40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

미치광이풀 모상근 배양에서 Tropane Alkaloid 생산성 증진을 위한 최적 생물학적 엘리시터 선발

정희영,강승미,강영민,김용덕,양재경,정영관,최명석 Plant molecular biology and biotechnology research 2003 Plant molecular biology and biotechnology research Vol.2003 No.-

Scopolamine and hyoscyamine which belong to tropane alkaloids are the pharmaceutically valuable anticholinergic drugs. In order to increase the productivities, the effects of elicitation were investigated during hairy root cultures of Scopolia parviflora. Biotic elicitors originated from 3 fungi and 1 yeast were prepared as homogenate and supernatant and added to 3-week-old cultures. Both of homogenate and supernatant of Candida albicans elicitors increased the scopolamine production. The production of hyoscyamine was enhanced by homogenate of Fusarium solani and supematant of C. albicans. Most of the other fungal elicitors were also improved on the tropane alkaloid production compared to non-treatment. Among the elicitors tested, C. albicans was proved the optimal biotic elicitor on tropane alkaloids production. These results will be served mass production of tropane alkaloids by large-scale production.

간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

위암에서의 중합효소 연쇄반응에 의한 Epstein - Barr 바이러스의 검출과 LMP1 , p53 , CD44 의 발현

이명아(Myung Ah Lee),홍영선(Young Seon Hong),강진형(Jin Hyung Kang),이경식(Kyung Shik Lee),유진영(Jin Young Yoo),이교영(Kyo Young Lee) 대한내과학회 2002 대한내과학회지 Vol.63 No.3

N/A Background : Epstein-Barr virus (EBV) is associated with various lymphoproliferative disorders and nasopharyngeal carcinoma. Recently some of the tumor cells of gastric cancer were observed to contain EBV sequence. We detected EBV using PCR to determine the frequency of EBV associated gastric cancer, which is the most common cancer in Korea. We also performed immunohistochemical staining for the latent membrane protein (LMP1), p53 and CD44 to investigate the possible mechanism in EBV-associated gastric cancer. Methods : Eighty-seven formalin-fixed and paraffin-embedded blocks (40 gastric adenocarcinomas, 34 adjacent normal tissues, 13 metastatic lymph nodes) from 40 surgically resected gastric specimens were studied. All patients were diagnosed as having gastric cancer at the Kang-Nam St. Mary's Hospital during the period of April 1995 to April 1997. DNA was extracted from each paraffin block and then we performed PCR and immunohistochemical staining for the LMP1, p53 and CD44. We reviewed the patients' charts for clinical information. Results : EBV was detected in 4 cases (10%) by EBV-PCR among the 40 patients. It was also detected in a metastatic lymph node in 1 patient. The immunohistochemical staining for the LMP1, p53 and CD44 was negative in all the EBV-positive cancer patients. Of the patients having these cancers, 2 had a poorly differentiated adenocarcinoma with a lymphoepithelioma-like morphology. Conclusion : The frequency of EBV-associated gastric cancer may be about 10% in Korea. Considering the negative result of the immunohistochemical staining for the LMP1, p53 and CD44, EBV-associated gastric cancer seems to have a different mechanism of tumorigenesis from ordinary gastric cancer or other EBV-associated cancers. This must be determined by further large scale studies. (Korean J Med 63:261-266, 2002)

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

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.

연령대별 요추 추간판탈출증 환자의 요근과 척추주위근 단면적에 대한 분석

공덕현 ( Deok Hyun Kong ),배광호 ( Kwang Ho Bae ),고호연 ( Ho Yeon Go ),강명진 ( Myung Jin Kang ),김준수 ( Jun Su Kim ),양기영 ( Kee Young Yang ),이재훈 ( Jae Hoon Lee ),은영준 ( Young Jun Eun ) 한방재활의학과학회 2010 한방재활의학과학회지 Vol.20 No.4

Objectives :This study was designed to evaluate the correlation of the cross-sectional areas(CSA) of paraspinalis(iliocostalis lumborum, multifidus, longissimus thoracis parts lumborum) and psoas muscle and sex, age, change of the VAS(visual analogue scale) and past history of chronic low back pain in patients suffering from HIVD(herniation of intervertebral disc). Methods :Medical records of 140 subjects with HIVD were retrospectively reviewed. The MRI(magnetic resonance imaging) findings on the patients were scanned and analyzed by PiView program to find the paraspinal and psoas muscle CSA and were evaluated by the correlation of sex, age, change of the VAS, and past history of chronic low back pain. Results :There was significant difference between groups in male and female, young-adults age and middle age, middle age and old age, young-adults age and old age. But the correlation of the paraspinal and psoas muscle CSA and past history of chronic low back pain were partially significant. On the other hand, the correlation of the paraspinal and psoas muscle CSA and change of the VAS were not significant. Conclusions :These results suggest that the cross-sectional areas(CSA) of paraspinalis and psoas muscle have relevance to sex and age.

