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.

요골동맥을 이용한 관동맥 중재시술의 경험

윤정한,이승환,김장영,이한요,이명옥,김승년,황성오,최경훈 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9

NDRG2 is one of novel intrinsic factors for regulation of lL-10 production in human myeloid cell

최승철,김광동,김종태,오상석,윤선영,송은영,이희구,조영경,최인표,임종석,김재화 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

NDRG2 is one of novel intrinsic factors for regulation of lL-10 production in human myeloid cell

최승철,김광동,김종태,오상석,윤선영,송은영,이희구,조영경,최인표,임종석,김재화 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

한국인 당뇨병 및 비당뇨병 환자에서의 뇌혈관 질환 유무에 따른 PAI-1 촉진자 유전자형과 인슐린저항성에 관한 연구

오승준,김영설,박철영,김덕윤,김성운,양인명,김진우,최영길,팽정령,정경천 대한비만학회 2000 The Korean journal of obesity Vol.9 No.2

연구배경 : 혈전현상을 특징으로 하는 질환에서는 Plasminogen activator inhibitor-1 (PAI-1) 이 높은 활성도를 보이는데, PAI-1 치는 당뇨병, 심근경색증, 비만 등에서 높다고 밝혀진 바 있다. 또한 당뇨병 환자들의 합병증의 주요한 병인은 죽상경화증으로 혈전현상이 특징인 질환에서 증가하는 PAI-1이 당뇨병 환자에서 높다. 목적 : 정상인에서의 PAI-1 유전자 촉진자의 유전자형의 분포 및 혈액농도를 관찰하고, 당뇨병 및 뇌혈관 질환 환자군에서의 PAI-1 유전자 촉진자 유전자형의 분포 및 혈액농도를 측정하여 정상인과 차이점을 알아본다. 당뇨병 환자군에서의 혈장 PAI-1 치와 인슐린 저항성, 전구 인슐린 등과의 상관관계를 살펴보고, 인슐린저항성과 대혈관질환의 지표로 사용될 수 있는지 알아보았다. 방법 : 대상으로는 정상인 76명, 제2형 당뇨병 환자 56명, 뇌혈관질환이 동반된 제2형 당뇨병 환자 48명, 뇌혈관질환 환자 51명을 선택하여, 환자의 혈액에서 인슐린, 공복시 혈당, 전구인슐린, 중성지방, 총콜레스테롤 및 기타 생화학 검사 및 이학적 검사를 시행하였다. 환자의 DNA를 채취하여 전사개시 -675bp를 포함하는 대립형질 특이 시발체를 사용하여 중합효소 연쇄 반응을 실시하여, 그 유전자형을 판독하였다. 결과 : 정상 대조군 76명 (46.4±11.1세), 2형 당뇨병 환자 56명 (58.3±12.6세), 뇌경색증 환자 51명 (63.1±13.2세) 대상으로 하였다. PAI-1 촉진자 유전자형의 (4G/4G, 4G/5G, 5G/5G)빈도는 정상 대조군이 각각 23.7%, 75.0%, 1.3%, 뇌경색 환자군이 19.6%, 66.7%, 13.7%, 뇌경색이 동반된 당뇨병 환자군이 33.3%, 58.3%, 8.3% 였다. (X2=12.6, p=0.05). 이러한 사실은 서구인에 비해 4G/4G, 5G/5G 동형 유전자형이 낮은 결과였다. 각 군별 혈장 PAI-1 농도는 정상 대조군 13.4, 1.8 ~ 65.2 ng/mL (중앙값 , 범위 ) 2형 당뇨병 환자군 14.4, 2.9 ~ 47.8 ng/mL, 뇌경색 환자군 21.9, 6.2 ~ 154.7 ng/mL , 뇌경색이 동반된 2형 당뇨병 환자군 28.8, 3.2 ~ 139.3 ng/mL 로 차이를 보였다 (p=0.000). 전체 대상에서 PAI-1 촉진자 부위의 유전자형에 따른 PAI-1 활성도와 항원 농도는 차이를 보이지 않았다. 그러나 PAI-1 활성도는 혈중 중성지방, 전구인슐린, 체질량지수와 독립적인 상관관계를 보였다 (p=0.000, p=0.000 and p=0.005). 