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.

Bernard Malamud의 Humanism : The FIxer를 중심으로

林喜鎭 尙志大學校 1997 論文集 Vol.18 No.-

The aim of this paper is to study Malamud's humanism in The Fixer. Bernard Malamud, one of the major Jewish American novelists treats "humanism" as one of the most significant themes in this book. In his search for the increased opportunity outside of shtetl, Yakov was arrested in Kiev, the city of anti-Semites, and charged with ritual murder of a Christian boy. In a solitary cell for two and a half year he is brutalized and dehumanized. In my view, his unendurable suffering is caused historically by the tragedy of Jewishness as born-loser and Schlemiel. In his soliary confinement, Yakov is kept in chains and experienced beating hunger, numbing cold, humiliating search six times a day. And he is offered the ways to escape his hard suffering. But he refuses the baits because he knows that his escape will be used against the Jews. And he comes to realized that a man can choose to make his suffering meaningful. This awareness is reflected in his changing attitude toward. Raisl, his wife, who is guilty of adultery: he accept his childless, delinquent wife, and her child, Chaim, as his legitimate son. It brings us to the humanism in Malamud. And what we have to note in Yakov is the change of recognition of history. His view of history has changed after suffering from deterministic to reformative one. In conclusion The Fixer explores the human suffering caused by racial injustice to Jews and expresses the humanism that can transcend this suffering. Malamud's message is clear the we must struggle for the recovery of humanity.

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

産褥期 感染 誘發 細菌의 生育을 억제하는 韓藥材 探索에 關한 硏究

임재연,성연수,김희진,이태균 동국대학교 한의학연구소 1997 東國韓醫學硏究所論文集 Vol.6 No.1

産褥期 感染이란 分娩後 生殖器의 細菌에 의한 感染을 意味하며, 産後 體溫上昇의 大部分은 骨盤感染에 의한 것으로 産褥期 感染의 重要한 指漂가 된다. 한의학에서 産後發熱의 病因病耭는 주로 邪毒感染, 血瘀, 外感, 血虛 등으로 보았으며, 치료는 一般的으로 産後疾患에는 處證이 많아 發表攻裏를 過度하게 하지 않고, 氣血과 營衛의 調和에 위주로 하나, 外感과 裏實證을 疏怒히 하면 안된다. 따라서 産後發熱을 惹起하는 各種 原因菌에 對한 客觀的인 抑制效果의 檢證은 産後發熱의 治療率을 높이는데 중요하다. 그 결과 산욕기감염을 유발하는 各種 細菌에 對해 黃連, 烏梅, 五味子 등의 水溶性 抽出物이 杭菌活性이 相對的으로 좋은 效果를 보였다. 따라서 産褥期 感染의 治療에 이들 韓藥材를 이용하면 보다 效果的일 것으로 생각된다. Deparment of Oriental Medicine, Graduate School of Dongguk University, Major in Oriental Ob & Gy. Various kinds of medicinal herbs and prescribed herb medicines which have usually been used for treatment of reducing fever, purging intense heat, and detoxication were secreened for antibacterial activity against Proteus vulgaris, S. aureus, and E. faecalis which causing puerperal infection. Minimal inhibitory concentrations of water- and ethanol-soluble extracts of Hwangyon(C. japonica), Omae(P. mume), and Omiza(S. chinensis) were determined and using thin-layer chromatography the extracts of Hwangyon and Omiza were separated. The results obtained were as follows: 1. The water-soluble extracts of Keumeunhwa(L. japonica), Chiza(G. jasminoides), Hwangyon(C. japonica), Dansam(S. miltiorrhiza), Omae(P. mume) and Omiza(S. chinensis) showed antibacterial activities against P. vulgaris ; among them, the extracts of Hwangyon, Omae, and Omiza showed high antibacterial activities. The water-soluble extracts of Keumeunhwa(L. japonica), Hwangyon(C. japonica), Hwangkeum(S. baicalensis), Hwangbaek(P. amurense), Dansam(S. miltiorrhiza), Daehwang(R. coreanum), Omae(P. mume), Omiza(S, chinensis), Gingseng(P. ginseng), and Gamcho(G. uralensis) showed antibacterial activities against S. aureus ; among them, the extracts of Hwangyon and Omiza showed high antibacterial activities. The water-soluble extracts of Banggi(C. trilobus), Daehwang(R. coreanum), Omae(P. mume), Omiza(S. chinensis), and Gamcho(G. uralensis) inhibited the cell growth of E. faecalis ; among them, Omae and 0miza showed high antibacterial activities. The extract of Hwangyon(C. japonica) and Omae(P. mume) showed no inhibition against E. coli. However, the extract of Omiza(S. chinensis) inhibited cell growth of both E. coli and B. subtilis. 2. The water- and ethanol-soluble extract of Hwangyon(C. japonica) showed antibacterial activities against P. vulgaries and S. aureus, those of Omae(P. mume) against P. vulgaris and E. faecalis, and those of Omize(S. chinensis) against all species tested, P. vulgaris, S. aureus, and E. faecalis. With the exception that ethanol-soluble extract of Hwangyon(C. japonica) showed much higher antibacterial activity against S. aureus than water-soluble one, antibacterial activities of both water- and ethanol-soluble ones were similar to each of other two medicinal herbs. 3.When the prescribed herb medicines were tested, Sambohwan showed antibacterial activities against P. vulgaris and S. aureus. No prescribed herb medicine inhibited the cell growth of E. faecalis. 4. Minimal inhibitory concentrations(MICs) of both water- and ethanol-soluble extracts of Hwangyon (C. japonica), Omae(P. mume), and Omiza (S. chinensis) against P. vulgaris were 2.5㎎/㎖, 10㎎/㎖, and 20㎎/㎖, respectively. Those of both Hwangyon (C. japonica) and Omiza(S. chinensis) against S. aureus were 1.25㎎/㎖ and 10㎎/㎖, respectively. MICs of water-soluble extracts of Omae(P. mume) and Omiza(S. chinensis) aganist E. faecalis were 2.5㎎/㎖ and 5㎎/㎖, and those of ethanol-soluble extracts were 5㎎/㎖ and 10㎎/㎖, respectively. Except for those of E. faecalis, the cell growth of P. vulgaris and S. aureus were inhibited by much lower concentration of ethanol-soluble extracts used. As a result, the antibacterial compounds against P. vulgaris, S. aureus, and E. aecalis are contained in the extracts of Hwangyon(C, japonica), 0mae(P. mume), 0miza(S. chinensis), the prescribed herb medicine, Sambohwan, and might be used for treatment of puerperal infection. Further study should be carried out to identify which compounds affect the cell growth inhibition of P. vulgaris, S. aureus, and E. faecalis.

