경막외 Morphine, Morphine 과 Nalbuphine 병용투여, Morphine 과 Droperidol 병용투여가 제왕절개술 후 통증조절에 미치는 효과에 대한 비교

김혜자,이정은,김동일 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

Effect of Epidural Morphine, Morphine with Droperidol and Morphine with Nalbuphine after a Cesarean Section Tong0Il Kim, M.D., Hye-Ja Kim, M.D., and Jung-Un Lee, M.D. Department of Anesthesiology, College of Medicine, Chungnam National University, Daejon, Korea Background: A number of recent reoprts have described the usefullness of the epidural injection of narcotics for the relief of postoperative pain. Morphine, an ??-receptor agonist, produces strong analgesic effects with side effects. Nalbupine, a ??-antagonist and ??-agonis, has an analgesic effect comparable to morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine alone and a combination of nalbuphine and droperidol respectively to morphine were sutudied in cesarean section patients. Methods: We divided 45 patients into 3 groups utilizing a two-day Boxter infusor in normal saline 100 ml at 2.0 ml/hr: Group M (n = 15) initially a 1 mg bolus + 2 mg/day of maintenance morphine. Group M + D (n = 15): initially received a 1 mg bolus + 2 mg/day of maintenance morphine + 1.25 mg/day of maintenance droperidol. Group M + N (n = 15): initially received a 1mg morphine bolus + 2 mg/day of maintenance morphine + 5 mg/day of maintenance nalbupine. The Analgesic effect was evaluated by a visual analogue scale (0-10) at 30 min, 4 hr, 12hr and 24 hr postoperatively and the incidence of side effects was observed too. Results: The average VAS scores are below 3 in all groups. In addition, there are no significant changes between groups. There are no significant differences in side effects between groups except sedation of patients is significantly (P < 0.05) high in group M + D. Conclusion: We concluded that the analgesic effect of epidural morphine, morphine with nalbuphine and morphine with droperidol are good in all patients and there is no significant difference even though there is a belief that a combination of nalbuphine or droperidol increases analgesic effects of morphine. Comparing the incidence of side effects in the three groups, the sedative effect of morphine with droperidol is increased significantly over the other two groups.intubation. (Korean J Anesthesiol 2001; 41: 324~329)

이화방어기제검사 표준화연구

김재은,김정규,박영숙,이근후 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.3

This study aimed at an evaluation of the reliability and validity of Ewha Defense Mechanism Test(EDMT) for standardization during the period from June 25 to July 10 with nationalwide sample which was standardized by Rhee Kun Hoo. Kin Jae Un. Kim Jung Kyu. and Park Young Sook. The number of subjects were 1.323 who were sampled by the method of proportional stratification on age. sex. education. local area variables. This test is composed of 20 defense mechanism subscales and total items of the test are 200. The results were as follows : 1) The range of means of each scales were from 2.70 to 3.34 and the range of items standard deviation was from .71 to 1.28. 2) The corrected item-total correlation coefficients were than .10 for all items except two items which was the index of internal consistancy. 3) The spearman-Brown split-half reliability coefficients were more than .66 and the retest reliability coefficients were more than .72 for all scales. 4) By the evaluation of the cross validation with “16 Personality Factor Inventory”. it was found that 11 factors were consistent with expectation among 16 factors so that the result of cross validity was moderately sufficient. 5) By the factor analysis. four factors were extracted. Factor 1 was “unstable sensitization defense mechanisms”which were acting out, displacement, somatization. dissociation. projection. and passive-aggressive behavior. Factor 2 was “ego-expansive defense mechanisms” which were composed of controlling. distortion. altruism. humor. and sublimation. Factor 3 was “ego-denial defense mechanisms” which were reaction formation. bragging identification. and regressin. Factor 4 was “reality evasive defense mechanisms” which were denial rationalization. suppression. anticipation. and evasion.

질소산화물의 급성 노출로 인한 폐 손상 1례

김정호,김대환,손병철,이창희,김정원,문덕환,이채언,김주인 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Lung injuries due to exposure to nitrogen oxides can occur in various process in industry. We experienced a case of chemical pneumonitis induced by accidental inhalation of nitrogen oxides emitted from the bath in an acid dipping operation. Case : Dyspnea, cough and blood-tinged sputum production, cyanosis, and tachypnea occurred after exposure to oxides of nitrogen. There were bilateral diffuse ground glass opacities in simple chest radiography and high resolutional computed tomography, hypoxemia in arterial blood gas analysis, mixed ventilation defect and reduced diffusion capacity in spirometry. As an oxygen and supportive therapy, after hospitalization, was given, the patient recovered completely from the lung injury on the 8th day after admission. There was no evidence of delayed onset of bronchiolitis obliterance or pulmonary edema in a follow-up for about 6 months. Conclusions : Acid dip operation require more efficient hooding and exhausting system for the prevention of lung injuries caused by inhalation of nitrogen oxides. Also health education for worker need.

