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.

우리 나라 보건관리대행서비스 평가 연구

하은희,조수헌,김선민,주영수,한상환,하미나,권호장,홍윤철,김창엽 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.1

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially in continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions,. Quality in terms of accessibility and continuity highly varied among institutions., To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.

자폐장애 아동의 염색체 분석

하재창,정철호,채성수 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.4

The authors studied chromosomal abnormalities in 30 autistic children meeting the diagnostic criteria of DSM-III-R in order to evaluate association between autistic disorder and fragile X syndrome. All samples were analyzed 100 metaphase cells on short-term lmyphocyte cultures in Medium 199 that contained FUdR. Numbers of chromosome were 46XX or 46XY in all samples. One autistic boy was found having one fragile X chromosome among 100 cells, but this finding is negative since positivity of fragile X syndrome was defined as 3% (3 out of 100) of cells being positive for fragile Xq27-28. Other chromosomal abnormalities, such as gap and breakage, were found in 3 boys. These results does not support the hypothesis that fragile X syndrome is an etiological factor in autistic disorder. Therefore, a further research of fragile X syndrome in larger populations of autistic disorder, mental retardation and normal control groups is needed to confirm whether fragile X syndrome plays any part in the development of autistic disorder.

산업재해 환자의 삶의 질, 자살사고 및 우울증상

김수인,연규월,하은희,우행원,김영철 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 최근 산업재해(이하 산재) 및 교통사고 발생이 증가하면서 사고 후유증으로 치료받는 환자들이 늘어나고 있다. 산재를 포함한 각종 사고들은 환자의 신체적 상태를 변화시킬 뿐 아니라 이로 인한 사회적, 직업적, 경제적 문제들을 초래하게 되고 환자의 삶 전체를 변화시킬수 있다. 본 연구에서는 산재가 환자들에게 미치는 정신적 영향을 알아보기 위해 산재 환자들과 대조군에서 삶의 질, 자살사고 및 우울증상을 비교하였다. 방 법 : 연구대상은 1999년 12월 21일부터 12월 30일 사이에 경상남도 울산 마산·창원지역의 입원한 산재환자 169명이었고 정상 대조군은 울산의 공업단지 내 일반근로자 166명이었다. 평가군과 대조군 모두 남성이었고, 19세에서 60세였다. 모든 대상에서 일반 인구학적 특성, 삶의 질, 자살사고, 우울 증상을 평가하였고, 산재 환자군의 경우 사고일시, 사고원인, 치료기간, 손상부위를 추가로 조사하였다. 주관적 삶의 질은 한국판 스미스클라인 비챰 삶의 질척도로 평가하였고, 자살사고는 Beck의 자살사고(思考)척도로 평가하였으며, 우울증상은 PRIME-MD를 개선한 Patient Problem Questionaire의 우울증 척도로 평가하였다. 결 과 : 산재환자군과 대조군간 일반 인구학적 요인에서 통계적으로 유의한 차이 없었다. 산재환자군이 대조군에 비해 유의하게 낮은 삶의 질 척도 점수를 나타냈고, 유의하게 높은 자살사고와 우울증상을 나타냈다(p<.05). 산재환자군에서 연령, 결혼상태, 치료기간과 삶의 질 점수는 관련이 있었다. 30대 이상의 연령에서 유의하게 낮았고 10∼20대 연령에서 유의하게 높았으며, 미혼이거나 이혼, 별거중인 경우 유의하게 삶의 질 점수가 낮았고, 치료기간이 길수록 낮았다. 치료기간과 자살사고가 관련있었으며, 치료기간이 길수록 자살사고가 많았다. 산재환자군에서 손상부위에 따라 삶의 질 점수, 자살사고 점수와 우울증상이 유의한 관련이 있었다. 삶의 질 점수는 요추부 손상군에서 높았고, 경추부 손상군과 다발성 좌상환자군에서 낮았다(p<0.01). 자살사고 점수는 경추부손상군과 다발성 좌상 환자군에서 높았고, 요추부 손상군에서 낮았다(p<0.01). 연구 대상군에서 삶의 질 점수, 자살사고 점수, 우울증상간 유의한 상관관계가 있었다. 결 론 : 본 연구 결과 산재환자들은 일반 근로자들과 비교하였을 때 삶의 질이 낮다고 느끼고 있었으며, 주관적으로 우울감과 자살사고를 많이 나타냈다. 