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.

May-Thurner Syndrome 환자의 좌측 하지 심부정맥혈전증 : Pigtail 카테터 회전을 이용한 치료의 효용성과 안전성 Lower Extremity Deep Vein Thrombosis of May-Thurner Syndrome

정구용,염차경,이주호,강병철 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1

다중 출력 MLP신경망을 이용한 한국어 음성인식에 관한 연구

鄭光宇,朴炳哲 成均館大學校 科學技術硏究所 1995 論文集 Vol.46 No.1

In this paper, to improve the performance of the speaker-independent speech recognition system, a new reural network model and learning algorithm were proposed. Recognition algorithm for performance improvement of the recognition system had two kinds. Several experimental results were given to prove the performance of proposed algotithm on the isolated digit recognition of the speaker- independent. First, the algorithm for extraction of the feature vector was proposed. it imported, to stabilize the sequence of the feature vector to input speech, the 'Inertia Term' between neighbor frames. If, caused the reducing fluctuation components produced on the sequence of the feature vector of speech signal and tine suppressing superposition of probability distribution between feature vectors. As a result, the ability of phoneme discrimination was improved on the speaker independent speech recognition system or 3.9%. Second, the Multi-Output MLP(MO-MLP) neural network structure was proposed. It had, for reflecting the variation of the feature of the phoneme which was produced on the variable phonological environment, the structure which was assigned several output nodes to the same phoneme. So, the convergence characteristic of the neural network could be improved by the proposed structure for complex learning data and this structure could improve the ability of recognition system by generating the multi-template pattern on a neural network for 8.4%.

말기신부전 환자에서 심혈관계 합병증 예측인자로서의 호모시스테인의 의의

정종훈,신병철,김현리 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Backgroud: Thromboembolic phenomena are major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). In the last years, the accumulation of evidence coming from studies in patients with chronic renal failure have demonstrated an increased relative risk of coronary artery disease (CAD) in association with hyperhomocysteinemia. We elucidate the effects of homocysteine on diagnostic marker of cardiovascular risk factor of patients with ESRD. Methods: One hundred thirty-three patients were enrolled in the study performed at a Chosun university hospital. Ninety patients were on dialysis (58 hemodialyzed patients and 32 peritoneal dialyzed patients). Hyperhomocysteinemia was defined as a fasting plasma homocysteine level more than 15 μmol/L. Results: A total 71 patients (53.4%) had hyperhomocysteinemia. The prevalence of hyperhomocysteinemia was 60.3%, 46.9%, 48.8% among hemodialysis, peritoneal dialysis and kidney transplantation, respectively. CAD was present in 40.6% of patients (54 patients). The mean homocysteine concentration was 22.35 ± 5.94 μmol/L and 15.07 ± 5.45 μmol/L in patient with (n=54) and without (n=79) CAD, respectively (p<0.01). There was significant difference including age, serum creatinine, cardiac troponin-T (cTn-T), homocysteine level, total cholesterol, CRP in the two group (p<0.05). Plasma homocysteine concentration showed significant positive correlations with age (r= 0.261, p<0.05), cTn-T (r= 0.244, p<0.05), CRP (r= 0.422, p<0.01) in overall and negative correlations with hemoglobin (r= -0.240, p<0.05) in dialysis patients. Conclusion: Hyperhomocysteinemia, elevation of cTn-T, and elevation of CRP were diagnostic markers of ischemic heart disease of ESRD patients undergoing hemodialysis and peritoneal dialysis. The homocysteine is more potential diagnostic marker than cTn-T and CK-MB in ischemic heart disease with ESRD patients.

