한국인에게서 그레이브스병 약물치료의 적정기간

이형숙,이동훈,정희선,이종우,김정은,신승수,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 그레이브스병의 치료에는 항갑상선제, 수술 및 방사성 요오드법이 선택되어 사용되고 있다. 이중 항갑상선제는 가장 많이 선호되고 있으나 낮은 관해율과 높은 재발율로 장기간 치료기간이 요구된다. 저자들은 그레이브스병 환자에게서, 선택되는 치료법의 선호도와 각 치료법의 관해율을 조사하고자 본 연구를 시행하였다. 또한 본 연구에서는 항갑선제 치료의 적정기간을 평가하고자 하였다. 방법: 아주대학교병원에 내원한 환자 중 1년 이상 추적관찰이 가능한 205명의 그레이브스병 환자를 대상으로 조사하였다. 항갑상제군, 수술군 및 방사성 요오드군은 각각 170명, 29명 그리고 6명이었다. ROC curve를 이용하여 약물치료의 예후예측인자를 분석하였다. 결과: 1) 그레이브스병 환자의 치료 방법의 선택은 항갑상선제군, 수술군 및 방사성 요오드군 각각 170명(83.0%), 29명(14.1%) 그리고 6명(2.9%)으로 항갑상선제 치료가 가장 선호되었다. 2) 그레이브스병의 관해율은 항갑상선제군, 수술군 및 방사성 요오드군에서 각각 60.0%(102/170명), 96.5%(28/29명) 그리고 83.0%(5/6명)으로 수술군이 가장 높았다. 3) ROC curve의 AUC는 치료기간과 진단시 TBII가 각각 0.709 및 0.648이었고 적절한 약물투여 추적 관찰기간은 26개월이었다. 결론: 그레이브스병의 일차 치료법으로는 항갑상선제가 선호되고 있으나 수술 및 방사성 요오드 치료군에 비해 상대적으로 낮은 관해율을 보였다. 따라서 항갑상선제 치료로 26개월 이상 관해가 되지 않을 경우에는 치료 방법의 변경을 고려하는 것이 관해율을 높이는데 도움이 될 것으로 생각된다. Background: Graves' disease in an organ specific autoimmune disease. Three kinds of therapeutic modalities (antithyroid drugs, ablation with radioactive iodine and subtotal thyroidectomy) are frequently performed for the management of this disease. The most popular therapeutic policy for the disease in Korea is antithyroid treatment. We analysed and compared the remission rates of all three modalities for Graves' disease, and evaluated the antithyroid modality to determine the correct duration of treatment. Subjects & Methods : The medical records of 205 patients with Graves' disease were reviewed. For the evaluation of the antithyroid modality medical treatment, antithyroid drugs were administered for more than 1 year. The prognostic factors associated with remission were analysed by means of an ROC curve. Results: 1) Of the 205 patients, proportions that received medical therapy, subtotal thyroidectomy and radioiodine therapy were 83.0, 14.1 and 2.9%, respectively. 2) The remission rates of the medical therapy, surgery and radioiodine therapy were 60.0, 96.5 and 83.0%, respectively. 3) The remission rate of the medical therapy was associated with the duration of medication and TBII activity. The determined proper duration for the antithyroid treatment was 26 months from the ROC curve analysis. Conclusion: The above results suggest that the proper duration of antithyroid treatment for Graves' disease is 26 months, after which time the subtotal thyroidectomy or radioiodine therapy should be considered if the disease has not remitted (J Kor Soc Endocrinol 18:24∼31, 2003).

양극성 기분장애에서 세로토닌 수용체 유전자의 다형성(102T/C)에 관하여

지익성,신석철,왕성근,이선우,신용재,김충수,김상국,최하석,오승용,류택근,이영호 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

Pneumatosis intestinalis and portal venous gas secondary to gefitinib therapy for Lung adenocarcinoma

( Joo Young Lee1 ),( Hye-suk Han ),( Sung-nam Lim ),( Young Kwang Shim ),( Yong Hyeok Choi ),( Ok-jun Lee ),( Ki Hyeong Lee1 ),( Seung Taik Kim ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

