사염화탄소 투여 흰쥐에서 간섬유화 진행에 따른 Propranolol 의 약동학적 지표들의 변화

이민호,강주섭,강문수,윤병철,이오영,함준수,변재원,윤창옥 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.2

Background/Aims : This study was designed to determine the effect of hepatic fibrotic severity on pharmacokinetics of propranolol in CC1q - treated rats. Methods - 1 mL/kg of 10% CC14 in olive oil was injected intramuscularly to rats twice weekly for 4, 6, 8 and 10 weeks, respectively (n=6). Control (n=6) was a sham - injected equal dose of olive oil for 10 weeks. After intravenous bolus injection of 2 mg/kg propranolol to rats, the serum propranolol concentrations were analyzed for 4 hours at various time points by a HPLC - fluorimetric system, and pharmacokinetic parameters such as Co, MRT, AUC, Vdss, tl/2(p) and CLp were determined. Then, a small amount of hepatic tissue was obtained and subjected to determination of the hepatic 4 - hydroxyproline content, which confirmed the hepatic fibrotic severity. Results : The serum concentrations of propranolol at 0.5, 1, 2 and 4 hours were significantly increased in CC1q-treated rats (p$lt;0.01). In proportion to the duration of CC4 treatment, Co and AUC were significantly increased, and Vdss and CLp were significantly decreased (p$lt;0.001). But MRT and t1/2(β) were not significantly changed. The hepatic 4 -hydroxyproline content was gradually increased in CC4-treated rats (p$lt;0.001). Conclusion - Gradual changes in pharmacokinetic parameters of propranolol were seen to be dependent on the hepatic fibrotic severity. We suggest that gradual dosage modification, according to their hepatic fibrotic severity, is necessary for many drugs administered to patients with chronic liver disease.(Korean J Hepatol 2001;7:181-188)

Cytochalasin B와 Colchicine이 생쥐 간장의 담세관과 간세포의 미세구조에 미치는 영향

박창현,장병준,엄창섭,엄창섭 대한해부학회 1998 Anatomy & Cell Biology Vol.31 No.2

요추 추간판탈출증 수술 후 임상 증상의 회복

신병준,김준범,조영훈,권희,서유성,김연일,나수균,최창욱 대한척추외과학회 1997 대한척추외과학회지 Vol.4 No.2

Study Design : The authors retrospectively analysed the recovery of clinical symptoms after surgical treatment of lumbar HIVD. Objectives : To investigate the incidence of clinical symptoms, the recovery rate and time after surgical treatment and the difference between L4-5 and L5-S1 lesion. Summary of Literature Review : There are many reports concerning the clinical result of surgical treatment for the HIVD. They usually describe the result as excellent, good, fair and poor. We can't get any information about the recovery rate and recovery time of each clinical symptom from the reports. Materials and Methods : Thirty-eight patients were treated by one level open discectomy from march 1991 to december 1995. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol, Results : In preoperative examination, SLR was positive in 82%, motor deficit in 76%, sensory deficit in 74%, DTR change in 50%, and radiating pain in 100%. The recovery rate of SLR was 96.8%, motor deficit ; 93.6%, sensory deficit ; 78.6%, DTR change ; 21 % and radiating pain ; 84.2%. The average recovery time of SLR was 3.4 months, motor deficit ; 1.9 months, sensory deficit ; 5.3 months, DTR change ; 4.1 months and radiating pain ; 3.2 months. Motor and sensory deficit was more frequent in L4-5 lesion but DTR change was usually noted in L5-S] lesion. The recovery rate and time showed no great difference between the two level. Conclusions : The recovery rate was higher in SLR, motor deficit and radiating pain rather than sensory deficit and DTR change. The recovery time was fastest in radiating pain but variable nature was noted in sensory deficit. Above results may be helpful to explain the prognosis of the lumbar HIVD.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

Cyclosporin A 반복투여에 의한 랫드 간장의 조직학적 변화

윤화중,손무호,장병준,권구범 건국대학교 동물자원연구센터 1998 動物資源硏究誌 Vol.19 No.-

This study was carried out to investigate the histological changes of rat liver by repeated treatment of cyclosporin A that has been widely used for treating some autoimmune diseases and immunosuppressive drug in organ transplantation. 70 Sprague-Dawley rats were kept in experimental circumstances for 2 weeks and 50mg/kg B.W of cyclosporin A was injected once a day subcutaneously for 7 days and sacrificed at 1 hour, 1 day, 3 days, 7 days, 14 days, 28 days after the last injection. Histological changes were observed by H & E, Oil red O, and Masson trichrome stains and the results obtained were as follows. 1. 26 percent of animals has died during the treatment of cyclosporin A, and the animals survived were observed to be dull and inactivated. 2. The mild cytoplasmic changes of hepatocytes in portal area were observed by H & E stain in 1 hour lapse group and this finding was recovered with time lapse. 3. The lipid accumulation in periportal areas was observed in 1 hour and 1 day lapse groups and this finding was recovered with time lapse. 4. Although the cytoplasmic changes and lipid accumulation were started in the portal area and moved to intermediated and central areas, the changes in the intermediate and central areas were not as severe as that of portal area. 5. No specific increase of connective tissue was observed in all groups. 6. Histological changes of rat liver induced by cyclosporin A were recovered with time lapse, and the entire recovery was observed in 28 days lapse group after the last injection.

