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.

자율적 테스트를 위한 VLSI의 테스터블 설계

노승용,김철주,홍완희,김성환,김영호,민병현 서울市立大學校 1988 論文集 Vol.22 No.-

In this pater, new design method for VLSI fault test are proposed by using built-in self test technique. The ordering algorithm for effective test pattern generation and the design method multi-input signature analysis for improving the fault detection capability are suggested. Also, a new multi-function BILBO(Built In Logic Block Observer) is sugested to reduce the hardware. By involbing the latch of sequential circuit into the BILBO, Built In Self Test can be executed effectively. The above proposed multifunctional BILBO was designed to operate both at a test pattern generator and a signature analyzer for reduction of the additional circuit and test time. Moreover, by using input and output line of multifunctional BILBO as a common, the external terminal are saved and the internal chip wiring can be done easily, and also the propagation delay of data signal is not ocurred. Through the implementation of test pattern generation and reordering and algorithm and multifunctional BILBO with C-language on the VAX 11/750(UNIX) computer, the efficienty of algorithm and the availability of designed method are verified.

마케팅 커뮤니케이션 도구로서의 스포츠 스폰서십에 관한 연구

노영태,이영덕,이상봉,박병주,전동호 釜山大學校 附設 體育科學硏究所 1998 體育科學硏究所 論文集 Vol.14 No.-

The objective of this paper is to build sports sponsorship strategic through studying the state of sports sponsorship and the case study in foreign country. I propose the sports sponsorship strategic in new approach to build the structure of more positive sports sponsorship and the understanding of sports player management in korea that greets 2002 World Cup. For that, To build newly sports sponsorship strategic must have the following requires; 1. The transition of think ; from cost concept to investment concept It is necessary the transition of think from cost concept which is a short startegic to investment concept. That is, it hope to the possibility of player lastingly than to immediately short effect which is used by activating player popular in advertisements. 2. More intensive services for customs It is necessary to show the goal accomplished possible for sports fans, ad maintain sponsorship in long run. In same time, we must aware the publics to be understood of a better cooperate image. 3. To secure a specialty It is necessary to bring up the linkage industry and the manpower of specialist for activating sports as a business dimension, not as a hobby and a nation representative. It must expand specialist to the scout management, the advertisement and the event opening.

외상성 뇌손상의 후유증으로 입원한 환자의 삶의 질 수준에 대한 연구 : 경도와 중증의 비교 Comparing Mild to Severe Cases

