• Journal of Yeungnam Medical Science
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• 제12권2호
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• pp.260-268
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• 1995

건전한 뇌의 수분 함량은 뇌혈류장벽의 투과성, 혈관내 정수압, 혈장의 삼투압 Na-K-APTase pump의 기능에 의해서 결정된다. 뇌허혈에 의해 이러한 기전이 파괴되면 세포 사이의 정상적인 수분이동이 영향을 받게 된다. 그러므로 뇌허혈이 생길 수 있는 수술의 경우에 분리 뇌관류를 하면 뇌허혈시 발생하는 독성 대사물을 발생을 억제하고 뇌혈류의 분포를 개선하여 신경세포의 손상을 줄이고 뇌부종을 감소시킬 수 있으리라 생각되어 토끼에서 분리 뇌관류 모델을 만들어 허혈 유도 후 관류군과 비관류군의 대뇌피질과 해면구의 비중을 정상 토끼와 비교하였다. 뇌허혈에 의해 관류군과 비관류군의 뇌비중이 유의하게 감소하여 뇌부종이 발생하였음을 나타내었고, 비관류군이 판류군보다 유의하게 감소하여 뇌부종이 더욱 현저하였던 것으로 보아 냉각 식염수로 뇌관류한 것이 뇌부종의 발생을 억제한 것으로 생각된다.

• Parasites, Hosts and Diseases
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• 제59권5호
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• pp.507-512
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• 2021

Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggi-do of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.

• 한국임상약학회지
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• 제31권3호
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• pp.180-187
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• 2021

Objective: We investigated arthralgia and myalgia associated with the use of oral bisphosphonate (BP) by conducting a survey of patient. Methods: The pharmacists conducted a survey between 1 Oct 2019 and 30 Sep 2020 among patients who were dispensed BP in community pharmacies to assess their demographic and medical characteristics, and their experiences with, and process for pain. Logistic regression analyses were performed to find the risk factors associated with the pain, and the odds ratios (OR) and 95% confidence intervals (CI) were determined. Results: A total of 160 patients who used BP participated in the survey (74 [46.3%] used risedronate; 61 [38.1%] used alendronate; 23 [14.4%] used ibandronate), and 20 (12.5%) of them experienced pain. Significant statistical differences of the characteristics between patients who experienced pain or not were observed regarding menopause, and parity. Compared with women who had one or two parity, women who had more than three parity were associated with the decreased risk of pain (OR, 0.24; 95% CI, 0.04-0.98). Moreover, steady exercise was associated with the decreased risk of pain compared to less exercise (OR, 0.37; 95% CI, 0.14-0.98). Conclusion: Our findings suggest that the risk of pain in BP-treated patients might be different regarding the different ingredients of BP, and dosing frequency. This survey highlights a need for a further safety research to understand the factors influencing the pain associated with the BP treatment.

• Journal of Dairy Science and Biotechnology
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• 제36권4호
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• pp.208-219
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• 2018

낙농업 및 유가공 제품의 생산과 유통에서 살모넬라 감염에 의한 살모넬라증의 발생은 빈번하며, 이 세균의 항미생물 제제에 대한 내성 증가 현상 또한 지속되고 있어 새로운 항미생물 제제의 수요는 감소하지 않는다. 세균막의 훼손은 세균 생존을 쉽게 위협할 수 있기 때문에 개발되는 항미생물 제제들은 주로 세균의 막을 표적으로 삼지만, 개발되는 제제들이 실제로 세균막의 훼손을 초래하는지 구별하는 것은 많은 노력과 비용을 수반한다. 본 연구에서는 E. coli 세포막 스트레스에 의해 발현이 유도되고, 세균막 외부공간에서만 위치하며, 그 구조상 많은 단백질의 구조 안정화에 기여할 것으로 예상되는 chaperone 단백질 Spy(spheroplast protein Y)의 유전자에 상응하는 살모넬라 spy 유전자에 gfp(green fluorescence protein) 오페론 융합체를 제조하여, 이 융합체가 Salmonella enterica의 두 혈청형 Enteritidis와 Gallinarum의 세포막 스트레스를 인지하여 GFP 발현량이 크게 증가하는 것을 확인하였다. 또한 세균막 스트레스 신호를 특이적으로 인지하는 이인자 신호전달 체계(two component signal transduction system)인 Bae와 Cpx들이 두 살모넬라 혈청형의 spy 유전자 전사 유도에 필수적임을 확인하였다. 따라서 본 연구에서 사용한 spy-gfp 오페론 융합체는 S. Enteritidis와 S. Gallinarum의 세포막 훼손을 특이적이고 신속하게 인식하는 biosensor로서 활용될 수 있을 것으로 판단된다.

