정신분열병 환자에서 Risperidone에 의한 Cytokine의 변화

김대진,김원,윤수정,고효진,최보문,전태연 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

기존의 항정신병약뮬인 haloperidol이나 clozapine과는 약물학적 특성이 다른 대표적인 약물인 risperidone을 사용하여 정신분열병 환자가 치료 전과 4주 치료 후에 어떤 면역학적 차이를 보이는지 6가지 cytokine의 혈장 농도를 측정하여 알아보았다. 방법: 1999년 2월부터 1999년 5월까지 카톨릭대학교 대전성모병원 정신과에 입원한 환자 중 DSM-IV 진단 기준에 의해 정신분열병으로 진단된 환자 25명을 대상으로 하였다. 입원 다음날 아침 8시 risperidone 투여전의 기본적인 cytokine농도를 측정하기 위해 혈액을 채취하였으며 제 2병일에 risperidone 2mg, 제 4병일에 4mg, 제 6병일에 6mg으로 증량하는 방식을 항정신병약물 치료를 하였다. 임상평가는 risperidone 투여 전과 투여 4주 후 정신과 전공의가 각각 PANSS 검사를 시행하였다. 혈장에서 IL-1β,IL-2, IL-6, IL-12, INF-□, TNF-α의 정량 측정은 ELISA kit (Endogen Inc., Woburn, MA, USA)을 사용하여 quantitative ELISA법으로 하였다. 결과: risperidone을 4주간 투여 후 환자 혈장 IL-12 농도가 유의하게 증가되었고 나머지 cytokine 농도는 유의한 변화가 없었다. 결론: 저자들은 연구에서 risperidone 치료 후 IL-12가 증가된 것은 이러한 항정신병약물치료가 면역반응 을 활성화시키는 역할을 한 것으로 시사된다. Objectives: This study was carried out to evaluate immunologic difference between baseline and after 4 weeks drug treatment with atypical antipsychotics(rispreidone) by measurement of serum concentration of 6 cytokines. Methods: The subjets were composed of 25 patients who are admitted at Dajeon St's Marys hospital of psychiatry department and diagnosed as schizophrenia by DSM-IV diagnositc criteria. We measured serum IL-1β, IL-2, IL-6, IL-12, INF-□, TNF-α concenatrations by quantitative ELISA method using ELISA kit(Endogen In., Woburn, MA, USA). The two psyciatrists per-formed PANSS examination between baseline and after 4 weeks risperidone treatments. Results: The serum level of IL-12 was increased significantly after medication of 4 weeks and the serum concentration of IFN-□ showed the tendency of decreasement but not significant. The serum level of the other cytokines showed no significant change. Conclusion: We spectulate that the increasement of IL-12 may contribute to role of activa-tion of immune response by treatment of antipsychotic medication(risperidone). This study is first trial of IL-12 study in neuropsychiatric field and IL-12 which play impor-tant role of immune response becomes interesting subjects in immune research.

Risperidone 조기 중단군 및 장기 유지군의 임상적 특성 비교

김광수,박원명,전태연,배치운,김대진,백인호,이철,김정수,한상익,최보문,장계호,고효진 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : Risperidone 투여후 조기 중단한 환자들과 장기적으로 계속 risperidone을 복용하고 있는 환자의 임상적 특성을 평가하고 나아가 risperidone장기 유지와 조기 중단의 요인을 분석하고 정신병리가 약물 투여에 미치는 영향을 조사하고자 하였다. 방 법 : 연구 대상자는 1996년 1월부터 1996년 12월까지 가톨릭대학교 의과대학 부속 8개 병원 정신과에서 risperidone을 투여 시작한 환자 580명중 DSM-IV기준에 의해 정신분열병으로 진단받고 투여 기간이 6개월 미만(조기 중단군)이거나 2년 이상(장기 유지군)을 경과하였으며 의무기록의 누락이 없는 210명을 선정하였다. 두 군간 임상적 특성을 조사하기 위하여 인구학적 변인, 정신병리학적 변인, 약물 투여기록 및 부작용 등을 과거 의무기록을 근거로 평가하였다. 결 과 : 대상환자 210명 중 조기 중단군이 67명(31.9%)이었고 장기 유지군은 143명(68.1%)이었으며 두 군간 인구학적 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 최대 용량은 유의한 차이가 없었으나 유지용량은 조기 중단군에서 4.49(±1.44)mg,장기 유지군에서 3.67(±1.50)mg으로 유의한 차이가 있었다(t=3.698, p<0.05). 또한, 이전 항정신병약물의 사용 기왕력 변인에서 조기 중단군은 기왕력이 없는 환자가 39명(58.2%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 27명(40.3%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 1명(1.5%)이었고, 장기 유지군은 기왕력이 없는 환자가 58명(40.6%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 77명(53.8%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 8명(5.6%)으로 유의한 차이가 있었다.(x²=6.559, df-=2, p<0.05). 결 론 : 본 연구결과에 의하면 가급적 환자 상태에 따라 낮은 최적 치료 용량을 투여하는 것이 장기잔의 투여를 바람직한 것으로 생각된다. 본 연구와 같은 대규모의 후향적 자연적 연구는 일반 실제 진료에서 risperidone의 효과 및 기타 다른 측면에서의 유용한 정보를 얻을 것으로 기대된다. Objective : This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. Method : Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. Results : Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The stating and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency amtipsychotic use was 27(40.3%), and the number of no previous use of antipsychotic was 58(40.6%), the number of high potency ntipsychotic use was 77(53.8%), the number of low potency antipsychotic use was8(5.6%) in long-term maintained group.(x²=6.559, df-=2, p<0.05). Conclusions : According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practial field.

