약물유해반응 이후 처방의 변경 유형과 치료 결과: Lamotrigine 관련 사례 분석

강정은 ( Jeong Eun Kang ),이경훈 ( Kyeong Hun Lee ),서비취 ( Bi Chwi Seo ),임정미 ( Jung Mi Lim ),서성연 ( Sung Yeon Suh ),조윤숙 ( Yoon Sook Cho ),서동인 ( Dong In Suh ) 대한천식알레르기학회 2023 Allergy Asthma & Respiratory Disease Vol.11 No.2

Purpose: This study aimed to describe the desperate situation where the clinician should make decisions to further manage patients having experienced adverse drug reaction (ADR) to lamotrigine that is indicated to not easily controlled neuropsychiatric diseases. Methods: A descriptive analysis was done by thoroughly reviewing medical records of patients who were reported to have ADR to lamotrigine in a regional drug-safety center between 2010 and 2018. Results: Eighty-four cases of lamotrigine-related ADRs occurred in 80 patients. Skin lesions were most commonly observed in 70 cases (83.3%) and 14 cases (16.7%) had severe ADRs. Sixty-three subjects (78.8%) discontinued lamotrigine, while 17 (21.3%) continued it. At the time of discontinuation, 30.0% were prescribed aromatic antiepileptic drugs. Among 4 subjects who were eventually prescribed lamotrigine again after a period of discontinuation, 3 (75.0%) experienced its recurrence. Among patients who had taken alternative medications, the incidence of ADRs was higher in those being prescribed aromatic antiepileptic drugs than in the others being prescribed other than aromatic antiepileptic drugs (P=0.013). Regarding the control of underlying diseases, as many as 65 (86.7%) and 68 (90.7%) failed to reach maintaining the resolved state from 6 months and 12 months after the substitution, respectively. Conclusion: Patients can be easily trapped between the recurrence of ADRs and the treatment failure to a certain drug like lamotrigine, in which we can hardly find a reasonable alternative to manage them. (Allergy Asthma Respir Dis 2023;11:72-76)

실내 공간의 직선객체를 이용한 영상 지오레퍼런싱 및 정확도 평가

강정인(Kang, Jeong In),이임평(Lee, Im Pyeong) 대한공간정보학회 2019 대한공간정보학회지 Vol.27 No.1

실내 공간의 변화를 빠르게 반영하기 위해 일반적으로 실내 공간정보 서비스는 영상을 기반으로 제공된다. 영상기반 서비스를 위해, 대상 공간에서 취득된 다수의 영상을 하나의 공통되는 기준 좌표계와 연계시키는 지오레퍼런싱 과정은 필수적이다. 실내 영상의 경우에는 지오레퍼런싱을 위한 지상 기준점 확보에 많은 어려움이 있었다. 이에 본 연구는 별도의 기준점 없이 실내 공간의 크기 정보만을 활용한 직선 객체 기반의 영상 지오레퍼런싱을 제안하고 정확도를 평가하였다. 제안된 방법은 기준점을 따로 획득할 필요가 없기 때문에 시간과 비용 측면에서 상당히 효율적으로 영상 지오레퍼런싱을 수행할 수 있다. 특히, 변화가 빠른 실내 공간 정보의 갱신에 효과적일 것으로 생각된다. In order to quickly reflect changes in indoor space, indoor spatial information services are generally provided based on images. For an image-based service, a georeferencing process is required in which a set of images acquired in a target space are associated with a common reference coordinate system. In the case of indoor images, there were many difficulties in acquiring reference points for georeferencing. In this study, we propose image georeferencing based on line objects using only indoor space size information without additional reference points and evaluate the accuracy. Since the proposed method does not need to acquire a reference point additionally, it can perform image georeferencing with considerable efficiency in terms of time and cost. Especially, it is thought that it is effective to update the indoor space information that changes rapidly.

