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A Study on Qian Yi(錢乙)'s Medical Though (전을(錢乙)의 의학사상(醫學思想)에 관(關)한 연구(硏究))

  • Oh, Jun Hwan;Kim, Ki Wook;Park, Hyun Kook
    • The Journal of Korean Medical History
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    • v.14 no.2
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    • pp.109-152
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    • 2001
  • Throughout this paper, I adjusted the study of 'Qian Yi'(錢乙)'s Medical Thought, and the following is the summary. 1. 'Qian Yi' wrote 'Xiao Er Yao Zheng Zhi Jue'("小兒藥證直訣", edited by 誾季忠), and there were 'Shang Han Lun Zhi Wei'("傷寒論指微"), 'Ying Ru Lun', however those are loss of the record. 2. Qian Yi's 'Zhi Jue'("直訣") was influenced by 'Lu Xin Jing', yet if we compare the quality of 'Sheng Li, Byeng Li, Bang Jae'(生理, 病理, 方劑), 'Lu Xin Jing' cannot be the foundation of 'Zhi Jue'. He took over 'Nei Jing, Shang Han Lun, Jin Gui Yao Lue, Shen Long Ben Cao Jing, Tai Ping Sheng Hui Fang'("內經", "傷寒論", "金?要略", "神膿本草經", "太平聖惠方") and put them together to the direct clinical experiences of pediatrics. 3. There is no reference regarding the difficulties of pediatric diagnosis and diseases in 'Huang Di Nei Jing'("黃帝內經") Before 'Bei Song'(北宋), regardless of the lack of data related to pediatric diseases, 'Qian Yi' established the pediatric system in 'Xiao Er Yao Zheng Zhi Jue' for the first time. 4. In his diagnosis of the pediatric diseases, he 'Si Zhen He Can'(四診合參), also considered in the eye exam seriously. In addition, he closely combined 'Wu Zang Bian Zheng'(五臟辨證), and diagnosis the pediatric diseases. 5. 'Wu Zang Bian Zheng', what Qian established method was based on 'Zheng Ti Guan'(整體觀) in 'Huang Di Nei Jing'. It was based on clinical experiences and established the perspectives of 'Tian Ren Xiang Ying'(天人相應). First of all, he pinpointed 'Zhu Zheng'(主證) clearly. Secondly, he pinpointed the relationships to symptoms and then, he distinguished a generic character of 'Xu, Shi, Han, Re'(虛, 實, 寒, 熱). Finally, he made an induction from genealogical pediatric physiology. 6. 'Qian Yi' took a serious view of 'Ban Zhen'(斑疹), the inadequate field in those days. At that time, he criticized on the habituation of the misuse of medication. He treated separately which 'Ji Jing'(急驚) as 'Liang Xie'(凉瀉) and 'Man Jing'(慢驚) as 'Wen Bu'(溫補). He proposed 'Cong Gan Zhu Feng, Xin Zhu Jing'(從肝主風, 心主驚) theory and formulated 'Jing Feng'(驚風) theory as well. 7. As an opponent of a tendency to misusage of medicine, 'Qian Yi' made out a prescription with pliant medicine. He emphasized on the treatment to 'Gong Bu Shang Zheng, Bu Bu Zhi Xie, Xiao Bu Jian Shi'(攻不傷正, 補不滯邪, 消補兼施) because he had so lucid demonstration to 'Xu Shi Han Re'(虛實寒熱) of the five viscera in the field of 'Bang Yak'(方藥). 8. There were no pediatrics schools at that time, however, the pediatrics was being made up gradually by 'Jin Yuan Si Da Jia'(金元四大家) who was influenced by 'Qian Yi'. He raised an objection to medical treatment using pliant medicine. 'Qian Yi' applied 'Qu Xia'(驅下) treatment using 'Han Liang'(寒凉) medicine. 'Han Liang Pai'(寒凉派) is greatly influenced by Qian. 'Chen Wen Zhong'(陳文中) had a great impact on 'Han Liang Pai' who used a 'Zao Shu Wen Bu'(燥熟溫補) medicine for treatment. Since 'Song Jin'(宋金), he had a tremendous influence on pediatrics treating patients in both 'Han Wen'(寒溫) ways. 9. 'Qian Yi' had an influence on his medical thoughts on future generations, especially to 'Wan Quan'(萬全) of 'Ming Dai', 'Wu Tang'(吳塘) of 'Qing Dai'(淸代) and 'Yun Shu Jie'(?樹珏) of 'Min Guo'(民國). 'Wan Quan' is an advocate of 'You Yu, Bu Zu Zhi Shuo'(有餘, 不足之說)of 'Xiao Er Wu Zang'(小兒五臟) that he revealed Qian's 'Wu Zang Bian Zheng'(五臟辨證). 'Wu Tang' disclosed Qian's 'Xiao Er Ti Zhi Shuo'(小兒體質說) and 'Xiao Er Ke'(小兒科)'s 'Yong Yao Lun'(用藥論), therefore, he uncovered pediatric physiological characteristics through the advocate of Qian's 'Zang Fu Rou Ruo, Ji Gu Nen Qie, Yi Xu Yi Shi, Yi Han Yi Re' (臟腑柔弱, 肌骨嫩怯, 易虛易實, 易寒易熱). 'Yun Shu Jie' developed intrinsic relationships among time, symptom and 'Tian Ren Xiang Ying Guan'(天人相應觀), What 'Qian Yi' stated about them. And also, he developed Qian's 'Di Huang Wan'(地黃丸), 'Xie Qing Wan'(瀉靑丸), 'Yi Huang San'(益黃散) clinical usages as well. 10. Regarding Qian's 'Wu Zang Xu Shi'(五臟虛實), it has an influence on 'Zhang Yuan Su'(張元素)'s 'Zang Fu Bing Ji Bian Zheng'(臟腑病機辨證). 'Di Huang Wan', 'Xie Qing Wan', 'Xie Xin Tang'(瀉心湯), 'Yi Huang San', 'Xie Huang San'(瀉黃散) are the standard prescription of 'Wu Zang Bu Xie'(五臟補瀉). It is under the influence of Qian's treatment. Besides, 'Qian Yi' took a serious view of 'Xiao Er'(小兒)'s 'Pi Wei'(脾胃). 'Qian Yi' had an impact on 'Li Dong Yuan'(李東垣) one of the member of 'Bu Tu Pai'(補土派). 'Di Huang Wan', which placed great importance on 'Bu Yi Shen Yin'(補益腎陰), had a great impact on 'Da Bu Yin Wan'(大補陰丸) and 'Jin Yuan Si Da Jia' as well. 11. In a theory of Qian's 'Wu Zang Bian Zheng', though it had been stated clearly in 'Wu Zang Bian Zheng', but he neglected in 'Liu Fu Bian Zheng'(六腑辨證). In prescription field, The problem with the medicine is that it is either toxic or mineral, therefore, we are not able to use those medicine in a clinical testing at the present time.

