약물 유해반응 보고지침 -임상시험의 안전성에 관한 정보 관리지침 -

지동현,김훈교,배진우,손동렬,김인범,전용관,박혜연 大韓臨床藥理學會 1998 臨床藥理學會誌 Vol.6 No.2

상호작용하는 두 개의 신경세표의 결합 원사상 모형

김치용,유영종,이상훈 인제대학교기초과학연구소 1997 자연과학 Vol.1 No.-

두 개의 상호작용하는 신경세포들의 동력학을 기술하는 두 개의 확산결합된 선형적으로 또는 비선형적으로 이질적인 2차원 원사상의 2보차원 등주기갈래질의 전역구조를 전산모사하였다. 회전수집합과 리야프노프지수를 계산하여 결합한 원사상의 주기적 상태, 두 주파수 또는 세 주파수와 관련된 준주기 상태, 그리고 혼돈 및 초혼돈적 상태들을 분류하는 기준을 설정하였다. 아놀드의 혀 및 주기적 새우 구조와 같은 동위상 또는 반위상 동조가 선형 또는 비선형 매개변수 공간에서 발견되어 결합계에서의 혼돈 갈래질의 보편적구조를 확인하였다. We analyse the codimentsin-two isoperiodic bifurcatin diagrams of two homogeneous and heterogeneous diffusively coupled circle mape. In-phase or out-of-phase periodic states, two-frequency or three-frequency quasi-periodic states, chaotic, and hyperchaotic states are graphically classified and charac-terized by rotaion set and lyapunov specturm. In-phase or out-of-phase Entrainment such as Amold's tongues and peridic shrimps appear in quasiperiodic or chaotic area of the linear or nonlinear parameter space. We also discuss the relevance of entrainment in coupled neural systems.

신경독성 물질에 폭로되지 않은 건강한 남자의 신경행동학적 검사 수행능력

이세훈,김형아,이원철,장성실,이경재,박정일,정치경 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1

Five items among neurobehavioral core test battery of World Health Organization, including Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention, were administered to the workers occupationally non-exposed to neurotoxic agents by operational guide for the WHO neurobehavioral core test battery. Subjects were volunteers from the industrial workers(117) and clerks(40). Detailed occupational history such as exposed agents including noise or vibration, educational level, residence, smoking and drinking habit were recorded. Most of the neurobehavioral tests were correlated with age and educational level. Smoking was correlated with pursuit aiming and digit symbol. Vibration affected pursuit aiming. Job type(industrial workers vs. clerks) and noise exposure did not affected among tested items. Multiple regression analysis was done for establishing predict equation to estimate normal ranges of the tests for male workers. Age was shown to be main independent variable affected for all tests except wrong dot of pursuit aiming. Educational level was also shown to affected most of the tests except Santa ana dexterity and wrong dot of pursuit aiming. Alcohol consumption affected Santa Ana dexterity, non-preferred hand, and smoking affected only wrong dot of pursuit aiming after multiple regression analysis.

상악호선에 torque 부여시 나타나는 상반작용에 관한 유한요소법적 연구

황치일,서정훈 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.2

This study was designed to investigate the reciprocal movement which was derived form application of active torque in ideal archwire by computer-aided three-dimensional finite element analysis of maxillary teeth and surrounding periodontal ligament composed of 2617 elements and 3725 nodes. Ideal archwire model was also made using the beam elements and the contact between the wire and the bracket slot was made using the gap element. In this study non-linear elastic behaviors of contact between the wire and the bracket slot were considered on. We put the active torque between the lateral and cenral incisor and between the second premolar and the first molar with/without cinch-back. The results were expressed by quantitative and visible ways. The findings of this study were as follows: 1. Reciprocal actions to active torque were complex system consisting of a combination of counter-torque, bucco-lingual linear displacement and tipping, rotation of the teeth, occluso-gingival linear displacement. 2. when active anterior crown labial torque was applied, crown labial tippings of the lateral were the greatest, and those of the central incisor was the next. Crown lingual tippings of the canine and the first premolar, mesial rotations and extrusion of the lateral and distal rotations and intrusion of the canine occurred. When anterior torque with the cinch-back was applied, amount of crown labial tippings of the lateral and central incisor were reduced. Amount of crown lingual tipping of the canine and the first premolar were increased. Mesial tippings and mesial rotations of the second, molar occurred. 3. When active posterior crown lingual torque was applied, crown lingual tippings of the first moalr were the greatest, and crown labial tippings of the second premolar and the first premolar were the next, the crown lingual tipping of the second molar were a little. Mesial rotations of the second premolar occurred but those of the first premolar didn't occurred.

