Cisplatin과 Tobramycin이 白鼠 Corti器에 미치는 영향에 關한 電子 顯微鏡的 硏究 : Ultrastructural Study

김동환,신태균,김무강,김홍선,김원식 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.1

In order to study the morphological changes of Corti’s organ in the rat treated with cisplatin and tobramycin, thirty-three rats, weighing between 200∼250g, were used, and divided into 4 groups, i.e., 3 rats were used for control, and 30 rats were used for 3 experimental groups. Each experimental group was divided into cisplatin-treated, tobramycin-treated, and both cisplatin and tobramycin treated group with 10 rats. Rats were injected with a single dose of 7.7㎎/㎏ of cisplatin intraperitoneally and 50㎎/㎏/day of tobramycin for 2 days intramuscularly, respectively or both. Treated rats were sacrificed on the 3rd and 5th day after the first injection. Results were as follows; 1. Cisplatin-treated group: Outer hair cells of Corti’s organ were degenerated with the formation of vacuoles and appearance of lysosomes, however, inner hair cells showed mild vacuolization. 2. Tobramycin-treated group: NO pathological changes were found in Corti’s organ. 3. Combined cisplatin and tobramycin treated group: Outer and inner hair cells showed vacuolization, appearance of lysosomes, myelin figures and multivesicular body. There were also multivesicular body in the inner phalangeal cell and myelin figure in the Reissner’s membrance. 4. Degeneration of Corti’s organ in the combined treated group was more sever than those of the single cisplatin-treated or tobramycin-treated group. 5. NO pathological differences of Corti’s organ in duration of postinjection were manifested in any groups. It can be concluded that cisplatin induces toxicity to inner ear and cisplatin enhance toxicity more in continued treated with tobramycin.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

Urapidil, Labetalol의 투여가 기관내 삽관시 심혈관계에 미치는 영향

신용섭,윤석화,손수창,이원형,이정은,황원재,김만수,김영주,김혜자,최세진 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

We have examined the comparative efficacy of small doses of intravenous urapidil and labetalol in blunting hemodynamic response to endotracheal intubation and surgical incision in 30 patients without cardiovascular diseases. After intravenous urapidil 0.2 mg/kg or labetalol 0.2 mg/kg anesthesia was induced with thiopental 5mg/kg. Endotracheal intubation was facilitated by vecuronium 0.15 mg/kg with priming principle and anesthesia was maintained with enflurane and nitrous oxide in oxygen. Systolic, diastolic and mean arterial pressure and heart rate were measured before administration of the drugs, 5 minute after administration, just prior to endotracheal intubation and 1, 3, 5, 10 minute after intubatin. Also the peak blood pressures and heart rate within 10 minutes after surgical incision were measured. Endotracheal intubation and surgical stimulation were associated with significant increases in blood pressures and heart rate in both urapidil and labetalol group. Comparison of the changes in systolic, diastolic, and mean artrial pressures and heart rate between urapidil and labetalol group showed no significant difference except peak systolic pressure after surgical incision. It is concluded that the pressor response to endotracheal intubation and surgical stimulation are not influenced significantly by urapidil 0.2 mg/kg or labetalol 0.2 mg/kg. However, urapidil and labetalol preloading may be similarly effective in the blunting of the increases in blood pressures with larger doses of the durgs during anesthetic induction.

한국인의 연, 망간, 알루미늄 및 실리콘의 혈중 농도

김정만,안정모,김원술,김정일,신해림,정갑열,김준연 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

