난치성 소아 간질에서 Felbamate의 치료 효과

김상정(Sang Jeong Kim),이준수(Joon Soo Lee),차병호(Byung Ho Cha),고창준(Chang Jun Coe) 대한소아신경학회 1995 대한소아신경학회지 Vol.2 No.2

연구 배경 : 지금까지 국내에서 사용되었던 다른 항경련제로 치료되지 않는 난치성 소아 간질에 있어서 felbamate(FBM)의 치료 효과를 알아보고자 본 연구를 시행하였다. 방 법 : 연세의대 세브란스병원 소아과에서 난치성 간질로 진단받은 환아 중 87명(남 55명, 여 32명)을 대상으로 그 동안 복용하던 항경련제는 그대로 복용하면서 FBM를 추가로 복용하게 하고, 그 효과를 1개월 간격으로 외래에서 추적 관찰하면서 발작의 빈도와 강도의 변화 및 부작용의 발현 여부 등을 조사하였다. 용량은 처음 15-30mg/kg/d을 3회 또는 4회로 나누어 투약하기 시작하여 증상에 따라 45mg/kg/d까지 증량하기도 하였으며, FBM 투여 후 발작이 악화된 환아들과 심한 부작용이 나타난 환아들은 투약을 중단하였다. 골수 억제, 간 독성, 신 독성 등의 부작용이 생기는지 알아보기 위하여 CBC(complete blood count) 및 혈액 화학 검사를 1개월 간격으로 시행하였다. 결 과 : 전체 대상 환아 중 felbamate 추가 투여 후 발작의 감소를 보인 환아는 43명(49.4%)이였고 그중 18명(20.7%)에서는 전혀 발작이 없었으며 10명(11.5%)에서는 50% 이상의 발작 감소를, 15명(17.2%)에서는 50% 미만의 발작 감소를 보였다. 발작의 유형에 따른 치료 결과는 50% 이상의 발작 감소를 기준으로 할 때 비분류 발작이 40%(6/15), Lennox-Gastaut 증후군이 36.7%(11/30), 부분성 간질이 33.3%(3/9), 전신성 간질이 24.2%(8/33)로 나타났다. Felbamate의 부작용은 6명(6.9%)에서 나타났으나 재생 불량성 빈혈은 나타나지 않았다. 결 론 : 소아 연령의 난치성 간질에 FBM를 추가 투여하여 비교적 좋은 효과를 관찰할 수 있었으며, 부작용의 발생은 매우 적었다. Background : We have done this study to observe the effect of felbamate(FBM) in patients with pediatric intractable epilepsy who are not respond to previously used antiepileptic drugs(AEDs) in Korea. Method : With 87 patients (55males and 32 females) at Yonsei University College of Medicine Severance Hospital who have poor treatment results with AEDs that are previously prescribed. FBM was added-on other AEDs. The change of seizure frequencies and intensities and the occurrence of adverse events were checked monthly at outpatient department. The FBM dosage was initiated at 15-30mg/kg/d and increased to 45mg/kg/d in some cases. FBM was stopped in patients who had experienced aggravation of symptoms or severe adverse reactions. We have done CBC and routine Chemistry monthly to monitor the occurrence of bone marrow suppression. hepatotoxicity. or nephrotoxicity. Result : Overall, 4. patients (49.4%) experienced reduction in seizure frequencies after FBM. Among them. 18 children (20.7%) had no seizure attack, 10 children (11.5%) experienced a 50% or greater reduction, and 15 children (19.2%) experienced a less then 50% reduction. The percentage of children who experienced 50% or greater reduction in seizure frequency were 40% (6/15) in unclassified seizure, 36.7% (11/30) in Lennox-Gastaut syndrome, 33.3% (3/9) in partial seizure, and 24.2% (8/33) in generalized seizure. Adverse events occurred in 6 children (6.9%), but no aplastic anemia. Conclusion : FBM add-on therapy is relatively effective in pediatric intractable epilepsy and adverse events were minor.