12-O-Tetradecanoylphorbol-13-Acetate에 의한 HL-60 세포 분화유도중 Vimentin 유전자 전사조절에 대한 AP-1의 역할

임규,김진희,권도원,김승민,이명선,윤경아,손미영,박종일,윤완희,황병두 충남대학교 생물공학연구소 1999 생물공학연구지 Vol.7 No.-

Purpose: To gain insight on the role of AP-1 in transcriptional regulation of vimentin gene during differentiation of HL-60 cells by 12-O-tetradecanoylphorbol-13-acetate (TPA), the levels of vimentin mRNA and AP-1 have been investigated with Northern blot hybridization and DNA mobility shift assay. Materials and Methods: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-inactivated fetal calf serum and antibiotics in a humidified 5% CO_2 at 37℃. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. EcoRI fragment of pVIM-GEM was used as probe for vimentin mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA probe(Upper strand, 5'-CGCTTGATGAGTCAGCCG- 3') for AP-1 binding activity was mixed with nuclear extracts in a 20 μl reaction volume containing 300 mM KCI, 60 mM HEPES, pH 7.9, 25 mM MgCI_2, 1 mM EDTA, 1 mM DTT, 60% glycerol, and 2 ㎍ of poly[dI-dC]. Results: TPA increased vimentin mRNA levels, with maximal stimulation reached at 24 hr. The level of vimentin mRNA was induced in proportion to the concentration of TPA. TPA-induced vimentin mRNA was almost reduced by actinomycin-D pretreatment. TPA-induced stimulation of vimentin gene was completely reduced by staurosporin pretreatment. In DNA mobility shift assay, AP-1 newly appeared at 24 hr during TPA-induced differentiation and was almost not detected after the pretreatment of staurosporin. Conclusions: These results suggest that the induction of vimentin mRNA during TPA-dependent differentiation in HL-60 cells may be mediated by protein kinases C signal transduction and AP-1 is important to transcriptional regulation.

고등학생용 스트레스 반응 척도의 교차 타당성과 신뢰성

임희진 대한보건협회 2003 대한보건연구 Vol.29 No.2

The purpose of this study was to examine cross-validity and reliability of the stress response scale by Lim & Eto(1998). The stress response scale consists of 22 subscales of 65 items for lugh school students. Three hundred eight high school students completed the stress response scale, and 116 students among them completed the same scale in one month to examine the test-retest reliability of the scale. As results of test-retest, reliability of subscales of the stress response scale ranged form .49 to .81 and 3 integrated scales were .78, .74 and .73. And, confirmatory factor analyses were applied to the data for cross-validation of the scale. The results indicated that the stress response scale has enough high reliability and validity.

