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.

정상 관동맥을 가진 심장 점액종 환자에서 발생한 급성 심근 경색증 1예

이정민,이현승,전은정,윤호중,정욱성,오용석,김철민,김재형,최규보,홍순조,이교영,심상인 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9

수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

Monocyte Chemoattractant Protein-1[MCP1] -2518 유전자 다형성과 주요 우울장애

배치운,이지현,신윤경,김태석,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Object : This study was designed to examine the association between monocyte chemoattractant protein-l (MCPl) -2518poly morphism and major depressive disorder (MDD). Methods : Ninety patients with MDD and 114 healthy controls participated in this study. Genotyping was performed by the polymerase chain reaction-restriction fragment length polymorphism method. Results : Genotype and allele distributions in patients with MDD were significantly different from those of the controls, In particular, subjects with the allele A were found to have an increased risk of MDD. Conclusion : The present study suggests that the MCPl -2518 polymorphism may have a potential role for susceptibility to MDD in the Korean population and thus calls for consecutive studies in order to pile up the data with larger different ethnic background.

크롬(Ⅵ)의 체내 흡수와 소실속도에 관한 연구

김현영,이성배,임철홍,이권섭,정용현,이종성,한정희,전윤석,황호순,이용묵 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.1

The CrO3 mostly used in plating. metal surface disposal, leather, cosmetic manufacturing, as an experiment material by repeatedly inhaling and exposure the male S.D. rats at a 0.00, 0.2., 0.50, 1.25 mg/㎡ concentration(particle size: 0.5-0.5 aerosol)6hours a day, 5day a week in 13weeks comparing with 2weeks, 8weeks of recovery group about the noxiousness of the experiment animal and the reduce scale of the CrO3 in the internal organ especially in blook and respiratory organ with the period of convalescent and clearance. The experiment results which we received are as follows. 1. In blood the RBC, HGB and HCT experiment, rats with 0.20, 0.50 mg/㎡ concentration showed that there were some decreases but not dependent. The kidneys absolute weight compared with control group was reduced intentionally(p〈0.05) and the lungs absolute weight compared with control group showed intentional increase(p〉0.05). 2. After the exposure of the experiment material, the whole blook, l\blood plasma and red blood cell in blood by (x): the period of convalescent, per (y); the decreasing of Cr concentration, was y=66.51 e -0.057x, y=67.2 e-0.101x, y=70.01 e-0.030 in 0.50 mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life (day)was estimated 12.0, 6086, 23.0 each. 3, After the exposure of the experiment material, the experiment animals lung, liver and kidneys by(x); the period of convalescent, per (y); the decreasing of Cr conentration, was y=1808 e-0.00493x, y=12.02e-0.0297x, y=67.61 e-0.0292x in 0.50mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life(day)was estimated 140.6, 23.3, 23.7, each, and including lung, liver with all of the experiment internal organs, the Cr clearance decreased as the exposure concentration increased.

치매방지 작업기구 사용이 항산화효소 활성에 미치는 영향

조경혜,박정은,윤지윤,문세보,박효영,정인옥,이정원 서울여자대학교 자연과학연구소 2001 자연과학연구논문집 Vol.13 No.-

We developed an occupational therapy tool to maintain and improve the cognitive function for the elderly who have senile dementia. 86 elderly people took a mininal mental state examination (MMSE) for the therapy to perform the occupational therapy, and divided into three groups based on avarage ages and MMSE values. The occupational therapy was treated three times per week for 10 weeks. The results showed that there were significant differences in the performing scores before and after the treatment ; the scores for the occupational therapy were increased significantly (p<0.001) and the performing time was shortened from 6-week throughout 10-week regimen. This study was to examine the effect on the activity of antioxidant enzymes by occupational therapy. The activities of antioxidant enzymes such as catalase, Glutathion-6-phosphate dehydrogenase (G6PDH), and superoxide dismutase (SOD) were increased to the normal standard by the occupational therapy for the elderly having dementia. The recovery of activities of antioxidant enzymes was obvious in severe demented elderly compared to those in normal or mild demented elderly. These results suggest that the occupational therapy had an beneficial effect on the protection against the oxidative stress especially for severe demented elderly, and the occupational tool need to be modified so as to improve the protection against the oxidative stress for normal and/or mild demented elderly.

농산물중의 잔류농약 실태에 관한 연구(Ⅰ) : 고체상 추출에 의한 농산물중 잔류농약 분석에 관한 연구 Analysis of Residual Pesticides in Agricultural Products by Solid-Phase Extraction

허옥순,이재관,이정성,서정혁,주인선,허수정,김세은,김정근,신영희,유미자,김지연,심규창,김성환 식품의약품안전청 1998 식품의약품안전청 연보 Vol.2 No.-

