근거 중심의 패혈증 치료에 대한 최신 지견

최정현 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

Severe sepsis and septic shock are conditions with a mortality rate about 50% despite of advances of antimicrobial treatment and supportive cares. Recently, investigators are trying to establish a scientific basis for identification of high-risk patients, or a standard practice for hemodynamic optimization and adjunctive pharmacologic therapies for these patients. Several randomized, Controlled trials and meta-analyses about certain therapies showed significant reduction of mortality and morbidity. This article is a clinical review of contemporary management strategies recommended with evidences for severe sepsis and septic shock.

임피던스 컨트롤을 이용한 로봇의 물체 끌기 경로 계획

최정현,박정현,황면중 제어로봇시스템학회 2023 제어로봇시스템학회 국내학술대회 논문집 Vol.2023 No.6

천웅(天雄)의 포제에 관하여

최정현,정병하,성만준,권동렬,Choi Jung-Hyun,Jung Byung-Ha,Seong Man-Jun,Kwon Dong-Yeul 대한한의학방제학회 2004 大韓韓醫學方劑學會誌 Vol.12 No.1

Aconiti Root(AR), has been used for about 2000 years, since recorded for low grade in 'Shinnongbonchokyung(Divine Husbandman's Herbal Foundation canon)'. It also recorded for Poisonous Drug in 'Myunguibyullok', 'Yaksungron', etc, and they advised when the AR is using for clinical desease it has to be processed. There are more than 13 processing methods, in records that related 39 parts which is recorded in ancient documents. In China, there are no standard of herb that using for clinical, cause of the traditional processing methods was cut since 1960s. In these days, they are using AR that recorded in Aconiti Tuber part of the processing records, in Guangdong and Shantung. In addition, the modification of Processed Aconiti Root(PAR) is also used for goods in Hongkong, Macao, and Southeast Asia. We studied the PAR for enhancing the importance of it, and multiply using. In this study, we search for the history of processing of AR, traditional theories of processing and clinical adaptation.

STUDY ON ENTRANCE SKIN DOSE AT PANORAMIC RADIOGRAPHY IN INCHEON, KOREA

최정현,김성철,한동균 대한방사선방어학회 2014 방사선방어학회지 Vol.39 No.4

Recently, the use of panoramic radiography has shown a constant increase, and significant research is underway. However,radiation exposure attracts less attention in dental radiography than in other types of radiography. We used an OSLD formeasurement of the entrance skin dose in eyeballs and the thyroid region, both of which are not covered by examinationsbut are included in radiographical regions and are sensitive to radiation, as well as orally in Incheon and reported the results. The entrance skin dose was 0.0282 mSv on average for the oral region, and 0.0259 mSv on average for the eyeball, and0.0261mSv on average, for thyroid gland. While there is no proper shielding method for the eyeball, a thyroid protector isnot used by most hospitals and most hospitals are equipped with an apron and a thyroid protector separately; thus, it isnecessary to use an integration of an apron and a thyroid protector and medical device manufacturers need to develop a methodfor controlling the length of the slit in the slit-type area of radiation occurrence in order to reduce unnecessary exposure.

가족 친화적 박물관 교육프로그램 개발 사례연구 : - 신문 박물관을 중심으로 -

최정현 한국박물관교육학회 2011 박물관교육연구 Vol.- No.6

I. 서론 II. 이론적 배경 1. 사회적 구성주의와 가족(또는 그룹) 단위 학습 2. 가족참여 프로그램 관련 선행연구 3. 가족 친화적 전시 및 교육프로그램의 요소 III. 가족 친화적 프로그램 개발 및 적용 1. 연구의 대상 및 방법 2. 프로그램 개발 3. 적용 및 결과분석 IV. 결론 참고문헌

발열성 호중구감소환자의 치료

최정현 대한종양외과학회 2005 대한임상종양학회 학술대회지 Vol.2005 No.9

EDI을 위한 OSI Layer 구현

최정현 광운대학교 인문사회과학연구소 1996 인문사회과학논문집 Vol.25 No.-

호중구 감소가 동반된 환자에서 발열에 따른 혈청내 IL-β, IL-6, TNF-α의 상승과 C-reactive protein과의 연관성

최정현,김유진,권혁상,김영환,정정조,유진홍,김양리,신완식,강문원 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.1

