한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

남자 고등학교 세팍타크로 경기의 공격기술에 관한 분석 연구

김영호,고문석,제임스전,이영익,차정훈,현종건,김범수,임종만,이석인 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

This research aims at analysis of attack technique in sepaktakraw games. For this purpose, 3 high school coaches observed and recorded each game Five times in videos of high school male players' thirty games in 2003. The conclusion from the analysis of the recorded data are as follows. 1. Scissors spike was the most popular (favorite) attack technique. Rolling spike, tapping spike and heading spike was popular in order. 2. Heading spike showed the highest success rate (73.5%) in attack technique. And tapping spike (69.5%), scissors spike (57.8%) and rolling spike (67.11) showed a lower success rate in order. In failure rate, heading spike (5.5%), tapping spike (36.5%), scissors spike (32.2%) and rolling spike (32.9%) had a higher percentage in order. 3. When receive was stable, the success rate in attach technique was 47.1%, the failure rate was 20.1%. On the other hand, when receive was unstable, the success rate in attach technique was 16.5%, the failure rate was 14.3%.

유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.

Isolation of a novel protein phosphatase2C in rice and its response to gibberellin

Amir Hossain, Md,Ahn, Chul-Hyun,Lee, In Suk,Jeon, Jong-Seong,An, Gynheung,Park, Phun Bum Elsevier 2018 Biochemical and biophysical research communication Vol.503 No.3

<P><B>Abstract</B></P> <P>Protein phosphatase 2Cs (PP2Cs) have been referred to act as negative modulators of the protein kinase pathways involved in different environmental stress responses and developmental processes. In <I>Arabidopsis</I>, PP2Cs have been extensively studied and some are known to negatively regulate abscisic acid signaling. In rice, PP2Cs are scarcely characterized functionally. Here, we identified a novel PP2C from rice (OsPP2C34), which is highly inducible by gibberellin (GA) and expressed in various tissues. Subcellular localization analysis in maize protoplasts using a green fluorescence protein fusion vector localized OsPP2C34 to the cytosol. Genetic analysis of T-DNA insertional mutants revealed that plant height and internode length were significantly shorter in mutants than in corresponding wild types under GA treatment. The induction of the GA-inducibleα-amylase genes <I>RAmy3E</I> and <I>OsAmy</I> was delayed in mutant plants. The substrate of OsPP2C34 was identified by immunoblotting using anti serine/threonine antibodies. A 65 kDa protein was phosphorylated in <I>Ospp2c34-1</I> but dephosphorylated in the wild type during early germination stage. Overall, the present results indicated that OsPP2C34 is involved inα-amylase expression of GA signal transduction pathway.</P> <P><B>Highlights</B></P> <P> <UL> <LI> OsPP2C34 is highly inducible by gibberellin (GA) and expressed in various tissues. </LI> <LI> OsPP2C34 is localized to the cytosol and involved in α-amylase genes inducible by GA. </LI> <LI> OsPP2C34 has dephosphorylation activity at its serine/threonine residues. </LI> <LI> OsPP2C34 is a positive regulator of the GA-dependent signaling transduction pathway. </LI> </UL> </P>

류마티스 관절염 환자의 T세포 수용체 Vβ 유전자 레퍼토리 분석

정성수 ( Sung Soo Jung ),황관표 ( Kwan Pyo Hong ),김동욱 ( Dong Yook Kim ),김태환 ( Tae Hwan Kim ),이인홍 ( In Hong Lee ),전재범 ( Jae Bum Jun ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),김성윤 ( Seong Yoon Kim ),이은영 ( 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1

