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.

동종 조혈모세포이식 후 발생한 치명적 홍역 폐렴 1예

백창렬,이동건,최정현,정현화,조유경,박훈준,이승훈,박윤희,이교영,민우성,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

As a result of the enlarging pool of unvaccinated children and young adults, there has been an increase in measles in our countries. In these situation, it has been reported that measles associated pneumoinia is easily complicated with fatal respiratory failure, espycially in immunocompromised patients. Herein we report the case of lethal measles pneumonia after allogenic hematopoietic stem cell transplantation in adults proven by autopsy. Recently, one case of measles was encountered in 39-year-old female patients after allogenic bone marrow transplanted case (chronic myelogenous leukemia), who progressed into interstitial pneumonia pattern, despite treatment including antibiotics, immunoglobulin. The patient died of giant cell pneumonia compatible with that of measles which was comfirmed in the section of necropsy lung specimen. (Korean J Infect Dis 33:301∼309, 2001)

SHOTCRETE 配合設計에 關한 實驗的 硏究

白榮植,金一憲,張喜相 慶熙大學校 1984 論文集 Vol.13 No.-

A series of laboratory test is performed to determine the optimum shotcrete mix design. Engineering properties of various cements and aggregates are tested. Using the results obtained in the tests, the standard concrete mix design can be obtained. Compatibility of cements and accelerators is also investigated by comparing the compress strength of shotcrete specimens with various types and contents of accelerators. Finally, a recommended shotcrete mix design is suggested for practical use in field.

Vinblastine Sulfate가 Mouse간장의 인산염 분해효소 활성에 미치는 영향

백태경,박희철,정호삼 한양대학교 의과대학 1987 한양의대 학술지 Vol.7 No.2

Vinblastine sulfate isolated from the vinca has been widely used as an anticancer drug. Vinblastine sulfate inhibits the formation of microtubules which are related to cytoskeleton, transport of molecules and cellular polarity. As a result, it inhibits the mitosis and brings to cellular necrosis. The author undertook the present study to investigate the effect of binblastine sulfate on phosphatase activity in the mouse liver. Albino mice, DDY strain, weighing 2gm were used as experimental animals. The experimental animals were sacrificed at 6, 12, 24, 36 and 48 hours after administration of 12 mg/kg of of vinblastine sulfate. The activity of alkaline phosphatase was observed by Gomori's method and the activity of adenosine triphosphatase was observed by the Wachstein-Meisel's method for histochemical study. The results obtained were as follows: 1. The activity of alkaline phosphatase was slightly increased in the central zone and decreased in the intermediate and periportal zone of the hepatic lobule of the 24 and 36 hours vinblastine sulfate treated groups. In 48 hour-vinblastine sulfate treated group, the activity of alkaline phosphatase was recovered to normal. 2. The activity of adenosine triphosphatase was slightly increased in the hepatic lobule of the 12 and 24 hours vinblastine sulfate treated groups but decreased in the 36 and 48 hour vinbalstine sulfate treated groups. Consequently, it is suggested that vinblastine sulfate cause to decrease the activity of alkaline phosphatase and adenosine phosphatase in mouse liver.

産婦人科 患者에서 分離된 Ureaplasma urealyticum의 生物學的 性狀

梁熙燦,崔大卿,張明雄,白太鉉,朴鼎圭 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

Isolation rates of Ureaplasma urealyticum from vaginal swab of 216 patients, 105 prostitutes and 100 college females was investigated. Also, minimal inhibitory concentration of isolated strains about tetracycline and minocycline was studied. The results were summarized as follows; 1. Out of 70 vaginitis patients, isolation rates of Ureaplasma urealyticum and Mycoplasma hominis were 34.3% and 15.7%, respectively. 2. Out of 54 cervicitis patients, isolation rates of Ureplasma urealyticum and Mycoplasma hominis were 37.0% and 11.0%, respectively. 3. Out of 92 other gynecological patients, isolation rates of Ureaplasma urealyticum and mycoplasma hominis were 44.6% and 16.3%, respectively. 4. Out of 105 prostitues, isolation rates of Ureaplasma urealyticum and Mycoplasma hominis were 54.3% and 75.2%, respectively. 5. Out of 100 college students, isolation rates of Ureaplasma urealyticum and Mycoplasma hominis were 23.0% and 7.0% respectively. 6. In the susceptibility patterns of isolated Ureaplasma urealyticum, resistant strains about tetracycline in patients, prostitues and college students were 75.2%, 73.6% and 69.5%, respectively 7. In the susceptibility patterns of isolated Ureaplasma urealyticum, resistant strains about minocycline in patients, prostitues and college students were 91.7%, 87.7% and 73.9%, respectively.

