玄蔘의 Saponin 成分 檢索 : on the Saponin of the Radix

남인숙,배병숙,최보향,최인수,최태수,김동언,김언주,정미영,조규옥 曉星女子大學校 藥學大學 學生會 1988 曉星藥誌 Vol.4 No.-

Crude saponin(100g) were obtained by extracting the radix(5kg) of Scrophalariae koraiensis Nakai. Crude saponin were positive in the Liebermann-Burchard test. We observed 5 sports by TLC using BuOH saturated with H_2O : ethyl acetate : water(4:1:5, upper phase) as solvent and 1% Ce(SO_4)_2 in 10% H_2SO_4 as a color former. We divided into 3 fractions by common column chromatography using BuOH saturated with H_2O : ethylacetate : water(4:1:5, upper phase) as solvent.

제 2급 와동에서 구치부 복합레진의 미세변연누출에 관한 연구

최수진,김미자,권혁춘 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.3

The use of flowable composite resins as liners in class Ⅱ packable composite restoration has been suggested by some manufactures. However, the contributions of this technique are unproven. The purpose of this study was to compare the gingival microleakage in class Ⅱ packable composite restorations with or without the use of flowable composite resins as liners. Slot cavities were prepared on both proximals of 80 extracted human molars and randomly assigned to 8 groups of 20 each. The gingival margins were located at 1mm above CEJ in 80 cavities (group1-4) and 1mm below CEJ in 80 cavities (group5-8). The prepared teeth were mounted in the customized tray with adjacent teeth to simulate clinical conditions and metallic matrix band (Sectional matrix) and wooden wedges were applied. After acid etching and application of Single Bond, each group was restored with the following materials using incremental placement technique: Group 1,5 (Filtek P60), group 2, 3, 4 and group 6, 7, 8 (AeliteFlo, TetricFlow, Revolution/Filtek P60). All specimens were thermocycled 500 times between 5℃ and 55℃ with 1 mimute dwell time, immersed 2% methylene blue dye for 24 hours and then rinsed with tab water. The specimens were embedded in clear resin and sectioned longitudinally through the center of restoration with a low speed diamond saw. Dye penetration at gingival margin was viewed at 20 margnification and analyzed on a scale of 0 to 4. Kruscal-Wallis One way analysis and Mann-Whitney Rank sum test were used to analyze the results. The results of this study were as follows. 1. The leakage values seen at the enamel margin were significantly lower than those seen at the dentin margin(P<0.05). 2. On the enamel margin, packable composite resins with flowable liners showed lower leakage than those without flowable liners, but there were no significant differences among the four groups(P>0.05). 3. On the dentin margin, four groups demonstrated moderate to severe leakage, and there were no significant differences in leakage values(P>0.05).

복합레진 적층계면에서 oxygen inhibition의 영향에 관한 연구

최수미,박재홍,최성철,김광철,최영철 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.3

The purpose of this study was to assess the effect on oxygen inhibition layer(OIL) for the interfacial bonding between resin composite layers, including shear bond strength, fracture modes and degree of conversion. The first layer of specimen was filled with Z-250(shade A3) and was cured for 40s. The second layer of specimen was filled with same composite(shade A1) and was cured for 40s. The first layer of specimens for each group were prepared by methods as followings. Control(curing in atmospheric air), Group1(curing against Mylar strip), Group2(scrubbed with a acetonesoaked cotton), Group3(using Tescera light cup), Group4(using Tescera heat cup), Group5(stored in disti1led water for 30days at 37℃), Group6 (using bonding agent). The results were as follows: 1. There was no statistically significant different shear bond strength between control and group 1(p>0.05). 2. Group 2 showed significantly lower shear bond strength than control and group 1(p<0.05). 3. The observation of the fracture surface leads to the evidence that a major difference occurs in the case of control, group1 and group 3 samples which break mainly cohesively while the other groups break in majority adhesively. 4. The results of FTIR showed that the degree of conversion was the highest in group 2 and the lowest in control group(p<0.05). It can be concluded that an OIL is not necessary for bonding with composite resin. But if a reduced critical amount of the unreacted monomer is present, it was detrimental to bonding additional layers of composite. Further study, such as the quantitative analysis of the unreacted monomer are required. 복합레진의 적층계면에서 산소억제층(oxygen inhibition layer:이하 OIL)의 영향을 연구하기 위해, 아크릴릭 몰드(하층)에 복합레진의 shade A3를 충전한 후 표면의 조건을 달리하여 중합하였으며 상층은 shade A1으로 충전하고 중합하였다. 대조군(OIL 존재), 1군(OIL 형성억제), 2군(OIL 형성억제+레진표면의 미반응 모노머 제거), 3군(가압하에 중합), 4군(열중합), 5군(시효처리), 6군(시효처리+본딩제 도포)로 하층의 계면조건을 다르게 하였다. 전단결합강도와 파절양상, 전환률을 분석하여 다음의 결과를 얻었다. 1. 전단결합강도 측정 결과 대조군과 제 1군 사이에 통계학적으로 유의한 차이가 없었다(p>0.05). 2. 제 2군은 대조군과 1군에 비해 낮은 결합강도를 보였다(p<0.05). 3. 제 3군은 가장 높은 결합강도를 보인 반면, 4군은 가장 낮은 결합강도를 보였다. 4. 6군은 5군보다 두 배 정도 높은 결합강도를 보였다. 5. 대조군과 1군 및 3군에서는 주로 응집성 복합레진파절이 일어난 반면 2군, 4군, 5군과 6군에서는 주로 접착성 계면파절이 일어났다. 6. FTIR로 전환률을 측정한 결과 2군에서는 50.55%로 가장 높았고, 대조군에서는 가장 낮았다(p<0.05). 전단결합강도와 전환률의 결과로 보아, OIL은 복합레진 계면의 결합에 필수적인 요인은 아니며, 표층의 미반응 모노머가 결합강도에 영향을 미치는 것으로 보인다. 향후 계면 결합강도에 영향을 미칠 수 있는 미반응 모노머의 정량적인 분석을 통한 추가적인 연구가 필요할 것으로 생각된다.

