서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

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

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

고콜레스테롤혈증 환자에서 활성화된 혈소판 Glycoprotein Ⅱb/Ⅲa의 증가

주승재,이재우,박양생 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.12

ADP에 의해서 활성화된 인혈관세포의 Prothrombin과 골타액단백 부착에 관여하는 Integrin avβ3, avβ5, a5β1의 특성

주승재,최휘,김성만,차태준,이재우 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1

Background : One of the most important features of integrins is that they exist in active and inactive states. Adenosine diphosphate (ADP), which is usually secreted from activated platelets, may activate integrins on vascular on vascular cells. Each integrin has its own activation-dependent ligands that have much higher affinity to active form than inactive one. Integrins that might mediate adhesion of human vascular cells to prothrombin(PT) and bone sialoprotein (BSP) after ADP stimulation were investigated. Methods : PT and BSP were used as activation-dependent ligands in adhesion assay. Adhesions of human umbilical vein endothelial cells (HUVEC) and human aortic smooth muscle cells (HASMC) were measured after stimulating with 100 μM of ADP, using ligand-coated 24-well plate and Fluorescence Multi-Well Plate Reader. Results : ADP activated HUVEC and HASMC to increase adhesions to PT and BSP in a dose-dependent manner. Adhesions of ADP-stimulated HUVEC to PT and BSP were almost completely inhibited by c7E3, a blocking monoclonal Ab to integrin β₃(96% and 92% inhibition, respectively), but not by P5H9, a blocking monoclonal Ab to integrin α_vβ_5. Adhesion of ADP-stimulated HASMC to PT was completely blocked by P5H9 (92% inhibition), but was not affected by c7E3. Adhesion of ADP-stimulated HASMC to BSP was partially inhibited either by P5H9 (46% inhibition) or by JBS5, a blocking monoclonal Ab to integrin inhibition), but was not affected by c7E3. However, it was completely blocked by cRGD (93% inhibition). Conclusion : These results indicate that the adhesion of ADP-stimulated HUVEC to PT or BSP was mediated by integrin α_vβ₃ and several integrins appeared to be involved in the adhesion of ADP-stimulated HASMC. While the adhesion of HASMC to PT was mediated by integrin α_vβ_5, the adhesion to BSP was associated with integrins α_vβ_5 and α_5β₁.

치매전문요양병원 병동부의 공간구성 특성에 관한 연구 : 공용생활공간을 중심으로

주현돈,박재승 한국의료복지시설학회 2007 의료·복지 건축 Vol.13 No.1

As the population of the elderly increases drastically year by year in Korea, this phenomenon is being a serious problem because of the increasing speed not having been showed ever all over the world. This thesis would propose the space organizing features for well-organized dementia hospital focused on the public living space. The way arranging each function is very important because values of the physical and functional accessibility have a wide range of value as each type of facility. Moreover, if the arranged function unit is the same as the territory of the space, it could be a good guideline on architectural planning.

수돗물 水質 改善에 따른 便益 分析

주용재,허승욱 단국대학교 1998 論文集 Vol.32 No.-

Environment economics is a rapidly expanding branch of the discipline. This is partly due to an increasing awareness of the seriousness of environment problems. Such recognition creates demand for economic evaluation of environment change. Contingent valuation method(CVM) has evolved and matured considerably during the past 30 years since David's pioneering study(1963) on hunting in the Maine woods. During this period contingent valuation method has been shown to be a useful tool in learning about preferences for public goods and has increasingly become accepted as an analytical tool in policy analysis. This paper considers models for evaluating the willingness to pay based on payment card contingent valuation survey data and has attempted to measure goodness of fit for the data obtained from the survey design. In this paper, data were analyzed by using the CVM, and an attempt was made to measure a functional relationship on the willingness to pay for citizens in Cheonan city, based on regression analysis using the method of ordinary least squares. It may be concluded that citizens of Cheonan really wants to improve their drinking water quality. The annual amount of willingness to pay for the improvement of drinking water quality in estimated from 5.947 million won to 7.806 million won at 95 percent confidence interval. The estimate of willingness to pay may be used as a guideline in drinking water policy.

GIS를 활용한 효율적인 농촌경관관리구역 설정에 관한 연구

서주환,최현상,변성진,안재홍,양희승 경희대학교 부설 디자인연구원 2002 예술· 디자인학연구 Vol.5 No.1

Land use and social, cultural and environmental safety, which are adapted to natural environment, based on the traditional agricultural society, are on the verge of collapse because our rural community was developing around economy value. Rural landscape has not been certified compared with urban and natural landscape in importance by the standard of functional aspect, economic value and use demand, so cultural, historical, traditional and agricultural landscape native to rural community are not evaluated exactly. The Purpose of the study is a efficient plan and management for a essential rural landscape. Therefore We Make out a landscape diagram for efficient landscape plan and management and Selection of the Rural Landscape Management Area.

Mixer-settler를 이용한 용매추출로 에칭폐액로부터 철과 니켈의 분리

이만승,이경주,이진영,안재우,오영주 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.12

Solvent extraction and stripping experiments were conducted to separate iron from a spent FeC13 etching solution containing nickel. In the operation of mixer-settler, 7 extraction stages with 1.0 M Alamine336 in toluene, led to 98% extraction percentage of iron at equal phase ratio, when the flow rate of organic and aqueous were 35 mL/min and 5 mL/min, respectively. At equal phase ratio of aqueous to organic, 10 stripping stages with 0.01 M HC1 solution resulted in 99% stripping percentage of iron when the flow rate of stripping solution and loaded organic were 5 mL/min and 35 mL/min, respectively. The concentration of iron in the stripped solution was 133 g/L and this solution could be reused in the etching of nickel lead frame. (Received June 15, 2004)

터키안와 및 상부 종양의 임상적 고찰

임재현,하은주,이종수,이승재,박효일 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

Tumorous lesion of intra- and suprasellar area showed unique clinical pictures and also was very hazardous and difficult to remove surgically because of the surrounding important anatomical structures. Here, authors analyzed 28 confirmed tumor of this area during last two and half years retrospctively. Histopathologically, 28 cases were classified in 14 pituitary adenoma cased6 cases of non-functioning adenoma, 1 GH-secreting adenoma and 7 cases of prolactinoma), 7 craniopharyngioma cases, 3 meninigioma cases and each one case of germinoma, Rathke's cleft cyst, pituitary abscess and hamartoma. Sexual incidence was 6 : 22 in male vs female ratio. Twenty two cases were measured its diameter over 2cm and they extended to suprasellar area in all cases. Five cases of microadenoma were analyzed and they were all enclosed in sella turcica. Visual impairment was the most frequent and prominent clinical symptom. of which incidence was 78.57% (22 cases). The next frequent symptoms were headache and generalized lethargy. Diabetes insipidus was a presenting symptom in 4 cases and hydrocephalus was noted in 4 cases preoperatively. Surgical intervention was carried out in 23 cases, by the way, the performed type of surgery in 21 cases was a conventional transcranial frontotemporal(pterional) microsurgical method. Post-operatively, diabetes insipidus was complicated in 78.26 % and pituitary hypofunction was noted 34.78%. Two cases of intracranial hemorrhage was developed after surgery and one was died. Through 6 to 28 months follow up. 82.1 % of cases were improved in its clinical status including 7 cured cases.

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.