소아 신장이식 환자에서 연령 및 성별에 따른 타크롤리 무스의 약동학적 차이에 관한 단일기관 연구

최재영,장경미,황영주,최봉석,박종광,윤영란,김찬덕,조민현,Choe, Jae Young,Jang, Kyung Mi,Hwang, Young Ju,Choi, Bong Seok,Park, Jong Kwang,Yoon, Young Ran,Kim, Chan Duck,Cho, Min Hyun 대한소아신장학회 2014 Childhood kidney diseases Vol.18 No.1

목적: 소아 신장 이식 환자에서 흔히 사용되는 면역 억제제 타크롤리무스는 성별, 연령별, 인종별로 다양한 약동학적 특성이 있음이 알려져 있다. 본 연구는 우리나라 소아신장 이식 환자가 가지는 타크롤리무스의 약동학적 특징을 파악하고 관련되는 인자를 알아보기 위해 시행되었다. 방법: 경북대병원 소아청소년과에서 신장 이식을 시행받고 초기 면역 억제치료로 타크롤리무스가 사용된 환자 9명을 대상으로, 사용된 약 용량과 혈중 최저 농도 등을 후향적으로 조사하였고 이들의 약동학적 특성을 성인 대조군과 비교하였다. 결과: 남아의 평균 약 용량은 여아에 비해 유의하게 높았으나 혈중 최저 농도는 두 군 간에 유의한 차이가 없었고 청소율 또한 남아에서 유의하게 높았다. 12세 이상의 평균 약 용량은 12세 미만에 비해 낮았고 혈중 최저 농도는 높은 경향을 보였으나 유의한 차이는 없었다. 성인은 12세 이상, 미만 모두의 경우 보다 유의하게 약 용량이 적었으나 혈중 최저 농도에서는 유의한 차이가 없었다. 또한, 청소율와 반감기에서도 모두 유의한 차이를 보였다. 결론: 소아 신장 이식에서 사용되는 타크롤리무스는 나이가 어릴수록, 남아의 경우에 좀 더 많은 용량을 투여해야 할 가능성이 있음을 확인할 수 있었다. 우리나라 소아 신장 이식 환자에서 타크롤리무스의 적절한 치료용량을 확인하기 위해서는 이상의 관련인자에 대한 추가적인 전향적인 연구가 필요하다고 사료 된다. Purpose: The pharmacokinetics of tacrolimus, one of the most widely used immunosuppressive drugs, are known to vary by sex, age, and ethnicity during pediatric transplantation. This study assessed the pharmacokinetic characteristics and associated factors of tacrolimus in Korean children receiving a kidney transplant. Methods: We retrospectively reviewed the pharmacokinetic data (therapeutic dose, trough level, clearance, and half-life) of 9 children who were given tacrolimus as one of their initial immunosuppressive drugs after kidney transplantation. In addition, we compared the findings to data from 10 adult kidney transplant recipients. Results: The mean age of our pediatric patients was 13.9 years, and the maleto- female ratio was 4:5. The mean dose of tacrolimus was $0.19{\pm}0.14$ mg/kg/day. The mean dose of tacrolimus for males was $0.23{\pm}0.12$ mg/kg/day, which was significantly higher than the dose for females ($0.16{\pm}0.14$ mg/kg/day). The trough level was not significantly different between both groups. The clearance rate of tacrolimus for males was also significantly higher than females. Although the dosage of tacrolimus for patients over the age of 12 years was lower ($0.18{\pm}0.13$ vs. $0.21{\pm}0.16$ mg/kg/day) and the trough level was higher ($8.2{\pm}4.5$ vs. $7.2{\pm}4.2$ mg/mL) than that for patients under the age of 12 years, there was no significant difference between them. However, there were significant differences between children and adults in dose, clearance, and half-life of tacrolimus. Conclusion: Out study suggests that the pharmacokinetics of tacrolimus tends to vary with sex and age. Therefore, large-scale prospective studies are required to verify the proper therapeutic dosage of tacrolimus in Korean children.

