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      • 결핵 치료 중 발생한 부작용으로 약제 변경한 환자들에 대한 임상적 고찰

        김호철,김호철,김이형,송재욱,고원중,전경만,송준휘,류연주,김우열,권용수,최재철,박소영 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

        목적: 일차 항결핵제 치료 중 부작용으로 약제변경을 한 환자들의 임상적 특성과 치료 경과에 대하여 알아보고자 하였다. 방법: 2009년 1월부터 12월까지 국내 10개 병원에서 일차 항결핵제 치료를 시작한 환자들 중에서 부작용으로 인해 약제를 변경한 환자들을 대상으로 변경 원인과 임상적 특성, 치료경과에 대하여 후향적으로 조사하였다. 결과: 일차 항결핵제치료를 시작한 환자는 총 2,601명이었고, 남자는 1438명(55.3%), 평균나이는 49.8±19.1세였다. 이 환자들 중 부작용으로 약제 변경한 환자는 230명(8.8%)이었고 남자는 116명(50.4%)이었고, 평균나이는 50.9±19.6세였다. 발생한 부작용으로는 간독성이 99명(43.0%)으로 가장 많았고 피부 이상반응은 63명(27.4%), 위장관 증상 46명(20.0%), 시력장애 31명(13.5%), 발열 23명(10.0%%), 백혈구 또는 혈소판감소증 15명(6.5%) 신기능장애 8명(3.5%), 손발저림 5명(2.2%) 순이었다. 나이, 체질량지수는 관련이 없었고, 당뇨(19%, p=0.02), 만성간질환(9%, p=<0.001) 및 폐외결핵(40%, p=0.047)이 약제부작용 발생과 관련이 있었다. 치료기간은 평균 294.5±189.7일로 더 길었으나 최종 치료성적과 재발여부에는 차이가 없었다. 결론: 일차 항결핵제 치료를 받는 환자들 중에서 기저질환으로 당뇨, 만성간질환이 있거나, 폐외결핵의 환자들에서 약제 부작용이 더 많았고 이로 인해 약제변경이 필요하였다. 그러나 약제를 변경한 경우에도 치료 성적에는 큰 차이가 없었다.

      • KCI등재
      • KCI등재

        Effect of different concentrations and ratios of ammonium, nitrate, and phosphate on growth of the blue-green alga (cyanobacterium) Microcystis aeruginosa isolated from the Nakdong River, Korea

        김호철,조복연,김한순 한국조류학회I 2017 ALGAE Vol.32 No.4

        Microcystis aeruginosa causes harmful algal blooms in the Nakdong River of Korea. We studied the effect of different concentrations and ratios of ammonium (NH4+), nitrate (NO3 -), and phosphate (PO4 3-) on growth of this species in BG-11 medium: each nutrient alone, NO3 - : NH4+ ratio, the N : P ratio with fixed total N (TN), and the N : P ratio with fixed total P (TP). The single nutrient experiments indicated that M. aeruginosa had the highest growth rate at NH4+ and NO3 - concentrations of 500 μM, and at a PO4 3- concentration of 5 μM. The NO3 - : NH4+ ratio experiments showed that M. aeruginosa had the highest growth rate at a ratio of 1 : 1 when TN was 100 μM and 250 μM, and the lowest growth rate at a ratio of 1 : 1 when the TN was 500 μM. The N : P ratio with fixed TN experiments indicated that M. aeruginosa had the highest growth rates at 50 : 1, 20 : 1, and 100 : 1 ratios when the TN was 100, 250, and 500 μM, respectively. In contrast, the N : P ratio with fixed TP experiments showed that M. aeruginosa had the highest growth rates at 200 : 1 ratio at all tested TP concentrations. In conclusion, our results imply that the NO3 - : NH4+ ratio and the PO4 3- concentration affect the early stage of growth of M. aeruginosa. In particular, our results suggest that the maximum growth of M. aeruginosa is not simply affected by the NO3 - : NH4+ ratio and the N : P ratio, but is determined by the TN concentration if a certain minimum PO4 3- concentration is present.