결론 : 결론적으로 PAI-1 촉진자 부위의 유전자형은 뇌경색증의 지표는 아니며, PAI-1 활성도를 결정짓는 인자는 유전적 요인보다는 혈중 중성지방, 전구 인슐린, 체질량지수와 같은 대사적 요인으로 생각된다. Plasminogen activator inhibitor-1 (PAI-1) is known be related to insulin resistance and several components of the large vascular disease. Notably, the high frequencies of diseases such as coronary heart disease or stroke are related to type 2 diabetes complications. We studied to find out whether the PAI-1 promother genotype could be a marker for cerebral infarction in type 2 patients. Subject patients were; 56 type 2 diabetics (age 58.3±12.6), 51 patients with cerebral infarction (age 63.1±13.2), 48 type 2 diabetics with cerebral infarction (age 64.8±9.3) , and 76 healthy control (age 46.4±11.1). The 4G/5G genotype of PAI-1 promoter was evaluated by polymerase chain reaction and endonuclease digestion. PAI-1 promoter genotype frequency (4G/4G, 4G/5G, 5G/5G) was 23.7%, 75.0% and 1.3% in healthy control, 17.9%, 67.9% and 14.3% in type 2 diabetes patients, 19.6%, 66.7% and 13.7% in cerebral infarction patients, 33.3%, 58.3% and 8.3% in type 2 diabetics with cerebral infarction (X^2=12.6, p=0.05). This finding is lower in frequency of 5G/5G homozygote than that reported in Caucasians. The plasma PAI-1 concentrations according to the disease were 13.4, 1.8 ~ 65.2 ng/mL (median, range) for healthy control, 14.4, 2.9 ~ 47.8 ng/mL for type 2 diabetes, 21.9 6.2 ~ 154.7 ng/mL for cerebral infarction , and 28.8, 3.2 ~ 139.3 ng/mL, for cerebral infarction with type 2 diabetes (p=0.000). In the all subjects, PAI-1 concentration and activity of PAI-1 promoter genotype did not show any significant difference. However, the PAI-1 activity was independently associated with serum triglyceride level, plasma proinsulin and BMI (p=0.000, p=0.000 and p=0.005 respectively). We concluded that PAI-1 genotype is not a marker for the cerebral infarction ; however, the genotype is related to PAI-1 concentration , and therefore it seems to be that metabolic factors such as triglyceride level or plasma proinsulin or BMI are more in relations with determining the PAI-1 concentration than the genotype.

