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국내 단일 병원 의료관계자들의 아나필락시스 인지도 조사
서대홍 ( Dae Hong Seo ),예영민 ( Young Min Ye ),김수진 ( Su Chin Kim ),반가영 ( Ga Young Ban ),김지혜 ( Ji Hye Kim ),신유섭 ( Yoo Seob Shin ),박해심 ( Hae Sim Park ),이수영 ( Soo Young Lee ) 대한천식알레르기학회 2016 Allergy Asthma & Respiratory Disease Vol.4 No.2
Purpose: Anaphylaxis is a rapidly progressive allergic reaction that requires precise recognition and immediate management. However, health care providers, awareness of anaphylaxis has not been acknowledged. The aim of this study is to investigate the extent of knowledge and principal management skills on anaphylaxis among medical personnel and students. Methods: We performed a questionnaire survey on knowledge, education, and managing skills for anaphylaxis to physicians, nurses, health personnel, and medical students in Ajou University Medical Center, from 26 June to 31 October, 2014. The survey contained 2 main sections: questions about demographic data and 2 types of questionnaire (type I for all participants and type II for only medical staffs) for self-assessment on anaphylaxis. Results: A total of 1,615 participants (128 doctors, 828 nurses, 436 students, and 223 health personnel) completed the survey. For questionnaire I, the percentages of correct answers in doctors, nurses, medical students, and health personnel were 77.5%, 56.4%, 47.8%, and 28.0% respectively, showing significant differences between groups (P<0.001). For questionnaire II, 93% of doctors and 75.6% of nurses indicated epinephrine as the drug of choice, and 79.7% of doctors and 71.3% of nurses selected the correct intramuscular route. More than 3 quarters of the doctors (80.5%) selected epinephrine within the first 5 steps of treatment, but only 48% included epinephrine within the first 3 steps. Conclusion: Our study showed considerable lack of knowledge on anaphylaxis among health care providers, especially on the specific management steps of anaphylaxis. As significant gaps on overall knowledge of anaphylaxis were observed between different groups of medical personnel, regular education should be implemented for each department in the health care setting. (Allergy Asthma Respir Dis 2016;4:133-139)
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내독소에 의한 다발성 기관기능장애의 발생에 있어서 Pentoxifylline 의 치료효과에 관한 연구
이겸철(Gyum Cjheol Lee),정승수(Sung Soo Jeong),김충기(Chung Kee Kim),서대홍(Dae Hong Su),임홍섭(Hong Sed Lim),김치대(Chi Dae Kim),홍기환(Ki Whan Hong) 대한내과학회 1998 대한내과학회지 Vol.54 No.5
N/A Objectives : Septic shock is characterized by the circulatory failure including vasodilation, hyporeactivity to vasoconstrictor agents and organ ischemia in association with multiple organ failure and increased platelet aggregation and blood coagulation. In the present study, we investigated the preventive effects of N-nitro- L-arginine methyl ester (I -NAME, 30mg/kg, i.p.), a non-selective nitric oxide synthase (NOS) inhibitor, S -methylisothiourea sulfate (SMT, 5mg/kg, i.p.) and pentoxifylline (PTX, 10mg/kg, i.p.) on the multiple organ dysfunction in a rat model of circulatory shock induced by bacterial endotoxin (E. coli lipopolysaccharide: LPS) and discussed the mechanism underlying the development of multiple organ failure. Methods . The effect of each other Nw-nitro-L- arginine methyl ester(L- NAME, 30 mg/kg, i.p.), a non- selective nitric oxide synthase(NOS) inhibitor, S-methylisothiourea sulfate(SMT, 5mg/kg, i.p.) and pentoxifylline (PTX, 10mg/kg, i.p.) were comparatively evaluated following inducing circulatory shock by means of infusion of bacterial endotoxin to thc rat model. Results : 1) The systemic mean arterial blood pressure deamsed by 48.7mmHg and vascular hyporeactivity to oradrenaline injection(l㎍/kg, i.v.) upon intravenous administration of LPS. 2) Endotoxemia for 6hours resulted in little change in the numbers of white blood cells and neutrophils but a significant reduction in the numbers of platelets. The variables were not affected by the inhibitors. 3) Endotoxemia for 6hours caused a significant increase in serum nitric oxide level (P<0.01) which was inhibited by SMT, but not by L-NAME and PTX. 4) Upon injection of LPS, serum creatinine(0,65± 0.08mg/dl) and urea(28.7±5.9mg/dl) were significantly elevated to 0.92±0.12 (P<0.05) and 54.3±2.1mg/dl (P< 0.01). These elevated levels were significantly attenuated by PTX but not by L-NAME and SMT. 5) Endotoxemia for 6 hours resulted in a significant increases in serum ALT(988.8±28.2 1U/L, P<0.01) and AST levels(l470.5±396.5 IU/I., P<0.01) from basal levels of ALT(67.8+ 11.7IU/I.) and AST(170.3±14.8IU/L). These increased activities were significantly attenuated by PTX, but not by L-NAME and SMT. The level of LDH(1279.8 ±156.2IU/L) was significantly increased by I.PS treatment to 2932.0519.9IU/L (P<0.05), which was inhibited by PTX. 6) Upon LPS treatnt, the myeloperoxidase activity in the lung homogenate was significantly increased by I.PS treatment (P<0.05), whereas that in the liver showed less change. The increased activity was reduced by PTX (P<0.05), but not by L-NAME and SMT. 7) The level of serum malondialdehyde, an index of lipid peroxidation by oxygen free radicals, was little influenced by LPS. Conelusion : Based on these results, it is summarized that PTX characteristically inhibited the development of multiple ogran dysfunction in a murine model of endotoxemia. Thus, it is concluded that the formation of TNF and increased activity of neutrophils may importantly contribute to the development of LPS-induced endotoxemia.
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서대홍,임홍섭,김충기,이겸철,조용구,정승수,심영웅,송갑영 대한감염학회 1998 감염 Vol.30 No.2
우상복부 동통, 발열과 오한 그리고 의식 둔화를 주소로 내원한 당뇨 환자에서 Klebsiella pneumoniae에 의한 가스형성 간농양을 균배양 검사를 통하여 진단하고 항생제 투여와 경피적 농양 배액술을 통해 증상의 호전을 보인 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Gas-forming pyogenic liver abscess is an uncommon, life-threatening, necrotizing infection that is usually found in poorly-controlled diabetic patients. Herein, we report a case of gas-forming liver abscess caused by Klebsiella pneumoniae, as proven by aspirated pus culture, in a 70-year old woman with diabetes mellitus. The patient was successfully managed with broadspectrum antibiotics and transhepatic percutaneous drainage and was discharged after 3 weeks of hospitalization. In conclusion, strict control of diabetes mellitus is the most important factor in the prevention of gas-forming pyogenic liver abscess.
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