국내 혈액질환 환자에서 침습성 아스페르길루스증의 구제치료로서 Voriconazole의 효과와 안전성

권재철,김시현,최수미,최재기,이동건,박선희,최정현,유진홍,신완식 대한감염학회 2010 감염과 화학요법 Vol.42 No.1

Background: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in patients with hematologic malignancies. We investigated the efficacy and safety of voriconazole (VCZ) when used as salvage therapy for IA in Korean adults with hematologic malignancies who had not responded to prior antifungal therapy. Materials and Methods: We retrospectively reviewed data, collected from January 2007 to October 2008, from patients with proven or probable cases of IA. All were probable IA cases, except for one proven case. All cases were refractory or intolerant to antifungal therapy prior to administration of VCZ. Efficacy and safety were assessed in patients treated with VCZ for more than 3 days and for more than one dose, respectively. A favorable response [complete (CR) or partial (PR)] was defined by significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results: Fifty patients who met the inclusion criteria were enrolled. There were 27 male and 23 female patients with mean age of 44.4 years (range, 15-65 years). Underlying diseases were acute leukemia (35 cases), chronic myelogenous leukemia (4 cases), myelodysplastic syndrome (3 cases), lymphoma (3 cases) and other hematologic diseases (5 cases). Twenty-two patients had received chemotherapy and 13 patients had undergone hematopoietic stem cell transplantation. The lung was the main infection site (94%) followed by the sinus (6%). Amphotericin B deoxycholate alone was the most frequent previous antifungal therapy. The mean duration of antifungal therapy prior to VCZ therapy was 13.9±8.8 days (2-44 days). The median duration of VCZ therapy was 19 days (interquartile range, 49 days). Sixteen patients (32.0%) showed favorable responses (CR:PR=8:8) at the end of VCZ therapy. The numbers of patients with stable disease, progression and death were, 6 (12%), 6 (12%) and 22 (44%) respectively. Most of those with unfavorable responses had relapsed underlying malignancies or refractory graft versus host diseases. Twelve patients developed drug-related adverse events but only one patient stopped VCZ treatment prematurely. Conclusions: VCZ demonstrated an acceptable level of toxicity in patients with hematologic malignancies but further studies are required to prove its efficacy as salvage therapy.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

환자만족도 조사설문지의 설문문항 배열에 따른 신뢰도 분석

최귀선,조우현,홍재석,이선희,강명근 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.2

Objectives : The purpose of this study was to evaluate the reliability of questionnaire according to item arrangement on patient satisfaction questionnaire. Methods : We developed the two types of questionnaire with different item arrangement. In the first type (A), questions were arranged according to medical service dimensions. Questions in the second type (B) were arranged according to medical process. Both questionnaires were composed of six dimensions: physical environments, process, competence, courtesy, information giving, understanding patients. Measurements were performed on a 5-score Likert scale. In an outpatients and inpatient survey, total 777 patients answered the type A (outpatients: 257, inpatients: 128) or Type B (outpatients: 257, inpatients: 135). In order to compare the internal consistency of two types. Cronbach's α were calculated. Multiple regression analysis was also performed to know which type of questionnaire explain more of the overall satisfaction. Results : In outpatient survey, type A questionnaire showed higher internal consistency than B except physical environments dimension. Also in inpatient survey, type A had higer internal consistency than B in four dimensions(process, competence, courtesy, understanding patients). In the results of multiple regression analysis, type A questionnaire (R² =0.53) explained more of the variation in overall satisfaction then B questionnaire (R2=0.43) in outpatient survey. In inpatient survey, type B questionnaire (R²=0.40) explained, more of the variation in overall satisfaction than type A questionnaire (R² =0.33).But the.difference of R was not significant in inpatient survey. Conclusion : The results of this study support that type A questionnaire has higer reliability in assessment of consumer satisfaction than type B.

原料의 種類와 形態에 따른 Aspergillus oryzae 麴의 生理活性 및 酵素力

최성현,정재홍,이상덕,손화영,성창근,오만진,김성렬 충남대학교 농업과학연구소 1997 농업과학연구 Vol.24 No.2

CNU O4-5 isolated from conventional Meju, which is used as raw material for making a soybean fermentation food, identified as an Aspergillus oryzae. To make koji, Aspergillus oryzae CNU O4-5 was cultured for 3-4 days at 30℃ with various grain materials such as flour, soybean powder, flour+soybean powder(1:1), soaked soybean and rice. The koji was evaluated for analyze the angiotesin converting enzyne(ACE) inhibition, antioxidative activity, superoxide dismutase(SOD) activity, amylase and protease activity, α-amylase and glucoamylase activities of flour koji wee higher than those of the koji soybean powder. However neutral and alkaline protease activities of flour koji were lower than those of flour+soybean powder and soybean koji. Amylase and protease activities of kojies of soaked soybean and rice showed very low level. The range of the ACE inhibition rate by hot water fraction of the kojies, which are cultured with various gain materials, were from 45% to 54%. The antioxidative activity of ethanol-fraction of koji, which is made by using the soybean powder or soaked soybean, prolonged for 6 days in lard at 60℃. The SOD activity of grinded fraction of koji, which is made by using the flour or soybean powder, was same as 2,000 units per g of each koji.

