정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

6-hydroxydopamine에 의한 Synaptosome의 Na^+-K^+ ATPase 및 Mg^++ ATPase의 비활성화에 대한 Cu^++의 역할

이경용,이정수,정명희,이광수 중앙대학교 의과대학 의과학연구소 1985 中央醫大誌 Vol.10 No.4

6-Hydroxydopamine(6-OHDA) is selectively accumulated in catecholamine-containing neurons and causes degeneration of nerve terminals when injected into animals. However, the exact molecular mechanism of toxicity remains uncertain. 6-OHDA is an unstable compound which autoxidizes extremely rapidly. Among the various metal ions, Cu^++ is an extremely reactive cation which is known to stimulate the autoxidation of several autoxidizable compounds, among them catecholes and hemoglobin. In the present study, role of Cu^++ was observed on both the production of reactive oxygen species and the inactivation of rat brain synaptosomal Na^+-K^+ ATPase and Mg^++ATPase caused by 6-OHDA. Synaptosomal Na^+-K^+ ATPase and Mg^++ATPase activities were significantly reduced by 6-OHDA. In reaction medium of pH 7.4 6-OHDA is autoxidized rapidly and during this process H_2O_2 and superoxide radical(o^1_2) were formed. Thus, the observed findings suggest that inactivation of these ATPases may be caused by reactive oxygen species. Cu^++ stimulated the rate of autoxidation of 6-OHDA in a dose dependent manner and this stimulation of the autoxidation of 6-OHDA by Cu^++ was prevented by EDTA, penicillamine, catalase and histidine. Effect of Cu^++ was also observed with Na^+-K^+ ATPase and Mg^++ ATPase activities. Inhibition of Na^+-K^+ ATPase and Mg^++ATPase activities by 6-OHDA was further enhanced by Cu^++ and these effects were effectively prevented by catalase and histidine. From the results obtained, it is suggested that Cu^++ stimulates the autoxidation of 6-OHDA and enhances the inactivation of synaptosomal Na^+-K^+ ATPase by 6-OHDA. Also, the inactivation of these ATPase may be attributed to singlet oxygen (O^1_2).

뇌 아밀로이드 혈관병과 고혈압성 뇌출혈의 감별에 있어서 Apolipoprotein Eε4와 점상 출혈 분포의 유용성

김용범,이광호,이수주,나덕렬,조수진,정진상,이원용 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

Fluoxetine이 Schedule-Induced Polydipsia가 유발된 백서 뇌에서 Tyrosine Hydroxylase 발현에 미치는 영향

