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.

조산의 임상적 고찰

정두용 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.8 No.-

Preterm delivery of infants before 37 completed weeks gestation complicates 8-10% of births and is considered as a leading cause of neonatal morbidity and mortality(Berkowitz and Papiernik, 1993). Moreover, the sequelae for those infants who survive often causes permanent disabilities with mental and physical impairment. Efforts to prevent preterm deliveries have been hampered by a poor understanding of the underlying pathophysiology, inadequate diagnostic tools, and generally ineffective therapies. However not all preterm deliveries are the consequence of preterm parturition. The major problems of preterm deliveries are preterm, premature rupture of fetal membranes, spontaneous preterm labor in pregnancies with intact fetal membranes, and complications of pregnancies that jeopardize fetal or maternal health(or both) that mandate delivery for reasons independent of labor or rupture of the membranes. The authors reviewed the medical records of 199 patients who had delivered preterm babies, of 210 babies of theirs including 11 sets of twins and of the same number of those who had given birth at term at the department of Obstetrics and Gynecology, Konkuk University Medical Center from January 1, 1995 to December 31, 1997 and tried to find out the risk factors that could cause preterm deliveries. The results were as follows: 1. The overall incidence of preterm delivery was 8.4%: 199 cases among 2,372 cases of total deliveries. 2. The mean age of the mothers of preterm babies(28.9±0.35 year) was statistically significantly higher than that of the mothers of term babies(27.8±0.25 year), (p<0.05). 3. The mean gravidity of mothers of preterm babies(2.92±0.14) was statistically significantly higher than that of the mothers of term babies(2.39±0.09), (p<0.05). 4. The mean parity of mothers of preterm babies(1.80±0.06) was statistically significantly higher than that of the mothers of term babies(1.62±0.04), (p<0.05). 5. The mean number of artificial abortion of the mothers of preterm babies(1.14±0.13) was significantly higher than that of the mothers of term babies(0.73±0.07), (p<0.05). 6. There was no significant difference between the mean hemoglobin concentration of the mothers of preterm and term delivery group. 7. The mean Apgar score of the babies of preterm and term babies were 6.96±0.19 and 8.73±0.05 at 1 minute; 8.56±0.14 and 9.78±0.04 at 5 minute. There were statistical significances among each of those values(p<0.05). 8. The perinatal morbidity and mortality rate of prematurely born babies were 60.5% and 27.1%. 9. The major obstetrical complications of preterm deliveries were preterm labor(44.2%), PROM(44.2%), followed by PIH(14.1%) and multiple pregnancy(11.1%). 10. The major postnatal complications of the premature babies were sepsis(15.8%), germinal matrix hemorrhage(15.2%), perinatal asphyxia(8.5%), hyaline membrane disease(5.5%) and patent ductus arteriosus(4.8%) in order.

난소절제가 흰쥐 대동맥의 미세구조에 미치는 영향

최용귀,전영희,백태경,백두진,정호삼 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.2

계태간의 Ito세포 발생에 관한 미세구조적 연구

정두용,신영철 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.1

본 연구에서는 Ito세포의 발생과정을 추구하기 위하여 부란 제2, 3, 4, 5, 6, 10, 14 및 18일에 얻은 계태간과 부화직후의 병아리간에서 얻은 간장의 미세구조를 관찰하였다. 원시Ito세포는 부란 제 4일후 계태간내 Disse 강에서 처음 관찰되었다. 이들 원시 Ito 세포는 가늘고 길거나 방추모양이었는데 세포질에서는 폴리리보솜과 조면내형질세망 및 중간형세사 등이 특징적으로 관찰되었다. 짧고 가는 초기의 원시원섬유는 부란 4일째의 계태간 Disse강에 나타났지만 횡문을 보이는 교원원섬유는 부란 제14일에서 볼 수 있었다. 지방소적과 용해조체는 부란 제10일의 Ito세포에서 처음 관찰되었는데, 지방소적과 용해소체나 조면내형질세망사이에 어떠한 관계가 있음직한 미세구조적 소견은 관찰되지 않았다. 그러나 Ito세포에 함유된 지방소적은 부란일수와 더불어 증가되는 경향을 보였다. 원시 Ito 세포와 미숙 혈구는 계태 간의 Disse 강에서 빈번히 근접하여 나타났지만 이들 세포간의 이행형은 찾아 볼 수 없었는데 이러한 점으로 미루어 Ito 세포는 태생기 간장에서의 조혈에 관계가 없는 것같이 보인다. In an attempt to clarify the developmental process of Ito cells and their possible relationship to the hemopoiesis, fine structures of the Ito cell in the developmental process were observed in the chick embryo liver taken at days 2, 3, 4, 5, 6, 10, 14 and 18 of incubation, and immediate after hatching. Primitive Ito cells appeared in the space of Disse of 4 day old chick embryo livers. They are slender or fusiform in shape and are characterized by the presence of numerous polyribosomes, well developed rough endoplasmic reticulum and 10 nm filaments. Collagen fibrils with typical period could be seen in the space of Disse of 14 day old chick embryo livers, althought very fine and short protofibrils apparantly early collagen fibrils were rarely present in 4 day old chick embryo. Lipid droplets and lysosomes appeared for the first time in the Ito cell of 10 day old chick embryos. The Ito cell containing lipid droplets increased in number with embryonic ages. Special topographical relations between lipid droplets and organelles such as rough endoplasmic reticulum or lysosomes, however, were difficult to recognize. It could not be observed the transition between primitive Ito cells and premature blood cells, although they were frequently seen close together in the space of Disse of chick embryo livers. This may indicate that there is no interrelation between Ito and blood cell developments in the chick embryo liver.