신생흰쥐 척수후근신경절 세포에서 전압의존성 $K^+$ 전류의 동정

김지목,정승준,김상정,김전,Kim, Ji-Mok,Jung, Sung-Jun,Kim, Sang-Jeong,Kim, Jun 대한약리학회 1997 The Korean Journal of Physiology & Pharmacology Vol.1 No.6

Dorsal root ganglion (DRG) is composed of neuronal cell bodies of primary afferents with diverse functions. Various types of ion channels present on DRG neurons may reflect those functions. In the present study, voltage-gated potassium currents in DRG neurons of neonatal rats were characterized by whole-cell voltage clamp method. Two types of delayed rectifier and three types of transient potassium currents were identified according to their electrophysiological properties. The delayed rectifier currents were named $I_{Ke}$ (early inactivating) and $I_{K1}$ (late inactivating). Steady state inactivation of $I_{Ke}$ began from -100 mV lasting until -20 mV. $I_{K1}$ could be distinguished from $I_{Ke}$ by its inactivation voltage range, from -70 mV to +10 mV. Three transient currents were named $I_{Af}$ (fast inactivation), $I_{Ai}$ (intermediate inactivation kinetics), and $I_{As}$ (slow inactivation). $I_{Af}$ showed fast inactivation with time constant of $10.6{\pm}2.0$ msec, $I_{Ai}$ of $36.9{\pm}13.9$ msec, and $I_{As}$ of $60.6{\pm}2.9$ msec at +30 mV, respectively. They also had distinct steady state inactivation range of each. Each cell expressed diverse combination of potassium currents. The cells most frequently observed were those which expressed both $I_{K1}$ and $I_{Af}$, and they had large diameters. The cells expressing $I_{Ke}$ and expressing $I_{Ke}$, $I_{Ai}$, and $I_{As}$ usually had small diameters. Judging from cell diameter, capsaicin sensitivity or action potential duration, candidates for nociceptor were the cells expressing $I_{Ke}$, expressing $I_{Ke}$ and $I_{Ai}$, and expressing $I_{Ke}$ and $I_{As}$. The types and distribution of potassium currents in neonatal rat DRG were similar to those of adult rat DRG (Gold et al, 1996b).

소아 백혈병 환자의 동종 조혈모세포이식 전처치로서 전신방사선 조사 포함군과 비포함군의 비교

김상정,한동균,백희조,김동연,남택근,황태주,국훈,Kim, Sang-Jeong,Han, Dong-Kyun,Baek, Hee-Jo,Kim, Dong-Yeon,Nam, Taek-Keun,Hwang, Tai-Ju,Kook, Hoon 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.4

목 적 : 본 연구의 목적은 소아백혈병 환자에서 이식 전처치로서 전신방사선조사(total body irradiation, TBI)군과 비방사선조사(non-TBI)군과의 이식 성적 및 예후를 비교하고자 하였다. 방 법: 1996년 1월에서 2007년 12월까지 전남대학교병원에서 조혈모세포이식을 시행 받은 소아백혈병 환자 77명을 TBI군(n=40)과 non-TBI군(n=37)으로 나누어 각 군 간의 이식 유형, 이식 시 질병상태, 전처치 방법, 이식 세포 수, 생착 속도, 이식편대숙주반응(graft-versus-host disease, GVHD)의 발생빈도, 이식 합병증, 사망원인, 전체생존율(overall survival, OS)과 무사건생존율(event free survival, EFS) 및 후기 합병증을 비교 분석하였다. 결 과 : 급성림프구성백혈병(acute lymphoblastic leukemia, ALL) 환자의 82.4% (28/34)는 TBI를 받았고, 골수계열 백혈병 환자의 72.7% (24/33)는 non-TBI 군이었다. 전체 환자를 대상으로 TBI 여부에 따른 5년 EFS은 두 군간 차이는 없었으나 (62% vs. 63%), ALL 환자에서는 TBI군이 non-TBI군에 비해 통계적으로 유의하게 우수한 5년 EFS을 보였다(65% vs. 17%; $P$=0.005). AML (acute myelogenous leukemia) 환자에서는 non-TBI군이 TBI군보다 더 높은 5년 EFS을 보였으나 통계적인 유의성은 없었다(73% vs. 38 %; $P$=0.089). GVHD 발생률, 생착, 사망원인과 후기 합병증은 두 군간 차이는 없었다. 결 론 : 전처치로서 TBI군과 non-TBI군은 비슷한 결과를 보였으나, ALL환자에서는 TBI군이 non-TBI군에 비하여 유의하게 우수한 5년 EFS을 보였다. 두 군간 후기 합병증의 발생 및 사회경제적 삶의 질을 비교하기 위하여는 많은 환자를 대상으로한 전향적 무작위 연구가 필요하리라 사료된다. Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; $P$=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; $P$=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.

