난치성 만성정신분열증 환자의 생활의 질에 미치는 정신사회치료 프로그램의 효과에 대한 예비연구

송동호,배민진,이종호,이홍식,김선경,서호석,김찬형,전지용 大韓神經精神醫學會 1995 신경정신의학 Vol.34 No.4

Objects : Recent studies of psychosocial adjustment after hospitalization have found that the combination of maintenance antipsychotic drug treatment and psychosocial treatment including psychoeducational program are highly predictive of social rehabilitation and reduction of subsequent relapse. Two groups of patients with refractory chronic schizophrenia were preliminarily compared to determine the effect of a psychosocial treatment program on the quality of life in refractory chronic schizophrenics in an open comparative trial. Methods : One group(N=11) was assigned to approximately six months of the psychosocial treatment program(including psychoeducation program and activity program such as interpersonal relationship program, social skill training, self management program, outings, etc), in a group format, twice a week and a fixed maintenance dosage of clozapine ; while scale(QLS) was used to provide an objective measure of changes in patient's psychosocial functioning and a general assessment of psychopathology was made using the Brief Psychiatric Rating Scale(BPRS). Results : Both BPRS total positive score and the QLS total score, especially in the intrapsychic foundation factor of the scale showed a statistically significant improvement in the psychosocial treatment group. But there was no significant change in both BPRS and QLS scores over a 6-month period in the non-psychosocial treatment group. A significant negative correlation was found between the negative symptom and changes of QLS total, instrumental role and common object and activities scores respectively after receiving a 6-month of the psychosocial treatment program. Conclusion : These results suggest that a psychosocial treatment program including the integration of psychoeducation and a skill training oriented activity program serve as an outpatient treatment modality to improve the quality of the life in refractory chronic schizophrenia. To further clarify the effect of psychosocial treatment in chronic schizophrenia, a randomized trial should be done.

Assessment of Aortic Annulus Dimensions for Patients with Hypertrophic Cardiomyopathy in Pre-TAVI Planning CT

송민철(Min-Cheol Song),김태은(Tae-Eun Kim),채희창(Hee-Chang Chae),서충범(Choong-Beom Seo),서은희(Eun-Hee Seo),대창민(Chang-Min Dae) 대한CT영상기술학회 2023 대한CT영상기술학회지 Vol.25 No.2

본 연구는 비후성 심근증 환자의 심장 주기에 따른 대동맥판륜의 형태학적 크기 변화를 측정하여 TAVI planning 3차원 영상처리시 대동맥판륜의 크기 측정 오류와 합병증을 최소화하고자 연구를 진행하였다. 2021년 4월부터 2022년 6월까지 본원을 내원하여 심전도 동조화 기법 TAVI planning CT 검사를 진행한 환자 중 심실중격 두께가 정상인 환자를 대조군 41명(78.92 ± 12.6세, 남성 44%), 비후성 심근증 환자를 실험군 31명(74.92 ± 10.8세, 남성 61%)으로 설정하였다. 심장 주기의 10% 간격으로 영상재구성하여 대동맥판륜의 면적, 둘레, 유효 직경, 면적 기반 직경, 둘레 기반 직경을 측정하여 비교 분석 하였다. 분석 결과, 심장 주기 동안 대동맥판륜의 면적, 둘레, 유효 직경, 면적 기반 직경, 둘레 기반 직경의 상대적인 변화는 각각 27.3%, 10.4%, 11.9% 12.6% 11.1%로 유의한 크기 변화를 나타냈다.(P<0.001) 대조군은 전체 심장 주기 중 수축기에서 대동맥판륜 각 측정인자의 최대값이 나타났으며, 실험군은 전체 심장 주기에서 측정 인자의 최대값이 불규칙적으로 나타났다. 또한 두 그룹 간 심장 주기 동안 대동맥판륜 측정 인자의 최대값 빈도 분포 분석 결과는 유의한 차이를 나타냈다.(P<0.05) TAVI 3차원 영상처리에 있어 비후성 심근증 환자의 경우 전체 심장 주기를 확인하여 대동맥판륜 크기가 가장 큰 심장 주기에서 측정하는 것이 정확한 크기의 인공판막 선택과 추후 합병증을 최소화하는데 큰 기여를 할 것으로 사료된다. The purpose of this study was to minimize the undersizing of aortic annulus size and reduce complications by analysis the size change of aortic annulus during the cardiac cycle in patients with hypertrophic cardiomyopathy. Patients were prospectively underwent an ECG-gated TAVI Planning CT. Retrospective study was conducted 41 normal group (78.92 ± 12.6 years; 44% males) and 31 hypertrophic cardiomyopathy group (74.92 ± 10.8 years; 61% males). The annulus plane was identified on reconstructions at 10% intervals of the cardiac cycle. Based on semi-automatically defined Aortic annulus, area, perimeter, effective diameter, area-derived diameter, perimeter-derived diameter were measured. The area, perimeter, effective diameter, area-derived diameter and perimeterderived diameter were significantly changes during the cardiac cycle with a relative change of 27.3%, 10.4%, 11.9%, 12.6% and 11.1% respectively. (all p < 0.001) During the cardiac cycles of groups normal and Hypertrophic myopathy, aortic annulus showed different dynamic changes. Different group showed a significant difference in the maximum values distribution plot. (p < 0.05) In patients with hypertrophic cardiomyopathy, reconstructing the entire cardiac cycle and selecting the largest annulus to TAVI planning is considered to contribute greatly to the accurate selection of the size of prosthesis in the procedure and minimizing TAVI complications.