산업장 근로자의 스트레스에 대한 한의계 연구경향

차윤엽 ( Yun Yeop Cha ),고연석 ( Youn Seok Ko ),이정한 ( Jung Han Lee ),정원석 ( Won Suk Chung ),신병철 ( Byung Cheul Shin ),전찬용 ( Chan Yong Jeon ),고호연 ( Ho Yeon Go ),선승호 ( Seong Ho Sun ),장보형 ( Bo Hyoung Jang ),송윤경 한방재활의학과학회 2013 한방재활의학과학회지 Vol.23 No.2

Objectives : The purpose of this study is to explore the trends of Korean medical study on stress in the industrial worker. Methods : We received numbers of the studies about stress in the industrial worker from 6 Korean web databases, using key words such as ‘Industry AND Stress’, ‘Oriental medicine AND Stress’, ‘Worker AND Stress’, ‘Workplace AND Stress’. We received 12 research papers and they were analyzed and the journals, the authors, the contents of 3 classification of those research papers. Results : Among them, we had 6 reviews of Dept. of preventive medicine and Dept. of third medicine, college of Korean Medicine, Won-kwang University, and the rest of them were 6 reviews. We had 4 reviews of Korean Journal of Oriental Preventive Medical Society, 2 reviews of the Journal of Traditional Korean Medicine, 2 reviews of Journal of Oriental Neuropsychiatry and so on. According to the contents of reviews, we had 7 reviews of correlation of industrial worker and stress, 4 reviews of cause on the industrial worker’s stress and 1 case report. Conclusions : We reviewed the trends of Korean medical study on stress in the industrial worker. The stress in the industrial workers were related with the type of occupation, social psychology, drinking, smoking, the satisfaction of job, the harmony of organization.And we knew that the musculoskeletal pain was related to the industrial worker’s stress. In the future, abundant case studies, follow-up trials and RCTs should be done about the industrial worker’s stress.

적외선열화상장치를 이용한 Buchanan plugger 표면의 온도상승 분석

최성아,김선호,황윤찬,윤창,오병주,최보영,정우남,정선와,황인남,오원만 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.4