췌장암 환자에서 알코올 내장신경 신경파괴블럭 후 발생한 간염

이상은,최석환,김영환,임세훈,이정한,이근무,정순호,최영균,김영재,신치만 인제대학교 2008 仁濟醫學 Vol.29 No.-

Splanchnic neurolytic block(SNB) with alcohol improves the management of pancreatic cancer pain. Adverse effects of alcohol SNB which include regional pain, hypotension, diarrhea, and acute alcohol intoxication are common, but acute hepatitis caused by alcohol neurolytic block is rare. A 63-year-old patient with pancreatic head cancer and liver metastasis had complete pain relief after both retrocrural tansdiscal SNB with 100% alcohol 10 ml. But, 1 day later, liver function test showed a high elevation in the aspartate aminotransferase (AST, 2182 IU/L) and alanine aminotransferase (ALT, 1807 IU/L). The patient had slight jaundice, general weakness, chilling, nausea and vomiting after SNB. Both AST and ALT decreased to 46 and 119 IU/L within 10 days with only supportive therapy. But, 19 days later, the patient died due to pneumonia. Our case illustrates the importance of clinical surveillance especially in patient with hepatic disease after alcohol SNB.

전기경련요법에서 remifentanil이 혈역학에 미치는 효과

정순호,이상은,임세훈,이정한,이근무,최영균,김영재,신치만 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: Electroconvulsive therapy (ECT) is often associated with transient hypertension and tachycardia. Acute hemodynamic change may produce serious complications. Remifentanil is a potent ultra short acting opioid and has been found to reduce blood pressure and heart rate. The goal of this study was to evaluate effects of remifentanil on seizure duration, recovery parameters and hemodynamic changes during ECT. Methods: Ten ASA Ⅰ, Ⅱ patients enrolled in this prospective, randomized trial, each receiving more than four electroconvulsive therapy. Patients were randomized to receive placebo, group P (propofol 1mg/kg+0.9% normal saline 1ml, n=10), and propofol with remifentanil, group R (propofol 1mg/kg+remifentanil 1ug/Kg n=10). Supplemental dose of propofol was given as required to achieve loss of consciousness. We recorded hemodynamic parameters, seizure duration, and recovery parameters. Results: Seizure duration and recovery parameters were similar in group R and group P. Blood pressure and Hear rate after ECT were significantly lower in group R. Conclusions: Remifentanil(1ug/kg) attenuated the acute hemodynamic response to ECT under propofol anesthesia without adversely affecting the duration of seizure activity and recovery profile. Adjunctive use of remifentanil may be good alternative regimens for ECT.

경막 천자 후 두통 치료 목적의 자가 혈액 봉합술 시행 중 발생한 기뇌증

정순호,김책,김영환,임세훈,이정한,이근무,최영균,김영재,신치만 인제대학교 2006 仁濟醫學 Vol.27 No.-

A 57-year-old woman who was suffered from chronic back pain and radiating pain to left leg visited the local pain clinic. An accidental dural puncture happened at the L4-5 intervertebral space during the procedure with the loss of resistance technique using air. The epidural needle was removed, and a new insertion was done at the L3-4 intervertebral space with administration of the 0.5% lidocaine 8 ml mixed triamcinolone 40 mg. On the next day, she visited again the local pain clinic with complaining of headache. During an epidural autologuous blood patch procedure, she complained of a severe headache, nausea, vomiting, and developed generalized tremor of abrupt onset. There was no evidence of a dural puncture during the procedure. She was referred to our hospital at once. A brain CT scan showed air-filled cavities in basal cistern. She was given conservative treatment during 14 days. After 10 days, follow up brain CT scan showed no air-filled cavity in basal cistern. She was discharged from our hospital without complications.

