남자 만성 정신분열병환자에서 Haloperidol과 Nimodipine의 병합사용이 혈장 HVA와 5-HIAA에 미치는 영향

김형섭,최애경,지성학,김수동,박성덕,김광현,Kim, Hyeong-Seob,Choi, Ai-Kyung,Jee, Sung-Hak,Kim, Soo-Dong,Park, Sung-Deok,Kim, Kwang-Hyeon 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

본 연구는 난치성 만성 정신분열병 남자환자 20명을 대상으로 항정신병약물인 haloperidol 올 2주간 일정량으로 유지한후 중추신경계에 비교적 선택적으로 작용하는 칼슘차단제인 nimodipine을 5주간 병합투여하였고 BPRS, Simpson-Angus Scale Averse events-Somatic Symptoms 등을 이용하여 nimodipine투여전, 투여후 1주, 3주, 5주에 임상반응을 평가하고 혈장 HVA, 5-HIAA농도를 투여전과 투여후 1주, 3주, 5주에 측정하여 다음과 같은 결과를 얻었다. 1) Nimodipine과 haloperidol의 병합투여시 전체 BPRS점수 및 사고소검사점수, 편집성소검사점수는 용량에 관계없이 기간에 따라 감소하는 추세를 보였으나, 특히 nimodipine 90mg을 병용투여하는 군의 경우 nimodipine투여전과 비교하여 3, 5주째에서 통계적으로 의미있게 감소하는 결과를 나타냈다(p<0.05). 2) Nimodipine과 haloperidol의 병합투여에 따른 부작용등은 통계적으로 의미는 없었으나 기간에 따라 감소하는 추세를 보였고, 임상적으로 관찰된 소견상 추체외로증상, 안구동통, 정서적 불안정, 심혈관계 부작용 등의 심각한 부작용은 없었다. 3) Nimodipine의 투여량 및 기간에 따른 혈장 HVA와 5-HIAA의 농도변화는 없었다. 4) BPRS점수가 20% 이상 감소하는 경우를 호전된 것으로 간주했을때 호전군과 비호전군간의 혈장 HVA 및 5-HIAA는 차이를 나타내지 않았고, 각 군에서 측정시기에 따른 차이도 보이지 않았다. 상기 결과로 보아 nimodipine이 혈장 HVA와 5-HIAA의 농도변화에 영향을 미치지 않으나 임상적인 호전은 나타내는 바 난치성 정신분열병환자, 노인환자나 항정신병 약물에 대해 부작용이 심한 정신분열병환자에서 nimodipine 병합사용이 유용할 것으로 사료된다. In an open labeled study, two fixed doses of nimodipine(45mg and 90mg daily) were added to the usual antipsychotic drug treatment (Haloperidol : mean dose=25mg/day) in 20 male chronic schizophrenics for 5 weeks. The purposes of this study were to evaluate the therapeutic effects and the effect an the changes of plasma homovanillic acid(HVA) and 5-hydroxyindoleacetic acid(5-HIAA) levels. The results were as follows : 1) Total BPRS score and thought cluster, paranoid cluster subscores showed linear decreasing trend over the course of the study(P<0.05). Especially the thought cluster and paranoid cluster subscores were significant difference between 45mg and 90mg dose of nimodipine(P<0.05). The improvement rates were 45,45% of 90mg and 11.11% of 45mg, but there was no significant difference between the 45mg and 90mg dose of nimodipine. 2) The scores of extrapyramidal symptoms and adverse events-somatic symptoms showed a linear decreasing trends over the course of study. 3) The changes in the mean plasma HVA and 5-H1AA concentrations by the dosages and durations of combining of nimodipine were not statistically significant. 4) There was no statistical significance in plasma HVA and 5-HIAA of the improved, non-improved goroup. Nimodipine has a possibility os on adjunctive agent for treatment resistant schizophrenics, elderly patients and liable patients for the Side effects to usual antipsychotic drugs. So we suggest that the dosage of nimodipine must be above 90mg/day in the treatment of schizophrenia.

