발열이 있는 6개월 미만의 영아에서 세균성 감염에 대한 Procalcitonin의 진단적 가치

김남효,이택진,김지희 대한소아감염학회 2009 Pediatric Infection and Vaccine Vol.16 No.2

Purpose : The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants <6 months of age. Methods : A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/μL) and an increased CRP level (>1.06 mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis. Conclusion : Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source. 목 적: 6개월 미만의 열이 있는 영아에서 세균성 감염을 진단하는 데 있어서 C-반응 단백질(CRP), 전백혈구 수치 (WBC)와 비교하여 혈청 procalcitonin (PCT)가 진단적 가치 가 있는지 알아보고자 연구를 시행하였다. 방 법 : 전향적인 연구방법을 채택해 2008년 7월부터 9월 까지 분당차병원 소아청소년과에 발열을 주소로 내원한 6개 월 미만의 영아를 대상으로 하였다. 내원 당시 체온, 흉부방사 선 검사, 뇨분석검사 및 배양검사와 함께 말초 혈액에서 WBC 를 포함한 전혈구 검사, CRP, PCT, 혈액배양검사를 진행하였 고, 임상 증상과 이학적 검사에 따라서 대변검사와 복부방사 선 검사, 수막염 진단을 위한 뇌척수액 검사도 진행하였다. 결 과: 총 71명의 영아가 연구에 포함되었고 이 중에서 26 명(36.6%)이 요로감염을 진단받았으며, 22명(31.0%)이 바이 러스성 수막염을 진단받았다. 다른 질환으로는 급성 인두염과 포진성 구협염이 각각 1명씩 진단되었고, 상부 호흡기 감염증 7명, 급성 세기관지염 8명, 급성 위장관염 4명, 균혈증 2명이 진단되었다. 요로감염군과 바이러스성 수막염군을 비교했을 때, WBC와 CRP수치는 요로감염군에서 통계적으로 유의하게 더 높은 수치를 보였으나, PCT수치는 두 군 사이에서 통계적 으로 유의한 차이를 보이지 않았다. ROC 곡선 분석에 의해 산출한 곡선 아래 면적은 WBC 0.792 (95% CI, 0.65-0.896), CRP 0.77 (95% CI, 0.626-0.879), PCT 0.568 (95% CI, 0.417-0.710)로 측정되었으며, 다중 로지스틱 회귀분석에 의 해 WBC가 11,920/μL보다 큰 경우와 CRP가 1.06 mg/dL보다 큰 경우는 요로감염을 진단하는 데 있어서 진단적 가치가 있음 을 확인하였다. 결 론: 6개월 미만의 발열을 주소로 내원한 영아에서 세균 성 감염을 예측하기 위한 인자로서 혈청 PCT수치에 대한 연구 가 부족하고 진단적 기준 역시 명확하지 않으므로 단독으로 해석함에 있어서 주의를 기울여야 한다.

Extended-spectrum β-lactamase 생성균주에 의한 지역사회 획득 소아 요로 감염의 위험 인자

김남효,이택진,김지희 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.6

Background:Extended-spectrum β-lactamase (ESBL) producing bacteria have been increasingly recognized in the community. The aim of this study was to identify risk factors for community-onset urinary tract infections (UTIs) by ESBL producers in children. Materials and Methods:We analyzed 854 episodes of community-onset UTIs in children diagnosed at CHA Bundang Medical Center from January, 2004 to April, 2009. The presence of ESBL in Escherichia coli and Klebsiella spp. was screened and confirmed by VITEK®-2 ESBL test. Controls were matched in a 2:1 ratio to case patients by age and sex. The clinical characteristics, risk factors, antimicrobial resistance, and treatment efficacy were compared with controls. Results:The most common pathogen was Escherichia coli (681 isolates), followed by Klebsiella pneumoniae (60 isolates), Enterococcus faecalis (23 isolates), etc. The number of isolated ESBL producers among the pathogens E. coli and K. pneumoniae was 25 (3.7%) and 7 isolates (11.7%), respectively. No significant differences were noted as to the UTI history prior to the present treatment, underlying urogenital anomaly, and clinical characteristics. Use of any antibiotics within a month (P=0.012, Odds ratio, 6.341, 95% confidence interval, 1.492 to 26.955) was related to the increased risk of community-onset UTI by ESBL producers. Conclusions:ESBL-producing bacteria has been identified in pediatric community-onset UTI, and the use of any antibiotics within the previous month was related to the increased risk of UTI by ESBL producers. Therefore, careful selection and use of antibiotics should be recommended for community-onset UTI in children. Background:Extended-spectrum β-lactamase (ESBL) producing bacteria have been increasingly recognized in the community. The aim of this study was to identify risk factors for community-onset urinary tract infections (UTIs) by ESBL producers in children. Materials and Methods:We analyzed 854 episodes of community-onset UTIs in children diagnosed at CHA Bundang Medical Center from January, 2004 to April, 2009. The presence of ESBL in Escherichia coli and Klebsiella spp. was screened and confirmed by VITEK®-2 ESBL test. Controls were matched in a 2:1 ratio to case patients by age and sex. The clinical characteristics, risk factors, antimicrobial resistance, and treatment efficacy were compared with controls. Results:The most common pathogen was Escherichia coli (681 isolates), followed by Klebsiella pneumoniae (60 isolates), Enterococcus faecalis (23 isolates), etc. The number of isolated ESBL producers among the pathogens E. coli and K. pneumoniae was 25 (3.7%) and 7 isolates (11.7%), respectively. No significant differences were noted as to the UTI history prior to the present treatment, underlying urogenital anomaly, and clinical characteristics. Use of any antibiotics within a month (P=0.012, Odds ratio, 6.341, 95% confidence interval, 1.492 to 26.955) was related to the increased risk of community-onset UTI by ESBL producers. Conclusions:ESBL-producing bacteria has been identified in pediatric community-onset UTI, and the use of any antibiotics within the previous month was related to the increased risk of UTI by ESBL producers. Therefore, careful selection and use of antibiotics should be recommended for community-onset UTI in children.

