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.

만성폐쇄성 폐질환 환자에서 적혈구 항산화효소의 변화

국기용,이만재,조희충,임영국,박일,김원식,이승일,이병래 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Toxic oxygen free radicals have been implicated as important pathologic mediators in many clinical disordesrs. Enhandng the intracellular content of antioxidant enzymes can provide means of limiting biological damage caused by oxygen free radicals. Many investigations have examined the potential of various oxyradical scavengers to modulate oxyradical injury. The oxygen free radicals play a role in the pathogenesis of chronic obstructive pulmonary disease. To investigate the pulmonary oxyradical injury and the protective role of antioxidant enzymes, author measured the amount of thiobarbituric acid reactants, the activiteies of antioxidant enzymes (superoxide dismutase, glutathione peroxidase, and catalase) and the sulfhydryl groups in serum and red blood cells from the chronic obstructive pulmonary disease groups and the normal controls. The thiobarbituric acid reactant in chronic obstructive pulmonary disease groups was increased than the controls in both serum and red blood cells, and the superoxide dismutase activity in red blood cells was no statistically difference in both groups. But, the glutathione peroxidase and catalase activities were lowered in chronic obstructive pulmonary disease groups than the controls. The sulfhydryl groups in serum and red blood cells were no statistically difference in both groups. These results suggest that the increased thiobarbituric acid reactant in chronic obstructive pulmonary disease groups mean oxygen radical toxicity, and the decreased glutathione peroxidase and catalase activities may play a role in cellular injury.

구강외과 영역의 수술에 있어서 Emazon의 진통·소염효과

김창수,엄인웅,민병국 최신의학사 1990 最新醫學 Vol.33 No.8

혈액질환에서의 핵의학적 이용

김병국 한국의학사 1985 診斷과治療 Vol.5 No.4

고온 접촉식 탐상용 초음파 탐촉자 개발 및 평가

김기복,김병극,이승석,윤남원,윤동진,안윤국 한국비파괴검사학회 2003 한국비파괴검사학회지 Vol.23 No.1

고온(500℃) 환경에서 접촉식 탐상이 가능한 초음파 탐촉자를 개발하고 평가하였다. 고온용 탐촉자는 Curie 온도가 600 ℃ 이상인 bismuth titanate 계열의 압전세라믹 소자, 텅스텐 분말과 inorganic binder를 혼합한 후면재, 알루미나 튜브, 전면재, 하우징 등으로 구성되었다. 기본 공진주파수가 각각 1.04 및 2.08 ㎒의 2 종류 탐촉자를 제작하였으며 각종 고온용 커플런트의 온도특성을 시험하였다. 개발된 고온용 탐촉자를 이용하여 강재 시편을 대상으로 시편에서의 초음파 반사신호를 측정한 결과 시편의 온도가 증가함에 따라 반사신호의 크기는 감소하였다. 고온에서 반복측정 실험결과 500℃에서 연속적인 접촉식 초음파 탐상이 가능한 것으로 나타났다. Piezoelectric ultrasonic transducers for high temperature contact measurement were developed. These high temperature ultrasonic transducers (HTUT) consisted of bismuth titanate piezoceramic element whose Curie temperature is higher than 600℃, a backing material of the mixture of tungsten powder and inorganic binder, an inner alumina tube, a wear plate and a housing. The operational frequencies of the HTUT were 1.04 and 2.08 ㎒, respectively. Various commercially available couplant for high temperature were evaluated and compared. As a couplant for high temperature ultrasonic testing between HTUT and test specimen, gold epoxy was selected. The peak amplitude of pulse-echo signals from steel test specimen decreased with increasing temperature. The operational temperature of the HTUT reached up to 500℃ at which the continuous contact measurement was possible.

