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.

수종의 고정성 보정장치에 따른 유성견의 치주조직 반응

조명훈,윤영주,김광원 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.1

교정력을 가한 후 각기 다른 재료로 제작된 고정성 보정장치를 적용한 경우에 발생하는 치주조직의 재형성과 치유과정을 조직학적으로 관찰하기 위해 건강한 치주상태를 가진 네 마리의 유성견을 대상으로 최초 교정력이 200gm이 되도록 견인 스프링 (sentalloy closed coil springR, Tomy Co., Japan)을 대상 치아에 결찰하여 1주일 간 교정력을 가한 후, 각각의 실험동물에 3가닥 호선인 0.018인치 DentaflexR(Dentarum Co., Germany), 3가닥 호선인 0.020인치 DentaflexR(Dentarum Co., Germany), 6가닥 호선인 0.0195인치 RespondR(G&H Co., U.S.A.)를, 그리고 자가중합형 레진 접착제인 Superbond C&BR를 고정성 보정장치의 재료를 이용하여 보정장치를 접착한 군과 보정장치를 접착하지 않은 군으로 나누어 3주간 적용 후 희생하여 H-E염색군, M-T염색군으로 나누어 광학현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1.0.0195인치 RespondR를 접착시킨 군은 0.018인치 DentaflexR, 0.020인치 DentaflexR, Superbond C&BR를 접착시킨 군에 비교할 때 압박측에서의 거대세포 침윤 감소와 긴장측에서의 신생골 형성 증가가 매우 두드러지게 나타났으며 치주인대는 형태와 배열에서 대부분 정상적인 소견을 보였다. 2.실험 1군의 모든 실험대상에서 압박측 치조골 내부의 괴사골이 관찰되었고, 압박측과 긴장측 모두에서 치조골 표면의 골양조직 및 sharped 섬유의 형성과 치주인대의 재형성 현상이 나타나는 것이 관찰되었다. 3.실험 2군은 실험 1군에 비교하여 압박측에서 거대세포 침윤이 현저히 감소되었고 치주인대는 거의 정상적인 소견을 보였다. 긴장측에서는 수층의 골침착을 보이며 치주인대 측으로 골양조직과 골아세포가 구상으로 나타나는 활성화 소견을 보였다. 이상의 결과에서 더 여러 가닥이 꼬인 6가닥 호선인 0.0195인치 RespondR(G&H Co., U.S.A.)를 보정장치로 적용한 경우가 다른 재료의 고정성 보정장치보다 더 활발한 신생골주 형성의 활성화 소견이 관찰되었으며 대조군과 유사한 배열과 형태를 보이는 정상적인 치주인대 섬유의 배열양상이 관찰되어 다른 재료들에 비교하여 치주조직의 초기 재형성과정을 더 신속하게 유도하는 것으로 사료된다. The purpose of this study was to evaluate the material for fixed type retainer, allowing physiologic tooth movement. and proper remodeling of periodontal tissue during retention period. The present study was performed to observe the histologic changes of periodontal tissue after application of different types of fixed type retainer after orthodontic tooth movement in young adult dogs. For this study, 4 young adult dogs were used as a experimental animal and experimental group was divided into three groups ; experimental group 1 contained right side maxillary third incisors and canines, experimental group 2 contained contralateral teeth of same animals, and control group contained mandibular premolars. And each dogs were applied the 4 different types of fixed type retainer to experimental group 1. The experimental teeth were ligated on the Sentalloy closed coil springR(Tomy Co., Japan) from maxillary third incisors and canines and applied orthodontic force at initial 200gm-forced during 1 week. All the experimental animals were sacrificed on the 3rd week after the orthodontic teeth movement and then the specimens were taken, fixed in formalin, embeded in parafin, sectioned 6-8μm in thickness and stained with Hematoxylin-Eosin staining, and Masson's trichrome staining method. Examined under the light microscopy. The following results were observed. There were observed that decreased infiltration of giant cells in pressure side and increased the new bone forming in tension side on the specimen of 6-stranded 0.0195' RespondR(G&H Co., U.S.A.) group. Periodontal ligament fibers were much compressed or elongated in 3-stranded 0.018', 0.020' DentaflexR(Dentarum Co., Germany), and Superbond C&BR(Sun Medical Co., Japan) groups. 2. In experimental group 1, necrotic bone inside the alveolar bone of pressure side, forming of the sharpey's fiber in osteoid tissue, and remodeling of the periodontal ligament were observed in all animals. 3. In experimental group 2, it was observed that the amount of bone resorption was equal or decreased in pressure side, and increased new bone forming and significantly decreased Infiltration of giant cell than the experimental group 1. By this results, it considered that 6-stranded RespondR(G&H Co., U.S.A.) wire was the most useful material allowing early periodontal tissue remodeling.