마그네슘 합금 판재의 평면 DIC 측정을 위한 지그 개발과 이를 활용한 단축 변형 특성 분석

강정은,유지윤,최인규,유제형,이창환,Kang, Jeong-Eun,Yoo, Ji-Yoon,Choi, In-Kyu,YU, Jae Hyeong,Lee, Chang-Whan 한국금형공학회 2021 한국금형공학회지 Vol.15 No.2

The specific strength of magnesium alloy is four times that of iron and 1.5 times that of aluminum. For this reason, its use is increasing in the transportation industry which is promoting weight reduction. At room temperature, magnesium alloy has low formability due to Hexagonal closed packed (HCP) structure with relatively little slip plane. However, as the molding temperature increases, the formability of the magnesium alloy is greatly improved due to the activation of other additional slip systems, and the flow stress and elongation vary greatly depending on the temperature. In addition, magnesium alloys exhibit asymmetrical behavior, which is different from tensile and compression behavior. In this study, a jig was developed that can measure the plane deformation behavior on the surface of a material in tensile and compression tests of magnesium alloys in warm temperature. A jig was designed to prevent buckling occurring in the compression test by applying a certain pressure to apply it to the tensile and compression tests. And the tensile and compressive behavior of magnesium at each temperature was investigated with the developed jig and DIC equipment. In each experiment, the strain rate condition was set to a quasi-static strain rate of 0.01/s. The transformation temperature is room temperature, 100℃. 150℃, 200℃, 250℃. As a result of the experiment, the flow stress tended to decrease as the temperature increased. The maximum stress decreased by 60% at 250 degrees compared to room temperature. Particularly, work softening occurred above 150 degrees, which is the recrystallization temperature of the magnesium alloy. The elongation also tended to increase as the deformation temperature increased and increased by 60% at 250 degrees compared to room temperature. In the compression experiment, it was confirmed that the maximum stress decreased as the temperature increased.

승모판 협착증에서 치료 방법에 따른 임상 및 심초음파 소견의 변화

조인종(In Jong Cho),김원(Woen Kim),김계훈(Kye Hun Kim),강경태(Kyung Tae Kang),안영근(Young Keun Ahn),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang),안병희(Byoung Hee Ahn),김상형(Sang Hyu 대한내과학회 2001 대한내과학회지 Vol.60 No.6

N/A Background : Although rheumatic mitral stenosis is still a prevalent and clinically significant valvular heart disease in Korea, the natural history of rheumatic mitral stenosis has not been clearly determined yet. The present study aimed to evaluate the clinical and echocardiographic changes in patients with rheumatic mitral stenosis according to different therapeutic modalities. Methods : A total of 91 patients (66 women; mean age, 50.9±12 years) with dominant rheumatic mitral stenosis and mitral valve area of less than 1.5 cm2 who were followed for more than 3 years (mean: 5.1 years) were included in this study. The subjects were divided into 3 groups according to the therapeutic modalities for mitral stenosis (A: medical therapy (n=31), B: percutaneous mitral valvuloplasty (n=30), C: mitral valve replacement (n=30)). Clinical and echocardiographic follow-up was performed before and immediately after therapeutic intervention such as percutaneous mitral valvuloplasty (PMV) and mitral valve replacement (MVR) and every year thereafter. Clinical symptoms and echocardiographic findings were compared between 3 groups. Results : The patients of group B consisted of less females and more younger (p=NS). Clinical symptom of dyspnea was more severe in group B and C initially (A: 1.8±0.8, B: 2.5±0.8, C: 2.9±0.7; A vs. B, A vs. C, p<0.05) but more improved in group B and C (A: 1.6±0.5, B: 1.3±1.0, C: 1.6±0.5; A vs B, A vs. C, p<0.05) during the follow-up. The prevalence of atrial fibrillation did not change significantly during follow-up. Mitral valve area decreased significantly in A group from 1.1±0.4 to 0.9±0.3 cm2 (p<0.05), but, no significant change was observed in group B and C. No significant changes were observed in the left ventricular end-diastolic, end-systolic dimensions, and ejection fraction during the follow-up period. No clinically significant aggravations of associated valvular