Carboxymethyl-chitin 제조공정의 단순화

한상문,안병제,김용우,김용범,유국현,이승진 대한화학회 2001 대한화학회지 Vol.45 No.4

CM-chitin은 화장품 분야에서 보습제, 유연제, 피부관리를 위한 세포활성제 및 미백제등으로 다양하게 이용되고 있는 것으로 알려져 있다. 본 연구에서는 CM-chitin제조공정을 기존의 방법에서 몇가지 절차를 배재하여 단순화 하였다. Chitin분말을 NaOH와 혼합하고 16hrs 동안 동결 및 교반을 통해 CICH_(2)COONa와 isopropyl alcohol혼합액을 첨가하였다. 그 결과 높은 치환도의 CM-chitin을 얻을 수 있었다. The water soluble carboxymethyl-chitin(CM-chitin) has been well known to be very useful to the cosmetic field as a moisturizer, a smoothener, a cell activater and a cleaner for face skin conditioning. In this study, the preparation process of CM-chitin was simplified with elimination of some procedures in the conventional method. The chitin powder was mixed with sodium hydroxide solution. And then a mixture of sodium monochloroacetate(or monochloroacetic acid) and isopropyl alcohol(or a mixed solution with water and isopropyl alcohol) was added to thorough the agitation and the freezing during 16 hours. The CM-chitin with a high degree of substitution by the improved process was obtained.

녹차 및 결명자 추출물의 교정용 브라켓과 치면 사이의 경계부에서 분리된 mutans streptococci에 대한 항균작용

임성훈,서정순,윤영주,김광원,유소영,김화숙,국중기,이병래,차종희,박재윤 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.5

본 연구는 치아우식증에 관련된 Mutans streptococci 표준균주 및 임상분리 균주의 성장억제를 유도할 수 있는 천연 생약추출물을 검색하기 위하여 실시되었다. 녹차추출물은 CHMC-2032를 사용하였으며, 결명자 추출물은 50% 에탄올을 이용하여 얻었다. 이들 추출물의 Mutans streptococci 표준균주 및 교정환자들에서 브라켓과 치면 사이의 경계부에서 분리된 각각 10 균주씩의 S. mutans 및 S. sobrinus에 대한 최소성장억제농도를 액체배지 희석법으로 구하였다. 그 결과 CHMC-2032의 S. mutans 및 S. sobrinus의 표준 균주, S. sobrinus의 대부분 임상분리 균주에 대한 최소성장억제농도는 5 mg/ml이었다. 그러나 결명자 추출물에 의한 S. mutans 및 S. sobrinus에 대한 세균 성장억제 효과는 미미하였다. 본 연구 결과 치아우식증의 예방적 측면에서 결명자차보다는 녹차를 마시는 것이 유리하며, CHMC-2032를 이용하여 구강양치용액을 제조하여 사용할 경우 교정환자를 포함하여 대부분의 사람에게서 치아우식증 예방 효과가 있으리고 추정된다. Mutans streptococci is the major causative factor in dental caries. Especially, orthodontic patients with fixed appliance are a risk group for dental caries. Because fixed appliances attached on teeth may change the environment of dental plaque, the enamel decalcification or dental caries around the bracket and band is a major side effect of orthodontic treatment. The aim of this study was to search plant extracts that have antimicrobial effect on mutans streptococci. Seed-extract of Casio tora were prepared with ethanol and CHMC-2032, the leaf-extracts from Camellia sinensis extract, was obtained extract, 2 type strains and 20 clinical isolates of mutans streptococci isolated from the interface between orthodontic brackets and tooth surfaces in the orthodontic patients were used in this study. The minimal inhibitory concentration of CHMC-2032 was 5 mg/ml on the S. mutans KCTC 3065, S. sobrinus KCTC 3088, and 8 clinical isolates of S. sobrinus. However, there was no antibacterial effect of seed-extract of C. tora on mutans streptococci. These data suggest that green tea may be more effective than the tea prepared from C. tora in the prevention of enamel decalcification or dental caries around brackets.

