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.

양극성 기분장애에서 세로토닌 수용체 유전자의 다형성(102T/C)에 관하여

지익성,신석철,왕성근,이선우,신용재,김충수,김상국,최하석,오승용,류택근,이영호 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

치료저항 정신분열병환자에서 Clozapine의 효과 및 안전성

지익성,김영희,신석철,왕성근,신윤오,이선우,김정란 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

In order to assess the efficacy and safety of clozapine, 50 in-patients with treatment-resistanat schizophrenia were evaluated using PANSS(Positive and Negative Symptome Scale for Schizophrenia), CGI(Clinical Global Impression), AMS(Abnormal Involuntary Movement Scale), Adverse Event-Somatic Symptoms, Neurological Rating Scale for EPS before and during treatment. Mean daily dosage of clozapine was 344.15±123.43mg at 12th week. A clinically significant improvement in positive, negative, and general psychopathology was noted as early as week 2 through 12 week. The tolerability of clozapine was generally found to be good. Drowsiness/sleepiness, Hypersalivation, and Constipation were the most common side effects. There was no neutropenia, and 3 patients suffered from seizures. These results suggest that clozapine is worth considering for the treatment-resistant patients

한국인 정신분열병 및 양극성 기분장애와 Catechol-O-Methyltransferase 유전자 다형성(Valine/Methionine)과의 연합연구

김명수,지익성,이선우,선석철,이영호 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 카테콜라민의 대사장애는 정신분열병과 양극성장애 같은 주요 정신질환에서 중요한 원인적 요인으로 주목받고 있다. Catechol-O-Methyltransferase(COMT)는 카테콜라민의 대사에 중요한 효소인데, COMT 유전자의 다형성(Val/Met)으로 인하여 COMT의 활동도가 달라진다. 본 연구는 COMT 다형성이 저신분열병과 양극성장애 같이 주요 정신질환의 발병에 있어서 유전적 요인으로 작용하는지 알아보기 위하여 시행되었다. 방 법 : 정신분열병 환자 128명과 양극성장애 환자 110명 그리고 정산이 176명 대상으로 중합효소 연쇄반을 이용하여 COMT 유전자의 유전자형과 대립유전자의 빈도를 비교하였다. 결 과 : 1)COMT의 유전자형은 정신분열병 환자군에서 Val/Val 76(59.4%), Val/Met 43(33.6%), Met/Met 9(7.0%)이었고, 양극성장애 환자군에서는 Val/Val 63(57.3%), Val/Met 35(31.8%), Met/Met 12(10.9)이었으며, 정상대조군에서 Val/Val 83(47.2%), Val/Met 79(44.9%), Met/Met 14(8.0%)이었다. 대립유전자의 빈도는 정신분열병 환자군에서는 Val 195(76.3%), Met 61(23.8%)이었고, 양극성장애 환자군에서는 Val 161(73.2%), Met 59(26.8%)이었으며, 정상 대조군에서는 Val 245(69.6%) Met 107(30.4%)이었다. 2)정신분열병 환자군, 양극성장애 환자군, 정상 대조군간의 유전자형(x²=7.541, df=4. P=0.110)이나, 대립유전자 (x²=3.268, df=2. P=0.200)에서 차이가 없었다. 정신분열병 환자군과 정상 대조군과의 비교에서 유전자형(x²=4.553, df=2. P=0.102)과 대립유전자(x²=3.199, df=1. P=0.081)에서 차이가 없었고, 양극성장애 환자군과 정상 대조군과의 비교에서도 유전자형(x²=4.907, df=2. P=0.086)과 대립유전자(x²=0.842, df=1. P=0.394)에서 차이가 없었다. 결 론 : 이러한 연구결과로 COMT 유전자 다형성(Val/Met)이 한국인 정신분열병과 양극성장애의 발병에 있어서 유전적 요인으로 작용할 것이라고 볼 수 없었다. Objective : Catechol-O-methyltransferase(COMT) is an important enzyme that inactivates biologically active or toxic catechols. Abnormal catecholamine transmission has been implicated in the pathogenesis of schizophrenia and bipolar disorder. Polymorphism(Val/Met) of the COMT gene polymorphism and schizophrenia and bipolar disorder in a Korean population. Method : COMT gene were genotyped with polymerase chain reaction and retriction enzyme NlaⅢ in 128 patients with schizophrenia, 110 with bipolar disorder, and 176 controls. Results : 1)The distribution of the COMT genotype in schizophrenic patients with Val/Val, Val/Met, Met/Met were 76(59.4%), 43(33.6%), 9(7.0%), in bipolar disorder patients were 63(57.3%), 35(31.8%), 12(10.9%), and in the controls were 83(47.2%), 79(44.9%), 14(8.0). The allele frequencies of the COMT gene in schizophrenic patients with Val and Met were 195(76.2%), 61(23.8%), in bipolar disoreder patients were 161(73,2%), 59(26.8%), and in the controls were 245(69.6%), 107(30.4%). 2)There were no differences in genotype distribution and allele frequencies of COMT gene polymorphism among the 3 groups. Neither patients with schizophrenia nor bipolar disorder differed in the genotype and allelic frequencies from the controls. Conclusion : These results suggest COMT gene polymorphism is not causally related to the development of schizophrenia and bipolar disorder in a Korean Population.