저자들은 1995년 3월에서 1995년 10월까지 성모병원에 입원한 급성 백혈병, 골수이형성증환자 중 항암제 치료나 기저질환으로 호중구가 감소된 상태에서 발열이 있었던 환자에서 발열을 전후로 하여 IL-1β, IL-6, TNF-α와 CRP의 상승정도를 측정, 비교하여 다음과 같은 결과를 얻었다. 1. IL-1β는 발열전 78.7±31.0 pg/ml에서 발열 후 120.6±88.8 pg/ml로 상승하였으나 통계학적 유의성은 없었다 (p=0.054). 그러나 IL-6의 경우 285.5±157.9 pg/ml에서 468.2±247.4 pg/ml로 증가하였고(p<0.01), TNF-α는 223.1±111.7 pg/ml에서 544.9±207.1 pg/ml로 증가하여(p<0.01)로 발열전에 비하여 통계학적으로 유의한 증가를 관찰할 수 있었다. 또한 CRP의 경우도 발열전 7.67±7.1 mg/L에서 발열후 126.8±37.1 mg/L로 증가하여 통계학적으로 유의한 상승을 보였다(p<0.01). 2. CRP의 상승 정도와 IL-1β, IL-6 그리고 TNF-α와 같이 발열에 관여하는 cytokine의 상승과의 연관관계는 관찰할 수 없었다. 3. 감염의 형태에 따른 CRP 및 IL-1β, IL-6, TNF-α와 같은 cytokine의 유의한 차이는 관찰할 수 없었다. 4. IL-6, TNF-α는 발열이 시작되면서 급속히 상승된후 상승된 수치가 유지되는 양상을 보였으나 IL-1β는 발열 2일째 까지 지속적으로 상승한 후 바로 떨어지기 시작하여 발열 3일째는 발열전과 유사한 농도까지 감소하는 것이 관찰되었다. CRP는 발열 후 급속히 상승하여 발열기간동안 지속적으로 상승되어 있는 경향을 보였다. 이상의 결과로 보아 현재 흔히 임상적으로 감염성 질환의 지표로 사용되고 있는 CRP는 패혈증과 패혈성 속을 매개하는 가장 중요한 cytokine인 IL-1β, IL-6, 그리고 TNF-α의 상승과 지속에 유사한 pattern으로 상승, 유지되어 감염의 진행정도를 파악하는데 있어 유용하다고 판단하였다. 그러나 CRP의 상승정도와 cytokine의 상승정도의 연관성은 없었으며 CRP와 cytokine의 상승정도로 감염의 형태, 예후등을 판정하기는 어려울 것으로 추정된다. 추후 더 많은 수의 환자를 장기간 추적 관찰하고 cytokine mRNA를 정량적으로 분석하는 방법을 병합한 정밀한 연구가 필요할 것으로 사료된다. Cytokiness, especially interleukin 1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNT-α) play a important role in the genesis and progression of the sepsis and septic shock. We monitored these three cytokines in 16 netropenic patients before and after the onset of febrile episode. Serum levels of IL-6 and TLF-α was significantly increased after onset of fever(p<0.01). IL-1β was also increased, but it was insignificant statistically(p=0.054). But the measurement of these cytokines has difficulties in clinical application in many aspects. So we also monitored CRP which is known as an acute phase reactant protein produced by IL-6 in the liver and clinically available with ease. CRP was also increased significantly after the fever(p<0.01). But its increase had no relationship with the increase of these cytokines. There was no difference in the extent of increment of these cytokines and CRP by the type of infection, too. But the kinetic patterns of the CRP and these cytokines was very similar. We conclude that CRP is a useful marker of infection and reflects the infectious process, but CRP as well as cytokines are not a useful predictor of the prognosis or the infectious etiology. In future, lager clinical trials and quantitative analysis of cytokine mRNA are needed.

펠비낙 경피흡수 제제화 및 약제학적 평가

최정현,김재백,고건일,손동환 圓光大學校 藥品硏究所 1996 藥品硏究所報 Vol.11 No.1

Felbinac is an effective non-steroidal anti-inflammatory drug used topically for the treatment of sprains, strains and soft tissue injuries. The patch was prepared with an impermeable backing layer and an adhesive matrix using Primal^(??), Acrysol^(??), some enhancers, solvents and felbinac. A peel test of the patch showed variable peel strengths ranging from 160 to 550g/12mm(width) in differing compositions. The polysorbate 80 and HCO-40 had lessening effects with decreasing peel strengths. The drug release rate from the patch was more than 50% in 4 hours and approximately 100% in 12 hours. The patch contained enhancer, linoleic acid or oleic acid, showed increasing effect on the permeation rate through the hairless mouse skin in vitro. In another experiment, skin permeation from the patch was increased according to dose. In a pharmacokinetic study of the patch, T_(max) and C_(max) were respectively 9 hours and 78.6ng/ml. The AUC_(0-24h) was 1.38㎍·hr/ml. The felbinac patch displayed higher drug absorption compared to the ointment. In conclusion from the above results, it was considered that the felbinac patch was useful as a NSAIDs, more effective than oinment, avoiding systemic side-effects.

발열성 호중구감소환자의 치료

최정현 대한임상종양학회 2005 대한임상종양연구 심포지엄 Vol.4 No.-