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.

1회선 분기점을 갖는 병행 2회선 송전선로의 고장점 표정 알고리즘

강상희,권태원,최면송,이승재 明知大學校 産業技術硏究所 2000 産業技術硏究所論文集 Vol.19 No.-

This paper presents a fault location algorithm of a single phase-to-ground fault on a parallel transmission line which contains a teed circuit. The method uses only the local end voltage and current signals. Zero sequence currents of other lines are calculated by distribution factors. Instead of zero sequence current, negative sequence current is used to remove the effect to load current and to calculate the voltage of a fault resistance. There are two distance equations in this algorithm. One of them is to calculate inner part fault location of the tap distance and the other equation is for outer part fault location of the tap distance, Correct fault distance is selected by the condition of each solution. Extensive simulation studies using EMTP have verified that the proposed algorithm can calculate an accurate fault distance in spite of effects of various error sources.

Think Aloud 프로그램을 통한 자기교시훈련이 정서 · 행동장애아의 문제행동에 미치는 영향

강정림,이승희 조선대학교 학생지도연구소 2004 生活指導硏究 Vol.23 No.1

This study aimed to examine the effects of self-teaching training through Think Aloud program on problem behaviors of children with emotional and behavioral disorders. To do this, one child was selected and was instructed by self-teaching training through Think Aloud program which was reconstructed by the researcher. Before and after the training, the child was observed with frequency recording methods on three behaviorsU crying loudly, asking for other's help by verbal expressions, and getting together with her peers. Results revealed positive effects of the training on the three behaviors. The results were discussed in relation to previous research and a suggestion was presented for future research.

Tobit 모형을 이용한 CVM 분석

강주훈,강희용,정승진 관동대학교 기업경영연구소 2004 경영논집 Vol.22 No.-

There, in general, exists a difficulty in evaluating the external effect of economic activities by measures. It is simply because the external economic effect often fails to reflect the market price in real market transactions. Because evaluating the social expenses or benefits from public goods or environmental pollution often relies heavily on indirect, individual and subjective decision, it often tends to be over or underestimated. This paper adopted a closed Contingent Valuation Approach; if a respondent agrees on a specific price at the first stage that makes it possible to advance with an increased price to the second stage in which the respondent may accept the increased price. Then the respondent pays the highest price In the regression analysis, the Probit Model and the Logit Model is used in case that the dependent variable is considered as the appropriate selectable variable. The Tobit Model can be more of an appropriate model than the Probit and Logit in terms of describing the highest paying price at the second stage through the closed and contingent valuation approach.

중공유리구에 고정화된 광촉매를 이용한 남조류의 증식억제

강민수,정익상,우승희,김성우,이동근 경상대학교 환경보전연구소 2001 環境保全硏究所報 Vol.9 No.-

Photocatalytic inactivation of Microcystisaeruginosa was carried out with the TiO₂-coated pyrex hollow glass beads under the illumination of UV light(370㎚ wavelength). After being irradiated with UV light in the presence of the TiO₂-coated pyrex glass beads, Microcystis aeruginosa, known as typical cyanobacteria, lost their photosynthetic activity, and the colonies of Microcystis cells were completely separated into individual spherical one. Complete photocatalytic inactivation of Microcystis aeruginosa was obtained in about 30min. Photosynthesis activity of the cyanobacteria could be inhibited effectively after being reacted photocatalytically with TiO₂ immobilized hollow glass ball.

Riblets을 이용한 난류 경계층의 표면 마찰항력 감소에 관한 연구

姜承熙,柳常新 한국항공대학교 1990 論文集 Vol.28 No.-

An experimental study on the skin friction drag reduction with riblets on the flat plate is presented. Riblets engraved on the flat plate modify the turbulent structure and the turbulent intensity of the wall region. The shapes and dimensions of riblets cross sections are reported as the major factors affecting the skin friction drag reduction in the turbulent boundary layer. Riblets of the circular and triangular cross sections are prepared for the experimental works. Reduction of the turbulent intensity of the triangular riblets is more pronounced than that of the circular riblets. Skin friction drag reduction about 9% is observed when a model of the triangular riblets is used. However, the drag reduction is almost not discernable when a model of circular riblets is tested.

