원내 소아 환자에서 보고된 약물 부작용 사례 분석

금민정,박은혜,고종희,김수현,김성은,석현주 한국병원약사회 2011 병원약사회지 Vol.28 No.3

Starting from introducing the adverse drug reaction monitoring system in 1988, KFDA selected several tertiary hospitals including Severance hospital as local pharmacovigilance centers to improve the system. The centers have been expanded to 15 units in 2009 and each center has been collecting, evaluating, and reporting adverse drug reaction cases. The Severance hospital has been also performing the role with ADR monitoring system in OCS. Since the pharmacovigilance research network was launched in July 2009, managing the information has been built up and each center participated in national ADR reporting activation. The centers of the pharmacovigilance research network are monitoring ADR focused about the child, the old, and the drugs that prohibited in more than 5 countries by UN. From among these,children used to be excluded from clinical trial due to ethic and safety reason. As a result, there is no standard of indication or dosage for children and many medicines used to treat children are not licensed for such use (off-label use). Furthermore, children may have different pharmacokinetics and dynamics to adults and therefore have particular vulnerability to ADRs. Moreover,considering many children cannot express their symptoms clearly, medications used for children require careful observation. Thus, we analyzed present condition of reporting and characteristics of ADR in children based on 130 examples (284 cases) of ADR in children less than 12 at Severance hospital from January 2008, to December 2009. Through this research, we would suggest that more safe and reasonable use of medications for children can be caused by intensive ADR monitoring and DUR for children,and tried to find some expected role of pharmacists

L-asparaginase와 PEG-L-asparaginase를 투여한 소아 급성 림프구성 백혈병 치료시 부작용 비교

금민정,박인혜,고종희,안지현,김성은,석현주 한국병원약사회 2013 병원약사회지 Vol.30 No.4

L-asparaginase (L-asp) is an essential drug for the treatment of acute lymphoblastic leukemia (ALL). However, it requires attention for several side effects. PEG-L-asparaginase (PEG-L-asp), which is formed by the covalent linkage of L-asp to polyethylene glycol (PEG), is also not safe from side effects. In this study, we considered 6 side effects (hypersensitivity, acute pancreatitis, coagulopathy, hyperglycemia, hepatotoxicity and elevation of blood ammonia levels) from 60 pediatric ALL patients who received L-asp and PEG-L-asp in severance hospitals between 2006 and 2010. Among them, 22 patients received only L-asp, and 38 patients were converted from L-asp to PEG-L-asp. Differences were evaluated by the chi-square test and Fisher exact test on the SAS software (version 9.2). Elevation of blood ammonia levels (P=0.0050), hypersensitivity (P=0.1219), bleeding risk (P=0.2839), and hyperglycemia (P=0.6194) were more frequent in the L-asp group. Hepatotoxicity (P=0.1968), thromboembolism (P=0.6432), and acute pancreatitis (P=0.7321) were more frequent in the PEG-L-asp group. The incidence for each side effect depends not only on the drug itself, but also on the patients’risk, treatment phase and so on. Hypersensitivity by treatment phase (P=0.0109) and bleeding tendency by patients’risk (P=0.0057) show statistical differences. Through this study, we would like to obtain supportive evidence and contribute to the safe consumption of drugs for children with ALL.

結婚 移住 女性의 韓國語 要請 話行 使用 樣相 : 家族 間 意思疏通 狀況을 中心으로

金珉貞(Kim Min-Jun) 중앙어문학회 2009 語文論集 Vol.42 No.-

The purpose of this paper is to analyse similarities and differences of the request speech acts spoken by Korean female speakers(KFS) and foreign immigrantfemalespeakers(FIFS)in Korean language.Thiswork is a preliminary research for applying the research result of this paper to the Korean language pragmatic education for FIFS. This paper considers two variances. The one is the situations thatthe request speech acts are occurred. And another one is the relations of speaker and hearer. 1) The situations of the request speech acts are divided into; ‘asking’ and ‘requesting’. 2) The relations of speaker andhearer are divided into the three cases that; speaker is superior tohearer, speaker is inferior to hearer, and speaker and hearer are in theequal position. From this work, it is found tha tFIFS's request speech acts include some differences with KFS's them.

