만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

리네졸리드와 반코마이신을 교대로 투여하여 치료한 지속성 메티실린 내성 황색포도알균 균혈증 1예

김낙현,김문석,장은선,강유민,김가연,장희창,박완범,김의종,김남중,오명돈 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for ≥7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

에이즈 환자의 거대세포바이러스 감염증

김홍빈,박상원,김남중,최희정,신동현,오명돈,김우호,정흠,최강원 대한감염학회 1998 감염 Vol.30 No.4

배 경 : 거대세포바이러스 감염은 인간면역부전바이러스 (Human Immunodeficiency Virus, HIV) 감염자에서 발생하는 가장 중요한 기회감염증의 하나이다. 특히, 국내에서는 95%이상의 국민이 거대세포바이러스의 1차감염을 경험한 상태이므로 에이즈 환자에서 거대세포바이러스 질환의 빈도가 높을 것으로 예상된다. 대상 및 방법 : 1987년 10월부터 1996년 9월까지 서울대학교 병원에서 추적 관찰하였던 128명의 HIV 감염자를 대상으로 하였다. 이들 환자의 의무 기록에서 임상 자료를 얻었다. 거대세포바이러스 망막염은 안과 전문의의 임상적인 소견으로 진단하였으며, 위장관 등 망막이외 부위의 거대세포마이러스 질환은 조직학적으로 확인된 경우에 한하였다. 결 과 : 대상환자 128명의 추적관찰기간은 중앙값이 6(0∼59)개월 이었으며 7명 (5.4%)에서 거대세포바이러스 질환이 발생하였다. 거대세포바이러스 질환은 망막염이 6예, 식도염이 2예, 대장염이 1예, 폐렴 및 부신감염이 1예, 범발성 감염이 1예였다. 거대세포바이러스 질환의 발생빈도는 CD4+ 림프구 수가 적을수록 높았으며, CD4+ 수가 200/㎣미만인 환자 중 15% (6/33)에서 거대세포바이러스 질환이 확인되었다. 11예 중 9예를 ganciclovir로 치료하였으며 이중 7예에서 호전 또는 진행의 억제가 확인되었다. 추적관찰이 가능한 6예 중 3예 (50%)에서 재발하였다. 결 론 : 국내 에이즈 환자에서 거대세포바이러스 질환은 비교적 흔한 기회감염증이다. Background : Cytomegalovirus (CMV) infection is one of the important opportunistic infections in immunocompromised patients. In Korea, seroprevalence of IgG against CMV is over 95%. Therefore, CMV diseases are expected to be a prevalent opportunistic infection in AIDS patients. in Korea. Methods : We reviewed the medical records of 128 patients with HIV infection who visited the Seoul National University Hospital during the period from Nov. 1987 TO Sep. 1996. All the patients were examined by one ophthalmologist and the diagnosis of CMV retinitis were made by funduscopic findings. Other CMV diseases were diagnosed when histopathologic examinations showed the characteristic cytomegalic cells. Results : Median duratior, of follow-up was 8 months. Eleven CMV diseases were found in 7 patients (5.4%): 6 patients ahd retinitis, 2 esophagitis, 1 colitis, 1 pneumonitis, and one patient developed disseminated infection. Fifteen percent (6/33) of the patients whose CD4+ lymphocyte counts were less than 200/㎣ at baseline developed CMV diseases. Out of the 9 cases treated with ganciclovir, 7 improved or were stabilized. No patient received maintenance treatment and 3 had relapsed. Conclusion : CMV diseases are common opportunistic infections in AIDS patients in Korea.

