재발성 류마티즘 환자에서 발작의 유발인자

주유철,이동민,양종태,신병철,임태영,서정균,정기영,최동헌,김원,조영신,고희관 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Palindromic rheumatism (PR) is known to be triggered without any obviously inciting events in most patients, although, in a few cases, attacks have been noted to relate to another events such as weather change, childbirth, ingestion of certain foods, or over-exercise. The aim of this study was to characterize the triggering factors on palindromic attacks. Materials and Methods : We evaluated sixty-four patients with PR for the presence of triggering factors and the relationship between attacks and triggering factors by interview of patients. We considered that there was an probable association between episodes and PR, if episodes within 24 hours prior to PR had triggered at least 50% of all attacks and a definite association between episodes and PR, if episodes within 24 hours prior to PR had triggered 100% of all attacks. Results : In 15 patients (35.9%), there was a possible association between episodes of PR and initiating events. In 8 patients (12.5%), there was a definite association between episodes of PR and initiating events. The triggering factors were physical over-activity including exercise (19/64: 29.7%), foods, such as rawfish, crab, and chicken, including alcohol (19/96: 19.8%). However, there were no difference between the groups with and without the triggering factor in sex ratio, duration and onset of PR, the positive rate of rheumatoid factor and involved sites. Conclusion : Our observations showed that PR was triggered by physical over-activity more than in previous reports and hypersensitivity to foods was a causative factor in some patients with PR. However, patients with triggering factors had a similiar clinical profile to patients without triggering factors.

유약 흰쥐에서 장 허혈이 장 조직에 미치는 영향 및 Interleukin-10의 효과

박영실,김동철,전정식 대한소아과학회 2004 小兒科 Vol.47 No.3

만성 정신분열병 환자에서 지연성 운동장애와 음성증상 및 인지기능 장애와의 연관성

심주철,반철식,성기수,이정구,정도운,정청,윤진상,김영훈 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: 정신과 전문병원에 입원해 있는 만성정신분열병 환자들을 대상으로 첫째 지연성 운동장애의 유병율과 위험인자들을 조사하고, 둘째 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성을 조사하고자 한다. 방법: 연구대상자는 마산동서병원에 입원 중인 환자 중 DSM-IV의 정신분열별 진단기준에 부합하며, 최근 3개월 이상 동일 용량의 항정신병약물 복용한 271명(남자 174명, 여자 97명)의 환자들이었다. 지연성 운동장애에 대한 평가는 Abnormal Involuntary Movement Scale(AIMS)을 이용하였고, DSM-IV와 Sc-hooler와 Kane(1982)의 진단기준 양자에 부합하는 환자들만을 지연성 운동장애군으로 분류하였다, 정신 분열병 정신병리에 대한 평가는 Brief Psychiatric Rating Scale(BPRS)와 Schedule for the Deficit Syndrome(SDS)을 이용하였고, 인지기능에 대한 평가는 Mini-Mental Status Examination(MMSE)을 이용하였다. 결과: 지연성 운동장애의 유병율은 50.9%이었고, 50세 이상, 남자에서 높았다. 그러나 입원기간과 항정신병 약물의 일일 사용량에 따른 차이는 없었다. 지연성 운동장애의 호발부위는 혀, 상지, 입술과 입 주위의 순이었다. BPRS 총점 및 소항목 척도점수와 SDS 척도점수는 지연성 운동장애의 유무에 따른 차이가 없었다. MMSE 총점 및 소항목 점수도 지연성 운동장애의 유무에 따른 차이가 없었다. 결론: 평균입원기간이 9년 이상인 만성정신분열병 환자들에게서의 지연성 운동장애의 유병율은 50.5%이었고, 연령이 가장 의미있는 위험인자임을 확인했다. 만성정신분열병 환자들이 주 대상인 본 연구에서는 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성은 입증하지 못했다. Objectives: The purpose of present study was to determine the prevalence rate of tardive dyskinesia and to search for its risk factors in chronically institutionalized schizophrenic subjects. We also examined the relationship between tardive dyskinesia and both negative symptoms and cognitive impairments in the same subjects. Methods: Subjects were 271 in-patients(174 males, 97 females) at Masan Dongsuh Hospital. They met DSM-IV criteria for schizophrenia and had been taking fixed doses of antipsychotics for at least 3 months. Tardive dyskinesia was assessed by Abnormal Involuntary Movement Scale(AIMS). Cases of tardive dyskinesia were ascertained by the criteria of Schooler and Kane (1982) and DSM-IV. The rating of psychopathology was acquired using Brief Psychiatric Rating Scale(BPRS) and Schedule for the Deficit Syndrome(SDS) and the assessment of cognitive function using Mini-Mental State Examination(MMSE). Results: The prevalence of tardive dyskinesia is 50.9% and the frequency of tardive dyskinesia was high est in male above the age of fifty. But there was no statistically significant relationship between the frequency of tardive dyskinesia and both the length of hospitalization and the daily dose of antipsychotics. The frequency order of abnormal movement in the patients with tardive dyskinesia was as follows : tongue, upper extremities, lips and perioral area. We couldn't find any significant difference in the total and subscale scores of BPRS between the groups with and without tardive dyskinesia. There were no differences in MMSE scores between the groups with and without tardive dyskinesia. Conclusion: This study gave us that the prevalence of tardive dyskinesia was high in chronically institutionalized schizophrenic inpatients and that age was the most significant risk factor of tardive dyskinesia. The relationship between tardive dyskinesia and both negative symptoms and cognitive impairment, however, was not revealed.

