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.

피나무(Tilia amurensis), 뽕잎피나무(T. taquetii), 일본피나무(T. japonica)의 형질분석을 통한 분류학적 한계

尹準九,張珍成,金輝,張桂羨,李興洙 서울大學校農業生命科學大學附屬樹木園 2003 서울大學校 樹木園 硏究報告 Vol.- No.23

본 연구는 한국산 피나무속의 3종(T.amurensis, T. insularis, T. taquetii)과 일본피나무(T.japonica)를 대상으로 6개 정량 형질(잎의 길이와 폭, 털의 밀도, 화경의 길이, 열매의 길이와 폭)을 비교 검토하였다. T.amurensis(피나무)와 T. insularis(섬피나무) T. taquetii(뽕잎피나무)는 기존에 잎의 크기와 털의 정도가 주요 형질로 알려져 있지만 본 연구결과 모두 뚜렷한 구분이 없는 연속변이를 보였다. 또한, 일본피나무와 국내 자생 피나무와 비교한 결과 기존에 알려진 화경의 길이에서 차이를 보였는데 제한된 개체를 근간으로 조사한 결과 일본피나무가 다소 긴 것을 확인하였다. 국내 자생 피나무, 섬피나무, 뽕잎피나무의 경우 독립된 종이기보다는 모두 피나무의 지역적 변이체임을 확인함과 동시에 동일종으로 처리하는 것이 타당하다고 생각한다. 그러나, 일본피나무의 경우는 좀 더 많은 개체수를 확보하여 화경의 길이에 대해 보다 자세한 조사가 이루어져야 할 것으로 생각된다. The hair density and type of leaf and bract, size of leaf and absence/presence of staminodes are important to recognize many taxa of Tilia. The systematic relationships among T. amurensis, T. insularis, T. taquetii in Korea and T. japonica in Japan were confused and were not clarified yet. Flower and fruit specimens of 121 individuals were sampled to investigate patterns of intraspecific variation and to evaluate the species delimitation among Tilia amurensis, T. taquetii, T. insularis, and T. japonica using six characters. The morphological differentiation among T. amurensis, T. insularis, and T. taquetii was not sufficient to warrant recognition of either specific or varietal status and should be treated as conspecific under T. amurensis. Based on results of limited number of specimens, the morphological discontinuity between T. amurensis and T. japonica was found only in peduncle length. Further study on this reproductive character are required to conduct any taxonomic treatment on these taxa.

국내 살모넬라 분리주에서 spvR 유전자 분포와 단일 뉴클레오티드 다형 연구

권혁준,박경윤,박주연,박용호,김선중,유한상 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 지금까지 병원성 살모넬라를 확인하기 위해 분자량이 큰 플라스미드의 존재 유무를 확인하여 왔으나 살모넬라 혈청형 및 검출 방법에 따라 양성율에 큰 차이를 보이고 있고, 일부 병원성 살모넬라 분리주에서 병원성 플라스미드가 관찰되지 않아 spv 유전자들의 유무에 대한 아른 확인방법이 필요하다. 본 실험은 국내 동물 유래 주요 살모넬라 혈청형에서 spvR 유전자의 분포를 알아보고, 병원성 살모넬라 분자진단을 위한 분자표지로써의 가치를 평가하기 위해 실행하였다. 재료 및 방법 : 국내 가축 유래 S. lyphimurium (ST, 26주), S. enteritidis (SE, 10주), S. pullorum (SP, 40주), S. gallinarum (SG, 53주)에 대해 GenBank에 등록된 ST, SE, SP의 spvR 유전자를 비교하여 ST와 SE 간에 차이를 보이는 single nucleotide polymorphism (SNP, 625번 뉴클레오티드)을 포함하도록 시발자를 합성하여 집락-PCR을 수행하였다. 증폭 산물(194bp)은 자동 염기서열장치를 이용하여 염기서열을 결정하였고, 제한효소인 MseI을 사용하여 PCR-RFLP를 실시하였다. 결과 : 집락-중합효소연쇄반응 결과 SP, SG, SE의 모든 (100%) 분리주에서 특이 증폭산물이 검출되었으나 ST의 경우 19주(73%)에서만 증폭되었다. 특히 병원성 관련 플라스미드가 관찰되지 않았던 SP 4주에서 특이적인 증폭산물이 검출되었다. 염기서열 분석결과 SE, SG, SP는 625번 뉴클레오티드에 아데닌을, ST는 구아닌을 가지고 있어 PCR-RFLP를 이용하여 쉽게 구분할 수 있었다. 결 론 : spvR에 대한 집락-중합효소연쇄 반응법은 병원성 플라스미드 검출법보다 SE, SP, SG 병원성 주를 신속하게 검출하는데 유용하고, 625번 뉴클레오티드의 SNP는 ST와 SE, SG, SP를 구분하는 분자표지로 사용될 수 있을 것으로 기대되며, ST에 비해 SE는 진화적으로 SG와 SP에 가까운 것으로 생각되었다. Background : The Salmonella virulence plasmid (spv) genes (spvR, A, B, C and D) on the large virulence plasmids of pathogenic Salmonella serotypes can replace the virulence of the whole plasmid. Recently, virulence plasmid-negative pathogenic Salmonella isolates were isolated. However, positive rates of spv genes among Korean Salmonella serotypes have been obscure. spv genes are conserved in compared to other virulence genes but there are single nucleotide polymorphisms (SNPs) conserved in only certain serotype. Such SNPs are useful for differentiation and understanding evolution of certain serotypes. Materials and Methods : Salmonella serotypes isolated from live stocks [Salmonella typhimurium (ST, 26), S. enteritidis (SE, 10), S. gallinarum (SG, 40) and S. pullorum (SP, 53)] were used for colony-PCR. A primer set covering single nucleotide polymorphism (SNP) at 625th nucleotide of spvR was designed. The nucleotide sequences of amplicons were determined by cyclic sequencing method and RFLP was performed by using MseI. Results : All isolates of SE, SG and SP, including four plasmid-negative isolates, showed specific amplicons but not all of ST (19/26, 73%) were positive to spvR. Based on the nucleotide sequence of 625th nucleotide and PCR-RFLP, SE, SG and SP [A(625)] and ST [G(625)] could be differentiated. Conclusion : spvR can be used as a molecular marker to detect virulent SE, SG, SP and the SNP may be useful for differentiation of SE, SG, SP and ST. According to the SNP study SE may be evolutionarily closer to SG and SP than ST.