交州 남만의 반란과 唐의 정책

김명희 호남대학교 2008 학술논문집 Vol.29 No.1

After the re-conquest of the native peoples of Jiao-zhou(交州: Nam-Viet) by the Tang and the establishment of a Chinese Administration there(Annan-Duhufu:安南都護府), Tang government had a false impression of finality. However the triumph of the Han(漢) over the Man(蠻) was never complete. The cruel and terrible conflict between Han(漢) and Man(蠻) were continued throughout Tang reign. After the first Tang settlement of the south early in the seventh century native resistance was concentrated, especially, in the coastal counties between Canton and Hanoi(Jiao-zhou:交州). The Feng(馮), Nong(儂) tribes and Ning(寗), Huang(黃) families were prominent in this resistance, which always threatened the main line of communications through Jiao-zhou. The other administrations of Guang(廣) and Gui(桂) in the north and east were relatively quiet. Among these Man tribes, the "Liao of Nan-ping(南平獠)" who inhabited a large region in southeastern Szechwan, and "Man of Xi-yuan(西原蠻)" were mainly dealt with in this article. There was comparative tranquility during the first half of the eighth century, except for vigorous revolt in Annam, and a series of insurrections in Lingnan(嶺南) in 722-728. Outbreaks became general in Jiao-zhou(交州) after the mid-century rebellion of An Lu-shan(755~763). The great Huang(黃巢:?~884) uprisings began in 875 and continued through most of the first half of the ninth century. The second half saw a major rising in Annan, supported by a large-scale invasion from Nan-zhao(南詔). It was suppressed by Gao Pian(高騈) and after that incident there was relative peace. Through presenting here a chronicle of the struggle of the Southern Natives(autochthons) to expel the hated aliens, we could deduce the fundamental characteristic of the relationship between Tang Han-ren(漢人) and Southern Man(南蠻).

牛.李黨爭 시기의 원진의 役割

金明姬 호남대학교 1999 호남대학교 학술논문집 Vol.20 No.1

Yuan Chen(원진:779-831), who shared the literary limelight with Po Chu-i(白居易:772-846), has been overshadowed by his friend in politics as well as in literary frame. Still Yuan Chen is known to be one of the best poet who wrote a quantity of poems lamenting upon the shadowy side of society and the life of high officials in mid-T'ang dynasty. His political career seems to be failed, because he served very short term as a minister in central government and most of his time spent as commissioner in province far out from the capital city of Ch'ang An (長安), and banishment from Ch'ang-an was regarded as punishment, because it was the hub of all cultural and political activities, where all the important decisions affecting the lives of the populace were made. After the An-Shih Rebellion which marks a key turning point in T'ang history, Ch'ang-an was sacked once more in 783 by mutinous troops. And the tivetans, who also took advantage of china's internal troubles and military weakness, revolted and marched to the capital. The bureaucrats in the court were divided in their views regarding the policies of the central government toward the outlying districts. Factions at court, divided politically and by social origin, became so strong that the entire administration was threatened. The Yuan-ho(元和) era was inaugurated in 806 under the emperor Hsien-tsung(憲宗:r.806-820), who came to the throne with eunuch and military backing. Meanwhile, under his own administration, new cliques formed around the aristocratic scholar-officials of the traditional hereditary ruling class on the one side, and newcomers or parvenus on the other. The latter, as a rule, were young intellectuals, whose backgrounds and sympathies identified them with the common people. It is to this new faction that Yuan Chen seems to have belonged, although by lineage he was a descendant of the imperial house of the Toba-Wei(拓跋魏:386-552) that ruled North China during the Southern and Northern dynasties. The so-called 'new faction' to which Yuan Chen belonged was led by Niu Seng-ju(牛僧孺:779-848) and Li Tsung-min(李宗閔:d.806), who represented the young intellectuals then rising to power through the examination system. They were more conscious of the sufferings of the people caused by official injustice and corruption, and they believed that social and political rather than military solutions were needed to remedy the nation's ills. The opposing faction was led by Li Te-yu(李德裕:787-850), son of the Chief Minister Li Chi-fu(李吉甫:758-812), who represented conservative elements with long ties of association to the imperial house and hereditary titles dating back to the founding the dynasty. The struggle for political power between these two factions, intensified by personal feuds among the party leaders, continued for almost fifty years, and weakened the bureaucratic structure upon which the empire rested and strengthened further the power of the eunuchs who had entrenched themselves in the central administration and armies. To stabilize its own position, each party tried to enlist the support of influential eunuchs. Yuan Chen began his own official career under complicated political climate and his political career fluctuated between high office and demotion and banishment, as if it had been planned long before his time. The emperor Mu-tsung (穆宗:821-824) favored him with special affection and appointed him to the position of chief minister. But party factionalism, eunuch intrigue, and power politics were too violently antagonistic at that time, and Yuan Chen could not keep the position for long, and even the emperor was unable to protect him from such enmity. Despite his brilliance as an administrator with high ideals, Yuan Chen was regarded, after all, as an 'upstart,' a parvenu. He pacifist policies antagonized the "palace guard" who believed that the authority of the central government must be restored by force. Moreover, too eager to have the clean government, he declared war against corruption and extortion wherever he found them. As a consequence of his exposure of illegal dealings and corruption in high places, he aroused the wrath of powerful political leaders and eunuch factions. Had Yuan Chen remained in the position of chief minister longer, it is possible he might have been able to accomplish some of the things he originally set out to do, and which party he had belonged to would never changed the matter. But his term in office lasted only a few months.

