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김종묵,주성빈 한국민간경비학회 2023 한국민간경비학회보 Vol.22 No.5
그간 다중운집 행사의 안전관리 체계 개선을 위한 범정부적 노력에도 불구하고, 특히 이태원 사고 이후, 국민들이 느끼는 다중운집 행사 안전관리에 대한 불안감은 다시 커지고 있어 이에 대한 개선 방안을 모색할 필요가 있다. 이 연구에서는 우선, 다중운집 행사의 개념을 공공행정상 위험의 관점에서 파악한 뒤, 이러한 다중운집 행사가 갖는 법적 의미와 다중운집 행사의 안전관리에 있어 경찰의 역할을 중심으로 검토하였다. 이어, 다중운집 행사 안전관리 개선 방안으로 현행 자치경찰제의 관련 법령의 입법적 보완, 관계 기관 및 단체 간의 협업 체계 강화, 다중운집 행사 안전관리 인프라 확충 및 활용도 제고, 매뉴얼의 정비를 제안한다. 제안된 개선 방안이 정책으로 구체화되어 국민들이 다중운집 행사의 안전관리가 개선되고 있다는 사실을 체감할 수 있기를 희망하며, 실제 국민의 생명과 신체도 보다 두텁게 보호되기를 기대한다.
중증 허혈성 지체질환 환자에서 시행된 vascular endothelial growth factor의 혈관신생 유전자치료 1예
김현중,장신이,김종묵,김선영,김병문,김원배 대한내과학회 2003 대한내과학회지 Vol.65 No.1
저자 등은 기존의 치료에 반응하지 않는 중증 허혈성 지체질환 환자를 대상으로 하여 vascular endothelial growth factor를 이용한 혈관신생 유전자 치료를 시행하 였다. 치료 후 환자의 허혈에 의한 하지 통증이 현격하 게 감소하고 상처의 진행이 멈추었으며 추적 하지혈관 조영술상에서 하지의 측부혈관이 많이 증가됨이 관찰되 어 이에 문헌고찰과 함께 보고하는 바이다. 감사의 글 본 유전자 치료는 동아제약 연구소, ㈜바이로메드와 의 공동연구로서 삼성서울병원의 윤리위원회, 생물학적 안정성위원회, 식품의약품안전청의 유전자 제조품목 허 가 및 임상시험 인허가를 획득한 연구입니다. Cardiac and Vascular Center, Samsung Medical Center, Seoul, Korea; ViroMed Co. Ltd. Seoul, Korea*; Institute of Molecular Biology and Genetics, Seoul National University, Seoul, Korea†; Research Laboratories, Dong-A Pharm Co, Ltd, Kyunggi-do, Korea‡ We report VEGF-induced angiogenic gene therapy in a patient with critical limb ischemia, who did not respond to conventional treatment. This patient was the first case in a dose-escalating series of phase I clinical trial. The patient had severe resting pain, gangrene and diffuse ulcer in his left foot. Total 1,000 μg of naked DNA encoding human VEGF165 was administered intramuscularly to 8 sites of the left lower extremity. Four weeks after the first 1,000 μg injection, a second 1,000 μg was administered to the same sites (total dose: 2,000 μg). After gene therapy, resting pain gradually reduced and the amount of analgesics taken by the patient decreased. The ischemic wound of lower extremity slightly improved. However, there was no complete wound healing at 12 weeks of treatment. Digital subtraction angiography at 12 weeks after gene therapy showed an increase in collateral vessels at the mid-tibial, ankle and foot arch levels. Immediately and up to 12 weeks, there was no complication related to gene therapy. These findings may be cautiously interpreted to indicate that intramuscular injection of naked plasmid DNA of VEGF165 may induce therapeutic angiogenesis in a patient with critical limb ischemia. Further clinical evaluation of VEGF-induced gene therapy is needed to evaluate the safety and efficiency of this treatment.(Korean J Med 64:85-90, 2003)
김현중,장신이,박중일,변종회,김동익,도영수,김종묵,김선영,김병문,김원배,김덕경 생화학분자생물학회 2004 Experimental and molecular medicine Vol.36 No.4
This phase 1 clinical trial tested the safety of intramuscular gene transfer by using naked plasmid DNA encoding the gene for VEGF, and analyzed the potential therapeutic benefits in patients with severe peripheral arterial disease (PAD). This study was an open-labeled, doseescalating, single-center trial on nine male patients with severe debilitating PAD who had not responded to conventional therapy. Seven had Buerger's disease and two had arteriosclerosis obliterans. Plasm id DNA (pCK) containing human VEGF165 was given by eight intramuscular injections in and around the area in need of new blood vessels. The study evaluated three escalating total doses (2, 4, and 8 mg of pCKVEGF165), with half of each total dose given four weeks apart. The follow-up duration was nine months. The gene injections were well tolerated without significant side effects or laboratory abnormalities related to gene transfer. Three patients showed transient edema in their extremities. Ischemic pain of the affected limb was relieved or improved markedly in six of seven patients. Ischemic ulcers healed or improved in four of six patients. The mean ankle-brachial index (ABI) improved significantly. Six of nine patients showed an increase in collateral vessels around the injection sites demonstrated by digital subtraction angiography. However, there was no relationship between the degree of ABI improvement and the dose given. Mean plasma levels of VEGF d id not increase significantly. In conclusion, intramuscular in jections of pCKVEGF165 can be performed safely to induce therapeutic angiogenesis in patients with severe PAD.