속박 (束縛) 과 침수 (浸水) 로 유도된 흰쥐의 스트레스성 급성 (急性) 위점막병변 (胃粘膜病變) 발생에 있어서 위산분비의 (胃酸分泌) 역할

민영일(Young Il Min),박충기(Choong Kee Park),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Jung Il Lee),박승준(Seung Joon Park),정주호(Joo Ho chung),정지창(Jee Chang Jung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1

N/A The possible roles of gastric acid secretion in the pathogenesis of stress ulcers induced by restraint with water-immersion for 7 hours in pylorus-ligated rats were investigated. Control rats with pylorus-ligation only did not show any gastric mucosa} lesion, and their mean gastric acid output was 449.2 ± 36.1 umol/rat. In contrast, the stressed rats, group II, showed multiple, punctate and hemorrhagic erosions in gastric mucosa, and mean gastric acid output was decreased to the level of 253.7 ± 27.3 umol/rat. Subcutaneous administration of histamine(40 mg/kg every 2.5 h for a total three times) to stressed rats augmented the lesion with severe multiple, linear and hemorrhagic erosions and mean acid output increased significantly (328.1 ± 31.5 umol/, p<0.005) compared with group II. Pretreatment with rantidine(20 mg/kg) or prostaglandin E2 (30 ug/kg) before exposure to stress reduced gastric lesion formation slightly with no significance. In ranitidine pretreated rats, mean gastric acid output was decreased significantly (120.1 ± 15.3 umol/rat, p<0.005) compared with group II. However, in prostaglandin pretreated rats, mean gastric acid output showed no significant changes. Therefore, it is suggested that increased gastric acid secretion seems to be an aggravating or a permissive factor rather than a major factor in the pathogenesis of stress-induced gastric mucosal lesions.

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.

만성 화농성 중이염의 세균학적 고찰

조남순,이영훈,강기훈,최제환,송태현,이병돈,장혁순,강주원,김연준 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and Objectives : Chronic suppurative otitis media is one of the frequent diseases in otolaryngologic field. It is important to choose of antibiotics in the management of infectious disease. But the organisms in infections have been changed and resistance to antibiotics has been grown as the development of antibiotics has been achieved. And so it has been necessary to recognize the changes of organisms and resistance in antibiotics. Our study was performed to identify the pathogens isolated from discharges in chronic otitis media and evaluate the antibiotic agents, to recognize the change of to resistance to·antibiotic agents and to use the appropriate anitiotics. Materials and Methods : Retrospectively, authors reviewed the backeriologic study of 114 cases of chronic suppurative otitis media who visited the Department of Otolaryngology, Soonchunhyang University in Seoul from Nov. 1996 to Oct. 1999 and analyzed 101 strains and its sensitivity test to various antibiotics. Result : In 93 cases in which pathogenic organism was isolated, single infection was 85 cases(91.4%) and mixed infection was 8 cases(8.6%). The most frequent pathogenic organism was Staphylococcus aureus(59.4%), Pseudomonas aeruginosa(13.9%), Providencia(4.8%), Alcaligenes(3.0%) and Streptococcus pneumoniae(2.9%) were the next. Methicilline-Resistance Staphylococcus aureus was 34 cases(57.6%) of Staphylococcus aureus. Staphylococcus aureus was sensitive to Vancomycin(96.7%), Trimethoprim-Sulfamethoxazole (57.6%), Cefuroxime(42.4%) and Ciprofloxacin(40.7%) but resistant to Penicillin(94.9%). Pseudomonas aeruginosa was sentitive Amikacin(100%), Ciprofloxacin(100%) and Gentamicin(67%). Conclusion : As MRSA recently was wide spread in community accquired infection as well as nosocomial infection, we must consider strict control of MRSA.

