QLF를 이용한 항우식 제품의 인공우식 재광화 효과에 대한 연구

송주현,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

본 연구는 항우식 제품인 저농도의 불소 양치액(500 ppm NaF)과 Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP)를 포함하는 치아 연고,그리고 이 두 제품을 같이 사용했을 경우,인공 우식 병소의 재광화 효과를 알아보고자 하였다. 제3대구치 협면에 인공우식을 유발하였고,시편을 16개씩 4군으로 나누어,28일 동안 매일 2회 다음과 같은 항우식 제품을 시편에 처리하였고,pH 순환 시스템을 적용하였다. 1군: 대조군(무처치) 2군: Tooth Mousse^(ⓡ) (GC Co. Japan) 3군: 치카치카^(ⓡ)(삼일제약. 한국) 4군: 치카치카^(ⓡ)+ Tooth Mousse^(ⓡ) 무기질 소실량(ΔQ)의 장기적인 변화를 Quantitative light-induced fluorescence (QLF)를 이용하여 관찰하여 다음과 같은결과를 얻었다. 1. ΔQ는 1군에서는 28일동안 유의성 있는 차이를 보이지 않았고,2군과 3군에서는 처치전에 비해 14일부터 유의성 있는 증가를 보였으며,4군에서는 7일부터 유의성 있는 증가를 보였다. 2. ΔQ는 1군 < 2군,3군 < 4군 순이었다. 3. ΔQ는 1군과 비교시 2군은 7일,3군과 4군은 3일부터 유의성 있는 증가를 보였고,2군은 3군과 전 기간 동안 유의차가 없었다. 4군은 2군과 3군에 비해 28일에 유의성 있는 증가를 보였다. 4. 모든 군에서 재광화 속도는 점차 감소하였다. The purpose of this in vitro study was to compare the remineralization effect of commercially available anticariogenic products, exactly low level fluoride mouthrinse(500 ppm NaF), tooth cream with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride mouthhnse plus tooth cream on artificial caries lesion. Artificial caries lesion was induced at the buccal surface of permanent third molar and the specimens were then divided (16 specimens/group) into four group. Twice a day during 28 days specimens of each group were treated with a commercially anticari.ogen.ic product as follows and applied to the pH cycling system. Group 1: control group (No treatment) Group 2: Tooth Mousse^(ⓡ) (GC Co. Japan) Group 3: chikachika^(ⓡ) (Samil Co. Korea) Group 4: chikachika^(ⓡ) + Tooth Mousse^(ⓡ) The long-term change of mineral loss(ΔQ) was evaluated by quantitative 1ight-induced fluorescence(QLF) and the following results were obtained: 1. ΔQ of Group 1 was not noticed statistically significant during 28 days comparing that prior to treatment. There was a statistically significant increase in ΔQ of Group 2 and 3 since 14 days. So was in ΔQ of Group 4 since 7 days. 2. ΔQ was increased as follows: Group 1< Group 2, 3< Group 4. 3. Comparing with Group 1, Group 2 was a statistically significant increase since 7 days and Group 3 and 4 were since 3 days. Comparing Group 2 with 3, there was not noticed statistically significant during whole duration. Group 4 was significantly higher than Group 2 and 3 after 28 days. 4. All groups demonstrated a decrease in the rate of remineraUzation as time goes on.

