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.

임신부의 인플루엔자 백신 접종률 및 관련요인

김미정,이승연,이광수,김아름,손동욱,정문현,박신구,박지현,이병익,이진수 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Background : During seasonal influenza epidemics and previous pandemics, pregnant women have been at increased risk for complications related to influenza infection. Although influenza vaccination has been widely recommended to pregnant women and immunocompromised hosts, the vaccination rate is presumed to be low in pregnant women. This study was aimed to evaluate the vaccination rate and factors associated with Influenza vaccination among pregnant women, who are at high risk for developing complications from the influenza. Materials and Methods : This study was carried out by telephone survey from April, 2007 to August, 2007. Women who were in their second trimester of pregnancy or above,- during October, 2006 and February, 2007, the recommended vaccination period, and had given birth at Inha University Hospital were selected as the study population. Immunization status, general understanding, and factors associated with vaccination were evaluated. Results : Among a total of 506 eligible pregnant women, 227 (44.8%) responded to the questionnaires. The influenza vaccination rate among the pregnant women was only 4% (9/227). Major reasons for not receiving vaccination were first, not awaring the necessity of immunization during pregnancy (48.5%, 110/227) and second, misunderstanding that it is prohibited during pregnancy (36.1%, 82/227). The major factors that influenced the compliance of vaccination were correct understanding and doctor's recommendation on the influenza immunization during pregnancy. Conclusions : The influenza vaccine coverage on pregnant women was very low and the awareness of influenza vaccination during pregnancy in general was inaccurate. Shift in perception is required and this can be achieved by educating the pregnant women on the safety and efficacy of vaccination. In addition, doctors' active encouragement to vaccination is highly recommended.

반려동물의 기생충검사 이론 및 실제

이성호,박영석,박병권,김상기,정지윤,박수진,박창식,김병수 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

The aim of this article is to improve human health and that of companion animals by improving the diagnosis and control of parasitic diseases. This is achieved by research into parasites of veterinary significance including zoonoses and the use of comparative systems to increase our understanding of some human parasitic diseases. We should promotes learning and teaching through knowledge and operates a diagnostic unit that offers a service to pet owner for indigenous and exotic parasitic diseases of companion animals. We must diagnose and treat them early. Zoonotic parasites are very important because many of animal parasites are zoonoses and give pain and death to human. Parasites are divided Protozoa, Helminthes and Arthropods. There are many protozoa, about 65,000 species. Arthropods are the vector of another diseases, such as virus, bacteria, protozoa and nematodes. Helminthes are composed of Trematoda, Cestoda, Nematoda and Acanthocephala. The target of Veterinary Parasitology is to recognize the characteristics of these parasites and subsequently diagnose, treat and control them. This article is intended to familiarize you with the essential facts and concepts of companion animal parasitology. Emphasis is placed on fecal sample techniques (comparison of fecal examination techniques; frequently found artifacts in fecal smears; direct Smear; zinc sulfate flotation; etc.) We recommend that the study be done to more references on animal parasites.

재발한 희돌기 교세포종에 대한 BCNU-CDDP 연속정주 화학요법

윤상민,이창훈,이승훈,송재욱,김종현 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

Eight patients with recurrent oligodendroglioma were treated with 1.3-bis(2-chloroethyl) nitrosourea(BCNU) and CDDP continuous infusion chemotherapy. They were 5 with benign oligodendrogliomas and 3 with anaplastic oligodendrogliomas. All the recurrent tumors had been treated with surgery and radiotherapy. Four patients had already received chemotherapy with ACNU. Seven of them showed response to continuous infusion chemotherapy. The time from the response to progression was 15 to 67 weeks. No severe complication of the chemotherapy was found. In conclusion, BCNU-CDDP continuous infusion chemotherapy is an effective treatment modality in recurrent oligodendrogliomas.

