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.

Methotrexate 치료를 받고 있는 활동성 류마티스 관절염 환자에서 etanercept의 유효성과 안전성에 관한 연구

최병렬,강태영,정청일,이혜순,엄완식,김태환,전재범,유대현,배상철 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 류마티스 관절염을 앓고 있는 한국인 중에 기존 DMARDs로 치료 실패하였고, 고정용량의 MTX를 복용하고 있는 환자들에 있어서 etanercept의 유효성과 안전성을 평가하고자 하였다. 방법 : 기존 DMARDs로 치료 실패한 활동성 류마티스 관절염 환자 76명을 대상으로 하여 단일군, 공개시험을 하였다. 대상 환자들은 고정용량의 MTX를 복용하면서 etanercept 25 mg을 1주일에 두 번 피하 주사하였으며 12주간 투여하였다. 유효성은 ACR 20, ACR 50,조조강직 시간으로 평가하였고, 약제의 안전성은 이상반응 등으로 평가하였다. 결과 : 대상 환자는 총 76명으로 평균 연령은 45.2세, 남자 5명, 여자 71명이었다. 84.4%인 54명이 12주째에 ACR 20을 만족하였고, 53.1%인 34명이 12주째에 ACR 50을 만족하였다. 조조 강직 시간은 치료 전 203.3분에서 치료 12주째 42.6분을 평균 74.5% 호전되었다. 가장 흔한 이상반응은 주사부위 반응이었다. 이외에도 상기도 감염, 오심, 안면부종 등이 발생하였으나 심각한 부작용은 없었다. 결론 : etanercept는 효과적이고, 안전한 류마티스 관절염 치료 방법이며 특히 MTX치료에도 불구하고 활동성인 류마티스 관절염에 기대되는 치료라고 할 수 있다. Background : This study was performed to investigate the efficacy and safety of etanercept in active rheumatoid arthritis patients with stable dose of methotrexate in Korean. Methods : In a 12 week, single arm, open trial, we assigned 76 patients with active rheumatoid arthritis who had an inadequate response to disease-modifying antirheumatic drugs. Patients received twice-weekly subcutaneous injections of etanercept 25 ㎎ while containing to receive methotrexate at a stable dose of 7.5~25 ㎎ per week. The clinical response was defined as the percent improvement in disease activity according to the criteria of the American Collage of Rheumatology (ACR) at 12 weeks. Results : Etanrecept led to significant improvements in disease activity and was safe and well tolerated. At 12 week, 84.4% of the patients receiving 25 ㎎ of etanercept achieved a 20% ACR response, and 53.1% of those receiving etanercept achieved a 50% ACR response. The most common adverse event was injection-site reaction. Other advanse events were upper respiratory infection, nausea, and facial edema, but there were no serious adverse events associated with etanercept. Conclusion : In active rheumatoid arthritis patients, etanercept was safe, well tolerated, and provided rapid clinical improvements.

신문 경제기사의 독이성에 관한 연구

최재완 경희대학교 커뮤니케이션연구소 1995 커뮤니케이션硏究 Vol.11 No.-

면외하중하의 이방성체 등속 계면균열 선단의 원주 전단응력

최성렬,박재완 嶺南大學校 工業技術硏究所 2004 工業技術硏究所論文集 Vol.32 No.2

The asymptotic circumferential shear stress of the propagating interfacial crack with constant velocity in bonded anisotropic materials under out of plane loadings is obtained. The maximum circumferential shear stress moves out of the interface as the crack velocity attains certain critical speed which is dependent an the properties of materials near to the interface. Referring to the maximum stress criteria, it could be shown that the three types of crack growth could be formed, such as straight/kinked/branched crack.

