녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.

학생정신건강검진 시범운영사업에 따른 추진방안

김현정,김윤영,이혜숙,현미나,남동현,김상원,안동현 韓國學校保健學會 2009 韓國學校保健學會誌 Vol.22 No.1

Purpose: The purpose of the study was to·find the strategies of mental health screening in school. Based on the literature review, we discuss the importance of screening students in schools for mental health problems. Methods: Data from the 2008 Korean Mental Health Screening in Schools(2008-KMHSS) are used to estimate the outline of this screening. We administered the questionnaire for satisfaction of 2008-KMHSS for students(N=1,280), parents(N=2,672), school nurses(N=75), teachers(N=685), district personnels(N=6), and mental health center staffs(N=37). Also we interviewed a part of them by telephone and e-mail. And we reviewed the tools and methods for screening students for emotional/behavioral problems. Results: Mental health screening in schools is a very important, yet worrisome, agenda that is in its very early stages. From the 2008 Korean Mental Health Screening in Schools, 9,588 students(12.9%) needed more evaluation in the first stage. Of these, 6,910(72.1%) completed the second stage screening. In this sample, 1,975(28.6%) utilized the mental health services in school or community. 38.3% of students and 43.7% of their parents notified the2008-KMHSS. But only 12.1% of students and 10.9% of their parents dissatisfied with the screening. 9.9% of teachers and 22.7% of school nurses dissatisfied with the screening. Among them the school nurses were mostly dissatisfied, and they complained work burden from KMHSS. Mental health center staffs complained similar issues. The Children's Problem-behavior Screening Questionnaire(CPSQ) and Adolescents' Mental-health & Problem-behavior Screening Questionnaire(AMPQ) were compatible to screen students in schools for mental health problems in first stage. Conclusion: Mental health screening in schools needs careful planning and implementation. For successful mental health screening in schools, several elements need to be considered: careful planning, collaboration, staff training, and integrative mental health programs and services in community or schools.

男性不育에 關한 文獻的 考察

安世永,曺東鉉,杜鎬京,朴民豪 慶熙大學校韓醫科大學韓醫學硏究所 1995 慶熙韓醫大論文集 Vol.18 No.2

I could get to the conclusions as follows after studying our professors Drs' books and current magazine on Male Infertility. 1. Most of Drs. considered the reason of male infertility as Weakness(虛勞), which specially meant Jung(精)(the essence of life, or in this case could be semen) scarcity, Jung coldness, Jung lackness. They attributed the infertility to the seminal disorder. 2. In the treatment for male infertility, they emphasized the principle of reinforcing Shin(腎) and rearing Jung and presented correcting inclination as the major treatment. 3. In the medication for male infertility, they presented both special decoction and common medication through analyzing clinical symptoms. Especially, they warned to be deliberate in using hot and blazing ingredients. 4. They emphasized the regimen as the way of gathering and preserving Jung. 5. The unification of Oriental and occidental medicine is the current trend in treating the male infertility. And the analysis of the causes using the advanced diagnostic exams is prominent. 6. Spleen weakness(脾虛), liver stagnation(肝鬱) and phligm stasis(痰壅) could be the cause of male infertility, but the main cause was Shin weakness(腎虛). 7. New trials such as Acupoint Injection and Heating Acupunture as well as new decoction, acupuncture and moxibustion are being explored for curing the male infertily.

