간내 담석과 동반된 간내 담도암에서의 p53과 Ki-ras의 발현

김명환,이성구,서동완,이승규,남승우,박능화,민영일,김연석,심기남,공경엽 대한소화기학회 1997 대한소화기학회지 Vol.30 No.5

Background/Aims: Hepatolithiasis or primary intrahepatic stones may be accompanied later by intrahepatic cholangiocarcinoma. This cancerous lesion is frequently associated with atypical hyperplastic epithelium that was suspected of being precancerous. To investigate the Ki-ras or p53 mutation may play a role in carcinogenesis, and to determine whether atypical hyperplastic epithelium may be precancerous, this study was performed in intrahepatic cholangiocarcinomas associated with hepatolithiasis. Methods: We examined 12 patients with intrahepatic cholangiocarcinomas associated with hepatolithiasis. Ki-ras point mutations were assessed by direct DNA sequencing. Expressions of p53 protein were immunohistochemically assessed. The overexpression of p53 and point mutation of Ki-ras were examined in normal, hyperplastic, atypical hyperplastic, and can- cerous tissues separately. Results: The expressions of p53 protein were detected in 4 (33%) of 12 cholangiocarcinomas and Ki-ras point mutations at codon 12 were found in 2 (17%) of 12 cholangiocarcinomas. In those two carcinoma cases which contained the mutant sequence of Ki-ras, the same point mutation from wild type GGT (glycine) to GAT (aspartic acid) was. found in the associated atypical hyperplastic epithelium. However, none of the normal and hyperplastic epithelium harbored Ki-ras or p53 mutations. Conclusions: The overexpression of p53 may play a part in the carcinogenesis of some intrahepatic cholangiocarcinomas associated with hepatolithiasis, whereas the role of Ki-ras mutations in those cases is dubious. However, Ki-ras point mutation at codon 12 may be responsible for either cancer or atypical hyperplastic epithelium associated with hepatolithiasis in certain cases, suggesting atypical hyperplastic epithelium may give rise to carcinoma.

Adult Patients with Congenital Muscular Torticollis Treated with Bipolar Release : Report of 31 Cases

Lee, Gun Sang,Lee, Myung Ki,Kim, Woo Jae,Kim, Ho Sang,Kim, Jeong Ho,Kim, Yun-Suk The Korean Neurosurgical Society 2017 Journal of Korean neurosurgical society Vol.60 No.1

Objective : We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. Methods : Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting. Results : The modified Lee's scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (p<0.05). The preoperative mean CMA was $15.4^{\circ}$ (range, 5.4-29.0), which was reduced to a mean of CMA of $6.3^{\circ}$ (range, 0-25) after surgery (p<0.05). The global satisfaction rating scale was 93.7% (range, 90-100). A transient sensory deficit on the ipsilateral lower ear lobe was noted in three cases. No significant permanent complications occurred. Conclusion : Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.

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.

