• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.13-19
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• 2011

The emergence of antibiotic-resistant pathogens is a Serious clinical problem in the treatment of infectious diseases that increase mortality, morbidity, hospitalization length, and the cost of healthcare. In particular, $Streptococcus$ $pneumoniae$ is a major etiologic pathogen of pneumonia, sinusitis, otitis media, and meningitis. As the definition of penicillin resistance to $S.$ $pneumoniae$ was recently changed, macrolide-resistant $S.$ $pneumoniae$ is a major resistant pathogen in the community. Infections caused by antibiotic-resistant strains are associated with incorrect use of antibiotics and critical clinical outcomes. For the appropriate use of antibiotics to treat infections, physicians always should have up-to-date information on the current epidemiologic status of antibiotic resistance for common pathogens and their susceptibility to antimicrobials. Appropriate selection of antimicrobials, strict control of infection, vaccination, and development of a feasible national policy of infection control are important strategies for the control of antimicrobial resistance. This review article focuses on the current status of antibiotic-resistant $S.$ $pneumoniae$ in community-acquired pneumonia in Korea.

• Pediatric Infection and Vaccine
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• 제26권2호
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• pp.124-128
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• 2019

의료관련 뇌실염/수막염(Healthcare-associated ventriculitis and meningitis)은 지역사회 수막염과 다른 역학적 특성과 병리 기전을 가진다. 일부에서는 전신 항생제투여 방법만으로 치료 반응이 불충분할 수 있으며, 이러한 경우 뇌실내로 적절한 항생제를 직접 주입하는 치료를 시도해 볼 수 있다. 본 저자들은 기존의 전신 항생제치료에 불응하는 Bacillus cereus에 의한 의료관련 뇌실염/수막염 환자를 뇌실내 반코마이신 주입요법으로 주요 부작용없이 성공적으로 치료하여 이를 보고하는 바이다.

• Korean Journal of Neurotrauma
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• 제13권1호
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• pp.9-14
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• 2017

Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

• 대한약침학회지
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• 제22권3호
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• pp.200-203
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• 2019

Syringoma is a benign eccrine sweat gland tumor that predominantly appears in females during puberty with multiple smooth papules measuring 1-2 mm in diameter. Common locations are on lower eyelids and cheeks. Vulvar syringoma is quite a rare, occurring condition with only a few cases reported. Here, we are reporting a case of 31-year-old female with vulvar syringoma associated with pruritus. The lesion was treated with carbon dioxide (CO2) laser ablation and 50% trichloroacetic acid (TCA) chemical peeling. Jaungo was used for wound care after laser abrasion. The combination treatment was effective for removing syringoma lesions. Post laser management with fusidic acid cream and jaungo cream was sufficient to prevent infection and promote wound healing.

• Journal of Preventive Medicine and Public Health
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• 제41권4호
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• pp.225-231
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• 2008

Objectives: Bioterrorism (BT) preparedness and response plans are particularly important among healthcare workers who will be among the first involved in the outbreak situations. This study was conducted to evaluate the current status of education for BT preparedness and response in health care-related colleges/junior colleges and to develop learning objectives for use in their regular curricula. Methods: We surveyed all medical colleges/schools, colleges/junior colleges that train nurses, emergency medical technicians or clinical pathologists, and 10% (randomly selected) of them that train general hygienists in Korea. The survey was conducted via mail from March to July of 2007. We surveyed 35 experts to determine if there was a consensus of learning objectives among healthcare workers. Results: Only 31.3% of medical colleges/schools and 13.3% of nursing colleges/junior colleges had education programs that included BT preparedness and responses in their curricula. The most common reason given for the lack of BT educational programs was 'There is not much need for education regarding BT preparedness and response in Korea'. None of the colleges/junior colleges that train clinical pathologists, or general hygienists had an education program for BT response. After evaluating the expert opinions, we developed individual learning objectives designed specifically for educational institutions. Conclusions: There were only a few colleges/junior colleges that enforce the requirement to provide education for BT preparedness and response in curricula. It is necessary to raise the perception of BT preparedness and response to induce the schools to provide such programs.

• 셀메드
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• 제4권1호
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• pp.5.1-5.8
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• 2014

Healthcare-associated infection represents a frequent cause of mortality that increases hospital costs. Due to increasing microbial resistance to antibiotics, it is necessary to search for alternative therapies. Consequently, novel alternatives for the control of resistant microorganisms have been studied. Among them, plant antimicrobial protein presents enormous potential, with flowers being a new source of antimicrobial molecules. In this work, the antimicrobial activity of protein-rich fractions from flower tissues from 18 different species was evaluated against several human pathogenic bacteria. The results showed that protein-rich fractions of 12 species were able to control bacterial development. Due its broad inhibition spectrum and high antibacterial activity, the protein-rich fraction of Hibiscus rosa-sinensis was subjected to DEAE-Sepharose chromatography, yielding a retained fraction and a non-retained fraction. The retained fraction inhibits 29.5% of Klebsiella pneumoniae growth, and the non-retained fraction showed 31.5% of growth inhibition against the same bacteria. The protein profile of the chromatography fractions was analyzed by using SDS-PAGE, revealing the presence of two major protein bands in the retained fraction, of 20 and 15 kDa. The results indicate that medicinal plants have the biotechnological potential to increase knowledge about antimicrobial protein structure and action mechanisms, assisting in the rational design of antimicrobial compounds for the development of new antibiotic drugs.

