국내 대학병원에서 정주용 Ciprofloxacin 사용의 적정성 평가

김신우,박효정,오원섭,김연숙,장현하,정숙인,정두련,이혁,염준섭,기현균,손준성,백경란,우건조,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 병원에서의 정주 ciprofloxacin 사용의 적정성을 평가하고자 하였다. 재료 및 방법 : 2003년 9월 25일부터 8개의 대학병원에서 정주 ciprofloxacin을 받았던 290명의 연속적으로 모집한 성인환자를 대상으로 약제사용 평가(DUE)를 전향적으로 수행하였다. 이 연구에 사용된 DUE 기준은 미국병원약사회의 기준을 국내 실정에 맡게 수정하여 사용하였으며 1) 사용의 정당성에 관한 항목, 2) 사용 시 준수되거나 시행되어야 할 사항에 대한 항목, 3) 부작용에 대한 항목, 4) 치료 효과에 대한 항목으로 나누어 조사하였다. 결과 : 환자의 평균 나이는 54세였다. 33예(26.9%)에서만 약제 사용의 적정성 측면에서 기준을 만족하였고 91예(73.1%)에서는 사용이 적절하지 않았다. 정주 cipro-floxacin의 부적절한 사용의 흔한 원인은 수술 전후의 예방약 사용, 비뇨기계 처치 전의 예방적 사용, 열성 질환에 대한 경험적 사용 등의 순이었다. 사용 시 준수사항 의 측면에서는 사용 전 배양검사(73.8%)와 사용 중 배양검사(68.6%)가 낮은 수행 정도를 보였으나 그 외는 비교적 높은 적정성(82.4-100%)을 보여주었다. 정주 ciprofloxacin사용의 합병증은 드물었다. 치료 효과의 면에서 치료반응은 93.3%였다. 결론 : 약제 사용의 정당성 기준에 따른 정주 cipro-floxacin의 부적절한 사용은 연구에 포함된 대학병원에서 매우 흔하였다(73.1%). 그러므로 적절한 항생제 사용에 대한 교육과 제도적 장치가 매우 필요한 것으로 판단되었다. Background : To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. Materials and Methods : We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. Results : Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. Conclusion : Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.

이온 交換樹脂에 依한 黴量水銀의 濃縮分析

김건신,송영신,朴允昌 성균관대학교 기초과학연구소 1985 論文集 Vol.36 No.2

Trace levels of inorganic and organic mercury ions in aqueous solution were concentrated on several ion exchange resins and their distribution coefficients were found by Cold Vapor Atomic Absorption (CVAA) technique. Of ion exchange resins used for experiments, moderately basic anion exchange resin (Cl^--from, Dowex-2 2×8-100) showed the best distribution coefficient, resulting in the effective concentration of mercury ions. Also, better distribution coefficients were obtained for highly crosslinked in exchange resins. As the temperature of mercury solution increased the amount of the mercury ions absorbed on the resins increased. Inorganic and organic mercury ions were selectively reduced by SnCl_2, NH_2OH·HCl and NaBH_4, respectively, and SnCl_2, NH_2OH·HCl showed a better results for inorganic mercury and NaBH_4 for organic mercury. Although the addition of NaBH_4 to solutions containing mercury ions as a reducing agent showed high absorbances, it did not obey Beer's law satisfactorily when the concentration became high. With the aid of HNO_3 and NH_4Cl sobution, sobutions containing both types of mercury could be preserved for more than a week. In solutions with inorganic and organic mercury ions, inorganic mercury ions were selectively determined by SnCl_2, NH_2OH·HCl. The organic mercury content of the solution could be determined after total mercury and inorganic mercury were analyzed separately.

