한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

웃음을 이용한 다중음성치료기법(SKMVTT<SUP>®</SUP>)이 성대용종 환자의 음성개선에 미치는 효과

김성태(Seong-Tae Kim),정옥란(Ok-Ran Jeong),안철민(Cheol Min Ahn) 한국음성학회 2008 음성과학 Vol.15 No.2

Vocal polyp is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy and/or laryngeal microsurgery. However, the existing therapeutic methods about vocal polyp are in great demand. The purpose of this study was to evaluate the effect of vocal improvement between laryngeal microsurgery and SKMVTT<SUP>®</SUP>(Seong-Tae Kim's Multiple Voice Therapy Technique), which was designed by the author. We identified 37 patients, who were diagnosed with unilateral vocal polyp, aged from 21 to 62 years(mean age: 46 years). 21 patients were treated by the SKMVTT<SUP>®</SUP> and the other 16 patients were only treated by the laryngeal microsurgery. All patients who were treated by the SKMVTT<SUP>®</SUP>, received 12 sessions of treatment, and were evaluated before therapy and after finishing the 12th session. The patients who were treated by laryngeal microsurgery, were evaluated prior to and at least 8 weeks after surgery. The results showed that the SKMVTT<SUP>®</SUP> produced better results compared to the laryngeal microsurgery alone. The SKMVTT<SUP>®</SUP> produced better results, especially, at the initial stage of voice therapy compared with those of laryngeal microsurgery. In this study, we can suggest that SKMVTT<SUP>®</SUP> may be useful in improving the voice qualities of vocal polyp patients. However, more data should be collected and evaluated to be widely used in other clinics.

24주간 추적하는 임상 연구에서 한국인 남자 알코올 의존 환자의 비재발률

강철중,김성곤,남궁기,조동환,이병욱,최인근,최용성,박성봉,제영묘,김현경,김성연 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objetives : In order to provide useful data tbr the further clinical studies with Korean alcohol-dependent patients, enrollment and non-relapse rates were investigated while alcohol-dependent patients wcre followed up for 24 weeks. Methods : The subjects of this study were alcohol-dependent male patients who, for the first time, visited a hospital among 3 groups of hospitals, University Hospital, General Hospital or Mental Hospital, or those who needed to be followed up after discharge from those hospitals. After assigning 12 subjects to each hospital, we investigated enrollment and non-relapse rates while cognitive-behavioral therapy and pharmacotherapy were provided. Results : 1) Forty-eight patients were enrolled and the rate of enrollment was 36.4%. The enrollment rate in the University Hospital group was 52.1%, in the General Hospital group 50.0%. and in the Mental Hospital group 10.4%. 2) In 48 patients, non-relapse rate was 27.1% at 12 week and 18.8% at 24 weeks after starting follow-up. It was 24.4% and 20.0% at 12 and 24 weeks, repectively, in the University Hospital group while the General Hospital group showed 33.3% and 16.7%, respectively, and the Mental Hospital Group showed 20.0% at both 12 and 24 weeks. Conclusion : These results provide important data for further clinical studies of Korean alcohol-dependent patients.

동종 골수이식 후 만성 이식편대숙주질환과 동반되어 신증후군으로 발현된 IgA 신병증 1예

정철권,김현수,박준성,정성현,조도연,최진혁,남동기,임호영,김명성,신규태,임현이,김효철 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

동종 골수이식 후 발생하는 신기능부전은 원인이 다양하여 감별에 어려움이 있다. 만성 GVHD는 흉선의 기능저하에 따른 면역관용의 실패로 발생되는 자가면역현상에 의해 발생되는 것으로 알려져 있으며 드물게 신장을 침범하여 신증후군을 일으키기도 한다. CaA의 용량을 줄이거나 투약중지 후 발생한 만성 GVHD에 동반된 신증후군의 경우 조기에 신조직검사를 시행하여 감별진단하고 CsA의 용량을 증량하거나 재투약하여 좋은 치료 결과를 보일 것으로 기대된다. 저자들은 문헌고찰을 통해 동종 골수이식 후 발생된 신증후군이 유사한 임상양상을 보이며 발생기전에 만성 GVHD와 자가면역현상이 연관되어 있음을 확인하였으며 동종 골수이식 후 신증후군의 임상양상을 보이는 환자에서 병리조직학적으로 lgA 신병증을 진단하고 이러한 lgA 신병증이 발생기전에 만성 GVHD와 자가 면역현상이 연관되어 있을 가능성을 최초로 확인하였으며 CsA를 이용하여 성공적으로 치료한 경험을 하였기에 보고하는 바이다. Renal insufficiency is occasionally encountered in allogeneic bone marrow transplantation and its cause is difficult to ascertain. Chronic graft-versus-host disease (GVHD) related to thymic dysfunction is immune-mediated and involves autoreactivity of T-lymphocytes derived from donor marrow to recipient's major histocompatibility complex(MHC) minor antigens. The clinical mainifestations of chronic GVHD are similar to those of autoimmune disease but kidney involvement is rare. Few cases of nephrotic syndrome with membranous nephropathy or minimal change nephrotic syndrome have been reported to be associated with chronic GVHD in allogeneic bone marrow transplant recipient especially after cyclosporine A(CsA) withdrawal, and these cases have responded well to CsA. Therefore, it is prudent to differentiate the cause of post-transplant renal insufficiency using renal biopsy and to start CsA in a case of nephrotic syndrome associated with chronic GVHD as early as possible. We report a case who had a massive proteinuria during the post-allogeneic marrow transplantation period. The cause of nephrotic syndrome was diagnosed as IgA nephropathy by renal biopsy. The patient was successfully treated with reintroduction of CsA.

