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.

고령자 급성 췌장염의 임상적 고찰

이진헌,강진경,박인서,송건훈,정재복,백용한,송시영,서정훈 대한소화기학회 1998 대한소화기학회지 Vol.32 No.3

Background/Aims: Inflammatory diseasas of the pancreas are not uncommon. The advanced age is one of the significant factors in assessing the severity of acute pancreatitis. It has been shown that the biliary tract disease is a more frequent cause of acute pancreatitis in the elderly than in the young. With the increased life span, the elderly are comprising a large proportion of the population. As a result, physicians are more often being faced with acute pancreatitis in the elderly. The purpose af this study was to evaluate clinical features of acute panereatitis in the elderly. Methods: A total of 188 patients with acute pancreatitis were reviewed. We investigated the differences of clinical characteristics between the elderly patients aged over 60 and the young patients aged under 60. Results: The sex distribution showed male preponderance in the young patients (M:F=2.4:1), but was nearly equal in the elderly patients (M:F=1.1:1). The most common cause of acute pancreatitis in the elderly was biliary tract disease (52.5%), while alcohol abuse was the most common cause in the young patients (38.8%), Local complications of acute pancreatitis, such as psuedocyst, necrosis, abscesses were not differently shown between the elderly (16.9%) and the young (20.2%) patients. Systemic complications including acute puhnonary failure occurred more frequently in the elderly patients than the young patients. The mortality rate of the elderly patients (5.1%) was not significantly different from that of the young patients (3.1%). Conclusions: To detect correctable underlying bihary tract diseases the elderly patients with acute pancreatitis should be completely investigated using endoscopic retrograde cholangiopancreatography (ERCP). In addition, the patient should be closely monitored for the development of the systemic complications during the disease process.

고령자 급성 췌장염의 임상적 고찰

백용한,서정훈,송건훈,이진헌,송시영,정재복,강진경,박인서,이수진 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

