신생 쥐 저산소-허혈성 뇌장애에 있어서의 Nimodipine의 치료효과

홍인희,김행미 경북대학교 의학연구소 1999 경북대학교병원의학연구소논문집 Vol.3 No.1

Purpose : Recent studies suggest that nimodipine, a potent calcium-channel blocker, may improve neurological outcome after experimental hypoxia-ischemic brain injury. This study was conducted to evaluate the therapeutic effect of nimodipine on hypoxia-ischemia in immature rat brain. Methods : Seven-day postnatal rats were subjected to hypoxia-ischemia by unilateral common carotid artery occlusion combined with 2 hours of hypoxia(in 8% oxygen at an ambient tempera-ture of 36℃). Then 20 rats received an intraventricular injection of nimodipine while the remaining 23 rats were injected with saline. Histologic examinations and morphometric analyses of brain tissue specimens were carried out 2 weeks after the hypoxia-ischemia. Resu1ts : Histopathological analysis of each rat showed that the brains of the nimodipine-treated animals were less damaged when compared with control rats treated with saline. Fifty percent of nimodipine treated rats but only 13% of saline-treated rats revealed normal histologic findings(p<0.05). Gliosis &/or nerve cell necrosis were observed, over three brain lobes in 15% of nimodi-pine-treated rats and 57% of saline-treated rats respectively(p<0.05). At the level of dorsal hippocampus, saline-treated rats revealed 0.18±0.17mm smaller ipsilateral cerebral hemispheres than contralateral hemispheres to artery disections but nimodipine-treated rats showed only 0.07±0.14mm smaller hemispheres(p<0.05). The difference between contralateral and ipsilateral cerebral cortex was 0.4±0.36mm in saline-treated rats and 0.11±0.14mm in nimo-dipine-treated rats(.p<0.05). The contraction of cerebral hemisphere and cortex were significantly reduced in nimodipine-treated rats. Conclusion : The finding indicates that post-insult nimodipine treatment in the immature rat decreases the extent of hypoxic-ischemic brain damage. (J Korean Pediatr Soc 1999;42:1552-1558)

소아 특발성 신증후군에서의 Cyclosporine A ( Cypol ) 의 장기 치료 효과

홍인희(Ihn Hee Hong),고철우(Cheol Woo Ko),구자훈(Ja Hoon Koo),조병수(Byoung Soo Cho),김지홍(Ji Hong Kim),육진원(Jin Won Yook),김병길(Pyung Kil Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.2

