동종 조혈모세포 이식 후 면역억제제 복용 환자에서의 약물 부작용 평가

장한나,고종희,오명현,손은선,김성은,석현주 한국병원약사회 2010 병원약사회지 Vol.27 No.1

Cyclosporine and tacrolimus are essential immunosuppressants for allogenic hematopoietic stem cell transplantation patients to prevent GVHD(graft versus host disease). However, these drugs have considerable interindividual variability in pharmacokinetics and a narrow therapeutic window. Maintaining optimal therapeutic blood concentration of these drugs is necessary to promote engraftment and to avoid toxicities. The side effects such as hyperlipidemia,hypertension, hyperglycemia, renal or liver dysfunction may cause a treatment-related death, and to treat these side effects may be administered with various medication. They can greatly affect the quality of life, morbidity and mortality of the patients. The objectives of this study were to evaluate the side effects of cyclosporine and tacrolimus in the allogenic hematopoietic stem cell transplantation patients under the routine clinical settings. From July 2008 to July 2009, we studied 30 patients with acute lymphocytic leukemia(ALL), acute myelogenous leukemia(AML), chronic myelogenous leukemia(CMA), aplastic anemia(AA), or myelo-dysplastic syndrome(MDS) who had received hematopoietic SCT in Yonsei University Health Care System. Patients’medical records and medication histories from graft pretreatment until discharge or death were reviewed retrospectively. We analyzed the patient's age, sex, underlying disease, donor, conditioning regimen, blood cyclosporine or tacrolimus concentration, medication side effects appeared after administration of immunosuppressive drugs, such as whether treatment-related death respectively. Results of comparing the cyclosporine and tacrolimus group did not show a big difference to hyperlipidemia, hypertension, renal dysfunction. Hyperglycemia and liver dysfunction in the tacrolimus group was significantly.

기저인슐린 투여 중인 당뇨병 환자에서 degludec/aspart 인슐린 복합제의 영향

장한나,양예슬,오태정,구보경,정혜승 대한내과학회 2019 대한내과학회 추계학술대회 Vol.2019 No.1

Impact of Influenza Infection on Febrile Seizures: Clinical Implications

장한나,이은혜 대한소아신경학회 2018 대한소아신경학회지 Vol.26 No.4

Purpose: Febrile seizures (FSs) are the most common type of seizure in the first 5 years of life and are frequently associated with viral infections. Influenza infection is associated with a variety of neurological conditions, including FSs. The purpose of this study was to evaluate the clinical implications of influenza infection in FSs. Methods: In total, 388 children with FS were divided into two groups: FS with influenza infection (n=75) and FSs without influenza infection (n=313). Their medical records, including seizure type, frequency, duration, and familial history of FSs or epilepsy, were retrospectively reviewed and the clinical characteristics of the two groups were compared. Results: In total, 75 of the 388 children (19.3%) had FSs associated with influenza infection; such children were significantly older than those with FSs without influenza infection (34.9± 22.3 months vs. 24.4± 14.2 months; P<0.001). The children who had more than two febrile seizures episodes were more prevalent in children with FS with influenza infection [40/75 (53.3%) vs. 92/313 (29.4%); P<0.01]. Children older than 60 months were more likely to have influenza infection compared to those aged less than 60 months [11/22 (50%) vs. 64/366 (17.5%); P=0.001]. Conclusion: Influenza infection may be associated with FSs in older children, and with recurrence of FSs. Its role in the development of afebrile seizures or subsequent epilepsy requires further investigation with long-term follow-up.

Management of Spontaneous Spinal Epidural Hematoma Developedin Children with Hemophilia

장한나,윤회수,박영실 대한소아혈액종양학회 2018 Clinical Pediatric Hematology-Oncology Vol.25 No.2

Spinal epidural hematoma (SEH) is a rare neurosurgical emergency in which pressure on the spinal cord leads to acute neurological deficits, and is a rare complication in children with hemophilia. We report three cases of SEH in severe hemophilia A. An 8-month-old boy who presented with non-traumatic acute-onset irritability was found to have SEH and was later diagnosed with hemophilia. The two other patients presented with neck pain and magnetic resonance imaging confirmed the diagnosis of SEH. Two patients who received conservative management fully recovered, however the patient who presented with progressive neurological abnormalities at the time of diagnosis, received surgery but later developed breathing difficulties and quadriplegia. Early diagnosis and immediate, aggressive, clotting factor replacement therapy are crucial when managing SEH in children with hemophilia. Immediate and aggressive factor replacement, accompanied by both neurological monitoring and early imaging, are essential for hemophiliac with suspected SEH.

