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.

경막외 혈종에서의 시야결손과 CT소견

조병일,하영수,강준기,송진언 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.4

The evidence of infarction within the territory of the posterior cerebral artery could be diagnosed clinically using follow-up CT scan in while it has been pathologically well proved entity when the tentorial herniation occurred particularly in cases of head trauma with intracranial hematoma, although its incidence was generally within 10%. Visual field defects in traumatic intracranial surface hematomas have been proposed as result of the compression of posterior cerebral artery or anterior cheroidal artery and directly optic tract or visual cortex. Authors experienced the infarction of occipital and temporal lobe on CT scans and the homonymous hemianopsia in 3 cases of 20 epidural hematomas after CT was available. The case histories and CT findings of the infarction were detailed and discussed. It may be stressed that the careful examination and frequent follow-up CT scan are performed even in epidural hematoma.

구개열에서 비인두강의 생리해부학적 구조와 과비음과의 연관성 연구

조준희,표화영,최홍식,최병재,손흥규,심현섭 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

비인강폐쇄란 연구개, 인두측벽 그리고 인두후벽간의 움직임이 서로 조화되어 구강과 비강을 나누어주는 괄약근 기전으로서 연하, 호흡, 발음 등의 생리적기능에 중요한 역할을 한다. 이 기능에 문제가 생긴 경우를 비인강폐쇄부전이라하며 그 원인으로는 (1) 연구개의 길이 및 움직임이상 (2) 비인두강의 해부학적 공간문제 (3) 인두 후벽과 측벽의 기능이상 등이 있다. 본 연구는 구개열 환자의 측면두부방사선계측사진을 통해 비인두강을 생리해부학적으로 분석하였으며 산출된 말소리의 과비음정도를 Nasometer로 평가하였다. 이로부터 얻은 정상군과 구개열환자군의 결과를 각각 비교하였으며, 비인강폐쇄부전과의 연관성을 알아보기 위하여 Anatomic VPI와 Nasalance score의 값을 비교분석하였다. 얻어진 결과는 다음과 같았다. 1. 측면두부방사선계측사진 결과, 연구개 길이, 연구개 두께, 비인강 깊이, 비인강 면적, Adequate ratio에서 두 그룹간 유의한 차이를 나타내었다. 2. Nasometer 결과. 모음/오/와 구강공명음문장, 구강장해음문장에서 두 그룹 간 유의한 차이를 나타내었다. 3. 구개열환자군에서 비인두강의 폐쇄부전 정도를 표현해주는 Anatomic VPI와 Nasalance score는 전반적으로 연관성이 없었다. 다만, 모음/이/와 일부 구강자음으로 이루어진 문장에서 다소의 상관성을 나타내었다. 결론적으로, 측면두부방사선계측사진과 Nasometer 각각의 검사결과에서 두 그룹간 유의한 차이를 찾아볼 수 있었으나, 구개열환자군내에서 비인강폐쇄부전을 표현하는 Anatomic VPI와 Nasalance score는 모음/이/와 구강자음을 포함한 문장을 제외하고는 전반적으로 연관성이 없었다. Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall. The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction. The following results were obtained : 1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups. 2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants. 3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated. In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group. Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.

