정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Systemic administration of low dosage of tetanus toxin decreases cell proliferation and neuroblast differentiation in the mouse hippocampal dentate gyrus

Bing Chun Yan,In Hye Kim,Joon Ha Park,Ji Hyeon Ahn,Jeong-Hwi Cho,Bai Hui Chen,Jae-Chul Lee,Jung Hoon Choi,Ki-Yeon Yoo,Choong Hyun Lee,Jun Hwi Cho,Jong-Dai Kim,Moo-Ho Won 한국실험동물학회 2013 Laboratory Animal Research Vol.29 No.3

In the present study, we investigated the effect of Tetaus toxin (TeT) on cell proliferation and neuroblast differentiation using specific markers: 5-bromo-2-deoxyuridine (BrdU) as an exogenous marker for cell proliferation, Ki-67 as an endogenous marker for cell proliferation and doublecortin (DCX) as a marker for neuroblasts in the mouse hippocampal dentate gyrus (DG) after TeT treatment. Mice were intraperitoneally administered 2.5 and 10 ng/kg TeT and sacrificed 15 days after the treatment. In both the TeT-treated groups, no neuronal death occurred in any layers of the DG using neuronal nuclei (NeuN, a neuron nuclei maker) and Fluoro-Jade B (F-J B, a high-affinity fluorescent marker for the localization of neuronal degeneration). In addition, no significant change in glial activation in both the 2.5 and 10 ng/kg TeT-treated-groups was found by GFAP (a marker for astrocytes) and Iba-1 (a marker for microglia) immunohistochemistry. However, in the 2.5 ng/kg TeT-treated-group, the mean number of BrdU, Ki-67 and DCX immunoreactive cells, respectively, were apparently decreased compared to the control group, and the mean number of each in the 10 ng/kg TeT-treated-group was much more decreased. In addition, processes of DCX-immunoreactive cells, which projected into the molecular layer, were short compared to those in the control group. In brief, our present results show that low dosage (10 ng/kg) TeT treatment apparently decreased cell proliferation and neuroblast differentiation in the mouse hippocampal DG without distinct gliosis as well as any loss of adult neurons.

액와 부 유방조직 1예

조소연,임연순,최혜영,명기범 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.2

부 유방조직은 발생학적 이상에 의하여 발생하며 주로 사춘기 이후에 증상을 보이는 질환으로 여러 아형이 있으며, 본 증례에서와 같이 임신과 무관하게 액외부에 일측성으로 피부표면의 병변 없이 이소성 선조직만 존재하는 경우는 매우 드물어 문헌고찰과 함께 보고한다. A case of unilateral accessory axillary breast tissue developed as a subcutaneous nodule unassociated with menstrual periods, pregnancy, or lactation in a 33-year-old parous woman. Histopathologic finding of the nodule revealed lobules of normal breast tissue forming islands of glandular tissue, This case belongs to one of the unusual forms of supernumerary breast tissue characterized by the presence of aberrant gland tissue alone. The literature is briefly reviewed.

