Chlamydomonas reinhardtii 에서 정제된 glutathione S - transferase 의 활성에 미치는 xenobiotics 의 영향

강시현,손장일,채영규,최영길 한국미생물생명공학회 1992 한국미생물생명공학회 학술발표초록집 Vol.1992 No.-

Eosinophilia, Pleural Effusion, Hepatitis, and Jaundice Occurring Early in Clozapine Treatment

강시현,이종일 대한정신약물학회 2013 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.11 No.2

Clozapine use is associated with various adverse events, some of which have received little attention, including eosinophilia,pleural effusion, and hepatitis. Because of the fatality of jaundice with hepatitis, it is necessary to understand the course and management of clozapine-induced eosinophilia and hepatitis. We report on a case in which the eosinophil count began to increase shortly after clozapine use, and pleural effusion and fever then developed at the time eosinophilia was at its peak level. Jaundice with hepatitis consecutively developed when all the above symptoms subsided. The liver function recovered rapidly after clozapine was discontinued. We recommend that patients who develop rapid eosinophilia at the beginning of clozapine treatment should be monitored with LFTs, chest X-rays, and urine analysis tests.

올란자핀-발프로에이트 병용 치료 시 발생한 가역적 호중구 감소증 2예

강시현,오중근,이종일,장안기 대한신경정신의학회 2010 신경정신의학 Vol.49 No.6

The novel antipsychotic, olanzapine, has structural and pharmacological properties similar to clozaine. Antipsychotic drugs, as well as mood stabilizers, can cause neutropenia, which can progress to life-threatening agranulocytosis if the medication is not discontinued. We report two cases of reversible neutropenia associated with a olanzapine-valproate combination treatment. This report suggests that patients treated with the combination of olanzapine and valproate should be monitored for the occurrence of leukopenia and neutropenia.

Usefulness of Videofluoroscopic Swallow Study with Mixed Consistency Food for Patients with Stroke or Other Brain Injuries

강시현,김돈규,서경묵,서종현 대한의학회 2011 Journal of Korean medical science Vol.26 No.3

This study evaluated the feasibility of mixed consistency foods test in patients with dysphagia which developed after stroke or other brain injuries. The findings of a videofluoroscopic swallow study (VFSS) were compared using single versus mixed consistency foods. Forty-nine patients with stroke or other brain injuries who had no significant abnormal findings in the single consistency food VFSS and started regular hospital diet were recruited for this study. Twenty-five (51%) of the 49 patients showed normal findings whereas 24 (49%) patients showed abnormal findings in the mixed consistency food VFSS. Abnormal findings included posterior spillage of liquid prematurely to pyriform sinus (n = 23), laryngeal penetration (n = 6), subglottic aspiration in the oral preparatory phase of swallowing (chewing), solid components (n = 2), and significant (more than 10%) residue in valleculae or pyriform sinus (n = 2). There was an increased risk of abnormal findings in mixed consistency food VFSS such as aspiration and penetration when a patient showed delayed pharyngeal delay time in single consistency food using liquids. In conclusion, VFSS protocols using mixed consistency foods would be useful before starting regular diet for patients after stroke or other brain injuries.

미추 경막외 주사침의 위치 확인 및 주사용액의 용량에 따른 확산

강시현,서경묵,김돈규,신주연 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.5

Objective: To know the accuracy of caudal epidural steroid injection procedure without fluoroscopy guidance, and determine ascending level of injected solution according to injection volume. Method: The subjects were 35 patients with low back pain. Needle insertion was performed without fluoroscopy, then we confirm the position of needle with fluoroscopy. The level of injected solution was measured with fluoroscopy and x-ray after injecting every 5 ml of solution, which is mixture of triamcinolone, 2% lidocaine, contrast medium, and normal saline. The effect of treatment was measured by Visual Analogue Scale (VAS).Results: Successful needle placement occurred in 27 cases without fluoroscopy. After injecting 20 ml of solution, the ascending level of solution were S1 in 8 cases, L5 in 12 cases, L4 in 8 cases, L3 in 1 case, L2 in 4 cases, L1 in 2 cases. In the comparison of the VAS before and after treatment, it was 6.3±1.2 and 2.9±1.3 respectively, which demonstrated statistically significant decrease (p<0.05). Conclusion: Caudal epidural injection could be performed more accurately under the fluoroscopic guidance. After injecting 20 ml of solution, the ascending level of the solution were restricted at lower lumbosacral area in most of cases.

