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.

당뇨병 환자에서 뇌간 청각신경 유발전위 잠복기의 연장- 기질적? 또는 대사성?-

김성민,권기한,이병철,엄근용,배종석 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

고관절 전치환술 후 합병된 비구 컵 해리와 동반된 활액낭종 : 증례보고 Case Report

성일보,정국진,박수철,김진호,정형진,황재광,염재광,정병현,안종국 대한고관절학회 2001 Hip and Pelvis Vol.13 No.1

대학생의 노인복지에 대한 인식도

차병준,김무룡,김기열,차경미,김귀희,김현실,서인선,임상규,이순자,위광복,남철현 慶山大學校 保健福祉硏究所 1999 保健福祉硏究 Vol.2 No.-

The purpose of this study is to grasp the change of consciousness of young people in order to seek new approach of policy for aged era. 1,200 students attending collages and universities in three small or medium sized cities were inquired for 2 months, from October 1 to November 30, 1996. The result is as follows. 1. The characteristic of the respondents of this survey is that they include 72.1% of women, 40.4% of people aged between 20 to 21, and 49.1% of people who do not have any religion. Those who are from big cities and those who are form farming villages or fishing village occupy equally 40.2%, those who reside in that cities for a long period 49.0%, and those who live with their family 60.9%. 2. The family feature of the subject is that 31.5% of them are those whose father is the age of 55 and more than 55, 10% of them are those whose mothers age is so, 33.1% of them have 5 family members, 29.5% of them have the family income of 1,000,000 to 1,490,000 won, 83.9% of them are from middle class, 47.7% of them are the people whose grand parents have passed away, 70.4% of them live apart from their grand parents, and 60.9% of them are second child. 3. 64.0% of males, 70% of respondents who are aged over 24, 58.1% of respondents who are from rural communities, 62.4% of respondents who live in rural area, and 58.3% of respondents who live alone, prefer to live with grand parents, marked higher rate than other groups. The groups whose father and mother are the age of more than 55 marked higher rate of 55.9% and 58% each than any other groups(p<0.05). The groups whose family member is less than three, whose grand parents both have passed away in middle class, who live with their grand parents, and who are second children, give more positive answers than any other groups. 4. Those who are older, who are buddhists, who are from rural area or live in rural area, whose family is small, whose family income is small, who are from lower class and whose grand parents are still alive, shows preference to support their parents after marriage. 5. Females(89.4%), those who are from small or medium sized cities(89%), who live with their family(85.6%), whose father is the age of 55 and more than 55, whose mother is the age of 54 and less than 54, whose family member is 6, who are from middle class, whose grandparents are still alive and who are the eldest child in their family, give more response that they prefer to live apart from their children in their old age than any other groups. 6. What elderly people need most right now is past time(42.3%), and the respondents whose age is 20 to 21, who are buddhists, who are from middle sized cities and live alone, whose parents are the age of more than 55, who have small family income, who live with their grand parents and who are second children show higher level than any other groups. 7. 76.8% of respondents answer that they do not need their parent's fortune, marked still higher rate than the opposite answer. Those who are older, who are buddhists, who are from big cities, who reside in rural area, who live alone and have smaller family, who are in bad family economic conditions and who live with grand parents present higher rate of positive response. 8. 59.3% of respondents reply that they think about death from time to time, and those who are female, who are in the age of 20 to 21, who are christian, who live with their family, whose siblings or other family members offer their education expenses show higher rate than any other groups. 9. 92.3% of respondents answer that the budget for welfare facility for elderly people is very small. The younger the respondents are and the worse economic condition they have among those who live in big cities, the more answered that. 10. 50% of respondents think social security should provide for their old age, and 42.8% of them believe they themselves provide against it. The respondence that social security ought provide for it appeared more among those whose age are over 24, who are female, who reside in rural area, who are christian, who are in bad economic condition, and who ever used medical institutions in recent one month, marked higher level than other groups. 11. The adequate time of retirement is 59.97±5.60 for public officers, the highest and 59.28±6.35 for teachers, the next. 12. 35.2% of respondents reply that the adequate budget for the old age after their retirement at the age of 60 is 220 million won, showed the highest level of respondence. 13. The factors which affect on the old people in the charged welfare facilities are sex(p<0.01), the type of housing(p<0.05) and whole family income(p<0.05). 14. The factors which affect on remarriage are sex(p<0.05) and religion(p<0.05). For varying old population and expanded welfare service for them, government and relevant authority should give more attention to secure the budget, establish effective plans to expand various program and the facilities for elderly people in order that elderly people spend the rest of life time more happily and more fruitfully. To do that, each college and university should open Health courses, and educate and inform about health and welfare.