소아 IgA 신병증의 장기 추적(평균 10.8년)에 따른 임상 경과 및 병리학적 변화

문창민,김병길,임범진,송지선,정현주,Moon, Chang-Min,Kim, Pyung-Kil,Lim, Beom-Jin,Song, Ji-Sun,Jeong, Hyeon-Joo 대한소아신장학회 2010 Childhood kidney diseases Vol.14 No.2

목 적 : 소아 IgA 신병증의 임상 양상 및 병리학적 분류(Haas 분류)와 임상 경과와의 상관 관계를 조사하여 이들이 예후를 반영할 수 있는지 알아보고자 하였다. 방 법 : 병리학적으로 IgA 신병증으로 진단받고 추적 중이던 환자들 중 추적 신생검을 시행한 20명의 환자를 대상으로 후향적으로 자료를 분석하였다. 결 과 : 최초 신생검시 평균 9.5세였고 남자 16명, 여자 4명이었으며, 최종 조직 검사까지 평균 10.8년이 경과하였다. 안지오텐신 전환효소 억제제 등으로 치료를 지속한 후 정상뇨 소견, 정상 혈압, 정상 크레아티닌 청소율(CCr)을 보이는 임상적 관해 상태의 환자는 10명(50%)이었으며, 비관해 상태의 환자 10명(50%)도 초기와 비교하여 호전된 경과를 보였고, CCr이 중등도 이상 저하되거나 말기 신질환 양상을 보이는 환자는 없었다. 최초 Haas 분류는 임상경과와 상관 관계가 없었다. 초기 고혈압은 5명(25%)에서 보였고 이는 임상 경과(P =0.010) 및 최종 Haas 분류(P =0.007)와 유의성이 있었다. 초기 CCr의 중등도 저하는 Haas 분류와 유의성이 있었으나(P =0.048), 임상 경과와는 상관관계가 없었다. 결 론 : 소아 IgA 신병증의 추적 기간 중 임상 경과는 양호하나 최초 Haas 분류로 임상 경과를 예측할 수는 없었으나 적극적인 조기 진단 및 치료로 말기 신질환으로의 진행을 지연시킬 수 있을 것으로 보인다. 초기 고혈압은 임상 경과 및 최종 Haas 분류와 유의한 상관관계를 보여 적합한 예후인자로 보인다. 최초 병리학적 소견은 임상 경과를 반영하지 못하나, 추적 Haas 분류가 예후를 반영할 수 있을지에 대해서는 보다 많은 추적 관찰 및 추적 신생검을 통한 연구가 있어야 할 것으로 보인다. Purpose : We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. Methods : From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. Results : Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P =0.01) and last Haas classification (P =0.007). None of the cases showed progression to CRF or ESRD. Conclusion : During a mean follow-up of $10.8{\pm}3.4$ years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