Clozapine 투여후 설사와 혈소판 감소증이 나타난 환자 1례

김진희,이창욱,김정진,김우선,백인호 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.3

The clozapine has been used to the treatment of schizophrenic patients unresponsive to conventional antipsychotics, but to administration of clozapine has been restricted because of its propensity to cause agranuloytosis. So side effects associated with the administration of clozapine have probably not been fully elucidated. The authors describe a case of a male schizophrenic who developed prefuse diarrhea, spiking fever and thrombocytopenia associated with the administration of clozapine. Discontinuance of clozapine therapy resulted in improvement of diarrhea and fever followed by normalization of the platelet count. Previous reports of adverse hematologic side effects and gastroenteric reaction induced by clozapine administration are also discussed. We suggest that the physician must keep in mind these side effects and administer clozapine cautiously.

과잉 PbO에 따른 Pb(Mg, Nb)O₃-PbTiO₃계 세라믹스의 압전특성

김규수,백동수,윤광희,이두희,박창엽,윤현상 연세대학교 산업기술연구소 1993 논문집 Vol.25 No.1

In this study, the dielectric, piezoelectric and structual properties of PMN-PT system ceramics were investigated with respect to the variation of PbO addition amount and sintering temperature. The specimen with 1.0wt% PbO addition exhibits relatively good sintering and piezoelectric properties, which has the density with 97.36%, the coupling constant(kp) with the value of 47.44% and the piezoelectric ?? with ?? at sintering temperature 1000℃ respectively.

효모에서 분리한 단백 메틸레스의 특성에 관한 연구

김보경,백운기,조만희,김창세 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

A cytochrome C - specific protein methylase Ⅲ was purified approximately 63 - fold from Saccharomyces cerevisiae. The unmethylated cytochrome C served as substrate for the enzyme. Horse heart apocytochrome C was found to be a better substrate than the native horse heart cytochrome C. This observation suggests that the in vivo methylation of cytochrome C in the yeast probably occurs before cytochrome C become attached to the mitochondria. In partly purified protein methylase Ⅲ the optimun pH is about 9.0, the enzyme activity is linearly proportional to the amount of enzyme protein up to about 30㎍ and also to time up to 15min. The Km values for horse heart cytochrome C and S - adenosyl - L- methionine were 1.33mM and 40㎛, respectively. S - adenosyl - L - homocysteine was found to be a competitive inhibitor for S - adenosyl - L - methionine, and the Ki value was 2.7 μM. The molecular weight of the enzyme was approximately 97,000, determined on sephadex S- 200 gel filtration. The regulation of cellular cytochrome C and the protein methylase Ⅲ are not coordinately related in a parallel manner.

