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.

화학과 생물 교과서에서 삼투 개념에 관한 설명 유형 분석

고영환,강대훈,박동조,김동욱,백성혜 한국과학교육학회 2002 한국과학교육학회지 Vol.22 No.4

이 연구에서는 고등학교와 대학교 화학과 생물 교과서에 제시된 삼투 개념에 대한 설명 유형 및 그림표현 유형을 분석하였다. 그리고 고등학교 화학Ⅱ 교과서와 생물Ⅱ교과서의 단원을 분석하였다. 분석 결과, 삼투현상에 대해서는 용매의 확산으로 설명하는 유형, 충돌로 설명하는 유형, 수화로 설명하는 유형, 농도의 평형으로 설명하는 유형 그리고 구멍을 막는 것으로 설명하는 유형 등 다섯 가지 유형으로 설명하고 있었다. 그리고 삼투 개념에 대한 설명 유형과 교과서에 제시된 그림 표현 유형 사이에 일치하지 않는 경우도 분석되었다. In this study, we analyzed types of explanation on osmosis concept that were represented in chemistry and biology textbooks of high school and college. There were 5 types of explanation on osmosis concept. The types of explanation were diffusion of solvent, collision, hydration, equilibrium of concentration and screen of holes. Last two types of explanation were classified into misconceptions. The various types of explanation on osmosis concept might cause to have be a reason that students had many misconceptions and to feel difficult to learn about osmosis concept. Many of textbooks is accord to types of concept explanation and figure explanation on osmosis but some is not

성인의 천미추부 종괴

조길환,이백권,장도명,김영진,안상태 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans. Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.

무갑상선 쥐에서 중식성 반흔의 새로운 실험모델

김영진,이백권,장도명,조길환,임풍 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.4

Proliferative scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the biology and effective therapy of these entities. Consequently we created an accurate reproductive animal model to systematically study them. Human proliferative scars were explanted into flaps based on isolated vascular pedicles in congenitally rats. We compared the procollagen type Ⅲ peptide levels of proliferative scar tissue before and after explanting. The procollagen type Ⅲ peptide levels of explanted proliferative scar tissue remained increased as before explanting. Histological analysis of the explanted proliferative scar tissue revealed that all explants retained their original histotypic character even after 1 year. We could also retain the volume of implanted proliferative scar for 1 year and studied in vitro cellular proliferation. Fibroblast cultures from explanted scars demonstrated less aggressive growth characteristic than those from original surgical specimens. The advantages of this animal model are as follows: 1. The explants retain their histotypical character for a long period. 2. Placement of the explants outside the dorsum of a nude rat makes serial observation and measurement easier. 3. Agents under test can be injected into the explants through a catheter inserted into a single pedicle of island flap without the possibility of spreading systematically.

이종마찰압접재 계면의 기계·금속조직학적 거동 및 파면특성 : STS304와 SM15C재를 중심으로 For STS304 and SM15C

오환섭,박경식,박준건,오정국,백영남 慶熙大學校 材料科學技術硏究所 1998 材料科學技術硏究論集 Vol.11 No.-

In this study is behavior of crack propagation and fracture under static tensile load, shear load, rotary bending fatigue load in friction welded dissimilar materials. Crack was observed in fine ferrite zone of SM15C and heat affected zone of STS304. Plastic flow was occured by friction welding process, so direction of crack is inclined with welded surface. Fatigue fracture most occurred in SM15C heat affected zone around interface. Fibrous zone with the view of macroscope and dimple pattern with the view of microscope were observed at fracture surface. Result is more metal micrstructure dependence than stress dependence by mechanical and metallic mechanics.

아동행동 조사표에 의한 입원한 행동장애 청소년 분류

이환배,백기청,곽영숙 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

To make a suchclassification of conduct disorder by using CBCL. the authors investigated 37 conduct disorders adolescents in Seoul National Mental Hospital during the period from June 1, 1987 to June 30, 1991. The results were as follows : 1) The total numbers of conduct disorder adolescents are 37 patient, and 4 clusters are subclassified. 2) In one way ANOVA. the scores of externalizing and internalizing showed statistically significance. 3) To compare the score of subscale factor, in parent form CBCL, delinquent, aggressive, hyperactive factor showed statistically significance, and the remainder factors are not significant. 4) In comparison between clinical data and clusters, the age of symptom onset showed statistically significance, and orders are cluster 4, cluster 2, cluster 3 and cluster 1. The X2 test, the sex showed statistically significant the ratio of females 60.0% in cluster 2, 14.3% in cluster 3, 12.5% in cluster 1 and 0% in cluster 4. 5) i) In the main and interaction effects between 4 clusters and 2 forme of CBCL in each matched CBCL subscale, external, internal. aggressive(P<0.001) and deliniquent(P<0.01) factor showed statistically significant. ii) In the two forms of CBCL, social, school and total factor showed statistically significant. The remainder factor showed statistically no significance. iii) In the clusters and two forms of CBCL. the external and aggressive and internal factor showed statistically significance and in the cluster 1, the score of YSR of external and aggressive factor are higher than parent form CBCL, and in cluster 3 the scores of parent form and higher. In cluster 4, the score of internal factor of parent form CBCL is higher than the self form.

