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.

黃化水素化合物이 紫外線B를 照射한 黑色마우스의 表皮멜라닌細胞의 形態에 미치는 影響

明基範,鞠泓一 梨花女子大學校 韓國生活科學硏究院 1989 韓國生活科學硏究院 論叢 Vol.44 No.-

C57BL 흑색마우스에 UVB를 매일 100mJ/cm^2씩 10일간 조사하여 표피멜라닌세포를 활성화시킨 후 5% cysteine과 5% glutathione이 표피멜라닌세포의 수적 변화와 멜라닌소체 형태변화에 미치는 영향을 관찰하여 다음과 같은 결과를 얻었다. 1. Cysteine 투여군에서는 멜라닌세포의 수적변화가 없었으며 glutathione투여 5주 후에서만 멜라닌세포의 수가 감소하였다. 2. Cysteine 투여군과 glutathione 투여군은 대조군에 비해 표피멜라닌세포내 멜라닌소체의 단축 길이와 stage Ⅳ 멜라닌소체 비율에 유의한 감소를 보여 멜라닌형성 억제제로서 의의있는 효과를 나타내었다. 3. 두 실험군간의 비교에서 멜라닌소체 단축길이는 glutathione 투여군에서 투여 3주 후에 cysteine 투여군보다 의의있게 감소되었으며, stage Ⅳ 멜라닌소체의 비율은 glutathione 투여군에서는 투여 3주 후에 cysteine 투여군에서는 투여 5주 후에 각각 유의한 감소소견을 보였다. 4. Glutathione 투여군에서는 멜라닌소체 단축길이와 stage Ⅳ 멜라닌소체의 비율이 모두 투여기간에 비례하여 감소되었다. 이상과 같은 결과로 황화수소화합물인 cysteine과 glutathione은 자외선 B조사로 활성화된 표피멜라닌세포내 멜라닌소체의 단축길이와 stage Ⅳ 멜라닌소체의 비율을 감소시킴으로써 멜라닌형성을 억제하고, glutathione이 cysteine보다 멜라닌형성억제에 우수한 효과를 나타냄을 알수 있었다. The effects of sulfhydryl compounds, cysteine and glutathione, on populations of melanocytes, the sizes of melanosomes and the ratios of melanosomal stages of epidermal melanocytes in UVB-irradiated C57BL black mice were evaluated. The results were as follow: 1. Both of cysteine and glutathione showed no significant diminution in the numbers of dopa-positive melanocytes except at the end of 5 weeks' treatment with glutathione. 2. Both of cysteine and glutathione showed significant diminution in short axis of melanosomes and the percentage of stage Ⅳ melanosomes of epidermal melanocytes. 3. The lengthes of short axes of melanosomes in glutathione-treated group were smaller than those in cysteine-treated group at the end of 3rd week of intraperitoneal injection. 4. In the glutathione-treated group, the short axes of melanosomes and the percentages of stage Ⅳ melanosomes decreased in proportion to the period of intraperitoneal injection.

2단 IMDCT Recursive 구조를 이용한 MPEG-2 AAC 복호화기의 필터뱅크 구현

박세기,강명수,오신범,이채욱 대구대학교 정보통신연구소 2003 情報通信硏究 Vol.2 No.1

MPEG-2 AAC(Advanced Audio Coding)는 높은 압축율과 고음질의 특성을 갖는 멀티채널 오디오 압축 표준으로 알려져 있고, 대우 낮은 비트율에서 방송 음질 수준의 오디오를 제공하기 위해서 고해상도 필터뱅크(high-resolution filter bank), 예측기법(prediction), 허프만 부호화(Huffman coding) 등을 결합하여 사용한다. MPEG-2 AAC 필터뱅크에서 부화화기와 복호화기에서 각각 수행하는 MDCT(Modified Discrete Cosine Transform)/ IMDCT(Inverse MDCT) 연산은 특히 많은 연산을 필요로 한다. 본 논문에서는 MPEG-2 AAC 실시간 복호화 시스템을 하드웨어로 구현시 IMDCT의 연산에 적합한 2단 IMDCT의 Recursive 구조를 제안한다. 그리고 메모리와 연산속도, 하드웨어의 복잡도를 기존에 제안된 알고리듬과 비교하였다. MPEG-2 Advanced Audio Coding(AAC) is the uideb used audio standard and offers the high-quality multi-channel surround audio AAC algonthm combines the coding efficiency of a high-resolution filter bank, prediction techniques, and Huffman coding to achieie the broadcast-qualitv audio at very low data rates The foruard and inperse modified discrete transform(MDCT) are two of the most computational) 1 intensive operation in the MPEG-2 AAC In this paper, we propose the suitable recursive structure at IMDCT process for MPEG-2 AAC real-time decoder, and compared the memory, the computation speed and complexity of hardware with the proposed algonsms