당뇨병 백서의 간세포에서 Glucokinase 활성도 및 유전자 발현에 대한 인슐린의 영향

강성이,팽정령,서광식,안규정,우정택,김성운,양인명,김진우,김영설,김광원,최영길 경희대학교 유전공학연구소 1993 遺傳工學論文集 Vol.5 No.-

목적 당대사의 조절 상태에 따른 생체 변화를 분자 수준에서 이해하고자 식이 조건을 달리한 정상 백서와 화학적으로 유도된 당뇨병 백서의 간조직에서 혈당수준과 인슐린치료 정도에 따라 나타나는 글루코키나제 활성도 및 유전자 발현을 분석하였다. 방법 스트렙토조토신 정맥투여 후 당뇨병의 유발을 확인하고, 인슐린을 1일 3회 3일간 복강내로 투여하여 상태를 안정시킨 후, 인슐린 투여군은 인슐린 투여 6시간이내에 그리고 인슐린 비투여군은 24시간 후 단두하여 채혈하고 복강을 열어 간조직을 채취하였다. 채취한 간조직에서 글루코키나제 활성도는 인산화된 포도당에서 NADH의 형성을 형광분광계로 측정하였으며, 글루코키나제 유전자 mRNA발현은 Northern 분석법을 이용하였다. 성적 정상 백서에서 공복상태와 식이를 섭취한 경우에 간조직의 글루코키나제 효소의 활성은 차이가 없었으나, 글루코키나제 유전자 mRNA 발현은 증가되었다. 당뇨병이 유발된 백서의 간조직에서 글루코키나제 효소의 활성 및 글루코키나제 유전자의 mRNA 발현은 정상 백서에 비하여 낮았다. 인슐린 투쳐 후 글루코키나제 효소의 활성 및 글루코키나제 유전자의 mRNA 발현이 증가되었고, 특히 혈당이 정상화된 경우에서 글루코키나제 유전자의 mRNA 발현이 증가도었다. 결론 인슐린에 의한 간조직에서 글루코키나제 효소의 활성 및 글루코키나제 유전자의 mRNA을 증가를 볼수 있었다. 당뇨병 백서에서 인슐린 투여 후에 혈당조절이 안된 경우 간조직의 글루코키나제 유전자의 mRNA 발현이 증가가 없는 것으로 보아 글루코키나제 mRNA의 발현에는 인슐린 이외의 다른 요소가 관여할 것으로 생각된다. The liver-specific hexokinase isoenzyme, referred to as glucokinase, is thought to play a key reglulatory role in hepatic glucose metabolism. The glucokinase gene is, therefore, of interest both because of its tissue-specific expression and because of the several regulatory processes that can be analyzed. The level of hepatic glucokinase activity appears to be determined essentially by regulation of the rate of enzyme synthesis, with insulin playing a leading role as an inducer. We investigated the role of insulin for the induction of glucokinase in the liver of diabetic rats. Experimental diabetes was induced by injection of streptozotocin 7 days before the experiment. Regular insulin was given by three days intraperitoneal injection at 8-h interval. The glucokinase mRNA in the liver was estimated by Nothern blot assay, as well as by fluorometric enzyme activity assay. Glucokinase activity was not reduced in the liver of normal fasting rats as compared to normal fed rats. And glucokinase activity was reduced in the liver of diabetic rats as compared to normal rats. In diabetic rats treated with insulin, glucokinase enzyme activity were increased. But glucokinase mRNA expression was only increased in normoglycemic diabetic rat with treated with insulin as compared to hyperglycemic rat. These data indicate that insulin stimulates hepatic glucokinase enzyme activity and mRNA expression. But other hormonal or metabolic factors may be contribute to regulation of glucokinase mRNA expression.

