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.

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

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.

쌍발 복합재 항공기의 세로 안정 미계수 추정

김칠영,이정모,은희봉,신충화,황명신 한국 항공대학교 항공산업기술연구소 1997 航空宇宙産業技術硏究所 硏究誌 Vol.7 No.-

본 연구의 목적은 비행시험으로부터 항공기의 동적 세로 안정 미계수를 결정하는 것이다. 일반적으로 미계수를 결정하는 방법은 풍동시험 방법, 분석적 방법 그리고 비행시험 방법등으로 나누어진다. 앞의 두가지 방법은 미계수 추정에 있어 많은 제한을 갖고 있으며 추정된 미계수의 유효성에도 문제가 있다. 따라서 비행 시험은 가장 정확한 미계수를 얻을 수 있는 방법이며 반드시 필요한 절차이다. 쌍발 복합재 항공기의 비행시험을 통해 자료를 획득하였고 최대공산법을 이용하여 세로 조종/안정 미계수를 추정하였다. 추정된 미계수를 이용하여 항공기의 운동을 시뮬레이션하여 실제 시험자료와 비교하여 좋은 결과를 나타냄을 알 수 있었다. The purpose of this paper is to find how to determine the longitudinal controllability and stability derivatives from flight test and to display the longitudinal stability of the Twinbee aircraft. There are various methods developed to find the derivatives : wind tunnel testing, predicted result from empirical data, flight test and so on. Among those methods, the estimation from flight test of real aircraft is the most reliable. We performed the flight test of Twinbee and recorded the states of aircraft. Using those states and parameter estimation algorithem based on the Maximum Likelihood (MMLE) criterion, we can estimate the controllability and stability derivatives. In this paper, we will show the process from designing the proper flight test input to estimation of derivatives.

隋唐代의 新儒學의 傾向

金明姬 호남대학교 1997 호남대학교 학술논문집 Vol.18 No.3

In the early T'ang, during the reigns of Kao-tsu T'ai-tsung, court patronage played essential role in promoting learning and scholarship. Between 631 and 635, the project, begun under Sui dynasty, of an authoritative edition of the Five classics (Book of Changes, Book of Documents, Mao Odes or Songs, Book of Rites, and Spring and Autumn Annals) was completed by committees led at various points by Yen Shin-ku (顔師古), K'ung Ying-ta(孔潁達 : 574-648), and T'ai-tsung's brother-in-law Ch'ang-sun wu-chi(長孫無忌 : d. 659). The result was the Wu ching cheng-i (五經正義) : The correct significances of the five Classics), It integrated, ranked, and summarized an extensive tradition in a single set of works. It was a kind of encyclopedia of Classical studies. The breakdown of the T'ang order after 755 harmed not only the immediate interests of those whose fortunes were tied to the state but also their faith in the correctness of the early T'ang cultural synthesis. The crisis of culture in scholarship appeared initially as a conviction that the cultural models of the past had not worked as intended. Gradually a far more enduring crisis of culture began to take shape, one that would consume the energies of intellectuals for the next three centuries: a crisis of faith in the ability of culture to influence human behavior. The men who led the way were mostly from great calns, although hot necessarily from the strongest branches, and they were well schooled in the literary habits and assumptions of the past. Yet their work helped destroy the aristocratic culture of medieval China and introduce and era of self-conscious inquiry and debate over ideas. Some authoritative reference works attribute the phrase of “literature is to convey moral truths(wen I tsai tao. 文以載道)”or the idea to Han Yu. Han did not say it (it appears in the writings of the moral philosopher Chou Tun-i in the eleventh century), but the mistake suggests the need to view the eighth century from the perspective of the T'ang past rather than of the Sung future. There were clusters of scholars in the new generation, each with its own program. Han Yu (韓愈 : 768-824), for example, found admirers in Li Ao(李 ), Chang Chi(768-830). Lin Tsung-yuan (柳宗元 : 773-819) had much in common with Han Yu, but was also associated with Lu Wen(772-881). The transformation of intellectual values is evident in the new acount of the decline and restoration of culture that emerged from Han Yu's circle : the story of the decline and recovery of the tao of the sages. It has been argued that Liu Tsung-yuan turned away from literary practice and helped free the Confucian revival from literature. Lin was uneasy with much that can be seen in Hun Yu : the exclusion of Buddhism, calims to authority, the conspicuous assertion of differences with contemporary standards. and pointed insults to polite conventions. He did not object to Buddhist teachings about mental cultivation. He envisioned the tao as ultimate and transcendent. The duty of scholars, Liu eventually concluded, was to create the wen that would lead men to enter' the tao of the sage on their own. In Liu's hands the textual tradition becomes qualities to be embodied in though and expression. The tao of the sage does not translate into a doctrinal statement; rather, it is to have the qualities that constitute good character, qualities one might look for in an official and a judge. This tao can be illuminated through writing as the scholar's way of responding to affairs of the world. In contrast to the early T'ang, the literary intellectuals of the latter half of the eighth century saw themselves as being in tension with the political order and their culture. Ku-wen encouraged this attitude and justified it. A Han Yu or Lin Tsung-yuan could bepart of the system while still claiming the high ground from which to criticize it. The idea that individual scholars could find a tao of the sage gave scholars grounds for claiming it meant unifying the empire under civil rule, restoring the vivil(wen: 文) after a century dominated by the military(mu: ) The intellectual history of the Northern Sung has its origins in the conviction of the first few decades that wen was a value common to the realms of both politics and learning. But it also has its origins in the difference between thesynthetic style of court scholarship and the moral outspokenness of ku-wen(古文).

