브루셀라균에 노출된 미생물 검사실 직원들에 대한 예방적 항생제 요법과 혈청학적 추적검사

이창섭,이혜수,이재현,박진희,최영실,황규잠,이흥범 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

The aerozolization is one of possible Brucella transmission mechanisms, particularly in air-borne exposed laboratory workers. In this study, seven laboratory workers were potentially exposed to B. abortus via aerosols. Two laboratory workers who sniffed an agar plate several times were considered to be at high risk for acquiring the disease, 5 workers who did not work directly with the strain were be considered at low risk of infection. Prophylactic antibiotics of doxycycline 200 mg/day and rifampin 600 mg/day were offered for 6 weeks in high risk workers and 3 weeks for low risk workers respectively. Enrolled workers were advised to check for serological testing of Brucella species every 3 weeks during a total period of 12 weeks. Compliance with taking medicine was 57.1% (4/7) and compliance for completing the serological tests was 85.7% (6/7). None of the laboratory workers developed clinical disease or tested positive serologically during 3 months of seroloaical testing and 1 year of clinical follow-up.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

계지의 항염 효과에 관한 연구

박히준,이지숙,이재동,김남재,표지희,강전모,최일환,김수영,심범상,이제헌,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : Cinnamomi Ramulus (CR), the young twing of Cinnamomi loureirii nees, has been used for treating symptoms related to pain. rheumatic arthritis and inflammation in Korean herb medicine. This study was carried out to investigate the anti-inflammatory effect of CR in vivo and in vitro. Methods : Extracts of CR were prepared and the chemical components of the extracts were examined by gas chromatography-mass spectrometry (GC-MS). The extracts were administrated to the rat paw edema model induced by carrageenan to evaluate the anti-inflammatory effect of CR. The expressions of nitric oxide (NO). prostaglandin E2(PGE2), inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 were also quantified in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages to survey the effect of CR in vitro. The main components were cinnamaldechyde and coumarin. Results : We examined the anti-inflammatory activity of the 80% ethanol extract of Cinnamomi Ramulus in vivo by using carrageenan-induced rat paw edema model. Maximum inhibition of 54.9% was noted at the dose of 1000㎎/㎏ after 2 hours of drug administration in carrageenan-induced rat paw edema and this showed a potent anti-inflammatory effect. Conclusions : The results showed that Cinnamomi Ramulus suppressed dose-dependently LPS-induced NO production in RAW 264.7 macrophages and also decreased iNOS protein expression. Cinnamomi Ramulus also showed a significant inhibitory effect in LPS-induced PGE2 production and COX-2 expression.

고량강의 항염증 작용에 대한 연구

박히준,이제현,김수영,심범상,구헌종,강전모,최일환,이재동,김남재,이지숙,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The use of herbal therapy is becoming an increasingly attractive approach for the treatment of various inflammatory disorders. The Alpiniae officinari Rhizoma is popular in Aisa as a traditional herbal medicine. Alpiniae officinari Rhizoma is a species of the ginger family(Zingiberacease). Method : This study was performed to investigate the anti-inflammatory effect of Alpiniae officinari Rhizoma extract by the methods of "carrageenan induced paw edema" and "Lipopolysaccharide-induced inflammatory mediators in mouse macrophage RAW 264.7 cells". Result : We suggest that Alpiniae officinari Rhizoma extract decreased paw volume induced by plantar injection of carrageenan. Also Alpiniae officinari Rhizoma extract inhibited nitric oxide, prostaglandin E₂production and induced nitric oxide synthase, cyclooxygenase-2 protein expression in Mouse macrophage RAW 264.7 cells stimulated with lipopolysaccharide. Conclusion : This study shows that Alpiniae officinari Rhizoma extract seems to have anti-inflammatory effect by inhibition of nitric oxide, prostaglandin E_(2) production and nitric oxide synthase, cyclooxygenase-2 protein expression.

