정신분열병 환자의 우울증에서 Paroxetine과 삼환계 항우울제 병용치료

심주철,공보금,박정환,윤영란,신재국,김정익,안동성,김용관,차인준,김영훈 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 마산동서병원에 입원중인 우울증이 동반된 정신분열증 환자 10명을 대상으로 사용중인 항정신병약물에 paroxetine과 저용량의 삼환계 항우울제를 6주간 병용투여한 후 우울증상에 대한 효과와 치료의 안전성 및 약물상호작용을 알아보았다. Paroxetine은 고정량의 항정신병약물과 삼환계 항우울제에 부가하여 일일 20㎎을 6주간 병용하게 하였으며, 임상상태는 HDRS, HARS, UKU Side Effect Rating Scale등의 평가척도를 사용하여 평가하였다. 또한 약동학적 약물상호작용은 삼환계 항우울제들의 혈장농도를 HPLC로 측정하여 분석하였다. 결과는 다음과 같다. 1) 10명의 전체 대상환자에서의 HDRS 평균점수는 TCA와 paroxetine 병용투여 6주후에 통계적으로 유의하게 감소되었다. 이중 40%의 환자에서는 병용투여 6주후에 HDRS 점수상 50% 이상의 감소를 보여, 일부의 환자들에서는 정신분열병에 동반된 우울증상의 치료에 소량의 삼환계 항우울제와 paroxetine의 병용치료가 효과가 있음을 확인하였다. 2) 두 명의 환자에게서 심각한 약물독성이 발생하였다. 이중 한 명은 삼환계 항우울제의 높은 혈중농도로 인한 항콜린성 위기(anticholinergic crisis) 소견을 보였으며, 다른 한 명은 인지기능 및 의식수준은 명료하였으나 망상과 환각증상이 약화되는 소견을 보였다. 따라서 본 연구에서 시도된 복합적 약물치료의 경우, 삼환계 항우울제의 혈중농도의 측정을 포함한 세심한 임상적 추적이 필요하다고 생각된다. 3) 기저치의 amitriptyline과 그 대사물인 nortriptyline의 농도합. imipramine과 대사물인 desipramine의 농도합은 각각 47.8-226.5ng/㎖. 80.5-395.6ng/㎖였으며 일반적으로 이들 약물들의 단독사용시에 문헌에 보고된 혈중농도를 훨씬 상회하고 있었다. 이는 병용투여된 항정신병 약물 약시 강력한 CYP2D6 효소억제제로서 기저치의 삼환계 항우울제들의 혈장농도를 이미 상당히 증가시켰던 것으로 판단되며, 그러한 결과로 인해 본 연구에서는 paroxetine이 이전의 문헌보고들과는 달리 뚜렷하게 삼환계 항우울제들의 혈장농도를 증가시키지 못하였다. 본 연구는 SSRI와 삼환계 항우울제의 병합 투여가 우울증의 개선 효과를 빠르게 하고, 치료역을 넓히고, 약물상호작용의 결과 paroxetine이 삼환계 항우울제의 혈중농도를 증가시킨다는 기존의 연구결과를 이용하여 정신분열병 우울증상의 치료에 parotextine과 소량의 삼환계 항우울제를 병용하는 방법을 시도해 본 연구이다. 저자들은 이러한 약물치료가 일부의 환자들에게서 효과가 있음을 관찰하였으나, 항정신병약물과 삼환계 항우울제를 병용투여 할 경우는 물론 이에 paroxetine과 같은 선택적 세로토닌 재흡수 억제제를 병용할 경우 복합약물상호작용의 결과로 약물독성의 위험성이 크며 세심한 주의가 필요함을 경험하였다. Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly. Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained : 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was found in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYP2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant in our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.

