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.

청하-영덕지역 양산단층의 운동사 및 관련단열 발달상태

채병곤,장태우 경북대학교 기초과학연구소 1994 慶北大學敎 基礎科學硏究所 硏究論文集 Vol.15 No.-

만성 B형 간염 환자에서 자발성 급성 악화의 원인 및 임상 경과

채명종,김병호,정경환,김남훈,동석호,김효종,장영운,이정일,장린 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.2

목적: 저자 등은 만성 B형 간염 경과 중 급성 악화가 심하게 발생한 환자에서 그 원인을 조사하고, 자발적 악화시 HBeAg 혈청전환 및 임상 경과에 대하여 알아보고자 하였다. 대상과 방법: 1992년 1월부터 2001년 12월까지 만성 B형 간염의 급성 악화로 입원하였던 환자를 대상으로 하였다. 중증 급성 악화의 정의는 AST/ALT가 정상 상한치의 10배 이상 증가한 경우로 하였다. 후향적으로 의무기록을 조사하여 성별, 연령, 원인, 간기능검사, 혈청학적 검사 및 생존 등에 대하여 성별 및 연령이 유사한 대조 환자군과 비교 분석하였다. 결과: 중증 급성 악화 환자는 남자 29명, 여자 15명 등 44명으로 평균 38.6±0.1세였다. 급성 악화 원인으로는 자발적 악화가 34예(77%), 약물 복용 7예(16%), 음주 2예(5%), HCV 중복감염 1예(2%)였다. 혈액검사에서 총 빌리루빈은 8.3±8.3 ㎎/dL, 알부민 3.6±0.7 g/dL, ALT 924±597 IU/L, 프로트롬빈 시간 1.58±1.29 (INR), α PF 108±163 ng/mL이었다. 자발적 급성 악화 34예 중 HBeAg 양성인 경우는 27예(79%)였으며, 추적 기간(579±459일) 동안 51.9%에서 HBeAg 혈청전환이 일어났으나, 3개월째 혈청전환율은 15%에 불과하였으며, 12개월 및 24개월째는 각각 18.5%, 48.1%였다. 한편 ALT가 199 IU/L 이하인 대조 환자의 경우는 같은 기간의 혈청전환율이 각각 4.3%, 10.9%로 낮았으며, 기저 ALT치에 따른 누적 혈청전환율도 200 IU/L을 중심으로 유의한 차이가 있었다(P<0.05). 간경변으로의 진행은 대조 환자군에 비하여 높은 경향을 보였으며(17.6% vs. 5.5%, P<0.08), 사망한 경우는 급성 악화군에서만 1예(2%) 있었다. 결론: 만성 B형 간염 환자 중 중증의 급성 악화는 자발적 악화가 가장 흔하였으며, 약 반수에서 2년내 HBeAg 혈청전환되었고 18% 정도에서 간경변으로 진행되었다. 그러나 3개월 이내의 조기 혈청전환은 15%로 낮았으며, 전반적인 혈청전환율도 외국의 보고에 비하여 다소 낮았다. Background/Aims: Acute exacerbation (AE) of chronic hepatitis B (CHB) can occur spontaneously, and may be followed by HBeAg clearance. HBeAg seroconversion often coincides with the normalization of liver biochemical tests and clinical remission. The purpose of this study was to identify the etiology and the clinical consequence of severe AE in Korean patients with CHB. Methods: The medical records of CHB patients with severe AE (defined by the sudden increase of ALT above 400 IU/L) who were admitted to Kyung Hee University Hospital between January 1992 and December 2001, were reviewed retrospectively. Forty-four patients were included in the severe AE group. Results: The most common etiology of severe AE was spontaneous exacerbation (77%). Drugs (16%), alcohol (5%), and HCV coinfection (2%) were suspected of causing AE in the remaining patients. HBeAg seroconversion at 12, 18, and 24 months following severe spontaneous AE was 18.5%, 40.7%, and 48.1%, respectively. These were significantly higher compared to CHB patients without AE (4.3%, 4.3%, and 10.9%, respectively). Seroconversion within 3 months, however, occurred in only 15% of CHB patients with AE. There was a tendency to progress to liver cirrhosis more frequently in the patients with AE as compared to the patients without AE (17.6% vs. 5.5%, P<0.08). Conclusions: Severe AE in patients with CHB is mainly caused by spontaneous exacerbation. Although HBeAg seroconversion occurs frequently in these patients, the rates are relatively low compared to those reported in other countries and early seroconversion is expected only in a small proportion. Further studies will be warranted to determine the efficacy of the early use of antiviral agents at the time of AE.(Korean J Hepatol 2004;10:99-107)

