폐결핵으로 오인된 역형성 거대세포 림프종 1례

현동우,박재용,강태경,박기수,박태인,김창호,손상균,권건영,이규보,정태훈,권삼,Hyun, Dong-Woo,Park, Jae-Yong,Kang, Tae-Kyung,Park, Ki-Soo,Park, Tae-In,Kim, Chang-Ho,Sohn, Sang-Kyun,Kwon, Kun-Young,Lee, Kyu-Bo,Jung, Tae-Hoon,Kweon, Sam 대한결핵및호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.1

저자들은 발열, 체중감소 등의 증상과 흉부 X-선 사진상 폐경화의 소견이 있었던 환자에서 폐의 병변이 역형성 거대세포 림프종으로 추측되는 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Anaplastic large cell lymphoma(ALCL) is a recently recognized large cell lymphoma characterized by large pleomorphic cells, with prominent nucleoli, expressing the CD30(Ki-1) antigen. It is often misdiagnosed as metastatic carcinoma, malignant histiocytosis or Hodgkin's disease. Primary pulmonary ALCL is extremely rare although it frequently involves extranodal sites, e.g. skin, bone, gastrointestinal tract, soft tissue and lung. We report a case of ALCL suspected as primarily involving lung.

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.

넘어짐 방지를 위한 생체역학적 반응

태기식,신화경 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.3

Dynamic postural control varies with the environmental context, specific task and intentions of the subject. In this paper, dynamic postural responses against forward and backward perturbations were experimentally determined using motion analysis system, electromyography and accelerometers. Ten young healthy volunteers, stood on a flat platform, were translated in forward and backward directions by an AC servo-motor. Joint angles, ground reaction forces(GRFs), electromyography and acceleration patterns at the heel and the sacrum were measured. The results based on the given perturbation showed that the dynamic postural balance recovery against forward-backward perturbations is achieved in the process of the ankle, the knee and then the hip. Joint flexion is important in the balance recovery against the forward perturbation, but joint extension is important against the backward perturbation. These responses depends on the magnitude and timing of the perturbation. From the present study the accelerometry-system appears to be a promising tool for understanding kinematic accelerative in response to a transient platform perturbation.

사고에 의해 하악골 폭경이 붕괴된 환자에서 견인골 신장술

태기출,강경화 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.2

하악골 정중부 골절은 종종 폭경의 붕괴를 초래한다. 견인골 신장술을 이용한 폭경의 회복은 교합재건에 만족스런 결과를 유도한다. 편측성과 양측성 하악폭경이 붕괴된 환자에서 견인골 신장술을 적용할 때 벡터와 힘의 적용에서 차이를 조인다. 본 연구는 이러한 차이를 교정학적 관점에서 살펴보고자 한다. The symphyseal mandibular fractures due to accidents happened in form of collapsed transverse arch and multiple teeth loss. And the collapsed transverse arch in mandible occurs with unilaterally or bilaterally. So that patient needs to recover arch width. Conventional approaches, however, are difficult to get appropriate transverse arch correction. Distraction osteogenesis is a unique form of clinical tissue engineering and biologic process of new bone formation between bone segments that gradually separately by incremental traction. Distraction osteogenesis is considered that great potential for correcting transverse mandibular deficiencies. In this paper, distraction osteogenesis applied to patients who had a unilateral or bilateral collapsed arch width in mandible. But it was necessary secrutinize consideration about periodontal conditions, biomechanical vectors, TMJ adaptations, and neuromuscular change during distraction osteogenesis period.

견인골 신장술을 이용한 상악 분절골의 전후방 이동 치험례

태기출,강경화,민승기 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Distraction osteogenesis for correction of skeletal reationship was introduced for lengthening legs by Ilizarov. And it is important to keep the Ilizarov principles for distraction osteogenesis. Distraction osteogenesis in midface area was recommendation treatment to reduce the treatment time and the side effects during orthodontic treatment. The patient's age, method of bone cutting, distraction rhythm, position of distraction device and consoildation period were consideration factors during distraction osteogenesis in midface area. In this article,we present a cases that were treated by using anterior segmental DO.

