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.

保釋制度 考察

鄭幸哲,全龍得 東義大學校 法政硏究所 1999 공공정책연구 Vol.15 No.-

입원 남성 및 여성 알코올리즘 환자의 인구학적, 임상적 및 인격적 특성비교

정원후,김성부,장기용,손진욱,박철수 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 1996년 5월 1일부터 1996년 7월 15일까지 부산·경남·대구 소재의 대형정신병원과 종합병원에 입원해 있는 여성 알코올리즘을 대상으로 하고, 또한 같은 기간에 국립부곡정신병원에 입원한 남성 알코올리즘을 비교군으로 해서 사회인구학적 특성, 음주양상, 음주와 관련된 문제점, 성격 및 정신병리등을 비교하여 남녀 알코올리즘에서의 원인과 임상적 특성에서의 차이점을 알고자해서 본 연구를 하게 되었다. 저자들이 작성한 반구조화된 설문지, MAST(Michigan alcoholism screening test). Zung의 SAS(Self-rating anxiety scale)과 SDS(Self-rating depression scale). MMPI(Minnesota Multiphasic Personality Inventory), SCL-90-R(Symptom checklist-90-revision) 및 EPQ(Eysenck personality questionnaire)등의 검사도구를 이용하였고, 그 결과를 독립표본 t-test(independent-samples t-test)와 χ²-test로 검정하여 다음과 같은 결론을 얻었다. 1) 여성 알코올리즘에서 남성 알코올리즘보다 더 낮은 교육 수준을 보였으며 초등학교수준 이하가 52.4%를 차지하였다. 반면에 남성 알코올리즘에서는 중학교·고등학교 수준이 76.7%였다.(p〈0.01). 2) 여성 알코올리즘에서 형제들 중에서 더 낮은 서열을 보였으며 세째딸이 1/3로 가장 많았고 다음이 외동딸로써 23.8%를 차지하였다. 반면 남성 알코올리즘에서는 장남이 46.7%였다.(p〈0.01). 3) 여성 알코올리즘이 사회경제적 수준에서 더 낮았다(p〈0,01). 4) 여성 알코올리즘의 음주시작동기는 대인관계를 위한 사교목적, 심리적 갈등이나 다른 정신적인 문제, 가족들과의 갈등 등이 비슷하게 많았다. 그러나 남성 알코올리즘에서는 대인관계를 위한 사교목적으로 음주하는 경우가 절대적으로 많았다.(p〈0.05). 5) 처음으로 음주를 시작한 연령은 여성 알코올리즘보다는 남성 알코올리즘에서 유의하게 더 어린 연령에서 시작하였다.(p〈0.001). 6) 1일 평균 음주량은 여성 알코올리즘에서 유의하게 더 적었다.(p〈0.01). 7) 금단증상경험, 알코올성 신체장애 및 음주로 인한 법적 처벌경험도 남성 알코올리즘보다는 여성 알코올리즘에서 유의하게 더 낮았다.(p〈0.05). 8) SCL-90-R에서 PSY척도에서 유의하게 여성 알코올리즘군에서 더 높았고, EPQ에서는 L척도에서 유의하게 여성 알코올리즘이 더 높았다(p〈0.05). 결론적으로 본 연구는 심리적 요인과 사회적 요인이 남녀 알코올리즘간에서 많은 차이가 있는 것을 알 수 있었으며, 여성 알코올리즘의 원인에는 심리적 또는 사회인구학적 요인이 더 밀접하게 연관이 되어 있음을 알 수 있었다. Objective : This study was designed to compare the characteristics of demographic data, clinical features, and personality in male and female alcoholics and to identify the clinically meaningful differences in the etiologies and the clinical features between the two groups. Methods : The study group was composed of 30 males and 21 females who were recruited into the impatient treatment. The researchers used self-reporting questionnaire composed of demographic data and drinking patterns, Michigan alcoholism screening test(MAST), self-rating anxiety scale(SAS) and self-rating depression scale(SDS) of Zung, Minnesota Multiphasic Personality Inventory(MMPI), symptom Checklist-90-revision(SCL-90-R), and Eysenck personality questionnaire(EPQ). The differences between the two groups were tested by chi-square test and independent-sample t-test. Result : 1) Education level of the female alcoholics was significantly less than that of male alcoholics(p〈0.05) and the birth order the female alcoholics was significantly higher than that of male alcoholics(p〈0.05). 2) The level of socioeconomic status of female alcoholics was significantly lower than that of male alcoholics(p〈0.01). 3) The initial motivations of female alcoholics were mainly due to social, psychological, and intrafamilial problems while those of male alcoholics were due to social problems. There were significant difference between the two groups(p〈0.05). 4) The onset of initial drinking in female alcoholics was significantly earlier than that of male alcoholics(p〈0.001). 5) The average amount of daily drinking in female alcoholics was significantly less than that of male alcoholics(p〈0.01). 6) Withdrawal symptoms, physical disorder, and social or legal problems induced by alcohol drinking in female alcoholics were significantly less than those of male alcoholics(p〈0.05). 7) The mean scores of PSY scale of SCL90R and of L scale of EPQ in female alcoholics were significantly higher than those of male alcoholics(p〈0.05). Conclusion : Demographic and psychosocial factors differed to a significant degree between male and female alcoholism. We suggest that these factors are more important in female alcoholism than in male one in the etiologies and the clinical features. These differences are due to more complex factors rather than simple ones, thus the further evaluations are needed to elucidate the differences in the etiologies between male and female alcoholism.