축산분뇨중의 암모니아성 질소 제거

진양오,최성우,김성우,김익성,신남철,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

The purpose of thus study were to investigate the proper conditions of struvite formation in synthetic wastewater and then to apply these conditions to effluent of anaerobic digester of livestock wastewater The conditions of struvite formation had been studied by many researchers. But a little conditions were different among them. Especially, according to suspended solid variation in livestock wastewater was investigated by few researchers. In experiment of synthetic wastewater, the proper conditions of struvite formation were pH 105, l50rpm of mixing rate, 10 minutes of reaction time, and 20 minutes of precipitation time. At same time, the ammonia nitrogen removal rates were about 99.7%, 95.5%, and 96% of synthetic wastewater, raw wastewater, and effluent of anaerobic digester of livestock wastewater at molar ratio of 2(Mg):l(N)2(P) respectively. The larger factor of NH₄/SS constant was, the more effective the removal rate of ammonium nitrogen, SS was, but the less effective COD_(cr), and TOC was. By using XRD analysis, the most certain compound in precipitate of synthetic wastewater was struvite.

UV-TiO₂광촉매 반응기를 이용한 미생물의 살균효과

김시욱,이정섭,정해광,박열,윤성명,유진철,이범규,이인화,박진열 조선대학교 환경공해연구소 1998 環境公害硏究 Vol.14 No.-

UV-TiO_(2) 반응기를 이용하여 Escherichia coli와 Aspergillus oryzae var. oryzae의 살균효과를 측정하였다. 254 ㎚에서 최대 14 watt의 자외선 방출량을 내는 램프를 원형 Pyrex유리관 중앙에 설치하였고 TiO_(2)는 석영관에 박막증착(Thin Film Coating)된 형태와 슬러리 형태로 나누어 회분식으로 살균정도를 측정하였다. E. coli에 대한 살균력은 1.7× 10^(7) cells/㎖에 대해 5분간 자외선 조사를 하였을 경우 2.0× 10^(2) cells/㎖으로 감소하였고, 자외선 조사와 함께 슬러리 형태의 TiO_(2)를 첨가하였을 경우에는 3.4× 10 cells/㎖으로, 자외선 조사와 함께 TiO_(2)가 석영관에 박막증착된 경우에는 7.6× 10^(2) cells/㎖으로 감소하였다. 한편 위와 같은 조건에 유리관 하부에서 기포를 주입후 11분 동안 자외선을 조사시킨 경우에는 1.3× 10^(2) cells/㎖으로, 자외선 조사와 함께 슬러리 형태의 TiO_(2)를 첨가하였을 경우에는 1× 100 cells/㎖으로, 자외선 조사와 함께 TiO_(2)가 박막증착된 경우에는 7.9× 10 cells/㎖을 나타내었다. 결국 UV-TiO_(2) 반응기에 사용되는 TiO_(2)가 슬러리 형태일 때 최대 살균효과를 나타내었으나 기포가 첨가되었을때는 오히려 살균에 장애를 받는 것으로 나타난 반면 석영관에 박막증착된 경우에는 기포가 첨가되는 것이 살균에 효과적인 것으로 관찰되었다. The killing effect of UV-TiO_(2) photocatalytic system on the Escherichia coli DH5-慣 and Aspergillus oryzae var. oryzae (KCTC 6095) was studied. The UV lamp which emits maximum 14 watts at 254 nm was set on the center of pyrex round glass tube. Two types of TiO_(2), one of which is slurry and another which is thin film coated form, were used to determine the killing effect. When UV was irradiated to 1.7 * 10^(5) cells/??of E. coli for 11 min, the living cell number decreased to 4.0 * 1.0^(0) cells/?? The effect of UV system together with slurried TiO_(2) was less than 1 cells/?? whereas that of UV-coated TiO_(2) system decreased to 7.1 * 10^(3) cells/?? To study the effect of bubble on the killing of microorganisms, air was bubbled to the bottom of glass tube. When 1.7 * 10^(5) cells/??were exposed to UV for 11 min in combination with air bubble, the living cell number decreased to 1.3 x 10^(2) cells/?? In the same condition except the addition of slurried TiO_(2), the living cells were 1 * 10^(2) cells/?? However, more cells could be killed by the system which consists of UV, coated TiO_(2), and air bubble (7.9 * 10^(1) cells/??. From these results, it was found that UV-slurried system is the most effective one, but its killing effect is not stimulated by air bubble. However, bubbling was very effective in the UV-coated TiO_(2) system.