Enterococcus faecium 19-46-4에 의한 Cholic Acid의 생산

정은영,김명수,이철훈,김병홍 한국산업미생물학회 1996 한국미생물·생명공학회지 Vol.24 No.5

항균활성을 갖는 혐기성 미생물에 대한 탐색연구에서 항균활성이 강한 Enterococcus faecium 19-46-4를 선발하여 혐기적 배양으로 이 균주가 생산하는 항생물질의 분리, 정제 및 이화학적 특성 및 구조분석을 행하였다. 40ℓ 균배양액으로부터 iso-butanol extraction, C-18 liguid column chromatography, HPLC등을 통해 약 100mg의 항균물질을 분리정제하여 KIST 194로 명명하였고, KIST 194를 UV, IR, ^1H-NMR, ^13C-NMR, EI-MS와 LC-MS 등의 기기분석을 한 결과 cholic acid (3α, 7α, 12α-trihydroxy-5β-cholan 24-oic acid)로 동정하였다. A facultative anaerobe Enterococcus faecium 19-46-4 was used to study the production of an antimicrobial substance in anaerobic conditions. Major part of the antibiotic activity was found in the culture filtrate of the bacterium. The active compound was extracted by an equal volume of iso-butanol and concentrated in vacuo (at 50℃) before purification by C-18 liguid column chromatography and HPLC. A chromatographically pure compound was obtained by two passages of HPLC columns, The compound appeared as a pale-yellow powder. The yield was about 2.5 mg l^-1 culture filtrate. The compound was named as KIST 194. KIST 194 were identified as cholic acid (3α, 7α, 12α-trihydroxy-5β-cholan 24-oic acid) based on its physico-chemical properties determined by UV, IR, ^1H-NMR, ^13C-NMR, EI-MS and LC-MS.

골인이 Morphine 중독 마우스의 금단 증상에 미치는 효과

정태호,김정철,채성철,강병조,이인자 최신의학사 1991 最新醫學 Vol.34 No.2

DC 링크의 분명한 수식화에 의한 AC-DC 조류계산

정형환,안병철,허동렬 동아대학교 공과대학부설 생산기술연구소 1997 生産技術硏究所硏究論文集 Vol.2 No.2

This report has been suggested a calculation method include the DC-Link equations into process of power flow repetition of AC system, on to use the fast decoupled method. The DC link model which consisted of thirteen non-linear equations could be expressed using nine non-linear equations in accordance with the consideration of system configuration and functional characteristic. In recognition of the advantage for DC transmission on a side of elevation upon an economical transmission through a lower loss and a stability enhancement, the estabishment of real system and this study are doing to activate in the world. Also in our land, the DC transmission between the shore and Jae-Ju Province is going to expedite in actual fact. Such as fact in today, it has been done to think that is meaningful to exhibit the effective power flow for advactage fo a memory capacity, a calculatot's speed, and can be known the electric power distributions of integrated AC-DC system.

돌와(Gynostemma pentaphyllum)엑기스가 白鼠의 肝臟障碍에 미치는 影響

丁明鉉,文永熙,姜壽鐵,李炳柱 조선대학교 약학연구소 1989 藥學硏究誌 Vol.11 No.1

This study was attempted to invesigate the effects of extract and crude saponins of Gynostemma pentaphyllum Makino on the activities of S-GPT, S-GOT, Al.P, LDH and the levels of total-bilirubin, total-cholesterol in the serum of nomal rats and experimentally CCl_4-intoxicated rats, and on the effect of body, liver and spleen weight in CCl_4-intoxicated rats. The results were shown as follows; The extract (GE.) and crude saponins were showed a significantly decrease in the activities of S-GPT, S-GOT, Al.P and the level of total bilirubin in the serum elevated by CCl_4, but crude saponins was more decreased than GE. The activities of LDH were significantly decreased of the 4th and the 6th days after administration of GE., and crude saponins was decreased in proportion to the number of days. The level of total cholesterol were significantly decreased in all sample groups. when compared with control group, but remarkably decreased in GE. 500㎎/㎏ and crude saponins 100㎎/㎏. The liver and spleen weight were decreased on the administration of GE. and crude saponins. According to the above results, it is thought that GE. and crude saponins exhibited significant antihepatotoxic activity in the CCl_4-intoxicated rats.

