백혈병 환아에서 동종 조혈모세포 이식 후 Cyclosporine의 혈중 농도와 이식편대 숙주질환 및 재발률과의 상관관계

강래영,박경호,손인자,오정미 한국병원약사회 2008 병원약사회지 Vol.25 No.2

Graft-versus-host disease(GVHD) is correlated with high mortality and morbidity after transplantation. However, GVHD could lower relapse rate through a graft-versus-tumor effect and improve survival. Recent large retrospective studies evaluate that the patient with acute or chronic GVHD is associated with decresed relapse rate. Also, a prospective trial in pediatric patients suggest that low dose of cyclosporine(CsA) is associated with statistically significant reduction in leukemic relapse. Therefore, the purpose of this study was to assess the influence of blood CsA concentration on GVHD and leukemic relapse. From september 1999 to october 2004, we studied 35 pediatric patients(40 transplantation cases) with leukemia who had received an allogenic hematopoietic stem cell transplantation in Pediatric Hemato-Oncology of Seoul National University Children Hospital. We retrospectively analyzed the age of transplantation, body surface area, sex, interval from diagnosis to transplantation, white blood cell(WBC) count at diagnosis, remission status, stem cell source, donor, compatibility of sex and blood type, conditioning regimen, GVHD prophylactic regimen, blood CsA concentration, GVHD incidence, relapse rate, graft failure, and mortality were analyzed. Also, a subgroup analysis was performed in 17 children who had more than three blood CsA concentrations which were sampled at the period of intravenous administration. There was no significant difference in patient related and transplant related characteristics, mean blood CsA concentration and relapse rate between the group with GVHD and non-GVHD. On subgroup analysis, there was no significant difference in patient related characteristics, the incidence of GVHD, relapse rate and mortality between the group of over the mean concentration and under the mean concentration at the period of intravenous administration. The blood CsA concentration was not a significant factor in the incidence of GVHD and leukemic relapse rate. However, the incidence of GVHD was too low to analyze exactly. Therefore, a prospective controlled study is needed for the enough patient number.

소아처방 조제에서 나타난 조제과오의 유형 및 관련인자 고찰

강래영,전긍주,김귀숙,한현주,손인자 한국병원약사회 2006 병원약사회지 Vol.23 No.1

Dispensing errors can delay medical treatment and threaten patient`s life. Especially, pediatric prescriptions need the more skillful dispensing knowledge and technique about dosage and formulation than adult. Moreover the incidence of dispensing error in pediatric prescriptions is higher than adult. Dispensing errors were recorded and analyzed in order to find out mistake types and related factors. Changes after education were also analyzed. Also we considered a counterplan to prevent dispensing errors. Dispensing error reports were obtained from April to September in 2004 and arranged monthly. In this period, 257,451 cases of inpatient's and outpatient's prescriptions were dispensed by thirteen pharmacists in Seoul National University Children's Hospital pharmacy. The total incidence of dispensing error was 0.11% during six month and the monthly incidence was 0.10% on April, 0.20% on May, 0.14% on June, 0.07% on July, 0.05% on August and 0.09% on September. This decrease was due to the repeat education of attentions in dispensing. The incidence of dispensing errors related with counting mistakes was 38%, 29% in relation with incorrect dosage, 27% in relation with administration of different medicines, and 3% in relation with different dosage form. Dispensing position which has the highest error was powder position followed tablet or capsule, and injection site. The mean incidence numbers of dispensing errors were 5.2 cases a month in 10 experienced pharmacists who worked more than one year at the hospital pharmacy, 7.4 in 3 pharmacists who worked less than one year at the hospital pharmacy and the ratio was 1.4:1(in a beginning pharmacist : in a experienced pharmacist). And the mean incidence numbers of dispensing errors were 3.5 cases a month in 8 experienced pharmacists who worked more than one year at the children's hospital pharmacy, 6.9 in 5 beginning pharmacists who worked less than one year at the children's hospital pharmacy and the ratio was 2:1. According to this data, we could comprehend that the experience in the pediatric pharmacy was more influential in dispensing error than the experience at the hospital pharmacy itself. We concluded that the factors of dispensing error incidence in pediatric prescription depend on the review of dispensing error cases, an experience in the pediatric pharmacy, and a charge quantity of dispensing work. Therefore, to diminish the incidence of dispensing errors we need to intensify a review of dispensing error cases, to revise the dispensing system, and to carry out double checking prescriptions and weight checking for the powder.