Blood Lead, Manganese, Aluminium and Silicon Concentrations in Korean Adults Jung Man Kim, Jung Mo Ahn, Won Sul Kim1), Jung Il Kim2), Hai Rim Shin, Kap Yeol Jung2), Joon Youn Kim Department of Preventive Medicine, College of Medicine and Industrial Medicine Research Institute. Dong-A University Department of Health Care, Handong University Sunlin Presbyterian Hotpital1) Department of Occupational Medicine, College of Medicine, Dong-A University2) 0bjectives : This study was performed to determine the reference values of blood lead, manganese, aluminium, and silicon in healthy adults. Methods : The subjects were 132 (67 male and 65 female), and classified to three age groups (≤39,40∼49, and 50≤). Hood lead, manganese and aluminium were analyzed by atomic absorption spectrophotometer, and blood silicon was analyzed by direct current plasma optical omission spectrometer. Results : Blood lead levels(geometric mean, S.D) were (3.49, 1.70) ㎍/dL in male auld (3.04, 1.65) ㎍/dL in female, but the difference is not significant, and there was no significant difference between age groups. Mean blood manganese level was 0.99±0.41㎍/dL, and there was no significant difference between sex or age groups. Mean blood aluminium level was 0.59±0.35㎍/dL and there was no significant difference between sex or age groups. Mean blood silicon level was 54.41±27.64㎍/dL in male and 43.34±23.51㎍/dL in female, and the level in male was significantly higher than that in female (p〈0.05). There was significant difference between age groups, and the oldest showed the highest level in male (p〈0.05), but no significant difference between age groups in female. Conclusions : Authors hope that this study would provide basic data for determininig reference values and evaluating health effects.

Photonic Crystals: Integration of Colloidal Photonic Crystals toward Miniaturized Spectrometers (Adv. Mater. 9/2010)

Kim, Shin-Hyun,Park, Hyo Sung,Choi, Jae Hoon,Shim, Jae Won,Yang, Seung-Man WILEY-VCH Verlag 2010 Advanced materials Vol.22 No.9

<B>Graphic Abstract</B> <P>The cover shows a schematic illustration of patterned colloidal photonic crystals with different bandgap positions. When an unknown light source impinges on the patterned photonic crystals, the light information can be identified from the reflection intensity profile of the constituent photonic crystals. The two optical microscopy images and background image display integrated photonic crystals with 20 different bandgaps spanning the entire visible range, and the SEM image shows the cross-section of the photonic crystal stripes, as reported by Shin-Hyun Kim, Seung-Man Yang, and co-workers on p. 946. <img src='wiley_img_2010/09359648-2010-22-9-ADMA201090022-content.gif' alt='wiley_img_2010/09359648-2010-22-9-ADMA201090022-content'> </P>

Implementation of UPT Service in WIN-Based Mobile Communication Networks

Yun Won Chung(정윤원),Min Young Chung(정민영),Dan Keun Sung(성단근),In Jeong Kim(김인정),Jung Keun Shin(신정근),Sung Kim(김성) 한국통신학회 1999 한국통신학회 학술대회 및 강연회 Vol.1999 No.4

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Cheol Won Hyeon,Won Lee,So Yoon Kim,Ji Yong Park,Su Hwan Shin 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.3

Background/Aims: Possible fatal complications arising from coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery disease itself, are likely to cause medical disputes. Presenting the current status and reasons for judgments given in lawsuits related to CAG/PCI, this study aimed to identify ways to prevent unnecessary disputes and medical malpractice suits related to CAG/PCI through lawsuit analysis. Methods: A total of 13 cases (20 judgments) found in the Supreme Court of Korea’s Written Judgment Management System from 1998 to 2017 were analyzed. Results: Coronary artery injury was the most common causative complication that led to lawsuits (n = 6, 46%). Six cases (46%) were ruled in favor of the plaintiff for violation of duty of care (n = 4) and duty of explanation (n = 2), respectively. Cases that violated duty of care included two errors in intra-procedure device manipulation, one in pre-procedure diagnosis, and one in management of post-procedure complication. Lack of explanation regarding the risk of complications was pointed out in both cases that violated duty of explanation. The average awarded amount for the damages was 114,436,064 Korean won. Conclusions: Physicians need not fear unfair judgments so long as they follow standard of care because the Court consistently looked at the probability, the foreseeability, and the evidence. Therefore, maintaining standard of care is important. Besides, specific, detailed, and comprehensible explanations, including the risk of complications in addition to the necessity of procedures, are important to ensure the patient clearly understands the possible risk of adverse outcomes.