12-O-Tetradecanoylphorbol-13-Acetate에 의한 HL-60 세포 분화유도중 Vimentin 유전자 전사조절에 대한 AP-1의 역할

임규,김진희,권도원,김승민,이명선,윤경아,손미영,박종일,윤완희,황병두 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

Purpose: To gain insight on the role of AP-1 in transcriptional regulation of vimentin gene during differentiation of HL-60 cells by 12-O-tetradecanoylphorbol-13-acetate (TPA), the levels of vimentin mRNA and AP-1 have been investigated with Northern blot hybridization and DNA mobility shift assay. Materials and Methods: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-inactivated fetal calf serum and antibiotics in a humidified 5% CO_(2) at 37°C. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. EcoRI fragment of pVIM-GEM was used as probe for vimentin mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA probe(Upper strand, 5'-CGCTTGATGAGTCAGCCG- 3') for AP-1 binding activity was mixed with nuclear extracts in a 20 μl reaction volume containing 300 mM KC1, 60 mM HEPES, pH 7.9, 25 mM MgCl_(2), 1 mM EDTA, 1 mM DTT, 60% glycerol, and 2μg of poly[dI-dC]. Results: TPA increased vimentin mRNA levels, with maximal stimulation reached at 24 hr. The level of vimentin mRNA was induced in proportion to the concentration of TPA. TPA-induced vimentin mRNA was almost reduced by actinomycin-D pretreatment. TPA-induced stimulation of vimentin gene was completely reduced by staurosporin pretreatment. In DNA mobility shift assay, AP-1 newly appeared at 24 hr during TPA-induced differentiation and was almost not detected after the pretreatment of staurosporin. Conclusions: These results suggest that the induction of vimentin mRNA during TPA-dependent differentiation in HL-60 cells may be mediated by protein kinases C signal transduction and AP-1 is important to transcriptional regulation.

Pb(Sn_½Sb_½)O₃-PbTiO₃-PbZrO₃계 압전 세라믹의 필터로서의 응용

임진호,조상희 경북대학교 공과대학 1987 工大硏究誌 Vol.16 No.-

The effect of the size of sintered body on the resonant characteristic of the Pb(Sn_½Sb_½)O_3-PbTiO_3-PbZrO_3 ceramics was investigated. The attenuation characteristics of ring-dot type and ladder type filter were also investigated. As the sintered body are small, the resonant characteristic (f_γ, f_α) and the center frequency are increased. The big difference between the ring-dot type and ladder type filter was the sharpness of bandwidth and the movement of center frequency. As the poling field increased, the K_p and bandwidth were also increased.

전환장애와 감별해야할 Meige 증후군 1예

임세원,김진세,정인과,박민규,이대희 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

Meige 증후군은 안검경련과 구-하악부의 근긴장이상을 특징적으로 보이는 신경학적 임상증후군이다. 발병원인은 아직 불분명하나 아세틸콜린과 도파민의 신경활성과다(excess neuronal activity)가 원인으로 여겨지고 있으며, 치료로는 향도파민성약물과 항콜린성약물, 그리고 보튤리듐독소 주사가 이용되고 있다. 그러나 증상양상이 다양하며 심리적 영향을 받으므로 전환장애 혹은 불안장애 등의 정신과적 문제로 오진되는 경우가 있다. 저자들은 49세 여자로 초기에 전환장애로 진단되었으나 Meige 증후군임이 밝혀져 성공적으로 치료되었던 환자 1례를 경험하여 문헌고찰과 함께 보고한다. A Meige's syndrome is a rare neurological syndrome characterized by blepharospam and oro-mandibular dystonia. Its pathophysiology is not clearly determined yet, but the hypothesis of dopaminergic and cholinergic hyperactivity is most widely accepted. Anticholinergic drugs, antidopaminergic drugs and botulism toxin injection are currently used for the treatment of Meige's syndrome. The Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder, because clinical features of the Meige's syndrome are very variable and affected by psychological factors. The authors experienced one case of a 49-year-old female patient who was initially misdiagnosed as conversion disorder but confirmed later as Meige's syndrome, and then successfully treated.

3상 생물막 유동상 반응기를 이용한 피혁폐수처리에 관한 연구

임경택,김춘희,손희정 동아대학교 환경문제연구소 1996 硏究報告 Vol.19 No.2

The object of this study is to survey the effect of media concentration, tannery wastewater hydraulic loading rate and its organic shock loading on substrate removal efficiency and biofilm, in the three-phase biofilm fluidised bed reactor (BFBR). The conclusions from experiment are as following : 1. MLVSS volume was increased with increasing volumetric loading rate. Behind 3.5 kgCOD/ ㎥-day, the substrate removal efficiency was observed above 90%. 2. The mean biofilm thickness was 163 μm and the highest dry biofilm density was observed 0.087 gVSS/㎤, during operation period. 3. With influent COD_(Cr), changes from 800 mg/l to 1,700 mg/l, the biofilm thickness was increased to 181 ㎛ and dry density was decreased to 0.063 gVSS/㎤.