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.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

烏貝散이 HCI-aspirin 으로 유발된 십이지장궤양에 미치는 조직학적 영향

구세광,이형식,김종대,한상원,김상찬,이재현 慶山大學校 基礎科學硏究所 1999 基礎科學 Vol.3 No.-

오패산이 HCI-aspirin tm으로 유발된 rat 십이지장궤양에 미치는 조직학적 영향을 관찰하기 위하여, 오패산을 1,3 및 5일 동안 경구투여하고 십이지장의 조직학적 변화를 관찰하였던 바 다음과 같은 결과를 얻었다. 실험 전 기간동안 대조군에서는 십이지장 융모의 위축과 붕괴가 관찰되었으며, 조직학적으로는 점막상피의 변성 및 탈락이 관찰되었고 점막고유층에서는 염증세포의 침윤(infilteration)의 소견이 관찰된 반면 오패산 투여군의 투여 1일에서는 대조군과 유사하게 관찰되었으나, 투여 3일후부터 점막상피의 첨부에서 경미한 카타르성 물질이 관찰된 이외에 정상군과 유사한 소견을 나타내었다. 이상에서 오패산이 십이지장궤양의 치유를 촉진시키는 것으로 관찰되었다. In order to study, the histological effects of Opeaesan on the duodenal ulcer induced by HCI-aspirin tm in rate, experiments were done by oral administration and observed histological profiles of the ulcerative lesions. Ulcerative lesions were unmerously detected in control groups especially in pylorus-duodenal junctions. Histologically, very severe injury to duodenal epithelium wer observed in control groups and these injuries were increased with time intervals. But in the Opaesan-administration groups, no gross lesion of ulcer were demonstrated and histologically minor injury to the mucosal epithelium were observed. Among the Opaesan treatment groups, most slight injuries to duodenal mucosa were detected in 5 days after administration when the histological profiles were similar to that of normal groups. According to these result, it is suggested that Opaesan should be used in treatment of the duodenal ulcer but the funcitonal mechanisms were unknown.

금속가공유 사용 근로자에서 발생한 과민성폐장염 1예

이선웅,고동희,진구원,박동욱,이정탁,송윤희,이상윤 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

서론: 과민성폐장염의 원인물질로 금속가공유는 외국의 경우 작업장의 집단발병 사례들을 중심으로 많은 보고가 되어 왔으나 우리나라에서는 아직 보고되지 않았으며,저 자들은 금속가공유에 1년간 노출된 근로자에서 발생한 과민성폐장염 1예를 발견하였기에 작업환경측정을 시행한 후 작업관련성을 평가하여 보고하는 바이다. 증례: 64세 남자 환자가 1년간 강관을 절단하는 작업을 한 후 호흡곤란을 주소로 내원하였다 노출력,임상적 소견 및 방사선학적 소견을 토대로 과민성폐장염으로 진단되었다. 작업환경 측정결과 공기 중 금속가공유,엔도 톡신,총 세균 및 곰팡이는 각각 0.531 mg/m³, 6.33 EU/m³ 100 CFU/m³ 및 75 CFU/m³이었고,금속가 공유 내 엔도톡신,총세균 및 곰팡이는 각각 1.5x10⁴EU/mL,4.6x10^(5) CFU/mL 및 1.8×10^(5) CFU/mL이었다. 고찰: 금속가공유 내의 원인항원에 대한 침강항체를 검사하지 못했으나,작업환경 측정결과 금속가공유가 일반적인 허용가능 수준 이상으로 오염되었으며,기존의 과민성폐장염 발생 사례들과 비슷한 수준 또는 그 이상으로 오염되어 있었다. 공기 중 금속가공유 농도 역사 NIOSH의 REL과 ACGIH의 NIC를 초과하고,기존의 사례들에 비해서도 대체적으로 높은 수준 이었다. 금속가공유 이외의 다른 원인에 대한 감별과 기존의 발생사례들과의 노출수준 비교를 통하여,저자들은 환자가 금속가공유에 의한 미생물 항원에 노출되어 과민성폐장염이 발생한 것으로 판단하였다. Introduction: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. Case report: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m³, 6.33 EU/m³, 100 CFU/m₃ and 75 CFU/m³, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5 X 10⁴EU/mL, 4.6 X 10^(5) CFU/mL and 1.8 X 10^(5) CFU/mL, respectively. Discussion: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