『唐會要』의 勅令 分析을 통해본 唐代의 賤民制度

金明姬 호남대학교 1988 호남대학교 학술논문집 Vol.9 No.-

The slavery system which played an important role in an agricultural-production throughout the Han dynasty, changed their role and we ight in society accordance with the decline of the dyrasty. During the six dynasties, the slave and the dependant were co-existed as dual-structure in society. when the T'any dyrasty established, the system had given place to the system of common-servile people and the system became fixed from then on. In this article, it focused on the inter-connection between the system and the economical changes, in particular, the land system. Among various historical materials, the edicts on the slaves from 「T'ang Hui-yao」 were chosen as main references. The contents of the edicts could be devided into three phases: first, the period of the restriction on the number of slaves which was allowed to be employed in one household; second, the prohibition on kidnapping of commoners and selling them as slaves; third, the prevention of employing foreign slaves inside the china proper. These three phenomena reflects the change of social circumstances; in order to prevent the commoner becoming the slave, the government had to issue the edicts in reducing the rumbers of slaves, and eventually the slave-status itself disappeared from society. At the same time, it reflects the variation of the ruling class on how they recognize the servile people. In other words the cognition for the servile class of the ruling-class such as royal-family and aristocrats had been undergo rapid changes. Despite the difficulties in its effectiveness, these succession of edicts on the servile class, influenced on the social understanding for the class, and on the whole, it contributed to the abolishment of the system from chinese society. Through various changes of social conditions, eventually the servile class which played an important role in chinese society, vanished altogether. From these aspects, the T'ang era was the transitional period which witnessed such changes.

