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.

사회활동과 우울의 관계에 대한 일 연구

김영범(KIM Young Bum) 지역사회학회 2015 지역사회학 Vol.16 No.1

본 연구의 목적은 사회활동을 몇 가지 유형으로 분류한 후 연령 집단에 따라 우울과의 관계에 차이가 있는지 살펴보는 것이다. 본 연구에서는 노년기를 80세를 기준으로 전기 노인과 후기 노인으로 구분하였는데, 전기 노인은 여전히 바람직한 심리ㆍ사회적 특성을 유지하고 있는 시기인 반면 후기 노인은 노년기의 부정적인 특성이 부각되는 시기이다. 본 연구에서는 사회활동을 공식적 사회활동과 비공식적 사회활동으로 구분하고 각각을 몇 가지 하위 범주로 구분한 후 우울과의 관계를 분석하였다. 본 연구에서 사용한 자료는 2012년 한국고용정보원에서 조사한 고령화연구패널(KLOSA) 4차 자료이며, 분석에 포함된 사례는 3,664명이다. 주요 결과는 다음과 같다. 공식적 사회활동은 우울 수준과 관련이 없는 것으로 나타난 반면, 비공식적 사회활동은 그 하위 범주에 따라 우울과 상이한 관계를 보이고 있다. 자녀전화는 두 집단 모두에서 우울과 부적 관계를 나타낸 반면, 자녀만남은 전기 노인집단에서 우울을 증가시키는 것으로 나타났다. 이와는 달리 친구만남은 전기 노인에서만 우울을 완화시키는 것으로 나타났다. 이러한 결과는 노인이 하나의 집단이 아니라 내적으로 다양한 집단이라는 점을 보여준다. The objective of the study was to analyze the relationship between the depressive symptom and the types of social activity elderly participated. The study postulated that the relationship between two would be different depending on age groups. For the analysis, the author divided age groups into two-young-old (65-79 age old) and old-old (80 or over aged) and the social activities into two-formal and informal activities. The number of the sample for the study was 3,664 persons and the age of sample was 65 or over. The results of the study were as follows. First, formal activities showed no significant relationships with depressive symptom in any age groups. Second, the level of contacting children by phone call showed negative relationship with depressive symptom in all age groups. Third, the level of face to face contact with children showed positive relationship with depressive symptom in young-old group. Fourth, the level of face to face contact with friends showed negative relationship with depressive symptom in young-old group.

비공식 사회지원망 종류와 삶의 만족도 : 전기 노인과 후기 노인의 차이를 중심으로

김영범(Kim, young Bum),윤혜경(Yoon, Hye-Gyung),윤현숙(Yoon, Hyun Sook) 지역사회학회 2019 지역사회학 Vol.20 No.3

본 연구의 목적은 비공식 사회지원망과 노인이 인식하는 삶의 만족도 사이의 관계가 전기 노인과 후기 노인에게서 차이를 보이는지 분석하는데 있다. 본 연구는 비공식 사회지원망을 가족·혈연지원망과 친구·이웃지원망으로 구분한 후 각각의 크기가 삶의 만족과 유의미한 관계를 보이는지 전기 노인과 후기 노인으로 나누어 분석하였다. 본 연구에서는 춘천 지역 거주 65세 이상 노인 1,000명에 대한 조사 결과를 활용하여 분석을 실시하였다. 본 연구의 주요한 결과는 다음과 같다. 첫째, 나이가 들수록 삶의 만족도는 증가하지만 후기 노년기에는 나이와 유의미한 관계를 보이지 않는 것으로 나타났다. 건강관련 요인 중 외로움, 우울이, 사회경제적 요인 중 소득은 노인의 삶의 만족도에 영향을 주는 것으로 나타났다. 둘째, 지원망 전체 크기는 노인의 삶의 만족과 유의미한 관계를 보이는 것으로 나타났다. 셋째, 전기 노인의 경우 가족·혈연이나 친구·이웃지원망의 크기가 삶의 만족과 유의미한 관계를 보이지 않는 반면 후기 노인의 경우 가족 지원망의 크기는 삶의 만족도와 유의미한 관계를 보이는 것으로 나타났다. The purpose of the study was to analyze the relationship between the types of informal social support networks and level of life satisfaction perceived by the elderly. The study focused on the difference of the relationship between the young old and old-old elderly group. This study divided informal social support network into family support network and non-family support network, and analyzed the relationship of each social support network size and life satisfaction in young old and old-old groups. In this study, we analyzed the survey results of 1,000 elderly people over 65 years of age living in Chuncheon. The main results of this study were as follows. First, life satisfaction increased with age, but there was no significant relationship with age in later age. Income among socioeconomic factors and loneliness and depression among health-related factors were found to affect the life satisfaction of the elderly. Second, the overall size of the support network was found to have a significant relationship with the life satisfaction of the elderly. Third, the size of family or non-family support network showed no significant relationship with life satisfaction in the young old elderly group, while the size of family support network had a significant relationship with life satisfaction in the old-old elderly group.

산후에 발병한 특발성 부갑상선 기능저하증 I 예

김정인,김상용,신병철,김경남,서영욱,이범주,김진화,배학연 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

Hypoparathyroidism is usually the result of an inadvertent surgical removal of all the parathyroid glands, In some instances, not all the tissues are removed, but the remainder undergoes vascular supply compromise secondary to the fibrotic changes in the neck after surgery, Previously, the surgery for hyperthyroidism was the most frequent cause of acquired hypoparathyroidism. Idiopathic hypoparathyroidism is a relatively rare disease that is characterized by hypocalcemia and hyperphosphatemia due to a parathyroid hormone deficiency of an unknown cause, It usually develops at a young age, and shows various clinical symptoms and signs accompanied with hypocalcemia. In addition, it is rarely associated with polyglandular autoimmune syndrome during the follow-up. Hypocalcemia and idiopathic hypoparathyroidism associated with labor and lactation are rarely reported condition previously. We here describe a case of a woman in whom the symptomatic severe hypocalcemia appeared after her delivery. We reviewed all the previously reported cases and suggest a possible physiological explanation for the association between pregnancy, lactation, and the appearance of symptomatic hypocalcemia.

