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.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

Antioxidant and hepatoprotective effects of Korean ginseng extract GS-KG9 in a D-galactosamine-induced liver damage animal model

Yun Ho Jo,Hwan Lee,Myeong Hwan Oh,Gyeong Hee Lee,You Jin Lee,Ji Sun Lee,Min Jung Kim,Won Yong Kim,Jin Seong Kim,Dae Seok Yoo,Sang Won Cho,Seon Woo Cha,Mi Kyung Pyo 한국영양학회 2020 Nutrition Research and Practice Vol.14 No.4

BACKGROUND/OBJECTIVES: This study was designed to investigate the improvement effect of white ginseng extract (GS-KG9) on D-galactosamine (Ga1N)-induced oxidative stress and liver injury. SUBJECTS/METHODS: Sixty Sprague-Dawley rats were divided into 6 groups. Rats were orally administrated with GS-KG9 (300, 500, or 700 mg/kg) or silymarin (25 mg/kg) for 2 weeks. The rats of the GS-KG9- and silymarin-treated groups and a control group were then intraperitoneally injected Ga1N at a concentration of 650 mg/kg for 4 days. To investigate the protective effect of GS-KG9 against GalN-induced liver injury, blood liver function indicators, anti-oxidative stress indicators, and histopathological features were analyzed. RESULTS: Serum biochemical analysis indicated that GS-KG9 ameliorated the elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) in GalN-treated rats. The hepatoprotective effects of GS-KG9 involved enhancing components of the hepatic antioxidant defense system, including glutathione, glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT). In addition, GS-KG9 treatment inhibited reactive oxygen species (ROS) production induced by GalN treatment in hepatocytes and significantly increased the expression levels of nuclear factor erythroid-2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) proteins, which are antioxidant proteins. In particular, by histological analyses bases on hematoxylin and eosin, Masson"s trichrome, α-smooth muscle actin, and transforming growth factor-β1 staining, we determined that the administration of 500 mg/kg GS-KG9 inhibited hepatic inflammation and fibrosis due to the excessive accumulation of collagen. CONCLUSIONS: These findings demonstrate that GS-KG9 improves GalN-induced liver inflammation, necrosis, and fibrosis by attenuating oxidative stress. Therefore, GS-KG9 may be considered a useful candidate in the development of a natural preventive agent against liver injury.

급성 뇌경색 환자에서 경색 위치가 심근 효소치 상승에 미치는 영향

윤경호,박현영,박성욱,장혁,김요식,조광호,유남진,김남호,오석규,정진원 圓光大學校 醫科學硏究所 2003 圓光醫科學 Vol.18 No.2

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

의료복지용 센서 및 시스템의 개발(Ⅱ)

조진호,강희동 경북대학교 센서기술연구소 1997 연차보고서 Vol.1997 No.-

본 연구에서는 향후 중요한 의료 복지시스템으로 국내외에서 널리 쓰이게 될 MSGC형 온라인 X선 촬영 사진 촬영 장치를 개발하고자 하였다. MSGC형 은라인 X선 촬영장치는 기존의 X선 필름에 비해 조사선량을 크게 낮출 수 있으며 계조도(gray level)및 범위가 디지털 x-ray 시스템에 비해 훨씬 넓다. 그리고 MSGC형 센서는 비슷한 메카니즘으로 작동되는 MWPC형 위치검출센서 보다 높은 해상도를 얻을 수 있으며 센서제작에 대량화와 간편성을 동시에 제공할 수 있는 잇점이 있다. 본 연구는 MSGC센서를 제작하여 이로부터 X선 조사선량에 관계되는 기체 증폭펄스를 얻기 위한 연구 분야와, 이 센서를 이용하여 영상이 얻어질 수 있도록 시스템을 제어하고 영상을 재구성 및 처리하는 두 가지 연구 분야로 나누어 진행된다. MSGC형 센서개발에서는 해상도가 높고 기체증폭이 안정적으로 일어날수 있는 센서를 설계 제작하였고 다양한 실험자료를 수집하였다. MSGC형 센서 개발에서 핵심부분은 기판의 재질과 마이크로스트립형 전극 그리고 챔버 및 기체 증폭이 일어났을 때의 펄스를 샤프하게 분리시켜 계수할 수 있는 기술이다. 디지털 X선 장치 제어 및 영상처리 연구에서는 1차 년도에 제작된 제어 컴퓨터와 X-ray 인터페이스 회로가 가진 수동 조작의 불편함, 타이밍 제어시 오차 발생 및 X-선 Expose속도의 한계 등의 문제점을 개선시킨 인터페이스 보드를 개발하였다. We have developed the MSGC type on-line digital radiography system that will used widely in medical welfare system in future. The MSGC type can reduce the X-ray exposure to the object significantly as compared with X-ray film and its the dynamic range of gray level is more wide than the conventional digital X-ray system. And the MSGC type sensor can obtain much higher resolution than the position detecting sensor of MWPC type which has a similar mechanism to MSGC type and also it can provide an advantage of mass-production and a simplicity to produce the sensors. We divided into two research fields. One is the field of implementing the MSGC sensor and measuring pulses produced by gas multiplication related with the X-ray. The other field is developing the method of controlling digital image acquisition part, image reconstructing, and processing. In the development of MSGC type sensor, we designed and implemented the sensor with a high resolution and a stable gas multiplication. And we collected various experimental data. In the development of MSGC type sensor, the core parts are the materials of substrate, microstrip type electrode and chamber, and technique to split the pulses of gas multiplication sharply and count them. In the field of system controlling and image processing, we developed the new-interface board which has been improved some problems in the first research step, i.e. inconvenient operations of control computer and X-ray interface circuit, error occurrence in timing control, and the limitation of X-ray expose velocity.