만성정신분열병 환자들에서 비정상적 불수의 운동과 혈당, 지질과의 상관관계

김형섭,김응조,이주호,지성학,Kim, Hyeong-Seob,Kim, Eung-Jo,Lee, Joo-Ho,Ji, Seong-Hak 대한생물정신의학회 2004 생물정신의학 Vol.11 No.2

Objects:It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. Methods:Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance- related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. Results:There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. Conclusion:In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of $HbA_1C$, waist, and weight are recommended for schizophrenics.

Haloperidol과 bethanechol 병합사용시 혈장 haloperidol 및 reduced haloperidol 농도에 미치는 영향

김형섭,안지영,여운태,조숙행,Kim, Hyeong-Seob,Ahn, Jee-Young,Yeo, Un-Tae,Jo, Suk-Haeng 대한생물정신의학회 1998 생물정신의학 Vol.5 No.1

Bethanechol, a cholinergic agonist, has been recommended for the management of peripheral anticholinergic side effects during the treatment of antipsychotic medications. But there have been few studies which have evaluated the drug interactions of antipsychotics and bethanechol, even the treatment effects of bethanechol on anticholinergic side effects. So the authors have evaluated whether psychopathology and plasma haloperidol and reduced haloperidol concentrations are significantly changed or not when bethanechol was administrated with maintained doses of haloperidol and other coadministrated drugs(such a benztropine). Also we have evaluated the abating effects of bethanechol on anticholinergic side effects during the treatment with haloperidol. Fifteen schizophrenics with higher than 5 of total score of anticholinergic side effects of 'Rating scale for side effect' were assigned to two groups, and bethanechol 30mg/day and 60mg/day were applied on each group for 4 weeks. The daily haloperidol dosages were fixed before 2 weeks of study. We assessed anticholinergic side effects by 'Rating scale for side effect' and psychopathology by BPRS, and plasma haloperidol and reduced haloperidol concentrations by HPLC at baseline, 2nd week and 4th week. The results were as followed, 1) there was no significant change of plasma haloperidol and reduced haloperidol concentration, 2) at baseline, the dosage of haloperidol showed significant correlation with the total score of anticholinergic side effect, but not at 2nd week and 4th week, 3) in 60mg/day group, dry mouth and the total score of anticholinergic side effects were significantly improved, but not in 30mg/day group, 4) there was no significant change of BPRS except withdrawal at 2nd week. These results suggest that coadministration of bethanechol influenced neither on psychopathology nor on plasma haloperidol and reduced haloperidol concentrations and that improved dry mouth and total score of anticholinergic side effects at 60mg/day.

한국어판 사회적응자기평가척도(SASS)의 신뢰도 및 타당도 연구

김형섭,김용구,윤충한,정한용,정영기,Kim, Hyeong-Seob,Kim, Yong-Ku,Yoon, Choong-Han,Jeong, Han-Yong,Cheong, Young-Ki 한국정신신체의학회 2000 정신신체의학 Vol.8 No.2

