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결핵균 약제감수성 검사의 비용효율성에 관한 다기관 연구
정석훈,이대동,최재철,김선주,신정환,정윤성,이은엽,오승환,배길한,장철훈 대한감염학회 2005 감염과 화학요법 Vol.37 No.1
목적 : 우리나라에서의 결핵균 감수성 검사는 검출 균주의 일부에서만 시행되고 있다. 본 연구에서는 모든 검출 균주들에 대해서 감수성검사를 실시하면서, 진료에 필요한 결과를 충분히 제공하고 경제적이면서 현실적인 감수성검사 방안을 제시하고자 한다. 재료 및 방법 : 5개 대학병원에서 일정기간 연속적으로 의뢰된 502균주의 감수성 결과를 분석하였다. 검사결과의 해석 및 2차 약제 감수성검사의 필요성은 NCCLS approved standard M24-A의 권고 기준에 따라 판단하였다. 결과 : 최소한 1가지 이상의 약제에 내성을 보인 경우는 초치료 환자의 10% (38/363), 재치료 환자의 61%(85/139)였으며, 다약제 내성을 보인 경우는 초치료 환자의 3% (11/363), 재치료 환자의 44% (61/139)였다. NCCLS 권고에 따라 2차 약제에 대한 감수성 검사를 시행하지 않아도 되는 경우는 초치료 환자의 96%, 재치료환자의 47%였다. 결론 : 초치료 환자는 95%에서 1차 약제에 대한 검사만으로 충분하므로 필요한 경우에만 2차 약제를 추가로 검사하고 재치료 환자에서는 1, 2차 약제를 동시에 검사할 필요가 있을 것으로 생각한다. Background : The anti-mycobacterial susceptibility test is performed on only a small percentage of clinical isolates in Korea. The aim of this study is to propose an anti-mycobacterial susceptibility testing scheme, which is not only economic and practical but also fully informative to physicians. Materials and Methods : The anti-mycobacterial susceptibility test results of 502 strains, isolated from five university-affiliated hospitals, were analysed. The interpretation of the results and the need for second-line drug susceptibility test were judged according to the recommendation of NCCLS M24-A guidelines. Results : The isolates from 10% (38/363) of treatment-navie patients and 61% (85/139) of retreatment patients showed resistance to at least one of the anti-mycobactial agents; 3% (11/363) and 44% (61/139) of isolates from each group were multi-drug resistant. According to the recommendation by NCCLS, the percentage of patients not needing the susceptibility test results for second-line drugs were 96% for treatment-naive and 47% for re-treatment patients. Conclusion : Since the susceptibility test against first-line drug is sufficient for 95% of treatment-navie patients with tuberculosis patients, susceptibility test against second-line drugs may be performed only when it is necessary. As for the re-treatment patients with tuberculosis, susceptibility test for both first-line and second-line drugs should be performed simultaneously.
大學卒業定員制의 實施에 따른 學生生活 指導方案에 關한 硏究
崔根爀,張忠根,李相祐,張鎭吉,張大熙 충남대학교 1982 學生生活硏究 Vol.10 No.1
Higher education in Korea is faced with a new situation since 1981 when the government implemented a college graduation quota system designed to broaden the opportunities for higher education, alleviate the problem of the students who fail the entrance examination, and improve the quality of college graduates. The change of the system has brought about several serious problems including how to supply enough faculty members, how to provide enough educational facilities, and how to cope with the huge increase in the number of students, 30% more than graduation quota. The greatest single problem resulting from the implementation of college graduation quota system is the psychological and emotional unease aroused among the students, because 30% of those students with unsatisfying results must be banished from college before their graduation. This study aims to find effective measures for student guidance that each of the colleges can implement to help students adjust to the changed circumstances. After objectively investigating the problems from the various educational environments, from the recent students' views of college, and from the psychological and emotional unease arising in them by the fear of failing to graduate from their college because of implementation of the graduation quota system, a survey was conducted by means of a questionnaire composed of 40 questions and by means of personal interviews, 5,903 students, who are influenced by the graduation quota system, attending 19 public and private universities and colleges selected throughout the country. The data obtained from this survey were statistically processed with the help of the C. N. U. Computer Center, and the ratios of the responses to each of the questions were analyzed and calculated according to the distinctions of the total, sex, region, and major. The conclusions that the interrelations among the variant factors from each of the questions which were surveyed, analyzed and arranged have suggested are as follows : 1. The original purpose of graduation quota system should continually be clarified and communicated to all students and a concrete, specialized guidance system should be established to guide the minority of the students (13%) who don't fully understand the basic properties of higher educational institutions. 2. The institutions should provide enough educational facilities and supply enough faculty memebers to solve the problem of accomodating the large numbers of students. At the same time, they should suggest how students should learn positively and effectively to gain an expert knowledge, and how professors should gain public confidence in grade evaluation. Accompanying those measures, the government should develop a good policy to expand and distribute job opportunities to college graduates. 3. The admission quota should be controlled depending on the rate of naturally failed students, and then the students' unease and suppression caused by excessive competition can be relieved. In addition, it is advisable that the banished students should be allowed to transfer to University of the Air without regard to their grades. 4. An education devised to let students have a sound sense and way of thinking should be accompanied by a guidance system which their seniors, parents and society take part in. 5. An atmosphere conducive to sweet and well-rounded friendship among classmates should be created, sound extra-curricular activities should be encouraged and the number of students and adviser professor is in charge of should be lessened to a reasonable number.
