양극성장애와 새로운 항경련제의 효과

남범우,서정석,정헌종,최진영 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Bipolar disorder, like epilepsy and migraine, is episodic in nature and psychiatric illness requiring lifelong treatment. So, it should not be surprising that anticonvulsants such as carbamazepine and valproate have proven efficacy as mood stabilizers. The newer anticonvulsants such as lamotrigine, gabapentin, topiramate, oxcarbazepine, tiagabine, and zonisamide may also be effective treatments for bipolar disorder. Identifying an anticonvulsant for use in bipolar disorder should take into account not only the pathophysiology of bipolar disorder but also the mechanism of action of the anticonvulsant. Evidence for effectiveness of these novel antiepileptic drugs in treating acute mania and depression as well as in preventing the recurrence of mania and depression is reviewed. In conclusion, although the novel anticonvulsants appear to be clinically useful, more controlled trials are needed to assess the effectiveness in bipolar disorder.

좌심방에 발생한 원발성 미분류 방추세포 육종 1례

조정환,홍그루,송인욱,손창우,정선영,남종호,김미진 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.2

일측폐환기 시 Propofol, Ketamine 및 Enflurane이 동맥혈 산소 분압과 이산화탄소 분압에 미치는 영향의 비교

우남식,이규창,김민정,김윤수 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

The mechanism which normally affects distribution of blood flow through unventilated areas of the lung is hypoxic pulmonary vasoconstriction, this acts to divert the blood to well ventilated alveoli, resulting in a better retio of ventilation to perfusion. Several reports have focused attention to the reduction or abolition of this reflex in the unventilated lung by most volatile anesthetic agents used in clinical practice. This response was not abolished by the intravenous anesthetic agents. 30 patients undergoing elective thoracic surgery were stuided to evaluate the effect of a propofol(n=10), ketamine(n=10) and enflurane(m=10) on the changes in PaO₂ and in PaCO₂ as reflections of shunt and ventilation respectively during one lung anesthesia. We have demonstrated that in all cases a PaO₂ in excess of 105.3mmHg, 79.5mmHg, and 177mmHg were achived with propofol, ketamine and enflurane. In all cases a PaCO₂ was under the 36.8mmHg. We concluded that both propofol and enflurane were satisfactory anesthetics for one-lung anesthesia. and ketanine was not ideal for one-lung anesthesia in adult patients.

一部 大學生의 B型肝炎 感染에 關한 疫學的 調査硏究

南貞祐,廉容泰,洪두루미 고려대학교 의과대학 1986 고려대 의대 잡지 Vol.23 No.1

Modern serologic techniques for the detection of HBsAg and Anti-HBs, particularly radioimmunoassay(R1A) and enzyme immunoassay(EIA), provided a technical foundation for more precise and sophisticated epidemiologic studies, of hepatitis B infection. Through a many study it has been revealed that the prevention and the control of hepatitis B infection have emerged as an urgent and serious problem in Korea. However, there are still some arguments on the prevalence rate, mode of transmission, control measures and so on, which hinder the development of certain countermeasures at national level. The authors have conducted this study on a total of 4,125 freshmen of 1983 academic year in Korea University to analyse the prevalence of HBsAg and Anti-HBs positives detected by RPHA and PHA methods in relation to a variety of factors such as socio-demographic, vaccination, family history, personal hygiene, past history of liver diseases and etc. The findings of the study were as follows; 1. Positive rates of HBsAg and Anti-HBs were 7.0 and 19.3% respectively. The rate for male was slightly higher than that of female. 2. In detecting HBsAg, sensitivity of RPHA against RIA method was 91.4% and specificity was 100% whereas sensitivity of PHA method was 51.9% and specificity was 88.9% respectively in detecting Anti-HBs. A question of false negative patient was raised in detecting Anti-HBs by PHA method. 3. Only two percent of HBsAg positive students were found to be acute hepatitis patients as a results of liver function test and 10% of them were thought to be in chronic state. 4. Among Anti-HBs Eegatives, the turn-out rate to positive after three times of vaccination with one of H-B-Vax and Hepavax were 61.0% by PHA method. But it was revealed to be 87.8% after reexamination of Anti-HBs negatives by the method of RIA. 5. The relationship of personal characteristics of subjects with the positive rate of HBsAg and Anti-HBs was analyzed. The communities with small population showed higher rates than ones with large population. For example, Cheju has shown the highest rate and was followed by Cholla Puk-Do and Kangwon-Do. In addition, the results suggested that the appearance of HBsAg and Anti-HBs associated with past history of liver diseases and family history of liver diseases, especially mother's past history. 6. Other factors including housing, past history of vaccination, skin test, acupuncture, behavior such as sharing tooth brush or razor with others and etc., have been reviewed but .there was no significant association with hepatitis B infection.

