• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.11a
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• pp.99-104
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• 1994

Renin-Angiotensin계는 정상 및 질병시의 혈압조절에 매우 중요한 역할을 담당하고 있음이 밝혀지면서, 이 조절계의 특정단계를 간섭함으로써 새로운 고혈압치료제를 개발하려는 연구가 일찍부터 시도되었다. (그림 1). 그 중에서 내인성 생리활성물질인 Angiotensin II의 합성을 차단하는 ACE 저해제는 임상적으로 고혈압 및 심부전치료제로서 유용성이 인정되어 현재 널리 사용되고 있다. ACE 저해제는 종종 마른기침, 발적과 같은 부작용이 나타나므로 이러한 부작용을 극복하려는 연구가 많이 있었으나 이는 작용기전에서 기인되는 것으로 해결에 한계를 보여왔다. 그런데 1982년 일본의 Takeda사의 연구진은 S-8307, 8308이라는 효과가 매우 약하기는 하지만 Angiotensin II 수용체를 선택적으로 차단하는 비펩타이드성의 AII길항물질을 특허 출원하였다. 미국의 Du Pont사는 AII길항약물이 효능은 그대로 유지하면서 ACE 저해제들의 부작용을 해결할 수 있을 것으로 예상하고 Takeda 화합물을 모핵으로하여, 많은 유도체들을 합성하면서 구조-활성 연구를 수행한 결과 비펩타이드성길항제인 Dup 753(Losartan, Cozaar$^{R}$) (2-N-butyl-4-chloro-5-hydroxymethyl-1-(2'-(1H-tetrazole-5-yl)biphenyl-4-yl) imidazole, potassium salt)을 발견하게 되었다. 이 Dup 753은 특별히 AII수용체중 혈압조절과 관련이 있는 AT1 수용체를 선택적으로 차단하는데, 효력은 ACE 저해제인 captopril과 유사하며, 경구흡수가 잘되고 지속시간이 길어 하루에 한번 먹는 경구제제로 개발되고 있는 것으로 알려져 있다. 이 Dup 753의 지속시간이 긴 것은 그 대사물인 Exp 3174에 기인하는 것으로 알려져 있으며, 대사체가 Dup 753에 비해 효력도 훨씬 더 높고 지속시간도 길어서, Dup 753은 일종의 prodrug적 개념이 들어있는 약물이라 할 수 있다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.466-472
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• 2021

This paper aims to guide experts who manage dementia by exploring the various non-drug interventions and analyzing the effective intervention methods applicable according to the functional level of the elderly with dementia. Fourteen studies were analyzed in this study. Meta-analysis was performed using the means, standard deviations, and the number of samples. Subsequent meta-analysis showed that the Holnis program had the largest effect size in cognitive function, the bakery activity program in memory, and the composite intermediation program with ADL was the largest. In addition, client-centric cognitive stimulation interventions showed the most significant effect sizes, while in depression and BPSD, rhythmic movement activities had the most significant effect size. Elderly with dementia exhibit various symptoms depending on their characteristics and the progress of the disease. Therefore, more efficient arbitration could be provided if the effects of each intervention can be applied differently.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.3
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• pp.178-187
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• 2009

Background : Atopic dermatitis is chronic exzemaous dermatitis and the recurrence rate of atopic dermatitis is high. Many patients are suffering from pruritus. Objective : This study compared ambulatory care with hospitalization for atopic dermatitis treatment of one patient, and investigated the effect of Oriental medicine program for atopic dermatitis patients during short term hospitalization. Method : We treated a 5 year-old boy with uncontrollable atopic dermatitis by ambulatory care and hospitalizaion. Herbal medication and herbal dressing was done samely during ambulatory care and hospitalization. Intensive life management, education for compliance was done only during hospitalization. Results : Even though he had been treated for 5 months by ambulatory care, he still suffered from severe itching, erythema, oozing and insomnia. Admission duration was 10 days. During admission, the SCORAD scores and subjective scores were decreased rapidly. Conclusion : We concluded that effects of the treatments can be different due to compliance of the patient and in that view the short term hospitalization program could be more helpful than ambulatory care for uncontrollable atopic dermatitis patients.

