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.

인터넷 의료상담에 관한 분석 및 연구

김영조,박홍표,정병수,최규철 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Telemedicine uses computer and telecommunication technologies to provide medical information and services. Telemedicine can be useful in any situation in which there is a physical barrier between the doctor and the patient. We analyzed medical consultations from Chosun University Hospital is home page (http://hosp.chosun.ac.kr) to find problems on the home page and to offer high quality medical information services. Methods : We collected 544 queries of medical consultation on our home page from May 1998 to May 1999. From medical consultation data on the internet web site of Chosun University Hospital, consulted documents were analyzed with regard to medical department, patients’ age, consultation by attorney, and dermatologic consultations. Results : The telemedicine system is a relatively satisfactory method to both patients and physicians due to easier access and almost rea1-time medical consultation through the world wide web. But several problems should be solved to provide a more effective and lawful telemedicine environment. Conclusion : As a consequence to analyzed medical consultations on our home page, there were several problems in our store-and-forwarding system. To establish an effective telemedicine system, we have to prepare protocols to receive sufficient information and patients have to send digital images to make help an accurate diagnosis. Also problems of liability, reimbursement and coordinated national policy need to be solved.

제7차 교육과정 개편에 따른 종교교육론의 쟁점과 새로운 방향

金鐵柱,高柄哲 韓國宗敎敎育學會 2003 宗敎敎育學硏究 Vol.17 No.-

이 글의 목적은 제7차 교육과정 개편에 따른 다양한 논의들을 탐색하여 종교교육 관련 쟁점들(points of issue)을 찾아내고, 이를 바탕으로 앞으로 진행되어야 할 종교교육의 방향성을 점검해보려는 것이다. 이 연구에는 시기별로 각 교육과정의 종교교육론을 성찰하면서 현행 종교교육론의 위치를 재구성하는 작업이 병행되었다. 현행 종교교육론의 쟁점을 종교교육론의 역사 속에서 재구성하는 작업은 앞으로 진행될 종교교육과 종교교육론에 보다 근본적인 문제와 방향성을 제기할 수 있기 때문이다. 소기의 목적을 위해서 먼저 2장 '제7차 교육과정의 종교교육론'에서는 제7차 교육과정에서 종교교육론이 규정된 방식들을 검토하였다. 3장 '종교교육론의 갈등 요인'에서는 제7차 교육과정의 종교교육론을 둘러싸고 발생된 갈등을 살펴보았으며, 실제로 "종교' 과목을 선택한 학교들의 반응을 중심으로 접근하였다. 마지막으로 4장 '종교교육론의 쟁점과 방향'에서는 앞의 논의를 종교교육론의 역사와 연관지어 쟁점화 시키면서 앞으로 진행될 종교교육의 방향에 대해 숙고하였다. The purpose of this research is to investigate various educational issues according to 7th. national curriculum standard. Through the process of this research, we tried to find out points of issue of religious education and examined the new directions of religious education that should be persued in the near future. While reflecting the curriculum policies on the religious education by the each time period of national curriculum revision, reorganizing current status of religious education was carried out. In the context of history of religious education, reorganizing the issues of current religious education can raise fundamental problems and directions of religious education in progress. To achieve these purposes, in chapter 2, in the title of 'religious education in the 7th. national curriculum standard' we reviewed how religious education was defined in the 7th. national curriculum standard. In chapter 3, 'the confrontational elements of religious education', we reviewed what have been caused by the 7th. national curriculum standard for the religious education. Also, we examined the reactions toward 7th. national curriculum standard from the mission schools which chosen religious subjects on their school curriculum. The chapter 4, in the title of 'points of issues of religious education and new direction', we made a reference to previous discussions of the article with the history of religious education. In this writing, we classified two different issues of religious education. The first issue was, the identity of religious education that have two oppositional points of views from the time of 4th. national curriculum standard. The second issue was the possibility of connection between 'religious education' and 'moral education'. As long as the current curriculum exist within the boundary of modem national curriculum standard, we clarified the fact that the debates on religious education should be proceed within the scope of consideration of coherence between religious education and modern national curriculum.

쇄석말뚝(CSP)의 압밀거동특성에 관한 실험적 연구

김유철,김병일,박용원 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

Crushed Stone Pile(CSP) is one of the ground improvement methods and is suitable for soft clays or loose silty sands. CSP has proven successful in increasing bearing capacity, reducing settlements, increasing time rate of consolidation. In this study several model tests were performed to evaluate the stress concentration ratio and the consolidation behaviour characteristics of CSP relevant to the area replacement ratio. Two rectangular model tanks(1.0m×1.0m×1.0× & 1.5m×1.5m×1.2m) are used and area replacement ration of 20%, 30%, 40%, are applied in the model tests. The results of model tests are compared with the model test results of SCP performed previously.

