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.

과학적 실재론과 포스트모던 과학철학 : 파인의 "자연적인 존재론적 태도"를 중심으로

정병훈 영남철학회 1996 哲學論叢 Vol.12 No.-

衛星通信에 관한 硏究 : Filter의 性能改善을 中心으로 Especially on the Improvement of Filter Performance

鄭憲相,宋鐵,劉炳守,朴暢均,白亨來,鄭鍾熙,李炅燮 조선대학교 동력자원연구소 1986 動力資源硏究所誌 Vol.8 No.2

There are two kinds of data transmission communication method, namely, Analog communication method and Digital communication method. The latter has many excellent characteristics as compared with the former. In order to design excellent Digital Filter, the window function is studied in this paper. The conventional time-domain windowing requires N/2 stored values of the data window and N multiplications. A class of windows, called binary windows, for the frequency-domain implementation of the Discrete Fourier Transform is proposed. They do not require multiplications or stored constants ; rather, they are replaced by shift and add operations. These windows offer excellent sidelobe behavior compared with the conventional windows.

급성하벽심근경색에서 전흉부유도 ST절 하강의 의의

정병천,배호상,곽동훈,김영태,배용학,황종현,임현주,류재근,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 급성하벽심근경색증 환자에서 심전도상 흔히 동반되는 전흉부유도 ST절 하강의 의의를 알아보았다. 방법 : 심근경색후 24시간에서 48시간에 얻은 심전도를 기준으로 52명의 급성하벽심근경색증 환자를 전흉부유도에서 ST절의 하강이 있는 군과 없는 군으로 나누었으며 심도자, 관상동맥조영술, 심초음파도 및 방사성 핵종을 이용한 좌심구혈율 측정 등을 시행하였다. 결과 : 1) 좌심실확장기말압은 전흉부유도에서 ST절의 하강이 있는 경우에서 16.9±5.33mmHg로 없는 경우의 11.0±4.02mmHg보다 유의하게 높았다(p<0.05). 그러나 운동량 및 좌심구혈을은 흥부 유도상 ST절의 하강이 있는 경우 7.6±3.0 METs 및 53.9±9.1%로 없는 경우의 9.1±2.7 METs 및 54.6±9.5%보다 낮았으나 통계적 유의성은 없었다(p=0.180, p=0.823). 2) 관상동맥조영술상 전흉부 ST절의 하강이 동반된 군에서는 유의한 좌전하행지나 좌회선지의 협착이 있는 경우가 60.9% 및 57.9%로 ST절의 하강이 없는 군에서의 34.5% 및 7.7%와 비교해 좌관상동맥에 협착이 동반된 경우가 많았다(p=0.050, p=0.001). 3) 관상동맥조영술상 세 혈관질환의 빈도는 흉부유도상 ST절의 하강을 보인 23예에서 10예로 ST절 하강이 없었던 29예중 2예에 비하여 유의하게 많았고(P=0.007), 단 혈관질환의 빈도는 ST절의 하강을 보인 군에서 23예중 5예로 ST절 하강이 없었던 29예중 17예에 비하여 유의하게 적었다(P=0.002). 두 혈관질환의 경우에는 각각 8예와 10예로 양군간에 유의한 차이가 없었다. 4) 흉부유도상 ST절 하강의 빈도는 단 혈관질환 22예 중 5예에서, 두 혈관질환 18예중 8예, 세 혈관질환 12예 중 10예에서 관찰되어 협착이 있는 관상동맥의 수가 많을수록 ST절의 하강이 나타나는 빈도가 많음을 보였다(p=0.00308). 그러나 흉부유도상 나타난 ST절의 하강을 모두 합하여 구한 ST절 하강의 합은 협착이 있는 관상동맥의 수와 통계적인 유의성이 없었다. 5) 심초음파도상 좌심실 하벽의 벽운동은 ST절 하강을 보인 군에서는 akinesia가 83.3%, hypokinesia가 11.1%, 정상 벽운동이 5.6%로, ST절 하강이 없었던 군에서의 dyskinesia가 3.6%, akinesia가 39.3%, hypokinesia가 25.0%, 정상 벽운동이 32.1%와 비교하여 ST절의 하강이 있는 군에서 유의하게 벽운동의 장애가 빈번함을 보였다(p=0.03891). 그러나 좌심실전벽, 측벽 및 중격부위에서는 유의한 벽운동의 차이가 없었다. 결론 : 급성하벽심근경색증 환자의 전흉부유도에서 ST절의 하강이 동반되는 경우 다혈관 질환의 가능성이 높으며 좌심실확장기말압이 상승되었고 운동능력은 감소되어 있었다. 또한 심초음파도상 좌심실하벽의 벽운동장애도 심하였다. 따라서 전흉부 ST절의 하강을 동반한 급성하벽심근경색증 환자는 전흉부유도에 ST절 하강이 없는 경우보다 예후가 불량할 것으로 생각되며, 보다 적극적인 치료가 필요할 것으로 생각된다. The purpose of this study was to determine the significance of precordial ST segment depression appearing during acute inferior myocardial infarction and to assess the correlation of that with angiographic finding. 52 patients were allocated into two groups based on the existence of precordial ST segment depression : 23 patients with ST segment depression and 29 patients without ST segment depression. The extent of coronary artery disease as well as the prevalence of significant stenosis (≥70%) in left anterior descending artery were more frequent in patients showing precordial ST segment depression than in patients not showing them (p=0.050) and the result were similar in cases of left circumplex artery (p=0.001). On echocrdiographic examination of left ventricular (LV) wall motion, it showed more severely decreased inferior LV wall motion in patients showing precordial ST segment depression than in patients not showing them (p=0.03891) even though the other segment of LV wall motion didn't show the statistical difference between both groups. The other cardiac parameters such as LVEDP, exercise amount (METs) and ejection fraction were tend to showing bad profile in patients with precordial ST segment depression. From the above results, we could deduce that patients with precordial ST segment depression have relatively large infarction or concomitant left coronary artery disease, so they need more caution and intensive theraphy.