여성생식계 상피세포에서 Glutathione S-Transferase 출현도에 관한 면역조직화학적 관찰

송계용,김석중,김미경,박용욱,유재형,박상철 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.2

Both placental form (GST-Pi) and basic form (GST-L) of glutathione S-transferase were studied in the epithelium of normal, tumor and tumor like lesions of female genital system. The results obtained were as follows : 1. Staining reaction of GST-Pi were moderate in normal cytotrophoblasts, mild in syncytiotrophoblasts, strong in corpus luteum, moderate to strong in salpingeal mucosa and in proliferative glands, moderate in secretory glands of indometrium and moderate in superficial squamous epithelium of cervix 2. Staining reaction of GST-L were mild in cytotrophoblasts and in syncytiotrophoblasts, of chorionic villi in corpus luteum, negative in salpingeal mucosa, very weak in proliferative glands, mild in secretory, glands of endometrium and in superficial squamous epithelium of cervix. 3. Staining reaction of GST-L were mild in cytotrophoblast and syncytiotrophoblast of choriocarcinoma, moderate in cytotrophoblasts, mild in syncytiotrophoblasts of hydatidiform mole, negative in mucinous epithelium of cust adenoma, in hyperplastia and adenocarcinoma, and mild in adenocarcinoma of cervix. 4. Staining reaction of GST-L were very weak in cytotrophoblasts and syncytiotrophoblasts of choriocarcinoma and in hydatidiform mole, negative in mucinous epithelium of cust adenoma, very weak in serous eptiethlium, negative to mild in hyperplastic and adenocarcinoma, mild in squamous cell carcinoma and adenocarcinoma of cervix. Therefore, staining reaction and distribution of GST-Pi and L isoengumes were different in normal and neoplastic cell of trophoblasts, salpinx, endometrin and cervix

청력장애가 불안 및 우울에 미치는 영향

송상욱,구정완,이원철 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

Hearing loss is a very common health problem throughout the world, although the number of hearing impaired individuals varies greatly in the countries. It is generally accepted that hearing impairment inevitably leads to a breakdown in communication and physical and mental health problems consequently. Nevertheless, few community based studies have been undertaken to examine both the mental and more general physical state of the hearing impaired patients. This study was conducted to evaluate the anxiety and depression in hearing impaired patients. Self-administered questionnaires including sociodemographic data were given to 336 subjects over the age of 18 years who visited the Health Management Center, Uijongbu St. Mary's Hospital for the routine health check up from January 1996 to April 1996 and three hundred seventeen samples (male: 197, female: 120) were selected. For the assessment of anxiety and depression we used Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) devised by Zung. And hearing impairment was evaluated using a Beltone Model 110 Audiometer. The results were statistically analyzed by ANOVA test and x²test. The results obtained were as follow: 1. The mean anxiety scores counted by SAS of 0-15dB HL(hearing loss) group(classified by the average loss in the better ear at 500, 1,000, 2,000Hz frequencies), 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 33.1±6.6, 32.2±5.9, 41.6±8.4, 42.8±6.0, respectively. And the mean depression scores counted by SDS of 0-15dB HL group, 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 37.4±7.7, 37.2±7.2, 46.2±8.4, 48.6±8.6, respectively. The more than 30dB HL group showed significant high scores in SAS and SDS than the less than 30dB HL group(p<0.001). 2. The frenquency of clinically significant anxiety disorder(SAS≥50) was 3.4% in less than 30dB HL group and 11.1% in more than 30dB HL group. The difference between two groups was statistically significant(p<0.05). 3. The frequency of clinically significant depression disorder(SDS≥50) was 5.1% in less than 30dB HL group and 39.5% in more than 30dB HL group. The difference between two groups was statistically significant(p<0.05). 4. When several important interaction variables related to anxiety and depression (such as age, sex, marital status, education level, economic status, occupation, religion) were stratified and we compared the groups between the more than 30dB HL and less than 30dB HL, most factors about anxiety and depression showed the significant differences in two groups. 5. Multiple logistic regression analysis revealed that hearing loss(p<0.05) predicted anxiety disorder(SAS≥50) and hearing loss(P<0.01), age(p<0.05) predicted depression disorder(SDS≥50). In conclusion, there was significant difference in anxiety and depression scores between more than 30dB HL (in the better hearing ear) group and less than 30dB HL group. This study suggested that anxiety and depression should be considered as adverse effects of hearing impairment.