목적 : 본 연구는 소아 특발성 신증후군에게 cyclosporine A(Cypol® , 종근당)를 장기 투여하여 이의 효과와 부작용을 관찰하고자 시행하였다. 방법 : 대상 환아는 특발성 신증후군 환아로서 스테로이드 의존성 또는 빈발 재발형(SD/FRNS) 46명과 스테로이드 저항형(SR) 5명으로 하였으며 이들에게 cyclosporine A를 1일 체중당 4-5mg을 경구 투여하고 스테로이드 제제(prednisolone 혹은 같은 역가의 deflazacort)는 격일요법으로 감량 투여하였다. 12개월의 조사 기간 중 매 2-4주 간격으로 외래 방문시 이들 환아에 대한 문진, 이학적 검사 및 각종 검사를 시행하였다. 결과 : 46명의 SD/FR NS 환아 중 28예(60.9%)에서 12개월간 관해가 지속되었고 16례(34.8%)에서는 1-2회의 재발이 있었으며 2예(4.3%)에서는 효과가 없었다. 혈청 단백, 알부민, 콜레스테롤 및 24시간 요 단백은 치료 개시 후 4주째부터 정상 수치를 보였고 BUN, creatinine 및 24시간 요를 이용한 사구체 여과율은 12개월간 변동 사항이 없었다. 5명의 SR NS 환아 중 4예에서 완전 또는 부분 관해가 유도되고 지속되었으며 1예에서는 반응이 없었다. Cyclosporine A에 대한 부작용은 다모증이 14예, 고요산혈증이 8례,저마그네슘혈증이 16예에서 관찰되었으나 이로 인해 투약을 중지할 필요가 없었으며 기타 CBC, 간기능 검사, 혈압 등은 12개월간 정상 소견을 보였다. Cyclosporine A 투여 12개월 때에 시행한 17예의 신장조직 검사소견상 8예(47.1%)에서 경도의 Cyclosporine A 신독성소견을 보였다. 결론 : 스테로이드 의존형, 빈발 재발형 및 스테로이드 저항형의 특발성 신증후군 환아에게 Cyclosporine A 는 유용하게 사용할 수 있을 약제로 생각되나 장기간 사용으로 초래되는 조직검사상의 신독성이 문제점으로 부각된다. 그러므로 다음 과제에서 신독성을 최소화하기 위하여 Cyclosporine A의 용량을 더 줄이고 또한 더 장기간 (2년 이상) 사용하여 얻을 수 있는 효과 및 약제의 안전성 여부를 확인하여야 할 것으로 생각한다. This multicenter collaboratory study was conducted to find out the long-term therapeutic efficacy and side effect of cyclosporine A(Cypol®, Chong Kun Dang) on children with idiopathic nephrotic syndrome who experienced frequently relapsing(FR), steroid dependent(SD), or steroid resistant(SR) pattern. Forty-six children with SD/FR NS and 5 children with SR NS were enrolled in this study. After induction of remission(SD/FR NS) with steroid or after 4 weeks of steroid therapy(SR NS), cyclosporine A was started in a dose of 4-5mg/kg/day in two divided dose and steroid(prednisolone or equivalent dose of deflazacort) was tapered slowly. During 12 months of study period, monthly check up of physical exam- ination and various laboratory tests including BUN, creatinine, Ccr and cyclosporine blood level were done. Out of 4i children with SD/FR NS, 28(60.9%) maintained sustained remission, 16(34.8%) showed 1 or 2 relapses during therapy and 2(4.3%) cases showed no response. At 4 weeks after therapy, values of serum protein, albumin, cholesterol, and 24 hours urinary protein excretion showed normal values. Four out of 5 children with SR NS showed complete or partial remission with cyclosporine A therapy and one child showed no response. Side reaction to cyclosporine A therapy showed hypertricosis in 14 cases, hyperuricemia in 8 cases and hypomagnesemia in 16 cases. However, other laboratory tests including CBC, liver profile, BUN, creatinine and GFR(creatinine clearance utilizing 24 hour urine) did not show any abnormalities during the 12 months of study period. We performed follow-up renal biopsy in 17 children after 12 months cyclosporine A treatment. Eight cases(47.1%) showed mild cyclosporine A nephrotoxicity like interstitial fibrosis and tubular atropy. In conclusion, present study shows that cyclo- sporine A(Cypol®, Chong Kun Dang) can be used quitely effectively in maintaining remission and de- creasing relapse rate on children with SD/FR or SR NS. However, because administration of cyclosporine A for 12 months is found to be associated with nephrotoxicity in a significant number of patients, we are planning further study using smaller dosage of cyclosporine A to reduce its nephrotoxic effect and for longer period of treatment(over 2 years).

비 확공성 골수강내 금속정을 이용한 대티골 간부 골절의 치료

이홍주,경희수,인주철,김풍택,오창욱,김신윤 대한골절학회 2000 대한골절학회지 Vol.13 No.4

Purpose: To evaluate the usefulness of unreamed nailing inthe treatment of femoral shaft fractures. Materials & Methods: Between March 1996 and June 1998, unreamed nailing with closed method was done for 74 patients with 82 femoral shaft fractures. The main indications for this treatment were multiple injury or isolated femoral fracture above Winquist type II. The influence of Winquist-Hansen classification, anatomical location, and open injury over bone union and the influence of injury severity score over general complication including fat embolism were investigated. Results: Primary union occurred in 76 cases(93%) with 6 cases of nonunion and 10(12%) of delayed union, and mean time to union was 27 weeks. In open fractures, the union time was delayed(32 weeks) rather than closed fracture. In Winquist classification, there was no stastical importance on time to union, but nonunion was most common in Winquist type IV. Anatomical location has no influence on time to union. In the view point of multiple injury, the group above 18 points(31 patients) in injury severity score had none of fat embolism, but the group below 18 points(43 patients) had 2 patients. Conclusion: The treatment of femoral shaft fractures by unreamed nailing had longer time to union with higher rate of delayed union, and we think that the theoretical ad vantage of decreasing pulmonary complications is controversial.

수용개작방법을 활용한 당뇨인의 발관리 실무지침 개발

정인숙 ( Ihn Sook Jeong ),박경희 ( Kyung Hee Park ),송복례 ( Bok Rye Song ),심강희 ( Kang Hee Sim ),한은진 ( Eun Jin Han ),홍은영 ( Eun Young Hong ),정영선 ( Young Sun Jung ),이선희 ( Seon Heui Lee ),박동아 ( Dong Ah Park ),정재심 병원간호사회 2015 임상간호연구 Vol.21 No.2

This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.