육안적 혈뇨를 동반한 요막관 농양 1례

최재영,박효민,이상인,황영주,조민현,Choe, Jae Young,Park, Hyo Min,Lee, Sang In,Hwang, Young Ju,Cho, Min Hyun 대한소아신장학회 2012 Childhood kidney diseases Vol.16 No.2

요막관 기형은 주로 제대 분비물이나 육아종으로 발견되는 경우가 대부분이며 증상이 없을 경우 발견하기 힘든 흔하지 않은 질환이며, 발견 시 나타나는 증상 또한 요막관 기형의 종류에 따라 다양한 경과를 보이므로 급성 복증 및 비뇨기계 질환과의 감별진단을 요한다. 진단으로는 초음파 및 복부 컴퓨터 단층촬영이 가장 좋은 도구로 알려져 있으며 수술적 절제 및 보존적 치료를 시행 할 수 있다. 본 증례는 열을 동반한 옆구리 통증, 육안적 혈뇨, 빈뇨 및 배뇨통을 주소로 내원하여 출혈성 방광염 및 급성 신우신염을 의심하여 치료한 환자로 입원 중 증상과 혈액 검사 소견의 악화로 시행한 복부 컴퓨터 단층촬영에서 요막관 농양을 진단하였다. 항생제 변경과 농양의 경피적 배액술 및 도관 유치를 통한 배농으로 치료되었다. 본 저자들은 육안적 혈뇨를 보인 환자에서 요막관 농양으로 진단된 경험을 보고하는 바이다. Since urachal abnormalities are uncommon and have various clinical manifestations such as umbilical discharge, periumbilical pain, recurrent urinary tract infection and abdominal mass according to its structure, it is not easy to diagnose. We report our experience of a patient with urachal remnant abscess who presented with gross hematuria initially, and improved after the management with intravenous antibiotics and percutaneous drainage of abscess.

Multiplex PCR을 이용한 Mycobacterium bovis와 Mycobacterium tuberculosis의 동정

장영부 ( Young Boo Jang ),김재명 ( Jae Myung Kim ),최재영 ( Jae Yeong Choe ),이햇님 ( Haet Nim Lee ),정석찬 ( Suk Chan Jung ),박영길 ( Young Kil Park ),구복경 ( Bok Kyung Ku ) 한국예방수의학회(구 한국수의공중보건학회) 2011 예방수의학회지 Vol.35 No.4

Tuberculosis (TB) is a significant disease for both humans and animals worldwide. The genus Mycobacterium includes several species that cause TB disease in humans and other animals. Amongst the members of the Mycobacterium tuberculosis complex (MTC), M. tuberculosis is mainly a human pathogen, whereas M. bovis has a broad host range and is the principal agent responsible for TB in domestic and wild mammals. M. bovis also infects humans, causing zoonotic TB through ingestion, inhalation. M. bovis accounts for only a small percentage of the reported cases of TB in humans. In recent years, TB in farmed deer has become a disease as public health importance in several countries. Nowadays, there has been rapid outbreak of bovine TB in cattle and deer in Korea. Investigations are needed to elucidate the relative importance of M. bovis on TB incidence in humans, especially in Korea where bovine TB remains a problem. Also, the human sources as the cause of animal infection, M. tuberculosis from the farm workers also important for TB control of animals in Korea. Differentiation between the causative organisms may only be achieved by sophisticated laboratory methods involving bacteriological characteristics, biochemical properties, and routine resistance to pyrazinamide (PZA). M. bovis shows inherently resistant to PZA whereas M. tuberculosis is susceptible to PZA. In this study, we developed a multiplex-PCR assay based on a 12.7-kb fragment for the differential detection of M. bovis and M. tuberculosis. A total of 131 M. tuberculosis complex isolates were randomly obtained from cattle and deers that were PPD positive. they all yielded M. bovis. M. tuberculosis was not isolated from animals. and, a total of 25 M. tuberculosis complex isolates which is resistant to PZA were obtained from patient. PZA resistant MTC in humans was caused entirely by M. tuberculosis. The multiplex-PCR protocol was highly species-specific and time saving for identification of M. bovis and M. tuberculosis. This multiplex-PCR assay will be easily used as a routine monitoring tool in veterinary and medical laboratories.