클로자핀 중단 이후 처방 패턴의 변화: 후향적 의무기록 분석

강시현 대한조현병학회 2021 대한조현병학회지 Vol.24 No.1

Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

중뇌 동맥 꽈리동맥류 파열에 의한 지주막하출혈 후의 인지저하 평가에 있어 수소자기공명분광법의 유용성

강시현,전민호,나효진,김상태 대한재활의학회 2007 Annals of Rehabilitation Medicine Vol.31 No.5

외상성 뇌손상 쥐에서 인체 골수유래 줄기세포의 손상부위로의 이동

강시현,전민호,김상태,조희진 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.5

Objective: To define the migration and differentiation of adult human mesenchymal stem cells (hMSCs) derived from bone marrow, and their effect on neurobehavioral and cognitive improvements, after traumatic brain injury (TBI) in rats. Method: Two days after TBI, 1×106 hMSCs were injected into the corpus callosum of fifteen rats, on the contralateral side of TBI. Eleven rats received sham-operation as a control group. Neurobehavioral and Barnes maze tests, and magnetic resonance spectroscopy (MRS) were performed on days 1 and 28 after TBI. Immunohistochemical staining was performed to evaluate distribution and differentiation of hMSCs on day 56. Results: After 28 days, scores on the neurobehavioral test, Barnes maze test, and magnetic resonance spectroscopy (MRS) were higher than on day 1 in both the stem-cell and control groups, but there were no between-group differences. On day 56, injected hMSCs stained positively with MAB- 1281 were distributed in ipsilateral corpus callosum, lesion boundary zone, parietal cortex, and thalamic area around the lateral ventricle. Conclusion: hMSCs injected to the contralateral side of TBI survive and migrate to various areas of the ipsilateral hemisphere. We observed no neurobehavioral or cognitive improvements in test animals, indicating the need to adjust experimental methodologies including the development of appropriate tests to evaluate neurobehavioral and cognitive functions of rats. Objective: To define the migration and differentiation of adult human mesenchymal stem cells (hMSCs) derived from bone marrow, and their effect on neurobehavioral and cognitive improvements, after traumatic brain injury (TBI) in rats. Method: Two days after TBI, 1×106 hMSCs were injected into the corpus callosum of fifteen rats, on the contralateral side of TBI. Eleven rats received sham-operation as a control group. Neurobehavioral and Barnes maze tests, and magnetic resonance spectroscopy (MRS) were performed on days 1 and 28 after TBI. Immunohistochemical staining was performed to evaluate distribution and differentiation of hMSCs on day 56. Results: After 28 days, scores on the neurobehavioral test, Barnes maze test, and magnetic resonance spectroscopy (MRS) were higher than on day 1 in both the stem-cell and control groups, but there were no between-group differences. On day 56, injected hMSCs stained positively with MAB- 1281 were distributed in ipsilateral corpus callosum, lesion boundary zone, parietal cortex, and thalamic area around the lateral ventricle. Conclusion: hMSCs injected to the contralateral side of TBI survive and migrate to various areas of the ipsilateral hemisphere. We observed no neurobehavioral or cognitive improvements in test animals, indicating the need to adjust experimental methodologies including the development of appropriate tests to evaluate neurobehavioral and cognitive functions of rats.

Drug Induced Parkinsonism Caused by the Concurrent Use of Donepezil and Risperidone in a Patient With Traumatic Brain Injuries

강시현,김돈규 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.1

A 69-year-old male patient with previous history of traumatic brain injury 5 months ago was admitted to the Department of Neuropsychiatry because of aggressive behavior and delusional features. After starting on 2 mg of risperidone per day, his delusion, anxiety, and aggressive behavior gradually improved. Two weeks later, he was given 10 mg of donepezil per day for his mild cognitive impairment. After 6 weeks of admission in the Department of Neuropsychiatry, he showed parkinsonian features including difficulty in walking, decreased arm swing during walking, narrowed step width, scooped posture, bradykinesia, tremor, and sleep disorder. To rule out the primary Parkinsonism, dopamine transporter imaging technique [18F]fluoropropyl-carbomethoxy-iodopropyl-nor-β-tropane positron emission tomography-computed tomography (18F]FP(IT PET-CT)) was performed, and dopamine transporter activity was not decreased. We considered that his parkinsonian features were associated with the combination of risperidone and donepezil. Both drugs were stopped and symptoms rapidly disappeared in several days.

구순구개열의 삼킴 및 언어문제

강시현 대한연하장애학회 2013 대한연하장애학회지 Vol.3 No.2

Proper management of swallowing problem in patients with cleft lip and cleft palate before and after proper operation is important for appropriate nutrition. Speech problem is common in patients with cleft palate because of the velopharyngeal insufficiency. I will review in this paper the characteristics of speech problem caused by the velopharyngeal insufficiency and offer several options for evaluation and management of swallowing and speech problems in cleft lip and palate. (JKDS 2013;3:58-61)