간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

Association of Vascular Endothelial Growth Factor Gene Polymorphisms with Susceptibility and Clinicopathologic Characteristics of Colorectal Cancer

Chae, Yee Soo,Kim, Jong Gwang,Sohn, Sang Kyun,Cho, Yoon Young,Ahn, Byung Min,Moon, Joon Ho,Jeon, Seoung Woo,Park, Jae Yong,Lee, In Taek,Choi, Gyu Seog,Jun, Soo-Han The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.3

<P>Since vascular endothelial growth factor (VEGF) is known to be a potent pro-angiogenic factor, we evaluated the potential association of two <I>VEGF</I> gene polymorphisms (-634G>C and 936C>T) with the susceptibility and the clinicopathologic characteristics of colorectal cancer (CRC). The <I>VEGF</I> genotypes were determined using fresh colorectal tissue from 465 patients who had undergone a surgical resection and peripheral blood lymphocytes from 413 healthy controls by PCR/DHPLC assay. For the -634G>C polymorphism, the -634 GC or CC genotype was associated with a decreased risk of CRC (odds ratio [OR], 0.62; <I>p</I>=0.001) as a dominant model of C allele, whereas the 936 TT genotype correlated with advanced stage/ metastasis, a high serum level of CA19-9, and an higher grade in patients with CRC. In the haplotype analyses, haplotype -634C/936C and -634G/936T were associated with a decreased susceptibility of CRC (OR, 0.53 and 0.56; <I>p</I><0.001, respectively). These observations imply that the <I>VEGF</I> gene polymorphisms may be associated with the susceptibility or clinicopathologic features of CRC. However, further studies of other <I>VEGF</I> sequence variants and their biological functions are needed to understand the role of the <I>VEGF</I> gene polymorphisms in the development and progression of CRC.</P>

조직 배양된 실험쥐 해마부위 신경원의 전기적 발작 손상에 대한 발열의 영향

채수안(Soo Ahn Chae),박용민(Yong Min Park),유병훈(Byoung Hoon Yoo),김동욱(Dong Wook Kim) 대한소아신경학회 2002 대한소아신경학회지 Vol.10 No.2

