호흡기감염증에 대한 Cefuroxime Axetil(Zinnat�)의 임상효과

김주옥,홍석철,김남재,서지원,김선영,노흥규 中央醫學社 1991 中央醫學 Vol.56 No.2

To evaluate the efficacy and safety of Zinnat in patients with respiratory tract infections, 20 patients were treated with Zinnat (250 mg b.i.d). Among 20 cases, 5 cases had pneumonia, 5 cases exacerbation of chronic bronchitis, 4 cases acute bronchitis, 3 cases bronchiectasis with infection, and acute tonsilitis, bronchial asthma with infection and emphysema with infection 1 case, respectively. The response was cure in 12 cases, partial response in 6 cases and no response in 2 cases. There were no significant clinical and laboratory side effects except dyspepsia and nausea (1 case) and diarrhea (1 case). Zinnat was considered to be useful agent against bacterial respiratory tract infections.

양성 갑상선 결절에서의 무수 알코올 치료 효과

김도희,나소영,이효진,홍우정,김군순,조영석,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

목적 : 양성 갑상선 결절 환자에서의 PEI의 치료효과 및 부작용을 알아보고자 하였다. 방법 : 양성 갑상선 결절 환자 88명을 대상으로 초음파 소견에 따라 낭종성 결절, 복합성 결절, 고형성 결절 등 세 그룹으로 분류후 전체 및 각각에 대한 PEI의 치료효과 및 부작용을 조사하였다. 결과 : 양성 갑상선 결절 환자 88명을 PEI로 치료후 결절의 크기가 50%이상 감소한 경우는 전체 환자중 77.2%이었고 각 결절별로 살펴보면 고형성 결절에서 52.6%, 복합성 결절에서 72.4%, 낭종성 결절은 92.5%이었다. 부작용은 동통, 결절내 출혈, 감염, 결절의 누출등이 있었으나 대부분 무증상이었다. 결론 : PEI는 양성 갑상선 결절 환자증 적응증을 잘 살펴 고려해 볼 수 있는 치료법이라 생각되며 특히 낭종성 결절 환자에서 주사기에 의한 흡인후에 재발한 경우 일차적인 치료로 PEI를 고려해 볼 수 있겠다. Ultrasonography(US)-guided percutaneous ethanol injection (PEI) has been performed for the treatment of autonomous functioning thyroid nodules, thyroid cysts, & cold thyroid nodules. The author studied the efficacy of PEI in the treatment of benign cold thyroid nodules both solid and cystic (complex & pure). Eighty-eight euthyroid outpatients (age:44.2±13.9years, 75 women and 13 men) with benign cold thyroid nodules or simple thyroid cysts (69 with a single nodule and 19 with a prominent nodule within multinodular goiter) were includied in this study. After PEI, each subtype of thyroid nodules was divided into three groups in according to volume reduction complete response (90% or more of volume reduction), partial response (50% or more of reducton but below 90%), and failure (below 50% or increase in size) group. Overall response rates of PEI for benign thyroid nodules were complete 45(51.1%), partial 23(26.1%), failure 20(22.7%). In 20 cold solid nodules, complete response was observed in 6(30.0%), partial response in 5(25.0%), and failure in 9(45.0%). In 28 complex cysts, complete response was observed in 8(28.6%), partial response in 12 (42.9%), and failure in 8(28.6%). In 40 pure cysts, complete response was observed in 31(77.5%), partial response in 6 (15.0%), and failure in 3 (7.5%). Side effects comprised pain 8 (9.2%), intranodular bleeding 13 (14.6%), extracapsular leakage 1(1.1%), infection 1 (1.1%), increased size l(1.1%), and none 64(72.7%). PEI may prove a safe & effective tool for the therapy of cold thyroid nodules in selected cases and may be the treatment of choice of recurrent thyroid cysts. However, further investigation involving a larger number of patients and a longer follow-up is needed.

HMG-CoA 환원효소 억제제에 의한 ICAM-1 유전자의 발현조절

김현진,정효균,홍우정,김군순,조영석,김도희,채수흥,구본정,송민호,노흥규,김영건 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1