B형 간염이 임신에 미치는 영향에 관한 연구

정두용 건국대학교 1995 學術誌 Vol.39 No.2

This study is a clinical and laboratory analysis of the effects of hepatitis B infection in pregnancy on the fetuses, neonates and infants. All pregnant women admitted for delivery to department of Obstetrics and Gynecology, Kon Kuk University Hospital from Jan., 1, 1992 to Dec.,31, 1993 were screened for hepatitis B viral markers such as anti-HBc and anti-HBs. The women who showed positivity for HBsAg were further studied for other viral markers including- HBeAg, anti-HBe, anti-HBc, IgG & IgM. The babies born to the HBsAg positive mothers were treated within 12 hours of birth with HBIG. They also received three doses of HBVax at birth mild one each at 1 and 2 months after birth. After 6 to 8 months of age, the efficacies of active and passive immunizations were tested. The results were as follows : The prevalence rate of HBsAg in the pregnant women was 3.5%. The prevalence rate was highest in the 30 to 39 years old age group, which was 5.4%. The positive rate of HBeAg among HBsAg positive mothers were 50%. The positive rate of anti-HBc among HBsAg positive mothers were 95%. The effects of HB infection on pregnancy outcome were as following : preterm delivery, 3.5 % ; premature rupture of membrane, 14% ; fetal distress, 4.6%. There was no significant effects on the birthweight of the babies born to the HBsAg positive mothers. Male babies were much more than female born to the HBsAg positive mothers. (M/F=53/33=1.6) One infant among 7 who were tested for HBsAg was found to be in acute HB infection despite the immunization.

폐경 여성의 호르몬요법의 새로운 임상적 지침과 대체요법

정두용,윤병일,김소정 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Recently the two studies - the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) - have provided us new and shocking knowledge that questions long-standing clinical practice and prescribing. Thereafter on October 6, 2002, NAMS (the North American Menopause Society) convened an Advisory Panel to develop clinical recommendations regarding the use of postmenopausal hormone therapy. Despite the proven benefits of HRT (hormone replacement therapy), beliefs about side effects and concerns about safety hinder acceptance of HRT among patients. So we present some updated and revised guidelines on HRT and their alternatives for the physicians and patients who have interests in HRT regimen. It seems clear that one of the essential requirements in HRT followed from this critical data of risk increases is to individualize HRT, choosing ingredients, doses and applications more adequate for the special condition of the woman.