유화조건이 홍화적색소의 물성에 미치는 영향

이승룡,장규섭,이석건,윤혜현,한태룡 충남대학교 농업과학연구소 2000 농업과학연구 Vol.27 No.1

상기 실험으로부터 얻어진 결과를 요약하면 다음과 같다. 1. Hunter-value를 측정한 결과 hunter L-value 즉, 백색도에 있어서는 glycerin+carthamin+locithin의 경우가 실온저장 및, 열악조건 그리고 광조사시에 있어서 모두 8 시간이 경과하면서부터는 급격하게 상승하는 모습을 보였다. 2. 실온하에서 hunter a-value 즉, 적색도에 있어서는 carthamin 첨가구가, b-value 즉, 황색도에 있어서는 paprika 첨가구가 더 강하게 나타났다. 열악조건에서는 실온저장의 경우와 다소 다른 양상을 보여주었는데. D.W+carthamin+lecithin의 경우에 있어서도 hunter L-value가 낮은 값을 나타냈으며, hunter a-value의 경우 soybean oil+paprika에서도 높은값을 보여주었다. 3. 유변학적 특성에 대한 실험에서 비교적 고점도를 가지고 있는 glycerin을 base material로하였을 때는 이에 비해 저점도라고 할 수 있는 soybean oil이나 증류수가 쓰여졌을 때보다 spindle의 rpm에 따른 viscosity나 shear rate 및 shear stress등의 같이 월등히 높은 값을 나타냈다. 그리고, 일반적으로 spindle의 rpm에 대한 shear rate 및 shear stress의 값은 비례적으로 증가하는 경향을 나타냈다. 유화제의 사용여부에 있어서는 lecithin을 사용했을 경우. 사용하지 않았을 때보다 높은 점도를 나타냈고, 동일한 조건에서 carthamin보다는 paprika가 두 배 정도 더 높은 점도를 나타냈다. 4. soybean oil을 사용한 실험구에 있어서는lecithin의 첨가유무가 점도에 아무런 영향을 미치지 않는 것으로 나타났으나, glycerin을 사용한 실험구에 있어서는 유화제인 lecithin을 병행했을 경우, 특이하게도 오히려 paprika에서보다 carthamin에서 더 높은 점도를 나타냈다. 5. Shear stress의 경우 soybean oil 첨가구와 glycerin 첨가구가 현저한 차이를 보이며 증가한 반면, shear rate에 있어서는 두 가지 경우모두 거의 같은 경향을 나타낸 점이 특이했다. This study was peformed to evaluate the food technological properties according to different emulsion state of carthamus red pigment. For making emulsion, lecithin was used as an emulsifier and polyglycerol monooleate(PGMO) and polyoxyethylene sorbitan monooleate(Tween 80) were used as an assistant, and glycerin, distilled water and soybean oil were used as base materials respectively. Paprika stock solution was used for comparing carthamin on the rheological properties. The results were described as following; 1. Hunter L-value was not drastically increased until passed by 8 hours for glycerin, carthamin, and lecithin mixed sample. 2. Hunter a-value was higher at carthamin added sample than others, and b-value was higher to paprika added sample than others. 3. The viscosity, shear rate and shear stress levels in which glycerin was used as base material were higher than soybean oil or distilled water. 4. In which soybean oil was used as base material, lecithin was not affected on the rheological properties. But, in which glycerin was used, the lecithin was higher affected on carthamin than paprika. 5. The value of shear stress was increased both carthamin and soybean oil. However, that of shear rate was shown similar trends.

외과계 병동 환자의 입원스트레스에 관한 연구

李鈺淑,鄭承姬 全北大學校 1994 論文集 Vol.37 No.-

This study was designed to find hospitalization stress events related to the experience of the surgical in-patients and to offer nursing intervention in order to reduce the degree of hospitalization stress of patients. The subjects were 100 surgical in-patients at an university hospital in Chon-Ju from July 1 to 20. 1993. Data were analyzed by SPSS/PC, using Mean, T-test, ANOVA. Pearson Correlation Coefficient. The result of the study were as follows : 1. The mean of the hospitalization stress score was 2.482(Maximum=4), this means that the degree of hospital stress was slightly high. 2. High scored items were 1)Thinking you might have pain for operation or diagnostic test; 2)thinking you might lose a kidney or some other organ; 3)knowing you have a serious illness. The other side, three lower scored items were l)to help a partial bed bath; 2)to admit for accident; 3)not having friends visit you. 3. The mean scores of hospital stress factors were in sequence : l)problems with medication(M=2.657) factor; 2)threat of serious illness(M=2.634) factor; 3)unfamiliality of surroundings(M=2.608) factor; 4)lose of independence(M=2.432) factor. 4. There was statistically significant difference in the degree of hospitalization stress according to demographic characteristics : age(F=3.492, P< .01). educational level(F=2.465, P< .05), job(F=2.630, P < .05), and previous hospitalization(T=2.53, P < .05).