목 적 : 간질환자들은 고열 발생시 발작의 발현이 증가하는 경향이 있다. 이것은 간질상태의 뇌에서 고체온이 신경원의 과흥분성 및 손상과 관련이 있음을 시사하는 것이다. 따라서 본 저자들은 실험쥐 해마부위 조직배양을 이용하여 신경원의 발작 손상에 대한 발열의 영향을 알아보고자 하였다. 방 법 : 실험쥐 해마부위 조직배양을 aCSF의 온도를 39℃까지 단순히 상승시킨 단순 발열군과 aCSF 온도의 상승 없이 36℃에서 조직을 유지시킨 단순 비발열군으로 분류하여 발열이 정상 신경원에 손상을 유발시키는지의 여부와 처음에 36℃에서 stimulus train을 가한 후 aCSF의 온도를 39℃까지 상승시킨 후 2번째 stimulus train을 가한 발열 발작군과 2번째 stimulus train을 가할 시에도 온도를 36℃로 유지시킨 비발열 발작군에서 발열중의 발작과 비발열중의 발작시 신경원 손상의 차이가 있는지를 알아보았다. 결 과 : 발열이 정상 신경원에 손상을 유발시키는지의 여부를 알아보기 위한 단순 발열군과 단순 비발열군 간의 신경원 손상정도 비교에서 해마의 CA1과 CA3 부위 모두에서 실험 24, 48, 72시간 경과 후 두 군간의 통계적으로 의미 있는 신경원 손상의 차이를 발견할 수 없었다. 발열증의 발작과 비발열증의 발작시 신경원 손상의 차이가 있는지를 알아보기 위한 발열 발작군과 비발열 발작군의 신경원 손상정도의 비교에서 해마의 CA1 부위이 션경원 손상정도는 AD 유발 후 24, 48, 72시간 경과 후 모두에서 발열 발작군이 비발열 발작군에 비하여 신경원 손상이 통계적으로 의미 있게 많았고, CA3 부위의 신경원 손상 정도는 AD 유발 후 24시간과 48시간 경과 후에서는 두 군간에 통계적으로 의미 있는 신경원 손상의 차이가 없었지만 72시간 경과 후에서는 발열 발작군이 비발열 발작군에 비하여 통계적으로 의미 있게 신경원 손상의 정도가 심하였다. 결 론 : 정상 뇌에서 단순 고체온은 신경원 손상을 유발시키지 않으나 간질상태의 뇌에서 고체온시의 발작은 정상체온에서의 발작시보다 신경원 손상을 심화시킬 수 있음을 시사하는 것이다. 이것은 간질 상태의 뇌에서는 발열이 발작으로 인한 뇌손상에 상승 효과를 유발시킬 수 있으므로 간질 환자에서 발열 발생 시 신속하고도 적절한 처치가 발열로 인한 발작으로 초래될 수 있는 뇌 손상을 예방하는데 중요할 것으로 생각된다. Purpose : Epileptic patients have a increasing tendency to develop seizure attack in high temperature. This finding suggests that high temperature may have an effect on neuronal hyperexcitability and injury of epileptic brain. Therefore, the influence of high temperature on normal and epileptic brain was studied in organotypic explant cultures of rat. Methods : Fourteen days-in-vitro cultures from 8 day-olf rat pups were perfused with standard aCSF bubbled with 95%/5% O/CO in a microchamber. Stimulus train(0.3 sec, 60 Hz) was applied to Schaffer collaterals in CA3 and extracellular field potential was recorded in the CA1 pyramidal layer. At 36℃ initially, AD was evoked. In high temperature(HT) group, the cultures were subjected to 39℃ for a period of 8 min before the second stimulus train was applied. They were then restored to 36℃ for 10 min. In normal temperature group, temperature was maintained at 36℃ for the second stimulus train. The cultures were returned to the incubator and observed serially for neuronal damage. Intensity of propidium iodide fluorescence indicative of neuronal injury was quantitated by digital image analysis. The cultures on the same insert that were not stimulated served as the unstimulated groups. Results : There was not a statistically significant difference in neuronal damage between the unstimulated high-temperature(HT) and normal-temperature(NT) group. In CA1 sector, % damage(mean±SEM) was 0.42±0.20 vs 0.27±0.05 at 24 hrs(HT vs NT)group, n=16 each, P>0.05, Student t-test); 1.81±0.79 vs 1.43±0.27 at 48 hrs(P>0.05); 3.50±1.32 vs 3.35±0.56 at 72 hrs(P<0.05). In CA3 sector, % damage was 0.34±0.10 vs 0.20±0.03 at 24 hra(P>0.05); 0.99±0.20 vs 0.83±0.23 at 48 hrs(P>0.05); 2.00±0.38% vs 2.26±0.35% at 72 hrs(P>0.05). Neuronal damage on AD induced cultures during febrile setting(n=16) was significantly higher than in nonfebrile setting(n=16). In CA1 sector, % damage was 6.63±2.56 vs 0.92±0.45 at 24 hrs(febrile setting vs nonfebrile setting, P=0.036); 26.37±7.44 vs 4.99±2.23 at 48 hrs(P=0.010); 38.59±9.63 vs 6.48±2.30 at 72 hrs (P=0.003). In CA3 sector, % damage was 1.23±0.48 vs 3.91±2.37 at 24 hrs(P=0.277); 13.09±5.75 vs 5.93±3.27 at 48 hrs(P=0.288); 27.86±8.68 vs 7.54±3.74 at 72 hrs(P=0.04). Conclusion : At high temperature, seizures in epileptic brain may be more injurious than seizures in normal temperature.

트랜시버 모니터링을 위한 RF-to-DC 65nm CMOS 전력 감지기

채수창(Soo-Chang Chae),장충근(Chung-geun Jang),김수정(Soo-Jeong Kim),안광호(Kwang-Ho Ahn),김기진(Ki-Jin Kim) 한국통신학회 2022 한국통신학회 학술대회논문집 Vol.2022 No.6

실험쥐 해마 절편 배양에서 성숙기에 따른 c-Jun 단백발현 양상과 전기적 발작으로 인한 신경원 손상 정도에 관한 연구

채수안(Soo Ahn Chae),이광인(Kwang In Lee),최응상(Eung Sang Choi) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.2

