• Toxicological Research
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• v.7 no.2
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• pp.257-265
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• 1991

실험동물을 이용한 생식독성시험 결과를 기초로 하여 화학물질의 인체내 최기형성 발현 잠재력을 추정하는 질적인 독성평가는 비교적 용이하다. 그러나 인체에 실제로 적용할 수 있는 생식 독성 평가를 위해서는 양적인 독성평가가 요구되는데 여러가지 기본원칙의 불일치성과 검색기술등의 부조으로 아직 학문적인 평가가 어려운 실정이다. 따라서 본 seminar에서는 양적인 독성 평가의 어려운 문제점에 대한 세계적 연구추세를 소개하는 일례로서, 독일 베를린 자유대 독성학 연구소에서 다년간 수행된, 약제의 동물실험결과를 토대로 최기형 효과에 대한 평가시 고려해야 할 제반요소와 원칙에 대해 다음과 같이 소개하고자 한다.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.867-872
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• 1998

Background: The fixed dose regimen with activated coagulation time(ACT) is the most commonly employed method for determining the required dosage of heparin and protamine during cardiopulmonary bypass(CPB). Material and Method: We performed a prospective study on a fixed dose regimen for analyzing adequate dosages of heparin and protamine, the incidence of heparin resistance and heparin-induced thrombocyt openia, factors affecting ACT during CPB, and changes of ACT during aprotinin usage. 300 units/kg of heparin were administered to patients, and ACTs were measured after 5 mins. ACTs were checked at 10 mins and 30 mins after the onset of CPB, and then at 30 min intervals thereafter. If the measured ACT was under 400 secs, we added 100 units/kg of heparin. The heparin was reversed with 1 mg of protamine for each 100 units administered. If the measured ACT was longer than 130 secs 30 mins after protamine administration or if there was definitive evidence of a coagulation defect, we administered a further 0.5 mg/kg of protamine. Result: We studied 80 patients(50 adults and 30 children) who underwent open heart surgery(OHS) at Seoul National University Hospital. Preoperative ACT was 114.3${\pm}$19.3 secs in adults, and 119.5${\pm}$18.2 secs in children. There were no differences in preoperative ACT due to age, body weight, body surface area, or sex. The preoperative ACT was not influenced by a positive past history of OHS. Ten adults(20%) and 3 pediatric patients(10%) needed additional doses of heparin to maintain the ACT above 400 secs. Additional protamine administration was needed in 9 adults(18%) and 10 children(33%). Heparin resistance was found in only two adults. Heparin-induced thrombocytopenia was detected in 2 adults and 1 child. During CPB, ACT was prolonged. 12 adult patients received a low dose of aprotinin and showed longer celite activated ACT compared to the control group.The kaolin activated ACT showed a lower tendency than the celite activated ACT in aprotinin users. Conclusion: In conclusion, fixed dose regimen of heparin and protamine can be used without significant problems, but the incidence of need of additional dosage remains unsatisfactory.

• Journal of Food Hygiene and Safety
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• v.15 no.1
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• pp.30-35
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• 2000

To investigate the effects of bacterial endotoxin on lipids and cytokines, and to explain the relationships between their changes, we carried out this study using experi-mentally Escherichia coli (E. coli) endotoxin-induced septicemic rabbits. The triglyceride and cholesterol concentrations in endotoxin groups were generally high (p<0.01 or 0.05) at all sampling time points (from 3hr to 24 hr), while phospholipid concentrations in endotoxin groups elevated in dose-dependent fashion at 3hr and 6hr after endotoxin injection compared to control group (p<0.05), There were significant negative correlations between lipids changes and cytokines (TNF-$\alpha$ and IL-1$\beta$) each other (p<0.05), and endotoxic rabbits having higher triglyceride of cholesterol levels shown relatively better conditions compared with others. As a result, the alterations in the lipid compositions caused by endotoxin may imply an active exhibition of the host defense mechanism rather than the disturbances of lipid metabolism.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.165-165
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• 1993

목적:지금까지 Risperidone의 치료 효능과 안전성에 대한 연구들이 모두 만성 정신분열병 환자들만을 대상으로 이루어졌고, 효율적인 약물 요법의 중요한 지침이 되는 유효치료용량(effective therapeutic dosage)에 대한 연구가 이루어지지 않고 있는 바, 본 연구에서는 초발인 급성 정신분열병 환자들을 대상으로 첫째, Risperidone의 항정신병 효과(antipsychotic effect)와 추체외로계증상(extrapyramidal symptoms)을 평가하고 둘째, Risperidone의 항정신병 효과와 혈장 Risperidone 및 9-hydroxyrisperidone 농도와의 상관관계를 분석하여 유효혈장농도(therapeutic dose range)와 유효치료용량(effective therapeutic dosage)의 존재 여부를 검토코자 한다. 방법: DSM-III-R 진단기준(APA 1987)예 의해 정신분열병형 장애로 진단된 환자 11명(남자 5, 여자 6)을 대상으로 Risperidone을 이중맹검법(double blind design)으로 6주간 투약하였다. 정신병리의 평가는 PANSS(Kay 1988)를 이용하였고 추체외로계 부작용의 평가는 ESRS(Chouinard 1980)를 이용하였다. 혈장 Risperidone 농도와 혈장 9-hydroxyrisperidone 농도는 Jansen사의 Radioimmunoassay Kit를 이용하여 3회 측정하였다. 결과: PANSS 점수는 Risperidone 투여 후 1주째부터 통계적으로 유의하게 감소하였다. Parkinsonism과 dyskinesa에 대한 physician's examination 점수는 전체 연구 기간 동안 유의한 변화를 보이지 않았다. Dystonia에 대한 physician's examination 점수는 Risperidone 투여 후 1주째에는 평균 5.96점으로 높았으나 2주째부터 통계적으로 유의하게 감소되어 6주째에는 유지되었다. 혈장 Risperidone 농도와 혈장 9-hydroxyrisperidone 농도는 PANSS 점수와 유의한 상관관계를 보이지 않았다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.98-104
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• 1998