토끼 허혈성 하지 모델에서 VEGF 발현 Naked DNA 벡터인pCK-VEGF의 근육내 투여가 측부혈관형성에 미치는 영향
체제건(Jei Keon Chae),전현순(Hyun Sun Jeon),박은진(Eun Jin park),김종묵(Jong Mook Kim),김덕경(Duk Kyung Kim),김선영(Sun Young Kim) 대한약학회 2001 약학회지 Vol.45 No.1
We have recently reported the development of a high efficiency expression vector, pCK, which can drive a high level of gene expression in mouse skeletal muscle. In this study, we tested the therapeutic potential of pCK expressing human VEGF165, pCK-VEGF, in the rabbit ischemic hind limb model. To determine the optimal dose of plasmid DNA, various concentrations of pCK-CAT, were injected into the muscle of a rabbit hind limb and the levels of CAT activity were determined. It was found that the expression level of the exgenously added gene became stable between 250 and 1,000ug. Based on this result, we tested whether intramuscular transfer of 500ug of pCK-VEGF could actually modulate collateral vessel development in a rabbit ischemic hind limb model. It was found that reative to the control group injected with the pCK lacking the VEGF sequence, single intramuscular doses (500ug) of pCK-VEGF produced statistically significant augmentation of collateral vessels as determinde by the angiographic vessel count, maximal blood flow by Doppler flowmeter, and the number of capillaries by histology. These results suggest that a single 500ug-delivery of pCK-VEGF is potent enough to induce sufficient angiogenic activity and achieve therapeutic benefit on this rabbit model.
중증 허혈성 지체질환 환자에서 시행된 vascular endothelial growth factor의 혈관신생 유전자치료
김현중 ( Hyun Joong Kim ),장신이 ( Sin Yi Jang ),김종묵 ( Jong Mook Kim ),김선영 ( Sun Young Kim ),김병문 ( Byong Moon Kim ),김원배 ( Won Bae Kim ),김덕경 ( Duk Kyung Kim ) 대한내과학회 2003 대한내과학회지 Vol.64 No.1
We report VEGF-induced angiogenic gene therapy in a patient with critical limb ischemia, who did not respond to conventional treatment. This patient was the first case in a dose-escalating series of phase I clinical trial. The patient had severe resting p
마우스에서 VEGF 발현 Naked DNA 벡터인 pCK-VEGF의 약동력학 및 조직내 분포
도현미(Hyounmie Doh),고준일(Jun-IL Ko),이종진(Jong-Jin Lee),손미원(Miwon Son),조홍찬(Hongchan Cho),김종묵(Jong-Mook Kim ),김병문(Byong-Moon Kim),김선영(Sunyoung Kim) 大韓藥學會 2001 약학회지 Vol.45 No.1
We recently developed a high dfficiency expression vector, pCK, which drives a high level of gane expresion in the skeletal muscles of mice. In this study, we investigated the pharmacokinetics and biodistribution of pCK-VEGF expressing human VEGF165 after intravenous or intramuscular administration. The quantity of pCK-VEGF in the tissues of mice was measured by the PCR method which has a detection limit of approxinately 1 pg of the exogenously added plasmid In the case of intravenous administration, the half life of the pCK-VEGF plasmid in the bloodstream was 1.68 min. After inter-muscular adminstration, the half life of pCK-VEGF plasmid in the bloodstrean was 6.78 min. At 90 min post-administration, 30% of the injected pCK-VEGF was found at the site of injection, where it persisted for up to 8 hours. Less than 1.6% of the injected pCK-VEGF plasmid DNA was detected in highly vascularized tissues such as the lung, kidney, and liver at 90 min post-administration administrated pCK- VEGF presisted for longer periods of time in muscls than in other tissues and that direct intra-muscular injection of pCK-VEGF might be useful for local therapeutic angiogensis.