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.

고속프레스의 동특성 해석

국정근,조병관 한국기술교육대학교 2003 論文集 Vol.10 No.1

According to the development of semi-conductor industry, the manufacturers ask high speed press with high resolution. But high speed operation accompanies mechanical vibrations. Therefore optimized kinematic structure to minimize vibration is required for a high speed press. And the growing competition in the industry asks the cost cutting and high pressing force. A motor used in a press makes pressing force and determine manufacturing cost. This paper desires to perform dynamic analysis for a high speed press so that motor specification and kinematic structure may be downsized and that cost and vibration may be reduced. For this purpose a high speed press was modeled with 3D CAD solid modeling system and using this CAD model dynamic analyses were performed with CAE S/W for multibody dynamic analysis. Through these analyses a motor appropriate to a high speed press was selected and link structure for feeding system of the press was modified to reduce vibration.

우리나라의 연과다 흡수 근로자들의 NAG 및 일부 신기능 지표

이병국,안규동,이성수 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

To clarify the effect of occupational lead exposure on renal function 354 lead workers working in 5 lead acid battery industries and 2 secondary smelting industries, and 144 control workers were studied for this study. Study variables for renal effect were urinary N-acetyl-B-D-glucosaminidase(NAG), urinary total protein (U-TP), blood urea nitrogen(BUN), serum creatinine (S-Cr), and serum uric acid (S-Ua). On th other hand, blood lead (PbB), zinc protoporphyrin in whole blood(ZPP). delta-aminoevulinic acid in urine (DALA), hemoglobin(Hb) and hematocrit(Hct) were selected for the variables of lead exposure. Information on age of lead workers was also obtained. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. The cross-sectional observation of total workers revealed that the means of NAG and U-TP were significantly increased by the increase of PbB and the means of NAG, U-TP and BUN were significantly increased by the increase of ZPP and the means of NAG and U-TP were significantly increased by DALA. The frequency of workers whose value of renal function indicators were over the normal criteria (BUN>20mg/dl; S-Cr1.2mg/dl; S-Ua>7.0mg/dl; NAG>7.0U/liter; U-TP>7.0mg/dl) by the level of PbB, ZPP and DALA were calculated. While the frequencies of over the normal criteria of NAG and U-TP by the levels of PbB and DALA showed dose-reponse relationship in total workers, respectively, those of NAG, U-TP, BUN and S-Cr by the level of ZPP showed dose-response relationship. When age is adjusted, NAG in high lead exposed workers (blood lead above 60 un/dl or blood ZPP above 150ug/dl or urine ALA above 10mg/l) and U-TP in high lead exposed workers(blood ZPP above 150ug/dl) were significantly higher than that of low lead exposed workers, respectively, but S-Cr in medium lead exposed workers (blood ZPP 100 - 150 ug/dl) was significantly lower than that of low lead exposed workers (blood ZPP below 100ug/dl). On stepwise multiple regression using renal function indicators as a dependent variable and PbB and age as independent variables, NAG, U-TP, S-Ua were contributed by PbB. With above results, NAG and U-TP were found to be reliable indicators who showed dose-response relationship with lead exposure and measurements of NAG and U-TP for lead workers whose relatively high expore is highly recommended.

결핵성 경부임파선염에 대한 임상적 고찰

김병국,이범식 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Although the incidence of tuberculosis has decreased recently, tuberculous cervical lymphadenitis is one of the common cause of neck mass in Korea. We performed a retrospective review for 61 cases with tuberculous cervical lymphadenitis, which were confirmed histopathologically in Department of Otolaryngology, ChungnamNational University Hospital between Jan. 1992 and Oct. 1995. The results were as follows : 1) Most cases were in the age group of 20-29 years old and the sex ratio of male to female was 1 : 1.08 2) The physical findings were painless lymphadenopathy in 35 cases (57.3%), hard nodes in 45 cases (73.8%) and mobile node in 45 cases (73.7%). 3) There were multiple lymphadenopathy in 43 cases (70.5%) and was solitary one in 18 cases (29.5%). Among 43 cases with multiple lymphadenopathy, 7 cases (11.5%) were bilateral. 4) The location of lymphadenopathy was posterior neck triangle in 37 cases (60.7%), anterior neck triangle in 13 cases (21.3%) and both triangle in 11 cases (18%). 5) The size of mass was smaller than 3cm in 38 cases (62.2%) and bigger than 3cm in 23 cases (37.8%). 6) The time interval from the onset of symptom to first visit was less than 5 months in 48 cases (78.7%), 6 months to 12 months in 8 cases (13.1%), over than 12 months in 5 cases (8.2%). 7) Associated pulmonary tuberculosis was seen in 19 cases (31.1%). 8) The excision and antituberculous medication were performed in 49 cases (80.3%) Incision and antituberculous medication were performed in 12 cases (19.7%). 9) The duration of antituberculous medication was 6 months in 7 cases (11.5%), 6 months to 12 9) The duration of antituberculous medication was 6 months in 7 cases (11.5%), 6 months to 12 months in 29 cases (47.5%), 18 months in 1 case (1.6%). 10) There was no palpable neck mass in 26 cases (53.1%), decreased mass in 17 cases (34.7%) stationary mass in 5 cases (10.2%), and increased mass in 1 case (2.0%) after or during the treatment.

