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        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.

      • Breeding of Tetraploid in Codonopsis lanceolata (Sieb. et Zucc.) Trautvetter by Colchicine Treatment

        Kim,Ik-Hwan,Kim,Hag-Hyun,Hong,Eui-Yon,Yun,Jong-Sun,Yun,Tae,Hwang,Ju-Kwang,Lee,Cheol-Hee 한국자원식물학회 2003 Plant Resources Vol.6 No.3

        Present studies were carried out to produce tetraploid plants by colchicine treatment using seeds, seedlings and shoot tips of Codonopsis lanceolata. Three tetraploid plants of C. lanceolata were produced from seeds which absorbed 0.1 % colchicine solution for 12 hours, and 0.5% colchicine solution for 1 and 6 hours from seedlings, respectively. But tetraploid was not produced from shoot tips treated by colchicine solution. Compared to diploid, tetraploid plants had larger stomata, but less number of stomata. Fresh weight of tetraploid plants was 1.4∼3.6 times heavier than diploid plants.

      • 간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과

        김금래,김주형,박원규,장재천,조재호,김태년,김준화,장병익 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

        Background: The purpose of this study was to determine the effectiveness of percutaneously place self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self-expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cased of Bismuth type Ⅱ,21 cases of Bismuth typeⅢa 8 cases of Bismuth type Ⅲb and 15 cases of Bismuth type Ⅳ. Stent placement was technically successful in all patients All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage of 91.9% There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60 ~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method of palliation of patients with hilar cholangiocarcinoma.

      • Breeding of Tetraploid in Platycodon grandiflorum (Jacq.)A. DC. by Colchicine treatment

        Kim,Ik-Hwan,Kim,Hag-Hyun,Hong,Eui-Yon,Yun,Jong-Sun,Yun,Tae,Hwang,Ju-Kwang,Lee,Cheol-Hee 한국자원식물학회 2003 Plant Resources Vol.6 No.3

        Present studies were carried out to produce tetraploid plants by colchicine treatment using seeds, seedlings and shoot tips of Platycodon grandiflorum in Campanulaceae. The most successful colchicine treatment for tetraploid production in P. grandiflorum was soaking treatment using 0.01 and 0.5% colchicine solution for 1 hour and 12 hours, respectively. Morphological characteristics of both diploid and tetraploid were similar, but tetraploid plants had more leaves. Compared to diploid, tetraploid had the larger stomata, but less number of stomata. Fresh weight of tetraploids was 20∼40% heavier than that of diploid.

      • SCIESCOPUSKCI등재
      • 폐쇄성 황달로 내원한 담관내 증식을 동반한 간세포암 1예

        김승범,김태년,이호찬,박재현,은종렬,장병익,이헌주,윤성수,배영경 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

        The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7 -9% The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth A 46-year-o1d woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filhng defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.

      • 잡견 적출기관의 Acetylcholine 작용에 대한 마취제의 영향에 관한 연구

        김익수,김태헌 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.1

        Severe bronchospasm occuring during general anesthesia is rare but potentially lethal anesthetic emergency. Several anesthetics charge with that situation. To assess correlation on airway smooth muscle, the authors studied the effects of three intravenous anesthetics, four muscle relaxants and three local anesthetics that used on acetylcholine 10ug/cc induced tone of mongrel dog tracheal chains. The results are summarized as follow: 1. In the intravenous anesthetics group, thiopental and propanidid induced dose-dependent relaxation on acetylcholine contracture significantly, while ketamine induced variable contraction according to dose administered. 2. In the muscle relaxants group, pancuronium and gallamine induced dose-dependent relaxation on acetylcholine contracture significantly, while succinylcholine and d-tubocurarine induced dose-dependent contracture significantly. 3. the local anesthetics group, lidocaine and procaine showed dose-dependent relaxation on acetylcholine contracture significantly, but tetracaine produced contraction at lower concentration and relaxation at higher concentration.

      • LPATS를 이용한 배전설비 뇌해예측 및 보수운용

        김세호,김태익 濟州大學校工科大學産業技術硏究所 1998 尖端技術硏究所論文集 Vol.9 No.2

        Lightning is the single largest cause of outages on distribution and transmission systems in lightning-prone areas. In this Paper, we analyze the damage modes ol distribution equipments by lightning and calculate the lightning-induced voltage by using analysis program. In the calculation of lightning -inducted voltage. it is used the various parameters obtained by LPATS being operated in KEPCO from 1995. Based on the lightning-induced voltage, we can predict the extent of damages in distribution systems. The result in this paper is very useful in finding fault location and rapid outage recovery by lightning and maintenance of distribution line equipment.

      • 겉보기 열용량법을 이용한 합금의 레이저 융용풀에서의 열 및 유동해석

        김우승,심복철,임익태 漢陽大學校 工學技術硏究所 1997 工學技術論文集 Vol.6 No.1

        An apparent capacity method is employed to solve numerically transient and steady state laser melting emblem of alloy. Momentum equations are solved in the liquid and mushy zones by using the SOLA-VOF algorithm. Using a laser with a top-hat profile, a wide range of studies are performed for steel. The streamline plots show the existence of rotating cell in the molten pool. It is found that the shapes of pool, the distributions of surface velocity and surface temperature are quite different from the case without convection effect in the mushy zone.

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