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.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

소음인(少陰人) 태음병(太陰病) 심하비증(心下?證)의 병증약리(病證藥理) 고찰

서영광,이지원,이준희,최원철,이의주,고병희,Seo, Young-Kwang,Lee, Ji-Won,Lee, Jun-Hee,Choi, Won-Cheol,Lee, Eui-Ju,Kho, Byung-Hee 사상체질의학회 2010 사상체질의학회지 Vol.22 No.3

1. Objective: Gastric Stuffiness (心下?證) in the Soeumin Taeeum symptomatology (少陰人 太陰病) in Sasang Constitutional Medicine shows an interesting evolutionary process. Originally found in the texts of Sanghanlun (傷寒論), the perspectives regarding the symptoms of Gastric Stuffiness were expanded by many medical scholars and Lee Jema. To comprehend the Jema's concept of Taeeum symptomatology and utilize his prescription clinically, it deserves to study on the Gastric Stuffiness in Donguisuseowon (東醫壽世保元). 2. Methods: Many texts including Sanghanlun (傷寒論) and Dongeuibogam (東醫寶鑑) were reviewed in order to track the evolutionary process concerning the symptoms of Gastric Stuffiness. Also, Lee Jema's works including the different versions of Donguisuseowon (東醫壽世保元) were reviewed to examine the development of Lee's concepts regarding the Gastric Stuffiness in the Soeumin Taeeum symptomatology. 3. Results and Conclusions: 1) Most of the previous concepts on Gastric Stuffiness were generally similar to those found in Sanghanlun, especially in that they addressed Yang deficiency of the middle triple energizeer as the central pathogenic process. 2) Lee Jema's views on the epigastric discomfort in the Soeumin Taeeum symptomatology evoloved over time and culminated in the finalized pathology and therapeutics appearing in his last work, the Shinchuk version of Donguisuseowon (東醫壽世保元). 3) 4 kinds of prescription which invented by Lee Jema to treat the Gastric Stuffiness in the Soeumin Taeeum symptomatology can be matched to the prescription of Sanghanlun respectively. However through evolutionary process of Jema's prescriptions, the indication of them expanded: not only to treat Gastric Stuffiness but to diverse symptoms of Soeumin.

업종에 따른 연 취급 사업장의 기중 연 농도 및 연 노출 수준 평가

이병국,김용배,리갑수,안현철,김화성,이용진,황규윤,장봉기,이성수,안규동 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to obtain an useful information for health management and biological monitoring of lead exposed workers, Authors tried to investigate air lead level and the lead exposed level of workers in lead industry according to occupational category. The subjects in our study were 2074 workers in 7 lead-using industries, and study subjects were divided into 4 occupational categories such as storage battery industry (type 1), primary smelting industry (type 2), secondary smelting industry (type 3) and litharge making industry (type 4). Blood zincprotoporphyrin concentration (ZPP), blood lead concentration (PbB) and urinary δ -aminolevulinic acid (ALAU), hemoglobin (Hb), hematocrit (Hct) were selected as the indices of lead exposure. Personal variables such as age, work duration were also collected. The results were as follows. 1. The geometric mean air lead in 9 lead-using industry was 0.1133±4.3120 ㎎/㎥, and that in type 1, 2, 3 and 4 was 0.1038±3.4952 ㎎/㎥, 0.0429±3.4329 ㎎/㎥, 0.1877±2.5123 ㎎/㎥ and 0.9961±5.2910 ㎎/㎥, respectively. 2. The mean ZPP in 9 lead-using industry was 53.1±28.0 ㎍/㎗, and that in type 1, 2, 3 and 4 was 52.0±24.8 ㎍/㎗, 48.0±16.4 ㎍/㎗, 109.8±85.6 ㎍/㎗ and 74.3±37.8 ㎍/㎗, respectively. There was significant difference in ZPP according to occupational category (P<0.01). The percents of lead workers whose ZPP were above 100 ㎍/㎗ in type 1, 2, 3 and 4 were 4.0%, 1.7%, 34.3% and 21.6%, respectively. 3. The mean PbB in lead-using industry was 26.0±11.2 ㎍/㎗, and that in type 1, 2, 3 and 4 was 25.3±11.1 ㎍/㎗, 26.7±8.8 ㎍/㎗, 50.3±15.2 ㎍/㎗ and 36.4±11.0 ㎍/㎗, respectively. There was significant difference in PbB according to occupational category (P<0.01). The percents of lead workers whose PbB were above 40 ㎍/㎗ in type 1, 2, 3 and 4 were 10.4%, 7.7% 71.9% and 43.2%, respectively. 4. While the correlation of Hb corrected PbB with ZPP was higher than non corrected PbB, the correlation of log-transformed ZPP with PbB was higher than non corrected ZPP. 5. Simple linear regressions of PbB and corrected PbB as independent variable with ZPP, log-transformed ZPP and ALAU as dependent variable were statistically significant (P0.01). Coefficient of determination of corrected PbB with other variables was higher than non corrected PbB. As the result of this study, it was suggested that reconsideration of environmental and biological monitoring program was highly recommended for secondary smelting and litharge making industry.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