腦半球의 選好와 學業成就 및 知能과의 相觀硏究

李聖求 단국대학교 사범대학 특수교육과 1983 특수교육 Vol.3 No.-

1. Problems The purpose of this study is to display which hemispheric preference is related to academic achievements and IQ. The major research problems are as follows: 1) The relationship between dominant hemispheric preference and academic achievements. (1) The students who have dominant left hemispheric functions will have a close interrelationship with school subjects which belong to same hemispheric functions. The school subjects are Korean Language, Mathematics, Chemistry, Biology, English, German and French. (2) The students who have dominant right hemispheric functions will have a close interrelationship with school subjects which belong to same hemispheric functions. The school subjects are Physical Educations, Music, Drawing, Technique and Industry. 2) The relationship between dominant hemispheric preference and intellectual factors. (1) The students who have dominant left hemispheric functions will have a close interrelationship with verbal and numerical ability. (2) The students who have dominant right hemispheric functions will have a close interrelationship with visuo-spatial ability. (3) The students who have integrated functions will have a close interrelationship with IQ. 2. Methods 1) Subjects: The subjects consisted of 327 first grade students of high school in Seoul. (boys: 159, girls: 168). They were sampled from academic track schools. 2) Instrument: "The Your Style of Learning and Thinking," Form-B was the assesment instrument employed to determine hemispheric preferences. 3) Procedure: The data were collected and scored using the scoring key contained in the Norms - Technical Mannual for Your Style of Learning and Thinking, Form-B (Torrance, et al., 1978). Each subject's responses were classified as being either right hemisphere oriented, left hemisphere oriented of hemispherically integrated. Then the sum total of all right hemispheric responses was calculated for each subject. Sums were also calculated for both the total left hemispheric and integrated responses of each subject. Each dominant hemisphere was compared with each school subject. Related school subjects were Korean Language, Mathematics, Chemistry, Biology, Physical Education, Music, Drawing, English, French, German, Technique and Industry. Related intellectual factors were verbal ability, spatial ability, numerical ability and IQ. 3. Results The results of this study are as follows: First, Mathematics, Chemistry, Biology and Numerical ability were confirmed as having significantly greater interrelationship with left hemispheric responses as expected in research problem. Second, Korean Language, English, French, German and Verbal ability didn't display any interrelationship with left hemispheric responses. Third, Technique and Industry displayed slightly significant interrelationship but Music and Physical Education didn't display any interrelationship with right hemispheric responses. Fourth, Spatial ability displayed higher significant interrelationship and Drawing also displayed slightly significant interrelationship with integrated responses. Fifth, IQ was confirmed as having closely significant interrelationship with integrated responses as expected in research problem. On the basis of the results, this study, as a whole, displayed Significant interrelationship as expected in research problems and the measuring instrument of hemispheric preference was proved to have some validity in this study. This study can be summarized as follows: First, Left hemispheric functions were more related to science and numerical ability than language subjects. Second, Technique and Industry displayed a bit of significant interrelationship with right hemispheric functions but they displayed negative interrelationship. Third, IQ and Spatial ability displayed greatly significant interrelationship and Drawing also displayed some significant interrelationship with integrated functions. Finally, As showed in this study, Science and Mathematics displayed strong tendancy toward left hemispheric functions. Those who insist the importance of hemispheric functions have critical viewpoint on the emphasis of left hemispheric functions. They insist that right and integrated hemispheric functions be developed. It will be necessary to make a good measuring instrument through more detailed item analysis and also necessary further studies testifying both hemispheric symmetry or dominant integrated functions. It the contents of learning can be programmed and students can be educated.

地方自治를 위한 基層組織으로서의 洞會의 機能開發模型

李南久,琴鍾友,鄭三澤,全相恒 경북대학교 1991 새마을 硏究論叢 Vol.12 No.-

크로이츠펠트-야콥 병

구본대,신동익,한현정,나덕렬,,이상복 관동대학교 의과대학 의과학연구소 2005 關東醫大學術誌 Vol.9 No.1

Creutzfeldt-Jacob disease (CJD) is one of the fatal prion diseases. Diagnosis of CJD is mainly based on clinical symptomatology of established criteria, characteristic electroencephalogram, specific cerebrospinal fluid protein measurement, prion protein gene analysis, prion protein isoform detection, and neuropathology. But spongiform change of brain pathology is the only definitive diagnosis of CJD. Clinical symptomatology of CJD includes behavioral disturbances, progressive dementia, cerebellar, pyramidal, and extrapyramidal signs. Most patients show progressive myoclonic jerks that involve either limbs or the entire body. The approximate incidence of CJD is 1 per million and occurs as sporadic, familial and iatrogenic forms. Variant CJD has the strong possibility of cross species transmission between human and cow. It has some differences in clinical and pathological aspects from sporadic CJD. Protease resistant prion protein of scrape isoform may lead to diverse neuronal death in CJD. Recent advannces in CJD reveal that apoptosis, proinflammatory cytokine expression and oxidative stress may play an important role of CJD pathogenesis. There areseveral therapeutic trials in CJD but no therapeutic regimensshow effective results. Although there is much progression about CJD in recent days, a lot of things still remained to be reveled.