척수로 전이된 후두엽 다형성 교아세포종 : 증례보고 A Case Report

윤상민,송재욱,이창훈,조경자,김종현,이승훈 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

The tendency of glioblastoma to metastasize to the cerebrospinal fluid(CSF) is well documented, reaching approximately 20% in autopsy series. Nevertheless, clinical symptoms from spinal seeding seem to be infrequent or are at least rarely diagnosed. The authors report a case of 41-year old female patient with a cerebral glioblastoma multiform who developed paraplegia due to a pathologically confirmed spinal matastasis.

미약한 경부기종에 의해 발생된 개의 부분적 기관협착

이성호,박영석,박병권,김병수,정지윤,박창식,김상기 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

A 10-year old male Pomerarian was presented with about a ten day history of stridor and severe paroxysmal honkinglike coughing which were aggravated with excitement and exercise. Auscultation revealed prominent inspiratory and expiratory crackles and wheezes over the caudal cervical trachea which were heard equally over both side of the chest, and a hemogram showed mild leucocytosis with mild dehydration. On the lateral radiographs of the neck and thorax, the cervical trachea was displaced ventrally by the air trapped between fascial planes of the cervical area near the thoracic inlet. It also revealed a marked narrowing of the tracheal lumen extending from the level of the fifth cervical to the second thoracic vertebra, and the lung field was judged to be within normal limits. There was no evidence of pneumomediastinum. A diagnosis of segmental tracheal stenosis was made. The emphysema of the retrotracheal area was thought to be a traumatic origin. The dog was treated successfully with strict cage confinement for a week. The tracheal stenosis caused by mild emphysema between the soft tissue of the cirvical area or mediastinum in the dog is very rare.

21세기 새로운 시대를 준비하는 원광대학교 의과대학의 교육목표 개정과정

이학승,김요식,송윤강,오재민,양연식,정선관 원광대학교 의과학연구소 2009 圓光醫科學 Vol.24 No.1

교육목적은 대학의 교육이 지향하는 대전제이다. 그러므로 대학교육 목적과 목표가 어떤가에 따라 교육과정과 교육방법이 달라진다. 원광대학교 의과대학의 교육목표는, '지덕겸수'로 요약되는 '과학과 도학을 겸비한 전인교육'의 건학정신과 '학술탐구'와 '덕성함양'의 원광대학교 교육목표와 일치하게 현재까지 유지되었다. 그러나 현행 교육목표의 여러 문제점이 발견되었고, 시대상의 변화에 따라 원광대학교 의과대학에서도 사회적 변화 빛 의료인에 대한 시대적 요구에 걸맞은 의학교육의 목적 및 목표의 재설정 과정을 시작하게 되었다. 그 결과 개정 작업을 통해 새로운 교육목표를 설정하게 되었으며 그 내용은 다음과 같다. 1. 기본진료능력을 지닌 의사를 양성한다. 2. 원불교 교리 이념을 반영한 윤리적, 도덕적인 의사를 양성한다. 3. 평생 학습하는 연구하는 의사 혹은 의과학자를 양성한다. 4. 사회적 책무를 수행하는 리더십을 갖춘 의사를 양성한다. 5. 지역 사회에 공헌하는 봉사정신을 갖춘 의사를 양성한다. Purpose : With the changes to the medical environments and to the medical educational systems, we aimed to evaluate the current mission statement of the School of Medicine, Wonkwang University, and to revise it. Methods : To establish the new goal and mission statement, a Special Committee for the Revision of Medical School Mission and advisory group were organized in 2008. This special committee conducted through five steps of action, which are composed of investigation, education, development, surveillance of various opinions, and announcement. Results : For the development of new goal and mission, the revised, final goal and mission statements decided through the five steps of action. The new mission of Wonkwang University School of Medicine was as follows; 1. Doctor who can diagnose and treat easily 2. Ethical and moral doctor who practice Won Buddhism 3. Doctor or Medical Scholar who studies lifelong study 4. Doctor who has leadership to social responsibility 5. Doctor who goes into service to a local community. Conclusion : The authors expect that the new goal and mission of Wonkwang University School of Medicine would be helpful in giving the guideline on the educational process of medical school and will give the information to reform the medical school system according to the rapidly changing educational environment.

