긴장증의 임상적 특성에 대한 고찰

송지영,윤도준,변재영,장환일 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.3

26 cases(9 males and 17 females) with catatonia features on admission were analyzed in terms of its clinical characteristics. The results obtained were as follows : 1) In the diagnostic distribution, more than a half of the cases were schizophrenic disorders(57.5%) and the others were major depressions(26.9%) and schizophreniform disorders(15.4%). 2) The catatonia signs were nonspecific and evenly distributed among a variety of clinical diagnostic entities. But the signs of negativism, mutism, and posturing appeared frequently in all cases. 3) Acute onset was prevalent(65.4%), ECT was more frequently applied(61.5%) and treatment response was better(70.9%) in the catatonia group than non-catatonia. Although the definition of catatonia is not clear yet, above results support the opinions of previous studies that catatonia should be understood as a heterogenous symptom complex. And not only schizophrenia but also affective disorder are associated with catatonia features. This suggests that we have to re-evaluate the concept of Kahlbaum's old description.

두개강내로 전이된 Adenoid Cystic Carcinoma 2례 : 증례보고 Report of Two Cases

송재욱,윤상민,이창훈,장지수,이승훈,조경자,강신광 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

The authors describe two cases of unusual intracranial metastatic adenoid cystic carcinomas. A 42-year-old woman had a right pariental epidural metastatic mass. presumed hematogenous. spread from a primary tumor in the parotid gland. In second case, a 32-year-old man had a intracranial metastatic adenoid cystic carcinoma mimicking calcified psammomatous meningioma on CT scans. We present these unusual cases with a review of relevant literature and a discussion of possible pathogenesis.

열대 지역에서 통일형 초다수성 벼 품종의 생육 및 수량성 비교

이지윤,준현,성환,손영보,송유천,한상익,박동수,권영업,이철원,이종희 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

림프절에 발생한 모반세포 봉입체 - 2예 보고 -

송지선,노태웅,김윤미,조상호,이광길 대한병리학회 2001 Journal of Pathology and Translational Medicine Vol.35 No.3

카이토산을 이용한 방사성스트론튬 오염의 치료

김지열,송호천,양광희,최근희,채기문,범희승,김광윤 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.3

본 연구에서는 마우스에 이미 오염된 방사성스트론튬(Sr-85)을 제거하는데 수용성카이토산이 어느정도 효과가 있는지 알아보고자 하였다. Sr-85를 정맥주사한 경우 주사후 1일째의 체내 잔류량은 72.9 ±5.7%, 5일째는 57.7 ±1.9%, 7일째는 54.2 ±1.4%로 서서히 감소하였으며, Sr-85를 복강내 주사한 경우는 주사후 5일째 54.4 ±1.2%, 15일째 50.6 ±0.8%로 정맥주사에 비해 낮은 잔류량을 보였다(5일째 잔류량의 비교, P<0.05), 0.3% 수용성카이토산을 1회 정맥주사해준 제21군 및 10% 수용성카이토산을 식이중에 섞어 먹인 제5군은 각각의 대조군에 비해 체내 잔류방사능의 차이가 없었으나 (P>0.05), 0.3% 수용성카이토산을 3일간 정맥주사한 제3군과 3% 수용성카이토산을 이틀 간격으로 15일간 복강내 주사한 제6군에서는 각각의 대조군에 비해 낮은 잔류방사능을 보였다. (P<0.01). 결론적으로 수용성카이토산을 연속적으로 정맥투여하거나 복강내 투여하는 경우에는 스트론튬의 골대사촉진 또는 골중의 스트론튬과의 반응등을 통해 그 배출을 촉진시킬 것으로 사료되었다. The aim of the present study was to elucidate the effect of the water soluble chitosans on the removal of contaminated radiostrontium(Sr-85) from the bone of mice. The remaining radioactivities in intravenously injected controls(group 1) were higher than in intraperitoneally injected controls (group 4, P<0.01). The % retention at day 5 were 57.7 ±1.9%, 54.4 ±1.2%, respectively. Single intravenous injection of 0.3% water soluble chitosan and continuous oral ingestion of 10% water soluble chitosan for 15 days were ineffective on the removal of contaminated radiostrontiums. Multiple intravenous or intraperitoneal injections of water soluble chitosan effectively removed contaminated radiostrontiums (P<0.01 vs controls). In conclusion, water soluble chitosan might remove once incorporated radiostrontium from bones of mice. further studies were needed to elucidate the mechanism of the removal.