만성 화농성 중이염의 세균학적 고찰

조남순,이영훈,강기훈,최제환,송태현,이병돈,장혁순,강주원,김연준 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and Objectives : Chronic suppurative otitis media is one of the frequent diseases in otolaryngologic field. It is important to choose of antibiotics in the management of infectious disease. But the organisms in infections have been changed and resistance to antibiotics has been grown as the development of antibiotics has been achieved. And so it has been necessary to recognize the changes of organisms and resistance in antibiotics. Our study was performed to identify the pathogens isolated from discharges in chronic otitis media and evaluate the antibiotic agents, to recognize the change of to resistance to·antibiotic agents and to use the appropriate anitiotics. Materials and Methods : Retrospectively, authors reviewed the backeriologic study of 114 cases of chronic suppurative otitis media who visited the Department of Otolaryngology, Soonchunhyang University in Seoul from Nov. 1996 to Oct. 1999 and analyzed 101 strains and its sensitivity test to various antibiotics. Result : In 93 cases in which pathogenic organism was isolated, single infection was 85 cases(91.4%) and mixed infection was 8 cases(8.6%). The most frequent pathogenic organism was Staphylococcus aureus(59.4%), Pseudomonas aeruginosa(13.9%), Providencia(4.8%), Alcaligenes(3.0%) and Streptococcus pneumoniae(2.9%) were the next. Methicilline-Resistance Staphylococcus aureus was 34 cases(57.6%) of Staphylococcus aureus. Staphylococcus aureus was sensitive to Vancomycin(96.7%), Trimethoprim-Sulfamethoxazole (57.6%), Cefuroxime(42.4%) and Ciprofloxacin(40.7%) but resistant to Penicillin(94.9%). Pseudomonas aeruginosa was sentitive Amikacin(100%), Ciprofloxacin(100%) and Gentamicin(67%). Conclusion : As MRSA recently was wide spread in community accquired infection as well as nosocomial infection, we must consider strict control of MRSA.

에틸 아크릴레이트 아이오노머의 성질에 미치는 양이온 크기의 영향

조규성,나연화,김희석,김준섭,박기주 조선대학교 생산기술연구소 1999 生産技術硏究 Vol.21 No.1

The effects of the size of cations on the properties of polyfethyl acrylate-co-metal acrylate) ionomers containing 3.8 mol% of ionic moiety were investigated. It was found that with changing cations, matrix T_(g)s seem to remain constant; however, cluster T_(g)s increase with decreasing the size of cations. Since ion-hopping occurs at a cluster T_(g) and the electrostatic force of ion pairs decreases with the size of ions increasing, it was suggested that the effect of the size of cation on a cluster T_(g) is operative, but not on a matrix T_(g). It was also found that activation energies for a cluster T_(g) were decreased with decreasing the size of cations; which means that the activation energy values for a cluster T_(g) are not directly related to the cluster T_(g)s. In the present study, the highest value of a cluster T_(g) for the Li ionomer may be one of the reasons why the Li ionomer has the lowest value for an activation energy.

용혈성 빈혈과 흑수열을 동반한 Chloroquine저항성 수입 열대열 말라리아 1예

조희충,국기용,박일,최연수,이승일 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.1

저자들은 최근 아프리카를 여행하는 도중 말라리아의 예방약제인 chloroquine을 복용하였음에도 불구하고 용혈성 빈혈과 흑수열을 동반한 chloroquine 저항성 수입 열대열 말라리아를 Fansidar를 투여하여 치료가 된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. This previously healthy 26 year-old student was admitted to Cho Sun university hospital due to paroxysmal high fever, dizziness of 2 weeks duration and he also noted passage of dark brownish colored urine of 3 days duration. He had made journey to Africa for 2 months before admission. He had taken chloroquine 1 week before his jurney and continued this weekly throughout his stay. On admission, there was fever of 38.5℃ and numerous parasitemia of ring form of P. falciparum in the peripheral blood smear. On physical examination, he had jaundice and splenomgaly. On laboratory examination, he had jaundice and splenomegaly. On laboratory examination hemoglobin was 5.Og / dl, reticulocytecount was 11%, plasma hemoglobin was 7.5mg /dl and urine hemoglobin was 2.5mg /dl. He received Fansidar on 2nd day of admission. Five days later, his blood was completely clear of parasite and 7th day after admission, all symptoms were almost improved and then he was discharged.

