국내 혈액질환 환자에서 침습성 아스페르길루스증의 구제치료로서 Voriconazole의 효과와 안전성

권재철,김시현,최수미,최재기,이동건,박선희,최정현,유진홍,신완식 대한감염학회 2010 감염과 화학요법 Vol.42 No.1

Background: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in patients with hematologic malignancies. We investigated the efficacy and safety of voriconazole (VCZ) when used as salvage therapy for IA in Korean adults with hematologic malignancies who had not responded to prior antifungal therapy. Materials and Methods: We retrospectively reviewed data, collected from January 2007 to October 2008, from patients with proven or probable cases of IA. All were probable IA cases, except for one proven case. All cases were refractory or intolerant to antifungal therapy prior to administration of VCZ. Efficacy and safety were assessed in patients treated with VCZ for more than 3 days and for more than one dose, respectively. A favorable response [complete (CR) or partial (PR)] was defined by significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results: Fifty patients who met the inclusion criteria were enrolled. There were 27 male and 23 female patients with mean age of 44.4 years (range, 15-65 years). Underlying diseases were acute leukemia (35 cases), chronic myelogenous leukemia (4 cases), myelodysplastic syndrome (3 cases), lymphoma (3 cases) and other hematologic diseases (5 cases). Twenty-two patients had received chemotherapy and 13 patients had undergone hematopoietic stem cell transplantation. The lung was the main infection site (94%) followed by the sinus (6%). Amphotericin B deoxycholate alone was the most frequent previous antifungal therapy. The mean duration of antifungal therapy prior to VCZ therapy was 13.9±8.8 days (2-44 days). The median duration of VCZ therapy was 19 days (interquartile range, 49 days). Sixteen patients (32.0%) showed favorable responses (CR:PR=8:8) at the end of VCZ therapy. The numbers of patients with stable disease, progression and death were, 6 (12%), 6 (12%) and 22 (44%) respectively. Most of those with unfavorable responses had relapsed underlying malignancies or refractory graft versus host diseases. Twelve patients developed drug-related adverse events but only one patient stopped VCZ treatment prematurely. Conclusions: VCZ demonstrated an acceptable level of toxicity in patients with hematologic malignancies but further studies are required to prove its efficacy as salvage therapy.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

고속·고정밀 금형가공센터 개발

최원선,김태형,이재윤 한국공작기계학회 2002 한국공작기계학회 춘계학술대회논문집 Vol.2002 No.-

In order to manufacture a precision mold/die by machining, users need high speed & precision mold/die machining center. So, for development of this machine, we intend to use linear motor that is instead of ball-screw, servo-motor and coupling, high-speed spindle of pressurized air journal bearing and composite materials. In this paper we research column moving type and table moving type. The former is mainly piling 3 axes on one moving body, the latter is consist of two independent carriages. Both types are available to high speed & precision machine, but we finally draw a conclusion column moving type due to an advantage of high-speed control of linear motor.

동적 치아접촉순간의 교합안정성의 평가와 저작근활성의 상호작용에 관한 연구

최재갑,김선하 慶北大學校 齒科大學 1991 慶北齒大論文集 Vol.8 No.2

최적의 교합상태에 관한 선학들의 주장에 의할 것 같으면 하악이 교두간위로 교합되는 순간에 견치와 구치부의 가능한 한 많은 치아들이 대칭적이고 동시적인 치아접촉을 이룰 때 저작계의 모든 구성요소들이 상호 원만한 작용을 나타낼 수 있을 뿐만 아니라 치아나 악관절에 대한 과도한 부하를 방지할 수 있다고 하였다. 그러나 최근까지도 치아접촉에 대한 시간적 평가에 관한 연구는 희소하였으며, 더욱이 치아접촉이 일어나는 순간에 있어서의 동적인 교합상태를 분석하는 것은 매우 어려운 일 중에 하나였다. 저자들은 최근에 개발된 T-Scan system을 이용하여 치아접촉이 일어나는 동적인 교합순간에 치아접촉점의 위치와 시간을 측정하였으며, 이로부터 치아접촉점의 좌우균등성, 전후방 분포, 치아접촉점 사이의 평균시간간격 등을 평가하였다. 또한 이러한 치아접촉점의 기록과 동시에 Bioeletric processor EM2와 K6-Diagnostic system을 함께 사용하여 교근과 전측두근의 근전도를 기록한 후 각각에 대한 근활성 비대칭지수(Asymmetry index)를 계산하였다. 이상의 실험을 28명의 측두하악장애환자와 22명의 대조군을 상대로 실시하였으며 그 결과를 상호 비교하여 다음과 같은 결론은 얻었다. 1. 측두하악장애환자에 있어서 치아접촉점의 좌우균등성은 감소되어 있었으며 치아접촉점 사이의 평균시간간격도 연장되어 있었다. 2. 치아접촉점의 전후방 분포에 있어서는 측두하악장애환자와 대조군 사이에 유의한 차이가 없었다. 3. 초기치아접촉에서의 교합안정성은 측두하악장애환자와 대조군 사이에서 유의한 차이가 없었지만, 전체적인 교합안정성과의 관계에 있어서는 높은 상관관계를 보여주었다. 4. 측두하악장애환자에 있어서 전측두근의 근활성 비대칭지수가 대조군에 비해 높게 나타났지만, 교근의 근활성 비대칭치수는 유의한 차이를 보여주지 않았다.