상처치유시 Antisense TGF-β1 Oligodeoxynucleotides가 Inducible Nitric Oxide Synthase발현 조절에 미치는 영향

최병민,곽현정,전창덕,임정식,박석돈,정헌택 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.4

Wound healing in the skin may be complicated by both microbial invasion and inflammation. Following injury, platelet degranulation releases a number of chemotactic factors including transforming growth factor (TGF-fl) and platelet derived growth factor (PDGF). TGF-19 is a cytokines that modulates many cellular function and gene expression. However, it is not known whether TGF-P could regulate inducible nitric oxide synthase (iNOS) gene expression during wound healing. Here we report that down regulation of TGF-Q gene expression by antisense oligodeoxynucleotides increase iNOS during wound healing. Our reverse transcription- polymerase chain reaction (RT-PCR) result has shown that antisense TGF-fil oligodeoxynucleotides (ODN) targeting the TGF-J11 translation initiation region markedly reduced TGF-(il mRNA levels in wounded skin. Also, marked reduction in TGF-fl1 mRNA after antisense treatment invited that the increment of iNOS mRNA in wounded skin. Therefore, our irnmunohistochemical studies revealed a "pattern of iNOS product in wounded skin treated antisense TGF-fl1 ODN that was similar to the pattern of RNA synthesis detected by RT-PCR. In conclusion, our results indicated that the regulatory actions of TGF fl1 on iNOS. might be involved in the initiation and faciliates the resolution of inflammation following wounding.

부비동 내시경 재수술 환자에서의 전산화 단층촬영 소견

정승규,하병석,동헌종 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.10

SEK1 카이네이즈 과발현(overexpression)생쥐 대식세포주(RAW264,7)의 Nitric Oixde(NO)유도성 세포고사 (apoptosis) 기전에 관한 연구

