었다. 부작용과 내약성은 양군에서 비슷한 성적을 나타내었다. 이상의 결과로 보아 터비나핀 1일 250㎎씩 2주간의 경구투여는 치료율, 안정성 및 부작용에서 이트라코나졸 1일 100㎎씩 4주간 치료효과와 유사하였다. In this randomized double-blind trial on multicenter study, the efficacy of the new antifungal agent, terbinafine was compared with the triazole antifungal agent, itraconazole, in the treatment of patients with various forms of tinea pedis. One hundred and ten patients(55 terbinafine, 55 itraconazole) with tinea pedis were enrolled. Eleven patients were lost to follow-up(5 terbinafine, 8 itraconazole) and 9 reported adverse reaction with premature discontinuation of therapy. And 90 patients were eligible for follow-up until 6 weeks after starting the treatment. Forty six patients received terbinafine 250㎎ daily for two weeks and 44 received intraconazole 100㎎ daily for 4 weeks. They were checked clinical symptoms and mycological improvement with KOH wet mount and culture during the study. Clinical and mycological cure rate of the terbinafine group was 6.5% at 1 week after intialtreatment, 23.9% at 2 weeks, 69.6% at 4 weeks and 89.1% at 6 weeks and that of the itraconazole group was 0% at 1 week after intial treatment, 22.7% at 2 weeks, 59.1% at 4 weeks, and 77.3% at 6 weeks. Adverse reactions and tolerability of both drugs were not different significantly. All these findings suggest that the effects of terbinafine 250㎎ daily for 2 weeks in the treatment of tinea pedeis was similar to that of intraconazole 100㎎ daily for 4 weeks.

