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.

Epithelioid 세포가 많은 Antioimmunoblastic lymphadenopathy 형의 T-세포 임파종. 면역 조직학적 검색을 실시한 증례 보고

백승호,강상균,김창진,강현욱,오도연 순천향대학교 1992 논문집 Vol.14 No.4

A peripheral T-cell lymphoma with a high content of epithelioid cells-an entity that reveals morphologic and clinical characteristics resembling those seen in angio-immunoblastic lymphadenopathy(AILD)-was separated from lymhoepithelioid cell lymphoma(Lennert' slymphoma, or LeL). It was considered a variant of the AILD type of peripheral T-cell lymphoma. AILD-PTCLep and LeL share so much similarities, clinically and morphologically, that they can't be differentiated each other. We experienced a case of AILD-PTCLep confirmed by a panel of immunohistochemistry and reviewed the differential points between the LeL.

결핵성 수막염 환자에서 결핵균 30 kDa 및 32 kDa 단백항원에 대한 항체반응의 비교

백태현,김선영,이건수,김화중,김성호,조은경,박정규 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

The 30 and 32 kDa antigens from Mycobacterium tuberculosis H37Rv culture filtrates, identified as biologically important proteins in the immune responses against mycobacterial infection, were purified and used in enzyme linked ummunosorbent assay (ELISA) for the determination in specific IgG and IgM levels in cerebrospinal fluids of 15 patients with tuberculous meningitis and 17 controls with nontuberculous diseases. High reactivity to both antigens was observed in tuberculous meningitis. Mean IgG and IgM antibody levels differed significantly (P < 0.001) between patients and con trols. Mean IgG antibody levels were also higher than IgM levels in tuberculous meningitis. A comparison of the antibody levels against the 30 and 32 kDa antigen within the tuberculous meningitis patients showed higher IgG reactivity to the 30 kDa than to the 32 kDa antigen, suggesting that the antibody response of these patients is directed predominantly against the 30 kDa protein. However, the patterns of reactivity to 30/32 kDa, 30 kDa and 32 kDa antigen in individual subjects were similar. By the cut-off value adding 2 stsndard deviation to the mean absorbance of controls, the sensitivity and specificity of the IgG antibody to the 30 kDa antigen were 100% and 94.4%, respectively. These values were higher than those obtained by 30/ 32 kDa and 32 kDa antigen. From the above results, it is suggested that the 30 kDa antigen may be dominant antigen and more valuable in the diagnosis of tuberculous meningitis than 32 kDa antigen.

NSIP와 BOOP의 고해상전산화단층촬영 소견과 비교

백상현,박재성,차장규,홍현숙,김대호,박성진,조준희,이혜경,최진수 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.2

Purpose: BOOP and NSIP also share similar clinical features such as subacute flu-like illness, the finding of bronchoalveolar lavage, the result of pulmonary function test and more favourable outcome than usual interstitial pneumonia(UIP). The author try to compare the HRCT findings of NSIP with BOOP by pattern and distribution of diseases. Materials and Methods: HRCT findings of histopathologically proven NSIP(Group Ⅰ; 6, Group Ⅱ; 7, Group Ⅲ; 2) in 15 patients(5 male, 10 female, age range, 39-69 years; mean age, 53 years), BOOP in 15 patients(6 male, 9 female, age range, 26-76 years; mean age, 52 years) were reviewed retrospectively. Results: The common pattern of the two diseases was admixed consolidation, ground glass attenuation & reticular densities with/without architectural distortion(NSIP; 53.3%, BOOP; 46.7%). The main component of the pattern wan predominantly consolidation(NSIP; 46.7%, BOOP; 73.3%) and ground glass attenuation(NSIP; 40.0%, BOOP;20.0%). Architectural distotion was more provinent finding with NSIP(mild ; 3, moderate ; 4, severe; 2) compared with BOOP(mild; 7, moderate; 2, severe; 0). The predominant overall distribution was lower lung, peribronchovascular & peripheral lung field in both of the two entities(NSIP;73.3%, BOOP; 73.3%). Peribronchovascular involvement was more common with NSIP(100%) than BOOP(80%), whereas peripheral involvement was more common with BOOP(93.3%) than NSIP(80%). Conclusion: The HRCT findings of NSIP and BOOP were similar in pattern and distribution. But NIP manifested more frequently ground-glass attenuation, whereas BOOP showed more frequently consolidation. Architectural distortion was more severe with NSIP than BOOP. NSIP invoved more frequently peribronchovascular space and BOOP were more common in peripheral lung field.

관상정맥동과의 연결이 없는 좌상대정맥의 CT 소견 : 1예 보고 case report

백상현,박재성,이혜경,홍현숙,김대호,조준희,박성진,차장규 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of a vessel that is present as a counterpart of normal right-sided superior vena cava(SVC) in early embryological development but normally disappears later. Its diagnosis can be confirmed by many noninvasive and invasive tests, or it is incidentally diagnosed at insertion into the left subclavian or jugular vein or thoracic surgery. If it is not associated with other congenital cardiac anomalies, it is usually asymptomatic and hemodynamically insignificant. We describe the chest radiograph and CT findings of bilateral SVC with drainage to left superior intercostal vein, hemiazygos, azygos vein and right SVC, and no connection of coronary sinus.

