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.

급결제 및 혼화제 종류가 숏크리트 내구성에 미치는 영향에 관한 연구

백신원,권소진,이영수,김의성,신용석 한국안전학회 2003 한국안전학회지 Vol.18 No.3

Concrete and shotcrete should withstand the conditions for which they have been designed, without deterioration, over a period of years. But concrete and shotcrete are being deteriorated according to aging by internal and external causes. Recently, many studies on the durability of concrete have been conducted. But the durability of shotcrete is rarely studied. So, in this study, chloride ion penetration test, freeze and thaw test, neutralization test were conducted to examine the durability characteristics of shotcrete with several accelerator and chemical admixture types. These results indicate that shotcrete with alkali free accelerator and with superplasticizer are durable. Therefore, the present study provides a firm base to make high performance shotcrete.

한국 어린이와 성인의 표준잇솔규격개발에 관한 연구

이원재,이병진,배광학,김영수,노정,문혁수,백대일,김종배 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.4

Purpose of this study was to obtain basic anatomical data for developing optimal toothbrush which is appropriate for Koreans Dental study models were examined by measuring the length from labial midline of deciduous canine to distal surface of deciduous second molar, from labial midline of permanent canine to distal surface of second premolar, from mesial surface permanent first molar to distal surface of permanent second molar, cervico-incisal length of deciduous central incisor, cervico-incisal length of permanent central incisor, from mesiobuccal cusp of deciduous maxillary second molar to mesiolingual cusp of deciduous maxillary second molar, from mesiobuccal cusp of permanent maxillary first molar to mesiolingual cusp of permanent maxillary first molar, from distolinual cusp of deciduous mandibular second molar to mesiolingual cusp of deciduous mandibular second molar, from mesiobuccal cusp of permanent mandibular first molar to mesiolingual cusp of permanent mandiblar second molar in 241 subjects. And the width of right hand was examined on each subjects by measuring the length of landmarks which were selected in handwrist X-ray film. Commercial toothbrushes sold in Korea were collected and the head length, head width, bristle length and handle length of toothbrushes were measured. The obtained results were as follows; 1. The head length of toothbrush which were appropriate for Koreans aged 6 to 8 was less than 21.8 mm. The head width length of toothbrush which were appropriate for Koreans aged 6 to 8 was less than 8.4 mm. The bristle length of toothbrush which were appropriate for Koreans aged 6 to 8 was more than 5.7 mm. The handle length of toothbrush which were appropriate for Koreans aged 6 to 8 was more than 84.3 mm. 2. The head length of toothbrush which were appropriate for Koreans aged 9 to 11 was less than 20.4 mm. The head width length of toothbrush which were appropriate for Koreans aged 9 to 11 was less than 8.4 mm. The bristle length of toothbrush which were appropriate for Koreans aged 9 to 11 was more than 9.3 mm. The handle length of toothbrush which were appropriate for Koreans aged 9 to 11 was more than 95.2 mm. 3. The head length of toothbrush which were appropriate for Koreans aged over 12 was less than 25.5 mm. The head width length of toothbrush which were appropriate for Koreans aged over 12 was less than 8.6 mm. The bristle length of toothbrush which wee appropriate for Koreans aged over 12 was more than 9.6 mm. The handle length of toothbrush which were appropriate for Koreans aged over 12 was more than 101.1 mm. 4. Some toothbrush for children was not appropriate because of its big size, and toothbrush sells in Korea must be diversified for appropriate selection.

떨어진 코끝의 코성형술 : 분류 및 교정 Classification & Correction

이백권,송진경,이종원,안상태,오영환 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.2

CS gas가 흰쥐 폐장내 Laminin 분포에 미치는 영향

김대영,정호삼,김원규,백두진 한양대학교 의과대학 1999 한양의대 학술지 Vol.19 No.1

It is known that laminin, a basement membrane-related glycoprotein, was present diffusely in the extracellular matrix throughout the mesenchyme in the developing lung tissues. In a recent study, we established that laminin plays an important role in the morphogenesis of embryonic mouse lung. This study was undertaken to localization of laminin in the alveoli and alveolar septa of lung after CS gas exposure to experimental animals, rats(Sprague-Dawley strain), weighing 150 ∼ 200 gm. The experimental rats were sacrificed on 12 hour, day 1, day 2, day 3, day 5 and day 7 after CS gas exposure, respectively. The specimens of lung were prepared for laminin immunoreactions. All of specimens for immunoreactions were observed with light microscope. The results obtained were as follows. 1. A few mononuclear cells were diffused into alveolar septa of lung, on 12 hour after CS gas exposure. Immunoreaction of laminin in extracellular matrix and basement membrane showed moderate positive reactions. 2. Lymphoid tissues in the alveolar septa were expanded and the numerous alveoli were collapsed or disappeared. Laminin-immunoreaction in this tissues showed moderate reactions on day 2 and day 3 after CS gas exposure. 3. On day 5, day 7 after CS gas exposure, lymphoid tissues in the alveolar septa were mostly disappeared. Intact alveoli were seen. Strong laminin immunoreaction were observed on the surface and interstitium of alveolar septa. It suggested that CS gas exposure to rat may induce the increase of laminin in the alveoli of lung after tissue failure.