경부심부감염에 대한 임상적 고찰

김병국,임동우 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

Deep neek infections, which affect fascial compartment of the head and neck and their contents, and its complications have remarkably decreased after the development of antibiotic therapy. But they may still result in significant morbidity and mortality in spite of using antibiotics. A retrospective study was performed on 40 patients with deep neck infections admitted for diagnosis and treatment at Chung-Nam National University Hospital, during 5-year period from January, 1991 to December, 1995. The results were as follows; 1. The site of infections were submandibular space in 15 cases(38%), parapharyngeal space in 12 cases(30%), retropharyngeal space in 3 cases(8%), parotid space in 3 cases(8%), sublingula space in 1 case(2%), pretracheal space in 1 case(2%) and mixed spaces in 5 cases(12%). 2. The possible etiologic events were URI in 14 cases(35%), odontogenic infections in 8 cases(20%), tonsillitis in 5 cases(13%), trauma in 4 cases(10%) and unknown origin in 3 cases(8%). 3. The main symptom was external swelling in 25 cases(63%). 4. The main isolated pathogenic organism were streptococcus and klepsiella species. 5. Complications were airway obstruction in 4 cases(10%), sepsis in 1 case(3%), mediastinitis in 1 case(3%), glomerulonephritis in 1 case(3%) and fistula of mouth floor in 1 case(3%).

Oualbain과 Verapamil이 심근칼슘저장고에 미치는 영향

김병국,엄대용,이상돈 중앙대학교 의과대학 의과학연구소 1981 中央醫大誌 Vol.6 No.1

The control isometric contraction of rabbit papillary muscle preparations were recorded by the stimulation 'frequency of 1 Hz. and priming stimulation were applied to activate the intracellular calcium by the stimulation frequency of 5 Hz. for 5 seconds. After the resting period, the amplitudes of contraction, were compared with that of control and the ratios were plotted with respect to time in a semi-log paper. The experiments were performed in a control Tyrode solution, high calcium solution, ouabain solution and verapamil solution. The following results were obtained; 1. la a normal Tyrode solution, the fast compartment which is responsible for the fast decay of intracellular calcium within 3-5 seconds after the priming stimuli and the slow compartment, slowly decayed one after 5 seconds, could be identified. 2. Although the fast components showed no significant differences between those in a normal Tyrode solution and in a high calcium (4mM) solution, the slow components showed a rather increasing tendency during the normal initial decay period up to 20 seconds and later on a decreasing tendency. 3. In a ouabain, 2.4 -4.8×10^-7M, treated preparation the amplitude of contraction during the control period was increased up to 1.5 times compared with that in a normal Tyrode solution and the characteristics of calcium pools were qualitatively similar to those in high calcium solution. 4. In a verapamil, 1.1×10^-6M, containing solution the amplitude of control contraction were reduced to two thirds compared with that in normal Tyrode solution and the fast component were markedly influenced, reversed its slope to increase slowly up to 20 seconds and then decayed. 5. The characteristics of intracellular calcium pools la a preparation of verapamil and high calcium conditions at the same time showed rather similar patterns with those in verapamil alone treated preparation. The above results showed that the intracelluar calcium pools were composed of two components which were fast and slow decaying ones, and that ouabain and verapamil would alter the characteristics of the calcium pools to increase and decrease the intracellular calcium respectively.

Lactobacillus Casei Bacteriophage의 pH에 대한 안정성

姜國熙,朴基文,尹快炳 成均館大學校 1982 論文集 Vol.31 No.-

Survivability of the phages active on the Lactobacillus casei YIT 9018 was studied in skimmiik at various pH. The phages of J1, φ1, TK93, PD2, and PD5 was used for this experiment. Decreases in phage titer in skimmilk at pH 4.0 were observed for 48 hrs. Viability of the phages was not changed for 7 days through the pH range of 8.0 to 5.0. At pH9.0, the titer reduction of phage TK93 was remarkably.