몬테카를로 방법을 이용한 고강도콘크리트 구조물에 대한 휨변형의 해석적인 연구

최광진,장일영,송재호,홍원기 金烏工科大學校 1995 論文集 Vol.16 No.-

The object of this thesis is an analytical study on flexural deformation of high strength concrete structures using Method. Using the established experimental data that has been presented in various documents the stress-strain relationship curves of high strength(500㎏f/㎠) models are proposed. Based on both methods of logarithm regression analysis and multiple regression analysis adopted in order to establish the relationships between design parameters, responsed random variables and flexural deformation analyzed using monte carlo simulation and simpson composite formula. Additional random variables are introduced to incorporate both the confidence in the analytical accuracy of engineering mechanics associated with structural response quantities and the uncertainty in the construction quality control. The result is expected to accomodate other important design parameter of high strength concrete design in treating reliability theory that practicing engineers and structural engineering.

산부식 시간에 따른 유전치 법랑질의 부식 유형에 관한 연구

최수미,최영철,박재홍,최성철 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.3

이 연구의 목적은 유전치 법랑질에서 무소주 법랑질 층이 있는 치경부에서의 적절한 산부식 시간을 알아보고자 함이다. 경희대학교 치과대학병원 소아치과에 내원한 환아에게서 발거한 치아 순면에 우식이 없는 건전한 치아 32개를 대상으로 실험 하였다. 발거된 유전치의 치경부 법랑질을 35% 인산으로 실험 1군은 15초,실험 2군은 30초,실험 3군은 45초,실험 4군은 60초간 산부식한 후 부식시간에 따른 법랑질 표면의 양상을 SEM으로 관찰하여 평가하였다. 1. 실험 1군에서는 Type 3가 75% 나타났으며 실험 2군과 3군 모두에서 Type 1이 38%, Type 2가 50%로 나타났다. 2. 실험 2군보다 실험 3군에서 산부식된 양상이 좀더 뚜렷하게 나타났다. 3. 실험 4군에서 Type 1이 25%. Type 2가 75%를 보였고 Type 3는 나타나지 않았다. 4. 실험 4군에서는 다른 실험군에서 보다 좀더 전형적인 산부식 양상을 보였다. 5. 설험군 간의 산부식 시간에 따른 부식 양상의 차이는 통계학적으로 유의한 차이를 보였다(p<0.05). 6. 산부식 시간이 길수록 부착에 유리한 Type 1과 Type 2가 주로 관찰되었으며 Type 3는 드물게 관찰되었다(p<0.05). 유전치에서 무소주 법랑질 층이 주로 존재하는 치경부 측에,와동의 변연부가 형성될 때에는 산부식 시간을 다소 길게 45∼60초 정도 하는 것이 수복물 유지를 향상시킬 것으로 여겨진다. The presence of a"prismless" layer on the enamel surface particularly on deciduous teeth has been reported by a number of workers. This structure, which appears to lack the normal prism delineations, could interfere with tag formation and hence, reduce bonding to such surfaces. The purpose of this study was to investigate the relationship of etching times on the effect of acid etching on primary enamel with respect to the quality of etching patterns. Labial surfaces of 32 extracted or exfoliated caries-free primary anterior teeth were used. 35% phosphoric acid gel was used only cervical regions of labial surfaces for each etching time group, 15, 30, 45 and 60 seconds. The surfaces were then washed with water for 20 seconds and dried with air spray for 20 seconds. 1. The Type 3 is 75% when the 15 seconds acid etching time was used. 2. The Type 1 is 38% and Type 2 is 75% when the 30 and 45 seconds acid etching time was used. 3. The Type 1 is 25% and Type 2 is 75% when the 60 seconds acid etching time was used. 4. An etching time of 60 seconds produced a constant and regular etching pattern. 5. There is a significant difference between the groups with respect to the patterns of etch achieved(p<0.05). 6. We confirmed that the acid induced patterns(type 1, 2) became more pronounced when the application time increased(p<0.05). 45∼60 seconds was the optimal time for etching on the primary enamel.

충진탑에서 가스흡수에 의한 물질전달과 수력학적 거동에 관한 연구

최동훈,김재홍,김일배,김옥택,김장호 동아대학교 환경문제연구소 1997 硏究報告 Vol.20 No.1

The use of packed column which apply efficient thermal material separation method has been required for absorption process. Absorption is applicable to waste gas from industrial process and incineration and odor control. Since we have used the lattice packing which was recently discovered in Germany, We can prevent drop of efficiency from maldistribution and channeling which were occurred when we use conventional packing. The lattice packing is efficient within the range of thermal, easy to manufacture, low production cost and make a variety of materials. This study aims to control the waste gas and odor with absorption. The dimension of packed column in which used in experiment is 0.45(d) × 2.0 m(H), and the result of and mass transfer apply to practical industry and environmental protection. The systems adopted for the absorption are Air/Water and NH3-Air/Water. We still cannot apply packed column to the domestic industry and environmental protection and depend on foreign technology, but this study will contribute to the industry and environment.

약물치료에 가역적 회복을 보인 갈색세포종에 동반된 확장성 심근증 1례

홍숙경,최현,이승철,천경일,김영철,한재룡,김미숙,정경태,박순창 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

파킨슨 증후군을 동반한 조발형 알쯔하이머병 1예

최은정,방현,임주혁,이재홍 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

Extrapyramidal signs (EPSs) frequently accompany Alzheimer's disease(AD). However, the pathogenesis or pathologic basis for the EPSs in AD remains unclear. We report a case of presenile onset progressive dementia later associated with hemiparkinsonism. Brain biopsy showed neurofibrillary tangles and amyloid plaques. compatible with Alzheimer's disease. There are a few report about dopamine transporter imaging of AD with EPSs. 1-123 IPT SPECT revealed a decreased uptake in both basal ganglia, more severe on the left side and in the caudal putamen, which is consistent with the finding of idiopathic Parkinson's disease. Alzheimer's disease and Parkinson's disease are thought to be coexistent in our patient.