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.

21C 신지식인 양성을 위한 Eng@internet 교육프로그램

강병우,조권수,이기정,이강노,홍남희 광주보건대학 2000 論文集 Vol.25 No.-

This study is an educational program chiefly designed for teaching all the students in Kwang-ju Health College English and internet at the same time, which was applied for the fourth field of a specializing program required by the Ministry of Education. The program is a knowledge enhancement one aimed at training men and women who will become the leaders with advanced knowledge for the 21st century. The International Education Cooperation Center established in the College will manage and supervise all the procedures, especially in developing curriculums and in training the students. There are three kinds of detailed courses in this program; the basic, the applied, and the one for qualifications. 1. The basic course, a grounding one for cultivating the men and women with advanced knowledge, consists of the education for practical use of a computer, internet English, and netiquette. This is a required course for the applied one, and the president in the college gives certification to the students who complete this course satisfactorily. 2. In the applied courses, there is the E-mail penpal--one that offers each student the opportunity to communicate with a native speaker, and the subject discussion course in which the students are able to exchange their ideas or thoughts at a time with multi-people with the same or similar interests or majors. The former is a required one for the latter. The students who complete this course satisfactorily the certified by the president at the college. 3. This course for the diversification of the student employment after graduation is classified into the six classes for the qualifications; the 1st and the 2nd grade data referer(or processor) throuhg internet, the specialized intelligence processor, the tourist guide, the 3rd grade English translater, and the simultaneous English interpretor. This course must be taken by the students who complete or are in the E-mail penpal or subject discussion course. To gain this, the programs offer various learning motivations; English speech, TOEIC, and English data referring contests, international exchange program, and so on. This program is expected to improve all the education at the college, especially curriculums and teaching methods, and have a mulitplier effect on various fields for other colleges, communities, and industries.

정신분열병의 생물학적 원인

강병조,원승희,김상헌 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

The authors reviewed the biological etiologies of schizophrenic disorder such as genetic, viral, neurodevelopmental, neural network, sunspots and cerebral diabetic hypothesis. The etiology of schizophrenic disorder remains to be confirmed. Although genetic possibilities were suggested by many investigators, the genetic genes and their transmission methods have not been clarified yet. The neurodevelopmental hypothesis was reviewed in detail. This hypothesis includes genetic hypothesis, viral hypothesis, obstetrical complication hypothesis, neutritional deficience theory, NMDA receptor hypofunction theory and neural network theory. The neurdevelopmental hypothesis means that several developmental trajectories, related to early brain insults as well as the genetic factors affection postnatal neurodevelopment, possibly lead to this illness. An excessive pruning of the prefrontal corticocortical, and corticosubcortical synapses, perhaps involving the excitatory glutaminergic inputs to pyramidal neurons, may underlie schizophrenia.

