중증 만성정신질환자 수의 추산 : Through Two Community Surveys 두 지역사회 조사를 중심으로

홍진표,김윤,배재남,정유진,강영호,양병국,김용익,김병후,이철,조맹제 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

국내 중증 만성정신질환자 수를 추정하기 위하여 일 농촌 및 대도시 지역의 지역의료보험 및 의료보호 대상자 중 1993년 1년간 의료기관에서 정신증 상병(ICD-9 code 상 290-299) 및 알콜 남용/중독, 성격장애 및 정신박약 진단하에 치료를 받은 적이 있는 사람에 대해 설문조사를 실시하였다. 연구자들이 개발한 진단도구를 이용하여 진단을 평가하고, Strauss-Carpenter scale 등을 이용하여 기능 장애를 평가하고 유병기간 등을 조사하였다. 결과를 요약하면 다음과 같다. 1) 진단평가상 정신분열병군(61.1%)이 가장 많았으며, 정동장애군(23.7%), 알콜장애군(11.2%), 기질성 정신장애군(4.0%)의 순서이었다. 2) 직업활동정도는 진단군별로 차이가 많았다. 지난 1년간 직업활동이 6개월 미만이거나 전혀 없는 환자 비율이 정신분열병군은 67.2%, 알콜장애군 52.0%, 정동장애20.8%의 순으로 정신분열병군이 가장 불량하였다. 3) 사회활동도 진단군별로 차이가 많아서 지난 1년간 의도적, 사회활동이 없는 비율이 정신분열병군이 가장 높았고(72.3%), 알콜장애군(32.0%), 정동장애군(20.7%)의 순이었다. 4) 국내 의료보험 및 사회복지시설 이용 자료 등을 토대로 본 조사 결과를 적용한 결과 국내중증 만성 정신질환자의 수는 약 8만 7천명으로 추산되었다. Objectives: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. Methods : Study populations were recruited from medical insurance data of two district areas ; one rural and the other urban areas. Subject were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November,1994. Results : According to diagnostic assessment schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. Conclusions : Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.

中學 科學敎育의 探究學習에 대한 評價問項 開發 (Ⅱ)

閔庚德,楊洪準,李善行,鄭遠佑,이병교,金裕漢,羅長薰 경북대학교 과학교육연구소 1985 科學敎育硏究誌 Vol.9 No.-

This study was accomplished to develope the evaluation items for inquiry learning in the 2nd grade Middle School Science for the consecutive study of the evaluation items for inquiry learning in the 1st grade Middle School Science(U-Hang Ki et al, 1984). In this study, paper and pencil test items and performance test items are made by analyzing the abilities of inquiry according to the contents and four basic experiments from each unit in the 2nd grade Middle school science. These evaluation items were applied to tke five classes of the 2nd grade of middle school to test their validity. It is desirable that performance test schuld be used for the evaluation for the abilities of inquiry which can not be evaluated by paper and pencil test. In the evaluation methods of performance test, tester evaluation, peer evaluation and self-evaluation can be applied to the science class in a multi-student class. In higher grade, however tester evaluation is more desirable than peer and self evaluation. It is found that peer evaluation and self-evaluation make possible the perfect study by feedback.

Paraquat 투여 백서에서 Cyclophosphamide와 Dexamethasone의 치료 효과

신정철,신양수,유병전,임현성,정태흥,박찬국,오금탁,이병래 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