      • F-35 Predictors of mortality in Patients with Rheumatoid Arthritis-Associated Interstitial Lung Disease

        김호철,( Jacob Joseph ),( Gary Cross ),( Joseph Barnett ),( Dong Soon Kim ),( Jin Woo Song ) 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-

        Background: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) has variable clinical course and poor prognosis; however, risk factors of them are not well defined. Methods: Patients diagnosed with RA-ILD (n=158; surgical lung biopsy, n=34) from May 1995 to July 2017 at Asan Medical Center were included and clinical data and high resolution CT (HRCT) scan images retrospectively analyzed. HRCT pattern was categorized as usual interstitial pneumonia (UIP) or non-UIP pattern, and the extent of emphysema, GGO, reticulation, consolidation, traction bronchiectasis and honeycombing was semiquantitatively scored. Fibrosis index was defined as sum of reticulation and honeycombing scores. Results: Median follow-up period was 54 months. Mean age was 60.9 year, 42.4% were male, 43.0% were smokers, and 41.8% showed UIP pattern on HRCT, respectively. 42.4% of patients died during follow-up. Non-survivors were older (64.0 vs. 58.6 years) and had more male (52.2 vs. 35.2%), ever smoker (55.2 vs. 34.1%), lower FVC (71.6 vs. 78.2% predicted) and DLco (56.9 vs. 64.9% predicted), and more UIP pattern (59.7 vs. 28.6%) and higher fibrosis index (27.0 vs. 13.5%) compared to survivors. In univariate Cox analysis, age, gender, smoking history, rheumatoid factor titer, FVC, DLco, UIP pattern and fibrosis index were significant; however, in the multivariate analysis, age (HR, 1.074), UIP pattern (HR, 1.944) and fibrosis index (HR, 1.053) were only significant. Conclusions: Older age, UIP pattern and higher fibrosis index on HRCT could predict poor prognosis in RA-ILD.

      • 低開發國 一次産品市況의 變遷에 관한 고찰

        金浩哲 東國大學校 1974 論文集 Vol.13 No.-

        The first product markets in the underdeveloped countries can be affected by their own conditions, but the most important element to be considered is the industrial fluctuation in the developed countries; a recession neglizible for the developed countries can deal a serious blow on the under developed countries. furthermore, the restriction of import on the product tightened in 1950's and 1960's caused the recessions in the underdeveloped countries. 1. The Market condition of the first product in 1950's and 1960's a. the long-term trend the causes for the worsening condition of the first product market in 1950's and 1960's are; a) import coefficient; America, which is low in import coefficient, became the center of world economy in 20th century and failed to make a development in harymony with the countries who supply the first product. b) the development of the substitutes; such as synthetic rubber and fibers played an important role in worsening the market condition of the first product. c) an error in the strategy of development; the worsening of the international market condition of the first product could be prevented by the use of the product for the domestic economic development. but the underdeveloped countries did not developed the economic field related with the first product. d) the increase in the worldwide supply ability; after the World War Ⅱ the supply ability of the first product increased not only in the underdeveloped countries but also in the developed countries such as America. b. the short-term trend caused by the fluctuation in the developed countreis. It is only natural for the underdeveloped countries supplying the first product to be affected by the fluctuation in the developed countreis but the question is the price of the first product is relatively low compared with the industrial product in the developed countries even in a boom period. a) the recession in 1957-58; during this period decrease in the industrial output in America is only 2%, and the price of the industrial product in ther-developed countries fell about 1%, while that of the first product in the underdeveloped countries did 6%. b) the recession in 1967; in March through August 1967, the prices of the first product feel sharply; copper 47%, rubber 29%, sugar 27%. 2. The Market condition of the first product in 1970's. a. the recession in 1970-71 (which caused the so-called stagflation) the index of the export prices in the developed countries in the first quarter of 1974 shows 3.6% rise compared with the previous year, while that of the import prices 2.7% rise. b. the excessive boom With President Nixon's New Economic policy of August 15, 1971, economy of America began the rising along with the other countries, America experienced the boom of more than 20 months, recording 15.2% of the rate of the nominal growth and 8% of the rate of the real growth in the first quarter of 1973. with the improvement of the market condition of the first product at home and the underdeveloped countries. c. the worldwide resource problem and the second stagflation With the worldwide economic development, the demand for the first product increased sharply, but as the resources, especially the important ones such as iron and energy, are limited in quantity, the resource shortage became one of the most difficult problem the world faces now, and the world economy experienced another stagflation in 1973 as the Arab used oil as weaponry and many countries tried to check the excessive boom. Prices of agricultural products all over the world are rising because of the bad harvest owing to the abnormal and unseasonable weather in many years. However the rise of the prices first product is helpful to the underdeveloped countries, in spite of the worldwide stagflation.

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