거주자우선주차제의 관리시스템 개발

금기정,이근희,이홍범,김명수 明知大學校 産業技術硏究所 2000 産業技術硏究所論文集 Vol.19 No.-

Increase of incoming level and improvement of welfare caused by rapid economic growth make a sudden increase of car-owners. Such according to vehicle increases, arose many social Problems centering around metropolis. This in Problems, the most parking problem mainly raise in relation between unequality of parking demand and supply. Though it is important that increase the quantity of parking zone in metropolis that develope rapidly motorization it is more meaningful that manage systematically at limited parking area in urban. With these problems, in developing The Parking Management Assistant System improve the problem that The Residential Parking Permit Program(RPPP)that carrying out in Seoul. The Parking & Geographic Management System(P&GMS) is constituted to develope systematically Parking Use Information that intend to use the parking area efficiently. Consequently improve indicated problem which existing system and improving of use efficiency. Furthermore The Parking Management System is expected to help the improvement of transportation information through connection to ITS, such as ATIS, that recognized as central function in The Parking Permit Zone Project which is executed in Seoul now.

치과용 아말감과 상아질의 결합강도에 관한 연구

임범순,김철위,김명국,백기석 대한치과기재학회 1996 대한치과재료학회지 Vol.23 No.1

The purpose of this study was to evaluate the shear bond strength of amalgam to dentin treated with the various bonding agents and to examine the failure mode after bond test. Four kinds of dental amalgam and six kinds of dentin bonding agents were used in this study. Copalite varnish was used for control group. The extracted human molars were mounted in a self-cured acrylic resin and the nonocclusal surface of the crown was exposed by grinding. A well-fitted wax mold was placed on the dentin surface and dentin adhesives were applied according to the manufacturer's instructions before condensing the amalgam. After condensation of the amalgam, specimens were stored at 37℃ and 100% relative humidity for 24 hours to complete hardening process. Specimens were aged in a deionized water at 37℃ for 24 hours, then tested in shear on a Instron universal testing machine at a cross-head speed of 0.2mm-min. From the experiment, the following results were obtained: 1. The bonding agents which included NTG-GMA, showed a low shear bond strength. It was observed that the fracture modes between bonding agents and amalgam were adhesive failure. 2. The bonding agents which included 4-META, showed a high shear bond strength. Some fracture modes between bonding agents and amalgam showed cohesive failure, although many fracture modes showed adhesive failure. 3. For the bonding agents which included a phosphate ester system, the shear bond strength showed large scattering depending on bonding agent. When specimens showed a high shear bond strength, the mixed (adhesive/cohesive) failure mode between bonding agents and amalgam were observed. 4. BDX produced a low shear bond strength. It was observed that the control group(CPL) was' not effective for amalgam bonding agent.

대상 포진 반흔 부위에 발생한 대상 편평 태선 1예

김지숙,김명화,최혜영,명기범 대한피부과학회 2004 大韓皮膚科學會誌 Vol.42 No.2

Many cutaneous reactions have been known to occur within resolved herpes zoster lesions. These include granuloma annulare, pseudolymphoma, lymphoma, granulomatous vasculitis, lichen planus and other dermatoses. The pathogenesis of these reactions remains unclear and it has been proposed that they may represent isotopic response. A dermatomal distribution in lichen planus is very rare. We report here a case of zosteriform lichen planus that was developed on the site previously affected by herpes zoster. (Korean J Dermatol 2004;42(2):217~219)