목적: 류마티스 관절염(rheumatoid arthritis; RA)의 병인에 있어 중추적인 역할을 하는 것으로 알려진 T세포에 관한 연구가 최근에 관심의 초점이 되고 있으나, 현재까지 한국인을 대항으로 시행된 보고는 없다. 한국인 류마티스 관절염 환자의 관절병변부위에서 T세포 수용체(TCR)의 Vβ유전자 사용의 빈도를 검색하여 한국인 류마티스 관절염 환자에서 사용되는 빈도가 높은 유전자계를 찾는데 목적을 두었다. 방법: 이에 저자는 T세포에 관한 연구의 일환으로 류마티스 관절염 환자 3명과 정상인 4명을 대상으로 말초 혈액과 활액 T세포로부터 추출한 RNA를 이용하여 cDNA를 합성한뒤 cDNA를 주형을 Vβ family specific oligonucleotide를 시발체(primer)로하여 반정량적 역전사 연쇄중합반응(semiquantative RT-PCR)을 시행하여 T세포 수용체(T cell receptor; TCR) Vβ 레퍼토리를 분석하여 다음과 같은 결과를 얻었다. 결과: 1. 정상인 4명의 말초혈액에서 T세포 수용체 Vβ유전자 평균사용빈도는 Vβ7(8.68±3.20%), Vβ3(7.83±2.03%), Vβ(6.74±1.43%)의 순서로 빈도가 높았으며, HLA-DR4 양성군(3명)에서는 Vβ8(7.39±1.71%), Vβ2(7.31±2.30%), Vβ1(7.22±1.54%)의 순서로 빈도가 높았고, HLA-DR4 음성(1명)에서는 Vβ3(17.79%), Vβ4(11.41%), Vβ24(9.8%)의 순서로 사용빈도가 높았다. 2. 류마티스 관절염환자 3명의 말초 혈액에서는 Vβ16(6.90±1.81%), Vβ18(6.89±0.80%), Vβ14(6.58±0.65%)의 순서로 빈도가 높았다. HLA-DR4 양성 환자군에서는 Vβ16(7.52±2.06%), Vβ14(6.96±0.04%), Vβ22(6.78±0.18%)의 순서로 빈도가 높았다. 각각 환자의 결과를 보면 첫번째 환자(HLA-DR4 양성)는 Vβ16(8.98%), Vβ14(6.99%), Vβ22(6.91%)의 순서로 빈도가 높았고, 두번째 환자(HLA-DR13 양성)는 Vβ18(7.79%), Vβ20(5.98%), Vβ24(5.90%)의 순서로 빈도가 높았다. 이를 종합해 보면 류마티스 관절염 환자의 말초혈액에서 Vβ16, Vβ20, Vβ14, Vβ18유전자계가 제한되어 사용되었다. 3. 류마티스 관절염환자의 활액의 T세포에서 Vβ유전자 평균발현빈도는 Vβ20(7.39±1.77%), Vβ18(5.60±1.31%), Vβ12(5.56±1.77%)순으로 높았으며, HLA-DR4양성인 환자군에서는 Vβ12(6.56±0.58%), Vβ20(6.44±0.94%), Vβ4(5.30±0.49%)순으로 빈도가 높았으며, HLA-DR4음성 환자에서는 Vβ20(9.29%), Vβ19(7.57%), Vβ18(7.07%)의 순서로 빈도가 높았다. 각각 환자의 결과를 보면 첫번째 환자(HLA-DR4 양성)는 Vβ12(6.15%), Vβ20(5.77%), Vβ7(5.74%)의 순서로 빈도가 높았고, 두번째 환자(HLA-DR4 양성)는 Vβ20(7.10%), Vβ12(6.98%), Vβ24(5.83%)의 순서이었고, 세번째 환자(HLA-DR13 양성)는 Vβ20(9.29%), Vβ19(7.57%), Vβ18(7.06%)의 순서로 빈도가 높았다. 활액 T세포에서는 Vβ20, Vβ12유전자계가 제한되어 사용되었다. 4. 말초 혈액에 비해 활액 T세포에서 TCR Vβ유전자 사용빈도가 1.5배 이상인 경우는 Vβ5.2, Vβ9, Vβ23 이었으나, 이들 유전자계가 활액 T세포 전체에서 차지하는 사용빈도에 있어서는 각각 Vβ5.2는 1.07±1.26%, Vβ9는 2.17±1.42%, Vβ23는 3.84+1.97%로 낮은 수치를 나타내었다. 각각 환자에서 비교했을때에 첫번째 환자(HLA-DR4 양성)는 Vβ23(3.69%:1.12%), Vβ5.1(3.51%:1.40%), Vβ12(6.15%:3.29%), Vβ6(3.35%:2.10%), Vβ2(5.74%:3.73%)의 유전자계에서, 두번째 환자(HLA-DR4 양성)는 Vβ9(3.58%:0.74%), Vβ19(4.67%:1.52%), Vβ5.2(2.52%:0.87%), Vβ10(4.25%:1.75%), Vβ1(5.74%:2.35%)의 유전자계에세, 세번째 환자(HLA-DR13 양성)는 Vβ6(2.68%:0.15%) Vβ9(2.17%:0.73%), Vβ11(2.30%:1.10%), Vβ20(9.29%:5.98%)의 유전자계에서 활액에서 말초혈액보다 1.5배이상 증가되어 사용됨을 볼수 있었다. 즉 활액에서 말초혈액보다 의미 있게 편향되어 사용되는 Vβ 유전자계는 각각 환자마다 다른 결과를 나타내었다. 5. 류마티스 관절염환자의 말초 혈액과 정상인의 말초 혈액의 T세포의 Vβ 유전자 사용빈도를 비교했을때 류마티스 관절염 환자의 말초혈액 T세포에서 Vβ16(6.90±1.81%:3.23±1.21%), Vβ18(6.89±0.80%:2.72±0.70%) 유전자계가 2배 이상으로 빈도가 높았고, HLA-DR4양성군만 비교하였을때도 Vβ16(7.52±2.06%:3.69±1.46%), Vβ18(6.45±0.28%:2.61±0.86%) 유전자계가 2배 이상 사용이 많았다. 결론: 이상의 성적으로 미루어 보아 류마티스 관절염 각각 환자마다 다른 Vβ 유전자계의 제한적 사용과 편향됨을 볼 수 있었으나, 공통된 유전자계의 증식은 볼 수 없었다. 