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.

복어중독에 의한 가사 상태에서 소생한 1예

송승찬,신진호,강석우,박경남,최호순,박근태,문희식,기춘석,이성희,윤병철,노우균,조균석,이민호 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.3

Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cation. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it deminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.

지구과학 수업에서 학습자 특성에 따른 수업목표의 효과

禹姝希,安炳鎬,金相達 경북대학교 과학교육연구소 1990 科學敎育硏究誌 Vol.14 No.-

The present study is designed to investigate the effects of instructional objectives according to the trait of learners on the Earth Science instruction. The types of cognitive style, adopted as the trait of learners in this study, are expressed in terms of the Field-Independent(FI) and Field-Dependent(FD) groups. Based on the result of the Group Embedded Figure Test, the subjects of this study, 100 second-grade high school girls in Taegu area, are divided randomly into two groups, each identically consisting of 25 FI and the same number of FD students. The instructional objectives are prepared according to the method by Gronlund(1970) After an hour of instruction covering ' the change of the earth's surface' with the instructional objectives for one group and without them for the other group, the same performance test is given to both of the groups. The main results of the test are summarized as follows: (ⅰ) There is no significant difference between the FI group with instructional objectives and the group with non-instructional objectives in the achievement of learning. (ⅱ) There is a significant difference between the FD group with instructional objectives and the group with non-instructional objectives in the achievement of learning. (ⅲ) There is a significant difference between the group with instructional objectives and the other group without them regardless of the types of cognitive style.

아세트산의 탈수반응을 위한 MCM-41의 표면개질 및 적외선 분광법을 이용한 표면특성 분석

우창수,박민태,이병민,이호인 한국공업화학회 2003 응용화학 Vol.7 No.1

Catalytic dehydration of acetic acid was performed over surface-modified MCM-41.Calcination of silylated MCM-41 under air regenerated successfully silanol groups as the active sites for dehydration of acetic acid. In-situ FTIR spectroscopy using pyridine as a probe molecule revealed that as the pretreatment temperature bofore silylation increased, the concentration of Lewis-acidic sites was enhanced. The enhanced concentration of Lewis-acidic sites augmented the bridged adsorption species of acetic acid on the surface of the modified catalyst, which significantly promoted the catalytic activity.

아세트산의 탈수반응을 위한 MCM-41의 표면개질 및 적외선 분광법을 이용한 표면특성 분석

우창수,박민태,이병민,이호인 한국공업화학회 2003 응용화학 Vol.7 No.2

Catalytic dehydration of acetic acid was performed over surface-modified MCM-41. Calcination of silylated MCM-41 under air regenerated successfully silanol groups as the active sites for dehydration of acetic acid. In-situ FTIR spectroscopy using pyridine as a probe molecule revealed that as the pretreatment temperature before silylation increased, the concentration of Lewis-acidic sites was enhanced. The enhanced concentration of Lewis-acidic sites augmented the bridged adsorption species of acetic acid on the surface of the modified catalyst, which significantly promoted the catalytic activity.

특발성 혈소판감소성 자반병과 쇼그렌씨 증후군이 동반된 원발성 담즙성 간경변증 1예

우태욱,김병호,심재준,김윤화,조경삼 대한내과학회 2004 대한내과학회지 Vol.66 No.1

저자들은 특발성 혈소판감소성 자반병을 가진 환자에서 전형적인 일차성 원발성 담즙성 간경변증의 양상이 나타나 혈청검사, 자가면역항체, 간조직 검사 등을 통해 특발성 혈소판감소성 자반병과 쇼그렌 증후군이 동반된 원발성 담즙성 간경변증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Primary biliary cirrhosis (PBC) is rare in Korea. Although its pathogenesis is not fully understood, immunologic dysregulation is suspected because it is frequently associated with other immunologic disorders. A few cases of primary biliary cirrhosis associated with idiopathic thrombocytopenic purpura (ITP) has previously been reported. However, PBC associated with ITP and Sjo¨gren's syndrome simultaenously has not been reported yet. We experienced a 72-year-old woman had been finally diagnosed as PBC, ITP and Sjo¨gren's syndrome. To the best of our knowledge, this is the first case in the world. We report this case with review of related literature.

응급실에 내원한 약물중독환자의 지역별 비교분석

임근우,박일영,유승진,나병호,오동렬,전해명,황주일,김세경 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

We reviewed retrospectively 230 patients who came to emergency room of Kang Nam St. Mary's Hospital and Uijongbu St. Mary's Hospital between 1. January and 31. December 1994. We classified them according to their age, sex, a sort of drug, the cause of poisoning, prehospital care, time-lapse to arrive at hospital after poisoning, psychiatric problem the status of patients. *We conclude as follows; 1. The male to female ratio was totally 1 : 1.98, 1 : 1.24 in a urban area, 1 : 2.43 in a rural area. 2. On age of the patients in this study, the peake incidence was between 20 and 39(55.2%). 3. On seasonal prevalence, the poisoning was most common in summer and spring, in urban area(35.7%) and rural area(37.0%) respectively. 4. The common drug were as follow; Doxylamine, Organophosphate, Acetaminophen in urban area, Paraquat, Organophospate, Doxylamine in rural area 5. The percentage of suicidal attempt were 81.8% and 87.7% in urban area and rural area respectively. 6. The poisoning patients had psychatric problem in 19.4% and 24.6%, in urban area and rural area respectively. 7. Before arrival to emergency room, 27.7% of patient was done prehospital care in rural area. 8. On arrival to emergency room, 95.1% and 73.8% of patients show stable vital sign in urban area and rural area respectively.