Paraquat (N,N'-dimethy 1-4,4'bipyrydinium : Gramoxone^(R), a widely used herbicide, is extremely toxic to all green plants and many eukaryotic organisms. In human, paraquat intoxication leads to multiple organ failure, it preferentially damages the lung, kidney and liver and may result in death. The participation of superoxide in initiating tissue damage by administration of paraquat is well known in which one electron reduction of paraquat leads to the formation of radical species which react with molecular oxygen to give superoxide. This process initiates immunological changes with the activation of neutrophilic leukocytes, which is related to further production of superoxide. In this experiment, therapeutic effects of cyclophosphamide and dexamethasone on blood cell count, malondialdehyde as a indicator of lipid peroxidation, and antioxidant enzymes levels in the lung, liver and kidney of paraquat intoxicated rats were inbestigated. The WBC count were significantly decreased by combined treatment of cyclophosphamide and dexamethasone in paraquat intoxicated rats at 3 and 5 days but RBC count were not changed. The contents of malondialdehyde were significantly decreased in the lung and Kidney by combined treatment at 10 days after paraquat intoxication. The catalase acitvities were markedly increased in the lung and liver of rats at 10 days after paraquat intoxication, and superoxide dismutase activities showed minimal changes in the lung, liver and kidney of rats by combined treatment. These results suggest that paraquat induced tissue damage in rats can be redeced by combined administration of cyclophosphamide and dexamethasone.

구리 인근 경기 동북 지역에서의 피부질환의 통계적 관찰

이창우,유희준,양홍윤,전재홍 한양대학교 의과대학 1996 한양의대 학술지 Vol.16 No.2

We reviewed 4,173 new out-patients visited dermatology clinic of Hanyan University Kuri Hospital (from November 1995 to October 1996) to study the prevalence of common dermatoses occurring in this region (northeastern area of Kyounggi province) and compared to those of other Korean data. Among 4,173 new out-patient, 1,866(44.7%) were male, and 2,307(55.3%) were female. Fifteen common dermatoses were found to be contact dermatitis(13.0%), dermatophytosis(9.1%), atopic dermatitis(8.4%), seborrheic dermatitis(8.1%), other eczemas(7.8%), urticaria(6.4%), acne vulgaris(4.9%), herpes zoster(3.4%), drug eruption(2.5%), bacterial infection(2.1%), psoriasis(1.9%), verruca(1.8%), vitiligo(1.4%), syphilis(0.5%), and scabies(0.5%) in order of frequency. The most frequently visited age group was those between the age 21 to 30 years old constituting 20.4% of total patients. On monthly visited number of patients, the highest was in January, and the lowest was November. The results suggest that age, sex and monthly distribution patterns in northeastern area of Kyounggi province are similar to those of other epidemiological reports in Korea except for the higher prevalences of contact dermatitis, seborrheic dermatitis and herpes zoster.

조선대학병원에서 경험한 삼일열 말라리아의 임상적 고찰

서영선,김양수,김태균,박유환,홍순표,정춘해 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.1

In the five years since 1993 Malaria has made a ceaseless attack on the native Koreans as an indigenously formed disease in addition to the imported one. This study was aimed at clinical symptoms and signs of Malaria which had occurred indigenously in Cheon-Nam. 18 cases were reviewed retrospectively in this study which was composed of 17 men and 1 woman. They were admitted to Chosun Hospital because of the indigenous Malaria in 1998. Fever and chill , the most frequent symptoms in early stages made a 100% occurrence followed by general myalgia(89%) and headache(83%). Physical examination of those admitted showed the splenomegaly most frequently in 61% of the patients. It took four to ten days to visit the hospital since the symptoms first occurred in the patients. Gametocytes among the Malarial life cycle were observed most commonly (91.3%) in the occurrence of the disease and the prestages of the life cycle as well. The hematologic abnormalities observed was Anemia(89%), Thrombocytopenia(61%), and Neutropenia(50%) in the order named. On the third hospital day since giving the standard Malarial drugs parasitemia decreased remarkably (1540/㎕ : Mean parasitic concentration) and 28th day of treatment no parasitemia were found. In conclusion the patients suffering from malaria in Cheon-Nam had been in an armistice area and the symptoms were so relatively mild that the responses to treatment were good and relapses occurred. But, it requires further epidemiologic survey and more concern about the indigenous Malaria.

