재발성 류마티즘 환자에서 발작의 유발인자

주유철,이동민,양종태,신병철,임태영,서정균,정기영,최동헌,김원,조영신,고희관 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Palindromic rheumatism (PR) is known to be triggered without any obviously inciting events in most patients, although, in a few cases, attacks have been noted to relate to another events such as weather change, childbirth, ingestion of certain foods, or over-exercise. The aim of this study was to characterize the triggering factors on palindromic attacks. Materials and Methods : We evaluated sixty-four patients with PR for the presence of triggering factors and the relationship between attacks and triggering factors by interview of patients. We considered that there was an probable association between episodes and PR, if episodes within 24 hours prior to PR had triggered at least 50% of all attacks and a definite association between episodes and PR, if episodes within 24 hours prior to PR had triggered 100% of all attacks. Results : In 15 patients (35.9%), there was a possible association between episodes of PR and initiating events. In 8 patients (12.5%), there was a definite association between episodes of PR and initiating events. The triggering factors were physical over-activity including exercise (19/64: 29.7%), foods, such as rawfish, crab, and chicken, including alcohol (19/96: 19.8%). However, there were no difference between the groups with and without the triggering factor in sex ratio, duration and onset of PR, the positive rate of rheumatoid factor and involved sites. Conclusion : Our observations showed that PR was triggered by physical over-activity more than in previous reports and hypersensitivity to foods was a causative factor in some patients with PR. However, patients with triggering factors had a similiar clinical profile to patients without triggering factors.

간세포의 기능적 변화가 그 미세구조 특히 교통반과 부착반에 미치는 영향에 관한 전자현미경적 연구

박영관,신영철 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.4

트레드밀 運動프로그램 適用이 高血壓者의 血壓과 血淸脂質 및 心肺機能에 미치는 影響

홍영우,황수관,박철빈 경희대학교 체육과학연구소 1995 體育學論文集 Vol.23 No.-

In order to clarify how the treadmill program influences the blood pressure, serum lipids, and cardiopulmonary function of the hypertensive adult, total 34 subjects-26 male subjects and 8 female subjects- in an age group of 30-65 year joined in a program of treadmill exercise which was carried out for 12 weeks sequentially. The intensity of exercise given to the subjects was within 50-80% of their maximun oxygen uptake, and they had exercise for 20-40 minutes a day which was executed for 5 days a week. And in order to find out any difference or change happening for the application of the program to the subjects, blood pressure, physical composition or structure, serum lipids, metabolism, and cardiopulmonary function were checked before and after exercise and compared with reference to the changes of blood pressure, heart rate, and oxygen uptake while the subjects were taking exercise. And those data were reviewed in terms of a male group and female group and a total group which includes both male and female subjects. Also the data were reviewed in an age group of less than 50 years and another age group of more than 50 years. And additionally, the data were reviewed in three groups concerning systolic blood pressure; a group whose systolic blood pressure decreased by 0-9 mmHg, another group whose systolic blood pressure decreased by 10-19 mmHg, and another group whose systolic blood pressure decreased more than 20 mmHg. And also they were reviewed in three groups regarding diastolic blood pressure; a group whose diastolic blood pressure decreased by 0-5 mmHg, and another group whose diastolic blood pressure decreased by 6-10 mmHg, and another group whose diastolic blood pressure decreased more than 11 mmHg. In the result of such a study, findings are as follows : 1.It appeared that systolic pressure and diastolic pressure in a stable condition after the execution of the program significantly decreased(p<0.001) in the male group and the total group, with also decreased heart rate showing as well in these groups. 2.It appeared that forced vital capacity(FVC), forced expiratory volume for 1 second percent(FEV1), and maximum voluntary ventilation(MVV) after the execution of the program significantly increased (p<0.05, p<0.01) in the male group and the total group, and however only maximum voluntary ventilation increased in the female group. Regarding age, FEV1 increased more in the age group of less than 50 years than in the age group of more than 50 years. 3.Body weight, persent body fat, and fat body weight decreased in all the groups-the male group, female group, and total group since the execution of exercise, and body fluids incresed only in the male group and total group. Regarding age, persent body fat decreased more in the male group whose age is less than 50 years and in the female group whose age is more than 50 years than in other groups. Regarding the decrease rate of blood pressure, the group in that systolic blood pressure decreased more than 20 mmHg in male body fat rate and the group in that diastolic blood pressure decreased more than 11 mmHg showed more decrease rare of blood pressure than other groups. 4.Total cholesterol(TCH), low density lipids protein(LDL), ratio of total cholesterol to high density lipids protein and triglycerides(TG) decreased in all the groups- the male group, female group and total group since the execution of exercise, however high density lipids protein increasing. Regarding age, total cholesterol decreased more in both the male and female groups whose age in under 50 years than both the male and female group whose age is above 50 years. And triglycerides decreased more in the female group whose age is under 50 than in the female group whose age is above 50. Regarding the decrease rare of blood pressure, the group in the systolic blood pressure decreased more than 20 mmHg in male triglycerides and the group in that diastolic blood pressure decreased within 6-11 mmHg showed more decrease rate of blood pressure than other groups. 5.Heart rate in exercise decreased after the execution of the program than before the execution of the program. 6.The increase of systolic blood pressure in exercise decreased in all the groups-the male group, female group, and total group, howere no change showing in their diastolic blood pressure. 7.The amount of oxygen uptake in exercise and after exercise incensed in all the groups- the male group, female group, and total group after the execution of the program than before the execution of the program. 8.Maximum oxygen uptake significantly increased(p<0.01) in all the groups-the male group, female group, and total group after the execution of the program. 9.A regression equation showing the relations between systolic blood pressure, heart rate and oxygen uptake was obtained, and it indcated a close relation between them. Based on the finding indicated so far, those results after the application of the treadmill exercise program to hypertensive adults such as decrease in blood pressure, weight, body fat rate, and body fat, increase of body fluids, improvement of the metabolism of serum lipids and cardiopulmonary function, and more increase of both systolic blood pressurea and diastolic blood pressure in the male group whose age is less than 50 years than in the male group whose age is more than 50 year-all these indicates significance. And also, based on the regression equation, the possibility to estimate heart rate and oxygen uptake with only systolic blood pressure is a noteworthy result of this study.