관동맥질환의 진단에 있어서 Exercise Treadmill Score 의 의의

서정평(Jeong Pyeong Seo),조인종(In Jong Cho),류문희(Mun Hee Rheu),박종수(Jong Soo Park),이명곤(Myung Kon Lee),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang) 대한내과학회 1997 대한내과학회지 Vol.52 No.3

N/A Objectives: The treadmill exercise eletrocardiography(ECG) is the most commonly used non- invasive method in the evaluation of patients with chest pain. But the accuracy of treadmill exercise ECG in detecting the coronary artery disease(CAD) is still controversial. To improve the accuracy of the treadmill exercise test, exercise treadmill score(ETS) based on exercise duration, degree of ST deviation, and treadmill anginal index during treadmill exercise ECG has been used. Methods: The authors calculated ETS by simple equation(total exercise duration-5×maximal ST- segment deviation during or after exercise-4×treadmill angina index) and analyzed coronary angiograms of 173 patients(mean age '55.5±8.7, male: female=2.7: 1) who underwent treadmill exercise ECG and coronary angiography in Chonnam University Hospital from January, 1990 through March, 1993. Results. 1) The studied subjects were subdivided into 3groups according to ETS. Group A(high risk, ETS≤11) were composed of 15cases(mean age 60.2±7.4, male: female = 1.2: 1), group B(moderate risk, 5>ETS≥11) 71cases(mean age 60.2±7.4, male: female=3.3:1), group C(low risk, ETS>5) 87cases(mean age 54.8±9.2, male-female =2.5:1). Clinical diagnoses of the studiedsubjects were 63stable angina, 61unstable angina, 3acute myocardial infarction, and 46 old myocardial infarction. On coronary angiographic findings, 61patients had single vessel disesase, 23patients had two vessel disease and 13patients had three vessel disease. 2) The sensitivity of the treadmill exercise ECG in diagnosing coronary artery disease was 88% and the specificity was 46%. 3) One hundred percent of group A patients had CAD and 54% of them had multivessel disease, 75% of group B had CAD and 27% of them had multivessel disease, and 33% of group C had CAD and 10% of them had multivessel disease. 4) There were no significant differences in the siite of stenotic lesion and degree of stenosis according to ETS in the patients with single vessel disease. 5) There were no significant differences in left ventricular ejection fraction and left ventricular end-diastolic pressure among three groups. Conclusion: Exercise treadmill score is useful in predicting the presence and severity of CAD and that low ETS less than -11 may be an indicator of multivessel coronary disease.

운동부하 검사상 무증상 심근 허혈 환자의 관동맥 병변 소견

조인종(In Jong Cho),서정평(Jung Pyung Suh),류문희(Moon Hee Rheu),이명곤(Myung Kon Lee),박종수(Jong Soo Park),박주형(Joo Hyung Park),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Chun Park),강정채(Jung Chaee Kang) 대한내과학회 1994 대한내과학회지 Vol.47 No.5

N/A Objectives: Silent myocardial ischemia is defined as the presence of transient ischemic alterations in absence of angina or its equivalents. In recent reports, silent ischemia comprises about 60-80% of total ischemic events in patients with symptomatic angina and its prognosis is similar to typical painful angina, So, we studied to compare the difference of coronary angiographic features between painful angina and silent angina in patients with positive treadmill exercise test. Method: We studied retrospectively coronary angiographic features of 34 patients; 20 patients with painful treadmill exercise test were grouped in A and 14 patients without pain were grouped in B. Both groups were positive in Thallium corynary perfusion scan. Results: 1) There were no significant differences in sex, age, smoking and hypertension between group A and B but diabetes were more prevalent in group A than in B(p< 0,05) 2) Total exercise duration, ST segment deviation and rate pressure product were not different between two groups in treadmill exercise test. Although treadmill score was significantly low in group A (p<0.05), there was no singificant difference between two groups in case of subtracting treadmill angina index from treadmill score. 3) In dipyridamole Tl scan, defect volume ratio was not different in two groups although defect index was significantly greater in group A(p<0.05). 4) In coronary angiographic findings, there were no sigificant differences in number of stenosed vessels, left ventricular ejection fraction and left ventricular end diastolic pressure, but right coronary artery lesion is more common in group A than group B(p<0,05). 5) The most common clinical diagnosis of studied subject was unstable angina, But there were no statistically difference between two groups. Conclusion: This results suggest that patient with silent myocardial ischemia has similar coronary artery disease to those with painful myocardial ischemia, Early detection and treatment of silent ischemia is essential in the management of ischemic teart disease.