리튬이 도핑된 막을 이용한 실리콘-실리콘 접합

정지원,주병권,최우범,정성재,이남양,최두진,오명환 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

Silicon-to-silicon anodic bonding was accomplished using lithium doped interlayer. Lithium doped interlayers were deposited on silicon substrates by electron beam evaporation, which has a fast deposition rate compared with sputtering method. Silicon-to-silicon bonding occurs in the range of temperatures from 250℃ to 300℃ with the applied voltages from 70V_(DC) to 100V_(DC). The bonding strength obtained from tensile test was about 5MPa under the condition of 80V_(DC) in 300℃. The surface morphology of lithium doped interlayer was studied with the atomic force microscopy (AFM). Finally, secondary ion mass spectroscopy (SIMS) analysis was carried out in order to investigate the role of the lithium ions in bonding mechanism.

제2형 당뇨병 남성 환자에서 유리 테스토스테론과 성호르몬 결합 글로블린 농도

남기덕,김영설,박철영,오승준,김덕윤,우정택,김성운,양인명,김진우,최영길 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.6

연구배경:인슐린저항성은 제2형 당뇨병과 심혈관질환의 주요한 위험 인자로 성호르몬과 상호 관계가 있다고 알려져 있다. 그러나 여성과는 달리 남성에서는 연령과 인슐린저항성에 따른 유리 테스토스테론과 성호르몬 결합 글로블린 농도의 변화에 대한 연구가 부족한 실정이다. 그러므로, 본 저자등은 제2형 당뇨병 남성 환자에서 정산인과 비교해서 유리 테스토스테론과 성호르몬 결합 글로블린 농도를 측정하고 연령에 따른 변화 정도를 알아보고자 하였다. 방법:대상 환자 모두에서 연령과 체질량지수, 총 콜레스테롤, 중성지방, 공복혈당과 인슐린 농도를 측정하였다. 혈중 유리 테스토스테론 농도는 방사면역측정법(radioimmunoassay)을 이용해서 측정하였고, 혈중 성호르몬 결합글로불린은 면역방사계측측정법(immunoradiometric assay)을 이용해서 측정하였다(Diagnostic System Laoratories, Wbster, TX, USA). 결과:1)제2형 당뇨병 남성 환자에서 정상 대조군 남성에 비해 성호르몬 결합글로불린은 104.1±35.0 vs 25.7±3.5 mole×10??로 의미 있게 높았으나(p<0.001), 유리 테스토스테론은 13.7±9.5 vs 13.6±6.5 ng/dL로 차이가 없었다. 2)연령과 성호르몬 결합 글로블린 사이의 상관 계수는 제2형 당뇨병 남성 환자에서 0.40로 중등고의 양의 상관 관계를 보였고(p<0.001), 정상 대조군 남성에서 0.11로 유의한 상관 관계를 보이지 않았다. 연령과 유리 테스토스테론 사이의 상관 계수는 제2형 당뇨병 남성 환자에서 0.08, 정상 대조군 남성에서-0.17로 모두에서 유의한 상관 관계를 보이지 않았다. 3)연령과 체질량지수를 보정한 후에 제2형 당뇨병 남성 환자와 정상 대조군 남성에서 혈중 인슐린 농도, 유리 테스토스테론과 성호르몬 결합 글로블린 사이에는 상관 관계가 없었다. 결론:제2형 당뇨병 남성 환자에서 정상 남성에 비해 성호르몬 결합 글로블린 농도가 증가되어 있었으며, 유리 테스토스테론은 차이가 없었다. 연령이 증가함에 따라 성호르몬 결합 글로블린이 제2형 당뇨병 남성 환자에서 정상 남성에 비해 증가 폭이 의미있게 컸으며, 유리 테스토스테론은 변화가 없었다. Background: Insulin resistance is a risk factor for cardiovascular disease and type 2 diabetes mellitus. There are many previous studies indicating that insulin lowers serum sex hormone-binding globulin levels, and there is inverse correlation between insulin resistance and serum sex hormone-binding globulin levels in women. However, in men, a limited number of studies are available to explain the effect of sex hormone on age and insulin. Therefore, the present study was undertaken to investigate the relationship among free testosterone, hormone-binding globulin and age in type 2 diabetic men and control subjects. Method: Age, body mass index, total cholesterol, triglyceride, fasting blood sugar, and insulin concentrations were examined on 89 type 2 diabetic men and 47 control subjects. The free testosterone level was measured by commercially available double-antibody system (Radioimmunoassay). The sex hormone-binding globulin level was also measured by commercially available double-antibody system(Immunoradiometric assay). Results: 1) Sex hormone-binding globulin level was significantly increased in patients with type 2 diabetes. However, there was no significantly difference in free testosterone level between the two groups. 