이기철,이정호,최영민,정주호,정홍경,이용민,김도형,이대환 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: Fluoxetine은 serotonin을 매개하여 간접적으로 dopamine 신경전달기능을 억제한다고 추정되고 있다. 또한 운동장애에서 운동기능의 악화를 유발한다고 알려져 있다. 그러나 신경세포체에서 fluoxetine이 dopamine에 어떠한 영향을 주는지는 아직까지 확실치 않다. 저자들은 schedule-induced polydipsia를 유발시킨 백서 뇌의 흑질, 복부피개영역, 미상핵에서 tyrosine hydroxylase(TH) 발현이 저하됨을 발견하였다. 이를 통해서 fluoxetine이 백서 뇌의 dopamine 기능에 긍정적인지 혹은 부정적인지를 규명하고자 하였다. 방법: 4주간의 schedule-induced polydipsia 과정을 거친 백서에서 면역죄치화학적인 방법으로 흑질, 복부피개영역, 미상핵의 tyrosine hydroxylase 발현이 저하됨을 확인한 후, 실험동물들에게 fluoxetine 10mg/kg를 3주간 복강내 주사하였다. 실험백서들을 희생시켜 뇌 조직을 적출하여, TH 면역조직화학 염색법을 이용하여 흑질, 복부피개영역, 그리고 미상핵의 TH 면역반응세포를 관찰하고 이를 정상백서와 비교하였다. 결과: 1) 다갈증이 유발된 백서의 흑질, 복부피개영역, 미상핵에서 tyrosine hydroxylase 발현이 정상백서 보다 저하됨을 관찰하였다. 2) 3주간에 걸친 fluoxetine 투여후 흑질, 복부피개영역, 미상핵의 tyrosin hydroxylase 발현이 다시 증가하는 소견을 보였다. 결론: Fluoxetine 만성투여가 흑질, 복부피개영역 그리고 미상핵의 tyrosin hydroxylase를 증가시키는 소견을 얻었다. 이러한 결과는 임상에서 dopamine 결핍과 연관된 질환들에서 fluoxetine을 만성투여하면 운동기능을 포함한 증상들의 개선을 가져올 수도 있다고 추정된다. Objective: It has been suggested that fluoxetine inhibits the dopaminergic neurotransmission by serotonergic mediation. And also, it has been shown to inhibit synthesis of DOPA in dopamine-rich areas of the rat forebrain. These dopamine-antagonistic capacity of fluoxetine is only supported by anecdotal report that the increased amount of motor disability in patients with idiopathic Parkinson's disease after exposure to fluoxetine. However, there is still no evidence of the direct effect of fluoxetine on dopaminergic neuronal cell body in the substantia nigra, VTA, caudate & putamen. This study was designed to evaluate the effects of fluoxetine in rat brain which showed decreased numbers of dopaminergic neuronal cell body induced by schedule-induced polydipsia(SIP). Method: We incidentally found that 4 weeks of schedule-induced polydipsic rats revealed the suppression of tyrosine hydroxylase expression in the substantia nigra, VTA, caudate & putamen with the immunohistochemistric measures. After 3 weeks of intraperitoneal injection of 10mg/kg of fluoxetine to the schedule induced polydipsic rats, the tyrosine hydroxylase expression was also measured with immunohistochemistry. We compared the tyrosine hydroxylase expression among the normal control, the polydipsic rats, and the rats with fluoxetine treatment. Results: 1) By contrast with the control, the polydipsic rats revealed the evidence of decreased tyrosine hydroxylase expression in the substantia nigra, VTA, caudate & putamen. 2)After daily injection of fluoxetine for 3 weeks, the polydipsic rats showed increment of tyrosine hydroxyase expression in those areas. Conclusions: In previous studies, a great deal of results suggest that fluoxetine negatively influence the dopaminergic systems indirectly via serotonergic activation such as inhibition of dopamine synthesis or transport system. Although our results are obtained from rodents, we suggest that fluoxetine directly and positively enhance the dopamine system in the substantia nigra, VTA, caudate & putamen. The chronic adminstration of fluoxetine may be helpful to dopamine-depleted condition in clinical situations. We anticipate the replication studies of our findings and well-controlled clinical trial.

호르몬 불응성 전립선암 환자에서 mitoxantrone과 prednisone의 병합화학요법 후 통증완화 및 삶의 질 측정

이홍우,이지열,김세웅,이충범,강성학,조용현,황태곤,박용현,윤문수 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

