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항암화학요법과의 순차적, 그리고 병행적 요법으로서의 aRVS 투여로 장기 생존과 좋은 삶의 질을 유지한 전이성 비소세포폐암 증례보고 (Case Report : Long-term Survival and Good-Quality of Life in Metastatic Non-small Cell Lung Cancer Patients Treated with Allergen-removed Rhus verniciflua Stokes (aRVS) as Sequential and Concurrent Treatment with Chemotherapy)

  • 이진수;박형준;채진;김경석;정현식;이상헌;최원철;전성하
    • 대한한방내과학회지
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    • 제32권1호
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    • pp.129-135
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    • 2011
  • This report documents a case in which the administration of an herbal product, an extract of the lacquer tree, Rhus verniciflua Stokes, as sequential and concurrent treatment with chemotherapy was associated with a long term survival and good quality of life in a patient with metastatic non-small cell lung cancer(NSCLC). A 51-year-old Korean female was referred to the $M{\cdot}{\mu}$ Integrative Cancer Center, East-West Neo Medical centrer, Kyung Hee University for stage IV, metastatic NSCLC. She was treated with aRVS alone for 19 months and then received 1st line paclitaxel/carboplatin combined with aRVS, 2nd line gefitinib, and 3rd line pemetrexed. The number of cycles of pemetrexed administered was seventeen. aRVS was restarted as the 13th pemetrexed was administered. Pemetrexed with aRVS is currently ongoing. This patient has been alive for 41 months, and has been keeping a good performance status so far. We suggest aRVS as sequential and concurrent treatment with chemotherapy is an effective alternative treatment strategy.

웰다잉 저해 요인의 관련성에 관한 융합 연구 (Convergence Research on Relationships among the inhibiting factors of Dying Well)

  • 이종형;안상윤;김용하;김광환
    • 한국융합학회논문지
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    • 제10권8호
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    • pp.37-44
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    • 2019
  • 본 연구는 좋은 죽음을 맞이하고 싶어 하는 사람에게 웰다잉을 하지 못하도록 저해하는 요인이 무엇인지 파악하고자 한다. 연구대상은 전국 17개 시와 도의 만 19세 이상 만 75세 미만의 성인 1,000명을 대상으로 선정하였다. 설문구성은 일반적 특성 4문항과 리커트의 7점 척도를 활용한 웰다잉의 저해요인과 관련된 20문항으로 구성하였다. 분석은 기술통계, 상관분석, 의사결정나무 분석을 수행하였다. 연구결과는 웰다잉을 저해하는 요인들에 관한 문항 중 '퇴행성 질병(치매 등)'은 5.502점, '통제력 상실(정신/신체)'는 5.268점 등으로 나타났다. 웰다잉 저해요인들 간의 상관성 분석에 있어서는 '안 좋은 부부관계와 안 좋은 자녀관계', '죽음교육을 받지 못함과 의료정책 홍보부족(웰다잉)', '안 좋은 자녀관계와 사람들의 무관심'의 순서로 유의한 양의 상관관계가 높게 나타났다. 이러한 연구결과를 고려하여 좋은 죽음을 맞이하기 위한 죽음교육을 구성 및 실시한다면 사회전체가 좋은 죽음을 위한 인식과 실천적 삶을 위해 노력하고 삶과 죽음 교육의 확대가 이루어 질 것으로 사료된다.

재입원 예측 모형 개발에 관한 연구 (A Study on the Development of Readmission Predictive Model)

  • 조윤정;김유미;함승우;최준영;백설경;강성홍
    • 한국산학기술학회논문지
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    • 제20권4호
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    • pp.435-447
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    • 2019
  • 불필요한 재입원을 예방하기 위해서는 재입원 확률이 높은 집단을 집중적으로 관리할 필요가 있다. 이를 위해서는 재입원 예측모형의 개발이 필요하다. 재원예측 모형을 개발하기 위해 1개 대학병원의 2016년에서 2017년의 2년간의 퇴원요약환자 데이터를 수집하였다. 이때 재입원 환자는 연구 기간 내에 2번 이상 퇴원한 환자라 정의 하였다. 재입원환자의 특성을 파악하기 위해 기술통계와 교착분석을 실시하였다. 재입원 예측 모형개발은 데이터마이닝 기법인 로지스틱회귀모형, 신경망, 의사결정모형을 이용하였다. 모형평가는 AUC(Area Under Curve)를 이용하였다. 로지스틱회귀모형이 AUC가 0.81로 가장 우수하게 나옴에 따라 본 연구에서는 로지스틱 회귀모형을 최종 재입원 예측 모형으로 선정을 하였다. 로지스틱회귀모형에서 선정된 재입원에 영향을 끼치는 주요한 변수는 성별, 연령, 지역, 주진단군, Charlson 동반질환지수, 퇴원과, 응급실 경유 여부, 수술여부, 재원일수, 총비용, 보험종류 등이었다. 본 연구에서 개발한 모형은 1개병원의 2년치 자료이므로 일반화하기에는 제한점이 있다. 추후에 여러 병원 장기간의 데이터를 수집하여 일반화 할 수 있는 모형을 개발하는 것이 필요하다. 더 나아가 계획에 없던 재입원 까지 예측을 할 수 있는 모형을 개발하는 것이 필요하다.

