喩昌의 生涯와 醫學思想

金秀烈,尹暢烈 대한한의학원전학회 1990 대한한의학원전학회지 Vol.4 No.-

At early Cheong (淸) dynasty, in medical aspect by dependent on practical studying attitude that must found a theory only by an evidence, there had been a tendancy that hoped direct research of sages' mind-eye by escaping the theory of individual classes since Geum-Won (金-元)dynasty. Yoo Chang(喩昌), born in Man-Ryeok(萬曆) 12th year of Myung(明) dynasty (A.D.1583) and dead in Gang-Hee(康熙) 3rd year of Cheong(淸) dynasty (A.D.1664). The results were as follows after studying his practical idea of medicine. 1. Yoo Chang, by recognizing the 《Sang-Han-Ron》 has lost its true meaning after commented by Wang hee(王熙), Lim Eog(林億), Seong Moo-I(成無己), etc. according to Bang Yoo-Jip's(方有執) Chak-Gan-Jung-Jeong(錯簡重訂) theory, he diversified the protocal of 《Sang-Han-Ron》 397 method and arranged under Six Meridian part.(六經) 2. The theory of Sam-Gang-Jeong-Rip(三網鼎立) can be summerized Gye-Ji(桂枝) syndrome which is the case of WInd(風) has injured Wi(衛) stage, Ma-hwang(麻黃) syndrome which is the case of Cold(寒) ahs injured Yeong(榮) stage, Dae-Cheong-Ryong(大靑龍) syndrome which is the case both of Wind-Cold(風寒) ahs injured Yeong-Wi(榮衛) stage, and there has been Sam-Gang-Jeong-Rip theory by anterior medical practitioners already but the person who formally used its Sam-Gang-Jeong-Rip term is Yoo-Chang. 3. Yoo Chang seized the On Byeng(溫病) by dividing three category and in Byon-Jeung-Si-Chi(辨證施治) he influenced to many aspect of establishment of later Byon-Jeung system On-Byong(溫病의 辨證體系) pertaining to Triple-Warmer by O-Dang(오당) introducing Triple-Warmer Theory.(三焦理論) 4. At Chu-Jo-Ron(秋燥論) of 《Eui-Moon-Beop-Ryol》, while 《Nae-Gyeong》 describing if humidity injury Lung, then occur a disorder in it, Yoo Chang recognized that of autuam when dryness injure Lung there occure a disorder is it so he insisted that at this case, must use Cheong-Joe-Goo-Pye method (淸燥救肺法) with herbs, pertaing to Gam-Yoo-Ja-Yoon(甘柔滋潤性) property and he invented Cheong-Joe-Goo-Pye-Tang.(淸燥救肺湯) 5. You Chang', so called, Dae-Gi(大氣) indicates Yang-Gi(陽氣) of chest, he insisted that man's creation and every physiological activity depends on maintainence of Dae-Gi, and it integrate Yeong-Gi(榮氣), Wea-Gi(衛氣), Jong-Gi(宗氣), Jang-Boo-Ji-Gi(臟腑之氣), Gyeong-Rak-Ji-Gi.(經絡之氣) 6. Yoo Chang's expression about partical function and character of stomach, not only bolster its theory of historical physician's expression, that is stomach is foundatness of postnatal period, but also it has correponding aspect with modern medicine and clinic. 7. Yoo Chang emphasized "if one cure a disease, be must understood the character of disease first and use drugs later"(先議病 後用藥) phrase about of drug usage, and his theory of Geup-Rew-Man-Joo method(急流挽舟) and three therapy of Simple Ascite(單腹脹) are all unique opinion based upon this phrase mentioned above. 8. Yoo Chang's practical idea of medicine greatly influenced to Jang Ro(張??), Hwang Won-A(黃元御), Oh Eui-Rak(吳儀洛) ,Joo Yang-Joon(周??俊), etc. and theory of Sam-Gang-Jeng-Rip(三網鼎立), Thriple Warmer Theory of On Byong (溫疫의 三焦論治), Chu-Jo-Ron(秋燥論), Dae-Gi-Ron(大氣論) etc. became important object to student of Sang-Han(傷寒) and On-Byeng.(溫病) 9. Yoo Chang's Writings has more practical meaning than other physician's, especially, later the idea of Sang-Han(傷寒) and On-Byong(溫病) greatly contributed to development of Sang-Han theory and formation of On-Byong theory.

만성 두부외상 환자에서 99mTc - HMPAO Brain SPECT의 임상적 유용성

서정호(Jung Ho Suh),김동익(Dong Ik Kim),정태섭(Tae Sub Chung),이종두(Jong Doo Lee),박창윤(Chang Yoon Park),정진일(Jin Ill Chung),김영수(Young Soo Kim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1

N/A Minima1 deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using Tc-99m-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with Tc-99m-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using Tc-99m-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

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.

