서울 강서지역 1개 대학병원에서 성인 급성 신우신염의 원인균과 항생제 감수성

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

목적 : 3년간 서울시 강서지역의 1개 대학병원에서 입원치료를 받은 성인 급성 신우신염 환자를 대상으로 원인균과 항생제 감수성을 조사하고, 향후 급성 신우신염의 초기 경험적 치료 항생제를 제안하고자 하였다. 방법 : 1999년 1월부터 2001년 12월까지 3년간 고려대학교 의과대학 구로병원에 상부요로감염으로 내원한 16세 이상 환자 229명의 의무 기록을 검토를 통하여, 인구학적 특성, 원인균, 항생제 감수성, 초기 항생제 사용 양상과 입원기간을 조사하였다. 결과 : 연구에 포함된 229명을 118명의 단순 신우신염군과 111명의 복잡 신우신염군으로 구분 하였다. 단수 신우신염의 평균 발생 연령은 38.2세와 복잡 신우신염 56.1세로 복잡 신우신염 환자의 연령이 유의하게 높았다(P<0.001). 양군 모두에서 원인균 중 E. coli의 분리율이 가장 높았으며 항생제 감수성 결과 ampicillin, trimethoprim-sulfame-thoxazole에는 높은 내성률을 보였고, ciprofloxacin, gentamicin, cefotaxime에 대한 감수성은 비교적 높았으나 복잡 신우신염의 경우 단순 신우신염에 비하여 ciprofloxacin, gentamicin에 대한 감수성이 다소 낮은 것을 확인할 수 있었다. 평균 입원 기간, 항생제 투여 기간에 있어서도 복잡 신우신염군에서 유의하게 길었다. 결과 : 본 연구의 결과 서울의 강서 지역에서 대학병원급에 치료 의뢰되는 단순 급성 신우신염의 치료에 있어 1차 항생제로 3세대 cephalosporin, aminoglycoside, quinolone 중 한가지를 초기 경험적 치료제로 사용을 고려하여야 할 것으로 사료된다. Background : The purpose of this study is to recommend the initial therapeutic regimen for adult patients with acute pyelonephritis (APN) according to the changes of antimicrobial susceptibility patterns of causative microorganisms isolated from patients with APN. Methods : We reviewed medical charts of 229 APN patients, who had been treated at Korea University Guro Hospital from 1st of January. 1999 to 31st of December, 2001. We investigated the demographic data, clinical findings, durations of hospital treatment, antimicrobial susceptibility patterns of the causative microorganisms and initial antibiotic regimens in patients with APN. Results : In this study, 229 adult patients with APN were classified into simple APN patients (118 patients, 51.5%) and complicated APN patients (111 patients, 48.4%). Mean age of patients with simple APN was 38.2±14.1 years old and that of patients with complicated APN was 56.1±14.9 years old. Mean age of patients with complicated APN was significantly higher than that of simple APN patients (P<0.0001). Escherichia coli was the most common microorganism both in simple APN (96.7%) group and in complicated APN (90.6%) group. Antimicrobial susceptibility of E. coli was at the low level of ampicillin (31%/20%) and trimethoprim-sulfamethoxazole (42.6%/34.2%) in each group. In contrast, ciprofloxacin (11.5%/22.7%), gentamicin (16.4%/22%) and cefotaxime (0%/8.2%) resistance remained at relatively lower level. In comparison of simple APN with complicated APN, ciprofloxacin and gentamicin resistances were higher in complicted APN group. Average duration of hospitalization (5.9±2.3 days/8.2±4.6 days) and duration of antibiotic use (12.1±3.9 days/15.3±10.0 days) were significantly longer in complicated APN. Conclusions: The results of this study suggests that 3rd cephalosporin, aminoglycoside or quinolone antibiotic would considered as one of the initial therapeutic regimen for patients with simple APN in southwestern Seoul.

운동분석 시스템 연구

황준,이주연,이승민 서울여자대학교 자연과학연구소 1998 자연과학연구논문집 Vol.10 No.-

Abnormal motion control mechanism sometimes performs false detection of the direction, thus makes target point runs off the track, also shows abnormal speed control or power control. This paper explains development of the tools that make scientific measure and various analysis available. This paper also explams how we get the motion control ability data from the horizontal and vertical line drawn on the touch screen by the patient, analysis of deviation analysis, and Turn-Amplitude study. We built a complete system based on this algorithm.