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

정중과잉치로 인해 회전된 상악 중절치의 치험례

이범의,김영재,김정욱,장기택,이상훈,김종철,한세현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

정중과잉치의 원인은 잘 알려지지는 않았지만 dental lamina의 hyperactivity에 의해 발생한다는 가설이 가장 많이 받아들여지고 있다. 이러한 정중과잉치의 병발증으로는 주변 영구절치의 맹출 장애, 만곡 치근, 치근흡수, primordial 혹은 follicular cyst의 형성, 회전, 이환된 부위의 총생 및 비정상적인 정중이개를 일으킬 수 있다. 이러한 이유로 영구전치의 회전이 야기되면 보통 공간의 부족은 적거나 없으며 재발이 흔하므로 과개선이 요구된다. 재발의 방지를 위해서는 조기치료, 과개선, 긴 보정기간, 적절한 접촉면의 형성, 짝힘의 사용, 그리고 수술적인 방법 등이 제안되어왔다. 이에 저자는 정중과잉치로 인하여 심하게 회전된 상악중절치를 주소로 내원한 환아에서 교정적, 외과적 술식을 이용하여 양호한 결과를 얻은 두 증례를 보고하는 바이다. The etiology of mesiodens is unknown but the most widely accepted theory is the hyperactivity of the dental lamina. Complications of mesiodens are delayed or prevented eruption of maxillary central incisors, displacement or rotation of permanent teeth, crowding of affected region, abnormal diastema or permanent space closure, dilaceration or abnormal root development of permanent teeth, primordial or follicular cyst formation, root resorption of adjacent teeth, eruption into nasal cavity. If mesiodens rotate the maxillary central incisors, space deficiency is not common and relapse is very common. So overcorrection is needed. To prevert the rotational relapse, early treatment, overcorrection, long retention period, properly formed proximal surface, use of coupled force, and surgical techniques have been suggested. The authors present two cases, whose chief complain were severely rotated maxillary incisors by mesiodens, treated by orthodontic and surgical technique and showed good results.

기능성 모노머를 포함한 자가부식형 상아질 접착제의 결합강도에 관한 연구

이재범,임호남 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.4

The purpose of this study was to ascertain the influence of functional monomers and bonding methods in self-etching dentin bonding systrms on shear bond strength. Seven commercially available self-etching dentin bonding systems were used. According to functional monomers, they could be divided into two phosphate groups(Clearfil SE, Prompt L-Pop), three dicarboxylate groups(MAC-Bond II, UniFil Bond, One-up Bond F), one anhydride group(AQ Bond) and one pyrophosphate group(Etch&Prime 3.0). According to bonding methods, Clearfil SE, MAC-Bond II and UniFil Bond were two-step self-etching systems and Etch&Prime 3.0, Prompt L-Pop, AQ Bond and One-up Bond F were one-step eslf-etching systems. The buccal surfaces of human molars were grounded flat to expose dentin suface and all bonding systems were appoied according to the manufacturers' instructions. The metal rings were placed on the bonded surface, and composite resin(Z100) were added on that surface and cured by light. The resin-bonded teeth were stored in water(37℃) for 24 hours, and these specimens were tested in a shear mode at a cross-head speed of 1.0mm/min using an Instron testing machine. The data for each groups were subjected to an ANOVA followed by the Duncan's multiple range test at p=0.05. The resin-dentin interfacces were obtained by cutting the specimen vertically and the interfacces were obserbed by SEM. Following results were obtained : The shear bond strength of self-etching dentin bonding systems which contained di-carboxyl and phosphate functional monomers were higher than that of the systems contained another functional monomers(p<0.05). Statistically, there was no signigicance between the one-step self-etching systems and the two-step self-etching systems(p>0.05). There was a trend that the thickness of hybrid layer was increased according to strength of acidity. But the thickness of hybrid layer was not correlation with the group of functional monomer, so that selection of bonding system containing adequate functional monomer was inportant on dentin bonding.