Cadmium Chloride가 흰쥐 신장에 미치는 영향에 관한 조직화학적 연구

이규식,백두진,김원규,정호삼,백태경,김영학 漢陽大學校 環境科學硏究所 1993 環境科學論文集 Vol.14 No.-

중공업의 발달에 따라 공장등지에서 중금속인 cadmium을 이용한 제품의 생산이 증가함에 따라 자연계내 토양, 물, 식물 등에 함유된 cadmium 뿐 아니라 공업제품과 공업 쓰레기에 함유된 cadmium은 쉽게 인체에 폭로되어 인체에 유해한 결과를 초래하게 된다고 알려져있다. 이에 저자는 cadmium이 생체내 신장에 특히 오랜기간 축적된다는 보고와 또 반감기가 긴 중금속이란 점에 착안하여 신장의 피질과 수질내 조직학적 변화를 관찰하고자 하였다. 실험동물은 사육실에서 순종 분리고 4년간 사육한 Wistar계 흰쥐를 사용하였다. 흰쥐에 체중 kg당 0.6mg의 cadmium chloride를 식염수 0.2ml에 용해하여 복강내로 10주간 매주 1회씩 투여한 후 희생기켜 신장조직을 paraffin 표본으로 제작하고 Mallory-Azan 염색을 시행하여 광학현미경으로 관찰한 후 다음과 같은 결과를 얻었다. 1. Cadmium chloride 10주간 투여후 1일 경과군에서 신장의 피질과 수질에 강한 Azan 염색반응을 보였으며 신사구체의 괴사와 수질 일부에서 간질성 섬유증식 및 울혈이 관찰되었다. 2. Cadmium chloride 10주간 투여후 1주 경과군에서는 신장의 피질과 수질에 중등도의 Azan 염색반응이 관찰되었고 신사구체의 국소적 괴사가 관찰되었다. 3. Cadmium chloride 10주간 투여후 2주 경과군에서는 신장의 피질에 중등도의 Azan 염색반응이 관찰되었으며, 4주 경과군에서는 피질과 수질에 약한 Azan 염색반응만 관찰되었다. 이상과 같은 결과로 미루어 cadmium chloride의 흰쥐에 장기간 투여는 미량이라도 신장의 신사구체의 괴사, 섬유화 등이 유발되나 투여후 4주 경과시는 손상이 회복되는 것으로 사료된다. The peritoneal injections of cadmium chloride(0.6mg/kg) per 1 week for 10 weeks were made. The cadmium chloride treated rats were sacrificed on 24 hours, 1 week, 2 weeks and 4 weeks after 10 weeks administration. And each of renal tissues from cadmium treated rat kidney was stained with Mallory Azan. 1. The severe glomerular necrosis, fibrosis and congestions in 1 day group were seen in the cadmium chloride treated rats medulla. 2. The moderately positive reaction for azan stain was seen in cortex and medulla of 1 week group in the cadmium chloride treated rats medulla. 3. The weakly positive reaction for azan stain was revealed in cortex and medulla of the rat kidenys on 2 weeks and 4 weeks after cadmium chloride administration for 10 weeks. It is concluded that the renal damage of rat resulted with administration of cadmium chloride may be recovered 4 weeks after injection.

우리나라 일부 석면사업장의 석면폐 유병률

백도명,백남원,최정근,손미아,임정기,이원진,문영한,박정선,최병순 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1

Asbestos industry has been in operation over 60 years in Korea. However, the prevalence of asbestosis has not been yet reported. With rapid turn-over of workers, previous cross-sectional studies of current workers on the job could not find cases with exposures long enough for the development of asbestosis. This study was done to evaluate asbestosis prevalence of those worksites with operation history of more than 20 years. In total, 139 workers from 5 worksites were examined. Asbestos industries covered in the study include 2 asbestos textile, 1 brake lining, and 2 ship repairing worksites. Chest x-ray was taken from all workers and read by two experts familiar with pneumoconiosis classification according to 1980 ILO guidelines. Those with findings compatible with asbestosis were further ckecked with high resolution computerized tomography (HRCT). Pulmonary function tests were done according to ATS guidelines, and occupational and previous medical history was taken through a standardized interview. Air-borne asbestos was measured according to NIOSH method 7400. The air-borne asbestos concentrations ranged from 0.2-1.3 f/cc for asbestos textile, from 0.7-1.0 f/cc for brake lining, and from 6.3-7.8 f/cc during asbestos removal at ship repairing worksite. Of the 139 workers 25 had abnormal chest radiographic findings, and 10 of them had findings compatible with pneumoconiosis. When work history and current asbestos measurements were accounted, 9 workers who had more than 10 years of asbestos exposure history showed chest radiographic findings of pneumoconiosis with Finally, 4 workers showed finding of pulmonary fibrosis and/or pleural thickening at HRCT, and 2 of them had restrictive lung function changes. The study results showed that, among 139 subjects, there were 4(3%) definite asbestosis cases confirmed with HRCT. The prevalence of probable asbestosis was 7% for 10-14 years of exposure, 13% for 15-19 years of exposure, and 23% for 20 or more years of exposure. The prevalence of compensable asbestosis with abnormal lung function was 4-6% for those with 15 or more years of exposure.

