아미노글리코사이드 사용제한에 따른 병원성 균혈증 유발 그람음성간균의 내성변화 및 임상적 의의

오종택,김신우,손종원,도병훈,한승우,신병철,박지현,이종명,김능수 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 항균제 오남용으로 인한 내성균의 출현, 약물부작용의 발생 및 약제 비용의 증가는 환자 개인뿐만 아니라 사회적으로 문제가 되고 있다. 본 연구는 항생제의 오남용을 막기 위한 제도의 일환으로 시행한 아미노글리코사이드 사용 제한정책의 비용 효과적인 측면을 조사하고 그람음성간균에 의해 병원성 균혈증이 발생한 환자들을 대상으로 이 정책이 항생제 내성률과 환자 사망률에 미치는 영향을 연구하였다. 방법 : 930병상 규모의 3차 병원인 일개 대학병원에서 아미노글리코사이드 사용제한정책이 시행된 직후인 2002년 3월에서 9월 사이에 그람음성간균(Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Stenotrophomonas maltophilia, Burkholderia cepacia)에 의해 발생한 병원성 균혈증 환자 60명(실험군)과, 이 정책이 시행되기 전에 입원한 환자들 중 균주별로 같은 수만큼 선별한 병원성 균혈증 환자 60명(대조군)의 의무기록을 후향적으로 조사하였다. 결과 : 아미노글리코사이드 사용제한정책이 시행된 시기인 2002년 3월에서 9월 사이에 처방된 아미노글리코사이드 사용량 및 비용을 이 정책이 시행되기 전인 2001년 3월에서 9월 사이와 비교한 결과, 아미노글리코사이드의 사용량(antimicrobial utilization density)은 사용제한 후 225.2에서 130.3으로 42% 감소하였고 약제 비용은 44% 감소하였다. 아미노글리코사이드 사용제한 후 병원성 균혈증을 유발한 그람 음성간균의 이 항생제에 대한 내성률은 유의한 변화를 보이지 않았으며 균혈증과 직접 연관된 사망률도 환자의 나이, 성별, 기저질환 및 원발병소 등을 보정할 경우 유의한 차이를 보이지 않았다(40.4% vs. 24.1%, P=0.11). 결론 : 아미노글리코사이드를 5일을 초과한 사용 시 감염전문가의 사전 승인을 필요로 하는 사용제한정책은 아미노글리코사이드의 사용량과 비용을 유의하게 감소시켰다. 또한 이 정책 시행 후 그람음성간균에 의한 균혈증 환자에서 균혈증으로 인한 사망률과 아미노글리코사이드에 대한 내성률은 유의한 차이가 없었다. Objective : To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). Methods : Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gramnegative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. Results : During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225,2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. Conclusion : Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.

EAF Slag의 해양복토제 활용을 위한 PO₄<SUP>­</SUP>-P 제거특성에 관한 연구

김재원(Jae-Won Kim),서종범(Jong-Beom Seo),강민경(Min-Gyeong Kang),김인득(In-Deuk Kim),오광중(Kwang-Joong Oh) 한국청정기술학회 2010 청정기술 Vol.16 No.4