거대아의 임상적 고찰

정두용 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

Although the definition of fetal macrosomia is variable by many authors, the delivery of the fetus weighing 4,000g or more brings many dangerous obstetrical and neonatal complications including shoulder dystocia, birth canal injuries, postpartum bleeding, voiding difficulty in the mother and brachial plexus inju(???)ry, humerus & clavicular fracture, meconium aspiration syndrome, hypoglycemia, and pneumothorax etc. in the neonate that lead to the increse in perinatal morbidity and mortality rate. The author studied 115 cases of women who gave birth to the large babies weighing more tan 4,000g among 4,151 cases of total deliveries in Kon-Kuk University Hospital during past 4 years from Jan., 1, 1992 to Dec., 31, 1995 with the brief review of literatures. The results were as follows. 1. The number and incidence of macrosomia weighing 4,00g or more was 115 and 2.77%, and those of macrosomia weighing more than 4,500g was 9 and 0.22% of total deliveries. 2. The man birthweight of the 115 cases of macrosomia was 4,210±20g. 3. The mean age of the mothers who gave birth to the macrosomia was 27.82±0.37 year and the age distribution of the mother was highest in the 25∼29 year group. 4. There was no tendency of the increase in the incidence of macrosomia as the parity increases. 5. The mean gestational age in the macrosomia group was 40.41±0.13wks and this was statistically significant from that of normal birthweight group(39.26±0.14잔). 6. The results of postpartum oral GTT were abnormal in 11 cases (9.6%) and this is not significant from that of normal birthweight group. 7. The mean weights of the mother who gave birth to the macrosomia and normal birthweight baby were 58.03±0.78Kg and 51.65±0.71Kg and this difference was statistically significant(P<0.05). The mean bodyweight at term in both groups were 71.99±0.78Kg and 64.29±0.74Kg, and also this difference was statistically significant(P<0.05). The mean weight gain during pregnancy in both groups were 13.91±0.41Kg and 12.66±0.38Kg, and the difference was statistically significant, too(P<0.05). 8. 12 women (17.9%) of multiparous macrosomia group had the previous history of delivering macrosomia. 9. Male to female ratio was 259:100 in the macrosomia group and this was quite significant from that of normal birthweight group(105:100). 10. 55 patients (47.8%) of the macrosomia group and 43 patients (37.4%) of the normal birthweight group were delivered by cesarean section and this difference was not statistically significant. 11. The indications for cesarean section in the macrosomia group were in the order of large baby (59.2%), previous cesarean section (20.3%), and fetal distress(11.1%). 12. The most common maternal antepartum complication was anemia(18.2%). And others were pregnancy induced hypertension(5.2%) and diabetes mellitus(2.6%). 13. The mean hemoglobin concentrations at delivery were 10.88±0.13g/dL in the macrosomia group and this was not statistically significant from that of normal birthweight group. 14. The most common intra and postpartum maternal complication was urinary tract infection(17.4%). And others were birth canal laceration(7.0%) and postpartum bleeding(6.1%). 15. The 1 minute and 5 minute Apgar scores in macrosomia group were quite significant from those of normal birthweight group(P<0.05). 16. Neonatal complications in macrosomia were severely depressed infant(1.7%), cephalhematoma(0.9%), brachial plexus injury(0.9%) and clavicularfracture(0.9%). There was no perinatal death in the macrosomia group.

조산 예측인자로서 Fetal Fibronectin과 자궁경부 개대 및 길이 측정의 임상적 의의

정두용,방세창,유정현,김소정 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Twenty seven pregnant women between 22 and 36 weeks of gestational age presenting with preterm labor, intact membrane and less than 3cm cervical dilatation visited the department of Obstetrics and Gynecology, KonKuk University Medical Center, Choongju Hospital from June 1, 1998 to March 31, 1999. These patients' cervicovaginal swabs were assessed for the presence or absence of fetal fibronectin by means of ROM-CHECK(monoclonal antibody assay) the positivity of which was revealed by a colorimetric reaction. Also cervical parameters such as cervical length, presence of funneling, funnel length and funnel width were measured by transvaginal ultrasonography. We compared the diagnostic performances of these results in the prediction of preterm delivery of patients with preterm labor and intact membranes. The results were as follows; 1. The overall incidence of preterm delivery(< 37 weeks) was 44%; 12 among 27 patients. 2. There were statistically significant differences in the mean Bishop scores(4.58±0.48 vs 2.13±0.36), the mean gestational age at first admission with preterm labor(33.33±0.38 vs 29.47±1.06 weeks), the mean gestational age at delivery(34.92±0.34 vs 38.27±0.34 weeks) and interval from first admission to delivery(284.2±103.1 vs 1,339.2±154.4 hour) and mean birthweight(2,620±100 vs 3,131±100g) between the preterm delivery group and term delivery group. 3. The positive rates of fetal fibronectin in the vaginal fluid of preterm delivery group and term delivery group were 42%(5/12) and 0%(0/15). 4. The mean cervical length, presence of cervical funneling, funnel length and funnel width were 22.25±2.61mm vs 30.67±1.63mm; 75%(9/12) vs 47%(7/15); 11.83±3.40mm vs 4.53±1.64mm; 11.50±2.92mm vs 6.07±1.87mm in preterm delivery group and term delivery group, and there were statistical significances in the mean values of cervical length and funnel length between each group. 5. The sensitivities and specificities of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a predictor of preterm delivery were 42% and 100%; 75% and 80%: 50% and 87%; 33% and 93%. The positive predictive values and negative predictive values of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and funnel width(≥16mm) as a predictor of preterm delivery were 100% and 68%; 75% and 80%; 75% and 68%; 80% and 64%. 6. The sensitivities and specificities of the combined use of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a predictor of preterm delivery were 83% and 67%. The positive predictive value and negative predictive value of the combination of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a whole as a predictor of preterm delivery were 67% and 83%.

