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      • KCI등재

        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.

      • 쇄골 중간부 골절후 불유합 및 지연 유합의 원인

        윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

        쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

      • KCI등재

        Paraquat 중독환자의 초기검사로서 sodium dithionite를 이용한 소변내 paraquat검출의 임상적 의의

        윤갑준,임경수,이진웅,김영식,이부수,박덕우,김선만,이강현,황성오,안무업 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

        Background : Mortality from paraquat intoxication depends upon plasma paraquat concentration. To know the severity of paraquat intoxication is important for directing therapeutic modality and predicting prognosis. Sodium dithionite test for urinary paraquat provides an easy and simple method to determine the severity of paraquat intoxication in emergency department. purpose : To determine whether the result urinary paraquat test by sodium dithionite can predict outcome in patients with paraquat intoxication in emergency department. Subjects : 48 patients(male 31, female 17, mean age 37 years) who had exposure to paraquat and presented within 24 hours after exposure. Result : Thirty five patients were positive in paraquat urine test and thirteen patients were negative. Clinical manifestations were more severe in positive patients than in negatives. Complication was much more in positives than in negatives. 28 of 35 patients(80%) in positives and 2 of 13 patients(15%) in negatives died. Conclusion : Positive test for urinary paraquat is associated with high mortality and morbidity from paraquat intoxication, and qualitative test for urinary paraquat by sodium dithionite is an useful method to determine the severity of paraquat intoxication in emergency department.

      • 유도선수들의 개인별 특성에 따른 성취동기에 미치는 영향 : mainly university students

        윤익선,김진표,권성준 龍仁大學校 武道硏究所 2002 武道硏究所誌 Vol.13 No.1

        This investigation used questionnaire which amended and made up for TSMI(Taikyo Sport Motivation Inventory) to verify what effect judo champions personal trait has on accomplishment motive. The subject of the study was 406 men, women judo champion's in Seoul and Kyung-Ki province. The personal trait which is an independent variation was set up as sexual distinction, grade, athlete career, economic standard, record of winning a prize and weight. According to this, the dependent variable for accomplishment motive to find out about accomplishment motive was foxed as competition, ambition, effort and self-confidence and the result of the research is followed as below. Firstly, there seemed to exist a significant difference in competition(p<.001), standard of ambition(p<.006) and self confidence(p.006) in accomplishment motive according to sexual distinction. Secondly, a significant difference in standard of ambition(p<.001) existed among the dependent variable of accomplishment motive according to grade. Result of Scheffe's pre-verification was that significant difference seemed to exist in 4th grade with the 1st and 3rd grade. Thirdly, all of the dependent variable; competition(p<.001), standard of ambition(p<.001), effort(p<.003) and self confidence(p.006) showed significant difference in accomplishment motive according to athlete's career. Scheffe's pre-verification showed that significant difference in competition existed in between 5-8 years and 8-10 years, and significant difference in standard of ambition in between 3-5 years and 8-10 years and also 3-5 years and 5-8년 and over 10 years group existed. Also significant difference in effort showed in 5-8 years and 8-10 years. Fourthly, the accomplishment motive according to the economic levels showed significant difference only in standard of ambition(p<.05) which is a dependent variable. Fifthly, The accomplishment motive according to the career of winning a prize showed a significant difference in competition(p<.01), ambition(p<.01) and effort(p<.05) among the dependent variable, and also Scheffe's pre-verification showed a significant difference in more than 7 times, less than 3times and less than 7 times in ambition. Sixthly, the accomplishment motive according to weight showed a significant difference in competition(p<.001) and effort(p<.05) among the dependent variable, and Scheffe's pre-verification showed significant difference in middle weight class with the lightweight and middle lightweight class in competition.

      • 급성 호흡곤란 증후군으로 발현된 폐결핵 1례

        윤여준,박성우,이준혁,장안수,박춘식 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

        Pulmonary tuberculosis as a cause of the acute respiratory distress syndrome is quite rare. The diagnosis of acute respiratory distress syndrome due to pulmonary tuberculosis is difficult because of the diversity of radiological patterns. The ability to identify patients at risk for the acute respiratory distress syndrome is important if therapies are to be developed to prevent the disorder. We experienced a young female compliants with mild fever, dyspnea who diagnosed pulmonary tuberculosis 1 months ago. She stoped anti-tuberculosis medication 2 day because confirmation of drug fever and after then sudden aggravated dyspnea. The clinical course of this case is similar with presentaion of ARDS. We started antituberculosis medication with steroid, which result in good prognosis.

