고령자 급성 췌장염의 임상적 고찰

백용한,서정훈,송건훈,이진헌,송시영,정재복,강진경,박인서,이수진 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

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.

고령자 급성 췌장염의 임상적 고찰

이진헌,강진경,박인서,송건훈,정재복,백용한,송시영,서정훈 대한소화기학회 1998 대한소화기학회지 Vol.32 No.3

Background/Aims: Inflammatory diseasas of the pancreas are not uncommon. The advanced age is one of the significant factors in assessing the severity of acute pancreatitis. It has been shown that the biliary tract disease is a more frequent cause of acute pancreatitis in the elderly than in the young. With the increased life span, the elderly are comprising a large proportion of the population. As a result, physicians are more often being faced with acute pancreatitis in the elderly. The purpose af this study was to evaluate clinical features of acute panereatitis in the elderly. Methods: A total of 188 patients with acute pancreatitis were reviewed. We investigated the differences of clinical characteristics between the elderly patients aged over 60 and the young patients aged under 60. Results: The sex distribution showed male preponderance in the young patients (M:F=2.4:1), but was nearly equal in the elderly patients (M:F=1.1:1). The most common cause of acute pancreatitis in the elderly was biliary tract disease (52.5%), while alcohol abuse was the most common cause in the young patients (38.8%), Local complications of acute pancreatitis, such as psuedocyst, necrosis, abscesses were not differently shown between the elderly (16.9%) and the young (20.2%) patients. Systemic complications including acute puhnonary failure occurred more frequently in the elderly patients than the young patients. The mortality rate of the elderly patients (5.1%) was not significantly different from that of the young patients (3.1%). Conclusions: To detect correctable underlying bihary tract diseases the elderly patients with acute pancreatitis should be completely investigated using endoscopic retrograde cholangiopancreatography (ERCP). In addition, the patient should be closely monitored for the development of the systemic complications during the disease process.