Eagle씨 증후군의 치험례

오승환,이상철,윤옥병,지유진,김여갑,류동목 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.3

Eagle's syndrome is the term given to symtomatic elogation of the styloid process or mineralization of the stylohyoid or stylomandibular ligament. Since ossification of stylohyoid ligament at cadeva was fist described by De Manchetics in 1652 and Weinlecher described clinical symptom which produced by elongated styloid process and osteotomy of styloid process in 1872, Clinical symptom which include sensation of a foreign body on the pharynx, dysphagai, dysphonia, referred pain, and mouth opening disturbance was termed by Eagle as Eagle's syndrome. then, case reports of Eagle's syndrome are presented. in these cases, the patient's chief complaints included periauricular radiating pain, mouth opening disturbance, foreign body sensation, dysphagia, tenderness on the neck. Through vairous X-ray examination and palpation of tonsillar fossa, elongted styloid process were confirmed. Under the general anesthesia there were successfully removed out via transoral approach technique, described by Eagle. after resented styloid process, they were freed from the symptoms without further complication. Therefor we reported these cases treated by surgical resection of styloid process with good results.

여고생들의 비만도에 따른 다이어트(diet)행동과 의식에 관한 조사

오수일,윤승호 江原大學校 附設 體育科學硏究所 1998 江原大學校附設體育科學硏究所論文集 Vol.- No.22

This research intents to determine the dietary behavior and awareness related to obese degree for 429 female senior students from a "C" city's humanity high school. Following is the result from research that carried out with method of responding the written questionnaires Investigated obese degree with Broca index Scale shows as 14.48% with over +10(obesity)and 63.86% with over-10-below +10(normal). Physical strength in subjective view indicates rather positive reponses: 41.7% with "Good" and 46% with "Average". The result didn't denote any significant collective variances correlated with obese degree. Female students who have experienced dite were 53.3% and significant collective variances correlated with obese degree were not shown. The reasons for dite noticeably show their interst in superficial apperance : "to be looked thinner" or "to improve the dressing figure and style". etc.(p<.001). For the method of dite. controlling the eating habit was the. dominant response, and fasting treatment(starving)was likely the most preferred mothed to control the eating habit(p<.001). 57.6%shows that they could not achieve their dietary goals. The result indicates that 46.1% of female students wish to continue on their diet. and it was more likely to be so for those who have a higher obese degree(p<.001). The bodily parts that the students who were on diet concerned were with exposable parts of their body like thigh. abdomen. calves. etc. They consider 5㎏ of weigh increment from their current weight as the obesity. and noticeable variances are shown according to obese degrss(p<.001). They responded that -5㎏∼-3㎏ is the difference between their current weight and ideal weight. and noticeable variances are shown according to bese degrss(p<.001). 10.000won were the amount that they can spend for diet. For the dietary problems that they mentioned were as "deterioration of health and physical strength" and exclusive dependence on dietary treatment"(p<.001). The result shows that the reliable sports for those who have normal weight or want to parallel with diet were swimming. running. aerobic dance and tennis. etc. The usual sports that they like are. in order. swimming. badmintion and basketball. and uninterested sports are. in order. running. soccer and baseball

동형접합성 단백 C 결핍 환아의 치과적 치험례

윤미,김승오,김종수,유승훈 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.2

단백 C 결핍증은 항응고인자인 단백 C의 결핍으로 혈전 색전증의 위험성이 높다. 선천성 단백 C 결핍증 중 동형접합성 단백 C 결핍증은 단백 C의 활성도가 측정되지 않을 정도로 낮고 1/25만~50만의 발생 빈도를 가지는 희귀한 질환이다. 동형접합성 단백 C 결핍증의 주요 증상은 자반성 및 괴사성 피부 병변, 반상출혈, 설명, 중추신경계의 혈전증 등이다. 본 증례는 동형접합성 단백 C 결핍증인 만 4세 여아로 치아의 전반적인 우식을 주소로 내원하였다 본 환아는 와파린 복용중이었고 치과치료시 합병증의 예방을 위해 소아청소년과에 협진 의뢰하였다. 와파린 복용 중단 시 혈전으로 인한 심각한 합병증이 예상되어 와파린을 적절하게 (INR 3~5) 복용하되 치과 치료 중 과다 출혈 시 신선냉동혈장으로 조절할 것을 권고받았다. 이 환아는 설명을 동반한 중증 장애 아이로 행동조절이 어려웠고 과다 출혈시 신속한 처치가 가능하도록 하기 위해 전신마취 하에 치과치료를 시행하였다. 저자는 치아의 전반적인 우식을 주소로 내원한 만 4세 단백 C 결핍 환아에 대하여 전신 마취 하 치과치료를 시행하였으며 다소의 지견을 얻었기에 보고하는 바이다. Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.