변압기 보호를 위한 Fuzzy Decision Making 알고리즘

강대훈,이승재,강상희,권태원 明知大學校 産業技術硏究所 1999 産業技術硏究所論文集 Vol.18 No.-

This paper presents a new fuzzy decision making algorithm for power transformer protection based on the Dempster-Shafer's theory of evidence. To distinguish internal faults from other transient states, four input variables are selected. Each time dependent fuzzy rule base is composed of twelve fuzzy if-then rules associated with their basic probability assignments (BPAs) for singleton - or compound-support hypotheses. Dempsters rule of combination is used to process the fuzzy rules and get the final decision. The proposed algorithm also has a capability to identify the inrush, over-excitation and external fault with current transformer (CT) saturation besides the internal fault.

뇌졸중 위험인자를 가진 어지럼 환자에서의 확산강조 자기공명영상

강형구,윤유상,이진희,박인철,이경룡,정상원,구홍두,김승호 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: The management of vertiginous patients is a great challenge to emergency physicians. We evaluated the diagnostic value of a diffusion-weighted image(DWI) in differentiating central vertigo from the peripheral vertigo in patients who presented no neurological symptoms other than risk factors for stroke. Methods: From March 2000 to February 2001, we retrospectively analyzed the cases of 68 patients who visited the emergency department with symptoms of isolated vertigo and who had risk factors for stroke. DWIs, computed tomograms(CT), and medical records were reviewed, and the final diagnose, the DWIs and the CT readings, the risk factors for stroke, and the time it took waiting for a DWI or CT scan were analyzed. Results: Of the 68 patients, 21(30.8%) had central vertigo: 15 vertebrobasilar transient ischemic attacks(VB-TIA), 4 brain stem infarctions, 1 cerebellar infarction, and 1 cerebellopeduncular infarction. The DWI showed a 28.6% sensitivity, a 97.9% specificity, and an 85.7% positive predictive value in diagnosing central vertigo. It also had a 100% sensitivity in detecting infarctions. Conclusion: A DWI had a comparable sensitivity to MRI in detecting central vertigo and small, but potentially, lethal infarctions in our patient population. We recommend clinical application of DWI in the emergency department evaluation of isolated vertigo patients with risk factors for stroke.

레이저 박피술의 피부면적 감소효과와 레이저 punch out 병변의 치유에 대한 실험적 연구

강동희,윤을식,구상환,안덕선,박승하 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

An experimental study was designed to analyze the surface reduction effect of ultrapulse carbon dioxide laser on the skin of guinea pigs receiving laser resurfacing. Two squares of skin measuring 3x3 ㎠ were designed on each side of the abdomen of guinea pigs(n=10). Five animals received laser resurfacing on their abdomen at energy of 250mJ/5 watt, and five other animals received 500 mJ/5 watt. On each animal, the left side square was treated with one pass of a CO2 laser, and the right side q=square was treated with two passes using a C.P.G. scanner. The size of the resurfacing area was determined by celluloid overlays at 1,2,3,4 and 6 weeks. Immediately following laser resurfacing, the area was decreased to 69%(left side) and 56%(right side) of the designed area in the 250 mJ/5 watt group, and 59% and 40% in the 500mJ/5 watt group. After 6 weeks, the resurfaced area had been reduced to 70% and 56% of the designed area in the 250mJ/5 watt group, and 60% and 40% in the 500mJ/5 watt group. As a result, the effect of surface reduction by CO2 laser resurfacing increased at a higher power and when more passes of the ultrapulse carbon dioxide laser were applied. The laser treated skin continued to maintain its contracted dimensions. These findings suggest that ultrapulse carbon dioxide laser may be an effective treatment method for rhytides. Another experiment was performed on multiple punch-out lesions on guinea pig skin(n=2) with 1,2,3 mm collimated hand pieces for the purpose of determining a new laser treatment method. After 4 weeks, on gross and histological examination, there were no differences in the healing of multiple punch-out lesions and the healing of punch-out lesions was complete without any scarring. These findings suggest that the laser punch-out method can be used for the treatment of acne scars.