Kang Dae-Gill,Sohn Eun-Jin,Choi Deok-Ho,Lee Seung-Ju,Lee Ho-Sub The Physiological Society of Korean Medicine and T 2006 동의생리병리학회지 Vol.20 No.1
A pharmacological inhibition of nitric oxide synthase (NOS) in rats produces vasoconstriction, renal dysfunction, and hypertension. The present study was aimed at investigating whether the methanol extract of Serous commixta cortex (MSC) ameliorates $N^G$-nitro-L-arginine methylester (L-NAME) induced hypertension in rats. Treatment of rats with L-NAME (10 mg/kg/day in drinking water, 5 weeks) caused a sustained increase in systolic blood pressure (SBP). Administration of MSC (100 or 200 mg/kg/day, p.o) significantly lowered the SBP in the L-NAME-treated rats and this effect was maintained throughout the whole experimental period. Moreover, ecNOS expression in aorta and kidney tissue from L-NAME treated rats was significantly restored dy administration of MSC. Furthermore, the impairment of acetylcholine (ACh)-induced relaxation of aortic rings in the L-NAME treated rats was reversed dy administering of MSC. The renal functional parameters including urinary volume, sodium excretion, and creatinine clearance (Ccr) were also restored by administering MSC. Taken together, the present study suggeststhat MSC prevents the increase in SBP in rats with L-NAME-induced hypertension, which may result from the up-regulation of the vascular and renal ecNOS/No system.
Vascular Relaxation by the Methanol Extract of <i>Sorbus</i> Cortex <i>via</i> NO-cGMP Pathway
Kang, Dae Gill,Lee, Jun Kyoung,Choi, Deok Ho,Sohn, Eun Jin,Moon, Mi Kyoung,Lee, Ho Sub Pharmaceutical Society of Japan 2005 BIOLOGICAL & PHARMACEUTICAL BULLETIN Vol.28 No.5
<P>The methanol extract of <I>Sorbus commixta</I> cortex (MSC) induced relaxation of the phenylephrine-precontracted aorta in a dose-dependent manner, which was disappeared by removal of functional endothelium. Pretreatment of the aortic tissues with <I>N</I><SUP>G</SUP>-nitro-<SMALL>L</SMALL>-arginine methyl ester (<SMALL>L</SMALL>-NAME), methylene blue, or 1<I>H</I>-[1,2,4]-oxadiazole-[4,3-α]-quinoxalin-1-one (ODQ) inhibited the vascular relaxation induced by MSC. MSC-induced vascular relaxations were also markedly attenuated by addition of verapamil or diltiazem, while the relaxant effect of MSC was not blocked by pretreatment with indomethacine, glibenclamide, tetraethylammonium (TEA), atropine, or propranolol, respectively. Incubation of endothelium-intact carotid arteries or of human umbilical vein endothelial cells (HUVECs) with MSC increased the production of guanosine 3′,5′-cyclic monophosphate (cGMP). Moreover, MSC-induced cGMP production was effect was blocked by pretreatment with <SMALL>L</SMALL>-NAME or ODQ. These results suggest that MSC dilates vascular smooth muscle <I>via</I> endothelium-dependent nitric oxide-cGMP signaling pathway, possible involvement of L-type Ca<SUP>2+</SUP> channel.</P>
Kang, Dae Gill,Moon, Mi Kyoung,Choi, Deok Ho,Lee, Jun Kyoung,Kwon, Tae Oh,Lee, Ho Sub Elsevier 2005 european journal of pharmacology Vol.524 No.1
<P><B>Abstract</B></P><P>Vasorelaxant and anti-inflammatory effects of a 1,2,3,4,6-penta-<I>O</I>-galloyl-β-<SMALL>D</SMALL>-glucose (PGG) isolated from the root barks of <I>Paeonia suffruticosa</I> and possible mechanisms responsible were investigated. PGG induced a concentration-dependent relaxation of the phenylephrine-precontracted rat aorta. This effect disappeared with the removal of functional endothelium. Pretreatment of the aortic tissues with either <I>N</I><SUP>G</SUP>-nitro-<SMALL>L</SMALL>-arginine methyl ester (<SMALL>L</SMALL>-NAME) or 1H-[1,2,4]-oxadiazole-[4,3-α]-quinoxalin-1-one (ODQ) inhibited the relaxation induced by PGG. Incubation of human umbilical vein endothelial cells (HUVECs) or carotid arteries isolated from rats with PGG increased the production of cGMP in a dose-dependent manner, but this effect was blocked by pretreatment with <SMALL>L</SMALL>-NAME and ODQ, respectively. PGG treatment attenuated tumor necrosis factor-α (TNF-α)-induced nuclear factor-kappaB (NF-κB) p65 translocation in human umbilical vein endothelial cells. In addition, PGG suppressed the expression levels of adhesion molecules including intracellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) induced by TNF-α. TNF-α-induced monocyte chemoattractant protein-1 (MCP-1) expression was also attenuated by addition of PGG. PGG treatment inhibited cellular adhesion of U937 cells onto human umbilical vein endothelial cells induced by TNF-α. Taken together, the present study suggests that PGG dilates vascular smooth muscle and suppresses the vascular inflammatory process via endothelium-dependent nitric oxide (NO)/cGMP signaling.</P>