연구목적 : 우울증 환자의 사회적 인지내용은 우울증을 치료하는 과정에서 치료목표가 될 수 있을 뿐만 아니라, 치료방법을 결정하는 초석이 된다. 또한 환자의 증상이 악화될 것인지 또는 재발할 것인지를 예측할 수 있는 좋은 지표이기도 하다. 그러나 우울증의 증상들을 평가하기 위한 척도와는 달리 아직 우리나라에서 사회적응성을 평가하기 위한 척도는 아직 소개된 바 없다. 이에 Bosc 등이 개발하였고, 유용성에 대해 이미 인정되어 있는 Social Adaptation Self-rating Scale(SASS)를 한국어로 번안한 척도에 대하여 신뢰도 및 타당도를 검증하였다. 방법 : SASS를 한국어로 번안하여 총 21문항으로 구성된 한국어판 사회적응 자기평가척도를 작성한 후 신체적, 정신적으로 건강한 정상인 291명과 우울증 환자 40명을 대상으로 시행하였다. 1) 한국어판 SASS의 신뢰도 검증결과 대상자 전원에 대한 Cronbach $\alpha$계수는 0.790. Spearman-Brown 반분신뢰도는 0.782(Guttman split-half=0.78) 이었다. 정상인 집단의 경우 Cronbach $\alpha$계수는 0.734. Spearman-Brown 반분 신뢰도는 0.619(Guttman split-ha1f=0.7318)였으며, 우울증 집단의 Cronbach $\alpha$계수는 0.8852. Spearman-Brown 반분신뢰도는 0.8852(Guttman split-half=0.8548) 이었다. 정상인 집단에서 45명을 대상으로 2주 간격으로 시행한 검사 재검사 신뢰도 검증결과는 r=0.653(p<0.01)으로서 비교적 시간적 안정성을 보였다. 2) 집단간 SASS 및 Purpsoe in Life(PIL) 검사 점수 차이의 검증에서 정상인집단의 SASS 총점 평균은 $40.12{\pm}5.27$, PIL 총점 평균은 $98.41{\pm}14.02$였고, 우울증 집단은 각각 $30.12{\pm}10.04$, $75.70{\pm}23.53$이였다. 두 점수 모두 우울증 집단에서 통계적으로 유의미하게 낮은 점수를 보였다(p<0.0l). SASS의 각 문항별 접수는 문항5, 문항 15, 문항 16, 문항 19를 제외하고 모든 항목에서 정상인 집단이 통계적으로 의미 있게 높은 점수를 나타냈다(p<0.0l). 3) 정상인 집단에서 SASS와 PIL간의 상관관계는 r=0.510으로서 통계적으로 의미 있는 상관관계를 나타냈다(p<0.0l). 우울증 집단의 경우 유병기간의 평균은 $52.17{\pm}83.86$개월로서 SASS, PIL, Beck's Depression Inventry(BDI) 및 우울증 이병기간과의 상관관계에서 SASS와 PIL는 정상인 집단과 마찬가지로 정적인(positive) 상관관계를 나타냈으나(r=.671), SASS와 BDI(r= -.609), PIL과 BDI(r= - .621) 척도간의 상관은 모두 통계적으로 의미 있는 부적인(negative) 상관을 나타내었다(p<0.01). 그러나 우울증의 이병기간과 SASS, PIL, BDI 척도간의 상관은 통계적으로 유의미한 상관을 나타내지 않았다(p>0.05). 4) SASS의 요인분석결과 정상인 집단의 경우 요인 1은 '사회활동'을 나타냈고, 요인 2는 '대인관계에 대한 적극성', 요인 3은 '자신감'을 나타냈다. 요인 4는 '외모의 중요성', 요인 5는 사회적응의 방법으로서 지적인 탐구'를 나타냈으며, 요인 6은 '사회활동에 대한 참여욕구'를 나타냈다. 우울증 집단에서는 요인 1에 SASS의 거의 모든 문항들이 해당되어 요인 1에 의한 단일 구조를 시사하였다. 요인 2는 '취미나 레저활동 욕구'가 관계되었다. 요인 3은 '가족 지향성', 요인 4, 5, 6은 '직업에 대한 흥미', '대인관계 추구', '의사소통 욕구'를 포함하고 있어 우울증 환자들이 사회적응상 가장 핵심적 문제들과 관계를 나타내었다. 결론 : 이상의 결과들로 보아 한국어판 SASS는 우울증의 사회적응성을 평가하기 위해 신뢰할 수 있고 타당한 척도라고 사료된다. This study was designed to testify the reliability and validation on the Korean version of the Social Adaptation Self-rating Scale(SASS) which was developed from Bose et al. for the evaluation of social motivation and behavior of depressed patients in 1997. Interests for the social world, those of social functioning, of patients were involved in the addition of new measure of disturbance. And those were distinct from abnormalities of thought, mood and symptoms of patients with major depression. As the previous reports there were several evidences that treatments may be less likely to be effective if the system they act on is dysfunctional. Thus, a better social situation favoured better outcome. As a matter of fact, however, those reports were developed in the course of the evaluation of interpersonal therapy(IPT) and cognitive therapy. Accordingly the conversed question -whether pharmacological therapy with antidepressants can impact on social functioning in addition to addressing the core features of illness- has been addressed. To date, anyhow, it is accepted that enhancement of social functioning may be a therapeutic principle in its own right and illness rarely divorced from social context. In terms of those concepts the introduction of an assessment of social functioning into pharmacotherapeutic studies of depression has been welcomed and might be a potent instrument for evaluating the relative pharmacoeconomic benefits of different treatments. Despite of many scales which were applied for the evaluation of symptoms in the patients with depression, however, the scale for the evaluation of social functiong has not been introduced in Korea yet. Thus, this study was designed to introduce the concepts of social functioning in the patients with depression and to testify the reliability and validation on Korean version of SASS. This Korean version of SASS was submitted to a reliability and validation procedure based on the data from healthy general population survey in 291 individuals and 40 patients with major depression. Cronbach a was 0.790 in total subjects group and the correlation of test-retest was statistically significant(y=0.653, p<0.0l). Thus, the Korean version of SASS might be shown to be valid and reliable. The results of multivariate analyses allowed the identification of 3 principle factors(factor 1 = intersts in social activities, factor 2 = active interpersonal relationship, factor 3 = selfesteem) in normal group, however, it could be counted as only one factor in the depression group because nearly total items of SASS were involved in factor 1. In the view of these results, the Korean version of SASS may be useful additional tool for the evaluation of social functioning in depression.