탄산음료 유발 법랑질 침식에 대한 항우식 제품의 예방 효과

송주현,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

본 연구는 항우식 제품인 Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP)를 포함하는 치아크림, 불소 바니쉬, 저농도 불소 양치액을 치아에 도포하는 것이 단시간 탄산음료에 의한 법랑질의 침식을 예방할 수 있는지 살펴보기 위해 계획되었다. 법랑질 시편에 다음과 같은 항우식 제품을 도포하였고, 인공타액에 24시간 보관한 후, 콜라에 1분 증류수에 1분씩 5회 번갈아 처리하였다. 1군: 대조군(무처치) 2군: CPP-ACP 치아크림군 3군: 불소 바니쉬군(1,000 ppm F) 4군: 저농도 불소 양치액군(227 ppm F) 5군: 불소 바니쉬 + CPP-ACP 치아크림군 6군: 저농도 불소 양치액 + CPP-ACP 치아크림군 미세경도와 침식깊이를 측정하였고, Quantitative light-induced fluorescence(QLF)를 이용하여 안정된 형광 격자에 대한 부피 형광 변화인 ΔQ를 측정하여 무기질 감소량을 평가하였다. 6일 동안 실험을 반복하여 다음과 같은 결과를 얻었다. 1. 미세경도는 1군≤2군≤4군<6군<3군≒5군 순이었다. 2. 평균 침식깊이는 5군≒3군<6군<4군≒2군≒1군 순이었다. 3. ΔQ는 1군≒2군≤4군≤6군≤3군≒5군 순이었다. ΔQ의 감소율은 1군과 2군, 4군과 6군, 3군과 5군이 각각 유사하였다. 4. ΔQ는 미세경도와 강한 양의 상관관계를 나타냈고(r=0.96, p<0.05), 침식깊이와는 강한 음의 상관관계를 보였다(r=-0.96, p<0.05). The aim of this study was to evaluate the preventive effect of commercially available anticariogenic products, specifically, the tooth cream containing Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP), fluoride varnish and low-level fluoride mouthrinse on enamel erosion induced by carbonated beverage in a short period of time. Enamel specimens were treated as follows and were then kept in artificial saliva for 24 hours followed by further processing by alternately soaking them in Cola beverage and in distilled water for 1 minute each five times. Group 1: control group (no treatment) Group 2: tooth cream with CPP-ACP Group 3: fluoride varnish (1,000 ppm F) Group 4: low-level fluoride mouthrinse (227 ppm F) Group 5: fluoride varnish + tooth cream with CPP-ACP Group 6: low-level fluoride mouthrinse + tooth cream with CPP-ACP Microhardness and erosion depth were measured and the mineral loss of each specimen was evaluated by measuring the volumetric fluorescence change(ΔQ) against the stable fluorescent grid using quantitative lightinduced fluorescence(QLF). The experiment lasted for 6 days repeated each day. The results were as follows: 1. The microhardness was increased as follows: Group 1≤2≤4<6<3≒5. 2. The mean erosion depth was increased as follows: Group 5≒3<6<4≒2≒1. 3. The ΔQ was increased as follows: Group 1≒2≤4≤6≤3≒5. The decrement of ΔQ was similar between group 1 and 2, group 4 and 6 and group 3 and 5. 4. The ΔQ showed positive correlation with microhardness (r=0.96, p<0.05), while it was negatively correlated to erosion depth (r=-0.96, p<0.05).

PCR-Restricition Fragment Length Polymorphism 방법에 의한 Borrelia burgdorferi Sensu Lato의 분류

송혜원,김홍,박상욱,엄용빈,김종배,박성언,김근희 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCINE 1999 Journal of biomedical laboratory sciences Vol.5 No.2