위선암에서 p53, MMP-2 및 TIMP-2의 표출

황호현,김의한,오미혜,조현득,양승하 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Gastric adenocarcinoma is the most common malignant tumor in Korea. Many oncogens have been found in malignant tumor cells. Among these oncogene, MMP-2 and TIMP-2 show important role in invasivness and metastasis of malignant tumor cells. P53 is regulator of cellular proliferation, and the over expression of p53 relate to malignant transformation and prognosis. To evaluate the expression of MMP-2, TIMP-2, and p53 according to histopathologic features and the relation between these antigens and prognosis in gastric adenocarcinoma, we have performed immune staining, using mouse anti-MMP-2, mouse anti-p53, and mouse anti-TIMP-2 for 91 cases. The results were as follows; 1) The expression rates of MMP-2, TIMP-2, and p53 in gastric adenocacinoma were 58.2%, 57.1%, and 49.5%, respectively. 2) MMP-2 and TIMP-2 in gastric adenocarcinoma showed reverse correlation.(p<0.001) 3) MMP-2 showed more higher expression rates in intesinal type and sell differentiated form of gastric adenocarcinoma, and in cases showing more deeper invasion and metastasis to lymph nodes in advanced carcinoma. 4) TIMP-2 in advanced carcinoma showed more lower expression rates in cases showing more deeper invasion and metastasis to lymph nodes. 5) MMP-2 expression and TIMP-2 non-expression showed more higher frequency in intestinal type of gastric adenocarcinoma and in cases showing more deeper invasion depth in advanced carcinoma. 6) p53 in advanced carcinoma showed more higher expression rates in cases more deeper invasion and metastasis to lymph nodes. Above results indicated that MMP-2 and TIMP-2 in gastric adenocarcinoma shows reverse correlation, and may be show reverse relation according to progression, type, invasion depth, and metastasis to lymph node. The expression of p53 may be related to metastasis to lymph nodes and degree of depth in advanced carcinoma.

중국동포들의 한국사회 적응실태 조사연구

황승연 경희대학교 아태지역연구원 1994 아태연구 Vol.1 No.-

치은연하 파절로 치조골 소실을 동반한 상악측절치에서 orthodontic extrusive remodeling후 임플란트 식립을 통한 심미수복 : 증례보고

황수연,손원준,한영철,배광식,백승호,이우철,금기연 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.1

심미적으로 중요한 전치부에서 단일 치아 임플란트를 이용한 보철수복은 임상의에게 새로운 도전과제 중의 하나가 되었다. 그러나 전치부에서 single-unit implant는 식립할 부위의 치조골 상태가 양호해야 하는데 치은연하 파절로 인해 치아 주위에 골 손실이 있는 경우 immediate implant는 심미적으로 문제를 야기할 수 있다. 따라서 본 증례는 "orthodontic extrusive remodeling"을 통해 파절치와 주위 조직을 교정적으로 정출시켜 임플란트 식립을 위한 연조직과 경조직을 증대시킨 후 임플란트 식립을 통해 상악측절치에서 성공적인 심미수복을 이룬 증례에 관한 것이다. The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling" was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.

의학동영상 정보의 원격 실시간 분석

이승민,이주연,황준 서울여자대학교 자연과학연구소 1997 자연과학연구논문집 Vol.9 No.-

In this paper, we have developed a client/server diagnosis system that process the information of motion picture real time. Development of motion analysis and diagnosis system can be used in medical clinic. Users manages clients only while the expensive image processing equipments are managed by server manager. Very high speed network is used for the communication between server and client. In this paper we propose a real time marker detection algorithm for remote real time system of analysis for information of medical image sequence.