Enterobacter cloacae에 의한 Cd(Ⅱ) 제거

백종수,원성호,김장규,신상규,김남기 成均館大學校 科學技術硏究所 1993 論文集 Vol.44 No.1

In order to obtain the basic data for the optimum condition to remove Cd(Ⅱ) biologically, the variation effect of Cd(Ⅱ) concentration and stirring rate on the removal of Cd(Ⅱ) were investigated by Enterobacter cloacae(ATCC 13047). The initial con-centrations of Cd(Ⅱ) were changed 10, 50, 100, and 500 ppm and the stirring rates 100, 150, and 200rpm. The initial pH and experimental temperature were fixed at pH 6.8 and 30℃. The results were obtained as follows : 1) The minimum growth inhibitorn ratio of Enterobacter cloacae was 42% at 10ppm of Cd (Ⅱ) and stirring rate 200rpm. 2) The maximum removal ratio of Cd(Ⅱ) was 8.6% at 200rpm and 50ppm of Cd(Ⅱ) by Enterobacter cloacae.

'1998 한국인 우울증 선별의 날' 참가자들의 사회인구통계학적 특성과 우울증 선별검사 결과

한상익,이성필,고효진,박원명,장계호,유태열,전태연,채정호,방승규,김광수,최보문,이정태,백인호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 1998년 정신건강의 날 기념 한국인 우울증 선별의 날 행사에 자발적으로 참여한 참가자들의 사회인구 통계학적 특성을 분석하고 우울증 선별검사 결과를 평가하기 위하여 본 연구를 시행하였다. 방 법 : 8개 병원에서 얻어진 619명의 자료를 사용하여 선별검사로 밝혀진 우울증의 유병율과 사회인구통계학적 특성 및 응답자의 정신과적 치료를 포함한 과거력 등을 조사하였다. 결 과 : 우울증 척도 점수는 응답자 전체 평균 57.5±13.8로 경도의 우울 증상이 있는 것에 해당되었다. 전체 응답자의 69.5%(430명)가 최소한 경도 이상의 우울 증상을, 43.1%(267명)가 중등도 이상의 우울 증상을, 18.4%(114명)가 고도의 우울 증상을 보였다. 고도의 우울 증상이 있는 응답자의 56.8%와 중등도의 우울 증상이 있는 응답자의 63.9%가 정신과 치료를 받은 적이 전혀 없었다. 나이가 29세 이하인 것과 전임근무 중인 직업상태는 각각 나이가 60세 이상인 것과 직업이 없는 것에 비교하여 우울증으로부터 보호하는 인자임을 시사하였다. 결 론 : '1998 한국인 우울증 선별의 날' 행사를 통하여 많은 우울증 환자들을 선별해낼 수 있었고, 이들의 우울 증상은 몇몇 사회인구통계학적 특성과 유의한 관계가 있음을 확인하였다. 우울증 선별의 날 행사를 통한 우울증에 대한 교육과 우울증 선별검사는 치료받지 못하고 있는 우울증 환자 및 기존의 치료 중인 환자 모두에게 유용한 프로그램임을 알 수 있었다. Objectives : This study was performed to analyze the sociodemographic characteristics of participants in '1998 Korean Depression Screening Day' and to evaluate the results of the screening test. Methods : By using the survey results of 619 volunteers from 8 hospitals, the authors examined the prevalence of depression detected at the screening test and sociodemographic characteristics and the psychiatric treatment history of respondents. The assessment measure was the Zung Self-Rating Depression Scale. Results : The mean depression score of all participants was 57.5±13.8 and it came under mild depression. Of all participants, 69.5%(N=430) had at least mild depressive symptoms, 43.1%(N=267) had at least moderate symptoms, and 18.4%(N=114) had severe symptoms. Never have 56.8% of respondents in the severely depressed range and 63.9% of those in the moderately depressed range had psychiatric treatment. The results suggest that the age group of 29-year-old or younger(relative to 60-year-old or older group) and full-time employment status(relative to unemployment) are protective factors of depression. Conclusions : By '1998 Korean Depression Screening Day', many depressed patients were detected and their depressive symptoms had statistically significant relationships with some sociodemographic characteristics. The results suggest that the education and screening test programs for depressive illness facilitated by Depression Screening Day are useful to the patients regardless of being under current treatment or not.