다양한 하악 이부 확장 패턴에 관한 연구

태기출,강경화,김경환 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

하악 이부 확장은 해부학적으로 가동성인 하악골에서 시행하는 견인골 신장술의 한 형태로 곡면화된 표면과 하악과두, 좁은 치열궁 형태로 많은 제약을 받게 된다. 본 연구는 이러한 한계를 보완하기 위해 적응되는 다양한 형태의 이부 확장을 이해하기 위해 시도되었다. 골 절단선의 위치와 견인 장치의 인치를 다르게 하여, 각 6가지 군으로 구분한 후 이부 확장을 시행 하였다. 이부 확장은 견인기의 위치와 골 절단선의 형태에 따라 다르게 이루어지는 결과를 얻었다. Mandibular widening is one method of mandibular distraction osteogenesis, which has anatomic limitations such as curved surface, mandibular condyle and narrow arch. The purpose of this study was to understand the biomechanics of various mandibular widening procedures. Experimental models consisted of 6 groups according to different osteotomy lines and distractor positions. The results of this study showed different expansion patterns, which meant the need for proper approaches in mandibular widening.

견인골 신장술을 이용한 안모 비대칭 환자 치험례

태기출,강경화,이수행,유석근 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.5

견인골 신장술은 막내골화를 유도하는 조직 공학으로, 두개안면기형영역에서 치료는 지난 10년간 지속되었다. 본 연구는 하악지를 절단한 후 구강내 견인장치를 사용하여 안모 비대칭을 치료한 증례이다. 안모 비대칭 환자를 치료하는데 섬세하게 견인골 신장술을 이용하면 성장기와 성장이 끝난 환자에게서 효율적인 치료방법으로 생각된다. Distraction osteogenesis is a well estabilished procedure of membraneous hone formation and has been used to correct craniofacial deformities in dentofacial orthopedic surgery area for decades. In this article, distraction osteogenesis is used for treatment of facial asymmetry. The patient underwent procedures to lengthen the mandibular ramus and body. After distraction, orthodontic treatment was done for occlusal settling.

흰쥐에서 탄수화물 종류가 운동시 당 및 지질대사에 미치는 영향

권태동,전중기,민경선,김형렬,장응찬 대구대학교 기초과학연구소 1998 基礎科學硏究 Vol.15 No.2

The purpose of this study was to investigate the effects of glucose, sucrose, and glucose polymer(GP) ingestion on the carbohydrate and lipid metabolism during treadmill running in rats. Rats were randomly assigned to normal, control and carbohydrate groups. Carbohydrate group was divided into glucose, sucrose and GP ingested rats. The experiment was carried out after overnight fasting. Rats were administrated either normal saline(control) or carbohydrates solutions of formulated glucose(6%), sucrose(6%) and GP(6%) via polyethlene tube to stomach before treadmill run. Exercise was loaded by a treadmill run at the speed of 1 km/hour for 30, 60 and 120 minutes. The results of experiment were as follows: Plasma glucose levels were decreased in proportion to the exercise time in control, but increased at treadmill run 30 minutes and then gradually decreased with the lapse of the exercise time in carbohydrates compared with normal rats. It decreased in control, glucose, sucrose and GP compared with normal rats in decreasing order at treadmill run 120 minutes(% change of plasma glucose level of control, glucose, sucrose and GP compared with normal rats were 67, 74, 87 and 91 in plasma glucose level at treadmill run 120 min., respectively). Plasma lactate levels were increased by the exercise loading compared with normal in control and carbohydrates ingested rats. It increased in control, sucrose and GP in increasing order compared with normal rats, at treadmill run 120 minutes(% change of plasma lactate level of control, glucose, sucrose and GP compared with normal rats were 167, 185, 149 and 114 in plasma lactate level at treadmill run 120 min., respectively). Plasma FFA levels had tendency to increase by the exercise loading compared with normal in control and carbohydrates ingested rats. It showed increase in the sucrose, glucose, GP and control rats in Increasing order compared with normal rats at treadmill run 120 minutes(% change of plasma FFA level of control, glucose, sucrose and GP compared with normal rats were 151, 153, 166 and 152 in plasma FFA level at treadmill run 120 min., respectively). Plasma acetoacetate levels were higher in control compared with carbohydrates ingested rats at treadmill run 30, 60 and 120 minutes. Plasma beta-hydroxybutyrate levels increased by exercise compared with normal rats in control and carbohydrates ingested rats at treadmill run 30, 60, 120 minutes. Plasma insulin levels were decreased in proportion to the exercise time in control compared with normal rats, but in carbohydrates ingested rats increased at treadmill run 30 minutes and then gradually deceased with the lapse of the exercise time compared with normal. In carbohydrates ingested rats, plasma insulin levies were higher than control. Hematocrit did not show any difference between control and carbohydrates rats at treadmill run 30, 60 and 120 minutes. From these experimental results, it is suggested that the exhaustion of skeletal muscle glycogen, the hypoglycemia, the overproduction of lactate and dehydration is delayed in carbohydrates ingested rats. GP of the carbohydrates is considered as the most effective for these effects. Therefore, intake of carbohydrates before exercise, especially GP seems to increase performance in the prolonged moderate exercise.