Avalanche Electron Trapping에 의한 SiO_(2) Layer 및 Si-SiO_(2) Interface 연구

한병국 慶山大學校 1997 論文集 Vol.15 No.1

Determination of the nature and distribution of oxide charge and interface state in MOS capacitors is important to an understanding of oxide charging phenomena. The oxide trap and interface state are studied by injecting carriers into the oxide layer from gate or silicon electrode and by generating carriers by means of ionizing radiation. Generally, the combination of avalanche injection for studding charging the oxide traps and the photo I-V method for determining the trap distribution in the oxide is the most effective way to study bulk oxide traps. In this paper by using the electron avalanche injection, C-V, and photo I-V method, charge trapping phenomenon within the oxide was investigated and then anomalous positive charge buildup from the interface state generation was observed.

성별 및 수준별 10학년 학생들의 과학 성취도 분석

이병국,강용희,유계화 慶北大學校 科學敎育硏究所 2004 科學敎育硏究誌 Vol.28 No.-

The purpose of this study is to examine the differences of science achievement by gender and by level of academic achievement. The subjects are consisted of 211 male and 212 female 10th graders in Daegu Metropolitan City and are also divided into three groups: low-, average-, and high-academic achievement level. All kinds of examinations which the subjects had taken during 2003 academic year were analyzed (e.g., the regular, trial, entrance diagnostic evaluation and formative examinations). The results indicate that statistically significant differences exist on the scores between male and female students. In general, the scores of female students (both low- and average-academic achievement level) are higher than male students. However, the scores for male students who had high level of academic achievement are higher than those of female students who had high level of academic achievement. Specifically, the scores of the regular examinations for female students are higher than those of male student. However, female students have no higher scores in the trial examinations than male students compared to the other examinations. This corresponds to Kimball(1989)'s hypothesis that female students are poor at the external examinations. In addition, the variation of scores is very steep in the entrance diagnostic evaluation and formative tests compared to regular and trial examinations. It seems that the achievement on tests does not determined by gender, however, the students' state of seriousness related to the tests. Additional analysis reveals that male students have made weaker achievement on scores of biology in the regular and trial examinations. Female students who had high-academic achievement level have made higher scores on the regular examination. In general, it seems that males had been more affirmative than females in the attitude related scientific subjects. However, there is no significant correlation between scientific attitude and science achievement. Based on the results of this study, there are no gender differences in the attitude for learning science. It appears that students who had high-academic achievement level are tended to have more positive attitude toward studying science.

DMSA를 이용한 연작업자들의 착화유발실험

김병기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1996 순천향산업의학 Vol.2 No.1

To validate a provocative chelation test with 2,3-dimercaptosuccinic acid (DMSA) and to find out the practical urine collection time of chelation for industrial setting, 14 lead workers in secondary smelting industry and 5 office workers were selected for this study. A single oral dose of 10 mg/kg DMSA were given to all subjects and urine was collected over the next 24 hours, urine volume and urinary lead concentration determined at 0, 2, 4, 6, 8, 10, 12, 24 hours. Before oral administration of DMSA, blood lead, blood ZPP, urine delta-aminolevulinic acid (ALA) and hemoglobin of all subjects were also checked The results obtained as follows: 1. The mean blood lead of lead exposed workers was 49.7 ± 13.7 ㎍/100ml and that of non-lead exposed workers was 5.7 ± 1.3 ㎍/100ml. The mean value of blood ZPP and urine ALA was significantly higher than control, but there was no difference of mean value in hemoglobin between lead exposed and non-exposed workers. 2. While mean urinary lead excretion before DMSA administration were 70 ± 32 ㎍/liter and 179 ± 72 ㎍/liter, it was increased 9.4 times with 659 ± 306 ㎍/liter in non-lead exposed workers, but it was increased 31.4 times with 5922 ± 2653 ㎍/liter. 3. To find out short time schedule for provocative chelation, correlation between 24 hours cumulative urine lead and other cumulative urine lead of short time such as 2, 4, 6, 8, 10, 12 hours revealed that correlation between 24 hours' urine lead and 4 hours' or 6 hours' urine lead was very high (r=0.930, r=0.981). It was concluded that 4 or 6 hours urine collection was quite enough for provocative chelation with DMSA.