정신분열병 환자의 우울증에서 Paroxetine과 삼환계 항우울제 병용치료

심주철,공보금,박정환,윤영란,신재국,김정익,안동성,김용관,차인준,김영훈 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 마산동서병원에 입원중인 우울증이 동반된 정신분열증 환자 10명을 대상으로 사용중인 항정신병약물에 paroxetine과 저용량의 삼환계 항우울제를 6주간 병용투여한 후 우울증상에 대한 효과와 치료의 안전성 및 약물상호작용을 알아보았다. Paroxetine은 고정량의 항정신병약물과 삼환계 항우울제에 부가하여 일일 20㎎을 6주간 병용하게 하였으며, 임상상태는 HDRS, HARS, UKU Side Effect Rating Scale등의 평가척도를 사용하여 평가하였다. 또한 약동학적 약물상호작용은 삼환계 항우울제들의 혈장농도를 HPLC로 측정하여 분석하였다. 결과는 다음과 같다. 1) 10명의 전체 대상환자에서의 HDRS 평균점수는 TCA와 paroxetine 병용투여 6주후에 통계적으로 유의하게 감소되었다. 이중 40%의 환자에서는 병용투여 6주후에 HDRS 점수상 50% 이상의 감소를 보여, 일부의 환자들에서는 정신분열병에 동반된 우울증상의 치료에 소량의 삼환계 항우울제와 paroxetine의 병용치료가 효과가 있음을 확인하였다. 2) 두 명의 환자에게서 심각한 약물독성이 발생하였다. 이중 한 명은 삼환계 항우울제의 높은 혈중농도로 인한 항콜린성 위기(anticholinergic crisis) 소견을 보였으며, 다른 한 명은 인지기능 및 의식수준은 명료하였으나 망상과 환각증상이 약화되는 소견을 보였다. 따라서 본 연구에서 시도된 복합적 약물치료의 경우, 삼환계 항우울제의 혈중농도의 측정을 포함한 세심한 임상적 추적이 필요하다고 생각된다. 3) 기저치의 amitriptyline과 그 대사물인 nortriptyline의 농도합. imipramine과 대사물인 desipramine의 농도합은 각각 47.8-226.5ng/㎖. 80.5-395.6ng/㎖였으며 일반적으로 이들 약물들의 단독사용시에 문헌에 보고된 혈중농도를 훨씬 상회하고 있었다. 이는 병용투여된 항정신병 약물 약시 강력한 CYP2D6 효소억제제로서 기저치의 삼환계 항우울제들의 혈장농도를 이미 상당히 증가시켰던 것으로 판단되며, 그러한 결과로 인해 본 연구에서는 paroxetine이 이전의 문헌보고들과는 달리 뚜렷하게 삼환계 항우울제들의 혈장농도를 증가시키지 못하였다. 본 연구는 SSRI와 삼환계 항우울제의 병합 투여가 우울증의 개선 효과를 빠르게 하고, 치료역을 넓히고, 약물상호작용의 결과 paroxetine이 삼환계 항우울제의 혈중농도를 증가시킨다는 기존의 연구결과를 이용하여 정신분열병 우울증상의 치료에 parotextine과 소량의 삼환계 항우울제를 병용하는 방법을 시도해 본 연구이다. 저자들은 이러한 약물치료가 일부의 환자들에게서 효과가 있음을 관찰하였으나, 항정신병약물과 삼환계 항우울제를 병용투여 할 경우는 물론 이에 paroxetine과 같은 선택적 세로토닌 재흡수 억제제를 병용할 경우 복합약물상호작용의 결과로 약물독성의 위험성이 크며 세심한 주의가 필요함을 경험하였다. Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly. Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained : 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was found in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYP2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant in our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

