기억력 저하를 호소하는 노인들을 대상으로 INM176를 3개월간 임상시험한 후의 치료성적 및 부작용 평가 보고

김지혜,고선규,고효정,권영아,김성환,김재경,김태은,박재우,서민영,송영란,이인수,김도관 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : We examined the effects of INM 176 (K-l107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. Methods : This was a prospective, 12 week, double-blind, Placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities ofDaily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. Results : The interaction effect of time (pre- and post-trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes ofADAS-cog, IADL, KGDS scores during the 12 week clinical trail ofINM 176 and placebo demonstrated favorable responses in the INM176 administered group. Conclusions : This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory, Further clinical trial should demonstrate its efficacy.

65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

..

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

백서의 복강내에 투여한 Mitomycin-C-Polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

송규상,강대영,최정목,노승무,정경수,오정연,김진향,양준목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

To evaluate the in-vivo effects of mitomycin-C-polyglycolic acid composite(MMC-PGA) the disk: shaped composite were implanted into the peritoneal cavity of the Sprague-Dawley rats. The pathologic changes were examined at various time points up to 12 weeks. Initially the soft tissue around the inserted disks showed capillary congestion at 3 days. Inflammatory infiltrates with foreign body giant cells appeared from the 2nd week and reached peak response at 6-8 weeks. These reaction diminished prominently at 12 weeks. No specific pathologic change was found in the liver, the kidneys, and the heart. The above results suggest that the MMC-PGA composite can serve as a new device for intraperitoneal chemotherapy of various types of cancers.

Risk of Traumatic Intracranial Hemorrhage From Low-Energy Falls in the Oldest-Old Patients

Sung Kyu Kim,Ki Young Jeong,이종석,Han Sung Choi,홍훈표,고영관 대한노인병학회 2016 Annals of geriatric medicine and research Vol.20 No.4

Background: The population of individuals classified as oldest-old (aged ≥85 years) has increased rapidly in recent years. The rates of morbidity from chronic diseases and physical dependence tend to be higher in the oldest-old compared with individuals classified as young-to-middle-old (aged 65-84 years). Therefore, the classification and evaluation of traumatic injuries in the oldest-old group are necessary. Herein we focused on the risk of traumatic intracranial hemorrhage from low-energy falls in older patients. Methods: Patient medical records from the Emergency Department after low-energy falls that occurred between November 2014 and April 2016 were retrospectively analyzed. Patients were divided into an older group (aged ≥65 years) and an adult group (aged 18-64 years); the older group was subdivided into the oldest-old group (aged ≥85 years) and a young-to-middle-old group (aged 65-84 years). The rate of intracranial hemorrhage and related factors were also investigated. Results: The older group had a greater risk of traumatic intracranial hemorrhage than the adult group (20% vs. 12.6%, p=0.019). Furthermore, more cases of traumatic intracranial hemorrhage were found in the oldest-old group than in the young-to-middle-old group (37.5% vs. 18.0%, p=0.024). Similarly, the risk of traumatic intracranial hemorrhage in the oldest-old was higher than in the young-to-middle-old group (p=0.032). Conclusion: The risk of traumatic intracranial hemorrhage from low-energy falls in the oldest-old patients was higher than in the young-to-middleold patients. Therefore, physicians need to pay particular attention to oldest-old patients, even to those with mental integrity and without neurological deficits.

고령자 남녀와 20대 남녀에 있어서 다양한 등속수축중 최대 모멘트의 비교

金智源(Ji-Won Kim),金相佑(Sang-Woo Kim),文基旭(Ki-Wook Moon),嚴光文(Gwang-Moon Eom),李泳揆(Young-Gyu Lee),南貞淑(Jung-Sook Nam),朴寬龍(Kwan-Yong Park),金耀翰(Yo-Han Kim),洪廷和(Jeong-Hwa Hong),朴炳奎(Bung-Kyu Park) 대한전기학회 2008 전기학회논문지 Vol.57 No.10