2) Sex hormone-binding globulin was positively correlated with age (r=0.4, p <0.001) in patients with type 2 diabetes. Sex hormone-binding globulin and free testosterone were not correlated with age in control sujects. 3) Free testosterone and sex hormone-binding globulin concentrations were not significantly related to serum insulin concentration after adjusting for age and body mass index. Conclusions: We observed increased sex hormone-binding globulin concentration in diabetes man, and was a positively related to age. Further studies are needed to understand the relationships between age, insulin resistance, testosterone, and sex hormone-binding globulin concentrations(J Kor Diabetes Asso 24:699~707,2000).

Efavirenz, indinavir, lopinavir, ritonavir의 LC-MS/MS를 이용한 동시 정량법

채정우,배경진,백인환,서정원,이병요,이은주,남진경,강원구,권광일 충남대학교 약학대학 의약품개발연구소 2009 藥學論文集 Vol.24 No.-

Efavirenz indinavir and kaleta (co-formulation of lopinavir and ritonavir) are important antiretroviral drugs which have been proved to be human immunodeficiency virus (HIV) protease inhibitors and reduced the morbidity and mortality associated with HIV-1 infection. A brief and fast high performance liquid chromatography coupled with electrospray mass spectrometry (LC-MS/MS, API 4000) method for the determination of 4 anti-retroviral agents (efavirenz, lopinavir, indinavir, ritonavir) in human plasma was developed and validated. A simple protein precipitation method was used on 100μl of human plasma. And internal standard solution (10 ng/ml methaqualone) 1ml and reconstitution solution (MeOH) 1ml were added. After vortexing for 30 s and centrifuging at 13,200rpm for 10min, 2μl of supernatant was injected into the column (XTerra MS C_(18) column, 2.1mm × 50mm 3.5㎛ particle size). The mobile phase consisted of MeOH and 0.1% formic acid in water (80:20 , v/v). The chromatogram was run for 1.5 min at a flow rate of 300μl/min. A triple quadrupole mass spectrometer was operated in a positive ion mode (lopinavir, indinavir, ritonavir) and negative mode (efavirenz), simultaneously and multiple reaction monitoring (MRM) was used for drug quantification. The precursor-to-product ion transitions of m/z 316→69 (efavirenz) and 629→447 (lopinavir) and 614→421 (indinavir) and 721→296 (ritonavir)were used to measure and quantify the analyte. The limit of quantitation (LOQ) was 50 ng/ml (efavirenz, indinavir, ritonavir) and 100 ng/ml (lopinavir). The weighted (l/y²) calibration curve was linear over human plasma range 50∼5000ng/ml (efavirenz), 100∼20000ng/ml (lopinavir), 50∼10000ng/ml (indinavir), 50∼2000ng/ml (ritonavir), correlation coefficient(r²) of 4 antiretroviral agents were higher than 0.998. Accuracies and intra-run precisions ranged within 86.60 and 113.29%, 1.06 and 11.16% for all 4 drugs analysed. This analytical method used to determine these drugs was fast and easy to perform, with minimal sample preparation, and without compromising precision and accuracy. The developed method was successful to determine antiretroviral agents in human plasma, and proved suitable for clinical pharmacokinetic study.

