류마티스성 승모판 협착증의 치료를 위한 경피적 승모판 성형술의 치료성적

김성은,조흥근,박성훈,박시훈 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.4

연구목적 : 류마티스성 승모판 협착증에 대한 유용한 치료법인 경피적 승모판 성형술의 본원의 단기 치료 성적을 알아보고자 하였다. 방법: 1993년 10월에서 1999년 4월까지의 이대목동병원에 내원한 류마티스성 승모판 협착증 환자 21명에서 투시조명 하에 경피적 승모판 성형술을 시행하였다. 시술전에 경흥부심초음파와 경식도초음파가 시행되었고, 시술후에는 경흉부초음파를 사용하여 혈역학적, 임상학적 변화를 비교하였다. 연구대상의 거의 모두가 NYHA class Ⅱ에 속했고, 5명이 심방세동을 가지고 있었으며, 모두 심초음파점수가 8이하였다. 좌심방에 혈전이 있는 경우로 혈전을 용해시킨 후 시술한 경우가 2예였다. 결과 : 경피적 승모판 성형술 이후의 평균 승모판구면적은 시술전의 1.16±0.36㎠에서 2.06±0.33㎠로 증가되었다. 경승모판 이완기 평균 압력차는 시술전 11.60±5.54mmHg에서 시술 후 4.93±2.53mmHg(p<0.001). 좌심방 크기는 46.41±14.66mm에서 42.03±15.01mm로(p=0.042), 그리고 심박출량은 4.21±1.25L/min에서 6.88±9.57L/min로(p<0.0001) 의미있는 호전을 보였다. 3도 이상의 심한 승모관폐쇄부전이나 심각한 시술후 합병증은 없었다. 결론 : 본원에서 약 6년간 시행된 경피적 승모판 성형술는 그 사례가 적고 시술전 예상되는 난이도 면에서 특이한 것은 없었지만, 시술후 합병증이 거의 발견되지 않았으며 혈역학적 측정상에서도 성공적인 시술을 보여주었다. 승모판구면적에 따른 시술후 단기내 호전의 정도는 거의 예측할 수 없었으나, 심초음파점수는 모두가 8점이하로 높은 성공율의 조건을 제공하였다. Objective : Percutaneous mitral valvuloplasty(PMV) became a treatment modality or mitral stenosis because of its low morbidity, short hospital stay, and low cost. We reviewed clinical and hemodynamic results after PMV for the patients with mitral stenosis in Ewha Womans University Mokdong hospital. Methods : We compared the results of echocardiographic, hemodynamic, and clinical parameters before and after PMV. PMV was performed under fluoroscopic guidance in 21 patients(M:4, F:17, mean age 43±12 years) with mitral stenosis from October 1993 to April 1999. Transesophageal echocardiography(TEE) and Transthoracic echocardiography(TTE) were performed for the evaluation of mitral valve, chamber size, and the presence of left atrial thrombus before procedures. TIE was also used for follow-up evaluation. On presentation, all patients showed at least NYHA class Ⅱ. Five patients had atrial fibrillation. Two patients with thrombus in the left atrium were included to study group after thrombolytic treatment with coumadin. Echo-score of our patients was not greater than 8. Results : Mean mitral valve area(MVA) by 2 dimensional or Doppler echocardiography was increased from 1.16±0.36㎠ before PMV to 2.06±0.33㎠ after PMV. There were marked improvements in transmitral gradients(11.60±5.54mmHg before PMV vs 4.93±2.53mmHg after PMV, p<0.001), left atrial dimension(46.41±14.66mm vs 42.03±15.01mm, p=0.042), and cardiac output(4.21±1.25L/min vs 6.88±9.57L/min, p<0.0001) following PMV, Severe(≥GⅢ) mitral insufficiency or severe postprocedural complications were not noted. This suggested that all procedure was successful. Conclusion : The Procedural success rate of PMV in Ewha Womans University Mokdong hospital was 100%. Low echo score of our patients might explain this high procedural success rate. Long-term-follow-up is warranted in the near future.

