발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

급성 심근허혈에 의해 윤발된 승모판 폐쇄부전의 기전에 관한 실험적 연구

강덕현,송현,송재관,김현숙,이재환,임희영,이재원,박성욱,박승정,송명근 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.8

중대산업사고 예방을 위한 종합위험관리체제(IRMS) 구축에 관한 연구

권혁면,성대현,김재현,임대식,김기영,편무욱,문일,고재욱,이영순,윤인섭 한국안전학회 2003 한국안전학회지 Vol.18 No.3

The Process Safety Management (PSM) by the Law of Industry, Safety and Health has been performed for preventing major accidents of chemical plants since 1996. In terms of preventing chemical accidents more precisely, it is essential to develop a tool for quantitative risk assessment. For this, KOSHA (Korea Occupational Safety and Health Agency) developed an Integrated Risk Management System (IRMS) . The system is designed to assimilate data on chemical plant hazards from external database, to integrate these data with location information (topographic and demographic), and to make them user-friendly accessible. The system consists of several main functions: display of five major Korean petrochemical complex layout, display of equipment layout with its information utilizing the external database, zonation of the hazard effected area with consequence analyses, the most probable accident scenario generation, accident/incident database and calculation of frequency of accident using equipment reliability database, etc. The highlight of IRMS is to provide the risk contours using GIS(Geographical Information System) technology. IRMS is intended to manage hazardous installation more systematically and effectively, to reduce the number of accident remarkably, further minimizing production loss in the plant. The system is now under application to about 500 PSM sites as well as and emergency authorities in Korea by KOSHA (Korea Occupational Safety and Health Agency)

온실재배와 노지재배한 금산 깻잎의 품질 특성과 향기성분

현광욱,구교철,장정호,이재곤,김미리,이종수 한국식품저장유통학회 ( 구 한국농산물저장유통학회 ) 2004 한국식품저장유통학회지 Vol.11 No.1

깻잎을 이용한 건강 식품을 개발하고자 먼저 깻잎의 주산지인 금산에서 5월 온실재배한 깻잎과 8월 노지재배한 깻잎들의 품질특성과 향기성분을 조사하였다. 시료깻잎 모두 4.0%의 조단백질과 0.8%의 조지방을 함유하고 있었고, 플라보노이드의 함량은 온실재배 깻잎 25.2%, 노지재배 깻잎 26.5%로 시료깻잎간에 큰 차이는 나타나지 않았으며 조사포닌 함량도 2,7%와 2,8%로 비슷하였다. 시료깻잎의 효소 활성은 오직 알칼리성 단백질 분해효소 활성만이 8월 노지재배 깻잎에서만 물 추출물 7.1 unit, 에탄올 추출불 11.8 unit을 보였고 기타 효소 활성은 없었다. 8월 노지재배 깻잎의 조직감 특성으로 먼저 견고성과 탄력성 등은 잎의 상층부와 중층부 보다 잎받침을 포함하는 하층부에서 높았고 응집성은 하층부가 약간 약하였으며 5월 온실재배 깻잎은 씹힘성이 다서 낮았을 뿐 노지재배 깻잎과 비슷하였다. 5월 온실재배와 8월 노지재배 깻잎에는 1-octen-3-ol, linalool, β-caryorhyllene, α-caryophyllene, α-famesene, perilla ketone, nerolidol, eugenol. α-cadinol 등 14종∼15종의 향기성분을 함유하고 있었고 주요한 향기성분은 perilla ketone 이었다. Quality and flavor compounds of perilla leaves cultivated in greenhouse(May) and field (August) in Geumsan province were investigated and compared. All perilla leaves contained 4.0% crude protein and 0.8% crude lipid. C겨de flavonoid contents of perilla leaves cultivated in greenhouse and field showed 25.2% and 26.5%, respectively and each crude saponin content was cultivated in field. Hardness and chewness of bottom parts of field-perilla leaves were higher than those of top and middle part, whereas the cohesiveness of top parts and middle parts of perilla leaves were higher than that of bottom part. Furthermore, texture properties of greenhouse-perilla leaves were similar with those of field-perilla leaves except chewness. Nine kind of flavor compounds such as 1-octen-3-ol, linalool, β-caryophyllene, α-caryophylene, α-franesene, perilla ketone, nerolidol, eugennl, α-cadinol were identified in greenhouse-perilla and field-perilla leaves, showing that main flavor compound was perilla ketone.