논에서 물과 양분관리에 따른 메탄(CH_4), 아산화질소(N_2O) 배출 특성

김건엽,박상일,송범헌,신용광 한국환경농학회 2002 한국환경농학회지 Vol.21 No.2

물관리방법을 달리한 상시담수와 간단관개에서 메탄과 아산화질소의 배출 양상과 서로 다른 종류의 유기물원 및 질소비료 시용에 따른 메탄과 아산화질소 배출을 비교하고 저감 할 수 있는 방법을 찾기 위해 본 시험을 실시하였다. 물관리방법으로는 상시담수 (이앙∼출수 35일까지 담수)와 이앙 35일 이후 중간낙수한 간단관개 (중간낙수기간 20일),그리고 시비방법으로는 토양을 검정한 시비량인 토양검정, 토양 검정시비량+볏짚 돈분액비, LCU 완효성비료 그리고 N을 시용하지 않은 대조구 등을 처리하여 메탄 및 아산화질소 배출량을 측정하였다. 메탄 배출량은 간단관개보다 상시담수에서 높았고, 아산화질소 배출량은 이와 반대로 나타났다. 유기물과 비료시용 종류에 따른 메탄과 아산화질소 배출량은 액비와 검정시비+볏짚시용구에서 가장 높았으며, LCU 완효성비료구에서 가장 낮았다. 지구온난화잠재력으로 환산한 온실가스 배출은 물관리 조건에서 상시담수가 간단관개보다 170∼208% 높았으며, 요소를 시용하고 상시담수를 기준 한 것과 간단관개로 물 관리하여 각 처리에 따라 온실가스 배출을 비교하면 요소는 41.4%, LCU 완효성비료 55.8%로 온실가스 배출을 줄일 수 있는 것으로 나타났다. 그리고 비료이용효율은 LCU완효성비료, 액비>검정시비+볏짖>검정시비 순이었다. Emission of methane and nitrous oxide affected by nitrogen fertilizer materials were measured simultaneously in rice paddy fields under flooding and intermittent irrigation in 2000. Studies focused on mitigating CH_4 emission from rice paddy fields are summarized and the possibilities and limits applied to world's rice cultivation are discussed. The mitigation options are water management, soil amendments, organic matter management, different tillage, rotation, and cultivar selection. Altering water management, in particular promoting midseason aeration by short-term drainage, is one of the most promising strategies, although these practices may be limited to the rice paddy fields where the irrigation system is well prepared. The test site was divided into two water managements: a continuously flooded plot which was maintained flooded by constant irrigation from May to September, and an intermittently drained plot in which short-term (20days) draining practices were performed one times during the flooding period. By total emission of GHGs converted by global warming potential (GWP), flooding plots were higher 170~208% than intermittent irrigation plots. For emission of GHGs in fertilizer materials, it was high in the order of Swine slurry>Urea+Rice straw>Urea>LCU. Basing on GHGs emission of urea fertilization under flooding as baseline GWP of urea fertilization and Latex-coated urea under intermittent irrigation showed lower GHGs emission by 41.4% and 55.8%, respectively. In this case fertilizer use efficiency (kg unhulled rice/kg of applied N) were 18.2~20.2 and 18.7~19.0 and 9.3 and 5.8~6.6 for Swine slurry and LCU and Urea+Rice straw and Urea in the continuously flooded and intermittently drained plot.

炭素纖維補强板에 의한 콘크리트 龜裂의 補修補强에 관한 基礎的 硏究

崔鳳鎭,文鍾健,宋河永,金乙鏞 大田産業大學校 1998 한밭대학교 논문집 Vol.15 No.1

Recently, it has been reported frequently that there exist early-stage deterioration such as cracking, scaling in many concrete structures due to the defect of construction and the environmental pollution. This paper was designed to evaluate the effectiveness of carbon fibre reinforced strips (CFRS) methods attached on cracks in concrete in order to repair and rehabilitate the damaged concrete structures mixed by 3 kinds of water-cement ratio and 2 kinds of aggregate. The test results presented that the CFRS method attached on the bottom of cracked concrete specimen appeared the most effective properties.