이러한 결과는 다른 연구보고와는 다른 결과를 보였고, 이것은 대상 환자의 질병의 유병기간이 다르고, 또 유전적인 배경, 생존 환경, 적용된 방법의 차이로 기인한다고 하는 기존의 보고와 부합된다고 사료되는데 질병의 진행단계에 따라 주로 면역반응을 일으키는 항원의 에피토프가 달라짐에 따라 여기에 대항하는 T세포들의 수용체도 이들 에피토프에 반응할 수 있는 수용체를 가진 코론들이 증식하게 된다는 epitope spreading theory에 부합되며, 이는 아주 초기에 질병을 시작하게 유도하는 항원의 특성을 규명하기 위해서는 환자선택이 연구결과에 결정적인 역할을 할 것으로 사료된다. 또 다른 가능성은 각각 환자마다 다른 Vβ유전자계의 증식된 클론들의 CDR3 연기 서열을 규명하여 비록 유전자 서열이 다를 지라도 항원과 결합하는 같은 성상을 갖는 아미노산 motif를 가질 가능성에 대해서도 연구가 필요하리라 사료된다. Objectives: Polymerase chain reaction (PCR) technology was eamine synovial fluid and peripheral T cells in patients with rheumatoid arthritis (RA) to determine the preferential usage of the T cell receptor(TCR) variable region (V) gene. Methods: Oligonucleotide primers specific for individual TCR Vβ gene families were used to amplify the TCR gene products in a semiquantitative assay of their relative utilization in unselected T cell populations. Results: The result of Vβ utilization was generally heterogenous, similar with previous reports. However, the mean expression of Vβ16 and Vβ18 in RA was more preferentially utilized compared to normal donors. The usage of Vβ in peripheral blood from 3 patients with RA demonstrated restrictions in Vβ16, Vβ20 and Vβ18 genes, respectively. Analyses of synovial fluid resulted in restriction in β12, Vβ20 and Vβ20, respectively. Although there was no significant pattern of skewed Vβ gene mean usage when comparing the synovial fluids with the peripheral blood T cells from RA patients, there were significant biased Vβ genes, Vβ12, Vβl and Vβ20, each 3 patients. As the HLA type is a determining factor in shaping TCR repertoire of peripheral T cells, we compared the Vβ utilization in HLA-DR4 expressing groups that have susceptibility and gene dosage effect in disease progression. It was a little different that comparing the pattern of Vβ usage in peripheral blood and synovial fluid from RA patients between HLA-DR4 positive and negative group. Conclusion: The results were consistent with the conclusion that the increased Vβ family T cells infiltrate synovium and are dependent on each patient and may be involved in inducing and maintaining the synovitis that characterizes RA The different outcome of each patient may be due to the difference in disease duration, genetic background and geographic region. A more important factor may be the stage of disease, because epitope induced immune reaction may change over time. Therefore, selecting patients early in the course of disease may be important and may facilitate the need for more in-depth TCR analysis in the future.