고전적으로 조건화된 해마 신경다단위활동의 적핵 손상후 변화

류재욱,조선영,김현택 한국심리학회 한국심리학회지 생물 및 생리 Vol.7 No.1

토끼의 순막 고전적 조건화동인 해마에서 기록되는 신경다단위활동은 학습이 진행되는 동안 조건반응의 출현을 앞서서 예고해주는 식으로 변화해간다. 학습과 관련된 이러한 해마의 신경반응은 순막 고전적 조건화에 결정적인 뇌구조물로 알려져있는 소뇌 중간핵을 필요로 한다. 즉 소뇌 중간핵을 손상시키면 해마의 신경반응은 조건화되지 않으며 이미 조건화되었던 신경반응도 사라진다. 그러나 소뇌 중간핵은 학습과 연관된 신경가소성이 형성되는 신경구조물중의 하나인 까닭에, 소뇌 중간핵을 손상한 경우에는 소뇌의 신경가소성이 수립되지 않으므로, 해마에 미치는 영향이 어떤 신경적 경로를 통해 일어나는지 설명하기가 곤란하다. 본 연구에서는 소뇌 중간핵의 주요 원심성 구조물인 적핵을 손상한 후 해마에서 학습과 관련된 신경반응이 발달하는지를 살펴보았다. 적핵을 손상하면 행동적 조건반응은 나타나지 않지만 소뇌 중간핵의 조건화된 신경반응은 발달하므로, 학습은 이루어지지만 행동적 조건반응의 수행이 차단되는 경우라고 볼 수 있다. 조건화 이전에 우측 적핵을 전해질 손상시킨 토끼들은 좌측 순막조건화훈련(CS:550ms 소리자극, US:100ms 공기분사, ISI:450ms) 8회기에 이르기까지 거의 행동적 조건반응을 보이지 않았으며, 조건자극 제시 기간동안 해마의 신경다단위활동 증가 또한 보이지 않았다. 훈련을 우측으로 전이시키지 행동적 조건반응의 출현과 함께 해마에서 학습과 관련된 신경반응을 보였다. 좌측으로 훈련을 재전이 시킬 경우 우측전이시에 발달한 해마반응과 행동반응은 다시 사라졌다. 이러한 결과는 소뇌로부터의 학습정보가 적핵을 통해서 해마의 조건화된 신경반응의 발달에 영향을 미침을 시사하며, 소뇌와 해마의 기능을 모사하는 인공신경망 연구에 위계적 모형을 제공해준다. Sears et al. showed that learning-related multiple unit activity (MUA) developing in the hippocampus during the classical conditioning of nictitating membrane response depends on the intactness of the cerebellar interpositus nucleus, that was confirmed by our recent study. The cerebellar interpositus nucleus is known to be an essential neural structure for this conditioning, and a place representing time-amplitude neural model of the conditioned response(CR). Lesioning the interpositus nucleus, therefore, abolishes the learning itself and as a result, the hippocampal MUA can not develop. In case the red nucleus, the principal output pathway of the interpositus nucleus is lesioned, the learning-related MUA in the interpositus nucleus can be recorded, which is possibly interpreted as the learning is established but the performance of CR is blocked. The present study was conducted to determine if the learning-related MUA could be developed in the hippocampus after lesioning the red nucleus, the target of the interpositus nucleus. Experimental rabbits were given unilateral electrolytic lesions of the red nucleus before the conditioning sessions (CS: 550msec tone, US: 100msec air puff, ISI: 450msec). Experimenal rabbits showed less than 8% CRs by the end of the 8th session, whereas the control animals showed on the average more than 80% CRs by the 4th session (F[1,10]=187.84,p<0.01). The control group showed typical increase of hippocampal MUA in the process of learning, while the group with the red nucleus lesion did not showed the increases of hippocampal MUA in the CS period(F[1,10]=10.67,p<0.05). These results suggest that the learning-related input from the interpositus nucleus via the red nucleus may play a critical role for the normal MUA development in the hippocampus.