세포질내 정자주입법(ICSI)에 있어서 정자흡입 및 난자내 주입방법에 관한 연구

이택후,김항진,송건호,김대근,전상식,박윤규,서태광,전병균,류은경,이은숙,문진수,김광철 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1

Study on Method of Sperm Aspiration and Injection into an Oocyte in Intracytoplasmic Sperm Injection(ICSI) Immobilization of spermatozoa prior to intracytoplasmic sperm iniection(ICSI) sometimes results in crooked tail and this makes it difficult to aspirate sperm into an injection pipette tail first. Head-first sperm aspiration into an injection pipette avoid this problem due to the bigger size of the sperm head. The effect of head or tail-first sperm injection into an oocyte on fertilization cleavage, percentage of grade I embryos and development to blastocyst stage in ICSI program has been studied. A single living immobilized spermatozoa from oligoasthenozoospermic patient was injected into an oocyte head-first or tail-first according to the treatment. Eighteen hours after microinjection, oocytes ware inspected for survival and fertilization Fertilized oocytes with two pronuclei were cultured in 30μl drop of mHTF supplemented with 10% heat-inactivated follicular fluid(FF) at 37℃. On day 2. embryo transfer was performed with cleaved embryos. The remaining 2-8 cell stage embryos were co-cultured with BRL cells in mHTF + 10% FF for 72 hours and the developmental stage was observed. The data were analyzed by Analysis of Variance. A total of 164 oocytes from 36 cycles were assigned to earth treatment and ICSI was performed(88 head-first, tail-first). The rates of normal fertilization were 81.8% and 76.3% for head-first and tail-first, respectively. Of the fertilized oocytes, the percentage of cleaved embryos and the percentage of grade 1 embryo among cleaved embryos were 88.9% and 68.8%, 93.1% and 74.1% for head-first and tail-first, respectively. Of the 2-8 cell embryos cultured, 44.4%(16/36) and 50.0%(10/20) for head first and tail first, respectively developed to blastocyst stage. There were no differences in fertilization, cleavage, rates of grade 1 embryos, and development to blastocyst stage. In conclusion, head-first or tail-first sperm injection into an oocyte in ICSI program does not affect fertilization and subsequent embryo development to blastocyst stage in vitro.

일 농촌지역의 우울 증상에 관한 역학연구 -위험요인 및 요인구조분석

하양숙,홍진표,김한규,이군희,한경자,조맹제,김용익,송미순,박성애,김창윤 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 세계적으로 널리 사용되는 우울증 척도인 the Center for Epidemiologic Studies Depression Scale(CES-D)을 이용하여 지역사회 주민의 우울증상의 정도를 평가하고, 우울증상의 위험요인을 분석하고, 한국인에서 우울증상의 요인구조를 알기 위해 본 연구를 실시하였다. 방 법 : 경기도 일 농촌 지역의 30세 이상 주민에 대해 무작위 군집 집락 추출을 실시하였고, 훈련된 면담원들이 가정 방문을 통하여 면접 및 자기보고 검사인 CES-D를 실시하였다. 총 1,315명에서 응답을 하였고 응답율은 59.3%이었다. 결 과 : CES-D에 의한 우울증 점수는 0∼5점이 57%정도를 차지하였고, 평균 점수는 남자 7.8점 여자 9.5점으로 비교적 낮은 편이었다. ANCOVA 분석 결과 비결혼, 저학력, 여성이라는 위험요인은 독립적으로 우울증상을 악화시키는 요인이었으나 연령은 통계적으로 유의하지 않았다. CES-D 결과를 요인분석을 시행한 결과 4가지 요인이 추출되었는데 우울증상 및 신체증상이 한 개의 요인으로, 다른 나라에서 보고되지 않는 정서적 고통이 별도의 요인으로 추출되었다. 결 론 : 국내 역학 조사에서도 외국과 유사한 우울점수 및 위험요인이 확인되었으나 우울증의 요인에서는 특이한 요인이 추출되었다. 한국인에 독특한 우울 반응에 관한 추가 연구가 필요하다. Objectives :The rates, correlates, and factor structure of depressive symptoms in a Korean rural sample were examined using Korean version of the Center for Epidemiologic Studies Depression Scale(CES-D). Methods : Door to door visiting survey was conducted by trained interviewers. A random cluster sample of 1,315 respondents, aged 30 and over completed the CES-D scale along with additional sociodemographic questionnaire. Results : In this sample, mean CES-D score of male and female were 7.8 and 9.5, respectively which were lower than those reported previously. Symptoms of depression were most common among the less educated, non-married and female according to ANCOVA. Age was not a significant risk factor for depressive symptoms. Different factor structures emerged from this sample as compared to other studies using this approach. Somatic symptoms and affective symptoms were combined as one factor and emotional hardship emerged as a separate factor. Conclusion : Symptoms scores and risk factors were similar to the results reported in other countries but unique factor structures were found in this study. Further research is needed about the Korean depressive symptomatology and related areas.

