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.

한국인 고정식 교정 환자의 치태, 치은염 및 탈회의 초기 변화에 관한 연구

강국진,손병화 대한치과교정학회 1999 대한치과교정학회지 Vol.29 No.3

구강내 고정식 교정장치의 장착으로 인해 치은염 및 치주염, 법랑질 탈회 및 치아 우식증, 치근 흡수, 치수변화 등 일시적 혹은 영구적 손상이 야기될 수 있다. 이러한 부작용발생의 원인으로 치태의 증가, 세균수의 증가와 조성의 변화 등을 들 수 있고 이러한 변화는 치은의 염증과 탈회를 유발한다. 이에 본 연구는 한국인 고정식 교정장치 장착환자에서 장치장착 전후의 치태, 치은염 그리고 탈회의 변화를 시간에 따른 변화, 남녀간의 차이 그리고 좌.우 소구치 부위간의 차이를 통해 알아보고자 전신질환이 없고, 여자의 경우 초경이 지난 사람을 대상으로 대조군은 연세대학교 치과대학생48명(남자 26명, 여자 22명)과 실험군으로 고정식 교정장치로 치료할 환자 73명(남자 36명, 여자 37명)을 모두 잇솔질교육(TBI)을 실시한 후, 치태치수, 치은염지수 그리고 탈회지수에 대하여 대조군은 3주 간격으로 2회를, 실험군은 최초측정을 하고 공정식 교정장치를 부착한 뒤 3주, 6주, 9주에 걸쳐 총 4회 측정을 실시하였다. 이상의 자료를 분석한 결과 다음과 같은 결론을 얻었다. 1. 치태지수(PI)는 고정식 교정장치 장착후 3주의 측정 이후 서서이 증가하였다. 2. 치은염지수(GI)는 고정식 교정장치 장착후 3주의 측정 이후 치태 지수의 증가보다 좀더 바른 속도로 증가하였다. 3. 탈회는 3주와 6주 사이에서 발생하기 시작하며, 탈회지수(DI)는 처음과 비교하여 6주 측정시부터 증가하기 시작하였으나 통계적으로 유의한 차이를 발견할 수는 없었다. 4. 좌.우 소구치 부위의 비교에서는 실험군의 치태지수와 치은염지수에서 우측에서 높은 값을 보였다. Intraoral fixed type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase cause gingival inflammation and enamel decalcification. The purpose of this study is to get knowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. for control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index 3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