이식형 중이용 청각보조 트랜스듀서 개발에 관한 연구

曺辰鎬,朴世光,李相欣 경북대학교 센서기술연구소 1995 연차보고서 Vol.1995 No.-

청각보조용 이식 중이를 위한 코일-영구자석형의 장치들을 체외기와 체내기로 나누어 설계 및 제작하고 실험하였다. 이식 중이용의 코일과 자석으로 된 진동부의 설계를 정량화시키기 위하여 중이와 진동체를 포함하는 일련의 시스템을 모델화시켜 해석하였다. 제작된 시스템의 체내기는 수신용 코일, 검파회로, 진동부 및 지지 샤프트 등으로 이루어지며 체외기는 음성 증폭부, 발진 및 변조부로 구성된다. 제작된 체내기를 고막과 청소골 및 내이가 보존된 사체의 측두골에다 이식한 다음 주파수 변화에 따른 청소골의 미소 진동을 진동 측정기로써 측정한 결과 각각 400㎐ 및 2.7㎑에서 피크를 갖는 곡선을 얻음으로써 이식형 중이의 실현 가능성을 확인하였다. 또한 전력 소아 및 다이나믹 레인지들을 고려하여 체외부인 송신부를 설계 제작하였으며 이들을 케이스를 포함하여 도합 18.5g의 귀걸이형으로 만들었다. We designed, developed and experimented coil-permanent magnet type device for implantable middle ear. We made a model of whole system including middle ear and vibrator and analyzed in order to quantificate design of vibration part, consisted of coil for middle ear and magnet. Internal unit consists of receiver coil, demodulation circuit, vibrator and supporting shaft and external unit consists of voice amplifier, oscillation and modulation circuit are developed respectively. After system developed, internal unit was implanted at temporal bone of carcass, minute vibration according frequency variation was measured by a vibration meter. Then, we confirmed the possibility of realizing middle ear implant by obtaining the curve whose peak values appear at 400㎐ and 2.7㎑, respectively. In addition, external unit was designed and developed considering power dissipation and dynamic range and it is an earring type device of 18.5g including case.

길안천(경북 안동)의 저서성대형무척추동물 군집변동 및 생물학적 수질평가

조희욱,김경호,노상은,박진영,서을원,이종은 7개 국립대학교 환경연구 논문집 공동발행 위원회 2004 공업기술연구 Vol.4 No.-

A biological assessment of water quality was carried out in Giran stream from May 203 to January 2004. The benthic macroinvertebrates collected seasonally from 5 field sites were identified mostly up to species level. The benthic macroinvertebrates collected from the surveyed sites were composed of 88 species, 68 genera,42 families, 14 orders, 5 class and 4 phyla. The dominance index (DI) showed the high-est as 0.802 at site 5 and the lowest as 1.643 at site 3. Ecological score of benthic macroinvertebrate (ESB) showed the highest as 103 at site 2 and the lowest as 63 at site 3. All surveyed sites were Oligosaprobic that the water quality estimated by ecological score of benthic macroinvertebratc community.