Background : ICAM-1 act as one of major adhesion molecules in the atherosclerotic lesion. ICAM-1 expression is mainly regulated at the level of transcription and depend on IFN-γ signal transduction pathway in which the STAT1 transcrption factor is a critical intermediate. IFN-γreceptor not only initiates tyrosine 701 phosphorylation of STAT1 by Jak1 and Jak2, but also phosphorylates serine 727 through the activation of Raf-1/MAP kinases. HMG-CoA reductase inhibitors have anti-atherosclertic effects, beyond normalization of hypercholesterolemia, by directly acting on endothelial cells, macrophages and vascular smooth muscle cells. HMG-CoA reductase inhibitors suppress the synthesis of isoprenoid intermediates such as geranylgeranyl-pyrophosphate or farnesylpyrophosphate. These effects results inhibitors suppress the synthesis of isoprenoid intermediates such as geranylgeranyl-pyrophosphate or farnesylpyrophosphate. These effects results inhibition posttranslational farnesylation and geranyl-geranylation processing of small GTP-binding preoteins and inhibition of normal signaling activities. Method : We made several 5'-deletion constructs of rat ICAM-1 promoter and analyzed the promoter activities by measuring the luciferase activity after transfection into ECV304 cells and smooth muscle cells. We checked the level of total and phosphorylated STAT1 protein by immunoblot analysis using specific antibodies. Results : Lovastatin inhibits IFN-γ-induced ICAM-1 gene expression in the ECV304cell. The cells pretreated with PD98059, MEKK inhibitor showed significantly low ICAM-1 RNA induction with IFN-γ stimulatio. IFN-γ induced phosphorylation of tyrosine 701 was not significantly changed by the pretreatment of lovastatin. But lovastatin suppresses IFN-γ-induced phosphorylation of ERK1/ERK2 which are responsible for the seine 727 phosphorylation in STAT1. Conclusion : We showed that HMG-CoA reductase inhibitors, lovastatin, suppresses IFN-γ mediated ICAM-1 gene expression through the inhibition of transcription. HMG-CoA reductase inhibitor suppresses IFN-γ-induced phosphorylation of serine 727 in STAT1 through the modulation of MAP kinases.

호흡기 감염증에 대한 Roxithromycin(Rulid^(�))의 임상 효과

노흥규,김남재,서지원,김주옥,김선영 최신의학사 1990 最新醫學 Vol.33 No.11

항결핵 6개월 단기요법의 성과 고찰

서지원,정연채,김남재,홍석철,김주옥,김선영,노흥규 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1

To evaluate the effect of 6-month short term antituberculosis chemotherapy with INH, Rifampin, Ethambutol, and Pyrazinamide(2HREZ/4HRE) in the patients with pulmonary and/or extrapulmonary tuberculosis, the authors prescribed 2HREZ/4HRE regimen in 79 tuberculosis patients for 6 months with measuring the sputum staining for AFB, chest X-ray findings, recurrence rates and possible side reactions of the treatment. The result were as follow; 1. Pulmonary Tuberculosis 1) Among the 56 pulmonary tuberculosis patients who had taken 2HREZ/4HRE regimen. 32 patients showed initial positivity in sputum AFB smear stain(57.2%). Negative conversion occurred usually within 2 months after initiation of chemotherapy and the mean period of negative conversion was 1.4 months. 2) Among the 56 pulmonary tuberculosis patients, chest X-ray finding changed in 41 patients (37.21%). From these 41 patients 39 patients showed continuous improvements in chest X-ray finding, though 3 patients showed initial aggravation in spite of continuous medication. The remainder 2 cases aggravated due to the failure of treatment. 3) Treatment failure occurred in 2 patients (3.57%) during the chemotherapy among 56 patients of pulmonary tuberculosis and they were infected with secondary drug-resistant strains of M. tuberculosis. 2. Extrapulmonary tuberculosis. Among 8 patients with tuberculous pleurisy and 15 patients with superficial tuberculous lymphadenitis, there were no evidence of treatment failure after completion of antituberculosis chemotherapy for 6 months with 2HREZ/4HRE regimen. 3. Follow-up study was performed from 6 months to 50 months after completion of antituberculosis chemotherapy and the relapse was not noted in both pulmonary and extrapulmonary tuberculosis patients group during this period. 4. Serum AST/ALT elevated in 9 patients(11.4%) during the treatment and this occurred usually within 3 months after the initiation of antituberculosis chemotherapy. However treatment interruption occurred in 2 patients (2.5%) due to the development of hepatitisone due to drug-induced hapatitis and the other due to type B viral hepatitis. In conclusion, we could find this 2HREZ/4HRE 6-months short-term antituberculosis regimen is effective and could be recommanded as a promising regimen for the treatment of tuberculosis.