갑상선호르몬 내성 증후군과 주의력결핍-과잉행동 장애

안동현 대한소아ㆍ청소년정신의학회 1994 소아청소년정신의학 Vol.5 No.1

요 약 갑상선호르몬 내성증후군(GRTH)과 주의력 결핍-과잉행동장애(ADHD)의 간계는 최 근에 매우 연구가 활발히 진행되면서, ADHD환아에서 갑상선 검사를 기본검사로 시행 할 것인가 여부가 또한 논란이 피과 있다. 저자는 ADHD 환아뿐 아니라 발달장애 환아에 서도 GRTH가 발견될 수 있다는 사항에 주목하여 이들 환자들에서 갑상선 검사를 시행하여 이상 유무를 조 사하고, 뚜렷한 이상소견을 보이는 관아들의 임상 양상을 밝혀 앞으로 이들의 가계 연구 및 유전자 연 구의 시작을 해보고자 하였다. 총 51명에서 검사가 시행되었고, 이중 T3,T4가 모두 정상범위를 벗 어나며, TSH가 정상 흑은 증가된 증례가 모두 11명이어다. 그들의 임상 특성과 진단등을 살펴보고, 앞 으로의 방향에 대해 토의하였다. ABSTRACT Recently several studies showed a strong and specific association of Attention-Deficit Hyperactivity Disorder(ADHD) and generalized resistance to thyroid honnone(GRTH). The recommandation that all children with ADHD be screened for GRTH is an newer controversial issue in child psychiatric Held. Author examined thyroid indices(T3, T4, TSH) is suggestive of the finding of GRTH_ cases. Therefore I suggest that child psychiatrist shoul and clinical characteristics in the 51 clinical populations with ADHD, developmental delay, and language disorders. The results are that 11 cases were out of the normal range of both T3 and T4 inspite of normal TSH. This findingd pay attention to ADHD symptoms secondary to GRTH and that all children with familial ADHD and developmental delay(in- cluding launguage disorder) be screened for thyroid abnormalities.

아동 학대 및 방임

안동현,강지윤 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.1

Child abuse and neglect are also becoming a serious threat to the health of children in Korea. Most of abused or neglected children are suffered from some mental problems, Psychiatrists are a important position to evaluate and/or treat the emotional or behavioral problems resulting from child abuse or neglect, It is crucial that psychiatrists define their role and develop the appropriate clinical skills to manage child abuse or neglect effectively. This article reviews the clinically relevant literature on the child abuse and neglect including the strategic agenda of the Korean Medical Association for promoting of optimal child health and development comprehensively.