선형계획기법(Linear Programming)에 관한 연구

고충석,이병철 제주대학교 1986 논문집 Vol.16 No.1

One of the most fundamental of the decisions a public administrator must make is the determination of how scarce resources should be allocated to competing activities. These scarce resources may be budgeted dollars, land for housing, manpower, equipment, or any other factor over which the administrator exercises control. Linear programming is concerned with the basic problem of the allocation of scarce resources. The purpose of this paper is to point out the problems and the major issues which are intimately related to apply Linear programming to real policy problem situation in the past and present in order to provide an effective and efficient framework, rather than to attempt any specific policy prescriptions and testing hypothetical propositions. Several other studies have used Linear programming to test hypothetical propositions and specific policy prescriptions. These studies have had unique analytic viewpoints and perspectives. They helped to improve Linear programming. Therefore, according to unique analytic viewpoint, this paper examines the role of quantitative analyses in public administration and decision making. Throughout this presentations several key features of the palper should be noted. First, this paper is tried to introduce the concepts of Linear programming as they relate to public administration. Second, the evaluation of quantitative analyses will be examined in light of the different levels of decisions a public administrator must make. Third, it is oriented toward the scientific method of problem solving and expands the steps involved in public problem solving. The final feature of the paper that should be noted is that each discussion of a model presents an analysis of how the model should be developed, a discussion of specific public oriented case studies(example problems), and an analysis of the potential/shortcomings of Linear programming model in public administration. The methodology adopted is based on the literature-survey. A review of the literature on Linear programming revealed a substantial methodologicall-especialy, hypothetical assumptions-shortcomings. These shortcomings are following as ; 1. Linearity 2. Additivity 3. Divisibility 4. Finiteness 5 Certainty and Static time period 6. Non-monetary performance ignorance For solving these shortcomings, this paper presents some ideas. A major conclusion is that Linear programming has varied according to the specific situations of policy pattern that were involved. Therefore, Linear programming application must flexibly consider the real specific policy situations. If this assumption is accepted, we think, The future of Linear programming application is very optimistic.

