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.

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.

라캉과 데리다의 정신분석적 독법에 관한 비교연구 : 포우의 「도난당한 편지」를 중심으로

박병주 忠州大學校 2007 한국교통대학교 논문집 Vol.42 No.-

The purpose of this study is to compare Lacanian view with Derridian view in reading "Seminar on The Purloined Letter" and "The Purveyor of Truth" So far, literature has been submitted to authority and the prestige of psychoanalysis. Psychoanalysis occupies the place of a subject and literature that of an object: the relation of interpretation is structured as a relation of master to slave. But in "Seminar on The Purloined Letter" Lacan sees the story as a parody of psychoanalysis. Thus, psychoanalysis becomes the example of the example. Finally, Lacan deconstructs the relation between literature and psychoanalysis. According to Lacan, there are three glances in "Seminar on The Purloined Letter". The first is a glance that sees nothing: the King and the police. The second, a glance which sees that the first sees nothing: The Queen ,then Minister. The third sees that the first two glances leave what should be hidden exposed to whomever would seize it: the Minister, and finally Dupin. But in "The Purveyor of Truth" Derrida adds narrator to three glances. Thus, according to Derrida there are four glances. To be short, in this paper we found out results as follows: In Lacan the narrator's place is excluded as a commentary. He transforms the entire seminar into analytical fascination with a content. But in Derrida the narrator is a specific status of his discourse which is not neutral.

암세포주의 세포외기질단백에 미치는 Nocodazole의 영향

정병욱,김주영,이융창 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.5

로렌스의「국화냄새」: 엘리자베스의 자기인식

박병주 韓國交通大學校 2013 한국교통대학교 논문집 Vol.48 No.-

This paper aims to analyze Lawrence’s ‘Odour of Chrysanthemums’ and identify Elizabeth’s Self Recognition. In reading the short story we must pay attention to Elizabeth’s mental change. During her marriage life she had always complained about her tipsy husband and late home-coming. The sense of her alienation leaded to her discovery about the meaninglessness of their life together. She claims to possess her husband, to shut off the possibility of growth. At last after her husband’s death she realized that she had been wrong to struggle against her husband. ‘Odour of Chrysanthemums’ tells one deep truth: you are what you are: you may make others pay for it and will certainly pay for it yourself. You may be given a moment of vision: usually too late. It is obvious that we can find out the possibility of her change at the end of story.

신품종 '미소' 느타리버섯 병재배 배지개발

이병주 외 한국버섯학회 2010 한국버섯학회지 Vol.8 No.1

본 시험은 충남농업기술원에서 개발한 신품종 '미소' 느타리버섯의 안정적인 생산을 도모하기 위하여 병재배에 적합한 최적배지를 개발할 목적으로 수행되었다. 여기에서 사용된 배지로는 포플러톱밥+비트펄프+면실박(5:3:2), 포플러톱밥+밀기울(8:2), 포플러톱밥+비트펄프+면실박(6:2:2), 포플러톱밥+비트펄프+면실박(4:4:2), 그리고 포플러톱밥+비트펄트+밀기울(7:1:2)을 사용하였다. 배지별 pH는 5~6이었고, C/N율은 19.7~28.3의 범위에 있었다. 초발이 소요일수는 5~6일 이었으며 접종 후부터 자실체 형성까지의 전체생육일수는 29~31일이 소요되었다. 버섯 자실체의 수확량은 '포플러톱밥+비트+밀기울(7:1:2)'배지에서 110.4g/병으로 가장 높은 수량을 나타냈다. 그러므로 '포플러톱밥+비트+밀기울(7:1:2)'배지를 이용하면 신품종 미소버섯의 병재배 배지에 적합할 것으로 판단된다. This study was carried out to develop the best medium of new oyster mushroom for bottle culture. The new oyster mushroom cv. Miso is a Pleurotus ostreatus developed at the Chungnam Agricultural Research & Extension Services. For the bottle culture media, poplar sawdust+beet pulp+cottonseed meal (5:3:2), poplar sawdust+wheat husk meal (8:2), poplar sawdust+beet pulp+cottonseed meal (6:2:2), poplar sawdust+beet pulp+cottonseed meal (4:4:2), and poplar sawdust+beet pulp+wheat husk meal (7:1:2) were used in 850cc PP bottle. The pH was 5~6 and the C/N ratio 19.7~28.3 in bottle culture media. The time of pinhead formation was 5 to 6 days. For the fruiting body formation after inoculation took 29~31 days. The yield of fruiting body of poplar sawdust+beet pulp+wheat husk meal (7:1:2) medium was the highest at 110.4g/bottle compared to other media. Therefore, such cultivation medium would be appropriate for the commercial production of bottle culture in the new oyster mushroom 'Miso'.

안구의 비색소성 모양체 상피에서 발생한 유두상 선암종 -1예 보고-

최현주,최영진,이연수,이은정,강석진,김병기,심상인 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

윌리엄 포크너의『소음과 분노』: 사랑의 부재와 가족의 붕괴

박병주 忠州大學校 2012 한국교통대학교 논문집 Vol.47 No.-

This paper aims to examine The Sound and the Fury by William Faulkner in terms of the loss of love and family’s disintegration. In the novel we can find out a nightmare group of characters, that is, an alcoholic, cynical father; a demanding and hypocritical mother, a helpless idiot, an obsession-driven suicide, a vicious materialist. The pathological aspects of family members drive the Compson to family disintergration. Finally, this study shows us that the loss of love among family members is responsible for The family’s disintegration.

카버의 단편소설에 나타난 텔레비전문화 비판 : 『우리가 사랑에 관해 이야기할 때 말하는 것』을 중심으로

박병주 忠州大學校 2009 한국교통대학교 논문집 Vol.44 No.-

In general, the criticism of Raymond Carver's short stories tends to take two directions because he is regarded as formal innovator as well as social realist. The first assigns Carver to minimalist school of fiction in 1970s. The second emphasizes the social and economic content. I resolve second direction in this essay. This paper aims to show that television culture is a rather hostile to American working class through analyzing What We Talk About When We Talk About Love in terms of social protest fiction. Thus, this study examines four short stories, "Why Don't You Dance?", "Mr coffee and Mr Fixit", "The Bath" and "After the Denim" in What We Talk About When We Talk About Love in order to identify the fact that Carver regards TV as an inhibitor of critical self-examination. Carver's stories take place at home where TV serves as cocoon against consideration of social discontent. In view of analyzing short stories we can say that television and its impact on working class are dominant in What We Talk About When We Talk About Love. Carver puts an emphasis on TV as the shaper of consciousness. Carver also shows the absence of working-class' critical reflection by television's static immediacy. For this reason, he is concerned with working class people's tragedies and failure to self-critical consciousness symbolized by television. In conclusion, it can be said that Carver greatly contributed to our understanding of television culture and working class in contemporary American society.

장기간 보관한 멸균물품의 오염 상태에 관한 연구

주홍순,조순덕,정재심,신동분,임바올라,노은지,이선희,송영미,최정화,백병윤,김미나 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1