우울 증상을 수반한 만성 정신분열병 입원환자에서의 Paroxetine 효과 : 이중맹검 위약대조 연구

한평주,백영석,오상우,전현태,김지영 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: 우울 증상이 있는 만성 정신분열병 환자를 대상으로 항정신병약물과 항우울제인 paroxetine 20mg을 병합 투여하여 우울 증상, 양성 증상, 음성 증상 및 일반적인 정신병리의 호전 여부를 밝히고자 하였다. 방법: DSM-IV 기준상 정신분열병으로 진단된 입원환자 중 우울 증상이 있는 49명을 대상으로 parox-etine과 위약을 이중맹검을 대조한 전향적 임상 연구로서 Hamilton Rating Scale for Depression (HRSD), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale (PANSS), Extrapyramidal Symptom Rating Scale(ESRS), UKU side effect rating scale(UKU), Clinical Global Impression(CGI)을 기저선과 1주, 2주, 4주, 6주의 시점에서 다섯 번 반복 측정하여 비교 검토하였다. 결과: 36명의 환자가 6주간의 실험을 마쳤다. Paroxetine군과 위약군을 비교해볼 때 HRSD 총점은 양군에서 의미있게 감소되어(p<.01) 우울 증상이 호전되었으나, 두 군간에 통계적으로 의미있는 차이는 없었다. 시간경과에 따라 항우울 효과는 paroxetine 군에서는 2주, 위약군에서는 4주 후부터 관찰되었다. 그리고 paroxetine군과 위약군 모두 PANSS 총점(p<.01)과 CGI 점수(p<.05)가 감소되어 전반적인 정신병리의 감소와 전체적인 임상적 호전을 보였으나, 두 군에서 양성 증상, 음성 증상, 일반적인 정신병리 그리고 약물 부작용은 유의미한 차이가 없었다. Paroxetine군에서 반응군고 비반응군으로 나누어 비교했을 때, 반응군이 비반응군보다 HRSD의 총점(p<.01)과 우울한 기분, 자살, 정신적 불안, 죄채감의 세부 항목에서 유의한 호전을 보였고(p</01),일과 활동, 초기 불면증, 건강염려증의 세부 항목이 호전되어(p<.05) 현저한 우울 증상의 호전을 보였다. 또한 반응군이 비반응군보다 BPRS 총점(p</01)과 PANSS의 일반적인 정신병리 점수(p<.05)가 낮게 나와, 일반 정신병리의 호전을 보였다. 결론: Paroxetine군과 위약군 모두에서 우울 증상의 감소가 있었지만, paroxetine군에서 항우울 효과가 빠르게 나타났다. 두 군간에 양성 증상, 음성 증상, 일반적인 정신병리와 부작용에 대한 차이는 없었다. Paroxetine군에서 반응군은 비반응군보다 우을 증상과 일반적인 정신병리에서 유의한 호전을 보였다. 즉 우울한 기분, 자살, 정신적 불안, 죄책감, 일과 활동, 초기 불면증, 건강염려증이 심한 정신분열병 환자에게 우울 증상을 회복시키는데 paroxetine 20mg의 병용 투여가 효과가 있었다. Objectives: This double-blind placebo-controlled study was conducted to demonstrate the improvement of depressive, positive and negative symptoms, and general psychopatholgy in depressed chronic schizophrenic inpatients with adjunctive paroxetine 20mg therapy in the morning. Methods: Forty nine chronic schizophrenic inpatients with depressive symptoms were randomly received adjunctive paroxetine of placebo for 6 week study period. Therapeutic effect and side dffects were evaluated by means of the Hamiltom Rating Scale for Depression(HRSD),The Brief Psychiatric Rating Scale(BPRS), the Positive and Negative Syndrome Scale(PANSS), the Extrapyramidal Symptom Rating Scale(ESRS), the UKU side effect rating scale(UKU), and the Clinical Global Impression(CGI) at baseline, first, second, forth, and sixth week of treatment in a controlled double-blind design. Results: 18 patients completed six weeks of paroxetine therapy, and 18 patients placebo therapy. 1) Comparison between paroxetine and placebo groups: (1) HRSD total scores in both groups were significantly decreased(p<.01) but there was no statistically significant difference between 2 groups. This study showed that significant effect in paroxetine group appeared at 2nd week of treatment(p<.01), while in placebo group at 4th week of treatment(p<.01). (2) PANSS, BPRS< CGI, ESRS, and UKU : In both groups, PANSS total scores and CGI scores were significantly decreased respectively(p<.01, p<.05) and thus indicated th im-provement of global psychopathology and entire effects. There were no significant differences between 2 groups in positive, negative symptoms, general psychopathology, and drug side effects. 2) Comparison between responding and nonresponding groups in paroxetine adjunctive therapy : (1) Compared with nonresponding group, responding group had significant decrease in HRSD total score(p<.01), in HRSD subitems such as depressed mood, suicide, psychic anxiety, and feelings of guilt(p<.01), and in other subitems such as work and activity, early insomnia, and hypochondriasis(p<.05). (2) Compared with nonresponding group, responding group had significantly decrease in BPRS total score(p<.01) and in general subscale of PANSS(p<.05). Conclusion: The results suggest that both paroxetine and placebo groups were improved in depressive symptoms, but paroxetine group had more rapid improvement than placebo group. There were no significant differences in positive symptoms, negative symptoms, general psychopathology, and drug side effects between two groups. Compared with nonresponding group in paroxetine adjunctive therapy, responding group had significant improvement in depressive symptoms and general psychopathology.