노승호,김성우 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.4

이 연구는 TBI는 정상인에 비해서 어느 정도인지 그리고 MTBI는 STBI에 비해서 어느 정도 수준인지 전반적인 삶의 질, 정신사회적 장해, 신경해동증상의 관점에서 평가하였다. MTBI환자 23명, STBI환자 23명과 대조군 31명을 대상으로 하였고 삶의 질에 대한 평가는 QOLI, SIP, HISCL, NRS를 사용하였다. 그 결과는 다음과 같다. 1) TBI군과 대조군 사이의 삶의 질 수준을 비교한 결과 QOLI, SIP, HISCL, NRS척도 모두에서 두 군간의 유의한 차이가 있었다(p<.01). 2) QOLI에서 MTBI군의 삶의 질 수준은 72.7±14.2였고 STBI군은 64.4±22.2로 두 군간의 유의한 차이는 없었으나, 대체적으로 MTBI군에서 낮은 경향을 보였다. 두 군 모두에서 직업활동과 삶에 대한 전망이 가장 높았으며, 두 군간의 차이는 지지적 유대관계에서 가장 컷다. 3) SIP에서 전체점수는 MTBI군이 73.9±10.6였고 STBI군은 63.4±22.6로 유의한 차이가 없지만 MTBI와 STBI간의 정신사회적 요인에서는 유의한 차이를 보였고(p<.05) 신체적 요인에서는 유의한 차이는 없었다. 4) HISCL에서 전체적인 증상은 MTBI군이 78.7±10.6이었고 STBI군은 67.2±21.6로 두 군간의 유의한 차이가 있었으며(p<.05). 특히 MTBI군에서 두통, 소음과 불면의 항목에서 의미있게 어려움을 호소하였다(p<.05). 5) NRS로 평가한 TBI군의 객관적인 증상은 두 군 모두에서 신체적 염려가 가장 높았으며 그 다음으로는 우울감, 불안 순이었다. 각 요인 중에서는 MTBI군이 신체적 관심, 우울, 피로 그리고 주의력 장애의 항목에서 STBI에 비해 유의한 차이를 보였다(p<.05). 이상을 요약하면 MTBI군도 STBI군에서와 마찬가지로 삶의 질의 전 영역에서 낮게 평가되었으며 오히려 MTBI군에서 주관적으로 느끼는 자신의 신체증상을 더 많이 호소하였으며, 객관적인 평가에서는 신체 증상, 우울 및 피로 등의 정서적 어려움을 높게 평가하였다. This study was designed to investigate the differences of quality of life(QOL) between traumatic brain injury(TBI) and control groups, and also between mild traumatic brain injury (MTBI) and severe traumatic brain injury(STBI) groups, in term of the global, the psychosocial and the neurobehavioral aspects of QOL. Twenty-three patients with MTBI, 23 patients with STBI and 31 normal control group were rated with a global measure(Quality of Life Index : QOLI), a psychosocial measure(Sickness Impact Profile : SIP), and a self-rating(Head Injury Symptom Checklist ; HISCL) and an objective symptom scales(Neurobehavioral Rating Scale ; NRS). The results were as follows : 1) Comparison with a control group showed that the brain-injured had experienced significant impairment in QOL measured by above all scales(p<.01). 2) On QOLI of the patients with TBI, the decrement of QOL was not significantly different between MTBI and STBI groups. In these groups, the severity of impairment was highest in activity(involvement in own occupation) and the next was outlook in life. 3) On the data from SIP, psychosocial dysfunction was significantly greater in MTBI than STBI(p<.05), whereas physical impairment was similar in both groups of TBI. 4) The severity of subjective complaints on HISCL was significantly greater in(p<.05). Particularly MTBI patients experienced more severe distress from pain, noise sensitivity, and insomnia than STBI patients(p<.05). 5) On NRS, the severity of objective symptoms of both TBI groups was highest in somatic concern, depressed mood, and anxiety in decreasing order. MTBI groups had significantly higher scores than STBI group on the subscales of somatic concern, depressed mood, fatigue, and inattention(p<.05). In summary, the decrement of QOL in the MTBI group was much the same as STBI groups. These data suggest that symptomatic MTBI as well as STBI patients may experience impaired QOL in a number of domains well beyond the acute post-injury phases, and that severity of injury, defined by duration of loss of consciousness and post-traumatic amnesia, and finding of neuroimaging techniques, is not appreciable related to the QOL.

가덕도주변 해역 해수의 중금속 함량

노미경,차미선,박근태,손홍주,문두호,이상준 부산대학교 환경문제연구소 2000 環境硏究報 Vol.18 No.-

The quantitative analysis of heavy metals(As, Cd, Cr, Hg, Pb, Cu) in the sea water around Kaduck island was conducted during the period of March, 1998 to September, 1998. The sea water in the four regions was sampled four times and the heavy metals were analyzed. The Heavy metal concentration of the sea water around Kaduck island was As 127.7㎍/ℓ , Cd 49.28㎍/ℓ , Cr 0.462㎍/ℓ, Hg 0.111㎍/ℓ, Pb 1.713㎍/ℓ, Cu 2.716㎍/ℓ in the average value, respectively.

無機系 一般廢棄物을 水分調節材로 한 畜糞의 堆肥化

盧載星,姜浩,洪性秀,李相運 忠南大學校 地域開發硏究所 1993 地域開發論叢 Vol.5 No.-

남매에서 발생한 심한 용혈성 빈혈과 간경변증을 동반한 Wilson 병 2례

노영일,박동호,서우철,문경래,박상기,박영봉,이미숙,전호종 조선대학교 1995 The Medical Journal of Chosun University Vol.20 No.1

We experienced two case of Wilson's disease in female and male sibling. The first case was a 10 year-old female who showed jaundice. pancytopenia and cirrhotic change in liver biopsy. She died 10 days after diagnosis. The second case of 7 year-old male showed specific symptoms and revealed increased AST/ALT, low serun copper level and increased 24 hour urinary copper excretion level He is being treated with D-penicillamine and follow up examinations.

