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.

임신부의 인플루엔자 백신 접종률 및 관련요인

김미정,이승연,이광수,김아름,손동욱,정문현,박신구,박지현,이병익,이진수 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Background : During seasonal influenza epidemics and previous pandemics, pregnant women have been at increased risk for complications related to influenza infection. Although influenza vaccination has been widely recommended to pregnant women and immunocompromised hosts, the vaccination rate is presumed to be low in pregnant women. This study was aimed to evaluate the vaccination rate and factors associated with Influenza vaccination among pregnant women, who are at high risk for developing complications from the influenza. Materials and Methods : This study was carried out by telephone survey from April, 2007 to August, 2007. Women who were in their second trimester of pregnancy or above,- during October, 2006 and February, 2007, the recommended vaccination period, and had given birth at Inha University Hospital were selected as the study population. Immunization status, general understanding, and factors associated with vaccination were evaluated. Results : Among a total of 506 eligible pregnant women, 227 (44.8%) responded to the questionnaires. The influenza vaccination rate among the pregnant women was only 4% (9/227). Major reasons for not receiving vaccination were first, not awaring the necessity of immunization during pregnancy (48.5%, 110/227) and second, misunderstanding that it is prohibited during pregnancy (36.1%, 82/227). The major factors that influenced the compliance of vaccination were correct understanding and doctor's recommendation on the influenza immunization during pregnancy. Conclusions : The influenza vaccine coverage on pregnant women was very low and the awareness of influenza vaccination during pregnancy in general was inaccurate. Shift in perception is required and this can be achieved by educating the pregnant women on the safety and efficacy of vaccination. In addition, doctors' active encouragement to vaccination is highly recommended.

반려동물의 기생충검사 이론 및 실제

이성호,박영석,박병권,김상기,정지윤,박수진,박창식,김병수 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

The aim of this article is to improve human health and that of companion animals by improving the diagnosis and control of parasitic diseases. This is achieved by research into parasites of veterinary significance including zoonoses and the use of comparative systems to increase our understanding of some human parasitic diseases. We should promotes learning and teaching through knowledge and operates a diagnostic unit that offers a service to pet owner for indigenous and exotic parasitic diseases of companion animals. We must diagnose and treat them early. Zoonotic parasites are very important because many of animal parasites are zoonoses and give pain and death to human. Parasites are divided Protozoa, Helminthes and Arthropods. There are many protozoa, about 65,000 species. Arthropods are the vector of another diseases, such as virus, bacteria, protozoa and nematodes. Helminthes are composed of Trematoda, Cestoda, Nematoda and Acanthocephala. The target of Veterinary Parasitology is to recognize the characteristics of these parasites and subsequently diagnose, treat and control them. This article is intended to familiarize you with the essential facts and concepts of companion animal parasitology. Emphasis is placed on fecal sample techniques (comparison of fecal examination techniques; frequently found artifacts in fecal smears; direct Smear; zinc sulfate flotation; etc.) We recommend that the study be done to more references on animal parasites.

Hinman 증후군(비신경인성 신경인성 방광) 1예

이경욱,채정호,이승주,김세웅,박원명,전태연,김광수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.3

Objectives : The Hinman Syndrome is a condition representing urinary voiding dysfunction in a neurologically intact child. This syndrome probably is an acquired behavioral and psychosocial disorders. We present a case presenting voiding dysfuntion with no neurologic etiology. Case : The departmcnt of urology consulted the department of psychiatry for a psychiatric evaluation of a 14-year-o1d girl with a history of recurrent urinary tract infections, enuresis, and urinary dribbling since early childhood. She visited the emergency room bccausc of severe abdominal pain and hematuria. She was admitted to the department of urology. Neurological tests showed no abnormality, but a retrograde cystogram showed free vesicoureteral reflux to the level of the dilated intrarenal collecting systems. Marked blunting and dilatation of the caliccs suggested longstanding urinary flow obstruction. She had a history of scparation anxiety disorder and was very competetive, perfectionistic, and nervous. She also had very poor relationships with her friends and had difficults in managing them. Afer admission, she had stent operation and cystostomy. Antidepressant and anxiolytic medications with supportive psychotherapy were administered to treat anxiety, tension and depression. Gradually, her depressive symptoms and voiding difficulties improved. Conclusions : Psychological factors such as a perfectionistic and obsessive personality, a history of severe separation anxiety, stressors from poor interpersonal relationships and Ihe failure of an entrance examination seem to have contributes to the development and exacerbation of the urinary dysfunction. Pharmacotherapy and supportive psycho-therapy may be efective in treating associated psychiatric problems of these patients with hinman syndrome.

미약한 경부기종에 의해 발생된 개의 부분적 기관협착

이성호,박영석,박병권,김병수,정지윤,박창식,김상기 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

A 10-year old male Pomerarian was presented with about a ten day history of stridor and severe paroxysmal honkinglike coughing which were aggravated with excitement and exercise. Auscultation revealed prominent inspiratory and expiratory crackles and wheezes over the caudal cervical trachea which were heard equally over both side of the chest, and a hemogram showed mild leucocytosis with mild dehydration. On the lateral radiographs of the neck and thorax, the cervical trachea was displaced ventrally by the air trapped between fascial planes of the cervical area near the thoracic inlet. It also revealed a marked narrowing of the tracheal lumen extending from the level of the fifth cervical to the second thoracic vertebra, and the lung field was judged to be within normal limits. There was no evidence of pneumomediastinum. A diagnosis of segmental tracheal stenosis was made. The emphysema of the retrotracheal area was thought to be a traumatic origin. The dog was treated successfully with strict cage confinement for a week. The tracheal stenosis caused by mild emphysema between the soft tissue of the cirvical area or mediastinum in the dog is very rare.

