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        발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

        정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

        목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

      • 어린이 김치 표준화에 대한 연구(1) : 어린이 김치의 담금법 개발 Development of the Preparation of Kimchi for the Children

        송영옥,전영수,권명자,빈성미,김은희,문정원,김명 부산대학교 가정대학 1995 家政大學硏究報告 Vol.21 No.-

        The purpose of this study is reporting the results of first trial for the standardization of children's kimchi in terms of brining standardization, development for the recipe ad pannel test for the children's kimchi. In order to develop the standard recipe for children's kimchi, our research team have visited kimchi factories, temples and houses located in Pusan and Kyung-Sang Nam Do province. Three kinds of chinese cabbage kimchi (hamyang, haeundae, and jinrae kimchi named by region where we collected) which got the top three highest score in panel testing was selected. The original recipes of these kimchi were sightly modified to prepared the kimchi at laboratory. Among three of them, hamyang kimchi which contained dried anchovy power was selected as a model kimchi for development of the children's kimchi recipe. We find out that the optimal salt concentration of brined cabbage and kimchi for the children's kimchi (sliced style kimchi, approximately 2.5X3cm a piece) that showed the hightest pennel score were approximately 1.5% and 2.0%, respectively. The salt concentration of brined cabbage became 1.5, 1.43, and 1.60% after 60 min at 10% brining solution, 45 min at 12% and 30 min at 15%, respectively. The developed recipe used for the children's kimchi at our team is as follows. The major ingredients used for the preparation of kimchi is brined sliced chinese cabbage (salt concentration is 1.5%) 1kg galic 11g, ginger 5.0g, red pepper powder 20.0g, fermented anchovy juice 25.0g, fermented shrimp juice 5.0g dried anchovy and sea weed extracts 30.0g, anchovy power 2.4g glutinious rice gel 40.0g, starch syrup, 10.0g, and apple juice 22.5g. The total acceptability test of developed children's kimchi (test kimchi) was carried out with 84 of 6th grade student during lunch time at elementary school in Pusan where has a school lunch program. Sixty nine percent of student answered test kimchi is very good, 25% of them said it is fair, and only 6% of students answered they didn't like test kimchil. However, for the kimchi supplied from school at lunch, 52% students answered the kimchi is good, 26% of them said it is fair, and 22% of them said they don't like school supplied kimchi. This result tells us that the test kimchi is better than school supplied kimchi and the test kimchi can be developed further as a children's kimchi.

      • 지능형 원격 네트워크 온실

        문병현,송주열,이현성,손경규,엄태환,김정우,김아름 대구대학교 정보통신연구소 2004 情報通信硏究 Vol.3 No.2

        The system designed in this paper, can mark the interior state of greenhouse using sensors of temperature, humidity and illumination on greenhouse interior by greenhouse system for farm village area's agriculture automation. And, the real time monitor is possible real time monitoring by camera. Also, system that can supply water using spring cooler system and humidifier. The proposed system can sustain a designed environment of the greenhouse through rentilation fan, fluorescent light and roof door control. TCP/IP is used for the remote control of state the sensors in the client program. 본 논문에서 설계된 시스템은 농촌 지역의 농업 자동화를 위한 온실 시스템으로 온실 내부에 온도, 습도, 조도 센서를 이용한 온실 내부의 상태를 표시할 수 있으며 카메라를 이용하여 실시간 관측이 가능하다. 또한 본 시스템은 지붕 개폐, 스프링 쿨러와 가습기를 이용한 수분 공급, 환풍기, 형광등 등을 통하여 온실 내부의 환경을 유지시킬 수 있다. 모든 센서를 이용한 상태와 온실 제어를 TCP/IP를 이용한 클라이언트 프로그램에서 원격으로 관리할 수 있다.