포타슘 술포네이트 폴리스타이렌 아이오노머의 기계적인 성질에 미치는 Crown ether의 영향

나연화,조규성,이법원,김준섭,유지강,박기주 조선대학교 생산기술연구소 1999 生産技術硏究 Vol.21 No.1

The effects of crown ether on the dynamic mechanical properties of potassium sulfonated polystyrene ionomer were investigated. As expected, it was found that when crown ether molecules were added to the ionomer, the crown ether molecules interacted with K^(+) cations and weakened the ionic interaction between K^(+)/sulfonate ion pairs of the ionomer significantly. Thus, no multiplets were present, and, in turn, no clustering was found. When the ether was added to interact with 50% of K^(+) cations, weak clustering was observed: the clustering was slightly stronger than that of a 50% neutralized ionomer. From this result, it was speculated that in the 50% neutralized sample H^(+) ⇔ K^(+) cation exchange occurs rapidly between -SO₃H and -S0₃K groups in multiplets. which weakens ionic interactions. In the 50% crown ether-added sample, however, -S0₃- group, instead of -S0₃H, is present, and thus no cation exchange is expected to occur.

원적산 봉수대 주변정비 기본계획

이상진,김기수,강영조,조승래,홍순연 東亞大學校 建設技術硏究所 2006 硏究論文集 Vol.29 No.2

문화재란 문화가치가 있는 사물로서 국가 가 종교적·세속적 근거에 따라 특별히 지정 한 재산이다. 문화재는 그것이 구현하는 정신적 가치와 시각적 음향적으로 표현하는 수단으로서 그 나라의 독특하고, 다양한 주체성을 보존하는 중요한 매체이기도 하다. 그러므로 문화재는 한나라의 민족역사와 문화로서 과거의 모습을 통해 현재 그리고 나아가 미래를 연결시키는 하나의 매개체인 것이다. 또한 문화재는 그 지역민에게 향토사적 인 자긍심 및 연대의식을 고취시키는 동시에 나아가 한 나라, 세계적인 관심사로 여겨 야 할 것이다. 원적산 봉수대는 양산군청 소재지에서 북쪽으로 약 9.2㎞, 통도사입구 마을인 신평에서 남쪽으로 8㎞지점에 있다. 이 봉수대는 경상남도 기념물 제 118호로써 원적산봉수대 보존회에 의해 복원된 문화재이다. 즉 다른 지역의 문화재와 달리 잊혀 져가는 문화재의 재생을 통해 다시 태어난 문화재인 것이다. 원적산 봉수대 주변정비 기본계획의 목적 은 지역민의 자긍심으로 복원된 봉수대와 주 변과 접근로를 체계적으로 정비를 함으로써 접근성, 전통성, 보존성을 높이고자 한다. 특히, 문화재보호를 위한 제반 법규 및 현지여건에 부합하는 정비방향을 설정하고, 전문 인력과 관련문헌을 바탕으로 문화재 주변을 역사성과 주민친화성, 기능성, 관광성을 함께 갖춘 문화공간으로서의 미래지향적 문화재정비 계획을 추구하고자 한다.

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

고도비만 환자에서 복강경 위소매절제술 후 발생한 누공의 내시경 치료 1예

류민선,심기남,조원영,김찬용,강현주,김미연,안소영,이윤표,조형원,정성애,이주호 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.2

Laparoscopic sleeve gastrectomy can reduce morbidity and mortality in patients with morbid obesity, but it can cause complications such as a gastrointestinal leak. A 30-year-old morbidly obese female who had type 2 diabetes mellitus and hypertension with estimated body mass index of 40.2 kg/m2 was admitted. Laparoscopic sleeve gastrectomy was performed. On postoperative day 19, a leak was suspicious on physical examination and radiologic findings. Conservative management was performed, but the patient was hemodynamically unstable and imminently septic. After laparoscopic drainage procedure, esophagogastroduodenoscopy was performed and revealed the fistula opening at staple line just below gastroesophageal junction. Fibrin tissue adhesive was injected around the fistula and the esophageal covered stent was inserted to cover the leak. At 14th days after stent insertion, the barium study confirmed no more leak. In this case, we experienced that the esophageal stent insertion with fibrin tissue adhesive injection may reduce recovery time of the fistula developed after laparoscopic sleeve gastrectomy