이동형 생체계측을 위한 임베디드 컴퓨팅

홍주현,진계환,박경순,조명찬,박길선,차은종,이태수 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

연구목적: 초소형 정밀 기계 기술로 제작된 2차원 가속도 센서와 916 MH2 단거리 고주파 데이터 통신 기술을 응용하여 인체의 운동상태를 자동으로 감지하고 분류하는 기법을 제안 하고자 하였다. 재료 및 방법: 인체의 신호를 획득하기 위하여 미국 버클리대에서 제작한 무선 센서를 등 산용 조끼의 전면상단에 부착해서, 대상자의 흉골 부위에 위치하도록 하고, 앉은 상태에서 일어서거나 눕거나 하는 동작 및 그 역동작이 일어날 때, 가속도 센서에서 감지되는 4가지 종류의 파형 현화에 해당되는 데이터를 무선센서 네트웍을 통해 획득하였다. 결과: 획득한 신호를 주성분분석(Principal Component Analysis)과 지원벡터머신(Support Vector Machine)을 사용하여, 2차주성분까지를 도표화하고 클러스터링 함으로써, 4개의 영역으로 분할하는 것이 가능함을 말 수 있었다 결론: 소형 센서들이 작동되는 임베디드 컴퓨팅 환경에서 일상생활 중에 발생하는 인체의 4가지 동작을 자동으로 감지하고 분류하는 것이 가능함을 보였다. Purpose: New monitoring and classifying method of human motion contort was pro- posed by using 2-axial MEMS accelerometer and 916 MHz short-range data communica-tion technology. Materials and Methods: The wireless sensor of MICA mote was attached to a woman mountain vest and located close to the subject's sternum. During four types of sub-ject's motion, that is, sit-to-stand, stand-to-sit, sit-to-tying, and tying-to-sit, waveform changes of the accelerometer data were acquired by wireless sensor network. Results: The acquired signal was analyzed by Principal Component Analysis(PCA) and Support Vector Machine(SVM) technique. By clustering the first and second principal components, four regions corresponding to the four types of motion, were clearly segment-ed. Conclusion: Human motion context during daily life could be monitored and classified automatically by using small sensors in embedded computing environment

아조벤젠 분자(Disperse Red 1)를 포함한 측쇄형 고분자에서 광유도 복굴절의 실시간적 조사

신희득,주원제,오차환,송석호,김필수,한양규 한양대학교 자연과학연구소 2001 自然科學論文集 Vol.20 No.-

아조벤젠 그룹을 포함한 측쇄형 고분자 필름(PDR1)에서 광 유도된 이방성을 실시간적으로 조사하였다. 수평, 수직한 흡수율의 변화를 광 유도된 복굴절의 기록, 감쇠, 소거, 완화 과정에 따라 측정하여, 매질 내의 아조벤젠 분자의 정렬상태와 복굴절과의 관계를 광 이성화과정으로 설명하였다. 또한 기록빔의 세기를 따른 수직, 수평한 흡수율의 변화와 유도된 복굴절의 관계를 조사하였다. The photo-induced anisotropy for a polymeric film(PDR1) containing azobenzene group as side-chain was investigated dynamically. The change of absrobances with parallel and perpendicular components was measured in recording, decaying, erasing and relaxation processes of photo-induced birefringence, so the relation between the alignment of azobenzene groups and the birefringence was well explained according to the photo-isomerization. Also, the dependence of the photo-induced birefringence on intensity of recording beam was investigated with changes of both absorbance and birefringence.

ARB 가공된 순동에서 소량의 잔류원소가 인장 거동에 미치는 영향

장영환,김상식,한승전,임차용,김창주 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.10

With the rapid advancement in electronic industries, there is a great interest on the nano grain sized, high-purity copper, which possesses both high-strength and high-conductivity, produced by severe plastic deformation (SPD). The nano grain sized materials, in general, show the unconventional mechanical behavior as a result of extremely high density of grain boundary area causing a rapid dynamic recovery during deformation. The commercially available, high-purity copper usually contains a small amount of trace phosphorous, and the presence of such element is believed to affect the rate of dynamic recovery, and eventually tensile behavior of pure copper. In the present study, the effect of trace phosphorous on the tensile behavior of accumulative roll bond (ARB)ed high-purity copper was examined. Both 99.99% pure oxygen-free copper (OFC) and 99.9% pure deoxidized high phosphorous copper (DHP) were used for the present study. It was found that the tensile strength of OFC ceased to increase after 2 ARB process cycles, while that of DHP increased continuously with ARB process up to 8 cycles, suggesting that the presence of trace phosphorous affected the rate of dynamic recovery significantly. Finally, it was discussed how the trace phosphorous affected the tensile behavior of ARBed, high-purity copper, based on the SEM, TEM and DSC(differential scanning calorimeter) observations. (Received February 17, 2004)