라임병의 원인균인 Borrelia burgdorferi에 대하여 각 균종의 표준균주와 진드기에서 추출한 DNA를 template로 PCR을 실시한 후 그 증폭산물을 Alu I으로 처리한 restriction fragment length polymorphism (RFLP) 방법으로 각 균종의 연관성을 조사하고자 하였다. 표준균주로 RFLP를 실시한 결과 B. burgdorferi sensu stricto와 B. garinii의 RFLP 형태 (50 bp, 70 bp, 150 bp)가 유사하였으며 B.afzelii에서는 다른 RFLP형태 (50bp, 110bp, 150 bp)를 관찰하였다. 그 중 B. afzelii KK-1과 B. garinii HP1은 새로운 RFLP 형태를 보여 B. afzelii와 B. garinii는 각각 2 types의 subgroup으로 분류할 수 있었다. 진드기 DNA에서 는 B. afzelii를 포함한 각 균종에 대하여 모두 유사한 RFLP 형태를 보였는데, 진드기 DNA에서 확인된 B. afzelii는 KK-1과 같은 군에 속하는 것으로 사료되었다. For the classification of B. burgdorferi sensu lato strains, PCR-restriction fragment length polymorphism (RFLP) analysis was performed. PCR was carried out with B. burgdorferi sensu lato specific primer set (BB uni set), and amplicons of 470-bp DNA were digested with Alu I. The Alu I restriction polymorphism of the amplicons provided a useful tool for identifying B. burgdorferi sensu lato strains. Both amplicons from B. burgdorferi sensu stricto and B. garinii except HP1 strain showed identical RFLP pattern (50 bp, 70 bp, and 150 bp), but amplicons from B. afzelii and B. garinii showed two types of subgroups, respectively. The result of PCR-RFLP using extracted DNAs from ticks was similar to those patterns of B. burgdorferi species including B. afzelii.

고속액체크로마토그래피를 이용한 혈장중 로바스타틴산의 분석 : 시료전처리로서 단백침전법 및 고상추출법의 비교 Comparison of Protein Precipitation Method and Solid Phase Extraction Method for Sample Pretreatment

송우헌,장정수,박은우,이상길,최영욱 중앙대학교 약학연구소 1997 약학 논총 Vol.11 No.-

Lovastatin(LV), one of the potent cholesterol-lowering agents, is an inactive lactone prodrug which is metabolized to its active open acid (Lovastatin acid. LVA). In order to optimize the assay procedure of LVA by high performance liquid chromatography(HPLC). solid phase extraction(SPE) method and protein precipitation method were employed for the pretreatment of plasma sample containing LV and LVA, and plasma sample was hydrolyzed under alkaline condition to transform all LV to LVA. Following pretreatment of plasma sample. 100ul of sample was injected onto a reversed-phase C_18 column and eluted with a acetonitrile-pH 3.0 phosphate buffer mixture(45:55 v/v) at a flow rate of 2.0ml/min. Ultraviolet detection was carried out at 238nm. It has been shown that all of LV in plasma was converted to LVA in vitro under alkaline condition. On SPE method, elution with acetonitrile-methanol mixture(75:25 v/v) indicated the highest recovery of LVA, but acid treatment of plasma sample before loading on SPE cartridge revealed little effect on recovery of LVA. Compared with two different pretreatment of plasma sample, SPE indicated better sensitivity and recovery.

890MHz에 대한 실내 무선통신의 경로손실 예측모델

송만종,홍성욱,김흥수 濟州大學校 工科大學 産業技術硏究所 1994 産業技術硏究報告 Vol.5 No.-

The indoor radio environment, radio propagation characteristics are affected by various types of scattering and multipath phenomena. In order to provide services in a building, it is very important to analyze the propagation characteristics of the indoor radio environment, In this paper, the multipath loss model at 890[MHz] for the indoor environment are presented. The validity of the results by the present model is confirmed by comparing measured data. By this comparison, we showed that the theoretical analysis suggested in this paper is applicable to an analysis of the indoor radio environment.

지속성 외래 복막투석 환자에서 염증 지표와 고해상도 B 모드 경동맥 초음파 소견의 연관성에 관한 연구

송현용,송영수,안철우,강신욱,최규헌,하성규,이현철,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

