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김한석,김명래,이성근,강상원,김기환,김형섭 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.1
Objective : This is to report the effectiveness of intraoral distraction osteogenesis for alveolar augmentation in the extremely atrophied alveolar defects and to review the clinical results of the 2 cases. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors(Martin, Germany) were applied in 2 patients with the severe acquired anterior maxillary and mandibular defect. After latent period for 1 week, the osteomized alveolar segments were distracted by 1 ㎜ a day (0.5 ㎜/l turn) for 8 days in case Ⅰ and 0.6 ㎜ a day(0.3 ㎜/l turn) for 10 days in case Ⅱ. The consolidation period was about 8 weeks in each case. Thereafter, 6 titanium threaded implants(Branemark, Restore) were simultaneously installed with removal of distractor. The implants were tested clinically and radiographically. Results : Amounts of acquired alveolar bone were 8 ㎜ in case Ⅰ and 6 ㎜ in case Ⅱ respectively, with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 8 weeks after distrction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects. However, for the better vector control of distracting segments and for anterior esthetics, customized distraction devices could be considered later.
Haloperidol과 Benztropine의 과량복용에 인한 항콜린성 증후군 치험 1례
조숙행,김형섭 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.5
The authors experienced an acute anticholinergic intoxication syndrome in a 17 year-old female schizophrenic patient who had taken overdose of haloperidol(??) and Benztropine (??). This patient showed restless agitation, confusion, disorientation, hallucination, purposeless overactivity, tarchycardia, urinary retention, pupil dilatation and reduced bowel motility. For the management of the patient, physostigmine(??) had been tried and proved to be dramatically effective.
정신분열병과 Neurotensin 수용체 유전자 다형성의 연합 연구
이유상,김형배,한진희,채영규,이정식,이혜순,주연호,김형섭,최인근,양병환 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6
연구목적: Neurotensin(NT)은 NT수용체와 결합하여 그 효과를 나타내는 neuromodulator 혹은 neurotransmitter로서 대뇌에서 도파민의 분비를 조절하는데 중요한 역할을 한다. 근래의 연구에 의하면 NT와 그 수용체는 대뇌에서 항정신병 약물의 효과를 매개하는 것으로 생각되고 있으며 약물치료를 받지 않은 정신분열병 환자의 뇌척수액에서 NT의 양이 적으로 보고되고 있어 이들은 정신분열병과 깊은 관련을 가지고 있을 것으로 추정된다. 최근 NT수용체의 유전자의 3`인접영역에서 정보가치가 높은 4 염기반복 다형성이 발견되어 이를 유전 표지자로 하여 정신분열병과의 연합을 알아보았다. 방 법: 서로 혈연관계에 있지 않은 정신분열병 환자 120명(남자 91명, 여자 29명)과 정상 대조군 106명(남자 84명, 여자 22명)을 대상으로 하였다. PANSS를 사용하여 양성 및 음성을 알아보았다. 말초혈액에서 DNA를 분리한 후에 중합효소연쇄반응을 사용하여 3`인접영역에 있는 4 염기 반복 다형성을 증폭하였고 silver staining한 후에 유전자형을 관찰하였다. chi-square 검증과 Bonferroni`s correction을 사용하여 환자군과 정상 대조군간의 대립유전자 빈도의 차이를 알아보았다. 또한 양성 및 음성 환자군으로 나누어 차이를 알아보았다. 결 과: 총 23개의 대립유전자가 관찰되었으며, 399bp의 대립유전자(A10)의 빈도가 환자군보다 정상대조군에서 통계적으로 유의하게 높았다(χ²=16.49, df=1, p<0.001). 음성 정신분열병 환자군과 정상대조군 사이의 비교에서는 정상대조군의 A10의 빈도가 환자군보다 유의하게 높았다(χ²=21.33, df=1, p<0.001). 성별 비교에서 남자 정신분열병 환자군은 대조군에 비하여 A10의 분포가 유의하게 적었다. (χ²=13.71, df=1, p<0.001) 결 론: NT 수용체 유전자와 정신분열병사이에 음성연합이 관찰되었다. NT 수용체 유전자가 일부 정신분열병의 발병과정에서 확실하지는 않지만 어떤 종류의 보호기능을 할 수도 있다는 것을 암시한다. Objectives: Neurotensin(NT), of which functions are evoked by its interaction with neurotensin receptors(NTR), coexists with mesolimbic dopamine and regulates endogenous dopamine release. Recent studies have shown that NT with NTR exerts neuroleptic-like activity within the central nervous system and may play an important role in the pathogenesis and in the treatment of schizophrenia. We have examined the gentic association between schizophrenia and tetranucleotide repeat polymorphism in the 3-flanking region of the NTR gene to investigate the possible contribution of the NTR gene to the schizophrenia susceptibility. Methods: Among 23 alleles identified, the subjects were 120 patients(male 91, female 29)with schizophrenia and 106 normal healthy controls(male 84, female 22). They were unrelated native Korean. PANSS was used to determine positive or negative subgroup in the schizophrenic patients. Using polymerase chain reaction and polyacrylamide gel electrophoresis, tetranucleotide repeat polymorphism(CCTT and CTT) in the 3`-flanking region of NTR gene was observed. For a comparison of NTR gene`s allelic frequencies between patients with schizophrenia and normal healthy controls, chi-square test and Bonferroni`s correction was performed. Results: The frequency of A10 allele(base pair size=399)was significantly higher in normal healthy controls than schizophrenia(χ²=16.4902, df=1, p<.000). In the comparison between schizophrenic patients with negative symptoms and normal controls, the frequency of A10 allele was significantly higher in normal healthy control subjects than patients with schizophrenia(χ²=21.33, df=1, p<0.001). In the case of male, the frequency of A10 allele of schizophrenia was significantly higher than normal controls(χ²=13.71, df=1, p<0.001). Conclusions: NTR gene was negatively associated with schizophrenia. NTR gene`s tetranucleotide repeat polymorphism may provide some protective function against schizophrenia.