정신분열병 및 정신분열형 장애에 대한 올란자핀의 효과와 안전성

안용민,강대엽,권준수,김창윤,김철응,반건호,신영민,이기철,이동우,이중서,조현상,채정호,김용식 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 본 다기관 공동임상연구는 국내 환자를 대상으로 새로운 항정신병약물인 올라자핀의 치료 효과와 안전성을 확인하고자 시행되었다. 방 법 : 1999년 7월부터 2000년 3월까지 국내 10개 병원에 방문한 정신분열병 및 정신분열형 장애 105명을 대상으로 비대조 개방 임상연구를 시행하였다. 중등도 이상의 정신병 증상을 지니거나, 부작용으로 약물교체가 필요한 경우 또는 기분장애 증상의 치료가 필요한 환자를 대상으로 하였다. 2∼7일간의 약물 배설기간 후에 1일 10mg의 올란자핀을 투여하였고, 이후로 3∼7일 간격으로 용량을 조절하여 총 8주간 투여하였다. 치료 효과는 PANSS(Positive and Negative Syndrome Scale), BPRS(Brief Psychiatric Rating Scale), CGI(Clinical Global Impression-Severity), MADRS(Montgomery-Asberg Depression Rating Scale), HAM-A(Hamilton Rating Scale for Anxiety)로 판정하였다. 안전성 평가는 자발적인 이상반응 보고, 활력징후와 혈액 검사 및 SAS(Simpson-Angus Scale), BARS(Barnes Akathisia Rating Scale), AIMS(Abnormal Involuntary Movement Scale)척도를 이용하였다. 결 과 : 105명중에서 85.7%인 90명이 8주간의 치료를 완료하였다. 평균 최빈 용량은 일일 16.1(±4.7)mg이었고, 종료시점에서의 BPRS전체 점수가 기저 상태에 비해 40%이상 감소된 반응군은 69.5%이었다. PANSS의 양성 증후군과 일반정신병리 뿐만 아니라 음성 증후군 소척도에서도 유의한 감소를 보였으며, 이 감소들은 치료 초기부터 나타나서 8주간 지속되었다. 43.8%의 피험자가 중등도 이상의 우울증상을 같이 지니고 있었으며, 올란자핀에 의해 MADRS와 HAM-A가 유의하게 감소하였다. 치료 기간 동안에 활력징후에는 뚜렷한 변화가 없었으나 체중은 8주간 지속적으로 증가하였다. SAS와 AIMS는 감소하였으며, 정좌불능증을 제외한 나머지 추체외로 증상의 발생비율도 낮았다. 임상적인 증상이나 징후를 동반하지 않는 ALT/SGPT의 상승을 보였지만 프로락틴을 포함하는 대부분의 혈액 검사상 뚜렷한 이상 변화는 없었다. 결 론 ; 비록 본 임상연구가 비대조 개방 임상연구로서 많은 제한점을 가지고 있지만, 올란자핀이 기존 약물에 내약성을 보이거나 기분증상을 동반하는 정신병에 치료 효과가 있었다. 그리고 기존 항정신병약물 치료시에 문제가 되었던 추체외로 증상과 고프르로락틴 혈증을 포함하는 대부분의 부작용면에서 안전성을 보여 주었다. Objective : This multicenter clinical trial was carried out to investigate the efficacy and the safety of olanzpine for the treatment of Korean patients. Mothod : 105 patients with schizophrenia and schizophreniform disorder, visited at 10 mental or university hospitals, had received an open and non-comparative treatment with olanzapine for 8 weeks. Patients had psychotic or depressive symptoms with the severity above moderate degree or intolerable side effects to previous antipsychotics. After a wash-out period of 2-7 days, 10mg olanzapine was prescribed initially to all the patients, and then the dosage could be adjusted within the range of 5-20mg/day of olanzapine by 3-7 days. Results : 90(85.7%) of 105 patients completed the 8-weeks trial and the mean modal dose of olanzapine was 16.1(±4.7%)mg/day. At the end of the trial, 73 patients(69.5%) were classified as responder, which was defined as 40% or more improvement in BPRS(Brief Psychiatric Rating Scale) score comparing to baseline. There was a significant reduction in the scores of PANSS(Positive and Negative Syndrome Scale)and subscales including negative symptom scores and CGI. Also weekly analysis showed that the reductions in scores were kept on for the whole period of the trial. 43.8% of all the patients had depressive symptoms at the baseline and total scores of MADRS(Montgomery-Asberg Depression Rating Scale) and HAM-A(Hamilton Rating Scale for Anxiety) were also reduced after the trials. Vital signs revealed no clinically significant changes but continuous weight gain was observed during the treatment with olanzapine. The scores of SAS(Simpson-Angus Scale) and AIMS(Abnormal Involuntary Movement Scale) for assessing the EPS(extrapyramidal symptoms)and tardive dyskinesia respectively were significantly decreased and only a few patients reported EPS as adverse events. Although mild and clinically non-significant of ALT/SGPT was observed, most laboratory parameters including plasma prolactin level showed to significant changes during the trial. Conclusions : Although this trial had many limitations because it was a non-comparative and open study, olanzapine showed high efficacy on the positive, negative and depressive symptoms in schizophrenia and schizophreniform disorder.In addition to that, olanzapine showed a substantially favorable safety profile, such as low incidence of EPS and hyperprolactinemia.

소아 및 청소년기 자살

안동현,황혜순 漢陽大學校 精神健康硏究 1999 精神健康硏究 Vol.18 No.-

친족강간의 평가와 대책

안동현 漢陽大學校 精神健康硏究 1994 精神健康硏究 Vol.13 No.-

정신의학과 폭력 : 개요

안동현 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.1

Violence is the most important part for human health by according to WHO. Human violence is the result of a complex interaction of the characteristics of the individual with influences in the environment, Psychiatrists must be prepared to evaluate and treat violent patients, but also are expected to serve as informed commentators regarding violence in society. In this special issues, 4 psychiatrists concerning violence in the clinical practice participated from the point of evaluation and management of violent patients : 1) Family Violence 2) Child Abuse and Neglect 3) Sexual Abuse.

자연과 실험의 개선점에 대한 연구 : 4ㆍ5ㆍ6학년 지구과학 분야를 중심으로

안병인,길윤경,채동현 全州敎育大學校 科學敎育硏究所 1999 科學 敎育 硏究 論文集 Vol.21 No.-

We are encountering fundamental change in the 21 century mathematics education. By NCTM standards, one of the new goals in mathematics education is to formate interest and confidence about mathematics. Hence, the purpose of this study is to investigate the effection that effects student on formation of interest and confidence about mathematics through TGT model.