목 적 : 구조적 및 전기적 발작 후의 c-Jun 단백발현의 차이가 미성숙 및 성숙 뇌사이의 발작으로 인한 신경원 손상의 차이를 설명할 수 있는지 알아보고자 본 연구를 시행하였다. 방 법 : 생후 8일된 실험쥐에서 해마의 기관형적 절편배양이 준비되었다. 배양 7일과 14일된 해마조직을 대상으로 실험을 시행하였다. 전기생리학적 실험은 Schaffer collaterals에 1 sec stimulus train(60 Hz, 0.1 msec rectangular pulses)을 가한 후 CA1에서 afterdischarge(AD)를 기록하였다. 전기생리학적 실험 후, 배양 조직을 배양기에 되돌려 놓고 신경원 손상 정도를 연속적으로 관찰하였다. 신경원 손상을 가리키는 PI 형광발현의 강도는 2 mM NMDA로 유발시킨 총 신경원 손상에 대한 백분율로 수량화 하였다. 본질적 및 전기자극 후의 c-Jun 단백질 발현 양상을 알아보기 위하여 Western blot을 시행하였다. 결 과 : 전기적 발작 후 24, 48, 72시간 경과시점의 CA1와 CA3 부위의 신경원 손상은 배양 7일된 미성숙 해마조직이 배양 14일된 성숙 해마조직 보다 의미있게 낮았다. 미성숙 배양 해마조직의 전기적 자극을 가하지 않아 구조적 c-Jun 단백발현이 성숙 배양 해마조직보다 의미있게 높았다. 미성숙과 성숙 배양 해마조직간 전기적 자극 후의 c-Jun 발현 정도는 의미 있는 차이가 없었다. 결 론 : 미성숙 배양 해마조직의 높은 구조적 c-Jun 발현이 발작으로 인한 차후 c-Jun 발현을 억제함으로서 미성숙 배양 해마조직이 성숙 배양 해마조직보다 발작으로 인한 신경원 손상이 미약한 결과를 가져온다고 생각한다. Purpose : Immaure brain is more resistant to seizure-induced neuronal damage than the adult brain in animal study. Immediate early genes such as c-jun play a critical role in neuronal damage. Therefore, we hypothesized that the difference of constitutive and electrically stimulated c-Jun expression would explain the difference in neuronal damage from seizures between immature and mature explant culture. Methods : Seven and 14 days-in-vitro(DIV) hippocampal explant cultures derived from 8-day-old rat pups were used. Extracellular field recording was done in cultures. A 1-sec stimulus train(60 Hz, 0.1 msec rectangular pulses) was applied to the Schaffer collaterals, and the afterdischarge was recorded in CA1 pyramidal layer. Cultures were returned to the incubator and observed serially. Intensity of propidium iodide fluorescence indicative of neuronal damage was quantitated as percent of total damage induced by 2 mM NMDA. Proteins extracted from individual cultures were analyzed by Western blot. Results : Constitutive c-Jun protein expression at 7 DIV was higher than that at 14 DIV. There was not a significant difference of c-Jun expression between the 7 DIV and 14 DIV cultures after electrical stimulation. Neuronal damage after electrical stimulation in the hippocampus at 7 DIV was significantly lower than at 14 DIV. Conclusion : The results show reduced neuronal injury from seizures in more immature culture. However, constitutive expression of c-Jun protein was higher. Higher constitutive expression may inhibit further induction of c-Jun from seizures and thus result in less severe neuronal injury.

응급의료센터를 내원한 소아 환자 중 신경계 질환의 경향 분석

박승완(Seung Wan Park)ㆍ채수안(Soo Ahn Chae)ㆍ이재희(Jae Hee Lee)ㆍ이정주(Jung Ju Lee)ㆍ윤신원(Shin Won Yoon)ㆍ임인석(In Seok Lim)ㆍ최응상(Eung Sang Choi)ㆍ유병훈(Byoung Hoon Yoo) 대한소아신경학회 2010 대한소아신경학회지 Vol.18 No.1

