카이토산을 이용한 방사성스트론튬 오염의 치료

김지열,송호천,양광희,최근희,채기문,범희승,김광윤 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.3

본 연구에서는 마우스에 이미 오염된 방사성스트론튬(Sr-85)을 제거하는데 수용성카이토산이 어느정도 효과가 있는지 알아보고자 하였다. Sr-85를 정맥주사한 경우 주사후 1일째의 체내 잔류량은 72.9 ±5.7%, 5일째는 57.7 ±1.9%, 7일째는 54.2 ±1.4%로 서서히 감소하였으며, Sr-85를 복강내 주사한 경우는 주사후 5일째 54.4 ±1.2%, 15일째 50.6 ±0.8%로 정맥주사에 비해 낮은 잔류량을 보였다(5일째 잔류량의 비교, P<0.05), 0.3% 수용성카이토산을 1회 정맥주사해준 제21군 및 10% 수용성카이토산을 식이중에 섞어 먹인 제5군은 각각의 대조군에 비해 체내 잔류방사능의 차이가 없었으나 (P>0.05), 0.3% 수용성카이토산을 3일간 정맥주사한 제3군과 3% 수용성카이토산을 이틀 간격으로 15일간 복강내 주사한 제6군에서는 각각의 대조군에 비해 낮은 잔류방사능을 보였다. (P<0.01). 결론적으로 수용성카이토산을 연속적으로 정맥투여하거나 복강내 투여하는 경우에는 스트론튬의 골대사촉진 또는 골중의 스트론튬과의 반응등을 통해 그 배출을 촉진시킬 것으로 사료되었다. The aim of the present study was to elucidate the effect of the water soluble chitosans on the removal of contaminated radiostrontium(Sr-85) from the bone of mice. The remaining radioactivities in intravenously injected controls(group 1) were higher than in intraperitoneally injected controls (group 4, P<0.01). The % retention at day 5 were 57.7 ±1.9%, 54.4 ±1.2%, respectively. Single intravenous injection of 0.3% water soluble chitosan and continuous oral ingestion of 10% water soluble chitosan for 15 days were ineffective on the removal of contaminated radiostrontiums. Multiple intravenous or intraperitoneal injections of water soluble chitosan effectively removed contaminated radiostrontiums (P<0.01 vs controls). In conclusion, water soluble chitosan might remove once incorporated radiostrontium from bones of mice. further studies were needed to elucidate the mechanism of the removal.

형광검출 역상 액체크로마토그래피에 의한 Histamine의 정량

유희춘,김형룡,김상현,김대기,이영미,김형민,안년형,신태용 우석대학교 의약품개발연구소 1996 藥學硏究誌 Vol.1 No.-

Histamine을 정확하고 신속하게 정량하기 위해 9.Fiuorenylmethyl chloroformate를 형광유도체화제로 하여 역상 HPLC법으로 정량하였다. 히스타민을 형광유도체화할 때 반응액의 pH, 반응시간, 형광유도체화제의 농도 등 최적 반응 조건을 검토하였다. 이 방법으로 히스타민을 분석한 결과 0.1~0.5ug/ml의 농도범위에서 상관계수가 0.922인 양호한 직선성을 나타내었으며 검출한계는 0.01??/ml였다. A rapid and simple method for the determination of histamine by reverse-phase high performance liquid chromatography with fluorescence detection was established. 9-Fluorenylmethyl chloroformate(FMOC) was used as fluorescent derivative reagent. The optimum conditions for the derivatiation such as pH, reaction time and he concentration of FMOC were investigated. Linearity of calibration curve was obtained between 0.1ug/ml/and 0.5ug/ml(r=0.922) and the limit of detection was 0.01ug/ml.

