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.

정신장애인 치료에 중요 역할 담당자의 정신질환에 대한 태도조사

김병후,정선욱,강연화,김윤,김창엽,홍진표,한오수,조맹제,김용익 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

Objectives : Attitudes of families of mentally ill, health personnels and community leaders to the mentally ill after the development and utilization of the community mental health program and reintegration of the chronically ill patients into society. This study was designed to compare the attitudes toward the mentally ill patient of the persons who have important role in treating the mentally ill and to find the variables influencing the attitudes. Methods : We measured attitudes toward mental illness in psychotic patients' families(N=139), community leaders(N=180) and health personnels(N=324) including mental health personnels before the implementation of community mental health services in Yonchon county and Seodaemun district area. The instrument used to measure attitudes was Opinion about Mental Illness(O. M. I.) scale. Results : 1) Health personnel showed lower Authoritarianism(Factor A) and higher Benevolence(Factor B) scores on the average than community leaders and psychotic patients families. 2) Current residence affect the attitudes in psychotic patients' families, not in community leaders and health personnels. Families in urban area showed lower Authoritarianism(Factor A) and Social Restrictiveness(Factor D) and higher Benevolence(Factor B) scores than in the rural areas. 3) Many patient variables were correlated to the attitudes of families. Duration of illness, number of recurrence, number of admission, age of patient and family burden were positively correlated mainly to Social Restrictiveness(Factor D). 4) Sex and religion of respondents showed no or weak relationship with the factor scores. Conclusions : Education for community leaders and families is required to achieve successful community mental health services. Community support program should be developed for chronic, recurrent and burdensome psychiatric patients in the first place.

Study on Microstructure and Mechanical Properties of the Al–25Cr–5Si (at%) Alloy Powder Using Gas-Atomization and SPS Process

Yong‑Ho Kim,Hyo‑Sang Yoo,Jeong‑Han Lee,Ik‑Hyun Oh,Hyun‑Kuk Park,Hyeon‑Taek Son 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.7

In order to investigate the microstructure and mechanical properties on Al–25Cr–5Si (at%) alloy, a mixed powder with pureelements and an alloy powder using a gas atomization process were used. Fine and high purity Al–25Cr–5Si (at%) alloypowder was successfully prepared by gas atomization and densified using a spark plasma sintering (SPS) process. The overallpowder size distribution of the mixed Al, Cr, and Si elemental powders was in the range of 10–15 μm. The atomized Al–Cr–Sialloy powder was fine and spherical in morphology and difficult to be formed by intermetallic formation. Densification wasclearly confirmed at 1000 °C, with almost isolated pores formed, by clear removal of pores between particles, deformationof particles, an increase in the number of contacts, and a change in size between particles. As a result of XRD analysis ofthe sintered compacts, single phase was observed using the mixed powder, but the compact using gas atomization remainedthe alloy phase even at the process temperature. The Vickers hardness of the compacts by mixed powder was observed at59.70 Hv and the compact using gas atomized powders on the temperature 1000 °C of the Vickers hardness increased to702.6 Hv. The compressive yield strength of the compact with mixed powder was 195.24 MPa and the compressive strengthof the compact with gas atomized powder increased to 802.07 MPa. It is considered not to be decomposed by the AlCrSi,Al13Cr4Si4and Al8Cr5phases sintering process, resulting from the improvement of mechanical properties.

유도 '되치기 본'의 개선 방안에 관한 연구

김의환,김도준,김규수,김관현,김종달,최종삼,조용철,박순진,윤익선,안병근,정 훈,김미정,한성철 龍仁大學校 武道硏究所 1999 武道硏究所誌 Vol.10 No.1

The purpose of this study was to reform practically a Korean Judo's Doechigi-Bon(Forms of Counterattack, judo's Gaeshi no Kata, Judo's Uradori no Kata, Judo's Gonosen no Kata) that was established in 1955 Korea, according to changing of techniques by Judo's modernization, in order to have Judo's carefulness and systematic diffusion. Reform procedure of Judo's Doechigi-Bon was 1st stage, Questionnaire survey 303 judokas, 2nd stage, Technical seminar by judo experts(12 judo professor) 4 times, 3rd stage, wording report for reform, 4rd stage, Discussion and judgement of Teaching and Judgement commission of Korean judo Association(KJA), 5th stage, Public hearing for reform in KJA, 6th stage, Report and decision of board of directors in KJA, 7th stage, public publication of Judo News(No.53) in KJA. Basic principle of reform of Judo's Doechigi-Bon were as table 1. Table 1. Basic principle of reform of Judo's Doechigi-Bon ------------------------------------------------------------------------------- Items Reformed Key Points of Judo's Doechigi-Bon ------------------------------------------------------------------------------- 1. Structure 1) Grand classification : Classified by 3 parts(1,2,3Gyo) 2)Medium classification : Te waza, Goshi waza, Ashi waza devided per each part(Gyo) 3)Sub-classification : Classified five techniques per each part(Gyo) 2. Contents 1) Selected established techniques as possible 2) Considered rationalty and overlapping of counterattack techniques 3. Decision of Conterattack techniques 1) Refered to results of Basic Questionnaire survey 2) Priority to decisions of Judo expert technical seminar -------------------------------------------------------------------------------- Reformed Korean Judo's Doechigi-Bon(Forms of Counterattack techniques-KJA, 1999) are as follows: 1. Gyo; ① Uki otoshi -> Uchi mata ② Harai goshi -> Harai goshi gaeshi ③ O soto gari -> O soto gake ④ Ko uchi gari -> Sasae tsurikomi ashi ⑤ O uchi gari -> Ko soto gari 2. Gyo; ① Ippon seoi nage -> Okuri eri jime ② Tsuri domi goshi -> Uki waza ③ Okuri ashi harai -> Okuri ashi harai ④ Ko soto gari -> Tai otoshi ⑤ Hiza guruma -> Hiza guruma 3. Gyo; ① Kata guruma -> Sumi gaeshi ② Tai otoshi -> Ko soto gari ③ Hane goshi -> Harai tsurikomi ashi ④ Uchi mata -> Tai otoshi ⑤ Tomoe nage -> O uchi gari