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

실험적 대장염에서 Tripotassium Dicitrato Bismuthate의 효과

송인상,송규상,설지영,장일성,배진선,윤완희 대한대장항문학회 1995 Annals of Coloproctolgy Vol.11 No.1

골수구성 백혈병 환자에게 발생한 결핵성 림프절염

이창섭,송진수,최평균,조재현,방지환,박경화,박완범,김홍빈,김남중,윤성수,박선양,김병국,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

혈액질환 가운데 결핵 발생이 증가한다고 알려진 것은 호지킨 림프종을 포함한 림프증식성질환 그리고 모양세포성 백혈병 등이 있다. 또한 동종 골수이식을 받은 환자에서도 결핵은 증가한다고 알려져있다. Kaplan 등은 골수구성 백혈병 환자에서 결핵 발생이 증가한다고 보고하였다. 그러나 골수구성 백혈병 환자에서 결핵의 발생이 증가하는 이유에 대해서는 아직까지 정확하게 밝혀지지 않았다. 저자들이 2년 동안 후향적으로 조사한 180명의 성인 골수구성 백혈병 환자들 가운데 결핵이 발생한 환자는 4명이었고, 발생 부위는 모두 림프절이었다. 결핵은 골수구성 백혈병의 특정 아형에만 국한되어 발생하지 않았지만, 50%에서 FAB 분류에 의한 M4였다. 림프절이 종대된 골수구성 백혈병 환자에서 특히, 결핵의 유병율이 높은 나라에서는 결핵성 림프절염도 감별진단에 포함시켜야 한다. During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.

일개 지방자치단체의 건강진전도 평가

고광욱,김윤지,송성은,김정민 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.1

Background: Healthy and sustainable community is essential component of development. But there has been no systematic reporting about healthy municipality in specific city, although economic development results in considerable progress. Method: According to the Ontario progress monitoring tool partial monitoring has been done. Survey to the stakeholder including public officers were done and analyzed. Result: Economic area were most lowly reported area. By specific item, direction of improvement were induced in each area including social environment and human health area. Green space, waste treatment, traffic problem, small health service benefit were major agenda among the stockholders. Conclusion: According to the Ontario progress reporting, we got good picture about healthiness of one municipality and concrete direction of improvement.

