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.

복강경하 질식 자궁적출술 30예의 임상적 고찰 : A Review of 30 Cases

윤병일,김소정,정두용,김수녕,손인숙,이지영 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Hysterectomy is the most common gynecologic operation. Traditionally, hysterectomy was performed either through an abdominal approach or through a vaginal approach. Recently, laparoscopic hysterectomy is quite often tried. To evaluate the effectiveness and value of LA VH(Laparoscopy Assisted Vaginal Hysterectomy), and to evaluate the possibility whether to rep;ace abdominal hysterectomy to LAVH, we analyzed our clinical cases. This clinical study is a retrospective review of 30 cases of LAVH from May 2002 to February 2003 at the department of Obstetrics and Gynecology, Chung- Ju hospital, Konkuk University. We evaluated age, parity, previous abdominal operations, indications of hysterectomy, combined operation, operating time, hemoglobin change, weight of uterus, hospital stay and postoperativeThe average operating time was 146 ± 42 minutes, the uterine weight was 239 ± 126 grams, and the mean postoperative hemoglobin loss was 1.7 ± 1.4 g/dl. The most common pathologic finding was myoma uteri(37%), and the second most pathologic finding was adenomyosis(20%) and myoma uteri with adenomyosis (20%). Serious complications were not appeared. LAVH provides a shorter hospital stay, quicker recovery, and the acceptable complication rate except incerased operating time than abdominal hysterectomy. This study suggests that LAVH appears more useful than TAH(Total Abdominal Hysterectomy) and could replace abdominal hysterectomy.

Narrow Band UVB로 치료한 진행성 반상 저색소증 1예

김병대,정예리,이근수,한승경 대한피부과학회 2003 대한피부과학회지 Vol.41 No.12

Progressive macular hypomelanosis is an idiopathic acquired hypopigmentary disorder first descri-bad in 1988. The disorder is characterized by ill-defined, non-scaly, round to oval, hypopigmented patches symmetrically localized on the trunk. No clinical symptoms have been observed. Currently, diagnosis is made on clinical grounds and any histological, laboratory investigations are not diagenositc. This disorder does not respond to conventional treatment and its clinical course is variable. We experienced a case of progressive macular hypomelanosis that was successfully treated with narrow band UVB phototherapy. (Korean J Dermatol 2003;41(12):1664~1666)

안구적출에 따른 위둔덕의 칼슘결합단백질의 재구축 및 상호 연관성

안병수,고길석,안명수,김경주,권안성,정명섭,박춘매,조병옥,김진우,Samudra Acharya,Parmeshwar Narayan Amatya,장인엽 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Background: Superior colliculus is a part of midbrain, and participates in the visual reflexes, It receives afferent fibers from optic nerve, visual cortex, and spinotectal tract. After optic deprivation, the microscopic structure of the superior colliculus changed. Calcium-binding proteins (CBPs) Play an important role in the neuronal protection, differentiation and reorganization of the central nervous system, Objectives and Methods: The effects of neonatal retinal deafferentation on a CBPs, calbindm D-28k (CB), Parvalbumin (PB) and calretimn (CR), and the existence of colocalization between the CBPs were examined immunohistochemically in the rat superior colliculus. Results: On the experimental (contralateral to enucleation) side of superior colliculus, the number of CB-immunoreactive (IR) cells was reduced (77.4% compared to control), but not fibers. The number of PB-IR neurons and fibers was also reduced on the experimental side (88.5% compared to control), In the other hand, the CR-IR cells were dramatically increased (642% compared to control), but CR-IR fibers were markedly decreased on the experimental side. The colocalization between CB-CR and PV-CR was rarely observed in the superior colliculus Conclusion: These results suggest that the changes of retinotectal projection may alter the expressional pattern of CBPs in different manners; relatively stable in CB- and PV-IR neurons and plastic in CR-IR neurons.

표피종양의 p27 발현에 관한 연역조직화학적 연구

이명기,정병수 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and objectives: p27 belong to the family of cyclin dependent kinase inhibitors, which are important negative regulators of the cell cycle. Loss of normal cell cycle regulation contributes to the development and progression of tumors. Although p27 may play role in tumor progression, the precise function and expressive pattern in epithlial tumors are less clear. The propose of this study was to investigated the expressive patterns of p27 in benign, precancerous and malignant epithelial tumors. Materials and Methods: Formalin-Fixed and paraffin-embedded tissue from 5 seborrheic keratosis, 5 actinic keratosis, 5 Bowen disease, 7 basal cell carcinoma, 13 squamous cell carcinoma were immunolabeled with monoclonal antibodies directed p27. Results: The seborrheic keratosis showed a very low expression of p27 in all cases. In two cases of actinic keratosis, p27 staining was observed in dysplastic cells that proliferative into dermis. The Bowen’s disease showed low expression of p27 except dyskeratotic cells. The basal cell carcinoma showed positive staininng in central portion of tumor lobules on 4 cases. The low expression of p27 staining was observed well-differentiated squamous cell carcinoma except dyskeratotic cells and horn pearls, but poory-differentiated squamous cell carcinoma showed moderate expression in 2 cases and high expression in 2 cases. Conclusion: These result represent that the decresae of p27 might related to tumorigenesis, and p27 expression might reflect the terminal differentiation of tumor cells.