정신분열병 환자에서 개념형성훈련이 위스콘신카드분류검사 수행능력에 미치는 효과

김성미,김희철,박영남 대한생물치료정신의학회 1996 생물치료정신의학 Vol.2 No.2

본 연구는 정신분열병 환자가 단계적인 학습방법으로 개념형성과 반환원리를 습득하여 위스콘신카드분류검사에 적용할 수 있는지를 평가하였다. 대항환자는 DSM-IV진단기준에 의해 정신분열병으로 진단된 입원환자중 급성 증상이 어느 정도 호전되어 검사에 협조할 수 있는 지점에 위스콘신카드분류검사를 연속 2회 실시하여 완성범주가 4범주 미만인 22명으로 하였다. 개념형성과 변환에 대한 학습을 3일간 시킨 후, 위스콘신카드분류검사를 일주일 후에 재시행하였다. 22명중 16명은 학습의 전과정을 마치고 평가를 받았으며, 6명은 학습도중 탈락되었다. 학습 전후 위스콘신카드분류검사 수행정도를 비교하였더니 평가항목중 주사도수, 총옳은 반응수, 총오류수, 보속반응, 보속오류, 개월형성수준, 완성범주수 및 첫 범주 완성시도수는 학습후 유익한 호전을 보였으나, 비오속오류와 개념틀유지실패는 학습 후에도 호전이 없었다. 학습을 마친군과 학습탈락군간에는 검사 당시의 양성증상 점수의 유의한 차이를 미쳤고 위스콘신카드검사 평가항목간에는 차이가 없었다. 본 연구의 결과는 일부 정신분열병 환자는 개념형성과 변환을 학습하여 응용하는 능력이 있다는 것을 보여주며 향후 이러한 학습효과가 장기간 지속될 것인지를 평가할 필요가 있다. Objectives: Schizophrenic patients perform poorly on the Wisconsin Card Sorting Test(WCST). This study evaluated the effect of concept formation training on the performance of WCST in schizophrenic patients. Method:Twenty two DSM-IV schizophrenic patients, who were hospitalized with acute symptoms and completed less than 4 categories on the pretraining WCST, received a training on a hierarchical cummulative concept formation. In this training, the subjects were trained to classify cards by a single dimension of color, from and number respectively. After mastering a single category classification, the subjects moved to classify cards by two dimensions of form and number. Last step was to classify cards by three dimensions of color, form and number as for WCST. In one week after the subjects mastered the training, WCST was readministered. Results: Sixteen patients completed training successfully. There were significant improvement in the number of trials administered, total number of corrects, total number of errors, perseverative responses, perseverative errors, conceptual level responses, number of categories completed and trials to complete first category after training, but nonperseverative errors and failure to maintain set did not improve. Conclusions: This results not only confirmed that a subgroup of schizophrenic patients were able to improve their WCST performance by remedial training, but also showed that schizophrenic patients were able to apply a learned concept to a different task.

생물전극 반응조를 이용한 영양물질 제거

김성완,윤철종,최성우,김성우,우성훈,신남철,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

We have investigated a performance of bio-electrode reactor for removal of nutrient like a nitrogen, phosphorus and organic substrate. Lab scale of bio-electrode reactor was operated with synthetic and tannery wastewater. Iron bar and stainless steel used for anode and cathode respectively. In experiment with synthetic wastewater, we were able to obtain the optimal current density range of 2.4-40 mA/dm² after 48 hrs operating time. And in that experiment, about 70~73% of ammonia nitrogen and 54~64% of phosphorus were removed. In experiment with tannery wastewater at 2.4-4.0 mA/dm², the removal rate of ammonia nitrogen, phosphorus and organic substract were about 62-69%, 45~59% and beyond 79% respectively.