급성 림프구성 백혈병 환아에서 항암화학요법 후 사용되는 Filgrastim과 Lenograstim의 효과 비교

최미혜,강래영,김귀숙,박경호,손인자,오정미 한국병원약사회 2008 병원약사회지 Vol.25 No.4

Granulocyte colony-stimulating factor(G-CSF) has been incorporated into the treatment regimens of many patients in an effort to decrease the risk of neutropenic complications, including febrile neutropenia after myelosuppressive chemotherapy regimens. In doing so, it could significantly reduce incidence and severity of neutropenic infection, thus decreasing morbidity and health care expenditure. Two formulations of recombinant human G-CSF(rhG-CSF), one non-glycosylated(filgrastim) and one glycosylated(lenograstim), are available. This study was undertaken to compare the hematologic effects of filgrastim and lenograstim after chemotherapy in children with acute lymphoblastic leukemia(ALL). From September 2005 to August 2006, 157 cases(87 filgratim, 70 lenograstim) with acute lymphoblastic leukemia who had received G-CSF after chemotherapy at Seoul National University Hospital department of pediatrics were studied. We retrospectively analyzed the duration of G-CSF treatment, neutropenia and the frequency of neutropenic fever, IV antibiotic treatment. There was no significant difference in duration of GCSF treatment(5.3±3.7 vs 4.6±3.1 days, filgrastim vs lenograstim, Mean±SD), time to absolute neutrophil count(ANC) recovery to above 500/mm3(5.1±3.7 vs 4.7±3.0 days), febrile days(2.3±1.6 vs 2.3±1.5 days), and duration of antibiotic treatment(6.0±3.0 vs 5.7±2.7 days) Also, frequency of neutropenic fever and antibiotic treatment were similar in both groups. In summary, in terms of their clinical effect on neutropenia, the two G-CSF preparations appeared to have identical activity. A large-scale randomized prospective studies are necessary to confirm and evaluate the efficacy of two types of G-CSF.

뷰-가이드 기반 부분 포인트 클라우드 파트 분할

노상준,강래영,김종원,김태원,백승혁,이규빈 제어로봇시스템학회 2021 제어로봇시스템학회 각 지부별 자료집 Vol.2021 No.12

As the quality of 3D sensors continues to advance in recent years, deep learning methods have been proposed to increase the performance of point cloud analysis such as object and scene recognition and perform well on point cloud analysis tasks by learning representations from large synthetic datasets constructed from CAD. However, point clouds generated by 3D sensors in the real-world are usually incomplete due to perspective view or occlusion by other subjects. In this paper, to tackle the limitations of prior works, we generated partial point cloud dataset using ModelNet40, ShapeNet-Part dataset to use it for deep learning model training and propose a method that utilize the projection score to include an implicit relationship between the partial point cloud and the camera view to improve the segmentation task. Our methods achieved better performance than prior works on shape classification and part segmentation. The code is available at http://github.com/gist-ailab/partial-pc-part-seg.

소아암 환아에서 Cisplatin 투여시 병용되는 Sodium thiosulfate(Ametox)의 신독성 예방 효과 평가

이정란,강래영,정선회,이혜숙,손인자,안효섭 한국병원약사회 2009 병원약사회지 Vol.26 No.1

Abstract: Cisplatin(CDDP) is an important chemotherapeutic agent used in a variety of cancers, however its nephrotoxicity is a dose limiting toxicity in chemotherapy. Sodium thiosulfate(STS) is one of the most widely used antidotes against CDDP, which has been using for prevention of CDDP induced nephrotoxicity in adults, In Pediatric Hemato-Oncology of Seoul National University Children Hospital, STS has been using for prevention of nephrotoxicity of CDDP since 2002, There are no evidences that STS prevents CDDP induced nephrotoxicity in pediatric patients, So we evaluated the efficacy of STS for prevention of CDDP induced nephrotoxicity. From 1997 to 2006, we retrospectively reviewed 39 pediatric patients who diagnosed neuroblastoma and treated by CCG321P2 regimen by using the Electonic Medical Record(EMR), 19 pediatric patients received only chemotherapy [STS(-) group] and 20 pediatric patients received STS with combination chemotherapy which contains CDDP [STS(+) group] before and after 2002. Blood urea nitrogen(BUN) and serum creatinine were measured to evaluate glomerular function. Na, K and Mg level in serum were measured and urine protein test was done to evaluate proximal tubu lar function. There were no significant differences in basal patients characteristics between the STS(+) and STS(-) group. But the STS(-) group revealed more increasing serum creatinine level with repeating chemotherapy cycles and more increasing incidences of hypomagnesemia and pro teinuria than STS(+) group. Therefore we concluded that STS in combination chemotherapy with CDDP have a positive effect on preventing cisplatin-induced nephrotoxicity in pediatric patients.