Cariogram을 이용한 모자간 우식활성도의 상관성 및 우식위험요소 평가

이석우,송제선,최병재,최형준,이제호 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.3

영유아기 치아우식증은 복잡하고 다인자적 질환으로 숙주 및 미생물, 식이, 시간 등의 위험요소에 의해 질환이 진행된다. 이 중 미생물로 대변되는 Streptococcus mutans(S. mutans)는 우식 개시에 있어 중요한 역할을 하며, 어머니를 통한 수직 감염이 잘 알려져 있다. 영유아기의 어머니를 통한 조기 감염은 향후 유치열기 우식 발생과 높은 연관성을 나타내므로 우식위험요소에 대한 조기 파악은 미래의 치아우식증 예방에 있어 매우 중요하다. 최근 치아우식증의 원인 및 이에 미치는 요소들에 대한 연구가 활발하게 이루어지면서 우식 진행에 대한 정확한 예측을 위한 여러 가지 우식위험도평가(caries risk assessment) 도구가 개발되었는데, 이 중 대표적인 한 가지가 Cariogram이다. Cariogram은 개인의 우식활성도 및 우식위험요소(caries risk factor)의 상호작용을 그래프로 나타낸다. 이번 연구의 목적은 3~5세의 중증 유아기우식증(Severe Early Childhood Caries; S-ECC)에 해당되는 어린이들과 그들의 어머니 사이에서 우식관련타액검사 및 최근 개발된 Cariogram을 이용하여 S. mutans의 수준 및 우식활성도에 대한 상관관계가 존재함과 우식위험요소 간의 연관성을 파악해 보았는데, 이를 통해 다음과 같은 결론을 얻을 수 있었다. 1. 중증 유아기우식증을 보이는 어린이에서 구강 내 존재하는 Streptococcus mutans의 수준은 비우식군보다 높았다(p<0.05). 2. 모자간 구강 내 존재하는 Streptococcus mutans 수준은 상관관계를 보였다(p<0.05). 3. 모자간 우식활성도를 Cariogram을 통해 측정해 본 결과 상관관계를 보였다(p<0.05). 4. 우식활성도에 미치는 우식위험요소는 어린이에서 숙주요소가 가장 큰 영향을 주는 것으로 나타났다. 이상의 결과로 S. mutans가 향후 치아우식증 발생 가능성을 예측하는데 있어 유용한 우식위험요소가 될 수 있으며, Cariogram을 통한 향후의 우식진행과 관련된 여러 가지 우식위험요소가 예측 가능하므로 이에 대한 조기 대처 및 예방적 처치가 가능하리라 사료된다. Dental caries during infantile and early childhood period is a complex disease resulting from multiple caries factors. Streptococcus mutans(S. mutans) plays a critical role in the initiation of caries, and its early transmission through mothers provides a strong etiologic factor for future development of caries in the primary dentition. Therefore, early detection of caries risk factor is important for prevention of caries. Recent studies about etiologic factors of caries have brought advent of various tools for caries risk assessment in order to predict progress of caries more accurately. Cariogram is a common tool for caries risk assessment, which illustrates present caries risk assessment and correlation of caries risk factors for an individual graphically. The aim of this study was to assess if there is any correlation in the level of S. mutans and caries activity and to verify the effect of caries risk factors between children with age ranging from 3 to 5 years with severe early childhood caries(S-ECC) and their mothers using caries-related salivary test and Cariogram. The results of this study were as follows. 1. Children with S-ECC had a statistically higher level of Streptococcus mutans compared to caries-free children(p<0.05). 2. There was significant correlation between mothers and their children in the aspect of the level of Streptococcus mutans(p<0.05). 3. When caries activity was assessed using Cariogram, significant correlation between mothers and their children was found(p<0.05). 4. When each caries risk factor was evaluated for its affect on caries activity, host was more influential factor compared to microorganism and diet in children. Based on these results, we could conclude that assessing the level of S. mutans can be an effective tool for predicting possibility of caries formation in future. Since prediction of future caries progression and evaluation of caries risk factor became possible with Cariogram, we may conduct early and preventive measures for treatment of caries.

양생방법에 따른 타일 선붙임 공법의 접착특성에 관한 실험적 연구

김우상,공민호,안무영,박병근,김성식,정상진 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

The objectives of the present study is to solve problems in PC tile before-fixing method using ordinary concrete by adopting the liquefaction method in manufacturing PC to which the tile before-fixing method is applied, and to provide basic information for the practical use of the PC tile before-fixing method, which uses high workable concrete, through manufacturing a complex body based on the optimal mix proportion.

고유동 콘크리트를 이용한 타일 선붙임 시공방법에 관한 기초적 연구

김우상,김제섭,공민호,박병근,김성식,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

The objective of this present study is to solve problems in PC tile pre-fixing method using ordinary concrete by adopting the liquefaction method in manufacturing PC to which the tile pre-fixing method is applied, and to provide basic information for the practical use of the PC tile pre-fixing method, which uses high workable concrete, through manufacturing a complex body based on the optimal mix proportion.