彎指症(CLINODACTYLY)의 治療

탁관철,이영호,이은정 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2

Clinodactyly refers to a curvature of a digit in a radial or ulnar direction in the coronal plane. The usual deformity is a radial deviation of the bilateral little fingers at DIP joint and caused by a developmental abnormality of growth in the middle phalanx. The abnormlity is inherited as an autosomal dominant trait with slight lack of penetrance. We have experienced 4 cases of clinodactyly in 2 patients on their bilateral little fingers and accomplished surgical correction of them with satisfactory results. There were generally two surgical options; a closing wedge osteotomy and an opening wedge osteotomy plus iliac or metatarsal bone graft. In 3 cases of moderate degree clinodactyly, the closing wedge osteotomy was applied. In a remaining severe case, we applied Reversing Wedge Osteotomy-authors` new modification of the opening wedge osteotomy. In that modification, a wedge of angulated middle phalangeal bone was osteotomized through a Z-plasty skin incision on radial side, reversed it, and re-inserted into the place to maximize correction of the angulation and gaining in the length.

공작기계 주축 거동시 발열에 의한 온도분포 특성에 관한 연구

임영철,김종관 朝鮮大學校 機械技術硏究所 2000 機械技術硏究 Vol.3 No.1

This paper has studied thermal characteristics of machine tool to develope high speed spindle and optimum design condidering the thermal deformation. Comparing the test data of temperature measurement and structural analysis data using FEM, we verifiedthe test validity and predicted thermal deformation, influence of spindle generation of heat, and established cooling system to prevent the thermal deformation. 1) The temperature rise of spindle system depends on increasing number of rotation and shows sudden doubling increment of number of rotation over 7,000rpm. 2) Oil jacket cooling can be effective cooling method below 8,000rpm but, over 8,000rpm, it shows the decrement of cooling effect. 3) Comparing FEM analysis results and revolution test results, we can confirmn approximate temperature change consequently, it is possible to simulate temperature rise and thermal distribution on the inside of spindle system. 4) We can confirm that simulated approach by FEM analysis can be effective method in thermal-appropriate design..

액상가압성형법으로 제조된 탄소나노섬유 강화 Cu 기지 복합재료의 인장 거동

장영환,김상식,정윤철,이상관 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.5

In the present study, the unidirectionally aligned carbon nanofiber (CNF) reinforced Cu composite was fabricated by the liquid infiltration process, and the deformation behavior of the composite was evaluated. For the unidirectional alignment of the severely entangled CNFs, the mechanical drawing process was utilized. The bundle of drawn Cu tubes compacted with the unidirectionally aligned CNFs was placed on the specially designed mold, which was subsequently canned, degassed, evacuated, heated at 1100℃ for 10 minutes in the electric furnace to liquefy the Cu, and finally transferred to the press. The optical and SEM micrographic observations of the final product demonstrated that, even though the CNFs were not uniformly distributed throughout the specimen due to the molten metal flow during melting process, the local unidirectionality was found to be preserved in those areas where the CNFs were densely distributed. Tensile test results showed that approximately two-fold increase in the tensile strength was obtained with the CNF reinforced Cu composite. Based on the micrographic and fractographic observations, the strengthening mechanism of the CNF reinforced Cu composite fabricated by the liquid infiltration process was discussed. (Received March 2, 2004)

비만여성이 운동프로그램에 따른 혈중지질 및 Immunoglobulin에 미치는 영향

고영호,임관철 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

The purpose of this study is to examine the effects of 8 weeks' resistance exercise program on blood lipid and immunoglobulin of 14 obese women (7 women for resistance exercise group and for badminton group each. As a result with regard to blood lipid and immunoglobulin before and after the B weeks' program, there were significant differences in resistance group: decreases in Total Cholesterol(3.76%), Low Density Lipoprotein Cholesterol (8.26%), Atherogenic lndex(40.99%), and an increase in High Density Lipoprotein(21.69%). Badminton group did not show any significant ditterences in TC, LDL-C, AL, and HDL-C. With regard to the changes of immunoglobulin, resistance group showed signilcant differences: IgA(19.70%), IIgG(12.99%), IgM(14.15%). There were no significant differences in badminton group. The results above indicated that the 8 weeks' exercise program had positive effects on coronary heart disease(CHD) risk factors. In the levels of immuanoglobulin, there were changes before and after the training, but between groups.

흰쥐 경동맥 풍선손상 모델에서 리포좀 전달체를 이용한 에스트로겐의 국소전달 효과

윤영섭,장양수,정광회,박요석,김형관,강웅철,권진욱,정보영,조상호,김성순 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8