This study was performed to evaluate the temperature rise on various position of the Buchanan plugger, the peak temperature of plugger's type and the temperature change by its touching time of heat control spring. The heat carrier system 'System B' (Model 1005. Analytic Technologies, USA) and the Buchanan's pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200℃ which Dr. Buchanan's "continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. In order to apply heat on the Buchanan's pluggers, the heat control spring was touched for 1, 2, 3, 4 and 5 seconds respectively. The temperature rise on the surface of the pluggers were measured at 0.5 mm intervals from tip to 20 mm length of shank using the infraed thermography (Radiation Thermometer-IR temper, NEC San-ei Instruments, Ltd, Japan) and TH31-702 Data capture software program (NEC San-ei Instruments, Ltd, Japan). Data were analyzed using a one way ANOVA followed by Duncan's multiple range test and linear regression test. The results as follows. 1. The position at which temperature peaked was approximately at 0.5 mm to 1.5 mm far from the tip of Buchanan's pluggers (p<0.001). The temperature was constantly decreased toward the shank from the tip of it(p<0.001). 2. When the pluggers were heated over 5 seconds, the peak temperature by time of measurement revealed from 253.3±10.5℃ to 192.1±3.3℃ in a touch for 1 sec, from 218.6±5.0℃ to 179.5±4.2℃ in a touch for 2 sec, from 197.5±3.0℃ to 167.6±3.7℃ in a touch for 3 sec, from 183.7±2.5℃ to 159.8±3.6℃ in a touch for 4 sec and from 164.9±2.0℃ to 158.4±1.8℃ in a touch for 5 sec. A touch for 1 sec showed the highest peak temperature, followed by, in descending order, 2 sec, 3 sec, 4 sec. A touch for 5 sec showed the lowest peak temperature (p<0.001). 3. A each type of pluggers showed different peak temperatures. The peak temperature was the highest in F type and followed by, in descending order, M type, ML type. FM type revealed the lowest peak temerature (p<0.001). The results of this study indicated that pluggers are designed to concentrate heat at around its tip, its actual temperature dose not correlate well with the temperature which Buchanan's "continuous wave of condensation" technique recommended, and finally a quick touch of heat control spring for 1 sec reveals the highest temperature rise.

'1998 한국인 우울증 선별의 날' 참가자들의 사회인구통계학적 특성과 우울증 선별검사 결과

한상익,이성필,고효진,박원명,장계호,유태열,전태연,채정호,방승규,김광수,최보문,이정태,백인호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 1998년 정신건강의 날 기념 한국인 우울증 선별의 날 행사에 자발적으로 참여한 참가자들의 사회인구 통계학적 특성을 분석하고 우울증 선별검사 결과를 평가하기 위하여 본 연구를 시행하였다. 방 법 : 8개 병원에서 얻어진 619명의 자료를 사용하여 선별검사로 밝혀진 우울증의 유병율과 사회인구통계학적 특성 및 응답자의 정신과적 치료를 포함한 과거력 등을 조사하였다. 결 과 : 우울증 척도 점수는 응답자 전체 평균 57.5±13.8로 경도의 우울 증상이 있는 것에 해당되었다. 전체 응답자의 69.5%(430명)가 최소한 경도 이상의 우울 증상을, 43.1%(267명)가 중등도 이상의 우울 증상을, 18.4%(114명)가 고도의 우울 증상을 보였다. 고도의 우울 증상이 있는 응답자의 56.8%와 중등도의 우울 증상이 있는 응답자의 63.9%가 정신과 치료를 받은 적이 전혀 없었다. 나이가 29세 이하인 것과 전임근무 중인 직업상태는 각각 나이가 60세 이상인 것과 직업이 없는 것에 비교하여 우울증으로부터 보호하는 인자임을 시사하였다. 결 론 : '1998 한국인 우울증 선별의 날' 행사를 통하여 많은 우울증 환자들을 선별해낼 수 있었고, 이들의 우울 증상은 몇몇 사회인구통계학적 특성과 유의한 관계가 있음을 확인하였다. 우울증 선별의 날 행사를 통한 우울증에 대한 교육과 우울증 선별검사는 치료받지 못하고 있는 우울증 환자 및 기존의 치료 중인 환자 모두에게 유용한 프로그램임을 알 수 있었다. Objectives : This study was performed to analyze the sociodemographic characteristics of participants in '1998 Korean Depression Screening Day' and to evaluate the results of the screening test. Methods : By using the survey results of 619 volunteers from 8 hospitals, the authors examined the prevalence of depression detected at the screening test and sociodemographic characteristics and the psychiatric treatment history of respondents. The assessment measure was the Zung Self-Rating Depression Scale. Results : The mean depression score of all participants was 57.5±13.8 and it came under mild depression. Of all participants, 69.5%(N=430) had at least mild depressive symptoms, 43.1%(N=267) had at least moderate symptoms, and 18.4%(N=114) had severe symptoms. Never have 56.8% of respondents in the severely depressed range and 63.9% of those in the moderately depressed range had psychiatric treatment. The results suggest that the age group of 29-year-old or younger(relative to 60-year-old or older group) and full-time employment status(relative to unemployment) are protective factors of depression. Conclusions : By '1998 Korean Depression Screening Day', many depressed patients were detected and their depressive symptoms had statistically significant relationships with some sociodemographic characteristics. The results suggest that the education and screening test programs for depressive illness facilitated by Depression Screening Day are useful to the patients regardless of being under current treatment or not.