인공타액에서 염소 및 황이온이 치과용 아말감의 전기화학적 부식에 주는 영향

김철위,김명국,백기석,임범순 대한치과기재학회 1996 대한치과재료학회지 Vol.23 No.2

The amalgam alloys contained the Ag, Sn, and Cu. Alloys containing Ag and Cu suffer sulfide tarnish and chloride corrosion. The purpose of this study was to evaluate the effect of Cl and S ions in artificial saliva on electrochemical corrosion dental amalgam and clarify the effect of sulfides on chlorides corrosion of dental amalgam. Eight types of dental amalgams were selected; four conventional dental amalgam alloys (BSA, CVX, HIA, and STF) and four high copper alloys (A21, LGA, LUX, and TYT). Fusayama's modified artificial saliva was used as standard electrolyte (concentrations of Cl and S ion were 12.22 mM/ℓ, 0.1mM/ℓ respectively). The concentration of Cl ions was modified to 1.22mM/ℓ, 12.22mM/ℓ, 24.44mM/ℓ, and 61.10mM/ℓ. As the Cl ions fixed at 12.22 mM/ℓ and 24.44mM/ℓ, the concentration of S ions in the artificial saliva was also modified to 0.1mM/ℓ, 0.5mM/ℓ, 1.0 mM/ℓ, and 5.0mM/ℓ. Specimens were tested by potentiostatic anodic polarization technique with scanning rate of 1 mV/sec. from -1200 mV to +800 mV at 37±2℃ From the experiment, the following results were obtained: 1. In the standard electrolyte, the corrosion resistance of the high-copper amalgams was higher than that of the conventional amalgams since the range of passivity for the high-copper amalgams was 200 mV wider than that of the conventional amalgams. 2. As the amount of chloride in the artificial saliva increased, the corrosion resistance of the conventional amalgams was decreased but the passivity of the high-copper amalgams was not changed. 3. When the concentraion of Cl was kept at 12.22 mM/ℓ, the increase of S had a little on the corrosion potential but caused increase of current density of the conventional amalgams. The corrosion resistance of the high-copper amalgams was decreased with similar trend to the conventional amalgams. 4. When the concentraion of Cl was kept at 61.10 mM/ℓ, the increase of S had a little on the corrosion behavior of the conventional amalgams. In case of high-copper amalgams, however, the corrosion resistance was decreased.