따라서 산재로 인한 우울 및 자살등의 증상을 예방하기 위해서는 조기 정신과적 치료 중재가 반드시 필요하다고 생각된다. Objective : As the occupational and traffic accidents are increased, patients who are treated for complications of accidents have been increased in recent years. Accidents including industrial injury affect the physical state of the patients and make social, vocational, and economic problems, so that they can affect the whole life of the patients. We performed this study to compare subjective evaluation of quality of life, depressive symptoms, and suicide ideation in both industrial injury patients and control subjects in order to know how industrial injury affect patients in psychiatric aspect. Method : The subjects were 169 inpatients who met the inclusion criteria of industrial injury patients and 166 healthy control subjects. All subjects were male and their age is from 19 to 60 years old. Demographic variables, quality of life, depressive symptom, suicide ideation were assessed in subjects. The types of injury and duration of treatment were assessed in patients. The quality of life was measured using the Korean version of SmithKline Beecham 'Quality of Life' Scale(KvSBQOL), and the suicide ideation was measured using the Scale for Suicide Ideation(SSI), and the depressive symptom was measured using the Dpression scale of Patient Problem Questionaire(PPQ) which were devised from Primary Care Evaluation of Mental Disorder(PRIME-MD). Results : 1) There were no significant differences in the general demographic variables between industrial injury patients and control subjects. 2)Scores of KvSBQOL were significantly lower, and SSI and Depression scale of PPQ were significantly higher in the industrial injury patients than control subjects(p<0.05). 3) In industrial injury patients, there was a correlation between the age and the scores of KvSBQOL(p<0.01). The scores of KvSQOL were lowest in older than 30's, highest in 10's-20's. No significant correlation was recognized between the age and the suicide ideation, the depressive symptoms. Threre was a correlation between the marital status and the scores of KvSBQOL(p<0.01). In unmarried, divorced or separated state, the scores of KvSBQOL were significantly lower than married state. There was a correlation between the the duration of treatment and the scores of KvSBQOL, the suicide ideation. As the duration of treatment was longer, the scores of KvSBQOL were significantly lower(p<0.01), and the scores of SSI were significantly higher(p<0.01). 4) In industrial injury patients, there was a significant correlation between the type of injury nd the scores of KvSBQOL, the suicide ideation, and the depressive symptoms. The scores of KvSBQOL were highest in the L-spine injury patients, lowest in the C-spine injury and multiple contusion patients(p<0.01). The scores of SSI were higher in the C-spine injury and multiple contusion patients, lowest in the L-spine injury patients(p<0.01). 5) In subjects, there was significant correlation between the scores of KvSBQOL, the scores of SSI, and the Depression scale of PPQ. Conclusion : Industrial injury patients feel bad about the quality of life and have more depression and suicide ideation. As a results, psychiatric intervention is needed for prevention of depression and suicide due to industrial injury.

