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.

혈우병 환자에 동반된 자발성 후복막강 출혈

김광일,김동호,우상민,이석주,김홍성,조인성,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Spontaneous retroperitoneal hemorrhage due to hemophilia A with impaired coagulopathy is very rare. Spontaneous retroperitoneal hemorrhage has been recorded as having originated from many retroperitoneal organs and blood vessels, and it may be due to local and/or systemic factors. In the majority of the patients, kidney and adrenal gland were the major site of hemorrhage. The systemic causes of spontaneous retroperitoneal hemorrhage are anticoagulation therapy and chronic hemodialysis. During the course of these treatments, hemorrhagic complications may occur at many site, including the retroperitoneal space. Blood dyscrasias including leukemia, polycythemia, sickle cell trait and hemophilia have been reported associated with spontaneous retroperitoneal hemorrhage. We report a case of spontaneous retroperitoneal hemorrhage occurred in a gemophilia A patient with brief review of literature

간세포암종에 대한 간동맥 화학색전술 후 발생한 급성호흡곤란증후군

조윤원,이정미,최자윤,유동훈,차라리,오혜원,김홍준,민현주,김현진,정운태,이옥재,하창윤,이선영 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.1

Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.

침엽수로부터 발생되는 방향성 테르펜의 배출속도 비교 연구

김조천,홍지형,강창희,선우영,김기준,임준호 한국대기환경학회 2004 한국대기환경학회지 Vol.20 No.2

In order to investigate the composition ratio and the emission rate of monoterpenes emitted from coniferous trees during summer, the enclosure chamber experiments were carried out for two tree species (Pinus densiflora and Pinus rigida). The major monoterpenes from the pine trees were α-pinene, β-pinene, myrcene and β-phellan-drene. There was no difference of the composition ratio between two sites for P. densiflora, but the difference was observed for P.rigida, Clearly, the ratio of β-pinene (26.1%) for P.rigida was higher than that of β-phellandrene (12%) at the Gumsung mountain site, but the ratio of β-phellandrene (22.2%) was higher than that of β-pinene (9.9%) at the Chiri mountain site. Particularly, the composition ratio of β-phellandrene was higher than that of β-pinene for P.densiflora, and the opposite trend was found for P.rigida at the Gumsung mountain site. The characteristics of the composition ratio between two species were similar at the Chiri mountain site. As a result of the emission rate measurements, it was observed that both sites did not show any significant β value (slope between emission rate and temperature) and ERs (Standard Emission rate at 30℃) difference. However, the β value and ERs at the Chiri mountain site were slightly greater than those of Gumsung mountain site for both pine species. P.densiflora(1.703 and 1.971㎍C/gdw/hr) showed the higher monoterpene ERs than those of P.rigida (0.572 and 0.698 ㎍C/gdw/hr) at both sites.

Lactobacillus acidophilus 88과 Lactobacillus bulgaricus IFO 13953간의 세포융합주의 특성에 관한 연구

조영배,김혜정,김성구,백형석,전홍기 부산대학교 유전공학연구소 1996 분자생물학 연구보 Vol.12 No.-

유산균의 균주개량방법의 일환으로 protoplast fusion 기법과 electrofusion법을 이용하여 protease 활성, lipase 활성, 내열성, 내산성 등이 우수한 L. bulgaricus 와 bacteriocin을 생산하는 L. acidophilus를 융합시켜 얻은 융합주들의 생리학적 성질을 검토하였다. 산 생성능, 내열성, 내산성, protease, lipase 활성 등은 L. bulgaricus가 L. acidophilus 보다 우수하였다. L. bulgaricus는 lactose와 sorbose를 이용하였으나 maltose와 sorbitol을 이용하지 못하는 반면, L. acidophilus는 maltose를 이용하고 lactose와 sorbose를 이용하지 못하였다. 융합주 가운데서는 3, 6, 7, 8, 10번이 모균주의 발효능 특성을 함께 지님으로서 재조합체임을 확인 할 수 있었으며, sorbitol의 경우 모균주에서는 발효능이 전혀 나타나지 않았음에도 불구하고 융합주 4, 7번이 발효능을 나타내어 융합과정에서 새로운 형질을 획득하기도 한다는 사실을 알 수 있었다. Lactase 활성은 모균주 모두 높은 β-galactosidase 활성을 보였으나, phospho-β-galactosidase 활성은 거의 없었으며 융합주들도 다소 차이는 있었지만 모균주와 유사한 효소 활성을 나타내었다. 발효에 있어서 key enzyme으로 작용하는 protease, lipase 등의 효소 활성도 모균주의 활성 보다 우수한 융합주도 존재하였다. Aninterspecific fusant was made from the protoplasts of two strains of lactobacillus genus (streptomycin and lincomycin resistant L. bulgaricus and kanamycin resistant L. acidophilus 88). The functional properties of the fusant were examined by determining bacteriocin productivity, acid producing activity, ability of carbohydrates fermentation and three important enzyme activities. The recombinant strain revealed bacteriocin productivity. Acid production and β galactosidase, phospho-β-galactosidase, lipase and protease activity of L. bulgaricus were better than those of L. acidophilus 88. Among fusants, β-galactosidase activity of two strains were better than that of the parent strains but phospho-β-galactosidase activity remarkably lower. One fusant revealed the improved proteolysis compared to that of the parent strains- Lipase activity of L. bulgaricus was better than that of L. acidophilus but another fusant exhibited the highest lipase activity.