지역사회와 병원에서 페니실린 내성 폐렴구균 감염의 임상적 특징 및 분자유전학적 성상

정희진,황병연,박정원,김우주,김민자,박승철,이영희 대한감염학회 2001 감염 Vol.33 No.2

Background : During the last three decades, the resistance of S. pneumoniae to penicillin has been rapidly increasing in many parts of the world, especially in Korea. To characterize the clinical features and epidemiology of penicillin-resistant S. pneumoniae (PRSP) infections in the community -and hospital, as well as to investigate the possible spread of resistant clone, we performed the antimicrobial susceptibility tests, pulsed filed gel electrophoresis (PFGE) and penicillin-binding protein (PBP) profile analysis of PRSP isolates. Methods : A total 48 PRSP isolates from patients who visited or were admitted to Korea University Guro hospital during the period form July 1998 to June 1999 were studied. Anitimicrobial susceptibility tests for 48 isolates were performed with microbroth dilution method to determine the minimal inhibitory concentration of 11 antibiotics. 39 isolates and 35 isolates were subjected to PFGE and PBP profile analysis, respectively to investigate the genetic relatedness between PRSP isolates. Results : Pneumonia was most common site of infection in the community and the hospital as 50%. There were no significant differences of clinical fentures and prognosis between community and hospital isolates. But, patients with serious underlying diseases had poor prognosis despite of acquisition site. High level penicillin resistance were observed in 69%, multi-drug resistance were 64.6% of isolates. PFGE showed that 13 of 29 community acquired infection were identical PFGE pattern but not that of 23F Spanish clone. There were various PFGE patterns were observed from community and hospital acquired infection isolates. Some of them were existed in both. PBP profiles showed more diverse, even if in isolates of the same PFGE pattern. Conclusion : In our study, high level penicillin resistance and multi-drug resistance were observed in PRSP clinical isolates. No clinical and prognostic differences were observed between community and hospital acquired infections. Molecular epidemiology study were suggest the there were various genotypes of PRSP within our society. Some of them were observed of the hospital and community. Therefore, there was an evidence of communication of PRSP clones between the community and hospital. (Korean J Infect Dis 33:112~122, 2001)

Capsicum chinense, 재래종 및 저항성 고추 유전자원에서 역병 저항성 계통 선발

김정훈,여승호,김동우,배수연,한정혜,황희숙,김병수 慶北大學校農業科學技術硏究所 2002 慶北大農學誌 Vol.20 No.-

2000년도에 검정에서 역병에 살아남은 개체들로부터 채종하여 육성한 Capsicum chinense 31계통에 대하여 역병 저항성을 검정한 결과 고도의 저항성을 나타내는 것은 발견되지 않았다. 2001년도의 검정에서 역병에 살아남은 개체로부터 채종한 재래종 26계통에 대하여 다시 역병 저항성 검정을 실시한 결과 KC180, KC230, KC195, KC194에서 다수의 개체가 살아남아 저항성을 나타내었다. 그러나 KC180과 KC230은 각각 AC2258과 CM334와 혼종된 것으로 관찰되었다. KC195와 KC194는 재래종의 형질을 유지하고 있는 것으로 관찰되었다. CM334의 보존 증식과정에 자연교잡이 일어난 것으로 보여 이의 순도향상을 위하여 채종년도별로 시료를 꺼내어 역병저항성 검정을 실시한 결과 가장 오래된 1992년도 채종종자에서부터 약간의 이형주가 관찰도기 시작하여 1995년부터 2001년도까지 시간이 경과함에 따라 많이 변형되어 있는 것을 알 수 있었다. 1992년도 종자에서 이형주를 제거하고 원형의 개체로부터 자식종자를 대량으로 채종하였다. 함께 공시한 AC2258은 순수한 것으로 확인되었다. 1995년도 채종 CM334 종자에서는 비록 혼종은 되었으나 측지발생이 적은 개체들이 발견되어 이들을 개체 선발하여 역병에 저항성이며 측지발생이 적은 계통으로 육성하고 있다. A total of 31 c. chinense lines selected from 2000 screening were tested again for resistance to P. capsici but resistance was not found in the lines. A total of 26 selections from Korean land races tested 2001 spring were tested again for resistance to P. capsici. KC180, KC230, KC195 and KC194 showed moderate resistance to P. capsici. However, it was apparent on the basis of hortivultural characteristics that KC180 and KC230 had been naturally crossed with AC2258 and CM334, respectively. CM334 and AC2248 seed lots that were increased in different years were taken out and tested for resistance to improve their genetic purity because the resistant genetic resources have been showing some off-types in the population. Off-types began to be found in 1992 seed lots and the proportion and degree of the offs was increasing with time up to 2001. Plants true to the type in 1992 seed lots were selected and their inbred seeds were mass produced in a net cage in the greenhouse. AC2258 included in the experiment number of lateral branching at cotyledonary axil, although they were off from the original in the experiment together was uniform. In 1995 seed lost of CM334, plants with resistance to P. capsici and low or no number of lateral branching at cotyledonary axil, although they were off from the original CM334, were found and selection was applied to breed lines fixed in the characters.