이기종간의 상호운용성을 지원하는 이동 에이전트 시스템

이명준,박양수,유양우,문남두,김진홍,안건태 울산대학교 2000 공학연구논문집 Vol.31 No.1

현재 대부분의 이동 에이전트 시스템들은 그들 자신의 구조를 가지며 서로 다른 방법으로 구현되어 있다. 이러한 에이전트 시스템들은 서로 다른 인터페이스를 제공하고 있어서 이기종의 에이전트 시스템에서 새성된 에이전트들은 상호 이동하여 작업을 수행할 수 없다. 이러한 문제를 해결하기 위하여 이동 에이전트 시스템간의 상호운용성 지원이 중요한 과제로 다루어지고 있다. OMG(Object Management Group)는 이질적인 에이전트 시스템간의 상호운용성을 증진시킬 목적으로 MAF(Mobile Agent Facilities)명세를 제안하였다. MAF명세는 MADAgentsystem과 MAFFinder 두개의 인터페이스로 구성되어 있으며 에니전트 관리, 코드의 이동성, 명명 규칙에 관한 기능을 제공한다. 본 논문에선는 OMG의 MAF 명세를 만족하는 SMART 이동 에이전트 시스템의 설계와 이의 구현에 대하여 설명한다 SMART 이동 에이전트 시스템의 구성은 에이전트를 실행시키는 환경을 제공하는 플레이스(place), 에이전트의 라이프사이클과 플레이스를 감시하는 모니터(monitor) 그리고 에니전트에게 시스템의 자원을 할당하는 자원관리자(resource manager)로 이루어져 있다. Most current mobile agent systems adopted their own architectures, being implemented in various ways. Since those agent systems provide different interfaces, agents created in one mobile agent system could not move to other agent systems to perform their tasks. To solve this problem, interoperability becomes one of the important issues on mobile agent systems. The OMG(Object Management Group) proposed the MAF(MAF(Mobile Agent Facilities) specification for the interoperability among heterogeneous mobile agent systems. the MAF specification contains MAF Agent System and MAFFinder interfaces, and defines agent management, code mobility and naming rules. In this paper, we describe the design and implementaion of the SMART mobile agent system which satisfies the OMG MAF specification. The SMART system consists of Places that provide execution environments for agents, Monitor that monitors life-cycle of agents and places, and Resource Manager that allocates resources of system for agent.

항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

Realgar transforming solution-induced differentiation of NB4 cell by the degradation of PML/RARa partially through the ubiquitin–proteasome pathway

Yang Hai,Xin Wang,Peng Song,Jian-yin Li,Longhe Zhao,Fei Xie,Xiang-min Tan,Qin-Jian Xie,Lan Yu,Yang Li,Zhengrong Wu,Hong Yu Li 대한약학회 2019 Archives of Pharmacal Research Vol.42 No.8

PML/retinoic acid receptor alpha (RARa), as ahallmark of acute promyeloid leukemia (APL), is directlyrelated to the outcome of clinical APL remedy. It isreported that arsenicals can effectively degrade PML/RARa, such as arsenic trioxide and realgar. However, thehigh toxicity or insolubility have hampered their clinicalapplications. Realgar transforming solution (RTS) wasproduced from realgar by bioleaching process in our lab. Previous studies demonstrated that RTS had a significantanti-cancer ability on chronic myeloid leukemia throughoncoprotein degradation. The capacity of RTS on treatingAPL is what is focused on in this study. The results showedthat RTS had a noticeable sensitivity in NB4 cell, and RTSremarkably down-regulated PML/RARa expression andinduced cell differentiation. Further, RTS could accumulatePML/RARa into the nuclear bodies and then executedegradation, which could be reversed by proteasomeinhibitor MG132. The results also exhibited that thereduction of RTS-induced PML/RARa expression accompaniedby the elevation of ubiquitin and SUMO-1 proteinexpression. Finally, PML and SUMO-1 had been demonstratedto be co-localized after RTS treatment byimmunofluorescence co-localization assay and immunoprecipitationassay. In conclusion, these results suggestedthat RTS-induced cell differentiation may attribute to thePML/RARa degradation partially through the ubiquitin–proteasome pathway.