Basic : Diagnostic value of simplified criteria in korean patients with autoimmune hepatitis (초)

( Bo Hyun Kim ),( Yoon Jun Kim ),( Sang Youn Hwang ),( Sook Hyang Jeong ),( Won Young Tak ),( Sang Hoon Ahn ),( Youn Jae Lee ),( Eun Uk Jung ),( Jung Il Lee ),( Jong Eun Yeon ),( Jae Seok Hwang ),( So 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)

Methotrexate in a Real-World Psoriasis Treatment: Is It Really a Dangerous Medication for All?

( Bo Ri Kim ),( Jungyoon Ohn ),( Chong Won Choi ),( Sang Woong Youn ) 대한피부과학회 2017 Annals of Dermatology Vol.29 No.3

Two cases of anterior mediastinal mass supported with extracorporeal membrane oxyg enation (초)

( Bo Young Lee ),( Jae Young Moon ),( Jin Won Huh ),( Chae Man Lim ),( Youn Suck Koh ),( Joon Bum Kim ),( Jung Hee Lee ),( Dok Hyun Yoon ),( Sang Bum Hong ) 대한내과학회 2012 대한내과학회 추계학술대회 Vol.2012 No.1

Validation of the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) and Dyspnea-12 Questionnaire in Bronchiectasis and Tuberculosis Destroyed Lung

( Bo Young Lee ),( Jae Seoug Lee ),( Jin Won Huh ),( Jin Woo Song ),( Chang Min Choi ),( Sang Bum Hong ),( Chae Man Lim ),( Youn Suck Koh ),( Woo Sung Kim ),( Dong Soon Kim ),( Sang Do Lee ),( Young I 대한결핵 및 호흡기학회 2011 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.112 No.-

Opportunistic diseases among HIV-infectedpatients: a multicenter-nationwide Korean HIV/AIDS cohort study, 2006 to 2013

( Youn Jeong Kim ),( Jun Hee Woo ),( Min Ja Kim ),( Dae Won Park ),( Joon-young Song ),( Shin Woo Kim ),( Jun Yong Choi ),( June Myung Kim ),( Sang Hoon Han ),( Jin-soo Lee ),( Bo Youl Choi ),( Joo Sh 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.5

Background/Aims: The frequencies of opportunistic diseases (OD< sub >s< /sub >) vary across countries based on genetic, environmental, and social differences. The Korean HIV/AIDS cohort study was initiated in 2006 to promote research on human immunodeficiency virus (HIV) infection in Korea, and to provide a logistical network to support multicenter projects on epidemiological, clinical, and laboratory aspects of HIV infection. This study evaluated the prevalence of OD< sub >s< /sub > among HIV-infected patients in the era of highly active antiretroviral therapy, and the risk factors associated with OD< sub >s< /sub >. Methods: The study enrolled 1,086 HIV-infected patients from 19 hospitals. This study examined the baseline data of the HIV/AIDS Korean cohort study at the time of enrollment from December 2006 to July 2013. Results: Candidiasis was the most prevalent opportunistic infection (n = 176, 16.2%), followed by Mycobacterium tuberculosis infection (n = 120, 10.9%), Pneumocystis jirovecii pneumonia (n = 121, 11.0%), cytomegalovirus infection (n = 52, 4.7%), and herpes zoster (n = 44, 4.0%). The prevalence rates of Kaposi``s sarcoma (n = 8, 0.7%) and toxoplasmosis (n = 4, 0.4%) were very low compared with other countries. The risk factors for OD< sub >s< /sub > were a low CD< sub >4< /sub > T cell count at the time of HIV diagnosis (odds ratio [OR], 1.01; p < 0.01), current smoking (OR, 2.27; p = 0.01), current alcohol use (OR, 2.57; p = 0.04), and a history of tuberculosis (OR, 5.23; p < 0.01). Conclusions: Using recent Korean nationwide data, this study demonstrated that an important predictor of OD< sub >s< /sub > was a low CD< sub >4< /sub > T cell count at the time of HIV diagnosis. Tuberculosis remains one of the most important OD< sub >s< /sub > in HIV-infected patients in Korea.