방사선 조사를 받은 흰쥐 망막 속얼기층의 미세구조

양석우,고정식,양남길,안의태,박경호 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

본 실험은 머리부분이 많은양의 방사선에 노출되었을 때 망막 속얼기층의 미세구조적 변화를 관찰하기 위하여 시행하였다. 실험동물로는 체중 200-250g의 흰쥐를 사용하였으며, 마취상태에서 머리부분에만 방사선을 조사하였다. 방사선 조사는 미쓰비시 선형가속기를 이용하여 조사거리 80cm, 구역 30cm X 30cm, 깊이 1.2cm 조건에서 1분당 200rad씩 연속조사하여, 3,000rad 또는 6,000rad를 조사한 후 6시간, 2일, 6일후에 희생시켰다. 각 동물은 1% glutaraldehyde- 1% paraformaldehyde액으로 관류고정하였다. 관류가 끝난 후 안구를 적출하여 톱니둘레를 따라 절단한 다음, 망막의 일정부위에서 조직을 떼어냈다. 떼어낸 조직은 2.5% glutaraldehyde- 1.5% paraformaldehyde액에 일차고정한 후 1%osmium tetroxide액에 이차고정하였다. 고정된 조직은 수세와 탈수과정을 거쳐 araldite혼합액에 포매한 다음 얇은 절편을 작성하여 uranly acetate와 lead citrate로 염색한 후 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 무축삭신경원의 세포질돌기는 전자밀도가 높은 어두운세포와 전자밀도가 낮은 밝은세포로 구분되었으며, 밝은 세포 가운데에는 과립형연접소포를 갖고 있는 돌기가 관찰되었다. 2. 3,000rad조사 후 6시간군의 경우 밝은 무축삭신경원이 세포질돌기와 신경절세포의 가지돌기는 팽대되었으며 사립체와 세포막이 파괴되는 모습이 관찰되었는데, 2일군의 경우 그 경향이 가장 심했다. 3. 3,000rad조사 후 6일군의 경우 부챗살아교세포의 영역이 넓어져서 전체적인 조직의 모습이 2일군의 것에 비하여 많이 회복되어 보였다. 4. 6,000rad조사 6일군의 경우 부챗살아교세포는 미세사가 많고 전자밀도가 높은 변성된 세포가 자주 관찰되었다. 이상의 결과를 종합해 보면 3,000rad의 방사선을 조사받으면 흰쥐망막의 속얼기층은 처음에는 무축삭신경원의 세포질돌기와 신경절세포의 가지돌기가 손상을 받았으나, 6일 후에는 부챗살아교세포의 영역이 넓어져서 많이 회복되었다. 그러나 6,000rad정도의 방사선을 조사하면 부챗살아교세포도 변성되어 속얼기층 전체가 변성된것으로 보아, 부챗살아교세포는 무축삭신경원이나 신경절세포에 비하여 방사선에 대한 저항성이 높다고 생각된다. This experiment was performed to study the morphological respones of the inner plexiform layer of the retina of rat following X-ray irradiation. Rats anethetized with sodium thiopental, were exposed only on their head areas with a single dose of 3,000rads or 6,000rads, respectively. Radiation was produced by Mitsubishi linear accelerator, at the speed of 200rads/min. The experimental groups were sacrificed on the 6th hour, 2nd hour, 2nd and 6th day after X-ray irradiation. Under anethesia, 1% glutaraldehyde- 1% paprformaldehyde solution was perfused through the heart. Pieces of the tissue taken from the posterior region of the retina were fixed in 2.5% glutaraldehyde- 1.5% paraformaldehyde, and in 1% osmium tetroxide, and embedded in araldite mixture. Ultrathin sections were stained with uranyl acetate and lead citrate solutions. From the ultrastructural study, following results were made: 1. Two types of amacrine cells, according to their elecrton densities, were found, i.e., light amacrine cell and dark amacrine cell. Granular synaptic vesicels were often observed in the light amacrine cells. 2. Two days after exposure to 3,000rads of X-ray, severe morphological changes were observed in cytoplasmic processes of light amacrine cells and dendrite of ganglion cells; i.e., edematous changes, framoentation of mitochondria, breakdown of cell membranes, etc. 3. Six days after exposure to 3,000rads of X-ray, many of the malformaitons were seen to be repaired, except the territory of activated Muller cell. 4. Six days after exposure to 6,000rads of X-ray, darkly degenerated Muller cell were frequently observed. From the above results, it was concluded that large amount of head-irradiation results the severe damages to the cytoplasmic processes of amacrince cell and the dendrites of ganglion cell in the inner plexiform layer of rat retina, but Muller cells are more radioresistant than amacrine and ganglion cells.

