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.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

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.

Altered Regulation of Renal Acid Base Transporters in Response to Ammonium Chloride Loading in Rats

Kim, Eun-Young,Choi, Joon-Seok,Lee, Ko-Eun,Kim, Chang-Seong,Bae, Eun-Hui,Ma, Seong-Kwon,Kim, Suhn-Hee,Lee, Jong-Un,Kim, Soo-Wan The Korean Society of Pharmacology 2012 The Korean Journal of Physiology & Pharmacology Vol.16 No.2

The role of the kidney in combating metabolic acidosis has been a subject of considerable interest for many years. The present study was aimed to determine whether there is an altered regulation of renal acid base transporters in acute and chronic acid loading. Male Sprague-Dawley rats were used. Metabolic acidosis was induced by administration of $NH_4Cl$ for 2 days (acute) and for 7days (chronic). The serum and urinary pH and bicarbonate were measured. The protein expression of renal acid base transporters [type 3 $Na^+/H^+$ exchanger (NHE3), type 1 $Na^+/{HCO_3}^-$ cotransporter (NBC1), Na-$K^+$ ATPase, $H^+$-ATPase, anion exchanger-1 (AE-1)] was measured by semiquantitative immunoblotting. Serum bicarbonate and pH were decreased in acute acid loading rats compared with controls. Accordingly, urinary pH decreased. The protein expression of NHE3, $H^+$-ATPase, AE-1 and NBC1 was not changed. In chronic acid loading rats, serum bicarbonate and pH were not changed, while urinary pH was decreased compared with controls. The protein expression of NHE3, $H^+$-ATPase was increased in the renal cortex of chronic acid loading rats. These results suggest that unaltered expression of acid transporters combined with acute acid loading may contribute to the development of acidosis. The subsequent increased expression of NHE3, $H^+$-ATPase in the kidney may play a role in promoting acid excretion in the later stage of acid loading, which counteract the development of metabolic acidosis.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common 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 Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

선천눈꺼풀처짐 교정술 후 발생한 난시변화

이동섭,김준모,우경인,장혜란,Dong Sub Lee,Joon Mo Kim,Kyung In Woo,Hae Ran Chang 대한안과학회 2006 대한안과학회지 Vol.47 No.9

Purpose: To determine postoperative astigmatic changes after surgery for congenital ptosis and the astigmatic changes depending on surgical method and to discern cases of postoperatively developed anisometropia or amblyopia. Methods: Fifty-one patients who underwent surgery due to congenital ptosis were reviewed. Refraction or cycloplegic refraction was conducted preoperatively and 3 to 6 months after surgery to measure astigmatic changes. Astigmatic changes in operated eyes were compared to control eyes. Astigmatic changes were compared depending on surgical method. Results: The mean astigmatism was 1.33±1.29D preoperatively and 1.48±1.13D postoperatively (P=0.10) and the mean astigmatic change in the ptotic and control eye was an increase in cylinder +0.56±0.55D and +0.68±0.72D (P=0.37). The mean astigmatic change of patients receiving frontalis sling was +0.57±0.67D which was similar to those who received levator resection (+0.56±0.50D). Newly developed anisometropia was found in three patients postoperatively due to an increase in astigmatism, but newly developed amblyopia was not found. Conclusions: The increase of astigmatism by ptosis surgery was not statistically significant and there was no statistically significant difference when accounting for surgical method. However, it is necessary to monitor refractive error carefully in younger patients to prevent amblyopia because postoperative increase of astigmatism can cause anisometropia.