• Journal of Industrial Convergence
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• v.20 no.10
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• pp.39-49
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• 2022

The purpose of this study was to systematic review about randomized controlled trials the characteristics and effect of non-pharmacological intervention on depressive symptom in elderly with mild cognitive impairment. We searched studies published from January 2011 to July 2021 in 3 databases. A total 1,455 studies were found and included 11 studies in final analysis. Methodological quality was assessment with the Cochrane's RoB(risk of bias) tool. Geriatric Depression Scale(GDS) was the most used as the assessment tool for identifying the depressive symptom. Intervention were yoga, psychosocial intervention, cognitive training, health education, multi-component intervention, game training, aerobic/pulmonary physiotherapy, art therapy, music reminiscence activity, memory specificity training, cognitive stimulation therapy and SWTW(sleep well, think well) program. Among the intervention programs, yoga, multi-component intervention and game training were effective in improving depressive symptom. This study provided a clinical evidence for planning and implementing intervention on depressive symptom in elderly with mild cognitive impairment.

• Korean Journal of Biological Psychiatry
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• v.1 no.1
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• pp.117-123
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• 1994

This study was performed to examine the role of neuroleptics may in the development of neurologic soft signs in patients with schizophrenia. Neurologic soft signs were evaluated in 28 neuroleptic naive patients with schizophrenia or schizophreniform disorder and 31 neuroleptic non-naive patients with schizophrenia using a structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale-Korean version(NES-K). Relationship to dose, duration and neurological side effects of neuroleptic treatment were also evaluated. Total scores of NES-K in neuroleptic naive group were significantly higher than those of non-naive group. Scores of motor coordination, sequencing of complex motor acts and others items in functional subcategories were also significantly higher in drug-naive patients. The sensory integration item was not different between two groups. After controlling covariates such ac dose of neuroleptics, age and sex, total scores, motor coordination and others items of NES-K were significantly higher in neuroleptic naive group. However there was no difference between drug naive and non-naive group in the sequencing of complex motor acts item due to effects of these covariates. In neuroleptic non-naive group the dosage of neuroleptics correlated with the motor coordination item, nor were there relationships between duration and side effects of neuroleptic treatment and neurologic soft signs. These findings suggest that neuroleptic treatment may play a only relative role in the development of neurologic soft signs in patients with schizophrenia and these abnormalities may be one of possible trait markers of schizophrenia. To elucidate this opinion, well-controlled, prospective study in same subjects will be helpful.

• Pediatric Infection and Vaccine
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• v.21 no.1
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• pp.9-21
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• 2014

Purpose: To determine the clinical significance of voriconazole therapeutic drug monitoring (TDM) in the pediatric population. Methods: Twenty-eight patients with invasive fungal infections administered with voriconazole from July 2010 to June 2012 were investigated retrospectively. Fourteen received TDM, and 143 trough concentrations were analyzed. All 28 patients were assessed for adverse events and treatment response six weeks into treatment, and at the end. Results: Out of 143 samples, 53.1% were within therapeutic range (1.0-5.5 mg/L). Patients administered with the same loading (6 mg/kg/dose) and maintenance (4 mg/kg/dose) dosages prior to initial TDM showed highly variable drug levels. Adverse events occurred in 9 of 14 patients (64.3%) in both the TDM and non-TDM group. In the TDM group, voriconazole-related encephalopathy (n=2, 14.3%) and aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation (n=8, 57.1 %) occurred with serum levels in the toxic range (>5.5 mg/L), whereas blurred-vision (n=2, 14.3%) occurred within the therapeutic range (1.18 mg/L and 3.9 mg/L). The frequency of voriconazole discontinuation due to adverse events was lower in the TDM group (0.0% vs. 18.2%, P =0.481). Overall, 57.2% of the patients in the TDM group versus 14.3% in the non-TDM group showed clinical response after 6 weeks (P =0.055), whereas 21.4% in the TDM group versus 14.3% in the non-TDM group showed response at final outcome (P =0.664). In the TDM group, >67.0% of the serum levels were within therapeutic range for the first 6 weeks; however 45.5% were within therapeutic range for the entire duration. Conclusion: Routine TDM is recommended for optimizing the therapeutic effects of voriconazole.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.321-321
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• 1994

