췌장이식의 성공률은 지난 10년 동안 상당히 상승되었다. International Pancreas Transplant Registry에 따르면 1995년 이래 미국에서만 매년 1,000건 이상의 췌장이식이 실시되고 있다. 장기이식후 나타나는 급성 거부반응은 이식 후 6개월 이내에 가장 높은 빈도수로 나타난다. 췌장이식환자에서는 신장을 이식한 것보다 두배나 높은 거부반응을 나타나며 이로 인한 입원율의 증가 항림프제(antilyinphocyte) 사용과 감염의 증가로 이환율이 높다. 더구나 Cyclosporine (CsA)을 기초로 한 면역억제제요법의 사용은 높은 급성 거부반응률(acute graft rejection)을 초래하여 이식한 장기의 조직손실이 문제가 되고 있다. 새로운 면역억제제인 Tacrolimus (FK506)의 사용은 이식환자에서의 거부반응을 감소시켜 생존율을 증가시키는 것으로 알려져 있다. Tacrolimus는 neutral macrolide로 cyclic peptide인 CsA과는 화학 구조는 매우 다르나 비슷한 면역억제 효과를 보인다. 하지만 Tacrolimus의 사용시 신경독성, 신독성, 특히 고혈당증의 발생률이 높아 일부 이식센터에서는 장기 이식 후에 사용하기를 꺼리기도 한다. 하지만 여러 연구논문에서 간과 신장 이식 후 급성 거부반응 예방에 Tacrolimus는 CsA에 비해 이점이 있는 결과를 발표하였다. 결과적으로, 현재 췌장이식 후 Tacrolimus를 기초로 한 면역억제의 효과에 대한 연구가 활발히 진행중이다. 따라서 본 연구에서는 1994-1996년 사이에 Tacrolimus 또는 CsA를 기초로 한 면역억제요법을 투여 받은 췌장이식환자 101명을 후향적으로 조사하여 Tacrolimus (n=54)와 CsA(n=57)의 급성 거부반응 예방 효과와 신부전 발생률을 비교하였다. 모든 환자는 항림프구 약물, Azathioprine, Prednisone을 이식 후 면역억제제로 투여 받았다 기준선으로부터 $20\%$ 이상의 혈청 creatinine의 상승이 있는 환자에서는 급성 신부전으로 정의하였고 신장생검법으로 거부반응을 진단하였다 Matched-pair analysis에 따르면 췌장이식환자의 6개월 생존율은 CsA군에서 $97\%$, Tacrolimus군에서 $96\%$로 별다른 차이가 없었으며 (p=0.57), 6개월간의 이식한 췌장의 보존율은 CsA군에서는 $88\%, Tacrolimus에서 $91\%$. 유의한 차이는 없었다(p=0.29). 췌장이식 후 6개월 동안 Tacrolimus의 사용은 생검으로 증명되는(biopsy-proven) 급성 거부반응의 발생빈도는 CsA보다 유의하게 낮았을 뿐만 아니라 (p<0.05) 거부반응 증상의 심각도 또한 감소시켰다 (p=0.03). 급성거부반응 발생빈도의 감소로 Tacrolimus군에서 antilymphocyte 치료가 유의하게 줄어들었다(p=0.01). CsA군에서 Tacrolimus보다 신부전의 발생률이 높았으나 통계학적 차이는 없었다. 췌장이식후의 최적의 면역억제요법의 결정하기 위해서는 향후 Tacrolimus와 CsA을 비교하는 전향적 무작위 연구가 필요하다.