Polymer ligand-assisted fabrication of multifunctional and redox-responsive self-assembled magnetic nanoclusters for bimodal imaging and cancer treatment

Yang, Hong Yu,Fu, Yan,Li, Yi,Jang, Moon-Sun,Lee, Jung Hee,Lee, Doo Sung The Royal Society of Chemistry 2018 Journal of materials chemistry. B, Materials for b Vol.6 No.35

<P>Multifunctional nanoplatforms that can combine diagnostic functions and therapeutic capabilities are highly required for the construction of novel cancer diagnosis-therapy integrative systems. In this work, we developed multifunctional and tumor redox-responsive magnetic nanoclusters (RMNs) by the self-assembly of iron oxide nanoparticles with a chlorin e6 (Ce6)-disulfide-linked polymer ligand. The core of RMNs could enhance the <I>T</I>2-weighted MR contrast capability, and the surface ligand could improve the system stability and load Ce6. In addition, the obtained RMNs also exhibited excellent biocompatibility and higher cytotoxicity upon near infrared (NIR)-irradiation. These RMNs with a size of ∼90 nm can effectively facilitate their accumulation in tumor sites through the enhanced permeability and retention (EPR) effect and subsequently are endocytosed into a highly reductive intracellular environment that activates fluorescence and photodynamic therapeutic antitumor activity. Furthermore, the <I>in vivo</I> imaging and therapy results not only confirmed that RMNs can as bimodal imaging probes for the early-stage diagnosis of cancer but also demonstrated the superior photodynamic therapeutic efficiency of RMNs in suppressing tumor growth. These results indicated that RMNs show great potential for simultaneous diagnostic imaging and photodynamic therapy.</P>

Multifunctional and Redox-Responsive Self-Assembled Magnetic Nanovectors for Protein Delivery and Dual-Modal Imaging

Yang, Hong Yu,Jang, Moon-Sun,Li, Yi,Lee, Jung Hee,Lee, Doo Sung American Chemical Society 2017 ACS APPLIED MATERIALS & INTERFACES Vol.9 No.22

<P>Nanoparticle (NP) based model carriers present an emerging strategy for protein delivery. However, constructing a multifunctional nanocarrier with high loading capacity, diagnostic imaging capacity, and controlled release capability is a tremendous challenge for protein delivery systems. Thus, we herein report on the fabrication of redox-responsive magnetic nanovectors (termed RMNs) through self- assembly of Fe3O4 NPs and redox-responsive polymer ligands, which could effectively transport protein and trigger intracellular protein release. These RMNs also exhibited low toxicity, high stability, biocompatibility, and T-2-weighted contrast-enhancement properties. In addition, they presented a quantized positively charged surface that had the capacity to load cyanine 5.5 (Cy5.5) labeled human serum albumin (HSA) with high loading efficiency (similar to 84%) via electrostatic interactions and which favored cellular uptake. Notably, studies of the in vitro protein release showed that HSA-Cy5.5-loaded RMNs (RMNs-HSA-Cy5.5) presented minimal cumulative release behavior under physiological conditions but release was rapidly enhanced under high glutathione concentration conditions. Confocal microscopy further revealed that protein was delivered and localized at the perinuclear region of tumor cells. Moreover, the in vivo imaging results confirmed that RMNs-HSA-Cy5.5 could serve as a dual-modal probe for simultaneous near-infrared fluorescence (NIRF) imaging and magnetic resonance (MR) imaging, which can be used for breast cancer diagnosis, and verified higher tumor accumulation of transported protein in a living body. Overall, we believe that these multifunctional RMNs exhibit great promise for protein delivery, cancer diagnosis and therapy, and multimodal imaging, as well as clinical applications.</P>