신생아기 장염에 의하여 발병된 Reye 증후군

방준석,남상정,이경화,배은주,박원일,이현숙,손배영,최환석,이홍진 대한소아청소년과학회 2006 Clinical and Experimental Pediatrics (CEP) Vol.49 No.3

Purpose : The prevalence of Reye syndrome has decreased since late 1980's. But we report that recently there were concentrative attacks of Reye syndrome after acute enteritis during the neonatal period. Methods : Clinical symptoms and laboratory results(quantitative organic acid analysis, routine chemistry, arterial blood gas analysis, serum ammonia) of seven patients admitted at the Samsung Medical Center, Sanggye Paik Hospital, Wonju Christian Hospital and Chuncheon Sacred Heart Hospital, referred from Jan. 2005 to Apr. 2005, were analysed retrospectively. The major clinical symptoms were derived from the patients' clinical records sended with urine samples and quantification of organic acids were done with gas chromatography and mass spectrometry. Results : The mean age of seven cases is 18 days and the major preceding symptoms were gastrointestinal symptoms(vomiting, diarrhea, refusal to feeding). The major clinical symptoms were clouded conciousness, repiratory difficulty, vomiting, seizures, and diarrhea. One patient died; that patient's serum ammonia was twenty times higher than normal. Conclusion : The seven patients were neonates. Reye syndrome has been known to be closely related with upper respiratory infections as a preceding disease and to internal use of aspirin, but in our study, the major preceding disease of the seven cases was gastrointestinal infection and none of these used aspirin. 목 적 : Reye 증후군의 유병률은 1980년 후반 이후 급격히 감소하였으나 최근 Reye 증후군이 신생아 시기에 급성 장염 후에 집중적으로 발병되어 보고하는 바이다.방 법 : 2005년 1월부터 2005년 4월까지 4개월간 삼성서울병원, 상계백병원, 원주기독병원, 춘천성심병원 등 4개 종합병원에서 본원 임상유전학 연구실로 분석이 의뢰되었던 환자 7례의 임상 소견, 검사 소견(유기산 대사분석, 일반 화학 검사, 동맥혈 가스검사, 혈청 암모니아)을 분석하였다. 임상 소견은 환자들의 증상 및 기본 검사 소견을 검체와 함께 보내온 환자 정보지를 분석하여 얻었고 유기산 분석은 gas chromatography와 mass spectrometry를 이용하여 정량 분석하였다. 결 과 : 7명의 환자들의 평균 연령은 18일이었고 이들의 주요 선행 증상은 위장관 증상(구토, 설사, 음식 거부)이였으며 임상 증상으로는 의식 장애, 호흡 곤란, 구토, 경련, 설사 등이었다. 사망은 1례에서 발생하였고 사망 환자의 암모니아 수치는 정상 암모니아 수치의 20배 이상 높은 수치를 나타냈다.

Efficacy of Statins on BMD or Fracture Risk in Postmenopausal Women

방준석 한국임상약학회 2006 한국임상약학회지 Vol.16 No.2

Topiramate for the Treatment of Binge Eating Disorder or Bulimia Nervosa : A Systemic Review of Human Clinical Studies and Case Reports

방준석,이유정 한국임상약학회 2007 한국임상약학회지 Vol.17 No.1

내 , 외인성으로 유도된 Nitric Oxide가 흰쥐의 통각전달에 미치는 효과

방준석,류정수,허인희 한국응용약물학회 1997 학술대회 Vol.1997 No.1

N/A

Endothelin-1이 유발하는 stereotyped behavior과 arterial blood pressure 상승에 NMDA receptor와 NO의 관련성