교통사고후 정신과로 장애감정 의뢰된 환자의 임상적 특징

김병철,김성곤,박제민,김명정,정영인 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

1994년 1월부터 1996년 12월까지 3년간에 걸쳐 교통사고후 법원으로부터 장애감정 의뢰되어, 부산대 학교병원 정신과에서 정신장애감정을 받았던 88명의 환자를 대상으로 임상적 특징을 조사하였던 바. 그 결과를 다음과 같이 요약할 수 있었다 1) 대상 환자 88명 가운데 58명(65.9%)이 남자, 30명(34.1%)이 여자였다. 낮은 교육과 사회경제적 수준을 가진 환자가 많았으며, 21세에서 50세까지의 사회 활동층이 과반수를 넘었다. 2) 수상당시 환자의 71.6%에서 뇌37상이 있었고, 다음으로 두개골 골절(36.4%), 뇌출혈(33.7%), 뇌혈종(26.1%). 뇌진탕(12.6%) , 축삭손상(10.2%) 등이 있었으며. 대상 환자의 9.1%에서는 뇌손상의 증거가 없었다. 3) 환자나 환자의 보호자가 주관적으로 호소하는'자각적 증상은 인지증상이 가장 많아 전체 대상 환자의 85.2%에서 있었고. 다음으로 신체증상(83.0%), 행동증상(69.3%), 정서증상(58.0%) 순이었던 반면에, 감정의가 판단한 탄각적 증상은 정서증상(80.7%7)이 가장 많았고, 다음으로 행동중상(77.3%). 인지 증상(63.6%), 신체증상(40.9%) 순이었다 4) 대상 환자의 48.8%에서 수상후 1개월과 6개월 사이에 정신의학적 증상이 발현하였고.6개월 이후에 나타난 경우는 9.1%에 불과하였다. 또한, 대상 환자의 61.4%에서는 증상이 있음에도 불구하고 감정 당시까지 정신의학적 치료를 받은 적이 없었고. 정신의학적 치료를 받았던 환자의 23.5%에서는 증상 발현 후 6개월이 경과한 뒤에야 치료를 받았다. 5) 감정시 모든 대상 환자에서 뇌영상겋사와 뇌파검사가 실시되었고, 이들 가운데 47.7%에서 비정상적인 뇌영상 소견을 보였다. 이상소견으로서는 뇌연화증이 가장 많았고, 다음으로 뇌위축, 축삭손상. 낭종 등의 순이었다. 뇌파는 환자의 86.4%에서 정상소견을 보였고, 뇌파 소견과 뇌영상 소견간에는 유의한 상관관계가 있었다. 6) 감정당시 대상 환자의 95.5%에서 최종적으로 정신장애가 확인되었고, 이중 두부외상에 의한 인격 변화가 가장 많았으며, 다음으로 두부외상에 의한 치매, 적응장애, 두부외상에 의한 우울장애, 뇌진탕후장애. 외상후 스트레스 장애 등의 순으로 많았다. 정신장애가 확인되었던 환자의 38.1%에서는 추후 계속적인 정신의학적 치료의 필요성이 인정되었다. 7) 외상 후유증으로 인한 지능의 변화 정도에 있어서 두부외상 관련인자 유무간에 차이가 있는지를 알아본 결과. 수상당시의 의식소실 유무간이나 외상후 섬망 유무간에는 차이가 있었고, 감정당시 실시되었던 뇌 영상검사상의 이상소견 유무간에도 차이가 있었다. In an attempt to obtain the basic data for mental disability evaluation in psychiatric casualties by traffic accidents,88 cases referred from the court for the purpose of mental disability evaluation for 3 years from 1974 to 1996 were surveyed. The results are summarized as fellows : 1) Among the 88 cases, 58 cases(65.9%) were male and 30(34.1%) were female. Cases with low educational and socioeconomic levels outnumbered those with high educational and socioeconomic levels. More than half of the cases were in socially active group with ages of 21 to 50years. , 2) At the time of accidents,11.6% of the whole cases were diagnosed as cerebral contusion, Which was the most common diagnosis. The next common diagnoses were skull 7acture(36.4%), brain hemorrhage(33.0%), brain hematoma(26.1%), cerebral concussion(12.6%), and axonal injury(107%) in order of frequency. In 9.1% of the cases there was no definite evidence of head injury was found. 3) During talc period of mental disability evaluation, the most common symptom was cognitive symptom(85.2%), and the next common symptoms were somatic(83.0%), behavioral(69.3%), and affective(58.0%) ones in order of frequency. On the other side, the most common psychopathology recognized by talc psychiatrists was affective symptom, which was present in 80.7% of the cases manifested during the period of evaluation, and the next common psycho-pathologies were behavioral(77.3%), cognitive(63.6%), and somatic(40.9%) symptoms in order of frequency. 4) Nearly half(48.8%) of oft whole patients manifested psychiatric symptoms such as cognitive, affective, behavioral, and somatic symptoms between the first and sixth months after traffic accidents. Only 9.1% of the cases developed psychiatric symptoms after six months of traffic accidents. Meanwhile,61.4% of the cases were never given psychiatric treatments despite the presence of psychiatric symptoms, and 23.5% of the cases given psychiatric treatments visited psychiatrists after six months of symptom development. 5) All of the cases took neuroimging studies such as brain CT or MRI and EEG during the period of mental disability evaluation. In 47.7% of the cases there were abnormal findings in neuroimaging studies among which encephalomalacia was the most frequent. The next abnormal findings were brain atrophy, axonal injury, cyst, and so on in order of frequency. On file other hand, in 86.4% of the cases EEG findings were within normal limit. 6) In 95.5% of the cases, mental disorders were confirmed, among which personality change due to head trauma was the most common, and the next common mental disorders were dementia due to head trauma, adjustment disorder, depressive disorder due to head trauma, postconcussional disorder, posttraumatic stress disorder, and so on in order of frequency. Mere than one third of the casts(38.1%) given psychiatric diagnoses were considered to need continuous psychiatric treatments at the time of mental disability evaluation. 7). Posttraumatic decline in intelligence tended to be affected by loss of consciousness and delirium, but not b? skull fracture and brain surgery. In brain imaging .and EEG studies performed during the period of mental disability evaluation, posttraumatic decrease in intelligence tended to be influenced by abnormal findings on brain imaging, but not EEG findings.