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.

연근의 열수 추출물이 흰쥐의 국소 뇌혈류량과 혈압에 미치는 영향

박성혜,신언환,구재근,이태헌,한종현 동아시아식생활학회 2005 동아시아식생활학회지 Vol.15 No.1

The purpose of this study was to measure the changes of regional cerebral blood flow(rCBF) and blood pressure(BP) in rats, following the intravenous injection of Nelumbo nucifera water extract. The measurement was continually monitored by laser-doppler flowmeter and pressure transducer in anesthetized adult Sprague-Dawley rats for about 2 to 2 and half hours through the data acquisition system composed of MacLab and Macintosh computer, The results of this experiment were as follows. Nelumbo nucifera significantly increased the changes of rCBF in rats. The rCBF of Nelumbo nucifera was not changed by pretreated propranolol, atropine, L-NNA and indomethacin. But the rCBF of Nelumbo nucifera was decreased by pretreated methylene blue. Nelumbo nucifera decreased the BP significantly, The BP of Nelumbo nucifera was not changed by pretreated propranolol, atropine, L-NNA and indomethacin. But the BP of Nelumbo nucifera was decreased by pretreated methylene blue. These results indicated that Nelumbo nucifera might increase the rCBF and decrease the BP which related to guanylyl cyclase activity.

흰쥐 Kupffer 세포에 대한 Propofol의 작용

박세훈,지대림,성언기,김희선,송인환,박희영,김준수,이덕희,박대팔 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.4

Background: Propofol has an antioxidant capacity and can be used for ischemia-reperfusion injury of the liver. However, the effects of propofol on the Kupffer cells have not been establisked. Methods: Kupffer cells were isolated and cultured from male Sprague-Dawley rats. The effects of propofol on the Kupffer cells were evaluated by a phagocytosis assay, TNF-α gene expression, and superoxide anion release after administering propofol in different concentrations on the cultured Kuprrer cells. Results: The latex bead phagocytosis by the Kupffer cells was suppressed when the Kupffer cells were exposed to propofol irrespective of concentrations. Higher propofol concentrations decreased the loss of Kupffer cells after latex bead phagocytosis. Propofol induced TNF-α mRNA expression in the Kupffer cells, but the mRNA expression level after 50㎍/ml of propofol decreased. The pattern of TNF-α mRNA expression induced by propofol was different to that induced by LPS: TNF-α mRNA was expressed continuously in the propofol-treated cells until 16 hours after exposure to propofol, whereas the level of TNF-α mRNA expression induced by LPS was evident after 2 hours and was not found thereafter. TNF-α production after propofol treatment was not higher than that of the control. Formazan presipitation did not show any qualitative differences between cells untreated or treated with propofol concentrations of 0.5, 5.0, and 50 ㎍/ml. Conclusions: These results showed that propofol might inhibit Kupffer cells. This suggests that propofol and be used for patients with ischemia-reperfusion injury of the liver. (Korean J Anesthesiol 2002; 43: 475~484)

충주 지역에서 10년간 급성심근경색의 임상관찰에 대한 연구

박봉안,류하근,이종혁,김인숙,류주성,유재등,이용구,문언수,김형수 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Background: The current treatments of acute myocardial infarct(AMI) Include noninvasive method using thrombolytics and invasive methods such as primary percutaneous transluminal coronary angioplasty(PTCA) and coronary artery bypass graft(CABG)surgery. Although there are many studies comparing the effectiveness of noninvasive and invasive methods, when large clinical centers, 20% of totar hospitals, were excluded, most middle-sized hospitals lacked personnels and facilities for the invasive methods. Thus they opted for the noninvasive methods. Therefore, in this study, the clinical characteristics of AMI patients and the results of thrombolytic & conservative treatment were observed. Method: 137 patients with acute myocardial infarct, who visited KonKuk University Medical Center, ChoongJu Hospital during Sept. 1990 to Sept. 1999 were analysed retrospectively using medical records. Result: The sexual compositions of patients were 63.5% male, and 36.5% female. The mean age for male patients were 56±12.9, and for female patients 68.7±9.6 (p<0.05). The mean age for female patients was significantly older than male patients. The patients in the thrombolytic treatment group had mortality rate of 6.25% which is lower than that of the conservative treatment group at 12% (p>0.05). Conclusion: Although in our study, small number of acute myocardial infarct patients caused the statistical insignificance, rapid revascularization by thrombolytic therapy within 6 hours of onset of symptoms improved mortality rate and early ambulation. And we had good results on AMI with thrombolytic agent in ChungJu including near rural area as primary emergency hospital. Therefore a prospective research with greater number of subjects is needed to develop better treatments for AMI.