아마인유와 해바라기 종자유의 혼합 급이가 식이성 고지혈증 흰쥐의 혈청 지질 성분에 미치는 영향

최운정(Woon-Jeong Choi),김한수(Han-Soo Kim),강정옥(Jeong-Ock Kang),김성희(Sung-Hee Kim),서인숙(In-Sook Su),정승용(Seung-Yong Chung) 한국식품영양과학회 1994 한국식품영양과학회지 Vol.23 No.1

n-3계 PUFA와 n-6계 PUFA의 배합 비율을 달리한 혼합유지의 고지혈증 흰쥐의 혈청 지질 개선 효과를 구명하기 위해 Sprague-Dawley계 숫흰쥐에게 돈지 (3.0%), 버터 (12.0%) 및 콜레스테롤 (0.75%)를 첨가 조제한 식이를 3주간 급여하여 고지혈증을 유발시킨후, 돈지 3.0%와 버터 12.0%식이를 대조군으로 하고 아마인유와 해바라기종자유를 사용, 그 배합 비율을 달리한 혼합유지 및 항 고지혈증 약제를 급여하여 2주간 실험 사육한 후 혈청의 지질성분을 분석 검토한 결과, 총 콜레스테롤 농도는 대조군에 비하여 2군(돈지3.0% + 올리브유 12.0%)을 제외한 여타 실험군에서 유의적으로 낮았으며, 특히 3군 (Cholestyramine 2.0%)과 5군 ( 돈지 3.0% + 아마인유 12.0%)에서 현저히 낮았다. HDL- 콜레스테롤 농도는 3군, 대조군, 5군 및 9군 (돈지 3.0% + 해바라기 종자유12.0%)에서 높았고, 총 콜레스테롤에 대한 HDL-콜레스테롤 농도비는 3군과 5군에서 높은 수준이었으며, 동맥경화지수는 3군과 5군에서 낮았다. 유리 콜레스테롤 및 콜레스테롤 에스테르 농도는 2군을 제외한 여타 실험군에서 유의적으로 낮았으며 특히 5군에서 더욱 낮았고, LDL 농도는 대조군에 비해 2군이 유의적으로 높은 반면 3군과 5군은 현저히 낮았다. 인지질 및 중성지질의 농도는 대조군 에 비해 5~9군에서 현저히 낮은 수준이었으나, 3군과 4군 (LR)에서는 중성지질 농도가 유의적으로 높았다. 이상의 결과에서 혈청 지질 개선 효과는 돈지 3.0%와 아마인유 12.0%의 혼합급여 및 cholestyramine 2.0%를 급여하였을 때 가장 높았다. This study was carried out to investigate the effect of the feeding mixture of linseed oil, rich in n-3 PUFA and the sunflower seed oil, rich in n-6 PUFA on the lipid metabolism in the dietary hyperlipidemic rats. After male Sprague-Dawley rats were induced hyperlipidemia by feeding the diet containing lard, butter and cholesterol for 3 weeks, then they were fed with the diet containing lard 3.0% and butter 12.0% for control, the mixture in different proportion of both linseed oil and sunflower seed oil and antihyperlipidemic drugs for 2 weeks. Analysis of the lipid component of the serum showed following results. Concentration of total cholesterol in serum was significantly lower in the other groups except group 2(lard 3.0% + olive oil 12.0%) than in the control group, especially in groups 3 (cholestyramine 2.0%) and 5(lard 3.0% + linseed oil 12.0%). HDL-C and the ratio of HDL-C to total cholesterol concentration were higher in groups 1, 3, 5 and 9 (lard 3.0% + sunflower seed oil 12.0%), while the atherosclerotic index was low in groups 3, 5. Concentrations of free cholesterol and cholesteryl ester in serum were significantly lower in the other groups except group 2 than in the control group, especially lower in group 5. Concentration of LDL was significantly higher in group 2 while it was remarkably lower in groups 3 and 5. Concentrations of phospholipid and triglyceride in serum were considerably lower in groups 5 to 9, while those of triglyceride in groups in 3 and 4 (liparoid) were significantly higher than in the control group. From the data on concentration of total cholesterol, HDL-cholesterol, LDL, phospholipid and triglyceride in serum, the results suggested that the feeding mixed with 3.0% lard and 12.0% linseed oil or 2.0% cholestyramine were most effective for the improvement of the serum lipids.