사염화탄소 투여 흰쥐에서 간섬유화 진행에 따른 Propranolol 의 약동학적 지표들의 변화

이민호,강주섭,강문수,윤병철,이오영,함준수,변재원,윤창옥 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.2

Background/Aims : This study was designed to determine the effect of hepatic fibrotic severity on pharmacokinetics of propranolol in CC1q - treated rats. Methods - 1 mL/kg of 10% CC14 in olive oil was injected intramuscularly to rats twice weekly for 4, 6, 8 and 10 weeks, respectively (n=6). Control (n=6) was a sham - injected equal dose of olive oil for 10 weeks. After intravenous bolus injection of 2 mg/kg propranolol to rats, the serum propranolol concentrations were analyzed for 4 hours at various time points by a HPLC - fluorimetric system, and pharmacokinetic parameters such as Co, MRT, AUC, Vdss, tl/2(p) and CLp were determined. Then, a small amount of hepatic tissue was obtained and subjected to determination of the hepatic 4 - hydroxyproline content, which confirmed the hepatic fibrotic severity. Results : The serum concentrations of propranolol at 0.5, 1, 2 and 4 hours were significantly increased in CC1q-treated rats (p$lt;0.01). In proportion to the duration of CC4 treatment, Co and AUC were significantly increased, and Vdss and CLp were significantly decreased (p$lt;0.001). But MRT and t1/2(β) were not significantly changed. The hepatic 4 -hydroxyproline content was gradually increased in CC4-treated rats (p$lt;0.001). Conclusion - Gradual changes in pharmacokinetic parameters of propranolol were seen to be dependent on the hepatic fibrotic severity. We suggest that gradual dosage modification, according to their hepatic fibrotic severity, is necessary for many drugs administered to patients with chronic liver disease.(Korean J Hepatol 2001;7:181-188)

Cronkhite-Canada 증후군 1예

이수걸,문창형,김무영,최성호,여동승,강필중,송철수,조몽,양웅석,허윤,문한규 대한내과학회 1992 대한내과학회지 Vol.42 No.2

저자들은 Cronkhite-Canada 증후군 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Cronkhite-Canada syndrome is a disease entity, including such characteristics as gastrointestinal polyposis associated with ectodermal changes-alopecia, hyperpigmentation of the skin and atrophy of the nails. But it has no familial tendency. In 1955, a report of 2 patients by Cronkhite and Canada established this entity as clinically distinct from any of the other known forms of gastrointestinal polyposis. Since that time, at least 53 similar casas has been described in the world literature, but no case has been reported in Korea.

The effect of participation benefits on online travel community members behavioral change: the moderating effect of extraversion

Jeong, Chang-Yoon(정창윤),Choi, Soo-Young(최수영),Kim, In-Sin(김인신) 한국호텔관광학회 2021 호텔관광연구 Vol.23 No.3

Effect of epidural corticosteroid injection on magnetic resonance imaging findings

( Min Soo Kim ),( Tae Yoon Jeong ),( Yu Seon Cheong ),( Young Wook Jeon ),( So Young Lim ),( Seong Sik Kang ),( In Nam Kim ),( Tsong Bin Chang ),( Hyun Ho Seong ),( Byeong Mun Hwang ) 대한통증학회 2017 The Korean Journal of Pain Vol.30 No.4

Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015.All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air. Results: The incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later. Conclusions: Pain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine. (Korean J Pain 2017; 30: 281-6)

CTLL - 2 세포주에서 transforming growth factor - β가 CD8의 발현유도에 미치는 영향

박수영(Soo Young Park),장윤혜(Yoon Hae Chang),조영주(Young Joo Cho) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.1

N/A Background: Transforming growth factor-β (TGF-β) has multiple regulatory effects on cells of the immune system, and it has been suggested that differentiation of lymphoid cells is influenced by low concentrations of this cytokine. Objectives : The aim of this study was to investigate the role of TGF-β in regulation of T cell growth and differentiation, and to compare this effect with that of other cell signals known to be important in T cell ontogeny. Methods .We used the CTLL-2 cell line in the presence of IL-2. Surface phenotype expression was analysed to see whether these cells could be switched to the other subtype of cells. Results : Treatment of CTLL-2 cells with TGF-β resulted in dose dependent growth inhibition and morphological changes. During routine passage, less than 5% of cells were CD8α positive, whereas 38% of cells expressed CD8α when treated with IL-2 plus TGF-β. However, TPA plus calcium ionophore, IFN-γ, or TNF-α caused no significant changes in the proportion of CD8 cells. Conclusion : Our results show that this experiment can be a useful model for investigating CD8 precursor potentials in populations of CD4-CD8- (double negative) cells, and such a model may offer a way to study the molecular regulation of CD8 gene expression.

