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.

소뇌에 발생한 과립구성 육종 : 증례보고

윤승환,변진수,홍순기,김헌주,한용표,양재승,조미연 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.8

Granulocytic sarcoma, a rare extramedullary solid tumor arising from early myeloid precursors, is capable of invading the meninges or the brain parenchyma. The tumor may occur during or after the onset of systemic myelogenous leukemia. On rare occasions, the tumor may evolve before the onset of systemic myelogenous leukemia. Children are affected more often than adults, but sex is not related. Although no definite target area of the brain can be demonstrated, there may be some predilection of the tumor for the posterior fossa. The authors report a case of 4-year-old-boy with granulocytic sarcoma occuring in the posterior fossa presenting with gait disturbance and torticollis. The patient was treated by surgical removal of the tumor, thereby avoiding the potentially lethal complication of a posterior fassa mass. This rare case is reported together a review of the literature.

두부손상시 발견된 뇌혈관질환

윤승환,변진수,홍순기,김헌주,한용표 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.10

Five separate incidences of patients with cerebrovascular disease(CVD) were revealed among 555 craniocerebral traumatic victims between 1991 and 1992. The 5 cases of with cerebrovascular disease revealed included 3 aneuryms. 1 arteriovenous malformation and 1 spontaneous intracerebral hematoma caused by angiographic study. The frequent use of computerized tomographic scans in the evaluation of head-injured victims can well demonstrate an intracerebral hemmorrhage, but may not get able to direct the associated cerebrovascular disease;whereas the efficacy of angiography, on the contrary, has been losing its popularity as diagnostic armamentarium. The importance of angiographic study should be considered, if clinical signs and/or brain CT ideate the possibility of cerebrovasular disease even during the course of head injury management.

호산구성 육아종에 병발된 동맥류성 두개골 골낭종 : 증례보고 Case Report

길승배,허철,변진수,한용표,김헌주,홍순기,김명순,홍순원,김윤미 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

A case of aneurysmal bone cyst(ABC1 secondary to eosinophilic granuloma of the skull is reported. In the skull the presence of ABC secondary to eosinophilic granuloma is rare. We reviewed the clinicopathological and radiological features of this type of eocinophilic granuloma at the cranium.

뇌경색후 발생한 Cortical Spreading Depression과 뇌경색 범위에 관한 실험적 연구

박윤관,이승민,김세훈,이기찬,주정화,이훈갑 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

Cortical Spreading Depression(CSD) is a transient depression of neuronal activity that spreads across the cortical surface and is associated with profound changes in blood flow, extracellular ion concentration. Direct Current(DC) potentials and cell membrane potentials. One of the electrophysiological disturbance in the periinfarct surrounding is spontaneous occurrence of repeated CSD like DC shifts associated with increased energy demand. Due to restricted blood flow to the periinfarct border zone, elevated metabolic demand is potentially harzardous. So the authors designed this experiment to verify the correlation between periinfarct cortical spreading depression and ischemic volume following permanent middle cerebral artery (MCA) occlusion in rats. Sprague-Dawley rats(n=27) were anesthetized with 0.5∼1% halothane, and artificially ventilated through a tracheal cannula. Arterial pressure, blood gases and body temperature were controlled. The middle cerebral artery(MCA) was occluded distally to the lenticulostriate branches. Measurements of CSD activity were made for 4 hours in each animal. Infarct volume was determined 6 hours later in 2, 3, 5-triphenyl tetrazolium chloride(TTC)-stained sections. For 4 hours after MCA occlusion, the CSDs were found in all experimental animals with a range of 2∼9 times. Those CSDs wer of varying duration, : "small"(<1 min) and "big"(> 1 min) SDs and mean of total duration of SD was 10.5±10.3 min during 4 hours of MCA occlusion. Neuropathological evaluation of brain infarct in the rats, which had been allowed to survive for 6 hours after MCA occlusion showed a mean volume of 89.7±45.3㎣. Serial observation of duration of CSD showed progressive prolongation only in 8 rats. The rest of them(n=19) did not show any prolongation. Neither the prolongation of duration of CSD nor the frequency of CSD in the penumbral zone correlated with the volume of infarct. However total duration of CSD was slightly related with the infarct volume after 6 hours of the permanent MCA occlusion(r=0.414, p=0.0318).