격투스포츠 선수의 스포츠맨십 분석

박태훈(Park Tae-Hoon),유기성(Yoo Ki-Seong),유원용(Ryu Won-Yong),김영욱(Kim Young-Wook),이양구(Lee Yang-Gu),공창빈(Kong Chang-Bin),이상호(Lee Sang-Ho),김태영(Kim Tae-Young) 한국체육과학회 2010 한국체육과학회지 Vol.19 No.3

This research examines whether difference that is some in inclination of combat sports player's sportsmanship is, and accordingly is purposeful to clear relation. combat sports (fencing, Taekwondo, boxing, induction, wrestling, wrestling) player who research target is having player life in middle·high·an university 399 people be . Used Korean-made measure (KMSOS) that Seong-changhun (2003) verifies changing based on Vallerand MSOS by a tool to measure sportsmanship of players. Data processing used SPSS 12.0 programs. Did reliability analysis that use Cronbach'a coefficient to verify believability of an irradiation tool, Difference of sportsmanship used t-test, one-way ANOVA. In this research, drew following conclusion. First, man appeared higher level than woman in wave and human desire, decision respect, and woman appeared higher level than man in victory or defeat excessive fondness. Second, exercise immersion, decision respect, victory or defeat excessive fondness appeared level that minority is taller than majority. Third, in exercise immersion high school player decision respect appear, and tendency of level that middle school playing the first stone is high in victory or defeat excessive fondness appeared. Fourth, striking radical type of player appeared higher level than Geuraepeulring type of player in companion respect factor. Fifth, player less than exercise career 4 years appeared higher level than player less than 7 years and player more than 7 years for victory or defeat excessive fondness factor. Sixth, Taekwondo for best and companion respect factor, high level appeared to boxing item players.

간 이식 환자에서 발생한 파종성 Scedosporium apiospermum 감염 1예

박현구,최성호,강호석,송주형,정지훈,소민욱,최상호,김양수,우준희 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

저자들은 다발성 뇌 농양을 동반한 치명적인 파종성 S. apiospermum 감염이 발생한 간 이식 환자를 경험하였다. 본 증례의 환자는 voriconazole로 치료하는 호전경과를 보이다가 진균성 뇌 동맥류 파열로 사망하였다. S. apio-spermum은 비교적 드문 진균으로 병리학적으로 Aspergillus spp.와 매우 유사하고 amphotericin B에 내성을 나타내므로 진단과 치료가 적절하게 이루어지지 못할 가능성이 많고 면역 기능 저하 환자에서 혈행성 전파를 통한 파종성 감염이 용이하게 발생하므로 높은 사망률을 나타낸다. 이식 환자를 비롯한 면역 기능 저하 환자에서 진균감염이 의심될 때 S. apiospermum과 같은 드문 진균에 의한 감염증도 감별진단에 포함해야 하겠다. Sedosporium apiospermum is a saprophytic fungus commonly found in soil and polluted water. This organism is known as a cause of mycetoma, which may occur in immunocompetent hosts following trauma. However, in immunocompromised patients, S. apiospermum can also cause life-threatening invasive disease, including central nervous system infection or disseminated infection. We report a fatal case of disseminated S. apiospermum infection in a 46-year-old woman after liver transplantation. Eight days postoperatively, she developed pneumonia, followed by altered mentality in the 15 days. A head CT demonstrated multiple brain abscesses. Sputum and stereotactic-aspirated brain abscess culture yielded S. apiospermum. Despite treatment with voriconazole, the patient died of intracranial hemorrhage.

DEA를 이용한 천주교 서울대교구 본당 운영의 효율성 평가

박해철,김성훈 中央大學校經營硏究所 2003 經營學論集 Vol.29 No.2

타리비드 정(오플록사신 100㎎)에 대한 파비드 정의 생물학적동등성

박완수,조성희,이헌우,임호택,홍성제,서성훈,류재환,이경태 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.1