Pulsed dye Laser-assisted intralesional photodynamic therapy in basal cell carcinoma (초)

( Gun Wook Kim ),( Seung Wook Jwa ),( Margaret Song ),( Hoon Soo Kim ),( Su Han Kim ),( Hyun Chang Ko ),( Moon Bum Kim ),( Byung Soo Kim ) 대한피부과학회 2011 초록집 Vol.49 No.10

The importance of dermoscopy for the diagnosis of acquired bilateral telangiectatic macules: angioid streak pattern reveals underlying chronic liver disease

( Gun Wook Kim ),( Jin Hwa Son ),( Jeong Min Kim ),( Margaret Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Acquired bilateral telangiectatic macules (ABTM) are a newly recognized clinical entity with multiple telangiectatic pigmented macules confined mostly to the upper arms. Objectives: To evaluate clinical and dermoscopic features in a group of 50 patients with ABTM and to determine the usefulness of dermoscopy for identifying patients with chronic liver diseases (CLD) Methods: Patients were selected from two tertiary teaching hospitals in Korea. Overall, 50 patients with ABTM in the skin were included in the study. The dermoscopic findings were graded on a 0-3 scale of severity: none (0), mild (1), moderate (2), severe (3). Results: We identified three valuable dermoscopic features in diagnosing ABTM including brown pigmentations, telangiectasia and angioid streak pattern. The brown pigmentations from the group without CLD were scored more severely than the group with CLD (mean score: 2.00 vs 1.48, P < 0.001). The mean severity score of telangiectasia from the group with CLD was higher than the mean from the group without CLD (2.14 vs 1.39, P < 0.001). The angioid streak pattern was characterized as bilateral, narrow and irregular lines configuring in a radiating fashion. The angioid streak pattern was observed in 63.0% of patients with and 26.1% of those without CLD (1.37 vs 0.35, P < 0.001). Conclusion: The detailed observations in ABTM with dermoscopy provide the first clues for the underlyingchronic liver disease.

P266 : Dermoscopic “Landscape painting patterns" as a clue for labial melanotic macules: an analysis of 80 cases

( Gun Wook Kim ),( Hyun Ju Jin ),( Hyun Ho Cho ),( Won Jeong Kim ),( Je Ho Mun ),( Margaret Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: Labial melanotic macules are benign pigmented lesions that may clinically mimic melanoma. Whereas the dermoscopic features of other pigmented skin lesions have been extensively described, little is known about labial melanotic macules. Objectives: To describe the dermoscopic aspects of labial melanotic macules and find schematic dermoscopic patterns to these lesions. Methods: A retrospective dermoscopic study was conducted on 80 lesions with histopathologically proved labial melanotic macules. Results: We describe and define, for the first time to our knowledge, landscape painting patterns found in 65 of 80 melanotic lesions (81.3%), characterized by parallel lines orcircle lines, overlapping vessels with background brown pigmentation. The background brown pigmentations were observed in 74 of 80 lesions (92.5%), the parallel lines in 62 (77.5%), the circle lines in 20 (25.0%), and overlappin vessels in 69 (86.3%). The structureless black pigmentations were only presented in 26 of 80 melanotic lesions (32.5%). Conclusion: Dermoscopy can be useful for the clinical detection of labial melanotic macules, and “Landscape painting patterns” may represent a dermoscopic clue for the diagnosis of these lesions.

The efficacy and toxicity of S-1 and cisplatin as first-line chemotherapy in recurrent or metastatic head and neck squamous cell carcinoma

Kim, Han Sang,Kim, Hye Ryun,Kim, Gun Min,Kim, Hyo Song,Koh, Yoon Woo,Kim, Se Hun,Choi, Eun Chang,Hong, Yun Kyoung,Sung, Ji Hee,Kim, Sun Mi,Kim, Joo Hang,Cho, Byoung Chul Springer-Verlag 2012 Cancer chemotherapy and pharmacology Vol.70 No.4