목 적:소아 응급 환자, 특히 발작이나 의식의 변화 또는 소실을 주소로 내원하는 환자들을 조기에진단하고, 적절하게 응급 조치를 한다면 심각한 합병증과 후유증 또는 사망을 예방할 수 있다. 지금까지 국내에서 응급의료센터에 내원한 신경계 질환 환자들에 대한 검증은 거의 없는 실정이나 외국에서는이미 여러 나라에서 조사가 이루어졌다. 신경계 질 환은 나라마다, 지역마다 다른 분포를 보이므로 우리나라의 자료를 분석하는 일은 의미가 있다고 하겠다.방 법: 2005년 1월 1일부터 2008년 12월 31일까지 중앙대학교병원 응급의료센터에 내원하여소아청소년과 진료를 받은 18세 미만의 환자 총18,922명 중 신경계 질환으로 최종 진단된 환자1,058명(5.6%)을 대상으로 하였다. 각 례에 대해응급 의무 기록지와 입원 병록지를 참고하였고, 이를 근거로 연령별 질환군, 계절별 질환군을 분석하였으며, 주증상별 최종 진단명을 후향적으로 조사하였다.결 과:남녀비는 1.5:1이었고, 연령별 분포상 2세부터 5세 미만이 가장 많았고 평균 연령은 3세였 다. 연령에 따른 흔한 질병은, 영유아기에는 열성경련이, 학령기에는 뇌수막염이, 청소년기에는 간질과두통이 가장 흔하였다. 계절별 분포는 2005년부터2007년까지는 계절별 차이가 크지 않았으나, 2008년에는 여름철에 내원한 환자수가 가장 많았다. 여름에는 뇌수막염이 다른 계절에 비해 월등히 많았으나, 다른 질환은 계절별 차이가 크지 않았다. 주증상 별 분포는 발작, 열, 두통, 구토의 순으로 많았으며,최종 진단명별 분포로는 열성경련(51%), 간질(21%), 뇌수막염(18%) 순으로 많았다. 최종 진료 형태별 분포로는 입원(70.0%), 귀가(27.9%), 자의퇴원(1.5%), 전원(0.6%) 순이었다. 신경계 질환의입원율은 전체 환자의 입원율(22.8%)이나 다른 계통 질환의 입원율 보다 높았다.결 론 : 신경계 질환 환자의 수는 매년 증가하고있으며, 다른 계통 질환에 비해 입원율이 높은 특성을 가지고 있다. 이는 보호자들의 불안과 신경계 질 환의 중증도와 관련이 있으므로 신경계 증상을 보이는 환자들을 조기에 진단하고 적극적으로 치료하는것 뿐만 아니라, 보호자들에게 충분한 설명을 하고안심을 시키는 것도 중요할 것으로 생각된다. Purpose : Pediatric emergencies with seizure and decreased mental status or loss of consciouseness may cause severe complications without early proper management. Distribution of neurological disorders may differ according to various demographics, it would be valuable to evaluate recent data in Korea. Methods : Patients who had neurological problems and below 18 years old were defined as case. 1,058(5.6%) cases who visited the emergency department of Chung-Ang University Hospital from January 2005 to December 2008 were analyzed. The patients were also divided into four age groups: age 1 year or younger, preschool children(2-5 years), middle childhood group(6-10 years), and adolescent group(11-18 years). Results : The male to female ratio was 1.5:1. Most children were between 2 to 5 years old(mean age=3 years). Febrile convulsion is the most common neurological disorders among infant and preschooler, meningitis is the most common among middle childhood, epilepsy and headache is the most common among adolescent. Main initial presentations were seizure followed by fever, headache and vomiting. Febrile convulsion was the most common neurological disorders followed by epilepsy and meningitis. Final dispositions of patients were admission, discharge, against medical device, and transfer to other hospital. Admission rate of patients with neurological disorders was higher than those of total patients. Conclusion : Neurological disorders are increasing in pediatric emergencies and have highest admission rate, mostly because of the parent's anxiety and severity of disease itself. Therefore, not only detect and treat neurological disorder in early stage, but also reassuring parent is important.

Comparison of 1-year clinical outcomes between prasugrel and ticagrelor versus clopidogrel in type 2 diabetes patients with acute myocardial infarction underwent successful percutaneous coronary intervention

Ahn, Kye Taek,Seong, Seok-Woo,Choi, Ung Lim,Jin, Seon-Ah,Kim, Jun Hyung,Lee, Jae-Hwan,Choi, Si Wan,Jeong, Myung Ho,Chae, Shung Chull,Kim, Young Jo,Kim, Chong Jin,Kim, Hyo-Soo,Cho, Myeong-Chan,Gwon, Hy Williams & Wilkins Co 2019 Medicine Vol.98 No.11