알레르기 환자에서 특이알레르겐 항체 양성율과 관련요인

이선화,남해선,이성수,안현철,황규윤,박준수,,박춘식 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.2

Recently, allergic diseases are very prevalent in Korea, resulting in physical and economic losses during the life. It is well-known that the principle therapy is identification, eradication, and desensitization of allergens. There are many allergic diagnostic tools for identification of specific-allergens. However, none of them is satisfied with its efficiency due to lack of validity. Recently MAST-CLA has been widely used in the allergic clinical fields because of its simplicity and simultaneous identification of allergens. This study was designed to determine the positivity of allergen-specific antibodies using MAST-CLA in patients with allergic diseases, and evaluate the efficacy for allergen detection, compared to results of skin prick test. During June 2000 - September 2001, 325 study subjects visited Soonchunhyang University Chunan Hospital for the evaluation of allergic problems. Among them, 289 subjects were diagnosed with allergic disease and included for the study. Thirty four subjects visited children's allergic unit were evaluated specific allergens using a skin prick test at the same time. Our result as follows; 1. The positive rates of allergen-specific antibodies and total IgE were 51.2% and 73.4%, retrospectively. 2. There was significant difference in positive rate in age group, showing highest in teen ages(73.6%), but insignificant difference in sex in allergen-specific antibodies. 3. The positive rate was 60.4% in allergic rhinitis, 51.3% in allergic dermatitis, 46.9% in bronchial asthma, and 39.1% in urticaria in order(P=0.073). 4. Significant difference in month or season was observed, with highest rate in April(78.1%) and May(72.1%). The highest season was in spring(62.7%), and then summer(52.8%), fall(50.3%), and winter(41.4%) in order (P=0.04). 5. The three highest allergen-specific antibodies were D. pteronyssinus(39.3%), D. farinae(38.3%), and house dust(24.3%) in Korean inhalant pannel, However, in food pannel types of allergen-specific antibody were different as D. farinae(18.5%), Alternaria(18.5%), house dust(17.3%). 6. There were significant agreements between MAST-CLA and Skin prick test (D. farianae Kappa=0.636;D. pteronyssinus Kappa=0.78, both P<0.001) In conclusion, MAST-CLA could detect allergen-specific antibodies in patients with allergic diseases as a simple and valid tool of screening of allergy. Especially, it could be a useful measure of multiple allergens simultaneously in children However, more detailed allergens and valid assay for unmeasured allergens should be identified for Korean-specific allergens.

