• 치위생과학회지
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• 제12권2호
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• pp.109-113
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• 2012

임상에서 분리한 총 174 균주의 S. pneumoniae를 대상으로 검체별, 연령별, 성별 분리빈도 및 levofloxacin의 내성도를 조사하였으며, 항생제 감수성 검사를 통해 다제내성도를 확인하였다. S. pneumoniae가 가장 많이 분리된 검체는 객담으로서 총 174 균주의 89.7%인 156 균주가 분리되었다. 특히 남성과 51세의 고령환자에서 분리빈도가 높았으며, 분리된 levofloxacin 내성 8 균주 모두는 penicillin, tetracycle, erytromycin, clindamycin 및 trimethoprim-sulfamethoxazoe 대한 다제내성도 함께 소유하고 있는 것으로 확인되었다. 분리된 levofloxacin 내성균주 SP32 (MIC $64{\mu}g/mL$)와 SP96 (MIC $8{\mu}g/mL$)의 QRDR 염기서열을 분석한 결과, SP32와 SP96 균주의 GyrA에서 Ser-81$\rightarrow$Phe로, SP96에서 Ser-11$\rightarrow$Gly으로 아미노산 치환이 각각 확인되었고, ParC에서는 두 균주 모두 Ser-79$\rightarrow$Phe으로 치환된 돌연변이가 확인되었다.

• Clinical and Experimental Pediatrics
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• 제56권4호
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• pp.165-175
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• 2013

Purpose: There was a global increase in the prevalence of oseltamivir-resistant influenza viruses during the 2007-2008 influenza season. This study was conducted to investigate the occurrence and characteristics of oseltamivir-resistant influenza viruses during the 2007-2008 and 2008-2009 influenza seasons among patients who were treated with oseltamivir (group A) and those that did not receive oseltamivir (group B). Methods: A prospective study was conducted on 321 pediatric patients who were hospitalized because of influenza during the 2007-2008 and 2008-2009 influenza seasons. Drug resistance tests were conducted on influenza viruses isolated from 91 patients. Results: There was no significant difference between the clinical characteristics of groups A and B during both seasons. Influenza A/H1N1, isolated from both groups A and B during the 2007-2008 and 2008-2009 periods, was not resistant to zanamivir. However, phenotypic analysis of the virus revealed a high oseltamivir $IC_{50}$ range and that H275Y substitution of the neuraminidase (NA) gene and partial variation of the hemagglutinin (HA) gene did not affect its antigenicity to the HA vaccine even though group A had a shorter hospitalization duration and fewer lower respiratory tract complications than group B. In addition, there was no significant difference in the clinical manifestations between oseltamivir-susceptible and oseltamivir-resistant strains of influenza A/H1N1. Conclusion: Establishment of guidelines to efficiently treat influenza with oseltamivir, a commonly used drug for treating influenza in Korean pediatric patients, and a treatment strategy with a new therapeutic agent is required.

• 농약과학회지
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• 제15권4호
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• pp.507-528
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• 2011

포장에서 농약 살포액의 조제, 살포 등의 작업을 수행하는 농작업자는 피부노출, 호흡노출경로를 통해 농약에 노출되며, 이러한 상황에서의 농약 노출에 대한 합리적인 위해성 평가를 위해서는 해당 영농상황에서 노출량을 정량적으로 측정해야 한다. 농약 노출 측정방법으로 patch, 장갑, 양말, 마스크를 이용하는 방법과 호흡 노출은 주로 고체흡착제와 공기흡입펌프가 연결된 personal air monitor를 사용하는 것이 좋을 것으로 판단된다. 이 농작업자의 정량적 피부 노출 측정법으로 유효할 것으로 판단된다. 노출 재료에 침착/부착된 농약량이나 고체흡착제에 포집된 농약량을 신체 전체에 대한 농약 노출량으로 외삽하기 위한 EPA 자료를 대체할 수 있도록 한국 사람의 표준 신체표면적 및 호흡률을 제안하였다. 중요한 노출 인자인 피부노출의 의복 침투율과 피부 침투율, 그리고 호흡노출의 침투율을 UK-POEM과 관련된 연구결과를 참고하여 다양하게 제안하였다. 노출 평가를 위한 살포 시간은 노출 측정 재료에 침착된 농약이 분석이 될 만큼 충분한 농약이 포집될 수 있도록 살포시간이 충분해야 하는데, 국내의 SS기나 동력분무기의 경우는 1반복 당 모두 약 20~40분에 살포(약 0.1~0.2 ha)로 해서 3반복 측정 결과를 4시간으로 환산할 것을 제안하였다.