디지털 및 일반 측방두부규격방사선사진에서 측정 방법에 따른 계측치의 비교

김미자,허경회,이원진,허민석,이삼선,이진구,안병근,최순철 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.1

Purpose : To compare cephalometric measurement between measuring methods in digital and conventional lateral cephalometric radiograph. Materials and Methods : Twenty digital and conventional lateral cephalometric radiographs were selected. In digital group, cephalometric measurements were performed manually using hardcopies and automatically using VCeph^(TM) program on the monitor. In conventional group, the same measurements were performed manually on conventional films, and for automatic measurement conventional films were digitized by scanner. All measurements were performed twice by 4 observers, and 24 cephalometric variables were calculated and the time spent for each measurement was recorded. The differences in measurements data and the time spent for each measurement were compared within each group. Intra-observer and inter-observer comparisons were performed. Results : In both groups, no statistically significant difference between manual and automatic measurements was observed and most of the variables didn’t show statistically significant differences between methods. The observer with less experience tended to show statistically significant differences of measurements between methods, and differences from other observers. The differences of measurements between methods in digital group were lesser than those of conventional group with statistical significance in 8 variables out of 24. With automatic method and in digital group, the spent time was shorter. Conclusion : With direct digital radiograph, automatic method using manually idenitified landmarks can be preferable in cephalometric analysis.

Fenton산화에 의한 쓰레기 埋立場 浸出水의 處理

김선희,이병대,김세정,이철희 嶺南大學校 工業技術硏究所 1995 工業技術硏究所論文集 Vol.23 No.1

This study was aimed to investigate treatment feasibility of leachate from landfill that was located in Bancheung-Dong Kyungbuk Talsung-Kun. From the analytical results of leachate, high concentration of organic and nonbiodegradable matters was contained. It could not be treated by biological process only thus required a combined treatment able to high rate COD removal efficiency. Two types of Fenton's oxidation were adapted in this study. The first one is pre treatment before biological treatment. The second one is post treatment after biological treatment. Thus, the optimal conditions in both methods were investigated. From the survey of treatment conditions, in case of pre treatment, the optimal condition was ?? 0.1, ?? 27.08, pH 3, temperature 30℃ and reaction time 2 hr. On the other hand, ?? 0.14, ?? 57.42, pH 3, temperature 30℃ and reaction time 1.25 hr was obtained for post treatment as optimal conditions. In the above optimal conditions, high COD removal efficiency was shown in pre and post treatment. Also it can be expected that nonbiodegradable matters are degraded and converted to biodegradable matters.

여드름 환자에서 adapalene 겔과 tretinoin 크림의 split-face 비교 연구

김영조,선정우,정병수,최규철 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background : Adapalene is a new synthetic naphtholic acid derivative with potent retinoid and antiinflammatory properties, developed for the topical treatment of acne vulgaris. Objective : This study was designed to compare the efficacy and safety of 0.1% adapalene gel with tretinoin cream(0.025% and 0.05%) in the treatment of grade I to V facial acne vulgaris. Methods : Forty acne patient volunteers were enrolled in this investigatormasked, left-right comparison, randomized, controlled, intraindividual study. 0.1% adapalene gel and tretinoin cream(0.025% or 0.05%) were applied once a day to one halfface by the volunteers for 30 consecutive days. Efficacy and cutaneous tolerance were accessed at baseline and week 1, 2, 3, and 4. Efficacy was determined by investigator counts of inflammatory papules and pustules, and non-inflammatory open and closed comedones, as well as global improvement. Clinical signs(erythema, desquamation, dryness) and subjective symptoms(pruritus, burning) were evaluated and scored weekly. Result : 0.1% Adapalene gel was more effective in treating acne lesions than tretinoin cream(p<0.05). Cutaneous side effect was limited to a mild retinoid dermatitis occurring in all treatment groups. However, patients treated with adapalene gel tolerated this therapy significantly better than those treated with tretinoin cream. Conclusion : 0.1% adapalene gel applied once daily was significantly more effective in reducing acne lesions and was better tolerated than tretinoin cream in the treatment of acne vulgaris.

