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.

모 연취급장 근로자들의 연폭로지표들과 혈압과의 관련성

임상복,김용배,이용진,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

In order to investigate the relationship between blood lead with other lead exposure indices and blood pressure in occupationally lead exposed male workers, 629 workers(515 lead exposed workers and 114 non lead exposed workers) in a storage battery factory were studied. Blood lead(PbB), zinc protoporphyrin(ZPP) and urinary δ-aminolevulinic acid(ALAU) were selected as an index of lead exposure. Height and weight were also meaured with calibrated automatic height-weight machine to produce fatness index directly. Personal information on smoking and drinking history were also collected. Blood pressure was mearured by trained nurses with automatic sphingomanometer. All workers took at least 30 minute rest before their measurement of blood pressure. The results obtained were as follows: 1. The prevalence rate of hypertension of lead exposed and non-exposed workers were 3.5% in both group without any difference. 2. There were no differences of systolic and diastolic pressure between groups divided by lead exposure, smoking habit, drinking habit. but the increase of age group made the difference of diastolic pressure, and only differenct of systolic pressure observed in age group of less than 20 and that of more than 40. 3. In pearson's correlation analysis, PbB was correlated with systolic pressure significantly, but not with diastolic pressure. PbB was also correlated with pressure difference(systolic pressure-diastolic pressure). 4. There were no significant increase of systolic, diastolic pressure and pressure difference by the increase of PbB and ZPP grouping. 5. Stepwise multiple regression analysis using systolic pressure as dependent variable and PbB, ZPP, ALAU, age, work duration, smoking habit, drinking habit and fatness (weight*0.9/height-100) as independent variables, revealed that PbB, age, drinking habit and fatness in order were significantly contributed to the dependent variable. 6. Stepwise multiple regression analysis using diastolic pressure as dependent variable and PbB, ZPP, ALAU, age, work duration, smoking habit, drinking habit and fatness (weight*0.9/height-100) as independent variables, revealed that ALAU, age and fatness in order were significantly contributed to the dependent variable. 7. Stepwise multiple regression analysis using pressure difference as dependent variable and PbB, ZPP, ALAU, age, work duration, smoking habit, drinking habit and fatness(weight*0.9/height-100) as independent variables, revealed that PbB, age and fatness in order were significantly contributed to the dependent variable. 8. Logistic analysis of hypertensive conditions with categorized blood lead and other selected categorized independent variables indicated that only age(40> and 40≤) and fatness(1.0> and 1.0≤) were significantly contributed to dependent variable with 95% significant odd ratio confidence interval. With above results, lead exposure in terms of blood lead seemed to be minimally contributed to the raise of blood pressure, and the effect of blood lead was found to be more prominent on the pressure difference than the systolic and diastolic pressure themselves.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

Carbosulfan의 피부자극성, 안점막 자극성 및 피부감작성등의 알러지성 효과에 관한 연구

이상훈,이동연,백경진,김태원,정두순,임종환,김명석,박병권,윤효인 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

Many studies have been published on the human health effects of carbosulfan toxicity. Carbosulfan used as an insecticide can produce an irritating and allergenic effect when acting on the skin. In this study, a sensitization test on albino guinea pigs and intradermal reactivity and occular irritation test on albino rabbits were carried out with carbosulfan. Signs of acute skin inflammation appeared along with the clinical symptom of chronic dermatosis caused by the solution irritating characteristics. Moreover, carbosulfan showed severe eye irritation with conjuctival redness and severe opacity on cornea. Preventive measures should involve workers' obligatory instructions on the noxious impact on human skin and strict observance of industrial safety rules.