• 의료법학
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• 제24권1호
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• pp.67-98
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• 2023

코로나19 발생 이후 우리의 모든 생활 영역에서 많은 변화가 있었는데, 그 중 하나가 마스크 착용 의무화였다. 팬데믹 등 상황 초기에 우리나라는 다른 국가들보다 선도적으로 '사회적 거리두기' 정책 등을 강하게 시행하면서 개인 공간을 제외한 거의 모든 공간을 이용할 경우 누구나 할 것 없이 마스크 착용은 의무였다. 물론, 의료기관을 이용하기 위해서는 무엇보다 마스크 착용이 먼저였고, 마스크 착용을 안 할 경우 출입이 거부 또는 제한되었다. 즉, HAI 예방 등을 위해 모든 의료기관 이용 환자는 코로나19 검사를 실시한 후, 음성 확인이 된 환자에 한해 대면에 의한 의료행위가 이루어지는 규제가 실시되었다. 이 과정에서 마스크를 착용하기 곤란한 장애인 등의 상황은 고려되지 못하였고, 응급환자가 제때 치료 또는 수술 등을 의료인으로부터 받지 못하는 상황이 벌어졌다. 이에 국가인권위원회는 마스크 착용을 모든 사람에게 강제하고 의료기관 출입을 허용하지 않는 것은 장애인 인권차별이라는 결정을 내렸다. 따라서 이 연구는 코로나19 상황에서 장애인의 특성을 고려하지 않은 감염병 전염 예방조치로 인해 장애인에 대한 차별이 발생한 사례와 국가인권위원회 결정에 대해 쟁점이 되는 사안을 검토하는 한편, 마스크 착용이 어려운 장애인에 대한 의료기관의 진료 거부 방지 대책의 필요성과 합리적인 방안을 모색하는 것을 목적으로 하였다.

• Pediatric Infection and Vaccine
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• 제30권1호
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• pp.33-38
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• 2023

Ralstonia mannitolilytica는 다양한 종류의 상수도에 퍼져 있는 그람 음성세균으로써 병원체로는 흔하지 않지만 골수염, 수막염, 균혈증, 패혈증 등 심각한 결과를 초래하는 기회감염을 일으킬 수 있다. 저자들은 신생아 중환자실에서 발생한 R. mannitolilytica bacteremia 단일사례를보고한다. 재태주수 38주 6일에 2,770 g으로출생한환아는대혈관전위, 심실중격결손, 폐동맥협착이 있어 신생아 중환자실로 입실해 프로스타글란딘E1을 투약 받았으며, 생후 7일부터 간헐적으로 발열이 있어 감염을 배제한 후 체온을 낮추기 위해 가습기를 사용하였다. 생후 34일에 39.2℃의 고열이 있어 시행한 혈액배양 검사에서 R. mannitolilytica가 동정되었다. 이전에 R. mannitolilytica가 기관에서 검출된 적이 없었을뿐더러 항생제 치료에도 균혈증이 지속되어 환경 조사 및 의료기기에 대한 감시 배양를 시행하였다. 환아에게 사용한 가습기에서 R. mannitolilytica가 동정되었고, 가습기 사용을 중단한 후로 균혈증, 발열이 호전되었다. 이 증례는 새로운 또는 흔하지 않은 감염이 있을 경우 감염원에 대한 면밀한 조사가 중요함과 적절한 항생제 치료에도 반응이 없을 경우 환경조사가 필요함을 시사한다.

• Journal of Trauma and Injury
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• 제35권2호
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• pp.76-83
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• 2022

Purpose: Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator-associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support. Methods: In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality. Results: Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46-17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m² had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32-14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30-14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013). Conclusions: Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m² on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.

• 융합정보논문지
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• 제8권5호
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• pp.19-27
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• 2018

본 연구는 간호학과에 재학중인 학생을 대상으로 의료관련감염관리를 위한 표준주의 지식, 수행의도, 수행에 대한 태도, 표준주의지침 수행을 위한 안전환경 및 수행도를 파악하고 이들 요인들이 간호대학생들의 표준주의 수행도에 어떠한 영향을 미치는 지를 규명하고자 시도되었다. 2018년 6월 15일부터 6월 30일까지 경기도 A대학교 간호학과 3~4학년 296명에게 설문지를 이용하여 자료수집을 하였다. 연구결과 대상자의 표준주의 수행도와 의료관련감염 관리지침 수행의도, 의료 관련감염 관리지침 수행에 대한 태도와 표준주의지침수행을 위한 안전환경은 각각 양의 상관관계로 나타났다. 대상자의 의료관련감염예방 수행도에 영향을 미치는 요인은 간호학생의 의료관련감염 관리지침 수행의도와 표준주의지침수행을 위한 안전환경으로 나타났으며 이 두 변수가 의료관련감염예방 수행도를 20% 설명하는 것으로 나타났다. 따라서 간호대학생들의 의료관련감염관리에 대한 표준주의의 수행도를 증진시키기 위해 수행의도를 높일 수 있는 교육프로그램의 개발과 보다 안전한 실습환경 조성이 필요할 것으로 사료된다.