LC-MS/MS를 이용한 S.D. Rat 혈장 중 Arctiin 분석법 개발

송병정,채정우,백현문,권광일 충남대학교 약학대학 의약품개발연구소 2014 藥學論文集 Vol.29 No.-

KIOM-MA128 is a novel oriental herbal medicine which is for atopic dermatitis and asthma. The purpose of this study was to develop on analytical method of arctiin in rat plasma after oral administration of KIOM-MA128. Analyte was separated on a Atlantis dC18 reverse phase column, using gradient mobile phase (A:B = acetonitrile: 0.1% formic acid in water) at a flow rate of 0.3 mL/min. Detection was performed by electrospray positive ionization mass spectrometry using multiple reaction monitoring of the transitions of arctiin at m/z 552.4 → 372.8 and internal standard (carbamazepine) at m/z 237.0 → 194.5. The limit of quantification was 1 ng/mL for arctiin. The precisions were lower than 15% and the accuracy was between – 12.21 and 3.2%. The maximum concentration found in plasma samples was 4.1 ng/mL. The present method was successfully developed for detecting arctiin in plasma and this results would be utilized to the further study.

측정오차와 외란을 고려한 유도전동기의 강인한 속도제어에 관한 연구

蔡英茂,尹炳道,金燦起,鄭憲主 충주대 산업과학기술연구소 1995 産業科學論文集 Vol.3 No.-

It is difficult to control industrial drive systems because of load disturbance, parameter variation and measurement noise. So a theorem is required to have robustness for the measurement noise and disturbance. This paper is among the researches of solving these problems. Sliding mode state observer is robust for measurement noise, modeling-error and load disturbance. The pole of sliding mode state observer can be placed at (0,0) in Z-plane for fast response. This method is, namely, deadbeat control. One side, sliding mode state observer output is discontinuous on a switching hyperplance, that causes harmful effects such as current harmonics and speed oscillation. In this paper, also the reducing method of the chattering of sliding mode state observer output is proposed. In this paper, the method of designing a robust sliding mode state observer taking account of the ability of disturbance and noise attenuation is proposed. Also, the proposed control system is digitally implemented with TMS320C31.

Clozapine이 혈당대사에 미치는 영향

채병진,강병조 대한생물치료정신의학회 2000 생물치료정신의학 Vol.6 No.1

This study was performed to determine if there is an increased risk of diabetes mellitus and/or impaired glucose tolerance and/or glycemic peak delay during clozapine treatment compared with haloperidol treatment. Oral glucose tolerance tests were used for 8 weeks to assess the prevalence of diabetes mellitus, impaired glucose tolerance and glycemic peak delay in 19 patients of the clozapine group compared with 15 patients of the haloperidol group. There were 2 dropouts in the clozapine group and 5 in the haloperidol group. So finally 17 patients in the clozapine group and 10 patients in the haloperidol group participated in this study. In the clozapine group, 6 patients(35%) had impaired glucose tolerance, and 7 patients(41%) had glycemic peak delay. In the haloperidol group, no patient(0%,) had impaired glucose tolerance, and 1 patient(10%) had glycemic peak delay. None of either group developed diabetes mellitus. In conclusion, subjects in the clozapine group had more impaired glucose tolerance and glycemic peak delay than subjects in the haloperidol group. However, this difference did not achieve statistical significance (p=0.056, p=0.079).

大邱地域住民의 生活體育 實態分析 : 早起運動參與度를 中心으로 Focusing on participation degree of populations exercising in the morning