사업장 근로자의 건강위험 평가도구 개발

정규철,이용애,홍윤철,조희숙,박혜숙,임현술,하은희 이화여자대학교 환경문제연구소 1998 이화환경연구 Vol.2 No.-

Health Risk Appraisal(HRA) is usually defined as a process by which we expect of individual's chances of acquiring specific diseases within a defined period of time. The concept of worksite as an area of health maintenance and promotion is newly developing. Our movement for health promotion of employees has been increasingly known in the worksite. The aim of this study is to develop health risk appraisal tools about health promotion at the worksite for employees. We performed this study by two steps: one step was to develop a HRA questionnaire of worksites in Korea, another was to evaluate the reliability of the questionnaire. For developing HRA questionnaire, we reviewed scientific examples at first, and then weighted the score by delphi. To evaluate the reliability of developed questionnaire, we carried out survey by test-retest method. A total of 131 employees completed HRA questionnaire on two times. The results are as follows. The total score of health risk in unhealthy workers was higher than that of healthy workers. The range of test-retest reliability of responses to the questionnaire was 0.57-0.94. Therefore it seems that this questionnaire was very suitable to assess the health behavior of workers. In conclusion, the developed HRA questionnaire can be used as a tool for evaluating health behavior and for providing health counseling materials.

이종 접합부재의 계면균열에 대한 파괴인성의 평가방법

정남용,박철희 崇實大學校 生産技術硏究所 2002 論文集 Vol.32 No.-

The application of bonded dissimilar materials to such indurstries as automobiles, aircraft, rolling stock, electronic devices and engineering stuctures is increasing gradually because these materials, compared to the homogeneous materials, have many advantages for material properties. In spite of such wide applications of bonded dissimilar materials, the evaluation method of fracture toughness on interface crack in the bonded components has not been established clearly. In this paper, the stress intensity factors were analyzed by boundary element method(BEM) for the bonded scarf joints with a crack, respectively. From static fracture experiments of the bonded scarf joints, an evaluation of fracture toughness on interface crack in the bonded components was proposed and discussed.