목적 : 호르몬 불응성 전립선암 환자의 생명을 연장시키는 치료법은 현재로는 없으며, 현 시점에서의 치료목표는 증상의 경감 및 소실에 따른 삶의 질 향상에 두고 있다. 호르몬 불응성 전립선암의 고식적인 치료에 일차적인 치료법으로 간주되는 mitoxantrone과 prednisone의 화학요법이 호르몬 불응성 전립선암 환자의 통증완화 및 삶의 질에 어떠한 영향을 미치는지 알아보았다. 방법 : 1998년 7월부터 1999년 12월까지 증상이 있는 18명의 호르몬 불응성 전립선암 환자를 대상으로 하였으며, 일차적인 치료의 목표는 환자 본인이 기록하는 McGill-Melzack 6단계 통증척도에서 진통제의 증량 없이 2점이 감소(또는 첫 점수가 1점일 경우 통증의 완전소실)하는 것으로 하였다. 이러한 기준은 최소 3주 간격으로 시행한 자가 기록조사에서 연속적으로 2번 이상 유지될 때 유효한 것으로 간주하였다. 건강과 관련된 삶의 질 측정은 전신적 치료의 임상적 응용을 위한 실제적인 측정방법으로 개발되어 환자가 직접 작성하는 전립선암 특이성 삶의 질 측정기구(Prostate Cancer-Specific Quality-of-Life Instrument : PROSQOLI)의 비례연속형의 자가측정 척도(linear analogue self-assessment scale : LASA)를 이용하였으며, ECOG performance status를 사용하여 전신상태의 변화도 측정하였다. 결과 : 통증의 경감으로 나타나는 고식적인 치료의 반응은 66.7%(12/18)에서 나타났으며, 반응의 지속기간은 2개월에서 10개월까지로 평균 4.2±3.6개월이었다. PROSQOLI로 측정한 삶의 질은 통증에 대한 고식적인 치료반응을 보인 12명(66.7%) 모두가 삶의 질이 개선되었으며 특히 통증, 변비, 소변보기, 전반적인 복지상태에서의 유의한(p<0.05) 증가를 보였다. 치료 후 혈장 PSA 수치는 고식적인 반응의 유무에 관계없이 별 다른 변화를 보이지 않았으며, 골주사 또는 전산화 단층촬영으로 측정한 방사선학적 병변은 고식적인 반응을 보인 2명을 제외하고 치료 전과 비교하여 차이를 보이지 않았다. 병합 화학요법과 관련된 특별한 부작용은 관찰되지 않았다. 결론 : 통증을 동반한 호르몬 불응성 전립선암에서 mitoxantrone과 prednisone의 병합화학요법은 66.7%의 환자에서 통증의 감소 및 삶의 질이 향상되었다. 현재는 혈장 PSA 수치, 병소의 크기나 개수등이 치료의 지침이나 치료결과의 판정을 위한 객관적인 기준으로 사용되는 경향이 있지만, 앞으로는 환자를 중심으로 통증을 포함한 삶의 질 측정이 고식적 치료 후 치료결과 판정에 있어 객관적이고 적절한 방법이 될 것이다. Background : There is no evidence that therapeutic modalities prolong the survival of patients with hormone-refractory prostate cancer nowadays. The main goal of treatment is therefore improvement in quality-of-life including palliation of symptoms. We performed this study to investigate the benefit of mitoxantrone and prednisone chemotherapy in patients with symptomatic hormone-refractory prostate cancer using relevant end points of palliation regarding to pain and quality-of-life. Methods : From July 1998 to December 1999, we assessed the 18 patients with symptomatic hormone-refractory prostate cancer receiving mitoxantrone and low dose prednisone. The treatment end point was a palliative response defined as a 2-point decrease in pain assessed by a 6-point pain scale complemented by patients (or complete loss of pain if initially 1+) without an increase in analgesic medication and maintained for two consecutive evaluations at least 3 weeks apart. Health-related quality-of-life was evaluated with a series of linear analogue self-assessment(LASA) scale of the Prostate Cancer-Specific Quality-of-Life Instrument (PROSQOLI) and performance status was also measured. Results : Palliative responses were observed in 12(66.7%) of 18 patients. The duration of palliative responses were 4.2±3.6 months(range: 2 to 10 months). Treatment was well tolerated without specific side effects. There were no differences in prostate-specific antigen (PSA) level following treatment and no significant changes of radiologic findings evaluated by bone scan and/or CT were noted except 2 cases after chemotherapy. All the responding patients had an improvement in quality-of-life scales and performance status, however serum PSA levels were not changed. Conclusions : Chemotherapy with mitoxantrone and prednisone provides palliation and an improvement in quality-of-life for more than half (66.7%) of the patients with symptomatic hormone-refractory prostate cancer.

난소 임신 10예의 분석

김용진,이충일,이해혁,남계현,이임순,이권해 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Ovarian pregnancy is an uncommon form of the ectopic pregnancies. The ovarian vascularity results in maternal hemorrhage early in the first trimester, which disrupts the pregnancy and usually ruptures the ovary with sufficient hemoperitoneum to require emergency operation. This report presents 10 cases of ovarian pregnancy by retrospective review between January 1986 and December 1995 at the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital. There was 19,849 deliveries and 637 ectopic pregnancies during same period. It showed that the incidence of ovarian pregnancy was 3.21 % of all ectopic pregnancies. The clinical features of ovarian pregnancy revealed that abdominal pain was the major symptom, and history of amenorrhea was obscure. Because of life-threatening course, the early diagnosis and treatment of ovarian pregnancy is important. The clinical diagnosis of ovarian pregnancy was more difficult than that of tubal pregnancy.