Effects of Ovarian Cycle on Hemodynamic Responses during Dynamic Exercise in Sedentary Women

Hyun-Min Choi,Charles L. Stebbins,Hosung Nho,Mi-Song Kim,Myoung-Jei Chang,Jong-Kyung Kim 대한생리학회-대한약리학회 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.6

This study tested the hypothesis that effects of the menstrual cycle on resting blood pressure carry over to dynamic exercise. Eleven healthy females were studied during the early (EP; low estrogen, low progesterone) and late follicular (LP; high estrogen, low progesterone) menstrual phases. Stroke volume (SV), heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), and total vascular conductance (TVC) were assessed at rest and in response to mild and moderate cycling exercise during EP and LP. During EP, compared to LP, baseline SBP (111±1 vs. 103±2 mmHg), DBP (71±2 vs. 65±2 mmHg) and mean arterial pressure (MAP) (84±2 vs. 78±1 mmHg) were higher and TVC (47.0±1.5 vs. 54.9±4.2 ml/min/mmHg) was lower (p<0.05). During exercise, absolute values of SBP (Mild: 142±4 vs. 127±5 mmHg; Moderate: 157±4 vs. 144±5 mmHg) and MAP (Mild: 100±3 vs. 91±3 mmHg; Moderate: 110±3 vs. 101±3 mmHg) were also higher, while TVC was lower (Mild: 90.9±5.1 vs. 105.4±5.2 ml/min/mmHg; Moderate: 105.4±5.3 vs. 123.9±8.1 ml/ min/mmHg) during EP (p<0.05). However, exercise-induced increases in SBP, MAP and TVC at both work intensities were similar between the two menstrual phases, even though norepinephrine concentrations were higher during LP. Results indicate that blood pressure during dynamic exercise fluctuates during the menstrual cycle. It is higher during EP than LP and appears to be due to additive effects of simultaneous increases in baseline blood pressure and reductions in baseline TVC.

Soymilk를 이용한 요구르트 제조 및 저장기간 동안의 품질변화에 관한 연구

신상민 ( Sang Min Shin ),송광영 ( Kwang Young Song ),서건호 ( Kun Ho Seo ),윤여창 ( Yoh Chang Yoon ) 한국유가공기술과학회 2012 한국유가공기술과학회지 Vol.30 No.2

This study was performed for analyzing the general composition and the change in the quality of soymilk-derived yogurts manufactured by adding skim milk and whey powder to soymilk heat-treated at 95℃/5 min and 120℃/10 min, respectively. 1. During the storage of soymilk yogurt, the concentrations of total solids, protein, fat, and lactose slightly decreased, whereas viscosity, content of ash and NPN, and the number of lactic acid bacteria remained unchanged. 2. The pH and titratable acidity changed rapidly in all soymilk yogurts after 3 h of incubation. 3. We found 7.8×108 lactic acid bacteria in the control sample, 4.7×108 and 5.02×108 in soymilk yogurt with skim milk, respectively, and 5.9×108 and 5.5×108, respectively in soymilk yogurt with whey powder according to degree of heat treatment with 95℃/5 min and 120℃/10 min. 4. The viscosity of yogurt samples became lower as the heat treatment increased in temperature and in the length of time. 5. The value of sensory evaluation was relatively high in soymilk yogurt with the added skim milk, which was heat-treated 95℃/5 min; however, the value was significantly lower than that of the control sample. 6. Lactose, glucose, and galactose were detected in all samples because lactose is degraded into glucose and galactose within 3 h of inoculation.