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

조기 능동 운동을 가능케 하는 굴건 수복 방법에 관한 생체외 연구

안상로,윤승호 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

The results of the flexor tendon repair within the digital sheath have been unpredictable due to peritendinous adhesion. It has been known that three factors are responsible for the formation of adhesion, that is, tendon sheath injury, tendon suture and immobilization. Of these three factors, immobilization is the only one that is theoretically under the control of the surgeon. This problem has led to the development of early active and protective mobilization techniques. However, there was no method providing enough repair strength to a point sufficient to permit early active flexion without risk of tendon rupture or large gap formation. Also the protective mobilization techniques produced a gap at the repair site and could not provide normal amplitude of tendon excursion. So, the author performed these four in vitro studies to obtain a method of flexor tendon repair permitting early active flexion against moderate resistance. The deduced tensile strength permitting early active flexion against moderate resistance is above 7.5kg. The extensor digiti quarti proprius tendon of adult pigs' foreleg was used as the experimental tendon. Each tendon repair was performed under magnification by the Meiji experimental opera tive microscope. The tensile strength in each experiment was tested with a Tensilon tensometer and the gap was measured at each kg. of tensile strength. The first experiment was the measurement of the tensile strength of two strands of 4-0 mersilene with one knot and six strands of 4-0 mersilene with three knots. The second experiment was the measurement of the tensile strength of the diagonal grasp from one grasp to four grasps with a knot, in the tendon end and with a knot far from the tendon end. The third experiment was the measurement of the tensile strength and gap formation of the author's method. Three interrupted sutures with. knots far from the tendon ends were placed in the tendon. Two sutures were placed in both posterolateral aspects of the tendon and one suture was placed in the anterior aspect of the tendon. Each suture grasped only one-sixth of the circumference of the tendon and was placed periph-erally to preserve the intratendinous vasculature. The fourth experiment was the measurement of the tensile strength and gap formation of modified Kessler's, Ketchum's and Savage's method. The following results were obtained. 1. The tensile strength of two strands of 4-0 mersilene with one knot and six srands of 4-0 mersilene with three knots was 2. 45kg and 7.20 kg. respectively which was similar to the deduced tensile strength of 2.5kg. and 7.5kg. respectively. 2. The tensile strength of three and four diagonal grasps with a knot far from the tendon end was 2.83kg. and 2.96kg. respectively which was above the deduced tensile strength of 2.5kg. 3. The tensile strength of the author's method was 8.04kg. which was above the deduced tensile strength of 7.5kg. The gap formation of the author's method with each kg. of tension was low as follows, 0 mm. at 1 kg., 0. 03mm. at 2 kg., 0. 16mm. at 3 kg. 0. 71 mm. at 4 kg. , 1. 53mm. at 5 kg., 2. 38mm. at 6 kg., 3.61mm. at 7 kg., 4.75mm. at 8 kg.. 4. The tensile strength of various methods was low and the gap formation of various methods. was large compared to the author's method. This author's method provided a high tensile strength and a minimal gap, so this method will. be one of the methods that permit immediate active finger flexion against moderate resistance even after tendon softening.

외상성 뇌손상 환자의 지능 장애와 K-WAIS 소검사내 분산도

오상우,김지영,노승호 圓光大學校 醫科大學 神經精神科學敎室 1997 圓光精神醫學 Vol.13 No.2

본 연구는 외상성 뇌손상 환자의 병전 지능을 추정하여, 추정된 지능을 현재 지능과 비교하고, K-WAIS 소검사내 분산도 분석을 시행하여 인지 기능의 효율성을 평가하고자 하였다. 연구 결과, 외상성 뇌손상 환자 집단은 정신분열증 집단이나 기타 임상 집단의 환자들에 비해 지능이 유의하게 저하되어 있었다. 그러나 소검사내 분산도 분석에서는 외상성 뇌손상 환자 집단이 다른 두 집단보다 인지적 효율성이 더 높았다. In this study, premorbid IQ in patients with traumatic brain injury were estimated and compared with measured IQ, and examined efficiency of cognitive function through K-WAIS intrasubtest scatter analysis. These results suggested that traumatic brain injury patient's IQ were significantly lower than those of the schizophrenia and other psychiatric patients. But traumatic brain injury patient's cognitive efficiency were higher than those of the schizophrenia and other psychiatric patients.