모파상의 작품에 나타난 공간과 움직임 그리고 물

조병준 한국프랑스어문교육학회 2000 프랑스어문교육 Vol.10 No.-

Dans les oeuvres de Pre´vost, il est tre`s difficile de saisir clairemement l'unite´ de la pense´e. Du fait de ses carrie`res litte´res et eccle´siastiques mouvemente´es. Pre´vost pose un des proble`mes fondamentaux de l'histoire des ide´es au de´but du XVIIIe sie`cle. Cette pe´riode est cones´de´re´e comme celle de la transition entre les deux syste`mes de la pense´e globale, le Classicisme et les Lumie`res. Comme le soulignent beaucoup de chercheurs, Pre´vost n'a jamais exprime´ clairement ses ide´es the´ologiques morales. Cette ambigui¨te´ de Pre´vost n'a provoque de nombreux de´bats concernant la nature de ses pense´es notamment celle de la "passion". Dans ce travail, a` travers l'analyse de ses romans, ses articles de revue et de dictionnaire, nous avons releve´ avec prudence, une affinite´ de la pense´e entre Pre´vost et Malebranche. Ce dernier est conside´re´ comme l'un des plus importants penseurs a` la fin du XVIIe sie`cle et au de´but du XVIIIe sie`cle en France. Malebranche de´veloppe le carte´sianisme dans un sens religieux en le reliant avec l'augustinisme. Que signifie donc cette influence de Malebranche pour Pre´vost´ Toute oeuvre de Pre´vost est axe´e sur la connaissance de l'homme. La conception de la nature humaine chez Pre´vost est e´troitement lie´e a` celle de l'augustinisme. Dans ses pense´es, le pe´che´ original joue le ro^le primordial. Il de´nonce ainsi fermement la passion corrompue par le pe´che´ original. Cependant, Pre´vost fait l'apologie de la passion primitive qu'il conside`re comme naturelle et innocente. Nous constatons que cette discre`te apologie de la passion est fortement influence´e par la pense´e de Descartes. De cette conception de la passion, nous pouvons nous apecevoir de l'une des caracte´ristiques du mouvement des ide´es de cette e´poque ou` commence la re´habilitation de la passion humaine. L'inte´re^t de Pre´vost pour Malebranche s'explique bien par la particularite´ de cette e´poque. Aux yeux de Pre´vost, le syste`me de pense´e de Malebranche, harmonisant le carte´sianisme et l'augustinisme, est un ide´eal qui peut satisfaire a` la fois sa pense´e morale et religieuse.

멀리뛰기와 높이뛰기선수 수직점프의 역학적 분석

조병준 한국운동역학회 2001 한국운동역학회지 Vol.11 No.3

The purpose of this study was to compare and analyze the characteristics of three kinds of vertical jump with broad jumpers and high jumpers. The subjects were teen-age broad jumpers and high jumpers in kyungpook, 6 in each. In experiment, two video cameras which have 60 frame per sec and a force platform for measuring ground reaction forces were used. For control-bars were set up to get real-space coordinates. The DLT method was used to obtain the 3-dimensional coordinates of the 21 body landmarks. The recorded images were subject to digitizing with KWON3N MOTION ANALYSIS PACKAGE. The kinematic variables which were related with three kinds of vertical jumps were as follows displacement and velocity of center of body, angle displacement(high joint of right-and-left legs, knee joint, ankle joint), angle velocity(high joint of right-and-left legs, knee joint, ankle joint). The mechanical variables were vertical components of ground reaction force, phase time of stance, impulse, power. Statistical analysis was performed by t-test (a =.05) in SPSS. The results of this study were as follows: 1. There was no significant differences between standing jump and running jump in velocity variation of center of body at the moment of landing, but there were significant differences between drop jump and each of two jumps. 2. The variation of angle velocity in hip joint was not great in the first half phase, but increased considerably in the second half phase. 3. There were no significant differences among three jump types in the maximal force through ground reaction force. In the case of broad jumpers, there was significant difference between standing jump and drop jump, which implied broad jumpers had stronger resistance ability to the impact. 4. In the impulse, high jumpers and broad jumpers showed difference in drop jump, but not in standing jump and running jump. 5. In the exertion of power in three jump types, standing jump and running jump showed similar variation, but drop jump showed different initial variation.

