성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

부신피질 자극호르몬 단독결핍 1례

박경식,이승현,최석영,박태규,이동화,이찬우,정성복,이인규 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

부신피질 자극호르몬 단독결핍은 국내에서 7례만이 보고된 희귀 질환이며 병인 및 경과 등 아직 불분명한 측면이 많다. 이는 질환지체의 희귀성도 있지만 치료후 자연경과에 대한 장기적인 추적검사가 이루어진 경우가 드물기 때문이기도 하다. 저자들은 비특이적인 전신증상을 주소로 내원한 폐경기후의 56세 여자 환자에서 자가면역질환의 증거없이 고프로릭틴혈증을 보인 부신피질 자극호르몬 단독결핍 1례를 경험하고 1년간의 부신피질호르몬 대치요법후 추적검사를 실시하였기에 문헌 고찰과 함께 보고하는 바이다. Isolated ACTH deficiency is a rare disorder which shows secondary adrenal insufficiency with normal states of other pituitary hormones. A 56-year-old postmenopausal woman complaining general weakness and intermittent mental confusion presented negligible serum cortisol and ACTH level with hyperprolactinemia and mild hyponatremia. Rapid ACTH stimulation test did not show significant increase of serum cortisol level. Combined pituitary stimulation test showed negligible response of cortisol and ACTH, and slightly decreased response of prolactin and gonadotropin. But the responses of TSH and GH were normal. There was no evidence of organic pituitary of hypothalamic lesion in brain MRI and antithyroid autoantibody was not detected in serum. After receiving 12 months of glucocorticoid replacement therapy, she skipped the medicine for 3 weeks and we performed follow-up endocrinologic tests. Serum ACTH and cortisol level was also negligible and prolonged ACTH simulation test showed normal response of serum cortisol. CRF stimulation test showed no response of serum ACTH. Basal prolactin level was decreased to near normal and combined pituitary stimulation test showed normal response of prolactin with slightly blunted response of TSH and GH. We concluded that the case was nonautoimmune origined isolated ACTH deficiency which was accompanied by hyperprolactinemia and resultant deficiency of gonadotropin, so we report this case with review of literatures.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

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위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

土壤中에 殘留하는 有機鹽素系 農藥의 作物體 吸收에 關한 考察

李奎承 제주대학교 1980 논문집 Vol.12 No.-

Absorption rate of some residual organochloro insecticides in soil to Chinese cabbages and garlics were investigated. α-and r- BHC was absorbed by Chinese cabbage with highly significant, and also the absorption rate of α-BHC showed four times higher than r-BHC. Heptachlor was absorbed with significant pooh Chinese cabbage and garlic, and garlic showed about 20 times higher absorption rate than that of Chinese cabbage.

유방의 비종양성 및 종양성 병변에서 actin과 broad-spectrum keratin 양성세포에 대한 면역조직화학적 검사

이규범,김인선,백승룡 고려대학교 의과대학 1989 고려대 의대 잡지 Vol.26 No.2

An immunohistochemical study was done in nonneoplastic and neoplastic breast diseases to detect the distribution and pattern of action-positive myoepithelial cells, and keratin-positive epithelial cells by using strept ABC method if formalin-fixed and paraffin-embedded tissues. The results obtained are as follows: 1. In 7 cases of fibrocystic diseases including sclerosing adenosis, a continuous layer of actin-positive myoepithelial cells and less prominent keratin-positive inner epithelial cells were noted. Actin reactivity was weaker in the smaller ducts. 2. The staining pattern with antibodies to actin and keratin in 11 cases of fibroadenoma was similar to that found in the fibrocystic disease, except more actin-positive myoepithelial cells in the intracanalicular type of fibroadenoma than those in the pencanalicular type. 3. In 13 cases of invasive ductal carcinomas, all showed actin-positive and keratin-positive tumor cells, and among them 4 cases revealed the heterogenity of tumor cells with both actin and keratin positivity. In 4 cases of invasive lobular carcinomas, actin-positive cells were found in all, whereas keratin -positive tumor cells were in only one.