염산 Bleomycin 병변내 주입을 이용한 사마귀 치료

강민정,임연순,최혜영,명기범 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.2

연구목적 : 지금까지 난치성을 보이는 사마귀의 치료로 Bleomycin 행변내 주사의 효과가 많은 연구에서 보고된 바 있다. 이에 저자들은 본 치료방법의 효과를 사마귀의 크기, 숫자, 위치 및 유병기간에 따라 판정하여 보다 효과적인 적응 대상을 알아보고자 했다. 방법 : 1995년 3월부터 1998년 2월까지 이화여자대학교 목동병원 피부과에 비성기성 사마귀로 내원한 환자중 다른 치료에 반응하지 않았거나, 재발한 경우, 크기가 0.5㎝ 이상이거나 7개 이상의 다발성 병변 , 혹은 조감 주위 병변을 보인 133명의 환자를 대상으로 Bleomycin 병변내 주사로 치료하였다. 1회 치료후 효과와 치료 종결후 완치율을 병변은 크기, 숫자, 위치, 유병기간에 따라 비교하였다. 결과 : 1) 환자의 연령 분포는 4세에서 45세였고, 남자 59명 여자 74명으로 1:1.24 비율이었다. 2) 첫 주사 치료후 96명의 환자에서 50% 이상의 병변의 수나 크기의 감소를 보였다. 크기별로는 0.5~0.9㎝의 87.5%에서, 병소의 수별로는 단일 병소의 76.9%에서 50% 이상의 병변의 크기나 수의 감소를 보여 가장 좋은 효과를 보였으나 통계적 유의성은 없었다. 또한 조갑주의 병변은 79.1%에서, 수부는 75.8%, 족부는 72.9%에서 50% 이상의 호전을 보였으나 족서부 병변은 53.4%로 가장 낮은 낮은 효과를 보였다. 유행병 기간은 6개월 이하인 31명(86.2%)에서 50% 이상의 효과를 보여 유병기간이 짧을수록 치료효과가 유의하게 증가하였다(p<0.05) 3) 치료 종결시 3개월 이후까지 재발없이 완치된 경우는 총 93명으로 69.9%였고 치료받은 병변의 수가 증가할 수록 완치율이 감소하였다, 부위별로는 조감주위가 77.1%로 가장 높았으며, 병변의 크기에 따른 일괄된 완치율의 차이는 없었다. 병변의 기간에 따른 완치율은 6개월 이하에서 80.6%로 가장 높았으며, 유병기간이 길수록 완치율은 감소하는 양상을 보였다. 4) 부작용은 환자 중 18.4%인 24명의 환자에서 발생하였으며, 유형별로는 3일 이상 지속된 동통과 홍반, 색소 침착 및 감염이 관찰되었으나, 모두 이후 호전되었으며, 1명에서 경한 조갑 능선을 동반한 변형이 관찰되었다. 결론 : 본 연구에서 사마귀에 대한 Bleomycin 병변내 주사효과가 병변의 크기에 따라 뚜렷한 차이를 보이지 않았으며, 심한 부작용이나 전신적인 독작용없이 조감주위병변 및 급성기 병변에서 높은 완치율을 보여 좋은 적응증이 됨을 확인하였다. 아울러 Bleomycin 병변내 주사의 효과 및 안정성에 있어서 시술자가 적당한 양의 약물을 주변부위로 부터 과도한 침습없이 정확히 병변의 기저부에 도달시키는 기술이 또하나의 중요한 변수가 됨을 반영하는 결과라 사료된다. Purpose:This study was to designed to evaluate the efficacy of intralesional injection of bleomycin for common warts and plantar warts according to size, number, location, and duration and to determine the appropriate indication of this treatment for warts. Materials & Methods : The objective patients had warts being refractory to previous treatment or large than 0.5cm in size or 7 or more lesions or periungal lesions. The intralesional injection with bleomycin hydrochloride 1㎎/㎖ had been performed single to six times at 3 week interval until complete resolution. Age of the patients ranged from 4 to 45 years, and male to female ratio was 1 : 1.25(59 : 74). Results : After first treatment of bleomycin intralesional injection, a reduction of 50% or more of the primary wart area was observed in 96(72.2%) of 133 patients. 93(69.9%) of 133 treated patients experienced complete cure after 1 to 7 injections. The efficacy of intralesional bleomycin injection for warts was not closely associated with the size of warts. However the duration and number of warts was inversely correlated with the efficacy of treatment. The highest cure rate was shown in patients with periungal warts(77.1%), and lowest in patients with plantar warts(53.3%). The side effects were observed in 18.4%(24 of 133) including persistent pain(17.3%), pigmentation(3.0%), erythema(1.5%), and mild nail dystrophy(0.8%), but no evidence of systemic toxicity was found. Conclusions : The efficacy of intralesional injection of bleomycin was not significantly related to the size, but closely related to the duration, number and site of the lesion. These results partly suggest that there is some important factors affecting the efficacy of treatment of bleomycin such as duration of the lesion and skillful injection of the agent into the wart tissue.

Bowen`s disease originated from verruca

( Eun Sun Kwon ),( Byoung Yong Koh ),( Ki Bum Myung ),( Seung ),( Hyun Cheong ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Bowen’s disease is a precancerous condition that has the potential to progress to squamous cell carcinoma. The human papillomavirus(HPV) infection is associated with bowen’s disease. And recently HPV DNA has been detected to up to 30% on the extragenital bowen’s disease lesions. A 49-year-old woman presented solitary erythematous plaque with verrucous central region on the right calf. At first the lesion was just small verrucous papule, but gradually enlarged and became erythematous. The biopsy specimen from verrucous central region showed hyperkeratosis, parakeratotic tier within the stratum corneum, acanthosis and papillomatosis with inward bending of rete ridges. These findings were appropriate for verruca. But the specimen also revealed the features of bowen’s disease. Numerous atypical and pleomorphic cells showed mitotic figures and loss of polarity throughout stratum malpighi. The upper dermis was infiltrated by inflammatory cells. And specimen was stained weakly positive for p53 and strongly positive for p16 and Ki-67. Based on the clinical and histopathologic findings, the skin lesion simultaneously had the features of bowen’s disease and verruca. Therefore we suggest that the bowen’s disease may resulted from verruca and be associated with HPV infection. Here, we present a case of bowen’s disease originated from verruca.

건초 섬유종 1예

문경원,김소연,최유원,명기범,김성현 대한피부과학회 2006 大韓皮膚科學會誌 Vol.44 No.4