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      • KCI등재

        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.

      • KCI등재
      • KCI등재후보

        K 대학병원 서어비스에 대한 소비자 만족도

        이태섭,박종원,이무식,윤능기,이충원,서석권 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

        Authors administered a questionnaire to 300 clients visited to the K University Hospital during August in 1992 to investigate the degree and related factors of consumer's satisfaction with the hospital services. Clients consisted of 82 in-patients and 158 out-patients, 52.4 percent of them was male. Four dimensions of satisfaction were assessed which were medical management, administration, environment and attitude. In-patients reported as dissatisfied with the waiting time during receipt, investigative medical procedures and pharmacy (64.7%), lack of conveniency facilities for patients and their guardians(48.8%) and provision of conveniency facilities in the ward(42.4%), unsanitary state of out- and in-hospital(41.5%). Out-patients reported dissatisfaction with the course of medical management and the time needed(70.3%), the waiting time during receipt, investigative medical procedures and pharmacy(68.3%), lack of conveniency facilities for patients and guardians(42.4%). But both in-patients and out-patients were satisfied with medical equipments, doctor's diagnosis reliability and medical effects, technician's attitude more than 50%. Canonical correlation analysis was done to find related sociodemographic factors to the four dimensions of satisfaction. Of the four canonical functions, the first was only statistically significant in in-patients. Its eigen value was 0.56 and its canonical correlation coefficient was 0.60. Satisfaction with environment and medical management was selected as important concept in dependent variables. Standardized canonical function of environment and medical management were 0.76 and 0.35 respectively. It was related with woman with high educational attainment and increasing number of hospital visits. In out-patients, the first, second and third function were statistically significant and their eigen values were 0.18, 0.4, 0.08 respectively which were small compared to those of in-patients. Their canonical correlation coefficient were 0.40, 0.35, 0.28 respectively. Low degree of environment but high degree of medical management satisfaction was noted in the first function which was related with old age, woman and professional occupation. Low degree of satisfaction with administration(second function) was related with city resident, non-professional occupation and young age. High degree of medical management but low degree of administration satisfaction(third function) was related with surgical visitor, man and non-professional occupation. The direction of hospital managerial strategies could be planned and general characteristics of dissatisfactory clients might be suggested with these results.

      • 기관지 방선균증의 임상 1례

        이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

        Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

      • SCOPUSKCI등재

        The Longitudinal Trend of Cardiac Surgery in Korea from 2003 to 2013

        Lee, Kyeong Soo,Kim, Chang Suk,Park, Jong Heon,Hwang, Tae Yoon,Kim, Sang Won,Sim, Sung Bo,Lee, Kun Sei The Korean Society for Thoracic and Cardiovascular 2016 The Korean Journal of Thoracic and Cardiovascular Vol.49 No.sup

        Background: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. Methods: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. Results: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. Conclusion: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.

      • KCI등재후보

        Growth Inhibition of Colon Cancer through Inactivation of STAT3 Pathway by IL-10 and IL-1ra Released from Murine Macrophage

        Jin Tae Hong, Dohee Won1, Mi Hee Park, Sun Mi Kown, Miran Jo, Sang-Yoon Nam, Beom Jun Lee, Young Won Yun, Ki-Wan Oh, Sang Bae Han 충북대학교 동물의학연구소 2011 Journal of Biomedical and Translational Research Vol.12 No.4

        The objective of this study was to determine the effect of macrophages on growth of human colon cancer cells. The results showed that co-culture of colon cancer cells with macrophages inhibited the growth of colon cancer cells (HCT116 and SW620) depending on the number of macrophages, RAW 264.7 cells, and activated THP-1 cells accompanied by down regulation of pSTAT3 in cancer cells. We also found that expression and release of cancer cell growth inhibitory cytokines, IL-1 receptor antagonist (IL-1ra) and IL-10, was increased in macrophages. Blocking of the STAT3 pathway with specific inhibitor and siRNA of STAT3 abolished the growth of colon cancer cells and expression of IL-1ra and IL-10. In addition, neutralization of IL-1ra and IL-10 with antibodies resulted in reversal of macrophage-induced inhibition of cancer cell growth. These data showed that IL-1ra and IL-10 released from macrophages inhibit growth of colon cancer cells through inhibition of the STAT3 pathway

