아미노글리코사이드 사용제한에 따른 병원성 균혈증 유발 그람음성간균의 내성변화 및 임상적 의의

오종택,김신우,손종원,도병훈,한승우,신병철,박지현,이종명,김능수 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 항균제 오남용으로 인한 내성균의 출현, 약물부작용의 발생 및 약제 비용의 증가는 환자 개인뿐만 아니라 사회적으로 문제가 되고 있다. 본 연구는 항생제의 오남용을 막기 위한 제도의 일환으로 시행한 아미노글리코사이드 사용 제한정책의 비용 효과적인 측면을 조사하고 그람음성간균에 의해 병원성 균혈증이 발생한 환자들을 대상으로 이 정책이 항생제 내성률과 환자 사망률에 미치는 영향을 연구하였다. 방법 : 930병상 규모의 3차 병원인 일개 대학병원에서 아미노글리코사이드 사용제한정책이 시행된 직후인 2002년 3월에서 9월 사이에 그람음성간균(Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Stenotrophomonas maltophilia, Burkholderia cepacia)에 의해 발생한 병원성 균혈증 환자 60명(실험군)과, 이 정책이 시행되기 전에 입원한 환자들 중 균주별로 같은 수만큼 선별한 병원성 균혈증 환자 60명(대조군)의 의무기록을 후향적으로 조사하였다. 결과 : 아미노글리코사이드 사용제한정책이 시행된 시기인 2002년 3월에서 9월 사이에 처방된 아미노글리코사이드 사용량 및 비용을 이 정책이 시행되기 전인 2001년 3월에서 9월 사이와 비교한 결과, 아미노글리코사이드의 사용량(antimicrobial utilization density)은 사용제한 후 225.2에서 130.3으로 42% 감소하였고 약제 비용은 44% 감소하였다. 아미노글리코사이드 사용제한 후 병원성 균혈증을 유발한 그람 음성간균의 이 항생제에 대한 내성률은 유의한 변화를 보이지 않았으며 균혈증과 직접 연관된 사망률도 환자의 나이, 성별, 기저질환 및 원발병소 등을 보정할 경우 유의한 차이를 보이지 않았다(40.4% vs. 24.1%, P=0.11). 결론 : 아미노글리코사이드를 5일을 초과한 사용 시 감염전문가의 사전 승인을 필요로 하는 사용제한정책은 아미노글리코사이드의 사용량과 비용을 유의하게 감소시켰다. 또한 이 정책 시행 후 그람음성간균에 의한 균혈증 환자에서 균혈증으로 인한 사망률과 아미노글리코사이드에 대한 내성률은 유의한 차이가 없었다. Objective : To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). Methods : Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gramnegative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. Results : During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225,2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. Conclusion : Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.

어린 나이에 피부암을 동반한 색소성 건피증 1예

신삼식,이지범,이승철,원영호 全南大醫大 2000 전남의대학술지 Vol.36 No.1

더블 팬터그래프형 매니퓰레이터의 설계 및 수평위치제어

홍대선,신중호,정원지,김성철 國立 昌原大學校 産業技術硏究所 1998 産技硏論文集 Vol.12 No.-

In this paper, a double pantograph type manipulator activated by two slider joints is proposed for a fuel handling machine in atomic power plants. The manipulator consists of two parallelogrammic structures considered as simplified 2-DOF linkage systems. The linkage motion is controlled in such a manner that the joint rates of two linkages are constant and the movement of end-effector is horizontal, because the constant joint rates have advantages for the stable movement of the system. In addition, the static deflection of the proposed mechanism was analyzed using a transfer-stiffness matrix method.

진상전류 추정에 의한 태양광 발전시스템의 최대출력제어

우정인,신동률,허태원,박지호,노인배 東亞大學校 大學院 1997 大學院論文集 Vol.22 No.-

Photovoltaic power may vary depending on the various solar cell has an optimal generating point to be able to get the maximum power tracking, in order to get the more power recovery on the switching control system. However the V-I characteristics of the solar array at the frequency have hysteresis, in such high frequency region the conventional controller based on no hysteresis can not be responsible for control of the photovoltaic power system. Therefore, in this paper we proposed a maximum power tracking technique to improve the operation in the region of high frequency[5KHz-30KHz] with added C-R differential circuit for zero cross switching. The distinguishing characteristics of this method is to be controlled by the estimated values of resistive current and sensed photovoltaic terminal voltage do not depend on the operating frequency. the experimental result of the power system is controlled by the proposed sampling.

기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

옥상정원의 이용실태 조사 및 활성화에 관한 연구(1)

손재룡,박태은,신지웅,이동원,이경회 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(계획계)

Nowadays we globally recognize the importance of the environmental preservation and the environmental energy. The developed countries have already made efforts to realize the saving of energy and the technology based on environment-friendly viewpoint. 'Roof garden' means the restoration of soil eco-system destroyed by rash urbanization and construction. It can also offer the resting place to people in the city. Now it is considered as the realistic way that can solve the serious problems like heat island, pollution and flood in the city fundamentally. In this research, we found out that the following results were obtained: 1) Roof garden is used by users in various objects. Stage, meeting, event, date etc. 2) Users want to design roof garden that have various space features: open and close space, wide and small space etc. 3) The group composed from one to five or more played roof garden. 4) The roof garden aboved have similar facilities excepted one or two. Vaitalization in roof garden remains as a matter to be discussed further.