아미노글리코사이드 사용제한에 따른 병원성 균혈증 유발 그람음성간균의 내성변화 및 임상적 의의

오종택,김신우,손종원,도병훈,한승우,신병철,박지현,이종명,김능수 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 항균제 오남용으로 인한 내성균의 출현, 약물부작용의 발생 및 약제 비용의 증가는 환자 개인뿐만 아니라 사회적으로 문제가 되고 있다. 본 연구는 항생제의 오남용을 막기 위한 제도의 일환으로 시행한 아미노글리코사이드 사용 제한정책의 비용 효과적인 측면을 조사하고 그람음성간균에 의해 병원성 균혈증이 발생한 환자들을 대상으로 이 정책이 항생제 내성률과 환자 사망률에 미치는 영향을 연구하였다. 방법 : 930병상 규모의 3차 병원인 일개 대학병원에서 아미노글리코사이드 사용제한정책이 시행된 직후인 2002년 3월에서 9월 사이에 그람음성간균(Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Stenotrophomonas maltophilia, Burkholderia cepacia)에 의해 발생한 병원성 균혈증 환자 60명(실험군)과, 이 정책이 시행되기 전에 입원한 환자들 중 균주별로 같은 수만큼 선별한 병원성 균혈증 환자 60명(대조군)의 의무기록을 후향적으로 조사하였다. 결과 : 아미노글리코사이드 사용제한정책이 시행된 시기인 2002년 3월에서 9월 사이에 처방된 아미노글리코사이드 사용량 및 비용을 이 정책이 시행되기 전인 2001년 3월에서 9월 사이와 비교한 결과, 아미노글리코사이드의 사용량(antimicrobial utilization density)은 사용제한 후 225.2에서 130.3으로 42% 감소하였고 약제 비용은 44% 감소하였다. 아미노글리코사이드 사용제한 후 병원성 균혈증을 유발한 그람 음성간균의 이 항생제에 대한 내성률은 유의한 변화를 보이지 않았으며 균혈증과 직접 연관된 사망률도 환자의 나이, 성별, 기저질환 및 원발병소 등을 보정할 경우 유의한 차이를 보이지 않았다(40.4% vs. 24.1%, P=0.11). 결론 : 아미노글리코사이드를 5일을 초과한 사용 시 감염전문가의 사전 승인을 필요로 하는 사용제한정책은 아미노글리코사이드의 사용량과 비용을 유의하게 감소시켰다. 또한 이 정책 시행 후 그람음성간균에 의한 균혈증 환자에서 균혈증으로 인한 사망률과 아미노글리코사이드에 대한 내성률은 유의한 차이가 없었다. Objective : To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). Methods : Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gramnegative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. Results : During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225,2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. Conclusion : Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.

연쇄중합효소반응을 이용한 태아성별진단

이희섭,김용신,김화선,김정중,김원신 원광대학교 생명공학연구소 1996 생명공학연구소보 Vol.4 No.1

For sex determination by the PCR method, oligoprimers to Y-chromosome gene, DYZ1, SRY, and AMGL were synthesized and genomic DNA was extracted from male and female placenta for the control use. DYZ1 represented 154 bp single band to 0.001pg/ml male genomic DNA but did not represent 154 bp band in female genomic DNA, SRY represented 341 bp band to 1 pg/ml male genomic DNA but did not represent 341 bp band in female genomic DNA, and AMGL represented 977 and 788 bp double band to 1 pg/ml male genomic DNA and 977 bp single band to 1 pg/ml female genomic DNA in 2% agarose gel electrophoresis stained with ethidium bromide. DYZ1 was 1,000-fold sensitive than SRY and AMGL. DYZ1 and SRY could not identify the PCR failure from female but AMGL identified. To increase the sensitivity, the dual amplification of AMGL was performed and the sensitivity increased to 1,000-fold. During the dual amplification of female genomic DNA mixed with male genomic DNA, 0.00125pg/l, 1:400 part male genomic DNA contamination represented double bands as male. In 2 cases of 46, XY female, DYZ1 and AMGL amplification represented male band but SRY amplification did not represent male band. It was suggested that SRY gene was deleted in two 46, XY female cases. for fetal sex determination, PCR with DYZ1, SRY, and AMGL was performed in 10 cases of chorionic villi and 15 cases of amnionic cells. By the comparison with karyotyping result, fetal sex determination was achieved successfully in all 23 samples using PCR of SRY and AMGL but false result was detected in 3 cases(13%) using DYZ1. According to our results, it was concluded that DYZ1 was 1,000-fold sensitive than SRY and AMGL but could not be used because of its false results, and AMGL and SRY must be used concomitantly for precise sex determination.

