발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

랫드에서 단일시험법을 이용한 반하 물추출물의 생식독성시험

이기남,유욱준,백인정,연정민,남상섭,이범준,남상윤,김윤배,강현규,안병우,김대중,황방연,노재섭,홍정섭,성하정,김순선,조대현,윤영원 충북대학교 동물의학연구소 2006 Journal of Biomedical and Translational Research Vol.7 No.1

본문참조

충돌사고 사례분석을 통한 구난시스템 개선에 관한 연구

정창현(Chang-Hyun, Jung),남택근(Taek-Kun, Nam),정중식(Jung-Sik, Jeong) 한국항해항만학회 2012 한국항해항만학회지 Vol.36 No.10

세계 해상교통량의 증가와 고속선의 증가로 해양사고 발생 가능성이 점점 높아지고 있으며, 그 피해 규모도 상대적으로 커지고 있는 추세이다. 국내에서는 2007년 허베이 스피리트호 사고, 2010년 천안함 사고에서와 같이 해양사고 발생시 초기대응의 미흡, 비상대응체계의 부재, 적절한 구조체계의 부족, 사고현장의 혼란 등으로 구난 활동이 지연됨으로써 막대한 인명 또는 재산상의 피해를 가져왔다. 사고 발생 후 적절한 피난처의 제공이나 신속한 사고처리는 사고선박으로부터 발생 가능한 잠재적인 환경오염 및 2차적인 피해로의 확산을 막을 수 있다. 따라서 최근 남해부근에서 발생한 선박 충돌사고의 구난과정을 살펴보고, 그 과정에서 도출된 문제점을 바탕으로 현재 국내 구난시스템에서 개선이 요구되는 부분을 제시하였다. 그 주요 내용으로는 외국의 피난처 지정 사례와 IMO 관련 지침을 바탕으로 피난처 제공에 대한 절차 수립의 당위성을 제시하였으며, 사고선박을 항내 또는 피난처로 이동시키기 위한 사고선박 예인지원시스템의 필요성을 제시하였다. 또한, ISU 가입을 위한 국가적인 지원방안의 검토와 사고 발생시 국내업체가 구난활동에 적극적으로 참여할 수 있도록 제도적 보완이 요구된다. There has been increasing the possibility of occurring the marine accident and become bigger the extent of damage with the growing number and high speed of ships. Also, there were tremendous loss of lives and properties in accidents of Hebei spirit in 2007 and Cheon Ahan war ship in 2010 with the insufficient salvage response and the lack of emergency response systems. When a ship has suffered an incident, the best way of preventing damage or pollution from its progressive deterioration would be to providing a place of refuge and to repair the damage rapidly. Therefore, it was examined the recent collision accident broken out near the Nam-Hae, and then suggested that it was necessary to be improved of the domestic salvage systems. It requires the procedures of providing a place of refuge, and the towing support system which make the damaged ship moved to the safe area, and joining of the ISU.

가미과루해백황금탕의 항고지혈증 효과

정은아,김윤경,김남재,김동현,이상인 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2001 No.-

Gamigwaruhaebaekwhanggum-Tang (GGHWT) have been evaluated for antihyperlipidemic effects on experimental hyperlipidemic rats and mice induced by Triton WR-1339, corn oil and high cholesterol-diet. Especially, GGHWT is formulated with Trichosanthis Fructus, Pinelliae Tuber, Aurantii Immaturus Fructus, Magnoliae Cortex, Allii Macrostemi Bulbus, Cinnamomi Ramulus and Scutellariae Radix. Oral administration of GGHWT at 500 mg/kg/day for 3 days significantly inhibited the increase of serum triglyceride and LDL-cholesterol, liver triglyceride in hyperlipidemic rats induced by Triton WR-1339. And, GGHWT significantly inhibited the increase of serum triglyceride in hyperlipidemic rats induced by corn oil. Also, administration of GGHWT (500 mg/kg, once daily for 1 week, p.o.) prevented the increase of serum total cholesterol, triglyceride, LDL-cholesterol, liver total cholesterol and triglyceride in 1% cholesterol-diet fed mice. These results suggest that GGHWT is effective for the treatment of hyperlipidemia.

고실 사구종 1례

신현수,윤태현,장희종,남정권 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.3

Lithium 중독증상에 대한 고찰

南正鉉 大韓神經精神醫學會 1979 신경정신의학 Vol.18 No.3

The author has tried to evaluate clinical correlation between toxic symptoms and serum level of lithium from an experience of mass intoxication. The intoxication was accidentally observed grom seven in-patients who had received lithium carbonate for the management of their manic symptoms. The accident occurred by measurement errer in capsuling of the lithium salt, resulting in doubling of its prescribed dosage. Moderate degree of toxic symptoms were noticed even at the serum level of 1.5mEq/L, severe degree symptoms such as confusion, muscle twitching and speech impairment at 1.5-3.0 mEq/L and far advanced degree symptoms with coma and generalized convulsion at 3.5mEq/L and higher. For the safer and effective therapeutic use of lithium, the serum level should be maintained at 1.4mEq/L and below. The toxic symptoms continued for over seven to ten days after dropping down of serum level to safe range Continuous observation and intensive care were should be recommended even after recovery of safe serum levelfor considerable period. Remedication of the lithium salt after disappearance of the toxic symptoms always resulted in reappearance of the symptoms even on the serum level under 1.0mEq/L. Remedication could be safely started at least two for our weeks after disappearance of the toxic symptoms. Poor food intake and previous cerebrovascular disorder were considered to be vulnarable to more severe intoxi cation, and the previous vascular disorder resulted in reappearance of the previous symptoms. The above findings were discussed in terms of possible correlation between clinical and laboratory data of the previous authors.