The purpose of the present study was designed to evaluate the bioequivalence of two ofloxacin tablets, Tarivid (Jell Pharm. Co., Ltd.) and Favid (ILHWA Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Twenty-four normal male volunteers, 23.67±3.12 year in age and 68.50±7.23 kg in body weight, were divided into two groups and a randomized 2x2 cross-over study was employed. After four tablets containing 100 mg of ofloxacin were orally administered, blood was taken at predetermined time intervals and concentrations of ofloxacin in plasma were deter mined using HPLC. Pharmacokinetic parameters such as AUC_(t) and T_(max) were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed AUC_(t), and C_(max) and untransformed T_(max). There were no sequence effects between two formulations in these parameters. The 90% confidence intervals for the log transformed data were acceptance range of log 0.8 to log 1.25 (e.g., log 0.94-log 1.04 and log 0.90-log 1.07 for AUC_(t) and C_(max) respectively). The major parameters. AUC_(t) and C_(max) met the criteria of KDFA for bioequivalence indicating that Favid tablet is bioequivalent to Tarivid tablet.

고콜레스테롤 혈증 환자에서 Cerivastatin(LIPOBAY, 의과학연구소)의 임상효과 및 안전성에 관한 연구

박성훈,김미연,정수진,이영숙,박창한,변은경,전성희 梨花女子大學校 醫科大學 醫科學硏究所 2001 EMJ (Ewha medical journal) Vol.24 No.3

목적 : Cerivastatin(LIPOBAY)은 최근에 개발되어 사용되기 시작한 HMG-CoA 환원효소 억제제로서 저용량으로 탁월한 콜레스테롤 강하효과를 보이는 약물이다. 저자들은 Cerivatatin(LIPOBAY)의 혈중 콜레스테롤 강하효과를 평가하고 약물의 안전성을 평가하기 위하여 본 연구를 시행하였다. 방법 : 고콜레스테롤혈증 환자 37명(남자 13명, 여자 24명)을 대상으로 하였다. 대상환자는 2주간의 저콜레스테롤 식이 후에도 혈청 콜레스테롤이 240㎎/㎗이상이거나, 관상동맥질환이 있는 환자는 혈청콜레스테롤이 220㎎/㎗이상인 경우 cerivastatin 0.4㎎을 8주간 복용하도록 하였다. 임상적 관찰과 검사실 검사(간기능검사, 일반혈액검사, 혈청지질검사)는 투약개시 후 4주 및 8주 후에 시행하였다. 결과 : Cerivastatin 0.4㎎을 4주간 투여한 후 측정한 LDL 콜레스테롤, 총콜레스테롤, triglyceride, 및 HDL 콜레스테롤은 각각 38%, 28.8%, 11.6% 및 7.8% 감소하였다. 총콜레스테롤/HDL 콜레스테롤 비 및 LDL/HDL비는 각각 20.8% 및 31.1% 감소하였다. 투약 8주후에 측정한 검사소견은 4주후에 비해 유의한 변화를 보이지 않았다. 한명의 환자(2.7%)에서 간기능 검사상 AST, 및 ALT의 지속적인 상승으로 투약을 중지하였다. 결론 : Cerivastatin 0.4㎎/day는 혈청콜레스테롤을 효과적으로 감소시켰으며 심각한 부작용은 볼 수 없었다. 따라서 적극적으로 LDL콜레스테롤을 낮출 필요가 있는 고콜레스테롤혈증 환자에서 cerivastatin은 효과적이고 안전한 약물이라고 생각된다. Objectives : Cerivastain(LIPOBAY) is recently developed HMG-CoA reductase inhibitor which is effective in lowering serum cholesterol levels at microgram does. We evaluated the clinical efficacy and safety of cerivastatin(LIPOBAY) in patients with hypercholesterolemia. Method : Thirty-seven patients(male : 13, female : 24) with hypercholesteolemia defined as baseline serum total cholesterol ≥240㎎/㎗, or ≥220㎎/㎗ in patients with known coronary artery disease were included for this study. After 2 weeks of low cholesterol diet, if the serum total choesterol level meet the criteria, cerivastain 0.4㎎/day was prescribed for 8 weeks. Clinical follow-up and laboratory tests were performed 4 weeks and 8 weeks after medication. Results : After 4 weeks of cerivastain 0.4㎎/day treatment, low density lipoprotein(LDL) cholesterol decreased 38% and total cholesterol decreased 28.8% from baseline. Triglyceride decreased 11.6%, and high density lipoprotein(HDL) cholesterol decreased 7.8% from baseline. Total cholesterol/HDL ratio decreased 20.8% and LDL/HDL ratio decreased 31.1% from baseline. After 8 weeks of treatment, no further significant changes were noted compared with the values at 4 weeks. Cervastatin was discontinued in one patient(2.7%) due to continuous liver enzyme elevation. Conclusion : Cerivastatin 0.4㎎/day is effective in lowering serum cholesterol levels without significant adverse reactions. Cerivastatin is effective and safe for patients with hypercholesterolemia who needs aggressive LDL cholesterol lowering.