      • 용융염 합성법에 의한 strontium barium niobate의 분말제도 및 소결성

        윤상옥,전종호 강릉대학교동해안지역연구소 1990 東海岸硏究 Vol.1 No.2

        NaCl-KCl 용융염 합성법에 의해 strontium barium niobate분말을 제조하여 합성온도에 따라 그 특성을 열분석, X-선 회절분석, 전자현미경 관찰, 선수축율 및 유전상수 측정을 통하여 조사하였다. 용융염 합성법에 의하면 650℃ 부터 pyrochrole상이 적은 strontium barium niobate분말의 제조가 가능하며 분말의 형상은 침상이다. 또한, 합성온도가 올라감에 따라 입자성장이 일어나 선수축율은 감소하는 반면 이방성이 증가하여 유전상수는 증가 하였다. Strontium barium niobate powders were prepared by NaCl-KCl molten salt synthesis method and their characteristics were evaluated by thermal analysis, X-ray diffraction analysis, SEM observation, and measurements of linear shrinkage and dielectric constant as a function of synthesis temperatures. The needle like strontiun barium niobate powders having low content pyrochrole phase could be prepared at 650℃ by the molten salt synthesis method. As the synthesis temperature increased, the linear shinkage decreased due to the growth of particles but the dielectric constant increased by the increase of anisotropic.

      • KCI등재후보

        개에서 이중 결찰법을 통한 동맥관 개존증의 완치 예

        윤헌영,정순욱,박희명,박철,정만복,김준영,한현정,황민,노병국,박상혁,장하영,박정윤 한국임상수의학회 2004 한국임상수의학회지 Vol.21 No.1

        A ten months old, female Yorkshire terrier weighing 2.88 kg referred to veterinary teaching hospital of college of veterinary medicine, Konkuk University because of syncope, cough and dyspnea. First hematological and serum chemical test revealed thrombocytopenia, mild anemia, and increase of concentration of ALP (195 U/L). On 57 days later, second hematological and serum chemical test revealed polycythemia, increase of concentration of ALP (211 U/L), and Tchol (387 mg/dl). Right atrium enlargement, main pulmonary artery bulge and cardiomegaly (VHS = 11.5) were observed in radiographic findings. Ultrasonographic images showed both right and left ventricular dilation and turbulent flow between the descending aorta and the main pulmonary artery in color Doppler imaging. ECG showed left ventricular enlargement, SA block, and electrical alternant. Thoracotomy was performed through left fourth intercostal incision under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. Cough and dyspnea disappeared on 5 days after operation. Turbulent flow was not found in color doppler imaging of ultrasonography on 10 days after operation. Ten months later after the operation, syncope could not exist any more.

      • 西海岸 綜合開發計劃 樹立을 爲한 關聯計劃 分析

        윤준상 公州大學校 産業開發硏究所 1997 産業開發硏究 Vol.5 No.-

        This study aims to investigate the related planning for the establishing of integrated development of west coast area and to suggest more efficient planning and policies to archive balanced regional development. In detail, this study reviewed the central and local government policies and planning. The major findings and suggestions of this study could be follows; 1) Recently, the west coast of chungnam, one of the typical lagging regions in the country draws a nationwide attraction for a base of West-Sea Rim. Thus, many a projects are being suggested and attempted. However, the region has serious limitations in structural rather than quantitative terms to be tackled. Those are concerned with ① poor endowment of hard and soft infrastructure, ② increasing intraregional disparity. 2) The top-down development strategy employed by the central government, in which development effects of centers has not contributed much to improving inequality structure. Since chungnam has been always least benefited from the fruit of high economic development and SOC development. 3) By the plannings and reports, the development potential of west coast of chungnam is very high and varius. So, planning and ploicy of this area must be setting up many-sided diversity. The development plan could be seperately presented as follows: ① west-north part of this area(Chonan, Asan, Tangjin, Soesan) - manufacuring industry area ② west coast area(Seochon, Hongsung, Taechon) -tourist area ③ west-south part of this area(Seochon, Janghang) - large industrial complex. 4) The central government as a coordinator and a cooperator with local governments provides directions of each region's development and assists large scale projects through financial supports, while local government prepares and implements its plans as a main body of regional development. And people's participation of planning should be widen.

      • SCIESCOPUSKCI등재

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