장애인 교육권 보장을 위한 특수교육법률 고찰

강경희,안병주,이선재,황정보,김청아 朝鮮大學校 社會科學硏究所 2007 社會科學硏究 Vol.28 No.2

반복적 부동화 스트레스가 신경활성 Steroid의 GABAА 수용체 조절작용에 미치는 영향

강헌구,강병조,하정희 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

신경활성 steroid들은 중추신경계의 말초성 benzodiazepine 수용체에서 합성되고, GABAA 수용체 복합체상의 독립적인 인지부위에 작용하여, GABAA 수용체에 대하여 효현활성을 나타내며, 스트레스에 대응하여 유리되는 내인성 조절자로 시사되고 있다. 그러나 신경활성 steroid의 신경전달조절 활성을 스트레스에 대한 반응도(reactivity)와 연관시켜 연구한 것은 아직 미흡한 실정이다. 이에 본 연구에서는 Sprague-Dawley rat에 2주간의 반복적인 부동화 스트레스를 부하한 후 반복적 스트레스에 의한 신경활성 steroid 활성의 변화를 검색하고자 하였다. 그리고 스트레스에 대하여 과도한 반응성을 보일 것으로 보고된 borderline-hypertensive rat을 대상으로 신경활성 steroid의 억제성 신경전달계인 GABA성 신경전달 조절활성을 비교 관찰함으로써, 반복적 부동화 스트레스에 대한 실험동물의 반응성에 대한 연구의 일환으로 신경활성 steroid의 신경조절작용을 검색하고자 하였다. 이를 위하여 Sprague- Dawley rat의 대뇌피질세포막에 있는 GABAA-benzodiazepine 수용체 복합체에서 대하여 신경활성 steroid인 pregnanolone의 [³H]flunitrazepam 결합반응을 항진효과를 비교, 검색하였다. 본 실험결과, Sprague-Dawley rat의 대뇌피질세포막에 있는 GABAA-benzodiazepine 수용체 복합체에서 신경활성 steroid인 pregnanolone은 [³H]flunitrazepam 결합반응을 항진시킴으로써 GABAA 수용체에 대하여 효현 활성을 나타내었으며, 2주간의 반복적인 부동화 스트레스에 의해 이러한 pregnanolone의 활성은 증강되었다. 한편, 스트레스에 대하여 과도한 반응성을 보인다고 알려진 borderline-hypertensive rat의 뇌조직에서도 Sprague-Dawley rat에 비하여 항진된 GABA성 신경조절활성이 관찰되었으며, 스트레스 부하에 대해서도 유사한 반응성을 나타내었다. 이상의 결과로부터 반복적인 부동화 스트레스는 스트레스에 대한 반응성의 일환으로 신경활성 steroid인 pregnanolone의 GABA성 신경전달 항진작용을 증강시킨다고 생각되었으며, 스트레스 유발 고혈압의 질환모델로 보고된 BHR에서는 동일한 스트레스에 대하여 과도한 반응성을 나타냄으로써 스트레스 관련 말초질환에서의 중추성 병인인자의 참여 가능성을 시사해주었다. Pregnanolone[5β-pregnan-3α-ol-one(pregnanolone)] is one of neuroactive steroids that are reduced metabolites of progesterone. Pregnanolone synthesis in the neuron or glia was regulated by peripheral benzodiazepine receptor agonist, which was consistently observed to be upregulated in the acutely stressed animals and humans. Pregnanolone is a potent positive modulator of the γ-aminobutyric acid(GABA) response that enhance the binding of [³H] flunitrazepam to the GABAA receptor. Recently, it was reported that chronic treatment with pregnanolone uncouples allosteric interactions between steroid and benzodiazepine recognition sites in cultured neurons. The present study was designed to assess the effect of repeated stress on the modulation of neuroactive steroid on the GABAA receptor. The effect of steroid on the ligands binding to GABAA receptor was investigated using cerebral cortices of unstressed and repeatedly immobilized Sprague-Dawley rats and borderline-hypertensive rats. Pregnanolone enhanced the binding of [³H]flunitrazepam to GABAA receptor in both of unstressed and repeatedly stressed Sprague-Dawley rats. However, repeatedly stressed rats showed significantly lower values in EC50 and higher values in Emax of enhancement binding of [³H] flunitrazepam than those of unstressed rats. Borderline-hypertensive rats, which are known to be overreactive to stress, showed higher basal binding of [³H]flunitrazepam to GABAA receptor, similar to those of stressed Sprague-Dawley rats. Borderline-hypertensive rats, in both control and stressed groups, showed similar pharmacological activity of pregnanolone with Sprague-Dawley rats. From these findings, it can be concluded that repeated immobilization stress enhanced the positive modulation of neuroactive steroid on the GABAA-receptor complex, and these pharmacological activity of neuroactive steroid might be a defensive reactivity to stress of individuals.

재발성 일과성 허혈 발작을 주소로 내원한 비-안와-대뇌 모균증 1예

강우열,이주헌,성영희,최일수,송홍기,이병철 대한노인병학회 2002 대한노인병학회지 Vol.6 No.3

Phosphorylation modulators에 의한 항암제 다제내성 유전자의 발현 조절

김선희,곽남희,강치덕,정병선 부산대학교 유전공학연구소 1995 분자생물학 연구보 Vol.11 No.-

암을 치료함에 있어서 항암제에 대한 다제내성(MDR)의 획득이 중대한 장애로서 지적되고 있으며, MDR 현상은 MDRI 유전자의 과잉 발현에 의한 것으로 알려져 있다. MDRI promoter 활성이 mutated ras 또는 raf-1 발현에 의하여 증강되는 현상을 좀 더 명확히 하기 위하여 암 환자의 조직검체를 사용하여 RNA slot-blot 분석법으로 MDRI 유전자의 발현과 이들 암 유전자의 발현과의 관련성을 조사하였다. 3개의 대장암 검체에서 이들 암유전자의 높은 발현과 함께 MDRI gene도 높은 발현을 나타내었다. Raf-1에 의한 MDRI promoter의 최대 활성 증강을 나타내는 DNA 배열은 이 promoter 영역내의 HSE 영역과 일치하며, 또한 이 promoter에 작용하는 regulatory clement가 has70 promoter와 매우 유사하여 heat-induced(42℃) p432-CAT 발현에 있어 protein phosphatase inhibitor의 효과를 조사하였다. Okadaic acid나 calyculin은 농도 의존적으로 heat-induced p432-CAT의 발현을 증강시켰다. 또한 p56-CAT 발현이 forskolin에 의한 증강 또는 H-87에 의한 감소를 나타내어 이러한 현상은 MDRI promoter내의 CRE 유사 배열이 기능을 나타내는 것으로 사료되어 MDRI promoter가 has70 promoter와 유사하게 조절되며, Raf-1 발현에 의한 MDRI promoter의 활성화는 MDRI promoter내에 존재하는 HSE와 관련됨을 시사하였다. Multidrug resistance(MDR) poses a serious clinical problem in chemotherapy of cancer. MDR results from overexpression of the MDRI gene which encodes a drug-efflux pump called P-glycoprotein. To confirm our observation that the expression of mutated ras or raf-1 gene increased MDRI promoter activity, it was examined whether MDRI gene expression were correlated with the expression of these oncogenes in clinical tumor samples using RNA slot-blot analysis. These oncogenes were correlated with the expression of MDRI gene in 3 colon tumor samples. Since DNA sequence exhibiting maximum activation of MDRI promoter by Raf-1 is associated with heat shock element of MDRI promoter region, and regulatory element contained in MDRI promoter is very similar to that of hsp70 promoter. The effects of okadaic acid or calyculin on the heat-induced(42℃) expression of p432-CAT were determined. Okadaic acid or calyculin A potentiated the heat-induced expression of p432-CAT in dose-dependent manner. In addition, stimulation or inhibition of p56-CAT expression by forskolin or H-87, respectively suggests functional operation of CRE element in MDRI promoter. It is suggested that the regulation of MDRI promoter activity is very similar to that of hap70 promoter.