정신분열병 환자들의 自己灣入에 관한 예비 연구

박성봉,김영미,전성일,이기철,김영훈,정영조,이영렬,이정호,최영민 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

목 적 : 정 신분열병 환자의 자기만입 정도에 영향을 미치는 인구학적 변인들 및 질병연관 변인들을 규명해 보고자 하였다. 또한. 환자들의 자기만입과 병식 사이의 연관성. 자기만입과 자존심 사이의 연관성을 알아보고자 하였다. 방 법 : 정신과 의사가 병록지와 면담을 통하여 대상 정신분열병 환자들의 인구학적 변인들 및 질병연관 변인들에 관한 자료를 얻고 환자들의 병식 정도를 평가한 후, 환자들로 하여금 자기보고형의 자기만입 척도와 자존심 척도를 시행하게 하였다. 총 111명의 환자가 연구대상으로 선택되었다. 결과: . 1) 여자가 남자보다 유의하게 높은 자기만입 척도 점수를 나타내었다 2) 질병연관 변인들 중 하위집단 사이에 자기만입 척도 점수의 유의한 차이를 보이는 변은 없었다. 3) 자기만입 척도 점수와 병식 점수 사이에 유의한 상관관계가 없었다. 4) 자기만입 척도 점수와 자존심 척도 점수 사이에 유의한 역상관 관계를 보였다. 결 론 : 본 예비 연구의 결과로 보아 정신분열 병 환자의 병식이 부족한 상태에서도 자기만입이 진행될 수 있으며. 자기만입이 심할수록 환자의 자존심이 저하되는 것으로 생각된다. 또한 여자 환자들이 남자 환자들보다 자기만입에 더 취약한 것으로 생각된다. 따라서 정신분열 병 환자의 이해와 치료를 위하여 자기만입에 관한 지속적인 연구가 필요할 것으로 생각된다. objective : This study was conducted to identify demographic variables and illness related variables which may affect the severity of self-engulfment in the patients with schizophrenia. We also studied the relationship between self-engulfment and insight, and the relationship between self-engulfment and self-esteem. Methods : Data on demographic variables and illness related variables for the subjects were gathered from hospital records and clinical interviews by the psychiatrists. Degree of insight for the subjects was assessed through clinical interviews by the psychiatrists. Degree of self-engulfment and self-esteem for the subjects was assessed from the self-engulfment scale and the self-esteem scale respectively. A total of 111 patients with schizophrenia were selected for statistical analysis. Results 1) The females exhibited significantly higher scores than the males on the self-engulfment scale. 2) There was no illness related variable, which exhibited a significant difference among subgroups on the self-engulfment scale. 3) There was no significant correlation between the self-engulfment scores and the insight 4) There was a significantly inverse correlation between the self-engulfment scores and the self-esteem scores. Conclusion : The results of this preliminary study suggest that self-engulfment may develop despite lack of insight and that there was inverse relationship between self-engulfment and self-esteem in the patients with schizophrenia. It also suggests that females are more subject to self-engulfment than males. So, authors suggest that it is valuable to do further studies of self-engulfment in the patients with schizophrenia.