<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>Although the new oral P2Y<SUB>12</SUB> inhibitors, prasugrel/ticagrelor have shown greater efficacy than clopidogrel in patients with the acute coronary syndrome, but they have not shown better efficacy in Korean patients. So we evaluated the efficacy of the prasugrel/ticagrelor in patients with myocardial infarction (MI) and diabetes, a more high-risk patients group.</P><P>From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 3985 patients with MI and diabetes who underwent PCI were enrolled between November 2011 and December 2015. The patients were divided into 2 groups: clopidogrel (n = 2985) and prasugrel/ticagrelor (n = 1000).</P><P>After propensity score matching, prasugrel/ticagrelor group showed a no significant difference in risk of the composite of cardiac death (CD), recurrent MI or stroke (hazard ratio [HR], 0.705; 95% confidence interval [CI], 0.474–1.048; <I>P</I> = .084). However, the risk of major bleeding was significantly higher in the prasugrel/ticagrelor group. (HR; 2.114, 95% CI; [1.027–4.353], <I>P</I> = .042). In subgroup analysis, major bleeding was significantly increased in the subgroup of creatinine clearance <60 ml/min/1.73 m<SUP>2</SUP>, hypertension, underwent a trans-femoral approach and diagnosed as NSTEMI among the prasugrel/ticagrelor group.</P><P>The use of prasugrel/ticagrelor did not improve the composite of CD, recurrent MI or stroke, however, significantly increased major bleeding events in Korean patients with MI and diabetes undergoing PCI.</P></▼2>

Changes in the Occurrence of Gastrointestinal Infections after COVID-19 in Korea

Ahn So Yun,Park Ji Young,Lim In Seok,Chae Soo Ahn,Yun Sin Weon,Lee Na Mi,Kim Su Yeong,Choi Byung Sun,Yi Dae Yong 대한의학회 2021 Journal of Korean medical science Vol.36 No.24

Background: After the global epidemic of coronavirus disease 2019 (COVID-19), lifestyle changes to curb the spread of COVID-19 (e.g., wearing a mask, hand washing, and social distancing) have also affected the outbreak of other infectious diseases. However, few studies have been conducted on whether the incidence of gastrointestinal infections has changed over the past year with COVID-19. In this study, we examined how the incidence of gastrointestinal infections has changed since COVID-19 outbreak through open data. Methods: We summarized the data on the several viruses and bacteria that cause gastrointestinal infections from the open data of the Korea Disease Control and Prevention Agency for 3 years from March 2018 to February 2021 (from Spring 2018 to Winter 2020). Moreover, we confirmed three most common legal gastrointestinal infectious pathogens from March 2016. Results: From March 2020, when the COVID-19 epidemic was in full swing and social distancing and personal hygiene management were heavily emphasized, the incidence of infection from each virus was drastically decreased. The reduction rates compared to the averages of the last 2 years were as follows: total viruses 31.9%, norovirus 40.2%, group A rotavirus 31.8%, enteric adenovirus 13.4%, astrovirus 7.0%, and sapovirus 12.2%. Among bacterial pathogens, the infection rates of Campylobacter and Clostridium perfringens did not decrease but rather increased in some periods when compared to the average of the last two years. The incidence of nontyphoidal Salmonella, Staphylococcus aureus, or enteropathogenic Escherichia coli somewhat decreased but not significantly compared to the previous two years. Conclusion: The incidence of infection from gastrointestinal viruses, which are mainly caused by the fecal-to-oral route and require direct contact among people, was significantly reduced, whereas the incidence of bacterial pathogens, which have food-mediated transmission as the main cause of infection, did not decrease significantly.