남성 건강검진 수진자에서 간기능 장애 및 비알코올성 지방간과 대사 증후군과의 관련성

최태성,유재영,김진석,장은철,박주언,김병익 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

..

백서 하악골의 기능적 전방위가 악관절 원판에 미치는 영향

배용철,경희문,장병천,성재현 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.4

This study was conducted to examine the changes in the shape of the Sprague-Dawley rats' articular disk following postural hyperpropulsion by observing their articular specimens through light and electronic microscopes after following 2-week and 4-week postural hyperpropulsion from their four weeks of age. The findings of this study are summarized as follow. It was shown that as compared with the control group, the experimental group indicated a significant increase in thickness of the 2-week groups' anterior and posterior portion of the articular disc. The experimental group showed statistically more significant increase in thickness of the 4-week groups' anterior portion of the articular disc than the control group. Light micrograph showed that the experimental group had more fibroblast in the anterior portion of the 2-week and 4-week groups than the comparing group. The 2-week groups showed in the findings through the electronic microscope that there were found the well developed and dilated RER which see-ms to actively synthesize the extracellular matrix including collagen, the cells with the well developed RER without distention which seems to actively synthesize the intracellular microfilaments due to the well developed free ribosome, and the typical chondroid cells. In addition, there was more fibroblast cell with the distended and well developed RER in the anterior area of the experimental group than that of the control group while fibroblast with the well developed RER and free ribosome was quite abundat. Based on the above result of this study, it was shown that the functional hyperpropulsion of the mandible causes the changes in the nature of the mechanical load to the certain portion of the articular disk. As a result, it seems that there may be occurred some changes in morphology of the disc by adaptation or confrontation with these changes at the cellular level.

하지 수술을 위한 경막외 마취시 Ropivacaine 과 Bupivacaine 의 비교

이상곤,민병우,반종석,문철준 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Comparison of Epidural Ropivacaine and Bupivacaine in Patients Undergoing Lower Extremity Surgery Chul-Jun Mun, M.D., Sang-Gon Lee, M.D., Jong-Suk Ban, M.D. and Byung-Woo Min, M.D. Department of Anesthesiology, Fatima Hospital, Daegu, Korea Background: Ropivacaine is an amide local anesthetic structurally related to bupivacaine. A ran-domized, double-blind study was performed to compare the clinical effectiveness of ropivacaine and bupivacaine in patients undergoing lower-extremity surgery. Methods: Forty-nine patients (ASA Ⅰ-Ⅱ) were randomized to receive 15 ml of 0.5% ropivacaine or bupivacaine. Twenty patients received 15 ml of ropivacaine and 20 patients received 15 ml of bupiva-caine at the L3,4 or L4,5 interspace. Parameters measured were the onset time, duration and spread of sensory block, the onset time, duration and degree of motor block, the quality of anesthesia and the heart rate and blood pressure profile during the block onset. Results: Demographic characteristics were similar among the groups. Seven patients were excluded from the study due to technical failure of the block, two patients were excluded due to insufficient data. The onset and duration of analgesia at T10 dermatome (mean ?? SD) was 18.9 ?? 7.0 minutes and 187.5 ?? 34.6 minutes respectively for ropivacaine, and was 15.2 ?? 8.8 minutes and 187.8 ?? 40.0 minutes respectively for bupivacaine. Maximum block height (mean ?? SD) was T6.5 ?? 2.0 for ropivacaine and T6.4 ?? 2.0 for bupivacaine. The incidence of complete motor block (Bromage scale 3) was low in the ropivacaine group, being 3/20 for ropivacaine and 12.20 for bupivacaine. Conclusions: The sensory blockade profile of ropivacaine, administered epidurally, is similar to that obtained with an equal dose of bupivacaine. However motor blockade with ropivacaine is less intense, less frequent, and of shorter duration than with bupivacaine. (Korean J Anesthesiol 2001; 41: 434~438)