소아의 연령별 Propionibacterium acnes에 대한 균체응집항체 및 동종혈구응집항체간의 비교연구

정화영,정상인,최철순,양용태 중앙대학교 의과대학 의과학연구소 1984 中央醫大誌 Vol.9 No.3

In general, the concentration of maternal IgG globulin in serum of the neonates falls rapidly within the first few months after birth and the production of IgM globulin develops in the maturing infants during the course of exposure to various antigens in the environment. The development of natural antibodies, ie., isohemagglutinins, IgM class, to ABO blood group substances and agglutinins, Ig class, to normal flora, in the early stage of life is important since not only they may act as bactericidal substances in nonspecific manners, but also could be immunological barometers on the normal function of humoral immune system. The high concentration of isohemagglutinins to human A or B blood group antigens and agglutinating antibodies to some of normal flora such as Propionibacterium acnes or Staphylococcus aureus were observed in normal human sera. It has been known that the serum concentration of IgM globulin usually reached adult levels by one year of age, while that of IgG globulins by five to six years of age. However, the levels of isohemagglutinins to A and B group substances and agglutinating to Propionibacterium acnes in children's sera and the ages in which the concentrations of their antibodies reached to abult levels are not clarified. In this study, the concentrations of isohemagglutinins to A and B blood group antigens and agglutinating antibodies to P.acnes serotype Ⅰ and serotype Ⅱ in the sera of 163 normal children, ranged from 0 day to 15 years of age, were measured by means of microtitration technique. The results obtained are as follows: 1. In the sera of 163 children under 15 years of age, there observed no significant difference in the titers of agglutinating antibodies to P. acnes serotype Ⅰ andⅡ. 2. Of 75 sera of children under one year of age, the numbers of sera in which agglutinating antibodies were not detectable or less than 1:4 to P. acnes serotype Ⅰ were 67(89.6%) and to serotype Ⅱ 53(70.7%), respectively. 3. Agglutinating antibody to P. acnes serotype Ⅰ in the children's sera reached adult levels by 7 years of age, but 100 percentages of antibody detection was observed only in the age group of 15 years old, whereas the adult levels of isohemagglutinins to A and B blood group antigens were observed in the age group of 6 months old. 4. No correlation were observed in normal children's sera between agglutinating antibody titre to P. acnes serotype Ⅰ and isohemagglutinin titre. These results indicated that the isohemagglutinins to ABO blood substances appeared in the earlier stage of life than did agglutinating antibodies to P. acnes.

진화 알고리듬을 위한 객체지향 모델링과 클래스 라이브러리 구현

정호연,이수연,곽재승,김용주,박기태,현철주 한국경영과학회 2000 經營 科學 Vol.17 No.2

In evolutionary algorithm, there exist various models for the evolution of the population with respect to schemes and strategies for reproduction, in the application of the algorithm to a specific problem, one model suitable to the problem is to be properly chosen and a program expert or a software is needed to help implement and test a designed algorithm. In this study, object oriented modeling and the class library for simple evolutionary algorithms(SEA) with one population is developed. The library proposed here can be used as a generalized tool for solving problems in a wide range of domains.

대형 상용차의 훼어링 시스템이 공기저항 감소 및 에너지 절감에 미치는 영향에 관한 수치 해석적 연구

김철호,정지용,박종배 서울産業大學校 1998 논문집 Vol.47 No.1

The objective of this numerical study is to understand the effect of the drag force reducing device(Fairing System) on a tractor-trailer transportation automobile. Until the middle of the 1980s, an aerodynamic effect on a vehicle was not interesting subject to study with because the price of petrol was comparatively low at the period. However a running vehicle is one of serious obstacles increasing the fuel consumption of the vehicle. To have reduction of the drag force on heavy-duty trucks, a device named a fairing system has been applied. Recently, heavy-duty trucks, which have the same kind of the drag reduction device, are quite often shown on the load in Seoul. However, without the exact engineering information of the design of the fairing system, it is hard to expect the best efficiency of the device to have the lowest fuel consumption of the truck. In here, the effect of the aerodynamic drag reduction system, named fairing system, of the tractor-trailer was studied numerically. The effect of four different shapes of the system on the drag reduction was also previewed. This is a part of the main project named the development of the design algorithm of the fairing system of heavy-duty trucks for energy saving in the transportation industry. From this study, a function of the drag reduction system of heavy-duty trucks, hundred billion Wons(￦) worth of energy can be saved annually from the transportation industry in Korea.

드릅나무(Aralia elata) 부탄올 추출물의 항암 및 면역 활성에 미치는 영향

김용규,남성윤,정연봉,이종철 慶星大學校 1994 論文集 Vol.15 No.2

The butanol fraction from the bark of Aralia elata SEEM(Araliaceae) showed marked antitumor and cytotoxic activity. The solid tumor growth inhibition ratio of the BuOH fraction againse sarcoma-180 was at highest level of 74.15% while administrating in the concentration of 100mg/Kg/day and life prolongation ratio showed 52.75% in the concentration of 100mg/Kg/day. In incubation of sarcoma-180 tumor cell with BuOH fraction, viability was 15.73%, the direct cytotoxic activity of Aralia elata was remarked in vitro. But the administered group being compared with the controlled group, no significant changes revealed in the immune reaction.

증후성 단일 소심부뇌경색의 임상적 및 방사선학적 양상

신원철,이태규,노용우,오재욱,장대일,정경천 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3