악성 갑상선 우연종의 임상상 및 초음파 소견의 진단적 가치

강한욱,김광원,이병완,강보현,김형훈,김범진,정재훈,민용기,이명식,이문규 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 최근 갑상선 초음파 검사의 빈번한 시행으로 갑상선 우연종의 발견이 증가하고 있다. 이러한 갑상선 우연종은 임상적으로 어떻게 접근하고 치료를 해야 하는지 적지 않은 문제가 되고 있다. 본 연구에서는 직경 1.5㎝ 이하의 갑상선 우연종의 유병률, 입상적 특징 및 초음파 특성, 그리고 가장 효율적인 진단적 접근에 대해 알아 봤다. 방법: 1999년 1월부터 2000년 12월까지 삼성서울병원 내과 및 일반외과로 갑상선 결절을 주소로 내원한 1457명을 대상으로 후향적 연구를 시행하였다. 우연히 발견된 직경 1.5㎝ 이하의 갑상선 결절을 가지는 환자들에서 갑상선 결절의 촉지 유무, 갑상선 기능검사, 항갑상선 항체, 갑상선 초음파 및 미세침 흡인세포검사, 99m^Tc 갑상선 스켄, 수술 조직검사 및 병기를 검토하였다. 결과: 분석한 갑상선 결절 1475예 중 갑상선 우연종의 유병률은 13.4%(198예)였다. 갑상선 우연종에서 악성률은 28.8%(57예)으로 나왔다. 양성 및 악성 갑상선 우연종에서 나이, 성별, 갑상선 기능검사, 결절 크기에는 의미 있는 차이는 없었다. 갑상선 스켄은 갑상선 우연종의 감별에 적합하지 않았다. 갑상선 결절의 초음파 지표 점수만이 양성 및 악석 갑상선 우연종의 감별에서 초음파 지표 점수의 민감도는 88.9%, 특이도는 74.4%, 양성 예측률은 92.4%로 나왔고 진단적 정환도는 85.5%였다. 갑상선암으로 수술을 받은 50명중 stage 1은 34명, stage 2는 6명, stage 3은 10명으로 대부분의 악성 갑상선 우연종은 낮은 TNM 병기로 나타났으나, 상당수에서는 국소 침범의 소견을 보였다. TNM 병기의 3기 환자 전부는 45세 이상이였고, 주로 갑상선암의 피막 침범에 의한 것이었다. 임파절 전이는 6명의 환자에서 나왔다. 결론: 악성 갑상선 우연종은 비교적 흔히 접할 수 있는 질환이며 양성 우연종과는 임상적으로 구별이 안 된다. 악성 갑상선 우연종은 발견 당시 대부분 낮은 병기이나, 갑상선의 피막 침범 및 임파절 전이가 상당수에서 발견되었다. 갑상선 우연종의 초음파 소견은 향후의 진단 방향을 제시하는 중요한 길잡이가 될 수 있다. 초음파 지표 점수 2점 이상의 갑상선 우연종에서만 초음파 유도 미세침 흡입검사를 권장한다. Background: High-resolution ultrasonography has made the detection of asymptomatic small thyroid possible. Recent increases in the detection of incidentalomas have created a clinical dilemma on how to properly manage such incidental nodules. We investigated the prevalence, clinical and ultrasonographic characteristics, and optimal diagnostic approach toward incidentally detected benign and malignant thyroid nodules of less than 1.5㎝ in size. Methods: A retrospective review was undertaken on the 1,475 patients who had visited Samsung Medical Center, Seoul Korea between January 1999 and December 2000. The review consisted of a physical examination of the thyroid gland, thyroid function test, antithyroid antibodies, thyroid ultrasonography, fine-needle aspiration biopsy, pathology and TNA staging of the incidentally detected thyroid nodules of less than 1.5㎝ in size. Results: The prevalence of thyroid incidentalomas was 13.4% and the malignancy rate within them was 28.8%. There were no significant differences in age, sex, thyroid function test and size between the benign and malignant incidentalomas. Ultrasonographic characteristics showed meaningful diagnostic value for the detection of malignancy in incidentalomas. Most malignant incidentalomas were of a low stage. Conclusion: Occult thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodules less than 1.5㎝; however, ultrasonographic findings can be used to decision of optimal management strategies (J Kor Soc Endocrinol 17:649∼656, 2002).

1차원 MWPC를 이용한 디지탈 사진촬영장치의 개발(Ⅲ)

강희동,조진호,박정병 경북대학교 센서기술연구소 1995 연차보고서 Vol.1995 No.-

Digital Radiography 장치로 응용하기 위한 1차원 MWPC를 이용하여 X-선 위치검출기를 설계 및 제작하였다. 위치검출 방법은 병렬판독법으로 얻으며 스캐닝장치를 이용해 X-선 영상을 얻는다. 제작한 검출기의 위치분해능은 0.8㎜이고, 동시성 선택회로를 고안하여 위치분해능을 0.4㎜로 향상시켰다. 실제 얻은 디지탈 값에서 각 채널에 대한 보정인자를 곱함으로써 영상의 균일성을 증가시켰다. 디지탈 X-선 영상은 0.4㎜의 scanning 간격으로 각종 피사체에 대하여 320×320 화소의 영상을 얻었다. X-ray position detector was designed and fabricated. The detector was applied to digital radiography system. One-dimensional MWPC(Multiwire Propotional Chamber) is the main component of this system. The way of detecting the position of incident x-ray is the parallel readout method. Digital image data are acquired by using fan beam x-ray and a scanning system. The spatial resolution of the detector is 0.8㎜. Spatial resolution was improved by a factor of two(0.4㎜) with help of the coincidence selection circuit. Uniformity was improved by converting data with calibration factor for each channel. With help of scanning system which has 0.4㎜ scanning pitch, x-ray digital images of 320×320 pixels were obtained for a fish and a chicken's foot. Bone image is appeared clearly in these images.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