고창·장성지역 삼림식생에 대한 식물사회학적 연구

김종홍,전영문,백근식,김원희 순천대학교 기초과학연구소 1998 基礎科學硏究誌 Vol.9 No.-

The Forest vegetation on the Koch'ang, Changsoˇng area was analyzed on the basis of the phytosciological data, And depending on physiognomy, actual vegetation map was drawn in 1:25,000 scale. the surveyed area was classified into 11 plant communities of Pinus densiflora community, Quercus variabilis community, Quercus mongolica community, Quercus serrata community, Quercus dentata community, Quercus acutissima community, Carpinus coreana community, Pinus thunbergii community, Pinus rigida afforestation, Cryptomeria japonica afforestation and Chamaecyparis obtusa afforestation. Afforestation of Pinus rigida, Cryptomeria japonica and Chamaecyparis obtusa showed poor vegetaton profile due to human Interferences. Apparently, P. densiflora community and mixed vegetation of Q. sp., as mainly Q. variabilis were dominated in study area.

Cisplatin에 의한 흰쥐 공장의 alkaline phosphatase 활성변화에 미치는 SOD의 영향

김성목,현성희,전영희,문원진,백두진 한양대학교 의과대학 1995 한양의대 학술지 Vol.15 No.1

Cisplatin has been widely used as an effective anticancer platinum compound. Cisplatin incorporates with intrastrand or interstrand of the DNA and it inhibits the synthesis of the nucleic acid and protein. During the treatment of cancer patients, cisplatin acts on normally proliferating cells, which results in nephrotoxicity, nausea, vomiting, anorexia, bone marrow suppression and inner ear damage. These toxicities are related to oxygen free radicals formation by cisplatin, which inhibits the activity of the catalase and admages the mitochondria. The author has demonstrated the effect of superoxide dismutase(SOD), one of the antioxidant enzymes, on changes of alkaline phosphatase activities in the jejunum of the cisplatin treated rats. A total of 60 healthy Sprague-Dawley rats weighing about 200gm were used as an experimental animals. Cisplatin(6mg/kg) was administered intraperitoneally with pretreatment of 15000unit/kg of SOD or not. The experimental animals are sacrificed at 6 hours, 12 hours, 24 hours and 3 days after the administration of cisplatin. A part of jejunum were obtained and fixed in 10%-neutral formalin at 4℃. The speciments were sectioned 16㎛ thickness in frozen cryostat. The activity of alkaline phosphatase was evaluated histochemically by Gomori's method and incubation time of sections of specimens was 30minutes. The results were as follows. 1. SOD increase the activity of alkaline phosphatase in the epithelium of jejunum of the rat. 2. The activities of alkaline phosphatase of the epithelium of the mucosa decrease in jejunum of 6 hours and 12 hours of cisplatin treated rats. In the 24 hours and 3 days, activities of alkaline phosphatase of the epithelium increase. The atrophied villi are observed in the 12 hours and 24 hours of cisplatin treated group. 3. The activities of alkaline phosphatase increase in 12 hours and 3 days of cisplatin treated group with SOD pretreatment, the activities decrease in 6 hours of cisplatin treated group with SOD pretreatment. The activities of alkaline phosphatase in the 24 hours of cisplatin treated group with SOD pretreatment show a decided decrease over those of control group with SOD pretreatment. The atrophied villi are seen in the 12 hours and 24 hours of cisplatin treated group with SOD pretreatment. 4. The activities of alkaline phosphatase in the cisplatin treated group with SOD pretreatment are higher than those in the cisplatin treated group, except 24 hours of cisplatin treated group. 5. There are very little changes of alkaline phosphatase activities in the lamina propria, submucosa and muscle layer of all groups. Consequently, these results suggests that cisplatin decreases the activity of the alkaline phosphatase and SOD pretreatment decreases the range of the change in alkaline phosphatase activity of jejunum of the cisplatin treated rats.