외과적 노출술을 이용한 매복된 하악 제 1 대구치의 자발적 맹출 유도

김은정,김난진,조호진,김현정,김영진,남순현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

하악 제 1대구치 매복의 발생 빈도는 전체 인구의 0.01%로 드물게 나타난다. 매복의 원인으로는 맹출 공간의 부족, 과잉치, 치성 종양이나 낭과 같은 맹출로상의 장애물, 유전적 요인, 내분비 질환, 외상 등이 있다. 하악 제 1대구치의 매복으로 인해 하안면 고경의 감소, 낭의 형성, 치관 주위염, 인접치의 치근 흡수, 부정 교합 등의 부작용이 생길 수 있으며, 치료 방법으로는 외과적 노출술, 교정적 견인, 외과적 재위치술, 발거 등이 있다. 다음의 두 증례는 하악 제 1대구치의 미맹출을 주소로 내원한 환아에게 외과적 노출술을 시행하여 원심 경사 매복된 하악 제 1대구치의 자발적 맹출을 유도한 증례들이다. Impaction of mandibular first molar is relatively rare and its overall frequency has been reported to be 0.01%. The etiology of impaction are lack of eruption space, physical obstacles such as supernumerary teeth, odontomas or odontogenic tumors, hereditary factors, functional disturbances of endocrine glands and traumas. Impaction of mandibular first molar can result in a short lower facial height, formation of a follicular cyst, pericoronal inflammation, resorption of the roots of neighboring teeth and malocclusion. The treatment options available for impacted teeth include surgical exposure, orthodontic forced eruption, surgical repositioning and surgical removal of unerupted molar. This report presents two cases of distally tilted and impacted mandibular first molars which were treated by surgical exposure. In these cases, we could observe spontaneous eruption of the impacted mandibular first molars after surgical exposure.

간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.

Electrically conductive graphene/polyacrylamide hydrogels produced by mild chemical reduction for enhanced myoblast growth and differentiation

Jo, Hyerim,Sim, Myeongbu,Kim, Semin,Yang, Sumi,Yoo, Youngjae,Park, Jin-Ho,Yoon, Tae Ho,Kim, Min-Gon,Lee, Jae Young Elsevier 2017 Acta Biomaterialia: structure-property-function re Vol.48 No.-