고등학교 화학 I 과정 “물” 단원에서 학업성취도 평가문항의 내용타당도 분석

백성혜,이은준,김정수,송영욱,김용진,정정인,한재영 이화여자대학교 사범대학 교과교육연구소 2008 교과교육학연구 Vol.12 No.1

학교 교육에서 평가는 교육목표 달성 확인 및 교수 계획 수립에 중요한 역할을 한다. 따라서 학생들의 학업성취도 평가는 높은 내용타당도를 가지고 있어야 한다. 즉, 학업성취도 문항은 수업목표에 비추어 적절하고 학습한 내용을 포괄할 수 있어야 한다. 학교 현장에서 평가 문항의 타당도는매우 중요한 반면, 실제 학교에서 사용되는 고등학교 화학 과목의 평가 문항들이 어느 정도 내용타당도를 가지고 있는지 조사되는 경우가 거의 없다. 따라서 이 연구에서는 학교현장에서 실시되는화학 학업성취도 평가문항이 행동차원과 내용차원에서 어느 정도의 내용 타당도를 가지는지 분석하고자 하였다. 이를 위한 연구의 대상은 제7차 교육과정에 의하여 개발된 동일한 화학Ⅰ 교과서를 교재로 사용하고 있는 5개 학교의 ‘물’ 단원에 대한 1학기 중간고사 평가문항이었다. 내용타당도 분석을 위한 과정은 첫째, 교과서와 교사용지도서에서 34개의 수업목표를 내용차원과 행동차원으로 이원 분류하였다. 둘째, 5개 고등학교의 평가문항에서 121개의 평가문항을 행동차원과 내용차원으로 이원 분류하였다. 셋째, 행동차원과 내용차원별로 각각 수업목표와 평가목표의 비율차 검증을 하였다. 연구 결과, 5개 학교에서 사용된 학업성취도 문항은 행동차원에서의 내용타당도는낮았지만 내용차원에서의 내용타당도는 높은 것으로 나타났다. 이는 고등학교에서 실시하는 학업성취도 평가에 있어서 행동차원의 내용타당도를 높이는 노력이 좀 더 필요하다는 것을 시사한다. 특히 행동차원 중 분석력, 종합력, 평가력 등 고등정신기능을 기르는 평가 문항의 개발에 노력을기울여야 한다. 이 연구를 통해, 평가 문항 제작에 대한 교사들의 전문성을 높이기 위해 다양한연수나 교육 프로그램이 개발될 필요가 있음을 알 수 있다. In school education, the evaluation plays an important role for the accomplishment ofeducational goal and for the planing of education. Thus, the achievement evaluation itemshould have high validity. The achievement evaluation items should appropriate for theeducational goal and include all the learning contents. Although the validity of achievementevaluation items is very important, little research was performed on how much the evaluationitems of high school chemistry course really have the content validity. Therefore, in this study we analyzed the validity of the chemistry achievement evaluation items used in schools in thedimension of behavior and content. For this, 5 different high schools were selected that used the same publisher's chemistry I textbook, and the middle semester achievement evaluation items were gathered. First, 34 instructional objectives were classified into the behavior domain and the content domain from the 'water' chapter in the textbook and the teacher's guide. Second, 121 evaluation items were classified into the behavior domain and the content domain. Third, the analysis of the ratio difference method were performed between the instructional objectives and the evaluation objectives. From the results, it was found that content validities of the behavior domain were low, but those of the content domain were high. These results implies that more effort should be paid to raise content validities of the behavior domain in achievement evaluation of high schools. Especially, the test items should be developed on the high level thinking skill such as analysis, synthesis, and evaluation. This study tells it is necessary to develop in-service teacher education program to raise the professionality of teachers on the evaluation items.

건조 재료를 사용한 콘크리트의 포장화에 관한 실험적 연구

한다희,박희곤,백민수,김성식,이영도,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

Most concrete is recently made of an aggregate which is properly absorbed, and earned in it in order to do capability at every fields. We have been close to demand new capability of high flowing and enduring for specific concretes. That is difficult to cope with claiming the efficiency on deterioration from lack of a high quality aggregate. Therefore, For solving the problems we apply to a packing method for using dried materials. That is to say it is a kind of making into an instant. In this study, There is a purpose to present fundamental data, comparing and analyzing a phenomenon about aggregate's absorption following the rate of adding water, for using existing materials.

非均質土層에 대한 Fragment Method에 관한 硏究

韓相賢,梁禹植,白榮植 慶熙大學校 1988 論文集 Vol.17 No.-

A Study is made on the 2-dimensional seepage problems using the fragment method. The method of fragment is an approximate analytical method of solution for any confined flow system of finite depth. The original fragment method is extended to the inclined impervious boundary and computer program is developed to obtain the head loss, discharge, and exit gradient under the dam. Accordingly, the fragment method can be recommend with confidence for practical use. The result is programed and a few case studies are examined.