배 경 : 저알부민혈증 및 C-반응 단백(C-reactive protein, CRP)이 증가된 지속성 외래 복막투석 환자의 사망률이 높은 정확한 이유는 밝혀져 않다. 혈액투석 환자에서처럼 복막투석 환자에서 저알부민혈증 및 염증반응이 심혈관계 질환 위험인자 인지 알아보고자 하였다. 방 법: 비당뇨병성 말기 신부전, 지속성 외래 복막투석 환자 93명의 심혈관계 질환 위험인자들과 복막 투과 특성 및 알부민, CRP 등의 염증지표에 따라 고해상도 초음파를 이용한 경동맥내막-중간막 두께, 내막-중간막 면적, 플라크의 유무 등을 단면적으로 비교하였다. 결 과: 복막 투과 특성은 고투과막군 14명, 중간 고투과막군 38명, 중간 저투과막군 31명, 저투과막군 10명으로 각 군간의 경동맥 내막-중간막 두께, 플라크 유무 및 내막-중간막 면적의 차이는 없었다. 기존 관상동맥 질환 환자는 8예(8.6%)로 내막-중간막 두께는 관상동맥 질환이 없는 환자보다 증가되었고(0.79±0.21 vs 0.60±0.11 mm, p<0.05) 플라크 형성은 더 많이 보이나 통계적 유의성은 없었다(75.0 vs 63.5%, p>0.05). 혈청 알부민치와 경동맥 내막-중간막 면적은 역상관관계를 보였다(r=-0.27, p<0.05). 저알부민혈증 환자(혈청 알부민 <3.5 g/dL)는 정상 알부민혈증 환자보다 내막-중간막 두께가 증가되었고(0.67±0.15 vs 0.61±0.12 mm, p<0.05), 플라크도 유의하게 많았다(68.0 vs 55.8%, p<0.05). 혈청 CRP치와 경동맥 내막-중간막 면적은 양의 상관관계가 있었으며(r=0.21, p<0.05) CRP가 높은 환자(≥0.8 mg/dL, n=18)에서플라크가 많이 관찰되었으나(65.8 vs 50.0%, p<0.05) 경동맥 내막-중간막 두께 및 내막-중간막면적은 양군간에 차이가 없었다. 다변량 회귀 분석상 경동맥 내막-중간막 두께에 영향을 미치는 인자는 고령, 높은 CRP, 기존 심혈관계질환, 낮은 혈청 알부민 순이였다. 결 론 : 복막투석 환자에서 고해상도 초음파를 이용한 경동맥 내막-중간막 두께 측정은 심혈관계 질환 유무 예측의 비침습적 검사가 될 수 있고 저알부민혈증 및 높은 CRP과 같은 만성염증 지속상태가 복막투석 환자에서 죽상 동맥 경화증의 발생을 증가시킨다고 가정할 수 있다. Background : Continuous ambulatory peritoneal dialysis(CAPD) patients with low albumin(LA) and signs of inflammation reflected by increased C-reactive protein(CRP) level have an increased mortality, but the mechanism of this phenomenon is not clear yet. Methods : To answer whether LA and inflammation also enhance cardiovascular risk in CAPD patients, we performed cross sectional study measuring carotid artery intima-media thickness(IMT), calculated intima-media area(cIM area) and the presence of plaque by high-resolution B-mode ultrasonography in 93 non-diabetic CAPD patients. Results : Patients with coronary artery disease (CAD, n=8) had significantly increased IMT(0.79± 0.21 mm vs. 0.60±0.11 mm, p<0.05) and higher prevalence of carotid plaques(75.0% vs. 63.5%) compared to the non-CAD patients. Significant inverse correlation was observed between serum albumin (SA) level and cIM area(r=-0.27, p<0.05). Those patients with LA(SA <3.5 g/dL) had significantly increased IMT compared to non-LA patients(0.67±0.15 mm vs 0.61±0.12 mm, p<0.05). Prevalence of carotid plaques was also significantly higher in LA patients (68.0% vs. 55.8%, p<0.05). CRP level revealed a significant positive correlation with cIM area(r=0.21, p< 0.05). Patients with high CRP(≥0.8 mg/dL, n=18) had higher prevalence of carotid plaques (65.8% vs. 50.0%, p<0.05) compared to those patients with CRP <0.8 mg/dL, but IMT and cIMT area were not different. By multivariate logistic regression analysis, old age, high CRP, history of CAD and low SA were the independent risk factors affecting IMT. Conclusion : Our study strongly suggests that low albumin and chronic inflammatory state of CAPD patients could be associated with increasing atherosclerotic cardiovascular disease. (Korean J Nephrol 2002;21(2):285-294)

