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.

열처리시 냉간가공된 Zircaloy-4합금의 미세조직 및 재결정 거동

林潤洙,崔洋鎭,鄭蓮眺,魏明鏞 大田産業大學校 1999 한밭대학교 논문집 Vol.16 No.1

Effects of heat-treatment on the microstructure and recrystallization behavior of cold-worked Zircaloy-4 were studied. We used 70% cold-rolled, thin strip specimens. Heat-treatment of the specimens were performed at temperatures between 300℃ and 800℃ for 30 to 5,000 minutes. The recrystallization behavior were observed by means of polarized optical microscopy and TEM. Hardness were measurement by Micro-victors hardness tester. As the annealing time increased, the temperature region of hardness drop moved to lower, because the recovery and recrystallization could occur in lower temperature. The recrysatllization of cold-worked Zircaloy-4 alloys was completed between 500℃ and 600℃ for 60 min. The size of recrystallized grain visibly increased at 800℃ for above 600 min. The activation energy(Q) for recrystallization of Zircaloy-4 alloys was determined by the time for constant fraction technique and it was 253KJ/mo1.

일부 성장기 학생 혈중 연농도의 성별 및 연령별 분포

임재언,강은용,최병선,서지영,홍연표,장임원,박정덕 중앙대학교 의과대학 의과학연구소 2000 中央醫大誌 Vol.25 No.2

Effect of Photoperiod, Temperature and True-leaf Stage in Bolting Rate of Chicory (Cichorium intybus L. var. sativus)

Lim,Jung-Dae,Seo,Jeong-Sik,Lee,Hyeon-Yong,Kim,Jong-Dai,Lee,Jin-Ha,Yu,Chang-Yeon 한국자원식물학회 2004 Plant Resources Vol.7 No.1

Root chicory (Cichorium intybus L. var. sativus) is potential alternative medicinal and sugar crop which accumulates a high amount of linear polyfructan, inulin in its roots. A problem in root production is that over-wintered stock plants often flower. Once the plant becomes reproductive, stem elongation and root growth slows and floral buds arise from every node, rendering the plants useless for propagation. The objectives of this research was to examine the effectiveness of manipulating environmental factors containing photoperiod, temperature and number of leaf states. The experiment was performed in growth chamber to create two photoperiods (8 h, and 16 h) with three temperature regimes (5℃/3℃, 10℃/8℃, and 15℃/13℃ day/night temperature) for a total of six treatments on three type of true-leaf stage of plant. Data of bolting rate, shoot and root length, shoot and fresh weight was invetigated in each treatments. This is the first report on changes in bolting rate and shoots and roots production during a whole growing season and differences in the effect of cold and photoperiod treatment depending on the true-leaf stage of plant.

Improved Micropropagation of Root Chicory, Cichorium intybus L. var. sativus.

Lim,Jung-Dae,Yang,Deok-Chun,Lee,Hyeon-Yong,Kim,Jong-Dai,Lee,Jin-Ha,Sung,Eun-Soo,Yu Chang-Yeon 한국자원식물학회 2004 Plant Resources Vol.7 No.1

The establishment of an efficient protocol for plant regeneration and micropropagation from leaf explant cultures of Chicory, Cichorium intybus L. var. sativus. is reported. Callus formation rate appeared 100% from explant in all growth regulators, but calli formed in the prensence of naphthaleneacetic acid (NAA) were appeared very compact and non-embryogenic state. The regenerated shoots were obtained from leaf explant cultures on solid MS medium containing different concentrations of cytokinins and auxin. The highest number of shoots (5.7) per explant and shoot growth (2.8cm) was obtained on MS medium containing 0.1 mg BAP L^-1 and 0.1 mg NAA L^-1. Indole acetic acid was the most suitable auxin for root formation among three auxins tested. 2,4-D had no effect on shoot and root formation.

염증이 있는 충수돌기의 초음파 진단 : 자가 위치선정법의 정확도 Accuracy of Self-localization Technique

장현정,임효근,김승훈,이민희,윤지영,김경아,임재훈,정연권 대한초음파의학회 1998 ULTRASONOGRAPHY Vol.17 No.4

한국인의 심근 조직내 카드뮴 농도의 참고치

박정덕,임헌방,최병선,권일훈,이상연,강은용,홍연표,장임원 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.1