방준석,류정수,허인희 한국응용약물학회 1997 학술대회 Vol.1997 No.1

N/A

담즙산의 생체 활성 물질로서의 역할

방준석,이유정,정지훈,손의동 한국임상약학회 2011 한국임상약학회지 Vol.21 No.2

The family of bile acids belongs to a group of molecular species of acidic steroids with very peculiar biological characteristics. They are synthesized by the liver from cholesterol through several complementary pathways and secreted into small intestine for the participation in the digestion and absorption of fat. The bile acids are mostly confined to the territories of the so-called enterohepatic circulation, which includes the liver, the biliary tree, the intestine and the portal blood with which bile acids are returned to the liver. In patients with bile acid malabsorption, the amount of primary bile acids in the colon is increased compared to healthy controls. Although the increase in the secondary bile acids including deoxycholic acid, is reported to have the potency to affect tumorigenesis in gastrointestinal tracts, there is no firm evidence that clinically relevant concentrations of the bile acids induce cancer. The list of their physiological roles, as well as that of the pathological processes is long and still not complete. There is no doubt that many new concepts, pharmaceutical tools and pharmacological uses of bile acids and their derivatives will emerge in the near future.

내.외인성으로 유도된 Nitric Oxide가 흰쥐의 통각전달에 미치는 효과

방준석,류정수,신창열,양성준,송현주,박전희,제현동,손의동,허인회 대한약학회 2001 약학회지 Vol.45 No.1

Nitric oxide is a labile, gaseous, broad spectrum second messenger that used in various tissues and cells. If it is induced by endogenously and exogenously in the neuronal cells, it is able to mediate analgesia or hyperalgesia at the periphery and in the spinal level respectively. This dual role of nitric oxide in the sensory system is very intriguing but has not been fully understood yet. In this experiment, acetylcholine (300 $\mu$g/paw), sodium nitroprusside (600 $\mu$g/paw), and L-arginine (300 $\mu$g/paw) represented antinociceptive effect to noxious topical stimulus, but pronociceptive responses followed by spinally application (20$\mu$g/5$\mu$l, 10$\mu$g/3$\mu$l, 500$\mu$g/5$\mu$l respectively). Calcium ion is critical element which activates nitric oxide synthase, therefore verapamil (300 $\mu$g/paw) and NOS inhibitor (20 mg/kg, L-NAME or L-NOArg) are injected into right hind paw (i.pl.). When verapamil is combined with NOS inhibitors analgesic effects through NO-cGMP pathway are inhibited as compared with ACh alone. Diluted formalin (2.5%), when injected into rats'hind paw (0.05 ml), elicited a biphasic algesic responses and nitric oxide had an analgesic effect on both $A\delta$ and C sensory nerve fibers which manipulate the phases respective1y. Nitric oxides, which produced from constitutive nitric oxide synthase, activated cyclooxygenase-type I and then prostaglandins are produced from them. So, indomethacin and ibuprofen, inhibitors of COX$_1$enzyme, when pretreated intraperitoneally (100 mg/kg) could reduce the hyperalgesic state. From these results, it is possible to imagine that the intrathecally administered NO donors expressed hyperalgesia through both long-term potentiation mechanism and arachidonic acid-prostaglandin cascade.

프리셉터 제도의 도입과 활용에 관한 인식 및 수용도에 대한 조사연구

방준석,장정훈,김수진,손의동,심상수,정지훈,최병철 한국임상약학회 2008 한국임상약학회지 Vol.18 No.1

Objective: The aim for this article was to evaluate and to clarify the current opinions of the registered pharmacists concerning their recognition and adoption rates about introducing the preceptorship into the clinical pharmacy internship and clerkship. Methods: A 25-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and on site, 90 over 240 (37.5%) registered pharmacists responded and the data were analyzed with comparison to the groups working in community and hospital pharmacies. Results: The overall answers were affirmative and the respondents were very interested in the application of the clinical preceptorship to the pharmacy educational and to their clinical settings. Moreover, the qualification level and the implementation methods were proposed in detail. Conclusion: Although ninety pharmacists showed their views differently, most of the respondents regarded the preceptorship as an adequate training system for the pharmacy students as well as junior pharmacists at the time of initiation of the new 6-year pharmacy education system in Korea.