정신분열병 및 정신분열형 장애에 대한 올란자핀의 효과와 안전성

안용민,강대엽,권준수,김창윤,김철응,반건호,신영민,이기철,이동우,이중서,조현상,채정호,김용식 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 본 다기관 공동임상연구는 국내 환자를 대상으로 새로운 항정신병약물인 올라자핀의 치료 효과와 안전성을 확인하고자 시행되었다. 방 법 : 1999년 7월부터 2000년 3월까지 국내 10개 병원에 방문한 정신분열병 및 정신분열형 장애 105명을 대상으로 비대조 개방 임상연구를 시행하였다. 중등도 이상의 정신병 증상을 지니거나, 부작용으로 약물교체가 필요한 경우 또는 기분장애 증상의 치료가 필요한 환자를 대상으로 하였다. 2∼7일간의 약물 배설기간 후에 1일 10mg의 올란자핀을 투여하였고, 이후로 3∼7일 간격으로 용량을 조절하여 총 8주간 투여하였다. 치료 효과는 PANSS(Positive and Negative Syndrome Scale), BPRS(Brief Psychiatric Rating Scale), CGI(Clinical Global Impression-Severity), MADRS(Montgomery-Asberg Depression Rating Scale), HAM-A(Hamilton Rating Scale for Anxiety)로 판정하였다. 안전성 평가는 자발적인 이상반응 보고, 활력징후와 혈액 검사 및 SAS(Simpson-Angus Scale), BARS(Barnes Akathisia Rating Scale), AIMS(Abnormal Involuntary Movement Scale)척도를 이용하였다. 결 과 : 105명중에서 85.7%인 90명이 8주간의 치료를 완료하였다. 평균 최빈 용량은 일일 16.1(±4.7)mg이었고, 종료시점에서의 BPRS전체 점수가 기저 상태에 비해 40%이상 감소된 반응군은 69.5%이었다. PANSS의 양성 증후군과 일반정신병리 뿐만 아니라 음성 증후군 소척도에서도 유의한 감소를 보였으며, 이 감소들은 치료 초기부터 나타나서 8주간 지속되었다. 43.8%의 피험자가 중등도 이상의 우울증상을 같이 지니고 있었으며, 올란자핀에 의해 MADRS와 HAM-A가 유의하게 감소하였다. 치료 기간 동안에 활력징후에는 뚜렷한 변화가 없었으나 체중은 8주간 지속적으로 증가하였다. SAS와 AIMS는 감소하였으며, 정좌불능증을 제외한 나머지 추체외로 증상의 발생비율도 낮았다. 임상적인 증상이나 징후를 동반하지 않는 ALT/SGPT의 상승을 보였지만 프로락틴을 포함하는 대부분의 혈액 검사상 뚜렷한 이상 변화는 없었다. 결 론 ; 비록 본 임상연구가 비대조 개방 임상연구로서 많은 제한점을 가지고 있지만, 올란자핀이 기존 약물에 내약성을 보이거나 기분증상을 동반하는 정신병에 치료 효과가 있었다. 그리고 기존 항정신병약물 치료시에 문제가 되었던 추체외로 증상과 고프르로락틴 혈증을 포함하는 대부분의 부작용면에서 안전성을 보여 주었다. Objective : This multicenter clinical trial was carried out to investigate the efficacy and the safety of olanzpine for the treatment of Korean patients. Mothod : 105 patients with schizophrenia and schizophreniform disorder, visited at 10 mental or university hospitals, had received an open and non-comparative treatment with olanzapine for 8 weeks. Patients had psychotic or depressive symptoms with the severity above moderate degree or intolerable side effects to previous antipsychotics. After a wash-out period of 2-7 days, 10mg olanzapine was prescribed initially to all the patients, and then the dosage could be adjusted within the range of 5-20mg/day of olanzapine by 3-7 days. Results : 90(85.7%) of 105 patients completed the 8-weeks trial and the mean modal dose of olanzapine was 16.1(±4.7%)mg/day. At the end of the trial, 73 patients(69.5%) were classified as responder, which was defined as 40% or more improvement in BPRS(Brief Psychiatric Rating Scale) score comparing to baseline. There was a significant reduction in the scores of PANSS(Positive and Negative Syndrome Scale)and subscales including negative symptom scores and CGI. Also weekly analysis showed that the reductions in scores were kept on for the whole period of the trial. 43.8% of all the patients had depressive symptoms at the baseline and total scores of MADRS(Montgomery-Asberg Depression Rating Scale) and HAM-A(Hamilton Rating Scale for Anxiety) were also reduced after the trials. Vital signs revealed no clinically significant changes but continuous weight gain was observed during the treatment with olanzapine. The scores of SAS(Simpson-Angus Scale) and AIMS(Abnormal Involuntary Movement Scale) for assessing the EPS(extrapyramidal symptoms)and tardive dyskinesia respectively were significantly decreased and only a few patients reported EPS as adverse events. Although mild and clinically non-significant of ALT/SGPT was observed, most laboratory parameters including plasma prolactin level showed to significant changes during the trial. Conclusions : Although this trial had many limitations because it was a non-comparative and open study, olanzapine showed high efficacy on the positive, negative and depressive symptoms in schizophrenia and schizophreniform disorder.In addition to that, olanzapine showed a substantially favorable safety profile, such as low incidence of EPS and hyperprolactinemia.

Fabrication and characterization of piezoelectric driven microdiaphragm resonating sensor for a biosensing application

Chae, Myung-Sic,Lee, Sang-Myung,Yoo, Yong Kyoung,Lee, Soo Hyun,Kim, Jinsik,Kim, Tae Song,Ahn, Dong June,Lee, Jeong Hoon,Hwang, Kyo Seon Springer-Verlag 2014 JOURNAL OF ELECTROCERAMICS Vol.32 No.4