Cadmium(Cd) is an ubiquitous, toxic and nonessential metal which is controversial about the association with a cardiovascular disease. In this study, we investigated the reference level of Cd in myocardium in Korean general population. The level of Cd and zinc(Zn) concentration in myocardium of 252 cases of "sudden and unexpected death" autopsies (male: 172, female : 60) aged 0 to 87 years was analyzed. The concentration of Cd and Zn was determined with atomic absorption spectrophotometer(Perkin-Elmer Model 5100) by flameless and flame method, respectively. The content of Cd and Zn in myocardium showed the log-normal distribution rather than normal distribution. Geometric mean concentration of Cd was 0.19 ㎍/g wet weight in myocardium. The level of Cd in myocardium was not significantly different between male (0.18㎍/g wet weight) and female (0.22㎍/g wet weight). Geometric mean concentration of Zn in myocardium was 25.25 ㎍/g wet weight. The level of Zn between male (25.13 ㎍/g wet weight) and female (25.57㎍/g wet weight) was not different. The deposit of Cd in myocardium was age-dependent of biphasic pattern, but the Zn level by age was not significantly different. The level of Cd in myocardium was increased to the fifties of age, thereafter a leveling-off was shown. The regression model of Cd deposit in myocardium by age was predicted as the following equation: Log Heart-Cd= -1.2726 + 0.0234 ·Age -0.0002 ·Age². The maximum Cd deposit in myocardium was estimated to be 0.26 ㎍/g wet weight at the age of 58.5 in Korean general population. In addition, the total Cd burden in heart by age was predicted as a following equation: Total Cd burden in Heart= -10.165+2.891 ·Age -0.0258 ·Age². The maximum heart burden of Cd was estimated to be 70.7㎍ at age of 55.4. The positive correlation between Cd and Zn was observed in myocardium. The linear regression equation was Log Heart-Zn = 1.4195+0.0262 ·Log Heart-Cd.

염산 Bleomycin 병변내 주입을 이용한 사마귀 치료

강민정,임연순,최혜영,명기범 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.2

연구목적 : 지금까지 난치성을 보이는 사마귀의 치료로 Bleomycin 행변내 주사의 효과가 많은 연구에서 보고된 바 있다. 이에 저자들은 본 치료방법의 효과를 사마귀의 크기, 숫자, 위치 및 유병기간에 따라 판정하여 보다 효과적인 적응 대상을 알아보고자 했다. 방법 : 1995년 3월부터 1998년 2월까지 이화여자대학교 목동병원 피부과에 비성기성 사마귀로 내원한 환자중 다른 치료에 반응하지 않았거나, 재발한 경우, 크기가 0.5㎝ 이상이거나 7개 이상의 다발성 병변 , 혹은 조감 주위 병변을 보인 133명의 환자를 대상으로 Bleomycin 병변내 주사로 치료하였다. 1회 치료후 효과와 치료 종결후 완치율을 병변은 크기, 숫자, 위치, 유병기간에 따라 비교하였다. 결과 : 1) 환자의 연령 분포는 4세에서 45세였고, 남자 59명 여자 74명으로 1:1.24 비율이었다. 2) 첫 주사 치료후 96명의 환자에서 50% 이상의 병변의 수나 크기의 감소를 보였다. 크기별로는 0.5~0.9㎝의 87.5%에서, 병소의 수별로는 단일 병소의 76.9%에서 50% 이상의 병변의 크기나 수의 감소를 보여 가장 좋은 효과를 보였으나 통계적 유의성은 없었다. 또한 조갑주의 병변은 79.1%에서, 수부는 75.8%, 족부는 72.9%에서 50% 이상의 호전을 보였으나 족서부 병변은 53.4%로 가장 낮은 낮은 효과를 보였다. 유행병 기간은 6개월 이하인 31명(86.2%)에서 50% 이상의 효과를 보여 유병기간이 짧을수록 치료효과가 유의하게 증가하였다(p<0.05) 3) 치료 종결시 3개월 이후까지 재발없이 완치된 경우는 총 93명으로 69.9%였고 치료받은 병변의 수가 증가할 수록 완치율이 감소하였다, 부위별로는 조감주위가 77.1%로 가장 높았으며, 병변의 크기에 따른 일괄된 완치율의 차이는 없었다. 병변의 기간에 따른 완치율은 6개월 이하에서 80.6%로 가장 높았으며, 유병기간이 길수록 완치율은 감소하는 양상을 보였다. 4) 부작용은 환자 중 18.4%인 24명의 환자에서 발생하였으며, 유형별로는 3일 이상 지속된 동통과 홍반, 색소 침착 및 감염이 관찰되었으나, 모두 이후 호전되었으며, 1명에서 경한 조갑 능선을 동반한 변형이 관찰되었다. 결론 : 본 연구에서 사마귀에 대한 Bleomycin 병변내 주사효과가 병변의 크기에 따라 뚜렷한 차이를 보이지 않았으며, 심한 부작용이나 전신적인 독작용없이 조감주위병변 및 급성기 병변에서 높은 완치율을 보여 좋은 적응증이 됨을 확인하였다. 아울러 Bleomycin 병변내 주사의 효과 및 안정성에 있어서 시술자가 적당한 양의 약물을 주변부위로 부터 과도한 침습없이 정확히 병변의 기저부에 도달시키는 기술이 또하나의 중요한 변수가 됨을 반영하는 결과라 사료된다. Purpose:This study was to designed to evaluate the efficacy of intralesional injection of bleomycin for common warts and plantar warts according to size, number, location, and duration and to determine the appropriate indication of this treatment for warts. Materials & Methods : The objective patients had warts being refractory to previous treatment or large than 0.5cm in size or 7 or more lesions or periungal lesions. The intralesional injection with bleomycin hydrochloride 1㎎/㎖ had been performed single to six times at 3 week interval until complete resolution. Age of the patients ranged from 4 to 45 years, and male to female ratio was 1 : 1.25(59 : 74). Results : After first treatment of bleomycin intralesional injection, a reduction of 50% or more of the primary wart area was observed in 96(72.2%) of 133 patients. 93(69.9%) of 133 treated patients experienced complete cure after 1 to 7 injections. The efficacy of intralesional bleomycin injection for warts was not closely associated with the size of warts. However the duration and number of warts was inversely correlated with the efficacy of treatment. The highest cure rate was shown in patients with periungal warts(77.1%), and lowest in patients with plantar warts(53.3%). The side effects were observed in 18.4%(24 of 133) including persistent pain(17.3%), pigmentation(3.0%), erythema(1.5%), and mild nail dystrophy(0.8%), but no evidence of systemic toxicity was found. Conclusions : The efficacy of intralesional injection of bleomycin was not significantly related to the size, but closely related to the duration, number and site of the lesion. These results partly suggest that there is some important factors affecting the efficacy of treatment of bleomycin such as duration of the lesion and skillful injection of the agent into the wart tissue.