The purpose of this study was to compare the pkarmacokinetic parameters of vancomycin using a 2-compartment model in 8 Korean healthy volunteers and 8 lymphoma patients. Vancomycin (1.0 g) was administered by IV infusion over 60 minutes. The $\beta-phase$ rate constant $(\beta)$, apparent volume of distribution at steady srate $(V_{ss})$, total body clearance (CL) and area under the plasma level-time curve (AUC) of vancomycin in healthy volunteers were $0.15\pm0.02\;hr^{-1},\;33.8\pm4.12\;L/kg,\;5.36\pm0.61\;L/hr\;and\;185.8\pm20.5\;{\mu}g/ml{\cdot}hr$, respectively. The corresponding values in lymphoma patients ere $0.09\pm0.02\;hr^{-1},\;38.2\pm5.11\;L/kg,\;4.58\pm0.52\;L/hr\;and\;218.3\pm22.9\;{\mu}g/ml{\cdot}hr$. There were significant differences (p<0.05) in ${\beta}$ and CL between healthy volunteers and lymphoma patients.

The pharmacokinetics of carbamazepine(100 mg/kg, oral) in the folic acid-induced renal failure rabbits was studied. Renal failure was induced by the i.v. injection of folic acid (50, 100, and 200 mg/kg). At folic acid dose of 100 and 200 mg/kg, the serum creatinine concentration (Scr) and blood urea nitrogen (BUN) increased significantly compared with control rabbits. Plasma concentrations and area under the plasma level-time curve (AUC) of carbamazepine increased significantly at folic acid dose of 100 and 200 mg/kg. The elimination rate constant (Kel) of carbamazepine decreased significantly, and half-life $(t_{1/2})$ of carbamazepine increased significantly at folic acid dose of 100 and 200 mg/kg. The serum creatinine concentration (Scr) correlated well with AUC and elimination rate constant (Kel) of carbamazepine, as well as BUN with AUC and elimination rate constant (Kel) of carbamazepine. These results suggest that adjustment of the dosage regimen of carbamazepine is desirable, and serum creatinine concentration (Scr) as well as BUN can be used for adjusting the dosage regimen of carbamazepine in renal failure.

The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

The anti-proliferating effects of some plants on hepatoma cell lines were studied by the 3-[4,5-dim-ethylthiazol-2yl]-2,5-diphenyl-tetrazolium bromide (MTT assay), to investigate the anticancer effect with some plants around here. As the result, we saw that the anti-prolferating effect to the plants. Among the plants, Equisetum arvense L. and Lactuca dentata Makino. var, flaviflora Makino of them relatively showed a good ant-proliferating effect. Capsicum annuum L. var. angulosum Mill (Leaf) was the best among them. We also examined morphological changes on the hepatoma cells in this process. In case of Capxicum annuum L. var. angulosum Mill, the tells become vague after 2 days, and then destroyed faster than others. We can fee also the condensated chromosome on the treated cells with Capxicum annuum L. var. angulosum Mill. And we also observed condensation through using a fluorescent microscope by PI staining, and observed DNA fragmentation.

The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

The educational backgrounds and research interests of pharmacy educators in Korea were analyzed to investigate the possibility of migrating the pharmacy education system from basic science-oriented to pharmacy practice-oriented. There are 257 full-time faculty members and 190 part-time members in twenty pharmacy colleges in 1999. Most of the full-time professors are majoring in basic pharmacy areas focused on the drug itself. Thirty nine percent of full-time professors are specialized in the fields of Medicinal Chemistry, $20\%$ in Biochemistry, $19\%$ in Pharmaceutics, and $18\%$ in Pharmacology-Toxicology. Only $4\%$ are related to the Pharmacy Practice Field. When we consider only the educational backgrounds of the educators, $89\%$ of full-time professors are related to the subjects of Korean Pharmacists Licensure Examination. Changes in educator's inclination will lead to the changes in pharmacy education and the contents of the test. There will be at least 38 job-openings due to retirements within next five years, and this will lead to approximately $15\%$ changes of current full time professors in Korean pharmacy education. More full-time professors will be needed in the area of pharmacy practice in order to focus on the pharmacy practice-oriented pharmacy education. Many distinguished characteristics of pharmacy educators between the private schools and the national universities are also discussed in the paper.