Doxorubicin과 Cyclophosphamide를 투여받는 유방암 환자에서 Pegfilgrastim과 Pegteograstim의 비용-효용 분석 (Cost-Utility Analysis of Pegfilgrastim and Pegteograstim in Patients with Breast Cancer using Doxorubicin and Cyclophosphamide)

  • 권수지;금민정;김재송;손은선;권경희
    • 병원약사회지
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    • 제35권4호
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    • pp.409-417
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    • 2018
  • Background : Febrile neutropenia (FN) is one of the side effects in the patients treated with chemotherapy, and the patients who have FN generally need immediate treatment with extended-spectrum antibiotics and hospitalization. Pegfilgrastim and pegteograstim, which are used for the prevention of FN as a granulocyte-colony stimulating factor (G-CSF), have been granted insurance coverage in the Republic of Korea for certain breast cancer patients using doxorubicin and cyclophosphamide (AC) from September 2016. Methods : The data of the patients with breast cancer using AC regimen and G-CSF were collected retrospectively. This study involves cost-utility analysis of pegfilgrastim and pegteograstim. In this study, we constructed a simple decision tree model for short-term observation and calculated quality-adjusted life year (QALY) and the direct medical costs from the medical provider's perspective. Results : From September 2016 to May 2017, 15 patients were treated with pegfilgrastim and 15 patients were treated with pegteograstim. As a result of dividing the average cost by QALY for each treatment group, it was observed that pegfilgrastim and pegteograstim were consumed 24,923,384 won and 22,808,336 won per 1QALY, respectively. Consequently, incremental cost effectiveness ratio (ICER) showed 2,115,048 won more per pegfilgrastim than pegteograstim per 1QALY, and the cost per 1QALY of both the drugs was lower than 30,500,000 won; the Koreans were willing to pay this amount. Conclusions : This study suggests that pegfilgrastim and pegteograstim can be used to improve the quality of life of breast cancer patients undergoing AC therapy. Among the two drugs, pegteograstim seems to be more cost-effective. However, since this study was conducted as a retrospective observation method on a small scale, it is associated with many limitations. Therefore, a long-term prospective cohort study is needed to supplement the present findings.

비용, 인공환기관련폐렴 발생 빈도에 있어서의 개방 기관내 흡인술에 대한 폐쇄 흡인술의 비교 (Comparison of a Closed with an Open Endotracheal Suction: Costs and the Incidence of Ventilator-associated Pneumonia)

  • 정재우;최은희;김진희;서효경;최지연;최재철;신종욱;박인원;최병휘;김재열
    • Tuberculosis and Respiratory Diseases
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    • 제65권3호
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    • pp.198-206
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    • 2008
  • 연구배경: 폐쇄관을 이용한 기관내 흡인은 임상적으로 중한 환자에게 생리적인 이점이 있지만, 병원성 균주에 의한 기관지 내의 집락화가 증가될 수 있다는 보고가 있다. 비용증가는 폐쇄흡인의 또 다른 제한점이다. 본 연구는 폐쇄흡 인 및 개방흡인에 따른 병원균주의 집락화와 인공환기관련폐렴의 빈도와 가격효율성을 비교해보고자 시행되었다. 방 법: 각각 한 달의 간격을 사이에 두고 내과계 중환자실에 입원한 환자들을 대상으로 다중사용 개방흡인, 단일사용 개방흡인, 다중사용 폐쇄흡인을 순차적으로 시행하였다. 비용, MRSA의 기관지내 집락화, 인공환기폐렴의 발생 률을 분석하였다. 결 과: 106명의 환자가 연구 대상으로 포함이 되었고, 이 중 20명의 환자가 다중사용 개방흡인을, 42명이 단일사용 개방흡인을, 44명이 다중사용 폐쇄흡인술을 시행받았다. MRSA의 집락화와 인공환기관련폐렴의 빈도는 세 군간에 의미있는 차이를 보이지 않았다. 입원 일당 소모되는 비용은 다중사용 개방흡인이 $10.58, 단일사용 개방흡인이 $28.27, 다중사용 폐쇄흡인의 경우 $23.76인 것으로 나타났다. 결 론: 다중사용 폐쇄흡인을 매 48시간마다 교환하는 경우 MRSA 집락화와 인공환기폐렴 발생 빈도는 비슷하였고, 기관내 흡인술에 있어서 비용면에서도 효율적인 방법임을 알 수 있었다.