영화의 역사서술과 역사교육의 가능성

金玟政(Kim Min-jung) 역사교육연구회 2005 역사교육 Vol.94 No.-

Historical films can be defined as fiction films that describe complex contexts of past events, illustrate situated conditions of film production periods and portray the unpredictable crossroads of individual decisions and historical conditions. Given that history is a domain in which people explore the past, the textuality of historical films is embedded in two different senses of time that films engage. One is the historical time that a film intends to portray. The other sense of time is the production period during which a film is created. Therefore, the two distinctive time periods of a film emerge as representations of the past event and as sociocultural artifacts. History teachers are often asked to be prepared and trained for increasing students" historical film literacy. To do so, they need to utilize films for teaching various senses of time, authorship, artistic mastery and the likelihood of the past. Practical suggestions for using films in history classrooms include 1) to seek with students appropriate information and reference with which they triangulate filmic representation with academic research, 2) to help students inquire about filmmakers, production times, core messages, and censorships, and 3) to facilitate students to appreciate and interpret artistic techniques and performance on screen for historical and symbolic meanings.

역사 교사의 현장연구 방법론 모색 : 실행연구를 중심으로

金玟政(Kim Min-Jung) 歷史敎育硏究會 2007 역사교육 Vol.103 No.-

This study claims action research of history teacher, by history teachers and for history teachers. Previous history education theories have been criticized for the lack of sensitiveness to the field. Even most field research turns out too scholastic to represent teachers’ problems and interests. To resolve this sort of dilemma, this study underlines the necessity of action research with which history teachers pursue research questions derived from their own teaching experience including classroom practice. Action research by history teachers should be collaborative work as well as qualitative studies in nature. This study exemplifies a case in which a history teacher investigates the national curriculum realized in her classroom, in particular, in her students’ historical understanding. With the help of action research, teachers are able to be a part of research community and therefore to dedicate to building a theory grounded on Korean educational settings. In order to empower history teachers as action researchers, educational system and conditions surrounding teachers should allow them opportunities and occasions in which they initiate their own research and reflect their teaching practices. Furthermore, this study suggests educational method courses and practicum for pre-serve teachers as well as in-service.

한 상급종합병원 내 Fentanyl Buccal Tablet의 의존 경향 파악 및 위험 요인 분석

최아름,금민정,고종희,김재송,손은선,권경희 한국병원약사회 2019 병원약사회지 Vol.36 No.4

Background and Objective : Previous studies on the safety of fentanyl buccal tablets (FBT) have often dismissed patients with a high likelihood of drug abuse or who have been strongly controlled by dose or usage of FBT. For these reasons, we could not confirm the current state of dependence or addiction of opioid pain medication in patients suing FBT in an actual clinical setting. The purpose of this study was to analyze the FBT use status in a tertiary hospital in Korea and the risk factors related opioid dependence tendency and to contribute to the safe use of FBT. Methods : We retrospectively reviewed electronic medical records of cancer patients admitted to the wards that received FBT at a tertiary hospital in Korea From January to May 2018. The proportion of patients with dependence tendency due to FBT was investigated. Logistic regression analysis was performed to determine the risk factors. The significance level was p 0.05. Results : Of the total 275 patients, four had FBT dependence tendency, with a ratio of 1.45%. Additionally, smoking history (odds ratio=23.51, p=0.02) and one-day immediate opioid analgesic dose excluding FBT (odds ratio=1.15, p=0.01) were the risk factors for dependence tendency on opioid analgesic due to FBT. Conclusions : The proportion of patients with dependence tendency due to FBT in a tertiary hospital at Korea was 1.45%, which was higher than the general incidence of dependence or addiction of opioid analgesics used to mitigate cancer pain. Thus, patients taking this drug should be closely monitored for dependence and addiction. Additionally, medical staffs must be fully aware of patients’risk factors. Although this study has limitations as a retrospective study, it may be reliable data for the safe use of opioid analgesic by confirming the dependence tendency and risk factors of FBT in clinical practice.

