잡견에서 Rapid Atrial Pacing에 의한 심방의 전기적 재현성과 이의 회복

남기병,김동운,차성일,이석재,홍종면,임승운,나기정,조명찬 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6

Clozapine 투여로 유발된 무과립구증 1례

이기철,정홍경,이정호,최영민,전성일,최수전 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

저자들은 clozapine 투여 29일이 경과한 시점에서 무과립구증을 보인 20세 여자환자 1례를 치험하였기에 문헌고찰과 함께 보고하였다. 무과립구증은 무균처치와 항생제투여 및 G-CSF와 GM-CSF를 투여하여 무과립구증 상태는 8일만에 회복되었다. Clozapine에 의해 유발된 무과립구증의 원인은 아직까지 확실치 않다. 현재까지 알려진 원인으로는 MHC(major histocompatibility complex region)의 우성인자가 원인이라는 제안과 대사산물이 자유기근으로서 골수세포를 억제한다는 설이 제안되고 있다. 저자들은 clozapine을 투여함에 있어서 환자의 선정, 위험인자들의 고려 및 철저한 CPMS 관리를 제안하고, 일단 무과립구증이 발생하면 즉각적으로 내과적인 도움을 받을 것을 권장한다. We report a 20-year-old female patient who developed clozapine-induced agranulocytosis on the 29th day of clozapine treatment. She recovered from the agranulocytosis on the 8th day of progression after treatment with G-CSF, GM-CSF, antibiotics and associated aseptic procedures. The cause of clozapine-induced agranulocytosis is still un known and it is proposed that the dominant gene of major histocompatibility complex region and the reactive metabolites which suppress the myeloid system may be responsible. We recommend that careful attentions such as the selection of patient, evaluation of the risk factors, and the thorough control of CPMS should be paid. If the agranulocytosis happens, it is helpful to consult to the department of medicine immediately.

에탄올을 장기간 섭취한 백서에서 Acamprosate 투여가 Nitric Oxide Synthase 발현에 미치는 영향

정홍경,이기철,이정호,이승휘,이희제,정주호 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

Clozapine이 백서의 Schedule-Induced Polydipsia에 미치는 영향

이기철,정홍경,이정호,홍승범,최영민,전성일,정재현,하준명 대한생물치료정신의학회 2000 생물치료정신의학 Vol.6 No.2

Object : This study was designed to evaluate the effects of clozapine which is one of most useful atypical antipsychotics in the schedule-induced polydipsic rat which is an animal model of obsessive-compulsive disorder. Methods : Spraque-Dawley rats were placed in automatic cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT- 60s) feeding schedule over 150-minute test session for 4 weeks. After 4 weeks of daily exposure to the FT-60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). Rats were stratified into clozapine(0.34mg/kg,i.p.), clozapine(14.63mg/kg,i.p.), clomlpramine(5mg/kg,i .p.), and vehicle (1cc/kg,i.p.) group and treated with each drugs for 3 weeks. To identify the non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5gm) of food per day which maintained them at their average body weight. Results : The results were as follows ; 1)After 4 weeks of scheduled feeding procedure, the experimental group showed significant differences than bolus control in the amount of water consumption as compared with their baseline of water intakes for 4 weeks. At the same periods, there were no differences between the experimental group and bolus control in the borty weight. 2)The clomipramine group, the clozapine 0.34mg group and the clozapine 14.63mg group showed significant decrease in the amount of water intake for at 2nd & 3rd week of drug treatment as compared with their baseline of polydipsic water intakes. But, the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. Conclusion : Above findings suggest that the fixed time feeding Procedure for Schedule induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. In clinical situation, the authors suggest that atypical antipsychotic drugs which act as serotonin and dopamine receptor antagonist may be helpful to improve the symptoms of the patients with treatment refractory obsessive-compulsive disorder.