원발성 두개골내 수막종 : 1예 보고 A Case Report

김대호,홍현숙,조준희,박재성,박성진,차장규,백상현,이혜경 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Primary intraosseous meningioma of skull is rare, and often confused with a primary bone tumor. We report a case of a 71 years old female patient with an intraosseous calvarial meningioma of frontal bone presenting as a solitary osteolytic skull lesion. Plain skull radiograph, CT and MR images show sharply marginated expansile bony lesion in frontal skull vault, and a small well enhanced soft tissue mass within bone. The mass is extracranially protruded to scalp, and is partially attached to the underlying dura. Outer and inner table of skull vault is slightly bulged out, suggesting intradiploic origin of the tumor. The tumor was treated with surgical excision and cranioplasty. Histological examination revealed fibrous meningioma.

Tryptophan Hydrxylase 유전자 다형성과 정신분열병 및 임상변인과의 관련연구

이성필,백인호,조희수,도규영 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 세로토닌의 속도조절효소인 tryptophan hydroxylase(TPH) 유전자의 다형성은 여러 정신질환의 발병과 임상양상과의 관련성이 연구되었으나 정신분열병 환자를 대상으로 한 연구는 없었다. 본 연구에서는 정신분열병의 발병 및 임상변인과 TPH유전자 다형성과의 관련성을 알아보기 위하여 정신분열병 환자와 정상인을 대상으로 TPH 대립유전자 및 유전자형의 빈도를 조사하였고 정신분열병 환자군에서는 임상아형, 자살사고 및 자살행동, 발병연령, 가족력여부 등의 임상적 변인과의 관련성을 알아보았다. 방 법 : 217명의 정신분열병 환자와 236명의 정상대조군을 대상으로 DNA를 분리하여 TPH 유전자를 증폭하고 제한효소 (Nhel)를 이용하여 유전자형을 구분하였다. 결 과 : 환자군과 정상대조군 사이에는 TPH 유전자형 및 대립유전자의 빈도에서 유의한 차이는 없었으나 자살행동을 보인 빈도는 각각의 유전자형에 따라 유의한 차이를 보였다(χ²=6.504 p=0.039). 그 외 임상아형, 발병연령, 가족력, 자살사고 등의 변인에 따른 유전자형의 빈도 차이는 없었다. 결 론 : TPH 유전자의 다형성은 정신분열병의 발병이나 임상양상, 자살사고, 가족력 및 발병연령과는 유의한 상관관계가 없으나 자살행동과는 관련이 있는 것으로 생각된다. Objectives : The genetic polymorphism of tryptophan hydroxylase (TPH), the rate-limiting enzyme in the biosynthesis of serotonin, has been to be related with various psychiatric disorders such as bipolar disorders. However, the role of TPH gene polymorphism in schizophrenia is totally unknown. Author examined the association of the TPH gene polymorphism with the development and the clinical variables of schizophrenia. Methods : Genomic DNAs from 217 schizophrenic patients and 236 healthy controls were isolated, and TPH gene was amplified using PCR. Amplified TPH DNA was digested with NheI and the polymorphism was examined by electrophoresis on agarose gel. Results : The allele frequencies and the genotypes of TPH gene were not significantly different between the schizophrenics and the control groups. They were also not associated with most of the clinical variables of schizophrenia such as subtypes, suicidal ideation, age at onset, and family histories. Among the clinical variables, only suicidal rate was highly correlated with genotype 218C/C. Conclusion : We found possible association of the suicical behavior with 218C/C polymorphism. However, it seems that A218C polymorphism of TPH gene does not associated with the development and other clinical variables of schizophrenia.

海水,魚貝類 및 生活下水에서의 Vibrio菌屬의 分離同定과 抗菌劑 感受性

金聖光,徐民濩,白成德 啓明大學校 醫科大學 1990 계명의대학술지 Vol.9 No.3

Vibrio species isolated from various marine enviromments during the period form April to SEptember 1989 in the East sea and the South sea of Korea were studied for species distribution and antibiotiv suseptibility test in vitro. The number of strains isolated were 221 among 324 total specimens, they were classified into V. parahaemolyticus (27.6%), V. alginloyticus (51.6%) and nonfermenting Vibrio species (20.8%), but V. choerae and V. vulnificus were not isolated. V. parahemolyticus were more frequently isolated from Kyungju gun (31.7%) among 41 specimens by regional groups an followed by Geojegun (26.7%) and Masan city (26.3%), and shellfish (8 among 28 specimens; 28.6%) were showed the higher isolation rate among specimens tested. V. alginolyticus were more frequentiy isolated from Kyungju gun (45.2%), and sea water (75 among 166 specimens) showed higher isolation rate than tee other specimens. Nonfermenting Vibrio species were more frequently isolated from Masan city than the other regions, and sea water (10 among 19 specimens;; 24.7%) showed higher isolation rate of this strains. During the period of this study, the increased temperature of sea witer was found to be a correlatioin with the increased frequency of isolation rate of Vibrio species. Among V. parahaemolyticus, all strains were rresistant to penicillin and ampicillin, 68.9% to carbenicillin, and only 3.3% to cephalothin, but no resistant strains to other drugs tested were found. MICs of cephalothin to most strains were 16-32㎍/㎖, thus the resistance criteria to this drug was not deremined.