• 보건행정학회지
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• 제25권4호
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• pp.323-332
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• 2015

Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.158-164
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• 2016

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

• Tuberculosis and Respiratory Diseases
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• 제59권6호
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• pp.619-624
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• 2005

연구배경 : 치료 경력이 있는 환자의 약제 내성은 진료의사의 처방의 적절성 및 환자의 복용 순응도를 복합적으로 나타내어 주는 지표가 될 수 있으므로, 우리나라에서 재치료 대상 결핵 환자에서 장기간의 약제내성률 추이를 파악하고자 하였다. 방 법 : 연도별 보건소 등록환자의 약제감수성 검사 결과 및 결핵연구원의 전산 입력된 자료를 활용하여 1981년부터 2004년 사이에 주요 약제에 대한 내성률의 변화를 분석하였다. 결 과 : Isoniazid 내성은 90%에서 20%로 감소하였다. Ethambutol 내성률도 45%에서 6%로 감소하였다. Rifampin 내성률은 13%에서 28%까지 증가하다가 13%까지 감소하였다. 다제내성률은 rifampin 내성률보다 약 2-3% 낮았다. Pyrazinamide 내성률은 5% 미만에서 10% 정도까지 증가하였다가 다시 5%까지 감소하였다. 2차약제에 대한 내성률은 1-2% 정도였다. 내성 빈도는 남녀 간에 차이가 없었으며, 대도시 지역이 중소도시/농촌지역보다 낮은 약제 내성률을 보였다. 결 론 : 우리나라보건소에 등록되는 재치료 대상 결핵 환자의 주요 항결핵 약제에 대한 내성률은 2004년을 기준으로 isoniazid 20%, rifampin 13%, 다제내성 11%, ethambutol 6%, pyrazinamide 5% 기타 2차 항결핵제에 1-3%로 나타났으며 1981년 이후 모든 항결핵 약제에서 그 내성률이 유의하게 감소하고 있었다.

• The Korean Journal of Physiology and Pharmacology
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• 제28권3호
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• pp.229-237
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• 2024

Cough is a common symptom of several respiratory diseases. However, frequent coughing from acute to chronic often causes great pain to patients. It may turn into cough variant asthma, which seriously affects people's quality of life. For cough treatment, it is dominated by over-the-counter antitussive drugs, such as asmeton, but most currently available antitussive drugs have serious side effects. Thus, there is a great need for the development of new drugs with potent cough suppressant. BALB/c mice were used to construct mice model with cough to investigate the pharmacological effects of pectolinarigenin (PEC). Hematoxylin-eosin and Masson staining were used to assess lung injury and airway remodeling, and ELISA was used to assess the level of inflammatory factor release. In addition, inflammatory cell counts were measured to assess airway inflammation. Airway hyperresponsiveness assay was used to assess respiratory resistance in mice. Finally, we used Western blotting to explore the potential mechanisms of PEC. We found that PEC could alleviate lung tissue injury and reduce the release of inflammatory factors, inhibit of cough frequency and airway wall collagen deposition in mice model with cough. Meanwhile, PEC inhibited the Ras/ERK/c-Fos pathway to exhibit antitussive effect. Therefore, PEC may be a potential drug for cough suppression.

• Tuberculosis and Respiratory Diseases
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• 제64권2호
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• pp.95-101
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• 2008

연구배경: 결핵의 치료력이 없는 결핵환자에서 발생하는 초회 약제내성은 결핵관리에 있어서 심각한 문제이다. 그러나 우리나라, 특히 민간의료기관에서 치료받는 폐결핵환자들의 초회 약제내성률에 대해서 잘 알려져 있지 않다. 본 연구에서는 천안지방의 한 3차병원에서 폐결핵환자들의 초회 약제내성률과 약제내성의 위험요소에 대해서 알아보았다. 방법: 2005년 9월부터 2007년 9월까지 단국대학교병원에서 객담 결핵균 배양검사 양성인 초치료 폐결핵환자 모두에 대해서 일차약과 이차약에 대한 약제감수성 검사를 시행하고 초회 약제내성의 양상과 함께 약제내성의 위험요소을 분석하였다. 또한 약제감수성 검사 결과가 치료 처방에 미치는 영향을 분석하였다. 결과: 총 156명의 초치료 폐결핵 환자에 대해서 약제 감수성 검사를 시행하였는데 한 가지 이상의 약제에 내성을 보인 환자는 21명(15.6%)이었으며 이소니아지드와 리팜핀에 동시 내성을 보이는 다제내성 환자는 1명(0.6%)이었다. 임상소견 중 초회 약제내성을 예측할 수 있는 독립적인 위험요소는 없었다. 약제감수성 검사 결과에 의해 15명(9.6%)의 환자에서 치료처방의 변경이 있었다. 결론: 폐결핵에서 초회 약제내성은 흔히 관찰되며 초 치료 폐결핵환자에서 약제감수성 검사는 환자치료에 도움이 된다.