In this paper, we investigated the maximum ankle joint plantarflexion moment (MPM) of young and elderly subjects during various modes of isokinetic contractions with special interest in the elderly females who were reported to have higher fall rate than the elderly males. Subjects include the young subjects (14 males: 22.7±2.5yrs, 13 females: 20.5±1.3yrs) and the elderly subjects (17 males: 65.8±10.5yrs, 26 females: 71.4±5.2yrs). The MPM was normalized by each subject's body weight. The MPM of elderly females was the weakest among the groups, particularly, at the eccentric contractions. The male-to-female ratio of MPM was greater in the elderly than in the young and the young-to-elderly ratio of MPM was greater in female than in male, both during the eccentric contractions. The result suggests that the decreased muscle force per body weight, especially at the eccentric contraction, may be one reason for the more frequent fall of the elderly female than the elderly male.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

HMG-CoA 환원효소 억제제에 의한 ICAM-1 유전자의 발현조절

김현진,정효균,홍우정,김군순,조영석,김도희,채수흥,구본정,송민호,노흥규,김영건 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1

Background : ICAM-1 act as one of major adhesion molecules in the atherosclerotic lesion. ICAM-1 expression is mainly regulated at the level of transcription and depend on IFN-γ signal transduction pathway in which the STAT1 transcrption factor is a critical intermediate. IFN-γreceptor not only initiates tyrosine 701 phosphorylation of STAT1 by Jak1 and Jak2, but also phosphorylates serine 727 through the activation of Raf-1/MAP kinases. HMG-CoA reductase inhibitors have anti-atherosclertic effects, beyond normalization of hypercholesterolemia, by directly acting on endothelial cells, macrophages and vascular smooth muscle cells. HMG-CoA reductase inhibitors suppress the synthesis of isoprenoid intermediates such as geranylgeranyl-pyrophosphate or farnesylpyrophosphate. These effects results inhibitors suppress the synthesis of isoprenoid intermediates such as geranylgeranyl-pyrophosphate or farnesylpyrophosphate. These effects results inhibition posttranslational farnesylation and geranyl-geranylation processing of small GTP-binding preoteins and inhibition of normal signaling activities. Method : We made several 5'-deletion constructs of rat ICAM-1 promoter and analyzed the promoter activities by measuring the luciferase activity after transfection into ECV304 cells and smooth muscle cells. We checked the level of total and phosphorylated STAT1 protein by immunoblot analysis using specific antibodies. Results : Lovastatin inhibits IFN-γ-induced ICAM-1 gene expression in the ECV304cell. The cells pretreated with PD98059, MEKK inhibitor showed significantly low ICAM-1 RNA induction with IFN-γ stimulatio. IFN-γ induced phosphorylation of tyrosine 701 was not significantly changed by the pretreatment of lovastatin. But lovastatin suppresses IFN-γ-induced phosphorylation of ERK1/ERK2 which are responsible for the seine 727 phosphorylation in STAT1. Conclusion : We showed that HMG-CoA reductase inhibitors, lovastatin, suppresses IFN-γ mediated ICAM-1 gene expression through the inhibition of transcription. HMG-CoA reductase inhibitor suppresses IFN-γ-induced phosphorylation of serine 727 in STAT1 through the modulation of MAP kinases.