산업장 소음에 노출된 근로자들의 활동 중 혈압과 심박동수

김영기,차태준,변주현,고광욱,이용환 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 산업장 근무 근로자들에 있어서 소음 노출이 혈압과 심박동수에 미치는 영향을 조사하고자 하였다. 방법 : 부산시 소재 한 주물공장 근무 근로자로서 소음 작업장에 근무하는 102명에 대하여 1998년 3-6월, 1999년 3-6월에 걸쳐 안정시 혈압과 청력손실정도, 일반적 특성이 조사되었다. 소음노출 정도는 noise dosimeter를 사용하여 오전 8시-오후 4시까지 8시간동안 측정하여 평가하였고, 활동 중 혈압과 심박동수는 ambulatory blood pressure로 오전 8 시-오후 10시까지 30분 단위로 측정하였다. 결과 : 연령과 흡연, 신체비만지수의 영향을 고려하였을 때 저연령층에서 85dBA이상의 고소음에 노출된 군에서 소음과 수축기 혈압간에는 유의한 양의 상관관계가 있었으나, 이완기 혈압과 심박등수에서는 유의한 결과를 얻지 못하였다. 연령의 구분없이 상관관계를 구하였을 때에는 수축기 혈압에서만 소음수준과 유의한 상관성이 있었다. 오전 8시-오후 10시까지 측정한 활동 중 혈압과 심박동수의 일일 변화는 40세미만의 저연령층에서는 심박동수에서만 근무후의 오후시간부터 감소하는 양상이 있었고 수축기 혈압과 이완기 혈압에서는 뚜렷한 변화를 발견할 수 없었다. 40세이상군에서는 수축기혈압과 이완기 혈압, 심박동수 모두 근무 중에는 비교적 높은 값을 유지하다가 오후부터는 감소하는 추세를 보이고 있었다. 각 연령군별 소음노출수준에 따른 활동 중 혈압과 심박동수의 비교에서는 40세미만의 연령층에서만 85dBA이상의 고소음군에서 심박동수가 유의하게 더 높은 결과를 얻었다. 결론 : 저연령층인 40세피만에서 85dBA이상의 고소음에 지속적으로 노출될 경우 수축기 혈압이 증가되어 있을 수 있음을 확인하였다. Objectives : This study was carriel out to evaluate the effects of Industrial noise on blood pressure and heart rate. Methods Resting blood pressure, hearing loss, and general characteristics of the 102 subjects who were engaged In a factory in Pusan were measured from March to June for two years, in 1998 and 1999. With noise dosimeter, noise exposure level was measured from 8 A.M. to 4 P.M. Ambulatory blood pressure and heart rate were also measured every 30 minutes from 8 A. M. to 10 p. M. Results : Controlling for age, smoking, and Quetelet's index, in subjects of under 40 years old exposed to higher than 85dBA, noise exposure and systolic blood pressure had astatistically significant correlation, and the same result was obtained in all subjects. The daily variability of ambulatory blood pressure and heart rate were observed in older than 40 years old group, but only heal·t rate in under 40 years old. Conclusions : The blood pressure and heart 1·ate would be elevated when the workers exposed to noise. And in under 40 years old, the systolic blood pressure was elevated to the workers exposed to higher than 85dBA.

Preparation of Chromane Derivatives via Indium-mediated Intramolecular Allylation Reactions

Cha, Joo-Hwan,Cho, Yong-Seo,Koh, Hun-Yeong,Lee, Eun,Kim, Yong-Tae,Yang, Hae-Hun,Kang, Han-Young Korean Chemical Society 2004 Bulletin of the Korean Chemical Society Vol.25 No.8

Erythrocyte sedimentation rate measurements by TEST 1 better reflect inflammation than do those by the Westergren method in patients with malignancy, autoimmune disease, or infection.