      • KCI등재

        초음파 펄스에코 신호의 3차원 처리

        송문호,손상락,조정호,성제중,안형근,장순재 한국비파괴검사학회 2003 한국비파괴검사학회지 Vol.23 No.5

        비파괴 시험을 위한 3차원 구조의 초음파 영상에는 다양한 결함을 명백하게 보여줄 수 있을 만큼 상세하고 쉽게 알아볼 수 있는 정보가 제공되어야 한다. 수년 동안 원자력 발전소에서 사용된 금속관에 발견되는 소규모의 균열은 전형적인 결함들인데, 이러한 밀리미터 이하의 균열이나 결함은 최종 3차원 영상에서 묘사되어야만 의미있는 검사가 될 것이다. 향상된 선명도와 그에 따른 결함의 발견 과정의 한 단계로써, 펄스에코(pulse-echo) 초음파를 사용한 3차원 영상제작 기술을 제안한다. 이 기술은 필요한 스캐닝과 펄스에코 데이터의 처리과정을 통한 검사로 3차원 물체의 3차원 영상을 생성하는데, 2차원 위너필터(Wiener filter)에 의해 초음파 빔을 선명하게 하는 기술을 포함한다. 제안하는 위너필터는 빔의 전달에서 펄스에코 데이터를 초음파 빔 방향의 수직방향에 따라 필터링한다. 이 3차윈 처리과정은 결함의 선명성을 증진시키고 사용자에게 3차윈 구조물의 좌우 회전 및 축 회전과 같은 조작 능력을 제공한다. 이러한 조작 능력은 3차원에서 다양한 결함들의 크기와 위치의 분명한 묘사를 가능하게 한다. Infrasonic imaging of 3-D structures for nondestructive evaluation must provide readily recognizable images with enough details to clearly show various flaws that may or may not be present. Typical flaws that need to be detected are miniature cracks, for instance, in metal pipes having aged over years of operation in nuclear power plants; and these sub-millimeter cracks or flaws must be depicted in the final 3-D image for a meaningful evaluation. As a step towards improving conspicuity and thus detection of flaws, we propose a pulse-echo ultrasonic imaging technique to generate various 3-D views of the 3-D object under evaluation through strategic scanning and processing of the pulse-echo data. We employ a 2-D Wiener filter that filters the pulse-echo data along the plane orthogonal to the beam propagation so that ultrasonic beams can be sharpened. This three-dimensional processing and display coupled with 3-D manipulation capabilities by which users are able to pan and rotate the 3-D structure improve conspicuity of flaws. Providing such manipulation operations allow a clear depiction of the size and the location of various flaws in 3-D.

      • SCOPUSKCI등재

        한국 정상인에서 연령에 따른 뇌혈류분포와 혈류예비능의 변화 : Tc-99m HMPAO SPECT 에 의한 연구

        문대혁,이희경,송호천,이재태,범희승,손혜경,정환정,민정준,김지열 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.3

        Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3±24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalami rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9±12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

      • 洞報 廢鑛山 周邊地域 土壤 內 重金屬 移動 分布

        문영옥,정송송이,최상민,김민철,박창웅,오광중 부산대학교 환경문제연구소 2003 環境硏究報 Vol.21 No.-

        In this paper, we study heavy metal transport and distribution of soils around Dong-bo abandoned mine area. Inside the mine, concentration of Cd, Ca, Zn are exceeded soil management standards. Outside of mine, concentration of Pb, as is exceeded soil management standards. Especially, concentration of Pb is higher than soil protection standard of 300㎎/㎏ in S-6 point which is tailing accumulation area. Although heavy metal concentration of mine water was higher than Unsuchon, water contaminated level was lower than soil. 30cm-depth soil is serious in S-6 point, heavy metal transport had influence on Unsuchon. Further more, we used pollution index(PI) to evaluate soil contamination totally, it exceeded standard "1" in S-6 points of surface soil and 30cm-depth soil. So it decided that contamination of heavy metal is more seriously than other sampling points. In contaminated soil, pH and organic contents are lower than non-contaminated soil. Therefore heavy metal concentration has influence on adsorption and retardation of soil by pH and organic contents variation. Moisture contents also encouraged heavy metal transport velocity, but less than pH and organic contents.

      • 심한 정신병적 증상을 나타낸 전신성 홍반성 루푸스 3례

        문혜원,강민희,송정수,박원,김철응,이정섭,배재남 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

        전신성 홍반성 루푸스(systemic lupus erythematosus, 이하 SLE)는 원인을 알 수 없는 자가항체 및 면역복합체로 인하여 여러 장기의 손상을 초래하는 질환이다. SLE의 신경정신의학적 증상에 대하여는 1872년 Kaposi에 의해 처음 기술되었다. 이때에 나타나는 임상적 양상은 상당히 다양하여 정신증, 우울증, 뇌졸증과 인지기능장애등을 포함한다. 이들은 종합적인 정신과적 평가를 위해 종종 협의진료가 의뢰되고 있다. SLE의 정신병적 증상은 환자의 사망률을 높이고 좋지 않은 예후를 시사하는 지표가 될 수 있기 때문에 조기 진단 및 치료가 요구된다. 그러나 SLE의 중추신경계 침범에 대한 명확한 진단기준이 마련되어있지 않고, 증상의 다양성과 변동성은 진단을 더욱 어렵게한다. 저자들이 경험한 심한 정신병적 증상을 보인 SLE 3례의 경우, 이들은 지남력 장애, 환시, 환청, 망상, 불안정한 기분을 보였고 자주 충동적이 되거나 난폭해져 자신 또는 타인에게 위험을 초래할 수 있었다. 현재까지 SLE의 정신병적 증상에 대하여 잘 알려져 있지는 않지만, 문헌고찰을 통해 발병기전, 분류진단, 임사양상, 치료등에 대하여 알아보았다. Systemic lupus erythematosus(SLE) is a disease of unknown etiology in which multiple organs are damaged by pathogenic autoantibodies and immune complexes. Neuropsychiatric manifestations in SLE were first described by Kaposi in 1872. These are so diverse that they include psychosis, depression, stroke, seizure and cognitive dysfunction etc.These patients are frequently consulted for psychiatric evaluation. Neuropsychiatric manifestations in SEL re also among the leading causes of morbidity and mortality and associated with poor long-term outcome. So it is essential to recognize and intervene these symptoms early. But the clear diagnostic criteria for CNS involvement in SLE have not been formulated, and diversity and fluctuation of illness make it difficult to confirm it. The authors reported three cases of SLE with severe neuropsychiatric manifestation. These patients showed symptoms such as disorientation, auditory and visual hallucibation, delusion and mood instability. They became frequently impulsive and violent and had risks to injure themselves or others. Although CNS involvement in SLE is not well known, we reviewed the pathogenesis, classification, diagnosis, clinical manifestation and treatment of them.