보조호르몬요법을 받는 여성 유방암 환자의 모발 변화와 치료 실태에 대한 기초 연구

이재경 ( Jae Kyung Lee ),김창현 ( Chang-hyun Kim ),홍동균 ( Dongkyun Hong ),정경은 ( Kyung Eun Jung ),서영준 ( Young-joon Seo ),김창덕 ( Chang-deok Kim ),이진선 ( Jin Sun Lee ),권인선 ( In Sun Kwon ),박상현 ( Sanghyun Park ),이영 대한피부과학회 2021 대한피부과학회지 Vol.59 No.7

Background: Hormone therapy, which includes tamoxifen and aromatase inhibitors, is the most common adjuvant therapy used for breast cancer. However, only a few studies have reported endocrine therapy induced alopecia. Objective: We investigated the effects of long-term adjuvant hormone therapy on hair in patients with breast cancer, in addition to patients’ concerns and current treatment for hair loss. Methods: Patients completed a questionnaire that included information on self-perceived hair changes after each adjuvant therapy session, distress, and current treatment for hair loss. Using a folliscope, we measured hair density and thickness in each patient and in healthy controls. Results: The study included 93 patients with breast cancer (mean age 51.9±9.8 years). The density and hair thickness were 106.36±21.85 hairs/cm2 and 0.07±0.01 mm in the patient group and 147.86±30.67 hairs/cm2 and 0.07±0.01 mm in the control group (n=98, mean age 52.10±8.40 years), respectively. The mean hair density was significantly lower in the patient group than in the control group; however, no statistically significant intergroup difference was observed in hair thickness. Among 76 patients who perceived hair changes after adjuvant therapy, 71.1% (n=54) were distressed with regard to hair changes. However, only 7.8% of the patients, including two who were treated by dermatologists, currently received treatment for hair changes. Conclusion: Dermatologists should be familiar with hair changes in patients with breast cancer and provide appropriate education to encourage patients to consult dermatologists for hair loss and thinning after breast cancer treatment. (Korean J Dermatol 2021;59(7):521∼526)

고양이 소뇌 치상핵 자극에 따른 전경골근의 근전도 변화

성재훈,김문찬,강준기,최창락 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.7

Through the use of stereotactic neurosurgical operation, some authors have employed chronic electrical stimulation of the dentate nucleus reduce spasticity and each trial on spastic patients has show marked clinical improvement. We investigated the eletrophysiological changes of cats after stereotactic electrical stimulation of the dentate nucleus to elucidate the possibility of clinical application and to evaluate the clinical results The M-wave is an initial response and the F-wave is a late response in the electromyography of a muscle, which is stimulated by its original controlling nerve itself. There is evidence that the sue of the F-wave is dependent on motor neuron excitability and its amplitude is increased significantly at spastic condition. If such a relationship exists, procedures which are cam& out to relieve spasticity might be exerted to change the F-wave sue and thus it might be possible to use the F-wave as an objective monitor during electrical stimulation of the dentate nucleus. We investigated this possibility in experiments on 10 cats weighing betHieen 27kg and 4.4kg. We studied the change% of M and F waves, recorded in EMG, after stereotactic stimulation to cerebellar dentate nucleus in cats. The results were as follows 1) The change of mean value of M-wave amplitude was not significant(contro1 group, 3591 ± 1029μV stimulation group, 3424± 927μV, 00.05). 2) The mean value of F-wave amplitude was significantly reduced about 56.7% after the dentate stimulation(contro1 p u p , 443.2± 119μV stimulation p u p , 251.3±99.4μV, P<0.05). 3) The F/M ratio also significantly reduced about 56.8% after the dentate stimulation(contro1 group, 12.5±1.9%, stimulation group, 7.1± 1.2%, P<0.05). Our experimental results demonstrated that the dentate stimulation markedly decreased the sue of F-wave amplitude and F/M ratio in the experimental cats and we concluded that theseelectrophysiological changes can be applied as a parameter of clinical evaluation of electrical dentate stimulation for the spasticity.

