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.

조선후기 천문학자 이덕성의 생애와 천문활동

안영숙,민병희,서윤경,이기원,AHN, YOUNG SOOK,MIHN, BYEONG-HEE,SEO, YOON KYEONG,LEE, KI-WON 한국천문학회 2017 天文學論叢 Vol.32 No.2

The life and astronomical activity of Lee Deok-Seong (李德星, 1720-1794) was studied using various historical sources, including the astronomical almanac, Seungjeongwon-Ilgi (Daily records of Royal Secretariat of Joseon dynasty), and the Gwansang-Gam's logbooks during Joseon dynasty (A.D. 1392-1910). We present the results of the study including the following main findings. First, from the investigation of Lee's family tree, we find that a number of his relatives were also astronomers, notably Samryeok-Gwan (三曆官, the post of calendrical calculation). Second, we find that he took part in the compilation of an annual astronomical almanac over a period of at least 16 years. His major achievements in the astronomy of the Joseon dynasty were to establish a new method of calendar-making calculation and to bring astronomical materials to the Joseon court through a visit to China. The Joseon dynasty enforced the Shixianli (時憲曆, a Chinese calendar made by Adam Shall) in 1654 without fully understanding the calendar. So an astronomer and an envoy were dispatched to China in order to master the intricacies of the calendar and to learn as much of Western science as was available in that time and place. Lee Deok-Seong worked at the Gwansang-Gam (觀象監, Royal Astronomical Bureau) during the reigns of King Yeongjo (英祖) and Jeongjo (正祖). As best as we can ascertain in relation with the calculations in the Shixian calendar, Lee visited China four times. During his trips and interactions, he learned a new method for calendar-making calculations, and introduced many Western-Chinese astronomical books to Joseon academia. Lee greatly improved the accuracy of calendrical calculations, even while simplifying the calculation process. With these achievements, he finally was promoted to the title of Sungrok-Daebu (崇祿大夫), the third highest grade of royal official. In conclusion, history demonstrates that Lee Deok-Seong was one of the most outstanding astronomers in the late-Joseon dynasty.

平地와 돋움地域을 通過하는 鐵道騷音의 傳達特性에 關한 硏究 : 湖南線을 中心으로 Focused on the Honam Line

이병윤,윤해동,조원희,김재수 順天靑巖大學 1999 論文集-順天靑巖大學 Vol.23 No.-

With rapidly industrial development, a railway has become of a main traffic means. But, the rail noise has caused much annoyance for the residents living nearby railway tracks. Therefore, in our country, for established of quite dwelling environment, execute regulation standard of railway noise from January 1, 1997. Efficiency soundproofing measures, however, are very difficult because of the lack of basic data and insufficiency of the existing research. In this point, this study attempts to survey the characteristics of attenuation and propagation of railway noise. And this study intends to get the basic data for establishment of a standard about railway noise.

이명의 유병률 및 이명유무에 따른 청력역치수준

이원철,최병철,오민화,박정일,김현욱,구정완 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.3

Objectives: In order to establish prevalence and characteristics of tinnitus and hearing thresholes according to tinnitus, this study was carried out. Methods: Nine hundred and thirty two subjects, undergone human dock or general health check-up and been in college, were surveyed to the questionnaire on the general characteristics, past medical histories, life styles, subjective symptoms about hearing, taking ototoxic drugs and were conducted on the hearing thresholds by pure tone audiometry. Results: Of the total population, 98 reported tinnitus, giving an overall prevalence of 10.5%, prevalence of tinnitus in the subjects with the factors influencing hearing thresholds were 17.4%, prevalence without the factors influencing hearing thresholds were 7.5%. Frequency of tinnitus of the total population was the highest in 'once per several months' (39.6%) and followed by 'once per several days'(29.7%), 'all day long' (16.5%) and 'several times per day' (14.3%). Complaint site of tinnitus was 41.8% in left ear or right ear, 39.6% in both ear and 18.7% in head. The 13.6% of the total subjects complained sleep disturbance. Hearing thresholds in the subjects without the factors influencing hearing thresholds tended to increase or decrease in 20 and 30 years old according to tinnitus, but those with tinnitus tended to increase more than those without tinnitus in 40 and 50 years old. Conclusions: Results also provide evidence that reports of tinnitus at the time of annual audiometric testing may be useful in identifying workers at greater risk for developing significant shifts in hearing thresholds. Awareness of the possible occurrence of tinnitus may encourage workers to cooperate more actively in a company hearing conservation programme.