소아에서 수술과 마취가 혈당치 및 심혈관계에 미치는 영향

최세진,김철호,안미정,김상수 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

The author observed pulse rate, blood pressure and blood glucose change in vari ous conditions of enflurane-nitrous oxide-Oxygen general anesthesia i. e. before anesthesia, after intubation and operation in 25 anesthetic cases of children aging from 4 years old to 10 years old at department of anesthesia of C. N. U. H. The following results were obtained. 1. It revealed increased pulse rate after intubation and operation than before anesthesia.. 2. It revealed increased blood pressure after intubation than before anesthesia. 3. It didn't reveal significantly increased blood glucose after intubation and operation than before anesthesia

국내 혈액질환 환자에서 침습성 진균 감염의 구제치료로서 Caspofungin의 효과와 안전성

최수미,박선희,이동건,최정현,유진홍,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.5

목적 : 본 연구에서는 국내 혈액질환 환자들에서 일차 항진균제를 부작용으로 인해 투여할 수 없거나, 일차 항진균제에 반응이 없는 침습성 진균 감염증의 구제치료로서 caspofungin의 효과와 이상반응에 대한 임상 경험을 소개하고, 예후인자를 분석해 보았다. 재료 및 방법 : Caspofungin은 첫날 70 mg, 이틀째 부터 50 mg을 하루 일회 투여하였고, caspofungin 종료시 그리고 종료 4주 후 반응을 평가하였다. 결과 : 총 55명의 환자가 분석에 포함되었고, 남자 32명, 여자 23명, 평균 나이는 38.2세(16-65세)였다. 기저 질환은 급성 백혈병 33명, 골수이형성 증후군 12명, 만성 백혈병 3명, 기타 7명이었다. 진균 감염은 확진 1명, 가능 5명, 추정 47명, 불확실 2명이었고, 감염 장소는 폐를 침범한 경우가 49명, 파종감염 6명이었다. 전체적으로 41.8% 환자에서 양호한 반응을 보였으며, 치료군, 치료후 기저질환의 상태, 침습성 진균 감염 진단시 호중구 감소증 여부, 스테로이드 등 면역억제제 사용 여부가 유의한 예후인자였다. 약제관련 이상반응은 14.5%에서 관찰되었고, 발열, 피부 발진, 간기능 저하 등으로 나타났다. 이중 4명에서 이상반응과 관련하여 투약을 중지하였고, 약제 중단 후 증상은 모두 호전되었다. Caspofungin 관련 신독성은 관찰되지 않았다. 결론 : Caspofungin은 국내 혈액질환 환자에서 침습성 진균 감염증의 구제치료에 효과적으로 안전하게 사용될 수 있겠다. 최근 여러 항진균제들이 개발되어 임상에 도입되고 있는 바, 항진균 작용 범위, 독성, 약역동학적 특성, 비용-효과면 등을 고려하여 환자별로 직절한 항진균제를 선택하도록 해야 할 것이다. Background : Invasive fungal infection (IFI) is an important cause of morbidity and mortality in patients with hematologic malignancy. Patients with IFI who fail to standard therapy have poor prognoses. We investigated the efficacy and safety of caspofungin (CAS) in Korean adults with hematologic diseases and IFI who did not respond to the conventional antifungal therapy. Materials and Methods : Patients with IFI refractory or intolerant to standard antifungal therapy received CAS 50 mg IV daily after 70 mg loading dose on day 1. Efficacy and safety of CAS were assessed in patients who received more than one dose. Favorable response [complete (CR) or partial (PR)] was defined as significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results : From Feb. 2004 to Feb. 2005, 55 patients who met the inclusion criteria were enrolled. There were 32 male and 23 female patients with mean age of 38.2 years (range, 16-65). Underlying diseases were acute leukemia (33 cases), myelodysplastic syndrome (12 cases), chronic myelogenous leukemia (3 cases), and other hematologic diseases (7 cases). Thirty-six patients were receiving chemotherapy and 13 patients were under hematopoietic stem cell transplantation (HSCT). The number of proven, probable, possible, and indeterminate IFI cases was 1, 5, 47, and 2, respectively. Conventional amphotericin B, intravenous itraconazole, and liposomal amphotericin B were administered for average of 14.9 days prior to administering CAS. Mean duration of CAS therapy was 12.8 days (range, 1-45). Twenty-three patients (41.8%) showed favorable responses (CR : PR=8 : 15) at the end of CAS therapy. Chemotherapy group, neutropenic state, remitted state of underlying disease, and no steroid therapy were significant prognostic factors for favorable response. Eight (14.5%) patients developed drug-related adverse events such as fever, skin eruption, and hepatic dysfunction which were reversible after discontinuation of CAS. Drug-related nephrotoxicity was not observed. Conclusion : On the basis of our investigation, CAS was effective and safe as a salvage therapy of refractory IFI or as an alternative for patients intolerant to standard antifungal agents.