가정 호흡재활 프로그램 관련 연구 논문 분석

오의금,김소희,김순희,박희옥,이춘화 성인간호학회 2002 성인간호학회지 Vol.14 No.3

Purpose: The purpose of this study was to analyze the trend of research on the use of home-based pulmonary rehabilitation. Method: Using Medline and CINAHL search engine, experiemental research, titled as 'home-based pulmonary rehabilitation' and 'chronic lung disease', statistics were collected. The total 29 experimental studies published between 1981 to 2000 were selected and analyzed according to the ATS guidelines. Result: 1) The study samples in research were mostly of men, whose lung function was moderate to severe. 2) The total period of the intervention program varied from 5 to 12 week. The program included excercise intervention and educational intervention. Psychosocial intervention was minimal. 3) The outcome of the home-based pulmonary rehabilitation had been measured mostly by physical aspects. Quality of life and cost were less frequently measured. 4) In terms of effectiveness of the home based pulmonary rehabilitation program, physiologic outcome, such as lung function and hematologic markers, there was more 'no effect' than 'positive effect', whereas there was more 'positive effect' in decreasing dyspnea, improving excercise capacity, and improving quality of life. Conclusion: Based on these findings, future research on home-based pulmonary rehabilitation should be emphasized and provide standardized protocol, including psychosocial intervention, and analyses on cost and quality of life.

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

강원도 원주지역 초·중·고등학생의 식습관 및 섭식행동에 관한 단면연구

허혜경,박소미,김기연,김춘배,안정숙,송희영,김기경 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1

Purpose : The purpose of this study was to investigate the dietary habits of students in order to identify risk groups according to their Body Mass Index (BMI), and to compare the eating behavior of students in the normal range (19<I≤24) and those in risk groups (BMI≤19, 24<I≤27, BMI>). Method : 1176 elementary school students, 850 middle school students and 672 high school City, were the participants The instrument for this study was a structured questionnaire that included demographic data as well as dietary habits, and the eating behavior instrument developed by Stunkard &essick(1985) and revised by Kim &im (1997). Result : 1) As students moved up in grade level their dietary habits became more irregular and the degree that students chewed food was reduced 2) As students moved up in grade level, a greater number of the students did not eat breakfast. The reasons given were that there were not enough time before classes started(40.4%) and a lack of appetite in the morning(10.6%) in high school students. 3) As for supper, from 67.8 to 81.9% of subjects reported having regular supper. However the rest of the subjects did not eat supper because of anorexia and fear of weight gain. 4) The results identified risk groups according to their BMI showed that for elementary school students, 55.9% were in the low weight group, 5.5% in the overweight group, and 0.9% in the obese group. For middle and high school students, 40.6% and 35.5% respectively were in the low weight group, 7.4% and 6.3% in the overweight group, and 4.1% and 2.5% the obese group. 5) Comparisons of the eating behavior of students in the normal weight group with that of those in the three risk groups showed that there were significant differences in 'hunger' and 'cognitive restraint of eating' in elementary school students, and significant differences in 'cognitive restraint of eating' in middle and high school students. Conclusion : The results of this study show that management of diet in school health sholud be addressed from both the aspect of lack of nutrition and that of excess nutrition. In other words, good diet is as important for students in the low weight group as it is f3r those in the overweight and obese groups. The estatblishment of good dietary habits and eating behavior in students, by nurses and dieticians should be done by providing repeated diet education and involvement in diet counseling.

척추관 협찬증 환자 진료 프로세스 개발

이환모,김호중,김긍년,안풍기,천자혜,김양수,신혜선,김인숙,정혜경,김영아,채형기,박인영 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

연구배경: 수술적 치료가 필요한 척추관협착증 환자들은 주로 60세 이상의 고령환자로장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술후환χ}들의 재원일수의 증가는병원의 병상가 동률을감소시키고, 전공의에게는불필요한 업무를 증가시킨다. 연구목적: 비용·효과면에서 최적화된 진료지침의 개발은 불필요한 의료비의 감소및 Hospital Induced Complication을 줄여 환자만족도를증진시킬 수 있으며, 각 환자에 대한전공의 업무를 줄일 수있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문 요양기관 연구방법: 정형외과및 신경외과의 척추관협착증환자 의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program (EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과': CP 적용전, 후비교를통해 재원일수는 3.8일 이 감소하였으며, 이에 따라 병상가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교검토중이다. 또한,CP 개발및 CP Master Program의 사용을 통한 전공의 업무감소에 대해 검토하고 있다.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.