정신분열병 환자들의 自己灣入에 관한 예비 연구

박성봉,김영미,전성일,이기철,김영훈,정영조,이영렬,이정호,최영민 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

목 적 : 정 신분열병 환자의 자기만입 정도에 영향을 미치는 인구학적 변인들 및 질병연관 변인들을 규명해 보고자 하였다. 또한. 환자들의 자기만입과 병식 사이의 연관성. 자기만입과 자존심 사이의 연관성을 알아보고자 하였다. 방 법 : 정신과 의사가 병록지와 면담을 통하여 대상 정신분열병 환자들의 인구학적 변인들 및 질병연관 변인들에 관한 자료를 얻고 환자들의 병식 정도를 평가한 후, 환자들로 하여금 자기보고형의 자기만입 척도와 자존심 척도를 시행하게 하였다. 총 111명의 환자가 연구대상으로 선택되었다. 결과: . 1) 여자가 남자보다 유의하게 높은 자기만입 척도 점수를 나타내었다 2) 질병연관 변인들 중 하위집단 사이에 자기만입 척도 점수의 유의한 차이를 보이는 변은 없었다. 3) 자기만입 척도 점수와 병식 점수 사이에 유의한 상관관계가 없었다. 4) 자기만입 척도 점수와 자존심 척도 점수 사이에 유의한 역상관 관계를 보였다. 결 론 : 본 예비 연구의 결과로 보아 정신분열 병 환자의 병식이 부족한 상태에서도 자기만입이 진행될 수 있으며. 자기만입이 심할수록 환자의 자존심이 저하되는 것으로 생각된다. 또한 여자 환자들이 남자 환자들보다 자기만입에 더 취약한 것으로 생각된다. 따라서 정신분열 병 환자의 이해와 치료를 위하여 자기만입에 관한 지속적인 연구가 필요할 것으로 생각된다. objective : This study was conducted to identify demographic variables and illness related variables which may affect the severity of self-engulfment in the patients with schizophrenia. We also studied the relationship between self-engulfment and insight, and the relationship between self-engulfment and self-esteem. Methods : Data on demographic variables and illness related variables for the subjects were gathered from hospital records and clinical interviews by the psychiatrists. Degree of insight for the subjects was assessed through clinical interviews by the psychiatrists. Degree of self-engulfment and self-esteem for the subjects was assessed from the self-engulfment scale and the self-esteem scale respectively. A total of 111 patients with schizophrenia were selected for statistical analysis. Results 1) The females exhibited significantly higher scores than the males on the self-engulfment scale. 2) There was no illness related variable, which exhibited a significant difference among subgroups on the self-engulfment scale. 3) There was no significant correlation between the self-engulfment scores and the insight 4) There was a significantly inverse correlation between the self-engulfment scores and the self-esteem scores. Conclusion : The results of this preliminary study suggest that self-engulfment may develop despite lack of insight and that there was inverse relationship between self-engulfment and self-esteem in the patients with schizophrenia. It also suggests that females are more subject to self-engulfment than males. So, authors suggest that it is valuable to do further studies of self-engulfment in the patients with schizophrenia.