소규모 도시의 생활폐기물 발생특성 : 동해시를 중심으로 For Donghae City

김승호,원철희,김병욱,임재명 江原大學校 産業技術硏究所 2002 産業技術硏究 Vol.22 No.B

This research was performed to investigate the generation and physico-chemical characteristics of municipal solid wastes. The results were as follows: i) The generation rate and bulk density were 0.157 kg/cap/d and 147.8 g/L in residential zone, respectively. In non-residential zone, the generation and bulk density were 1.71 kg/cap/d and 85.6 g/L, respectively. Consequently, bulk density of non-residential zone was lower than that of residential zone. ii) The wastes consisted of 90% of combustibles and 10% of incombustibles in residential zone. And the wastes from non-residential zone was composed 85% of combustibles and 15% of incombustibles. iii) Water content was estimated at 47∼50% in residential zone and restaurants. In non-residential zone, except restaurants, water content was in the range of 10∼30%. Ash content was nearly 10% in overall zone.

도심지 하수관거의 I/I 및 CSOs 특성

김병욱,최승철,원철희,임재명 강원대학교 부설 석재복합신소재 제품연구센터 2003 석재연 논문집 Vol.8 No.-

본 연구에서는 도심지 하수관거의 특성을 파악하기 위하여 원주시를 대상으로 수질 및 유량 조사를 통하여 기존 하수관거의 침입수/유입수(I/I) 분석 및 하수관거 정비사업시 우선순위 결정을 위한 자료제공과 강우시 CSOs의 발생특성을 분석, 결과를 고찰하였다. 그 결과 원주시의 조사지점별 평균 BOD는 원주하수종말 처리장 설계기준과 비교하여볼 때 26.O~60.7%로 매우 낮게 배출되는 것으로 조사되었으며, 평가기법에 의한 원주시 도심지역의 I/I율은 평균하수량의 35.7~74.6%로 매우 높은 것으로 조사되었다. 또한, 강우시 발생하는 CSOs는 배수유역의 크기와 강우량, 강우강도, 차집용량에 따라 큰 유량차이를 보였으며, CSOs의 수질분석결과 강우초반부 초기세척(First-flush)현상으로 수질이 급격히 상승하였다가 감소하는 것으로 나타났으며, CSOs의 BOD부하를 살펴보면 일평균 BOD부하의 18.7~38.5%이상으로 인근수역으로 미처리되어 배출되는 것으로 조사되었다. 이와같이 하수관거의 I/I율과 CSOs의 발생특성은 조사지점의 특성에 따라 큰 차이가 있으므로 관거정비사업시 이에 대한 충분한 조사 및 분석이 이루어져야 할 것이다. Infiltration/Inflow(I/I) is the major deterrent to the successful performance of the sewer and the treatment systems. An excessive I/I in a sanitary sewer system can hydraulically overload the sewer lines and the wastewater treatment plants and combined sewer overflows(CSOs) are untreated wastewater during storm events. The characteristics of the CSOs are extremely variable, depending upon local physical conditions such as topography, soil conditions, degree of development and imperviousness of surface. As a result of the flow rate and water quality monitoring, biochemical oxygen demand(BOD) concentration was significantly low as 26.0-60.7% of 173mg/L which is a design standard of wastewater treatment plant. I/I rate of sewer in the center of Wonju city evaluated by assessment method was very high as 35.7-74.6% of total flow. Furthermore, 18.7-385% of BOD load of CSOs during wet weather was discharged into watershed with being untreated. As stated above, I/I running into sewer system should be considered before everything when sewer system is improved and CSOs generated during wet weather should be necessarily deliberated for design of water treatment plant and improvement of sewer system.

코먼레일 單汽筒 디젤엔진에서 GTL 熱料의 噴射時期 變化에 따른 排出物 特性에 關한 硏究

金秉儁,崔源鶴,柳鍾植,李海喆,車京玉 명지대학교 산업기술연구소 2008 産業技術硏究所論文集 Vol.27 No.-

Recently, alternative fuels are drawing more attentions due to the increasing need for lower emission characteristics and fuel consumption rate in automotive engines. The GTL(gas to luquid) is the one of most favored candidates. It has higher cetane number(more than 75) and almost negligible sulphur and aromatic contents. Therefore, enhanced emission characteristics are expected even in the application in diesel engines without any modification. In this study, the cylinder pressure and heat release, emission characteristics with fuel injection timings are compared between diesel and GTL fuel in the single cylinder diesel engine. Noticeable reduction in PM, THC and CO emission are observed due to lower sulphur and aromatic contents in GTL. Also, the ignition delay decreased due to higher cetane number of GTL , which slightly decreased the amount of NOx emissions. With the retards of main injection timing. NOx decreases more for the case of GTL, while the level of THC and CO emissions still remains lower than the case of diesel. Therefore, there is much room for the control of injection timiing for NOx reduction without sacrificing THC and CO emissions. With the retards of main injection timing, Small size distribution of PM became lager and there amount increased. But from all conditions, size distribution of PM for the case GTL was lower than Diesel.