골절단을 이용한 급속 치아이동 후 치수 및 치주조직 변화

강경화,김은철,이선경,임채웅,마쓰다 기꾸,태기출,김상철 대한치과교정학회 2004 대한치과교정학회지 Vol.34 No.2

본 연구는 골절단을 이용한 치아-치조골 분절의 급속 치아이동 후 치수, 치주인대 및 치조골의 변화를 유성견에서 평가하고자 하였다. 하악 제4소구치의 근심, 원심, 치근단 부위에서 피질골을 절단하여 치아-골 분절을 형성하고 하악 제3소구치를 발거하면서 협측, 설측 부위의 피질골을 삭제하였다. 1주 휴지기 부여에 따라 휴지기군과 비휴지기군으로 나누어 치아의존형 견인장치로 6일 동안 견인하고 강화기를 거친 후 0주, 1주, 2주, 4주, 6주, 8주에 희생시켜 치수, 치주인대 및 치조골의 조직 변화를 임상적, 방사선적, 조직학적 및 면역화학적으로 평가하여 다음과 같은 결과를 얻었다. 1. 치아이동 양과 강화기 동안의 조직 치유 양상에서 휴지기 유무에 따른 차이는 없었다. 2. 견인측에서 골형성은 강화기 8주까지 계속되었는데 강화기 1-2주에 가장 활발하였으며 6-8주간의 변화는 적었다. 3. 비휴지기군의 강화기 1주에서 치조골 흡수 및 파골세포 출현, 염증세포 침윤이 가장 많았으며, 특징적으로 파상아세포가 압박측의 치주인대와 치수 내에 나타났다. 4. TGF-β는 치조골의 골기질 및 골모세포, 파골세포, 치수 내 파상아세포에서 강양성 발현을 보인 반면 치수, 백악모세포, 무세포성 백악질에서 경미한 양성 발현을 나타내는 부위 특이성이 있었다. 5. TGF-β는 견인측 치주인대의 치조골에 인접한 혈관 및 치주인대세포, 골모세포에서 강화기 초기 1-2주에 주로 발현되었으며 6주 이후에는 발현이 크게 감소하였다. The movement of tooth-bone segments by osteotomy can simultaneously shift tooth and surrounding alveolar bone in a relatively short period. The purpose of this study was to evaluate the tissue changes in pulp, periodontal ligament, and alveolar bone in rapid tooth bone movement with osteotomy. The mandibular 3rd premolar of a dog was extracted and cortical bones of the buccal and lingual area were eliminated, and then cortical bones around the mesial and distal area of root, and below the root apex of the mandibular 4th premolar were osteotomized. After a one week latency period, a tooth-borne distraction device was activated for 6 days. And pulp, periodontal ligament and alveolar bone were evaluated clinically, radiologically, histologically and immunohistochemically at 0, 1, 2, 4, 6, 8 weeks of the consolidation period and conclusions were reached as follows. 1. Latency period didn't affect total amount of tooth movement and healing process of tissue during consolidation period. 2. Bone formation continued through 8 weeks of consolidation in distracted side, with a high peak at 1-2 weeks, and the lowest at 6-8 weeks of consolidation. 3. At 1 week of consolidation, alveolar bone resorption, osteoclast appearance and inflammatory cell infiltration were the most active, and dentinoclasts characteristically appeared on the pulp and pressure side of the periodontal ligament. 4. The expression of TGF-β was area-specific, as it was strong-positive at bone matrix, osteoblast, osteoclast of alveolar bone, and dentinoclast inside pulp, but weak in pulp, cementoblast and acellular cementum. 5. The expression of TGF-β was generally observed at the initial 1-2 weeks of consolidation at vessels, periodontal ligament cells, and osteoblast near alveolar bone on the distraction side of the periodontal ligament, and was significantly decreased after 6 weeks of consolidation.

새로운 isoquinoline 유도체, AQ44의 혈관평활근 수축에 미치는 영향

김보경,김윤선,용준환,장병준,박태규,조성일,장기철,이상목 한국노화학회 1998 한국노화학회지 Vol.8 No.3