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.

절삭조건과 AE 신호들과의 관계에 관한 실험적 연구

조종래,정윤교,원종식 창원대학교 공작기계기술연구센터 1999 연구업적집 Vol.1 No.1

This paper investigates the relationship between cutting conditions and Acoustic Emission(AE) signals; AEavg, AErms, AEmode, as the base working to monitor the tool wear with in-process. For this purpose. cutting tests were conducted on a CNC lathe with comprehensive cutting conditions. It is known that AEavg and AErms are increased as the increasing of cutting velocity and depth of cut respectively. The new parameters, derived from AEavg and AErms, which may be used for the in-process detection of tool wear is discussed. It is also known that AEmode may also be applied for in-process monitoring to make the self diagnosis system because of its stability to the variation of cutting conditions.

응급의료센터로 내원한 급성심근경색증 환자

정윤석,김준식,유인술,조준필 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Early reperfusion can prevent myocardial necrosis, and clinical trials with reperfusion therapy demonstrating a significant reduction in acute myocardial infarction(AMT) mortality have dramatically changed the treatment paradigm for AMI. All patients with symptoms and ECG findings suggestive of AMI should be considered for treatment with thrombolytic agents. However, only a minority of AMI patients actually receive a thrombolytic therapy. Many patients are often excluded from treatment because they do not meet the criteria for age, duration of the chest pain, and a qualifying ECG. And late arrival at the hospital is a frequently cited reason for not giving a thrombolytic agent. To confirm the reason for not receiving an early reperfusion therapy, we obtained the data for the clinical characteristics, the time intervals between the symptom onset and the start of a thrombolytic agent infusion, the method of reperfusion therapy, the reason for not giving a thrombolytic agent and overall outcomes by retrograde chart review. During the 12-month study period between July 1994 and June 1995, 113 patients were finally diagnosed to AMI, who presented to Emergency Center of Ajou University Hospital in total 30,819 patients. The results were followings: 1. The average age was 59±12 years old, the ratio of male to female was 3.2:1. The direct visited patients to our hospital were 31 and the transfered were 82. 2. The chief complaints were chest pain(86.7%), dyspnea, dyspnea, and mental change. The common preceding diseases were angina pectoris(10 cases), old myocardial infarction(9 cases), congestive heart failure(2 cases) and typical chest pain but not diagnosed(23 cases). The risk factors were smoking(81 cases), hypertension (46 cases) and DM (22 cases). 3. 75 patients had arrived within 12 hours from symptom onset and 38 patients after 12 hours. 45cases (54.7%) were performed the reperfusion therapy ; 31 patients were taken the thrombolytic therapy by tissue-type Plasminogen Activator. 4. The most common reason for not receiving a reperfusion therapy was the time delay and the main was the patient/bystander factor. 5. 75.2%(85 cases) of the patients discharged with or without complications, 7.1% (8 cases) died, 10.6% (12 cases) discharged moribundly, and 7.1% (8 cases) discharged against advise. In conclusion, the time delay was the first reason for not receiving a reperfusion therapy in AMI patients. And the education for the AMI symptom and BLS (Basic Life Support) to the people, good EMS(Emergency Medical Service) system, early definite diagnosis and aggresive therapy may decline the mortality rate.

C^(++)과 신경망을 이용한 In-process 감시 시스템의 구축

조종래,정운교 한국공작기계학회 2002 한국공작기계학회 추계학술대회논문집 Vol.2002 No.-

Monitoring of the cutting trouble is necessarily required to do Factory Automation and Intelligent manufacturing system. Therefore, we constructed a monitoring system using neural network in order to monitor of the cutting trouble. From obtained result, it is shown that the cutting trouble can be monitored effectively by neural network

육상 양식장 인접해역의 해양학적 환경특성

조규대,이충일,김동선,양윤정 한국환경과학회 2002 한국환경과학회지 Vol.11 No.4

Field observations for research of oceanographic characteristics in waters adjacent to fish farm on land and water quality at area where water is supplied to fish farm and area where water is discharged from fish farm are carried out in coastal waters of Pyoson located in the southeastern region of Jeju Island in March, May, August and November of 2000. Semidiurnal tides to the northeast and southwest dominate. The mean velocities of current around neap tides and spring tides are 8.52㎝·s^-1, 28.36㎝·s^-1, respectively. The difference of temperature between area where water is supplied to fish farm and area where water is discharged from fish farm is about 0.6℃. Seasonal variation range for temperature and salinity is 13.5℃ and 3.5psu, individually. Concentrations of nitrate(NO_3), phosphate(PO_4^3-), silicate(SiO_2) and COD(chemical oxygen demand) are high in autumn. Particularly, concentrations of nitrate and COD in winter and spring at station where water is supplied to fish farm are higher than these at station where water is dischared from fish farm. However, concentration of phosphate and silicate at station where is supplied to fish farm in spring, summer and autumn is higher than that at station where water is dischared from fish farm. Water quality in the study area is grade 1 and this level is kept up in the whole year.