Myelodysplastic Syndrome의 혈액학적 소견

박찬정,조한익,김상인,이재훈,김병국,김노경 大韓血液學會 1984 大韓血液學會誌 Vol.19 No.2

골수구성 백혈병 환자에게 발생한 결핵성 림프절염

이창섭,송진수,최평균,조재현,방지환,박경화,박완범,김홍빈,김남중,윤성수,박선양,김병국,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

혈액질환 가운데 결핵 발생이 증가한다고 알려진 것은 호지킨 림프종을 포함한 림프증식성질환 그리고 모양세포성 백혈병 등이 있다. 또한 동종 골수이식을 받은 환자에서도 결핵은 증가한다고 알려져있다. Kaplan 등은 골수구성 백혈병 환자에서 결핵 발생이 증가한다고 보고하였다. 그러나 골수구성 백혈병 환자에서 결핵의 발생이 증가하는 이유에 대해서는 아직까지 정확하게 밝혀지지 않았다. 저자들이 2년 동안 후향적으로 조사한 180명의 성인 골수구성 백혈병 환자들 가운데 결핵이 발생한 환자는 4명이었고, 발생 부위는 모두 림프절이었다. 결핵은 골수구성 백혈병의 특정 아형에만 국한되어 발생하지 않았지만, 50%에서 FAB 분류에 의한 M4였다. 림프절이 종대된 골수구성 백혈병 환자에서 특히, 결핵의 유병율이 높은 나라에서는 결핵성 림프절염도 감별진단에 포함시켜야 한다. During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.

Description of Mycobacterium chelonae subsp. bovis subsp. nov., isolated from cattle (Bos taurus coreanae), emended description of Mycobacterium chelonae and creation of Mycobacterium chelonae subsp. chelonae subsp. nov.

Kim, Byoung-Jun,Kim, Ga-Na,Kim, Bo-Ram,Jeon, Che Ok,Jeong, Joseph,Lee, Seon Ho,Lim, Ji-Hun,Lee, Seung-Heon,Kim, Chang Ki,Kook, Yoon-Hoh,Kim, Bum-Joon Microbiology Society 2017 International journal of systematic and evolutiona Vol.67 No.10

<P>Three rapidly growing mycobacterial strains, QIA-37 T, QIA-40 and QIA-41, were isolated from the lymph nodes of three separate Korean native cattle, Hanwoo (Bos taurus coreanae). These strains were previously shown to be phylogenetically distinct but closely related to Mycobacterium chelonae ATCC 35752 T by taxonomic approaches targeting three genes (16S rRNA, hsp6 and rpoB) and were further characterized using a polyphasic approach in this study. The 16S rRNA gene sequences of all three strains showed 99.7% sequence similarity with that of the M. chelonae type strain. A multilocus sequence typing analysis targeting 10 housekeeping genes, including hsp65 and rpoB, revealed a phylogenetic cluster of these strains with M. chelonae. DNA-DNA hybridization values of 78.2% between QIA-37 T and M. chelonae indicated that it belongs to M. chelonae but is a novel subspecies distinct from M. chelonae. Phylogenetic analysis based on whole-genome sequences revealed a 95.44 +/- 0.06% average nucleotide identity (ANI) value with M. chelonae, slightly higher than the 95.0% ANI criterion for determining a novel species. In addition, distinct phenotypic characteristics such as positive growth at 37 degrees C, at which temperature M. chelonae does not grow, further support the taxonomic status of these strains as representatives of a novel subspecies of M. chelonae. Therefore, we propose an emended description of Mycobacterium chelonae, and descriptions of M. chelonae subsp. chelonae subsp. nov. and M. chelonae subsp. bovis subsp. nov. are presented; strains ATCC 35752(T)(=CCUG 47445(T) = CIP 104535(T) = DSM 43804(T) = JCM 6388(T) = NCTC 946(T)) and QIA-37(T) (= KCTC 39630(T) = JCM 30986(T)) are the type strains of the two novel subspecies.</P>