Poster Session : PS 1239 ; Pulmonology : Azathioprine Induced Cholestatic Hepatitis in Patient with Boop

( Hyung Woo Kim ),( Joo Han Song ),( Kyung Soo Chung ),( Song Yee Kim ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam Kim ),( Se Kyu Kim ),( Joon Chang ),( Moo Suk Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Azathioprine is widely used as an immunosuppressive drug in infiammatory bowel disease, many autoimmune disease and after organ transplantation to avoid rejection. Azathioprine has adverse reactions like hepatotoxicity. We report a case of azathioprine induced cholestatic hepatitis in patient with bronchiolitis obliterans organizing pneumonia(BOOP). A-37-year old woman was admitted because of pruritus and jaundice. She took transbronchial lung biopsy, bronchoalveolar lavage for cough, dyspnea and GGO patterns on chest computed tomography(CT) scan before she admitted. And it was revealed that she had BOOP. So she had been followed and treated for BOOP with prednisolone from 23th Nov 2012 and azathioprine from 8th Jan 2013. 42 days after taking Azathioprine, routine blood test was taken. Serum bilirubin, alkaline phosphatase(ALP), aspartate transaminase(AST), and alanine aminotransferase(ALT) was elevated(Bilirubin 4.4mg/dL, AST 75IU/L, ALT 104IU/L) and. Other laboratory test, including prothrombin time, serum albumin, and serum protein were within normal range. There was no history of alcohol abuse or herbal medication intake at this period. To exclude other reasons for hepatotoxicity, serological test was performed. The patient tested to negative for Hepatitis A, B, and C as well as for other markers of autoimmune hepatitis. CT scan showed hepatomegaly with lymph node enlargement and there was no evidence of bile duct obstruction. And TPMT(thiopurine methyltransferase) genotyping was done and revealed to be wild type. Azathioprine was stopped and she was monitored for laboratory changes. Because it was regarded as azathioprine induced cholestatic hepatitis and jaundice, we considered not to do liver biopsy. Day 55 after starting azathioprine therapy, total bilirubin reached peak (12.3mg/ dL). The patient was discharged on day 63 with cholestatic parameters of 115U/L(ALP), 36U/L(γ-GT), and 11.5mg/dL(total bilirubin). After 2 months, total bilirubin was decreased to normal(0.8mg/dL). Treatment of BOOP has been continued only with oral steroid.

Overexpression of Insulin Degrading Enzyme could Greatly Contribute to Insulin Down-regulation Induced by Short-Term Swimming Exercise

Min Sun Kim,Jun Seo Goo,Ji Eun Kim,So Hee Nam,Sun Il Choi,Hye Ryun Lee,In Sik Hwang,Sun Bo Shim,Seung Wan Jee,Su Hae Lee,Chang Joon Bae,Jung Sik Cho,Jun Yong Cho,Dae Youn Hwang 한국실험동물학회 2011 Laboratory Animal Research Vol.27 No.1

Exercise training is highly correlated with the reduced glucose-stimulated insulin secretion (GSIS), although it enhanced insulin sensitivity, glucose uptake and glucose transporter expression to reduce severity of diabetic symptoms. This study investigated the impact of short-term swimming exercise on insulin regulation in the Goto-Kakizaki (GK) rat as a non-obese model of non-insulin-dependent diabetes mellitus. Wistar (W/S) and GK rats were trained 2 hours daily with the swimming exercise for 4 weeks, and then the changes in the metabolism of insulin and glucose were assessed. Body weight was markedly decreased in the exercised GK rats compare to their non-exercised counterpart, while W/S rats did not show any exercise-related changes. Glucose concentration was not changed by exercise, although impaired glucose tolerance was improved in GK rats 120 min after glucose injection. However, insulin concentration was decreased by swimming exercise as in the decrease of GSIS after running exercise. To identify the other cause for exercise-induced insulin down-regulation, the changes in the levels of key factors involved in insulin production (C-peptide) and clearance (insulin-degrading enzyme; IDE) were measured in W/S and GK rats. The C-peptide level was maintained while IDE expression increased markedly. Therefore, these results showed that insulin down-regulation induced by short-term swimming exercise likely attributes to enhanced insulin clearance via IDE over-expression than by altered insulin production.