볼엔드밀 加工에서 남겨진 커습體積의 仕上加工 特性에 關한 연구

김명수,천상진,맹희영 서울産業大學校 1997 논문집 Vol.46 No.1

The polishing characteristics of machined surface after ball end milling are studied in this paper quantitatively to investigate the optimum machining time including polishing and milling process. The polishing experiments are formulated into the incremental changing task of sand paper meshes bounded by the allowable limit roughness for each abrasive grit size. Testpieces are prepared by milling the flat steel block to have the terraced surface for the different milling crossfeed and cutter size, and polishing device installed on a grinding machine table, which simulates the actual polishing work as specified stroke and acting pressure. The polishing efficiency is investigated during the polishing experiment, and then eventually polishing time is evaluated for the various kinds of conditions, and it is finally analyzed the total machining time which is estimated by adding the milling time to the polishing time of corresponding testpieces. Although the polishing work is shortened as the initial roughness of milled surface becomes small, the total machining time is revealed as the minimum value at a testpiece prepared by milling condition of 1.5mm crossfeed and 20mm cutter size, which means the most economic machining balance between milling and polishing work partitions.

심근침범을 동반한 Becker형 근이영양증 환자에서 확인한 Dystrophin 유전자 Exon결실

김광일,오병희,이무용,채인호,신수,박성섭,김효수,손대원,이명묵,박영배,최윤식,이영우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

唐代의 良賤制와 北魏의 良奴制에 관한 硏究

金明姬 湖南大學校 1990 호남대학교 학술논문집 Vol.11 No.1

Throughout the period of Ch'in-Han, Nan-Pei Chao and T'ang dynasty, the system of servility had seen some changes in its contents, the form of institutions and the term in its expression of the system. During Han dynasty, the term slavery became a settled institution. From then on slaves were seen as a group having a distinct customary in society. In Pei-Wei dynasty the institution had changed the purpose of it. Shaowen ti(孝文帝) institutionalized Liang-nu(良奴) System. The Liang-nu system, compared to slavery, focused on increasing commoners' number and also counted them as more important factor for the foundation of imperial power. Some scholars opinioned that the system came out from an intention of unification of China under the Northern tribes' power and also emphasized the energy of Pei-Wei dynasty and the T'ang system had been the result of these sino-synthetic rule. It is not yet fully varified, however, whether the T’ang servile system were developed from the Slavery system or inherited the commoner-slavery system. In this article, an assumption that T’ang servile system derived directly from commoner-slavery system and strongly inter- connected together. In the beginning of T’ang dynasty, it was not easy task for the government to divide all the people into two definite categories, such as Liang or Nu, for instances, a group of pu-ch’u, Kwan-hu and cha-hu who were gradually becoming to play an important role in society during six dynasties, could neither be categorised intc slave class nor as commoner class. For the T’ang government, an establishment of a new system in society was needed and subsequently a system of law & statutes were legalized. Accordance with such condition the common-servile system also came into being by the law. The common-servile system, as in commoner and slave system, it aimed to increasing the number of commoner within the status-order of government. In this respect, the two systems have close connections to each other not only by the periodic space but also by their characteristics.

唐代 南方任官과 南方文化에 관한 小考

김명희 호남대학교 2005 호남대학교 학술논문집 Vol.26 No.1

The focus of this paper lay in analyzing how the immigration of Tang northern families to Lingnan(嶺南) influence the society of Lingnan during the Tang dynasty, both socially & culturally. During the Tang dynasty, the Southern Region, including Guangdong(廣東) & Nanhai(南海) was not yet fully developed. Still the area was gradually beginning to gain significant attentions in various ways and also to emerge as an attractive area for the economic development. In the early Tang, some northern families changed their native places to Lingnan when they became officials there. It was also a place thet received banished prisoners and demoted officials. In particular, three officials Zhang Jiuling(張九齡:713~741)ㆍJiang Gongfu(姜公輔)ㆍLiu Zhan(劉瞻), whom their ancestors were demoted previously to Lingnan, were later promoted to the prime minister(宰相) of the central government of Tang in each respective periods. There were a lot of other cases similar to those three officials. Also after the An Lushan(安祿山) rebellion, the northern families who escaped from the wars in the north influenced Lingnan's economy, society & culture greatly and the economic conditions were improved by them. Among those various influences, cultural divelopment was the most important factor, it seemed Cultural advancement brought the unity in politics with the central government. The descendants of the demoted officials or vanished prisoners beginning to participate in central government politics and were promoted to high post enough to making important policies. Gradually, cultural tendency of China-proper & Southern-area were assimilated into harmonious unity.