Astromicin sulfate의 약동학 및 안전성 평가

정숙인,김연숙,오원섭,복혜숙,김명민,최경업,김연화,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3

목적 : Astromicin은 aminoglycoside계 항생제와 유사한 화학구조와 특성을 지니고, 기존의 aminoglycoside와 유사하거나 향상된 임상효과 및 부작용을 지닌 것으로 알려져 있다. 저자들은 astromicin의 약동학적 특성을 분석하고, astromicin 투여 환자를 대상으로 한국인에서 그 임상적 및 세균학적 효과와 안전성을 평가하고자 하였다. 대상 및 방법 : 약동학적 지표는 정상성인 남자를 대상으로 astromicin 200㎎을 30분간 정주한 후 24시간까지 혈장 및 뇨 검체를 수집하여 one-compartment open model에 따라 분석하였다. 중증으 세균감염이 있는 18세 이상의 환자를 대상으로 병용 또는 단독 투여한 후 임상적 효과와 세균학적 효과를 판정하였고, 치료전과 후의 순음청력검사와 혈청 크레아티닌으로 이독성과 신독성을 평가하였다. 결과 : 정상 성인 남자 12명을 대상으로 약동학적 지표를 평가하였고, 최고혈장농도는 투여 종료시점(C_(0))에서 16.87±1.68㎍/mL였으며, 반감기는 1.86±0.43 시간 이었고, AUC_(0-12h)은 38.12±10.57㎍ㆍhr/mL, Vd는 0.18±0.02L/㎏, CL은 5.25±2.07L/hr였다. 이러한 약동학적 지표는 다른 aminoglycoside와 유사한 결과를 보였다. 59명의 환자를 대상으로 시행한 임상적 효과 분석에서는 단독요법을 시행한 50명 중 임상적 치유율 94%, 세균학적 치유율 100%를 보였고, 순음청력검사를 시행한 48례의 환자중 의미있는 청력감소 소견은 관찰되지 않았으며, 신독성 또한 전혀 나타나지 않았다. 결론 : Astromicin의 약동학적 지표는 다른 aminoglycoside의 약동학적 지표와 비슷한 양상을 보이므로 향후 astromicin의 약물농도 감시에 있어서 다른 aminoglycoside의 치료적 약물 농도 감시 방법과 유사한 방법을 적용할 수 있으리라 기대된다. 또한 임상적 치유율이 우수하면서 신독성이나 이독성이 적어 세균 감염 환자의 치료에 있어서 단독 또는 병합 요법으로 비교적 안전하게 사용할 수 있으리라 생각된다. Astromicin(Fortimicin®) has some characteristics in common with other aminioglycoside antibiotics, although it has a unique chemical structure, which is different from them. This study was performed to elucidate the pharmacokinetic (PK) parameters of astromicin following single-dose intravenous infusion of 200 mg and to evaluate clinical efficacy and safety of astromicin in Korean populations. PK parameters of astromicin were determined in 12 healthy volunteers (65.5±5.2㎏). The plasma and urine samples were collected up to 24hrs. PK variables were calculated by fitting individual concentration-time curves to a one-compartment open model. Plasma level at the end of infusion was 16.87?1.68 ㎍/mL and declined to 1.05±0.35 (㎍/mL 8hr later. The half-life was 1.86±0.43 hr. Apparent volume of distribution was 0.18±0.02 L/㎏g, and total body clearance was 5.25±2.07 L/hr. These values were similar to those of other aminioglycosides. Clinical efficacy and safety were eviuated in 59 patients with moderate to severe bacterial infections who needed parenteral antibiotics. Among 50 patients who recieved astromicin monotherapy, 49 (98%) had favorable clinical reponse and 28 (100%) had favorable bacteriological response. Serial audiograms revealed no change in all of 48 patients. No nephrotoxicity was observed in all patients. Conclusively, our data suggest that therapeutic drug monitoring of astromicin can be conducted in a similar fashion as other aminioglycosides and astromicin is a useful and safe antibiotic in the treatment of severe bacterial infections.

