Intracavitary Radiation Therapy for Recurrent Cystic Brain Tumors with Holmium-166-Chico : A Pilot Study

Ha, Eun Jin,Gwak, Ho-Shin,Rhee, Chang Hun,Youn, Sang Min,Choi, Chang-Woon,Cheon, Gi Jeong The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.54 No.3

Objective : Intracavitary injection of beta-emitting radiation source for control of cystic tumors has been tried with a benefit of localized internal radiation. The authors treated cystic brain tumor patients with Holmium-166-chitosan complex (Ho-166-chico), composed of a beta-emitting radionuclide Holmium-166 and biodegradable chit polymer, and evaluated the safety and effective measurement for response. Methods : Twenty-two patients with recurrent cystic brain tumor and/or located in a deep or eloquent area were enrolled in this pilot study. The cyst volume and wall thickness were determined on CT or MRI to assess radiological response. The activity of Ho-166-chico injected via Ommaya reservoir was prescribed to be 10-25 Gy to the cyst wall in a depth of 4 mm. Results : There was neither complications related to systemic absorption nor leakage of Ho-166-chico in all 22 patients. But, two cases of oculomotor paresis were observed in patients with recurrent craniopharyngioma. Radiological response was seen in 14 of 20 available follow-up images (70%). Seven patients of 'evident' radiological response experienced more than 25% decrease of both cyst volume and wall thickness. Another 7 patients with 'suggestive' response showed decrease of cyst volume without definitive change of the wall thickness or vice versa. All patients with benign tumors or low grade gliomas experienced symptomatic improvement. Conclusion : Ho-166-chico intracavitary radiation therapy for cystic tumor is a safe method of palliation without serious complications. The determination of both minimal effective dosage and time interval of repeated injection through phase 1 trial could improve the results in the future.

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.

Graves 병 환자에서 항갑상선제 투여에 의한 TSH 수용체 항체의 변동에 관한 연구 : 치료 용량 및 기간에 따른 차이 및 임상상과의 관계 its relation to dose and duration of treatment~and clinical features

이문호,조보연,문대혁,고창순,민헌기,서교일 대한내과학회 1986 대한내과학회지 Vol.30 No.3

We undertook a prospective study of 59 patients with Graves' disease in order to clarify the influence of antithyroid drug on the immunological indices and to determine the association of the changes of TSH receptor antibodies activities with drug dosage, duration of treatment and clinical features according to mode of antitbyroid drugs treatment. Patients were divided into two groups. High dose group included 28 patients and conventional dose group 31 patients. We measured TBII activities, antimicrosomal antibodies, and the size of goiter every 3 months, comparing them with clinical features and laboratory findings. TBII activities declined from R months until 9 months following drug treatment. Therafter no significant change of TBII activities were observed. Antimicrosomal antibodies showed the same pattern of change. There was no statistically significant difference of declining rate of TBII activities, antimicrosomal antibodies, and reduction of size of thyroid between two treatment groups. TBII activities fell into normal range in 15 patients among those 44 patients who had been followed for more than 9 months (8 high dose group, 7 conventional dose group). In those 15 patients, TBII activities and frequency of exophthalmos were less than those whose TBII activity did not normalized. We conclude that TSH receptor antibodies activities and antithyroid autoantibodies are diminished by antithyroid drug treatment in patients with Graves disease and there is no relationship between dose of drug and declining of TBII activities. We suggest that changing levels of TBII activities might be secondary phenomenon which can be achieved by control of thyroid function by antithyroid drug rather than direct immunosuppressive effect of antithyroid drug per se.

Low-level Green and Red Laser Treatment of Shaochong (HT9)·Dadun (LR1) and Shaohai (HT3)·Yingu (KI10) Acupoints in a Rat Model of Focal Cerebral Ischemia

Na, Chang-Su,Kim, Wang-In,Jang, Ho-Sun,Youn, Dae-Hwan,Moon, Young-Min,Jeong, Sung-Ho,Cheon, Min-Woo The Korean Institute of Electrical and Electronic 2015 Transactions on Electrical and Electronic Material Vol.16 No.2

Low level laser therapy (LLLT) has facilitated an improvement in acupuncture treatment. In this study, we stimulated Shaochong (HT9), Dadun (LR1), Shaohai (HT3), and Yingu (KI10) acupoints with pulsed laser diodes 532 nm [green laser] and 658 nm [red laser] in rats with induced middle cerebral artery occlusion(MCAO). The animals were divided into 6 groups: intact control; MCAO control without LLLT; LLLT with red laser at HT9·LR1 and HT3·KI10 (RR); LLLT with green laser at HT9·LR1 and HT3·KI10 (GG); LLLT with green laser at HT9·LR1 and red laser at HT3·KI10 (GR); and LLLT with red laser at HT9·LR1 and green laser at HT3·KI10 (RG). We evaluated the immunohistochemical changes in the hippocampal CA1 region, and complete blood count changes. Compared to the MCAO control group, the RG group showed a significant decrease in Bax and cytochrome c levels in the hippocampus, and a significant increase in hemoglobin level, hematocrit, total white blood cell, neutrophil, lymphocyte, monocyte, and erythrocyte counts.

