연 착화제 효능에 관한 동물실험적 연구

김정만,김병권,김성환,서병성,김인식,김용규,정갑열,김준연 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.1

연 착화제 효능에 관한 동물실험적 연구

서병성,김준연,김정만,김용규,정갑열,김성환,김인식,김병권 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

This experiment was carried out to compare the efficacy of 2,3-dimercaptosuccinic acid(DMSA) and calcium ethylenediamine tetraacetate(CaEDTA) as chelating agents for lead poisoning. The rats had been fed water containing 0.5% lead acetate for 3 months and randomly divided into three groups. We administered DMSA only for group I(n=5), CaEDTA only for group II(n=5), and both DMSA and CaEDTA for group III(n=10), for 4 days. We evaluated urinary lead(PbU) level, blood lead(PbB) level and blood zinc protoporphyrin(ZPP) level before and after administration of the chelating agents. The results obtained were as follows; 1. After administration of chelating agents, the mean PbU levels, which were 248.2㎍/dl, 252.6㎍/dl and 270.0㎍/dl in group I, II and III before administration, were increased to 484.6㎍/dl, 479.9㎍/dl and 1,792.1㎍/dl in group I, II and III, respectively(p<0.05). 2. After administration of chelating agents, the mean PbB levels, which were 67.4㎍/dl, 59.9㎍/dl and 62.5㎍/dl in group I, II and III before administration, were decreased to 38.1㎍/dl, 36.3㎍/dl and 31.3㎍/dl in group I, II and III, respectively(p<0.05), but there were no different changes of ZPP level among groups. 3. The blood lead clearances, which were calculated by PbB level before and after administration of chelating agents, were 49.8%, 43.5% and 39.5% in group III, I and II, respectively.

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.

Koebner 현상이 동반된 전신성 광택태선 1예

김기준,김시용,김영조,최규철,정병수 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.1

Lichen nitidus is a rare chronic dermatitis of unknown etiology. It is characterized by round, flat-topped, flesh-colored papules 2 to 3 mm in diameter that may occur in groups but do not coalesce. The lesions of lichen nitidus are usually localized to the upper extremities, genitalia, chest, and abdomen, but less commonly, they may be generalized. Although the eruption is usually asymptomatic, it is sometimes mild pruritic, and the Koebner phenomenon may be observed very exceptionally. We reported a case of generalized lichen nitidus with Koebner phenomenon.

필라델피아 염색체 양성 급성골수성백혈병에서 Imatinib Mesylate로 분자학적 관해를 유도한 후 성공적인 자가 말초혈액 조혈모세포이식이 시행되었던 1예

김여경,이제중,이병환,변정래,조덕,이일권,정익주,양동욱,김형준 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.1

저자들은 필라델피아 염색체 양성 급성골수성백혈병 환자에서 복합항암화학요법으로 혈액학적 완전관해를 유도하고, imatinib mesylate를 이용하여 분자학적 관해를 유도한 후, 성공적으로 자가 말초혈액조혈모세포이식을 시행하였던 1예를 경험하였기에 이를 보고하는 바이다. Philadelphia chromosome (Ph¹)-positive acute myeloid leukemia (AML) is very rare disease, comprising 3~4% of the AML, and is a clinically distinct entity with poor clinical outcome with conventional chemotherapy. We report a case of Ph¹-positive AML who underwent successful autologous peripheral blood stem cell transplantation after achieving a molecular remission with imatinib mesylate.

기도 이물의 임상적 고찰

김영석,이승규,이민재,백병준,오천환 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Aspiration of foreign bodies into the airway is a common problem in spite of efforts to educate the public and it can be sometimes fatal accidents. A retrospective study has been performed for 34 cases of airway foreign bodies, which were obtained from April 1994 to August 1998 at Chunan hospital of Soonchunhyang University. The results were as follows: 1) Among the 34 cases, 26 cases(76.4%) were under the age of 3. The ratio of male and female was 1.4:1. 2) The most common symptom after foreign body aspiration was intractable cough(38.2%). 3) Abnormal findings in the chest X-ray films were found 24 cases(70.6%) and the most common abnormal radiologic feature was combination of pneumonia and atelectasis(37.5%), followed by combination of pneumonia and emphysema(16.6%), pneumonia alone(16.6%). 4) The nature of foreign body was vegetables in 20 cases(58.8%), miscellaneous in 11 cases(32.4%), metals in 2 cases(5.9%) and plastics in 2 cases(5.9%). 5) By distribution of the location of foreign bodies, 26 cases(76.4%) were located in the main bronchus(20 cases in right side and 6 cases in left side), 5 cases were in trachea, 2 cases were in larynx and 1 case was located at carina level. 6) By duration of foreign body lodgement in the airway, 15 cases(44.1%) were found within 24 hours, 9 cases(26.5%) were within 7 days, 7 cases(20.6%) were within 30 days and 3 cases(8.8%) were found over 1 month. 7) In mode of treatment, ventilating bronchoscopic removal under general anesthesia was performed in 29 cases(85.3%), thoracotomy with bronchotomy in 2 cases, thoracotomy with lobectomy in 1 case and postural drainage in 2 cases. 8) Complication rate according to the nature of foreign body was most high in vegetables(68.2%). 9) Correlation between complication rate and the duration of the foreign bodies in situ was definite.