파손된 치면열구전색제의 수리 방법에 따른 미세누출 비교

강명봉,현홍근,김영재,김정욱,장기택,이상훈,한세현,김종철 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

치면열구전색은 수 십년간 교합면 우식의 예방에 가장 효과적인 방법 중 한가지로 알려져 왔다. 하지만 치면열구전색제의 마모와 파절 때문에 치면열구전색제의 재시술 또는 수리를 필요로 하게 되었다. 본 연구의 목적은 파손된 치면열구전색제를 수리할 때 치질과 잔여 전색제의 표면처리 방법에 따른 미세누출 차이를 알아보고자 하는 것이다. 120개의 영구 대구치에 치면열구전색제를 적용하고 인위적인 파손을 만든 뒤 인공타액에 4주 동안 보관하였다. 4주 후 근심 또는 원심의 치면열구전색제가 완전히 파손 양상을 나타내는 치아 60개를 선택하여 각각 15개씩 4개 군으로 나누어 실험에 사용하였다. 각 군을 산부식만 시행한 경우(1군), air-abrasion만 시행한 경우(2군), 산부식 후 결합제를 적용한 경우(3군), air-abrasion 후 결합제를 적용한 경우(4군)로 나눠 각각의 치아를 표면처리한 후 치면열구전색제를 도포하였다. 고온(55℃)과 저온(5℃)에서 각각 30초씩 500회의 열순환을 시행한 뒤 미세누출도를 검사하여 다음과 같은 결과를 얻었다. 1. 치면열구전색제/치면열구전색제 경계면에서 미세누출도는 결합제 사용 유무에 관계없이 air-abrasion을 처리한 2군, 4군에서 산부식을 사용한 1군, 3군보다 낮은 값을 보였고(p<0.05) 1군과 2군, 3군과 4군 사이에는 통계적 유의차가 없었다(p>0.05). 2. 치면열구전색제/치아 경계면에서 미세누출도는 결합제를 사용한 3군, 4군에서 결합제를 사용하지 않은 1군, 2군보다 낮은 값을 보였고(p<0.05) 산부식을 사용한 1, 3군과 air-abrasion을 사용한 2, 4군 사이에는 통계적 유의차가 없었다(p>0.05). 3. SEM 상에서 치면열구전색제를 산부식 처리하였을 때 표면거칠기의 증가가 적었으나 air-abrasion 하였을 경우 표면거칠기가 현저하게 증가하는 것을 관찰하였다. The aim of this study was to investigate whether differences in surface treatment Prior to repair influenced the seal of a resin fissure sealant placed on the occlusal surfaces of permanent molar teeth. One hundred and twenty extracted human molars were selected and a light curing sealant was placed on their occlusal surface following cleaning by prophylaxis and acid etching. The teeth were deliberately damaged, and then stored in artificial saliva for four weeks. Sixty teeth with the desired morphology of sealant failure were randomly divided into four groups where one group was treated with only etching agent, another by only air-abrasion, another by applying an etching agent followed by a bonding agent, and the last by air-abrasion followed by a bonding agent each. After sealant application, the samples were thermocycled and the degree of microleakage was determined. The results were as follows: 1. In the sealant/sealant interface, group 2(0.22), 4(0.23) using air-abrasion showed a significantly lower microleakage score than group 1(0.38), 3(0.35) using an etching agent(p<0.05). There were no statistically significant differences(p>0.05) between groups 1, 2 and groups 3, 4. 2. In the sealant/tooth interface, group 3(0.20), 4(0.20) which used a bonding agent showed a significantly lower microleakage score than group 1(0.35), 2(0.40)(p<0.05). There were no statistically significant differences (p>0.05) between groups 1, 3 and groups 2, 4. 3. In SEM examination, while sealant surfaces treated with etching did not result in highly rough surfaces, those treated with air-abrasion did show rough surfaces.

KAL기 추락에 의한 대량재해의 개인식별

강신몽,이원태,고영창,최상규,김윤희,이홍석,서재관,윤중진,이혜경,최득린,김종열,윤창육,변명식,이장홍 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

Individual identification is an important part in medicolegal field especially in mass disaster. At July, 27, 1989, KAL KE-803 was crashed on landing at Tripoli International Airport, Liba. The plane was caught in fire and sixty eight Koreans were sacrified. The majority of victims were severely charred and injured. The authors examed all dead bodies and successfully identified all the cases through visual, anthropological, odontological, radiological and pathological methods including fingerprint and blood typing.