소의 대동맥 내피세포에서 산화저밀도 지단백에 의한 아포프토시스에 백일해 독소 및 콜레라 독소가 미치는 영향

손호영(Ho Young Son),강성구(Sung Ku Kang),강무일(Moo Il Kang),차봉연(Bong Youn Cha),이광우(Kwang Woo Lee),장상아(Sang Ah Chang),최윤희(Yoon Hee Choi),문성대(Sung Dae Moon),안유배(Yoo Bae Ahn),손현식(Hyun Sik Son),윤건호(Kun Ho Yoon) 대한내과학회 1999 대한내과학회지 Vol.56 No.5

Objectives : Oxidized LDL is thought to play a key role in atherogenesis. Among their wide variety of biological properties, oxidized LDL injures the endothelium as an early event of atherogenesis. However, the mechanisms by which oxidized LDL injures endothelial cells are not definitely known. In order to evaluate the involvement of GTP-binding protein on the mechanism of apoptosis, we studied the effects of pertussis and cholera toxin on oxidized LDL-induced apoptosis in bovine aortic endothelial cells(BAECs). Methods : Oxidized LDL elicited apoptosis in cultured BAECs as shown by characteristic morphological and biochemical changes. Chromatin condensation and nucleus fragmentation were visualized by using fluorescence microscopy of intact cells staining by acridine orange/ ethidium bromide. DNA fragmentation was quantified by an ELISA with specific antibody for bromodeoxyuridine- labelled DNA fragments and confirmed with DNA ladder formation. Results : Studies using a combination of bacterial toxins which change the function of GTP-binding protein suggest that oxidized LDL-induced apoptosis was regulated by GTP-binding protein. Oxidized LDL-induced apoptosis was not changed by pretreatment of BAECs with pertussis toxin. In contrast, pretreatment with cholera toxin completely prevented the oxidized LDL- induced apoptosis. Conclusion : These results show that oxidized LDL induces apoptosis of BAECs and suggest that cholera toxin-sensitive G-proteins are involved in signal transduction of oxidized LDL-induced apoptosis of BAEC.

Characterization of changes in global gene expression in the brain of neuron-specific enolase/human Tau23 transgenic mice in response to overexpression of Tau protein.

Woo, Jong-Min,Park, So Jung,Kang, Ho Il,Kim, Byoung Guk,Shim, Sun Bo,Jee, Seung Wan,Lee, Su Hae,Sin, Ji Soon,Bae, Chang Joon,Jang, Mee Kyung,Cho, Chunghee,Hwang, Dae Youn,Kim, Chuel Kyu D.A. Spandidos 2010 INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE Vol.25 No.5

<P>Tau is a neuronal phosphoprotein responsible for the formation of the neurofibrillary tangles in Alzheimer's disease. To characterize the changes in global gene expression in the brain of transgenic mice that overexpress human Tau23 protein in response to the increase of Tau23 phosphorylation, total RNA extracted from the hippocampus of 12-month-old transgenic and wild-type mice was converted to cDNA, labeled with biotin and hybridized to oligonucleotide microarrays. The microarray results were confirmed by real-time RT-PCR and Western blotting method. It was determined that 43 genes were up-regulated and 8 genes were down-regulated by Tau23 in transgenic mice compared to controls, based on the arbitrary difference in the 2-fold change. Among the up-regulated transcripts, those encoding for transporter and oxidoreductase were dramatically over-represented, followed by those related to regulatory molecule, cytoskeletal protein, signaling molecule, and extracellular matrix protein. Genes encoding for transcription factor, regulatory molecule, miscellaneous function, and chaperone were significantly reduced in the down-regulated group. The major genes in the up-regulated categories included Ecrg4, Folr1, Defb11, Aqp1 and Soctdc1. The major genes in the down-regulated categories were Ncor1, Gpm6a, and Hspd1. These results indicate that the microarray analysis identifies several gene functional groups and individual genes that respond to a sustained increase in Tau23 phosphorylation levels in the brain of transgenic mice. In addition, the results suggest the microarray test is a useful tool for increased understanding of the role of Tau23 protein in regulating neurodegenerative disorders.</P>

혈액투석에서 투석액 칼슘농도와 칼시트리올이 골대사에 미치는 영향

염지연 ( Ji Youn Youm ),김현철 ( Hyun Chul Kim ),이영철 ( Young Chul Lee ),최종욱 ( Jong Wook Choi ),박준성 ( Joon Sung Park ),이창화 ( Chang Hwa Lee ),강종명 ( Chong Myung Kang ),김근호 ( Gheun Ho Kim ) 대한내과학회 2011 대한내과학회지 Vol.81 No.6