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Dehydrating and bacterial elimination effects of fecal dehydrating system for reducing bovine mastitis derived from environmental contamination (환경유래 젖소유방염 저감을 위한 우분뇨 탈수 시스템의 탈수 및 유방염 원인체 제균 효과 규명)

  • Kim, Dong Hyeok;Lim, Jung Ju;Lee, Jin Ju;Kim, Dae Geun;Chang, Hong Hee;Lee, Seung Joo;Lee, Yun Beom;Chang, Dong Il;Lee, Hu Jang;Min, Won-Gi;Kim, Sang Hun;Oh, Kwon Young;Kim, Suk
    • Korean Journal of Veterinary Research
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    • v.49 no.3
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    • pp.257-263
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    • 2009
  • Bovine mastitis is an important disease causing serious economic loss in dairy production and food poison in public health. Escherichia coli and Staphylococcus aureus are the major causative agents of bovine mastitis. These bacteria were found in milk and environmental condition such as feces, water, soil and so on. Bovine mastitis causative micro-organisms can survive in 1-2 weeks in feces and bed complexes. Low level of percentage of water content (PWC) of feces and bed complexes can reduce the spreading of bovine mastitis incidence from environmental contamination. In this study, we developed the fecal dehydrating system and determined the elimination rates of bovine mastitis causative agent from feces and bed complexes. To develop the fecal dehydrating system, the screw pressurized dehydrating system was used and the maximum rate of dehydrating was reached to 52% PWC using 90% PWC (wet base) of fecal and bed complexes. The elimination rates of the dehydrating system for E. coli and S. aureus were reached at 41.19 $\pm$ 7.84% to 62.55 $\pm$ 8.71% in various percentages of PWC of feces and bed complexes (80, 85 and 90%). These results suggested that the application of fecal dehydrating system would reduce the exposure of dairy cattle to bovine mastitis causing agents contaminated feces and bed complexes, and can be used for environmental bovine mastitis control avoiding misuse or abuse of chemical disinfectants and antibiotics in dairy farm.

