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.

차아염소산나트륨 처리와 멸균법이 근관 치료용 파일의 부식에 미치는 영향에 관한 연구

양원경,라윤식,이영규,손호현,김미리 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.2

근관 치료시 많이 사용되고 있는 K-flex S-S 파일 (Maillefer, USA)과 Profile Ni-Ti 파일 (Maillefer, USA), K-3 Ni-Ti파일 (SybronEndo, USA)의 부식 정도를 보기 위하여 총 360개의 20번 file을 1) 멸균소독 방법 (고압가열멸균소독, E-O gas 소독) ,2) 근관세척 액 (5.25% 차아염소산나트륨, 생리식염수) ,3) 멸균소독 횟수 (1, 5, 10회 ) 에 따라 36개 실험군으로 나누었다. 각각의 파일을 각 군별로 처리한 뒤, 세 명의 검사자가 광학 현미경 하에서 25배의 배율로 검사하여 0; 부식 없음, 1; 경도의 부식, 2; 중등도의 부식, 3; 심한 부식으로 점수화 하였다. 심한 부식을 보이는 파일의 표면은 SEM으로 관찰하였고 Kruskal-Wallis test (p < 0.05)를 이용하여 통계 분석 처리하여 차아염소산나트륨 접촉 여부와 멸균소독 방법의 차이에 의한 부식 정도를 평가하였다. 그 결과 고압가열멸균소독을 10회 시행한 파일은 통계적으로 유의한 차이를 보여 부식 정도가 심하였고, 1회나 5회 고압가열멸균소독을 시행한 파일과 E-O 가스로 소독한 파일들은 부식의 정도가 경미하여 통계적으로 유의하지 않았다. 차아염소산나트륨 접촉 여부와 제조사 혹은 파일 재료에 따른 유의성 있는 차이는 없었다 A variety files made of stainless steel (S-S) or nickel-titanium (Ni-Ti) are used during endodontic treatment. The purpose of tt)is study was to evaluate the corrosion susceptibility of S-S and Ni-Ti endodontic files. Three brands of files were used for this study: K-flex S-S files (Maillefer, USA), Profile Ni-Ti files (Maillefer, USA), K-3 Ni-Ti files (SybronEndo. USA). 120 files of each brands (21mm, ISO size #20) were divided into 12 groups according to 1) sterilization methods using Autoclave or Ethylene Oxide (E-O) gas, 2) Irrigation solutions using 5.25% NaOCl or Saline, 3) the number of sterilization (1, 5, 10 times), After above procedures, each of the files was inspected by three examiners with a light microscope and camera at X25. Each file was judged and ranked according to the following criteria: 0;, no corrosion, 1; mild corrosion, 2; moderate corrosion, and 3; severe corrosion. The files of high score were examined under the Scanning Electron Microscope. Data were statistically analyzed with the Kruskal-Wallis test (p < 0.05). Most of the ten time-autoclaved files had showed mild to moderate corrosion. But, one or five time-autoclaved files did not show corrosive surface. NaOCl treatment and E-O gas sterilization did not influence on corrosion. There was a significant difference in corrosion susceptibility between sterilization methods and the number of autoclaving. However, there was no significant difference between brands and file materials.