• 한국임상약학회지
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• 제12권1호
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• pp.29-38
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• 2002

Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

• Tuberculosis and Respiratory Diseases
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• 제72권6호
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• pp.475-480
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• 2012

Background: Pyrazinamide (PZA) is an effective antitubercular drug that becomes toxic to Mycobacterium tuberculosis when converted to pyrazinoic acid by pyrazinamidase (PZase), encoded by mycobacterial pncA. A strong association was noted between the loss of PZase activity and PZA resistance. The causative organisms in extrapulmonary tuberculosis are rarely cultured and isolated. To detect pncA mutations in specimens from extrapulmonary tuberculosis as confirmative diagnosis of mycobacterial infection and alternative susceptibility test to PZA. Methods: Specimens were collected from clinically proven extrapulmonary tuberculosis. pncA was sequenced and compared with wild-type pncA. Results: pncA from 30 specimens from 23 donors were successfully amplified (56.6% in specimens, 59% in donors). Six mutations in pncA were detected (20.0% in amplified specimens, 26.1% in specimen donors) at nucleotide positions of 169, 248 and 419. The mutation at position 169 results in substitution of aspartic acid for histidine, a possible allelic variation of M. bovis that have intrinsic PZA resistance. The mutation at position 248 changes proline into arginine and that at position 419, arginine into histidine. Conclusion: DNA-based diagnosis using pncA may be simultaneously useful for the early diagnosis of mycobacterial infection and the rapid susceptibility to PZA in extrapulmonary tuberculosis. A potential implication of pncA allelic variation at 169 might be suggested as a rapid diagnostic test for M. bovis infection or Bacille Calmette-Gu$\acute{e}$rin (BCG) reactivation.

• 약학회지
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• 제43권2호
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• pp.180-197
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• 1999

Acute and subacute oral toxicity of $HELIKIT^{TM}$ ($^{13}C-urea$) were carried out in Sprague-Dawley rats of both sex. The toxicity of $HELIKIT^{TM}$ was compared with urea($^{12}C-urea$ which is used for control). In acute toxicity studies, we daily examined number of deaths, clinical signs, body weights and pathological examination for 14 days after single oral administration of HELIKIT or urea($^{12}C-urea$) at a dose of 5000 mg/kg. The subacute oral toxicity was investigated in Sprague-Dawley rats treated with $HELIKIT^{TM}$ at a dose of 40, 200 and 1,000 mg/kg/day or $^{12}C-urea$ at a dose of 1,000 mg/kg/day for 4 weeks. In acute toxicity studies, $HELIKIT^{TM}$ and urea did not show any toxic effect in rats and oral LD50 value was over 5,000 mg/kg rats. In subacute toxicity studies, no death occured and no drug-related changes were found in clinical observations; body weight, food consumption, opthalmoscopy. auditory test, urinalysis, hematology, blood chemistry, gross pathological examination or organ weight between $HELIKIT^{TM}$, urea and control groups. In histopathological examinations, the slight thickening of mucosa of the limiting ridge in the stomach was noted in the animals treated with $HELIKIT^{TM}$ at a dose of 1,000 mg/kg/day and also the changes in urea group at a dose of 1,000 mg/kg/day was found, but all of these changes in the changes in ures group at a dose of 1,000 mg/kg/days was found, but all of these changes in the stomach regressed after withdrawal of the test article for 2 weeks and reversibility of the effect was revealed. These results indicate that the non toxic dose level of $HELIKIT^{TM}$ was 1,000 mg/kg/day in the 4 weeks-repeated dose study, suggesting that the substitution of $^{13}C$ for carbon in urea molecule has no effect on the toxicity of urea and changes in stomach are reversible.

• BMB Reports
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• 제44권1호
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• pp.34-39
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• 2011

Resistance to PAI-1 is a factor which confers clinical benefits in thrombolytic therapy. The only US FDA approved PAI-1 resistant drug is Tenecteplase$^{(R)}$. Deletion variants of t-PA have the advantage of fewer disulfide bonds in addition to higher plasma half lives. A new variant was developed by deletion of the first three domains in t-PA in addition to substitution of KHRR 128-131 amino acids with AAAA in truncated t-PA. The specific activity of this new variant, $570\;IU/{\mu}g$, was found to be similar to those found in full length t-PA (Alteplase$^{(R)}$), $580\;IU/{\mu}g$. A 65% and 85% residual activity after inhibition by rPAI-1 was observed for full length and truncated-mutant form, respectively. This new variant as the first PAI-1 resistant truncated t-PA may offer more advantages in clinical conditions in which high PAI-1 levels makes the thrombolytic system prone to re-occlusion.