월경전증후군의 진단분류학적 개념 및 원인과 치료 : Nosology, Etiology, and Treatment

문석우,서정석,류은정,남범우 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Since the emergence of the term premenstrual syndrome (PMS) in the 1950s, PMS has become an increasingly discussed topic in popular media sources. Thus self management techniques are easily accessed by women through the media or through their peers. Premenstrual dysphoric disorder (PMDD) comprises extremely distressing emotional and behavioral symptoms. Women with PMDD report premenstrual symptoms, primarily mood symptoms, that are severe enough to seriously interfere with their life style and relationships and usually do not respond to conservative and conventional interventions. Although women with PMS are most often seen in primary care or by their obstetricians/gynecologists, the result of recent study suggested a high rate of missed diagnoses. The premenstrual syndromes include the more common PMS, the less prevalent PMDD, and menstrual psychosis. The etiology of PMS and PMDD is still largely unknown. That PMS and PMDD are primarily biological phenomena is underscored by recent, convincing evidence. Therapeutic interventions for PMS and PMDD range from the conservative to treatment with psychotropic medication and, for the more extreme cases, hormonal therapy or surgical procedures.

뇌졸중후 우울증

문석우,서정석,남범우,최진영 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

In recent years, depression is most commonly reported psychiatric condition after stroke, poststroke depression(PSD) has attracted world-wide interest. This review focuses on the major research themes that have emerged. Pooled data from studies, have wide variation in results is due to different criteria for patient selection, different evaluation methods, diagnostic criteria and poststroke intervals, conducted throughout the world have found prevalence rates for from 18% to 65%. The diagnosis of PSD is most appropriately based on a structured mental state exam and DSM-N criteria for depression due to stroke with major depressive-like episode or depressive features. Rarely, poststroke patients may also develop bipolar mood disorder. The treatment of PSD, single antidepressant showing efficacy and electroconvulsive theraphy(ECT) and behavioral therapies have also effective. The progression of recovery following stroke can be altered by treating depression, which has been shown to improve recovery in activities of daily living(ADL) and cognitive impairment and to decreased mortality. The mechanisms underlying the association of stroke and mood disorder are important areas for future investigation.