아세클로페낙 연질캡슬(클란자 에스 연질캡슬)의 개발

용철순,이경희,최진석,박병주,정세현,김용일,박상만,배명수,김귀자,김영식,유창훈,강성룡,유봉규,이종달,최한곤 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.1

To develop and aceclofenac soft capsule, four preparations with various solubilizers were prepared and their dissolution test was carried out. Among four preparations tested, a preparation with ethanolamine was selected a formula of aceclofenac soft capsule (Clanza S^(™), since it showed the fastest dissolution rate. Bioequivalence of aceclofenac tablet, Airtal^(™)(Dae-Woong Pharmaceutical Co., Ltd.) and aceclofenac soft capsule, Clanza S^(™)(Korea United Pharmaceutical Co., Ltd.) was evaluated according to the guideline of KFDA. Fourteen normal male volunteers (age 20-25 years old) were divided into two groups and a randomized 2×2 cross-over study was employed. After oral administration of one tablet or capsule containing 100 ㎎ of aceclofenac, blood ws taken at predetermined time intervals and the concentration of aceclofenac in plasma wa determined with an HPLC method under UV detector. The pharmacokinetic parameters (C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameters using logarithmically transformed AUC_(t), C_(max) and T_(max) between Airtal tablet and Clanza soft capsule were 2.89%, 0.18% and 43.0%, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(1.250(e.g.log(0.81) - log(1.23) and log(0.89) - log(1.14)) for AUC_(t) and C_(max), respectively. Thus, the criteria of the KDFA guidelines for the equivalence was satisfied, indicating that Clanza S^(™) soft capsule is bioequivalent to Airtal^(™) tablet.

가토에서 일측 요관 부분 및 완전폐색시 신장과 요관의 조직학적 변화

김상현,김용웅,육승모,한동석,노안식,임재성,김홍식,나용길,설종구 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

This study was designed to clarify histologic changes in the experimental rabbit kidney and ureter after unilateral partial or complete ureteral obstruction. A total of 20 adult white rabbits were divided into 4 subgroups in the partial obstruction followed by 2 weeks, the partial obstruction followed by 4 weeks, the complete obstruction followed by 2 weeks, and the complete obstruction followed by 4 weeks. The normal control group was consisted of 5 adult white rabbits. The kidneys and ureters for light microscopy were fixed in 10% neutral formalin, embedded in paraffin and stained with hematoxylin and eosin. Abnormal histologic fingings showed in ipsilateral kidney and ureter of all subgroups(such as dilatation of uriniferous tubule, focal necrosis and desquamation of epithelium, interstitial fibrosis, glomerular congestion, widening of Bowman's space, dilatation of ureter, epithelial cell atrophy or loss, interstitial fibrosis and interstitial inflammation). These findings were most severe in the group of the complete-obstructed ureter for 4 weeks. No significant changes showed in contralateral ureter of all subgroups. The degree of obstruction was severe and period of obstruction was long, the histological changes in ipsilateral side were severe. Despite of changes in ipsilateral side no abnormal findings showed in contralateral side. We suggest that long term experimental investigation of histologic changes in ipsilateral side and compensatory changes in contralateral side have to be studied.

콘크리트의 급속염화물침투시험에 의한 염화물이온 확산계수 평가에 관한 실험적 연구

김갑수,조봉석,장종호,김재환,김용로,김무한 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

Chloride ions are considered to be the major cause of steel corrosion in concrete structures exposed to seashore environments and also permeation of chloride is controlled by chloride diffusion. Therefore, the study on chloride diffusion of concrete have been done so far by many researchers. In this study, several factors such as capacity of voltage, time of an electric current, concentration of NaCl solution, water-cement ratio, and temperature of the solution were examined to grasp what influence they were on the chloride ion diffusion properties using the Rapid Chloride Penetration Test(RCPT) by electrophoresis. Also standing on the basis of the such result application possibility of Rapid Chloride Penetration Test(RCPT) used in this study will be evaluated and the basic data on the durability design for the chloride attack will be suggested.