교육방송 프로그램이 고등학생들의 학력신장에 미치는 효과

최재완,임성규,이효녕 慶北大學校 師範大學 科學敎育硏究所 2007 科學敎育硏究誌 Vol.31 No.-

이 연구는 고등학교 1학년 학생들이 교육방송에 의한 학습을 장기간 지속적으로 시청했을 때 학력에 미치는 효과를 검정하고 현행교육방송의 실태와 개선점을 알아보고자 한다. 대구광역시 내 동일학군에 소재한 일반계 고등학교 중에서 교육방송에 의한 학습을 한 실험집단(A고교)과 교육방송을 하지 않고 자율학습을 한 비교집단(B고교)간의 성취도를 비교하였다. 4월부터 교육방송 수업을 시작한 후 5월 과 11월에 시행된 두 차례의 전국연합학력 평가에서 「수리탐구 I 영역」의 성적을 비교하였다. 그 결과 두 집단간 평균점수 차이가 유의미하다고 나타났다. 그리고 두 집단의 최하위 성적 급간(하위 10% 이내)을 제외한 모든 급간에서 실험집단이 비교집단 보다 성적이 많이 향상되었다고 나타났다. 실험집단을 대상으로 현행 교육방송 프로그램에 대한 의견 조사 결과,개선할 점으로 프로그램 내용의 수준별 편성,보다 다양한 자료의 활용,강의 진행 속도의 조절,그리고 지도방법의 개선 등을 들고 있다. The purpose of this study was to investigate the effect of EBS programs on the Scholasstic Achievement of high school students and make suggestions for facilitating EBS programs in high school. The academic performance of two group of different school students in Daegu was compared; One is experimental group(A school) and the other is comparative group(B school). The experimental group(A) studied through EBS programs for average 21 hours a week, while the comparative group(B) were not given any chance to take advantage of the EBS programs at all. The comparison between the two results of May and November trial exams indicated that in the case of the upper level students belonging to top 10%, the mean scores of the experimental group has increased more remarkably than that of the comparative group.

직업적 디메틸아세트아미드(Dimethylacetamide) 노출에 의해 집단적으로 발생한 독성간염

최태성,우극현,김진석,박완섭,함정오,정상재,유재영 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : DMAC에 노출된 후 집단적으로 발생한 독성 간염 7례보고. 방법 : 2000년 2월 신설된 스판덱스 섬유제조 공장에 근무하는 생산직 근로자 178명중 2000년 2월 부터 8월까지 7명이 간장질환이 발생하였다. 환례들의 나이는 23∼47세였고, 남자 5명, 여자 2명이었다. 이들에 대해 혈액검사, 간 초음파 검사 등의 임상검사와 작업장 조사를 실시하였다. 결과 : 근무 부서는 중합 1명, 방사 1명, 권취 4명, 그리고 포장 1명이며 평균근무기간은 10주였다. 주 호소 증상은 심한 피로감, 어지럼증 및 황달이었고, 검사실 소견상 독성간염의 소견을 보였다. A, B 및 C형 간염 표지자 검사는 모두 음성이었고, 간초음파 소견상 특이 소견이 없었다. 문진 상 알코올 성 간염을 일으킬 정도의 음주력이나 최근 약물 복용력을 가지고 있는 환례는 없었다. 입원 후 보존적인 치료로 모두 급속히 호전되었다. 초기에 발생했던 환례에서 퇴원후 DMAC에 재 노출되어 독성 간염이 재발되었다. 이후 모든 환례들은 퇴원 후 DMAC 비노출 부서로 전환하였고, 퇴원후 지속적인 추적검사에서 간 효소 수치가 완전히 정상화되었고, 정상화되는 기간은 1∼2개월 정도 소요되었다. 결론 : 환례들의 임상증상, 검사결파, 노출력 및 과거력상 DMAC에 의한 독성간염으로 추정된다. Dimethylacetamide is widely used in the production of plasics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide (DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubln, alanlne aminotransferase (ALT), and aspartate aminotransferase (AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.

시비량이 생강의 생육 및 수량에 미치는 영향

최재을,김정선,이은정,이완재 충남대학교 농업과학연구소 1998 농업과학연구 Vol.25 No.2

This experiment was carried out to define the effects of application amounts of the chemical fertilizers on plant growth and yield of the ginger. The results obtained are summarized as follows. Plant height of the ginger was 45.3 cm at lower level of fertilizer, 52.6 cm at recommended level, and 49.4 cm at higher level. Leaf area, stem number, and stem diameter were more significantly increased at higher level of fertilization compared to recommended rate. Dry weight of shoots and rhizomes were significantly increased with the increase of fertilization level. Stem number, stem diameter, leaf area, dry weight of shoots, and fresh weight of rhizomes were positively correlated with the amounts of fertilizer applied. Yield of rhizomes were 1, 653 kg at lower level of fertilizer, 2,248 kg at recommended level and 2,428 kg at higher level, respectively. Ginger yield showed 7.4% higher at higher level of fertilization compared to recommended rate.