일개 대학병원 직원에서 인플루엔자 백신접종 후 이상반응

최새로운,김수미,이진수,김은실,정문현 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

Influenza vaccination on health care workers in a university hospital was conducted using inactivated split vaccines from two pharmaceutical companies (A, B), December 2003. Among 1,880 health care workers, 1,404 (74.7%) were vaccinated and 714 (50.8%) responded to the questionnaires about adverse reactions. Pain and redness at the injection site, febrile sensation, and restricted occupational activities were reported by 316 (44.3%), 141 (19.7%), 169 (23.6%), and 62 (8.7%) participants, respectively. There was no serious adverse events. The incidence of adverse reactions was similar to the previous reports. No statistical difference was detected according to the vaccines company.

산부식 시간에 따른 유전치 법랑질의 부식 유형에 관한 연구

최수미,최영철,박재홍,최성철 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.3

이 연구의 목적은 유전치 법랑질에서 무소주 법랑질 층이 있는 치경부에서의 적절한 산부식 시간을 알아보고자 함이다. 경희대학교 치과대학병원 소아치과에 내원한 환아에게서 발거한 치아 순면에 우식이 없는 건전한 치아 32개를 대상으로 실험 하였다. 발거된 유전치의 치경부 법랑질을 35% 인산으로 실험 1군은 15초,실험 2군은 30초,실험 3군은 45초,실험 4군은 60초간 산부식한 후 부식시간에 따른 법랑질 표면의 양상을 SEM으로 관찰하여 평가하였다. 1. 실험 1군에서는 Type 3가 75% 나타났으며 실험 2군과 3군 모두에서 Type 1이 38%, Type 2가 50%로 나타났다. 2. 실험 2군보다 실험 3군에서 산부식된 양상이 좀더 뚜렷하게 나타났다. 3. 실험 4군에서 Type 1이 25%. Type 2가 75%를 보였고 Type 3는 나타나지 않았다. 4. 실험 4군에서는 다른 실험군에서 보다 좀더 전형적인 산부식 양상을 보였다. 5. 설험군 간의 산부식 시간에 따른 부식 양상의 차이는 통계학적으로 유의한 차이를 보였다(p<0.05). 6. 산부식 시간이 길수록 부착에 유리한 Type 1과 Type 2가 주로 관찰되었으며 Type 3는 드물게 관찰되었다(p<0.05). 유전치에서 무소주 법랑질 층이 주로 존재하는 치경부 측에,와동의 변연부가 형성될 때에는 산부식 시간을 다소 길게 45∼60초 정도 하는 것이 수복물 유지를 향상시킬 것으로 여겨진다. The presence of a"prismless" layer on the enamel surface particularly on deciduous teeth has been reported by a number of workers. This structure, which appears to lack the normal prism delineations, could interfere with tag formation and hence, reduce bonding to such surfaces. The purpose of this study was to investigate the relationship of etching times on the effect of acid etching on primary enamel with respect to the quality of etching patterns. Labial surfaces of 32 extracted or exfoliated caries-free primary anterior teeth were used. 35% phosphoric acid gel was used only cervical regions of labial surfaces for each etching time group, 15, 30, 45 and 60 seconds. The surfaces were then washed with water for 20 seconds and dried with air spray for 20 seconds. 1. The Type 3 is 75% when the 15 seconds acid etching time was used. 2. The Type 1 is 38% and Type 2 is 75% when the 30 and 45 seconds acid etching time was used. 3. The Type 1 is 25% and Type 2 is 75% when the 60 seconds acid etching time was used. 4. An etching time of 60 seconds produced a constant and regular etching pattern. 5. There is a significant difference between the groups with respect to the patterns of etch achieved(p<0.05). 6. We confirmed that the acid induced patterns(type 1, 2) became more pronounced when the application time increased(p<0.05). 45∼60 seconds was the optimal time for etching on the primary enamel.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.