우심방을 침범한 거대 비호지킨씨 림프종 1예

강상범,진승원,이은경,박용현,최용호,김용주,박준철,김재형,홍순조,최규보,권종범,원용순,박건,이은희 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

휘발성유기화합물(VOCs)의 변이원성 검정

박종천,이용탁,송현철,이우범 國立麗水大學校 環境問題硏究所 2004 環境硏究論文集 Vol.6 No.-

The mutagenicity of six kinds of VOCs(benzene, m.p-xylene, chloroform, toluene, methylethylketone, 1,2-dichloroethane) detected in high concentration and frequency in Kwangyang Bay was investigated. VOCs are water-insoluble and volatile. Therefore, when they are tested by the classical Ames test in the assay of mutagenicity, there may be experimental errors. To overcome this limitation, modified Ames test was used to assay mutagenicity of VOCs. By this modified Ames test, we could obtain much more satisfactory results. Even at extremely low concentration(0.0001㎍/㎖). bezene, m,p-xylene, and methylethylketone showed a weak mutagenicity. When S-9 mixture is added in the assay system, all tested VOCs except methylethylketone showed mutagenicity. When Salmonclla typhimurium TA 98 and Salmonella typhimurium TA 100 are exposed to VOCs of high concentration(100㎍/㎖). the number of colony decreased irrespective of the S-9 mixture treatment. It seem to be that the decrement results from the toxic effect of high concentration of VOCs.

강진만에서 미생물의 년 변화

박종천,오재영,정용욱,주현수,이원교,유춘만,이우범 國立 麗水大學校 환경문제硏究所 2001 環境硏究論文集 Vol.4 No.-

The biological surveys were performed at seven sites in the Gangjin bay from February, 1998 to November, 2001. In order to analysis of environmental variation, numbers of heterotrophic bacteria, general fungus and fecal coliforms were enumerated in each sample. The result showed that variation range of heterotrophic bacteria, general fungus, and fecal coliforms were 2.9 x 10^(3)~9.6 x 10^(3) CFU/ml, 17.2~80.1 CFU/ml, and 6.3~682.5 CFU/100ml for four tears(1988~2001), respectively. Density of heterotrophic bacteria and general fungus were gradually decreased for four tours, while fecal coliforms were suddenly increased. Specially, numbers of fecal colifoms were increased the more 100 times in 2001 than that 1998. We think that it was probably caused a little rainfall in February, 2001. There result suggests that ecosystem of Gangjin bay were mainly regulated by 2~3 factors, which were inflow of fresh water, salinity and variation of water temperature.

PCR-Select cDNA Subtraction을 이용한 Allomyces macrogynus의 팡이실의 성장 관련 유전자의 분리

박중규,구용범 인제대학교 1998 仁濟論叢 Vol.14 No.1

Allomyces macrogyuns의 이배체 꼬리홀씨들은, 공세포로 전환된 후, 실뿌리에 이어 팡이실을 형성하는데, 팡이실로 성장하는 과정에서 대기중의 산소의 고갈로 인하여 길이 성장이 급격히 촉진된다. 본 연구에서는, 길이 성장에 관련하는 유전자를 분리하기 위해서 보통의 대기 조건에서 자란 팡이실(Normoxia)과 하나의 탈산소제를 처리한 조건에서 자란 팡이실(Hypoxia)을 수확하여 PCR을 이용한 cDNA subtraction(PVR-select cDNA subtraction)을 수행하였다. PCR로 선택된 subtracted cDNA는 pGEM-T vector에 삽입 후, 대장균에 클로닝하여, 115개의 형질전환체를 무작위적으로 골라 slot blot hybridization을 하였다. 그 결과, 대부분의 클론이 Normoxic 조건에서 보다 Hypoxic 조건에서 다량 발현되는 유전자로나타났으며, 이들 중에서 60개의 클론을 DNA 염기 서열 분석하였더니 19가지의 서로 다른 염기 서열로 동정되었다. 이 유전자들을 Genbank Database와의 유사성을 조사했을 때, 염기 서열상 이미 알려진 유전자와의 유사성이 적었으나, 아미노산 서열상으로는 몇 가지 단백질들과 유사한 것으로 나타났다. 60개의 클론 중에서 높은 빈도로 나타나는 4가지 클론을 northern hybridization하였더니, 대략적으로 각각 0.9kb, 1.9kb, 1.9kb, 2.8kb의 mRNA로 전사되는 것으로, Hypoxic 조건의 팡이실에서 특이적으로 발현되는 것으로 나타났다. Diploid zoospore of Allomyces macrogynus form hyphae after encystment and rhizoid formation. It was the linear growth of hyphae that was stimulated on their growth by oxygen depletion in the atmosphere. In this study, CDNA subtraction with PCR(PCR-select cDNA subtraction) between hyphae incubated under normal atmosphere(Normoxia) and hyphae incubated with an oxygen absorbent(Hypoxia) were performed in order to isolate the genes related to the linear growth. PCR-select Subtracted cDNAs were cloned into E. coli JM 109 using pGEM-T vector. Total 115 transformants were randomly selected and analysed by slot blot hybridization. Most of them were found to be expressed in higher level in Hypoxic condition than in Normoxic condition. Of them, 60 clones were sequenced. They were identified as 19 clones, since nucleotide sequence of 60 clones was identical. Nucleotide homology search of these clones showed no significant homology with known genes, whereas amino acid sequence homology revealed that they had some homology with known proteins. Northern hybridization analysis of 4 frequently appeared clones among 60 clones confirmed that they were expressed in higher level in Hypoxic condition and their mRNA sizes were approximately 0.9kb, 1.9kb, 1.9kb, 2.8kb, respectively.

