• 한국산학기술학회논문지
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• 제10권9호
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• pp.2516-2522
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• 2009

본 연구는 혈액에서 분리되는 미생물의 균종과 항균제 감수성 검사 결과 양상은 환자의 일반적 특성에 따라 다르므로 혈액배양 결과를 분석한 자료는 감염증 환자의 경험적 치료를 위한 중요한 근거가 되고, 특히 ESBL을 생성하는 균주의 경우 항균제의 사용과도 밀접한 관련이 있어 이 연구를 하게 되었다. 혈액배양 결과와 항균제 내성 결과를 분석한 결과는 다음과 같다. 1. 39.305건의 혈액배양이 의뢰되어 양성 환자 수는 2,216명(20.0%)이었고, 이중에서 ESBL양성 환자 수는 40명 이었으며, 혈액배양 양성은 4,798건(12.2%)이었으며 ESBL양성 균주는 86건(중복 배양 균주 포함)이었다. 2. ESBL을 생성하는 세균 중에서 분리된 균종은 E. coli, K. pneumoniae, K. oxitoca의 순 이었다. 3. 성별로는 여자가 다소 많았고, 연령별로는 50세 이상의 군에서 E. coli, 1세 미만의 군에서는 K. pneumoniae, K. oxitoca 의 분리가 많았고, 지역별로는 충청남도 13명(32.5%)로 가장 많았다. 4. 3년간 일개대학병원의 혈액배양에서 ESBL양성인 균종 중 가장 흔히 분리되는 것은 E. coli이고, K. pneumoniae, K. oxitoca 등이 다음으로 분리 되었고, 50세 이상의 환자에서 E. coli의 분리 비율이 높았다.

• 대한임상검사과학회지
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• 제51권3호
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• pp.294-300
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• 2019

국내시판 김치로부터 분리한 probiotics의 병원생 미생물에 대한 억제효과와 항균제 내성을 조사하기 위해 35종의 국내시판 김치에서 총 140주의 probiotics를 분리하였으며, 16S rRNA 염기서열 분석을 통해 L. plantarum이 53주(37.9%), E. faecium 27주(19.3%) 그리고 L. rhamnosus 7주(5.0%) 순으로 동정되었고, 12종(species)의 다양한 병원성 미생물 즉 S. Typhi, S. Enteritidis, E. coli O157:H7, S. flexneri, NAG Vibrio, L. monocytogenesis, Y. enterocolitica, S. aureus, S. pyogenes, G. vaginalis, C. albicans, P. acne에 대한 전체적인 항균성은 69주(49.3%)이었으며, 균종별로 살펴보면 L. plantarum 75.5%, L. sakei 66.7%, E. faecium 40.7%, 그리고 L. rhamnosus 28.6% 순이었다. 또한 디스크 확산법에 의한 18종의 다양한 계열의 항균제에 대한 내성시험 결과 nalidixic acid가 98.6%의 내성을, S 83.6%, gentamicin 75.7%, vancomycin 73.6%, norfloxacin 72.1%, 그리고 ciprofloxacin 67.9% 순으로 나타났다. 결론적으로 본 실험에서 다양한 항균활성과 광범위한 항생제 내성을 지닌 L. plantarum, L. sakei, 그리고 E. faecium 균주가 장기 항생제 치료환자에 대한 유용한 설사 치료용 및 Candida 속이 야기하는 여성질염 치료제로서의 사용이 유용할 것으로 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.417-430
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• 2019

The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

• Journal of Korean Neurosurgical Society
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• 제65권6호
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• pp.834-840
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• 2022

Objective : C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count are inflammatory markers used to evaluate postoperative infections. Although these markers are non-specific, understanding their normal kinetics after surgery may be helpful in the early detection of postoperative infections. To compliment the recent trend of reducing the duration of antibiotic use, this retrospective study investigated the inflammatory markers of patients who had received antibiotics within 24 hours after surgery according to the Health Insurance Review & Assessment Service guidelines and compared them with those of patients who had received antibiotics for 5 days, which was proven to be non-infectious. Methods : We enrolled 74 patients, divided into two groups. Patients underwent posterior lumbar interbody fusion (PLIF) at a single institution between 2019 and 2020. Group A included 37 patients who received antibiotics within 24 hours after the PLIF procedure, and group B comprised 37 patients who had used antibiotics for 5 days. A 1 : 1 nearest-neighbor propensity-matched analysis was used. The clinical variables included age, sex, medical history, body mass index, estimated blood loss, and operation time. Laboratory data included CRP, ESR, and WBC, which were measured preoperatively and on postoperative days (POD) 1, 3, 5, and 7. Results : CRP dynamics tended to decrease after peaking on POD 3, with a similar trend in both groups. The average CRP level in group B was slightly higher than that in group A; however, the difference was not statistically significant. Multiple linear regression analysis revealed operation time, number of fused levels, and estimated blood loss as significant predictors of a greater CRP peak value (r²=0.473, p<0.001) in patients. No trend (a tendency to decrease from the peak value) could be determined for ESR and WBC count on POD 7. Conclusion : Although slight differences were observed in numerical values and kinetics, sequential changes in inflammatory markers according to the duration of antibiotic administration showed similar patterns. Knowledge of CRP kinetics allows the assessment of the degree of difference between the clinical and expected values.