신속 · 정밀하고 효율적인 짠류농약 검출을 위하여 극싱칼럼 (Extrelut-3')을 사옹한 SPE법을 시도하였다. 시료는 채소류체 사용하는 농약중 잔류성이 있고 식품공전상 시험 전처리가 각각 다른 Chlorothalonil등 6종의 농약을 선정하고 그들 표준액에 대한 PPIR수준의 농도로추출용라의 종류 및 용매량 등의 추출조건을 달리하여 회수율 등을 측정한 결과 최적의 분석조건을 얻었다. 1) 추출 용매량은 증가할수록 추출 수율이 높았고,용매 종류에 대한 추출수율은 각 농약별로 다소 차이는 있었으나 극성 정도가 비교적 높은 Ethyl acetate애서 평균 추출수율이 가장 높았다 2) 최대 평균회수율은 Ethyl acetate 60mL를 사웅할 경우로서 93.6%였다. 3)표준액을 시료에 첨가한 시험에서도 역시 Ethyl ace늘to가 푼출수율이 가장 높았으며 불순물 분리제거 효과도 LLE법 보다 월등히 우수하였다. 4) 각 농약별 검출한계는 치소 0.001ppin으로 농산물 중 미량 잔류하는 농약을 검출할 수 있을 것으로 사료된파. 그러므로 SPE법은 LLE법보다 경제적인 방법으로 판명되었으며, 앞으로 농산물 중 잔류농약 분석에서 LEE법을 대치할 쑤 있을 것으로 기대된다. Solid-phase extraction by polar column(Extrelut-3') was attempted to develope the fast and efficient method of detecting pesticide of farm product.5·ix kinds of pesticide used in farming fieldfrequently and different in pretreatment, were chosen from Korea Food Cord. Optfmal analysis condi-tions were determiBed from t31e recovery rate of standard pesticides according to extraction solvent andextraction volurae. Extraction yietd was increased as solvent polarity and extraction volume. Maximumrecovery rate was acquired at 93.6% when 60mL of ethyl acetate was used as eluent. Tllis method wasmore effective than liquid-liquid partition extract·ion method to eliminated the impurity and had 0.001ppm of detection limit. Therefore. solid-phase eEl=raction was expected to be economical substitute fortraditional liquid-liquid extT·action method.

SD Rats를 이용 1-hexene의 흡입독성 연구

김현영,임철홍,정용현,이권섭,이성배,이준연,한정희,전윤석,이용묵 한국환경독성학회 2001 환경독성보건학회지 Vol.16 No.4

The purpose of this study was to investigate the acute (4 hours) and repeated-dose (6 hours a day, 5 days a week, 4 weeks) toxic effects of I -hexene on Sprague- Dawley (SD) rats which were treated by inhalation. The results were as follows; I. The median lethal concentration (LC_(50)) was estimated 52,694 ppm (confidence limit 95%; 49,494~55,447 ppm) in acute inhalation. Abnormal clinical signs related to the l-Hexene were not observed with the acute inhalation dose. Gross findings of necropsy revealed on evidence of specific toxicity related to the 1-hexene, II. By repeated inhalation exposure the body weight of male were more or less reduced by the dose of 2,500 ppm and 5,000 ppm compared with control group. However there were no significant variation hematology and blood biochemistry for the exposed rats compared with the control rats. Abnormal clinical signs and gross findings of necropsy related to the 1-hexene were not shown. In conclusion when we exposed I-hexene to SD rats for 4 weeks, 5 days per week, 6 hours per day, the Lowest observed effect level (LOEL) was over 2,500 ppm and Non observed effect level (NOEL) was below 500 ppm.

양극성 장애와 Monocyte Chemoattractant Protein-1 유전자 다형성

배치운,김태석,장우영,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : Several studies suggested that cytokines could be involved in the pathogenesis of mood disorders, while data for bipolar disorder is relatively deficient (BD). BD, Knowned to have a inherited tendency, has been considered to be related with T-helper cell system. This study was designed to investigate the association between polymorphism of monocyte chemoattractant protein-1 (MCP1) gene at promoter-2518 and BD. Methods : Patients with BD (n=92) in accordance with DSM-FV criteria and control subjects (n=114) participated in this study. DNA was extracted from whole blood and the MCP-1 gene promoter region was amplified by polymerase chain reaction-based method. Results : Genotype and allele distributions in patients with BD were not different from those of control subjects (p=0.587 ; p=0.384). Genotype and allele distributions in accordance to presence or absence of suicide attempt (p=0.423), family history (p=0.733) and psychotic feature (p=0.436) were not different between the two groups. Conclusion : Present study suggests that the MCP1 promoter -2518 polymorphism may not affect the susceptibility and clinical diversity of the development of BD.

정신분열병과 Glutathione S-Transferase M1유전자 다형성

배치운,조자현,김연주,김태석,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study aimed to test the possible association between Glutathione S-Transferase Ml gene (GSTMl) variants and schizophrenia. Methods : One hundred and eleven inpatients with schizophrenia and 130 healthy controls were recruited. Genotyping was performed by polymerase chain reaction-based method. Results : The GSTMl null genotype was significantly more frequent in patients with schizophrenia than in controls (p=0.014, odd ratio=1.93, 95% confidence interva1=1.115-3.351), while GSTMl genotype vahants were not associated with either tardive dyskinesia (TD) or total Abnormal Involuntary Movement Scale (AIMS) scores. Conclusion : The present study suggests that the GSTMl polymorphism may confer susceptibility to the development of schizophrenia but not to TD, at least in Korean population.