Effect of Water Extract of Cynanchi Wilfordii Radix in RANKL-induced Osteoclast Differentiation (백하수오(白何首烏) 물 추출물의 파골세포 분화에 미치는 영향)

  • Ahn, Yong-Hwan;Oh, Jae-Min;Lee, Myeung-Su;Jung, Jong-Hyuk;Chae, Soo-Uk;Moon, Seo-Young;Jeon, Byung-Hoon;Choi, Min-Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.2
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    • pp.160-165
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    • 2012
  • Osteoporotic fracture became a serious social problem, which related with mortality and morbidity in old age population. Osteoclast which is responsible for bone resorption is originated from hematopoietic cell line and plays a key role osteoporotic bone loss. Cynanchum wilfordii (Asclepiadaceae) roots have been used in Korean folk medicine for the treatment of diabetes mellitus and aging progression. Also, recent studies have shown that the extract and fractions of Cynanchi Wilfordii Radix have various pharmacological actions including scavenging free radicals, enhancing immunity, reducing high serum cholesterol, and anti-tumor activity. However, the effect of extract of Cynanchi Wilfordii Radix in osteoclast differentiation had not been reported. Thus, we evaluated the effect of Cynanchi Wilfordii Radix on receptor activator of nuclear factor-${\kappa}B$ ligand (RANKL)-induced osteoclast differentiation. Through our study, we found that Cynanchi Wilfordii Radix significantly inhibited osteoclast differentiation induced by RANKL. Cynanchi Wilfordii Radix suppressed the activation of p38 pathway and $NF{\kappa}B$ in bone marrow macrophages (BMMs) treated with RANKL. Also, Cynanchi Wilfordii Radix significantly inhibited the mRNA expression of c-Fos, tartrate-resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), nuclear factor of activated T cells (NFAT)c1 and cathepsin K in BMMs treated with RANKL. Particularly, Cynanchi Wilfordii Radix inhibited the protein expression of c-fos and NFATc1. Taken together, our results demonstrated that Cynanchi Wilfordii Radix may be useful treatment option of bone-related disease such as osteoporosis leads to fracture of bone and rheumatoid arthritis.

A study on slope protection works in cemetery establishment area ( I ) - The case of a public cemetery in Kangnung city - (묘지 조성사업지의 비탈면 보호공법에 관한 연구( I ) - 강릉시 시범 공설묘지 조성사업을 중심으로 -)

  • Chun, Kun-Woo;Yoo, Nam-Jae;Cha, Du-Song;Yi, Myong-Jong;Park, Wan-Geun;Han, Sang-Kyun
    • Journal of Forest and Environmental Science
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    • v.16 no.1
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    • pp.17-33
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    • 2000
  • The construction of a public cemetery in Kangnung city includes terraced graveyard with cutting or banking in mountain which has severe altitude differences with a slope of $30^{\circ}$. Therefore, there are scattered cutting and banking sections with vertical height more than 15m. Especially, if the slope failure or the loss of a graveyard happens after graveyard establishment due to surface flow and inflow around. it is difficult to repair, causing serious public censure. Accordingly, revegetation works were examined that need protection of slope. The specific content of the study was the selection of slopes requiring special care through blueprint and field investigation. the measurement of the physical property of slope and the situation of vegetative growth, the investigation of vegetation in slopes and the selection of vegetation. and the analysis of soil condition of slopes and the physical condition of slope sediment. On the basis of investigations some alternatives were proposed.

