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 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염 2예

신성철,백경란,정재홍,송봉근,김동희,전경만,채제욱,손준성,정숙인,오원섭,송재훈 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

국균은 호흡기를 통해 유입되며 심한 면역기능저하 환자에서 기회감염을 일으키는 진균이며 주로 혈관을 따라 폐를 침범하고 심장과 골침범은 매우 드문 것으로 알려져 있다. 저자들은 급성 림프구성 백혈병 환자에서 발생한 침습성 국균 심내막염을 2예을 경험하였다. 19세 남자환자로 동종 조혈모세포이식 후 발생한 고열과 요통의 원인으로 감염성 심내막염 진단하에 수술결과 국균에 의한 감염으로 확증되어 수술적 절제술과 liposomal amphotericin B로 치료하였으나 국균 심내막염의 재발과 국균 척추염의 악화, 뇌 출혈로 사망하였다. 23세 남자환자로 관해요법 후 발생한 고열과 요통의 원인으로 국균 심내막염과 국균 척추염 진단하에 수술적 절제술과 amphotericin B로 치료하여 1년 2개월 동안 국균 심내막염의 재발은 없었으나 지속적인 백혈병의 재발과 국균 척추염의 악화, 침습성 폐 국균증으로 사망하였다. Although Aspergillus endocarditis has rarely been reported, it can cause fatal complications in hematologic malignancy patients and allogeneic stem cell transplant recipients. We experienced two cases of aspergillus endocarditis developed in acute lymphoblastic leukemia patients. Case; A 19-year-old patient developed Aspergillus endocarditis after allogenic hemopoietic stem cell transplantation. He was treated with surgical intervention and liposomal amphotericin B. He died of recurred Aspergillus endocarditis and cerebral hemorrhage probably related with aspergillosis of central nervous system. Case 2; A 23-year-old patient developed invasive Aspergillus endocarditis after induction chemotherapy. Aspergillus endocarditis was successfully treated by surgical intervention and amphotericin B. He died of refractory neutropenic fever and sepsis after the third relapse of leukemia and repetitive chemotherapy. He probably had invasive pulmonary aspergillosis without evidence of endocarditis recurrence. Because the mortality of Aspergillus endocarditis is very high, early diagnosis and surgical intervention are very important for better outcome.

Modeling and Numerical Investigation of the Biomechanical Interaction for Human-Rifle System

Chae, Je-Wook,Lee, Young-Shin The Korean Society of Mechanical Engineers 2004 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.18 No.12

This paper represents the description of a complex mathematical model of biomechanical interaction for human-rifle system during shooting. The model is developed by finite element method using bar elements. And three typical shooting positions, i.e. standing, kneeling and prone are used. Characteristics of interior/exterior ballistics and behaviors of human-rifle system are evaluated by this model, which takes into account the influence of environment, bullet, powder, barrel geometry parameters and anthropological parameters. The results of this study can be applied to anthropology, biomechanics, medical science, gait analysis, interior ballistics and exterior ballistics.

Technical trend of warrior platform R&D for the future soldier system

Je-wook Chae(채제욱),Eui-jung Choe(최의중),Jun-mo Ahn(안준모),Myung-kyu Park(박명규) 대한기계학회 2023 대한기계학회 춘추학술대회 Vol.2023 No.11

Modeling and Numerical Investigation of the Biomechanical Interaction for Human-Rifle System

Je-Wook Chae,Young-Shin Lee 대한기계학회 2004 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.18 No.12

This paper represents the description of a complex mathematical model of biomechanical interaction for human-rifle system during shooting. The model is developed by finite element method using bar elements. And three typical shooting positions, i.e. standing, kneeling and prone are used. Characteristics of interior/exterior ballistics and behaviors of human-rifle system are evaluated by this model, which takes into account the influence of environment, bullet, powder, barrel geometry parameters and anthropological parameters. The results of this study can be applied to anthropology, biomechanics, medical science, gait analysis, interior ballistics and exterior ballistics.<br/>

NCW 기반 미래병사체계 연구개발 기술동향

채제욱(Chae Je-Wook),최의중(Choe Eui-Jung),김현준(Kim Hyun-Jun),이준호(Lee Jun-Ho),이성배(Lee Sung-Bae) 제어로봇시스템학회 2012 제어로봇시스템학회 합동학술대회 논문집 Vol.2012 No.7

미래병사체계(이하 개인전투체계)란 화기, 피복 및 휴대품에 이르기까지 혁신적인 첨단기술을 적용하여 소부대 전투원이 네트워크 중심전(NCW) 작전 환경하에서 Sensor to Shooter 기능을 수행할 수 있도록 병사의 능력을 극대화하는 것이다. 특히 네트워크 중심전에서의 역할이 크게 대두되리라 예상된다. 이를 위하여 5가지 기본전략 즉 치명성, 지휘통제, 생존성, 임무지속성 및 기동성을 향상시켜 병사를 통합 시스템화하여야 한다. 이에 따른 모듈 통합형 개인전투체계의 핵심소요기술을 식별하고 연구개발 기술동향을 분석하고자 한다. Future soldier as a weapon system is connected with the real time network system. That will be more powerful than any other soldier. Future warrior system is developed for future warrior to operate optimized sensor and shooter on future combat situation taking into account Network Centric Warfare environment. So future warrior is needed to systemized considering lethality, Command & Control, survivability, sustainability and mobility. Therefore we identified the key technology of Integrated Modular Future Soldier System and analyzed the State of the Art of Integrated Modular Future soldier system by Technical Breakdown System.