모 축전지 회사 근로자들의 연폭로 지표에 대한 경시적 관찰

강명식,김용배,이용진,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

Lead poisoning is still prevalent and one of important occupational disease in Korea. To prevent undue high lead burden and maintain good health condition of lead workers in lead using industries, periodic health examination and regular biological monitoring of lead workers are often required in addition to the fundamental improvement of their working condition. To evaluate the effect of comprehensive occupational health program with regular biological monitoring on the level of lead exposure of lead workers in lead using industries, 11 year database from 1983 to 1994 of one storage battery factory was reviewed. From 1983 to end of 1986 only periodic health examination was provided to the lead workers, but from 1987 comprehensive occupational health program with regular biological monitoring was provided to maintain better health condition of lead workers. Selected study variables for lead exposure were blood lead(PbB), zinc protoporphyrin in blood(ZPP), δ-aminolevulinic acid in urine(ALAU), hemoglobin(Hb), hematocrit(HCT). Information on sex, age and work duration was also reviewed. 5 years data from 1983 to 1987 and 3 years data from 1990, 1993 and 1994 were available for all lead exposure indices except ALAU which has only 5 years data from 1983 to 1997. The results of 11 years longitudinal observation of lead indices are all follows: 1. The mean value of ZPP of lead workers in 1983 was 148.7±73.1 ㎍/㎗(Male: 145.5±72.3, Female: 168.1±79.1), whereas that of ZPP of lead workers in 1994 was decreased to 64.3±32.7 ㎍/㎗(Male: 60.2±28.8, Female: 95.2±43.4). 2. The mean value of PbB of lead workers in 1983 was 56.4±18.8 ㎍/㎗(Male: 55.59±19.1, Female: 59.6±19.1), whereas that of PbB of lead workers in 1994 was dcreased to 35.4±11.9 ㎍/㎗(Male: 35.7±12.0, Female: 32.8±10.8). 3. The mean value of Hb of lead workers in 1983 was 14.1±1.4 g/㎗(Male: 14.4±1.1, Female: 11.7±0.8), whereas that of Hb of lead workers in 1994 was increased to 15.6±1.5 g/㎗(Male: 15.9±1.2, Female: 12.9±1.1). 4. Blood lead is most highly correlated with ZPP(r=0.522, male:0.54 and female:0.50) and also correlated with ALAU and work duration also. 5. The simple regression analysis of PbB and ZPP showed different coefficient of regression by the measurement year, but there was no difference of coefficient of regression between sex. The slope of equation of pooled data for 1983-1986 without comprehensive occupational health program was 2.16 and differed from that of pooled data for 1987-1994(1.25). This difference suggests that the unit effect of blood lead on ZPP was relatively smaller in later period of comprehensive occupational health program than carly period without comprehensive program. The slope change in the analysis of linear regression of PbB on ZPP in lead workers can be used to evaluate the possible effect of health intervention to prevent undue high lead absorption in lead using industries. 6. 11 years occupational health service in this storage battery factory brought out considerable improvement of health status of lead workers in terms of decrease of PbB and ZPP and increase of Hb and the improvement was more remarkable after the introduction of comprehensive occupational health program.

절수에 의한 Mongolian Gerbil 장기중량변화에 관한 분석연구

김무강,이기훈,이강이,송치원,이경열,권효정,박미선,정승혁,이행연,김명철 충남대학교 수의과대학 동물의과학연구소 2000 動物醫科學硏究誌 Vol.8 No.-

In this study, authors measured the each organ weight of the long term water deprived Mongolian gerbil, after then we calculated the mean, standard deviation, variance coefficient of the real measured organ weight and induced the organ weight change quantity, rate of quantity, deviation between measured and theological organ weight, deviation rate, sum of deviation rate, organ weight change rate, rate of organ weight by the mathematical formula. The results obtained as follow 1. The weight of the brains, lung, and testis were abruptly decreased after water deprived until the 5th day, after then slowly decreased until the 20th day. 2. The weight of the heart was decreased gradually from the first day until the 20th day. 3. The weight of the liver was abruptly decreased until the 10th day, after then the more slowly decreased until the 20th day. 4. The weight of the thymus, spleen, kidney, and pancreas were abruptly decreased until the 15th day, after then increased slowly until 20th day but the weight of the kidney was abruptly increased from the 10th day. 5. The organ weight change rate and the rate of the each day organ weight were very diversified.

Tetrahydroisoquinoline Alkaloids가 쥐의 동맥과 뇌균등질의 α-Adrenoceptors에 미치는 영향

이현석,백선하,황수현,박인성,김은상,정진명,한종우,장기철,장기철 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.1

ATHB12, an ABA-lnducible Homeodomain-Leucine Zipper (HD-Zip) Protein of Arabidopsis, Negatively Regulates the Growth of the Inflorescence Stem by Decreasing the Expression of a Gibberellin 20-Oxidase Gene

Ora Son,허윤선,김윤경,이현정,김성한,김미란,남경희,이명석,김부용,박종범,박정안,이석찬,Atsushi Hanada,Shinjiro Yamaguchi,이인정,김승기,윤대진,Eva So¨derman,천충일 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

ATHB12, an ABA-lnducible Homeodomain-Leucine Zipper (HD-Zip) Protein of Arabidopsis, Negatively Regulates the Growth of the Inflorescence Stem by Decreasing the Expression of a Gibberellin 20-Oxidase Gene

Ora Son,허윤선,김윤경,이현정,김성한,김미란,남경희,이명석,김부용,박종범,박정안,이석찬,Atsushi Hanada,Shinjiro Yamaguchi,이인정,김승기,윤대진,Eva So¨derman,천충일 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

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).