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현신영,이건수,박선양,이순용,국훈,백상훈,장인진 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.4
Purpose: Beroctocog alfa is a second generation recombinant factor VIII manufacturedby removing the B-domain from factor VIII. This prospective clinical trial was conducted to evaluate the efficacy, safety, and pharmacokinetics of beroctocog alfa in patients of ages ≥12 years previously treated for severe hemophilia A. Materialsand Methods: Seventy subjects received beroctocog alfa as an on-demand treatment for acute hemorrhage. Results: The final hemostatic effect was excellent in 35 subjects (50%) and good in 26 subjects (37.1%). The drug showed an overall efficacyrate of 87.1%. The majority of acute hemorrhages was treated by administeringthe study drug once (86.2%) or twice (10.0%), and the mean dose administered per single infusion was 28.55±6.53 IU/kg. Ten subjects underwent 12 surgical procedures,and hemostatic efficacy was excellent in seven cases (58.3%) and good in five cases (41.7%), showing a 100% efficacy rate. A total of 52 of 88 subjects (59.0%) experienced 168 adverse events. There were 18 serious adverse events (10.7%) in 11 subjects, and two (mild dyspnea and facial edema) in one subject were related to the study drug. Only one subject formed a de novo factor VIII inhibitor, for an occurrencerate of 1.4% (one-sided 95% upper confidence limit: 3.85%). The final eliminationhalf-life was 13.3 h and 12.6 h at baseline and 6 months after administration, respectively. Conclusion: Our results suggest that beroctocog alfa is safe and efficaciousas either an on-demand treatment for acute hemorrhage or a surgical prophylaxisin patients with hemophilia A.
현신영,한상훈,김수정,장지은,김윤덕,조현수,이정연,정준원,민유홍,송재우,김진석 대한의학회 2016 Journal of Korean medical science Vol.31 No.4
The aim of this study was to identify the risk factors associated with severe bacterial infection (SBI) in multiple myeloma (MM) patients during treatment with bortezomibbased regimens. A total of 98 patients with MM were evaluated during 427 treatment courses. SBI occurred in 57.1% (56/98) of the patients and during 19.0% (81/427) of the treatment courses. In the multivariate analysis for the factors associated with the development of SBI in each treatment course, poor performance status (Eastern Cooperative Oncology Group ≥ 2, P < 0.001), early course of therapy (≤ 2 courses, P < 0.001), and pretreatment lymphopenia (absolute lymphocyte count < 1.0 × 109/L, P = 0.043) were confirmed as independent risk factors. The probability of developing SBI were 5.1%, 14.9%, 23.9%, and 59.5% in courses with 0, 1, 2, and 3 risk factors, respectively (P < 0.001). In conclusion, we identified three pretreatment risk factors associated with SBI in each course of bortezomib treatment. Therefore, MM patients with these risk factors should be more closely monitored for the development of SBI during bortezomib-based treatment.
고장현,신영구,이미영,정춘희,남수민,성중경,정필문,노진규,신장열 대한당뇨병학회 2008 Diabetes and Metabolism Journal Vol.32 No.3
Background: Postmenopausal status is associated with a 60% increased risk for metabolic syndrome. It is thought to be associated with decreased estrogens and increased abdominal obesity in postmenopausal women with metabolic syndrome. The purpose of this study was to investigate the association between metabolic syndrome components and menopausal status.Methods: A total of 1,926 women were studied and divided into three groups according to their menstrual stage(premenopausal, perimenopausal or postmenopausal). The presence of metabolic syndrome was assessed using the National Cholesterol Education Program's(NCEP) Adult Treatment Panel Ⅲ criteria. Results: The prevalence of metabolic syndrome was 7.1% in premenopause, 9.8% in perimenopause, and 24.2% in postmenopause. The strong correlation was noted between the metabolic syndrome score and waist circumference in postmenopause(r = 0.56, P < 0.01) and perimenopause(r = 0.60, P < 0.01). Along the menopausal transition, the risk of metabolic syndrome increased with high triglyceride after the age-adjusted(odds ratio(OR) 1.517 [95% confidence interval(CI) 1.014~2.269] in perimenopausal women and OR 1.573 [95% CI 1.025~2.414] in postmenopausal women). In addition, the prevalence of metabolic syndrome increased in accordance with elevated alanine aminotransferase(ALT) and gamma-glutamyl transpeptidase(GGT) levels. Conclusion: Triglyceride and waist circumference were important metabolic syndrome components, though ALT and GGT may also be related for predicting metabolic syndrome during the transition to menopause. (KOREAN DIABETES J 32:243-251, 2008)
신영전(Young-Jeon Shin),남정현(Jung Hyun Nam) 대한사회정신의학회 2001 사회정신의학 Vol.6 No.1
국가정신보건정책은 그 문제의 심각성, 문제의 크기 측면 모두에서 중요한 국가보건정책 중의 하나임에도 불구하고, 그간 상대적으로 정책의 관심에서 벗어나 있었으며, 체계적인 접근이 이루어지지 못해왔다. 그러나 1995년말 정신보건법의 제정과 보건복지부내 정신보건과의 설치이후 정신보건부문에 빠른 변화가 나타나고 있다. 이 연구에서는 국가정신보건체계의 궁극적인 목표를‘국민들의 건강한 삶의 연장을 위한 정신건강의 증진’,‘정신질환을 가진 사람들의 건강한 삶의 연장’,‘정신건강의 불균형 해소’로 설정하였다. 개념적인 목표로‘정신질환자 및 가족들의 기본적 삶의 수준확보’,‘정신보건서비스의 접근도 향상’,‘정신보건서비스의 질 향상’,‘효율적인 국가정신보건체계구축’으로 설정하고 이의 달성을 위한 국가정신보건체계를 제시하였다. 또한, 이 체계 모형에는 국가정신보건정책의 대상, 서비스의 유형과 수준들을 포함하였다. 또한 제안한 국가정신보건체계의 구축전략으로써 자원부문, 조직 및 전달체계부문, 재정부문, 관리체계부문의 정책안들을 제시하였다. 이상의 작업에 설정한 국가정신보건의 목표, 모형 및 시행전략은 앞으로도 많은 전문가와 환자 및 가족들의 검토와 비판을 통하여 더욱 현실적이고 구체적인 정책안으로 발전하여야 할 것이다. In spite of its importance and seriousness, mental health has received little attention from politicians and administrators and a systematic approach has been lacking in Korea for a long time. However, the legislation of the Law for Mental Health in 1995 has brought about dramatic changes in the area of mental health. This study was conducted to develop a model and strategies for a national mental health system in Korea. Four goals and six objectives have been proposed. The four goals are: ensuring the essential conditions for life, and improving the accessibility, quality and efficiency of mental health service. The six objectives are:to reduce the incidence and prevalence of mental illness, to reduce mortality associated with mental illness, to reduce the extent and severity of problems associated with specific mental disorders, to develop mental health services, to promote good mental health and reduce the stigma attached to it, and to promote the psychological aspects of general health care. The national mental health system model has been designed to achieve these goals and objectives. The model includes the target population, the type and level of mental health services and four infra-structures - resource and organization, delivery, management and economic support. Finally, political measures and strategies to establish the national mental health system have been proposed.