암환자가 지각한 사회적지지, 희망과 삶의 질과의 관계

태영숙,강은실,이명화,박금자 고신대학교 전인간호과학연구소 2002 전인간호과학연구 학술모음집 Vol.- No.-

The Relationship among Percieved Social Support, Hope and Quality of Life of Cancer Patients Tae, Young Sook. Kong, Eun Sil. Lee, Myung Hwa. Park, Geum Ja The purpose of this study was to investigate the relationship among percieved social support, hope and Quality of life of the cancer patients and to gain the baseline data for development of nursing intervention program for promoting quality of life in cancer patients. The design of this study was a cross sectional correlational survey. The subjects were 220 out and in-cancer patients in 5 general hospitals in Pusan The data were collected from July 2 to August 1,2001. The instruments were the Percieved social support scale(16 items, 5 point scale) had developed by Tae(1986), Hope scale(12 items, 4point scale) developed by Nowotny(1989) and Quality of life scale(31 items, 10 point scale) developed by Tae et. al(2000). The data was analyzed by the SPSS/PC+ program using frequency & percentage, item mean & standard deviation, t-test, ANOVA & Scheffe test, Pearson's correlation coefficient. The results of this study was as follows : 1) The item mean score of quality of life was 6.05±1.16 (range 0-10) .The heighest score of subarea of the quality of life was the spiritual wellbeing area (7.09±1.63) and the lowest score was social wellbeing area(5.53±1.65). The mean score of perceived social support was 52.65±10.32 (최고 1, 최저 80). The mean score of family support was32.71±6.66 (range 1- 40) and the mean score of medical team support was 19.93±5.95 (range 1- 40). The mean score of Hope was 37.02±5.64 (range 1-48). 2) There were statistically significant difference in the score of quality of life according to the life effect of religion (F=3.97, p=0.00), treatment method(F=2.94, p=0.01), area of diagnosis (F=3.48, p=0.01), stage of disease (F=13.74, p= 0.00). 3) There was significant correlation between perceived social support(r=0.44, p= 0.000 ; family support: r=0.334, p=0.000, medical support; r=0.395, p=0.000), hope(r=0.563, p= 0.000) and quality of life. In conclusion, there was a significant relationship among perceived social support, hope and quality of life. Therefore perceived social support, hope intervention programs should be developed to improve the quality of life in cancer patients.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

젊은 남자에게 발생한 통상성 간질성 폐렴과 동반된 폐암 1예

박종숙,이준혁,박성우,장안수,박춘식,박재성,백상현,고은석,신화균 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Usual interstitial pneumonia(UIP) is relatively rare disease of lung parenchyme under the age of 50. Lung cancer is reported to occur as a complication of UIP, but has not been reported in young age patient with UIP in Korea. A 35-year-old man was admitted to the hospital because of dyspnea, cough and mild fever. He had been suffered from dyspnea during 3 years. The dyspnea worsened recent 1 month ago. He had been treated with pneumonia at another hospital during 4 months before this admission. Chest radiographs and High resolution CT showed subpleural and basal dominant reticular opacities in both lung with no change until now. He was smoker and his occupation was car engine-man dealing with benzene. UIP is suspected by history and radiologic findings. Operation for open lung biopsy was performed to obtain lung specimen via video-assisted thoracoscopic surgery. Patient's pathologic examination showed UIP combined with adenocarcinoma in RLL superior segment and posterobasal segment and RLL lobectomy was done. After operation, the patient has been in cancer free condition so far. We report a case of UIP combined with lung cancer in young man with brief review of the literature.

오존이 옥수수 잎의 光系Ⅱ 活性과 葉綠體의 微細構造에 미치는 影響

鄭華淑 慶北大學校 師範大學 1988 敎育硏究誌 Vol.30 No.-

To clarify the effects of ozone on photosynthesis and ultrastructure of chloroplasts, the changes of chlorophyll a, b and carotenoid content, soluble protein content, CP-complex, PS Ⅱ activity and ultrastructure of chloroplasts of corn (Zea mays L.) leaves induced by ozone treatment was investigated. Corn leaves were treated with ozone at 0.05ppm and 0.5ppm concentration in dark and light. The leaves of corn plants were illuminated at 20,000 lux and placed in darkness at growth chamber equipped with ozonizer. Under the light condition, pigments and protein contents and the rate of DCIP photoreduction were gradually reduced with the increase of ozone concentration and treatment time, but reduced much less in darkness than in light at the same treatment time. The injury of ozone was more accelerated in light than in darkness. With treatment of 0.5ppm ozone for 8 hours in light, pigments content were reduced by 21% in chlorophyll a, 32% in chlorophyll b, 11% in carotenoid and protein content was also reduced by 54% for 6 hours in light. When CP-complexs and thylakoid polypeptide were separated by SDS-PAGE, CPI band was disappeared, LHCP and thylakoid polypeptide bands were changed with 0.5ppm 24 hours in light. The rate of DCIP photoreduction was inhibited by 82% for 5 hours in light. With treatment of 0.5ppm ozone for 6 hours in light, the first indication of ozone injury was swelling of the thylakoids in the chloroplasts of mesophyll cell in the corn leaves. Later the entire chloroplasts were deformed and chloroplast envelopes were disrupted.