경동맥 죽종의 색혈류 도플러 초음파 소견

오연희,김승현,이성우,어경윤 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

한국인의 뇌경색의 가장 중요한 원인은 경동맥 죽종으로 알려져 있다. 저자들은 경동맥 죽종의 복식 초음파 및 색혈류 도플러 초음파영상을 비교·분석 하였다. 죽종 침범의 범위는 총경동맥+내경동맥+외경동맥 혹은 분지부 47.9%, 총경동맥 24.4%, 총경동맥+분지부+내경동맥 11.1%등이었다. 경동맥 협착은 중등도 53.6%, 경도 26.1%, 중도 16.3%, 위험도 3.1%, 완전폐쇠 0.9%. 표면의 형태는 매끄러운 경우 53.1%, 경도 불규칙 41.3%, 심한 불규칙 3.9% 그리고 표면 궤양이 동반된 경우 1.7%였다. 또한 죽종 내부구조의 음영도상 균일한 경우 90.5% 였고 죽종의 음영은 등에코성 40.2% 석회화 25.1%, 저에코서 22.3%등이었다. 결론적으로 복식 초음파와 색혈류 도플러 영상은 경동맥 죽종 진단에 있어서 정확하고 안전한 비침습적인 진단방법이다. Several reports have been documented that carotid atheroma presented as the mostimportant cause of cerebral infarction in Korea. Authors analysed the atheroma imaging of the carotid artery in the patients with cerebral infarction patients using duplex sonography and color flow imaging. The atheroma extents were CCA(common carotid artery)+ICA(intemal carotid artery)+ECA(external carotid artery) or BIF(bifurcation) 47.9%. CCA(common carotid artery) 24.4%, CCA(common carotid artery)+BIF(bifurcation)+ICA(lntemal carotid artery) 11.1 %. The percents of stenosis of carotid arteries were moderate 53.6%, mild 26.1 %. severe 16.3%, critical 3.1 % and occlusive 0.9%. The surface characters were smooth 53.1 %, mild irregular 41.3%, severe irregular 3.9% and ulcerated 1.7%. The atheroma texture was homogenous 90.5%, and the echogenicities of atheroma were isoecboic 40.2%, calcification 25.1 %, hypoechoic 22.3%. We concluded that duplex sonography and color flow imaging were accurate and safe non-invasive method detecting of carotid atheroma.

호남지역 역도 선수들의 스포츠 상해에 관한 연구

윤오남,위승두,서영환 한국스포츠리서치 2001 한국 스포츠 리서치 Vol.12 No.4

This study aims to present basic data for prevention of injuries and improvement of competitive power in weight lifting. For this, 42 high school lifters and 50 university lifters were inquired about injuries and the results were analysed as follows : 1. The injuries are caused by chronic fatigue(51.86%, highest), weather, intensity of physical activities, and technical characteristics . 2. Most injuries are caused when lifters are sitting(43.1%) in pulling up. In clean and jerk, sitting causes many injuries. In reinforcement, squat causes 43 injuries, the highest. 3. Consider injured part of lifters : 226 injuries o f(85.28 %) shoulder joints, 58 cases (45.31%) of muscular inflammation of elbow part, 205 cases(82.66%)of lumbago on waist part, 232 cases(88.55%)of pain on the knee, 40 cases(33.90%) of muscular cramp on the leg and 85 injuries(57.82%) of the ankle. 4. Consider the frequency of injuries : 10.00 times of sprains of shoulders, 2.00. times of bruise of the elbow, 3.33 times of lumbago of the waist, 3.39 times of pains of the knee and 10.50 times of ankle fractures. 5. As for first aid for injuries, there are 52 cases(55.91%)of putting PAS. Lifters with injuries usually went to hospital for treatment(50 cases and 5.76%). The period of treatment is one through five days(31 cases and 33.3%). Finally, lifters consider sound rest for prevention of injuries after treatment of injuries(61 cases and 65.59%). Lifters and relevant staff should concentrate on establishment of safety countermeasure and should examine types and parts of injuries to reduce injuries. Lifters with injuries should see professional doctors for proper treatment which would prevent aftereffects and bring complete recovery.