      • 포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

        황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

        Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

      • KCI등재후보

        인공지능 모델에 따른 한국 프로야구의 승패 예측 분석에 관한 연구

        김태훈 ( Tae-hun Kim ),임성원 ( Seong-won Lim ),고진광 ( Jin-gwang Koh ),이재학 ( Jae-hak Lee ) (사)한국빅데이터학회 2020 한국빅데이터학회 학회지 Vol.5 No.2

        본 연구에서는 인공지능 모델에 따른 한국 프로야구의 승패 예측 분석에 관한 연구를 했다. 승리할 팀과 해당 팀의 최종 리그 순위를 예측했고, 사용자의 편의를 위해 웹사이트도 구축했다. 각 1·3·5이닝 별로 가장 정확도가 높으면서도 오차가 적은 모델을 최적 모델로 선정해 승·패 결과를 예측했고, 이를 토대로 순위표를 작성했다. 결과표는 2020년 개막인 5월 5일부터 8월 30일까지의 예측 결과를 바탕으로 작성했다. 기아타이거즈가 아닌 다른 구단끼리의 경기는 실제 결과를 사용했다. 머신러닝 모델은 KNN과 AdaBoost가 최적 모델로 선정되었으며, 실제 순위와 비교해 본 결과, 경기가 진행될수록, 예측 결과의 순위 오차가 점점 작아지는 것을 확인했다. 딥러닝 모델은 89%의 정확도를 기록했고, 머신러닝 모델과 마찬가지로 경기를 진행할수록 예측 결과 순위 오차가 작아지는 것을 확인했다. 실험 결과는 한국 프로야구 승·패 결과 예측뿐 아니라 다양한 분야에서 사용할 수 있을 것으로 사료된다. 방송국에서 야구 경기를 중계하는 중 이닝별로 인공지능 알고리즘이 예상한 승·패 여부를 중계화면에 띄울 수 있다. 시청자들에게 새로운 흥미를 일으킬 수 있을 것이고, 나아가 구단의 감독들이 이닝마다 데이터를 분석해 경기 중 유동적으로 승리하기 위한 전략을 세울 수 있을 것으로 기대된다. In this study, we conducted a study on the win-loss predicton analysis of korean professional baseball by artificial intelligence models. Based on the model, we predicted the winner as well as each team’s final rank in the league. Additionally, we developed a website for viewers’ understanding. In each game’s first, third, and fifth inning, we analyze to select the best model that performs the highest accuracy and minimizes errors. Based on the result, we generate the rankings. We used the predicted data started from May 5, the season’s opening day, to August 30, 2020 to generate the rankings. In the games which Kia Tigers did not play, however, we used actual games’ results in the data. KNN and AdaBoost selected the most optimized machine learning model. As a result, we observe a decreasing trend of the predicted results’ ranking error as the season progresses. The deep learning model recorded 89% of the model accuracy. It provides the same result of decreasing ranking error trends of the predicted results that we observe in the machine learning model. We estimate that this study’s result applies to future KBO predictions as well as other fields. We expect broadcasting enhancements by posting the predicted winning percentage per inning which is generated by AI algorism. We expect this will bring new interest to the KBO fans. Furthermore, the prediction generated at each inning would provide insights to teams so that they can analyze data and come up with successful strategies.

      • 홈 네트워크에서 스케일러블 어플리케이션 서비스 방법

        이윤주(Yun-Ju Lee),임태범(Tae-Beom Lim),김경원(Kyung-Won Kim),문재원(Jae-Won Moon),이석필(Seok-Pil Lee) 한국멀티미디어학회 2010 한국멀티미디어학회 학술발표논문집 Vol.2010 No.2

        홈 네트워크 상에서 다양한 디지털 기기들 간에 멀티미디어 콘텐츠를 공유/연동하는데 있어, IPTV환경에서 응용프로그램을 비디오, 오디오, 그리고 이미지 파일과 같이 공유/연동할 수 있도록 하는 방법을 제안하고 사용자의 편의성을 증진시키고 시청 환경이 서로 다른 디지털 기기에 동시 적용 가능하며 다양한 시청 환경에 최적화된 사용자 인터페이스를 제공하도록 한다.

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