      • KCI등재

        Job Shop 형태를 갖는 주문생산 환경에서의 계층적 생산계획 및 통제 Framework의 설계

        송정수,문치웅,김재균 한국경영과학회 1999 經營 科學 Vol.16 No.2

        This paper presents a framework for the hierarchical PPC(Production Planning and Control) in make-to-order environment with job shop The characteristics of the environment are described as 1) project with non-repetitive and individual production, 2) short delivery date, 3) process layout with large scales manufacturing, 4) job shops The PPC in a make-to-order typically are organized along hierarchical fashions A model is proposed for the hierarchical job shop scheduling based on new concepts of production system, work and worker organization Then, a new integrated hierarchical framework is also developed for the PPC based on concepts of the proposed job shops scheduling model Finally, the proposed framework has been implemented in the Electric Motor Manufacturing and the results showed good performance

      • 뇌실외 배액술 관리에 대한 이해 및 업무수행 실태

        김정숙,윤미선,송소이,이지은,문경선,고지운,임분남,김경희,박경숙 중앙대학교 간호과학연구소 2001 중앙간호논문집 Vol.5 No.2

        The objective of this study was to investigate the managing realities of EVD and provide a descriptive survey with the attempt to obtain basic data needed for the standardization of EVD management. For that purpose, 220 questionnaire copies were distributed to those nurses who were working with intensive care units at university hospitals, general hospitals, semi-general hospitals in Seoul, Kyongki-de and local areas. Of 158 returned questionnaire copies, 139 were used for analysis. Data were collected during the term of academic seminars of Neurosurgery Nursing Committee and KICA (Korea Intensive Care Association), ranging from Oct. 26 through 27. 2000. The tools utilized a structured questionnaire form consisting of 21 questions on general characteristics, the level of understanding, the level of work performance, standard management guidelines, etc. The data collected were analysed with frequency, percentage, mean vague, chi -square test using the SPSS 10.0 program Findings were revealed, as follows: For managing the prevention of EVD infection, aseptic technique was found to be of the most importance (48.9%),'the technique should be carried out at an operation room'(92.8%), but it was actually performed at intensive care units (over 51.5%). 'The term of antibiotics use should be less than 7 days' (81.8%), while it was actually executed for less than 7 days (49.5%). 'The proper time of quittance from it should be within less than 7 days'(74.1%) but actual quittance was executed only by 51.1%. 'Set exchange is needed' by 54.0% but actual exchange was implemented merely by 28.1%. 'The subject of management should be nurses' was reflected by 40% but actually 52.0% were carried out. As a result of hating analysed the understanding of the management of EVD by general characteristics, a significant difference was found in the necessity for set exchange by hospitals, in the time of quittance of a catheter, and in ablution items by work experience. The result of hating analysed the work performance levels of EVD management by general characteristics revealed that a significant difference in administration facilities of medicine by the classification of hospitals, especially the use of antibiotics and the quitting time of a catheter by the classification of intensive care units, and in the use of antibiotics and ablution items by the standard management guidelines.

      • 再生骨材 콘크리트의 特性에 미치는 잔골재 混合의 影響에 關한 實驗的 硏究

        李正熙,宋河永,文鐘健,趙明元 大田産業大學校 1997 한밭대학교 논문집 Vol.14 No.1

        It is becoming increasing1y difficult and expensive for construction contractors not only to dispose of building waste and demolition rubble but also to obtain natural aggregates of good quality for concrete product and building construction. As one of solutions for the above-mentioned problems, this study was planned to suggest a fundamental data and method for producing recycled aggregate concrete using crushed cement bricks as fine aggregates. In this study, one normal concrete with natural river sand as fine aggregate and crushed stone as coarse aggregate and three recycled aggregate concretes according to the mix proportion of recycled fine aggregate substitution ratio of 35%, 65%, 100% were made using tile water-cement ratio of 45% and 65%.

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