조갑진균증의 치료에서 터비나핀과 이트라코나졸의 이중맹검 비교연구 : 공동연구

김기홍,최종수,송준영,김상원,김수찬,안성구,성열오,서순봉 대한화학요법학회 1995 대한화학요법학회지 Vol.13 No.2

저자들은 새로 개발된 alyllamine계 항진균제인 터비나핀의 발톱의 조갑백서에서 치료 효과, 내약성 및 부작용 등을 평가하기 위해 triazole계의 이트라코나졸과 이중 맹검으로 비교 조사하였다. 치료방법은 터비나핀은 250㎎/days로 12주간, 이트라코나졸은 100㎎/day로 124주간 복용하고 양군 모두 치료 시작 후 36주까지 추적 관찰하였다. 조사방법은 조갑진균증 환자에 대해 치료에 대해 설명후 동의서를 받고 장기간 치료가 부적합한 경우를 제외한 149명(터비나핀군 74명, 이트라코나졸군 75명)이 치료를 받았으며 이중 25명이 탈락하고 13명이 부작용등으로 치료를 중지하여 111명(터비나핀군 51명, 이트라코나볼군 60명)이 치료를 완료하였다. 1. 임상적인 소견은 점진적으로 호전되었으며, 치료 시작후 36주에는 병변조갑의 감소 비율로 볼때 터비나핀군은 51명중 완전치료가 24(47.0%), 76%이상 호전이 18명(35.3%), 51%~75% 호전이 6명(11.8%), 26~50% 호전이 2명 (3.9%), 25% 이하의 호전을 보인 예는 1명(2.0%)였다. 이트라코나졸군은 60명중 완전치료가 27(45.0%), 76% 이상 호전이 14명(23.3%), 51%~75%호전이 9명(15.0%), 26~50% 호전이 2명(3.9%), 25% 이하의 호전을 보인 예는 1명(2.0%)였다. 이트라코나졸군은 60명중 완전치료가 27(45.0%), 76% 이상 호전이 14명(23.3%), 51%~75%호전이 9명(15.0%), 26~50% 호전이 7명 (11.7%), 25% 이하의 호전을 보인예는 3(5%)였다. 2. KOH도말 검사에서 음성 소견을 보인 비율은 터비나핀은 24주 후 50예(98.0%)였으며, 36주후에는 모두 음성을 나타내었고, 이트라코나졸은 치료 24주 후 51예(85.0%)였고, 36주후에는 59예(98.3%)에서 음성을 나타내었다. 진균배양 검사에서는 치료 12주 후에 터비나핀군은 51예중 44예에서 (86.3%), 이트라코나졸군은 60예중 52예에서 각각 음성이었으며(86.7%), 치료 36주 후에는 양군 모두에서 음성이었다. 3. 내약성은 양군 모두 시간이 지나면서 증가하였으며, 터비나핀은 moderate이상이 98~·00%였고, 이트라코나졸은 moderate이상이 96.7~100%였다. 4. 부작용은 위장관 증상이 가장 많았고 터비나핀은 23명, 이트라코나졸은 37명이었고, 2명, 3명에서 각각 일시적인 간효소치의 상승이 있었다. 이상의 결과로 보아 조갑진균증의 치료에 터비나핀 1일 250㎎씩 12주간의 경구투여는 치료율, 안정성 및 부작용에서, 추천할 만한 치료법이라 생각된다. In this randomized double-blind trial on multicenter study, the efficacy of the new antifungal agent, terbinafine(Lamlsil) was compared with the triazole antifungal agent, itraconazole, in the treatment of patients with onychomychosis. One hundred and forty nine patients(74 terbinafine, 75 itraconazole) with onychomlychosis were enrolled. Twenty five patients were lost to follow up and 13 reported adverse reaction with premature discontinuation of therapy. And 111 patients were eligible for follow-up until 36 weeks after starting the treatment. Fifty one patients received Lamisil(terbinafine) 250mg daily for twelve weeks (terbinafine group) and 50 received itraconazole 100mg daily for 24 weeks (itraconazole group). They were checked clinical symptoms(onycholysis, subungual hyperkeratosis, paronychyal inflammation, color change, brittleness, ridging, normal length of nails) and mycological improvement with KOH wet mount and culture during the study. Clinical improvements were slow but progressive. In terbinafine group of 5t patients, 24 patients(47.0%) were completely cleared and 18 patients(35.3%) were improved more than 76%, and 6 patients(11.8%) were improved in 53-75%. In itraconazole group of 60 patients, 27 patients(45.0% ) were completely cleared and 14 patients(23-3%) were improved more than 76%, and 9 patients(150%) were improved in 51-75% . In mycologic study, cure rate of the terbinafine group showed all negative at 36 week after the treatment while ittraconazole group showed all negative in culture but negative KOH in 98.3%. Adverse reactions and tolerability of both the drugs were good and net different significantly. All these findings suggest that the efficacy of Lamisil(terbinafine) 250mg daily for 12 weeks in the treatment of onychomycosis was similar to that of itraconazole 100mg daily for 24 weeks.

연작업자들에서 혈중 및 골중 연량과 조혈기능 지표 사이의 관련성에 ALAD 다형질성이 미치는 영향

김화성,이성수,김용배,황보영,리갑수,안규동,장봉기,이병국 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.1