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

우리나라 도시와 농촌 지역 주민의 혈중 연 및 혈중 Zinc Protoporphyrin농도 비교 연구

김준연,김병권,홍영습,이용언,정갑열 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

The study was carried out on healthy population in urban and rural area, in order to compare the level of blood lead (PbB) and blood zinc protoporphyrin (ZPP) between the population living in each area from July 1 1994 to December 31 1994. We stratificated the results with sex, age and area. The results obtained were as follows; 1. In urban area, overall mean of the PbB level was 7.08±1.61㎍/dl and both men and women had the highest level of PbB, which were 8.15±0.85㎍/dl, 6.90±1.48㎍/dl, in less than 39 years old group. In rural area, overall mean of the PbB level was 6.75±1.61㎍/dl and both men and women had the highest levels of PbB, which were 7.25±2.29㎍/dl, 7.00±2.92㎍/dl in 40∼49 years old group. And there was statistically significant difference between mean of the men's PbB level in urban area and that in rural area (p<0.05). 2. In urban area, overall mean of the ZPP level was 32.08±8.28㎍/dl and men had the highest level of ZPP, which was 29.59±5.13㎍/dl, in 40∼49 years old group, and women had that, which was 36.83±7.95㎍/dl, in less than 39 years old group. In rural area, overall mean of the ZPP level was 34.54±11.31㎍/dl and men had the highest level of ZPP, which was 32.10±5.45㎍/dl, in less than 39 years old group and women had that, which was 40.17±14.02㎍/dl, in 40∼49 years old group. And there was statistically significant difference between mean of the men's ZPP level in urban area and that in rural area (p<0.05). 3. There was statistically significant difference in PbB and ZPP between men and women group in both area (p<0.05) but not significant among age group in both area (p>0.05).

연골양 한관종 1예

김기준,김영조,정병수 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Chondroid syringoma, also called cutaneous mixed tumor, is a solitary, well-demarcated, firm intradermal or subcutaneous nodule which mainly occurs on the head and neck. Histopathologically, the tumor is composed of pleomorphic components of both epithelial and mesenchymal elements. Chondroid syringoma has been argued about, with differentiation toward eccrine or apocrine units. We report a case of chondroid syringoma in a 51-years-old male patient who has a solitary, 1.0 × 0.7㎝ in sized, firm, erythematous nodule on his nose.

새열기형의 임상적 고찰

김장묵,김대식,백승혁,한동렬,김희중,백병준,오천환 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

Background and Objectives : Branchial cleft anomalies are encountered rarely in clinical practice. We reviewed medical records of branchial cleft anomalies according to age and sex distribution, site distribution, characteristics of mass on physical examination, location of mass, preoperative diagnosis, type of branchial cleft cyst and report our experience with 25 cases of branchial cleft anomalies. Materials and Methods : A review of medical records was performed on 25 cases of branchial cleft anomalies diagnosed in pathologic report from January, 1990 to March, 2000. Result : Sex distribution was 11 male and 14 female, age distribution was most common in third decade which was 8 cases(32%). Site distribution was predominant in left side(13 cases), and in physical examination, the characteristics of the mass was nontender(76%), mobile(60%), soft(80%). The lesion site was submandibular area in 2 cases, upper 1/3 portion of sternocleidomastoid muscle(SCM) in 2 cases, middle 1/3 portion of SCM in 20 cases and parotid area in 1 case. The preoperative diagnosis was branchial cleft cyst in 16 cases, cervical lymphadenitis in 3 cases, tuberculous lymphadenitis in 3 cases, branchial cleft fistula in 1 case, dermoid cyst in 1 case and parotid mass in 1 case. Among 25 cases, first branchial cleft cyst was seen in 4 cases, second branchial cleft cyst in 20 cases and second branchial cleft fistula in 1 case. Conclusion : The clinical history of recurrent neck inflammatory episodes in young patients and nontender, mobile, soft neck mass should raise the suspicion of this entity. Investigation using CT scanning in combination with aspiration is useful. Treatment of all branchial cleft anomalies is complete surgical excision because there is lack of spontaneous regression, a high rate of recurrent infection, the possibility of other diagnosis, and rare malignant degeneration. Complete removal without complications depends on a good understanding of regional embryogenesis, a knowledge of the surrounding structure, and awareness of the different anatomical presentation.