MgCl₂溶液內에서 STS 304 HP Stainless Steel 熔接部의 破壞擧動에 對한 硏究

金永奭,丁太權,朴昌彦,洪錫柱,梁仁榮,金基玉,朴煥奎,李茂錫,曺圭宰,鄭在康 조선대학교 생산기술연구소 1983 生産技術硏究 Vol.1983 No.-

This paper is based on an experiment analysing the stress corrosion cracking behaviour of welding specimens compared to that of non-welding specimens of STS 304 HP stainless steel in corrosion solution. As a corrosion condition, stainless steel has been known to be the most fragile in a solution of 42% MgCl₂heated to the boiling point, therefore the experiment was carried out in this condition. The experiment was carried out with argon gas TIG welding specimens and non-welding ones made of stainless steel plates, thickness 2mm, by tensile force. At this time, the tensile force was taken to be the value of the yield strength of the tensile test specimens divided by the safety factor of 3.0 to 3.5, 4.0, 4.5, and 5.0. In this paper, the relations between Time of Initial Crack, Time of Failure, Time of Final Fracture and Crack Propagation Length were investigated and then plotted. Furthermore, the relations between Stress Intensity Factor K proposed by Irwin and the Time of Initial Crack, the Time of Failure, the Time of Final Fracture were calculated and plotted. At the last, all the relations plotted were expressed to normal equations by computer, and the equations were used to analyse the data obtained in the experiment. The conclusions obtained in this study are as follows: 1. Welding materials, compared with non-welding ones, as the Time of Initial Crack, the Time of Failure, and the Time of Final Fracture were generally very fast, appeared to be a phenomenon of unstable brittleness fracture. 2. Non-welding materials, compared with welding ones, as the safety factor was larger or the working stress was smaller, appeared to be a phenomenon that the longer had had greater durability. Therefor, welding materials must be considered enough to be used in heate affected and stress corrosion atmosphere. 3. The normal equations of the Time of Initial Crack and the variation rate to the same Stress Intensity Factor K are as follows: (A) Non-welding T =259702.4-5451.2 K+28.386 K² T = -5451.2+28.386 K (B) Welding T= -332.693+28.043 K-0.211 K² T' =28.043-0.211 K here, T; Time of Initial Crack, T'; Variation Rate of Time of Initial Crack to Stress Intensity Factor K, K ; Stress Intensity Factor.

양성 갑상선 결절에서의 무수 알코올 치료 효과

김도희,나소영,이효진,홍우정,김군순,조영석,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

목적 : 양성 갑상선 결절 환자에서의 PEI의 치료효과 및 부작용을 알아보고자 하였다. 방법 : 양성 갑상선 결절 환자 88명을 대상으로 초음파 소견에 따라 낭종성 결절, 복합성 결절, 고형성 결절 등 세 그룹으로 분류후 전체 및 각각에 대한 PEI의 치료효과 및 부작용을 조사하였다. 결과 : 양성 갑상선 결절 환자 88명을 PEI로 치료후 결절의 크기가 50%이상 감소한 경우는 전체 환자중 77.2%이었고 각 결절별로 살펴보면 고형성 결절에서 52.6%, 복합성 결절에서 72.4%, 낭종성 결절은 92.5%이었다. 부작용은 동통, 결절내 출혈, 감염, 결절의 누출등이 있었으나 대부분 무증상이었다. 결론 : PEI는 양성 갑상선 결절 환자증 적응증을 잘 살펴 고려해 볼 수 있는 치료법이라 생각되며 특히 낭종성 결절 환자에서 주사기에 의한 흡인후에 재발한 경우 일차적인 치료로 PEI를 고려해 볼 수 있겠다. Ultrasonography(US)-guided percutaneous ethanol injection (PEI) has been performed for the treatment of autonomous functioning thyroid nodules, thyroid cysts, & cold thyroid nodules. The author studied the efficacy of PEI in the treatment of benign cold thyroid nodules both solid and cystic (complex & pure). Eighty-eight euthyroid outpatients (age:44.2±13.9years, 75 women and 13 men) with benign cold thyroid nodules or simple thyroid cysts (69 with a single nodule and 19 with a prominent nodule within multinodular goiter) were includied in this study. After PEI, each subtype of thyroid nodules was divided into three groups in according to volume reduction complete response (90% or more of volume reduction), partial response (50% or more of reducton but below 90%), and failure (below 50% or increase in size) group. Overall response rates of PEI for benign thyroid nodules were complete 45(51.1%), partial 23(26.1%), failure 20(22.7%). In 20 cold solid nodules, complete response was observed in 6(30.0%), partial response in 5(25.0%), and failure in 9(45.0%). In 28 complex cysts, complete response was observed in 8(28.6%), partial response in 12 (42.9%), and failure in 8(28.6%). In 40 pure cysts, complete response was observed in 31(77.5%), partial response in 6 (15.0%), and failure in 3 (7.5%). Side effects comprised pain 8 (9.2%), intranodular bleeding 13 (14.6%), extracapsular leakage 1(1.1%), infection 1 (1.1%), increased size l(1.1%), and none 64(72.7%). PEI may prove a safe & effective tool for the therapy of cold thyroid nodules in selected cases and may be the treatment of choice of recurrent thyroid cysts. However, further investigation involving a larger number of patients and a longer follow-up is needed.