유기산혈증-유기산 분석 8년의 정리

방준석,임시홍,이경화,배은주,박원일,이홍진 대한소아청소년과학회 2006 Clinical and Experimental Pediatrics (CEP) Vol.49 No.3

목 적 : Reye 증후군의 유병률은 1980년 후반 이후 급격히 감소하였으나 최근 Reye 증후군이 신생아 시기에 급성 장염 후에 집중적으로 발병되어 보고하는 바이다.방 법 : 2005년 1월부터 2005년 4월까지 4개월간 삼성서울병원, 상계백병원, 원주기독병원, 춘천성심병원 등 4개 종합병원에서 본원 임상유전학 연구실로 분석이 의뢰되었던 환자 7례의 임상 소견, 검사 소견(유기산 대사분석, 일반 화학 검사, 동맥혈 가스검사, 혈청 암모니아)을 분석하였다. 임상 소견은 환자들의 증상 및 기본 검사 소견을 검체와 함께 보내온 환자 정보지를 분석하여 얻었고 유기산 분석은 gas chromatography와 mass spectrometry를 이용하여 정량 분석하였다. 결 과 : 7명의 환자들의 평균 연령은 18일이었고 이들의 주요 선행 증상은 위장관 증상(구토, 설사, 음식 거부)이였으며 임상 증상으로는 의식 장애, 호흡 곤란, 구토, 경련, 설사 등이었다. 사망은 1례에서 발생하였고 사망 환자의 암모니아 수치는 정상 암모니아 수치의 20배 이상 높은 수치를 나타냈다. Purpose : The prevalence of Reye syndrome has decreased since late 1980's. But we report that recently there were concentrative attacks of Reye syndrome after acute enteritis during the neonatal period. Methods : Clinical symptoms and laboratory results(quantitative organic acid analysis, routine chemistry, arterial blood gas analysis, serum ammonia) of seven patients admitted at the Samsung Medical Center, Sanggye Paik Hospital, Wonju Christian Hospital and Chuncheon Sacred Heart Hospital, referred from Jan. 2005 to Apr. 2005, were analysed retrospectively. The major clinical symptoms were derived from the patients' clinical records sended with urine samples and quantification of organic acids were done with gas chromatography and mass spectrometry. Results : The mean age of seven cases is 18 days and the major preceding symptoms were gastrointestinal symptoms(vomiting, diarrhea, refusal to feeding). The major clinical symptoms were clouded conciousness, repiratory difficulty, vomiting, seizures, and diarrhea. One patient died; that patient's serum ammonia was twenty times higher than normal. Conclusion : The seven patients were neonates. Reye syndrome has been known to be closely related with upper respiratory infections as a preceding disease and to internal use of aspirin, but in our study, the major preceding disease of the seven cases was gastrointestinal infection and none of these used aspirin.

골관절염 치료제 히알우론산 임상연구결과의 Systemic Review

방준석 한국임상약학회 2007 한국임상약학회지 Vol.17 No.1

Background: The multitude of the therapeutic usefulness of intra-articular injection of hyaluronate on oateoarthritis of the knee is still in question. The objective of this systemic review was to elucidate both the therapeutic efficacy and the safety of intra-articular administration of hyaluronic acid for degenerative osteoarthritis of the knee joints. Methods: I searched MEDLINE and Korea Medical Database (KMbase) from January 1990 to April 2007 using a combination search terms for knee osteoarthritis and hyaluronic acid and a filter for randomized controlled trials. I extracted data on pain at rest, and during or just after movement, on joint function, and on adverse events. Results: Ten trials that reported usable quantitative information on any of the predefined end points were identified and included in the systemic review. Intra-articular injection of hyaluronic acid can decrease symptoms of osteoarthritis of the knee. The study revealed significant improvements in pain and functional outcomes with few adverse effects. However, there was significant between-study heterogeneity in the estimates of the efficacy of hyaluronic acid. Sub-group analysis showed that lower methodological quality such as a single-blind or single-center design resulted in higher estimates hyaluronic acid efficacy, and that patients older than sixty years of age and those with the most advanced radiographic stage of osteoarthritis were less likely to benefit from intra-articular injection of hyaluronic acid. Conclusion: According to the currently available evidence, intra-articular hyaluronic acid has been proven clinically effective for the patients bearing the knee osteoarthritis with NSAID-induced GI troubles or inapplicable to any surgery, and may be associated with lower risk of adverse events.