반말체 어미 ‘-게’의 의미기능 연구

이한민 ( Lee Han-min ),조은영 ( Cho Eun-young ) 국어학회 2015 국어학 Vol.74 No.-

본고는 조은영·이한민(2011)에서 정리하였던 연결어미에서 종결어미화된 ‘-게’의 의미기능과 문법화 과정의 연장선상에서 추가적인 ‘-게’의 용법으로 [가정]과 [추측유도]의 의미기능을 살피고자 하였다. [가정] ‘-게’구문은 조건절인 선행절과 결과절인 후행‘-게’절로 구성되며, 선행절의 부정을 이끄는 반어적 진술의 수사의문문으로 사용된다. [가정] ‘-게’는 선어말어미 ‘-었-’이 결합할 수 있는 점, 후행 ‘-게’절이 단독으로 쓰일 수 없는 점, 의미적으로 후행절의 내용이 선행절을 강조하는 기능을 한다는 점에서 [완료결과] ‘-게’와 연관성을 보인다. [추측유도] ‘-게’구문은 화자가 알고 있는 어떠한 사실에 대하여 청자의 ‘추측을 유도’하는 발화에서 사용되며, 설명의문문 형식이나 선택의문문 형식으로 쓰이지만, 청자로부터 신정보를 얻기 위한 질문으로는 사용되지 않는다. [추측유도] ‘-게’절은 선어말어미 ‘-었-’이 결합할 수 있는 점, 이미 이루어진 상황 혹은 확정된 사실에 대한 것이라는 점에서 [완료결과] ‘-게’와 유사한 의미를 보인다. 그러나 단독으로 사용될 수 있는 구문인지, 발화의 초점이 ‘-게’절에 있는지의 여부에서 차이를 보인다. [가정]은 [완료결과]와 통사적, 의미적으로 비슷한 부분이 많고, [완료결과]와 동일한 형식의 문장이 [가정]의 쓰임을 보이는 과도기적 형태도 존재한다. 따라서 [가정]은 [완료결과] 이후에 연결될 수 있는 단계로 볼 수 있다.[추측유도]의 경우에는 [완료결과], [가정]과 통사적, 의미적으로 공통적인 부분이 있지만, 조은영·이한민(2011)에서 정리한 종결어미 ‘-게’의 단계별 의미기능과 함께 다룰 수 있을지에 대해서는 결론을 내리지 못하였다. [추측유도]가 연결어미 ‘-게’에서 문법화한 종결어미가 아니라 다른 기원을 갖는 ‘-게’의 의미기능일 수도 있다는 가능성도 열어 두어야 할 것이다. 다만, [추측유도] ‘-게’가 공시적인 쓰임에서 연결어미 ‘-게’에서 문법화한 종결어미의 의미기능들과 연관성을 가지는 것은 분명하다. This paper tries to figure out the additory usage of final ending ‘-ge’―the semantic function of [supposition] and [assumption inducement]― as an extension to the grammaticalization process of final ending ‘-ge,’ originated from a connective ending ‘-ge’ organized by Cho, Eun-Young & Lee, Han-Min (2011). The sentence structure of [supposition] ‘-ge’ is consisted of the antecedent clause, which is a conditional clause, and the following clause ‘-ge’ clause, and is used as a rhetorical interrogative of an ironic statement denying the antecedent clause. It also shows some correlation with [completion result] ‘-ge’, considering the fact that ‘-ge’ can be combined with the tense prefinal ending ‘-eoss-’, and that following ‘-ge’ clause cannot be used by itself, and that the following clause can emphasize the antecedent clause semantically. The sentence structure of [assumption inducement] ‘-ge’ is often used when inducing a listener to make an assumption of a matter that a speaker already knows. However, it is not used as a question to get a new information from the listener although it may be used in a form of a wh-question or an alternative question. [Assumption inducement] ‘-ge’ clause shows some similar meaning with that of a [completion result] ‘-ge’ clause regarding the fact that it can be combined with the tense prefinal ending ‘-eoss-’ and that this clause is about something that has already happened or determined. However, it shows some differences in that whether this sentence structure can be used alone or its focus point of utterance is on ‘-ge’ clause itself. There exists several similarities between [supposition] and [completion result] in syntactic and semantic context, in addition to a transitional phase in which a sentence is used as a [supposition] clause when sentence structures exhibit identical features to [completion result]. Thus, it can be seen that [supposition] is a connecting stage following the [completion stage]. In case of [assumption inducement], there exists several similarities between [assumption inducement], [completion result] and [supposition] in syntactic and semantic context. However, the authors were not able to draw a definitive conclusion as to whether [assumption inducement] can be dealt with changing meanings of semantic functions of final ending ‘-ge,’ organized in Cho, Eun-Young & Lee, Han-Min (2011). Thus, there is an implied possibility that [Assumption inducement] may not be a grammaticalized final ending ‘-ge’ but that of different origins with dissimilar semantic functions. In the synchronic use, however, it is certain that [assumption result] ‘-ge’ has a definitive correlation with semantic functions of final endings that are grammaticalized in the connective ending ‘-ge.’

Factors associated with the risk of colorectal neoplasia in young adults under age 40

Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

한강하구지역에서 월동하는 재두루미(Grus vipio)의 개체군 감소

이화수(Hwa-Su Lee),신주열(Ju-Yeol Shin),이시완(Si-Wan Lee),강태한(Tae-Han Kang),윤순영(Soon-Young Yoon),김정수(Jungsoo Kim) 한국조류학회II 2012 한국조류학회지 Vol.19 No.4