정병학,소홍섭,박래길,정헌택 圓光大學校 醫科學硏究所 1998 圓光醫科學 Vol.14 No.2

Nitric oxide (NO) induces apoptotic cell death in murine RAW 264.7 macrophages. To A elucidate the NO-induced apoptotic mechanisms in SEK1/MKK4 overexpressed RAW 264.7 cells, we generated clones of RAW 264.7 cells which stably overexpressd kinase inactive SEK1 (RAW/SEK1-KI) or wild type SEK1 (RAW/SEK1-WT). Treatment of kinase inactive SEK1 transfected RAW 264.7 cells (RAW/SEK1-KI) with sodium nitroprusside (SNP), a NO donor, significantly decreased the cell viability than that of RAW control cells which were treated with the same amount of SNP. However, RAW/SEK1-WT cells were less susceptible to NO induced apoptosis. Furthermore, the treatment of NO with farnesyltransferase inhibitor (FTI) of Ras or MEK inhibitor (PD098059) significantly increased the apoptotic death of RAW/SEK1-KI. However, SB203580, a specific p38 inhibitor, did not affect NO-induced apoptosis of kinase inactive SEK1 transfected RAW 264.7 cells. For a while, caspase 3-like protease activity in NO plus FTI treated RAW/SEK1-KI cells were more increased than that of NO only. In addition, nuclear transcription factor kB (NFkB) was significantly activated in NO-treated RAW/SEK1-KI cells, whereas these transcriptional factor was not markedly activated in NO-treated RAW/SEK1-WT cells. Supershift analysis demonstrates that NFkB was composed of mainly p50 homodimer. Also pyrrolidine dithiocarbamate (PDTC), a strong inhibitor of NFkB, significantly inhibits the NO-induced apoptosis in RAW/SEK1-KI cells. Taken together, we suggest that SEK1 may play anti-apoptotic role in RAW cells from NO-induced apoptosis via the modulation of NFkB. In addition, in the absence of SEK1 kinase cascade activation, the viability of RAW cells may be mainly dependent on Ras/Raf/MEK/ERK pathway.

유식세포 분리분석기를 이용한 T 세포아군의 분석

安秉庸,鄭憲鐸 圓光大學校 基礎自然科學硏究所 1989 基礎科學硏究誌 Vol.8 No.1

단크론 항제 Anti Leu-3a, Anti Leu-2를 사용하여 유식세포 분리분석기를 이용한 정상인 30명과 간염환자 60명의 말초혈액 T 세포아군을 정량분석한 결과 다음과 같다. 1. 정상인의 말초혈액 림프구 중 T1^+, T4^+, T8^+, T4^+/T8^+ 비율은 각각 70.7±35%, 42.1±3.7%, 29.0±3.4%, 1.56±0.21%였다. 2. 바이러스성 간염환자에서 T4 양성세포 비율은 만성 바이러스 간염환자 보다는 급성 바이러스 간염환자에서 증가되는 경향을 보였으며, T8 양성세포비율은 급성 바이러스 간염환자 보다 만성 바이러스 간염환자에서 증가됨을 보였다. 3. 만성 간염환자에서 T1 양성세포가 급속히 감소됨을 보였다. 이와 같은 결과로 보아 간염환자의 면역기능이 발병학적인 T1 양성세포의 현저한 감소로 보아 만성간염환자의 방어기능은 NK(Natural Killer)세포가 주로 역할을 하는 것으로 사료된다. The impeortance of a balance between helper and suppressor cell in maintaining immune homeostasishas recently been illustrated and abnormalities in these T cell subsets have been associated with anumber of himan diseases. It is well known that immune respone to a virus may be regulated byimmumoregulatory network. In this study author analysed the subset of lymphocyte in peripheral bloodduring acute or chronic viral hepatitis. In healthy adults, the percentage of T1^+, T4^+,T8^+, and T4^+/T8^+ratio was 70 7±3.5%, 42.1±3.7%, 29.0±3.4%, and 1.56±0.21, respectively. In viral hepatitis, the percentage of T4^+ was tended to be increased in acute hepatitis than chronic hepatitis and the percentageof T8^+ was tended to be increased in chronic hepatitis than acute hepatitis. The percentage of t1^+was significantly decreased in chronic viral hepatitis than healthy adults. On the basis of these resultsthis study suggested that immunologic response in considered a likely pathogenic determinant in viralhepatitis and NK cells play a role in the host defence responses to chronic viral hepatitis.

고전압 응용을 위한 4H-SiC Schottky Barrier Diode의 제작 및 특성

금병훈,강수창,박종대,신무환 명지대학교 대학원 1998 대학원논문집 Vol.2 No.-

This paper discusses about the processing and characterization of the high breakdown voltage 4H-SiC Schottky Barrier Diode. Two types of the devices were fabricated one was fabricated using the passivation layer and the other was fabricated without the passivation. In case of the device with passivation layer, breakdown voltages were in the range 120 V to 300 V, which is quite higher compare to the devices fabaricated from Si or GaAs. However, this value is lower than the theoretically predicted value. The reverse leakage current of the devices was quite low which is less than 10^7 Amp at the reverse bias voltage of 220 V.

유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.