국내 사람 브루셀라증 환자에 대한 3년 간의 추적 관찰 연구

이창섭,권근상,백병걸,박상원,이흥범 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

목적 : 2002년 증례 보고 이후, 사람 브루셀라증 환자는 급격하게 증가하고 있는 실정임에도, 이와 관련된 장기간의 임상 증상과 혈청학적 추적 관찰에 대해서는 아직까지 보고된 적이 없다. 본 연구에서는 2003년 전북 일부 지역에서 집단 감염된 11명의 사람 브루셀라증 환자를 대상으로 장기간의 임상 경과와 혈청학적 변화를 알아보고자 하였다. 재료 및 방법 : 2003년 전라북도 정읍 지역에서 사람 브루셀라증으로 진단된 11명의 환자를 대상으로 10명의 환자가 임상 증상에 대한 추적 관찰에, 11명의 환자가 혈청학적 추적 검사에 포함되었다. 사람 브루셀라증의 추적검사는 standard tube agglutination test (SAT)로 시행하였고, 혈청학적 음성 전환은 SAT titer 1:40 이하로 정의하였으며, 브루셀라의 임상 증상이 진단 전 1년 미만으로 지속되었던 경우를 조기 회복기로, 1년 이상 지속되었던 경우를 지연 회복기로 정의하였다 결과 : 대상은 남자 8명, 여자는 3명이었고 이들의 평균 연령은 45세였다. 11명 중 10명이 축산업자였으며, 1명은 수의사였다. 3년 후 까지도 임상 증상이 남아 있다고 호소하는 환자는 8명(80%)이었으며, 만성 피로, 관절통이대부분이었고, 그 외 발열(1), 두통(2), 안통(1), 체중감소(1), 어지럼증(2)이 일부 있었다. 그러나 3년 후 추적 관찰에서 60% 이상 지속적으로 남아있는 증상은 만성 피로와 관절통이었다. 치료 기간은 최소 6주에서 최고 52주까지 다양하였으며, 중앙값은 11주였다. 혈청학적 추적 검사는 최소 11개월에서 최고 39개월까지 실시하였으며, 중앙값은 22개월이었다. 혈청학적 음성으로 전환된 시점은 치료시작 후 최소 5개월에서 최고 16개월이었으며 중앙값은11개월이었다. 결론 : 사람 브루셀라증에 걸렸던 환자들은 피로나 관절통과 같은 임상 증상이 지속적으로 남아 있을 수 있다. 그러나 이러한 증상이 재발을 의미하는 것은 아니기 때문에 항생제의 지속 복용은 필요하지 않다. 본 연구에서 혈청학적으로 마지막 음전된 시점이 치료 시작 후 16개월이라는 점으로 보아, 혈청학적 추적 검사는 치료 시작 후 최소 16개월 이상은 필요하다고 생각된다. Background : The first probable case of human brucellosis in Korea was reported in 2002. Since then there has been a gradual increase in the incidence and prevalence of the disease. There has not been any long-term follow-up investigation of the clinical course and serologic profiles of the disease in Korea. The present investigation is a 3 year clinical and serologic follow-up of human brucellosis patients in Chonbuk province. Materials and Methods : The investigation involved a total of 11 patients who were positively diagnosed with brucellosis in 2003. Clinical manifestations were evaluated either directly or via telephone interviews. The serologic follow-up was done by standard tube agglutination test (SAT). Negative sero-conversion was defined as an SAT titer less than 1:40. Early convalescence was defined as clinical manifestations of brucellosis observed within 12 months of diagnosis, and delayed convalescence was defined as clinical symptoms persisting longer than 12 months. Results : A total of eleven patients (8 males and 3 females; with a mean age of 45 years) participated in the study. Ten patients were livestock workers and one was a practicing veterinarian. Three years after the initial diagnosis, chronic fatigue and arthralgia were persistently observed in more than 60% of the patients in delayed convalescence. There was no evidence of relapse or reinfection of the disease. The median duration of antibiotics treatment and serologic follow-up were 11 weeks and 22 months, respectively. Negative sero-conversion was noted between 5 and 16 months after the initiation of treatment (with a median 11 months). Conclusion : Although the human brucellosis patients developed chronic symptoms such as fatigue and arthralgia even after negative sero-conversion, there was no evidence of any relapse or reinfection. This may mean that antibiotic intervention is not a justifiable recommendation. We also suggest that serologic monitoring be performed for at least 16 months after the initiation of treatment.