A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.169-175
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• 2006

Purpose: Esophagogastroduodenoscopy (EGD) is a very useful procedure in diagnosing gastrointestinal diseases. However, there can be some difficulty in performing this procedure in children due to the associated discomfort. Recently, sedative agents such as midazolam have been introduced to alleviate this problem quite successfully. In our study, we attempted to confirm the safety and efficacy of midazolam use by monitoring the vital signs of children undergoing endoscopy. Methods: We analyzed data on 244 children who received EGD in the department of pediatrics at Severance Hospital, Yonsei University between August 2003 and July 2005. We evaluated $O_2$ saturation, heart rate and change of mental status before and during the procedure and analyzed the results using the SPSS 12.0 package (Chi-square test, cross table method, etc.). Results: There was no significant difference in vital signs measured before and during EGD between midazolam treated and non treated children. There was no significant relationship between the amount of midazolam given and $O_2$ saturation or a change of mental status. Regarding the $O_2$ saturation, it was decreased during EGD in both groups with p<0.01 though no difference was noted between the groups; the $O_2$ level was maintained above 95% in all patients. The heart rate was also increased during EGD in both groups with a p<0.01; however, no significant difference was noted between the groups. Conclusion: We confirmed the safety of low dose midazolam by evaluating the vital signs of children during endoscopies. However, the doses used were not sufficient for sedation or to obtain an amnestic effect.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.761-772
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• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1995.04a
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• pp.94-94
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• 1995

Aspalatone (APT)의 예상되는 항산화 작용을 검색하기 위하여 Doxorubicin(Dox.) 유발독성 (Dox.의 작용 발현 기전은 oxyradical 생성에 의해 매개됨)으로 인하여 변화되는 항산화 효소계 및 과산화지질 생성에 대하여 APT의 효과를 검색하고, 별도로 Hydroxyl radical 생성에 미치는 APT의 효능을 검정하기 위하여 ESR spin trapping technique을 이용하여 ㆍOH/DMPO ESR signal을 검정하여 아래의 결과를 얻었다. Dox 투여 2일 후에 생쥐 심장에서 얻어진 SOD-1의 보상성 유도는 APT 병용 투여로 억제되었고, Catalase 활성을 유도하였으나 MBA 치에는 유의한 변화가 나타나지 않았다. 반면에 간에서는 APT으로 인하여 GSH-PX가 현저히 유도되었고 (다른 항산화 효소에는 유의한 변화가 나타나지 않았음), MDA 치가 억제되었다. 한편 Fenton 반응동안 증가되었던 ㆍOH/DMPO ESR signal은 APT에 의해 억제되었다. 이상의 결과에서 APT의 항산화성 효능이 인정되지만, Dox. 및 APT 각각의 용량 및 노출 시간의 상관성, 그리고 생화학적인 결과에 대한 (미세)조직학적인 확인이 요구되며 각각의 실험군, 즉 aspirin, maltol에 대한 효능/효력 검정도 추가로 보완되어야 할 것으로 생각된다.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.1
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• pp.9-15
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• 2011

배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.4
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• pp.762-768
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• 2004

Chromium has been known to be involved in the glucose metabolism, and hence the utilization of cellular glucose is impaired in the chromium deficiency. Chromium has been recognized as an essential nutrient since the finding of low-molecular-weight Cr-binding substance (LMWCr) as a biological modifier of insulin action. Clinical chromium deficiency associated with glucose intolerance that respond to the administration of chromium. The major impediment to the use of orally administered chromium is poor absorption of trivalent chromium in its inorganic form. Trivalent chromium is more available in yeast md, more recently, as chromium picolinate for oral absorption. The widespread use of these supplements has resulted in controversy regarding chromium's role as a nutrient, its use for treatment of insulin resistance, and its potential toxicity. Most recent evidence strongly supports tile conclusion that there is little fear of toxic reactions from chromium consumption. This report reviews the evidence for the potential toxicity of chromium supplements in contrast with its usefulness as a nutrient or therapeutic agent in the treatment or prevention of insulin resistance.