고등부 유도 지도자의 지도행동 유형분석

이준희,윤익선 龍仁大學校 武道硏究所 1997 武道硏究所誌 Vol.8 No.2

In this assentation I tried to investigate and analyze the actual behaviors of the coaches of the high level male and female team and the behaviors that the players of the team prefer. I came to conclude like the followings through the analysis of 432 Leadership scale for sports from 30 coaches and 432 players in the 30 teams which is constitute of the 20 coaches and 309 players in 20 male high level teams and the 10 coaches and 123 players in 10 female high level teams. 1) The coaches in the male teams are better in efficiency of teaching because the male team coaches are better in the background variables of age, career, and the career of winning the prize. 2) In the assentation on the actual of coach the male team coaches have the strongest disposition of behavior that influence on the advancement of the game, whereas the female team coaches the strongest disposition of democratic behavior. Considering such the differences of leadership behaviors, the coaches of male team have the disposition of emphasis of the task, whereas the coaches of female team emphasis of the relations. 3) In the research of leadership scale among the teams, the male players prefer behavior of training and indicating, positive reward, social support, democratic, and then authority behavior whereas the female players positive reward, social support, democratic, training and indicating and then authority. 4) In the research of preferable behavior, male players prefer the training and indicating, positive reward, social support, and then authority behavior, whereas the female players positive reward, social support, democratic behavior, training and indicating and then authority behavior. The male players were found to prefer such behaviors as influence the advancement of the game power directly, whereas the female players most prefer such behaviors as reward the results of the game. 5) In the comparison of the leadership behaviors that male and female players prefer, the male players have stronger disposition to want training and indications, authorities than female players,, whereas the female players prefer the democratic behaviors, social supports, positive rewards. 6) In the differences of the actual behaviors the players want from the coach, the male players differs in the democratic behaviors most, whereas the female players in the authority behaviors. 7) In the research on the differences of the behaviors the coach actually do and the players expect, ·in the training and indications, the male team players were a little more satisfied than the female team players. ·in the democratic behaviors, the male team players were more unsatisfied. ·in the authority behaviors, the female team players want more authorities from the coaches. ·in the social supports, the female team players were more unsatisfied. ·in the positive rewards, the female team players were more unsatisfied.

急性特發性心囊炎의 1例

金星潤,孫宜錫,李禎均,許鳳烈,咸駿洙,金鮮宙 대한의학협회 1977 대한의학협회지 Vol.20 No.9

CM적용을 통한 효율적인 재건축 사업 활성화 방안

김해선,윤준선,백준홍 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

People are concerned with Quality of living in these days. This concerns naturally increase people's interests in real estate especially housing reconstruction. Due to the apartment housing has been deteriorated, the residence want to reconstruct the apartment housing that had been build in the late 70's. The problem for this matter is that an association is not Qualified in reconstruction. It makes many problems such a miss-processing and fairness. If CM service is applied in reconstruction industry, participant of reconstruction will gain benefits and solve many complicate problems. In this study, we can define how to adapt CM services in housing reconstruction by comparing to CM service with needs of association that is obtained through analyzing

Olanzapine 복용 이후 당뇨병 케톤산증이 발생한 정신분열병 환자

이중선,김진용,안준호,김창윤 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

The use of olanzapine has been associated with clinically significant hyperglycemia (exacerbation of existing diabetes, new-onset type 2 diabetes and diabetic ketoacidosis). We report a case of diabetic ketoacidosis (DKA) in 30-year-o1d male patient with schizophrenia who was on olanzapine. When he was admitted to the hospital because of DKA, he had been taking olanzapine for 43 months. 14 months before the admission, his fasting and 2 hour postprandial serum glucose levels were normal. He had no personal and family history of diabetes mellitus. He had no risk factor for diabetes mellitus except for obesity (body mass index : 39.2 kgW). He also hadno precipitating factors for DKA such as infection or myocardial infarction. Periodic monitoring for changes in serum glucose levels in patients taking olanzapine may be needed.

국내 민간투자(SOC)사업의 효율화 방안에 대한 연구

이호경,김상철,윤준선,백준홍 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The purpose of this study is to examine the theoretical concept and practical example of Social Overhead Capital(SOC) project based on development of nation the world. Also, the critical access is to find the way we can develop domestic SOC project underway in private and nationwide. Furthermore, anther access is to propose clearly how to utilize BOT, BTO in financial, technical, CM method focusing on more systematic and effective result.