청소년 친화적인 공동주택 공간특성에 관한 연구 - 수원 A지역 현상설계안을 중심으로 -

김남효,방선주,Kim, Nam-Hyo,Bang, Seon-Joo 한국주거학회 2009 한국주거학회 논문집 Vol.20 No.3

For the young period, privacy is a crucial factor in establishing one's own identities, values and relationships. The capacity of residential environment to protect individual's privacy takes considerable part in influencing psychological and physiological development of adolescents. This study analyzed adolescents residential values and the elements of spatial plans for the passage and outdoor in Apartment Design Competition of Suwon A district in 2008. One hundred and ten middle and high school students living in Metropolitan area were selected and questionnaire was conducted during February 7 to February 15 in 2009. The data was analyzed by SPSS 11.0 program using one-way ANOVA and crosstab. The study results were summarized as follows; First, the adolescents valued 'safety' the most, regardless of their age and gender and the safety of adolescents commuting should be considered. Second, protecting their own private territories was next important element among other elements. Privacy can be protected by using movable walls, changing the doorway, dividing parents' and adolescents independent territory. Third, in terms of convenience, choosing location of children's room and walking way should be considered. Forth, from the survey, demand for indoors leisure activity was highly valued and required for aesthetic point of view. Considering the sculptures and facilities must satisfy the aesthetics and practicality. Fifth, in terms of social needs, 61.6% of people answered positively to the community facilities for social relationship. Residential environment affects enormous part of adolescents emotional and academic development. Therefore, designing residential areas for adolescents friendly should reflect the demands for safety, territory, convenience, aesthetic and social life.

청소년의 여가와 리조트 공간디자인에 관한 연구 - 'H' 리조트 증설 현상설계안을 중심으로 -

김남효,박은정 한국청소년시설환경학회 2009 청소년시설환경 Vol.7 No.1

‘생각의 탄생’(로버트 루트번스타인, 미셀 루트번스타인 지음, 박종성 옮김, 에코의 서재 펴냄)