임신중 산전 초음파로 진단된 자궁근종의 임상적 고찰

서정호,김윤숙,김대원,이동운,최규연,이정재,이임순 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Objectives: To study the clinical manifestations; time, mode of delivery, size of myomas and outcome of pregnancy in cases of myomas that were detected prior to pregnancy or during the antenatal care and after delivery. Methods: We statistically analyzed 76 patients with uterine myomas in pregnancy admitted to Soonchunhyang Seoul Hospital during the period of Jan. 1999 and Dec. 2001. Results: The results are as follows. 1. The mean age of patients in the detected group and undetected group were 32.9 years and 32.3 years, respectively. There was no difference in the proportion of primarity between the detected group(98.2%) and the undetected group(79.6%) 2. The most common type of uterine myoma in both groups was intramural myoma (detected group 94.1% vs undetected group 81.3%). The uterine myomas were most commonly located in the anterior portion and fundus(detected group 52.9% and 23.5% respectively vs undetected group 47.4% and 23.7% respectively) and the proportion was not significantly different between the two groups. Uterine myomas with a diameter of 3cm or more in the detected group were detected by clinical examination and ultrasonogram. Rate of uterine myomas with a diameter of 3cm or more in the detected group is 76.5% and less than 3cm is 54.2% which detected incidentally at delivery. 3. The proportion of term infants were detected group 88.2% vs undetected group 91.5%. 4. The most common indications for cesarean section in both groups were cephalopelvic disproportion and repeated cesarean section (detected group 41.2% and 45.8% respectively vs undetected group 11.8% and 18.6% respectively) and there was no significant difference between the two groups. 5. Secondary pathologic changes in the all myomectomy specimens were degeneration in both groups but there was no necrosis or sarcomatous change. 6. Antenatal complications were preterm labor, premature repture of membranes, spontaneous abortion, malpresentation, and placenta previa. Intrauterine growth retardation and placental abruption were not seen in both groups. Conclusion: Myoma detected by ultrasonogram before or during pregnancy is not a significant implication of pregnancy outcome.

유암의 새로운 예후인자들의 임상적 의의

왕희정,백인욱,유석진,오미혜,서연림,장석효,이혁상 인제대학교 1994 仁濟醫學 Vol.15 No.1

유암예후에 영향을 미치는 전통적 3인자로 종양의 크기, 전이액와임파절의 수 및 menopausal status를 들 수 있고, 이 외에 최근에는 면역학과 분자생물학의 비약적 발달로 호르몬 수용체, DNA ploidy, cathepsin D, pS2 protein 및 다양한 oncogene들의 증폭이나 과발현 등이 새로운 독립적 예 후인자로 보고되고 있다. 저자들은 유암 110례의 10년 추적조사 성적을 기반으로 이들 새로운 예후인자중 c-erbB-2 oncoprotein, cathepsin D 및 pS2 protein의 과발현이 전통적 예후인자들과 상관성이 있는지와 독립적 예후인자로서 의의가 있는지를 확인하고자 본 연구에 착수하였다. This study was undertaken to define the prognostic value of the overexpression of c-erbB-2 oncoprotein, cathepsin D and pS2 protein in 40 breast cancer patients. The results were as follows : 1.Overall, 32% of patients were positive for c-erbB-2 oncoprotein. Positive staining correlated with menopause status, tumor size and TNM staging, but not wish axllary nodal status. Although there was apparent difference in cumulative survival rates between positive-and negative-staining groups, it was not statistically significant(p=0.0625). 2.52.5% of patients were positive for cathepsin D. Positive staining did not correlate with menopause status, axillary nodal status or tumor size. There was no statistical difference in cumulative survival rates between positive-and negative-staining groups of cathepsin D. 3.57.5% of patients were positive for pS2 protein. Positive staining did not correlate with menopause status, axillary nodal status, tumor size or tumor stage. There was no statistical difference in cumulative survival rates between positive-and negative-staining groups of pS2 protein.