서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

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.

통풍성 관절염의 임상적 고찰

윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.

척수를 손상시킨 후 꼬리정맥에 주입한 사람탯줄혈액세포가 뇌줄기에 미치는 영향

김종중,정윤영,박영란,문영민,현영식,정영욱,문정석 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Background and Objectives: Stem cells are a valuable resource for treatment of many disease, but limited access to stem cells in some organs such as brain restricts their utility. Many approaches have been attempted to restore the function following brain stem injury (BSI) and spinal cord injury (SCI). The use of the human umbilical cord blood cells (hUCB) - a rich source of nonembryonic or adult stem cells - has recently been reported to ameliorate the behavioral consequences of stroke. Mateiials and Methods: Forty rats were divided into 8 groups: (1) SCI l+hUCB (infused 1 day post injury); (2) SCI 2+hUCB (infused 2 days post injury); (3) SCI 3+hUCB (infused 3 days post injury); (4) SCI 4+hUCB (infused 4 days post injury); (5) SCI 5+hUCB (mfusedt 5 days post injury); (6) SCI 6+hUCB (infused 6 days post injury); (7) LO+hUCB (laminectomy+hUCB); and (8) LO (laminectomy only). SCI was produced by compressing the spinal cord for one minute with an aneurysm clip calibrated to a closing pressure of 50 g. We report here that immunhistotochemical identification of fluorescent hUCB positive cells in the brain stem after compressed spinal cord injury using mouse anti-human mitochondria monoclonal antibody (MAB1273). Results: All SCI+hUCB (1-8) groups contained fluorescent hUCB positive cells in the all area of the brain stem. But especially a large number of fluorescent hUCB positive cells were observed in the whole area of the brain stem of the experimental 5 (SCI 5+hUCB) and 6 (SCI 6+hUCB)groups. No hUCB positive cells were found in the brain stem of group with non-injured spinal cord of these animals and group with laminectomy only. Conclusion: These results suggest that hUCB are potentially useful as a vector for treating a variety of the central nervous system disorders, and we are sure that continuous of stem cell study will give an best opportunity to treat the uncurable disorders in the future.

성인에서 장기간 Furosemide오용과 연관된 신수질 석회화

김윤구,이윤하,이규백,장세호,김대중,오하영,김보현,김미경,조윤숙 대한신장학회 1996 대한신장학회잡지 Vol.15 No.4

性別 및 年齡에 따른 體格과 體力의 特性과 變化에 關한 縱斷的 硏究 Ⅰ : 體育專攻 大學生을 中心으로 Emphasised on College Men of Physical Education

金尙國,姜東洹,金昇一,徐再均,金耕知,孫斗玉,鮮于攝,崔榮烈,尹宇相,金亨燉,方永鎭,李錫元 慶熙大學校 體育科學大學 1988 體育科學論叢 Vol.- No.1

The purpose of this study was to compare the characterists and change in physique and physical function by college student of physical education major(287males and 40 females of age groups ranging from 18 to 26). The results were as following; 1) The characteristics of physique and physical function by sex and age. ① The male group of 18yrs old showed higher values in Height, Weight, Upper Limb Length, Strength, Flexibility, and Vital Capacity than any other groups, but female group showed lower values in Height, Weight, Chest Girth, Lower Limb Length, Thigh, Girth, Calf Girth and all of the Physical function. ② The male group of 19yrs old showed high values in power and Agility, then female group showed in Strength and Flexibility. ③ The male group of 20yrs old showed the lower values in Weight, Waist Girth, Upper Limb Length, Fore Arm Girth, Thigh Girh.Calf Girth, Vital Capacity, and female group are very lowed in Upper Arm Lenght, Fore Arm Length, Skin Fold Thickness and 5 minute Run. ④ The male group of 23yrs old showed the high values in Upper Arm Girth, Fore Arm Girth and Balance, and then female group higher in Weight, Chest Girth, Waist Girth, Upper Arm Girth, Fore Arm Girth, Thigh Girth, Power, Shuttle Run, Balance and vital capacity than any other age Groups. ⑤ In male group, Chest Girth, and Blood Pressure were significantly related, and Side Step and Trunk Extension were nagatively related to the age at 0.1% level, and then in female group, Sargent Jump, Standing Long Jump and Vital Capacity were showed a significantly related at 0.5% level. 2) The difference of physique and physical function between male and female by age. ① Everage difference in whole physique items except skinfold thickness was 9.8%, and that 21.1% in all of physical function except Trunk Flextion between male and female group subjects. ② About the ages, the 18yrs old male group showed the 22.8% higher values of 26 items, but 22yrs old male group were about 12.2% in 23 items, thus it is very lower than any other groups. 3) The difference of physique and physical function between General group and physical education group in age-matched. ① In the physique male physical education groups showed about 7% higher in Weight, Chest Girth, Upper Limb Length, Upper Arm Girth, Thigh Girth, and female group showed about 7% higher in Weight and Upper Limb Length. ② In the physical function, Trunk Flextion, 5 minute Run, and Blood Pressure(Diastolic) were about 8% high values in whole group, and female group showed about 8% higher in Standing Long Jump, Shuttle Run, and Trunk Extension. ③ In 22yrs old male and female physical education group were very dominated in physique and physical function than the other age group against the general group.

