조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

풍력발전 단지조성을 위한 바람환경 분석

김현구,최재우,손정봉,정우식,이화운 한국대기환경학회 2003 한국대기환경학회지 Vol.19 No.6

An analysis of wind environments using computational fluid dynamics and an evaluation of wind resources using measurement data obtained from meteorological observation sites at Homi-Cape, Pohang have been carrid out for siting a wind farm. It was shown that a numerical simulation using computational fluid dynamics would provide reliable wind resource map in complex terrain with land-sea breeze condition. As a result of this investigation, Homi-Cape wind farm with 11.25 MW capacity has been designed for maximum power generation and 25.7GWh electricity production is predicted.

PECVD 공정에 의한 TiC, TiN 및 Ti(CN)의 마찰 마모 특성 연구

이봉구,오성모,전찬열,김정기,김동현 한국공작기계학회 2005 한국생산제조학회지 Vol.14 No.2

In order to determine the wear properties of PECVD ceramic coatings, wear process was evaluated using the coated pin of Falex Tribo system. Coating materials deposited wear the TiC, TiN and Ti(CN). An experimental process was established to determine the tribological characteristics of friction and wear behavior under the variation of applied load, temperature and sliding distance by the Falex test machine. The experimental results indicate that TiN coatings compared with TiC coatings on the materials have the excellent friction and wear characteristics. However TiC coatings compared with TiN coatings have a low friction coefficient with steel and good thermal stability, and Ti(CN) has the excellent anti-wear property as well as the superiority of extreme pressure property. Compound coatings compared with simple coatings show improved tribological characteristics.

한반도 바람지도 구축에 관한 연구 : I. 원격탐사자료를 이용한 해상풍력자원 평가 I. Evaluation of Offshore Wind Resources Using Remote-Sensing Data

김현구,이화운,정우식 한국대기환경학회 2005 한국대기환경학회지 Vol.21 No.1

In order to understand regional wind characteristics and to estimate offshore wind resources, a wind map of the Korean Peninsula was established using remote-sensing data from the satellite, U.S. NASA QuikSCAT which has been deployed for the SeaWinds Project since 1999. According to the linear regression result between the wind map data and in-situ marine-buoy data, the correlation factor was greatly improved up to 0.87 by blending the remote-sensing data of QuikSCAT with U.S. NCEP/NCAR CDAS reanalysis data to eliminate precipitation interference and to increase temporal resolution. It is found from the established wind map that the wind speed in winter is prominent temporally and the South Sea shows spatially high energy density over the wind class 6. The reason is deduced that the north-west winds through the Yellow Sea and the north-east winds through the East Sea derived by the low pressure developed in Japan are accelerated passing through the Korea Channel and formed high wind energy region in the South Sea; the same trends are confirmed from the statistical analysis of the meteorological observation data of KMA.

항히스타민제의 대리결과변수로서 히스타민에 의한 피내주사반응 유용성에 대한 고찰

한나영, 송병정, 백현문, 정에벤, 유영훈, 전지현, 구성우, 윤휘열, 권광일 충남대학교 약학대학 의약품개발연구소 2017 藥學論文集 Vol.32 No.-

In this study, it is reviewed that histamine-induced wheal and flare responses are potential sur-rogate endpoints for predicting the clinical effects of antihistamines in patients with allergic skin diseases. Histamine plays an important role in allergic response by inducing degranulation of mast cells due to allergen exposure and mediating the inflammatory reaction. Thus, suppression of histamine-induced wheal and flare has been noted as surrogate markers for efficacy of Hl receptor antagonists. In addition, allergy skin prick test and intradermal test using histamine have been used to diagnose the histamin-induced allergic reaction. However, it has been well known that allergic diseases are not only mediated by histamine. but also by var-ious immunological inflammatory responses. Previous studies reported that there is a lack of evidence about the correlation between antihistamines to predict clinical efficacy and antihistamine efficacy, although hista-mine-induced wheal and flare responses may be useful indicators of the dose-response relationship. In con-clusion, the evaluation for the suppression of wheal and flare after histamine injection is reasonable for de-termining the treatment of allergic simple skin diseases, but there is a limit to evaluate the efficacy in com-plex inflammatory diseases mediated IgE or T cells, or other immune complex. Therefore, further studies are needed to identify additional surrogate endpoints to predict the therapeutic effect of antihistamines in other inflammatory diseases such as allergic rhinitis, atopic conjunctivitis, allergic asthma, and so on.