환자의 마취전후 병력 또는 불편요서의 현황(2)

강태훈,양홍석,김진윤,최병권,조형상 중앙대부설한국의과학연구소 1990 한국의과학 Vol.22 No.4

MAN 급의 망에서 공정성 개선에 관한 연구

강상욱,윤정오,최병진 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(C)

In this paper we introduce a solution to improve the unfairness problem and to remove the waste of bandwidth in the distributed queue dual bus system. This solution requires only a minor modification of the current protocol and further shows no bandwidth wastes when we try to resolve the unfairness problem occurred in current DQDB protocol. There has been many problem in DQDB system in terms of fairness of sending message in each node. In order to solve this problem, Bandwidth Balancing technic and proportional assignment technic have been introduced. It is, however, to note that the waste of bandwidth problem is still existing in those technics, even though there has been significant improvement as to the fairness problem. In this paper we introduce a new solution to remove the waste of bandwidth problem while we are still obtaining the improved fairness of the network. By following this new solution, the simulation result shows higher throughput and lower message delay than previously proposed technics.

양방과 한방에 대한 인식 조사

강병조,채병진,권도훈,김풍택,김재식 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

In order to find out whether or not the general public have understanding of modern and oriental medical practices and if they do what the extent of their understanding is, 640 subjects were chosen over a four-month period in 1998. They were given questionnaires to answer and the key results of the study are as the following:1. The public were found to prefer modern medicine to oriental medicine.2. About 1/3 were using both modern and oriental medicines.3. 4/5 of the cases believed certain diseases are to get better efficacy from oriental medicine and such diseases are known to be neuraligia, myalgia, stroke, lumbago and gastric disease.4. 3/4 believed that modern medicine is good for treatment while oriental medicine is good as restorative.In summary, this study show that major medical system is modern medicine and oriental medicine is only for restorative and complementary.

양방과 한방에 대한 인식 조사

강병조,채병진,권도훈,김풍택,김재식 경북대학교 병원 2002 경북대학교병원의학연구소논문집 Vol.6 No.1

In order to out whether or not the general public have understanding of modern and oriental medical practices and if they do what the extent of their understanding is, 640 subjects were chosen over a four-month period in 1998. They were given questionnaires to answer and the key results of the study are as the following: 1.The public were found to prefer modern medicine. 2.About 1/3 were using both modern and oriental medicines. 3.4/5 of the cases believed certain diseases are to get better efficacy from oriental medicine and such diseases are known to be neuraligia, mylgia, stroke, lumdago and gastric disease. 4.3/4 believed that modern medicine is good for treatment while oriental medicine is good as restorative. In summary, this study show that major medical system is modern medicine and oriental medicine is only restorative and complementary.

표면처리된 복합레진에 대한 수리용 레진의 결합강도에 관한 연구

강현숙,최호영,민병순,박상진,최기운 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.1

Composite resin repair requires strong bond strength between the new and old materials. The objective of the current study was to identify the optimal treatments for sufficient bond strengths. Bondings between same kinds of materials and cross bondings using chemical curing composites and light curing composites were tested. Surface treatments included the methods of sand-blasting, acid etching and coating of bonding agent. Seven kinds cases of combinations from three kinds of methods were experimented and compared with a control group of which surfaces were highly polished. Measurements of shear bond strength and observations of surface morphologic changes using a scanning electron microscope were done. Following conclusions were drawn 1. The highest bond strength among composite resins were exhibited by the treatment of the sand-blasting and the coating of bonding agent. 2. Acid etched surfaces showed the lowest bond strength. Bond strengths obtained from experimental groups including acid etching were lower than those obtained from same kinds of experimental groups without acid etching. 3. Simple method of the coating of bonding agent produced the slightly increased bond strength on chemical curing composite and reduced bond strength on light curing composite. 4. Bonding surfaces of chemical curing composite resin showed slightly higher bond strengths than light curing composite resin, however significant differences were not confirmed statistically. 5. More significant irregular surfaces were created by sand-blasting method than acid etching method. 6. A principal component of fillers of both resins was silicon. Acid etching method produced the seperations and degradations of fillers, these were significant on light curing composite resins which containing barium fillers.