Biomass 유래 퓨란계 단량체를 이용한 폴리에스터의 중합 및 특성 연구

정용석(Yong Seong Chung),이영철(Young Chul Lee),서강진(Kang Jin Seo),김명준(Myeong Jun Kim),정지혜(Ji Hea Jeong),노시태(Si Tae Noh) 한국고분자학회 2011 폴리머 Vol.35 No.6

바이오매스에서 유래된 2,5-dihydroxymethylfuran(DHMF)을 KMnO4 산화반응으로 furan-2,5- dicarboxylic acid(FDCA)를 합성하였다. 합성한 FDCA와 다이올류를 에스테르화 반응과 축중합 반응을 진행시 켜 폴리에스터를 중합하였다. 폴리에스터는 NMR을 통해 조성을 분석하였고 DSC와 TGA를 통해 열적특성을 분 석하였다. 합성된 폴리에스터의 고유점도는 0.78∼1.2 dL/g으로 상용화된 poly(ethylene terephthalate)(PET) 와 비슷하였다. 다이올의 길이가 증가할수록 Young`s modulus와 strength는 낮아지고 elongation-to-break는 높아지는 경향을 확인하였다. 합성한 poly(ethylene furandicarboxylate)(PEF)의 Young`s modulus는 3551 MPa, strength는 103 MPa로 상용화된 PET와 비슷하였다. Furan-2,5-dicarboxylic acid (FDCA) was synthesized by KMnO4 oxidation of 2,5-dihydroxymethylfuran( DHMF) derived from biomass. Polyesters were synthesized by esterification and polycondensation of FDCA with various diols(ethane-1,2-diol, propane-1,3-diol, butane-1,4-diol, hexane- 1,6-diol, decane-1,10-diol). The composition of polyesters was characterized by using 1H NMR. Thermal properties of the polyesters were characterized by DSC and TGA. Intrinsic viscosities(IV) of the polyesters were measured to be 0.78∼1.2 dL/g comparable with IV of commercial poly(ethylene terephthalate)(PET). As the chain lengths of diols increased, Young`s modulus and strength decreased and elongation-to-break generally increased. Young`s modulus and strength of the polyesters were measured to be 3551 MPa and 103 MPa, respectively, comparable with commercial PET.

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.

Enterococcus faecium 19-46-4에 의한 Cholic Acid의 생산

정은영,김명수,이철훈,김병홍 한국산업미생물학회 1996 한국미생물·생명공학회지 Vol.24 No.5

항균활성을 갖는 혐기성 미생물에 대한 탐색연구에서 항균활성이 강한 Enterococcus faecium 19-46-4를 선발하여 혐기적 배양으로 이 균주가 생산하는 항생물질의 분리, 정제 및 이화학적 특성 및 구조분석을 행하였다. 40ℓ 균배양액으로부터 iso-butanol extraction, C-18 liguid column chromatography, HPLC등을 통해 약 100mg의 항균물질을 분리정제하여 KIST 194로 명명하였고, KIST 194를 UV, IR, ^1H-NMR, ^13C-NMR, EI-MS와 LC-MS 등의 기기분석을 한 결과 cholic acid (3α, 7α, 12α-trihydroxy-5β-cholan 24-oic acid)로 동정하였다. A facultative anaerobe Enterococcus faecium 19-46-4 was used to study the production of an antimicrobial substance in anaerobic conditions. Major part of the antibiotic activity was found in the culture filtrate of the bacterium. The active compound was extracted by an equal volume of iso-butanol and concentrated in vacuo (at 50℃) before purification by C-18 liguid column chromatography and HPLC. A chromatographically pure compound was obtained by two passages of HPLC columns, The compound appeared as a pale-yellow powder. The yield was about 2.5 mg l^-1 culture filtrate. The compound was named as KIST 194. KIST 194 were identified as cholic acid (3α, 7α, 12α-trihydroxy-5β-cholan 24-oic acid) based on its physico-chemical properties determined by UV, IR, ^1H-NMR, ^13C-NMR, EI-MS and LC-MS.