국내 시판 항생제의 허가 용량 및 용법의 적정성에 대한 고찰 : 국내 약제사용설명서(package insert)와 미국 Physicians' Desk Reference의 비교 Comparison of Domestic Package Inserts with Physicians' Desk Reference

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

목적 : 국내 시판중인 항생제의 1일 투여량과 투여간격의 적정성을 확인하고 적응증 및 중증도에 따른 항생제 용량 제시 여부를 확인하기 위하여 항생제 시판시 KFDA의 허가사항을 담은 약제사용설명서을 미국 FDA 공인 약제에 대한 사용지침으로 쓰이고 있는 PDR(Physicians' Desk Peference)과 비교하였다. 방법 : PDR에 등재되어 있는 항생제 중에서 시럽 및 도포용 항생제를 제외한 총 61종에서, 국내에 시판되어 있는 51종 항생제의 약제사용설명서를 대상으로 1일 투여량, 투약횟수, 적응증 및 중증도에 따른 설명 정도를 비교하였다. 결과 : 1) 1일 투여량 비교 : 비교 가능한 전체 항생제에서, 약제사용설명서가 PDR보다 적은 용량을 제시한 경우는 경구용 8종, 주사용 11종으로 총 19종(37%)였으며, 많은 용량을 제시한 경우는 경구용만 2(4%)종이었고, 동일하거나 비슷한 용량을 제시한 경우는 경구용 15종, 주사용 15종으로 총 30(59%)종이었다. 약제사용설명서에서 적은 용량이 제시된 항생제 중 경구용인 cefdnir, cefixime, cefpodoxime, ofloxacin, levofloxacin, norfloxacin(6종), 주사용인 cefazolin, cefotetan, ceftizoxime, meropenem (4종) 등 반수이상의 약제가 일본제약회사로부터 국내에 수입된 약들이었으며 일본의 약제 사용설명서와 동일한 용량을 제시한 것을 알 수 있다. 2) 투여간격 비교 : 비교가능한 항생제 51종 중에서 국내약제사용설명서가 PDR과 동일한 투약횟수, 투여간격을 제시한 항생제는 30종(59%)이었다. 국내 약제사용설명서가 PDR보다 적은 투약횟수, 긴 투여간격을 제시한 항생제는 9종(17%)이었다. 오히려 많은 투약횟수, 짧은 투여간격을 제시한 항생제가 12종(24%)이나 되었다. 경구용만 비교하였을 경우 국내 약제사용설명서가 PDR보다 적은 투약횟수를 제시한 항생제는 없었으며, 동일하세 제시한 경우는 15종, 빈번한 투약횟수를 제시한 경우는 10종이었다. 주사용 항생제에서 국내 약제사용설명서가 PDR보다 긴 투여간격을 제시한 항생제는 9종, 동일한 경우는 15종, 짧은 투여간격을 제시한 경우는 2종이었다. 3) 적응증 및 중증도에 따른 비교 : 약제사용설명서에서 적응증 또는 중증도에 따른 용량에 대한 설명이 부족한 경우는 경구용 13종, 주사용 7종으로 총 20종(39%)이었으며, PDR에서는 경구용 1종, 주사용 2종으로 총 3종(6%)이었다. 결론 : 항생제에 첨부되는 약제사용설명서 및 약제사용설명서를 바탕으로 편집되는 의약품집이 항생제를 처방하는 의사들이 용법과 용량을 결정함에 있어 참고 역할을 하고 있으나, 국내의 시판 허가사항을 담은 약제사용설명서가 많은 수에서 적응증 또는 중증도에 따른 1일 투여량과 투여간격에 대한 정확한 정보를 제공하고 있지 못하고 있다. Background : The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. Materials and Methods : Package inserts about antibiotics, only oral or parenteral agent, wereperused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. Results : Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases: 15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases: 8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases : 10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases: 13 oral and 7 parenteral agents) revealed no information for dose adjustment commons to indications or the severity of infection. Conclusion : This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.

사람주나무잎의 페놀성 성분

안영진,이승호,강신정,황방연,박웅양,안병태,노재섭,이경순 영남대학교 약품개발연구소 1996 영남대학교 약품개발연구소 연구업적집 Vol.6 No.-

A chemical examination of the phenolic compounds in the leaves of Sapium japonicum (Euphorbiaceae) has led to the isolation of eleven phenolic compounds. containing five hydrolysable tannins and six flavonoids. On the basis of chemical and spectroscopic evidences, the structures of these compounds were confirmed to be galic acid(1), 5-O-caffeoyl quinic acid(2), 1-O-galloyl-3, 6-(R)-HHDP-β-n-glucose(coriiagin)(3), 1-O-galloyl-2.4-(R)-DHHDP-βn-glucose (furosin)(4), 1-O-galloyl-2.4-(R)-DHHDP-3.6-(R)-HHDP-β-m-glucose(geraniin)(5), astragalin(6), trifolin(7), afzelin(8), quercetin(9), isoquercitrin(10) and rutin(11). Among them geraniin was the main component.