정신분열증에서 공존하는 신체질환에 대하여

지익성,왕성근,신석철,이선우,황선희,신용재,김정란,배경도 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

In order to determine the frequency of physical illness in schizophrenia, 107 schizophrenics were assessed with physical exam and routine laboratoy test. The results were as follows 1) Among the total number of 107 schizophrenics, 31 had the physical illness(29%), and among the schizophrenics with physical illness, female outnumbered male at the rate of 17:14. 2) There was no difference between schizophrenics with physical illness and schizophrenics without physical illness in demographic characteristics. 3) Classification of physical illness were disease of skin 7 (22.6%), musculoskeletal system 5(16. 1%), ENT(ear nose throat) 3(9.7%), endocrine system 3(9.7%), circulatory system 2(6.5%), respiratory system 2(6.5%), digestive system 1(3.2%), genitourinary system 1(3.2%), infection 1(3. 2%), eye 1(3.2%) respectively Authors suggest that physical exam and routine laboratory test should be done for all hospitalized psychiatric patients

탄광부 진폐증의 운동지수

조영선,김세곤,문우기,유재인,정치경 가톨릭대학 산업의학 센타 산업의학연구소 1984 韓國의 産業醫學 Vol.23 No.3

Exercise index(EI) was measured on 933 pneumoconiosis patients (865 patients with small rounded opacities and 68 patients with large opacities) and 176 suspected pneumoconiosis patients from Korean anthracitic mines, in order to evaluate the ventilatory impairment of pulmonary function according to the chest radiographic findings of pneumoconiosis. Exercise index was obtained from the maximum breathing capacity (MBC) and the exercise ventilation volume(EV) which were measured by spirometer and two step-test. Classification of pneumoconiosis was based on the international classification of ILO U/C. The results were as follows: 1. The mean value of E1 was significantly increased in pneumoconiosis patients with large opacities(46.0%) than in patients with small rounded opacities(26.5%) and with suspected pneumoconiosis(25.0%). The number of jpatients in substandard EI was 97.1% in patients with large opacities but 49.4% in patients with small rounded opacities and 40.3% in patients with suspected pneumoconiosis. 2. The mean values of EI and the number of patients in substandard EI were markedly increased in pneumoconiosis patients with small rounded opacities and suspected over 50 years of age. However, the number of patients in substandard EI showed no association with age in pneumoconiosis patients with large opacitis. 3. In pneumoconiosis patients with small rounded opacities, the mean values of EI and the number of patients in substandard EI showed significant association with the profusion (category) but no significant association with the type of small rounded opacities. 4. In pneumoconiosis patients with large opacities, the mean values of EI and the number of patients in substandard EI showed no significant difference between patients complicated with and without pulmonary tuberculosis. 5. No significant association of EI and the number of patients in substandard EI with the size of large opacities was observed in pneumoconiosis patients with large opacities, however, the mean values of EI showed increasing tendenccy in category B and C compared to category A.

성폭력 피해여성의 경험에 관한 연구

정연강,권혜진,지순주,남선영,김경희 韓國學校保健學會 1996 韓國學校保健學會誌 Vol.9 No.1

This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiousity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", 'avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging", "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "infromation availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporation the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthness. 6. The older the victims, The weaker the senses of being taken aback and filthness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 13. The more closed the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 17. The less available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The more familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 21.The less familiar the subjec is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 22. The more likely the response to 'being taken aback' and 'filthines' is 'informing' and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypothneses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined wit weak sexual curiosty and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness' , further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamilar. 3) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protecvice and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despit the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequnecy is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohension is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

Fast Computation of Zernike Moments Using Three Look-up Tables

Sun-Gi Kim,Whoi-Yul Kim,Young-Sum Kim,Chee-Hang Park 대한전기학회 1997 Journal of Electical Engineering and information S Vol.2 No.6

Fast Computation of Zernike Moments Using Three Look-up Tables

Kim, Sun-Gi,Kim, Whoi-Yul,Kim, Young-Sum,Park, Chee-Hang The Korean Institute of Electrical Engineers 1997 Journal of Electrical Engineering and Information Vol.2 No.6

Zernike moments have been one of the most commonly used feature vectors for recognizing rotated patterns due to its rotation invariant characteristics. In order to reduce its expensive computational cost, several methods have been proposed to lower the complexity. One of the methods proposed by mukundan and K. R. Ramakrishnan[1], however, is not rotation invariant. In this paper, we propose another method that not only reduces the computational cost but preserves the rotation invariant characteristics. In the experiment, we compare our method with others, in terms of computing time and the accuracy of moment feature at different rotational angle of an object in image.