신축학교 실내공기질이 초등학생들의 인지기능에 미치는 영향

김태섭,김선주,박시영,전만중,김규태,김창윤,정종학,백성옥,사공준 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 신축초등학교와 대조학교를 선정하여 교실 내 포름알데히드와 TVOCs를 측정하고 컴퓨터 신경행동검사를 이용하여 실내공기 오염물질이 학생들의 인지기능에 미치는 영향을 평가하였다. 방법: 신축초등학교 5학년 71명을 실내공기 오염물질 노출군으로 하고, 개교한지 12년째인 대구시의 일개 초등학교 5학년 2학급 63명을 대조군으로 하여 실내공기 오염물질농도 측정 및 컴퓨터 신경행동검사를 실시하였다. 결과: 신축학교에서 의도적으로 창문을 개방한 학급에서 1교시 포름알데히드 농도는 34.6 ㎍/㎥, 4교시에는 27.3 ㎍/㎥, 창문을 개방하지 않은 학급에서 1교시 80.2 ㎍/㎥, 4교시 127.1 ㎍/㎥, 대조학교에서는 2학급 각각 1교시에 12.6 ㎍/㎥, 7.5 ㎍/㎥, 4교시에 19.8 ㎍/㎥, 25.2 ㎍/㎥였다. TVOCs의 경우 신축학교의 의도적으로 창문을 개방한 학급에서 1교시에 농도는 487.2 ㎍/㎥, 4교시에 428.2 ㎍/㎥, 창문을 개방하지 않은 학급에서 1 교시에 농도는 1,283.5 ㎍/㎥, 4교시에 1,715.4 ㎍/㎥, 대조학교의 경우 2학급에서 각각 1교시에 농도는 240.9 ㎍/㎥, 150.8 ㎍/㎥, 4교시에 농도는 371.9 ㎍/㎥, 448.0 ㎍/㎥였다. 부호숫자 짝짓기의 평균반응시간은 대조학급이 1교시에 2,585 msec에서 4교시에 2,459 msec으로 감소한 반면 신축학교의 창문을 의도적으로 개방한 학급은 2,343 msec에서 2,510 msec으로, 평소대로 수업한 학급은 2,340 msec에서 2,563 msec으로 반응시간이 각각 167 msec, 223 msec 증가하였다. 1교시의 부호숫자 짝짓기 의 반응시간을 100%로 했을 때 창문을 의도적으로 개방 한 학급은 4교시에 5.9% 증가하였고(p<0.01), 평소대로 수업한 학급은8.3% 증가하였다(p<0.01). 반면에 대조학급은 4교시에 5.0% 감소하였다(p<0.01). 결론: 향후 학교의 실내공기질의 안전성 평가는 샘플링 된 공기의 오염수준의 측정뿐만 아니라 학생들의 건강영향도 함께 고려되는 것이 바람직할 것이다. Objectives: Most studies on the indoor air quality of newly built schools have focused only on the number of schools exceeding a standard or on subjective symptoms, such as sneezing, irritated eyes and an irritated nose. However, there has been no report on how poor indoor air quality affects children's academic performance. This study evaluated the effects of indoor air quality on the neurobehavioral performance of elementary school children. Methods: This study measured the indoor air pollutants and compared children's performance, using a computerized neurobehavioral test, between a newly built and a 12-year-old school. In addition, a questionnaire was administered regarding the indoor air quality related symptoms of children in a newly built and a 12-year-old school. Results: In the newly built school, the formaldehyde levels in the 1^(st) and 4^(th) classes with an open window were 34.6 and 27.3 μg/㎥, respectively. The levels in the 1^(st) and 4^(th) classes with the window closed were 80.2 and 127.1 μg/㎥, respectively. In the 12-year-old school, the formaldehyde levels in 1^(st) and 4^(th) class with open and closed window were 12.6 and 7.5 μg/㎥, and 19.8 and 25.2 μg/㎥, respectively. With respect to total volatile organic compounds, the levels in the 1^(st) and 4^(th) classes with the window open in the newly built school were 87.2 and 428.2 μg/㎥, respectively. In the 1^(st) and 4^(th) classes with the window closed, the total volatile organic compounds were 1,283.5 and 1,715.4 μg/㎥, respectively. In the 12-year-old school, the total volatile organic compounds were 240.9 and 150.8 μg/㎥, and 371.9 and 448.0 μg/㎥ in the 1^(st) and 4^(th) classes, respectively. In the case of a newly built school, the performance of the students in the neurobehavioral test in the 4^(th) class with the window closed was 8.3% lower than for those in the 1^(st) class with the window closed, but was only 5.9% lower when the windows were open. There was a statistical significant difference in the total numbers of symptoms between the two schools. Conclusions: These results suggest a proper evaluation of the indoor air quality within schools is required into both the level of contamination and the health effects of these contaminants toward children.