말기 신부전 환자에서 투여 경로에 따른 유전자 재조합 인 Erythropoietin(Epokine^(�))의 효과와 안정성에 대한 연구 : 제 4상 연구 A Phase 4 Single Center Study

송현용,윤향숙,강신욱,최규헌,하성규,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

목 적 : 국내 독자적 기술로 첫 개발된 유전자 재조합 인 에리트로포에틴(Epokineⓡ)의 투여방법에 따른 유효성과 안정성을 알아보고자 하였다. 방 법 : Epokineⓡ을 주당 100-150 U/kg, 주 2회, 12주간 피하 주사하여 목표 또는 안정된 혈색소치 유지 후 무작위로 피하 및 정맥 주사군으로 나누어 12주간 혈액투석 및 복막투석 환자13명, 28명에서 유효성, 안정성을 분석하였다. 결 과 : 양군에서 혈색소치와 헤마토크릿은 Epokineⓡ 투여 2주 후부터 증가, 혈색소치가 혈액투석 환자는 투여 전 7.3 g/dL, 투여 12주 9.5 g/dL, 24주 10.6 g/dL로, 복막투석 환자는 6.8g/dL에서 12주 10.2 g/dL, 24주 10.8 g/dL로 증가하였다. 양군에서 교정 망상적혈구수(%)는투여 1주 후부터 전 기간동안 증가하였다. 혈청 내 철분, ferritin치는 양군에서 투여 2주 후부터감소, 총 철분 결합능은 투여 2주 후부터 증가하였다. 12주째 혈액투석 환자에서 많은 Epokineⓡ용량이 필요했으나(142.2±20.5 vs 117.3±33.6 U/kg/wk, p<0.001) 24주 후 양군의 용량차이는 없었다(123.6±41.5 vs 99.2±49.3 U/kg/wk, p>0.05). 혈액투석 환자에서 피하 주사가Epokineⓡ 투여용량이 더 적었으나(97.4±15.4 vs 145.4±2.9 U/kg/wk, p<0.002) 복막투석 환자는 차이가 없었다(93.0±60.2 vs 105.4±9.7 U/kg/wk, p>0.05) 연구기간 중 9명(18.8%)에서혈압강하제 추가가 필요한 혈압상승, 근육통 동반 상기도 감염 유사증상 및 두통 등의 부작용이 있었다. 대부분 자연소실 혹은 대증요법으로 치유되었고 2명이 부작용으로 탈락하였다. 결 론 : 말기 신부전 환자의 빈혈 개선에 사용하는 Epokineⓡ의 효과는 복막투석 환자에서 더 좋았으며 투여 경로는 정맥주사보다 피하주사가 높음을 알 수 있었다. Background : We evaluated the clinical efficacy and safety of recombinant human erythropoietin(Epokine^(ⓡ)). Methods : A comparative prospective study of intravenously and subcutaneously administrated Epokine^(ⓡ) conducted 13 patients performing hemodialysis and 28 patients performing continuous ambulatory peritoneal dialysis with end-stage renal disease. Epokine^(ⓡ) was given initially at a dosage of 100 unit/kg, subcutaneously, two times a week. The patients had achieved stable or more than 10 g/dL of hemoglobin level for 12 weeks and then we randomized switching intravenously or subcutaneously administrated Epokine^(ⓡ) for another 12 weeks. Results : Hemoglobin(g/dL) and hematocrit(%) increased significantly from baseline levels beginning from 2 weeks after Epokine^(ⓡ) administration. In HD patients, hemoglobin increased significantly from 7.3 to 9.5 after 12 weeks and to 10.6 after 24 weeks. In CAPD patients, hemoglobin increased significantly from 6.8 to 10.2 after 12 weeks and then 10.8 after 24 weeks(p<0.05). Corrected reticulocyte count(%) was significantly increased from baseline levels beginning from 1 week after Epokine^(ⓡ) administration and continuously increased during study period in both group. Serum ferritin and serum iron decreased significantly and total iron binding capacity increased significantly after 2 weeks. At 12 weeks, HD patients were significantly needed more dosage of Epokine^(ⓡ) than CAPD patients(142.2±20.5 vs 117.3±33.6 U/kg/wk, p<0.001), but at 24 weeks, the dosage was not different(123.6±41.5 vs 99.2±49.3 U/kg/wk, p> 0.05). In HD patients, intravenously administrated Epokine^(ⓡ) group was more dosage than subcutaneously group(97.4±15.4 vs 145.4±2.9 U/kg/wk, p< 0.002), but CAPD patients were not different by administration method(93.0±60.2 vs 105.4±9.7 U/kg/ wk, p>0.05). The 9 cases(18.8%) were suffered from headache and flu-like syndrome, but these side effects were not severe and disappeared from conventional therapy. Conclusion : Epokine^(ⓡ) administration is safe and effective in treating anemia of ESRD patients and subcutaneously administration is significantly more effective than intravenously. (Korean J Nephrol 2002;21(2):190-198)

