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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.
송계용,김숙이,서중석,지제근 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.3
To observe the developing process of human fetal eccrine sweat gland during the intrauterine life, an electron microscopic study was carried out based on 12 fetuses ranging from 20 to 42 weeks of gestation. These fetuses were the products of induced deliveries found to have not associated disease or congenital anomalies at the autopsy. Following observations were made. The various types of cell consisting coiled portion of eccrine sweat gland were recognized at the 20th weed of gestation and they were clear cells, undifferentiated dard cells, myoepithelial cells. clear cells were located in central central portion and dark or myoepithelial cells were in peripheral portion. While undifferentiated dark cells were randomly distributed in the straight portion of eccrine sweat gland. The differential points between clear cell and undifferentiated dark cell were its round nucleus and glycogen contents. Marked hydropic changes of clear cells were noted at the 30th week of gestation. Secretory granules were noted at the 31st week of gestation. Secretory cells in the coiled portion of eccrine sweat gland was not fully mature until the 42nd week of gestation. Clear cells showed clear cytoplasm, abundant free ribosomes and scanty organelles. Undifferentiated dark cells showed many mitochondria and few glycogen. Secretory granules were rarely seen. Myoepithelial cells showed a few mitochondria, glycogen and microfilaments. Among three portions of eccrine gland, duct lumen in the acral and coiled portion were formed through the intracellular canaliculus and in the straight portion were made through the intercellular canaliculus. The main basic morphological mechanism of the lumen formation were microvesicle formation and pinched off phenomenon.
정숙인,천정학,홍종락,고영민,정만표,권오정,이종헌,백경란,송재훈 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2
기관지성 방선균증은 매우 예외적이고 드물며 임상양상이 다양하여 폐암과의 감별이 어렵기도 하지만 기관지내시경 검사를 통해 진단할 수 있고 항생제 투여로 완치될 수 있는 질환이다. 저자들은 기관지석과 함께 발현한 기관지성 방선균증을 장기간의 경구 항생제 요법으로 완치한 1례를 경험하였기에 보고하는 바이다. Endobronchial actmomycosis is considered as an exceptional event. We report a case of a 49-year-old woman who presented with cough and exertional dyspnea for 20 months. Her chest X-ray showed calcified lymph nodes in the right lower paratracheal and subcarinal area and consolidation in the right middle lobe. Bronchoscopic examination demonstrated whitish broncholithiasis with mucosal nodularity in the bronchus intermedius obstructing the lumen near-completely. The biopsy specimen revealed sulfur granules and calcified material which were consistent with actmomycosis. Prolonged oral antibiotic treatment resulted in complete recovery, without need for surgical resection.
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.
김송자,김인숙 조선대학교 1981 The Medical Journal of Chosun University Vol.6 No.-
A total of 217 cases of diabetes mellitus who were admitted to Chosun university during three years and eight months from January, 1977 to August, 1980. The results were summerized as following : 1. Of 217 cases of diabetes mellitus, male and female ratio of the patients was 1.4:1 and the highest incidence of diabetes mellitus was in fifth decade of age in both sex. 2. Common symptoms were polydipsia(42.9%), Polyuria(32.7%), general weakness(30.3%), fatigability(28.6%), and polyphagia(23.0%). 3. Frequent complications were infection(25.3%), retinopathy(14.7%), hypertension(12.9%), neuropathy(8.8%), and liver cirrhosis(8.3%). 4. The fasting blood sugar levels before treatment were developed high in 150-200㎎%(26.8%). 5. Hypercholesterolemia(over200㎎%) was seen in 36.0% of diabetes mellitus. 6. Blood pressure of diabetes mellitus was higher than that of normal persons. 7. The result of therapy had fair control to the treatment with diet and insulin.
유아 비만과 관련된 유아특성과 어머니의 식생활관리 및 양육행동
이송숙,김영희 충북대학교 교육 ·생활연구소 생활과학연구센터 2003 생활과학연구논총 Vol.7 No.1
The purpose of this research was to investigate the personal characteristics and environmental factors related to children's obesity. Subjects of this study were composed of 3∼5-year-old children of 7 kindergartens located in Cheongju and Cheongwon. The weight types of children had been classified into normal, over-weight, and obesity groups under WLI value. Data were analyzed by SPSSWIN with the method of frequency, percentage, t-test, F-test and Duncan post-hoc test. The results of this study were as follows: 1. Weight types of children were related to children's eating behaviors such as surfeit(overeating), gluttony, light eating and eating speed. That is to say, overweight and obesity group children ate more and they were more gluttonous than normal weight group of children. Normal weight group ate little compared with overweight and obesity group. Children of obesity group ate faster than children of normal and overweight group. 2. Children's eating behaviors were associated with their psychological characteristics such as sociality and activity. Children of obesity group were lack of sociality and activity compared with normal weight and overweight group. 3. Mother's control of children's eating habits was found to be related to the recognition of children figure and advice of reducing weight. Mothers considered normal weight children as thin and overweight and also evaluated obesity as normal or fat. Also they frequently urged overweight or obesity group to reduce weight. 4. There were statistically significant differences in mothers' parenting behavior according to the weight types. Normal weight children got more mothers' support parenting behavior than did overweight and obesity children. This research suggest that obesity group of children is not much different from children of overweight group.