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A Study on the Marine Traffic Risk Assessment by using Ship Handling Simulator (선박조종 시뮬레이터를 이용한 해상교통 위험도 평가에 관한 연구)

  • Park, Young-Soo;Kim, Jong-Sung;Kim, Chol-Seong;Yong, Jeong-Jae;Lee, Hyong-Ki;Jeong, Eun-Seok
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.19 no.2
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    • pp.138-144
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    • 2013
  • Large and small marine accidents which are related to vessel's navigation are happening continuously and these maritime accidents have caused loss of lives and properties, and serious maritime environmental pollution damage. It is also true that maritime pollution damage is increasing due to these accidents, probability of growth of seaborne volume and complicated maritime traffic environment. Korea, recently, is developing an evaluation index which can assess sea risk through the evaluation of maritime traffic environment and provide danger and general information with relation to maritime traffic environment on target sea area to evaluate maritime traffic safety. In this paper, we intend to confirm the validity of maritime traffic safety on the basis of vessel navigator's risk consciousness and various sailing conditions by using the ship handling simulator. To confirm the validity of sailing vessel's maritime traffic safety, we use analysis of variance. By using analysis of variance, we analyze vessel navigator's characteristics, distance, speed and encounter type between vessels. Through multiple comparison of each factor's risk difference, we can confirm the change of numerical value of risk difference in statistical aspect.

Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서 Osmotic-Controlled Release Oral Delivery System Methylphenidate의 치료순응도)

  • Kim, Bongseog;Lee, Jeong-Seop;Kim, Eui-Jung;Sung, Hyung-Mo;Shin, Yun Mi;Hwang, Seong-Hye;Yoo, Hanik K.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.65-72
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    • 2014
  • Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities

  • Lee, Byoung Hun;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Yongjung J.;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.251-257
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    • 2018
  • Objective : The aim of this study was to investigate clinical and radiological outcomes of patients who underwent posterior vertebral column resection (PVCR) by a single neurosurgeon in a single institution. Methods : Thirty-four consecutive patients with severe spinal deformities who underwent PVCR between 2010 and 2016 were enrolled. The radiographic measurements included a kyphotic angle of PVCR levels (VCR angle), sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis (LL), and spinopelvic parameters. The data of surgical time, estimated blood loss, duration of hospital stay, complications, intraoperative neurophysiologic monitoring, and the Scoliosis Research Society (SRS)-22 questionnaire were collected using a retrospective review of medical records. Results : The VCR angle, LL, and SVA values were significantly corrected after surgery. The VCR and LL angle were changed from the average of $38.4{\pm}32.1^{\circ}$ and $-22.1{\pm}39.1^{\circ}$ to $-1.7{\pm}29.4^{\circ}$ (p<0.001) and $-46.3{\pm}23.8^{\circ}$ (p=0.001), respectively. The SVA was significantly reduced from $103.6{\pm}88.5mm$ to $22.0{\pm}46.3mm$ (p=0.001). The clinical results using SRS-22 survey improved from $2.6{\pm}0.9$ to $3.4{\pm}0.8$ (p=0.033). There were no death and permanent neurological deficits after PVCR. However, complications occurred in 19 (55.9%) patients. Those patients experienced a total of 31 complications during- and after surgery. Sixteen reoperations were performed in twelve (35.3%) patients. The incidence of transient neurological deterioration was 5.9% (two out of 34 patients). Conclusion : Severe spinal deformities can be effectively corrected by PVCR. However, the PVCR technique should be utilized limitedly because surgery-related serious complications are relatively common.

The Assessment of pH Variation for Neutralized Acidic Areas using Lysimeters by Seasons (라이시미터를 이용한 중화처리된 산성화경사지의 계절별 pH 용탈특성 평가)