다발성 모기질종 1예

신봉석,정병수,최규철 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Pilomatricoma, often called calcifying epithelioma of Malherbe, is a tumor with differentiation toward hair cells, particularly hair matrix cells. It presents as a firm, deep-seated nodule that is covered by normal or pink skin. It is occuring usually as a single lesion which is most commonly found on the face, neck, or proximal upper extremity. Multiple lesions are quite unusual, comprising only 2-3.5% of cases. A 32-year old man had 3 subcutaneous nodules on the both upper extremities. Histological findings of the lesion showed the typical pattern of pilomatricoma. We presented herein one case of multiple pilomatricoma with the review of literatures.

모반을 실로 묶어 발생된 화농성 육아종양 병변 1예

신봉석,정병수,최규철 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Pyogenic granuloma is a benign vascular, inflammatory proliferation that appears following minor trauma in children and young adults. The exact pathogenesis of pyogenic granuloma is unknown, but its formation is closely related to minor trauma, chronic irritation, and hormonal influences. A 52-year old woman visited us with a protruding nodule on the right zygoma area. The nodule was pedunculatedby trauma of tied up nevus. Based on the histological finding, we diagnosed post-traumatic pyogenic granuloma like lesion developed within melanocytic nevus.

다양한 표피 종양에서 Matrix Metalloproteinase-2와 Matrix Metalloproteinase-9 발현에 관한 면역조직화학적 연구

박홍표,최규철,정병수 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background and Objectives: Degradation of basement membranes and extracelluar matrix is a essential step in tumor cell migration, invasion and metastasis formation. Two types of Matrix metalloproteinases (MMPs), MMP-2 and MMP-9 are active in the digestion of type Ⅳ collagen, the main constituent of the basement membrane. Based on this background, we investigated the expression patterns of Type Ⅳ collagenase (MMP-2 and MMP-9) in squamous cell carcinoma, adenoid (acantholytic) squamous cell carcimoma, and its precancerous conditions, actinic keratosis and Bowen's disease by immunohistochemical technique. Materials and Methods: Formalin-fixed and paraffin-embedded tissues from 5 actinic keratosis, 5 Bowen's diseases, 5 adenoid squamous cell carcinoma, and 5 squamous cell carcinoma were immunolabelled with monoclonal antibodies directed against MMP-2 and MMP-9. Result: For MMP-2, actinic keratosis, Bowen's disease, adenoid squamous cell carcinoma, and squamous cell carcinoma was expressed to relative low level in tumor cells. Bowen's disease showed a negative staining for MMP-9, but in microinvasive area of actinic keratosis and adenoid lining cells of adenoid squamous cell carcinoma was a positive staining or MMP-9. In Bowen's disease, squamous cell carcinoma, and adenoid squamous cell carcinoma, dyskeratotic cells and acantholytic cells were stained for MMP-2 but for MMP-9, only in adenoid squamous cell carcinoma. Conclusion: This finding suggested that MMP-9 may be related to tumor invasion to surrounding stroma and that MMP-2 and MMP-9 may be involves in the apoptotic process of the tumor cells.

급성 단핵구성 백혈병에서 발생한 피부 백혈병 1예

김영조,홍문희,정병수 조선의대 1996 The Medical Journal of Chosun University Vol.21 No.2

소아와 청장년기 아토피 피부염 환자에서 MAST 화학발광법에 관한 비교연구

김성한,최규철,정병수 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.3

Background and Objective: The MAST-CLA (multiple allergosorbent test-chemiluminescent assay) is a new assay for serum allergen specific IgE and allows many allergens to be tested simultaneously. Futhermore, it has shown good sensitivity, specificity and a correlation with the RAST and skin prick test. The purpose of this study was comparatively to evaluate results of the MAST-CLA between child and adolescence atopic dermatitis. Materials and Methods: Our study was designed by analyzing outpatients with atopic dermatitis through the MAST-CLA with a total IgE and allergen specific IgE in fifty children and twenty adolescence patients. Results: The results were as followings; 1) Among the subjects, 77% (child group; 76%, adolescence group; 80%) of patients showed elevated serum total IgE levels and 57.1% (child group; 50%, adolescence group; 75%) revealed at least more than one allergen specific IgE by the MAST-CLA. But, this did not show statistical significance. 2) Patients positive rates of commonly detected allergens were D. farinae 47% (child group; 42%, adolescence group; 60%), D. pteronyssinus 34% (child group; 28%, adolescence group; 50%), house-dust 23% (child group; 20%, adolescence group; 30%). But, all food allergens were positive lower than 5%. 3) The positive allergen specific IgE in food allergens was detected in only child atopic dermatitis patients. This difference between child and adolescence group showed statistical significance(P=0.027). 4) Good correlation was obtained between total IgE levels and number of positive allergen speficif IgE in the MAST-CLA, with 0.465 correlation coefficient. Conclusion: Our results suggest that MAST-CLA may be used as an effective method to evaluate inhalant allergens in adolescence more than child atopic dermatitis patients. Additionally, it is recommended that more speficif allergens should be added to Korean panel of MAST-CLA.