등속성 장비를 이용한 1 Repetition Maximum의 추정

이석인,임승길 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

The purpose of this study was to propose proper velocity and variable for muscle strength evaluation, develop regression euqations to predict one repetition m "aximum(1-RM) from isokinetic test. Thirty normal subjects underwent isokinetic knee extension/flexion test at 30, 60, 90, 180deg/sec, one leg extension 1-RM and two leg extension 1-RM. The results of this study indicate that one leg extension 1-RM and two leg extension 1-RM may be predicted with an acceptable degree of accuracy. Stepwise selection regression analysis production the following equations to predict one leg extension 1-RM and two leg extension 1-RM from isokinetic knee extension/flexion test at 30, 60, 90, 180deg/sec. One Leg Extension 1-RM = 12.865 + 0.335 (Maximum repetition total work). (60deg/sec, R²=.624, p<.001) Two Leg Extension 1-RM = 8.374 + 1.119 (Torque 30deg) + 0.784(Acceleration time). (60 deg/sec, R²=.556, p<.001) Two Leg Extension 1-RM = 66.479 + 1.086 (Torque 30deg) - .718(Work/Body weight ratio) + 0.486(Work first third) + 1.445(Angle of peak torque). (180deg/sec, R²=.648, p<.001).

유기산 첨가가 닭뼈(대퇴골) 스톡(stock)에 용출되는 무기질량에 미치는 영향

이승언,南出隆久,大谷貴美子,최석현,한재숙 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.5

The focus of this study was the influence of organic acids such as acetic, citric and malic acid on the dissolution of calcium (Ca), magnesium (Mg), and phosphorus (P) on chicken thigh bone. As the concentration (0, 0.5, 1, 2, 4%) of acetic, citric, and malic acid increased, the resultant contents of calcium, magnesium, and phosphorus were higher than that of the control. When the boiling time (2, 4, 6, 8, 12 hours) was increased, dissolved amounts of several minerals from the chicken thigh bone increased- Calcium dissolved the most when chicken stock was boiled for 12 hours with 4% of malic acid added. In addition to minerals, amino acids and proteins were further extracted by adding organic acids. The soup stock, which contains minerals such as calcium, can be obtained by boiling the chicken thigh bone for 12 hours with an organic acid.

혀에 작용하는 capsaicin에 관한 감각 정보의 특성

이배환,김기석,김기영,진춘조,나흥식,홍승길 한국심리학회 1999 한국심리학회지 생물 및 생리 Vol.3 No.1

본 연구는 혀에 작용하는 capsaicin이 유발하는 감각 정보의 특성을 알아보기 위해 수행되었다. α-chloralose로 마취한 고양이에게 기계적 자극, 미각자극, capsaicin을 혀에 도포하고, 동통 유발 물질과 capsaicin을 혀의 동맥에 주입하면서 고삭신경과 설신경에서 신경의 활동을 기록하였다. 고삭신경에서 혀에 도포한 capsaicin에 대한 반응은 미각 자극 및 혀의 동맥에 주입한 동통 유발 물질에 대한 반응과 상관이 있었다. 혀의 혈관에 주입한 capsaicin에 대한 고삭신경의 반응은 혀에 도포한 capsaicin 및 혀의 혈관에 주입한 동통 유발 물질에 대한 반응과 상관이 있었다. 설신경에서 혀에 도포한 capsaicin에 대한 반응은 동맥에 주입한 동통 유발 물질에 대한 반응과 상관이 있었다. 혀의 혈관에 주입한 capsaicin에 대한 설신경의 반응은 혀에 도포한 capsaicin 및 혀의 혈관에 주입한 동통 유발 물질에 대한 반응과 상관이 있었다. 이러한 결과는 capsaicin이 혀에 작용할 때 동통뿐만 아니라 미각에 관한 정보도 유발한다는 것을 시사한다. 이때 미각에 관한 정보는 고삭신경을 통해 중추로 전달되며, 동통에 관한 정보는 설신경을 통해 전달되지만, 동통에 관한 정보가 고삭신경을 통해 전달될 가능성도 배제하지 못한다. The present study was performed to investigate the characteristics of sensory information produced by capsaicin in the tongue. Activities of the chorda tympani(CN) and lingual nerves(LN) were recorded while taste stimuli and capsaicin were being applied topically, and capsaicin and algesics were being injected intra-arterially to the tongue of cats anesthetized with α-chloralose. Responses of the CN fibers to topically applied capsaicin were correlated with those to taste stimuli and intre-arterially injected algesics. Responses of the CN fibers to intra-arterially applied capsaicin were correlated with those to topically applied capsaicin and intra-arterially injected algesics. Responses of the LN fibers to topically applied capsaicin were correlated with those to intra-arterially injected algesics. Responses of the LN fibers to intra-arterially aplied capsaicin were correlated with those to topically applied capsaicin and intra-arterially injected algesics. These results suggest that capsaicin provoke taste as well as pain sensation in the tongue. Taste information produced by capsaicin is conveyed to the brain via the CN and pain information via the LN. However, the possibility that pain information may be conveyed via the CN can not be excluded.