골수검사를 시행한 철결핍성빈혈의 임상적 고찰

안기완,홍승만,전의섭 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.2

Iron deficiency is a common one of nutritional deficiency, which denotes a deficit in total body iron. resulting from iron requirements that exceed iron supply. It remains the most common cause of anemia, both in the Korea and world wide. The development of iron deficiency progresses in stage. storage iron depletion occurs first. at this stage, a bone marrow aspirate staine with Prussan blue shows marked reduced or absent deposits of iron in macrophages and accompained by a decreased in the level of serum ferritin. in the next stage, the iron binding capacity of the serum rises, followed by a drop in serum iron. the final stage is the development of microcytic and hypochromic in circulating red cells. Bone marrow examinations is not essential diagnostic modality of iron deficiency anemia (IDA), but is necessary for early definitive diagnosis of IDA. So, We studied 65 cases of IDA patients who were performed bone marrow aspiration and biopsy. and 60 cases of normal healthy control from January 1990 to necember 1993 in Cho-sun University. The results of the analysis were as follows : 1) The total number of 65 patients were 26 males and 39 females. The peak incidence was at ages of 21-30 years and mean ages was 34.8 years. 2) Gastrointestinal bleeding was the most common cause of IDA (gastric ulcer 23.1%, duodenal ulcer 9.2%, gastric cancer 9.2% and hemorrhagic gastritis 4.2 %). 3) Most patients showed medical attention because of general (61.5%), gastrointestinal (58.5%) or cardio-pulmonary (36.9%)symptoms. 4) The mean hemoglobin level was 7.71± 0.83 g/dl, Mean corpuscular volume(MCV) 71.63± 4.56 fL, Red cell volume distribution width(RDW) 17.23±0.72 %, corrected reticulocyte 1.49±0.45%, serum iron 35.07±25.45 ug/dl, TIBC 352.44±43.99 ug/dl and serum ferritin 8.93±8.42 ng/ml. The peripheral red cell morphology was mainly microcyhz and hypochromic ficture(89.2% and 87.7%). Bone marrow iron stians showed that the suitable iron was absent, grade 0 in 92.3% and grade 1 in 7.7% 5) All cases were treated with iron preparation and 26.2% with blood transfusion(from 1 unit to 15 units). 69.2% showed complete recovery with therapeutic maneuvers and 30.1% relapse or no reponse which was probably stemmed from uncorretability(9.2%), uncooperability (9.2%), side effect(3.1%) and replapse of underlying diseases(6.2%). IDA is not definitive diagnosis, but one of the clinical sign of etiologic diseases. So, for the definintive treatment. it is important that the etiologic diseases were corrected.

세로토닌성 항우울제가 백서의 Schedule-Induced Polydipsia에 미치는 영향

이기철,이정호,박중섭,최영민,전성일,정홍경,하준명,정재현 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

Object : Schedule-induced polydipsia is considered as an animal model of obsessive-compulsive disorder inrats. The authors evaluated the chronic effects of fluoxetine and clomipramine as serotonergic antidepressants and haloperidol as dopaminergic antagonist on the schedule-induced polydipsia in rat.Methods : Spraque-Dawley rats weighing 200-250gm were individually housed, maintained and allowed free access to water for 1 week. And then the rats were placed on a restricted diet. To induce polydipsia, rats were placed in automatic cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT 60s) feeding schedule over 150-minute test session for a day. Water was available at all times during the feeding schedule in automatic cage. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). 4 groups of rats were administered fluoxetine(5mg/kg/i.p.), clomipramine(5mg/kg/i.p.), haloperidol(0.1mg/kg/i.p.), vehicle(1cc/kg/i.p.) for 3 weeks. Rats were tested once a week to access schedule induced polydipsic behavior. The chronic effects of experimental drugs on schedule induced polydipsic behavior were analyzed with repeated analysis of variance and Scheffe test as a post-hoc comparison.In order to measure water consumption in non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5 gm) of food per day which maintained them at their average body weight.Results and Conclusion : The results were as follows ;1) After 4 weeks of daily feeding procedure with fixed time schedule for 60 seconds per day, the experimental group showed significant differences than the control in the amount of water consumption as compared with their baseline water intakes. At the same periods, there were no differences between the experimental group and the control in body weight. 2) The clomipramine treated group and the fluoxetine treated group showed significant decrease in the amount of water intake as compared with their baseline of polydipsic water intakes for 3 weeks of treatment. However, the haloperidol treated group and the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. 3) At 2 weeks of drug treatment, clmipramine treated group(16.88±6.51ml) and the fluoxetine treated group(22.50±10.35ml) showed significantly lower amounts of water intake than the haloperidol treated group (41.25±7.06ml) or vehicle control group(37.50±12.54ml). And also the clomipramine treated group(13.75±5.18ml) and the fluoxetine treated group(18.75±3.54ml) showed significantly lower amounts of water intake than the haloperidol group(35.00±11.65ml) and the vehicle control(34.38±6.78ml) at 3 weeks of drug treatment. Above findings suggest that the fixed time feeding procedure for schedule-induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. The author confirmed that schedule-induced polydipsia was successfully decreased for 3 weeks of administration of clomipramine and fluoxetine but there was no response to haloperidol.