폐쇄성 기도 질환자에서 기관지 확장제 반응에 대한 평가

최희진 ( Hee Jin Choi ),김기범 ( Ki Bum Kim ),조영복 ( Young Bock Cho ),조인호 ( Ihn Ho Cho ),정진홍 ( Jin Hong Chung ),이관호 ( Kwan Ho Lee ),이현우 ( Hyun Woo Lee ) 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.3

성별과 연령층에 따른 병,의원의 의류 제품 소비 경험 -환자복 및 의료보조용품 개선 방안 도출을 위해

정인희 ( Ihn Hee Chung ),이윤정 ( Yun Jung Lee ),유효선 ( Hyo Seon Ryu ),최혜선 ( Hei Sun Choi ),정혜원 ( Hae Won Chung ),홍경희 ( Kyung Hi Hong ),박명자 ( Myung Ja Park ) 韓國衣類學會 2010 한국의류학회지 Vol.34 No.1

Review of the Current Status of Intra-Arterial Thrombolysis for Treating Acute Cerebral Infarction: a Retrospective Analysis of the Data from Multiple Centers in Korea

Lee, Deok Hee,Na, Dong Gyu,Ihn, Yon Kwon,Kim, Dong Joon,Kim, Eung Yeop,Kim, Yong Sun,Lim, Soo Mee,Roh, Hong Gee,Sohn, Chul-Ho The Korean Radiological Society 2007 KOREAN JOURNAL OF RADIOLOGY Vol.8 No.2

<P><B>Objective</B></P><P>The purpose of the study was to review the current status of intra-arterial (IA) thrombolysis in Korea by conducting a retrospective analysis of the data from multiple domestic centers.</P><P><B>Materials and Methods</B></P><P>The radiologists at each participating institution were asked to fill out case report forms on all patients who had undergone IA recanalization due to acute anterior circulation ischemia. These forms included clinical, imaging and procedure-related information. A central reader analyzed the CT/MR and angiographic results. The rates of successful recanalization, hemorrhagic transformation and functional outcome were obtained. The univariate analyses were performed together with the multivariate analysis.</P><P><B>Results</B></P><P>We analyzed the data from 163 patients, and they had been treated at seven institutes. The initial imaging modalities were CT for 46 patients (28%), MR for 63 (39%), and both for 54 (33%). Various mechanical treatment methods were applied together in 50% of the patients. Radiologically significant hemorrhage was noted in 20/155 patients (13%). We found various factors that influenced the recanalization rate and the occurrence of significant hemorrhagic transformations. The favorable outcome rate, reported as modified Rankin Scale ≤ 2, was 40%, and the mortality rate was 11%. The factors that predicted a poor functional outcome were old age (<I>p</I> = 0.01), initially severe neurological symptoms (<I>p</I> < 0.0001), MR findings of a wide distribution of lesions (<I>p</I> = 0.001), involvement of the basal ganglia (<I>p</I> = 0.01), performance of procedures after working hours (<I>p</I> = 0.01), failure of recanalization (<I>p</I> = 0.003), contrast extravasation after the procedure (<I>p</I> = 0.007) and significant hemorrhagic transformation (<I>p</I> = 0.002). The subsequent multivariate analysis failed to show any statistically significant variable.</P><P><B>Conclusion</B></P><P>There was a trend toward increased dependency on MR imaging during the initial evaluation and increased usage of combined pharmacologic/mechanical thrombolysis. The imaging and clinical outcome results of this study were comparable to those of the previous major thrombolytic trials.</P>

알쯔하이머병의 행동적 정신병리 평가척도 한국어판 (BEHAVE-AD-K)의 신뢰도 및 증상군별 점수 분석

서국희(Guk-Hee Suh),손현균(Hyun Gyun Son),신형주(Hyongju Shin),김인명(In-Myoung Kim),홍상의(Sangeui Hong),박종한(Jonghan Park),최인근(Ihn-Geun Choi),김상국(Sang Kook Kim),연병길(Byeong Kil Yeon) 대한노인정신의학회 2001 노인정신의학 Vol.5 No.1