• 식물병연구
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• 제28권1호
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• pp.26-31
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• 2022

Pseudomonas syringae pv. actinidiae (Psa)는 키위에 세균성 궤양병을 일으키는 병원균이다. Psa 균주는 유전적 및 생화학적 특징에 따라 5개의 biovar로 나누어진다. 그중 biovar 2와 3이 국내에서 발견되어 광범위한 피해를 주고 있다. Psa를 방제하는 효율적인 방법 중 한가지는 streptomycin과 같은 항생제를 사용하는 것이다. 그러나, 이 항생제에 저항성을 갖는 균주가 국내에서 분리되었고, 선행 연구에서 biovar 2 균주의 저항성이 strA-strB 유전자에 의한 것으로 밝혀졌다. 본 연구에서는 Psa biovar 3 균주에서 streptomycin 저항성의 분자적 기작을 밝히고자 하였다. 실험실에서 선발된 streptomycin 저항성 균주의 리보솜 단백질 S12를 암호화하는 유전자인 rpsL의 염기서열을 결정한 결과, 43번째 또는 88번째 코돈에서 자연발생적 점 돌연변이가 일어난 것을 확인하였다. 한편, 두 곳의 키위 과수원에서 분리된 4개의 streptomycin 저항성 biovar 3 균주에서는 민감성 균주에서 AAA인 rpsL의 코돈 43이 AGA로 단일 염기 치환이 일어났고, 이는 아미노산을 lysine에서 arginine으로 변화시키게 된다. 국내에서 발견된 biovar 3 균주 모두의 저항성 기작은 rpsL 유전자의 돌연변이에 기인하였다.

• 한국병원경영학회지
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• 제10권1호
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• pp.48-70
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• 2005

The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.

• 농촌의학ㆍ지역보건
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• 제18권2호
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• pp.105-119
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• 1993

The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

• 디지털융복합연구
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• 제14권6호
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• pp.325-333
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• 2016

본 연구는 일개 대학병원의 수술 예방항생제 사용의 실태 및 적정성 평가 주기별 변화를 분석, 향후 수술 예방항생제 사용 및 평가 지침에 대한 기초자료를 마련하는 것을 목적으로 시행되었다. 요양급여 적정성 평가가 시행된 첫해인 2007년 1차 평가부터 2008년, 2009년, 2010년, 2012년, 2014년을 조사기간으로 선정하였다. 본 연구를 위해 건강보험심사평가원의 요양급여 적정성 평가 자료를 이용하였으며, 위수술, 대장수술, 담낭절제술의 평가지표 중 최초 투여시기 1항목, 항생제 선택 3항목, 투여 기간 2항목의 연도별 변화 추이를 분석하였다. 분석결과, 항생제 투여일수는 위수술의 경우, 2007년 13.5일에서 2014년 1.5일로 감소하였고, 대장수술은 2007년 12.8일에서 2014년 1.5일로 감소하였다. 담낭절제술 또한 2007년 6.9일에서 2014년 0.6일로 감소한 것으로 나타났다. 위와 같은 결과를 토대로, 수술 예방항생제 사용의 질적 향상을 위하여 의료진들이 충분히 받아들일 수 있을 만한 권고사항(또는 지표) 의 마련 및 그러한 권고사항의 효율적인 배포와 전달을 위한 노력이 필요할 것으로 생각된다. 더불어 병원이 스스로 장애 요인을 파악하여 개선할 수 있도록 모니터링 제도 실시를 고려해 볼 수 있을 것이다.

• 한국어병학회지
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• 제32권1호
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• pp.37-43
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• 2019

전 세계적으로 양식 산업의 급속한 성장으로 인해 수산생물의 생산량 증가와 함께 질병발생이 증가함에 따라 수산용의약품의 사용량이 매년 증가하고 있다. 수산용의약품은 수산생물질병의 예방 및 치료에 필수적인 반면, 의약품의 오 남용으로 인해 항생제 내성균 증가 및 수산식품의 위생학적 안전성에 심각한 문제를 야기할 수 있다. 따라서 본 연구에서는 국내에 위치한 모든 수산질병관리원을 조사하고, 여기서 판매되는 수산용의약품을 지역별로 2012년과 2015년에 비교 조사하였다. 더불어 수산용의약품의 판매경로를 조사함으로서 수산식품안전성 강화를 위한 기초자료로서 활용이 가능하다. 나아가 향후 연구에서는 수산양식장에서 직접 사용하는 의약품의 양을 집계하여 본 연구 결과와 비교분석 후 효과적인 수산용의약품 관리체계를 마련해야할 것이다.

• Journal of Veterinary Science
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• 제25권2호
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• pp.23.1-23.15
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• 2024

The widespread use of antimicrobials causes antibiotic resistance in bacteria. The use of butyric acid and its derivatives is an alternative tactic. This review summarizes the literature on the role of butyric acid in the body and provides further prospects for the clinical use of its derivatives and delivery methods to the animal body. Thus far, there is evidence confirming the vital role of butyric acid in the body and the effectiveness of its derivatives when used as animal medicines and growth stimulants. Butyric acid salts stimulate immunomodulatory activity by reducing microbial colonization of the intestine and suppressing inflammation. Extraintestinal effects occur against the background of hemoglobinopathy, hypercholesterolemia, insulin resistance, and cerebral ischemia. Butyric acid derivatives inhibit histone deacetylase. Aberrant histone deacetylase activity is associated with the development of certain types of cancer in humans. Feed additives containing butyric acid salts or tributyrin are used widely in animal husbandry. They improve the functional status of the intestine and accelerate animal growth and development. On the other hand, high concentrations of butyric acid stimulate the apoptosis of epithelial cells and disrupt the intestinal barrier function. This review highlights the biological activity and the mechanism of action of butyric acid, its salts, and esters, revealing their role in the treatment of various animal and human diseases. This paper also discussed the possibility of using butyric acid and its derivatives as surface modifiers of enterosorbents to obtain new drugs with bifunctional action.