헬리코박터 파이로리 균 진단용 ^13C-요소 캅셀의 개발

용철순,김용일,김지만,강성훈,권기철,이종달,김종국,사홍기,최한곤 한국약제학회 2002 Journal of Pharmaceutical Investigation Vol.32 No.1

The purpose of this study was to develop a new ^13C-urea- containing capsule for diagnosis of H. pylori. The urea-containing capsules were prepared with various diluents such as polyethylene glycol (PEG), microcrystalline cellulose, sodium lauryl sulfate and citric acid. The dissolution test, ^13C-urea breath test and stability test were then performed on the capsules. Microcrystalline cellulose and sodium lauryl sulfate retarded the initial dissolution rates of urea. However, PEG increased the initial dissolution rates of urea. Furthermore, two formulae composed of PEG, [^13C-urea/PEG (38/1.9 mg/cap)] and [^13C-urea/PEG/citric acid (38/1.9/1.9 mg/cap)] had the maximum DOB value, about 16 at 20 mim, while the formula composed of only 38 mg ^13C-urea had the maximum DOB value at 30 min. The results indicated that PEG improved the sensitivity of ^13C-urea in the human volunteers. The capsule [^13C-urea/PEG (38/1.9 mg/cap)] was stable for at least six months in 25 and 37℃. Thus, a PEG-containing capsule, [^13C-urea/PEG (38/1.9 mg/cap)] would be a more economical, sensitive and stable preparation for diagnosis of H. pylori.

흔치않은 대상포진 치험 2예 : 비전형적 부위와 다른 부위로 재발한 예 Unusal Dermatome and Recurs Other Dermatome

김정미,조은경,조정선,최용석,한영수,한정호,김두응,최진영 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Herpes zoster is well known as an acute, self-limited disease of unilateral sensory dermatome caused by varicella-zoster virus and characterized by grouped vesicular skin eruption and pain over several dermatomes as well as single. This virus usually affects the thoracic dermatome and there are a few reports that this virus involves lower lumbar or sacral area, and recurrent cases. We experienced 2 cases that zoster virus involved L4 or S2 dermatome and left typical skin lesions, of which one was a recurrent case involving different dermatome at an interval of 8 years and the other was a rare case involving sacral dermatome.

이하선관 절단의 임상적 고찰

김한용,김병삼,김환익,이삼용,조백현 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2

본 병원에 내원한 절단된 이하선관 환자 총 20명(남자:10명 여자 10명)중 4명을 제외한 16명에서 추적조사가 가능하였으며 이 중 14명에서 이하선관의 원활한 관통이 이루어졌고 1명에서 관의 폐세기 생겨 2차 수술이 필료 했으며 다른 1명의 경우 농의 배출이 있었으나 항생제 투여와 구강위생등으로 별 다른 문제 없이 치료 되었고 또 1례의 이하선 타석을 치험하여 보고하는 바이다. Due to increasing trend of traffic accident, number of patient has been gradually increased. Facial injury, for its anatomical vulnerability, is most common site of injury and greatly exceeding injuries of other body region in trauma patient. There are occasional report of Stensen`s duct damage accompanying facial injury and much problem can arise when first aid is performed without knowledge of anatomy or concern for patient. Generally, Stensen`s duct located at mid 1/3 portion of line passing through tragus of ear and subnasale, another word, above the masseter muscle. Once deep lacerated wound has occurred in this region, one must suspect damage of Stensen`s duct. Among the 20 patients (Male: 10, Female:10) who have beeb treated at Chonnam National University Hospital for severed Srensen`s duct, 14 cases have obtained favorable result, not counting 4 patients with whom follow-up study was not possible. In unsuccessful cases of two, 1 case required secondary operation due to occurance of ductal stricture. In another case, leakage of pus has been observed but with proper oral care and antibiotic administration, it has been treated withiut any difficulty. Facial nerve injury accompanying Stensen`s duct been frequently observed, buccal branch being the most common site of involvement. Time interval from severance of duct to repairing the duct was 7 to 21 hours on average and time delay of this level has not impose much limit to obtain successful result. Suture material for Dowel, no matter what kind used, has achieved favorable result and time interval of 9 to 21 days given before the removal was long enough to obtain successful operative result without any development of complication. It is generally accepted view that salivary stone is most common disease entity among the salivery glands and ducts, and stone mostly occur in submandibular duct and rarely in Stensen`s duct. We have performed end-to-end anatomosis using a 23 guage polyethylene catheter as a Dowel in severed duct in 20 patients who have been admitted our hospital for cut repair and obtained satisfiable result. In 1 case, we have experienced stone on the Stensen`s duct, therby reporting this case with through reviews of literature.