후천성 림프관종과 동반한 소타액선의 선종양 증식

윤정훈,조세인,김수관 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.6

A 24-year-old male presented clinically as an asymptomatic tumor-like nodule associated with superficial multiple hemorrhagic papules on the right retromolar area. A histological examination revealed acanthotic epithelium and dilated lymphatic vessels in the submucosa together with a proliferation of mucous salivary gland tissue. The clinical and histological features were compatible with those of lymphangiectasis or acquired lymphangioma and adenomatoid hyperplasia of the minor salivary glands. This patiend had past history of third molar extraction 2 years ago. The exact nature of this lesion is not known, but obstruction of the lymph vessels due to a pervious tooth extraction has been suggested as a possible cause. In addition, local trauma may play a role of the pathogenesis of adenomatoid hyperplasia of the minor salivary glands.

Clostridium difficile 장염에 의한 속발성 유전분증에서 발현된 독성 장염

조형원,정혜경,강현주,이윤표,강혜원,심기남,정성애 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

Amyloidosis is characterized by extracellular deposition of protein fibrils in one or multiple organs. AA amyloidosis is secondarily occurred to be related with chronic infections or inflammatory diseases. We report a 67-year-old man suffered from secondary AA amyloidosis related with chronic Clostridium difficile colitis after repeated total hip replacement surgery. Infection control is the most important treatment of AA amyloidosis secondary to chronic infection. However, the patient’s C. difficile colitis was not controlled well, eventually toxic megacolon with sepsis was developed. Consequently, he had to take total colectomy, but he expired with multi-organ failures. We suggested that early surgical procedure might be one option for intractable C. difficile colitis complicated with secondary amyloidosis.

특발성 자발성 신장 파열 1예

윤재철,김원,조규종,홍정석,이미우,장성은,오세현,임경수 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Primary aldosteronism is a syndrome characterized by hypertension, hypokalemia, suppressed plasma renin activity, and elevated serum aldosterone levels. Conn first described it 1955 in association with adrenal cortical adenoma(Conn's syndrome). Today, it can be divided into at least six distinctive sub-groups. The diagnosis of primary aldosteronism is usually suspected when the patient presents with poorly controlled hypertension with hypokalemia. The main issues in the evaluation of primary aldosteronism are to differentiate an adenoma from hyperplasia and to localize the adenoma. Basic hormonal studies and computed tomographic(CT) scanning can be used effectively for that differentiation. An adenoma is one of a few potentially curable forms of hypertension, and it is best treated by removing the adrenal tumor. We experienced a case of a typical adrenal adenoma. The patient was a 37-year-old male who had experienced in both his legs over a period of several days a weakness due to hypokalemia. He was diagnosed using basic hormonal studies and adrenal CT scanning. After, he received laparoscopic adrenalectomy and was discharged with improved condition.

AE 신호의 주파수분석에 의한 Chatter진동의 감시

조대현,이상태,원종식,정윤교 韓國工作機械學會 2000 한국생산제조학회지 Vol.9 No.5

A machine tool generally has some serious stability problems in the form of tool chatter during the cutting process. Chat-ter vibration deteriorates the surface finish, reduce tool and machine life, accelerates machine tool system component wear, and may lead to an unacceptable noise sound in the working environment. In this study, the behavior of spectral density of AE signal and principal cutting force signal in order to monitor the chatter vibration in the cutting process has been investi-gated. From the results, the reliability of proposed monitoring method has been confirmed.

One Arm Curl 동작의 Simulation

조동욱,서국웅,윤양진,김정태,조승제 釜山大學校 附設 體育科學硏究所 1997 體育科學硏究所 論文集 Vol.13 No.-

In recent years, numerical simulation of human body motion has received an increasingly wider range of application. Computer simulations have greatly contributed to the understanding of kinematics and dynamics of human motion. Such simulations are being used in ergonomics to better understand and thus improve the interaction of persons with machines and with workplace configurations. In sports, the simulations are being used to optimize performance, to develop equipment for injury prevention, and to speed and enhance recovery from injury. Then in this study simulated one arm curl motion for understanding force and moment in arm's each joint, and this segment modeling was used 2-dimension, 3-link system. From simulation of mathematica 3.0 we found kinematic and kinetic factors with imaginatively lift of dumbbell and simulated random value of the last curl angle, weight of dumbbell, cycle of motion and so on. The conclusions of this study is as follows ; 1. As this study link system, weight of dumbbell influence not a stance and motion but magnitude of force and moment. 2. The force showed even as smooth curve in all cycle. Moment showed biggist between 0.5sec and 1.5sec. The magnitude order is shoulder, elbow and wrist joint. 3. Motion of system in this study is very similar human arm's motion considering that law of inertia and helped effectively delegation of force. 4. Mathematica is useful language as simulation program. Forward it needs study about modeling and simulation on muscle factors, also human body simulation.