반려동물의 기생충검사 이론 및 실제

이성호,박영석,박병권,김상기,정지윤,박수진,박창식,김병수 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

The aim of this article is to improve human health and that of companion animals by improving the diagnosis and control of parasitic diseases. This is achieved by research into parasites of veterinary significance including zoonoses and the use of comparative systems to increase our understanding of some human parasitic diseases. We should promotes learning and teaching through knowledge and operates a diagnostic unit that offers a service to pet owner for indigenous and exotic parasitic diseases of companion animals. We must diagnose and treat them early. Zoonotic parasites are very important because many of animal parasites are zoonoses and give pain and death to human. Parasites are divided Protozoa, Helminthes and Arthropods. There are many protozoa, about 65,000 species. Arthropods are the vector of another diseases, such as virus, bacteria, protozoa and nematodes. Helminthes are composed of Trematoda, Cestoda, Nematoda and Acanthocephala. The target of Veterinary Parasitology is to recognize the characteristics of these parasites and subsequently diagnose, treat and control them. This article is intended to familiarize you with the essential facts and concepts of companion animal parasitology. Emphasis is placed on fecal sample techniques (comparison of fecal examination techniques; frequently found artifacts in fecal smears; direct Smear; zinc sulfate flotation; etc.) We recommend that the study be done to more references on animal parasites.

국내 주개류의 질적 특성에 관한 연구

민달기,전승렬,정연규,이병찬 연세대학교 산업기술연구소 1993 논문집 Vol.25 No.1

The Waste generated in Korea have three main distinctive features such as heavy generation, highly portion of briquette ash and organic fraction of municipal solid waste(OFMSW). The management of wastes is confined into simple landfill, and furthermore the suitable landfilling site is subject to restriction. Therefore, Korea government has serious excutive problems to manage the wastes. The establishment of data-base and the evaluation of the characteristics about wastes should be done before any affair. Therefore, in this study, such characteristics as OFMSW form, cooking condition, three composition, density, element analysis, and heating value were evaluated. According to the results of this study, generated from domestic kitchen have vegetable waste more than half of total kitchen wastes, and is characterized by high moisture content, low heating value. In addition, it was found that the improvement of food distribution system and meal preparation program would be the most powerful method to reduce the wastes, and reducing the moisture content from the wastes could make the cost of the wastes management cheaper.

미약한 경부기종에 의해 발생된 개의 부분적 기관협착

이성호,박영석,박병권,김병수,정지윤,박창식,김상기 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

A 10-year old male Pomerarian was presented with about a ten day history of stridor and severe paroxysmal honkinglike coughing which were aggravated with excitement and exercise. Auscultation revealed prominent inspiratory and expiratory crackles and wheezes over the caudal cervical trachea which were heard equally over both side of the chest, and a hemogram showed mild leucocytosis with mild dehydration. On the lateral radiographs of the neck and thorax, the cervical trachea was displaced ventrally by the air trapped between fascial planes of the cervical area near the thoracic inlet. It also revealed a marked narrowing of the tracheal lumen extending from the level of the fifth cervical to the second thoracic vertebra, and the lung field was judged to be within normal limits. There was no evidence of pneumomediastinum. A diagnosis of segmental tracheal stenosis was made. The emphysema of the retrotracheal area was thought to be a traumatic origin. The dog was treated successfully with strict cage confinement for a week. The tracheal stenosis caused by mild emphysema between the soft tissue of the cirvical area or mediastinum in the dog is very rare.