급성 조증에서 기분안정제와 리스페리돈의 병합 투여 효과 : 다기관 개방연구

김광수,배치운,윤진상,김영훈,이양현,지익성,이철,송혜경,최성구,박원명 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Ohjective : The primary purpose of this study was a replication of the effectiveness and tolerability of rispehdone in the treatment of patients with acute mania in very larger cohon in naturalistic treatment setting to extend the data on the effect and tolerability of risperidone in the treatment of patients with acute mania to Asian population. Methods : A total of 909 patients with DSM-TV criteria of bipolar disorder current manic and hypomanic episode, entered this large, open, multicentre study. The Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale (SARS) were measured at baseline and weeks 1, 3 and 6, for the assessment of effectiveness and extra-pyramidal symptom (EPS). Results : This study showed statistically significant reduction of scores on the YMRS and CGI-s (mean change=-23.5±11.8, p<0.0001 ; mean change=-2.7±1.5, p<0.0001, respectively) from the baseline to the endpoint (week 6). Number of patients with 50% reduction or more in the YMRS and CGI-s scores was 693 (77.8%) and 630 (70.7%) at endpoint, respec-tively. There were no statistically significant increments of scores on SARS. Risperidone was generally well tolerated. Conclusion : The present larger open study demonstrates that hsperidone add-on therapy is effective and tolerable in treat-ment of bipolar disorder, replicating results in various controlled and uncontrolled studies from Western countries.

네모나프라이드의 유효성 및 추체외로 부작용 : Haloperidol 및 Risperidone과의 자연관찰적 개방형 비교연구 A Naturalistic Open Comparative Study with Haloperidol and Risperidone

서영수,김용관,신동환,공보금,이정구,박정환,윤성환,정치영,이상경,김영훈 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.2

Objectives : This open prospective study was performed in order to evaluate the efficacy and extrapyramidal adverse effects of nemonapride in the schizophrenic patients, and was compared wit one of typical antipshchotics. haloperidol and one of atypical antipsychotics, risperidone. Methods : Thirty male and female schizophrenic patients(DSM-Ⅳ) were treated for 12 weeks with haloperidol(n=10), risperidone(n=10) and nemonapride(n=10). The overall efficacy was assessed at baseline, 1st week, 2nd week, 4th week, 8th week, and 12th week by the Positive and Negative Syndrome Scale for Schizophrenia(PANSS). Also the overall safety was assessed in the same time period by the Extrapyramidal Symptom Rating Scale(ESRS). Results : There were no significant differences in PANSS scores(total, positive, negative, and general psycho­pathology subscale) among haloperidol, risperidone, and nemonapride groups, Treatment responders, defined as at least 20% reduction of baseline total PANSS score, were achieved by 8 patients(80%) in haloperidol group, 10 patients(100%) in risperidone group, and 8 patients(80%) in nemonapride group. And there were no significant differences in ESRS total scores among haloperidol, risperidone, and nemonapride group. Inter-group comparison among haloperidol, risperidone and nemonapride group, as assessed by the ESRS, revealed no significant differences in the shifts to the maximum score, 9.4(±9.4), 6.2(±8.4), and 11.3(±8.1) respectively, and also revealed no significant differences in the mean time reaching the maximum score, 4.5(±4.5) week, 7.8(±4.8) week, and 4.6(±4.4) week, respectivily. Conclusion : There wee no significant differences in the efficacy and extrapyramidal adverse effects among haloperidal, rispecridone and nemonapride groups. These results suggest that nemonapride was as efficacious and safe in he treatment of schizophrenia, as well known and widely used antipsychotics, haloperidol and risperidone.

Rocuronium의 애별투여방법이 모지내전근의 이완에 미치는 영향

최영균,김승수,이원진,조광래,이상은,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 인제대학교 2009 仁濟醫學 Vol.30 No.-

Objective : There are controversies in pnmmg technique of rocuronium whether it can or can't shorten the onset time. We want to compare the effects of two different priming doses and intervals of rocuronium. Materials and Methods : After giving propofol, 50 patients were randomly assigned to 5 groups. Group I received a placebo, followed 3 min later by rocuronium 0.6 mg/kg. Priming doses and intervals of Group II, Ill, N, V were 0.06 rng/kg and 2 min, 0.12 mg/kg and 2 min, 0.06 rug/kg and 3 min, 0.12 mg/kg and 3 min, respectively. Total dose of rocuronium was 0.6mg/kg. Train of four (TOF) count or ratio and 1st twitch height of TOF (T1) were monitored with 15 secondsintervals. TOF ratio of each groups just before bolus injection, duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were compared. Results : Duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were decreased in priming groups compared to Group 1 (P < 0.01) In group V, significant depression of TOF ratio just before bolus injection was seen (P < 0.05). Conclusion : Priming technique with rocuronium is effective method to shorten the onset of neuromuscular block. But priming dose of rocuronium itself could cause hypoxia and aspiration in awake patients and should be used carefully. Priming dose of rocuronium 0.06 mg/kg and 2 minutes interval maybe relatively safe method.