Haloperidol Decanoate치료중인 정신분열증 환자의 혈청 할로페리돌 농도에 관한 연구

양병환,고용철,김광일,강보경,이경옥,신호상 漢陽大學校 精神健康硏究 1997 精神健康硏究 Vol.16 No.-

敗令散 및 補中治濕湯이 Puromycin Aminonucleoside로 誘發된 白鼠의 腎症에 미치는 影響

梁文浩,曺東鉉,安世永,鄭定烈,杜鎬京 慶熙大學校韓醫科大學韓醫學硏究所 1995 慶熙韓醫大論文集 Vol.18 No.2

The effects of Paeryungsan and Bojungchiseubtang on rats with nephrosis induced by a single intravenous injection of puromycin aminonucleoside(PAN), 2.5mg/100g of body weight were evaluated in the present study. The effects of Paeryungsan and Bojungchiseubtang on PAN nephrosis were evaluated by measuring ①the concentrations of albumin, total protein, total lipid, cholesterol, triglyceride, creatinine, blood urea nitrogen and uric acid in the serum, ②the amount of volume, protein, glucose and creatinine of the 24hours urine ③the concentration of blood in the urine, intake water, and by observing the changes of microscopic findings of kidney. The results are summerized as follows; 1. In the control group, the concentrations of cholesterol, creatinine, blood urea nitrogen in the serum, the amount of protein and glucose of 24 hours urine, creatinine of 24 hours urine and 24 hours urine volume on the 22th day were significantly increased. On the other hand, the concentration of albumin in the serum, the amount of creatinine of 24 hours urine on the 8th day, the volume of 24 hours urine and the intake water on the 8th, 15th day were decreased significantly. Electron microscopic findings were the segmental obliteration of the foot processes, swelling and villous transformations of the visceral epithelial cells and partial increase of the mesangial matrix. 2. In Paeryungsan group, the decrease of albumin in the serum and intake water were inhibited significantly. But the increase of the concentrations of cholesterol and blood urea nitrogen in the serum were inhibited significantly. And the amount of creatinine of 24 hours urine was increased significantly. There was no significant difference between Paeryungsan group and the control group in electron microscopic findings. 3. In Bojungchiseubtang group, the decrease of albumin in the serum and intake water were inhibited significantly. But the increase of the concentrations of cholesterol, total lipid, creatinine, blood urea nitrogen in the serum and the amount of protein in the 24 hours urine were inhibited significantly. The concentration of protein in the serum was increased significantly. There was no significant difference between Bojungchiseubtang group and the control group in electron microscopic findings. To conclude, PAN nephrosis was induced by a single intravenous injection of PAN 2.5mg/100g of body weight on rats. It can be inferred that Paeryungsan group has the effects of improving hypoalbuminemia in nephrotic syndrome and relieving azotemia when nephrotic syndrome is accompanied by the acute renal failure. It can be inferred that Bojungchiseubtang may improve proteinuria, hypoalbuminenia, hyperlipidemia in nephrotic syndrome. But there was no significant difference between Paeryungsan and the control group, between Bojungchiseubtang group and the control group in electron microscopic findings. So I hope that there will be further studies on the effect on the alterations of glomerular polyanion sites, and on the functioning mechanism of Paeryungsan and Bojungchiseubtang in the future.