Background/Aims: Whereas higher dialysate calcium (Ca) levels may pose a risk of hypercalcemia, lower levels may induce a negative Ca balance. We evaluated the effect of lowering dialysate Ca levels from 1.75 to 1.5 mmol/L and explored the appropriate use of calcitriol to regulate bone metabolism in hemodialysis patients. Methods: The dialysate Ca levels of 36 patients were reduced from 1.75 to 1.5 mmol/L. They were divided into three groups according to basal intact parathyroid hormone (iPTH) level (group 1, iPTH<150 pg/mL, n=21; group 2, iPTH 150-300 pg/mL, n=7; group 3, iPTH>300 pg/mL, n=8). Data were collected at 3-month intervals for 1 year. Results: Throughout the study period, no significant difference in phosphate binders, serum Ca, phosphorus (P), or Ca × P products was observed among groups. However, iPTH, alkaline phosphatase (AP), and calcitriol dosage patterns differed among groups. In group 1, iPTH and AP increased significantly over 12 months (p=0.01). In group 2, iPTH and AP showed no significant changes. In group 3, iPTH and AP declined significantly over 12 months (p=0.02). Calcitriol dosage did not change in groups 1 and 2, but increased significantly in group 3 (p=0.001). Conclusions: After converting hemodialysate Ca levels from 1.75 to 1.5 mmol/L, the initially different iPTH concentrations converged to a modestly elevated level. The use of 1.5 mmol/L hemodialysate Ca may thus be appropriate for both high- and low-turnover bone disease if phosphate binders and calcitriol are combined appropriately. (Korean J Med 2011;81:751-758)

상백피봉약침요법(桑白皮蜂藥鍼療法)을 포함한 한방치료(韓方治療)로 증상(症狀)은 소실(消失)되었으나 CT추적관찰상(追跡觀察上) 변화(變化)가 없는 요추(腰椎) 추간판(椎間板) 탈출증(脫出症) 1예(例)

이병훈,김철홍,서정철,윤현민,송춘호,안창범,장경전,Lee, Byung-Hoon,Kim, Cheol-Hong,Seo, Jung-Chul,Youn, Hyoun-Min,Song, Choon-Ho,Ahn, Chang-Beohm,Jang, Kyung-Jeon 대한약침학회 2001 Journal of pharmacopuncture Vol.4 No.2

By process of treatment for a case which diagnosed as HNP of left posterolateral aspect of L4/5 disc and treated from the 10th, May 2001 to the 23rd, Jun 2001, the results are as follows. Method & Results : This patient was medicated Hwallaktang-gami, taken acupuncture, phototherapy, TENS, electric acupuncture, exercises, Mori Cortex-bee venom acupuncture. As a result, the patient's clinical symptom were improved but a computed tomagraphy confirmed L4/5 and L5/S1 HNP was not changed as seen on repeated CT scanning. Conclusion : These results suggest that among conservative therapies the oriental medical treatments including Mori Cortex-bee venom acupuncture improve clinical symptom effectively. But in this case, the structure of herniated disc was not changed.

Bone Marrow T Cells are Superior to Splenic T Cells to Induce Chimeric Conversion After Non-Myeloablative Bone Marrow Transplantation

( Hyun Sil Park ),( Seok Goo Cho ),( Min Jung Park ),( So Youn Min ),( Hong Seok Chang ),( Hee Je Kim ),( Seok Lee ),( Chang Ki Min ),( Jong Wook Lee ),( Woo Sung Min ),( Chun Choo Kim ),( Ho Youn Kim 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.3

Background/Aims: The bone marrow functions not only as the primary B-lymphocyte-producing organ but also as a secondary lymphoid organ for CD4 and CD8 cell responses and a site of preferential homing and persistence for memory T cells. Bone marrow T (BM-T) cells are distinguished from peripheral blood T cells by surface phenotype, cytokine secretion profile, and immune functions. In this study, we evaluated the alloreactive potential of donor lymphocyte infusion (DLI) using BM-T cells in mixed chimerism compared to that using spleen T (SP-T) cells. Methods: Cells were prepared using established procedures. BM-T cells were obtained as a by-product of T-cell depletion in BM grafting and then cryopreserved for subsequent DLI. We performed DLI using BM-T cells in allogeneic mixed chimera mice on post-BMT day 21. Results: When the same dose of T cells, 5-10×105 (Thy1.2+), fractionated from BM and spleen were administered into mixed chimeras, the BM-T group showed complete chimeric conversion, with self-limited graftversus-host disease (GVHD) and no pathological changes. However, the SP-T group showed persistent mixed chimerism, with pathological signs of GVHD in the liver and intestine. Conclusions: Our results suggest that DLI using BM-T cells, even in small numbers, is more potent at inducing chimeric conversion in mixed chimerism than DLI using SP-T cells. Further study is needed to determine whether cryopreserved BM-T cells are an effective cell source for DLI to consolidate donor-dominant chimerism in clinical practice without concerns about GVHD. (Korean J Intern Med 2009;24:252-262)

腦卒中 患者 形態에 關한 臨床硏究

윤현민,안창범,송춘호,손인석,장경전 대한침구학회 2003 대한침구의학회지 Vol.20 No.2

Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. and among the 52 cases of Stroke cerbral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebeller or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of execising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.