상염색체우성 다낭신의 임상경과 및 합병증

이상주,이영모,이한규,최대은,박기현,이강욱,신영태 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Autosomal dominant polycystic kidney disease(ADPKD) is one of most common hereditary disorder. It is potentially fatal and the major mobilities are hypertension and renal failure. To elucidate clinical characteristics and outcomes of ADPKD, 67 ADPKD patients were analyzed retrospectively. The male to female ratio was 48 years for males and 42 years for females. The factors leading to the dignosis of ADPKD were flank or abdominal pain (46%), palpable abdominal mass (24%), incidental findings (18%), gross hematuria and headache. Urinalysis result showed hematuria (31%), proteinuria (19%), pyuria (18%). Among renal complications hypertension (67%) was the most common. Other complications were urolithiasis (16%) upper urinary tract infection (9%), cyst infection (7%). Azotemia was observed in 24% of cases. Echocardiography showed left ventricular hypertrophy in 24% and valvular regurgitation in 18% of cases, but there was no mital valve prolapse. Cerebrovascular events occurred in 6 cases (2 cases of intervertebral hemorrhage and 4 cases of cerebral infarction). Hipatic cyst were observed in 64% of cases. Eighteen cases culminated in end stage renal failure (ESRF) at an of 47. According to this study, the most common complications of ADPKD was hypertension (67%), ESRF (27%), and cerebrovascular event (9%). Hypertension was more frequently observed in increased creatinine group than normal.

혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

한국인에서 다변성 D12S391 유전좌의 집단유전학적 연구

이용욱,김성민,구태완,이혜린,강일호,한길로,이혜승,황적준 大韓法醫學會 1999 대한법의학회지 Vol.23 No.1

The hypervariable short tandem repeat(STR) locus D12S391 was investigated in a Korean population. A total of 14 alleles were detected by size under denaturing conditions in 517 unrelated individuals. To confirm all of the alleles detected in a Korean population, a total of 34 fragments were sequenced. Prior to allele designation, we constructed the allelic ladders containing 11 alleles sequenced in this study. Allele 18 is the most common with a frequency of 0.281 in Koreans, and one variant allele 19.3 which have been confirmed by sequencing, was detected. The observed heterozygosity, the power of discrimination (PD), and the mean exclusion chance (MEC) for the locus D12S392 is 0.781, 0.946 and 0.652 , respectively. No deviation from Hardy-Weinberg equilibrium was observed in a Korean population (p=0.557). In the 424 meioses in 105 Korean families confirmed using other 17 STR loci, no mutation was detected in locus D12S391. The STR locus D12S391system is useful both for the analysis identification and parternity.

신장질환이 동반된 고혈압 환자에서 칼승길항제 Felodipine의 효과

신영태,정민수,이순구,김성숙,이강욱 大韓臨床藥理學會 1993 臨床藥理學會誌 Vol.1 No.1

地方政府의 福祉政策의 決定要因 分析

이병태,안강식 진주여자전문대학 1995 論文集 Vol.18 No.-

The results of this study are as follows : First, The correlation of socioeconomic variables except old age(65) with welfare expenditures is negative. Second, Socioeconomic variables exert no direct effect on the social welfare expenditures. Third, Interparty competition among politics variabls affects on grant-in-aid as administrative system variable which influences on the social welfare expenditures, and also interparty competition exerts direct affect on the social welfare expenditures. Finally, Granr-in-aid as administrative system variable has significant relation with welfare expenditures and it has the greatest influence(β=.40) of all variables. This means cental government has serious influence on welfare expenditure determination in local government level.

Alcoholics 환자와 Alcohol Dehydrogenase

강병조,이종학,신창규,정태호 대한생물치료정신의학회 1995 생물치료정신의학 Vol.1 No.2

저자들은 만성알콜중독의 원인으로 음주자의 성격, 사회요인 등 여러가지 문제들이 게재되어 있지만 유전적 요인도 중요하리라고 생각되어 만성알콜중독자로 진단되어 국립부곡정신병원에 입원가료 중인 환자 30명을 대상으로 ADH2의 다형현상(polymorphism)을 조사하여 알콜중독자가 아닌 건강한 한국인의 유전자형과 비교한 결과 다음과 같은 결과를 얻었다. 만성알콜중독자 30명 중 ADH2-1/ADH2-1 형을 갖는 사람이 27명이었으며 ADH2-1/ADH2-2를 갖는 사람이 3명이었다. ADH2¹의 gene frequencies는 0.68이었으며 ADH²의 gene frequencies는 0.32로서 정상 한국인과 비교하여 유의한 차이가 없었다. This study was performed to know the gene polymorphism of alcoholic dehydrogenase(ADH)-2 in 30 Korean alcohol addicted patients who were admitted at Bugok National Mental Hospital. The results were as follows ADH2-1/ADH2-1 type among 30 alcohol addicts were 27 and ADH2-1/ADH2-2 type were 3. Gene frequencies of ADH2-1 were 0.68 and gene frequencies of ADH2-2 were 0.32 These results were not different from the gene polymorphism of ADH2 in non-alcoholic Korean healthy adults.