김포시와 고양시 일대의 한강하구 지역은 우리나라에서 재두루미의 가장 중요한 월동지 및 중간기착지로 알려져 있지만, 이 지역의 조류 서식환경은 심각한 개발압력과 인간의 간섭으로 인해 지속적으로 나빠지고 있다. 따라서 본 연구에서는 2007-2008년과 2011-2012년의 월동시기에 본 지역에 도래하는 재두루미를 대상으로 월동 개체군 크기 변화와 월동지역 내에서 과거와 현재의 취식지역 이용 현황 등을 조사하여 개발행위가 이들의 서식에 미치는 영향을 확인하였다. 본 지역에서 월동하는 재두루미 개체군은 평균 124.9개체(2007-2008년)에서 59.0개체(2011-2012년)로 감소하였으며, 주요 취식지역에서 확인된 개체수는 평균 77.7개체에서 24.1개체로 감소하여 월동개체군의 감소폭에 비해 주요 취식지역의 이용 개체수의 감소폭이 더 크게 나타났다. 유형별 분석에서는 가족군에 비해 무리군의 개체수가 많이 감소한 것으로 나타났으나, 홍도평 지역의 가족군 이용 개체수는 변화가 나타나지 않았다(Mann-Whitney test. Z=-0.26, p=0.979). 그리고 과거 다수의 재두루미가 주요 취식지역으로 이용하였던 송포동과 평동지역은 2012-2013년 조사에서는 거의 이용하지 않는 것으로 나타났다. 이는 위 지역의 개발행위(예: 제 2자유로 건설 등)와 깊은 연관성이 있는 것으로 생각된다. Han-river estuary in Gimpo and Goyang city is well known as one of the most important wintering and stopover sites for migrating White-naped Crane (Grus vipio) in Korea. Nowadays, habitat quality of this area is getting worse due to serious development pressure and high human disturbances. So, we wanted to know whether development actions affected total wintering population change in Han-river estuary and feeding group pattern of White-naped Crane in main feeding habitats between the 2007-2008 and 2011-2012 wintering period. Average wintering population was decreased 124.9 to 59.0 and population of main feeding site also decreased 77.7 to 24.1. But decrease rate of main feeding site population was higher than total wintering population. Non-family feeding population was more decrease than family feeding population in the flock type analysis. But family feeding population of Hongdopyong was maintained from past and present (Mann-Whitney test. Z=-0.26, p=0.979). However, almost all White-naped Crane din not use both feeding sites, Pyong-dong and Songpo-dong, where were deteriorated habitat quality by human act.

고요산혈증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이종은,이준숙,이찬구,이한정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : Serum uric acid has now been identified as a marker for a number of metabolic and hemodynamic abnormalities. The aim of this study is to evaluate risk factors which influence hyperuricemia in the citizens of Asan. Method : The study design was cross-sectional and research subjects were 1086 citizens of Asan. General characteristics, cigarette smoking, alcohol consumption, and past history were obtained by interview using a structural questionnaire. Also, we measured height, weight and blood pressure, and serum uric acid of the subjects. Results : The mean serum uric acid level was 5.27 ㎎/㎗ in men and 4.01 ㎎/㎗, in women, In the multiple logistic regression analysis, statically significant risk factors of hyperuhcemia were gender, body mass index, blood lead concentration, and serum creatinine. Conclusion : Our results suggest that gender, body mass index, blood lead concentration, and serum creatinine might be the most important risk factors of hyperurcemia. Education program as well as routine check-up for serum uric acid was highly recommended for the effective prevention of hyperuricemia.