일개 대학병원에서 일년간 분리된 반코마이신 내성 장구균의 임상 분자역학적 연구

송진영,김창억,김성욱,우흥정,김미란,이규만,이란,장미화,정희진,김우주 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.4

목적 : 한강성심병원에서는 2000년 3월 반코마이신내성 장구균이 처음 분리되어, 원내전파를 막기 위한 노력을 하였으나, 분리가 지속되었다. 따라서 이에 대한 좀더 자세하고 객관적인 자료를 얻기 위해 본원에서 분리된 반코마이신내성 장구균에 대한 임상분자 역학적 연구를 시행하게 되었다. 방법 : 2000년 3월부터 2001년 2월까지 한림대학교 한강성심병원에서 분리된 장구균을 대상으로 디스크 확산법, 최소발육억제 농도등의 측정을 통해 반코마이신 내성여부를 확인하였으며, 반코마이신내성 장구균을 대상으로 PFGE를 시행하여 형별 분석을 하였다. 결과 : 분리된 균주는 총 32균주로 모두 E. faecium이었다. 항생제 내성 검사 결과 모두 Van A형이었다. PFGE 결과 1a형이 8검체, 1b형이 5검체, 2a형이 4검체, 2b형이 4검체, 3a형이 2검체, 3b형이 5검체였고, 그 외 4, 5, 6형이 각각 1검체씩이었다. 총 32균주 중 56%(18/32)의 균주가 같은 시기, 같은 병실에서 동일한 PFGE 형을 보이면서 분리되었다. 결론 : 반코마이신내성 장구균의 PFGE 분석 결과 여러 종류의 반코마이신내성 장구균이 유행하였음을 알 수 있다. 그러나 같은 기간, 같은 병실에서 분리된 균주의 PFGE 형이 같은 것이 상당수 있었다. 이는 반코마이신내성 장구균의 원내 전파가 있었음을 의미한다. 따라서 반코마이신내성 장구균의 전파의 발생 및 전파 방지를 위해서는 보다 효과적인 감염관리 활동이 필요할 것으로 생각된다. Background: Vancomycin-resistant enterococci(VRE) have been a rising problem worldwide. In March 2000, VRE was first isolated from a patient in Hangang Sacred Heart hospital. Although efforts to prevent transmission of VRE were performed, isolations continued. So molecular epidemiological study of VRE was done. Method : The minimal inhibitory concentration(MIC) to vancomycin and teicoplanin, and pulsed field gel electrophoresis(PFGE) pattern of VRE isolated from March 2000 to February 2001 were evaluated. Results : 32 VRE were isolated. All of the VRE were Enterococcus faecium and showed Van A resistance phenotype. We found out that a significant number of VRE isolated during same period and in same room, were same PFGE patterns. (18 cases/ 32 isolates= 56%) Conclusion: This study demonstrated the spread of VRE of same PFGE patterns. It suggests the nosocomial spreads of VRE.