UN / CEFACT 전자문서의 XML 변환규칙

정용규(Yong-Gyu Jung),김운섭(Un-Seob Kim) 한국정보과학회 2002 한국정보과학회 학술발표논문집 Vol.29 No.1A

전자문서교환(EDI, Electronic)은 기업과 기업간에 컴퓨터와 컴퓨터의 통신을 통하여 필요한 거래문서를 구조화된 형식으로 교환하여 업무를 처리하는 방식을 말한다. 그동안 EDI 표준은 북미를 중심으로 한 ANSI X.12를 시작으로, 이에 대응되는 유럽중심의 UN/CEFACT 표준이 제정되었다. UN/CEFACT로 표준을 통합하기로 합의한 양대 표준은 또 다른 XML환경을 접하게 되었다. ISO TC154에서는 UN/CEFACT전자문서의 XML변환에 관한 논의하게 되었으나 표준으로 권고되지 못하고 있는 실정이다. 이런 표준간 연동의 문제를 위하여 본 논문에서는 Speaking Tag방식과 UN/CEFACT Tag방식의 두가지를 제안하며 각각에 대해 변환규칙을 제안한다.

Fluoxetine 투여와 관련된 양측 측두하악관절 손상 1예

배치운,김연주,김태석,김정진,이창욱,이수정,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

We hereupon present a case of injured temporomandibular joint (TMJ) associated with fluoxetine monotherapy-inducedrepeated yawning. Further information is needed regarding the relationship between fluoxetine administration and clinically significant yawning. Clinicians should be more careful to listen to their patients when they describe unexpected reactions to medications.

정신분열병과 Glutathione S-Transferase M1유전자 다형성

배치운,조자현,김연주,김태석,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study aimed to test the possible association between Glutathione S-Transferase Ml gene (GSTMl) variants and schizophrenia. Methods : One hundred and eleven inpatients with schizophrenia and 130 healthy controls were recruited. Genotyping was performed by polymerase chain reaction-based method. Results : The GSTMl null genotype was significantly more frequent in patients with schizophrenia than in controls (p=0.014, odd ratio=1.93, 95% confidence interva1=1.115-3.351), while GSTMl genotype vahants were not associated with either tardive dyskinesia (TD) or total Abnormal Involuntary Movement Scale (AIMS) scores. Conclusion : The present study suggests that the GSTMl polymorphism may confer susceptibility to the development of schizophrenia but not to TD, at least in Korean population.

항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구

김우진,심주철,공보금,강제욱,문정준,김정은,김민걸,박민경,김성진,김현정,정도운 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:This study was to identify weight & metabolic changes in first-episode psychotic patients with antipsychotics use and investigate the differences of weight & metabolic changes between first-episode psychotic patients and controls with antipsychotics use. Method:In this retrospective study, twenty eight first-episode psychotic patients and twenty eight controls with schizophrenia, schizoaffective or bipolar disorder defined by DSM-IV criteria were included. Information about demographic and clinical characteristics of the subjects was gathered from the medical records. Also body weight, sBP, dBP, fasting glucose, lipid profile and WBC count were evaluated before and after antipsychotics use. Rogistic regression was conducted to assess factors associated with weight gain. Results:First-episode psychotic patients showed more weight and BMI changes than controls after antipsychotics use, and these changes continue over 12 months. On the other hand, there were no significant factors associated with weight gain. Conclusion:The results of present study suggest that antispychotics is one of the major causes inducing weight gain of psychotic patients and antipsychotics-induced weight gain is more vulnerable to drug-naive first-episode psychotic patients.

정신분열병 환자에서 얼굴 영상의 작동기억 장애 : 기능자기공명영상연구

이창욱,김태석,주라형,박주미,박여진,김종진,전신수,배치운,김정진,이수정,이철,백인호 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : Impaired processing of facial information is one of the broad ranges of cognitive deficits seen in patients with Schi-zophrenia. We aimed to elucidate the differences in brain activities involved in the process of facial working memory between schizophrenic patients and healthy comparison subjects. Methods : Twelve patients with schizophrenia were recruited along with twelve demographically matched healthy volunteers as a comparison group. Functional magnetic resonance imaging (fMRI) was used to assess cortical activities during the Perfor-mance of a 2-back working memory paradigm using images of neutral faces as mnemonic content. Rcsults : The patient group performed the tasks with reduced accuracy. Group analysis revealed that the left fusiform gyrus, the right superior frontal gyrus, the bilateral middle frontal gyri/insula, the left middle temporal gyrus, the precuneus, the quadrangular lobules and the vermis of cerebellum showed decreased cortical activities in the patient group. On the other hand, an increased level of activation in the lateral prefrontal cortex and the pahetal lobule was observed from the patient group, all in the right hemisphere. Conulusion : A decreased level of activity in the left fusiform gyrus among the patient group implicates inefficient processing of facial information. An increased level of activation in prefrontal and parietal neural networks from the patient group confirms earlier findings on the impaired working memory of patients with schizophrenia.