• 수면정신생리
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• 제16권1호
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• pp.22-27
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• 2009

Regulation of respiration differs significantly between wakefulness and sleep. Respiration during wakefulness is influenced by not only automatic control but also voluntary and behavioral control. Sleep is associated with definite changes in respiratory function. With the onset of sleep, voluntary control of ventilation that overrides automatic control during wakefulness becomes terminated. Also ventilatory response to various stimuli including hypoxemia and hypercapnia is decreased. With these reasons respiration during sleep becomes fragile and unstable so that marked hypoxemia can be happened in patients with lung disease especially during REM sleep. Obstructive sleep apnea may also be developed if upper airway resistance is increased in addition to these blunted ventilatory responses.

• 한국가금학회지
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• 제18권3호
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• pp.209-218
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• 1991

An experiment was conducted to examine the efficacy of spray vaccination against Newcastle disease (ND). Four different coarse sprayers and four different diluents were compared in particle size, immune response and respiratory reaction. The smaller particle size of sprayer was, the better efficacy was and the more respiratory reactions were appeared. Of four diluents, antibody responses and resistance to challenge were higher with skim milk and gelatin, respectively .When day-old broiler chicks with maternal antibodies were vaccinated by coarse. sprayer B with B$_1$strain diluted in 1% skim milk, they showed 100% protection at two weeks of age and 50% from 4 to 8 weeks of age. Another group which boostered at 2 weeks of age by drinking water vaccination showed 100%, 70%, 50%, 40% protection at 2, 4, 6, 8 weeks of age, respectively. Although spray vaccination against ND in this experiments showed similar efficacy, compared to conventional methods, this method may not be appropriate in our field condition because of respiratory vaccinal reaction.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2000년도 하계종합학술대회 논문집(5)
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• pp.121-123
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• 2000

Changes in breathing pattern and apnea both can be !he result of sleep disorders. The focus of this paper is to develop methodologies to monitor the breathing pattern and to detect apnea. An accurate recording of the respiratory phase can be carried out with different methods. One of these methods is the use of a thermocouple, which reacts to the variation in air temperature, placed in the nose and mouth of the patient. The K-type thermocouple was used because it has high reliability, thermo-stability, and good corrosion resistance. And also, it has a considerable long time constant that gives a low cut-off frequency, well below the respiratory frequency and thereby causing a large phase difference. The result showed that timing of respiration was accurately obtained with the AD595, amplifier for K-type thermocouple.

• The Korean Journal of Pain
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• 제6권2호
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• pp.270-274
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• 1993

Massive extradural spread, distinguished from subarachnoid injection that sometimes follows the introduction of small amounts of local anesthetics or narcotics during attempted epidural anesthesia or analgesia, has been attributed to subdural injection. A 64-year-old woman was admitted for partial radical hysterectomy under general anesthesia after insertion of lumbar epidural cathter by loss of resistance technique with 5 ml of air. In this case, we experienced severe respiratory depression and loss of consciousness after administration of 4 mg of morphine for postoperative pain control. We confirmed air shadows at right silvian and suprasella cisterna region by CT scanning. Patients was recovered without sequele after 2 days, As this case resembles a "massive epidural", it is suggested that subdural injection rather than epidural injection may explain the phenomenon.

• Tuberculosis and Respiratory Diseases
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• 제58권3호
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• pp.243-247
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• 2005

연구배경 : 한국에서 결핵환자의 유병률은 지속적으로 감소하고 있으나 약제에 대한 내성은 치료 실패의 중요한 요인이다. 국가적인 조사가 시행되지 않는 현 시점에서 지속적인 내성률 조사가 더욱 필요하다. 이에 저자들은 최근 4년간 서울 소재 한 대학병원에서 조사된 결핵균의 내성률 및 관련된 위험인자를 조사하였다. 대상 및 방법 : 1999년 3월부터 2003년 3월까지 한양대학교 의료원에서 치료 받은 결핵환자 중 결핵 배양 및 감수성 검사를 시행한 239명을 대상으로 하였다. 결 과 : 239명 중 한가지 이상의 약제에 내성을 보인 경우는 25명(21.8%)였고, 다제 내성 결핵은 30명(12.6%)이었다. INH, RFP, EMB, SM, PZA의 내성률은 각각 18.4%, 13.8%, 11.7%, 6.7%, 8.4%였다. 과거 결핵 치료력이 있는 환자는 90명이었으며 이들 중 약제 내성률은 36.7%, 다제 내성률은 25.6%였다. 약제 내성을 보인 환자의 63.5%는 과거 치료력이 있었으며 약제 감수성군의 과거 치료력은 30.5%였다. 결 론 : 서울에 소재한 한 대학병원에서 조사된 결핵 내성률은 21.8%, 다제 내성 결핵의 비율은 12.6%였다. 과거 결핵 치료력이 있는 경우에 약제 내성률이 높았다.