아포모르핀 투여가 고전적 순막 조건화의 소거와 해마의 다단위 활동, θ파에 미치는 효과

이두현,류재욱,김재일,김기석 한국심리학회 1995 한국심리학회지 생물 및 생리 Vol.3 No.1

암페타민의 투여가 해마에서 제1유형 θ파를 유발시켰다는 연구 결과는 해마의 θ파와 관련된 기능들이 카테콜라민성 통로에 의해 매개됨을 시사하였다. 이에 도파민성 통로에만 특정적으로 작용하는 아포모르핀이 해마 θ파를 유발시키는가를 보고자 본 연구를 실시하였다. 아울러 해마의 다단위활동, 고전적 순막 조건화의 소거에 미치는 효과도 살펴보았다. 토끼에게 고전적 지연조건화를 훈련시킨 후 소거절차를 시행하면서 미리 해마에 삽입한 미세전극을 통해 해마 뇌전도와 다단위활동을 기록하였다. 소거절차가 시작되기 직전에 한집단(아포모르핀집단)에서는 아포모르핀 0.5㎎/㎏을 피하 주사하였고, 다른 한집단(손상집단)에서는 조건화가 끝난 직후 미리 삽입한 손상용 전극을 통해 내측중격을 손상시키고 소거절차가 시작되기 직전에 역시 아포모르핀을 피하 주사하였다. 반면에 통제집단은 조건화가 끝난후 아무런 사전 조치 없이 소거절차를 시작하였다. 실험결과 아포모르핀집단은 통제집단이나 손상집단보다 더 높은 제1유형 θ파 비율을 보였다. 이는 아포모르핀이 암페타민처럼 제1유형 θ파를 유발함을 시사하였다. 그리고 통제집단의 경우 정상적인 소거가 일어난 반면 아포모르핀 집단이나 손상집단의 경우 소거 초기시점부터 약 20%의 조건반응률을 보였고, 이러한 조건반응률은 소거절차가 끝날때까지 계속되었다. 따라서, 내측중격의 손상 유무와 상관없이 아포모르핀은 조건반응의 소거보다는 인출을 방해하는 것으로 나타났다. 해마의 다단위활동의 경우 아포모르핀을 투여하면 내측중격의 손상 유무에 상관없이 통제집단보다 더 높은 반응률을 보였다. In this study, interactions among hippocampal θ rhythm, hippocampal MUA, and dopamine pathway that ascends to medial septum from brain stem reticular formation was investigated. First, rabbit's NMR were conditioned with delay conditioning procedure. In extinction session, the one group(apomorphine group) was treated with apomorphine(0.5㎎/㎏) which was known to be dopamine agonist. The other group(lesioned group) was lesioned medial septum after delay conditioning and was treated as the former group. The control group was extincted conditioned response without any other procedures. There were increses of type 1 θ rhythm only in apomorphine group, but a little conditioned response in contrast to any other group. This result suggest that the apomorphine brought about type 1 hippocampal θ rhythm and kept conditioned response from being retrieve rather than being extincted.

GMAHN에서의 네트워크 성능 향상에 관한 연구

金在浩,李光培,金玄郁,劉忠烈,河載承,裵振勝 明知大學校 産業技術硏究所 2008 産業技術硏究所論文集 Vol.27 No.-

Recently, Wire-rireless combination study is being studied very actively with the advent of Ubiquitous environment, using wireless device such as PDA, Cellular Phone loading multi-hop communication that connects wired internet network very easily and controls the system and shares the information in anyplace. The past algorithm, wired and wireless combination that connect between Ad Hoc Network and wired network is being focused only on the study of heterogeneous network interface. The proposed algorithm established independent multi-path between source node and destination node to prevent data loss when errors happen in route. The proposed algorithm established independent multi-path between source node and destination node to prevent data loss, and trasmitted data packet to destination node very quickly and promoted network reliabiliy when errors happen in route.

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.

관동맥연축의 진단을 위한 Ergonovine Echocardiography의 안전성 및 임상적 유용성

송재관,박성욱,강덕현,조구영,나득영,이내희,이철환,홍명기,김재중,박승정 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

Melt spinning 법으로 제조된 Ti-Ni-Cu 합금리본의 상변태거동 및 형상기억특성

金載勳,崔美善,李喜佑,金泰俊,김연욱,南泰鉉 대한금속재료학회 2002 대한금속·재료학회지 Vol.40 No.7

Phase transformation behavior and shape memory characteristics of Ti-Ni-Cu alloy ribbons fabricated by melt spinning have been investigated by means of differential scanning calorimetry, X-ray diffraction, optical microscopy and thermal cycling tests under constant load. With increasing linear velocity and decreasing ejection pressure, transformation start temperatures of ribbons decreased and stability of the B19 martensite was lowered, comparing to those of alloys fabricated by conventional casting since the cooling rate increased. Only after heat treating ribbons at temperatures higher than 873 K where recrystallization occurred, the B19 martensite was observed in Ti-40Ni-10Cu alloy ribbons. Transformation elongation and hysteresis associated with the B2-B19 transformation in Ti-Ni-Cu alloy ribbons decreased with increasing Cu-content, which was attributed to the decrease in lattice deformations. Transformation elongations of ribbons were larger than those of alloys made by casting, which was closely related to a texture developed in ribbons.