Energy Saving을 위한 V/f 추종제어

신우석(Woo-Seok Shin),최재영(Jae-Young Choe),이돈시(Don-Sl Lee),최규하(Gyu-Ha Choe) 대한전기학회 1993 대한전기학회 학술대회 논문집 Vol.1993 No.7

고조파 제거 및 무효전력 보상을 위한 3상 전력용 능동 필터의 제어에 관한 연구

박민호(Min-Ho Park),최규하(Gyu-Ha Choe),최재영(Jae-Young Choe) 대한전기학회 1989 대한전기학회 학술대회 논문집 Vol.1989 No.7

소아의 메타콜린 기관지유발검사에서 PC₂₀-FEF_25%-75% 및 △FVC에 대한 분석

김현아 ( Hyeon A Kim ),권정은 ( Jung Eun Kwon ),안지영 ( Ji Young Ahn ),최재영 ( Jae Young Choe ),김동섭 ( Dong Sub Kim ),박숙현 ( Sook Hyun Park ),현명철 ( Myung Chul Hyun ),최봉석 ( Bong Seok Choi ) 대한천식알레르기학회(구 대한알레르기학회) 2021 Allergy Asthma & Respiratory Disease Vol.9 No.3

Purpose: Forced expiratory flow between 25% and 75% (FEF_25%-75%) is known to sensitively reflect bronchial obstruction. Methacholine challenge test (MCT) has shown varying reduction levels of forced vital capacity (FVC) with the reduction in forced expiratory volume in 1 second (FEV₁) in asthma. The aim of this study was to evaluate the clinical implication of provocative concentration causing a 20% fall in FEF_25%-75% (PC₂₀-FEF_25%-75%) and the percentage fall in FVC at the PC₂₀ dose of methacholine (△FVC). Methods: A total of 194 children who visited the hospital due to respiratory symptoms and underwent MCT were analyzed retrospectively. The patients were divided into 3 groups. Group I had both PC₂₀-FEV₁ and PC₂₀-FEF_25%-75% above 16 mg/mL; group II had a PC₂₀-FEF_25%-75% that fell below 16 mg/mL but PC₂₀-FEV₁ was 16 mg/mL or above; group III had a PC₂₀-FEV₁ and a PC₂₀-FEF_25%-75% that both fell below 16 mg/mL. Results: In group II, PC₂₀-FEV₁ was lower (P=0.026) and the rate of change in FEV₁ and FEF_25%-75% from baseline to 16 mg/mL of methacholine concentration was greater than in group I (both P<0.001). Levels of PC₂₀-FEF_25%-75% were higher in group II compared to group III (P<0.001). △FVC showed a correlation with PC₂₀-FEV₁ (P<0.001) only in the whole group. Conclusion: In asthmatic children, PC₂₀-FEF_25%-75% may be associated with bronchial hyperresponsiveness. △FVC was not associated with other parameters in either group. For subjects with a positive finding of PC₂₀-FEF_25%-75% and a negative finding of MCT, the progression to asthma can be suspected. (Allergy Asthma Respir Dis 2021;9:141-147)

공격적인 치료저항군 정신분열병 환자에 대한 Carbamazepine 병용투여 효과 : 이중맹검 교차연구

오동열,박강규,최재영 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.6

We studied adjunctive effects of carbamazepine to haloperidol in 15-nonresponding chronic schizophrenic patients who were suitable for John Kane criteria of nonresponding Schizophrenics and also showed aggressive behaviors before the study. We performed the study with a placebo controlled double blind cross-over design. The results were as follows : 1) There was no statistically significant difference between the carbamazepine and placebo administered groups in the changes of total BPRS scores, although carbamazepine administered group showed more improvement in total BPRS scores and some BPRS subscales. 2) Hostility improved continuously in carbamazepine administered group, besides, psychological symptoms such as anxiety, suspiciousness, hallucinatory behavior, conceptual disorganization, unusual thought content, and guilty feelings were also improved. 3) Serum prolactin concentrations were little changed in carbamazepine-placebo administered group, and in placebo-carbamazepine administered group, serum prolactin concentrations were considerably decreased at carbamazepine administration, so it is difficult to conclude a certain relationships between serum prolactin level and carbamazepine administration at present. The results suggest that adjunctive use of carbamazepine to neuroleptics maybe useful drug regimen for some case of nonresponding schizophrenics, especially carbamazepine showed some improvement in hostility score.

심실중격결손을 동반한 폐동맥폐쇄에서 선천적우회순환의 기시 및 분포 : A Cineangiographic Study

최재영,이종균,차응석,설준희,이승규,최규옥 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9