한국인 담석증에 대한 임상적 고찰

김광하(Gwang Ha Kim),옥창민(Chang Min Ok),김병진(Byung Jin Kim),주형준(Hyung Jun Joo),송철수(Chul Soo Song),송근암(Guen Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

N/A Background/Aitns: It has been reported frequently that clinical features of gallstone diseases in Koreans were different from those of Occidentals. These differences were thought to be due to inherent racial difference and acquired living habits. The purpose of this study is to evaluate whether the pattern of gallstone disease changes or not in Korea. Methods: We analyzed 5,488 cases of gallstone diseases which were reported in Korea frorn 1966 to 1994. We divided the period into 6 groups: the first period was 1,000 cases reported from 1966 to 1970, the second was 331 cases from 1971 to 1975, the third was 1,000 cases from 1976 to 1980, the fourth was 1,957 cases from 1981 to 1985, the fifth was 1,000 cases from 1986 to 1990, and the sixth was 200 cases from 1991 to 1993. Results: The age group of highest incidence was the fifth and sixth decade. The incidence below the third decade showed a decreasing tendency. In contrast, the incidence above sixth decade showed an increasing tendency. The male to female ratio was 1:1.25 to 1:1.71 and had no periological change. The duration of illness of highest frequency was below 6 months. In the case of duration above 5 years these was a decreasing tendency. The major complaints of biliary stone were right upper quadrant pain and tenderness. Nausea, vomiting, jaundice, and radiating pain showed a decreasing tendency. The major laboratory findings were leukocytosis, elevated SGOT and SGPT, elevated alkaline phosphatase, hyperbilirubinemia and hypoalbuminemia. Of these, only hypoalbuminernia had a decreasing tendency. By the second period, the main diagnostic procedures were oral cholecystogram and intravenous cholecysto- graphy. From the fourth period, ultrasonography, ERCP, CT and PTC were been used comrnonly. For the location of gallstone, the gallbladder stone revealed the only increasing tendency, the common bile duct stone had a decreasing tendency, and the intrahepatic duct stone had no periological change. From 1980, the cholesterol stone became the main composition of gallstones. But, there was no periological change between early and late 1980s. Positive bacterial culture rate was 57.0% and the most common microorganism was E. coli. Klebsiella and Enterobacter. Pseudomonas showed an increasing tendency. Of the diseases associated with gallstone, only diabetes had an increasing tendency. The frequency of residual stone had an increasing tendency. Conclusions: The age of peak incidence of gallstone diseases was the fifth and sixth decades and there was a little predominance in females. From 1980, the cholesterol stone becarne the main composition of gallstones. For the location of gallstone, the gallbladder stone showed an increasing tendency and the common bile duct stone revealed a decreasing tendency. These suggested clinical features of gallstone diseases in Koreans are somewhat similar to those of Occidentals. (Korean J Gastroenterol 1997;29:352 - 361)

Bioconversion of ginsenoside Rc into Rd by a novel α-L-arabinofuranosidase, Abf22-3 from Leuconostoc sp. 22-3: cloning, expression, and enzyme characterization.

Liu, Qing-Mei,Jung, Hae-Min,Cui, Chang-Hao,Sung, Bong-Hyun,Kim, Jin-Kwang,Kim, Song-Gun,Lee, Sung-Taik,Kim, Sun-Chang,Im, Wan-Taek N.V. Swets en Zeitlinger 2013 Antonie van Leeuwenhoek Vol.103 No.4

<P>A novel α-L-arabinofuranosidase (Abf22-3) that could biotransform ginsenoside Rc into Rd was obtained from the ginsenoside converting Leuconostoc sp. strain 22-3, isolated from the Korean fermented food kimchi. The gene, termed abf22-3, consisting of 1,527 bp and encoding a protein with a predicted molecular mass of 58,486 Da was cloned into the pMAL-c2x (TEV) vector. A BLAST search using the Abf22-3's amino acid sequence revealed significant homology to that of family 51 glycoside hydrolases. The over-expressed recombinant Abf22-3 in Escherichia coli BL21 (DE3) catalyzed the hydrolysis of the arabinofuranoside moiety attached to the C-20 position of ginsenoside Rc under optimal conditions of pH 6.0 and 30 C. This result indicated that Abf22-3 selectively converts ginsenoside Rc into Rd, but did not catalyze the hydrolysis of glucopyranosyl groups from Rc or other ginsenosides such as Rb1 and Rb2. Over-expressed recombinant enzymes were purified by two steps with amylose-affinity and DEAE-cellulose chromatography and then characterized. The kinetic parameters for α-L-arabinofuranosidase showed apparent Km and Vmax values of 0.95 0.02 μM and 1.2 0.1 μmol min(-1) mg of protein(-1) against p-nitrophenyl-α-L-arabinofuranoside, respectively. Using a purified MBP-Abf22-3 (10 μg/ml), 0.1 % of ginsenoside Rc was completely converted to ginsenoside Rd within 20 min.</P>