염화 제2수은이 흰쥐 신장에서의 지질 과산화와 Catalase 활성도에 미치는 영향

이숭구,하경란,고현철,신인철,서대규 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.2

In an attempt to define the early biochemical determinants that participate in the pathogenesis of mercuric chloride-induced nephrotoxicity, especially focusing on oxygen free radicals, we studies malondialdehyde(MDA) level and catalase activity in renal cortex of the rats at 24, 48 and 72 hr after the injection of mercuric chloride. Wistar albino rats weighing 180 to 220gm were injected subcutaneously with mercuric chloride(HgCl₂, 2mg/kg). The result obtained can be summarized as follows: 1.The group treated with mercuric chloride showed significantly lower MDA level at 24, 48 and 72hr after the infection as compared to that of control group. 2.The group treated with mercuric chloride showed significantly higher catalase activity at 24hr and lower catalase activity at 72hr after the infection as compared to that of control group. These results suggest that the excessive oxygen free radicals resulting from the depression of catalase activity is an important determinant in pathogenesis of mercuric chloride-induced nephrotoxicity.

장기 구매력평가 가설의 공적분 분석

李成九 明知大學校 經濟硏究所 1995 경영연구 Vol.12 No.1

장애인생활시설 개별화 프로그램 분석 연구

이상복,구원옥,이원령,신윤희,박영균 대구대학교 특수교육재활과학연구소 2005 특수교육재활과학연구 Vol.44 No.1

본 연구는 장애인생활시설에서 생활하는 장애인의 사회 복귀를 위한 재활서비스 중 교육서비스를 보다 전문적으로 제공하기 위해 장애인생활시설에서 실시된 개별화프로그램을 분석하는데 목적이 있다. 이러한 연구 목적을 바탕으로 사회복지법인 성요셉 복지재단 S재활원, S요양원을 선정하였고, S재활원에서 2년 간 실시된 개별화프로그램의 장기목표, 단기목표, 계획평가 자료를 빈도 분석하여 퍼센트(%) 처리(Valid Percent)를 하였다. 장애인생활시설에서 실시된 개별화프로그램 특징은 다음과 같다. 첫째, 자립생활과 사회 복귀를 위해 필요한 기초생활기능의 습득에 중점으로 두고 있었으며, 연구대상시설이 생활시설이기 때문에 가정에서 이루어지는 일상생활기능 습득이 우선으로 이루어지고 있었다. 둘째, 지체부자유 장애를 지닌 생활인은 운동기능의 습득과 보행에 관련된 교육계획 비율이 높으며, 정신지체 장애를 지닌 생활인은 소근육 운동, 협응, 건강관리와 관련된 교육이 이루어졌다. 셋째, 기본적인 사회 생활에 필요한 글자 읽기, 수세기, 셈하기 등의 기초적인 학습기능을 습득할 수 있는 교육계획이 실시되었다. 넷째, 교육계획에 대한 생활인의 성취 정도는 평균적으로 60% 정도로 다소 낮게 나타났다. The purpose of this study was to analysis of individualized education program for the people with disabilities in the residential facilities. As the subject of research, 2 residential facilities in the Sungyoseb Welfare Foundation participated in the study. Long-term goals, short-term objectives and evaluation result in the individualized education programs carried out in 2 residential facilities for the past 2 years were analyzed a frequency and showed percent(%). The results showed as follows : Analysis results of Individualized Education Program for the people with disabilities in the residential facilities are shown like following; First, the facilities manly provided the persons with disabilities with the educational programs for improving basic functional skills in their daily living lives. Second, the persons with physical disabilities was provided with the educational programs for improving in their motor skill and self-walking. And the person with mental disabilities was provided with the educational programs for improving in their promotion of health. Third, the persons in facilities was provided the educational programs for improving basic learning skills like a counting, reading, calculating in their social living. Fourth, the recording data sowed the average 8 out of 10 short-term plans were reached to about 60% of the unsatisfactory levels.