정상임신 산모와 중증자간전증 산모의 혈소판지수 비교

박용범,한지수,정동근,이인식,김암,민원기,지현숙,목정은 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

The purpose of this retrospective study was to define platelet indices in severe preeclampsia(N=98) and to compare them to normal nonpregnant values(N=93) during the years 1990-1993 in the Department of Obstetrics and Gynecology, College of medicine, University of Ulsan, Asan Medical Center. Indices evaluated included platelet count, mean platelet volume, and platelet distribution width. Means platelet volume was statistically different between two groups, however mean platelet count was significantly decreased(p=0.029) and platelet distribution width was significantly increased(p=0.0001) and platelet distribution width was significantly increased(p=0.0001) in severe preeclampria. Mean platelet volume versus platelet count in normal pregnancy showed a significant inverse nonlinear relationship(r=-0.39, 9<0.001) and that in preeclampsia was congruent with notmal nonpregnant valus. With same mean platelet volume, platelet distribution width showed tendency to shift to right in severe preeclampsia. These findings support the concept of severe preeclampsia as a compensated state of increased platelet comsumption comparing with normal pregnancy. We concluded from above results that quantification of platelet indices may have some value in screening for and following severe preeclampsia.

소아의 혈관내 응고증후군

박용훈,김홍배,강덕식,이상범 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

We have reviewed 11 cases of Disseminated Intravascular Coagulation (DIC) admitted to the Pediatric department of Kyungpook National University Hospital from January 1981 to July 1982. Age distribution showed 4 cases below, year of age including 2 neonatal cases, 2 between 1 to 5 years of age, 2 between 6 to 10 years of age and 3 between 11 to 15 years of age. Three of these 11 cases are male and the rest 8 female. DIC developed within the first 5 admission day in 7 cases, from the 6th to the 10th day in one and after the 10th in three. Factors predisposing to DIC included infection (11 cases) which were usually systemic, shock, recent surgery and malignancy. Diagnostic coagulation studies included low platelet count below 100,000/cumm (all 11 cases), prolonged PT (10 cases) and PTT (all 11 cases). All patients had abnormal hemorrhage and the majority being petechiae on the skin (8 cases) followed by oozing from the injection site (6 cases), melena (4 cases), epistaxis (3 cases), bleeding from the oral cavity (3 cases), intracranial hemorrhage (1 case) and hematuria (1 case). Local ischemic manifestations probablly due to the thrombus formation were respiratory distress (9 cases), mental disturbance (9 cases), diarrhea (8 cases), abdominal pain (7 cases) and acrocyanosis (3 cases). Shock due to systemic circulatory disturbance was also seen in 5 cases. Treatment included transfusion of fresh whole blood and Vitamin K admimistration in all cases, plalelet transfusion in 6 cases, Corticosteroid administration in 4 cases and none received Heparin. Only 3 cases showed improvement and the rest discharged hopelessly and/or died. key words: Disseminated Intravascular Coagulation.

여가 레크리에이션 프로그램의 개발 방향에 관한 연구

박용범,이재형 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

This study aims to present the way to investigate the program of leisure recreation considering each age. Firstly, the program of leisure recreation for teenagers should be developed in their school firstly in the way of multiple methods and should be applied both in their school and home connectedly. And, the program for friendship, small group and working teenagers should be developed, too. Secondly, the program for housekeepers should be developed by each ward office and university. They should be operated in the class of health sport and hobby. And, a lot of leisure program should be investigated to develop their ability. Thirdly, for old ages, the program should be carefully excluded the existed form and contents as possible as t can. And it should be developed toward more hard and complex step. t needs to work connectedly in silver house and welfare house for old ages. Furthermore, t should be communicative program to communicate with other ages freely through the existed institute as Silver House(where old ages live together) and Care house(place to take care the old ages).

대학생들의 스포츠 유형에 따른 여가 만족도

박용범,이재형 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

The Purpose of this study was to the relationship between type of sports activity and leisure satisfaction among collegiate. The main purpose of this study was to examine the effects of the type in sports activity on leisure satisfaction by compering the difference of psychological, educational, social, physiological, relaxational, and environmental satisfaction. Subjects of this study were sampled 696 the collegiate(392 male, 301 female) by the random sampling method. The method of statistics used to analysis the collected data are frequence, covariance analysis, correlation analysis, multiple regression analysis, and path analyze using multiple regression analysis. Based on the procedures and results, the following conclusions were warranted 1. Background variables such as sex, income, and self-rated health among sociodemographic characteristics in fluence on participation in physical education of culture and leisure satisfaction. That is to say, The more men than women are and the higher income, self-rated health people have the more they participation in physical education of culture and leisure satisfaction is high, 2. Participation in physical of culture has positive effect on leisure and so decreases the degree of it. 3. The type of sports activity among the collegiate has an influence on the psychological satisfaction, That is, difference in psychological satisfaction according to the type of sports of sports activity, and individual event is the highest. 4. The type of sports activity among the collegiate has an influence on the social satisfaction, That is, difference in social satisfaction according to the type of sports of sports activity, and team is the highest. 5. The type of sports activity among the collegiate has an influence on the social satisfaction. That is, difference in educational satisfaction according to the type of sports of sports activity, and team is the highest. 6. The type of sports activity among the collegiate has an influence on the physiological satisfaction. That is, difference in physiological satisfaction according to the type of sports of sports activity, and team is the highest. 7. The type of sports activity among the collegiate has an influence on the relaxatiorral satisfaction. That is, difference in relaxational satisfaction according to the type of sports of sports activity, and special event is the highest. 8. The type of sports activity among the collegiate has no an influence on the environmental satisfaction.