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.

과량의 인슐린 투여로 인한 인위성 저혈당증 1예

김준우,안철우,남주영,김똘미,김영균,추적금,박종숙,박진아,조승현,김동연,김도연,윤수지,이경열,차봉수,김경래,임승길,이현철,허갑범 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

본 저자들은 인위적인 인슐린 투여로 인한 인간성 저혈당증 1예에서 보존적인 치료로 의식기능은 회복하였으나, 현저한 인지능력 저하를 하였기에 문헌고찰과 함께 보고하는 바이다. Factitious hypoglycemia is a covert attempt to lower the blood glucose concentration with insulin or a sulfonylurea agent. This attempt is mainly performed by the patients themselves. In a large series of diabetics who had overdosed on drug, less than 5% had used insulin for suicidal or homicidal purposes. Additionally, 4 of 204 hypoglycemic episodes were due to a suicide attempt with insulin. The onset of insulin action, its peak level, and duration, and the degree of hypoglycemia, are determined by insulin's pharmacokinetics. However, the final outcomes are not associated with the amount of insulin used. The complications related to insulin overdose are cerebral damage and hypokalemia. Other complications include, pulmonary edema attributed to congestive heart failure and hypertensive crisis, as well as respiratory insufficiency. We report this case with a review of the literature.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

독성물질의 세포사 기전 및 세포사 유발물질의 검색법 개발에 관한 연구(Ⅰ) : 독성물질로 인한 파킨슨병 모델에서의 세포사 기전 연구 Study on the cell-death mechanisms of toxin-induced parkinsonism

강태석,김종민,서경원,김영옥,김준규,오재호,이윤동,김규봉,오정자,송연정,임종준,전범석,문전옥,최광식 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

MPTP 독성물질이 도파민성 신경세포에 선택적으로 작용하여 산화성 손상에 의한 신경세포사를 일으키는 것을 이용하여 파킨슨병의 동물모델을 만들고, 이를 통해서 아폼토시스를 비롯한 포사의 기전에 대한 연구 및 너코틴의 신경세포 보호효과 여부를 판정하는 실험을 병행하고자 하였다. 파킨슨꾐의 동물모델을 MPTf 독성 물질을 이용하여 확립하였으며, MPTP(30mgag, i.p.)를 투여한 후 1, 2,3, 4, 5일째 흑질 조직을 채춰하여 tarm로 박걸하여 tyrosine hydroxylase 면역조직화학염색을 수행하여 cell countif우한 결과, control은 57.635ce11s, 1일째 친.OfDells,2일째 57.9±6cells,3일릴 없.3±죠ells, 4일째 49.0츠3cells, 5일째 39.4±Scells료 4, 3일째 뚜렷한 신경세포 수의 감소를 보였다. 신경세포사 기전 규명을 위한 아폼토시스 분걱에서는 벼PTP 투여 후 1, 2, 3, 4, 5일째 조직을 채취하여 Hoechst staining, TUNEL staining을 수곡하였는데 양성 반응을 보인 신경세포는 관찰되지 않아. 아폼토시스로 인한 세포사가 관찰되지 않았다. bIPTP 파킨슨병 동물모델에서 nicotine 보호효과 탐색에 관한 실험은 nicat푸e 0.2mgAg을 5일 퐁안 투여 후 리『fP(30mgag)를 CS7Bt/6 마은스에 복강 내주사로 nicotine과 병용 투여한 후 1, 2, 3, 4, 5일째 뇌를 적출하땄다. 신경세포사가 뚜렷이 관찰되기 시작하는 4, 5일째의 신경세포 수의 감소 정도를 20. 30% 정도 약화시키는 경향을 보였으나, nicotine 보호효과에 대한 추가 실헝이 현재 수행 중에 있다. The cause of Parkinson's disease (PD) is largely unknown. However, free radical toxicit? may plaf a role ip. the degeneration of substantia nigra, which is the Hajorfocus of pathological damages in PD. Recently, a neuroprotective effect of nicotine in PD has been suggested. Therefore, the mechanism of neurodegenerafion and protective potential o( nicotine in PD were investigated in the experimental modeB of Pll using a neurotoxin, C57BL/6mice were administered with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 30 mg/kg,j.p.). The degree of neurodegenerafion was determined by immunohistochemical stainiHB oftyrosine hydroxylase (TH). TH-positive cells on nigral sections were found 56.0 ±4, 57.9 ±6,52.315ce11s, 49.0±3cells, and 39,4±Scells at days 1, 2, 3, 4, 5, respectively (controls : 57.6±Scells). Hoechst and TUNEL staining showed no evidence of apoptosis. The exandnation on themice co-adrunistered with nicotine(0.2mgAg) and MPTP(30mgag) revealed a tendency ofnicotine protective effects. At days 4 and 5, the degree of TH-positive cells was decreased by20-30%, In corclusiffn, the role of apoptosis was not evidenced in this MPTP modeB of PB.The possible proteccon by nicotine should be elucidated with further studies.