<P><B>Abstract</B></P> <P>Graphene and graphene derivatives, such as graphene oxide (GO) and reduced GO (rGO), have been extensively employed as novel components of biomaterials because of their unique electrical and mechanical properties. These materials have also been used to fabricate electrically conductive biomaterials that can effectively deliver electrical signals to biological systems. Recently, increasing attention has been paid to electrically conductive hydrogels that have both electrical activity and a tissue-like softness. In this study, we synthesized conductive graphene hydrogels by mild chemical reduction of graphene oxide/polyacrylamide (GO/PAAm) composite hydrogels to obtain conductive hydrogels. The reduced hydrogel, r(GO/PAAm), exhibited muscle tissue-like stiffness with a Young’s modulus of approximately 50kPa. The electrochemical impedance of r(GO/PAAm) could be decreased by more than ten times compared to that of PAAm and unreduced GO/PAAm. <I>In vitro</I> studies with C2C12 myoblasts revealed that r(GO/PAAm) significantly enhanced proliferation and myogenic differentiation compared with unreduced GO/PAAm and PAAm. Moreover, electrical stimulation of myoblasts growing on r(GO/PAAm) graphene hydrogels for 7days significantly enhanced the myogenic gene expression compared to unstimulated controls. As results, our graphene-based conductive and soft hydrogels will be useful as skeletal muscle tissue scaffolds and can serve as a multifunctional platform that can simultaneously deliver electrical and mechanical cues to biological systems.</P> <P><B>Statement of Significance</B></P> <P>Graphene-based conductive hydrogels presenting electrical conductance and a soft tissue-like modulus were successfully fabricated via mild reduction of graphene oxide/polyacrylamide composite hydrogels to study their potential to skeletal tissue scaffold applications. Significantly promoted myoblast proliferation and differentiation were obtained on our hydrogels. Additionally, electrical stimulation of myoblasts via the graphene hydrogels could further upregulate myogenic gene expressions. Our graphene-incorporated conductive hydrogels will impact on the development of new materials for skeletal muscle tissue engineering scaffolds and bioelectronics devices, and also serve as novel platforms to study cellular interactions with electrical and mechanical signals.</P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

HMG-CoA 환원효소 억제제에 의한 ICAM-1 유전자의 발현조절

김현진,정효균,홍우정,김군순,조영석,김도희,채수흥,구본정,송민호,노흥규,김영건 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1

Background : ICAM-1 act as one of major adhesion molecules in the atherosclerotic lesion. ICAM-1 expression is mainly regulated at the level of transcription and depend on IFN-γ signal transduction pathway in which the STAT1 transcrption factor is a critical intermediate. IFN-γreceptor not only initiates tyrosine 701 phosphorylation of STAT1 by Jak1 and Jak2, but also phosphorylates serine 727 through the activation of Raf-1/MAP kinases. HMG-CoA reductase inhibitors have anti-atherosclertic effects, beyond normalization of hypercholesterolemia, by directly acting on endothelial cells, macrophages and vascular smooth muscle cells. HMG-CoA reductase inhibitors suppress the synthesis of isoprenoid intermediates such as geranylgeranyl-pyrophosphate or farnesylpyrophosphate. These effects results inhibitors suppress the synthesis of isoprenoid intermediates such as geranylgeranyl-pyrophosphate or farnesylpyrophosphate. These effects results inhibition posttranslational farnesylation and geranyl-geranylation processing of small GTP-binding preoteins and inhibition of normal signaling activities. Method : We made several 5'-deletion constructs of rat ICAM-1 promoter and analyzed the promoter activities by measuring the luciferase activity after transfection into ECV304 cells and smooth muscle cells. We checked the level of total and phosphorylated STAT1 protein by immunoblot analysis using specific antibodies. Results : Lovastatin inhibits IFN-γ-induced ICAM-1 gene expression in the ECV304cell. The cells pretreated with PD98059, MEKK inhibitor showed significantly low ICAM-1 RNA induction with IFN-γ stimulatio. IFN-γ induced phosphorylation of tyrosine 701 was not significantly changed by the pretreatment of lovastatin. But lovastatin suppresses IFN-γ-induced phosphorylation of ERK1/ERK2 which are responsible for the seine 727 phosphorylation in STAT1. Conclusion : We showed that HMG-CoA reductase inhibitors, lovastatin, suppresses IFN-γ mediated ICAM-1 gene expression through the inhibition of transcription. HMG-CoA reductase inhibitor suppresses IFN-γ-induced phosphorylation of serine 727 in STAT1 through the modulation of MAP kinases.

