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.

간질발작후 MRI 영상에서 뇌 종창을 보인 3예 보고

홍현숙,김대호,이혜경,박재성,박성진,조준희,차장규,백상현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

We report seizure induced brain swelling in three patients. MRI revealed a cortical, subcortical(3/3), and basal ganglia(2/3) high signal intensity on T2- weighted and FLAIR images. The lesion shows low signal on T1-weighted image, and enhanced after contrast administration. Follow up study after 27 days in one case revealed complete resolution of the lesion. The reversible MRI findings may be the results of a local brain swelling, breakdown of blood-brain permeability, and a defect of cerebral autoregulation during seizure activity. The transient nature of such findings have to be considered in the differential diagnosis such as reversible ischemia, migraine, inflammation and infection.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

단순 남성 임균성 요도염에서의 levofloxacin과 ofloxacin의 치료 효과 비교

김재홍,권상진,유희준,노영석 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.4

Ofloxacin의 광학적 L-isomer 활성체로서 광범위한 항균 파장을 가지며 항균 활성이 약 2배로 알려져 있는 levofloxacin의 단순 남성 임균성 요도염에 대한 유용성을 평가하고자 단순 남성 임균성 요도염의 치료 약제로 그 효과가 입증된 ofloxacin을 대조약으로 하여 그 치료 효과를 비교 분석하였다. 1995년 8월부터 1996년 6월까지 요도 배농을 주소로 서울 중구 보건소 성병질료실에 내원한 환자중 요도 분비물의 그람염색이나 임균 배양 검사로 단순 임균성 요도염으로 진단된 환자중 치료 효과를 추적 관찰 할 수 있었던 남자 환자 79명을 대상으로 하여, 이들 환자를 levofloxacin 200㎎ 1회 경구 복용 환자군과 ofloxacin 400㎎ 1회 경구 복용 환자군으로 나누어 치료 효과에 대한 연구를 시행한 결과 이미 알려져 있던 ofloxacin의 임균성 요도염에 대한 효과와 마찬가지로 levofloxacin 200㎎ 1회 경구 복용 치료의 경우에도 단순 남성 임균성 요도염에 우수한 치료 효과를 보였으며, 부작용도 발견되지 않았다. PPNG가 높은 빈도로 발생하고 있는 국내의 현상황에서 levofloxacin은 임균성 요도염의 치료시 1회 복용의 간편함뿐만 아니라 적은 용량 투여로도 우수한 치료 효과를 보이고, 부작용의 발현도 없는 안전하게 추천할 만한 우수한 경구용약제라고 생각된다. Background : The gonococcal urethritis is one of the most widely distributed sexually transmitted disease in the world. Recently, there are needs of new effective antibiotics for the development of the resistant strains of gonococcus. So we evaluated the effect of levofloxacin on uncomplicated male gonococcal urethritis. Methods : According to the random number sheet, we divided the patients into the group A and group B. The group A were treated with a single 200mg oral dose of levofloxacin and the group B with a single 400mg oral dose of ofloxacin. Results : 38 out of 39 patients(97.4%) treated with levofloxacin were successful in the treatment and 39 out of 40 patients(97.5%) treated with ofloxacin. Postgonococcal Urethritis noted in 9 patients(23.1%) from group A, and 10 patients(25.0%) from group B. Conclusion : As a results of this, it is considered that a single dose of 200mg levofloxacin has an excellent effect like a single dose of 400mg ofloxacin for the treatment of the uncomplicated male gonococcal urethritis.

스테로이드 여드름과 여드름양 발진에서 Malassezia (Pityrosporum) 효모균의 출현 빈도

이수근,김재홍,양홍윤,김윤석,유희준,손숙자 대한의진균학회 1998 대한의진균학회지 Vol.3 No.1

Background: Steroid acne is a folliculitis that can result from a systemic or topical administration of steroid and has been described as showing similar clinical pictures to Malassezia folliculitis, but there have been few reports about the incidence of Malassezia in steroid acne and other acneiform eruptions. Objective: Our purpose was to describe the incidences of Malassezia in acneiform eruptions and to discuss about the relationship between clinical steroid acne and Malassezia folliculitis. Methods: The history, clinical features, direct microscopy, histopathological analysis, and therapeutic results of 125 cases with steroid acne or other acneiform eruptions were described and compared. Results: Over 80% of patients with acneiform eruption receiving systemic steroid revealed significant numbers of Malassezia in the lesional follicle. Conclusion: Steroid acne and other acniform eruptions showing discrete follicular papules and/or pustules localized to the upper trunk or acneiform facial skin lesions associated with multiple acneiform lesions on the body in the summer period should be suspected as Malassezia folliculitis. [Kor J Med Mycol 3(1): 24∼32]

교정치료시 동통관리를 위한 TENS.

오희명,홍성준 대한치과교정학회 1989 대한치과교정학회지 Vol.19 No.2

Pain and pain management have long been items of central concern in dentistry. Although they are given little attention in orthodontics, virtually every patient wearing orthodontic appliances experiences and complains of some extent of pain, and someones have suffured from severe throbbing pain. A form of stimulation-produced analgesia, Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive, non-pharmacologic pain control techiques. The clinical application of TENS to orthodontic patients may lead to better patient compliance. And I want to discuss some basic knowledge of this TENS.