서사체로서의 문학과 영화 : 프리쉬와 쉴렌도르프의 『호모 파버』비교

김명희 한국독일언어문학회 2004 독일언어문학 Vol.0 No.23

In dieser Arbit wde Frischs Roman 'Homo faberd mit Schlilndorffs Film 「Homo faber」verglichen. Walter Faber, der Protagonist in Frischs Roman, ist dw T ypus des rationalistischen Menschen des 20. Jahrhunderts, der sich mit Technik umgibt und der dieser Technik vertraut. Der Roman ist in zwei Stationen geglidert. Die erste Station berichtet von Fabers Notlandung bis zum Unfall und dem Tod seiner Tochter Sabeth und dem Wiedersehen mit Hanna. Ebenso enthat die erste Station Riickblenden, in denen Faber von seiner Jugendzejt erzat, von seinem Verh&nis zu Hanna und der Trennung von ihr. Die zweiten Station berichkt von der &it nach Sabeths Tod und besteht aus Aufieichnungen Fabers im Krankenhaus und seinem Tagebuch. Die zweiten Station steiellt eine Interpretation der ersten Station dar, In der zweiten Station versucht Faber zu einer Neuorientierung in Befllg auf seine Einstellung gegeniiber sich selbst, seinen Mitmenschen und der Natur zu kommen, Der Roman scheint ein Buch iiber die Liebe zu sein. Doch schon der Titel Homo faber venveist auf die anderen grol3en Thernen des Romans, Natur-Mensch-Technik, Identitlitsproblematik und Zeitkritik. Frisch hat im gescheiterten Leben Fakers diese Liebeshmdlung mit diesen Themen verbunden. Walter Faber berichtet und kommentiert als Ich-Erziihler riickblickend die Ereignisse der Vmgangenheit. Der sich erinnernde Ich-Erzfthler Faber ist als erlebendes Ich selbst Teil der erz2hIten Welt. Der Ich-Erzhler Faber gilt als subjektiv und unzuverlassig. Seine Subjektiviut schlw sich in der Auswahl und Anordnung der beichtekn Ereignisse nieder. Faber gibt die Geschehnisse nicht chronologisch wieder, Schlondorffs Film Homo faberJ beginnt mit Fabers Abschied von Hanna am Flughafen in Athen. Dime Szene kehrt am Ende des Films wieder. Dazwischen erlebt der Zuschauer in einer Rtickblende die Ereignisse chronologisch mit, die zur Begegnung Fabers nit seiner Tochter ftihrten, die EntwicMung ihrer Homo faberJ verglichen. Liebesgeschichte, den UnfaU Sabeths, ihren Tod und das Wiedersehen mit Hanna Die fragmentarische Erz2hlstrUktur des Romans wird zu einem weitgehend linearen Handlungsablauf gestrafft. Die Ereignisse nach Sabeths Tod, die in der zweiten Station des Romans geschildert werden, ebenso wie Fabers Krankheit und eigenes voraussehbares Ende, und vielen Reflexionen des Ich-Erz&lers werden im Film eliminiert. Im Film Schlondorffs insgesamt meldet sich die Stimme des Ich ErMers funfzehnmal zu Wort. Der Einsatz der ErzWerstimme, die als 'voice over' die Filmbilder begleitet, verweist deutlich auf die Ich-ErzWweise der likarischen Vorlage. Das 'voice over' Verfahren funktioniert als distanzierendes Element, als ein Instrument der Mittelbarkeit, das den Frotagonisten Faber eindeutig als Erzdder der Geschichte kennzeichnet. Der Einsatz der Erzahlerstimme erhoht die Affinittit des Films zur Vorlage. Doch die visuelle Gestaltung des Films entzieht sich der subjektiven Perspektive. Die Kamera ist nicht an Faber gebunden, sondern w N t sich ihre Blickrichtung quasi selbst. Die Filmszenen weichen somit von der subjektiven Perspektive der literarischen Vorlage ab und erreichen die Wirkung einer auktorialen ErzWhaltung. Die visuelle Ebene des Films verrnittelt dem ktrachter durch ihre auktoride Struktur eine objektive Realit&. Die Themen des Roman Frischs gehen verloren zwischen den 'voice over' Verfahren des Ich-Erzihlers und den distanzierten Bildem der auktonal gestalteten Visuellen Ebenen. Schlondorff hat aus Frischs zeitkritischer Technikertragbdie ein sentimentales Liebesdrama, ein gefdliges und konventionelles Erz&hlkino gemacht. Schlondorffs Film FHomo faber, verdeutlicht Mijglichkeiten und Grenzen der Literatur-verfihungen.

唐·憲宗과 元和中興

金明姬 호남대학교 2003 호남대학교 학술논문집 Vol.24 No.1

Xianzong(□宗:806-820) was the last Tang imperial reformer and was counted as the strongest emperor in late Tang times. He won authority by personally leading successful campaigns against rebel provinces(fan-zhen:□□814-819), and his economic and administrative reforms gave the dynasty another half-century of efficient empire-wide administration. Murdered by two discontented eunuchs, Xianzong was succeeded by his son Muzong(□宗;7:820-824). Xianzong combined a strong sophisticated knowledge of the political forces within his own court and had relatively better relationship with his ministers than his predecessors in an appropriate way. The years between the aftermath of the An Lu-shan(安□山:755-763) rebellion and the accession of Xianzong in 805 saw no basic changes in the provincial structure, despite the major events which occurred. At that particular period, the essential task of recovery was to show the power of the central government on the battlefield. As Prof. Twitchett express the situation, "Xianzong had no illusions about the possibility of a rapid restoration of central power, and moved with caution and sought to exploit opportunities as they arose." Further, because he did not see the provincial problem purely in military terms, Xianzong set to work on the institutional reforms with his newly appointed ministers. It surely is apparent that the purpose of reforms were not purely for the welfare of the populace. However, due to the restoration of central power by the government, most of the provinces had kept relatively peaceful state. When we make an assessment on his achievement, there can be a few different opinions; relatively positive one or the opposite. More than anything else he inherited a replenished treasury and a strong central army from Dezong and his imperial position was essentially secure. Another major resource was the bureaucracy which, despite outbreaks of factionalism and signs of corruption, was in a relatively healthy state and contained many brilliant officials such as Li Ji-fu(李吉□), Li Jiang(李□), Pei Du(□□) and Yuan Zhen(元□). The court possessed, then, the resources needed for strong central action. He seems to have chosen his men well and in return to have inspired their confidence. Li Ao(李□) commented on the Xianzong's reign as follows; 'of all restoration monarchs since antiquity none have come up to this', and from this phrase we could glimpse at the confident sentiment of the times.