목 적 : 혈중 연량 및 골중 연량과 조혈기능의 생화학적 지표사이의 관련성에 f-aminolevinicacid dehydratase 효소의 유전형질의 다형질성이 어떠한 영향을 주는지를 알아보고자 연작업자 450명을 연폭로군으로 연폭로가 없는 85명을 대조군으로 선정하였다. 방 법 : 조혈기능의 생화학적 지표로는 혈중ZPP, 요중 ALA, 혈색소 및 혈구용적치를 택하였고, 이들 상호관계에 영향을 줄 수 있는 교란변수로서 성, 연령, BMI, 흡연습관, 음주습관 및 연작업자들의 경우 연폭로 기간을 조사하였다. 결 과 : 동형유전형질인 ALADI을 가진 연작업자들은 407명으로 전체의 90.4 %이었으며, 대조군에서도 77명으로 전체의 90.6 %로서 양군간에 차이가 없었다.동형 유전형질을 가진 연작업자들보다 이형 유전형질을 가진 연작업자들의 골중 연량과 혈중 ZPP의 평균값이 적었으나 통계적으로 유의하지 않았고 나머지 연구변수들의 평균도 유전형질의 구분에 따른차이는 없었다. 성, 직력, BMI, 흡연여부, 음주여부 등의 흔란변수를 통제한 후 혈중 연량 및 골중 연량과 ALAD유전형질이 혈색소에 미치는 영향을 구한 바 혈중 연량과 골중 연량만이 혈색소에 유의한 영향을 주었을뿐 ALAD 유전형질은 유의한 영향이 없었다. 반면에 혈구용적치의 경우에는 혈중 연량과 골중 연량 그리고 유전형질 모두가 유의한 영향을 주지 못했다.요중 ALA를 종속변수로 하고 관련 혼란변수를 통제한 후 혈중 연량과 ALAD 유전형질 그리고 양자의 교호작용을 독립변수로 한 회귀분석들에서 혈중 연량 및 골중 연량과 ALAD 유전형질 모두가 주효과(main effect) 및 교호작용(effect modifies-tion)이 유의하석 이형 ALAD 유전형질을 가진 연작업자들의 ALAU가 동형의 유전형질을 가진 연작업자들보다 상대적으로 낮은 값을 나타냈다.혈중 ZPP를 종속변수로 하고 관련 혼란변수를 통제한 후 혈중 연량과 ALAD 유전형질 그리고 양자의 교호작용을 독립변수로 한 회귀분석들에서 혈중연량 및 골중 연량과 ALAD 유전형질 모두가 음의주효과(maln effect)가 나타나서 이형 유전형질의 연작업자들의 혈중 ZPP가 동형 유전형질의 연작업자보다 상대적으로 적은 값을 나타냈으나 교호작용(effect modification)은 없었다. 결 론 : 상기 결과로 미루어 ALAD 유전형질은 혈색소에는 유의한 영향을 주지 못했으나 ALAU 및 혈중 ZPP에는 유의한 영향을 주어 동형의 유전형질인 연작업자보다 이형의 유전형질 연작업자들이 상대적으로 낮은 ALAU와 혈중 ZPP값을 보여주어이형유전형질이 연에 보호효과가 있다는 가설을 돼받침하였다 Objectives : To evaluate the effect of ALAD polymorphism on the relationship of blood and bone lead with hematologic biomarkers in lead exposed workers, 450 lead exposed workers and 85 non-lead exposed workers were selected. Methods : Blood lead and tibia bone lead were selected as parameters of lead exposure and blood ZPP, urinary ALA (ALAU) , hemoglobin (Hb) and hematocrit (Hct) were chosen as parameters of hematologic effect of lead exposure. Genotype of each subject was assayed and expressed as ALADI and ALAD2. Demographic information such as sex, age and personal habit of smoking and drinking were collected. Job duration of lead exposed workers was also obtained. Results : The overall prevalence of the variant allele, ALAD2 in lead exposed workers was 9.6 %(43 out of 450 lead workers) which was not differed from control workers (9.4 % : 8 out of 85) . The means of tibial lead and blond ZPP in lead workers with ALAD2 were lower than those of lead workers with ALAD1, but the differences were not statistically significant. After adjusting for possible confounders (sex, job duration, BMI, drinking and smoking status) only blood lead and bone lead contributed negatively to the level of hemoglobin with statistical significance without any contribution of ALAD genotype. On the other hand, no significant effect of blood lead, bone lead and ALAD genotype were observed on the level of hematocrit after controlling possible confounder. ALAD genotype in the multiple regression analysis of blood lead fed bone lead with log transformed urinary ALA (LogALAU) after adjusting for possible confounders showed significant main and interaction effect on LogALAU simultaneously, which resulted lower LogALAU in lead exposed workers of ALAD2 than ALAD1. It was also observed only main effect of ALAD gene type on blood ZPP after adjusting possible confounder resulting lower ZPP in lead workers of ALAD2 than ALAD1. Conclusions : With above results, it was found that ALAD polymorphism did not affect on the level of hemoglobin and hematocrit, but ALAD polymorphism made significant effect on the association of blood and bone lead with urinary ALA and blood ZPP. The lower urinary ALA and blood ZPP in ALAD2 lead workers suggested that ALAD2 genotype may be supportive for the protective effect of lead.

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.