그람양성구균에 대한 Teicoplanin과 Vancomycin의 시험관내 항균력

최태열,김경숙,전용관,서일혜,김정욱,이웅수,안정열,김홍석,정재용,최효선,김덕언,유진우 대한감염학회 1994 감염 Vol.26 No.1

An increasing frequency of methicillin resistant S. aureus(MRSA), methicillin resistant coagulase negative staphylococci(MRCNS) and Enterococcal infection have been observed in recent years. Teicoplanin is a new glycopeptide antibiotic obstained from the Actinoplanes teicomycetius. The molecular structure and spectrum of antimicrobial activity of teicoplanin is simillar to those of vancomycin, and has been reported to have an excellent in vitro and in vivo effect against various gram-positive infections. Therefore, we evaluated the in vitor susceptibility of gram positive cocci, such as, S. aureus, coagulase negative Staphylococci(CNS), and Enterococci to teicoplanin and vancomycin. The total 253 strains consisted of MSSA(40), MRSA(53), MSCNS(47), MRCNS(48), and Enterococci(65). They were assayed by disc diffusion and agar dilution. During the study, 57% of S. aureus and 49% of CNS showed resistance to methicillin. The inhibitory diameter of teicoplanin was 15-20mm in MSSA, 12-19mm in MRSA, 13-24mm in MSCNS, 11-23mm in MRCNS, and 15-22mm in Enterococci respectively, and showed sensitivity in all but 8 strains(3.2%). The range of the minimum inhibitory concentration (MIC) of teicoplanin to MSSA, MRSA, MSCNS, MRCNS and Enterococci were 9.12-2.0㎍/ml, 0.25-2.0㎍/ml, & 0.25-32㎍/ml, 0.12-1.0㎍/ml respectively. One case of S. haemolyticus was resistant to teicoplanin (32㎍/ml) by the agar dilution method. Eight minor (3.2%) and one major(0.4%) error was observed when the MIC and disk diffusion data were correlated with teicoplanin. As for vancomycin the inhibitory diameter was 17-21mm in MSSA, 15-21mm in MRSA, 18-26mm in MSCNS, 18-25mm in MRCNS, and 16-22mm in Enterococci respectively. The range of the MIC of vancomycin to MSSA, MRSA, MSCNS, MRCNS, and Enterococci were 0.25-1.0㎍/ml, 0.25-4.0㎍/ml, 0.5-2.0㎍/ml and 0.5-2.0㎍/ml respectively. One minor error (0.4%) was seen with the vancomycin disk. The MIC90 of MSSA and MRSA exhibited the same results in teicoplanin (1.0㎍/ml, 1.0㎍/ml), and vancomycin(2.0㎍/ml, 2.0㎍/ml). MSCNS and MRCNS exhibited greater MIC90 with teicoplanin(4.0㎍/ml, 8.0㎍/ml) than vancomycin(2.0㎍/ml, 2.0㎍/ml). Incontrase Enterococci were more susceptible to teicoplanin(0.5㎍/ml) than to vancomucin (2.0㎍/ml). Results from this analysis indicated that both teicoplanin and vancomycin were very excellent for gram positive infections, especially those resistant to methicillin.

