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.

갑상설관 낭종에서 발생한 유두상 선암 1례

윤종근,노환중,왕수건 釜算慶南耳鼻咽喉科學會 1994 임상이비인후과 Vol.5 No.2

大邱 都心部再開發事業의 改善方案에 關한 硏究

尹炳九,金正煥 啓明大學校 産業技術硏究所 1988 産業技術硏究所 論文報告集 Vol.10 No.-

The future will confront us with other tasks, probably even lager assignments for urban planning. There will have to be a gradual intergration of "urban renewal planning" into the scope of encompassing urban planning measures. Urban renewal planning is a task for many branches of science. This study attempted to pressent the concepts and objectives of urban renewal planning for CBD Daegu and describe the legal foundations, Preparatory work. excution and financing.

일부 지하철 근로자와 소방공무원의 직무 스트레스 요인 비교

윤석환,최숙정,신동훈,정인성,하정숙 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.3

울릉군 도동항 해변광장 조성 기본계획

황정환,윤국진 경주대학교 건설환경연구소 2005 建設環境論叢 Vol.- No.7

The seaside plaza at the Dodong-port of Ulleung-gun is cognized having characters of space. these characters are a gateway connecting to land, the image of Ulleung's symbol, cleanness as a whole and The scenery is beautiful beyond expression. But the seaside plaza be jammed up and be disordered with visitors, natives and mobiles, and then they didn't make the best use of the expressionist nature and landscape on the images of Ulleung of cleanness and pleasant. Therefore this study was to plan on the seaside plaza at the Dodong-port toward the heightening of Ulleung's symbol, identity, individuality through the presentation of images on cleanness and pleasant, and the expropriation of variety activities on the visitors and natives. The seaside plaza was designed with seven schemes those can be summarized as follows. The first was the adaptation of an existing variety outer functions and activities, the second was the efficient distribution of hard-pavements and green-fields, the third was the treatment of existing slopes and terraces, the fourth was the adaptation of the existing understructures and facilities, the fifth was the creation of nightscape for a night use, the sixth was for harmony of forms and functions like a meet, chat, rest, stroll and assembly, the last was the preparation for erecting a symbolic structure in the future.

낙상으로 인한 좌심실 파열 후 생존한 환자 1례

배택환,김행재,정윤석,김준식,조준필,이철주 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Blunt or nonpenetrating chest injuries are common after motor vehicle accidents or falls. Blunt injury to the heart ranges from contusion to rupture. Cardiac rupture, however, is un-common and associated with a very high mortality rate ; left ventricular rupture due to falling is even more rare. We experienced a case of left ventricular rupture of the heart caused by a fall, which the patient survived. A 63-year-old man fell off a ladder and presented with hypotension from left hemothorax and pericardial tamponade. The hemothorax was relieved via an emergency closed thoracostomy but dyspnea and hypotension continued. And so, echocardio-graphy was done and pericardial tamponade was detected. Emergency left thoracotomy was done to repair the rupture site. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and immediate surgical treatment.

만성 C형 간염 환자에서 페그인터페론 알파2a와 리바비린 병합 치료중 발생한 벨마비 1예

김일환,장제혁,유충헌,최규남,고정해,김윤정,서광원,김지현,박성재,박은택,이연재,이상혁,설상영 인제대학교 2008 仁濟醫學 Vol.29 No.-

페그인터페론과 리바비린 병합요법은 만성 C형 간염의 일차 치료법이다. 저자들은 만성 C형 간염 환자에서 페그인터페론 과 리바비린 병합 요법 중에 발생한 벨마비 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 5년 전부터 만성 C형 간염을 앓아온 48세 남자이며, PEG-IFN α-2a 135μgm 피하주사 주1회와 하루 1200㎎의 리바비린을 투여하였다. 치료시작 후 9개월째 환자는 오른쪽 안면의 근력약화를 호소하였으며 벨마비로 진단되었다. 페그인터페론과 리바비린 병합요법을 지속하면서 관찰하였다. 환자의 벨마비는 페그인터페론 치료를 중단하지 않았음에도 3개월후 증상이 회복되고 이후 벨마비 재발 없이 현재 경과관찰 중이다. 만성 C형 간염에서 페그인터페론과 리바비린 병합 요법시 벨마비의 발생 가능성을 염두에 두어야 하겠다. A Case of Bell's Palsy Associated with Combination Therapy of Pegylated Interferon Alfa-2a (PEG-IFN) and Ribavirin for Chronic Hepatitis C Virus Infection Pegylated interferon alfa(PEG-IFN α) and ribavirin therapy is the first line treatment for chronic hepatitis C. Mild complications of the therapy are common, but more serious complications are rare. We report here a case of Bell's palsy that occurred in a patient with chronic hepatitis C virus infection during combination therapy of PEG-IFN α-2a and ribavirin. The patient was 49-year-old man with chronic hepatitis C (genotype 1b) for 8 years. He had compensated liver cirrhosis with splenomegaly. Therapy with PEG-IFN α- 2a 135mcg/week and ribavirin 1200mg/day was initiated. After 9 months of the therapy, the patient showed a loss of muscular tone on the right side of his face. A diagnosis of Bell's palsy was made. The Bell's palsy resolved over 3 months despite continuation of the combination therapy.

무균성 수막염 환자에서 분리한 enterovirus의 혈청형 및 계통발생학적 분석

이정희,안병윤,반성환,김상현,김의종 대한임상미샐물학회 2000 Annals of clinical microbiology Vol.3 No.2

위암의 근치절제술 후 생존율과 예후인자

차윤정,박진영,장정환,김성환,김권천,조현진,민영돈 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Gastric cancer is still the leading cause of cancer death in Korea, and surgery remains the only method of treatment that offers the potential for a cure. Purpose: The aims of this study are to examine the outcome of the patients with gastric adenocarcinoma who underwent curative resection and to identify the prognostic factors leading to improved survival rates in these patients. Materials and Methods: The medical records of 278 patients with gastric adenocarcinoma, treated curatively at the Chosun University Hospital between January 1990 and December 1994, were reviewed retrospectively from January 2000 to March 2000. Follow-up was obtained for 250 patients(89.9%). The survival rates were calculated by the Kaplan-Meier method, and the significance of differences between patient factors(age and sex), tumor factors(location, size, gross type, tumor depth, lymph node metastasis, and stage) and treatment factors(operation method and reconstruction type) were evaluated statistically by the log-rank test. Results: The overall five-year survival probability was 59.6%. There was no survival difference according to age and sex. The 5-year survival rates according to the tumor depth were 97.0% for Tl, 74.5% for T2, 39.6% for T3, and 23.1% for T4(p=0.0000); to the lymph node metastasis were 81,4% for N0, 51.9% for N1, and 21.2% for N2(p=0.0000); to the TNM stage were 96.7% for stage I a, 79.5% for stage I b, 68.8% for stage II, 52.9% for stage III a, 25.9% for stage III b, and 7.5% for stage IV(p=0.0000). Other statistically significant differences were shown in tumor location, size, gross type, operation method, and reconstruction type after subtotal gastrectomy. Conclusion: The most definitive prognostic factors affecting the survival rate of gastric adenocarcinoma were tumor depth, lymph node metastasis, and tumor stage. The keys to successful outcome includes early diagnosis and curative resection with radical lymph node dissection at early stage as possible.

설근부종양 절제시 측인두 접근법의 의의

노환중,윤종근,왕수건,전경명 釜算慶南耳鼻咽喉科學會 1996 임상이비인후과 Vol.7 No.2