주상복합건물의 구조형식에 따른 환경영향 비교연구

이강희,김상범,양재혁 대한건축학회 2004 대한건축학회논문집 Vol.20 No.7

The further building industries are required to include the economic aspects and the environmental aspects simultaneously, where the assessment of these two areas make it possible to select the proper alternative at planning stage. In various assessment ideas in planning process, the estimation of the energy consumption, CO₂ emission and SO_x emission could be effectively utilized to compare and analyze the environmental influence within various alternatives. In this paper, it aimed at providing the unit of energy consumption, CO₂ emission and SO_x emission as an assessment item in according to the structural type of the residential complex building and comparing the environmental impacts at the Steel Reinforced Concrete and Reinforced Concrete. This study found that Steel Reinforced Concrete is better than the RC type building in energy consumption. But SRC is a little unfavorable than the RC type building in CO₂ emission and SO_x emission.

Clozapine이 백서의 Schedule-Induced Polydipsia에 미치는 영향

이기철,정홍경,이정호,홍승범,최영민,전성일,정재현,하준명 대한생물치료정신의학회 2000 생물치료정신의학 Vol.6 No.2

Object : This study was designed to evaluate the effects of clozapine which is one of most useful atypical antipsychotics in the schedule-induced polydipsic rat which is an animal model of obsessive-compulsive disorder. Methods : Spraque-Dawley rats were placed in automatic cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT- 60s) feeding schedule over 150-minute test session for 4 weeks. After 4 weeks of daily exposure to the FT-60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). Rats were stratified into clozapine(0.34mg/kg,i.p.), clozapine(14.63mg/kg,i.p.), clomlpramine(5mg/kg,i .p.), and vehicle (1cc/kg,i.p.) group and treated with each drugs for 3 weeks. To identify the non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5gm) of food per day which maintained them at their average body weight. Results : The results were as follows ; 1)After 4 weeks of scheduled feeding procedure, the experimental group showed significant differences than bolus control in the amount of water consumption as compared with their baseline of water intakes for 4 weeks. At the same periods, there were no differences between the experimental group and bolus control in the borty weight. 2)The clomipramine group, the clozapine 0.34mg group and the clozapine 14.63mg group showed significant decrease in the amount of water intake for at 2nd & 3rd week of drug treatment as compared with their baseline of polydipsic water intakes. But, the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. Conclusion : Above findings suggest that the fixed time feeding Procedure for Schedule induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. In clinical situation, the authors suggest that atypical antipsychotic drugs which act as serotonin and dopamine receptor antagonist may be helpful to improve the symptoms of the patients with treatment refractory obsessive-compulsive disorder.

복직근 및 박근 근피판술을 이용한 골반 및 서혜부 연부조직 결손의 재건

이재화,정윤규,김주봉,유대현,황성관,이훈범,김석원 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Many operations for the reconstruction of the pelvic area have been studied until now. The local muscle flap is often used for the closure of these complex wound. But, these local muscle flaps may not be available for reconstruction due to the factors of infection, radiation, and surgical trauma. Since rectus abdominis muscle and gracilis muscle were introduced, their use has been steadily increased for the reconstruction of soft tissue defect of the pelvic area. Inferiorly based rectus abdominis muscle flap and the gracilis muscle flap have been adopted for well-vascularized soft tissue coverage of the defect of pelvis and groin area. These techniques were utilized in seven patients. Of these patients, rectus abdominis muscle flap was used on four patients and three patients were treated with gracilis muscle flap. Among these, chronic osteomyelitis of pelvic bone has been managed with inferiorly based rectus abdominis muscle flap in three patients. No complication has been found. The mean postoperative follow-up period was 26 months, with a range of 12 to 39 months. In conclusion, these muscles are functionally expandable , and provide adequate tissue volume with sufficient blood supply away from the zone of injury, and readily transposed into the pelvis and groin area through subcutaneous tunnel, and serve as an antibiotic delivery system that aids in the eradication of infection. These findings suggest a reconstructive option for the defect of pelvis and groin, and/or bone infection in this area.