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      • KCI등재후보

        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.

      • 韓國河川의 流出率과 流出指標로서의 洪水直前 流量

        金熙鍾,柳又秀,金佳鉉,申東守,韓健模,全裕燦 東亞大學校 大學院 1984 大學院論文集 Vol.9 No.-

        This paper is a study on relation between run-off ratio and antecedent discharge, run-off ratio and antecedent discharge per unit area, antecedent discharge and antecedent precipitation, by the data from the five major river basins in Korea and the small river basins in Pusan. The Nak-Dong rivers(An-Dong upper stream) f=0.4780+0.0124 ln qA r=0.99 qA=0.3368e0.1101R r=0.99 f=0.5793+0.0146 ln(qA/A) r=0.99 The Nak-Dong rivers except Ga-song station f=0.2017-0.0840 ln qA r=0.75 f=0.7012+0.0750 ln(aA/A) r=0.71 The Han rivers f=-0.0035+01267 on qA r=0.75 f=1.1311+0.1263 ln(qA/A) r=0.71 L=302.9064-43.8490 ln qA r=0.84 The Geun rivers(Mu-sin Cheon) f=0.295+0.1823 ln qA r=0.93 f=0.8417+0.1823 ln(qA/A) r=0.93 L=40.0456+62.0346 ln qA r=0.94 The Yeong-san rivers f=0.3766+0.0598 ln qA r=0.79 f=0.8084+0.0599 ln(qA/A) r=0.79 The Seom-jin rivers f=-1.3875+0.6505 ln qA r=0.92 f=2.1633+0.3465 ln(qA/A) r=0.76 Small river basin in Pusan f=0.3635+0.1120 ln qA r=0.87

      • KCI등재후보

        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.

      • KCI등재후보

        혈액질환 환자에서 조혈모세포 이식과 화학요법 후의 침습성 진균감염의 분석

        유진홍,최정현,이동건,최수미,신완식,김춘추 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

        목적 : 조혈모세포 이식이나 화학요법을 받은 혈액질환 환자에서 침습성 진균감염의 양상을 분석하고 예후 인자를 정하기 위하여 이 연구를 실시하였다. 방법 : 2000년 3월부터 2001년 2월까지 가톨릭 조혈모세포이식센터에 입원한 318명의 환자들 중 진균 감염으로 의심되어 항진균제를 투여받은 122명의 환자를 대상으로 후향적 분석을 실시하였다. 결과 : 74명의 환자가 EORTC/MSG 기준에 의해 침습성 진균증으로 판정되었다. 이들 중 6명이 확진이었고, 46명이 추정, 22명이 가능 증례이었다. 가장 많이 침습된 장기는 하부 호흡기이었다(72/74). 사망률은 32.4%이었다. 단변량 분석으로 예후 인자를 도출한 결과 입원 기간, 진단까지 걸린 시일, 그리고 amphotericin B의 총 투여량이 유의한 인자로 나왔다. 그러나 다변량 분석을 시행한 결과 입원 기간만이 독립적으로 유의하게 영향을 미치는 예후 인자로 산출되었다. 결론 : 침습성 진균 감염은 현재도 조혈모세포 이식이나 화학요법 후의 중요한 합병증으로 작용하고 있음을 알 수 있었다. 진균 감염 합병증의 예후에 영향을 미치는 요소로 입원 기간이외에 진단의 신속성과 항진균제의 투여도 유의한지에 대해서는 후속 연구를 통해 재치 규명해야 할 것으로 생각된다. Background : Invasive fungal infections (IFI) are one type of representing total infections in compromised patients. To analyze the characteristics and to determine the prognostic factors of IFI in patients with hematologic diseases undergoing hematopoietic stem cell transplantation (HSCT) and/or chemotherapy. Methods : We retrospectively reviewed consecutive patients (n=122) who received antifungal treatment with the impression of fungal infection complicating post-HSCT or chemotherapy from March-2000 to February-2001. Results : Seventy-four out of 122 registered patients belonged to the IFI on the basis of EORTC/MSG criteria. Six patients were proven IFI, 46 were probable, and 22 were in the category of possible one. The most commonly involved organ was lower respiratory tract (72/74). The mortality was 32.4%. Univariate analysis revealed duration of hospitalization, days to diagnosis of IFI, and total amount of amphotericin B as significant prognostic factors. But multivariate analysis determined only duration of hospitalization from these variables as an independently influencing factor on the prognosis. Conclusion : Invasive fungal infection is still the major threatening complication of HSCT and chemotherapy. Further follow-up and extension of this study is necessary to elucidate more prognostic factors.

      • 연약지반 위에 시공되는 교대의 측방유동에 대한 안정성 평가

        유남재,김동건,전상현 江原大學校 産業技術硏究所 2010 産業技術硏究 Vol.30 No.B

        In this paper stability about lateral soil movement of bridge abutment constructed on the soft ground, reinforced with the sand compaction pile (SCP) and the preconsolidaton methods, was evaluated by using the centrifuge testing facility which stress conditions in field could be reconstructed in the laboratory. The layouts of model such as ground condition, sand compaction piles and abutment was determined on the basis of similitude law with the reduced scale of 1/200. Construction sequences of installing SCP, preparing reclaimed ground, preconsolidating ground and building the piled bridge abutment were reconstructed during centrifuge modelling and measurements of movement were followed in each sequence. From analyzing the results of measuring movements of the model abutment and the ground, measured lateral movement of model abutment was found to be within the allowable value so that stability of abutment against lateral sliding was secured.