올란자핀

김문두,정성훈,김철진 대한생물치료정신의학회 1997 생물치료정신의학 Vol.3 No.1

현재까지의 전통적인 항정신병약물은 음성증상에는 거의 효과가 없었고, 양성증상에만 효과가 있었으며, 그마저도 약 30-40%의 환자들에서는 치료적인 효과가 없었다. 또한 추체외로 증상이나 지발성 운동장애 등의 부작용이 많았다. Olanzapine은 이와 같은 기존의 전형적인 항정신병 약물의 제한점이 크게 개선된 약이며 clozapine과는 달리 무과립구증을 유발하지 않으므로 현재 임상적으로 기대가 크다. Olanzapine은 세로토닌 5-HT2A/C, 도파민 D1, D2, D3, D4, 무스카린M1-5, 아드레날린 alphal, 히스타민 H1수용체에 친화도가 높다. 세로토닌 5-HT2 차단작용이 도파민 D2 차단작용보다 강하여 추제외로 증상의 빈도가 적고 지발성 운동장애의 위험이 적다. 항콜린성 작용과 세로토닌 5-HT2A/C 수용체에 대한 길항작용, 상대적으로 약한 D2길항작용으로 양성 증상 뿐만 아니라 음성증상에도 유의한 효과가 있다. Olanzapine의 주된 대사 경로는 cytochrome P-450-CYPIA2, flavincontaining monooxigenase(FMO 3 system), N-glucuronidation이며, 그외에도 cytochrome P-450-CYP2D6, CYP2C19등으로도 대사가 되기 때문에 어느 한가지 효소에 의해 대사나 약력학이 영향을 받지 않으므로 약물 상호작용도 적다. Olanzapine은 정신분열증의 양성과 음성증상에 모두 효과가 있고 장기 유지치료에도 효과가 있다. 또한 치료불응성 정신분열증에도 치료효과가 있다는 보고들이 있다. 또 정신분열증 뿐만 아니라 분열정동장애, 정신분열양 장애, 양극성 장애, 물질 유도성 정신병적 장애에 모두 사용 가능하다. 용량은 5-20㎎이 추천된다. 치료후 첫 3-6개월에 양성, 음성증상의 호전이 있고 대개는 1년에 고평부(plateau)에 이른다. 그래서 최소 6개월은 사용후 그 효과를 판단해야 한다. Traditional antipsychotics have lack of efficacy in 30% to 40% of patients with schizophrenia, lack of efficacy in the treatment of negative symptoms of psychosis, and are primarily effective in ameliorating the positive symptoms of schizophrenia. Also these agent have a number of side effects, such as extrapyramidal symptoms and tardive dyskinesia. Olanzapine is new drug that has much difference from traditional antipsychotics in view of these limitations of traditional antipsychotics and is spared some of clozapine's major difficulties, such as agranulocytosis. olanzapine has affinity for serotonin 5-HT2A/C receptors, dopamine D1, D2, D3, D4 receptors, muscarinic M1-5 receptors, adrenergic alpha1 receptors, histamine H1 receptors. Olanzapine's ability for blockade of serotonin 5-HT2 receptor is greater than it's ability for blockade of dopamine D2 receptors and olanzapine has low incidence of extrapyranmidal symotoms and low risk for developing tardive diskinesia. Olanzapine also has anticholinergic effect and antagonist actions for serotonin 5-HT2A/C receptor, relatively weak antagonistic actions for dopamine D2 receptor, so olanzapine has significant efficacy for not only positive symptoms but also negative symptoms. The most important pathways for olanzapine metabolism are cytochrome P450-CYP1A2, flavin-containing monooxigenase(FMO 3 system),N-glucuronidation. Minor pathways include cytochrome P450-CYP2D6, CYP2C19. Olanzapine has minimal drug interaction due to it's multiple metabolic pathways. Olanzapine has efficacy for both positive and negative symptoms of schizophrenia, long-term maintenace treatment. Olanzapine also has efficacy for treatment refractory schizophrenia, schizoaffective disorder, schizophreniform disorder, bipolar disorder, substance induced psychotic disorder. Recommended does are 5-20㎎/day. We should decide for effectiveness for olanzapine after using 1 year, since improvements in positive and negative symptoms seen in the first 3 to 6 months often plateaued within 1 year.