Hinman 증후군(비신경인성 신경인성 방광) 1예

이경욱,채정호,이승주,김세웅,박원명,전태연,김광수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.3

Objectives : The Hinman Syndrome is a condition representing urinary voiding dysfunction in a neurologically intact child. This syndrome probably is an acquired behavioral and psychosocial disorders. We present a case presenting voiding dysfuntion with no neurologic etiology. Case : The departmcnt of urology consulted the department of psychiatry for a psychiatric evaluation of a 14-year-o1d girl with a history of recurrent urinary tract infections, enuresis, and urinary dribbling since early childhood. She visited the emergency room bccausc of severe abdominal pain and hematuria. She was admitted to the department of urology. Neurological tests showed no abnormality, but a retrograde cystogram showed free vesicoureteral reflux to the level of the dilated intrarenal collecting systems. Marked blunting and dilatation of the caliccs suggested longstanding urinary flow obstruction. She had a history of scparation anxiety disorder and was very competetive, perfectionistic, and nervous. She also had very poor relationships with her friends and had difficults in managing them. Afer admission, she had stent operation and cystostomy. Antidepressant and anxiolytic medications with supportive psychotherapy were administered to treat anxiety, tension and depression. Gradually, her depressive symptoms and voiding difficulties improved. Conclusions : Psychological factors such as a perfectionistic and obsessive personality, a history of severe separation anxiety, stressors from poor interpersonal relationships and Ihe failure of an entrance examination seem to have contributes to the development and exacerbation of the urinary dysfunction. Pharmacotherapy and supportive psycho-therapy may be efective in treating associated psychiatric problems of these patients with hinman syndrome.

VRSA에 대한 항생물질을 생산하는 방선균의 분리

이지연,양시용,고은지,이승구,김시관,조왕식,송민동 建國大學校 自然科學硏究所 2002 建國自然科學硏究誌 Vol.13 No.2

본 연구가 VRSA에 대한 신규 항생물질 생산 균주를 얻기 위하여 실시하였다. 국내외에 채취한 토양시료에서 분리한 방선균 중, 임상분리 VRSA와 돌연변이 유발 VRSA에 대해 항균성을 나타내는 JY-24를 선별하였다. 선발 균주는 원통형의 포자 모양을 갖고 있으며, Bennett's 배지에 배양시 aerial mycelium color는 흰색을 나타냈으며, reverse side color는 대체로 노란색을 나타내었다. 항균물질 생산을 위한 탄소원으로는 fructose, mannose, 질소원으로는 yeast extract가 가장 우수하였으며 glucose의 첨가로 항균 물질 생산성이 증가하는 것으로 나타났다. 최적 초기 pH는 pH 7로 나타났으며, 28 ℃, 37℃, 45 ℃의 온도에서 균이 성장하는 것으로 나타났다. 또한 배양기간에 따라 항균물질 생산성을 조사한 결과, 임상분리 균주에 대해 5일 배양 시 가장 높았으나, 3일 배양과 7일 배양 시 동일한 생산성을 나타내 생산속도가 빠르며, 안정한 물질인 것이 파악되었다. 향후 균주동정 및 항균물질 정제에 관한 연구를 수행하고자 한다. An antibiotic substance producing strain JY-24, effective to the VRSA (Vancomycin-resistant Staphylococcus aureus), was isolated from soil. The spore chain of JY-24 was cylindrical, and its sulface was smooth. The aerial mass color of the strain was white, and its reverse side color was yellow. The strain did not produce soluble pigment. For the production antibiotics, fructose, mannose and yeast extract were favorable as carbon and nitrogen sources. Optimal initial pH for the production of the antibiotic was pH 7. Accumulation of the antibiotic in the culture broth reached at maximal level after 5 days cultivation in Bennett's medium.

漢代 經學에 미친 數術學의 影響 : 董仲舒의 春秋學을 중심으로

이연승 서울대학교 종교문제연구소 2002 종교와 문화 Vol.0 No.8