석회 흔입 점토의 강도 특성

여재호,권무남,구정민,김현기 경북대학교 농업과학기술연구소 2000 慶北大農學誌 Vol.18 No.-

This study was conducted to investigate most effective the optimum lime content for lime-clay modification. To achieve the aim, characteristics of compaction and compressive strength were tested by adding of 0, 5, 10, 15 and 20% lime (Hydrated lime) of dry weight of the clay. Distilled water was added 10, 15, 20 and 25% of dry weight of lime-clay mixture. In this test, the compressive strength of the specimens was measured according to the following curing period : 7, 21, 28, 35 and 49 days. The results are as follows. (1) As lime additive increased, the optimum moisture content of lime-clay mixture was increased and the maximum dry density was decreased. (2) the soil mixture of 20% of the moisture content and 10% of lime additive was shown the maximum compressive strength. (3) As curing period longer, the compressive strength was increased but after 21 curing days, the increasing rate of compressive strength was low as compared with earlier its value. (4) In the range of 20% of the moisture content, compressive strength of mixture of 10% lime additive increased twice compared with that of mixture of 0% lime additive. (5) All of the lime-clay are possible to use for an sub-base material and 20% of moisture content of lime-clay mixture is possible to use for a base material.

국내 호중구감소성 발열 환자에게 경험적 항진균제로 투여한 Amphotericin B deoxycholate와 Itraconazole 주사제의 비용-확인분석 : 예비보고