정신분열병 환자에서 Risperidone에 의해 유발된 조증 2례

정두훈,윤도준,유희정,송지영 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

저자들은 정 신분열병 환자에서 risperidone에 의해 유발된 조증, 경조증 각 1례를 경험하였기에 국내에서는 최초로. 문헌고찰과 함께 보고한다. 증례 1은 22세의 여자 긴장형 정신분열병 환자로 3년전 발병 당시 약물치료후 유지요법 없이 지내다가 4∼5개월 전부터 사회적 위축, 식사량 저하. 말수가 줄어드는 등의 음성증상이 심해져 외래에서 risperidone 2mg을 일 주일간 처방하였다. 환자는 약물순응도가 낮아서 모두 6회에 걸쳐 억지로 투약하여 이 기간에 총 6∼8mg복용후 2∼3일 만에 조증이 발생되었다. 입원후 risperidone을 중단하고 lithium과 고용량의 정형 항정신병약물(chlorpromazine 1200mg 또는 haloperidol 20mg)을 10일간 투여하여 일부 조증이 호전되었다. 증례 2는 29세 남자로 3년 전부터 피해망상, 독극망상을 보이는 망상형 정신분열 병으로 항정신병약물을 처음 투여한 환자였다. 38일간 2mg 사용 시에는 양성증상 및 음성증상의 호전을 보이다가 3mg으로 증량된 후 일 주일만에 뚜렷한 경조증을 보였다. Risperidone을 중단하고 chlorpromazine 300mg을 투여하자 5일 만에 경조증이 완전히 회복되었다. 두 예 모두 risperidone 단독투여에 의한 것이었고, 기분안정제 병합투여, 약물남용 정신질환의 병력이나 가족력, 동반 신체질환은 없었다. Risperidone의 세로토닌(5-HT₂) 차단효과는 도파민(D₂) 차단작용과 함께 정신분열 병에서 음성증상과 정동중상을 호전시킬 뿐 아니라 항우울효과를 나타내며. 일부 환자에서 조증 및 경조증을 유발시키는 것으로 보인다. 기분장애와 분열정동장애에서도 risperidone에 의해 조증이 유발 또는 기존 조증중상이 악화되었다는 증례보고가 있고. 강박장애 등 다른 정신질환으로도 적응증이 확대되고 있으므로, 임상의들은 드물지만 이런 정신과적 부작용의 발생 가능성에 대해 알아야 하겠고. 특히 기분장애나 분열정동장애에서 사용할 경우 기분안정제의 병합투여와 최소 치료용량으로 서서히 증량할 것을 권하는 바이다. 또한 조증유발의 위험인자가 있는 경우는 기분안정효과가 있는 clozapine의 사용이 권장된다. We report the first two cases of manic and hypomanic episodes respectively induced by risperidone treatment done to schizophrenics in Korea. One case was a 22-year-old woman with catatonic schizophrenia. Since 3 years ago, she had shown psychotic symptoms, but with was poor treatment compliance. She had mainly negative symptoms such as social withdrawal, decreased food intake, mutism, and symptoms had been worsened since last 4-5 months. Prior to closed ward admission, she was prescribed 2mg/d of risperidone for a week at OPD. Two days artier taking medicine totally 6-8mg, she revealed manic features. After hospitalization, risperidone was discontinued and then, lithium 900mg/d and high dosage of conventional antipsychotics(chlorpromazine 1200mg/d or haloperidol 20mg/d) were prescribed . About on the l0th day of hospitalization, there was limited improvement of her manic symptoms. The other case was a 29-year-old man with a 3-year history of paranoid schizophrenia. He was never exposed to antipsychotics before. His main symptoms were delusions of being poisoned and of persecution. His positive and also negative symptoms were alleviated by 38 days of risperidone 2mg/d trial. However, one week after dosage increment to 3mg/d, hypomanic symptoms appeared. Risperidone medication was discontinued and was replaced by chlorpromazine 300mg/d. The hypomanic episode was resolved over 5 days. In both of the two cases, manic episodes occurred by monotherapy of risperidone without mood stabilizer, and there were no history of substance abuse and other psychiatric disorders, family history of psychiatric disorders, and comorbid physical illnesses. It is hypothesized that the potent blockade effect on serotonin(5-HT₂) receptor of risperidone causes antidepressant effect as well as therapeutic effect for negative and affective symptoms in schizophrenia. Risperidone would induce manic or hypomanic features in schizophrenic patin of preexisting manic symptoms by risperidone treatment in mood disorder and schizoaffective disorder. Risperidone is being used more widely, even for obsessive-compulsive disorder and other psychiatric disorders. It is necessary for clinicians to recognize manic switch, one of psychiatric side effects by risperidon trial. It is recommended that the combination of mood stabilizer wish risperidone or usage of talc minimum effective dose of risperidone may bewefal especially in the patients with mood disorders or schizoaffective disorders. Clozapine which has mood-stabilizing properties is also beneficial in risk groups of risperidone-induced mania.