Objective:The aims of this study were to (1) validate the inter-rater reliability of the BEHAVE-AD, Korean version, to (2) analyze the quantitative relationship between severity of Alzheimer's disease (AD) and mean scores on each of the BEHAVE-AD categories and mean total BEHAVE-AD score. Design:Cross-sectional study of geriatric patients with AD evaluated at a mental hospital for the elderly. Sample:Fifty-two consecutive patients diagnosed with probable Alzheimer's disease (AD) according to NINCDS-ADRDA diagnostic criteria. Results:In reliability study, significant correlations were obtained for all BEHAVE-AD symptoms category scores and for mean total BEHAVE-AD scores. Analysis of BEHAVE-AD scores as a function of disease severity demonstrated a non-linear relationship between severity of behavioral symptoms and the global and cognitive advance of AD. Score analysis of the BEHAVE-AD indicates that these behavioral disturbances become most severe in the moderate and moderately severe stages of AD. Conclusion:All the results proved the cross-cultural validity and reliability of the BEHAVEAD, Korean version. Furthermore, these results have implications for the methodology of pharmacological trials of putative cognitive enhancer compounds in AD.

도파민 수용체 제 2 형 Exon 8 유전자 다형성과 알코올 의존의 임상 양상

이소희(So Hee Lee),이분희(Bun-Hee Lee),이준석(Jun-Seok Lee),채영규(Young Gyu Chai),최미란(Mi Ran Choi),한달무리(Dal Mu Ri Han),지 홍(Hong Ji),장경호(Gyeong-Ho Jang),신혜은(Hye Eun Shin),최인근(Ihn Geun Choi) 한국중독정신의학회 2013 중독정신의학 Vol.17 No.1

Objectives : Various single nucleotide polymorphisms (SNPs) of dopamine D2 receptor (DRD2) genes have been reported to be involved in the susceptibility to alcohol dependence. We investigated the association of exon 8 (E8) SNP in the DRD2 gene with alcohol dependence in Korean subjects and examined their associations with severities of depression, craving, and alcohol-withdrawal symptoms. Methods : The DRD2 E8 A/G polymorphisms were genotyped in a case-control sample consisting of 245 alcohol-dependent (AD) patients and 130 healthy controls (HC). Severities of de-pression, craving, and alcohol-withdrawal symptoms were examined with BDI, PACS, and CIWA-Ar in AD patients. Results : The genotype or allele frequencies of DRD2 E8 A/G had no significant differences between AD and HC groups (χ 2 = 2.659, p=0.265; χ 2 =2.694, p=0.107). AD with A/A genotype and A allele in E8 had significantly higher BDI scores (F=3.705, p=0.029; t=2.073, p=0.040), although there were no significant differences in PACS and CIWA-Ar scores among genotypes or alleles of E8 A/G. Conclusion : The present study suggests the possibility that DRD2 E8 polymorphisms have an impact on the AD phenotype, such as an increased depressiveness in Korean patients with alcohol dependence.

Role of NF-κB Binding Sites in the Regulation of Inducible Nitric Oxide Synthase by Tyrosine Kinase

Young Sue Ryu,Jang Hee Hong,Jong Ho Lim,So Hyun Bae,Ihn Sub Ahn,Jeong Ho Seok,Jae Heun Lee,Gang Min Hur 대한생리학회-대한약리학회 2001 The Korean Journal of Physiology & Pharmacology Vol.5 No.1

<P> In macrophages, lipopolysaccharide (LPS) alone or in combination with interferon-γ (IFN-γ) has been shown to release a nitric oxide (NO) through the increase of the transcription of the inducible nitric oxide synthase (iNOS) gene. To investigate the exact intracellular signaling pathway of the regulation of iNOS gene transcription by LPS plus IFN-γ, the effects of protein tyrosine kinase (PTK) inhibitor and protein kinase C (PKC) inhibitors on NO production, iNOS mRNA expression, nuclear factor-κB (NF-κB) binding activity and the promoter activity of iNOS gene containing two NF-κB sites have been examined in a mouse macrophage RAW 264.7 cells. LPS or IFN-γ stimulated NO production, and their effect was enhanced synergistically by mixture of LPS and IFN-γ. The PTK inhibitor such as tyrphostin reduced LPS plus IFN-γ-induced NO production, iNOS mRNA expression and NF-κB binding activity. In contrast, PKC inhibitors such as H-7, Ro-318220 and staurosporine did not show any effect on them. In addition, transfection of RAW 264.7 cells with iNOS promoter linked to a CAT reporter gene revealed that tyrphostin inhibited the iNOS promoter activity through the NF-κB binding site, whereas PKC inhibitors did not. Taken together, these suggest that PTK, but not PKC pathway, is involved in the regulation of the iNOS gene transcription through the NF-κB sites of iNOS promoter in RAW 264.7 macrophages by LPS plus IFN-γ.