본 연구에서는 제강전기로 슬래그를 해양복토제로 활용하기 위한 인제거 특성실험을 실시하였다. 제강전기로 슬래그의 PO₄<SUP>-</SUP>-P 제거 특성에 관한 시험 결과, 슬래그 내의 CaO는 Ca<SUP>2+</SUP>와 OH<SUP>-</SUP>로 이온화됨에 따라 PO₄<SUP>-</SUP>-P와 반응하여 HAP를 형성함으로써 용액 중에 존재하는 PO₄<SUP>-</SUP>-P를 효과적으로 제거하는 것으로 나타났다. 연속반응기를 통한 해수 내 PO₄<SUP>-</SUP>-P의 지속적인 유입에 대한 제거특성을 확인한 결과, 칼럼 내 PO₄<SUP>-</SUP>-P 농도는 반응 3일 이후 급격히 감소하여 10일 이후에는 0.5 ppm 이하로 나타났다. 실제 연안해역의 저질을 이용한 제강전기로 해양복토제 적용실험 결과, 반응 25일 후 PO₄<SUP>-</SUP>-P 발생량을 93∼ 98% 저감시키는 것으로 나타났다. 이러한 결과를 바탕으로 제강전기로 슬래그를 해양복토제로 활용할 경우 PO₄<SUP>-</SUP>-P 제거 및 억제효과가 있으며, 파쇄선별 등 별도의 추가공정 없이 적은 량으로도 사용 가능할 것으로 판단된다. This study estimated the possibility of phosphate removal characteristics to utilize EAF(electric arc furnace) slag as submarine cover material. The major phosphate removal mechanism was a certain formation of HAP precipitation occurred by the ionization reaction between Ca<SUP>2+</SUP> and OH<SUP>-</SUP>, which were leached from the EAF Slag. Another phosphate removal mechanism was the adsortion of EAF slag surface. As a result of PO₄<SUP>-</SUP>-P removal characteristics using continuous column reactor, PO₄<SUP>-</SUP>-P concentration decreased rapidly after 3 days and 10 days later, it show under 0.5 ppm. The result as applied in real sea water, shows that the phosphate removal effects were 93∼98% by the subaqueous sediment removal using the EAF slag. In conclusion, EAF slag is useful in PO₄<SUP>-</SUP>-P removal and control and it is possible to use without additional process like crush and selection.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

간척지에서 옥수수 나방류 해충 3종의 발생소장

이휘종,최원영,김상열,서종호,황정동,오성환,정진교,김주일,구현나,김길하 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

Occurrence of three troublesome lepidopterous pests, Ostrinia furnacalis, Helicoverpa armigera and Pseudaletia separata in corn cultivation of the reclaimed land were recorded using sex pheromone traps from 2012 to 2014. In case of O. furnacalis adult, two generations were observed in a year and its occurrence pattern was very regular. The 1st generation showed the highest occurrence in late May-early June and the 2nd generation was in late July-early August. On the other hand, H. armigera occurred at least three times a year but its occurrence was somewhat irregular. H. armigera adult showed the highest occurrence in mid May, late June, early August, respectively in 2012 but their occurrence patterns of the 2nd and 3rd generations were varied in 2013 and 2014. In case of P. separata, a few number of adult were captured during the survey period, indicating few number of P. separata migrated from China. Based on the control effect of O. furnacalis by Etofenprox and Carbofuranin 2012, June 26 treatment showed the highest control rate with 96.8% for Etofenprox, 85.8% for Carbofuran, respectively. Late treatment at June 19 and June 26 significantly decreased the control rate of O. furnacalis and June 26 treatment showed the lowest control rate of 1.9% for Etofenprox. 18.1% for Carbofuran, respectively.

외배엽 이형성증 환자의 임상적 치험례

오소희,권순원,김종수,김용기,임헌송 대한소아치과학회 2000 大韓小兒齒科學會誌 Vol.27 No.2

Ectodermal dysplasia(외배엽 이형성증)은 외배엽성 기관에 한가지 이상의 선천적 이상소견을 특징으로 하는 질환이다. Ectodermal dysplasia는 약 120종류 이상이 보고되고 있고, 이 중 Hypohidrotic ectodermal dysplasia가 가장 잘 알려져 있으며 이는 성염색체 열성인자에 의해 유전되며 남성에서 호발한다고 한다. 임상증상으로는 무한증, 감모증, 무치증 혹은 핍지증이 가장 특징적이다. 이외에도 무피지증, 손톱이형성증, 가늘고 성긴 머리카락, 두드러진 이마, 안장코, 돌출된 안와상부, 입술의 돌출과 함께 피부가 건조하고 땀샘이 결핍되어 있어서 더위를 참지 못하고 발열이 일어나기 쉽다. 본 증례의 환자는 단국대학교 치과병원 소아치과에 내원한 6세 6개월된 남아로써 무치증을 보이는 Hypohidrotic ectodermal dysplasia로 진단되었고 환자의 심미적, 기능적 결함을 해소하기 위해 총의치로 치료를 시행하는 동안 다소의 지견을 얻어 이를 보고하는 바이다. 주요어 : 외배엽 이형성증, 무치증, 총의치