심맥관계 활동과 관련있는 연수 척수로 세포에 작용하는 신경흥분전달물질에 대한 연구

서동만,김상정,임원일,김전,김종환,Seo, Dong-Man,Kim, Sang-Jeong,Lim, Won-il,Kim, Jun,Kim, Chong-Whan 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.5

본 연구는 동맥혈압의 조절에 결정적 역할을 하는 상부연수 복외측부에 존재하는 심맥관계 활동과 관련 있는 신경세포들에 대해 iontophoresis 법으로 투여한 신경흥분전달물질의 작용기전을 규명하고자 하였다. 이를 위해서 $\alpha$-chloralose로 마취한 고양이를 실험동물로 하여 연수의 복외측부에 multibarrel 전극을 삽입하여 심맥관계 활동과 관련 있는 신경세포의 활동을 세포외기록법으로 확인한 후 세포에 iontophoresis법으로 투여한 glutamate, GABA(\ulcorner-aminobutyric acid) 및 bicuculline의 효과를 관찰하여 다음과 같은 결과를 얻었다. 1) 자발적으로 활동전압을 보이지 않는 세포에서 glutamate를 10초 주기로 5초간 iontophoresis할 때 주기적인 세포활동을 기록할 수 있었고 이 활동은 동시에 가한 GABA에 의하여 억제되었다. 2) 자발적으로 활동하고 있는 세포들에 대하여 glutamate를 투여하였을 때 활동전압의 빈도가 증가하였고 GABA에 의해서 억제되었다. 3) GABA억제제인 bicuculline을 단독으로 투여시 활동전압 빈도의 증가는 뚜렷하지 않았으나 GABA와 동시 투여시에는 GABA의 억제작용을 차단하였다. 4) GABA의 작용은 RVLM(rostral ventrolateral medulla) 세포의 주기적 활동과 basal discharge 모두를 감소시켰으나 주기적 양상이 없어진 세포는 드물었다. 5) 말초에 가한 유해자극에 의하여 유발된 신경세포 활동이 GABA에 의하여 억제되었다. 이상의 결과로부터 $\alpha$-chloralose로 마취한 고양이에서 GABA는 RVLM에 존재하는 심맥관계 신경세포들에 대하여 억제적으로 작용하나 bicuculline의 투여후에도 이들 세포들의 주기적 활동이 유지되는 점으로 보아 RVLM세포의 자발적 흥분에 대하여 감압반사의 흥분이 기여하는 바가 크지는 않을 것으로 사료된다. The medullospinal tract cells are known to play an important role in the control of the cardiovascular activities. To clarify the modes of action of the neurotransmitters on these cells, glutamate, GABA(${\gamma}$-aminobutyric acid) and bicuculline were applicated iontophoretically into the rostral ventrolateral medulla in adult cats anesthetised with ${\alpha}$-chloralose. Followings are the results obtained : 1. The spontaneous activities of the cardiac-related neurons in rostral ventrolateral medulla (RVLM) were increased by the glutamate and decreased by the GABA. 2. Bicuculline, an antagonist of GABA, alone didn't increase the frequency of the action potentials, but could reverse the cellular response to the GABA, simultaneously applicated. 3. GABA seemed to decrease the peak as well as the basal discharge of the neurons in RVLM, but hardly changed their periodicities. 4. The cellular responses of RVLM evoked by the peripheral nerve stimulation could be inhibited by the iontophoretically released GABA. In conclusion, GABA seemed to act as an inhibitory neurotransmitter on the cardiac- related neurons in RVLM of the cats anesthetized with ${\alpha}$-chloralose. But the maintenance of the periodicities of these cells after the application of bicuculline suggested that the afferent activity of the baroreceptor didn't play a key role in the spontaneous activities of the RVLM neurons.

회전전극 이용한 협개선 원자로냉각재배관 자동용접

조재훈(Che-Hoon Cho),정두식(Du-Sik Jeong),김상정(Sang-Jeong Kim) 대한용접·접합학회 2018 대한용접학회 특별강연 및 학술발표대회 개요집 Vol.2018 No.11