호도약침액(胡桃藥鍼液)이 독성물질(毒性物質)에 의한 간조직(肝組織) 손상(損傷)에 미치는 영향(影響)

이경태 ( Kyung Tae Lee ),김철홍 ( Cheol Hong Kim ),윤현민 ( Hyoun Min Youn ),장경전 ( Kyung Jaen Jang ),안창범 ( Chang Behm Ahn ),송춘호 ( Choon Ho Song ) 대한경락경혈학회 2005 Korean Journal of Acupuncture Vol.22 No.1

Objectives: This study was carried out to determine whether Juglandis Semen herbal acupuncture (JSA) exerts the protective effect against toxic agent-induced liver cell damage. Methods: The cell damage was estimated by measuring lactate dehydrogenase (LDH) release, and lipid peroxidation was estimated by measuring malondialdehyde (MDA), a product of lipid peroxidation, in rabbit liver slices. Results: When tissues were incubated with 0.5 mM Hg for 10~120 min, LDH release and lipid peroxidation were increased as a function of incubation time, and these effects were significantly prevented by addition of 0.1 % JSA. Hg increased LDH release and lipid peroxidation in dose-dependent manner over the range of 0.1~1 mM concentrations, which were reduced by 0.1 % JSA. When tissues were treated with 0.5 mM Hg in the presence of 0.05~1 % JSA, LDH release and lipid peroxidation induced by Hg were prevented by JSA in a dose-dependent fashion. JSA at 0.5 and 1 % prevented completely effects of 0.5 mM Hg. When tissues were treated with 0.5 mM Hg for 60 min, LDH release and lipid peroxidation were increased, which were significantly prevented by addition of 0.1 % JSA. tert-Butyl hydroperoxide (tBHP) increased LDH release and lipid peroxidation, which were significantly reduced by 0.1 % JSA. Such protective effects were similar to those of N,N`-diphenylp-phenylenediamine (DPPD), a potent antioxidant. When tissues were treated with 0.5 mM Hg, activities of catalase and glutathione peroxidase were inhibited, and glutathione content was also reduced. Such effects were prevented by JSA, but not by DPPD. JSA prevented Hg-induced morphological changes. Conclusions: These results indicate that JSA exerts the protective effect against liver cell injury induced by toxic agents through antioxidant action, and this effect may be attributed to an increase in activities of endogeous anitoxidant enzymes and GSH content. However, antioxidant effect of JSA is different from that of a well-known potent antioxidant DPPD.

상백피봉약침요법(桑白皮蜂藥鍼療法)을 포함한 한방치료(韓方治療)로 증상(症狀)은 소실(消失)되었으나 CT추적관찰상(追跡觀察上) 변화(變化)가 없는 요추(腰椎) 추간판(椎間板) 탈출증(脫出症) 1예(例)

이병훈,김철홍,서정철,윤현민,송춘호,안창범,장경전,Lee, Byung-Hoon,Kim, Cheol-Hong,Seo, Jung-Chul,Youn, Hyoun-Min,Song, Choon-Ho,Ahn, Chang-Beohm,Jang, Kyung-Jeon 대한약침학회 2001 Journal of pharmacopuncture Vol.4 No.2

By process of treatment for a case which diagnosed as HNP of left posterolateral aspect of L4/5 disc and treated from the 10th, May 2001 to the 23rd, Jun 2001, the results are as follows. Method & Results : This patient was medicated Hwallaktang-gami, taken acupuncture, phototherapy, TENS, electric acupuncture, exercises, Mori Cortex-bee venom acupuncture. As a result, the patient's clinical symptom were improved but a computed tomagraphy confirmed L4/5 and L5/S1 HNP was not changed as seen on repeated CT scanning. Conclusion : These results suggest that among conservative therapies the oriental medical treatments including Mori Cortex-bee venom acupuncture improve clinical symptom effectively. But in this case, the structure of herniated disc was not changed.