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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Apoptotic Effect of Co-treatment with Chios Gum Mastic and HS-1200 on G361 Human Melanoma Cell Line

Young-Joo Hur,Young-Ki Kim,Hyun-Ho Kwak,Gyoo-Cheon Kim,Seung-Eun Lee,In-Ryoung Kim,Chul-Hoon Kim1,Bong-Soo Park 대한해부학회 2009 Anatomy & Cell Biology Vol.42 No.2

Chios gum mastic (CGM) is a resinous exudate obtained from the stem and the main leaves of Pistacia lenticulus tree native to Mediterranean areas. Recently it reported that CGM induce apoptosis in a few cancer cells in vitro. Bile acids and their synthetic derivatives induced apoptosis in various kinds of cancer cells and anticancer effects. It has been reported that the synthetic chenodeoxycholic acid (CDCA) derivatives showed apoptosis-inducing activity on various cancer cells in vitro. This study was undertaken to investigate the synergistic apoptotic effect of cotreatment with a natural product, CGM and a CDCA derivative, HS-1200 on G361 human melanoma cells. To investigate whether the co-treatment of CGM and HS-1200 compared with each single treatment efficiently reduced the viability of G361 cells, MTT assay was conducted. To investigate augmentation of apoptosis in G631 cells co-treated with CGM and HS-1200, DNA electrophoresis, Hoechst staining, proteasome activity assay, flow cytometry, Westen blot analyses, immunofluorescent staining and confocal microscopy were performed. In this study, G361 cells co-treated with CGM and HS-1200 showed several lines of apoptotic manifestation such as nuclear condensations, DNA fragmentation, the reduction of MMP and proteasome activity, the decrease of DNA content, the release of cytochrome c into cytosol, the translocation of AIF and DFF40 (CAD) onto nuclei, activation of caspase-9, caspase-3, PARP and DFF45 (ICAD), and up-regulation of Bax whereas each single treated G361 cells did not. Although the single treatment of 40 μg/mL CGM or 25 μM HS-1200 for 24 hrs did not induce apoptosis, the co-treatment of them induced prominently apoptosis. Therefore, combination therapy of CGM and HS-1200 could be considered, in the future, as an alternative therapeutic strategy for human melanoma.

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

흉통의 양상에 따라 분류한 불안정형 협심증 환자의 임상적 소견의 비교

김명수,김성구,정호석,온영근,신원용,김철현,최태명,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background and aims : The clinical syndrome unstable angina pectoris that encompasses a variety of symptoms and clincal presentations of transient episode of myocardial ischemia, was devided to several subgroups. Also, it has variable pathophysiologic factors to cause myocardial ischemia. According to clincal presentation, coronary angiographic finding and prognostic factor, the result of unstable angina pectoris is variable. In fact, there were a few data reported on the prognosis of wide spectrum of patients with unstable angina. However, the precise risk of subgroups according to classitication has not been established because it was difficult to compare between studies. We classified unstable angina pectoris by clinical nature of chest pain, and performed to establish and compare the clinical presentations, coronary angiographic findings, treatement and prognosis of patients with unstable angina within subgroups of classification. Methods : Retrospenctive data for 164 unstable angina pectoris patients admitted to the Internal Cardiology Division of Soon Chun Hyang University Hospital from May 1996 to July 1999 was analyzed. The patients were classified into one of the following categories: Class I, new onset of severe angina; Class II, acceleration of previous chronic stable angina; Class III, angina at rest. Clinical presentations, echocardiographic findings, coronary angiographic findings, treatment and prognosis were compared. Results : From the total 164 patients, the subjects of classes were as follows : Class I, 46 cases (28.1%); Class II, 74 cases (45.1%); Class III, 44 cases (26.8%). In view of age distribution, the 7th decade had the highest incidence, and then, 6th, 8th decades were followed. There was no baseline differences among the 3 classes with respect to gender, number of risk factors. Significantly, class II showed more severe findings in abnormal Q wave 15 cases (20.8%), total occclusive lesion 10 cases (20.8%) and three vessel coronary disease 11 cases (22.9%) than other classes. The change of ST segment was significantly apparent (p<0.02) among class I 28 cases (60.8%), class III 26 cases (59.0%), comparing with class II 30 cases (40.5%). Class III had the higher incidence of one vessel coronary artery disease than class I and III. The heparin treatment was performed in 99 cases (60.1%). The incidence of nonfatal myocardial infarction was much more in class I and III, each 4 cases (8.7%, 9.8%) than in class II 1 cases (1.4%). In-Hospital death was occurred in class I and II, each 1 case. Conclusion : The patients with the acclerated angina from chronic stable angina had more severe coronary artery disease than other classes, but they had better in-hospital prognosis.

자기정렬공정에 의한 GaAs/ AlGaAs 광위상변조기의 제작 및 특성 측정

김병성,정영철,변영태,박경현,김선호,임동건 광운대학교 신기술연구소 1996 신기술연구소논문집 Vol.25 No.-

MOCVD(metal-organic chemical vapour deposition) 방법으로 성장시킨 이중 이종접합구조GaAs / AlGaAs 웨이퍼를 이용하여 광위상변조기를 제작하였다. 제작과정에서 도파로와 절연층의 형성시 동일 포토레지스트 패턴을 이용하는 자기정렬공정을 개발하여 그 효용성을 입증하였다. Fabry-Perot 간섭법을 이용하여 변조기의 위상변조효율을 측정하였으며, 1.31㎛ 파장에서 TE 편광의 경우 22.5˚/Vmm의 위상변조특성을 얻었다. An optical phase modulator is fabricated in GaAs / AlGaAs double heterostructure wafer grown by MOCVD. A self-aligned process, in which the same photoresist pattern is used for both the waveguide etching and the insulation layer formation, is developed and is found to be very useful. Fabry-Perot interference technique is applied to the measurement and the phase modulation efficiency is measured to be 22.5˚/Vmm at 1.31㎛ for TE polarization.

Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

한약에 의해 유발된 급성 간질성 신염 2례

김덕윤,박동건,김응석,강영모,양창헌,이정호,이동철,이영현,김정란 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

간질성 신염은 신장의 간질을 선택적으로 침범하는 염증성 질환으로 여러가지 원인에 의해 유발되며, 이 중 약물에 의한 경우는 각종 항생제, 비스테로이드성 진통제, 항경련제, 이뇨제, 면역억제제등에 의한 증례들이 보고되고 있다. 현재 각종 질환-특히 만성질환-의 치료에서 한약이 차지하는 비중이 적지 않으나, 그 각각의 성분들이 유발할 수 있는 부작용들에 대한 연구는 거의 없는 실정이다. 저자들은 관절염 치료를 위해 중국산 한약을 복용한 후 복통, 피로감 및 육안적 혈뇨를 주소로 내원한 두 환자에서, 단백뇨와 신기능 장애를 보여 시행한 신조직 생검상 급성 간질성 신염에 합당한 병리학적 소견을 보이고, 한약 복용 중지 후 급속한 회복을 보여, 한약에 의해 유발된 것으로 사료되는 급성 간질성 신염 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Acute interstitial nephritis is a disease characterized by renal interstitial inflammatory cell infiltration and acute renal functional deterioration. This is caused mainly by antibiotics, NSAID and diuretics such as thiazide, but cases induced by herb medication are rare. We experienced two cases of acute interstitial nephritis after treatment with herb medication. One 71-year-old female patient and the other 60-year-old female were admitted to the hospital because of general weakness and gross hematuria. Microscopic hematuria, pyuria, and proteinuria were presented. After definitive diagnosis with a renal biopsy, we noted rapid recovery of renal function by drug withdrawal and steroid therapy. We report these cases with a review of the referenced literatures. Key Words : Herb medication, Acute Interstitial nephritis.

TiAIN을 코팅한 WC공구의 절삭성능에 관한 연구

김현자,최현철,김영대,김일선,노태영,이규용 釜慶大學校 2001 釜慶大學校 論文集 Vol.6 No.-

Thin film of TiAlN was deposited onto ISO P20 tungsten carbide cutting insert tip substrate specimen using the FVAS (filtered vacuum arc system) at the substrate temperature of 80℃. Cutting and wear tests have been performed to the TiAlN coated and uncoated WC specimen, respectively under the same cutting conditions for the comparison. Cutting forces and tool wear of coated and uncoated carbide cutting tools were investigated by means of cutting length and cutting forces. Also tool wear and tool life were analyzed using the 3ch tool dynamometer amp lifier and oscilloscope. In this study cutting tests for the cutting performance of TiAlN coated WC-Co P20 to the steel alloy of SNCN420 have been curried out. Through the comparisons of cutting forces during the cutting tests and tool wear, we got the conclusions as follows.; ① In usual cutting conditions, main cutting force component showed higher value than the thrust force normal to the cutting direction especially cutting forces in the of early stage on cutting tests. But, after loosing the protective hard thin film on substrate or insert tip, the thrust force normal to the cutting direction showed much higher than main cutting force component. ② Within the range of 0.3㎜ build up edge in P20 insert tip, TiAlN coated tip was evaluated more stable in flank wear and less in crater wear than the uncoated specimen. ③ Through the wear growth curve of the specimen, tool life differences of uncoated and TiAlN coated tip at high speed (V=250[m/min]) was higher than the low speed(V=200[m/min]) case, compared to the average but the tool wear was almost same in both specimen for the case of normal wear occurred.

하악 자가 이식골에서의 임프란트

김용각,이태희,김철,김성진,김혁 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

In mandibular tumor treatment case,mandibulectomy is frequently performed.This mandibulectomy may result in facial changes, esthetic and phonetic problems, reduced mastication and swallowing functions. When we treat this patients, using primary reconstruction with autogenous bine graft or secondary reconstruction with delayed bone graft after applied bridge plate removal. After bone graft is done, prosthodontic treatment is essential for the rehabilitation of facial esthetics, phonetics and mastications. But, tissue-supported prostheses have the problems of frequent breakdown of underlying bone anf soft tissue, increasing risk of intraoral infection, mobility of prostheses, unsatisfactory function, problems in esthetics, poor patient co-operation. Now, osseointegrated implants are used as the main treatment of fully or partially edentulois state of mandible, long term clinical data are satisfactory, too. So, we may choose the implant,as the useful prosthodontic treatment method of mandibular reconstruction using autogenous bone graft. Regardless of this harmful situation, as astivity(in malignant madibular tumor), and relatively poor condition of grafted bone, thoughtful treatment plan, delicate and technique, persistent follow-ups make much more satisfactory results than those of removable prostheses. So. we reported a good results in the case of implat-retained protheses after mandibulectomy and autogenous bone graft.