김남효 한국청소년시설환경학회 2008 청소년시설환경 Vol.6 No.4

공공적 종합병원 현상설계안의 공간계획에 관한 연구 - 서울의료원 현상설계를 중심으로

김남효 한국청소년시설환경학회 2008 청소년시설환경 Vol.6 No.1

주거단지내 쓰레기 자동집하시설의 투입구 사용성 분석

김남효,신미옥,최옥주,리해성 한국기초조형학회 2010 기초조형학연구 Vol.11 No.5

It is a significant issue that the pollution of resource of the new developed cities and residential complex, although nowadays environmental friendly consideration is a hot trend. Since the beginning of time people have needed to find a way of disposing of their trash. Automatic installed garbage system is evaluated as a very environmental and low pollution solution that move recycled or food garbage fast and safe through underground pipes. This paper analyze the input design of usability that helps residents transmit and clean conveniently town. The information was obtained through direct observations and questionnaires based on human factors and universal principles. The result is as follows. First, although the functions of system are basically similar, the exterior forms of input are so various that user satisfactions are also different signified Second, convenient factors show that residents satisfied relatively the location of input and free transmit. But the narrow size of input hole and the heights of that are unsatisfied comparatively. Third, safety factors show that automatic opening & shutting safe better than in hand, surrounding light are insufficient at night. Controlling in detail the Offensive odors and cleanness. Color factors that combination comfortable colors are preferred than brilliant chroma and grey tones.This research is studied on viewpoint of usability of disposal traits. Technical improvement based on functional needs are expected before long. 친환경이 트렌드가 되어가는 요즘 신도시나 집합주거 지구들에서 고민하는 부분이 바로 환경오염에 대한 부분이다. 쓰레기 자동집하시설은 땅 속에 매설된 관로로 쓰레기를 이송함으로 무공해하고 친환경적이라는 평가를 받았다. 본 연구는 시민들의 편리와 깨끗한 환경을 위하여 도입한 쓰레기 집하시설이 진정 시민들에게 편리함을 제공해주고 깨끗한 환경을 제공해 주는 시설이 되기 위하여 주민이 직접 이용하게 되는 투입구에 대한 디자인을 인간공학이론과 유니버설이론을 토대로 사용 중인 투입구에 대한 평가와 설문조사를 통해 사용성에 대하여 분석하였다. 분석 결과는 다음과 같다. 첫째, 같은 쓰레기 관로수송시스템이지만 투입구 형태가 다름으로 지구별 사용자의 만족도가 다른 것으로 나타났다. 둘째, 편리성 항목에서 투입구의 위치와 쓰레기를 버리는 시간대에 대하여서는 만족하며, 투입문의 크기가 작은 것에 대하여, 투입문의 높이가 높은 것에 대하여 불만족 하는 것으로 나타났다. 셋째, 안전성 항목에서 자동개폐방식보다 수동개폐방식이 손끼임 현상이 많은 것으로 나타났고 옥외 투입구의 경우 밤에는 주변이 어둡다고 느꼈다. 그 밖에 악취와 깨끗함 부분에서도 개선을 요구하였고 미관적인 부분에서도 높은 채도나 무채색 보다 색채가 적절히 들어간 것을 선호하는 것으로 나타났다. 본 연구는 투입구에 대하여 사용성 측면에서만 조사, 분석하였다. 투입구의 유지관리를 위해서는 전반 시설의 기계적인 작동에 대한 부분도 고려되어 투입구 디자인에 반영되어야 할 것이다.

Extended-spectrum β-lactamase 생성균주에 의한 지역사회 획득 소아 요로 감염의 위험 인자

김남효,김지희,이택진 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Background : Extended-spectrum β-lactamase (ESBL) producing bacteria have been increasingly recognized in the community. The aim of this study was to identify risk factors for community-onset urinary tract infections (UTIs) by ESBL producers in children. Materials and Methods : We analyzed 854 episodes of community-onset UTIs in children diagnosed at CHA Bundang Medical Center from January, 2004 to April, 2009. The presence of ESBL in Escherichia coli and Klebsiella spp. was screened and confirmed by VITEK??-2 ESBL test. Controls were matched in a 2:1 ratio to case patients by age and sex. The clinical characteristics, risk factors, antimicrobial resistance, and treatment efficacy were compared with controls. Results : The most common pathogen was Escherichia coli (681 isolates), followed by Klebsiella pneumoniae (60 isolates), Enterococcus faecalis (23 isolates), etc. The number of isolated ESBL producers among the pathogens E. coli and K. pneumoniae was 25 (3.7%) and 7 isolates (11.7%), respectively. No significant differences were noted as to the UTI history prior to the present treatment, underlying urogenital anomaly, and clinical characteristics. Use of any antibiotics within a month (P=0.012, Odds ratio, 6.341, 95% confidence interval, 1.492 to 26.955) was related to the increased risk of community-onset UTI by ESBL producers. Conclusions : ESBL-producing bacteria has been identified in pediatric community-onset UTI, and the use of any antibiotics within the previous month was related to the increased risk of UTI by ESBL producers. Therefore, careful selection and use of antibiotics should be recommended for community-onset UTI in children.

미술장식품의 유형과 가로경관과의 상관성에 관한 연구 : 서울시 테헤란로 가로경관을 중심으로 Focused on the Seoul Teheran streetscape

김남효,송준호,이현재,이상호,송성진 대한건축학회 2001 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.21 No.2

The problems with the environmental sculptures outside building did not make the characteristics of the specific environment and did not form a big flow in the urban contextualism. The purpose of this study is to provide a practical guide for the present conditions and the preference of environmental sculptures in streetscape. The data are collected through questionnaire surveys from passengers on the Seoul Teheran Street and college students majoring in architecture. 15 samples of sculptures are preferences, and analyzed by the statistics. As a result, the present conditions of artistic environmental sculpture are mostly dissatisfied on ornamental, spatial and cultural contextualism for the better streetscape. Also the sculpture should be constituted with Che principles of form, size, color, materials, location, harmony, and given the identity of streetscape.

앱시스산 의존적 전사조절 신호 전달 구성 유전자

김남효,김범기 한국육종학회 2014 한국육종학회지 Vol.46 No.1

Abscisic acid (ABA) is a stress hormone that functions in abiotic stress adaptation in plants. Thus many efforts have been made to identify the molecular mechanisms of ABA signal transduction pathways. Recently there were big advances in understanding molecular mechanisms of ABA dependent expression. From the ABA receptors to the transcription factors, signaling components were discovered and the biological networks among the components were identified. In this review, we describe the ABA signaling components and the rice orthologues identified. These show that signaling network systems of ABA are highly conserved in dicot and monocot plants and we are able to manipulate the ABA signaling components to develop the abiotic stress tolerant crops.