Cha, Choong-Hwan,Park, Chan-Jeoung,Cha, Young Joo,Kim, Hyun Kyung,Kim, Duck Hee,Bae, Jae Hoon,Jung, Jae-Seol,Jang, Seongsoo,Chi, Hyun-Sook,Lee, Dong Soon,Cho, Han-Ik Williams Wilkins Co 2009 American journal of clinical pathology Vol.131 No.2

<P>We compared the TEST 1 (Alifax, Padova, Italy) and Westergren methods of measuring the erythrocyte sedimentation rate (ESR) to assess inflammation. The ESR was measured by both methods in 154 blood samples from patients with malignancy (n = 69), autoimmune disease (n = 44), or infection (n = 41). Total protein, albumin, and C-reactive protein (CRP) levels were measured in each plasma sample, and albumin and alpha(1)-, alpha(2)-, beta(1)-, beta(2)-, and gamma-globulin fractions were measured by capillary electrophoresis. TEST 1 ESR values were significantly lower than the Westergren values, by 10.9 mm/h. We found that the correlations of TEST 1 ESR values with inflammatory protein levels (total protein, globulin, CRP, and alpha(1)-, alpha(2)-, beta(2)-, and gamma-globulin) were better than those obtained using the Westergren method. These findings indicate that ESR measurements by TEST 1 reflect inflammation better than do those by the Westergren method in patients with malignancy, autoimmune disease, or infection.</P>

Preparation of Chromane Derivatives via Indium-mediated Intramolecular Allylation Reactions

Joo Hwan Cha,조용서,Hun Yeong Koh,이은,Yong-Tae Kim,Hae-Hun Yang,강한영 대한화학회 2004 Bulletin of the Korean Chemical Society Vol.25 No.8

Evaluation of the TEST 1 erythrocyte sedimentation rate system and intra- and inter-laboratory quality control using new latex control materials.

Cha, Choong-Hwan,Cha, Young Joo,Park, Chan-Jeoung,Kim, Hyun Kyung,Cha, Eun-Jong,Kim, Duck Hee,Honghoon,Jung, Jae-Seol,Kim, Mi-Jung,Jang, Seongsoo,Chi, Hyun-Sook,Lee, Dong Soon Walter de Gruyter 2010 Clinical chemistry and laboratory medicine Vol.48 No.7

<P>The erythrocyte sedimentation rate (ESR) test has been considered to be a simple procedure, not requiring quality control (QC). However, QC is essential for accuracy and precision. We evaluated the TEST 1 ESR system and performed QC procedures using newly developed latex control materials in three hospitals.</P>

APX-115, a first-in-class pan-NADPH oxidase (Nox) inhibitor, protects db/db mice from renal injury

Cha, Jin Joo,Min, Hye Sook,Kim, Ki Tae,Kim, Jung Eun,Ghee, Jung Yeon,Kim, Hyun Wook,Lee, Ji Eun,Han, Jee Young,Lee, Gayoung,Ha, Hun Joo,Bae, Yun Soo,Lee, Sae Rom,Moon, Sung Hwan,Lee, Sung Chan,Kim, Ga Nature Publishing Group 2017 Laboratory investigation Vol.97 No.4

<P>Recent studies have suggested that renal Nox is important in the progression of diabetic nephropathy. Therefore, we investigated the effect of a novel pan-NOX-inhibitor, APX-115, on diabetic nephropathy in type 2 diabetic mice. Eight-week-old db/m and db/db mice were treated with APX-115 for 12 weeks. APX-115 was administered by oral gavage at a dose of 60 mg/kg per day. To compare the effects of APX-115 with a dual Nox1/Nox4 inhibitor, db/db mice were treated with GKT137831 according to the same protocol. APX-115 significantly improved insulin resistance in diabetic mice, similar to GKT137831. Oxidative stress as measured by plasma 8-isoprostane level was decreased in the APX-115 group compared with diabetic controls. All lipid profiles, both in plasma and tissues improved with Nox inhibition:APX-115 treatment decreased Nox1, Nox2, and Nox4 protein expression in the kidney. APX-115 decreased urinary albumin excretion and preserved creatinine level. In diabetic kidneys, APX-115 significantly improved mesangial expansion, but GKT137831 did not. In addition, F4/80 infiltration in the adipose tissue and kidney decreased with APX-115 treatment. We also found that TGF-beta stimulated ROS generation in primary mouse mesangial cells (pMMCs) from wild-type, Nox1 KO, and Duox1 KO mice, but did not induce Nox activity in pMMCs from Nox2 knockout (KO), Nox4 KO, or Duox2 KO mice. These results indicate that activating Nox2, Nox4, or Duox2 in pMMCs is essential for TGF-beta-mediated ROS generation. Our findings suggest that APX-115 may be as effective or may provide better protection than the dual Nox1/Nox4 inhibitor, and pan-Nox inhibition with APX-115 might be a promising therapy for diabetic nephropathy.</P>