連續放射能 測定監視器에서 較正常數의 에너지依存性 計算

李秀容,陸鍾澈,河正雨 대한방사선 방어학회 1981 방사선방어학회지 Vol.6 No.1

A method is presented by which precise evaluation of radioactive concentrations in liquid or gaseous effluent released from large nuclear facilities is possible. Calculations have been made of the calibration constants at different energies for a commonly used liquid and gaseous effluent monitors as well. It is expected that the method could be applicable to the particular monitors with different geometrical configuration with simple modifications.

퍼지모델링을 이용한 저속비대선의 선미형상 주요치수 결정

김수영,김현철,정성재,하문근,안당,신수철 釜山大學校生産技術硏究所 1998 生産技術硏究所論文集 Vol.55 No.-

본 연구에서는 유전자 알고리즘을 적용한 퍼지모델링 기법을 이용하여 저속비대선에서 선미형상의 주요치수를 결정하고, 이를 실적선과 비교하였다. . This paper presents a method that determines the stern profile dimensions for full, slow-speed ship using fuzzy modeling, applied the genetic algorithm and compares with the database of ships

동충하초 투여가 최대하 운동 시 지방연소에 미치는 영향

김철우,이용수,이상현,이상호,하민수,윤영조,이재일 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.4

The purpose of this study was to evaluate effects of Cordyceps militaris on fat oxidation during submaximal exercise. Fifteen healthy male collegiate students(ingestion group, N=7; control group, N=8) participated as subjects after signing an informed consent following overnight, subjects completed maximal graded execise test on treadmill to determine exercise intensity(50%VO2max). To evaluate the fat oxidation using indirect calorimeter, it was performed submaximal treadmill to determine exercise lasting. 40min at 50%VO2max after 5day and consumed Cordyceps militaris on separate days. This study was used 2×4 two way repeated ANOVA to analyze physiological and metabolic variables between two groups and metabolic variables between two groups and four exercise periods(l0min, 20min, 30min 40min), and used Scheffe to post-hoc test. Significance was set at α=.05. The results of this study were as followed: First, there were significantly highest in ingestion group for V02, percentage of fat oxidetion(%fat), fat per kilocarolies(Fkcal), and total per kilocarolies(Tkcal)(p<.05), but respiratory exchange ration(RER) and heart rete(HR) were significantly lower in ingestion group(p<.05). Second, RER, %fat, Fkcal were significantly difference in 10, 20, 30, 40min of exercise period(p<.05). This results suggest that there is the effect of Cordyceps militaris on fat oxidation submaximal exercise. Additionally, to evaluate effect of Cordyceps militaris as ergogenic aid, it should be required the future study that included extend subjects, various dosage, and chronic consumption.

고온에서 회전하는 터빈엔진 디스크의 응력해석

황수철,국정한,조재웅,하영민 한국공작기계학회 1995 한국생산제조학회지 Vol.4 No.4

This study includes thermal plasticity analyses for a turbine rotor with the simple geometry and the boundary conditions. When centrifugal or thermal stress are applied at the high temperarture material of engine blade, stress distributions in material σ_rr, σ_θθ, τ_rθ. Mises stress) are analyzed by computer simulation(ABAQUS) as followings; 1. The maximum stress at the radial direction (σ_rr) is applied at the upper middle part of spline hole. 2. The maximum stress at the tangential direction (σ_θθ) is applied at the upper right boundary of spline hole. 3. The maximum shear stress (τrθ) in (-) direction is applied at the upper middle part of spline hole. 4. The maximum Mises stress is applied at the upper right boundary of spline hole. This stress is due to the critical stress by which rotor can be fractured according to elapsed time.

트레이닝 특수화에 의한 척추만곡 상태에 미치는 영향

김영국,하철수 江原大學校附設 體育科學硏究所 1996 江原大學校附設體育科學硏究所論文集 Vol.- No.20

For a study to influence on modification of the spinal column by exercise. statistical hypothesis tests between right handed unbalance exercise group,30 baseball players, and balance exercise group,30 gymnastics players, were accomplished. P< .01 denote the probability of spinal column moidfication caused by unbalance exercise and different data will be shown in right handed baseball players between gymnastics players. 1. To the influence on lordosis, the probability of accepting is highly significant. P, the level of significance denote P< .01. It me ans lordos is was influenced by unbalance exercise. 2. To the influence on kyphosis, the result is not significant by P < .10. 3. To the influence on soliosis,result at cervical number 5 and thoracic number 3 are not significant by P< .10, but the result at lumba number 2 is highly significant by P < .001. 4. To the influence on spinal curvature, the result is not significant by p < .10. 5. To the influence on lumbar-sacral angle, the result is not significant by p <.10. 6. To the influence on sacral angle, the result is significant by p < .05. 7. To the influence on COBB analysis for lordosis and kyphosis, the result is very significant by P < .001.

개 대뇌겉질에서 Platelet-Derived Growth Factor α-Receptor의 출생 후 발달에 관한 면역조직화학적 연구

윤영,안병수,김인정,양경철,박선홍,김기훈,박도영,김장만,문정석,장인엽,조하영 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background and Objectives : The localization of platelet-derived growth factor-α receptor (PDGF-α R) was commonly restricted to oligodendrocyte progenitors during late embryonic and postnatal development. However, several studies recently demonstrated that mature neurons could also synthesize PDGF-α, Materials and Methods : In the present study, to analyze the distributional pattern of PDGF-αR during postnatal development of the canine cerebral cortex, we used immunohistochemistry on sections of canine brain tissue. Results : We found that neurons of various regions of cerebral cortex exhibited the immunoreactivity to PDGF-αR as early as postnatal day 0, and slightly decreased after postnatal day 14. Whereas neuronal PDGF-αR were maintained at all ages, the oligodendroglia-like expression of PDGF-αR could not be confirmed. Conclusion : The localization of PDGF-αR in immature and mature neurons supports the several roles of PDGF during development, protection and survival of neurons.