가상공간의 가공 공정과 상태 구현에 관한 연구

이수훈,김봉석,홍민성,김종민,JUN NI,박상호,송준엽,이창우,하태호 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

This paper presents virtual machining system in order to realize turning process in virtual space. A reliable virtual turning process simulation was developed based on the surface shaping system which is capable of considering geometric model, thermal error model, and vibration model. Accuracy of surface shape resulting from proposed machining simulator was verified experimentally. This paper also developed the watchdog agent that continuously assessed, diagnosed, and predicted performance of products and machines in machining. The Watchdog agent extracted feature signal using time-frequency analysis among various signals from multi-sensor and evaluated machining condition using performance confidence value.

Medicinal Chemistry : EVALUATION OF CADMIUM-INDUCED NEPHROTOXICITY USING URINARY METABOLOMIC PROFILES IN SPRAGUE-DAWLEY MALE RATS

( Yu Kyung Lee ),( Eun Young Park ),( Shi Won Kim ),( Ji Yeon Son ),( Tae Hyung Kim ),( Won Gu Kang ),( Tae Chun Jeong ),( Kyu Bong Kim ),( Seung Jun Kwack ),( Jae Won Lee ),( Suh Mann Kim ),( Byung M 영남대학교 약품개발연구소 2015 영남대학교 약품개발연구소 연구업적집 Vol.25 No.-

The aim of this study was to investigate urinary metabolomics profiles associated with cadmium (Cd)-induced nephrotoxicity and their potential mechanisms. Metabolomic profiles were measured by high-resolution 1H-nuclear magnetic resonance (NMR) spectroscopy in the urine of rats after oral exposure to CdCl2 (1, 5, or 25 mg/kg) for 6 wk. The spectral data were further analyzed by a multivariate analysis to identify specific urinary metabolites. Urinary excretion levels of protein biomarkers were also measured and CdCl2 accumulated dose-dependently in the kidney. High-dose (25 mg/kg) CdCl2 exposure significantly increased serum blood urea nitrogen (BUN), but serum creatinine (sCr) levels were unchanged. High-dose CdCl2 (25 mg/kg) exposure also significantly elevated protein-based urinary biomarkers including osteopontin, monocyte chemoattractant protein-1 (MCP-1), kidney injury molecules-1 (Kim-1), and selenium-bingding protein 1 (SBP1) in rat urine. Under these conditions, six urinary metabolites (citarate, serine, 3-hydroxyisovalerate, 4-hydroxyphentllactate, dimethylamine, and betaine) were involved in mitochondrial energy metabolism. In addition, a few number of amino acids such as glycine, glutamate, tyrosine, proline, or phentlalanine and carbohydrate (glucose) were altered in urine afrer CdCl2 exposure. In particular, the metabolites involved in the glutathione biosynthesis pathway, including cysteine, serine, methionine, and glutamate, were markedly decreased compared to the control. Thus, these metabolites are potential biomarkers for detection of Cd-induced nephrotoxicity. Our results further indicate that redox metabolomics pathways may be associated with Cd-mediated chronic kidney injury. These findings provide a biochemical pathway for better understanding of cellulat mechanism underlying Cd-induced renal injury in hunmans.

운동과 활성 산소ㆍ황산화물의 관계에 관한 고찰

김도준,오봉석,전형권 龍仁大學校 1999 용인대학교 논문집 Vol.17 No.-

The purpose of this study was to review for further understanding of the possible mechanisms of free radical formation during exercise and the relation of exercise and exercise induced oxidative stress and the antioxidant system. Acute or chronic strenuous exercise results in excessive production of reactive oxygen species(ROS). This ROS production may lead to lipid peroxidation and protein oxidation in the exercising muscle. Now, the results of study on the role of non-enzymatic defense system was not clear. Further study is necessary to get clear results of antioxidants. But, exercise induced oxidative stress may be reduced by antioxidant ingestion. Therefore, it is necessary to study on proper exercise for reduction of oxidative injury and for efficient practice of intensive exercise by antioxidant administration.