아세클로페낙 연질캡슬(클란자 에스 연질캡슬)의 개발

용철순,이경희,최진석,박병주,정세현,김용일,박상만,배명수,김귀자,김영식,유창훈,강성룡,유봉규,이종달,최한곤 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.1

To develop and aceclofenac soft capsule, four preparations with various solubilizers were prepared and their dissolution test was carried out. Among four preparations tested, a preparation with ethanolamine was selected a formula of aceclofenac soft capsule (Clanza S^(™), since it showed the fastest dissolution rate. Bioequivalence of aceclofenac tablet, Airtal^(™)(Dae-Woong Pharmaceutical Co., Ltd.) and aceclofenac soft capsule, Clanza S^(™)(Korea United Pharmaceutical Co., Ltd.) was evaluated according to the guideline of KFDA. Fourteen normal male volunteers (age 20-25 years old) were divided into two groups and a randomized 2×2 cross-over study was employed. After oral administration of one tablet or capsule containing 100 ㎎ of aceclofenac, blood ws taken at predetermined time intervals and the concentration of aceclofenac in plasma wa determined with an HPLC method under UV detector. The pharmacokinetic parameters (C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameters using logarithmically transformed AUC_(t), C_(max) and T_(max) between Airtal tablet and Clanza soft capsule were 2.89%, 0.18% and 43.0%, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(1.250(e.g.log(0.81) - log(1.23) and log(0.89) - log(1.14)) for AUC_(t) and C_(max), respectively. Thus, the criteria of the KDFA guidelines for the equivalence was satisfied, indicating that Clanza S^(™) soft capsule is bioequivalent to Airtal^(™) tablet.

학교조직의 구조 개선에 관한 연구

박병량,주철안,성병창 釜山大學校 敎育硏究所 1995 敎育硏究 Vol.5 No.1

The purpose of this study is to develop the restructuring options for the schools in Korea. The study draws basic directions for the school restructuring by reviewing the literature which cover school restructuring works. It also analyzes structural and managerial problems of Korean primary and secondary schools. Finally, it suggests restrcturing options for the improvement of the schools. The major findings from the study are as follows. 1) The educational reforms from the middle of the 1980s focus on the change of school organization. The main approaches of the reforms have been strengthening of central bureaucratic control, strengthening of community participation, school-site management, teacher empowerment, and restructuring centered on teaching-learning. Recent reform literature tend to emphasize the four approaches except strengthening of central bureaucatic control. 2) In general the recent literature on school restructuring, on school organization, and on educational reform policy of the central government seemed to recommend the following: the basic directions of school restructuring should be toward client-centered education, self-managing school management, democratic school management, professional school management, teaching & learning centered school management, school management relevant for the future in which information technology is important. 3) Schools in general consist of three structural parts: a teaching & learning organization, academic affairs management, and student management organization. The analysis of our primary and secondary school organization shows that schools are management affairs oriented rather than teaching & learning oriented. Therefore, the organizations should be restructured to have more flexible and organic teaching-learning organization. Academic affairs organization and management organization should be restructured to support teaching and learning more effectively. In conclusion, we recommend that our shcool organization be restructured to upgrade the effectiveness of teaching & learning, to raise the autonomy & professionalism of school management, and to respond to the educational needs of clients.

EMTP MODELS를 이용한 2차 아크 모델링 기법에 관한 연구

안상필,김병천,김철환 成均館大學校 科學技術硏究所 1998 論文集 Vol.49 No.2

The most frequent faults on overhead transmission lines are single-phase to ground arc faults in air. On HV/EHV lines, the single-phase autoreclosure is an effective means to clear the fault while retaining the system stability. For the improvement of an adaptive SPAR(Single-Phase Auto-Reclosure) and novel protection schemes, it is important to simulate arc faults. But, it is difficult to reproduce the real arc behaviour, i.e. the extinction phenomenon exactly by computer simulations due to extremely random behavior of secondary arc. For simplicity of simulation processing, a simulation language, called MODELS, is used. It has been added to the EMTP, which permits to interface control system with power system. This paper proposes a new computer modeling techniques for the primary and the secondary arc separately, which can be implemented with EMTP MODELS routine, and the the performance of the proposed model is simulated on a typical 154 [kV] korean transmission line system.