비파괴시험 및 수치해석기법에 의한 콘크리트 포장슬래브의 구조적 평가

이승원,노병철 尙志大學校 1996 論文集 Vol.17 No.-

A study on structural evaluation of cement concrete pavement slabs has importance as a basic research required for the analysis of sturctural behavior and the estimation of remaining life, and the development of new analytical design method. In this study, transfer rates in terms of deflections of concrete pavement salbs are examined to analyze the dowel bar effect and the location. Back calculation for material properties of concrete pavement slabs is also performed based on the FWD(Ralling Weight Deflectometer) deflection measurements.

주요우울증에 대한 벤라팍신의 효과 및 안전성

이민수,남종원,강성민,연병길,오병훈,이철,정인과,채정민,백인호 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요우울증 환자에서 벤라팍신의 치료 효과와 안정성을 조사하기 위해 다기관 개방연구를 시행하였다. 방 법 : DSM-IV 진단 기준에 의거하여 주요우울증으로 진단된 환자중 벤라팍신 투여에 동의한 환자를 대상으로 하였다. 선택된 환자에서 다른 항우울제를 복용하고 있는 경우 14일 이상의 약물 배설기간을 가진후 벤라팍신을 6주간 투여하였으며, 기준점, 1주, 2주, 4주, 6주 후에 HAM-D, MADRS, 그리고 CGI등을 사용하여 평가하였다. 본 연구기간중 발생된 모든 부작용은 부작용의 발생 및 소설 시기, 심한 정도, 발생 빈도, 벤라팍신과의 관련성, 관련 조치 및 결과에 대하여 증례기록서에 기록하도록 하였다. 결 과 : 총 141명을 대상으로 하였으며, 이중 94명(66.7%)이 6주간의 연구를 완결하였고, 47명(33.3%)이 중도탈락하였다. HAM-D총점수는 벤라팍신 투여 1주후부터 유의한 감소를 나타내었으며, 2주,4주, 6주후에도 지속적인 감소를 보였다. MADRS의 총점수도벤라팍신 투여 1주 후부터 유의한 호전을 나타내었으며, 2주, 4주, 6주 후에도 지속적인 감소를 보였다. CGI에서도 기준점, 1주, 2주, 4주, 6주 후 각각의 시점 사이에 유의한 호전이 보였다. 활력징후, 일반 혈액학, 생화학, 심전도 검사 등에서 유의한 변화는 없었다. 벤라팍신과 관련된 부작용으로 흔히 보고한 증상은 오심(10.6%), 소화불량(9.5%), 변비(8.5%), 현기증(8.5%)등 이었다. 결 론 : 다기관 개방연구를 통해 주요우울증 환자에 대한 벤라팍신의 투여는 우울증상의 호전에 효과적이었으며 안전하였다. Objective : A Multicenter open-label study was conducted to evaluate the clinical efficacy and safety of venlafaxine for the tretment in patients with major depression. Method : The study was done in patients with major depression diagnosed by DSM-IV who accepted venlafaxine medication. In cases of the patients taking other antidepressants, 6 weeks of venlafaxine medication was carried out after 14 days of drug excretion period and evaluation using HAM-D, MADRS, and CGI was done at baseline, and after 1, 2, 4, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, relationship with venlafaxine, managements and results have been putted into the records. Results : A total of 141 patients were enrolled. Among 94 of them finished the 6 weeks of research and 41 of them did not make it through the research. Total HAM-D scores showed significant decrease after 1 week of venlafzxine medication and continous decrease through the study period. Total scores of MADRS also showed significant improvement after 1 week and continuous decrease through the study period. Similarly, CGI showed significant improvement between baseline, 1, 2, 4, and 6 weeks. There were no significant changes in vital sign, CBC, chemistry, and EKG. The commonly reported side effects of venlafaxine were nausea(10.6%), indigestion(9.5%), constipation(8.5%), and dizziness(8.5%). Conclusion : According to the results, venlafaxine was effective and safe in the treatment of patients with major depression.