실험동물에서의 내분비계 교란물질인 DEHP, DBP의 생체내 영향

정지윤,이성호,박영석,박병권,김병수,김상기,박창식,강경선,이영순 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

The major protocol features of the rodent uterotrophic assay have been evaluated using a range of reference chemicals. The protocol variables considered include the selection of the test species and route of chemical administration, the age of the test animals, the maintenance diet used, and the specificity of the assay for estrogens. The rodents were ovariectomized under general anesthesia via bilateral flank incisions and randomly assigned to groups of 5 animals. This study investigated the estrogenic effects of phthalates, which are DEHP and DBP, suspected as endocrine disruptors. It is concluded that three daily subcutaneous administration of test chemicals, which are di-ethylhexyl phthalate(DEHP) and di-n-butyl phthalate(DBP), to 9 week-old rodents. The results revealed that DEHP & DBP show similar uterotrophic activity in the rat and the mouse, using subcutaneous administration. DEHP and DBP failed to affect any of these parameters, which are body weight, mammary gland, vaginal and uterus histopathology. but, DBP increased uterus weight to only one rat of 1.0 g/kg group. The results conform the need for rigorous attention to experimental design and criteria for assessing estrogenic activity.

한국형 손기능 작업표본검사의 신뢰도 및 타당도

임승건,최재욱,장기연,김지연 한국장애인고용공단 고용개발원 2012 장애와 고용 Vol.22 No.2

The purpose of this study is to secure the stability of the Korea hand function work sample test by conducting verification of reliability & validity. In order to verify reliability⋅validity of developed Korea hand function work sample test, the test based on 206 people with disabilities was conducted. The each existing Purdue Pegboard and developed Korea hand function work sample test were conducted randomly, and the test-retest method was conducted by same examiner repeatedly in order to measure reliability of Korea hand function work sample test. The criterion validity were verified, and sensitivity․specificity were shown by written ROC curves. The criterion validity was verified by comparison with Purdue Pegboard which is used as existing useful tool. First, all correlations of Korea hand function work sample test in the test-retest reliability are significant from 0.01 level and it shows very high correlations of more than 0.95 between the tests. Second, the Korea hand function work sample test shows high correlation between the existing Purdue Pegboard and test. Third, the predictive power of the AUC value was appeared high with 0.886, 0.868 in the results of the Korea hand function work sample test by using ROC curves. Fourth, Korea hand function work sample test was developed as useful tools with high convenience degree & failure prediction comparing to Purdue Pegboard. The Korea hand function work sample test is significant for the first developed work sample test tool in Korea which secured reliability and validity and it is expected to help for practical service provision of vocational evaluator for the disabled. 본 연구의 목적은 국내에서 개발된 한국형 손기능 작업표본검사의 신뢰도 및 타당도 검증을 실시하여 장애인의 손기능을 평가하고, 직업능력을 예측하는데 활용할 수 있도록 검사의 안정성을 확보하는 것이다. 한국형 손기능 작업표본검사의 신뢰도⋅타당도 검증을 위해 15세-55세의 비장애인 56명, 장애인 206명(지체장애인, 지적장애인, 정신장애인, 뇌병변장애인)을 대상으로 하였다. 본 연구에서 수집된 자료는 SPSS WINDOW 13.0을 사용하여 통계처리 하였다. 검사-재검사 신뢰도를 위해서 반복측정 상관분석을 하였고, 민감도․특이도는 medcalc 프로그램 version 11.4.1을 사용하였고 ROC curves를 작성하여 한국형 손기능 작업표본검사와 퍼듀펙보드의 장애 예측 정도를 나타내었다. 준거 타당도 검증을 위해 기존의 도구와 paird t-test 및 카이제곱(chi-square) 검정을 실시하여 분석하였다. 분석결과 첫째, 한국형 손기능 작업표본검사는 검사-재검사 신뢰도에서 모든 상관이 0.01 수준에서 유의미하고 검사 간 상관이 0.95이상의 매우 높은 상관을 보이는 것으로 나타났다. 둘째, 한국형 손기능 작업표본검사가 기존의 퍼듀펙보드와 검사 간 상관이 높은 것으로 나타났다. 셋째, 한국형 손기능 작업표본검사는 장애 예측 민감도와 특이도를 ROC curves를 사용해서 나타낸 결과 AUC 값이 0.886, 0.868로 예측력이 높은 것으로 나타났다. 본 연구를 통해 국내에서 개발된 한국형 손기능 작업표본검사는 신뢰도와 타당도가 확보된 작업표본검사 도구라는 점에서 의미가 있고 장애인 직업능력평가의 실질적인 서비스 제공에 도움이 될 것으로 기대된다.