정신분열병의 인지치료

정영철 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

지금까지의 정신증상 특히 망상과 환청에 대한 정신치료적 입장은 긍정도 부정도 아닌 중립적 태도로 충분히 환자의 이야기를 들어주는 지지적 형태의 소극적 치료였다고 볼 수 있다. 그러나 인지치료는 직면이 아닌 범위내에서 논리적이고 경험적 방법을 이용하여 적극적으로 증상의 공략을 추천하는 치료법인 것이다. 이와같은 점에서 인지치료는 정신증상을 직접적으로 다루는 새로운 치료도구라는 의미가 있다. 또한 그 이론과 치료기법이 명료하고 손쉬워서 누구나 조금만 관심을 가지면 시행할 수 있는 강점도 가지고 있다. 그러므로 국내의 많은 정신과 의사들이 정신분열증의 인지치료에 대해 긍정적인 관심을 가짐으로서 이에 대한 임상적 적용 및 연구활동이 활성화 되기를 기대해 본다. There are two kinds of cognitive dysfunction in schizophrenia : one is a cognitive deficit and the other is a cognitive distortion. Cognitive therapy addresses these two issues. First, cognitive deficit means the poor function of attention, information-processing and recalling which may be present as a primary or secondary symptoms. So, the correction of cognitive deficit is important in terms of the rehabilitation of schizophrenic patients and the prevention of illness itself in cognitive-vu1nerable candidates. The treatment programs of cognitive deficit are as follows : attention skills training, letter recognition training, retraction-time task and Wisconsin Card Sorting Test. Secondly, cognitive distortion means the irrational thinking processes which occur to those who have a maladaptive schema. As a result of this, lots of psychiatric symptoms including delusions and hallucinations can be explained depending upon what types of schema and irrational thinking have involved. Specific therapeutic techniques are as follows socratic questioning, peripheral questioning, agreement to differ, tactic withdrawal, alternative explanation, empirical testing and collaborative empiricism. Sound and good therapeutic relationships are essential to the success of cognitive therapy like the other therapeutic approaches. And if we practice cognitive therapy with a systematic manner and impatience, it will be an another valuable therapeutic tool for the management of psychotic symptoms.

섬유소 분해효소 생성 미생물의 분리 및 특성

鄭永哲,姜仁秀,金希淑 진주여자전문대학 1991 論文集 Vol.14 No.-

Of 7 cellulolytic isolates which produced both cellulase complex and xylanase at 40℃ or 42℃ under the neutral pH range, LBC505 and CYC10 strains were a potent cellulase producer isolated from soil, and found to be similar to Pseudomonas sp. Cellulolytic thermophilic F204 and F1020, were also isolated from soil and identified as Bacillus sp. from its taxonomical characteristics, except for its ability to grow at high temperature and pH. Pseudomonas sp. and thermophilic alkalophilic Bacillus sp. produced CMCase, avicelase and β-1, 4-glucosidase as well as xylanase in culture filtrate. The optimal temperature and pH for cell growth and cellulase production of Pseudomonas sp LBC505 and CYC10 were 42℃, pH 6.8-7.0, respectively, and Bacillus sp. F204 and F1020 were 50℃, pH 10.0. The maximal cellulase complex and xylanase acitivities were obtained by cultivating Pseudomonas sp in improved medium, FCY medium, containing 2% CMC, 0.5% yeast extract, 0.3% polypeptone, 0.2% (NH₄)₂SO₄, 0.5% NaCl, 0.2% K₂PO₄, 0.05% MgSO₄·7H₂O, 0.04% CaCl₂, 0.02% FeSO₄·7H₂O, 0.001% MnSO₄·7H₂O, at 40-42℃ for 48hrs. Cellulase complex and xylanase production of Bacillus sp. in an improved medium(FTA) containing the best compound investigated were higher 1.4-2.3 times than that in initial medium(PY-CMC) and its enzyme activity was maximal when grown at 50℃ for 36hrs.

파킨슨씨병 환자에 있어서 자가부신수질 이식술

정상섭,박상근,오성훈,김선호,윤도흠,박정수,양우익,최인준,안영수,김경환,박창일,김진수,이현철 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.6

Recent experimental studies and clinical cases have suggested that grafting tissue from the adrenal medulla into the brain may alleviate the symptoms of Parkinson's disease. Autologous adrenal medullary grafts into the striatum was performed stereotactically in two patients with Parkinson's disease. Both patients were bedridden preoperatively, but 4 months after the surgery both became ambulatory and one was even capable of returning to his job. Even though the number of cases was small⑵ and the follow-up period was short, this study shows that adrenal medullary transplantation into the striatum may have some beneficial effects in patient with Parkinson's disease. Further experimental and clinical trials are necessary to see whether this procedure will be a recommendable surgical treatment for patients suffering from Parkinson's disease.