관상동맥 중재술을 시행 받은 40세 이하의 ST 분절 상승과

박종춘 ( Jong Chun Park ),조정관 ( Jeong Gwan Cho ),김주한 ( Ju Han Kim ),홍영준 ( Young Joon Hong ),안영근 ( Youngkeun Ahn ),강정채 ( Jung Chaee Kang ),김남윤 ( Nam Yoon Kim ),박인혜 ( In Hyae Park ),정명호 ( Myung Ho Jeong ) 대한내과학회 2012 대한내과학회지 Vol.82 No.2

Background/Aims: The prevalence of coronary artery disease has increased in young adults. We evaluated the differences in clinical characteristics and clinical outcomes in young patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Methods: A total of 164 patients with acute myocardial infarction who underwent percutaneous coronary intervention were divided into two groups: the STEMI group (120 patients; mean age, 35.7±3.8 years; 118 males) and the NSTEMII group (44 patients; mean age, 35.7±4.3 years; 43 males). We analyzed clinical and angiographic characteristics and major adverse cardiac events (MACE), including death from any cause, non-fatal myocardial infarction, target lesion revascularization, and coronary artery bypass graft surgery, during a 1-year clinical follow-up of the two groups. Results: During hospitalization, Killip class II acute myocardial infarction (5.8% vs. 15.9%, p=0.041) was observed more frequently in the NSTEMI group. The levels of troponin-I (66.9±103.6 vs. 26.6±38.5 ng/mL, p=0.014) and N-terminal pro-brain natriuretic peptide (733.0±1,018.1 vs. 476.2±374.5 pg/mL, p=0.012) were significantly higher in the STEMI group. One-year MACE did not differ between the two groups. By multiple logistic regression analysis, bare metal stents (odds ratio, 3.360; 95% confidence interval, 1.105-10.217; p=0.033) and high lipoprotein (a) levels (odds ratio, 1.047; 95% confidence interval, 1.020-1.075; p=0.001) were independent predictors of 1-year MACE. Conclusions: Young patients with STEMI and NSTEMI have similar clinical outcomes. Bare metal stents and high serum lipoprotein (a) levels are independent predictors of MACE during 1-year clinical follow-ups in young patients with acute myocardial infarction. (Korean J Med 2012;82:175-184)

건강검진 수진자들에서 성별, 나이 및 체질량지수에 따른 간효소치의 상세 분포 연구

최승호 ( Seung Ho Choi ),양종인 ( Jong In Yang ),이창현 ( Changhyun Lee ),변희진 ( Hee Jin Byun ),강정묵 ( Jung Mook Kang ),김세룡 ( Se Young Kim ),임정윤 ( Jeong Yoon Yim ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.4