모델동물의 병태.생리 유발 유전자 기능 연구 : 당뇨모델동물의 췌장 β-세포를 이용한 비만발생에 관한 연구 Effect of development of diabetes by fatty acid in animal model

황대연,김용규,강태석,황진희,임채형,강현구,이주은,허영범,장인석,조정식,채갑용 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

체장 β세포에 지방이 축적되는 lopotoricity 현상은 인슬린 비의존성 당뇨 (Non InsuBin Dependent Diabetes Mellitus :NIDDM)의 발생과 상당히 밀접한 관계가 있으며, 췌장 β세포의 lipoapoptosis는 세포막형성에 관여하는 sphingomyelin의 전군체안 ceramide의 과생산에 의해 유도된다는 보고가 있다. 그러나, 지방산 종류에 따른 췌장 β세포에서의 세포사멸 (apoptosis)유발 기작에 대해서는 야직까지 보고된 바가 없파. 또한, 지방세포에서 생성되며, 지질대사, 음식섭취 및 체중조절에 관여하는 렙틴 (leptin)과 렙틴 수용체와의 관계 역시 체장 세포에서 명착하게 밝혀져 있지 않다. 따라서 본 연구에서는 6주령 53와 Zucker rat의 췌장으로부터 췌도를 분리하는 기술을 확립하고, 배양된 췌장 췌도 세포와 MS-1세포주에 불포차즌방산 (n-3 linolenic acid; n-6 :linoleic acid), 포화지방산 (stearic acid), conjugated linoleic acid (CLA)를 포함하는 4 가지의 지방산을 처리한 후 이들이 췌장 』세포의 사멸에 미치는 영향을 다양한 apoptosis 관련 유전자의 발현을 분석함으로써 확인하고자 하였다. 그 결과 SD rat으로부터 마리 당 평균 약 500개의 췌장 췌도를 분리하는데 성공하였으며, 4 종류의 지방산 중 포화지방산인 stearic acid를 처리하여 ONA fragmentation 증가를 관찰하였다. 또한 RT-PCR 방법을 이용하여 분리된 췌도 세포에사의 Bcl-2, Bax, iNOS가 지방산의 종류에 따라 서료 다른 발현양상을 나타낸다는 」라실을 관귿하였다. 이러한 떤구 결과는 지방산의 종류에 따라 췌장 췌도 세포에서의 세포사멸 유발 효과를 겋증하였으며, 이러한 연구결과는 복잡한 당뇨발병 원인 규명에 중요한 정보를 제공할 것으로 사료된다. Fat contents within the pancreatic islets are closely related to lipotoxicity which induces apoptosis, resulting in non insulin dependent mellituse(NIDDM). High level of fat may contribute to both insulin resistance and obesity in rodent and humans but the evidence is limited. To determine whether dietary fatty acids affect pancreatic cell function, the INS-1 cells and the pancreatic islets isolated from SD and Zucker obese(fa/fa) rats(6 wk, prediabetic stage) were cultured with stearic acid and CLA. As a result, DNA fragmentation laddering was substantially decreased in the INS-1 cells and the isolated pancreatic islets cultured with 2mM CLA compared with those with stearic aced. To investigate the mechanism by which CLA alleviates cell apoptosis as indicated by DNA fragmentation assay, we examined mRNA expressions of apoptosis-related proteins including Bax and Bcl-2 associated with cell death agonist and antagonist, respectively in the both INS-1 cells and islets cultured with 2 mM fatty acids. Bax mRNA expression was not markedly altered by either stearic acid or CLA, whereas Bcl-2 mRNA expression was noticeably enhanced by CLA compared with stearic acid. However, there were no changes in cell apoptosis and cell apoptotic-regulating gene products in the both INS-1 cells and isolated islets treated without or with 2 mM CLA. It is concluded that CLA may have a beneficial effect for maintenance of cell viability via increased Bcl-2 protein expression compared with steraic aced, which lead to delay or prevent, at least somewhat, the onset of NIDDM in the physiological status.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Recurrent thrombosis after endovascular treatment for malignant superior vena cava syndrome

( Sang Ho Lee ),( Sun Young Kim ),( Heung Tae Kim ),( Chang Woo Shim ),( Ho Seok Chi ),( Hye In Lee ),( Do Il Choi ),( Hyun Bum Kim ),( In Jun Lee ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Endovascular treatment (EVT) including angioplasty and stenting is an effective treatment for superior vena cava (SVC) syndrome. Recurrence of SVC syndrome is mainly caused by tumor progression and occurs in around 20% after EVT, but sometimes venous thrombosis within stent accounts for recurrence of SVC syndrome. Anticoagulation after EVT is still a controversial issue. In our case, a 73 year-old man with SVC syndrome caused by mediastinal lymph node metastasis from non-small cell lung cancer underwent EVT followed by anticoagulation with low molecular weight heparin (LMWH), but symptomatic progression due to in-stent thrombosis necessitated the second procedure after two weeks. A total of 4 sessions of EVT and anticoagulation with LMWH, warfarin and rivaroxaban did not induce durable resolution of in-stent thrombosis. The 4th EVT was done with stent -graft, but computed tomography after the last procedure revealed remained thrombus in SVC and newly developed pulmonary thromboembolism during warfarinization. Our case suggests refractory in-stent thrombosis could develop despite of anticoagulation after EVT for SVC syndrome.