정신분열병 환자의 삶의 질과 정신사회적 특성과의 관계

김경진,설지환,백영석,김재현 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study was to identify the relationship between quality of life and psychosocial characteristics in patients with schizophrenia. Methods : The subjects were eighty nine patients with schizophrenia according to DSM-IV. The Korean Quality of Life Scale (K-QLS) and the Korean modified Scale to measure Subjective Well-being under Neuroleptic treatment (KmSWN) were used to assess quality of life. The psychopathology of each patient was assessed by the Positive and Negative Syndrome Scale (PANSS). The Scale to Assess Unawareness of Mental Disorder (SAUMD) was used for differentiating presence and absence of insight. The Social and Occupational Functioning Assessment Scale (SOFAS), the Scale of Social Support (SSS), and the Family Adaptability and Cohesion Evaluation Scale (FACES) were used for assessing psychosocial characteristics. The correlation between the scores of each quality of life scale and other scales was examined, and multiple regression analysis was performed to assess the contribution of the scores of each quality of life scale to other scales. Results : The K-QLS score was significantly related to the scores of the PANSS, the SAUMD, the social conflict domain of the SSS, and the SOFAS. The KmSWN score was significantly related to the scores of the PANSS, the SOFAS, the social conflict domain of the SSS, and the FACES. In multiple regression analysis, the scores on the PANSS (32.9%), the SAUMD (5.8%), and the FACES (4.0%) were contributed to the score on the K-QLS, and the scores on the social conflict domain oftheSSS (17.3%) and the FACES (12.9%) were contributed to the score on the KmSWN. Conclusion : The relation between the K-QLS score and the scores of other scales means that the objective quality of life increases according to decreased the severity of symptom, the high level of insight and the socio-occupational function. And the relation between the KmSWN score and the scores of other scales means that the subjective quality of life increases according to the perceptions to the high level of social support, the low level of social conflict, and the high level of family adaptability and cohesion. The objective quality of life assessed by the K-QLS is affected primarily by the severity of symptoms, and the subjective quality of life assessed by the KmSWN is affected by the subjective perceptions of social conflict, family adaptation and cohesion. These findings suggest that the treatment of symptoms is important in the treatment of schizophrenic patients, but that it is also important to approach to the psychosocial characteristics to increase subjectivesatisfaction from the quality of life in them

산소와 연소 단원에서 과학적 개념 형성을 위한 수업 전략의 효과

엄상수,고영환,백성혜,박국태 한국교원대학교 과학교육연구소 2000 청람과학교육연구논총 Vol.10 No.1

The purpose of this study was to investigate the effectiveness of teaching strategies for scientific conceptions in the units of oxygen and combustion in elementary school science textbook. 70 elementary school 6th grade students in Seoul participated. They were divided into experimental group and controlled group. Five scientific concepts were adopted from the units of oxygen and combustion in the 6th grade science textbook. Subjects' preconceptions were investigated by pre-questionnaires. A series of 6 instructional sessions based on the teaching strategy of cognitive confliction theory were given to the experimental group. By the end of the instructional session, a post-test was administered to both experimental and controlled groups. There was a statistically significant difference between post-test gains of the experimental and controlled groups. These results support the notion that the teaching strategy was effective for changing from preconceptions to scientific concepts.

Clomipramine을 투여하여 치료된 강박장애 2례

김보연,이규환,채영래,이철,백인호 최신의학사 1990 最新醫學 Vol.33 No.1

산소와 연소 단원에서 과학적 개념 형성을 위한 수업 전략의 효과

엄상수,고영환,백성혜,박국태 한국초등과학교육학회 2000 초등과학교육 Vol.19 No.2

The purpose of this study was to investigate the effectiveness of teaching strategies for scientific conceptions in the units of oxygen and combustion in elementary school science textbook. 70 elementary school 6th grade students in Seoul participated. They were divided into experimental group and controlled group. Five scientific concepts were adopted from the units of oxygen and combustion in the 6th grade science textbook. Subjects' preconceptions were investigated by pre-questionnaires. A series of 6 instructional sessions based on the teaching strategy of cognitive confliction theory were given to the experimental group. By the end of the instructional session, a post-test was administered to both experimental and controlled groups. There was a statistically significant difference between post-test gains of the experimental and controlled groups. These results support the notion that the teaching strategy was effective for changing from preconceptions to scientific concepts.