이온보조반응법으로 처리한 알루미나 코아의 인장결합강도에 관한 연구

김형섭,우이형,권긍록,최부병,최원국,Kim, Hyeong-Seob,Woo, Yi-Hyung,Kwon, Kung-Rock,Choi, Boo-Byung,Choi, Won-Kook 대한치과보철학회 2000 대한치과보철학회지 Vol.38 No.5

This study was undertaken to evaluate the tensile bond strength of In-Ceram alumina core treat-ed by ion assisted reaction(IAR). Ion assisted reaction is a prospective surface modification technique without damage by a keV low energy ion beam irradiation in reactive gas environments or reactive ion itself. 120 In-Ceram specimens were fabricated according to manufacturer's directions and divided into six groups by surface treatment methods of In-Ceram alumina core. SD group(control group): sandblasting SL group: sandblasting + silane treatment SC group: sandblasting + Siloc treatment IAR I group: sandblasting + Ion assisted reaction with argon ion and oxygen gas IAR II group: sandblasting + Ion assisted reaction with oxygen ion and oxygen gas IAR III group: sandblasting + Ion assisted reaction with oxygen ion only For measuring of tensile bond strength, pairs of specimens within a group were bonded with Panavia 21 resin cement using special device secured that the film thickness was $80{\mu}m$. The results of tensile strength were statistically analyzed with the SPSS release version 8.0 programs. Physical change like surface roughness of In-Ceram alumina core treated by ion assistad reaction was evaluated by Contact Angle Measurement, Scanning Electron Microscopy, Atomic Force Microscopy; chemical surface change was evaluated by X-ray Photoelectron Spectroscopy. The results as follows: 1. In tensile bond strength, there were no statistically significant differences with SC group, IAR groups and SL group except control group(P<0.05). 2. Contact angle measurement showed that wettability of In-Ceram alumina core was enhanced after IAR treatment. 3. SEM and AFM showed that surface roughness of In-Ceram alumina core was not changed after IAR treatment. 4. XPS showed that IAR treatment of In-Ceram alumina core was enabled to create a new functional layer. A keV IAR treatment of In-Ceram alumina core could enhanced tensile bond strength with resin cement. In the future, this ion assisted reaction may be used effectively in various dental materials as well as in In-Ceram to promote the bond strength to natural tooth structure.

우울증 치료에 있어서 약물의 Combination과 Augmentation 전략

김형섭,Kim, Hyeong-Seob 대한생물정신의학회 2000 생물정신의학 Vol.7 No.2

Even the pharmacotherapy is more effective than placebo for the treatment of depression, the outcome of pharmacoltherapy remains unsatisfactory for many patients. Apart from side effects, there are two major limitations of antidepressant therapy. One is the delayed onset of improvement and another is partial response. In order to address these clinical dilemmas, many psychiatrists more commonly employ add-on therapy. In past, the practice of using multiple drugs to enhance treatment response was called polypharamcy, and was disparaged as poor clinical practice. However, with improved understanding of how drugs affects the central nervous system and increased communication in journals and on computer networks about the relative merits of specific combinations, the scientific basis for the combining drugs is being defined. Indeed, the use of multiple medications as a stratege to enhance response has become both acceptable and widespread now a days. It is now referred to more positively as add-on therapy, co-medication, combination therapy, or drug augmentation. Thus, as the methods of practical strategies for treatment of depression, switching classes antidepressant drugs, combination therapy, augmentation strategies and brief treatment algorithm will be presented with items of considerations. However, when combination of drugs being tried, knowledges about the action of mechanism, pharamcokinetics, and pharmacodynamics are essential to cope with the possible adversive reactions and to get the appropriate responses for the treatment of depressive symptoms.

