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기관지폐 이형성증의 추가 치료제로서의 Montelukast
김혜미,송지은,이순민,박국인,남궁란,이철,박민수 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.2
목 적 : 기도 및 폐 간질의 염증은 기관지폐 이형성증의 중요한 기전으로 알려져 있다. 염증매개 물질의 하나인 cysteinyl leukotrienes는 기관지 수축, 점액 분비, 부종을 일으켜 폐에 손상을 준다. 저자들은 기관지폐 이형성증 환자의 추가 치료제로서 montelukast의 안전성 및 효과를 연구하고자 하였다. 방 법 : 2007년 3월부터 2008년 1월까지 연세대학교 의과대학 영동세브란스병원 및 신촌세브란스병원 신생아 중환자실에 입원하여 montelukast를 복용한 15명의 기관지폐 이형성증 환자를 montelukast 군으로 지정하였으며 2005년 5월부터 2007년 2월까지 영동세브란스병원 및 신촌세브란스병원 신생아 중환자실에 입원하여 montelukast를 복용하지 않은 15명의 기관지폐 이형성증 환아들을 대조군으로 지정하였다. montelukast는 1 mg/kg/d를 하루에 두번 나누어 구강으로 복용하게 하였으며 평균적으로 12주 동안 복용하였고 기존의 기관지폐 이형성증 치료의 추가 치료제로 사용하였다. 결 과 : Montelukast 군은 15명 모두 생존하였으며 특이 이상 반응 없었고 생체징후, 혈액검사 모두 정상 소견 보였으며 montelukast 복용 2주 후부터 ventilator index가 대조군에 비해 유의한 감소를 보였다. 다른 호흡 지표들도 대조군에 비해 더 감소하였으나 통계학적으로 의미는 없었다. 결 론 : 본 연구 대상 환아 중에서는 기관지폐 이형성증의 기존치료에 추가로 사용된 montelukast에 특이 이상 반응이 없었으며, 대부분 well-tolerable한 것으로 나타났다. 또한 1 mg/kg/d의 montelukast는 치료 2주째부터 기계적 환기의 기간을 줄여 주어 기관지폐 이형성증의 추가 치료제로써 효과가 있음이 확인되었다. 그러나 montelukast 치료 및 예방의 효과 및 안전성을 확립하기 위해서는 더 많은 수의 환아를 대상으로 대규모의 다기관 무작위 대조 연구가 시행되어야 할 것으로 여겨진다. Purpose : Inflammation plays a potential role in the pathogenesis of bronchopulmonary dysplasia (BPD). Strategies for preventing BPD include respiratory management, antioxidants, nutritional treatment, and others such as anti-inflammatory agents. We aimed to assess the safety, tolerability, and efficacy of montelukast (MK), a cysteinyl leukotriene 1 receptor antagonist, as an add-on therapy in BPD. Methods : In addition to currently available standard measures such as oxygen supplementation, bronchodilators, nutritional support, and/or diuretics, montelukast was administered to 15 preterm infants with BPD. MK was given orally (1 mg/ kg/d) for a mean period of 12 weeks. We compared safety and efficacy parameters with historical controls. Results : All 15 patients survived, and no differences were found in the incidence of adverse reactions between the 2 groups. The ventilation index was significantly improved after 2 weeks in MK group compared with historical controls. There were no significant differences in other respiratory parameters (MAP, oxygen dependency, and ventilator dependency) between the groups, but the MK group showed trends of greater improvement. Conclusion : Administration of MK 1 mg/kg/d was well tolerated in preterm BPD patients as an add-on therapy. We demonstrated that after 2 weeks of MK administration of 1 mg/kg/d, MK had beneficial therapeutic effects on BPD patients as an add-on to the standard therapy. Further multicenter randomized controlled clinical trials are needed to confirm the efficacy and safety of MK as a useful supplement to standard therapy for BPD patients.
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pH-Responsive Polymeric Micelles from Sulfamate-Conjugated Block Copolymers
김혜미,이형일 한국고분자학회 2015 Macromolecular Research Vol.23 No.2
We synthesized block copolymers containing sulfamate linkage in the hydrophobic block that is cleavableto pH change. 2-(trimethylsilyloxy)ethyl methacrylate (HEMATMS) was polymerized from poly(ethylene oxide)(PEO) macroinitiator via atom transfer radical polymerization (ATRP), resulting in PEO-b-PHEMATMS with differentlength of PHEMATMS blocks. TMS groups were deprotected in the presence of potassium fluoride (KF), andin situ transformed to sulfamate groups by reacting with sulfamoyl chloride. The resulting block copolymer was furtherfunctionalized with trityl groups, yielding in PEO-b-PHEMA-tritylsulfamate. Molecular weight and molecularweight distribution were determined by gel permeation chromatography (GPC), and degree of polymerization (DP)of PHEMATMS blocks was measured by 1H NMR spectroscopy. These block copolymers were self-assembled asmicelles in water and dissociated into unimers by lowering pH of the solutions, which was demonstrated by dynamiclight scattering (DLS). We also showed that pyrene, a model hydrophobic dye, was loaded efficiently into themicelles and released upon pH-triggered disruption of micelles.
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김혜미,김선화 한국정신건강사회복지학회 2008 정신보건과 사회사업 Vol.30 No.-
This study examines the acculturative stress of foreign migrant workers in Daejon, Korea. Using Berry and Kim (1988) and Williams and Berry (1991)’s conceptual framework on acculturative stress model as a theoretical guide, this study examines the effects of language ability, work-related experience and the level of education and income as SES variables and social support on the level of acculturation stress of the migrant workers. To assess relative strength of the effect of each measure, a four-stage hierarchical regression analysis was conducted. The findings reveal that age, marital status, change in work status, and community support were significant predictors of acculturative stress of foreign migrant workers. This result shows that with all control variables and other predicting variables held constant, the older, single migrant workers whose work status has changed in the past tend to experience a higher acculturative stress level and that those who perceive of having more support from their community tend to experience less acculturative stress. These findings suggest for development of better and more protective policy measures to secure their employment status. More specifically, the finding on social support indicates a need for the expansion of community organizations in both quantity and quality for providing better and support-oriented services to these migrant workers.
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