Sunitinib 투약 환자의 용량감량 및 중단 사유 분석

노지혜,강래영,이용화,이혜숙,김향숙,이주연 한국병원약사회 2013 병원약사회지 Vol.30 No.3

Sunitinib, an oral multi-targeted kinase inhibitor, is used as a primary treatment agent in patients with metastatic or recurrent renal cell carcinoma. High incidence of sunitinib adverse drug reactions was reported in Asian patients. The objective of this study was to identify and characterize the reason for dose reduction or discontinuation of the sunitinib treatment. We, retrospectively, collected the data from patients who received sunitinib from March 2007 to August 2011. A total of 171 patients were included in this study. Among them, 77 patients (45.0%) required dosage reduction of sunitinib. 59 patients (34.5%) discontinued sunitinib immediately without dosage reduction. Of all patients who required dosage reduction, 37 patients (48.1%) continued with sunitinib. Dosage reduction or discontinuation due to adverse effects was observed in 96 of 171 patients (56.1%). The type of adverse effects, which required dosage modification, was as follows : intolerance (30.2%), hematologic toxicity (13.5%), dermatologic toxicity (11.5%), gas-trointestinal toxicity (11.5%), hypertension (8.3%), bleeding (7.0%) and others. Dosage reduction or discontinuation due to adverse events was significantly more common in patients who were female, old and known to have brain metastasis. In conclusion, this study confirmed that the incidence of dose reduction or discontinuation of sunitinib due to adverse events is high in Korean patients. The main type of adverse effect that required dosage modification is intolerance, hematologic toxicity, and skin toxicity. Women, old age and patients with brain metastasis are more susceptible to sunitinib adverse effect. This information might be helpful for pharmacists to counsel patients receiving sunitinib and to improve their medication adherence.

유방암 환자의 항우울제 처방 현황 및 영향요인 연구

이혜민,강래영,김수연,이유정 한국임상약학회 2013 한국임상약학회지 Vol.23 No.3

물품조립 AI - 조립설명서 기반 로봇의 작업계획 생성 시스템

백승혁,신성호,강래영,이성주,이주순,육태경,전창현,김종원,유연국,박성호,윤준호,이준석,이규빈 한국로봇학회 2021 로봇과 인간 Vol.18 No.1

의료기관 의약품 부작용 발생 공유 및 중재, 약물안전카드 발급시스템 현황 조사

두고은,석정연,조윤숙,조윤희,강래영,김현지,진현정,박소영,최민정,서영은,문보경,최지홍,강민규,강민경,민미나,김우경,강균화,이경은,김수진,이재천,김윤희,김홍태,유기동,서윤이,이경운,손현아,이영희,아영미,이주연 한국병원약사회 2022 병원약사회지 Vol.39 No.3

Background : This study aimed to investigate the current status of adverse drug event (ADE) history sharing, intervention, and drug safety card issue system in medical institutions. Methods : A total of 126 member hospitals of the Korean Society of Health-System Pharmacists (response rate 25.9%) participated in this survey. Results : The survey results showed that 87.3% of the respondents had an ADE report system and most of them assessed causality (83.9%) and severity/seriousness (67.8%). About 85.6% of hospitals had a clinical alert or information system for prescriptions related to previous ADE history. Hard stop, soft stop, and passive alerts (information only) were generated in 11.0%, 38.1%, and 62.7% of the respondent hospitals, respectively. The criteria for generating alerts were mostly based on causality or severity/seriousness. Among hospitals with an ADE report system, 41.5% had a system issuing drug safety cards (Adverse drug reactions card, ADRs card). Among hospitals issuing ADR cards, 71.4% and 51.0% used causality and severity/seriousness assessment on the decision to issue, respectively. Frequent drug classes for which ADR cards were issued were contrast agents, antibiotics, and non-steroidal anti-inflammatory drugs. Identified barriers to implementing the ADR card issue system were the absence of standard guidelines, lack of awareness, and shortage of manpower. Conclusion : ADE report system was well established in 87% of respondent hospitals but around 40% of them had a system for issuing ADR cards. To extend the issuance and use of ADR cards, it is necessary to develop a standard procedure for recording, reporting ADRs, and issuing ADR cards.

중소형항만의 화주유인증대를 위한 모형개발에 관한 연구 -군산항을 중심으로-

여기태(Ki-Tae Yeo),박은보(Eun-Bo Park),강래영(Rai-Young Kang) 한국항만경제학회 2004 韓國港灣經濟學會誌 Vol.20 No.1

Although the small and medium ports are actually competing with various strategies, the definition and structural understanding of small and medium ports are not known very much. Therefore this study has launched from this fact, and has the objective of obtaining the structural model for increasing shippers' attraction of small and medium ports. The process began by abstracting the components that composed the success factors through recent research, and grouping it by FA(Factor Analysis) method. Also, by using the FSM(Fuzzy Structural Modeling) method to understand the structure of the grouped components, and the structural model for increasing shippers' attraction of small and medium ports was able to obtain as the result. When analyzing the obtained structural model, easiness of shipment, connection to hubport and efficiency of hinterland network came out to be the most important component groups.