장티푸스 진단에 있어서 Vi-Indirect Fluorescent Antibody Test의 민감도 및 특이도

장경희,류동렬,박성하,박병규,이준구,염준섭,최영화,송영구,김현숙,정윤섭,김준명 대한감염학회 1998 감염 Vol.30 No.4

목 적 : 장티푸스는 체액의 세균배양검사에서 Salmonella typhi의 분리로 확진하지만 조기진단을 위해서는 혈청학적인 검사가 도움이 된다. 저자 등은 1989년 이후 장티푸스진단에 S. typhi의 Vi항원을 이용한 간접형광항체법 (Vi-indirect fluorescent antibody test : Vi-IFAT)을 도입하였다. 이에 지난 7년간의 검사결과를 토대로 Vi-IFAT의 민감도 및 특이도를 규명하고자 하였다. 방 법 : 1989년부터 1996년까지 연세대학교 의과대학 세브란스 병원에 발열을 주소로 내원하여 Vi-IFAT가 의뢰된 환자 중 발열의 원인이 확진된 744명의 환자를 대상으로 하였으며, Vi-IFAT에 있어서 양성반응은 1:64이상으로 하였다. 결 과 : 1) 세균배양검사에서 확진된 장티푸스 환자 178예 중 168예에서 양성반응을 보여 민감도는 94.4%이었다. 항체가는 1:64가 89예, 1:128이 36예, 1:256이 27예, 그리고 1:512가 16예이었다. 위음성이었던 10예의 항체가는 1:32가 7예, 1:16이하가 3예이었다. 2) 발열을 주소로 내원한 환자 중 장티푸스 이외의 다른 질환으로 확진된 566예 중 538예에서 음성반응을 보여 특이도는 95.1%이었다. 항체가는 1:32가 117예, 1:16이하가 421예이었다. 위양성이었던 28예의 항체가는 1:64가 23예, 1:128이 5예이었으며, 장티푸스 이외의 살모넬라증이 4예, 요로계감염이 10예, 소화기계감염이 6예, 호흡기 계감염이 5예, 악성 종양이 2예, 그리고 바이러스 감염이 1예이었다. 3) Vi-IFAT 양성인 196예 중에서 장티푸스는 168예로 양성예측율은 85.7%이었으며, Vi-IFAT 음성인 548예 중 장티푸스 이외의 발열질환은 538예로 음성예측율 98.2%이었다. 4) 배양검사와 Widal test 사이의 일치율 (Kappa value)는 0.28로 poor agreement를 보였으며 Vi-IFAT와 Widal test 사이의 Kappa value는 0.74로 good agreement를 보였다. 그러나 배양검사와 Vi-IFAT 사이의 Kappa value는 0.86으로 excellent agreement를 보여 일치율이 가장 높은 검사는 배양검사와 Vi-IFAT라 할 수 있겠다. 5) 장티푸스 환자에 있어서 Vi-IFAT의 양성율은 발열기간이 1중 미만인 환자에서는 68%, 1내지 2주인 환자에서는 89.5%, 2주이상인 환자에서는 100%이었다. 결 론 : Vi 항원을 이용한 간접형광항체법 (Vi-IFAT)은 장티푸스 진단에 높은 민감도 및 특이도를 가지며, 또한 조기진단에 있어서도 임상적으로 유용함을 확인할 수 있었다. Background : Typhoid fever is diagnosed by culture or serological study. The confirmative diagnosis of typhoid fever is made by culture of the causative organism usually from body fluids. Serological test is a supportive diagnositic tool, which is useful for early diagnosis. In Severance Hospital, Vi-indirect foluorescent antibidy test(Vi-IFAT) using the Vi-antigen of Salmonella typhi has been used in the diagnosis of typhoid fever since 1989. We investigated the test results from the past 7 years, in order to clarify the sensitivity and specificity of Vi-IFAT. Methods : A retrospective study was done on patients whose chief complaint was fever and who were tested using Vi-IFAT in the Severance Hospital from 1989 to 1996. The positive value for Vi-IFAT was defined as 1:64 or higher. Results : The sensitivity and specificity of Vi-IFAT for typhoid fever was 94.4% and 95.1%, respectively. The positive and negative predictive values were 85.7% and 98.2% respectively. Positive rates of Vi-IFAT after fever onset increased with time and 68% were positive before the first week. From the first to the second week, 89.5% were positive and after the second week, 100% were positive. Conclusion : Vi-IFAT is not only a valuable serologic test for the diagnosis of typhoid fever, but also useful in the early diagnosis of the disease.

경사진 육면체에서 태양열에 의한 증발 현상에 관한 연구

김병철,장원택,윤재원,박준성 朝鮮大學校 機械技術硏究所 2006 機械技術硏究 Vol.9 No.1

Four solar stills that were fabricated each with cubes and glazing tilted angles of 15°, 30°, 45°, 60°, were compared with the quantities of condensed water. The quantities of condensed water were analysed with the weather conditions and temperatures for three months, On fine days, the quantity of average condensed water was more similar to those of 15° and 30°than to those of 45° and 60°, The quantity of condensed water produced by those of 45° and 60° were very irregular compared to those of 15° and 30", On rainy days, the quantity of condensed water was the most in that of 30° than those of the other angles and in cloudy, rainy and sunny conditions, the condensation quantity was the largest in that of 60°.