노후화영향을 고려한 S.R.C.기둥과 R.C.기둥의 시간의존적 신뢰성 해석

손승현,김희규,홍기섭,홍영균 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

The structures are generally deteriorated with time, and then the strengths of them shall be lowered. Considering decrepitude, the strengths of a steel reinforced concrete (S.R.C.) and reinforced concrete (R.C.) columns are affected by variations in the strengths of concrete and steel, the cross-sectional dimensions of concrete and steel section, the placement of steel section and reinforcing bars and the strength model itself: Their factors are stochastic variables; elapsed time after construction, crack and neutralization or carbonation of concrete, corrosion of reinforcing bars, etc. On each case of S.R.C & R.C. columns, these several variables, the strengths which have been acquired by using Time Dependent Reliability analysis method, will be analyzed and compared with the strength by reinforced concrete criteria and LRFD(Load & Resistance Factor Design) criteria. The stochastic strengths of members suggested in this study will be useful for the life-cycle management.

구개열 아동 언어의 진단 평가

신효근,고승오,홍기환,서정환,고도흥,김현기 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

간세포성 암종과 담관암종에서 Glutathione S-Transferase π의 면역조직화학적 발현

한상영,손영기,이종훈,박희승,노명환,최석렬,최홍조,허기영 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.31 No.1

뇌진탕후 증후군 환자의 임상심리학적 특성

김영미,이기철,이정호,홍승범 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

본 연구는 1990년부터 1994년까지 인제대학교 의과대학 상계백병원 신경정신과에서 치료받았던 환자 중, 두부 외상의 기왕력이 있고, ICD-9의 뇌진탕후 증후군의 진단기준을 만족하는 환자 28명과 무작위로 선정된 32명의 신경증 대조군에게 시행했던 K-WAIS alc MMPI의 결과로, 두 집단을 비교하여 다음과 같은 결과를 얻었다. 1) 인구동태학적 지표에서 뇌진탕후 증후군 집단이 신경증 대조군에 비해 평균 연령, 교육 연한에서 의미있는 차이를 보였다. 2) 한국판 웩슬러지능검사(K-WAIS)에서 뇌진탕후 증후군 집단이 언어성 검사 중 기본 지식 문제와 숫자 외우기, 어휘 문제, 동작성 검사중 빠진곳 찾기, 바꿔쓰기에서 보통 범위 이하의 점수를 보였으나 신경증 대조군 집단은 보통범위 이상의 점수를 보였다. 3) 다면적 인성 검사(MMPI)에서 뇌진탕후 증후군 집단은 타당도 척도에서 역전된 V자형을 보였고, 하위척도 중 Hs척도가 의미있게 높은 결과를 보였다. 4) 뇌진탕후 증후군 집단의 군집 분석에서 첫번째 군은 타당도 척도에서 낮은 정도의 V자형을 보였고 Hs척도가 상승하였고, 두번째 군은 타당도 척도에서 역전된 V자형을 보였고 하위척도중 Hs, D, Pa, Pt, Sc척도가 의미있는 상승을 보였다. 이상의 결과로 보아, 뇌진탕후 증후군 환자들은 신경증 대조군 환자들과 비교하였을때 자신의 증상으로 인한 정서적인 고통을 많이 받을 뿐만 아니라, 인지 기능상의 손상이 심함을 알 수 있었다. Object : This study was conducted to investigate the clinicopsychological characteristics of patients with postconcussional syndrome. Methods : K-WAIS and MMPI were applied to 28 patients with postconcussional syndrome and 32 random-sampled neurotic controls. The means between two group were compared by ANCOVA. Cluster analysis was also applied to T-scores of the MMPI in patients with postconcussional syndrome. Result : 1. In demographic data, there were significant differences in mean age and education period between postconcussional syndrome group and the control group. 2. In postconcussional syndrome, Information, Arithmatics, Vocabulary and Picture Completion and Digit Symbol scores of K-WAIS were lower than that of mean score. 3. In MMPI profiles, reliability scale was inverted ‘V’pattern, and Hs scale was highly significant for postconcussional syndrome. 4. In postconcussional syndrome, cluster analysis was applied to each subscale of the T-score of MMPI, and two subgroups were extracted. 1) The first subgroup showed that reliability scale was low V pattern, and Hs scale elevated. 2) The second subgroup showed that reliability scale was inverted V pattern, and Hs, D, Pa, Pt, Sc scale elevated significantly. Conclusion : The patients with postconcussional syndrome were more severely ill, not only in emotional distress but also in cognitive dysfunction, than that of neurosis control.