다양하고 복잡한 기전에 의하여 정교히 조절되고 있는 면역 체계의 비정상적인 기능에 비롯된 자가 면역 질환을 개선, 치료하기 위하여 지금까지 많은 면역 조절제가 개발되어 온 바 있으며, 이들의 면역 조절 기전은 약물에 따라 그 효능에 있어 차이가 크고 독성등의 부작용등으로 인해 그 사용이 현저히 제한되고있는 경우가 많아 보다 안전하고 효능있는 새로운 면역 조절제의 개발은 아직도 매우 중요한 의의를 지니고 있다. 이러한 관점에서 본 연구실에서는 천연물로부터의 새로운 면역 조절제의 검색을 수행하여 온 바 있으며, 그중 Brazilin이 Low-dose Streptozotocin의 반복 투여에 의해 유도되는 당뇨병 상태의 면역 조절 기능에 미치는 영향에 대해서 검색하고자 하였다. 실험의 결과를 종합하여보면, Brazilin은 외부항원 (SRBC)의 유입시 정상 대조군에 비해 현저히 저하되어 있는 T cell의 기능을 정상 대조군 혹은 그 이상으로 증가시키는 효과를 나타내었으며, B cell의 기능 역시 활성화 시키는 것으로 관찰되었다. 이로부터 Brazilin은 Streptozotocin 유도 당뇨병 상태의 면역기능을 정상화시키는 면역 조절활성을 갖는 것으로 판단되었다.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.65-65
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• 1993

봉합율의 최적 조건을 구하기 위해 다양한 방법으로 리포좀을 제조했으며, 인지질과 봉합 약물의 비는 20:1 이상이어야 하고, 리포좀 제조 방법에 따라 봉합율이 차이가 났으며, REV, REV를 freezing-thawing한 것과 SUV를 freezing-thawing한 리포좀에서 봉합율이 좋았다. REV를 freezing-thawing한 리포좀이 가장 좋았다 (66.7%, BPB; 115.7 ug trypsin/mg lipid). 콜레스테롤의 함량은 봉합율과 안정성을 고려하여 인지 질과의 비를 7.3으로 고정시켰다. 안정성은 투과성, light scattering, qucnching 등으로 측정했으며,4$^{\circ}C$,용액 상태에서 두 달 이상동안 보관했을 때 약 10% 정도가 리포좀 내에서 빠져나왔으며, 리포좀의 크기 변화는 거의 일어나지 않았다. Calcein봉합 리포좀을 Vero E6 cell에 투여했을 때, 매우 적은 양이 cell내로 들어가는 것을 형광 현미경으로 확인할 수 있었다.

• Anxiety and mood
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• v.4 no.1
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• pp.42-48
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• 2008

Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.752-756
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• 2007

Purpose : The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 4000 without electrolytes and lactulose, evaluating the efficacy and safety for the treatment of constipation in children. Methods : Fifty-six children with chronic functional constipation were randomly assigned to receive polyethylene glycol 4000 (24 patients) or lactulose (32 patients). Patients or their parents reported defecation frequency, stool consistency, abdominal pain, stool incontinence and side effects after 1, 3, 6 and 12 months of treatment. Percentage of recovered patients were compared with each group. Results : Defecation frequency, abdominal pain and stool incontinence were improved in each group. At 12 months of follow up, 60% of patients treated with polyethylene glycol and 57.7% of patients treated with lactulose were considered as recovered. Conclusion : In this study, both polyethylene glycol and lactulose were equally effective and safe in the long-term treatment of constipation in children. There were no significant differences in recovery rates between 2 groups.