      • 안벽구조물에 대한 Centrifuge 모형실험과 수치해석

        유남재,김동건,전상현 江原大學校 産業技術硏究所 2009 産業技術硏究 Vol.29 No.B

        In this paper centrifuge model tests and numerical analysis on the coastal structure on the marine deposits of sand were performed to investigate the behavior of structure and foundation under the condition of wave action in field. In centrifuge model experiments, construction sequence of coastal structure such as preparation of sand deposit, excavation replacement, rubble mound with crushed stones and installment of coastal structure was reconstructed and the behavior of ground settlement during stage of construction was observed during tests. For the final stage of simulating the horizontal movement of coastal structure due to wave force, horizontal load was applied by horizontal loading apparatus being specially designed so that horizontal displacement of structure could be observed. Numerical analysis were also carried out and its results were compared with test results to assess the property of centrifuge mode experiments with respect to the behavior of structure as well as ground.

      • Glow放電法에 의한 α-Si蒸着裝置의 製作과 그 試料의 特性

        유동선,현옥배,고년규,황정남,정원모,이철주 연세대학교 자연과학연구소 1981 學術論文集 Vol.7 No.-

        Glow방전법에 의해서 SiH_4를 분해하여 α-Si 박막을 얻을수 있는 장치를 제작하였다. 이 SiH_4기체는 수소기체속에서 10%로 희석되였으며, 진공방전함속에서 rf 전압에 의하여 분해된 Si는 유리기판위에 증착된다. α-Si박막은 1~1.6 A˚/sec의 증착율로 약 7000 A˚의 두께까지 증착되였다. α-Si 박막의 흡수계수는, 2.3 eV의 photon energy 영역에서 약 10^4 cm^-1이고, 그 optical gap은 약 2.1 eV였다. 이 박막의 증착율은 전극간격에 따라 변하고 있으나, 최적전극간격과 기체유입량은 각각 2.6cm와 1~2cc/min였다. Apparatus capable of producing α-Si film by the glow discharge method was designed and constructed in this study. The monosilane gas which is diluted in H_2 gas to 10% is decomposed in the reaction chamber by rf oscillation. The apparatus is composed of a reaction chamber, a rf generator, a cooling system, etc. The α-Si thin film is produced at a deposition rate of 1~1.6 A˚/sec to a thickness of about 7000 A˚. Its absorption coefficient is about 10^4 cm^-1 in the photon energy region of ~2.3 eV, and its optical gap is about 2.1 eV. The deposition rate for the film is controlled by varying the distance between electrode and substrate. The optimum distance and gas flow is about 2.6 cm and 1~2 cc/min, respectively.

      • KCI등재

        전자상거래의 비용우위 효과에 관한 소비자 지각 : 인터넷 쇼핑몰 이용자를 중심으로 Concentrated on Consumers' Perceptions on the Internet Shopping Mall

        유동근,서영호,조임현 한국경영과학회 1999 한국경영과학회지 Vol.24 No.4

        Since the Internet was applied for commercial purpose, many companies have been making use of the internet in electronic commerce and the internet has brought many changes on consumer and supplier behaviors. It seems that consumers and suppliers can obtain more accurate information rapidly and pay less for the same product/service than in traditional commerce. This study tries to investigate the difference in the cost factors perceived by consumers between traditional commerce and the Internet commerce. Empirical results show that there is no significant difference in consumers' perception of cost factors between traditional commerce and the internet commerce Contrary to general perception, a large number of consumers do no, believe that the internet commerce is generally more economical than traditional commerce. The factors where the consumers think Internet commerce has cost advantages are search cost and purchasing cost. However, consumers are understanding the benefits of the internet commerce and are expecting that internet commerce bring about economic advantages in consumer markets in the near future.

      • 확률론적 해석법에 의한 연직배수 영향인자 민감도 분석

        유남재,전상현,정길수,김동건 강원대학교 산업기술연구소 2006 産業技術硏究 Vol.26 No.B

        A probabilistic analysis model, one of reliability analysis methods introducing the concept of probabilistic variables, was developed to investigate the uncertainty of dominant factors influencing the degree of consolidation in the radial consolidation theories. Based on the developed probabilistic analysis model, sensitivity study of those factors was performed to find their trends of affecting the degree of consolidation in the vertical drain method. Various radial consolidation theories, Proposed by Barron(1948), Hansbo(1979), Yoshikuni(1979) and 0noue(1988), were used for this parametric study with the influencing factors such as size of smear zone, reduction ratio of permeability in the smear zone, discharge capacity, permeability for horizontal flow and coefficient of consolidation for horizontal flow. As results of this sensitivity study, for the given consolidation theory, contribution of each factor to the degree of consolidation was figure out and compared to each other. For the given value of each factor, the sensitivity to the degree of consolidation in the various theories was evaluated and their applicability and limitations were assessed.

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