로터리킬른 반응로를 이용한 폐슬러지 활성탄의 제조와 세공구조 및 흡착특성

강화영,박상숙 順天大學校 1999 論文集 Vol.18 No.1

We have tried to wasted biological sludge as a starting material to produce a low-cost adsorbent alternative for activated carbon and for reuse of wasted materials. The carbonated sludge was chemically activated with phosphoric acid. To find out the optimum conditions for activated carbon, chemical activation was used with varying: carbonization time, activation agent, activation temperature and activation time. The activated products were characterized by measuring iodine adsorptivity, methylene blue adsorptivity, specific surface areas, yield, pore structure and SEM photograph. The products activated by phosphoric acid in a rotary kiln reactor operated around 700℃ had iodine adsorptivity, methylene blue adsorptivity, and specific surface area of 312.4mg/g, 32.2 mg/g, and 96.6㎡/g with yields of 84.1wt%, respectively.

국내 5개 3차 병원의 β-lactam계 항생제 사용 실태 및 Klebsiella pneumoniae의 항생제 내성과의 상관 관계

정숙인,박경화,권기태,고관수,오원섭,정두련,백경란,염준섭,장현하,김신우,손준성,송재훈 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

Background : This study was performed to evaluate the prescribing pattern of β-lactam antibiotics and the relationship between antimicrobial resistance and antimicrobial use in 5 tertiary care hospitals in Korea. Materials and Methods : Data on annual patient-days and annual consumption (defined daily dose (DDD) per 100 patient-days) of β-lactam antibiotics from 2003 to 2005 in 5 tertiary hospitals were analyzed. To determine the antimicrobial resistance in K. pneumoniae, broth microdilution test and double disk synergy were performed according to the CLSI performance standards. Spearman's correlation coeffient was used to determine the relationship between antibiotic consumption and resistance. Results : The prescription of β-lactam antibiotics in 5 tertiary hospitals markedly varied. In two hospitals, increase in consumption of β-lactam antibiotics was more than 30% during recent 3 years. The higher consumption of β-lactam antibiotics significantly correlated with the higher rate of antibiotic-resistant K. pneumoniae in 5 tertiary care hospitals. Conclusion : Continuous surveillance of antibiotic use is needed to encourage appropriate prescribing of antibiotics and to reduce antibiotic resistance. 목적 : 항생제의 오남용으로 인한 내성균의 발현 및 급속한 확산이 전세계적으로 문제시 되고 있다. 특히 병원은 항생제 내성의 중심점에 있는 것으로 여겨진다. 본 연구에서는 최근 3년간 국내 5개 3차 병원의 β-lactam계 항생제의 사용량을 조사하고, 각 병원별 항생제 사용량과 K. pneumoniae의 항생제 내성률과의 상관관계를 알아보고자 하였다. 재료 및 방법 : 국내 5개 3차 병원에서 2003년 1월부터 2005년 12월까지 병원 입원 환자를 대상으로 연도별 재원연인원수와 각 β-lactam계 항생제의 총사용량을 수집하여 DDD (defined daily dose) per 100 patient-days로 환산하여 비교하였다. 2005년 6월부터 8월까지 각 병원의 임상검체에서 동정된 K. pneumoniae를 수집하여 액체배지미량희석법으로 항생제 감수성 검사를 시행하였고 ESBL(extended-spectrum β-lactamase) 생성 여부는 double disk synergy test를 시행하였다. 항생제 사용량과 내성의 상관관계는 Spearman 상관관계 분석을 시행하였다. 결과 : 5개 병원 중 3개 병원에서는 연도별 β-lactam계 항생제 사용량이 비슷하게 유지되었으나, 2개 병원에서는 2003년에 비해 2005년에 항생제 사용량이 30% 이상 증가하였다. β-lactam계 항생제 중 제제별 비율은 각 병원마다 차이가 있었으나, 3세대 cephaosporin의 사용이 가장 많았고 2세대 ceaphlosporin, β-lactam/β-lactamase inhibitor, 1세대 cephalosporin 순이었다. 경구용 β-1actam계 항생제의 사용량(r=0.900, P<0.037)과 2세대 cephalosporin의 사용량(r=0.900, P<0.037)은 각각 K. pneumoniae의 ESBL 생성과 양의 상관관계가 있었다. Ceftazidime의 사용량은 K. pneumoniae의 ceftazidime 내성률과 양의 상관관계가 있었다(r=0.900, P<0.037). 반면 imipenem의 사용량은 piperacillin/tazobactam 내성과 음의 상관관계가 있었다(r=-0.900, P<0.037). 결론 : 최근 3개년간 항생제 사용량은 병원별로 차이가 있으나 일부 병원에서는 증가하였다. β-lactam계 항생제의 사용량은 K. pneumoniae의 항생제 내성과 상관관계가 있었다. 항생제 사용을 줄임으로써 항생제 내성을 감소시킬 수 있을 것으로 기대되며, 병원별로 항생제 사용에 대한 지속적인 감시가 필요할 것이다.

