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체계적 문헌고찰 및 메타분석: 크론병 환자에서 Infliximab과 Adalimumab의 유효성 비교
박재은,정서일,서재경,강혜영 한국보건의료기술평가학회 2021 보건의료기술평가 Vol.9 No.1
Objectives: Infliximab and adalimumab are common biologic agents to induce remission state among patients with Crohn’s disease. Although, direct head-to-head studies comparing the clinical outcomes of the two treatments are sparse, several observational trials have been conducted recently. In this study, we performed systematic literature review and meta-analysis of cohort studies to compare the effectiveness of infliximab and adalimumab. Methods: We searched four databases, Ovid-Medline, Embase, PubMED, and Cochran Library. Observational studies comparing infliximab and adalimumab in patients with Crohn’s disease were selected. Quality of studies was assessed, and meta-analysis was conducted using a random effect model. In addition, subgroup analyses were performed based on the diagnostic criteria, biologics naïve/relapse and patients’ ethnicity. Results: Of the total 2,209 searched studies, 8 studies were included in the analysis. No significant difference in clinical remission between Infliximab and adalimumab was found [risk ratio (RR) 0.98, 95% confidence interval (CI) 0.90−1.07, heterogeneity: p=0.08, I2=45%]. In subgroup analysis, we found that the effectiveness of adalimumab was significantly better than infliximab (RR 0.77, 95% CI 0.61−0.98) in Asian population, however, due to the insufficient number of included studies for Asian population, careful interpretation is needed. Conclusion: The effectiveness of infliximab and adalimumab is comparable in observational studies. Follow-up studies are needed to find out treatment outcomes in different ethnicity.
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박재은,한지숙 한국식품영양과학회 2023 Journal of medicinal food Vol.26 No.6
We examined the effects of HM-chromanone (HMC) on alleviating hyperglycemia and protecting pancreatic β-cells from streptozotocin (STZ)-induced damage in C57BL/6J mice. HMC was administered to STZ-induced diabetic mice at 10 or 30 mg/kg, for 14 days. Thereafter, changes in fasting blood glucose levels, insulin-secretion, histopathological examination of pancreas islet cell and apoptotic protein levels, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay were determined. The results revealed that HMC dose-dependently improved blood glucose concentrations and alleviated pancreatic islet cells damage. In diabetic mice, degeneration of the islet cells was observed wherein they appeared shrunken, with hyaline deterioration, nuclear dissolution, and condensation. However, morphology of the islet cell was restored, and nuclei were visibly rounded in the HMC (30 mg/kg)-administered diabetic mice. In addition, β-cell numbers were markedly increased in HMC mice compared to STZ-induced diabetic mice, and the number of cells stained with glucagon was decreased. HMC markedly decreased the expression of proapoptotic proteins and increased antiapoptotic proteins, and the number of apoptotic cells detected by TUNEL was elevated. HMC decreased expression of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in diabetic mice. Moreover, HMC increased antioxidant-enzymes activity, and decreased reactive oxygen species generation. In conclusion, the results demonstrate the potential of HMC to alleviate hyperglycemia by protecting the pancreatic β-cells in diabetic mice.
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Exploring the Assumptions that Underlie Knowledge Elicitation in Classroom Interaction
박재은 이화여자대학교 교과교육연구소 2020 교과교육학연구 Vol.24 No.1
From a conversation analytic perspective, this paper explores the assumptions underlying the elicitation of knowledge display, in particular relation to an elicitation method. It begins with the classification of elicitation methods into the opening up and limiting methods, depending on whether teachers open up the opportunity to answer to all students, or limit it to one at a time. Based on the premise that teachers have certain expectation about the cohort’s access to a required answer and that this expectation is tied to how the answer is elicited, the paper focuses on evidencing the correlation between teachers’ answer anticipation and the use of an elicitation method, particularly, the opening up method. The examination of 12 video-recorded Korean primary school EFL classes suggests that the opening up method is used, conveying varying levels of teachers’ answer anticipation, expressed on a continuum of ‘only a few, possibly none of the cohort, can answer’ anticipation at one end and ‘all can answer’ anticipation at the other. This suggests that the opening up method is the default mode of elicitation reflective of all levels of answer anticipation, which is contrasted to the limiting method skewed toward one end of the continuum.
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Ciprofloxacin 치료에 반응이 없는 유입된 장티푸스 1예
박재은,정문현,이진수,김진주 대한감염학회 2007 감염과 화학요법 Vol.39 No.1
장티푸스는 개발도상국에 흔하며, 항균제 내성이 증가하여 치료가 어렵다. 장티푸스 1차 치료제에 내성인 경우에도 퀴놀론은 치료 효과가 있으며, 경구 투여가 가능하므로 3세대 세팔로스포린 주사제에 비해 가격이 싸고 투여하기가 간편하여 개발도상국에서는 장티푸스 치료에 1차 선택제이다. 최근 아시아 지역에서 nalidixic acid에 내성인 장티푸스가 발생하고 이런 내성균은 퀴놀론 제제로 치료가 어렵다. 저자들은 최근 파키스탄에서 감염된 nalidixic acid 내성 장티푸스 예를 경험하였고 문헌 고찰과 함께 임상 경과를 보고한다. 31세 파키스탄 남자로 파키스탄에서 귀국한 후 열이 생겨 14일 후 내원하였다. 경험적으로 경구 ciprofloxacin을 7번 투여했으나 임상적 호전이 없었고, ceftriaxone 주사제로 바꾼 후 호전되었다. 혈액 배양에서 Salmonella Typhi가 확인되었고, nalidixic acid에 대해서는 최소억제농도가 32 ㎍/mL 이상으로 내성이었고 ciprofloxacin에 대해서는 최소억제농도가 1.0 ㎍/mL으로 검사실 기준으로는 감수성이었다. Salmonella enterica serovar Typhi infection is widely prevalent in developing countries; its treatment has been complicated by the emergence of resistance to antimicrobial agents. Fluoroquinolones are orally administered antimicrobials effective against typhoid fever, including that caused by the multidrug-resistant S. Typhi. They are relatively inexpensive and more convenient to administer com pared to third-generation cephalosporins; hence, they constitute the drugs of choice for the treatment of typhoid fever in developing countries. In Asian countries, however, resistance to nalidixic acid-a prototype of quinolone antibiotics-diminishes the value of fluoroquinolones with regard to the treatment of typhoid fever. We experienced a case of nalidixic acid-resistant S. Typhi infection imported from Pakistan that was clinically refractory to ciprofloxacin treatment. A 31-year-old male presented with a fever of 14 days' duration after returning from his native Pakistan. Oral ciprofloxacin was empirically administered for three days without any beneficial effect. His illness, however, improved after the administration of ceftriaxone for three days. Blood culture revealed the presence of S. Typhi that was resistant to nalidixic acid (minimal inhibitory concentration ≥32㎍/mL) but susceptible to ciprofloxacin (minimal inhibitory concentration=1.0㎍/mL) in vitro.
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