Background/Aims: The aim of this study was to examine the distribution of range of liver enzymes according to age and BMI in each gender using large-scale data. Methods: Data were gathered from 65,715 subjects who underwent a routine health check-up and did not have HBsAg and anti-HCV. Boxplot analysis was used to examine the distribution of range of liver enzymes according to age and BMI in each gender. Multivariate linear regression analysis was performed for assessment of the association of liver enzymes with age and BMI, and to determine whether the range of liver enzymes was affected by risk factors for metabolic syndrome in each gender. Results: ALT, AST, and GGT levels showed significant association with BMI in both male and female after adjusting for age. The range of ALT, AST, and GGT levels varied more widely according to the increase in BMI in males than in females, and this finding was more prominent in younger subjects than in older subjects. All risk factors for metabolic syndrome were shown to affect liver enzyme levels in male subjects. However, although most risk factors for metabolic syndrome affected liver enzyme levels, there might be weak or no effect of fasting hyperglycemia on AST, and low serum HDL-cholesterol level on GGT in female subjects. Conclusions: Age, BMI, and other risk factors for metabolic syndrome had a significant effect on the distribution of range of liver enzymes in each gender, even in this study conducted from Korean health checkup subjects. (Korean J Gastroenterol 2014;64:213-223)

DSS로 유도된 마우스 대장염 모델에서 꽃새우 추출물의 항염증 효능

최유민(Yu Min Choi),박지선(Ji Sun Park),강정은(Jeong Eun Kang),최수철(Soo Cheol Choi),이성훈(Sung Hoon Lee),이인아(In-Ah Lee) 한국식품영양과학회 2021 한국식품영양과학회지 Vol.50 No.9

꽃새우는 우리나라 서 · 남해안에 분포하며 철분, 칼슘, 타우린 등 다양한 영양소가 들어있다. 본 연구에서는 꽃새우 추출물을 이용하여 LPS로 염증이 유도된 RAW 264.7 세포와 DSS로 염증이 유도된 ICR mouse 모델에서 항염증 효과를 실험하였다. RAW 264.7 세포와 마우스의 대장 조직을 이용해 RT-PCR을 진행하였을 때 꽃새우 추출물 투여는 염증성 사이토카인인 IL-6, TNF-α, IL-1β와 염증매개 물질인 iNOS, COX-2의 발현이 감소하였다. 또한, 대장 조직 내 단백질 발현을 유의하게 감소시켰으며, 대장 조직 손상을 개선하였다. 이와 같은 연구 결과를 보아 꽃새우 추출물은 in vivo와 in vitro에서 염증성 사이토카인을 억제하는 효과가 있음을 제시하고 있다. 꽃새우가 염증성 장 질환 치료 및 예방에 효과적인 물질로서의 가치를 입증하기 위해서는 염증 반응에 영향을 미치는 성분 확인이 필요하다고 사료된다. Trachysalambria curvirostris is a crustacean found near the southwest coast of Korea which contains various nutrients such as iron, calcium, taurine, and chitosan. In particular, chitosan has anti-inflammatory, antibacterial, anticancer, and antioxidant effects. The purpose of this study was to evaluate the anti-inflammatory effect of the extract of Trachysalambria curvirostris on inflammatory bowel disease (IBD). Inflammatory factors (COX-2, IL-1β, IL-6, iNOS, TNF-α) in cells and colon tissue induced by lipopolysaccharide (LPS) and dextran sulfate sodium (DSS) were confirmed using RT-PCR. The generation of cytokines (IL-6, TNF-α) in the colon tissue protein of ICR mice caused by DSS was measured by ELISA. Compared to the LPS and DSS groups, the expression level of inflammatory cytokines showed a reduction in the group treated with the Trachysalambria curvirostris extract. Similarly, the ELISA results showed that the expression level of inflammatory cytokine decreased compared to the DSS group. As a result of H&E staining using mouse colon tissue, it was possible to observe a lower invasion of inflammatory cells in the Trachysalambria curvirostris treated group than in the DSS group. It is necessary to conduct additional research on the exact mechanism of reaction to identify the active components in the Trachysalambria curvirostris extract, and to prove the value of the Trachysalambria curvirostris for IBD prevention and treatment.