만성 화농성 중이염의 세균학적 고찰

조남순,이영훈,강기훈,최제환,송태현,이병돈,장혁순,강주원,김연준 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and Objectives : Chronic suppurative otitis media is one of the frequent diseases in otolaryngologic field. It is important to choose of antibiotics in the management of infectious disease. But the organisms in infections have been changed and resistance to antibiotics has been grown as the development of antibiotics has been achieved. And so it has been necessary to recognize the changes of organisms and resistance in antibiotics. Our study was performed to identify the pathogens isolated from discharges in chronic otitis media and evaluate the antibiotic agents, to recognize the change of to resistance to·antibiotic agents and to use the appropriate anitiotics. Materials and Methods : Retrospectively, authors reviewed the backeriologic study of 114 cases of chronic suppurative otitis media who visited the Department of Otolaryngology, Soonchunhyang University in Seoul from Nov. 1996 to Oct. 1999 and analyzed 101 strains and its sensitivity test to various antibiotics. Result : In 93 cases in which pathogenic organism was isolated, single infection was 85 cases(91.4%) and mixed infection was 8 cases(8.6%). The most frequent pathogenic organism was Staphylococcus aureus(59.4%), Pseudomonas aeruginosa(13.9%), Providencia(4.8%), Alcaligenes(3.0%) and Streptococcus pneumoniae(2.9%) were the next. Methicilline-Resistance Staphylococcus aureus was 34 cases(57.6%) of Staphylococcus aureus. Staphylococcus aureus was sensitive to Vancomycin(96.7%), Trimethoprim-Sulfamethoxazole (57.6%), Cefuroxime(42.4%) and Ciprofloxacin(40.7%) but resistant to Penicillin(94.9%). Pseudomonas aeruginosa was sentitive Amikacin(100%), Ciprofloxacin(100%) and Gentamicin(67%). Conclusion : As MRSA recently was wide spread in community accquired infection as well as nosocomial infection, we must consider strict control of MRSA.

방사선치료 조사영역 내에 발생한 설암 환자에서 입체조형방사선치료 경험 : 증례보고

조문준,장지영,김기환,김병국,송창준,김준상,김재성 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Objectives : We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods : A 64-year-old male patient was diagnosed with T4NOMO supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2NOMO. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from 7×6.4 to 8×8㎠, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results : In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion : Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.

달리기속도 변화에 따른 지면반력 비교분석

조병준,이민형 한국운동역학회 2001 한국운동역학회지 Vol.11 No.1

In this study, running motion was measured at 5 given velocity. The subjects of this study were high school middle-long distance players and non-players who participated with bare feet. To achieve this study, force platform and running timer were used. In addition, dynamic variables were calculated in Gait Lab for Window 2.0 using kinematic variables that were educed by segment measuring coefficient and Kwon3D motion analysis program. By using the statistics for ground reaction force variables, following conclusions were obtained. 1. On the ground reaction force of vertical direction, players showed greater impulse than non-players in Fz1 while non-players showed greater impulse than players in Fz2. Players arrived mort rapidly at the peak point than non-players in Tz1 and tz2. Players showed greater impulse than non-players averagely in Fy1 and Fy2, players arrived more rapidly at peak point than non-players in Tz1 and Tz2. 2. On the vertical impulse, players showed greater than non-players. The positive and negative impulse were low, it was appeared that players were more efficient than non-players in running.

방사선치료 조사영역 내에 발생한 설암 환자에서 입체조형방사선치료 경험 : 증례보고

조문준,장지영,김기환,김병국,송창준,김준상,김재성 충남대학교 암공동연구소 2003 암공동연구소 업적집 Vol.3 No.

Objectives : We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods : A 64-year-old male patient was diagnosed with T4NOMO supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2NOMO. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from 7×6.4 to 8×8㎠, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results : In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion : Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.

탄성 저항운동의 수직점프에 대한 운동학적 분석

조병준 한국운동역학회 2001 한국운동역학회지 Vol.11 No.3

The purpose of this study was to analyze before and after the elastic resistance training and give the information of various mechanical variable in vertical jump through training. The subject of this research was 14 male in K university. Leg squat and leg flexion and extension was executed the progressive over load method of 8 weeks as Metal spring-Tubex combined training. The intensity of exercise was 60 - 70 % Max S. The frequency of exercise was three times in a week. The time of exercise was about 20 minutes. Cinematographic analysis and ground reaction force were measured by pre and post experiments. After analyzing Cinematographic and ground reaction force, the following findings are obtained: 1. The time of jump was a little shortened through elastic resistance training. 2. The velocity of motion and ability of recoil action and extension power of lower limb were increased. 3. Impulse was a little decreased, but no significant difference. The height of jump was appeared to significant increase. 4. The change of velocity appeared similarly before and after training, but the velocity of decreasing appeared rapidly after training. The velocity of increasing appeared similar pattern, but after training appeared rapidly after knee maximum flexion. 5. The change of acceleration pattern appeared to delay remarkably knee maximum flection.