그람양성구균에 대한 Teicoplanin과 Vancomycin의 시험관내 항균력

최태열,김경숙,전용관,서일혜,김정욱,이웅수,안정열,김홍석,정재용,최효선,김덕언,유진우 대한감염학회 1994 감염 Vol.26 No.1

An increasing frequency of methicillin resistant S. aureus(MRSA), methicillin resistant coagulase negative staphylococci(MRCNS) and Enterococcal infection have been observed in recent years. Teicoplanin is a new glycopeptide antibiotic obstained from the Actinoplanes teicomycetius. The molecular structure and spectrum of antimicrobial activity of teicoplanin is simillar to those of vancomycin, and has been reported to have an excellent in vitro and in vivo effect against various gram-positive infections. Therefore, we evaluated the in vitor susceptibility of gram positive cocci, such as, S. aureus, coagulase negative Staphylococci(CNS), and Enterococci to teicoplanin and vancomycin. The total 253 strains consisted of MSSA(40), MRSA(53), MSCNS(47), MRCNS(48), and Enterococci(65). They were assayed by disc diffusion and agar dilution. During the study, 57% of S. aureus and 49% of CNS showed resistance to methicillin. The inhibitory diameter of teicoplanin was 15-20mm in MSSA, 12-19mm in MRSA, 13-24mm in MSCNS, 11-23mm in MRCNS, and 15-22mm in Enterococci respectively, and showed sensitivity in all but 8 strains(3.2%). The range of the minimum inhibitory concentration (MIC) of teicoplanin to MSSA, MRSA, MSCNS, MRCNS and Enterococci were 9.12-2.0㎍/ml, 0.25-2.0㎍/ml, & 0.25-32㎍/ml, 0.12-1.0㎍/ml respectively. One case of S. haemolyticus was resistant to teicoplanin (32㎍/ml) by the agar dilution method. Eight minor (3.2%) and one major(0.4%) error was observed when the MIC and disk diffusion data were correlated with teicoplanin. As for vancomycin the inhibitory diameter was 17-21mm in MSSA, 15-21mm in MRSA, 18-26mm in MSCNS, 18-25mm in MRCNS, and 16-22mm in Enterococci respectively. The range of the MIC of vancomycin to MSSA, MRSA, MSCNS, MRCNS, and Enterococci were 0.25-1.0㎍/ml, 0.25-4.0㎍/ml, 0.5-2.0㎍/ml and 0.5-2.0㎍/ml respectively. One minor error (0.4%) was seen with the vancomycin disk. The MIC90 of MSSA and MRSA exhibited the same results in teicoplanin (1.0㎍/ml, 1.0㎍/ml), and vancomycin(2.0㎍/ml, 2.0㎍/ml). MSCNS and MRCNS exhibited greater MIC90 with teicoplanin(4.0㎍/ml, 8.0㎍/ml) than vancomycin(2.0㎍/ml, 2.0㎍/ml). Incontrase Enterococci were more susceptible to teicoplanin(0.5㎍/ml) than to vancomucin (2.0㎍/ml). Results from this analysis indicated that both teicoplanin and vancomycin were very excellent for gram positive infections, especially those resistant to methicillin.

cDNA array 방법을 이용한 망간에 노출된 흰쥐 뇌기저핵의 유전자발현 분석

이채관,노성민,문덕환,,김정호,손병철,김대환,이창희,김휘동,김정원,김종은,안진홍,이채언 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study investigated the gene expression profile in basal ganglia of manganese-exposed rats based on cDNA array analysis. Methods: For cDNA array, 25 male Sprague-Dawley rats (250±25 g) were intraperitoneally injected with 25 ㎎/㎏ B. W./day of MnCl2 (0.3 ㎖) for 10 days. For dose-related gene expression analysis, rats were intraperitoneally injected with 0.2, 1.0, and 5.0 ㎎/㎏ B. W/day of MnCl2 for 10 days. Control rats were injected with an equal volume of saline. RNA samples were extracted from brain tissue and reverse-transcribed in the presence of [α^(32)P]-dATP. Membrane sets of the Atlas Rat 1.2 array Ⅱ and Toxicology array 1.2 kit (Clontech, Palo Alto, CA) were hybridized with cDNA probe sets. Northern blot hybridization method was employed to assess the dose-related gene expression. Results: Fifty-two genes showed significant changes in expression of more than two-fold. Twenty-eight were up-regulated and 24 were down-regulated in the manganese-exposed group compared to the control. Among the 52 genes, 28 genes including nuclear factor I-X1 (NF1-X1), neuroligin 2 and 3, mitochondrial stress-70 protein (MTHSP70), neurodegeneration-associated protein 1 (Neurodap 1), multidrug resistance protein (MDR), and endoplasmic reticulum stress protein 72 (ERP72), were reported for the first time related to the manganese-induced neurotoxic-metabolism in the rat basal ganglia. According to the dose-related gene expression analyses, MTHSP70, Neurodap 1 and ERP72 genes were up-regulated compared to the control even in the group exposed to low manganese dose ( 0.2 ㎎/㎏ B.W./day). Conclusions: Twenty-eight genes detected for the first time in this study were closely related to the manganese-induced neurotoxic-metabolism in the rat basal ganglia and further study of these genes can give some more useful information about the manganese metabolism.