크롬(Ⅵ)의 체내 흡수와 소실속도에 관한 연구

김현영,이성배,임철홍,이권섭,정용현,이종성,한정희,전윤석,황호순,이용묵 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.1

The CrO3 mostly used in plating. metal surface disposal, leather, cosmetic manufacturing, as an experiment material by repeatedly inhaling and exposure the male S.D. rats at a 0.00, 0.2., 0.50, 1.25 mg/㎡ concentration(particle size: 0.5-0.5 aerosol)6hours a day, 5day a week in 13weeks comparing with 2weeks, 8weeks of recovery group about the noxiousness of the experiment animal and the reduce scale of the CrO3 in the internal organ especially in blook and respiratory organ with the period of convalescent and clearance. The experiment results which we received are as follows. 1. In blood the RBC, HGB and HCT experiment, rats with 0.20, 0.50 mg/㎡ concentration showed that there were some decreases but not dependent. The kidneys absolute weight compared with control group was reduced intentionally(p〈0.05) and the lungs absolute weight compared with control group showed intentional increase(p〉0.05). 2. After the exposure of the experiment material, the whole blook, l\blood plasma and red blood cell in blood by (x): the period of convalescent, per (y); the decreasing of Cr concentration, was y=66.51 e -0.057x, y=67.2 e-0.101x, y=70.01 e-0.030 in 0.50 mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life (day)was estimated 12.0, 6086, 23.0 each. 3, After the exposure of the experiment material, the experiment animals lung, liver and kidneys by(x); the period of convalescent, per (y); the decreasing of Cr conentration, was y=1808 e-0.00493x, y=12.02e-0.0297x, y=67.61 e-0.0292x in 0.50mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life(day)was estimated 140.6, 23.3, 23.7, each, and including lung, liver with all of the experiment internal organs, the Cr clearance decreased as the exposure concentration increased.

Infliximab으로 호전된 장관 증상없이 발생한 구강-안면 크론병

정보용 ( Bo Yong Jung ),이석호 ( Suck Ho Lee ),정승규 ( Seung Kyu Chung ),이창균 ( Chang Kyun Lee1 ),이태훈 ( Tae Hoon Lee ),정일권 ( Il Kwun Chung ),김선주 ( Sun Joo Kim ),조현득 ( Hyun Deuk Cho ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.6

Crohn`s disease is a chronic inflammatory bowel disease that can involve the whole gastrointestinal tract. The orofacial manifestation of Crohn`s disease, which is rare, can develop irrespective of intestinal involvement. These orofacial lesions are often misdiagnosed as simple oral ulcers. Corticosteroids are the mainstay of therapy for orofacial Crohn`s disease. However, infliximab, the chimeric monoclonal antibody to tumor necrosis factor-α, is now considered as a primary treatment because of the disease`s relatively high rate of steroid resistance. We present a case of deep oral ulcer and periorbital swelling in a 65-year-old woman. She was diagnosed with intestinal Crohn`s disease 7 years ago, which was in remission after treatment with an immunosuppressive agent (azathioprine). The patient was given the diagnosed with orofacial Crohn`s disease and successfully treated with infliximab. (Korean J Gastroenterol 2012;59:437-440)