당귀와 천궁 및 시호의 병용 경구 투여에서 흰쥐 혈중 Decursinol 농도의 비교 검토

박노정,김남재,이경태,서성훈 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2001 No.-

This study was performed to elucidate the influence on the plasma decursinol concentration after administration of combined decursin and Cnidii Rhizoma or decurisin and Bupleuri Radix extracts in comparison with single decursin admimistration. The identification of decursional isolated from Angelica gigas was carried out by GC/MS and the concentration of decursinol in the plasma after oral administration was determined by HPLC. The value of area under the plasma concentration (AUC) and the maximal concentration (Cmas) of decursinol after administration of methanol and ether Angelicae Gigantis Radix extract was higher than those of single decursin-treated group. It was also found that the AUC and the Cmax of decursional after combined administration with decursin and Cnidii Rhizoma were higher than those of decursin administration, whereas those of combined with decursin and Bupleuri Radix was lower. Moreover, the studies were performed with decursinol only or with combined decursinol and Cnidii Rhizoma/Bupleuri Radix, both of combined treatment increased the plasma decursinol concentrations compared with decursinol-treated group in rats. On the basis of these results, it is concluded that co-existing substances or co-administration with other drugs may influence the plasma levels of decurisinol after oral administration.

Losartan(Cozaar®)의 강압효과에 관한 임상적 연구

박성훈,박영미 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.4

연구배경 : 로자탄은 angiotensin Ⅱ수용체들 중 AT, 수용체를 선택적으로 차단함으로써 혈압강하효과를 나타내며, 마른 기침이나 혈관부종과 같은 ACE차단제의 부작용이 거의 없다. 방법 : 로자탄 50mg/day를 제1기 및 제2기의 고혈압환자 22명(남자:12명, 여자:10명, 평균 나이:51±11세, 나이분포:33±70세)의 환자에게 12주간 투여하여 약제의 혈압강하효과 및 안전성을 평가하였다. 결과 : 혈압은 투약후 2주부터 하강하기 시작하여 6주에 최대강하를 보였다. 6주와 12주 사이의 혈압변동은 통계적 유의성은 없었다. 12주에 측정한 평균혈압은 로자탄 투여전에 비해 수축기혈압이 19mmHg, 이완기 혈압이 11mmHg 하강하였다. 로자탄 투여후 심각한 임상적 또는 검사상의 부작용은 발생하지 않았으며, 부작용으로 인하여 투약을 중단한 예도 없었다. 결론 : 로자탄(Cozaar®)은 제1단계 및 제2단계 고혈압에 대한 1일 1회 단독치료제로서의 안전하고 효과적인 혈압강하제로 생각된다. Background : Although angiotensin converting enzyme inhibitors have provided plausible effect for the management of hypertension and congestive heart failure, it does have drawbacks such as dry cough in as much as 15 to 30% of patients and incomplete blocking of angiotensin Ⅱ production. Losartan(Cozaar®) is the first angiotensin Ⅱ receptor antagonist that has become clinically available as an antihypertensive agent. Because the agent effectively blocks the final common pathway of renin-angiotensin system, it is recognized as an ideal drug for the treatment of hypertension. Method : We tested the antihypertensive effect and clinical safety of Losartan(Cozaar®) 50mg/day in 22 patients(male : 12, female : 10, age : 51±11, range : 33-70) with stage I and Ⅱ hypertension from July 1998 to October 1999. The patients were enrolled in the study after two weeks of washout period if the patient was using other antihypertensive drugs. Blood pressure and side effects were monitored at zero, second, sixth, and twelfth week. Baseline chemistry was done before drug administration and follow-up chemistry was done at twelfth week. Results : Losartan(Cozaar®) showed good patient compliance and good antihypertensive effect without significant changes of laboratory results or clinical complications. At twelfth week, mean systolic blood pressure dropped l9mmHg, and mean diastolic blood pressure dropped 11㎜Hg. The heart rate showed no significant change during the study period. Blood pressure was controlled below 140/90mmHg in 12(54.5%) patients with Losartan 50mg/day. Five patients complained of minor side effects(dizziness, facial numbness, epigastric discomfort, etc) but no patients discontinued medication due to side effects. Conclusion : Losartan(Cozaar®) is a safe and effective antihypertensive agent for the treatment of stage Ⅰ and Ⅱ hypertensive patients as a single once-a-day treatment.

좌전하행지 관동맥 개구부위의 망사형의 관(Slotted Tube)스텐트와 나선형 코일(Coil)스텐트 삽입후 단기 및 장기 암상 경과의 비교

박훈기,박성욱,이일수,이상곤,김진우,이근,정상식,이철환,홍명기,김재중,박승정 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6