정규직과 비정규직 노동자의 기업복지 차이 연구 : 한국노동패널(KLIPS) 6차 자료를 중심으로

배화숙 한국사회복지정책학회 2005 사회복지정책 Vol.21 No.-

본 연구는 급증하고 있는 비정규직 노동자에 대안 기업복지 제공 현황을 정규직노동자와 비교함으로써 비정규직의 상대적 취약성을 검토하고, 분석결과를 통해 기업복지에서 비정규직 노동자의 소외와 차별을 완화시키기 위안 대안을 제시하였다. 이를 위해 2003년 한국노동패널 6차 자료에서 임금 근로자 4053명을 대상으로 분석하였다 분석결과 비정규직 노동자는 정규직 노동자에 비해 소규모 기업에 더 많이 고용되어 있으며, 여성 노동자의 비율이 높고, 연령층도 높은 편이었다. 기업복지 급여 제공의 대부분 항목에서 정규직과 비정규직 노동자 간에는 유의미한 차이를 보이고 있었다. 급여를 실제로 받을 수 있는가에 대해서도 식사비 보조와 같은 가장 기본적 급여를 제외한 나머지 문항에서는 정규직 노동자와 비정규직 노동자간 유의미한 차이를 보여주었다. 그리고 비정규직 노동자 내에서 집단을 구분하여 차이를 비교한 결과 남성 비정규직 노동자와 여성 비정규직 노동자간에는 식사비용 보조항목 외에는 유의미안 차이가 나타나지 않았다. 시간제 비정규 노동자와 그렇지 않은 비정규 노동자간에는 식사비용 보조, 학비보조, 경조사 지원 등에서 유의미안 차이가 나타났다. 반면, 직접 고용과 간접 고용 간에는 전체 항목에서 유의미안 차이가 나타나지 않았다. 이상의 분석결과를 바탕으로 비정규직 노동자의 기업복지와 관련한 문제해결을 위해서는 정규직 노동자와 비교하여 불평등한 급여를 최소좌하여 복지의 차이를 줄여가는 정책들이 제시되어야 하고, 다양한 기업복지 프로그램 개발 및 사내근로 복지 기금과 같은 자원이 형평성 있게 분배될 수 있도록 해야 하며, 아울러 공공 산업복지의 확대를 통해 근로기간 동안의 복지에 대안 소외가 퇴직 후 혹은 노후에 연결되지 않도록 정책적 노력이 필요하다. Non-standard workers have sharply increased because of Structural change of Labor market. However, the existing non-obligatory welfare services have limited to protect contingent workers. The purpose of this paper are to examine the distinction of non-obligatory welfare services between standard and non-standard workers. This study used the individual data of KLIPS(6th) collected in 2003. From data analysis, this study found the non-standard workers' employment conditions have serious problems and were discriminated against the standard workers in being supported not only the public welfare program but also the non-obligatory welfare service. Therefore, this study emphasizes to develop the various non-obligatory welfare programs and to compel the redistribution program for prevention of welfare discrimination and including the contingent workers in society.

시금치(Spinacia oleracea L.)엽록체의 광합성 전자전달 활성에 미치는 linolenic acid의 영향

鄭華淑,鄭培善 慶北大學校 師範大學 1990 敎育硏究誌 Vol.32 No.-

The effect of unsaturated fatty acids on photosynthetic electron transport reaction in isolated choroplasts is investigated to clarify the changes of PS Ⅱ and PS Ⅰ electron transport rates, Chl. a fluorescence intensity, and photosynthetic oxygen evolution. In photosystem Ⅰ, an increase in the electron transport rates occurs in the presence of 10 to 80 μM linolenic acid, followed by a decline in rate from 100 to 300 μM linolenic acid. In photosystem Ⅱ, a decrease in the electron transport rates occurs in the presence of 10 to 20 μM linolenic acid. The efficiency of C_18 unsaturated fatty acids/linolenic (C_(18:3)). linoleic(C_(18:2)) oleic(C_(18:1)) on PS Ⅱ and PS Ⅰ electron transport rates is established in order C_(18:3)>C_(18:2)>C_(18:1) At a low concentration(10-80 μM) of linolenic acid a decrease in Chl. a fluorescence yield was due mostly to the inhibition on the donor side of PS Ⅱ. At a high concentration (100-300 μM), an increase in Chl. a fluorescence yield was due additionally to the inhibition on the acceptor side of PS Ⅱ.

學校事故와 損害賠償責任

韓恩淑,延和駿 청주대학교 교육문제연구소 1998 교육과학연구 Vol.12 No.-