기관골 신생증 1예

오영상,이은우,정종혁,문승원,김수현,김동한,양혁승,박정환,박경옥,강성수,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Tracheobronchopathia osteoplastica is a rare disorder of unknown cause characterized by the projection of numerous bony or cartilaginous submucosal nodules into the tracheobronchial lumen with sparing of the posterior membranous portion of tracheobronchial tree. In the past, most of the cases were diagnosed as secondary finding at autopsy. Nowaday, the key component of the evaluation is flexible fiberoptic laryngoscopy and bronchoscopy, which typically demonstrates irregular spicules of subrnucosal bone and cartilage projecting into the tracheobronchial lumen and causing various degrees of airway obstruction. A 45 years old man was visited Sunchon St. Carollo hospital due to discomfort on throat. We saw several nodules just below vocal cord via laryngoscope. The computed tomography revealed multiple small calcified nqdules on trachea and both main bronchi. Pathologic finding of bronchoscopic biopsy showed abnormal proliferation of bony and cartilagious nodules in the tracheal submucosa. These fingdings were consistent with tracheobronchopathia osteoplastica. We report here on a case of tracheobronchopathia osteoplastica with review of literature.

비장경색이 동반된 쯔쯔가무시병 1예

오종찬,이범주,장재현,원경준,박경희,김동민,박치영,정춘해 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Tsutsugamushi disease is an acute febrile illness caused by Orientie. tsutsugsmushi. It is characterized by fever, myalgia, lymphadenopathy, and rash. And it can be easily diagnosed by characteristic eschar and serologic testing. Nearly all of the patients with tsutsugamushi disease improve with antibiotics such as doxycycline. However, the fatality rate of untreated cases is seven to ten percent. Splenic infarction is not common disease which is caused by occlusion of the main splenic artery or any of its branches. It is mainly caused by emboli that arise from cardiovascular disease, but sometimes by regional thrombosis associated with leukemia, myeloproliferative disorder, sickle cell anemia, pancreatitis, splenic torsion and septicemia. We experienced one case of tsutsugamushi disease with splenic infarction, which was improved after doxycycline treatment finished.

장군봉(봉화군) 일대의 식물상

한종원, 양선규, 최슬기, 장창석, 김규식, 오병운 忠北大學校部設基礎科學硏究所 2007 自然科學硏究 Vol.21 No.-

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백두대간(추풍령-덕유산)구간의 식물상

한종원, 양선규, 최슬기, 장창석, 오병운 忠北大學校部設基礎科學硏究所 2007 自然科學硏究 Vol.21 No.-

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AE 신호 분석에 의한 구성인선의 감지

오민석,원종식,정윤교 창원대학교 공작기계기술연구센터 1999 연구업적집 Vol.1 No.1

This paper investigates the feasibility of using acoustic emission signal analysis for the detection of built-up edge during machining. Experiments were conducted on a CNC-lathe using conventional carbide insert tools under various cutting conditions. The cutting forces were also measured for comparisons. Experimental evidence is presented which indicates that the presence of a built-up edge can significantly affect the generation of acoustic emission in metal cutting. It is shown that under conditions in which a built-up edge is generated, the variation of AErms signal with cutting speed can be quite different from the generally accepted linear, monotonic increase as previously reported. The feasibility of utilizing AErms in built-up edge sensing is suggested.