소화성 궤양 출혈에 대한 내시경적 순수에탄올 국소주사요법의 치료 효과 및 예후

김태호,이동호,김유선,정현채,송인성,김용태,이경미,박민정,김정룡,김주성,윤용범,이진혁,이국래,최일주 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

Background/Aims: Endoscopic injection therapy improves the outcome in bleeding peptic ulcer, but the optimum regimen is unknown. Although endoscopic injection therapy is effective in controlling initial hemorrhage from a peptic ulcer, between 10% to 30% of patients suffer rebleeding. The aim of this study was to evaluate the initial and ultimate success rate of hemostasis, the rebleeding rate, hospital stay (days), and the emergency operation rate in patients who had undergone endoscopic ethanol injection for bleeding peptic ulcer. Methods: Thirty nine patients presented with active bleeding (spurting), visible vessels, or blood clots on endoscopic findings were given an endoscopic ethanol injection with a total of 1.0∼3.0 ml of ethanol. The initial and ultimate success rate of hemostasis, rebleeding rate, and emergency operation rate after the endoscopic injection was evaluated. Results: 1) The initial success of hemostasis was 38/39 (97.4%). 2) The rebleeding rate after ethanol injection was 8/39 (20.5%). ) The success rate of the second trial of ethanol injection was 3/8 (37.8%). 4) Emergency operations were conducted in5/39 (12.8%). 5) The ultimate success rate of hemostasis was 34/39 (87.2%). 6) There were no mortalities [0/39 (0%)] related to the ethanol injections and bleeding peptic ulcers. 7) There were no complications [0/39 (0%)] related to the ethanol injections. 8) The mean duration of hospitalization was 9.5 4.5 days. Conclusions: Endoscopic ethanol injection in the treatment of bleeding peptic ulcers was as effective and safe as any other injection or mechanical hemostatic method. Further prospective studies or endoscopic trials for hemostasis are needed to reduce the rebleeding rate and emergency operation rate of bleeding peptic ulcer.

탄산을 첨가한 슬러리 쉴드 터널에서의 침투 거동 및 굴진면 안정성 평가

이익범,최기훈,이인모,Lee, Ik-Bum,Choi, Ki-Hoon,Lee, In-Mo 한국터널지하공간학회 2013 한국터널지하공간학회논문집 Vol.15 No.4

최근 연약지반 터널 현장에 활용되는 슬러리 쉴드 TBM은 굴진면으로 슬러리가 주입됨으로 그 안정성을 확보하는 공법이다. 하지만 간극이 과다하여 슬러리에 의한 폐색이 발생하지 않는 조립질 지반에서는 적용이 어렵기 때문에 첨가제를 혼입하여 사용하기도 한다. 본 연구에서는 첨가제의 역할로서 탄산가스를 주입함으로 슬러리가 주입되었을 때에 간극 내에 탄산가스가 흡착하여 폐색현상을 촉진시키는 효과를 규명하였다. 실내실험 결과 탄산 혼입에 따라 슬러리 쉴드 터널이 적용 가능한 유효입경이 1.0 mm에서 2.6 mm가량으로 증가하였고, 필터계수 ${\lambda}$가 $0.007sec^{-1}$이상인 경우에 탄산에 의한 효과가 발생함을 알 수 있었다. Slurry shield tunnelling ensures stability by pressurizing the tunnel face with the slurry contained in the chamber. It resists water and earth pressure in order to prevent the failure in the tunnel face during tunnel excavation. If the ground is relatively coarse, slurry can not clog the tunnel face and excessive slurry infiltration will occur. In this case chemical compounds or additives should be added to the slurry in order to improve the clogging phenomena at the tunnel face. In this study, the effect of the carbon dioxide gas as an additive to the slurry instead of chemical compounds on the capability of enhancing the clogging in the tunnel face is investigated. Bubbles arising from the carbonate-added slurry are trapped in the soil voids enhancing the clogging capability. This effect is studied in this paper by performing laboratory model tests simulating in-situ conditions, and by adopting the fine particle clogging theory. Tunnel face stability analysis was also performed and it was found that the effective size ($D_{10}$) of soils which can guarantee tunnel stability utilizing the carbonate-added slurry increased from 1.0 mm up to 2.6 mm. Moreover, Stability analysis showed that the tunnel face is stable if the ${\lambda}$(deposition coefficient) value is greater than $0.007sec^{-1}$.