한약에 의해 유발된 급성 간질성 신염 2례

김덕윤,박동건,김응석,강영모,양창헌,이정호,이동철,이영현,김정란 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

간질성 신염은 신장의 간질을 선택적으로 침범하는 염증성 질환으로 여러가지 원인에 의해 유발되며, 이 중 약물에 의한 경우는 각종 항생제, 비스테로이드성 진통제, 항경련제, 이뇨제, 면역억제제등에 의한 증례들이 보고되고 있다. 현재 각종 질환-특히 만성질환-의 치료에서 한약이 차지하는 비중이 적지 않으나, 그 각각의 성분들이 유발할 수 있는 부작용들에 대한 연구는 거의 없는 실정이다. 저자들은 관절염 치료를 위해 중국산 한약을 복용한 후 복통, 피로감 및 육안적 혈뇨를 주소로 내원한 두 환자에서, 단백뇨와 신기능 장애를 보여 시행한 신조직 생검상 급성 간질성 신염에 합당한 병리학적 소견을 보이고, 한약 복용 중지 후 급속한 회복을 보여, 한약에 의해 유발된 것으로 사료되는 급성 간질성 신염 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Acute interstitial nephritis is a disease characterized by renal interstitial inflammatory cell infiltration and acute renal functional deterioration. This is caused mainly by antibiotics, NSAID and diuretics such as thiazide, but cases induced by herb medication are rare. We experienced two cases of acute interstitial nephritis after treatment with herb medication. One 71-year-old female patient and the other 60-year-old female were admitted to the hospital because of general weakness and gross hematuria. Microscopic hematuria, pyuria, and proteinuria were presented. After definitive diagnosis with a renal biopsy, we noted rapid recovery of renal function by drug withdrawal and steroid therapy. We report these cases with a review of the referenced literatures. Key Words : Herb medication, Acute Interstitial nephritis.

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

베체트병 환자에서 Azathioprine으로 유발된 급성 췌장염 1례

김기향,권민정,김동기,김애란,김윤정,박지훈,이영태,박보민,김동욱 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Although many drug are thought capable of initiating acute pancreatitis, following azathioprine administration represents the 5% incidence by far the highest recorded incidence to date. We report a 35-year-old male who developed acute pancreatitis in the course of treatment with azathioprine for Behcet's disease. He was admitted due to abdominal pain, diarrhea, and fever for 10 days. Serum amylase and lipase levels were 510U/L and 3702U/L respectively. The abdominal CT scan revealed diffuse enlargement of the pancreas. There was no history of alcohol use or gall bladder disease. We considered drugs, especially azathioprine, as the cause of acute pancreatitis. We diagnosed it as acute pancreatitis. The patient was treated conservatively with hydration and analgesics. The symptom subsided within four days. Five days later, azathioprine was resumed. And the patient complained of abdominal pain. The elevated levels of serum amylase and lipase confirmed the recurrence of pancreatitis. His symptom subsided when azathioprine intake the stopped, and the serum amylase and lipase levels returned to normal level within five days.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.