단일 기관 내 Steroid-Refractory Graft-versus-Host Disease 환자에서의 Ruxolitinib 반응성 평가

최지원,금민정,고종희,손은선,유윤미 한국병원약사회 2023 병원약사회지 Vol.40 No.2

Background : Graft-versus-host disease (GVHD) is a complication reported in 30–50% of patients who receive homologous hematopoietic stem cell transplantation. Although systemic corticosteroids are recommended as primary treatment, approximately 50% develop steroid-refractory GVHD (SR-GVHD) with high mortality. In May 2022, ruxolitinib was approved by the Ministry of Food and Drug Safety for the treatment of SR-GVHD, but there is limited data on treatment responses in Korean patients. The purpose of this study was to evaluate the effectiveness of ruxolitinib in patients with SR-GVHD. Methods : We enrolled patients with GVHD who had received ruxolitinib treatement at Severance Hospital between January 2017 to July 2022. We evaluated the overall response rate (ORR) and non-relapse mortality (NRM) at the time of ruxolitinib discontinuation. Patients and GVHD characteristics were analyzed according to the responder and non-responder groups of ruxolitinib, and the steroid-sparing effect was estimated based on whether the co-administered steroids were reduced. Results : There were no significant differences in baseline patient characteristics and GVHD characteristics between the responder and non-responder groups. The overall responsive rate (ORR) for ruxolitinib was 50% (22 of 44 patients). During the administration of ruxolitinib, 91% of responders and 46% of non-responders experienced a reduction of steroid dose reduction (p<0.01). The NRM was 10% in the responder group and 64% in the non-responder group (p<0.01), and the main cause of death was infection. Conclusion : The results demonstrate that ruxolitinib has a steroid-sparing effect in patients with SR-GVHD, as evidenced by the higher number of patients who experienced steroid dose reduction and the lower NRM in responders than non-responders. This suggests the possibility of reducing steroid-induced infection risk and mortality.

혈액종양환자에서 종양용해증후군 위험 분류에 따른 예방적 약물 사용

이수경,금민정,고종희,손은선,유윤미 한국병원약사회 2023 병원약사회지 Vol.40 No.1

Background : Tumor lysis syndrome (TLS) is a metabolic syndrome caused by the release of intracellular uric acid, potassium, and phosphorus into the blood due to sudden tumor necrosis. If inadequate prophylactic therapy for TLS or treatment is delayed, complication risks may increase. Therefore, it is important to identify patients at high risk of TLS before chemotherapy. In this study, appropriate prophylactic drug use for TLS risk groups was investigated, and its association with TLS occurrence was analyzed. Methods : From January 2019 to December 2021, electronic medical records of adult hematologic oncology patients aged ≥19 years who were hospitalized for their first chemotherapy for hematological tumors were retrospectively analyzed. Diagnosis, hematological and laboratory values, and administration information of allopurinol and rasburicase were collected. TLS risk was evaluated according to the 2010 TLS management recommendation by Cairo et al. Appropriate prophylactic drug use and the TLS occurrence were analyzed. Results : Of 561 patients, 366 (65.2%), 159 (28.3%), and 36 (6.4%) were in low-risk, moderate- risk, and high-risk groups, respectively, by TLS risk classification. A total of 138 (24.6%), 420 (74.9%), and three (0.5%) patients received undertreatment, proper treatment, and overtreatment in TLS prophylaxis, respectively. Multiple logistic regression analysis showed that TLS risk was higher in the high-risk group than in the low-risk group (adjusted OR: 17.14, 95% CI: 5.56-52.87). In terms of the adequacy of TLS prophylaxis, the TLS incidence was the highest in those with under-prophylaxis, although the difference was not statistically significant. Conclusion : Classifying the high-risk group before chemotherapy in hematological malignancies patients is a major predictor of future TLS development. In under-prophylaxis cases, the TLS incidence tended to increase, especially in high-risk groups. Therefore, the decisions of TLS prophylactic drug should be appropriately implemented and monitored before chemotherapy.