시비량이 생강의 생육 및 수량에 미치는 영향

최재을,김정선,이은정,이완재 충남대학교 농업과학연구소 1998 농업과학연구 Vol.25 No.2

This experiment was carried out to define the effects of application amounts of the chemical fertilizers on plant growth and yield of the ginger. The results obtained are summarized as follows. Plant height of the ginger was 45.3 cm at lower level of fertilizer, 52.6 cm at recommended level, and 49.4 cm at higher level. Leaf area, stem number, and stem diameter were more significantly increased at higher level of fertilization compared to recommended rate. Dry weight of shoots and rhizomes were significantly increased with the increase of fertilization level. Stem number, stem diameter, leaf area, dry weight of shoots, and fresh weight of rhizomes were positively correlated with the amounts of fertilizer applied. Yield of rhizomes were 1, 653 kg at lower level of fertilizer, 2,248 kg at recommended level and 2,428 kg at higher level, respectively. Ginger yield showed 7.4% higher at higher level of fertilization compared to recommended rate.

건축 단열재의 장기 경년변화에 따른 열전도율 변화에 관한 실험 연구 Ⅱ

최현중,정영선,김경우,강재식,이승언 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The objective of this study is to test for thermal conductivity of architecture insulation materials in domestic buildings with environmental condition change. In study, we measured change of thermal conductivity with test temperature change, long-time leaving and change of contained water rate. For long-time leaving test, the specimens of building insulation materials were kept in test conditions, which were influenced by the outside environment. The results of the study show 1) the contained water rate of artificial mineral fiber insulations was big for others, 2) thermal conductivity rose as test temperature(median) grew up and 3) the extruding insulations and hardened Urethane foam changed thermal conductivity with environmental condition and time elapse.

개인적 특성에 따른 무용활동 참가가 무용활동 만족 및 자아개념 형성에 미치는 영향

최선,김갑구,이재우 韓國舞踊敎育學會 2002 韓國舞踊敎育學會誌 Vol.13 No.2

The purpose of this paper is to research influence of dance participation on dance satisfaction and building ego based on personal specificity. The result drawn by analyzing data are following; 1. Female students present high level of participation period compared to male students. Second grade students present the highest level of participation period. 2. Satisfaction - circumstance and physiological surrounding - from dance activities of female students present high much high level than that of female students. Satisfaction of first grade students appear highest compare to rest of them.Especially, Educational satisfaction of modern dance majoring students present much higher than other group. 3. Ego of modern dance majoring students present the highest level compare to rest group. Based on the result, participation of dance provide to review one's circumstance, to increase satisfaction of knowledge needs and provide opportunities to facilitate social activity with the age.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

地域間 均衡開發政策을 위한 都市 및 地域의 集積分析에 관한 硏究

崔在善 中央大學校 社會科學硏究所 1987 社會科學硏究 Vol.1 No.-

A problem freequently faced by regional economists and planners when attempting analytical solutions to difficult policy problems is the lack of clearly delineated tyes of regions. The purpose of this paper is to classify Korean 192 cities and counties into 25 subregions based on homogeneous profile of 33 economic, social demographic and natural characteristics of regional entities in korea. This research utilized the methods of Multivariate Analyses such as Principal Component Analysis, Factor Analysis, Clustering Analysis and Multiple Discriminant Analysis to cluster the Korean cities and counties into 25 groups based on the regional characteristics. The final method of Step-wise Multiple Discriminant Analysis (BMDP 7M) has resulted in such findings as follow: 1. 172 cities and counties of 1975, and 192 counties and cities of 1984 were clusterd into 26 homogeneous groups with the total variance of 74 per cent and 86 per cent, respectively. 2. The Multiple Discriminant Analysis showed probabilities of group memebership and derived disrciminant functions by the way of cannonical reduction with 86 per cent of discriminant variance. 3. The First discriminant function showed that the positive weights of cannonical coefficients implied the urban characteristics, while the negative the rural orientaion in 1975. In 1984 these tentendcies were shown more clear throughout the nation. 4. Most of the urnan areas showed strong urban orientation in manufacturing, service and wholesale functions, with strong self-supporting potential of local finance, while the rural areas showed the reverse situations. In conclusion, it is strongly recommended that the National Land Development Planning and Regional Development Planning should be formed and implemented based on the regional characteristics by group and type as recommended in this research.