만성 간질환에 대한 DDB(Biphenyl Dimethyl Dicaboxylate)의 임상적 효과

이헌영,임의혁,김성걸,김진희,육은주,성자원,김병호,정형용,강대영,김영건 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

To investigate the effects of short-term administration of DDB(Biphenyl Dimethyl Dicarboxylate) for decreasing elevated serum aminotransferase levels in chronic liver diseases, authors applied 3 capsules of DDB per day at each meal time for 35 patients and compared with 35 patients treated with other conservative management. The following results were obtained. 1. Serum alanine aminotransferase (ALT) levels significantly decreased from 247.1± 180.0 IU/L of pretreatment level to 96.6±126.0 IU/L, 61.1±62.7 IU/L and 38.0±26.8 IU/L after 1, 3 and 6 months of treatment(p<0.05) and effective rates were observed in 60.0%, 71.4% and 88.6% of patients after 1, 3 and 6 months of treatment. 2. Serum aspartate aminotransferase (AST) levels decreased also significantly from 167.8±96.9 IU/L of pretreatment levels to 124.4±155.0 IU/L, 77.9±49.6 IU/L, 60.6± 46.9 IU/L after 1, 3 and 6 months of treatment(p<0.05), but decreasing pattern of serum AST was less significant than that of serum ALT. 3. No significant difference were observed in the serum ALT and AST changes according to the cause and duration of hepatitis. 4. No significant adverse effects were observed in whole patients treated with DDB. It is suggested that small dose administration of DDB is effective for decreasing serum aminotrans ferase levels in chronic liver disease in which other conservative management was not effective.

거액전자자금이체에서의 지급지시의 효력

강원진,이병렬 한국통상정보학회 2001 통상정보연구 Vol.3 No.1

본 연구는 미국의 거액전자자금이체에서의 지급지시의 효력을 검토하고 그 시사점을 제시한 것이다. 거액전자자금이체에서의 지급지시의 효력은 원지시인으로부터 구속력을 가진 지급지시의 발행, 수신은행의 지급지시에 따른 승낙, 그리고 수익자에 대한 체무이행으로 발생된다. 이와 같은 지급지시는 원지시인의 지급지시취소, 수신은행의 지급지시거절, 그리고 무권한적인 지급지시인 경우에 그 효력이 소멸된다. 즉, 원지시인으로서 입증된 전송자가 발행한 지급지시를 수신은행이 승낙하는 경우에만 지급지시가 정상적으로 이행되어 전자자금이체가 완료된다고 할 수 있다. 따라서 원지시인과 수신은행은 원지시인에 대한 입증과 지급지시의 진정성을 확보하여야 한다. 이러한 입증과 진정성 문제를 해결하기 위하여 관련 당사자들은 특히 보안절차의 확립에 관하여 약정하는 것이 중요하다.

무시멘트 금속-금속 관절면 고관절 전치환술의 단기 추시

최원식,안재훈,이병기 대한고관절학회 2001 Hip and Pelvis Vol.13 No.1