갑상선 세포에서 전사보조활성인자인 CBP와 CIITA의 인터페론-감마 활성 부위에 대한 조절 : CBP and CIITA on GAS(Interferon- γ Activated Site)-Mediated Transcription in Thyroid Cells

채수흥,홍우정,김군순,조영석,김도희,김현진,구본정,송민호,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1

Background : In the previous stuides, we identified that the interferon-r activated sequence (GAS) in the 5-flanking region of rat ICAM-1 gene is major element for interferon-r-inducible expression of the gene in rat thyroid cells, FRTL-5. We here, investigated the role of transcriptional coactivators, CBP(CREB binding protein) and CⅡTA (class Ⅱ transactivator) in the modulation of the activity of GAS which could interacts with signal transducers and activators of transcription-1 and 3 (STAT1 and STAT3). Methods : The expression of CBP RNA and protein were quantitated in FRTL-5 after stimulation with interferon-r (IFN-r), thyroid stimulating hormone (TSH), forskolin and methimazole. Direct association of CBP with STAT were analyzed by immunoprecipitation. The transcriptional roles of CBP and CⅡTA in the regulation of GAS were assessed by the cotransfection with their expression vectors with reporters; 5-deletion constructs of rat ICAM-1 promoter or 8xGAS-luc constructs, into FRTL-5 thyroid cells. Results : The level of CBP RNA and protein were not changed by the treatment with TSH, IFN-r, forskolin and methimazole in FRTL-5, FRT and BRL liver cells. The CBP could be directly associated with STAT1. Furthermore, the overexpression of CBP significantly increases the both promoter activities; rat ICAM-1 gene promoter which has GAS element and 8xGAS-luc cassette constructs. However, the cotransfection of CⅡTA decreased the constitutive and CBP-mediated transactivation of rat ICAM-1 promoter and 8xGAS-luc cassette constructs. Conclusion : We identified that the two tanscriptional coactivators; CBP and CⅡTA has differential roles in the regulation of transcriptional activity of GAS drived promoter. CBP increases the GAS activity through the direct binding with STAT1, but CⅡTA inhibited the CBP-mediated transactivation of GAS activity.

폐경후 골다공증 환자에서 체질량지수에 따른 Alendronate의 효과

조영석,나소영,이효진,홍우정,김군순,김도희,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

배경 : 폐경후 골다공증은 심각한 문제로 대두되고 있다. 현재 Alendronate는 폐경후 골다공증의 치료제로서 널리 쓰이고 있다. 저자는 Alendronate의 골밀도에 효과를 알아보고 골다공증의 위험인자에 따른 Alendronate의 반응 정도를 평가하기 위하여 본 연구를 수행하였다. 방법 : Alendronate를 평균 12개월간 복용한 35명의 폐경후 골다공증환자에서 체질량지수와 폐경후 기간에 따른 치료효과를 조사하였다. 결과 : 전체 대상군에서 Alendronate 10㎎을 12개월간 투여한후 골밀도의 평균 변화율은 요추와 대퇴골 경부에서 각각 7.83±7.39%와 2.99±9.22%이었다. 과체중군에서 평균변화율은 요추와 대퇴골 경부에서 각각 7.15±4.5%와 3.05±2.86%였다. 양군간에 통계적 유의성이 있는 차이는 없었다. 폐경후 7년이 경과되지 않은 군에서의 평균변화율은 요추와 대퇴골 경부에서 각각 6.9±5.3%와 5.71±0.08%였다. 양군간에 통계적인 유의성이 있는 차이는 없었다. 결론 : 마른체형이 골다공증의 발병에는 영향이 있으나, Alendronate 치료효과의 차이는 없는 것을 확인할 수 있었다. 더불어 폐경이 있고 7년이 초과된 군과 년이 경과되지 않은 군에서의 Alendronate 치료효과의 차이는 없는 것을 확인할수 있었다. 이는 골흡수가 상당히 진행된 상태에서도 Alendronate가 치료효과를 가지고 있음을 반영한다고 할 수 있겠다. Postmenopausal osteoporosis is a serious health problem. The aminophosphonate Alendronate is widely used for treatment of postmenopausal osteoporosis. We studied the effect of l0㎎ of alendronate given daily for mean 12 months on bone mineral density in 35 women(mean age 61yrs. mean BMI 23.24㎏/m^(2)) with osteoporosis. An over weight group is defined such that BMI was above 23㎏/m^(2). All the women received 1500㎎ calcium carbonate daily. The bone mineral density of L-spine and femoral neck was measured by dual-energy X-ray absorptiometry. Alendronate increased BMD at mean 12 months at the L-spine (7.15±4.5%) and femoral neck(3.05±2.86%) in normal women. Alendronate increased bone mineral density at 12 months at the L-spine(6.00±5.3%) and femoral neck(4.17±4.87%) in overweight women. There was no difference between two groups. In the less than 7 years group of postmenopausal duration. alendronate increased bone mineral density at 12 months at the L-spine(6.9±4.9%) and femoral neck(3.18±7.1%). In the more than 7 years group of postmenopausal duration, alendronate increased hone mineral density at 1% months at the L-spine(6.5±5.3%) and femoral neck(5.71±0.08%). There was no difference between two groups. In postmenopausal women with osteoporosis, therapy with alendronate produced significant increases in BMD of the L-spine and femoral neck in both group. There was no difference between normal and over-weight groups. and between less than 7 years group and more than 7 years group of postmenopausal duration.