관상동맥질환에서 Tc-99m Methoxyisobutyl Isonitrile (MIBI) Myocardial SPECT의 이용 : Dipyridamole 심근부하 SPECT와 관상동맥조영술과의 비교 A Comparison between Coronary Angiography and Tc-99m-MIBI Myocardial SPECT

이강욱,전은석,박종훈,신영태,노흥규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

In order to evaluate clinical utilities of Tc-99m MIBI dipyridamole stress myocardial SPECT in patients with coronary artery disease (CAD), we compaired tomographic and polar map images of Tc-99m MIBI myocardial SPECT with the results of coronary angiography in 25 patients with CAD (myocardial infarction 13,angina pectoris 12) in Chungnam National University Hospital from Oct. 1991 to Oct 1993. Percutaneous transcoronary angioplasty (PTCA) was done in three patients of 25 CAD patients and follow up SPECT studies were done in same three patients within 2 months after PTCA. The results were as follows : 1. Mean age of patients was 57.4 years. Man was 2.7 times more than woman. 2. Sensitivity and specificity of Tc-99m MIBI myocardial SPECT for the detection of coronary artery stenosis in patients with myocardial infarction were 92.7 % anf 85 %, respectively. 3. Sensitivity and specificity of Tc-99m MIBI myocardial SPECT for the detection of coronary artery stenosis in patients with angina pectoris were 100 % and 67 %, respectively. 4. After PTCA size of perfusion defects in stress SPELT images was decreased in all three patients . With the results above,we thought that Tc-99m MIBI myocardial SPECT is useful noninvasive method to detect stenosed coronary artery in patients with CAD and it can be used as a method to evaluate the result of PTCA.

신장질환과 동반된 고혈압 환자에서 Cicletanine HCl이 신기능에 미치는 영향에 관한 연구

이강욱,신영태 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Cicletanine HCl is the first delivative of the furopyridines, a new class of antihypertensive agents. The properties of cicletanin HCl involve increased prostacycline release, vascular H_1, H_3, receptor antagonism and modulation of intracytosolic free calcium. In order to evaluate the effect of cicletanine HC1 to renal function in hypertensive patients with renal disease, we examined twenty one patients with hypertension and renal disease in Chungnamnam National University Hospital, before and four weeks after administration of cicletanine HCl 100 mg per day . The results were as follows : 1. Mean age of patients was 50 years and man was 1.3 times more than woman. 2. Eight with hypertensive nephropathy, 7 with unknown cause chronic renal failure and 6 patients with diabetic nephropathy were included. 3. Systolic, diastolic and mean blood pressure of all patients decreased significantly, and 62 % of patients showed normalized blood pressure at end point of study 4. Parameters of renal function such as BUN, serum creatinine and creatinine clearence were not changed. 5. Amounts of 24 hour uninary protein excretion in patients goup with massive proteinuria ( >3.0 g/day,n = 13 ) decreased significantly, 4 weeks after cicletanine HCl administration. 6. Serum cholesterol, triglyceride, ALT, AST, uric acid, muscle enzyme and serum electrolytes shch as sodium, potassium, calcium and phosphorus remained unchanged. 7. There was no significant side effect during 4 weeks course of cicletanine HCI administration. With results above, we think that cicletanm HCl can be used safely in hypertensive patients with renal disease.

장시간 수술시 Propofol과 Enflurane의 마취 유지 효과 및 술후 각성도에 대한 비교

김태요,윤재승,이강창,정영표,안선연 圓光大學校 1995 論文集 Vol.30 No.2

There has not been particular attention focused on the comparative benefits and risks of propofol anesthesia with inhalation anesthesia in the operations of long duration. This study was assessed the anesthetic efficacy and the speed of recovery from propofol or enflurane anesthesia in patients undergoing the long term operations. The propofol group (n=25) receiver 2.0 - 2.5mg/kg propofol intravenously for the induction of anesthesia and followed by propofol infusion(6 - 12mg/kg/h). The enflurane group (n=25) was induced as the propofol group and followed by enflurane(1-2 MAC) addministration. All patients received nitrous oxide (50%) in oxygen immediately after tracheal intubation. All anesthetic agents were stopped at the time of last stitch. The hemodynamic changes were recorded and the recovery was assessed with the time from discontinuation of all anesthetics to extubation and the indices of consciousness at early recovery(recall name, eye opening on command, raise hand on request and coughing on request). The recovery tests showed no differences between the groups. Systolic pressure after intubation in propofol group was significantly increased (p<0.05), compared with enflurane group. In propofol group, seven patients received fentanyl because of light anesthetic depth. The frequency of nausea and vomiting was similar between the groups. In conclusion, the long propofol anesthesia was not associated with faster recovery than enflurane anesthesia and propofol as an agent of anesthetic maintenance was unfavorable.

Alcoholics 환자와 Alcohol Dehydrogenase

정태호,신창규,이종학,강병조 경북대학교 병원 1998 경북대학교병원의학연구소논문집 Vol.2 No.1

저자들은 만성알콜중독의 원인으로 음주자의 성격, 사회요인 등 여러가지 문제들이 게재되어 있지만 유전적 요인도 중요하리라고 생각되어 만성알콜중독자로 진단되어 국립부곡정신병원에 입원가료 중인 환자 30명을 대상으로 ADH2의 다형현상(polymorphism)을 조사하여 알콜중독자가 아닌 건강한 한국인의 유전자형과 비교한 결과 다음과 같은 결과를 얻었다. 만성알콜중독자 30명 중 ADH2-1/ADH2-1 형을 갖는 사람이 27명이었으며 ADH2-1/ADH2-2를 갖는 사람이 3명이었다. ADH2¹의 gene frequencies는 0.68이었으며 ADH²의 gene frequencies는 0.32로서 정상 한국인과 비교하여 유의한 차이가 없었다. This study was performed to know the gene polymorphism of alcoholic dehydrogenase(ADH)-2 in 30 Korean alcohol addicted patients who were admitted at Bugok National Mental Hospital. The results were as follows ADH-2/ADH2-1 type among 30 alcohol addicts were 27 and ADH2-1/ADH2-2 type were 3. Gene frequencies of ADH2-1 were 0.68 and gene frequencies of ADH2-2 were 0.32 These results were not different from the gene polymorphism of ADH2 in non-alcoholic Korean healthy adults.