• 한국식품위생안전성학회지
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• 제35권6호
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• pp.607-617
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• 2020

인체 바이오모니터링(Human biomonitoring, HBM) 데이터는 뇨와 혈액 등 생체지표으로부터 환경유해물질의 측정을 통해 획득되며, 다양한 노출원과 경로로부터 노출되는 유해물질의 인체노출수준 및 건강영향과의 상관성을 파악하기 위해 매우 중요하다. 국내의 경우 식품의약품안전처를 비롯한 국가기관의 다양한 HBM 프로그램을 통하여 HBM 데이터가 생산되고 있다. 그러나, 목적, 시기, 연구자 및 측정 장비의 차이에 의하여 서로 다른 형식에 따라 생산되다 보니, 데이터의 호환성의 문제로 인하여 특정 HBM 데이터를 신속하게 조회해야 하거나 인구집단별 시간적 추이분석 내지는 다른 국가의 자료와 비교에 난점을 가지고 있다. 따라서, 본 연구에서는 HBM 데이터를 체계적으로 데이터베이스(Database, DB)화하고 활용성을 증진하게 시킬 목적으로 지식 모델링을 실시하였다. 지식 모델링은 HBM 데이터의 생산되는 변수들을 그룹화하고 관계를 분석하여 2차원 구조의 개체 및 집합론에 기초한 방법론인 관계형 데이터 모델링 기법을 활용하여 실시하였다. 지식모델은 조사대상자를 인구집단으로 중심으로 설문자료, 측정자료, 노출 평가자료 개체로 구성하고 그 안에 속성들을 정의하고, 개체간에 관계를 설정하는 방식으로 구성하였다. 또한, 도출된 지식 모델을 기반으로 식품의약품안전처에서 2006년-2018년까지 수행한 HBM의 원시데이터를 수집, 정제 및 정규화하여 통합 DB를 구축하였다. 이와 같이 통합된 HBM-DB는 개별 자료원 내지는 특정 자료원들을 선택하여 기간별 농도 수준에 대한 통계분석은 물론, 다양한 검색조건을 통하여 데이터 추출을 할 수 있는 구조로 구축하였다. 본 HBM-DB는 관계형 DB모델로 구축되어 지속적인 대용량 DB 축적이나 HBM 데이터 해석을 위한 도구로써 효율적으로 수행할 수 있을 것으로 생각된다.

• 대한임상검사과학회지
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• 제54권2호
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• pp.133-141
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• 2022

혈류 감염(BSI)의 주요 원인균의 하나로 입원환자에서 이환율과 사망률을 높이는 칸디다의 항진균제 내성률을 조사하여 칸디다 혈증(candidemia)의 경험적 치료 방침에 중요한 정보를 제공하고자 한다. 2009~2018년 S병원의 혈액배양 검사에서 분리된 Candida 균주(973건) 중 Candida spp. (932 균주)에 대한 fluconazole 감수성 시험결과에서 4.7% (N=44)가 내성(resistant, R)을 보였고 C. albicans, C. parapsilosis, C. tropicalis, C. glabrata에서 내성 균주를 확인하였다. 또한, Candida spp. (947 균주)의 amphotericin B에 대한 감수성 결과에서는 내성(N=6, 0.6%)이 나타났고, 전체 Candida spp.(973 균주)에 대한 flucytosine 감수성 시험에서는 내성(N=23, 2.4%)을 보였다. Candida spp. (768 균주)의 voriconazole에 대한 감수성 시험에서는 내성(N=24, 3.1%)을 보였다. C. albicans는 fluconazole (N=23, 6.9%), voriconazole (N=21, 6.0%)이 내성이고 통계학적으로 C. albicans과 non-albicans Candida species은 fluconazole (P=0.039), voriconazole (P<0.001)로 나타났다. 칸디다 혈증의 감염률을 이해하고 예방하기 위한 감시 시스템이 요구되고 항진균제의 적절한 투여와 치료가 요구된다. 따라서 항진균제 감수성 결과의 모니터링을 통한 칸디다의 내성을 추적하는 감염감시활동 정책이 필요할 것으로 사료된다.