초등학교 수학영재, 과학영재, 일반 학생의 학습유형 및 교수방법 선호도 비교

이신동(Lee Shin Dong),원재권(Won Jae Gourn),김기명(Kim Ki Myoung) 한국영재교육학회 2007 영재와 영재교육 Vol.6 No.2

본 연구는 Kolb의 4가지 학습유형에 따라 초등학교 수학영재, 과학영재, 일반 학생의 학습유형을 비교해 보고, 학습유형에 따라 교수방법 선호도가 어떻게 달라지는지 확인하기 위한 것이다. 이를 위해 지역교육청 2곳의 영재교육원 초등학교 수학ㆍ과학영재 학생 각60명, 일반 학생은 초등학교 2곳의 6학년 120명 총 240명을 연구 대상으로 하였으며, 이들의 학습유형검사ㆍ교수방법선호도 검사의 자료를 수집ㆍ분석하였다. 검사도구로는 Kolb(1999)의 학습유형검사(LSI), Renzulli, Rizza, & Smith(2002)의 교수방법 선호도 측정 검사지를 활용하였다. 본 연구의 결과 수학영재 학생과 과학영재학생의 학습유형은 차이가 없었으나 영재학생과 일반학생의 학습유형에는 차이가 있었으며, 동화적 학습자 유형을 제외한 발산적 학습자, 수렴적 학습자, 조절적 학습자 유형은 고유하게 선호하는 교수방법들을 가지고 있었다. 또한 수학영재 학생과 일반학생은 학습유형에 따른 교수방법 선호도에 차이가 없었으나, 과학영재 학생은 학습유형에 따fms 교수방법 선호도가 다르게 나타났다. 이런 결과는 영재학생과 일반학생의 학습유형이 서로 다르고 그에 따른 교수방법도 다르다는 것을 나타낸다. 따라서 교실수업을 담당하는 교사들은 학생들의 학습유형에 맞는 교수방법을 제공하여 교수적합성을 달성함과 동시에 교수 효과를 극대화하기 위해서 각각의 학습유형과 교수방법에 대한 충분한 이해가 선행되어야 할 것이다. The purpose of this study is to compare the learning styles of the mathematics gifted, the science gifted, and general students at elementary schools by Kolb"s four learning styles, and ascertain how the preference of instructional methods become different by learning style. To achieve the purpose in this study, the four propositions were set as follows: First, what differences exist among the mathematics gifted, the science gifted and general students in terms of learning style? Second, what differences exist in terms of the preference of instructional methods by learning style among the mathematics gifted, the science gifted, and general students? To solve the abovementioned propositions, this study targeted 60 elementary school-level mathematics gifted students, 60 science gifted students at gifted students education institutes, and 120 six graders at Elementary School: this study targeted a total of 240 students. For the learning style test used in this study, ""Learning Style Inventory (LSI),"" which originally presented by Kolb in 1976, but was revised anew in 1999, and was translated by Lee, Shin-dong (2005), was used. As a test to measure the preference of instructional methods, ""Measure of Student Preference for Instructional Techniques,"" developed by Renzulli, Rizza, and Smith (2002), and translated by Lee Shin-dong (2005) was used. The confidence levels of the tests were good, respectively. The analysis of the collected test responses was tested through a confidence analysis, technical statistics, MANOVA, and Sheffe test was used for follow up test. The SPSS 12.0 Program was used for the analysis. The analytical results of the collected data are presented as follows: Firstly, there was no difference in the learning style of the mathematics gifted and the science gifted, but there was difference in the learning style of the gifted and general students. Secondly, it was identified that divergent learners, convergent learners, regulated learners, except for assimilative learners, had their preferred instructional methods. Thirdly, there was no difference in the preference of instructional methods by learning style and gender between the mathematics gifted and general students. The science gifted students had different preference of instructional methods by learning style, but they did not show any difference on the preference of instructional methods by gender. In conclusion, the divergent learners and convergent learners are judged to be more active in learning activities and have higher learning motivation. Teachers taking charge of classroom teaching should provide instructional methods in line with such learning styles so as to achieve the adequacy of instruction, and draw maximum instructional effects. Those teachers also need to pay more attention to enhancing learning motivation of the relatively passive regulated learners and assimilative learners.