탈지작업 근로자의 트리클로로에틸렌 폭로에 관한 조사

박두용,김형아,김창엽,백남원,조정진,김양호,이광묵 가톨릭대학 산업의학 쎈타 산업의학연구소 1989 韓國의 産業醫學 Vol.28 No.4

Trichloroethylene(TCE) is a widely used organic solvent, especially in degreasing process of metal manufacturing, however few data concerning its exposure and poisoning were obt-ainable. This survey was performed for more information of TCE exposure in this country. Urine sanmples were collected from 144 TCE handling workers and 46 non-TCE-exposed workers. TCE concentrations of four workshops in working environment were analyzed. The results were as follows; 1. TCE exposed workers were 48 male and 96 female employees. Average total duration of employment of these workers was 39.0 months, average duration of works per day was 10.7 hours, and average duation of TCE handling was 469.7 minutes. 2. The average concentration of urine total trichloro-compounds was 156.32㎎/ g crea-tinine, and that of trichloroacetic acid was 69.2㎎/g creatinine. Of those workers, 78 workers had the concentrations of urine trichloroacetic acid over 75㎎/g, which is the biological exposure index (BEI) of urine trichloroaxetic acid in Korea. Duration of work per day and duration of TCE- related work were significantly longer in the group of workers whose urine trichloroacetic acid concentration was over the criteria level of BEI. 3. TCE concentrations of three workshops were over the level of ACGIH TLV(threshold limit value), 50ppm in TWA (time -weighted average). In remaining one workshop, duration of TCE related works was only one hour per day. There was statistically significant correl-ation between the concentration of TCE in working environment and the proportion of workers in a workshop whose urinary trichloroacetic acid concentration was over the criteria level of BEI. 4. Responses to self-administered questionnaire were not meaningful for differentiation of psychoneurologica symptoms due to chronic TCE exposure from othres.

두양금속 주식회사의 효율적인 정보관리 데이터베이스 시스템의 구축

공용해,박두순,안종근,정재헌 호서대학교 반도체제조장비국산화연구센터 2000 학술대회 자료집 Vol.2000 No.1

기업의 효율적인 데이터베이스시스템 구축은 정보화 사회에서 반드시 필요한 사안으로 이를 통해 자료연계, 최신 정보의 입수 등 기존의 회사 생존 전략을 벗어난 세계화와 정보화를 유지할 수 있다. 이를 위하여 중소 업체에서는 한 번에 많은 투자를 해야되는 종합 정보화시스템의 도입보다는 생산 관리, 인사 관리, 회계 관리 등 각각에 대해 프로그램들을 개발하여 사용하고 있으나, 서로 각각 개발된 프로그램들은 그 활용도나 연관성 면에서 유용성이 떨어지게 마련이다. 따라서 이들 시스템간에 서로 자료를 교환하고, 의사결정을 위한 정보를 효과적으로 제시해 주는 종합 정보관리 시스템을 구축하여야 하는데, 이를 위하여 기존에 개발된 영업관리, 생산 관리, 인사 관리, 회계 관리 등의 프로그램들을 통합하는 것이 새로운 시스템을 개발하는 것보다 경제적, 기능적 측면에서 매우 유리하다 할 것이다. 따라서, 본 연구에서는 두양금속 주식회사의 기존에 사용중인 영업관리, 생산 관리, 인사 관리, 회계 관리 시스템의 통합을 목표로 하여, 이미 구축된 시스템을 분석하고 연계하여 효율적인 정보 관리 시스템을 구축하고 있다.