Antifungal Effects of Silver Nanoparticles (AgNPs) against Various Plant Pathogenic Fungi

  • Kim, Sang-Woo;Jung, Jin-Hee;Lamsal, Kabir;Kim, Yun-Seok;Min, Ji-Seon;Lee, Youn-Su
    • Mycobiology
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    • 제40권1호
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    • pp.53-58
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    • 2012
  • This research is concerned with the fungicidal properties of nano-size silver colloidal solution used as an agent for antifungal treatment of various plant pathogens. We used WA-CV-WA13B, WA-AT-WB13R, and WA-PR-WB13R silver nanoparticles (AgNPs) at concentrations of 10, 25, 50, and 100 ppm. Eighteen different plant pathogenic fungi were treated with these AgNPs on potato dextrose agar (PDA), malt extract agar, and corn meal agar plates. We calculated fungal inhibition in order to evaluate the antifungal efficacy of silver nanoparticles against pathogens. The results indicated that AgNPs possess antifungal properties against these plant pathogens at various levels. Treatment with WA-CV-WB13R AgNPs resulted in maximum inhibition of most fungi. Results also showed that the most significant inhibition of plant pathogenic fungi was observed on PDA and 100 ppm of AgNPs.

담즙산의 생체 활성 물질로서의 역할 (Roles of Bile Acid as an Active Biological Substance)

  • 방준석;이유정;정지훈;손의동
    • 한국임상약학회지
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    • 제21권2호
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    • pp.49-56
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    • 2011
  • The family of bile acids belongs to a group of molecular species of acidic steroids with very peculiar biological characteristics. They are synthesized by the liver from cholesterol through several complementary pathways and secreted into small intestine for the participation in the digestion and absorption of fat. The bile acids are mostly confined to the territories of the so-called enterohepatic circulation, which includes the liver, the biliary tree, the intestine and the portal blood with which bile acids are returned to the liver. In patients with bile acid malabsorption, the amount of primary bile acids in the colon is increased compared to healthy controls. Although the increase in the secondary bile acids including deoxycholic acid, is reported to have the potency to affect tumorigenesis in gastrointestinal tracts, there is no firm evidence that clinically relevant concentrations of the bile acids induce cancer. The list of their physiological roles, as well as that of the pathological processes is long and still not complete. There is no doubt that many new concepts, pharmaceutical tools and pharmacological uses of bile acids and their derivatives will emerge in the near future.

Identification and Phylogeny of the Human Endogenous Retrovirus HERV-W LTR Family in Human Brain cDNA Library and Xq21.3 Region

  • KIM, HEUI-SOO;TIMOTHY J. CRO
    • Journal of Microbiology and Biotechnology
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    • 제12권3호
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    • pp.508-513
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    • 2002
  • Human endogenous retroviral long terminal repeats (LTRs) have been found to be coexpressed with sequences of genes located nearby. It has been suggested that the LTR elements have contributed to the structural change or genetic variation of human genome connected to various diseases. The HERV-W family has been identified in the cerebrospinal fluids and brains of individuals with schizophrenia. Using a cDNA library derived from a human brain, the HERV-W LTR elements were examined and five new LTR elements were identified. These elements were examined using a YAC clone panel from the Xq21.3 region linked to psychosis that was replicated on the Y chromosome after the separation of the chimpanzee and human lineages. Fourteen elements of the HERV-W LTR were identified in that region. Those LTR elements showed a high degree of sequence similarity ($91.8-99.5\%$) with previously reported HERV-W LTR. A phylogenetic tree obtained from the neighbor-joining method revealed that new HERV-W LTR elements were closely related to the AXt000960, AF072504, and AF072506 from the GenBank database. The data indicates that several copy numbers of the HERV-W LTR elements exist on the Xq21.3 region and are also expressed in the human brain. These LTR elements need to be further investigated as potential leads to neuropsychiatric diseases.

기관지 결핵으로 오인된 틀니조각 흡인 1례 (A CASE OF FOREIGN BODY ASPIRATION CONFUSED WITH ENDOBRONCHIAL TUBERCULOSIS)

  • 김치홍;김보경;문진성;김선명
    • 대한기관식도과학회지
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    • 제2권2호
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    • pp.238-243
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    • 1996
  • Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

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Vascular Plants of Hyangro-bong in Gangwon-do, Korea

  • Kwon, Mi Jeong;Han, Gab-Soo
    • Journal of Forest and Environmental Science
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    • 제31권2호
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    • pp.136-148
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    • 2015
  • Hyangro-bong is located on the northern side of the civilian access control line and therefore has gone through natural ecological succession without human interference. Currently, it forms a distinctive natural ecosystem in which rare wild animals and plants are various. It is located in the Baekdudaegan mountain system and plays an ecologically important role as a bridge that connects the Geumgang mountain and Seorak mountain. This study investigated the flora of the eastern parts, Forest Genetic Resources Reserve Area, of Hyangro-bong. A total of 363 vascular plants that belonged to 77 families, 206 genera, 310 species, 3 subspecies, and 47 varieties were found in the study area. Rare and endangered plants identified in this study included the critically endangered Swertia wilfordii and endangered Irisuniflora var. caricina. Furthermore, 4 vulnerable species, Hanabusaya asiatica, Codonopsis pilosula, Leontopodium japonicum, and Taxus cuspidata, were found. A total of 7 families and 14 taxa including Aconitum pseudolaeve and Clematis fusca var. coreana were confirmed as endemic plants. Naturalized plants belonging to 4 families, 11 genera, and 13 species were distributed along the Hyangro-bong forest roads.