• The Korean Journal of Physiology and Pharmacology
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• 제7권3호
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• pp.157-162
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• 2003

Our earlier studies found a significant correlation between the activities of ranitidine N-oxidation catalyzed by hepatic flavin-containing monooxygenase (FMO) and the presence of mutations in exon 4 (E158K) and exon 7 (E308G) of the FMO3 gene in Korean volunteers. However, caffeine N-1 demethylation (which is also partially catalyzed by FMO) was not significantly correlated with these FMO3 mutations. In this study, we examined another common mutation (V257M) in exon 6 of FMO3 gene. The V257M variant, which is caused by a point mutation (G769A), was commonly observed (13.21% allele frequency) in our subjects (n=159). This point mutation causes a substitution of $Val^{257}$ to $Met^{257}$, with transformation of the secondary structure. The presence of this mutant allele correlated significantly with a reduction in caffeine N-1-demethylating activity, but was not correlated with the activity of N-oxidation of ranitidine. In a family study, the low FMO activity observed in a person heterozygous for a nonsense mutation in exon 4 (G148X) and heterozygous for missense mutation in exon 6 (V257M) of FMO3 was attributed to the mutations. Our results suggest that various point mutations in the coding regions of FMO3 may influence FMO3 activity according to the probe substrates of varying chemical structure that correlate with each mutation on the FMO3 gene.

• 대한방사성의약품학회지
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• 제6권2호
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• pp.61-68
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• 2020

Aggregated neurofibrillary tangles (NFTs) are a pathological hallmark in Alzheimer's disease (AD) and many radiopharmaceuticals targeting NFTs have been developed so far. Among these, [¹⁸F]flortaucipir (TAUVID^TM) is the first approved radiopharmaceutical in the Food and Drug Administration (FDA) to image tau pathology. In the present study, we describe the optimized radiosynthetic method for the routine production of [¹⁸F] flortaucipir using a commercialized automation module (i.e. GE TRACERlab^TM FX_FN pro). [¹⁸F]Flortaucipir was prepared by nucleophilic substitution from its N-tert-butoxycarbonyl protected nitro precursor, tertbutyl 7-(6-nitropyridin-3-yl)-5H-pyrido[4,3-b]indole-5-carboxylate, at 130℃ for 10 min in dimethyl sulfoxide. The mean radiochemical yield was 20 ± 4.3% (decay-corrected, n = 47) with the molar activity of 218 ± 32 GBq/µmol at the end of synthesis. The radiochemical purity was determined to be above 95%. The overall production time including quality control is approximately 100min. The final produced [¹⁸F]flortaucipir injection meets the USP criteria for quality control. Thus, this fully automated system is validated for clinical use.

• 의료법학
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• 제23권2호
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• pp.3-36
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• 2022

의약품 리베이트 문제를 해결하기 위해서는 위법행위를 한 자를 제재하는 것과 함께 리베이트를 하지 않아도 의약품 판매촉진 경쟁에서 이길 수 있는 방법을 제공하는 구조적인 법 제도 개선이 필요하다. 이전에 국회와 정부는 제재를 강화하는 방안에만 노력을 기울였다. 그 결과 2014년 처분 대상 의약품을 시장에서 퇴출시킴으로써 제약회사에게 막대한 손실을 입힐 수 있는 제재 방법인 급여정지 제도를 도입하였다. 하지만 제도 도입 3년 만에 급여정지 처분이 환자의 의약품 접근권을 침해한다는 문제를 인식하고 2018년에 급히 급여정지 제도를 폐지하였다. 국회는 2021년 상징적으로 남아 있던 3차 위반 시 급여정지 처분도 모두 과징금 갈음이 되도록 입법을 하였다. 이렇게 급여정지 처분에 대한 입법자의 반성적 입장이 분명하지만 보건복지부는 구법 기간 동안의 리베이트에 대해서는 구법 상 급여정지 처분을 하여야 한다는 법 해석을 하고 있다. 구법 상 보건복지부 재량으로 되어 있는 과징금 갈음에 대해서도 법 개정 전 구법 하에서 취했던 좁은 기준을 그대로 유지하고 적극적으로 재량을 행사하지 않겠다는 입장이다. 본고에서는 급여정지 제도 도입의 이유가 된 의약품 리베이트 문제를 개관하고 급여정지 제도의 도입, 폐지 경위를 살핀 후 급여정지 처분의 위헌적 요소와 급여정지 처분의 위법성을 검토한다.