Disease-miRNAdb: a manually-curated database for the investigation of the microRNA-human disease relationship

Shin, Jae Moon,Lim, Wooyoung,Lee, Kyung-Mi,Won, Jung Im,Jung, Da Woon,Nho, Chu Won,Kang, Kui Dong,Yoon, Jee Hee,Cho, Yoon Shin Springer-Verlag 2017 Genes & Genomics Vol.39 No.12

<P>MicroRNAs (miRNA) of approximately 22 nucleotides are fundamental molecules in cellular biology that act by modulating target gene expression. As a post-transcriptional/translational regulator, the role of miRNAs in human disease is highly expected. Recently, a rising number of miRNAs that are associated with a variety of human diseases have been reported in the literature. Aiming to provide a comprehensive of resource of miRNAs that are related to the human disease, we built the Disease miRNA Database (Disease-miRNAdb). MiRNAs from three groups of diseases including kidney disease, cancer, and metabolic disease were manually curated in the current version of database located on a user-friendly online website (http://disease-miRNAdb.hallym.ac.kr). In addition, this database also includes information regarding single nucleotide polymorphisms (SNPs) located in pre-miRNAs, miRNA flanking regions, and 3'-UTRs of miRNA target genes. The generation of genetic variation in these regions may result in a loss or gain of miRNA-target gene interactions, which may influence the development of disease. Thus, information regarding miRNA-related SNPs will be useful in the discovery of disease-associated miRNAs in human populations by employing SNP association analysis for the disease of interest. Disease-miRNAdb will be continually maintained with up-to-date information to provide a current and valuable resource for investigating the roles of miRNAs in human disease.</P>

Poster Session 3 / N-16 : Screening of chemokine receptor interacting protein by two hybrid system

(Jee Won Joung),(Sook Yeon Lee),(Seung Hwa Hong),(Won Shin),(Ho Jung Oh),(Young Ju Choi),(Jae Ho Jin),(Seon Mi Kim),(Hong Ki Min),(Yeo Won Sohn),(Jung Woo Kim) 한국생화학분자생물학회 (구 한국생화학회) 1999 생화학분자생물학회 춘계학술발표논문집 Vol.- No.-

Selection of Vaccinia Virus-Neutralizing Antibody from a Phage-Display Human-Antibody Library

( Yong Won Shin ),( Ki-hwan Chang ),( Gwang-won Hong ),( Sang-gu Yeo ),( Youngmee Jee ),( Jong-hyun Kim ),( Myoung-don Oh ),( Dong-hyung Cho ),( Se-ho Kim ) 한국미생물생명공학회(구 한국산업미생물학회) 2019 Journal of microbiology and biotechnology Vol.29 No.4

Although smallpox was eradicated in 1980, it is still considered a potential agent of biowarfare and bioterrorism. Smallpox has the potential for high mortality rates along with a major public health impact, eventually causing public panic and social disruption. Passive administration of neutralizing monoclonal antibodies (mAbs) is an effective intervention for various adverse reactions caused by vaccination and the unpredictable nature of emerging and bioterrorist-related infections. Currently, vaccinia immune globulin (VIG) is manufactured from vaccinia vaccine-boosted plasma; however, this production method is not ideal because of its limited availability, low specific activity, and risk of contamination with blood-borne infectious agents. To overcome the limitations of VIG production from human plasma, we isolated two human single-chain variable fragments (scFvs), (SC34 and SC212), bound to vaccinia virus (VACV), from a scFv phage library constructed from the B cells of VACV vaccine-boosted volunteers. The scFvs were converted to human IgG1 (VC34 and VC212). These two anti- VACV mAbs were produced in Chinese Hamster Ovary (CHO) DG44 cells. The binding affinities of VC34 and VC212 were estimated by competition ELISA to IC₅₀ values of 2 μg/ml (13.33 nM) and 22 μg/ml (146.67 nM), respectively. Only the VC212 mAb was proven to neutralize the VACV, as evidenced by the plaque reduction neutralization test (PRNT) result with a PRNT₅₀ of ~0.16 mg/ml (~1.07 μM). This VC212 could serve as a valuable starting material for further development of VACV-neutralizing human immunoglobulin for a prophylactic measure against post-vaccination complications and for post-exposure treatment against smallpox.

재조합 사람성장호르몬(소바트로핀)의 KFDA표준품(KS 98/674) 설정연구

신원(Won Shin),정지원(Jee Won Joung),진재호(Jae Ho Jin),Adrian F. Bristow,손여원(Yeo Won Sohn) 대한약학회 2001 약학회지 Vol.45 No.2

The complexity and variability of both the biologicals and the bioassays used to test them led to the use of the reference standard- a sample of the product of defined purity and potency, against which all preparations of that product must be calibrated. In order to prepare and establish KFDA reference standard for recombinant human growth hormone(somatropin), somatropin substance was filled in ampoules in National Institute for Biological Standards and Control(NIBSC). The candidate KFDA reference standard for somatropin(designated as 98/674) was evaluated to determine the suitability of serving as a KFDA reference standard for somatropin by the collaborative study, in which 10 laboratories participated. Physicochemical analysis and in vivo bioassay were performed by direct comparison with the international somatropin standard 88/624. 98/674 was identified as somatropin by SDS-PAGE, IEF, peptide mapping, and HPLC. Determination of somatropin content by SE-HPLC yielded a mean estimate of 2.01mg somatropin per ampoule. Data from the study also yielded mean values of 0.39+/-0.26% for high molecular weight impurities by SE-HPLC and mean values of 2.13 +/- 1.29 % for somatropin related proteins by RP-HPLC. Estimates of relative potency by weight gain bioassay in the hypophysectomised rats showed that relative potency of KS 98/674 was 1.07 against IS 88/624. Based on the results of the collaborative study, the candidate reference standard for somatropin is suitable to serve as a KFDA reference standard for somatropin.