圓光醫大 附屬 第2病院 神經精神科 患者에 對한 統計的 考察(Ⅱ)

박민철,장광철,김상원,김한주,유미경,김훈,유용진,김현정,박남진,오상우,이귀행,노승호,백영석 圓光大學校 醫科大學 神經精神科學敎室 1992 圓光精神醫學 Vol.8 No.1

본 연구는 1986년 7월 11일부터 1991년 7월 10일까지 원광의대 부속 제2병원 신경정신과에서 의래 및 입원치료를 받았던 6,072명의 환자를 대상으로 병원 역학조사를 실시하고 그 결과를 1차조사 (박민철 등1986)와 비교했다. 1.전체 환자 중 남자가 54.4%로 여자보다 많았고, 이리와 이리 인접지역이 84.0%로 대부분의 지역을 나타났다. 의료보장상태는 보험환자가 57.1%, 의료보호환자21.8%, 일반환자 21.1%였으며 연령별로는 20대 24.6%, 30대 22.8%로 20대 30대가 절반정도를 차지했다. 2.외래환자에서는 신경중성장애가 46.0%로 가장 많고 정동장애, 경련성장애 순이며, 입원환자에서는 정신분열증이 30.5%로 가장 많고 기질성정신장애, 정동장애의 순이었다. 3.남자는 신경증성쟝애(23.4%), 정신분열증, 기질성정신장애 순이고 여자는 신경증성장애(39.9%), 정동장애, 정신분열증의 순이었다. 남자가 여자보다 많은 진단은 알코올정신장애(94.6%), 기질성정신장애, 소아정신장애 순이고, 여자가 남자보다 많은 진단은 정동장애(64.5%), 신경증성장애였다. 4.진단별 연령분포에서 신경증성장에는 30대(25.3%), 20대, 40대 순이고, 정신분열증은 20대(40.5%), 30대, 40대 순이며, 정동장애는 20대, 30대, 50대 순이나 비교적 비슷한 융이었다. 5.진단별 발병연령에서 신경증성장에는 20대, 30대가 절반이고,정신분열증은 20대(51.3%), 10대, 30대 순이며 정동장애는 20대(30.7%), 30대, 50대 순이었다. 진단별 평균 발병연령은 신경증성장애 32.7세, 정동장애 36.1세, 정신분열증 23.6세였다. 6.진단별 이병기간은 2년이상이 신경증성장에 28.3%, 정신분열증 68.5% 정동장애 43.9%인데 전체적으로 41.0%였다. 진단별 평균 이병기간은 정신분열증 73.2개월, 정동장애 45.5개월, 신경증성장애 29.5개월이었다. We examined epidemiologic study of 6,072 patients who visited Wonkwang Neuropsychiatric hospital since July 11 of 1986 until July 10 of 1991 and compared this results with previous study(Park et al 1986). The study revealed as follows:1. Of total patients males visited this hosptial more than females as 57.1%, Most of them(84.0%) resided Iri and neighbouring Iri. In the point of insurance, insured patients, medicaid patients and uninsured patients were 57.1%, 21.8% and 21.1% respectively. On the distribution of age, the twenties, the thirties were 24.6%, 22.8% respectively and twenties and thirties were about half of total patients. 2. Of outpatients neurotic disorder was the most as 46.0%, secondly mood disorder and thirdly convulsive disorder, but of inpatients schizophrenia was the most as 30.5%, secondly organic mental disorder and thirdly mood disorder. 3. Of males neurotic disorder was the most as 23.4%, secondly schizophrenia, and thirdly organic mental disorder, but of females neurotic disorder was the most as 39.9%, secondly mood disorder and thirdly schizophrenia. alcoholic mental disorder(94.6%), organic mental disorder, child mental disorder were mostly found in males,but mood disorder(64.5%) and neurotic disorder were mostly found in females. 4. On the distribution of age neurotic disorder was found the most in the thirties(25.3%), next in the twenties and in the forties, and schizophrenia was found the most in the twenties(40.5%), next in the thirties and in the forties, but mood disorder was found the most in the twenties, next in the thirties and in the forties but revealed similar rates relatively. 5. On the distribution of age of onset neurotic disorder developed nearly half during the twrnties and the thirties, schizophrenia developed mostly during the twenties (51.3%), secondly the teens and thirdly the thirties, but mood disorder developed firstly the twenties(30.7%), secondly the thirties and thirdly the fifties. on the average age of onset of illness neurotic disorder, mood disorder and schizophrenia were 32.7 years, 36.1 years and 23.6 years respectively. 6. On the duration of illness more than two years was 28.3% in neurotic disorder, 68.5% in schizophrenia and 3.9% in mood disorder and on the average duration of illness schizophrenia, mood disorder and neurotic disorder were 73.2 months, 45.5 months and 29.5 months respectively.