지속적인 휴먼서비스 전달을 위한 협력 네트워크의 회복력에 관한 연구

장한나,황태연,홍민철,정승현,이명석 한국정책분석평가학회 2015 政策分析評價學會報 Vol.25 No.1

협력 네트워크는 다양한 위협요인과 내·외적 충격에 노출되어 있으며 회복력을 갖추지 못한 네트워크는 쉽게 와해되어 실패사례로 전락할 가능성이 높다. 지속적인 협력관계를 위해 네트워크의 회복력이 중요한 요소임에도 불구하고 아직까지 이에 대한 논의가 부족한 실정이다. 본 연구는 협력 네트워크의 유지와 발전을 위한 네트워크 회복력에 관한 연구를 진행하였고, 그 결과는 다음과 같다. 첫째, 충격 이전의 네트워크 초기 특성에 따라 회복력이 상이할 수 있다. 휴먼서비스 네트워크 구축 시 네트워크가 견고해질 수 있도록 정부의 지원 및 가이드라인 제시와 지역사회 내 정당성 확보 및 협력관계 및 신뢰관계 구축이 요구된다. 둘째, 초기 동기 및 정당성의 변질은 협력 네트워크를 와해시킬 만큼의 강력한 위협요인이 될 수 있다. 파트너 간의 합의에 의해 형성된 초기의 동기 및 정당성이 변질되지 않도록 정기적인 모임을 통해 지속적으로 확인할 필요가 있다. 셋째, 협력 네트워크의 위협요인은 하나 이상의 문제가 연쇄되어 나타날 수 있다. 한 차원의 문제가 다른 문제 발생으로 연결되지 않도록 이에 대한 포괄적인 예방 및 대안이 요구된다.

시금치(Spinacia oleracea)와 비트(Beta vulgaris) 중 살충제 Thiamethoxam의 잔류특성

장한나,김민,김은별,장서영,김영신,임치환 한국농약과학회 2020 한국농약과학회 학술발표대회 논문집 Vol.2020 No.11

Synthesis and Properties of Novel Y-type Polyurethanes for Electro-Optic Applications

장한나,이가영,이주연 한국고분자학회 2008 한국고분자학회 학술대회 연구논문 초록집 Vol.33 No.2

발포기내의 공간속도에 따른 PTFE 버블의 크기 변화

장한나,이우근,이명화 한국대기환경학회 2019 한국대기환경학회 학술대회논문집 Vol.2019 No.11

Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes

장한나,양예슬,이성옥,오태정,구보경,정혜승 대한내분비학회 2019 Endocrinology and metabolism Vol.34 No.4

Background: Conflicting results have been reported on the efficacy of insulin degludec/insulin aspart (IDegAsp) compared to basalinsulin in type 2 diabetes. We investigated the effects of changing basal insulin to IDegAsp on glycemic control and sought to identify factors related to those effects. Methods: In this retrospective study of patients from three referral hospitals, patients with type 2 diabetes using basal insulin withhemoglobin A1c (HbA1c) levels less than 11.0% were enrolled. Basal insulin was replaced with IDegAsp, and data were analyzedfrom 3 months before to 3 months after the replacement. Results: Eighty patients were recruited (52.5% male; mean age, 67.0±9.8 years; mean duration of diabetes, 18.9±8.5 years; meanHbA1c, 8.7%±1.0%). HbA1c levels increased during 3 months of basal insulin use, but significantly decreased after changing toIDegAsp (8.28%±1.10%, P=0.0001). The reduction was significant at 6 months in 35 patients whose longer-term data were available. Patients with a measured fasting plasma glucose (m-FPG) lower than their predicted FPG (p-FPG) by regression from HbA1cshowed a significant HbA1c reduction caused by the change to IDegAsp, even without a significantly increased insulin dose. However, patients whose m-FPG was higher than their p-FPG did not experience a significant HbA1c reduction, despite a significantlyincreased insulin dose. Furthermore, the HbA1c reduction caused by IDegAsp was significant in patients with low fasting C-peptidelevels and high insulin doses. Conclusion: We observed a significant glucose-lowering effect by replacing basal insulin with IDegAsp, especially in patients witha lower m-FPG than p-FPG.

PVDF막 표면에 폴리비닐알코올 코팅을 통한 분리막의 투과특성 및 막오염 제어

장한나,김인철,이용택 한국막학회 2014 멤브레인 Vol.24 No.4

본 연구에서는 소수성 PVDF막 표면에 중성 친수성 고분자인 Poly(vinyl alcohol) (PVA)를 코팅한 후 순수 투과도를 측정하고 대표적인 단백질 오염물질인 bovin serum albumin (BSA)에 대하여 파울링 실험을 수행하였다. BSA 용액 20ppm 조건에서 파울링 실험을 수행한 결과, 코팅 전 막에 비하여 순수 투과도는 감소하였지만 내오염성은 현저히 증가됨을 알 수 있었다. 코팅된 PVA의 분자량이 커질수록 순수 투과도는 감소하였으나, 내오염성이 증가하는 경향을 보였다. 또한, 코팅된 PVA의 농도가 높아질수록 순수 투과도는 감소하였고, 내오염성이 증가하였다. 이는 접촉각과 AFM 측정 결과와 관련하여 코팅 후 막 표면에 친수성의 증가와 거칠기가 감소했기 때문으로 여겨진다. In this study, a hydrophobic polyvinylidene fluoride (PVDF) membrane was modified by coating neutral hy-drophilic poly(vinyl alcohol). The flux of pure water was measured and then fouling test was conducted with bovin serum albumin (BSA) as model protein foulant. As a result, the experiments showed that pure water flux was decreased but an-ti-fouling property was significantly enhanced. Pure water flux with increasing molecular weights of the polymer was de-creased and fouling resistance was enhanced. Also, Pure water flux with increasing solution concentration was decreased and fouling resistance was enhanced. It is probably due to the increase in hydrophilicity and decrease in roughness of the mem-brane surface, as revealed by contact angle and AFM analysis.