일 대학병원에 입원한 노년기 양극성 장애 환자의 인구학적 및 임상적 특징

조숙현(Sook Hyun Cho),정한용(Han Yong Jung),권영준(Young Jun Kwon),이소영(So Young Lee),김양래(Yang Rae Kim),김윤정(Yun Jung Kim) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Objectives : As the elderly population is continuing to increase, psychiatric diseases of the elderly are becoming an important social issue. This study looks into the demographical and clinical features of the elderly patients diagnosed with bipolar disorder in a University hospital. Methods : The study subjects include patients admissioned in the closed wards of Soonchunhyang Seoul hospital and Cheonan hospital from March, 2000 to February, 2005 who met the DSM-IV-TR criteria for bipolar disorder at the time of discharge. A total of 146 patients (76 men, 70 women) medical records were studied retrospectively. Subjects older than the age of 50 at time of admission were grouped as the old age group, whereas those who were younger than 50 as the young age group. Also among the old age group, those who had the first onset of episode under the age of 50 were grouped as the early onset group, whereas those who had the first onset after the age 50 were grouped as the late onset group. Results : The number of bipolar disorder patients in the young age group and old age group were 73 and 73 respectively. The number of early onset group and late onset group were 46 and 23 respectively. The old age group had a relatively higher incidence of bipolar II disorder than the young age group. Also in the old age group there was a higher incidence of hypomanic or depressive episode rather than manic episode compared to the young age group. And in the old age group psychotic symptoms were less common and the mean admission length shorter than the young age group. Additionally in the old age group treatment with Lithium monotherapy or with no mood stabilizers at all were relatively common. Among the old age group, late onset group had a higher rate of bipolar II disorder than the early onset group. Conclusion : This study shows differences in the demographical and clinical features among different age groups. But additional research would be required to determine whether the bipolar disorders in the elderly or late onset group are actually a different type of disorder from those of the young.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

Contribution of stress and coping strategies to problematic Internet use in patients with schizophrenia spectrum disorders

Lee, Ju-Yeon,Chung, Young-Chul,Song, Je-Heon,Lee, Yo-Han,Kim, Jae-Min,Shin, Il-Seon,Yoon, Jin-Sang,Kim, Sung-Wan Elsevier 2018 Comprehensive psychiatry Vol.87 No.-

<P><B>Abstract</B></P> <P><B>Introduction</B></P> <P>Internet use is already high and increasing rapidly among people with psychotic disorders, but there have been few studies on problematic Internet use (PIU) among patients with schizophrenia spectrum disorders. This study aimed to measure the prevalence of PIU and identify the factors associated with PIU among patients with schizophrenia spectrum disorders.</P> <P><B>Methods</B></P> <P>A cross-sectional survey was performed that included 368 outpatients with schizophrenia spectrum disorders: 317 with schizophrenia, 22 with schizoaffective disorder, 9 with schizophreniform disorder, and 20 with other schizophrenia spectrum and psychotic disorders. The severity of psychotic symptoms and levels of personal and social functioning were assessed by the Clinician-rated Dimensions of Psychosis Symptom Severity (CRDPSS) scale and the Personal and Social Performance (PSP) scale, respectively. PIU was evaluated using Young's Internet Addiction Test (IAT). Additionally, the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Rosenberg Selfesteem Scale (RSES), and Brief Coping Orientation to Problems Experienced (COPE) Inventory were administered.</P> <P><B>Results</B></P> <P>PIU was identified in 81 (22.0%) of the 368 patients with schizophrenia spectrum disorders. Subjects with PIU were significantly younger and more likely to be male. Scores on the HADS, PSS, and dysfunctional coping dimension of the Brief COPE Inventory were significantly higher, and RSES scores were significantly lower, in the PIU group. Logistic regression analysis indicated that PIU in patients was significantly associated with scores on the PSS and dysfunctional coping dimension of the Brief COPE Inventory.</P> <P><B>Conclusions</B></P> <P>Patients with schizophrenia spectrum disorders and PIU were significantly more likely to have high levels of perceived stress and dysfunctional coping strategies. Patients with schizophrenia spectrum disorders who also engage in PIU may benefit from interventions that help them to develop appropriate skills for coping with stress.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Patients with schizophrenia spectrum disorders showed a high prevalence (22.0%) of problematic internet use (PIU). </LI> <LI> High levels of perceived stress rather than psychopathology itself contributes to the development of PIU in stabilized patients with schizophrenia. </LI> <LI> Our results indicate that managing stress and developing coping strategies are important for the prevention of PIU among this group of patients. </LI> </UL> </P>