부부관계의 주관성 연구

김분한,이희영,정영미,이은영,김흥규 성인간호학회 2001 성인간호학회지 Vol.13 No.2

This sutdy was undertaken to find out the perception of marital relationship and to understand the typology. The Q-population consisted of 153 statements that were collected and 33 Q-samples were selected. The P-samples for this study were made up of 30 who were married. Each responded to a Q-set of marital relationship according to 9-point scale. The results of Q-sorting were coded and analysed using QUANL PC program. Typological observations were as follows. 1) One in body and spirit type : In type 1, couples had different backgrounds respectively but felt one in body and spirit. 2) Companionship type : 2. Couples had not so much a hierarchial as a horizontal relationship. Couples perceived themselves as interdependent and friends. 3) Adaptation type : Couples readily adapted themselves to a marital relationship. They only depended on their spouses at times and stressed the relationship. Marriage was accepted as destiny rather than choice. On the basis of these results, we suggest: When a marriage is in trouble, that we assess the type of marital relationship in advance and intervene with a proper program. In addition, practical intervention programs need to be developed tailored to the type of subjective perception about the marital relation

가성부갑상선 기능저하증 환아의 구강 증상 : CASE REPORT

김성오,홍은경,최형준,이제호,손흥규 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.2

부갑상선 호르몬은 혈중 인농도를 낮추고, 칼슘농도를 증가시키는 호르몬으로 부갑상선기능저하증은 부갑상선이 존재하지 않거나 비정상적으로 기능하여 이 호르몬의 분비가 감소되는 질환이며, 가성부갑상선기능저하증은 부갑상선 호르몬 분비는 정상이나, 이 호르몬에 대한 괄과 신장의 반응이상으로 혈중 칼슘 농도가 감소되고 인농도가 증가되는 질환이다. 가성부갑상선기능저하증은 임상적으로 성장 및 발육부전, 둥근 얼굴, 조기 골단폐쇄로 인한 단지증, 이소성 연조직 석회화, 비만, 두개관의 비후, 정신지체, 백내장 등이 나타난다. 구강내 소견으로는 치아의 맹출지연, 법랑질형성부전이 가장 큰 특징이며, 그 외에 결손지, 부정교합, 높은 구개궁, 확장된 치근관과 짧은 치근, 치수강 내 석회화, 높은 우식 이환율, 치근막의 비후 등이 관찰된다. 본 증례에서 환아의 구강내 소견은 맹출한 하악 4전치와 상악 좌우측 영구 중절치, 상악 우측 영구 측절치, 상, 하악 제 1대 구치에서 법랑질형성부전을 보였고, 다수의 유치에서 심한 동요도를 보였다. 방사선 소견으로는 대부분의 미맹출된 영구치들도 법랑질형성부전이 관찰되었으며, 특히 영구 견치의 경우 심한 치관의 형태이상을 볼 수 있었다. 또한 유치의 비정상적인 치근흡수가 나타났고, 하악 전치의 경우 치근형태가 짧고, 치근단이 둥근 형태로 나타났다. 이에 저자는 가성부갑상선기능저하증인 환아의 구강내 소견에 대해 보고하고자 한다. The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view, severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

소아의 변색된 치아에서 Vital Bleaching을 이용한 치료 증례

김보혜,손흥규,이종갑 大韓小兒齒科學會 1992 大韓小兒齒科學會誌 Vol.19 No.2

Discoloration of teeth, especially maxillary incisor, that appears in various types and severties causes a major problem in esthetic aspect. The attributing factors can be classified into extrinsic and intrinsic factors : chewing tabacco, coffee, and tea are some example of the former, and intake of tetracycline, fluorosis, pulpal necrosis, iatrogenic agents, systemic condition, genetic factors, and aging process are, the latter. Treatment of a discolored vital tooth include full crown restoration, direct or indirect venner restoration, vital bleaching, and so on. Several vital bleaching techniques have been developed since Capple first introduced a bleaching case using oxalic acid in 1877. Nowadays, the technique that utilizes both hydrogen peroxide and bleaching light is most preferred. The pulpal effect of vital bleaching medicaments and lights have been controversal, but it has been also noted that 98℉~141℉, 30~35% hydrogen peroxide causes only mild reversible inflammation. In these cases, 12 and 10-year-old sisters showed generalized brown discoloration of teeth. Their primary dentitions were normal color, and there were no history of discolored teeth. The exact cause could not be found, but tooth color was improved by vital bleaching of four times. For the better esthetic results, combination therapy of repeated bleaching and veneering restoration is recommended.