  • Oh, Seungjin;Oh, Minah;Park, Chan-O;Jung, Munho;Lee, Jai-Young
    • Journal of the Korean Geosynthetics Society
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    • v.14 no.4
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    • pp.79-86
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    • 2015
  • Korean territories has formed about 70% of mountainous areas that have acidified serious level to average pH 4-5. There are a number of abandoned metal mines about 1,000 in Korea. However, mine tailings and waste rock included heavy metals are exposed to long-term environment without prevention facility or treatment system. Thus, ongoing management and monitoring of soil environment are required. Most of abandoned mine scattered in forest areas of slopes. Soil erosion due to continuous rainfall in the slopy areas can cause the secondary pollution by the influence eutrophication of water system and the productivity loss of the plant. Therefore, this study would like to estimate pH leaching rate by artificial rainfall using waste neutralization-agent in lysimeter. Moreover, the potentially of secondary pollution related to precipitation is figured out through the experiments, and the optimal planting methods would examinate after neutralizing treatment in soil. Experiments composed three kinds of lysimeter; lysimeter 1 had filled only acidic soil, lysimeter 2 had neutralized soil, and lysimeter 3 had planting plants after neutralized soil. In the results, lysimeter 2 showed the lowest pH leaching, and there is not specific relativity with pH leaching of the seasonal characteristics.

Effects of Moxi-tar Herbal Acupuncture at Cheonchu (ST25) on Crohn's Disease Induced by TNBS in Mices (천추(天樞) 상응부위에 구진약침(灸津藥針) 자극(刺戟)이 TNBS로 유도(誘導)된 크론병에 미치는 영향)

  • Kim, Yong-Tae;Ahn, Seong-Hun;Kim, Jae-Hyo;Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.25 no.2
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    • pp.159-177
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    • 2008
  • Objectives : Crohn's disease is a severe chronic inflammation that is treated mainly by immunosuppression, which often has serious side effects. There is need to develop new therapeutic methods or drugs that have few side effects in order to treat this disease. Acupuncture with Moxi-tar at Cheonchu (ST25) has anti-inflammatory properties, but the mechanism of its anti-inflammatory actions is unclear. We investigated the protective effects and speculated the mechanisms of acupuncture with Moxi-tar at ST25 on trinitrobenzene sulfonic acid (TNBS) induced colitis in mice which is a well known Crohn's disease animal model. Methods : 5 % TNBS was treated at day 1 and day 7 into rectum of mice. To investigate therapeutic effects of acupuncture with Moxi-tar at ST25, acupuncture was carried out on day 3, and day 6. For the data analysis, we observed macroscopic and microscopic findings of the colon. Weight and width of the colon, degree of damage, changes of body weight, and myeloperoxygenase (MPO) activity were checked. For analysing protein expression, we carried out immunohistochemical staining and Western blot. For analysing mRNA expression, RT-PCR was carried out. Results : TNBS induced damages on the colon of mice, while acupuncture of Moxi-tar at ST25 suppressed TNBS mediated damages similar to those on the colons of mice in the control (not treated with TNBS) group. The average body weight of TNBS treated mice (77.4%) was decreased compared with that of the control mice (105%), and acupuncture with Moxi-tar at ST25 suppressed the loss of body weight caused by TNBS (from 77.4% to 95.3%). TNBS induced infiltration of immune cells in all layers of the colon while acupuncture with Moxi-tar at ST25 suppressed infiltration of immune cells caused by TNBS. Furthermore, acupunctured with Moxi-tar at ST25 suppressed macro-, micro- colonic damages caused by TNBS. Acupunctured with Moxi-tar at ST25 dramatically improved the clinical and histopathological symptoms such as the increase in weight of the distal colon and the MPO activity in TNBS-induced colitis. Acupuncture with Moxi-tar at ST25 down-regulated the nuclear transcription factor kappa B ($NF-{\kappa}B$) activity and suppressed tumor necrosis factor-a (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-1${\beta}$), and intracellular adhesion molecule-1 (ICAM-1) expressions caused by TNBS. Conclusions : Acupuncture with Moxi-tar at ST25 helps recovery from the TNBS-induced colonic damage by down-regulation of $NF-{\kappa}B$ activity and suppressing of TNF-${\alpha}$, IL-1${\beta}$, and ICAM-1 expressions. This may be an important method for the treatment of Crohn's disease.

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A Study on Acute Kidney Injury Caused by Intravenous Colistimethate in Critically Ill Patients (중환자에서 Colistimethate 정맥내 투여와 관련된 급성 신손상에 대한 연구)

  • Oh, Myunghyun;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.307-315
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    • 2013
  • Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.