LPG를 이용한 동력경운기 디젤기관의 연소성능

이승규,김성태,조기현 경상대학교 농업생명과학연구원 2001 농업생명과학연구 Vol.35 No.-

농용LPG기관의 개발을 목적으로 단기통, 4행정 농용디젤기관과 이를 개량한 LPG기관을 사용하여, 기관의 성능시험을 실시하고, LPG기관을 탑재한 동력경운기를 이용하여 포장실험을 수행하였다. 성능시험은 기관의 회전수를 1200 rpm에서 2200 rpm까지 200 rpm씩 증가시키면서 실시하였고, 포장시험은 기관의 정격출력으로 실시하였다. 그 결과를 요약하면 다음과 같다. 디젤기관의 출력은 5.4 kW에서 9.9 kW로, 또 LPG기관의 출력은 5.5 kW에서 9.6 kW로 각각 증가하였으며 두 기관의 출력의 차이는 크지 않았다. 디젤기관의 연료소비율은 297 g/kWㆍh에서 279 g/kWㆍh으로 점감하다 315 g/kWㆍh까지 증가하였다. 또 LPG기관의 경우에는 320 g/kWㆍh에서 285 g/kWㆍh로 점감하다 330 g/kWㆍh까지 증가하였으며, 디젤기관에서의 연료소비율이 1.6-8.6% 만큼 낮게 나타났다. 디젤기관의 배기가스의 온도는 510℃에서 614℃로, 또 LPG기관에서의 배기가스 온도는 495℃에서 608℃로 각각 증가하였으며, 디젤기관에서의 배기가스의 온도가 10-18℃ 만큼 높게 나타났다. HC배출농도는 디젤기관의 경우 17 ppm에서 8 ppm으로 점감하다 16 ppm으로 증가하는 등, 낮은 HC배출농도를 보인 반면 LPG기관의 경우에는 250 ppm에서 100 ppm으로 급감하다가 125 ppm까지로 증가하였으며, LPG기관에서의 HC배출농도가 디젤기관의 6.8-15.7배로 높게 나타났다. CO비출농도는 두 기관 모두에서 1% 미만으로 낮게 나타났으며, 디젤기관의 경우 LPG기관에 비해 28.0-90.5% 만큼 낮게 나타났다. 디젤기관에서의 NOx배출농도는 410 ppm에서 730 ppm으로 증가하다가 650 ppm까지로 감소하였고, LPG기관에서는 300 ppm에서 570 ppm으로 증가하다가 540 ppm으로 감소하였으며, 디젤기관에서의 NOx배출농도가 16.8-33.3% 만큼 더 높게 나타났다. 디젤기관에서의 매연 배출농도는 75%에서 90%의 높은 범위에서, 또 LPG기관에서는 25%에서 35%의 낮은 범위에서 각각 증가하였으며, 디젤기관의 매연배출농도가 LPG기관에 비해 61.1-66.7% 만큼 높게 나타났다. LPG기관을 탑재한 동력경운기를 이용한 포장실험 결과, 기관의 회전수변동이 디젤기관과 유사하게 나타났으며, 시간당 1ℓ의 LPG로 포장작업이 가능하였다. NOx와 매연의 발생은 디젤기관에 비해 훨씬 적었다. In order to develop an engine for power tillers using the liquefied petroleum gas(LPG), a conventional diesel engine for power tillers was modified to a LPG using engine. Combustion performances of the experimental LPG engine and the diesel engine were tested at various engine speeds. And actual field tests for the engine as a power source of a power tiller were performed to analyze performance of the engine. Brake horse power, temperature of the exhaust gas and the smoke of both engines increased as the engine speed was increased. At the engine speed of 1800 rpm, it was observed that fuel consumption rate and HC concentration in the exhaust gas were lowest while NOx concentration was highest. The brake horse power of the LPG engine showed nearly same value as that of diesel engine. CO concentration of both engines showed below 1%. The exhaust gas temperature, the concentration of NOx and the smoke in the exhaust gas of the LPG engine showed lower values than that of the diesel engine. However, the fuel consumption rate and the HC concentration of the LPG engine were higher than that of the diesel engine. In field test, the LPG engine and the conventional diesel engine showed similar plowing performances. However, the LPG engine installed power tiller showed lower NOx and smoke values compared to those of the diesel engine.

치아 이상의 발생 빈도와 양상에 관한 연구

이제호,손홍규,전승준,최형준 大韓小兒齒科學會 1996 대한소아치과학회지 Vol.23 No.2

An object definition of the anomaly is not avaliable and most investigators define the term differently or fail to describe their criterion.Because dental anomaly may lead to many complications,early detection and diagnosis of dental anomalies are essential steps in the evaluation of the child patient and in treatment planning.These procedures require detailed medical and dental histories,through clinical examination and the use of radiographs.So,this study was designed to find out the prevalece of dental anomalies.The clinical and roentgenographic examination was undertaken for 8,054 children at age from 0 to 15 years and statistical analysis was done.The results were as follows: 1.Among the examined subjects 2,134 subjects(26.5%) showed dental anomalies.The prevalance of individure dental anomalies were as as follows:Supernumerary teeth 15.6% congenitally missing teeth 6.6%,fusion 2.2%,odontoma 0.35%,microdontia 1.2%,macrodotia 0.05%,gemination 0.22%,talon cusp 0.36%,dens evaginatus 0.24%,dens invaginatus 0.15%,dilaceration 0.27%,taurodontism 0.09%,abnormal tooth position 1.7%,natal $ neonatal teeth 0.92%,amelogenesis imperfecta 0.01%. 2.Significant correlations between the groups with individual dental anomalies were as follows:between groupⅠand other groups,there was nagative correlation,especially groupⅠ and groupⅡ.And the correlation coefficient between male and female showed differences. 3.For the supernumerary teeth group,the prevalence of male was higher than female(p<0.001).While for the congenitally missing teeth,macrodontia,microdontia,abnormal tooth position group,the prevalence of female was greater than male(p<0.001). 4.For the congenitally missing teeth group,the mandibular primary lateral incisor showed the highet incidence in primary dentition,while mandibular lateral incisor in permanent dentition.In the mandible(72.5%),this site showed higher prevelence than in maxilla.In this case with deciduous congenitally missing teeth,the prevelence of successive permanent congenitally missing teeth was about 33.9%,the incidence was highet in mandibular lateral incisors. 5.Most supernumerary teeth existed on middle area and showed inverted position and unerupted state.In addition,supernumerary teeth showed higher incidence on maxilla(99.3%). 6.In the case with deciduous fused teeth,the prevelence of successive permanent congenitally missing teeth was 39.9%,while that of successive permanent fused teeth was 2.7%.And the highet rate of the prevalence(40.3%) appeared in fusion of mandibular deciduous lateral incisor and canine. 7.In the case of odontoma,the prevelence was higher in maxilla(78.6%) and anterior region(82.7%) the mandible and posterior region.