몬테 카를로 方法을 利用한 運續基礎의 破壞確率

白榮植,金漢晟 慶熙大學校 1982 論文集 Vol.11 No.-

A study is made on the probability of failure for a strip footing using the Monte Carlo Method. Both the soil properties(cohesion, internal friction angle and unit weight) and applied load are assumed to be normal variated. The confidence limits are determined under the specified confidence level. The pseudo-normal random variables are generated using the computer program package. Use is made of the Hansen equation to compute the ultimate bearing capacity. The negative safety margine (allowable bearing capacity - load) is defined as the failure of the footing. Finally, the probability of failure is expressed as follows. P_f=M/N where N: Total number of trials M: Total number of failures out of N A computer program is developed to take care of the computations mentioned above. Finally, a numerical example is analysed using the developed program. Some of the results include; (1) The reliability of the strip footing can be expressed in terms of the provability of failure instead of the conventional factor of safety. (2) Both the soil properties and applied load are assumed to be normal variated. This means that they are interval estimated instead of conventional point estimation. Therefore the dispersion of the data can be reasonably taken into account for the analysis. (3) Using the Monte Carlo Method the probability of failure is defined as P_f=M/N (4) It is hoped that type of footings with ground water table be analyzed using the similar procedures as well as the strip footing.

우울증 환자에서 Cortisol 일일변화 검사의 의의

채영래,한상익,백인호 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.4

This study was designed to investigate whether depressed patient showed increased plasma contisol level compared with nondepressed patients and to examine whether diurnal variation is preserved or flattened in depressed patients and whether diurnal variation itself could be a useful diagnostic procedure in depression. We studied also the possible relationship between the diurnal variation of cortisol secretion and the degree of symptomatic improvement with antidepressant administration in major depression patients. The results were as follows : 1) The value of serum cortisol levels checked before antidepressant administration were 8.44±4.89㎍/dl, 5.74±3.19㎍/dl, 3.18±3.54㎍/dl, 10.75±5.23㎍/dl at 12AM, 4PM, 11PM and 8AM respectively in endogenous depression group, and 6.39±3.29㎍/dl, 6.25±3.75㎍/dl, 2.74±1.85㎍/dl, 10.79±4.77㎍/dl respectively in control group. There were no significant differences in serum cortisol levels between both groups(Table 2). 2) In 31 endogenous depressives, 18(58.1%) maintained diurnal variation of cortisol level and 13(41.9%) showed flattened variation. However, of 16 control group(schizophrenics and dysthymic disorder patients), 11(68.8%) maintained diurnal variation of cortisol secretion and5(31.2%) showed flattened variation. As a result, the sensitivity, specificity and predictive value of diurnal cortisol test for endogenous depression were 42%, 67%, and 72% respectively 3) In 26 major depression patients, 11 patients who showed flattened diurnal variation of cortisol secretion had significantly high "agitative depression" factors of Hamiltion Rating Scale for Depression compared with 15 patients who maintained diurnal variation. 4) Among 15 major depression patients whose diurnal variation was preserved, 12(80.0%) showed marked improvement of depressive symptoms with antidepressant administration and 3(20.0%) did not. Among 11 major depression patients whose diurnal variation was disturbed, 6(54.5%) improved and 5(45.5%) did not. There were no significant differences in symptomatic improvement between two groups.

단삼추출물의 항산화능 검색 및 약과에의 첨가효과

김윤화,한영실,백재은,송태희 한국조리과학회 2003 한국식품조리과학회지 Vol.19 No.4

This study was carried out to investigate the antioxidant activities of Dansam (S. miltiorrhiza). The Dansam (S. miltiorrhiza) was extracted with ethanol and methanol, and the extracts were fractionated with hexane, chloroform, ethyl acetate and butanol and water, in that order. The antioxidant activities of Dansam (S. miltiorrhiza) were determined by measuring the radical scavenging effects, using the 1, 1-diphenyl-2-picryl-hydrazyl (DPPH) method. The electron donating ability was shown to be about 50% (IC50) at concentration of L-ascorbic acid, Dansam that reflected eliminatory effect by 50% were 9.48㎍/㎖, 8.28㎍/㎖ and 12.59㎍/㎖ respectively. According to the results of the above antioxidation experiments, those for the group with the added Dansam showed a decreased oxidation, but the antioxidation increased with time. With a storage temperature of 60℃ for 5 days, the acid value for the relative antioxidant activities were higher than in the Control group. The peroxide values for the relative antioxidant activities were also higher than in the Control group. The TBA values for the relative antioxidant activities were higher than in the Control group.