이동건,송영구,유진홍,최수미,최정현,박선희,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : 진균감염이 점차 증가되고 있고 이를 치료하기 위한 비용 역시 증가하고 있지만 국내에서는 비용분석에 대한 연구가 거의 없는 실정이다. 본 연구에서는 호중구감소성 발열 환자에게 경험적 항진균제로 amphotericin B deoxycholate (ABV)혹은 정맥내 itraconazole (ITZA)을 투여할 때의 약물경제학적 측면을 후향적으로 비교해보고자 하였다. 재료 및 방법 : 같은 반응률을 보인다고 가정한 비용-확인분석 모델을 이용하여 가톨릭대학교 조혈모세포이식센터에서 혈액종양으로 항암치료 혹은 조혈모세포이식을 시행한 환자를 대상으로 자료를 수집하였다. 항진균제 투여에 대한 정보는 기존에 출판된 논문 및 학회 심포지움자료를 참고하였고, 논문에서 얻지 못한 정보는 가톨릭대학교 성모병원 의무기록실, 정보지원팀, 진료비관리팀의 협조를 받아 2003년 6월 1일부터 11월 30일까지의 자료를 분석하였다. ITZA에 대한 자료는 2003년 11월 제한적으로 1차 약제로 사용할 수 있게 되었던 때의 자료와 경험을 참조하였다. 결과 : 320명의 환자 중 149명(46.5%)에서 경험적 항진균제를 사용하였고 평균 투여일수는 ABV 17.0일, ITZA 9.8일이었다. 이상반응 발현율은 ABV 54%, ITZA 5%였다. ABV 투여환자 중 11명 (7.4%)에서 혈액투석을 평균 6.5일간 시행하였다. ITZA 투여시 간독성으로 혈장분리반출술, 인공간 등이 필요한 경우는 없었다. 경험적 항진균제를 ABV로 시작한 군(ABV군)은 1인당 1,229,495원, ITZA로 시작한 군(ITZA군)은 1인당 1,434,605원이 소요되어 ITZA군에서 205,110원 (16.7%)이 더 소요되었다. 평균 16일간 항진균제를 사용하여 1일 12,819.4원의 차이가 있었다. 결론 : 비용-확인 분석법에서 ITZA군이 ABV군 비해 하루 12,819.4원의 비용이 더 소요되었다. 비록 ITZA군에서 비용이 더 들었지만 1일 약가차이인 4.7배와 비교하여 많이 감소하여 항진균제의 비용을 1일 약가로 비교하는 것보다는 재원일수, 이상반응 발현율 등을 고려하는 총입원비용으로 약물경제학을 비교하는 것이 더 합당할 것으로 사료된다. 그 외에 환자의 예후, 삶의 질, 사회적 간접비용 등을 고려하는 전체적인 약물경제학을 비교하는 잘 계획된 전향적 연구가 추가로 필요하겠다. Background : The increasing incidence of systemic fungal infections and the rising medical cost have focused the need to determine the economic issues of antifungal agents. Nevertheless there have been only few reports about the cost analysis in Korea. We retrospectively investigated to compare the pharmacoeconomic aspects of amphotericin B deoxycholate (ABV) with those of intravenous itraconazole (ITZA) in the empirical treatment of febrile neutropenic patients. Materials and Methods : Through the cost-identification analysis model, on the presumption that two groups would show identical response, we collected data of patients who received hematopoietic stem cell transplantation (HSCT) or chemotherapy in Catholic HSCT center from Jun 1, 2003 to Nov 30, 2003. The literatures about information on antifungal therapy were extensively reviewed. Other unpublished information was provided by information assistant team, cost management team, and medical record unit in the same hospital. Results : Empirical antifungals were given to 149 out of 320 patients (46.5%). The average duration of administration were 17.0 days for ABV and 9.8 days for ITZA. The rates of adverse events were 54% and 5% for ABV and ITZA, respectively. Eleven (7.4%) patients given ABV received hemodialysis for 6.5 days in average. Among patients given ITZA, none developed hepatotoxicity requiring plasmapheresis or artificial liver. It cost 1,229,495 won/patient for the ABV group (starting ABV as empirical antifungal agent) and 1,434,605 won/patient for the ITZA group (starting ITZA as empirical antifungal agent) which was 16.7% more expensive than ABV group. When we compare the average daily cost for 16 days, the ITZA group spent 12,819.4 won/patient/day more than the ABV group. Conclusion : The cost-identification model in this study revealed that ITZA group cost more than ABV group. However, the difference in expense decreased when 1 day-cost was compared (4.7 times greater than ABV). It would be more reasonable to consider the total cost of anti-fungals during the hospitalization rather than 1 day cost in considering pharmacoeconomics. Well designed prospective study considering prognosis of patients, quality of life, and indirect social cost should be warranted.

좌심실 이완기 장애 평가에서 Atrioventricular Plane Displacement의 임상적 중요성

정연손,조구영,이태유,김근숙,최창순,류제헌,최민호,박우정,임종윤,이영 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.12

대기오염 확산 해석을 위한 포항지역 기상장 연구 : 바람장 수치모의 Numerical Simulation of Wind Field

이화운,정우식,김현구,이순환 한국대기환경학회 2004 한국대기환경학회지 Vol.20 No.1

Sea/land circulation system is a representative mesoscale local circulation system in coastal area. In this study, wind fields around coastal area, Pohang, which is affected by this system was investigated and its detailed characteristic analysis was carried out. The following can be found out from the numerical simulation. Generally, at nighttime mountain winds prevail and land breeze toward the coastal area was well simulated. During daytime, valley wind and sea breeze was simulated in detail. Especially, as a result of analyzing the land breeze path, it could be found along the coastline as it flows out through low land coastal area. In order to investigate the accuracy of model results, wind speed, temperature and wind direction of continuous typical sea/land breeze occurrence day was compared with observation data. Analyzing the characteristics of local circulation system was very hard because of horizontally sparse observation data but from the above result, a numerical simulation using RAMS, which satisfies the spatial high resolution, will provide more accurate results.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.