最近 8年間의 精神神經科 入院 外來 및 患者에 對한 統計的 考察(1960年∼1967年)

李哲奎,盧英一,張煥一,金明源,任允明,韓東洙,吳承煥,金光日 大韓神經精神醫學會 1969 신경정신의학 Vol.8 No.1

1) The number of the out-and in-patients had increased year after year (Table Ⅰ & Ⅲ). 2) Schizophrenia was the greatest number of the in-patients and its rate to whole was 49.1 percent, and neurosis was the greatest number of the out-patients and its rate to whole was 41.66 per cent (Table Ⅰ & Ⅶ). 3) In in-patients, hysteria revealed relatively large in percentage as 11.8% than the other groups (Table Ⅰ). 4) The rate of the male hysteria patients to all male patients was 3.5 per cent and the rate of female hysteria was 20.5 per cent (Table Ⅱ). 5) In in-patients, all the patients of general paresis and alcoholism were only males in sex(Table Ⅱ). 6) In in-patients of schizophrenia, the ratio of the male patients to the female patients was 57.0 : 43.0, but the each rate of each total numbers of the all diseases of the both sexes was almost same (Table Ⅲ). 7) The largest age group of the all patients was between 21∼30 years old, and the next was between 31∼40 years in in-patients (Table Ⅲ). 8) The largest age group of schizophrenia patients was between 21∼30 years and that of M.D.R patients was between 31∼40 years in in-patients (Table Ⅲ). 9) In in-patients of hysteria, the largest age group was between 31∼40 years, and the next was between 21∼30 years (Table Ⅲ). 10) The results of treatment in in-patients were as followings; Recovered; 27.6% Much improved; 43.1% Slightly improved and no changed; 28.2% (Table Ⅳ) 11) The results of treatment in schizophrenia of the in-patients were as followings; Recovered; 19.1% Much improved; 48.3% Slightly improved and no changed; 32.1% (Table Ⅴ) 12) The mode of treatment had been somewhat changed during last 8 years from 1960 to 1967 in treatment of the in-patients (Table Ⅵ). (1) The combined therapy of tranquilizers and EST had been increased, but the therapy of tranquilizer alone or EST alone had been decreased, compared to 1960. (2) The therapy of ICT in the treatment of in-patients had been much decreased.

A Multicenter Analysis of Clinical Features and Long-Term Outcomes of POEMS Syndrome in Korea

Kook Hye Won,Jang Ji Eun,Min Chang-Ki,Yoon Dok Hyun,Kim Kihyun,Bang Soo-Mee,Park Yong,Lee Jae Hoon,Yoon Sung-Soo,Kim Jin Seok 대한의학회 2024 Journal of Korean medical science Vol.39 No.2

Background: POEMS syndrome is a rare form of plasma cell dyscrasia characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal proteins, and skin changes. Owing to its low incidence, there are few reports regarding this syndrome. This multicenter study included 84 patients diagnosed with POEMS syndrome in South Korea. Methods: We retrospectively evaluated 84 patients diagnosed with POEMS syndrome at 8 hospitals in South Korea between January 2000 and October 2022. The clinical characteristics and treatment outcomes were analyzed. Results: The median patient age was 53 years (range, 26–77 years), and 63.1% of the patients were male. All patients had peripheral neuropathy, and 81 (96.4%) had monoclonal plasma cell proliferation. Plasma vascular endothelial growth factor levels were available for 32 patients with a median of 821 pg/mL (range, 26–12,900 pg/mL). Other common features included skin changes (54.2%), volume overload (71.4%), and organomegaly (72.6%). Of the 84 patients, 75 received initial treatment (local radiotherapy, 6 [8.0%]; chemotherapy, 17 [22.7%]; both chemotherapy and local radiotherapy, 9 [12.0%]), upfront autologous stem cell transplantation (ASCT), 43 (57.3%; with induction chemotherapy, n = 12, 16.0%; without induction chemotherapy, n = 31, 41.3%). The median follow-up duration was 40.7 months. The 5-year overall survival (OS) was 78%, and the 5-year progression-free survival (PFS) was 55%. Patients who underwent upfront ASCT and were diagnosed after 2014 had a longer OS and PFS. Conclusion: The demographics of Korean patients with POEMS syndrome were similar to those reported previously. Because of the introduction of new treatment agents and the reduced rate of transplant-related mortality related to ASCT, the treatment outcomes of Korean patients with POEMS syndrome have improved in recent years.