혼합형 뇌졸중의 임상적 의의 : 비색전성 뇌경색 환자를 중심으로

이병철,유경호,도화범,권기한,황성희,김형철,강익원 대한신경과학회 1996 대한신경과학회지 Vol.14 No.1

월경주기 증상의 요인 분석

이수일,유태혁,강종선,안석철,이병욱,김헌,석재호 大韓神經精神醫學會 1986 신경정신의학 Vol.25 No.1

404 nurses and nurse-aids rated their experiences of 45 symptoms(Moos' Menstrual Distress Questionnaire) of the menstrual, premenstrual and intermenstrual phase on a 4 point scale separately. The 45 symptoms were inter-related and factor analyzed separately for each phase. six common clusters of symptoms emerged from 3 phases, which were labeled concentration, motor tension, pain, pleasurable affect, autonomic reactions and water retention. Four clusters of symptoms emerged from premenstrual phase. These clusters were labeled instabillity, withdrwal reactions, depression and headache. The factor named unpleasurable affect emerged from intermenstrual and menstrual phase. Above findings were differed from the results of Moos' study in which eight basically replicated clusters of symptoms emerged from three phases. Through discussion of validity of this scale, and differences between results of Moos' and this study, we came to the conclusion that sampling of subjects, prospective longitudinal symptoms reporting, amount of variance in a symptom over the course of menstrual cycle and proper choice of factor analysis method would be salient variables to construct valid scale for measuring menstrual cycle symptoms.

Screening panoramic radiographs in a group of patients visiting a Health Promotion Center

Lee, Jae-Seo,Kang, Byung-Cheol 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.4

Purpose : To report the incidence of radiological findings from screening panoramic radiographs and verify the validity of the panoramic radiography for screening purposes. Materials and Methods : Six thousand one hundred and sixty panoramic radiographs taken from the patients visiting the Health Promotion Center of CNUH were selected for this retrospective study. Panoramic radiographs were examined into the following pathologic conditions : the presence of periodontal bone loss, dental caries, periapical radiolucencies, retained roots, impacted supernumerary teeth, impacted third molars, odontoma, cystic lesions other than radicular cyst, sialoliths, and mixed radiolucent-radiopaque lesions Number of pathologic conditions and Prevalence values were recorded. Results : The prevalences of pathologic conditions were 72.9% of periodontal bone loss, 32.2% of dental caries, 11.9% of periapical radiolucencies, 10.8% of retained roots, 0.4% of root fracture, 1.0% of impacted supernumerary teeth, 1.0% of impacted third molars, 0.06% of odontoma, 0.08% of cystic lesion other than radicular cyst, 0.2% of prolonged retention of deciduous tooth, 0.1% of sialolith, and 0.04% of mixed radiopaque and radiolucent lesion. Conclusion : Although the panoramic radiograph should not be used to replace intraoral radiographic and clinical examinations, this study showed that many dental pathologic conditions could be detected on panoramic radiographs. The panoramic radiograph might serve as a diagnostic aid in dental health evaluation programs.

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

황금(黃芩)의 4-VO로 유발한 흰쥐뇌허혈에 대한 신경방어효과

李秉哲,林康鉉,金榮玉,金善礪,安德均,朴虎君,金護哲 대한본초학회 1999 大韓本草學會誌 Vol.14 No.2

Scutellariae Radix(SR), the root of Scutellaria baicalensis G_EORGI, whose property, flavour and channel tropism is bitter in flavour, cold in property(寒), acting on the lung, gallbladder, stomach and large intestine channels(歸?,?,?,大??), has the effects of clearing away heat and dampness(淸熱??), purging fire, detoxicating(?火解?), stopping bleeding(止血) and preventing miscarriage(安?). This drug is one of the popular drugs in traditional Korean medicine, which has been used to antipyretic, antibacterial, antitoxic and antihypersensitive effects. So this study was planned to check the neuroprotective effect of SR on the global ischemia induced by 4-vessel occlusion in Wister rats. and SR extract was lyophilized after extraction with 70% methanol. We induced 4-vessel occlusion for 10 minutes and reperfused again. The number of CA1 pyramidal neurons were counted after 7 days of reperfusion under the cresyl violet staining. The result obtained that in 4-VO ischemia, SR showed significantly neuroprotective effects(1,000 and 500 ㎎/㎏ of SR extracts, p<0.05) compared with control group. Each neuroprotective ratio was about 27.4 %, 23.2 % respectively. Consequently, Scutellariae Radix has neuroprotective effects on the global ischemia induced by 4-vessel occlusion in Wistar rats.