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.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

인체 유방암종에서 Cyclic-Dependent Kinase Inhibitor, p27^Kip1 발현의 의의

송상용,김덕환,서연림,고영혜,김대식,남석진,양정현 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

자기 효능의 개념 분석

서순림,이은남,박송자,양영희,이동숙,최은옥,구미옥,김인자,이인숙,김성재,박영임,이은옥 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

Today human needs for health promotion and maintenance are increasing. The nursing progression has a great responsibility for helping clients to practice good health behavior. self efficacy was found to be potent predictor in initiating and maintaining the health-related behavior. Therefore, the concept is important in nursig intervention for change of health behavior. The purpose of this paper was to analyze and clarify the meaning of the concept, self efficacy. This study used Walder & Avant's process of concept analysis. Critical attributes of self efficacy were : 1) positive perception of his won capability; 2) intrapersonal strength; 3) possibility of being learned; 4) individuality; 5) specificity; 6) generalizability. Antecedents of self efficacy consist of those facts that 1) new situation occurs; 2) individuals have needs to change the new situation; 3) there are some required actions in new situation. Consequences occurring as a result of self efficacy consist of those facts that 1) individual initiates the of failure; 5) cope with the situation; 6) controls the situation; 7) the level of self efficacy is enhanced; 8) the level of self-esteem is enhanced.

1.6[kW]급 고역률 단상 ZCS-PWM 승압형 컨버터의 특성

서기영,문상필,김주용 慶南大學校 附設 工業技術硏究所 2003 硏究論文集 Vol.21 No.2

본 논문은 1.6[㎾]급 고역률 단상 펄스 폭 변조 승압형 컨버터의 영전류에서 액티브 스위치의 소프트 정류 특징을 나타낸다. 일반적인 펄스 폭 변조방식과 소프트 공진 기술의 적절히 통합하고 있다. 입력전류 형상은 평균 전류 모드 조절과 지속적인 인덕터 전류 모드를 가지고서 얻어진다. 이 새로운 PWM 컨버터는 액티브 스위치의 영전류 턴-온 턴-오프를 가진다. 이는 고전력 장치에 종속된 IGBT에 적절하다. 1.6[㎾]의 400[Wdc]를 출력전압으로부터 동작원리 이론적 분석, 설계, 그리고 실험적 고찰을 통해서 나타내었다. 측정된 효율과 역률은 각각 96.2[%]와 C99[%]이며 입력전류의 전 고조파 왜율은 3.94[%]이고, 입력전압 전 고조파 왜율은 3.8[%]을 나타낸다. This paper presents a 1.6[㎾]class high power factor(HPF) single-phase pulse width modulation(PWM) boost converter featuring soft commutation of the active switches at zero current It incorporates the most desirable properties of conventional PWM and soft switching resonant techniques. The input current shaping is achieved with average current mode control and continuous inductor current mode. This new PWM converter provides zero current turn on and turn off of the active gate bipolar transistors(IGBT's). The principle of operation, the theoretical analysis, a design example, and esperimental results from a laboratory prototype rated at 1 6[㎾] with 400[Vdc] output voltage are presented The measured efficiency and the power factor were 96 2[%] and 0.99[%], respectively, with an input current. Total Harmonic Distortion(THD) equal to 3.94[%], for an input voltage with THD equal to 3.8[%], at rated load

정상 임신 개월에 따른 Lipoprotein에 관한 연구

서란,홍영숙,성낙응 梨花女子大學校 醫科大學 醫科學硏究所 1986 EMJ (Ewha medical journal) Vol.9 No.1

This study was undertaken to determine the pattern of changes in serum protein and lipoproteins in pregnancy. We have measured lipoprotein composition in age-matched non-pregnant and pregnant women(month 2, 3, 5, 9 and 10). The results are as follows: 1) Serum protein and protein content in HDL were higher and those in VLDL and LDL were lower in early pregnancy compared to non-pregnant women and all become similar to non-pregnant women in late pregnancy. 2) Serum cholesterol and cholesterol content in VLDL were higher until late preanancy and those in LDL and HDL were lower in early pregnancy and belome similar to non pregnant women in late pregnancy. 3) Serum phospholipid and phospholipid lontents in VLDL and LDL except in HDL increased during pregnancy. 4) Serum triglyceride and triglyceride contents in HDL and LDL except VLDL increased markedly during pregnancy. In conclusion the huperlipidemia of pregnancy is well recognized although the mechanisms responsible for its development remain unknown and need to be investigated further.

불완전한 검사하의 정기검사정책에 관한 연구

서용성,박영택 成均館大學校 科學技術硏究所 1995 論文集 Vol.46 No.2

Some systems such as early warning system should be inspected occasionally in order to detect failures. If the system is inspected too frequently, the inspection cost increases. On the other hand, if the number of inspections is reduced too much, the undetected system downtime cost increases. Thus, it is of interest to find effective inspection schedule, which minimizes the sum of inspection and downtime costs. Periodic inspection policies under imperfect inspection for the case are considered.

7個 結晶系의 唯一 X-線 回折强度 資料

徐日煥,金光柱,秋錦洪,李珍昊,林星秀,柳保盈,金文執 충남대학교 자연과학연구소 1992 忠南科學硏究誌 Vol.19 No.1

한 結晶의 構造는 唯一單位의 X-線 回折强度資料로부터 決定될 수 있다. Miller指數(hkl)의 函數인 回折强度Ⅰ(hkl)는 異常 散亂(anomalous scattering)이 無視될때 對稱中心點群 卽 Laue群의 對稱性을 나타낸다. 이 論文에서는 모든 結晶系에 對한 回折强度의 唯一單位를 Laue群들의 對稱性으로부터 誘導하여 놓았다. Crystal structures can be determined from the unique data of X-ray intensity. As the X-ray intensity Ⅰ(hkl), which is a function of diffraction plane (hkl), has a center of symmetry assuming anomalous scattering is negligible Ⅰ(hkl) shows the symmetry of a centrosymmetric point group, i.e., a Laue group. In this paper the unique data of the intensity for all crystal systems have been derived from the symmetries of Laue groups.

농촌경관 중요요소의 조작을 통한 경관평가 : 농촌 문화마을을 대상으로 The case of Rural Culture Village

서주환,심성보,전영임,박태희,조영배 경희대학교 부설 디자인연구원 2002 예술· 디자인학연구 Vol.5 No.1

This study does questionnaire over recognition of landscape, major landscape and impressive site in rural community, and research visual preference through precessing pictures with a computer about major landscape. The landscape with natural fabric generally harmonizing with background is high in preference. Also, though major landscape factors are similar, preference is different according to shape, size, quality and color.