모빅 캡슐(멜록시캄 7.5㎎)에 대한 멜락스 캡슐의 생물학적동등성

이예리,염승복,고연정,고정길,김호현,이희주,이경률 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.5

A bioequivalence of Melax capsules (Chong Kun Dang Pharm., Korea) and Mobic™ capsules (Boehringer Ingelheim Korea) was evaluated according to the guideline of Korea Food and Drug Administration (KFDA). Single 15 mg dose of meloxicam of each medicine was administered orally to 24 healthy male volunteers. This study was performed in a 2 x 2 crossover design. Concentrations of meloxicam in human plasma were monitored by a high-performance liquid chromatography. AUC, (the area under the plasma concentration-time curve from time zero to 72 hr) was calculated by the linear trapezoidal rule method. C_(max) (maximum plasma drug concentration) and T_(max) (time to reach Cma,.) were compiled from the plasma concentration-time data. Analysis of variance was performed using logarithmically transformed AUC, and C_(max). No significant sequence effect was found for all of the bioavailability parameters. The 90% confidence intervals of the AUCt ratio and the C_(max) ratio for Melax™/Mobic™ were 0.95 - 1.04 and 0.98 - 1.14, respectively. This study demonstrated a bioequivalence of Melax™ and Mobic™ with respect to the rate and extent of absorption.

요추부 수술후 통증관리를 위하여 실시한 Morphine Sulfate를 이용한 Caudal Block의 효과

윤승환,박형천,김은영,전병윤,이홍식,이성근 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.6

중등학교 체육수업 운영실태와 문제점 및 미래의 과제

이광재,김윤래,김승재,황향희,김수남 江原大學校附設 體育科學硏究所 1996 江原大學校附設體育科學硏究所論文集 Vol.- No.20

The purpose of this study was to offer the basic materials on the secondary physiscl education. The subjects were 129 physiscl education teachers at K provience. The results were as follows: In teaching learning methods, the more educated experience teacher had the more improvement feeled. In the degree of difficulty of current physiscl curriculum, the more educated experience teacher had, the higher it was to be thought. In the goal achievement, the more educated experience had, the more it affected the goal achievement. The efficiency and ability of methods was not shown a significant difference among educated experience group, but shouled be consider it. The equipment and implement of goal achievement was not show a significant difference among educated experience group, but should be consider it. The evaluation of propriety and objectivity and on psychomotor, affective, and cognitive domain was not shown a significant difference.

정신분열병 환자와 직계 가족의 마음이론 능력 결함

이정임,이승환,김승연,배성만 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.2

Objectives Theory of mind (ToM) is the ability to conceptualize other people's mental states in order to explain their behavior. This study compared the ToM ability of schizophrenia patients, their first-degree biological relatives, and healthy controls. Methods ToM animation test was administered to schizophrenia patients (N=28), their healthy first-degree relatives (N=26), and healthy controls (N=28). The Korean version of schizotypal personality questionnaire (SPQ) was used to assess the schizotypal personality trait of all three groups. Results Schizophrenia patients and their first-degree relatives showed decreased accuracy on ToM animation test compared to healthy controls [F(2,78)=29.75, p<.001]. Additionally, first-degree relatives performed worse than the control group and better than schizophrenia patients. First-de-gree relatives had similar SPQ scores compared to healthy controls but showed decreased ToM accuracy compared to healthy controls. Conclusion ToM deficits in schizophrenia patients are apparent. The ToM deficit in first-degree relatives of schizophrenia patients raises the possibility that ToM deficit may be a endophenotype for schizophrenia pathology.

알코올의 섭취가 흰쥐의 혈액과 간의 지질대사에 미치는 영향

이명숙,김영연,김효숙,김매하,전진순,서진숙,송선미,양영재,윤원손,이미라,이효영,정승현 誠信女子大學校 生活文化硏究所 2004 生活文化硏究 Vol.18 No.-

To investigate the effects of ethanol on the lipid metabolism in blood and liver, twenty one male Sprague Dawley rats had orally taken the 25% alcohol and 50% alcohol by 5g per Kg of weight during 3 weeks after the adjusting period. For the energy balance, 85% sucrose and 45% sucrose was added in control group and 25% alcohol group each. The weight was reduced by alcohol treatment according to the levels, otherwise the weight of liver and heart was little increased in alcohol groups rather than in control without significance. Moreover, RBC, WBC, hemoglobin and hematocrit were increased by alcohol treatment according to the levels without significance. Otherwise, adjusted bilirubin levels by 100g of weight was significantly increased by alcohol treatment dose dependently. Alcohol induced RBC degradation and increased circulated bilirubin because of liver damage. For blood lipid profiles, blood cholesterol was increased in 50% of alcohol group compared to that of 25% and control groups, otherwise, blood triglycerides (TG) was increased by 30% in 25% alcohol groups rather than in control but not significantly different. The hepatic lipid composition, cholesterol levels in alcohol treatment groups was lower than those in control. The hepatic TG was not influenced by alcohol treatment. The two reasons of decreasing hepatic lipids were suggested by 85% sucrose of control for energy balance more synthesized cholesterol and TG than those in 25 or 50% alcohol groups, and by cholesterol and TG could not be synthesized because of liver damage from alcohol.