부신절제후의 위점막 점액세포의 미세구조

양남길,구광일,안의태,고정식,박경호 順天鄕大學 1989 순천향대학논문집 Vol.12 No.3

방사선 조사를 받은 흰쥐 망막 속얼기층의 미세구조

양석우,고정식,양남길,안의태,박경호 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

본 실험은 머리부분이 많은양의 방사선에 노출되었을 때 망막 속얼기층의 미세구조적 변화를 관찰하기 위하여 시행하였다. 실험동물로는 체중 200-250g의 흰쥐를 사용하였으며, 마취상태에서 머리부분에만 방사선을 조사하였다. 방사선 조사는 미쓰비시 선형가속기를 이용하여 조사거리 80cm, 구역 30cm X 30cm, 깊이 1.2cm 조건에서 1분당 200rad씩 연속조사하여, 3,000rad 또는 6,000rad를 조사한 후 6시간, 2일, 6일후에 희생시켰다. 각 동물은 1% glutaraldehyde- 1% paraformaldehyde액으로 관류고정하였다. 관류가 끝난 후 안구를 적출하여 톱니둘레를 따라 절단한 다음, 망막의 일정부위에서 조직을 떼어냈다. 떼어낸 조직은 2.5% glutaraldehyde- 1.5% paraformaldehyde액에 일차고정한 후 1%osmium tetroxide액에 이차고정하였다. 고정된 조직은 수세와 탈수과정을 거쳐 araldite혼합액에 포매한 다음 얇은 절편을 작성하여 uranly acetate와 lead citrate로 염색한 후 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 무축삭신경원의 세포질돌기는 전자밀도가 높은 어두운세포와 전자밀도가 낮은 밝은세포로 구분되었으며, 밝은 세포 가운데에는 과립형연접소포를 갖고 있는 돌기가 관찰되었다. 2. 3,000rad조사 후 6시간군의 경우 밝은 무축삭신경원이 세포질돌기와 신경절세포의 가지돌기는 팽대되었으며 사립체와 세포막이 파괴되는 모습이 관찰되었는데, 2일군의 경우 그 경향이 가장 심했다. 3. 3,000rad조사 후 6일군의 경우 부챗살아교세포의 영역이 넓어져서 전체적인 조직의 모습이 2일군의 것에 비하여 많이 회복되어 보였다. 4. 6,000rad조사 6일군의 경우 부챗살아교세포는 미세사가 많고 전자밀도가 높은 변성된 세포가 자주 관찰되었다. 이상의 결과를 종합해 보면 3,000rad의 방사선을 조사받으면 흰쥐망막의 속얼기층은 처음에는 무축삭신경원의 세포질돌기와 신경절세포의 가지돌기가 손상을 받았으나, 6일 후에는 부챗살아교세포의 영역이 넓어져서 많이 회복되었다. 그러나 6,000rad정도의 방사선을 조사하면 부챗살아교세포도 변성되어 속얼기층 전체가 변성된것으로 보아, 부챗살아교세포는 무축삭신경원이나 신경절세포에 비하여 방사선에 대한 저항성이 높다고 생각된다. This experiment was performed to study the morphological respones of the inner plexiform layer of the retina of rat following X-ray irradiation. Rats anethetized with sodium thiopental, were exposed only on their head areas with a single dose of 3,000rads or 6,000rads, respectively. Radiation was produced by Mitsubishi linear accelerator, at the speed of 200rads/min. The experimental groups were sacrificed on the 6th hour, 2nd hour, 2nd and 6th day after X-ray irradiation. Under anethesia, 1% glutaraldehyde- 1% paprformaldehyde solution was perfused through the heart. Pieces of the tissue taken from the posterior region of the retina were fixed in 2.5% glutaraldehyde- 1.5% paraformaldehyde, and in 1% osmium tetroxide, and embedded in araldite mixture. Ultrathin sections were stained with uranyl acetate and lead citrate solutions. From the ultrastructural study, following results were made: 1. Two types of amacrine cells, according to their elecrton densities, were found, i.e., light amacrine cell and dark amacrine cell. Granular synaptic vesicels were often observed in the light amacrine cells. 2. Two days after exposure to 3,000rads of X-ray, severe morphological changes were observed in cytoplasmic processes of light amacrine cells and dendrite of ganglion cells; i.e., edematous changes, framoentation of mitochondria, breakdown of cell membranes, etc. 3. Six days after exposure to 3,000rads of X-ray, many of the malformaitons were seen to be repaired, except the territory of activated Muller cell. 4. Six days after exposure to 6,000rads of X-ray, darkly degenerated Muller cell were frequently observed. From the above results, it was concluded that large amount of head-irradiation results the severe damages to the cytoplasmic processes of amacrince cell and the dendrites of ganglion cell in the inner plexiform layer of rat retina, but Muller cells are more radioresistant than amacrine and ganglion cells.

화상 카메라을 이용한 이동체 자동 추적 기법

양경부,조경호 제주대학교 공과대학 첨단기술연구소 2006 尖端技術硏究所論文集 Vol.17 No.1

Image processing field that is required the large number of data and a fast processing time is appling and developing to a various filed because of computer's development. But an object tracking is very difficult with a moving camera. In this paper we applied a difference frame method and HSI color model in this automatic tracking system for moving object.

수학성적과 타교과성적의 상관성 연구

양성호,오경사 濟州大學校 師範大學 科學敎育硏究所 1999 科學敎育 Vol.16 No.-

This study focuses on finding the correlation between Math scores and the scores of other subjects on a nationwide achievement test for middle school second year students. Each subject is grouped according to geographical location and sex. First we mention the 7th cumculum integrated education and the theory of correlation and determine a correlation coefficient between Math and other subjects. On the basis of the data collected, we have tried to find a relationship between Math achievement and achievement in other areas of study, with achievement being defined in terms of test scores. From this information, we suggest a way to apply the results of this study to the classroom. In this way, this study will be a guide for middle school Math education and it will also be helpful for the students themselves.