• 대한의용생체공학회:의공학회지
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• 제42권6호
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• pp.259-267
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• 2021

Recently, the market for personal health care and medical devices based on Bluetooth Low Energy(BLE) has grown rapidly. BLE is being used in various medical data communication devices based on low power consumption and universal compatibility. However, since data errors occurring in the transmission of medical data can lead to medical accidents, it is necessary to analyze the causes of errors and study methods to reduce data error. In this paper, the minimum communication speed to be used in medical devices was set to at least 800 byte/sec based on the wireless electrocardiography regulations of the Ministry of Food and Drug Safety. And the data loss rate was tested when data was transmitted at a speed higher than 800 byte/sec. The factors that cause communication data error were classified, and the relationship between each factor and the data error rate was analyzed through experiments. When there were two or more activated peripherals connected to the central, data error occurred due to channel hopping and bottleneck, and the data error rate increased in proportion to the communication distance and the number of activated peripherals. Through this experiment, when the BLE is used in a medical device that intermittently transmits biosignal data, the risk of a medical accident is predicted to be low if the number of peripherals is 3 or less. But, it was determined that BLE would not be suitable for the development of a biosignal measuring device that must be continuously transmitted in real time, such as an electrocardiogram.

• 대한기관윤리심의기구협의회지
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• 제4권2호
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• pp.36-41
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• 2022

Purpose: The purpose of this study is to evaluate how university hospital Institutional Review Boards (IRBs) in Korea classify risk when reviewing clinical trial protocols. Methods: IRB experts (IRB chairman, vice chairman, IRB administrator) in the university hospitals obtaining a Human research protection program (HRPP) or IRB accreditation in Korea were asked to fill out the Google Survey from September 1, 2020 to October 10, 2020. Result: Among the 23 responder hospitals, 8 were accredited by the American Association for Human Research Protection Program (AAHRPP) and 8 were accredited by the HRPP of Ministry of Food and Drug Safety (MFDS). Seven were accredited by Forum for Ethical Review Committees in Asia and the Western Pacific or Korea National Institution for Bioethics Policy. Thirteen of 23 hospitals (56.5%) had 4 levels (less than minimal, low, moderate, high risk), 4 hospitals had 3 levels (less than, slightly over, over than minimal risk), 1 hospital had 5 levels (4 levels plus required data safety monitoring board), and 1 hospital had 2 levels (less than, over than minimal risk) risk classification system. Thirteen of 23 hospitals (56.5%) had difficulty classifying the risk levels of research protocols. Fourteen hospitals (60.9%) responded that different standards among hospitals for risk level determination associated with clinical trials will affect the subject protection. Six hospitals (26.1%) responded that it will not. Three hospitals (13.0%) responded that it will affect the beginning of the clinical trial. To resolve differences in standards between hospitals, 14 hospitals (60.9%) responded that either the Korean Association of IRB or MFDS needs to provide a guideline for risk level determination in clinical trials: 5 hospitals (21.7%) responded education for IRB members and researchers is needed; 3 hospitals (13.0%) responded that difference among institutions needs to be acknowledged; and 1 hospital (4.3%) responded that there needs to be communication among IRB, investigator, and sponsor. Conclusion: After conducting a nationwide survey on how IRB in university hospital determines risk during review of clinical trials, it is reasonable to use 4-level risk classification (less than minimal, low, moderate, high risk); the most utilized method among hospitals. Moreover, personal information and conflict of interest associated with clinical trials have to be considered when reviewing clinical trial protocols.

• 한국임상약학회지
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• 제32권2호
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

• 한국물환경학회지
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• 제39권3호
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• pp.231-239
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• 2023

Public sewage treatment facilities are a necessary infrastructure for public health that treat sewage generated in cities and basin living areas and discharge it into rivers or seas. Recently, the role of public sewage treatment is receiving attention as a place of use of wastewater-based epidemiology (WBE), which analyzes human specific metabolic emissions or biomarkers present in sewage to investigate the environment to which the population is exposed in the water drain. WBE is mainly applied to investigate legal and water-law drug use or to predict and analyze the lifestyle of local residents. WBE has also been applied to predict and analyze the degree of infectious diseases that are prevalent worldwide, such as COVID-19. Since sewage flowing into public sewage treatment facilities includes living information of the population living in the drainage area, it is easy to collect basic data to predict the confirmation and spread of infectious diseases. Therefore, it is necessary to establish a new role of public sewage treatment facilities as an infrastructure necessary for WBE that can obtain information on the confirmation and spread of infectious diseases other than the traditional role of public sewage treatment. In South Korea, the sewerage supply rate is about 95.5% and the number of public sewage treatment facility is 4,209. This means that the infrastructure of sewerage is fully established. However, to successfully drive for WBE , research on monitoring and big-data analysis is needed.