한방약물로부터 항고지혈증 치료약물개발(3) : In vitro에서 가미과루해백황금탕 및 구성약물의 항고지혈증 활성 Antihyperlipidemic Effects of Gamigwaruhaebaekwhanggum-Tang and Its Constituent Herbal Medicines in vitro

정은아,김남재,김윤경,김동현,이상인 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2001 No.-

80% extract of Gamigwaruhaebaekbaekju-Tang (GGHBT), Gagamgwaruhaebaekbaekju-Tang (GGGHBT) and Gamigwaruhaebaekwhanggum-Tang (GGHWT) remarkably showed inhibitory effects on HMG-CoA reductase, lipid peroxidation of rat liver and LDL oxidation, and DPPH free radical scavenging effect in a dose-dependent manner. Especially, GGHWT which is formulated with Trichosanthis Fructus, Pinelliae Tuber, Aurantii Immaturus Fructus, Magnolia Cortex, Allii Macrostemi Bulbus, Cinnamomi Ramulus and Scutellariae Radix on the basis of Gwaruhaebaekbaekju-Tang listed on the traditional medicinal references showed more effective hypocholesterolemic activities in vitro bioassay than the other prescriptions.

자기회귀 모델을 이용한 팔운동 근전신호의 기능분리

南文鉉,金正鉉,金洛敎 建國大學校 附設 産業技術硏究所 1992 논문집 Vol.17 No.-

본 연구에서는 AR 모델을 이용한 인간의 팔운동 근전신호의 기능분리에 관한 방법을 제시하였다. 4가지 기능의 팔운동 시에 근전신호의 특성을 잘 나타낼수 있는 매개변수를 공분산범과 연속적 최소제곱 알고리즘을 이용하여 각 기능에 대한 모델의 매개변수와 적정차수를 결정하였다. 또한 팔 기능을 분류하기 위한 신뢰구간은 총합제곱오차의 평균과 표준차로 결정하였다. AR 모델의 오차를 이용하여 각 운동에 대한 기능분리를 실행한 결과 차수가 4차일 때 가장 높은 인식률을 얻을 수 있었으며, 차수가 증가할수록 인식률은 감소하였다. 따라서 본 연구의 결과는 의용생체공학이나 재활공학에 응용할 수 있으리라 기대한다. In this thesis, general method using autoregressive model in the functional separation of the myoelectric signal of human arm movements are suggested. Covariance method and sequential least squares algorithm were used to determine the model parameters and the order of signal model to describe four arm movement patterns; the forearm flexion and extension, the wrist pronation and supination. The confidence interval to classify the functions of arm movement was defined by the mean and standard deviation of total squares error. With the error signals of autoregressive(AR) model, the result showed that the highest success tate was obtained in the case of 4th order, and success rate was decreased with increase of order. This technique might be applied to biomedical-and rehabilitation-engineering.

부적응 도식과 우울간의 관계에서 정서조절방략의 매개효과

정미현,김남재 덕성여자대학 학생생활지도연구소 2008 學生生活硏究 Vol.24 No.-

This research explored cognitive emotion condition tactic, behavioral emotion control tactic, and empirical emotion condition tactic, each media effect and causal effects in he relation of maladjustment diagram and depression and tactic more affecting depression. 388 women's university students were given to answer to the maladjustment diagram Questionnaire, Emotion Regulation Strategy Questionnaire(ERSQ) and Self-Rating Depression Scale(SDS). Depression were 48 scores over, selected from among the 388 students. To explore the relation of maladjustment diagram, each emotion condition tactic(cognitive, behavioral, empirical), a correlational analysis was conducted and a regression analysis was conducted. And based on that, a structural equation model was built and the adequacy was verified. The correlational analysis showed static correlation with depression in emotion deficiency, desertion/unrest, distrust/abuse, social isolation/alienation, deficiency/value, failure, risk/disease vulnerability, fusion/immaturity self-sacrifice, emotional depression, and the selection of negative thinking, inactive thinking, blaming others in cognitive emotion control tactics, and the selection of emotion acceptance in behavioral emotion control tactic, and the selection of indulgence and overeating in empirical emotion condition tactic. The regression analysis, showed the selection of emotion deficiency, distrust/abuse, social isolation/alienation, defect value, risk/disease vulnerability as maladjustment diagram variables affecting depression via cognitive emotion control tactics(negative thinking, inactive thinking, blaming others), and that of social isolation/alienation, failure, risk/disease vulnerability as maladjustment diagram variables affecting depression via. Thus structural equation model verification was conducted to confirm the causality affecting depression using these maladjustment diagram variables and each emotion control tactic. The analysis showed that maladjustment diagram affects depression via partial media of cognitive emotion control tactics(negative thinking, inactive thinking, blaming others), and significantly affects depression partial media of empirical emotion control tactics(indulgent activity and overeating) whose adequacy was supported. The causal effect indicated that the route of maladjustment diagram and depression via partial media of cognitive emotion control tactics rather than via empirical emotion control tactics had a higher effect. Regardless of correlation with depression in behavioral emotion condition tactic(emotion acceptance), it showed insignificant result of media effect between maladjustment diagram and behavioral tactic, which was discussed.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.