뇌손상시 교세포의 작용에 관한 전자현미경적 연구

양남길,고정식,안의태,박경호 순천향대학교 1984 논문집 Vol.7 No.1

뇌조직의 별성 또는 질병과정에서 각종 신경교세포의 역활을 비교 검토하기 위하여 일차적으로 창상 치유과정의 실험을 시행했다. 뇌조직의 미세구조가 확연하지 못한 부위가 많은 점을 고려하여 이번 실험에서는 이미 저자들이 오랫동안 연구하여 미세구조의 특징을 잘 알고 있는 뇌기저핵의 fundus striati를 주변구조로부터 외각적으로 분리시킨 상태에서 1, 2, 3, 7, 14, 28일간 생존시켜 창상 치유과정에서, 각 미세구조별로 퇴행과정과 교세포 종류별 활동상황을 전자현미경으로 관찰하여 다음과 같은 결론을 얻었다. (1) 창상 후 형태학적 변화는 투사세포의 괴사, 외래 신경축삭과 종말의 괴사, 괴사종말과 연접한 연접후구조의 부종과 극돌기 합입등으로서 이미 발표한 성적들??과 같았다. (2) 수술초기에는 원형질성 섬유세포가 neuropil전역에 걸쳐 활동성으로 바뀌고, 모든 퇴행성 구조를 감싸면서 다른 구조와 분리시켰다. (3) 분리된 퇴행성 구조물은 용해되기 시작했다. (4) 미세교세포가 증가하였고 이들 세포는 다량의 지방소적을 함유하고 있었다. (5) 혈관주위세포는 기저막으로 싸인채 팽대되며, 주변에는 미세교세포와 이행형이면서 기저막이 없는 세포들이 많이 출현하여 뇌대식세포의 혈액세포 또는 혈관주위세포 기원설에 일치하는 형태학적 소견을 보였다. (6) 회돌기교세포는 변성축삭으로부터 수초의 회수작업등의 수동적 반응을 보였다. (7) 교세포의 비교판독 결과 대식세포는 외인성 이물질을 파괴소화시키는 작업을 수행하며, 원형질성 성상세포가 모든 변성구조물의 용해·흡수·제거작용을 이행하고, 최종적으로 섬유성 성상교세포가 빈자리의 섬유화를 완성한다. (8) 조직의 섬유화가 치유과정과 동시에 이루어지는 것은 뇌의 신경세포재생이 이루어지지 못하는 주요 원인으로 생각된다. Structural variations of the neuroglial cells in the degenerating nervous tissues are points of arguements in the neuromorphological field. The short of ultrastructural information on the specific nuclei is one of the critical points in the study of neuroglial activities, because the exact readings of the ultrastructural elements are essential for the differentiation of glial-target relationships. Having the experiences of extensive studies on the fundus striati nucleus (Nucleus accumbens septi) during the last 10 years, we have studied the glial-target relationships following the surgical isolation of the fundus striati uncleus of cat. Surgery was performed by vertically inserting a stainless stell tube-knife, measuring 5mm in diameter, into the brain down to the base of the skull. The blood supply to the tissue cylinder was maintained through the vessels at the base of the skull. The blood supply to the tissue cylinder was maintained through the vessels at the base of the brain. After the survival time of 1, 2, 3, 7, 14 and 28 days, cats were perfused with a mixture of 1% paraformaldehyde-1% glutaraldehyde in phosphate buffer (pH 7.4) and postfixed in osmium tetroxide solution. The ultrathin sections were counterstained with uranyl acetate-lead citrate, and were examined in a JEM 100CX electron microscope. The results are as follow: 1. In the primary stage, the protoplasmic astroglial cells are activated throughout the neuropil. They fill the large area between neuronal elements, and separate the degenerating elements from the intact elements. 2. The astroglial cells attack and dissolve the degenerated elements. 3. The microglial cells increase in number and are activated. 4. In the later stage, around the capillaries, there accumulate many hypertropied pericytes, activated brain macrophages, and the cells of transitional forms between pericytes and macrophages. 5. Ameboid microglia or macrophages also can separate the altering elements from the intact elements. 6. Oligodendroglia shows passive reaction of retraction its myelinating lamellae from degenerating axons. 7. Glial fibrosis actively spreading in the degenerating nervous tissue was suspected as the possible reason of loss of regenerative function in central neuronal cells.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.