후방순환계 뇌동맥류의 임상분석

임동준,이훈갑,정흥섭,김봉룡,권택현,이기찬,서중근 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.11

韓國 西北部 休戰線 近傍 및 서울 近郊에서의 自然農 벼 試驗耕作物 中 重金屬 檢出에 關한 硏究

金東俊,朴奉奎 梨花女子大學校 韓國生活科學硏究院 1976 韓國生活科學硏究院 論叢 Vol.17 No.-

30年間 人間千涉을 받지 않고 自然狀態로 放置되어 있던 西北部 體戰線近方 京畿道 坡州郡 郡內面 白蓮里 및 사람의 千涉이 頻繁한 서울 近郊 高陽郡 中面 白石里에서 農藥과 化學肥料를 施用하지 않고 有機肥料에 依存하는 自然農을 試驗耕作하였다. 이러한 自然農耕作에서 生産된 玄米, 7分搗米, 및 土壤에서 水銀을 檢出하였는데 水銀劑 撒布를 行한 一般農에서 生産된 것에 比하여 有意義한 差가 있었다. 土壤이 水銀에 依하여 汚染되어 있더라도 새로이 水銀劑를 撒布하지 않는 限 穀粒에는 極히 적은 量의 水銀이 含有된다. 穀粒에 含有되어 있는 水銀이나 鉛 같은 重金屬이 搗精過程에서 糠層의 脫落과 더불어 적어진다. 穀粒中의 鉛은 耕耘機나 車輛의 排氣, 灌漑水 等에 起因한 農産物의 重金屬汚染부터 離脫하는 手段으로 自然農을 勸奬한다. 또한 子然農 適格地로서 體戰線 近方 自然地를 推薦한다. The organic farming with compost without the use of chemical fertilizer and pesticide has been tried in Tong Ⅱ Chon near the North-western DMZ and Baik Ma in the suburb of Seoul. The mercury, lead, and cadmium in soil and crops during the farming have been analyzed with the Dithizone method for this study. The contents of heavy metals in soil and crops of the organic farming were found to be significantly less than those of the farming with the pesticides. In spite of the contamination with mercury in soil, the residual toxic mercury was scarcely traceable in the rice grain unless additional agricultural pesticide is applied. The mercury and lead in the rice grain were reduced in the process of milling of the rice-bran. The lead content in the rice was contaminated from the exhaust gas of motor vehicles, and the cadmium from the irrigation water. The organic farming should be considered as the tool of minimizing the contamination of heavy metals from the agricultural pesticides, the exhaust gas of motor vehicles and the irrigation water. The natural field near DMZ that has not been spoiled yet by the environmental pollution should be highly recommended for the organic farming.

비침습적 검사를 이용한 수술후 하지 심부 정맥 혈전증의 감시

김영욱,정한준,윤봉호,김신윤,이상국,변경환,김태헌 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

Deep vein thrombosis is recognized as a common complication in surgical patients in western countries especially in patients with high risk factors. The purposes of this study were to detect leg DVTs in early postoperative period by non-invasive surveillance and to analyze the risk factors of DVT. One hundred seventy one patients who underwent major operations(67 curative resection of colorectal cancer, 64 total hip replacement, 38 femur operation for fracture, and 2 colon resections for benign colon disease) were included for the prospective surveillance of leg DVT within 2 weeks after the operations. For the surveillance of leg DVT, strain gauge plethysmography(SPG) and Duplex scanning of both legs were completed for all patients except 10 patients. These 10 patients were examined in only one leg. The patients with past history of leg DVT or under prophylactic anticoagulant therapy were excluded from this study. To determine the risk factors related with leg DVT formation, age and sex of the patients, indication of surgery or surgical procedures, duration of operation, position during the operation, duration of postoperative immobilization, and preoperative serum level of antithrombin III (AT- III) were analyzed using Chi-square test. After performing SPG of 342 legs, 38 legs, showed abnormal on venous outflow/venous capacitance discriminant line chart, and 13 legs of 12 patients showed the finding(s) suggesting DVT on duplex scanning. Among the patients with abnormal duplex findings, 7 limbs(53.8%) were symptomatic, but the remaining 6 legs were silent. In 6 (15.8%) patients of 36 femur operations, 3(4.7%) of 64 total hip replacements and 3(4.5%) of 67 curative resections of colorectal cancer developed DVT by duplex scanning in the iliac(5), femoral-popliteal(6), and isolated calf(2) veins. After analyzing the risk factors, we could not find any statistically significant(p<0.05) factor related with leg DVT.