Ciprofloxacin 제제의 생물학적 동등성에 관한 연구

최철희,신재국,신완균,유호진,이경훈,정원석,장인진,신상구 대한화학요법학회 1991 대한화학요법학회지 Vol.9 No.1

국내 시판중인 ciprofloxacin 제제인 Citopcin®(250㎎ tablet)의 동등성을 검토하기 위해 제조원인 Bayer사의 Citopcin®(250㎎ tablet)를 기준제제로 하여 18명의 건강한 남성 피험자를 대상으로 500㎎ 1회 교차 경구 투여후 약동학적 성상을 분석비교한 결과는 다음과 같다. 시험제제의 생체 이용율의 지표인 AUC, C_(mao), T_(max) 및 MRT들의 평균치는 백분율차이에 있어 모든 기준제제 지표의 ± 20% 이내였으며, 이들 생체 이용율 지표들은 분산분석 검정에서 차이를 인지할 수 없었다.생체 이용율 지표들의 기준제제에 대한 백분율 90% 대칭 신뢰구간 검토시 모든 경수들에서 ± 20% 이내의 조건을 만족하였으며 AUC의 경우에는 대칭형 신뢰구간으로 변환시 95% 신뢰구간에서도 동등성의 조건을 만족하였다, 이상의 시험결과로 시험제제인 Citopcin®은 기준제제인 Ciprobay®와 생물학적 동등한 제제로 판단되었다. The pharmacokinetics of ciprofloxacin was studied for the evaluation of the bioequivalence of the generic ciproflocacin products. Two single doses of 500㎎ each of ciprofloxacin(Ciprobay® 250㎎ tablet as a reference compound and Citopcin® 250㎎ tablet s a test compound) were administered orally to ighteen male volunteers in a balanced, randomized crossover design. Pek plasma levels of ciprofloxacin were observed about 1 hour after the doses and the peak concentrations of both products were similar(Ciprobay®, 3.18㎍/㎖; Citopcin®, 2.89㎍/㎖). The values of other pharmacokinetic parameter of ciprofloxacin computed for Ciprobay® are presented in that order: AUC=13.53:12.47㎍·h/㎖, T_(max)=1.28:1.14 hours; MRT=5.30:5.08 hours; t_(1/2)β=3.65:3.47 hours. No satistically significant, differences were detected when AUC and the other parameters were compared with the method of ANOVA. Using the criteria of 90% confidence interval for the assessment of bioequivalence al the parameters were acceptable. The products were found to be equivalent on the premise that no significant difference was detected when the relevant pharmacokinetic parameters were compared, and the confidence limit analysis showed acceptable results.

초등학생들의 열과 온도에 대한 대안개념 조사

최행숙,김은경,백성혜,이길재,정완호 한국교원대학교 과학교육연구소 2001 청람과학교육연구논총 Vol.11 No.1

In this study, the contents of elementary school science textbooks related to 'heat and temperature' are analyzed and alternative conceptions of "heat and temperature" among students enrolled in grades 4, 5 and 6 are investigated. 259 students were selected from a elementary school located in urban area. The relationships between students' alternative conceptions and the content of elementary science textbooks are also examined. Students' conceptions are analyzed from their answers to a paper-and-pencil test. The typical alternative conception of "heat and temperature" held by students was follows. They think that "heat" is a material and "temperature" is value of heat amount. They can't distinguish between "heat" and "temperature". Their explanation of "heat and temperature" is focused on hot or cool sensation and other observable characteristics of a material. A textbook analysis indicated that contents on "heat and temperature" were organized without the viewpoint of particle motion theory. This may be one of the causes of students' alternative conceptions.

이중관 기포탑에서의 비뉴튼류의 기-액간 물질이동

한승환,김상렬,최재욱,최일곤 東亞大學校 1991 東亞論叢 Vol.28 No.1

The effect of draught tube dimension, properties of CMC aqueous solution and gas velocity on the gas holdup, ??, and the volumetric liquidphase masstransfer coefficient, ??, in a bubble column with draught tube were measured in highly viscous-pseudo plastic carboxymethylcellulose aqueous solution. The results were as follows : 1. ?? and ?? increase with increasing gas velocity and decrease with increasing concentration of CMC aqueous solution. 2. ?? and ?? increase with being enlarged diameter ratio of draught tube but specially ?? decreases to some degree in the CMC concentration of 0.05∼0.7wt%. 3. Correlations among various parameters having an influence on ?? and ?? were expressed by Eq. (16) and Eq. (17), respectively. ??