폐경후 골다공증 환자에서 체질량지수에 따른 Alendronate의 효과

조영석,나소영,이효진,홍우정,김군순,김도희,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

배경 : 폐경후 골다공증은 심각한 문제로 대두되고 있다. 현재 Alendronate는 폐경후 골다공증의 치료제로서 널리 쓰이고 있다. 저자는 Alendronate의 골밀도에 효과를 알아보고 골다공증의 위험인자에 따른 Alendronate의 반응 정도를 평가하기 위하여 본 연구를 수행하였다. 방법 : Alendronate를 평균 12개월간 복용한 35명의 폐경후 골다공증환자에서 체질량지수와 폐경후 기간에 따른 치료효과를 조사하였다. 결과 : 전체 대상군에서 Alendronate 10㎎을 12개월간 투여한후 골밀도의 평균 변화율은 요추와 대퇴골 경부에서 각각 7.83±7.39%와 2.99±9.22%이었다. 과체중군에서 평균변화율은 요추와 대퇴골 경부에서 각각 7.15±4.5%와 3.05±2.86%였다. 양군간에 통계적 유의성이 있는 차이는 없었다. 폐경후 7년이 경과되지 않은 군에서의 평균변화율은 요추와 대퇴골 경부에서 각각 6.9±5.3%와 5.71±0.08%였다. 양군간에 통계적인 유의성이 있는 차이는 없었다. 결론 : 마른체형이 골다공증의 발병에는 영향이 있으나, Alendronate 치료효과의 차이는 없는 것을 확인할 수 있었다. 더불어 폐경이 있고 7년이 초과된 군과 년이 경과되지 않은 군에서의 Alendronate 치료효과의 차이는 없는 것을 확인할수 있었다. 이는 골흡수가 상당히 진행된 상태에서도 Alendronate가 치료효과를 가지고 있음을 반영한다고 할 수 있겠다. Postmenopausal osteoporosis is a serious health problem. The aminophosphonate Alendronate is widely used for treatment of postmenopausal osteoporosis. We studied the effect of l0㎎ of alendronate given daily for mean 12 months on bone mineral density in 35 women(mean age 61yrs. mean BMI 23.24㎏/m^(2)) with osteoporosis. An over weight group is defined such that BMI was above 23㎏/m^(2). All the women received 1500㎎ calcium carbonate daily. The bone mineral density of L-spine and femoral neck was measured by dual-energy X-ray absorptiometry. Alendronate increased BMD at mean 12 months at the L-spine (7.15±4.5%) and femoral neck(3.05±2.86%) in normal women. Alendronate increased bone mineral density at 12 months at the L-spine(6.00±5.3%) and femoral neck(4.17±4.87%) in overweight women. There was no difference between two groups. In the less than 7 years group of postmenopausal duration. alendronate increased bone mineral density at 12 months at the L-spine(6.9±4.9%) and femoral neck(3.18±7.1%). In the more than 7 years group of postmenopausal duration, alendronate increased hone mineral density at 1% months at the L-spine(6.5±5.3%) and femoral neck(5.71±0.08%). There was no difference between two groups. In postmenopausal women with osteoporosis, therapy with alendronate produced significant increases in BMD of the L-spine and femoral neck in both group. There was no difference between normal and over-weight groups. and between less than 7 years group and more than 7 years group of postmenopausal duration.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

신경회로망에 의한 용접 결함 종류의 정량적인 자동인식 시스템 개발에 관한 연구

김재열,김영석,김병현,유신,김훈조,정진홍 한국공작기계학회 1997 한국생산제조학회지 Vol.6 No.1

A neural network approach has been developed to determine the depth of a surface breaking crack in a steel plate from ultrasonic backscattering data. The network is trained by the use of feedforward three-layered network together with a back-scattering algorithm for error correction. The signal used for crack insonification is a mode converted 70˚ transverse wave. A numerical analysis of back scattered field is carried out based on elastic wave theory, by the use of the boundary element method. The numerical data are calibrated by comparison with experimental data. The numerical analysis provides synthetic data for the training of the network. The training data have been calculated for cracks with specified increments of the crack depth. The performance of the network has been tested on other synthetic data and experimental data which are different form the training data.