유방암에서 PCR을 이용한 p53 유전자의 Codon 175에서의 점돌연변이에 관한 연구

김영철,김종석,김선한,목영재,최상용,문홍영,구범환 고려대학교 의과대학 1993 고려대 의대 잡지 Vol.30 No.2

The p53 gene, which is located in the short arm of chromosome 17, has been a constant source of fascination since its discovery at 1979. Allelic deletion coupled with mutation of the remaining allele is a theoretical hallmark of functional inactivation of tumor suppressor gene, and mutation and/or deletion of p53 gene is to be the most frequently observed genetic changes in breast cancer related to a single gene. In the present report, we have attempted to determine a point mutation at codon 175 which is known as one of four hot spots within highly conserved regions of the p53 gene where almost all of the reported mutations cluster A 304-bp fragment of exon 5 of p53 gene in fresh tissue of breast carcinoma was amplified by polymerase chain reaction (PCR), digested with Hha I restriction endonuclease, and electrophoresed. A point mutation was studied by observation of polymorphism with ethidium bromide staining under ultraviolet transillumination. The result revealed all of 14 carcinomas had wild-type p53 gene.

한국판 알바니 공황-공포 질문지 타당화 연구

김지혜,양종철,김정범,임기영,이소영,유범희 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

일차성 식도이완불능증의 풍선확장술후 치료효과의 객관적 평가지표

손영해,나호영,조성범,주영은,김현수,최성규,유종선,김세종 全南大醫大 2001 전남의대학술지 Vol.37 No.2

인터넷 중독 청소년들의 정신병리 및 대처 방식

안영균(Young Kyun Ahn),신영철(Young Chul Shin),고복자(Bok Ja Koh),심진현(Jin Hyun Shim),김범조(Bum Jo Kim),이승민(Seung Min Lee),이길홍(Kil Hong Lee) 한국중독정신의학회 2005 중독정신의학 Vol.9 No.1

This study was conducted to investigate the differences in psychopathology and coping strategies among internet addictors, over users and non addictors in high school students. Subjects were 273 high school students in Seoul city. Self rating questionnaires included demographic data, Young’s Internet Addiction Scale, SCL-90-R, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and The Way of Coping Strategy. Subjects were classified into 3 groups (addiction, over use, non addiction) by Internet Addiction Scale score. Prevalence of internet addiction was 4.3% and male adolescents were more addictive than female. Students who were mainly involved with internet chatting or game showed higher internet addiction score. The addiction group and over use group showed higher level of somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, and paranoia than non-addicted group. Addiction group and over use group used passive coping strategies more frequently in the stressful situation than nonaddicted group. Also, the regression analysis for finding out causal factors that predicts internet addiction showed that emotion relieving strategy were important variable which predict internet addiction. Interpersonal sensitivity and emotion relieving coping strategy was important to predict addiction. This study showed that problematic internet use was closely associated with psychopathology and psychiatric comorbidity. And high interpersonal sensitivity and emotion relieving coping strategy were related with internet addiction in adolescence.

젊은 노년층의 운동지속의지에 대한 참여동기와 참여만족의 영향력

김범수(Kim, Bum-Soo),원영신(Won, Young-Sin),고대선(Ko, Dae-Sun) 한국웰니스학회 2017 한국웰니스학회지 Vol.12 No.3

본 연구의 목적은 젊은 노년층의 운동참여에 대한 참여동기, 참여만족이 지속적참여의지에 영향을 주는 요인이 무엇인지를 밝히는 것이다. 연구대상은 60-70세 노년층으로 총 305부의 설문지를 실제 분석 자료로 사용하였다. 자료처리는 Window용 SPSS 통계 Package 15.0 Version을 이용하여 빈도분석, 기술통계, 상관관계, 위계적 회귀분석 방법을 실시하였다. 위계적 회귀분석 결과는 다음과 같이 나타났다. 첫째, 노인들의 참여만족에 영향을 주는 요인으로 배우자와 내적동기가 가장 중요하다는 것을 알 수 있다. 위계적 순서로는 내적동기가 가장 높으며, 배우자가 그 다음 순으로 중요도 순위가 결정된다. 둘째, 노인들의 지속적참여의지에 영향을 주는 요인으로 내적동기, 무동기, 참여만족이며, 그 중 내적동기가 가장 높으며, 참여만족, 그리고 무동기 순으로 중요도 순위가 결정된다. The purpose of this study was examined effect of participation motivation and participation satisfaction on exercise adherence intention of young-old age. The subjects were a total 305 people that they were participate in the regular exercise. The collected data were analyzed frequency, descriptive statistics, correlation and hierarchical regression analysis using the SPSS-Win 15.0 program. The results of hierarchical regression analysis were appeared as follows. According to the results of hierarchical regression analysis, significant factors influencing participation satisfaction were spouse and intrinsic motivation. Secondly, according to the results, significant factors influencing exercise adherence intention were intrinsic motivation, amotivation, participation satisfaction. It is important that exercise adherence intention is main factor to intrinsic motivation on the young-old elderly.

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)