蔡鴻遠,金柄斗,李敏炯,金基學,朴宇奎 慶北大學校 體育科學硏究所 1991 체육과학연구지 Vol.7 No.-

The purpose of this study is to get the source materials to activate mass sports of regional populations. At first, it was by sex, age, and occupations examined and analysed populations that would participate in physical activities from 5 to 8 Am at 28 pate-up mountains and 477 workplaces, schools, public facilities, and commercial facilities sontrolled by 7 district offices in Daegu. The mothod of investigation made a preliminary inquiry in advance and set in place 70 investigators in entrance of path-up mountains and sports facilities. Especially, the occupational classification was adopted from socilolgical job calssification model and every result value of analysis was dealed and compared with percentage by means of Daewoo Corona 286 PC. Accordiangly, the concrete conclusions are summarized as follows : 1) The total number of persons participating in mass sports in the morning is 18,045(men 10,850 : 59%, women 7,465 : 41%), and it is about 1% level by the rate of population and low participation rate in comparison with advanced nations. ① It is showed that the participation value in proportion to sex is 17.4% more in men's case taking 10,587 persons(58.7%) than 7,458 persons(41.3%) in women's case. ② Taking the dimensions of participation degree in proportion to age, it is taken the most value in fifties age with 5,092 persons (28%), showing in sixties, forties, thirties, twenties age in sequence. ③ Taking the dimensions of participation degree in proportion to occupation, it is taken the most value in housewife with 5,569 persons (31%), showing the unemployed, independent enterprise, technical expert, clerical work, deministrative position, student, technical work, manual labor, agriculture and forestry, and fishery in sequence. 2) Judging from the participation degree in proportion to district office, it is taken the most value in Mam-gu with 3,821 persons(21.2%) and Dalseo-gu with 3,776 persons(20.9%) and the least in Joong-gu with 1,612 persons(8.9) and Seo-gu with 1,589 persons(8.8%). It is assumed that low participation value in Joong-gu and Seo-gu should result from deficient facilities and close space of urban.

彈性抵抗 Tubex 運動이 腕回轉 파워에 미치는 效果

蔡鴻遠,金柄斗,李敏炯,林銖遠 慶北大學校 體育科學硏究所 1990 체육과학연구지 Vol.6 No.-

The purpose of this study is to analyze the effect of elastic recoil tubex exercise for development of shoulder rotation power, 9 male players were selected out of the volleyball players in kpu. The experiment was focused on full swing, half swing, chest full and pull down with tube(1 Tubex tension-1½ Tubex tension). The exercise duration was 8 weeks, and it's frequency was 4-5 times or 5-6 times a week, and they got tests twice : one at the begining of the experiment, and the other 8 weeks later. The test was measured at 60°/sec, 180°/sec and 240°/sec using cybex 340 system, the result of which are as follows : ① Peak torque The wrist showed significant (P<.01, P<.05) increases in the extension at 60°/sec, 180°/sec and 240°/sec, and only the flexion at 240°/sec (P<.05). In the elbow, only extension, was significant (P<.05) increase at 240°/sec. Also in the shoulder, only extension was significant (P<.01, P<.05) increase at 60°/sec, 180°/sec and 240°/sec. But in te shoulder, the adducation and abduction appears nonsignificant. ② Muscle endurance ratio The result of the test upon both the flexion and the extension in the wrist were statistically significant (P<.01) at 240°/sec. ③ Flexion / extension ratio The ratio of Flexion and extension apperar nonsignificant decrease after experiment. but there was only significant (P<.05) decrease in wrist at 180°/sec.

가족성 고콜레스테롤혈증 유병자에서 HMG Co-A Reductasen Inhibitor 및 Bile Acid Resin의 투여로 인한 아킬레스건 황색종의 감소

채인호,한기훈,박영배,조주희,김효수,손대원,김철호,오병희,이명묵,최윤식,서정돈,이영우 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

인지질 베지클의 입자 크기 및 형태(morphology) 변화에 대한 지방산의 영향 고찰

채병근,임경희 한국공업화학회 2002 응용화학 Vol.6 No.2

In spite of the usefulness of phospholipid vesicle, there are limitations of its appication to drug delivery system due to its low stability. Fatty acids are widely distributed in an living organisms as a constituent of various complex lipids. There is the effect of size reduction by addition of fatty acids to vesicle as other nonionic amphiphiles, its degree is varied with the mole fraction and the acyl chain length of fatty acid. The effective size of headgroup is reduced because of hydrogen-bonding interaction between phospholipid and fatty acid, and vesicle will be smaller hydration shell, this leads to size reduction. Fully protonated fatty acids are only very weakly hydrophilic and thus it offers dilution tolerance to vesicle. In proportion to reducing of chain length of fatty acid, the morphology of vesicle shifts highly to the low dimension microstructure(i.e vesicle to bilayer and/or cylindrical structure). In the present work, I studied the potential of phospholipid/fatty acid mixture for transdermal drug delivery system.