연마방법에 따른 복합레진의 활택도에 관한 연군 -Atomic Force Microscope를 이용한 연구

김형섭,우이형,Kim, Hyeong-Seob,Woo, Yi-Hyung 대한치과보철학회 1997 대한치과보철학회지 Vol.35 No.4

This study was undertaken to compare by Atomic Force Microscope the effects of various finishing and polishing instruments on surface roughness of filling and veneering composite resins. Seven composite resins were studied : Silux Plus (3M Dental Products, U.S.A.), Charisma (Heraeus Kulzer, Germany), Prisma THP (L.D.Caulk, Dentsply, U.S.A.), Photoclearfil (Kuraray, Japan), Cesead (Kuraray, Japan), Thermoresin LC (GC, Japan), Artglass (Heraeus Kulzer, Germany). Samples were placed and polymerized in holes (2mm thick and 8.5mm in diameter) machined in Teflon mold under glass plate, ensuring excess of material and moulded to shape with polyester matrix strip. Except control group (Polyester matrix strip), all experimental groups were finished and polishied under manufacturer's instructions. The finishing and polishing procedure were : carbide bur (E.T carbide set 4159, Komet, Germany), diamond bur (composite resin polishing bur set, GC, Japan), aluminum-oxide disc (Sof-Lex Pop-On, 3M Dental Products, U.S.A.), diamond-particle disc (Dia-Finish, Renfert Germany), white stone bur & rubber point( composite finishing kit, EDENTA, Swiss), respectively. Each specimens were evaluated for the surface roughness with Atomic Force Microscope (AutoProbe CP, Park Scientific Instruments, U.S.A.) under contact mode and constant height mode. The results as follows : 1. Except Thermoresin LC, all experimental composite resin groups showed more rougher than control group after finishing and polishing(p<0.1). 2. A surface as smooth as control group was obtained by $Al_{2}O_{3}$ disc all filling composite resin groups except Charisma and all veneering composite resin groups except Thermoresin LC(p<0.05). 3. In case of Thermoresin LC, there were no statistically significant differences before and after finishing and polishing(p>0.1). 4. Carbide bur, diamond bur showed rough surfaces in all composite resin groups, so these were inappropriate for the final polishing instruments.

아두이노 기반 사물인터넷을 이용하여 압력센서와 진동모터를 사용한 비닐 하우스 폭설 경고 시스템

김형섭(Hyeong-Seob Kim),이수홍(Su-Hong Lee),홍선기(Sun-Ki Hong) 대한전기학회 2016 대한전기학회 학술대회 논문집 Vol.2016 No.7

CAD/CAM 시스템을 이용한 Custom abutment의 제작

김형섭(Kim Hyeong-Seob) 대한치과의사협회 2012 대한치과의사협회지 Vol.50 No.3

CAD/CAM systems (computer-aided design / computer-aided manufacturing) used for decades in restorative dentistry have its application to implant dentistry. This study aimed to overview CAD/CAM systems used implant dentistry, especially emphasizing custom implant abutments manufacturing. CAD/CAM custom abutments present the advantages of being specific to each patient and providing a better fit than the stock and cast custom abutments. This cutting edge technology of virtual-designed and computer-milled implant abutments will likely replace traditional implant restorative protocols and become the standard for implant dentistry in the foreseeable future.

치과용 임플란트 시스템의 기계적 가공오차에 관한 연구

김형섭(Hyeong-Seob Kim),권긍록(Kung-Rock Kwon),한중석(Jung-Suk Han) 대한턱관절교합학회 2008 구강회복응용과학지 Vol.24 No.1