조선업 근로자의 누적외상성질환 실태와 누적외상성질환 범용 작업위험도 평가도구를 이용한 작업분석

한상환,백남종,박동현,장기언,이명학,박종태,김대성,이연숙,백경자,신용수,송동빈 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.4

Cumulative trauma disorders were surveyed in a cross-sectional study of 100 male shipyard workers an 43 male office workers. And baseline checklist for risk assessment of cumulative trauma disorders was applicated in a ship making process. Cases of cumulative trauma disorders were defined using physical examinations and electronic diagnostic mathods. Data on demographics, individual factors(medical condition), work organization and psychosocial aspects of work were obtained by questionnaire. Association between the above factors and cumulative trauma disorders were assessed by multiple logistic regression models. 29(29%) participants of male shipyard workers and 4(9.2%) study subjects of male office workers met our case definitions for cumulative trauma disorders. The myofascial pain syndrome of neck muscles(12% of participants) and carpal tunnel syndrome(5% of participants) were the major two medical conditions in shipyard workers. The odds of male shipyard workers for cumulative trauma disorders to male office workers was 3.15 after adjustment of age(95% C. I. : 2.25-5.44). And the variables such as duration of present job, HIVD condition, and surges in workload were associated at least one of the cumulative trauma disorders in the final models(p<0.05). This study indicates that workrelated upper extremity musculoskeletal disorders are relatively common among shipyard workers, and shows that the psychosocial factors is not likely to be related to the occurrences of these disorders in heavy workers. Also we developed baseline checklist for risk assessment of cumulative trauma disorders. The checklist was unique in that its expected users were industrial hygienists and occupational healthing nurses who did not have much ergonomic background and in that it was targeted to Korean workers in various types. As the first application of the checklist, shipyard workers were evaluated.

四天王寺의 密敎的 特性에 關한 硏究

김상태,박언곤 대한건축학회 2004 대한건축학회논문집 Vol.20 No.4

Each buddhist temple expresses its own dogmatic ideology. During the Unified Silla Period, Esoteric Buddhism became widely accepted since it was embraced by both the Zen and the Dogmatic Buddhism. The ideology of the Esoteric Buddhism, which started out with the triangular composition, uses the geometric elements of circles, squares, half circles, and triangles which forms the Cosmos, to complete the Mandala image. Because Esoteric Buddhism and the two pagoda buddhist temple(Sachunwangsa Buddhist Temple Site) started to appear around the same period, we might be able to find the compositional elements of the two pagoda buddhist temple that remains unknown to these days.

연접 부호화 기법에 의한 무선 ATM의 성능 개선

조성언,박기식,홍희식 順天大學校 1999 論文集 Vol.18 No.1

In this paper, we have analyzed and simulated the BER and CLP of Wireless ATM(WATM) cells adopting the concatenated FEC technique in Rician fading channel. Also, in Rician fading channel, we have contrived the performance improvement by introducing the fading compensation technique of inserting pilot symbols into the concatenated FEC. From the results, in Rician fading channel, it is known that since the superior BER performance in low ?? results in the divergence when the Viterbi decoder is conducted first, the performance difference of about 2 [dB] occurs between the theory analysis and the simulation. Besides, from the only simulation results, it is known that the system performance adopting the concatenated FEC technique by inserting pilot symbols is improved about 1 [dB] better in terms of ?? than the system performance adopting the only concatenated FEC technique.