1차원 MWPC를 이용한 디지탈 사진촬영장치의 개발(Ⅲ)

강희동,조진호,박정병 경북대학교 센서기술연구소 1995 연차보고서 Vol.1995 No.-

Digital Radiography 장치로 응용하기 위한 1차원 MWPC를 이용하여 X-선 위치검출기를 설계 및 제작하였다. 위치검출 방법은 병렬판독법으로 얻으며 스캐닝장치를 이용해 X-선 영상을 얻는다. 제작한 검출기의 위치분해능은 0.8㎜이고, 동시성 선택회로를 고안하여 위치분해능을 0.4㎜로 향상시켰다. 실제 얻은 디지탈 값에서 각 채널에 대한 보정인자를 곱함으로써 영상의 균일성을 증가시켰다. 디지탈 X-선 영상은 0.4㎜의 scanning 간격으로 각종 피사체에 대하여 320×320 화소의 영상을 얻었다. X-ray position detector was designed and fabricated. The detector was applied to digital radiography system. One-dimensional MWPC(Multiwire Propotional Chamber) is the main component of this system. The way of detecting the position of incident x-ray is the parallel readout method. Digital image data are acquired by using fan beam x-ray and a scanning system. The spatial resolution of the detector is 0.8㎜. Spatial resolution was improved by a factor of two(0.4㎜) with help of the coincidence selection circuit. Uniformity was improved by converting data with calibration factor for each channel. With help of scanning system which has 0.4㎜ scanning pitch, x-ray digital images of 320×320 pixels were obtained for a fish and a chicken's foot. Bone image is appeared clearly in these images.

정밀전단시의 유한요소 해석을 위한 파단기준 연구

강대철,전병희,이원평,성부용 韓國工作機械學會 2000 한국생산제조학회지 Vol.9 No.5

The Tailor Welded Blanks(TWB) are using various materials (different thickness, strength and different materials) can be welded together prior to the forming process. Therefore, TWB applications have become little by little important in automobile industries, because it has more light weight and process reduction. A burnish area is very important for TWB using laser welding. In this paper, evaluated failure criterion, effect of clearance and distance of between pad and punch by computer simulation. We used element separation method for fracture. And applied a plastic strain to failure criterion. According to the analysis results, we obtain failure criterion, when plastic strain is 2.0. The burnish area and clearance were inverse proportional.

단열관을 위한 환상공간 내에서의 복합열전달의 실험적 연구

강병희,권순석 동아대학교 공과대학부설 생산기술연구소 1996 生産技術硏究所硏究論文集 Vol.1 No.2

A study of conjugate heat transfer in the cylindrical annulus for an insulated tube has been studied experimentally with Mach-Zehnder interferomater. The solutions have been obtained for the range of the Raleigh number, Ra=3613∼6961, the demensionless insulated wall thickness, W/D_i=1.18, 1.69 and the dimensionless gap width, S/W=0.3, 0.6 and 0.8. As S/W increase, the temperature turns reversely and the convection heat transfer is active as Ra increase. The heat transfer rate increases at Ra≥4961, W/D_i=1.69. But the heat transfer rate decreases at S/W≒0.6 and then increases as S/W increases at Ra=3613, W/D_i=1.69. In the case of Ra=3613, W/D_i=1.69, the heat transfer rate in minimized at S/W≒0.6. Therefore, it is defined that the optimum demensionless gap width for insulation is (S/W)_opt≒0.6 at Ra=3613, W/D_i=1.69. The heat transfer rate decreases at S/W≒0.6 and then increases as S/W increases at Ra=3613∼6961, W/D_i=1.18. Therefore, optimum demensionless gap width for insulation is (S/W)_opt≒0.6 at Ra=3613 ∼6961, W/D_i=1.18.