노인 낮병원의 심리사회적 치료 프로그램이 노인의 신경인지기능과 우울 증상에 미치는 효과

유계준,송정은,오병훈,안석균,이홍식,오희철,구은형,황혜숙,이은철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

노인에게 있어서 신경인지기능의 저하와 우울 증상은 가장 흔한 장애이며 신체적, 정신적인 면에 많은 영향을 미치고 있다. 또한 이러한 장애중 비임상군에서 심리사회적 치료개입의 효과가 보고되고 있다. 이러한 측면에서 지역사회에서 노인에게 제공되는 심리사회적 치료개입의 중요성이 높아지고 있다. 이전의 연구에서는 대상이 특정 집단이거나, 비교군이 없거나, 치료효과에 대한 추적 관찰이 이루어지지 않는 등의 제한점이 있었으며, 현재 국내의 노인 낮병원은 소수에 불과하고 이러한 낮병원의 치료효과에 대한 연구는 거의 없는 실정이다. 따라서 본 연구는 지역사회 정신보건센터에서 운영하는 노인 낮병원에 참가하는 노인들을 대상으로 낮병원의 심리사회적 프로그램이 노인들의 신경인지기능과 우울 증상에 미치는 효과와 이에 대한 유지 효과의 유무를 알아보고자 하였다. 경기도 광주군 정신보건센터의 노인 낮병원에 참여한 노인을 치료군으로, 치료를 거부하거나 치료 중 탈락한 노인을 비교군으로 하여 10주간의 낮병원 치료전후와 치료종결 후 10주에 신경인지기능은 한국형 간이 정신상태검사(이하 MMSE-K)로, 우울 증상은 단축형노인우울척도(이하 SGDS)로 평가하여 두 군을 비교하였고 치료군의 치료 직후와 치료종결 후 10주를 비교하였다. 연구결과 노인 낮병원의 심리사회적 치료가 시간에 따른 SGDS점수 변화에 통계학적으로 유의한 영향을 미쳤으며, MMSE-K점수 변화에는 통계학적으로 유의한 영향을 미치지 않았다. 또한 10주 추시가 가능했던 치료군 중 약 43%가 10주 후 SGDS가 증가하여 호전되었던 우울증상의 악화를 보였다. 본 연구 결과 노인 낮병원의 심리사회적 치료 프로그램 개입은 노인에게 있어서 우울 증상을 호전시키며 신경인지 기능에는 직접적인 영향을 미치지 않는 것을 알 수 있었다. 또한 상당수에서 심리사회적 치료 개입으로 인한 우울 증상의 호전이 유지되지 않음을 알 수 있었다. 이는 노인우울증상의 치료에 낮병원의 심리사회적 치료 프로그램이 효과적일 수 있음과 치료 후 이를 유지하기 위한 부가적인 치료개입의 필요성을 시사한다. Cognitive impairment and depression are the most common symptoms affecting the elderly on physical and mental states. Studies have shown that these symptoms in mild cases are improved by psychosocial intervention, emphasizing the importance of therapeutic intervention provided in the community. The purpose of this study was to investigate whether the psychosocial program at a geriatric day care service has any therapeutic effect on the cognitive function and depressive symptoms in the elderly and whether such effect can be maintained. The experimental group was composed of 37 elderly patients attending the day care service at the mental health center located in Kwangju county, Kyonggi province. The control group was composed of 22 elderly patients who either refused intervention or who dropped out of the program. Cognitive function was assessed with the Korean version of the Mini-Mental State Exam(MMSE-K), and depressive symptoms were assessed with the Short-form Geriatric Depression Scale(SGDS). The experimental group and the control group were compared on the score of on each test, which was administered before and after the program and 10 weeks after discontinuation of program. In the experimental group, the scores acquired immediately after the program and at 10 weeks of follow-up were also compared. The results showed that psychosocial intervention at a geriatric day care service was significantly associated with the change in SGDS scores dependent on time but not significantly associated with the change in MMSE-K scores. In the experimental group whose follow-up assessment was possible, it was further shown that 43% of patients had increased SGDS scores 10 weeks after the program ended, indicating that depressive symptoms had worsened. This study suggests that psychosocial therapeutic intervention in the geriatric day care service improve depressive symptoms but not cognitive functions in the elderly. In addition, for a considerable percentage of subjects in the experimental group, the improvements in depressive symptoms were not sustained after the intervention was withdrawn. These findings proposes a need of strengthening therapeutic intervention to maintain such effect.

죽재를 이용한 콘크리트의 사용성에 관한 실험적 연구

鄭熺孝,金洪俊,李承列,黃俊碩 경상대학교 생산기술연구소 2002 工學硏究院論文集 Vol.2 No.-

The purpose of this study is about the possibility of using bamboo to reinforce concrete in comparison with the reinforced concrete in the same experimental condition by conducting concrete using bamboo material and mechanical test of a bamboo. As a substitute material for the reinforced concrete, to check the possibility of using concrete with bamboo material either saving iron resources or developing lighter material was tried. Conclusions of this study can be summarized as follows; In contrast to reinforced concrete, bamboo concrete was failed brittly about cracked state, the failure was occurred by slip between concrete and bamboo before it reached yielding stress of bamboo. In the pullout test, bamboo pullout specimens were crushed by brittle crack and steel bar pullout specimens by pullout failure.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

皮膚科 外來 癩患者의 動態

宋浚榮,朴義守,徐舜鳳,徐基錫,河龍馬,孫在卿,金基洪,金蘭姬 大韓癩學會 1981 癩學 會誌 Vol.14 No.1