항우울제 장기 투여에 의한 흰쥐 해마에서 PhosphoCREB의 발현 증가

김소양,한진희,이창욱,백인호 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 저자들은 paroxetine(selective serotonin reuptake inhibitor). desipramine(selective norepinephrine reuptake inhibitor), moclobemide(reversible monoamine oxidase inhibitor)의 항우울제를 흰쥐에 장기 투여한 후 해마에서 phosphoCREB의 발현정도를 측정하고 이를 항정신병약물, 항불안제 및 control을 장기 투여하였을 때의 발현정도와 비교해 보고자 하였다. 방 법 : 실험동물로는 체중 200∼300g의 Sprague-Dawley 수컷 흰쥐 240마리를 사용하였고, paroxetine 투여군, desipramine 투여군, moclobemide 투여군, haloperidol 투여군, lorazepam 투여군과 대조군으로 나누고 각각의 약물을 1일간, 3일간, 7일간, 14일간 각각 하루 한차례씩 복강내 주입을 하였다. 흰쥐는 마지막 투약 15분후에 대뇌를 적출하였고 면역조직화학법을 이용하여 해마에서 발현되는 phosphoCREB(+)신경원 수를 측정하였다. 결 과 : 항우울제인moclobemide 투여군에서 3일째부터 phosphoCREB의 발현을 증가시켜 7일째와 14일째 모두 증가되었고 paroxetine 투여군과 desipramine 투여군도 7일째와 14일째 증가를 나타내었다. 그러나 항우울제가 아닌 약물을 투여한 군(lorazepam 투여군과 haloperidol 투여군)에서는 대조군과 비교하였을 때 투여 기간에 따른 phosphoCREB의 증가는 없었다. 결 론 : 다양한 항우울제의 장기 투여는 항정신병약물과 항불안제의 장기 투여와 비교하면 모두 해마에서 phosphoCREB의 발현을 증가시킴을 알 수 있었다. 따라서 이는 다른 약제와 구별되는 항우울제만의 특이한 공통적 약물작용기전으로 생각된다. Objectives : This study was designed to assess the expression of phosphoCREB in rat hippocampus after chronic administration of various antidepressants in comparison with chronic administration of antipsychotic and antianxiety drugs. Methods : Male Sprague-Dawley rats(200-300g) were used for this experiment. The subjects were divided into 6 groups according to specific treatment agents(paroxetine, desipramine, moclobemide, haloperidol, lorazepam, vehicle) which were administered daily for 1day, 3day, 7day, and 14days by intraperitoneal injection respectively. Brains were removed 15 minutes after the last treatment. PhosphoCREB immunoreactivity was measured by phosphoCREB(+) cell counts in hippocampus of rats. Results : Expression of phosphoCREB was significantly increased from day 3 in moclobemide group, from day 7 in paroxetine and desipramine groups, and increased most significantly from day 14 in all antidepressant-administered groups, with no increase in other two groups(lorazepam and haloperidol groups) throughout the experiment and even after 14 days of treatment. Conclusion : These result suggest that increased expression of phosphoCREB after chronic administration of antidepressants, not of antipsychotic or antianxiety drugs, demonstrates pharmacolgical specificity of antidepressant treatment in rat hippocampus regardless of their receptor preference.

저농도 복합유기용제 노출근로자의 신기능 변화에 관한 연구

김정원,백수동,이창희,김정호,강동묵,문덕환,이채언 한국산업위생학회 2001 한국산업보건학회지 Vol.11 No.2

Objectives: The authors evaluated the effects on renal function of workers chronically exposed to low-level organic solvent mixtures. Methods : The authors measured the level of urine β 2-microglobulin(β2-MG) and microalbumin as biochemical markers or renal function and damage in 29 male workers exposed to organic solvents for more than five years and compared their results with those of 30 male office clerks as a reference group. Results: 1. The mean values of hemoglobin, hematocrit, SGOT, SGPT, γ-GTP were all with in normal limits and there was no significant difference, except for hemoglobin(p<0.01), between exposed and reference group. 2. The value of BUN and serum creatinine were within reference limits and there was no significant difference between exposed and reference group. 3. The difference of mean values of urine microalbumin corrected by urine creatinine were statistically significant(p<0.01), but those of urine β2-MG was not. 4. There were no correlation of urine hippuric acids with BUN, serum creatinine, urine microalbumin and β2-MG. 5. There were no significant difference of BUN, serum creatinine, urine microalbumin and β2-MG upon work duration. Conclusion: It is assumed that chronic low-level organic solvent exposure in these workers shows early renal dysfunction, glomerular changes. The result corresponds to previous studies showing the relationship between hydro-carbon exposure and glomerulonephritis. For evaluation of impairment on kidney tubules, we need further study using more precise markets and long-term follow-up.