여름철 참나무속의 이소프렌 배출속도 비교에 관한 연구

김조천,김기준,홍지형,선우 영,임수길 한국대기환경학회 2004 한국대기환경학회지 Vol.20 No.1

In order to compare the NVOC (Natural Volatile Organic Compound) emission rates from oak trees, the emission rates of isoprene were quantitatively measured in situ based on tree species and region. As a result, the emission rates from Quercus serrata T. were found to be 1000 times greater than those from Quercus acutissima C. However, the emission rates at the Chiri and Gumsung mountain sites did not show any significant differences in summer. Cuvette tests using four different oak species also supported that there was a tremendous difference in emission rates between Quercus serrata T. and Quercus acutissima C. It was found that the emission rates from the trees were highest on the order of Quercus serrata T., Quercus aliena B., Quercus acutissima C. and Quercus variabilis B.

스포츠 관광 활성화를 위한 마케팅 전략

조충현,김홍식,이동헌 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.4

This study was the marketing strategy based on sports tourism, which affects the tour industry. The study used the simple random sampling method in the group of the Kwang-Ju district citizens. The group representatives were directly interviewed, and 277 interviewees replied with concern. The rest of the interviewees were not interested in the survey. The general characteristics of the interviewees -- gender, age, education, job, monthly salary. --were used to analyze the items related to the marketing strategy for the traditional wrestling. In the product selling strategy, there was a significant difference depending on the job and age difference. The interest put on the game changed according to the age difference. The suggested policy is as follows. There is a need for a certain space, in order to provide the public relations of the date and location of the sports tourism match, which will be the product selling strategy. Also, the promotion strategy, using various events, is required urgently. Moreover, it would be good to have more than just viewers of family and friends, but to develop more active programs with higher participation level. This study is, valuable, in the sense that it offers fundamental information related to the traditional wrestling and its marketing strategy, when there is no such information in this field. It is expected for the readers to utilize this study to investigate more into the field, or to look up for new plans to activate the sports tourism.

심근경색 환자에서의 헤파린 사용시 장요근 혈종과 연관된 후복막강내 자발적 출혈 1예

김효정,김도연,황민규,조홍근 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.10

원형 비강진 1예

김영조,박홍표,정병수,최규철 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Pityriasis rotunda is an uncommon cutaneous disorder consisting of asymptomatic, strikingly circular, scaly lesions on the trunk and extremities, with the histologic appearance of ichthyosis vulgaris. A case of pityriasis rotunda in a 35-year-old woman in whom no diagnosable disorder could be demonstrated is presented.

김치 유산균인 Lactobacillus sp. JJ-2001이 생산하는 Bacteriocin에 관한 연구

조영배,조우제,조영임,이은주,김성구,전홍기 부산대학교 유전공학연구소 1997 분자생물학 연구보 Vol.13 No.-

The microorganisms producing bacteriocin from kimch were screened, and among them,a strain showing the highest bacteriocin activity and stability was isolated. Based on the taxonomic characteristics of its morphological, cultural and physiological properties, the isolatef strain was characterized as Lactobacilius sp..To identify optimal conditions for the growth and the production of bacteriocin from the isolated strain,nutrient source, initial pH, and culture temperature were evaluated. Physiochemical properties of bacteriocin was also investigated. The potimal condition for the production of bacteriocin and the cell growth was obtained at 2% glucose, 1% beef extract as organic nitrogen source,1%(NH_4)_2SO_4 as inorganic nitrogen source,and 0.1% Tween 80. The isolated strain showed the maximum growth at 25℃. The inhibitory range of its antimicrobial substance aginst gram positive bacteria was marrow and its inhibitory activity was maintained between pH3.0 and pH8.0. The antimicrobial activity of bacteriocin from the isolated strain was stable at 50℃.