해수와 해산물에서 분리된 Listeria 속에 대한 항균제 감수성시험과 Inactivation 시험

강치희,이승철,황용일 慶南大學校 附設 基礎科學硏究所 2000 硏究論文集 Vol.14 No.-

주요 식중독균으로 주목받고 있는 Listeria sp.를 경남지역의 해수와 해산물에서 분리하여 항균제 감수성시험, 온도에 대한 균의 감수성 시험, 시험균주의 증식곡선, 내염성 시험과 pH에 대한 균의 증식관계를 조사하였다. 해수와 해산물에서 분리동정된 18주의 Listeria sp.에 대하여 디스크 확산방법으로 항균제 감수성 시험을 실시하여 ampicillin에 55.6%, cephalothin에 100%, chloramphenicol에 100%, clindamycin에 100%, erythromycin에 100%, gentamicin에 100%, kanamycin에 77.8%, methicillin에 83.3%, streptomycin에 50%, tetracycline에 83.3%, vancomycin에 100%의 감수성을 각각 보였다. 온도에 대한 증식억제효과는 55℃에서 30분간 처리에서는 영향이 없으나 60℃에서는 L.monocytogenes Type 1과 L.monocytogenes Type 4, L. ivanovii, L. welshimeri는 20분 처리로 사멸하였으며 L.monocytogenes ATCC 19111과 L. monocytogenes Scott A, L. innocua는 25분 처리로 사멸하였다. 65℃처리에서는 L. monocytogenes Type 4와 L. innocua, L. ivanovii는 15분에서 사멸하였으며 L. monocytogenes ATCC 19111과 L. monocytogenes Scott A, L. monocytogenes Type 1, L. welshimeri는 20분간 처리로 사멸하였다. 분리된 Listeria sp.의 내염성은 8% 이상에서는 지연된 유도기가 관찰되었으며 6% 염을 첨가한 0.6% TSA-YE배지에서는 정지기에서 흡광도(590nm)가 0.67에서 0.87의 범위에 있었으며, 8% 염에서는 정지기의 흡광도가 0.44에서 0.73이었고, 10% 염에서는 흡광도가 0.18에서 0.63이었으며, 12% 염에서는 OD 값이 0.03에서 0.2로 측정되어 염의 함량이 높을수록 저해 정도도 높았다. pH에 대한 증식영향은 pH 5.0에서보다 pH10에서의 증식이 빠른 것으로 보아 Listeria sp.는 비교적 높은 pH에서 생육가능 함을 보였다. Eighteen of Listeria species, a potent food poisioner, were isolated from sea food and seawater in Kyungnam area. These strains were tested for the sensitivities of antibiotics and temperature as well as for the resistances to high salt concentrations and the cell growth in different pHs and media compositions. The average sensitivities (%) of the eighteen listerias in disc diffusion method were following : ampicillin 55.6, cephalothin 100. chloamphenicol 100, clindamycin 100, erythromycin 100. gentamycin 100, kanamycin 77.8 methicillin 83.3, streptomycin 50, tetracyclin 83.3 and vancomycin 100. The viability of Listeria species was not so affected by heat treatment at 55℃ for 30 min. However, L. monocytogenes Type I and IV, L. ivanovii and L. welshimeri ceased to grow at 60℃ in 20 min. In contrast, the growth of L. monocytogenes ATCC19111, L. monocytogenes Scott A and L. innocua was affected in 25 min. L. monocytogenes type IV, L. innocua and L. ivanovii stopped growing at 65℃ in 15 min. L. monocytogenes ATTCC19111, L. monocytogenes Scott A, L. monocytogenes Type I, and L. welshimeri did not sustain at 65℃ for 20 min. The growth of the listerias were lagged in the presence of over 8% NaCl. In TSA-YE medium containing 6% NaCl, the optical density (OD) at 590mm of the cell culture reached stationary phase from 0.67 to 0.87. At 8% NaCl, the stationary phase OD of the culture was from 0.44 to 0.73. At 10% NaCl, the stationary phase OD of the culture was from 0.18 to 0.63. At 12% NaCl, the OD of the culture from 0.03 to 0.2. Therefore, higher salt concentrations created greater inhibition for the cell growth, Finally, the growth rates of the listereas were higher at pH 10 than at pH 5, which implies that the growth of the listerias was favorable in the alkaline pH.