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.

Dimethylphthalate와 Ethyleneglycol의 에스테르 交換 反應에 關한 硏究(2)

孫秉淸,鄭舜旭 弘益大學校 1985 弘大論叢 Vol.17 No.2

The transesterification reaction between dimethylphthalate and ethyleneglycol was kinetically investigated in the presence of various metal chloride catalysts at 180℃. The reaction was followed by the measurement of distilled methanol from the micro measuring cylinder. The transesterification reaction was first-order kinetics with respect to the concentration of dimethylphthalate, ethyleneglycol and catalyst. From the examination of relationship between rate constant and reciprocal absolute temperature, the activation energy has been calculated as 22.62 Kcal with cupric chloride catalyst, 32.26 Kcal with zinc chloride catalyst.+the highest reactivities were found for electronegativity values between 1.4∼1.7.

Langmuir-Blodgett 法을 위한 (3-Alkyl Benzimidazolium)-TCNQ(1:1) 錯物의 合成

孫秉淸,閔丙卨,鄭舜旭 弘益大學校 科學技術硏究所 1993 科學技術硏究論文集 Vol.3 No.-

Dimethylphthalate와 Monoethanolamine의 에스테르 交換反應에 關한 硏究

孫秉淸,鄭舜旭 弘益大學校 1983 弘大論叢 Vol.15 No.2

The transesterification reaction between dimethyphthalate and monoethanolamine was kinetically investigated in the presence of various metal acetate catalyst at 110℃. The reaction was followed by the measurement of distilled methanol from the micro measuring cylinder The transeterification reaction was first-order kinetics with respect to the concentration of dimethylphthalate, monoethanolamine and catalyst. From the examination of relationship between rate constant and reciprocal absolute temperature, the activation energy has been caculated as 9.843 Kcal with cadmium acetate catalyst, 12.30 Kcal without catalyst. The highest reactives were found for electronegativity values between 1.4~1.7.

메타크릴산 메틸과 디에탄올아민의 에스테르 교환반응에 대한 음이온 촉매의 영향

孫秉淸,朴根浩 弘益大學校 1987 弘大論叢 Vol.19 No.2

The transesterification between diethanolamine and methyl methacrylate was kinetically investigated in the presence of zinc compound catalysts at 120℃. The amount of reacted methyl methacrylate was measured by gas chromatography, and the reaction rate also measured from the amount of reactants under each catalyst. The transesterification was carried out in the first order with respect to the concentration of diethanolamine and methyl methacrylate, respectively. The over-all order was 2nd. The apparent rate constant(k') was found to obey first kinetics with respect to. the concentration of catalyst. It shows that according to an increase in basicity of anionic species the rate constant increase, and that a linear relationship exists between ln k and pKa.

디메틸프탈레이트와 디에탄올아민의 에스테르 교환 반응에 관한 연구

孫秉淸,趙南奭 弘益大學校 1984 弘大論叢 Vol.16 No.2

The transesterification reaction of dimethylphthalate with diethnolamine was kinetically investigated in the presence of various metal acetate catalysts at 130℃. The reaction was followed by the measurement of distilled methanol from the reaction vessel. The transesterification reaction showed the first-order kinetics with regard to the concentration of dimethylphthalate, diethanolamine and catalyst, respectively. From the examination of relationship between rate constant and reciprocal absolute temperature, the activation energy was calculated as 9.93Kcal on the transesterification reaction with cadmium acetate catalyst, 14.69Kcal without catalyst.

에스테르 交換反應에 對한 醋酸鹽 觸媒의 影響에 關한 硏究

孫秉淸,金德夏 弘益大學校 1982 弘大論叢 Vol.14 No.2

The transesterification reaction between dimethylphthalate and ethyleneglycol was kinetically investigated in the presence of various metal acetate catalysts at 185℃ The reaction was followed by the measurement of distilled methanol from the reaction vessel. The transesterification was found to obey thiry-order kinetics with respect to dime thylphthalate and ethyleneglycol and catalyst. From the examination of relationship between rate constants and reciprocal absolute temerature, the activation evergy has been calculate as 25.90 Kcal with cobalt acetate catalyst. The highest reactivities were found for the metal acetate catalysts with the electron egativity values between 1.4 and 1.7.

복강경하 질식 자궁적출술 30예의 임상적 고찰 : A Review of 30 Cases

윤병일,김소정,정두용,김수녕,손인숙,이지영 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Hysterectomy is the most common gynecologic operation. Traditionally, hysterectomy was performed either through an abdominal approach or through a vaginal approach. Recently, laparoscopic hysterectomy is quite often tried. To evaluate the effectiveness and value of LA VH(Laparoscopy Assisted Vaginal Hysterectomy), and to evaluate the possibility whether to rep;ace abdominal hysterectomy to LAVH, we analyzed our clinical cases. This clinical study is a retrospective review of 30 cases of LAVH from May 2002 to February 2003 at the department of Obstetrics and Gynecology, Chung- Ju hospital, Konkuk University. We evaluated age, parity, previous abdominal operations, indications of hysterectomy, combined operation, operating time, hemoglobin change, weight of uterus, hospital stay and postoperativeThe average operating time was 146 ± 42 minutes, the uterine weight was 239 ± 126 grams, and the mean postoperative hemoglobin loss was 1.7 ± 1.4 g/dl. The most common pathologic finding was myoma uteri(37%), and the second most pathologic finding was adenomyosis(20%) and myoma uteri with adenomyosis (20%). Serious complications were not appeared. LAVH provides a shorter hospital stay, quicker recovery, and the acceptable complication rate except incerased operating time than abdominal hysterectomy. This study suggests that LAVH appears more useful than TAH(Total Abdominal Hysterectomy) and could replace abdominal hysterectomy.

寫眞 乳劑用 硬膜劑 合成과 應用

金榮燦,孫秉淸 弘益大學校 科學技術硏究所 1994 科學技術硏究論文集 Vol.5 No.-

Methylmethacrylate와 n-Butylalcohol의 에스테르 교환반응에 관한 연구

鄭舜旭,朴根浩,孫秉淸,金忠一 弘益大學校 1988 弘大論叢 Vol.20 No.2

The transesterification reaction between methylmethacrylate and n-butyl alcohol was kinetically investigated in the presence of constant quantity of inhibitor and various metal acetate catalyst at 120℃. The quantity of n-butylmethacrylate produced in the reaction flask was measured by gas-chromatography, and the reaction rate was investigated by measuring of the quantity of the product the reaction under various catalysts. The transesterification was carried out in the first order reaction kinetics with respect to the concentration of methylmethacrylate and n-buty1 alcohol, respectively. The linear relationship was show between rate constant and absolute temperatures, and the activation energy of 14.7Kcal for the reaction with zinc acetate catalyst was calculated. The maximum reaction rate was appeared at the range of 1.5 to 1.6 of electro-negativity of metal ions.