Rician 페이딩 채널에서 WATM 셀의 성능 개선에 관한 연구

조성언,박정현,백승선 順天大學校 1998 論文集 Vol.17 No.1

This study has analyzed theoretically the effect of fading to design effective wireless ATM system. The CNR, CLR, and CER of wireless ATM system adopting FEC coding and diversity reception techniques have been derived in fading environment. From the results, CLR in the HFEC which puts more importance on coding gain than coding rate, it show(62, 32, 5)FEC coding having higher coding gain is more adequate. And also, it has to consider CER and MaxU data together in the PFEC performance, because emphasizing the error correction ability to lessen CER cause inefficient use of channel by the added redundancy bit. (438, 384, 6) FEC coding is more appropriate in the CER and MaxU. it is showing the CER and MaxU value when dividing (438, 384, 6) FEC. The more division is the less CER value in the CER, but in the MaxU, when a wires ATM cell is divide by more then two WATM cell, it leads to increase of overhead due to more header transmission, and finally to relatively poor MaxU value in the case of going over the certain bound of CNR value. (240, 192, 6) FEC code is proper than (438, 386, 6) code when considering CER and MaxU data in the payload division. Using diversity technique to wireless ATM cell header improves MRC to about 1.7 dB of Eb/No than SC under the Rayleigh fading environment, and to 2 dB of Eb/No under Rician fading (K=5). Also using the diversity technique to wireless ATM cell Payload under Rician fading environment improves MRC to 3dB of Eb/No than SC in both case of K=5 and K=10.

曼茶羅의 空間體系와 寺刹建築의 空間構成에 關한 硏究

金尙泰,朴彦坤 홍익대학교환경개발연구원 1998 환경개발연구논문집 Vol.3 No.-

Thoughtful transformation of Buddhism was emerged by that Mandala was transmitted to Korea, this transformation, a standard model of early temple's arrangement, was based on establishment of Buddhist temples. As the spatial system which was divided into three space ; a boundary, four sides and a main Buddhist sanctum, was transformed to mountainous temple and Mandala of Esoteric Buddhism's main thought effected and traditional belief was absorbed, these transformations pulled off the spatial system of three levels and showed the emergence of gates and sanctums which was the gate of both the four Devas and Mahavairocana and the sanctum of both Yak-Sa and Myung-Bu and gates of a mountain god, Sam-sung and Chil-Sung which was traditional space of Korea. Mandala of Avatamska unified the basic thought of Buddhist temples. On the base of these thought, the basic form of Buddhist temples's arrangement was the iconology of Mandala. In the four sides ; east, west, south and north, As the result that the function of the northern sanctum of Arhant and the southern sanctum of Myung-Bu which was comprised of Vairacana was emerged frequently but both the eastern and the western sanctum wasn't emerged was obtained, It is that as the function of the eastern and western sanctum is not necessary in making three Buddha which is the side buddha of Vairocana, making the sanctum corresponded to Vairocana is not necessary. As I result through the base of this, the spacial system of Mandala is the system of basic though in planning a Buddhist temples and means the system of Korean Mandala which is based on Vairocana from the system of three levels in Buddhist temple sites to in present mountainous Buddhist temples.

슬라이딩 평면을 이용한 I-PD 제어계의 구성

김성근,박건우,고태언 동의대학교 산업기술개발연구소 2001 産業技術硏究誌 Vol.15 No.-

In this paper, I-PD controller by nearal network is designed using variable structure controller. The I-PD control system is stable in the sense that the error is inside the constraint set, the variable structure controller is idle. If the error hits the boundary of constraint, the variable structure controller begins operation to force the error back to the constraint set. Applying this control technique to the position control system using a DC servo motor as a driver, the control performance of controller is verified by the results of computer simulation.