다직종 암환자 교육·상담에 대한 설문 개발과 환자 만족도 조사

이민정,금민정,김재송,김수현,손은선,이상글,송수경,최혜진,Lee, Min Jeong,Geum, Min Jung,Kim, Jae Song,Kim, Soo Hyun,Son, Eun Sun,Lee, Sang Geul,Song, Su Kyung,Choi, Hye Jin 한국임상약학회 2018 한국임상약학회지 Vol.28 No.2

Background: Presently, a multidisciplinary team of doctors, pharmacists, nurses, and dietitians provides patient education to impart information on chemotherapy. However, studies on multidisciplinary education satisfaction are inadequate. In this study, we aimed to contribute to the improvement of quality of multidisciplinary education counseling for patients with cancer by developing a satisfaction questionnaire and analyzing the satisfaction survey. Methods: A questionnaire was developed by an expert group, and the responses were recorded using the 5-point Likert scale. After conducting a pre-test, factor analysis was performed to evaluate validity. The reliability of the questionnaire was measured by Cronbach's alpha coefficient. A satisfaction survey was conducted by self-administration method. Results: Based on the results of factor analysis, factors can be divided into two parts: "overall education" and "each team member's education" (total 14 questions). The construct validity and reliability of the questionnaire are sufficiently high. Fifty-one patients took the survey between January 2, 2018 and January 20, 2018. Twenty-six (51%) patients responded that they were "very satisfied" and 22 (43.1%) patients responded that they were "satisfied". Conclusion: By developing a questionnaire on multidisciplinary education counseling for patients with cancer, it is possible to perform evaluation and research of cancer patient education. This study will contribute to the management and improvement of quality of multidisciplinary education.

제2형 당뇨병 환자에서 Dapagliflozin이 혈당과 심혈관계질환 위험인자에 미치는 영향 및 안전성

이혜진,금민정,김재송,김수현,손은선 한국임상약학회 2017 한국임상약학회지 Vol.27 No.4

Background: Dapagliflozin is an oral selective inhibitor of sodium-glucose cotransporter 2(SGLT2), the kidney transporter chieflyresponsible for glucose reabsorption from the glomerular filtrate. Because this mechanism does not require the action of insulin,dapagliflozin rarely causes hypoglycemia. Dapagliflozin may affect blood glucose control as well as blood pressure and the bodyweight which are one of the cardiovascular disease risk factors. However, dehydration and ketoacidosis are reported as the sideeffects of the dapagliflozin treatment and the safety issues have been occurred. The aim of this study is to analyze the effectivenessand adverse events of dapagliflozin in Korean patients. Methods: From December 2014 to August 2015, we retrospectively reviewedthe electronic medical records of type 2 diabetes patients who were prescribed dapagliflozin at Severance Hospital. Results: A totalof 202 Korean patients were enrolled in this study. The effectiveness in the reduction of blood glucose was statisticallysignificant(p<0.001). Dapagliflozin decreased 0.74% of HbA1c after 24 weeks. Significantly more participants achieved the targetHbA1c level(HbA1c<7%) after 24 weeks(n=42, 35.3%) than before taking dapagliflozin(n=21, 17.6%). Blood pressure decreased 5.7mmHg s ystolic b lood p ressure(SBP), 1.9 mmHg d iastolic b lood p ressure(DBP) a fter 24 weeks. M ore than o ne q uarter ofparticipants(n=35, 29.4%) experienced weight loss. Most common adverse event was genitourinary symptoms. Conclusion: In thisstudy, the effectiveness of dapagliflozin in improving glycemic control, blood pressure control, and weight loss was statisticallysignificant. However, elderly and female patients, who have higher incidence of adverse events, should use dapagliflozin cautiously.