식도 정맥류 출혈에 대한 내시경적 경화요법의 장기 관찰 결과

정정명(Jung Myung Chung),최하진(Ha Jin Choi),윤중근(Jung Kun Yoon),김병제(Byoung Jae Kim),박경태(Kyung Tae Park),김상정(Sang Jeong Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A Esophageal Varices Bleeding is one of the major causes of death among the patients with liver cirrhosis or portal hypertenison, and it represents,50% mortality each episode of bleeding. As the method for the treatment of Esophageal Varices Bleeding, supportive cares such as Balloon tamponade, infusion of vasopressin are usually practiced but the results of therapy have been found unsatisfactory. Although surgical therapy can also be expected to improve the one-year survival rate, its long-term survival rate is very low because of high incidence of morbidity. For the purpose of improving these therapeutic defects, Endoscopic Injection Sclerotherapy has been tried as a new method and its good effects have been reported recently. Endoscopic Injection Sclerotherapy is so effective on the emergency treatment of Esophageal Varices Bleeding. However, it gives rise to many debates on the improvement of long-term survival rate. To investigate long-term prognosis of Endoscopic Injection Sclerotherapy, we evaluated the survival rates and the therapeutic effects on 150 patients with Esophageal Varices Bleeding, who were treated by Endoscopic Injection Sclerotherapv and could be followed up by the Department of Internal Medicine, In-Je Medical College. The results are as follow;. 1) Rebleeding occurred in,53 cases(35.3%) among patients followed up over one month after the first Endoscopic Injection Sclerotherapy. The incidence of rebleeding was highest within 6 months, noted in 23 cases (15.3%) which were 43.3% of all rebleedings. 2) Major complications of Injection Sclerotherapy were 6 cases of aspiration pneumonia. 4 cases of esophageal ulcer, 3 cases of esophageal stenosis, and of mediastinitis.Among all 16 cases fatal complications were estimated in cases. 3)During the follow up-period, 66 cases (44.0%) were expired. 26 cases (17.3%), which were 39.4% of all mortality, of expired cases were within one month after Sclerotherapy. The causes of their deaths were of hepatic failure in 35 cases(23.3%), of hepatoma in 16 cases (10.7%). of uncontrolled bleeding in 13 cases (8.7%), and of complications in 2 cases (1.3%). 4) The one-year survival rate of the patient afteer Sclerotherapy was 70.0%, and the four-years survival rate 40.0% (8 cases of 20 cases were survived). The survival rate of those patients was concerned with Child's Classicfication and remarkeable reduction in survival rate was noted in Child's class C. As the preceeding results, it isconsidered to be obvious that Endoscopic Injection Sclerotherapy is a recommendable method for the treatment and Esophageal Varices Bleeding. However, still high frequency of rebleeding and Hospital mortality are considered as projects to be improved hereafter.

원폭 피폭자와 그 자녀들에 대한 임상적 및 염색체 이상에 관한 연구

김동수,백용균,박상길,정정명,최하진,김상정,최원락 대한내과학회 1986 대한내과학회지 Vol.31 No.4

Presented in this paper is the data from clinical labaratory examination of 50 Korean atomic-bomb survivors (in Hiroshima and Nagasaki, Japan in 1945). Of them, 15 survivors were karyotyped from their lymphocyte culture for both $quot;stable$quot; and $quot;unstable$quot; types of chromosomal aberrations. Eight of their offspring could be tested for the chromosomal changes and SCE as well. The results were as follows: 1) All survivors were found to have suffered from various diseases, particularly from respiratory disease. Two had malignancies, viz., one case having squamous cell carcinoma of uterine cervix and another adenocarcinoma of stomach. 2) Serum total protein and serum albumin levels were found to be decreased in 18% and 27% of the survivors, respectively. Alkaline phosphatase, SGOT, IgG and IgM were increased in 22%, 6.3%, 36.7% and 13.6% of the survivors, respectively. IgA was within normal limit in all cases. 3) Stable type of chromosomal aberrations was discovered in none of the survivors and the offspring examined. However, approximately 50% of the survivors showed significantly higher incidence of chromatid breakage than normal controls. 4) None of the offspring showed the chromatid breakage, but 75% of them showed significantly higher rate of SCE when compared to controls.

신혈관근지방종의 1례

김상정,이시억,박희상,김기현 인제대학교 1998 仁濟醫學 Vol.9 No.4

A 55 year-old male was admitted with complaints of gross hematuria arid right flank pain for 5 days. After laboratory and radiologic studies, we presumed renal cell carcinoma and performed embolization and nephrectomy. Histologic examination turned out to be an angiomyolipoma. So we report this case with review of literatures.

신생쥐 와우 변연세포에서의 항이뇨호르몬의 효과

이준호,김상정,김전,김기환,이준호 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.5