제2형 당뇨병 환자에서 Voglibose와 Acarbose의 비교임상연구

정인경,정재훈,민용기,이명식,이문규,김광원,정윤이,박중열,홍성관,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:아카보스와 보글리보스는 ­glucosidase inhibitors로써 비록 약리학적 작용이나 부작용에 있어서 두 약물간에 차이가 있다는 것은 잘 알려져 있으나 당뇨병 환자를 대상으로 아직 이에 대한 두 약물간에 직접적인 비교에 대해 연구된 바는 없었다. 이에 저자등은 국내 2형 당뇨병 환자에 대해 유효성과 부작용 발현에 대해 두 약제를 비교하고자 무작위법에 의한 위약 대조군의 이중 맹검법 연구를 시행하였다. 방법:시험 약제 투여 4주간의 관찰기를 설정하여 공복혈당의 변화가 30㎎/dL 이하이고, 식후 혈당이 200㎎/dL 이상인 환자로 기타 제외 기준에 해당하지 않은 환자 53명을 대상으로 하여 보글리보스 군(24명)과 아카보스 군(29명)으로 무작위로 나누었다. 치료기간은 총 8주로 하였으며, 4주간 간격으로 혈청학적 검사와 부작용을 분석하여 치료 효과가 부작용을 평가하였다. 결과:1)혈당 변화:보글리보스군은 식후 1시간 혈당이 치료 후 4주, 8주째 의미 있게 감소하였도, 아카보스군은 식후 1시간과 2시간 혈당이 치료 후 4주, 8주째 의미있게 감소하였다. 또한 관찰기 혈당에 대한 치료 4주째 감소량은 아카보스군에서 더 큰 경향을 보였으나, 치료 8주째에는 두 군 간의 강하정도에 의미있는 차이가 없었다(p=0.569). 2)인슐린 치의 변화:보글리스 군은 식후 1시간 인슐린 치가 치료 전에 비해 치료 4주, 8주째 감소하는 경향을 보였고, 공복 인슐린이나 식후 2시간 인슐린치는 치료전 후에 의미 있는 차이가 없었다. 아카보스군에서는 치료 전후로 공복 인슐린, 식후 1시간과 2시간 인슐린치에 의미 있는 차이를 보이지 않았다. 두약제 간에 치료 전과 치료 8주사이의 식후 2시간 인슐린의 감소량이 보글리보스 군에서 의미있게 높았다(p=0.040). 3)당화혈색소:보글리보스 군은 치료 전에 비해 치료후 당화혈색소가 감소하는 경향을 보였고, 아카보스군은 치료 전에 비해 의미있게 감소하였다. 당화혈색소 변화량은 두 군간에 의미 있는 차이는 없었다(p=0.412). 4)지질대사의 변화:중성지방, 콜레스테롤, 고밀도 진단백 콜레스테롤에 대해 두 군간에 의미 있는 차이는 없었다. 5)부작용:소화기계 부작용의 빈도는 치료 4주째 보글리보스 군에서 의미 있게 낮았으나(p=0.028), 치료 8주째 부작용의 빈도는 두 군간에 의미 있는 차이가 없었다(p=0.215). 결론:2형 당뇨병 환자에서 보글리보스와 아카보스의 두 약제의 임상적 유효성과 부작용발현에 대해 비교한 결과 치료 후 8 주 후 혈당강화효과는 두 약제간에 유사한 효과를 보였으나 보글리보스군에서 4주째의 초기 위장관 부작용이 적었다. Background : Acarbose and voglibose are alpha-glucosidase inhibitors. Although different pharmacological effects and adverse abdominal events associated with the two drugs have been reported, no study directly compared acarbose and voglibose in diabetes has been undertaken. To compare the pharmacological effects and gastrointestinal adverse events between two drugs, a randomized, placebo-controlled, double-bind study was performed in type 2 diabetes patients. Methods : The period of study was 12 weeks(observation period: 4 weeks; treatment period: 8 weeks). Fifty-three patients were randomized into two groups(the acarbose group: 24 patients; the voglibose group: 29 patients). The serum glucose, insulin, fructosamine, HbA_1c, cholesterol, triglyceride and the incidence of adverse events were measured. Results : 1) The reduction of glucose from before treatment to 4 weeks after treatment was significantly higher in the acarbose group, but the change before treatment and 8 weeks after treatment in the two groups was similar(p=0.569). 2) The insulin significantly decreased after voglibose treatment(p=0.040). 3) HbAa_1c level tended to decrease in voglibose group, and there was a significant decrease after acarbose treatment. However, the change in HbA_1c level before and after treatment was similar between the two groups(p=0.412). 4) The two drugs did not cause any other changes in the total, HDL-cholesterol and triglyceride. 5) The number of patients with gastrointestinal adverse events was significantly low 4 weeks after voglibose treatment (p=0.049), but the incidence in the two groups was similar after 8 weeks(p=0.215). Conclusions : Acarbose and voglibose significantly improved postprandial hyperglycemia in diabetes. The incidence of gastrointestinal adverse events was low 4 weeks after voglibose treatment(J Kor Diabetes 26:134~145, 2002).

三槽式便所를 設置한 濟州道內 一部落民의 寄生蟲感染率 推移

蘇鎭琸,李根泰,鄭坪林,李在興,李定熙,金英漢,洪淳億 최신의학사 1968 最新醫學 Vol.11 No.8

Three compartment stool tank system was established in March, 1965 to each of the houses . of Yongheungri, Cheju-do. The trend of parasites prevalence, faithfulness of the people to paractice the system and effectiveness of the system for destruction of ascaris eggs were examined. 1. Only 22 houses among 65 utilized the system for 3 years. The remained 43, gave up to practice; 10 because of the destruction of the cemented tank and 33 due to the shortage of. food stuffs, for hogs. In this island, the people have been raised hogs with human excrets. 2. The prevalence of ascaris infection in the village and in Sinwom-ri, a control village where the human feces were used as food stuffs for hog, were as follows: Yongheung(%) Sinwom(%) March 1965 before medication 52.0 43.0 Dec. 1965 after medication 15.1 21.2 Feb. 1968 22.7 30.8 3. Ascaris eggs in the 3rd compartment, were destroyed 94-100%, whereas the eggs in semi-formed feces in hog sty survived 94%.