견착사격시 인체-화기 시스템 거동해석

채제욱(Je-Wook Chae),이성배(Sung-Bae Lee),최의중(Eui-Jung Choe),이준호(Jun-Ho Lee),여운주(Woon-Ju Yeo),김현준(Hyun-Jun Kim) 대한기계학회 2008 대한기계학회 춘추학술대회 Vol.2008 No.5

This paper represents the description of a study on behavior analysis of the Human-Rifle System under the shooting condition with small arms using bio-mechanics approach. This study can determine the calculations for standing shooting posture. The model includes the solution of interior ballistic processes and the behavior of Human-Rifle System. The numerical investigations are given in terms of influence of anthropological and geometrical parameters in the case of 7.62 ㎜ small caliber machine gun. This study makes it possible to investigate the influenced wide class of parameters, interior ballistics, exterior ballistics, rifle and human for assessment firing accuracy from different small arms weapon system. Additionally this makes it possible to correct the shooting posture taking into account their personal anthropological characteristics. Given modeling and simulation method can be applied to anthropology, biomechanics, medical science, gait analysis, interior ballistics and exterior ballistics.

단반동 주퇴작동식 소구경 화기의 동역학적 거동 특성 연구

채제욱(Je-Wook Chae),최의중(Eui-Jung Choi),이성배(Sung-Bae Lee),이찬(Chan Lee),이영신(Young-Shin Lee),홍계정(Gye-Jung Hong) 대한기계학회 2004 대한기계학회 춘추학술대회 Vol.2004 No.10

The operating principle of the small arms is well known. But it was difficult to apply the theory for real weapon system without analyzing dynamic characteristics. In this study, we designed short-recoil operated weapon system and then studied design parameters, such as mass of moving parts, stiffness of spring, etc. After that we made and test the experimental launcher system according to the result of analysis. As the simulation result is good agreement with the test result, it is expected that these technique can be applied to the development of similar weapon systems.

개인화기 총열 표면처리 및 시험에 관한 연구

채제욱(Chae Je-Wook),김인우(Kim In-Woo),이영신(Lee Young-Shin) 대한기계학회 2004 대한기계학회 춘추학술대회 Vol.2004 No.4

This paper includes the comparative study between Cr plating and nitriding process with an aim at improving corrosion, wear and maintainability for KNR(Korean Next Generation Rifle) 5.56㎜ barrel. The endurance test was conducted to compare the performance of standard barrel, Cr plating barrel and nitriding barrel. Main activities are described as follows; optimal Cr plating and nitriding process set-up for KNR 5.56㎜ barrel; durability test of each barrel(20,000 rounds); salt water i㎜ersion test; dispersion, initial velocity, inner diameter data acquisition. According to the results of this firing test, Cr plating barrel is superior to standard barrel and nitriding barrel in view of corrosion, wear and maintainability

Effect of Rice Cultural Practices on Water Percolation, Irrigation Requirement, and Nitrogen Leaching under Lysimeter Condition

Dea-wook Kim,Je-Cheon Chae,Sung-Won Kim 韓國作物學會 2001 Korean journal of crop science Vol.46 No.1

In this lysimeter experiment, temporal changes of water percolation rate, irrigation requirement and No3 --N leaching were investigated under different cultural practices that were no-till direct seeding on flooded paddy (NTDSF), till direct seeding on flooded paddy (TDSF), and transplanting. The highest water percolation rate of 3,001 l/m2 was measured in NTDSF. Others were 2,551 l/m2 and 2,210 l/m2 in TDSF and transplanting. Water percolation rate in NTDSF and TDSF was increased by 36% and 15% compared to transplanting. Water percolation rates in all cultural practices were increased remarkably from the reproductive growth stage and relatively large amount of water loss through percolation was measured even after the reproductive growth stage. A total irrigation requirement was 3,469 l/m2 in NTDSF and 2,898 l/m2 in TDSF. That was equivalent to 45% and 21 % of increase compared to 2,389 l/m2 in transplanting. The largest No3 --N leaching through the entire rice growing period was 701 mg/m2 in NTDSF and was followed by 494 mg/m2 in TDSF and 465 mg/m2 in transplanting. The ratios to the total amount of No3 --N leaching at the vegetative growth stage, reproductive growth stage and ripening stage were 31 %, 41 % and 28% in NTDSF; 21 %, 48% and 31 % in TDSF; and 18%, 48% and 35 % in transplanting.