참지식 부직포여과 활성슬러지 시스템의 가정 오수처리 적용 타당성 조사 연구

임태진,서규태,이택순,문병현 7개 국립대학교 환경연구 논문집 공동발행 위원회 2002 환경연구논문집 Vol.2 No.1

An experimental study was conducted to investigate the applicability of non-woven fabric filter as an alternative separation material in membrane combined activated sludge process. The most advantage of the fabric filtration activated sludge system is the low operation and maintenance cost resulting from the ready available material and gravity filteration. The system was consisted of two reactors, anoxic and aerobic one with working volume of 0.28㎥ and 0.47㎥, respectively. The non-woven fabric filter module was immersed in the aerobic compartment for separation of activated sludge by gravity filtration. Although the system showed high potential to treat domestic wastewater the initial leakage of bio-solid from the reactor and reduction of permeate flux were main problems of the system. The initial flux of 0.4㎥/㎡/day reduced to 0.2㎥/㎡/day in 12 days operation at 133㎝ water head. During the stable operation period, average SS concentration of effluent was 1.8㎎/L showing 96.4% removal. Organic removal efficiency was 98.3% as COD_Cr and 91.6% as BOD with the effluent concentration, 14.4㎎/L and 1.5㎎/L, respectively. T-N removal efficiency was 60% at C/N ratio 4.5.

All-Trans Retinoic Acid에 의한 HL-60 세포 분화유도중 H2B Histone, c-Myc 및 DNA Topoisomerase I 발현에 관한 연구

임규,박정동,최병한,이용진,김계영,이명선,장은미,김삼용,권기량,곽상태,황병두 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

Effects of all-trans retinoic acid(retinoic acid) on DNA replication, H2B histone and DNA topoisopmerase I(Topo I) gene expression have been investigated in human promyelocytic leukemia cell line HL-60. DNA synthesis decreased at 24 hours after exposure of retinoic acid in the HL-60 cells. H2B histone mRNA rapidly reduced at 48 hours and Topo I and c-myc mRNA at 24 hours in retinoic acid-exposured HL-60 cells, respectively. The levels of c-myc, H2B histone and Topo I gene expression were reduced in proportion to the concentration of retinoic acid. The H2B histone mRNA in retinoic acid-exposured cells was elevated by cycloheximide treatment, while the level of Topo I mRNA was constant. These results suggest that regulations of H2B histone, c-myc and Topo I gene expression are different from one another, and repression of Topo I gene is closely correlated with c-myc gene during retinoic acid-induced differentiation of HL-60 cells.

백서 간재생중 H2B Histone 유전자 발현에 대한 Octamer Binding Transcription Factor의 역할

임규,방재웅,최두식,손미영,이영철,박청,김태동,김영래,박종일,윤완희,박승길,황병두 한국노화학회 2001 한국노화학회지 Vol.11 No.1

A. 高校 科學 (生物·地球科學) 및 數學科 探究學習의 評價模型 定立과 評價紙 開發

李相協,權炳奎,林在圭,孫文求,吳岱燮,楊洪準,梁承榮,姜用熙,林成圭,金正遠,金吉民,兪正在 경북대학교 과학교육연구소 1982 科學敎育硏究誌 Vol.6 No.-

Currently the evaluation of high school science and mathematics learning has been too much knowledge-centered without concerning the inquiring ability or scientific attitude. This study, therefore, was made for the purpose of establishing of evaluation model for high school science (biology and earth science) and mathematics learning and its evaluation items. In this paper, the research was done about three fields, biology, earth science and mathematics. 1. For the biology, the evaluation methods of inquiry learning were studied with the foreign references, and proper evaluation items were suggested. 2. For the earth science, after analizing 5 kinds of earth science textbook of current using in high school, essential 19 items were selected. 5 of them were tested in test group and control group, then, the results were analized. 3. For the mathematice, the teaching elements of「Set」and「Flow chart」in mathematics (Ⅰ) were selected and structured. Detailed teaching objects were established and evaluation items were introduced.

현행 중학교 과학 실험·실습교육에 대한 교사들의 견해와 개선방안

이윤종,기우항,김영호,정원우,양승영,강용희,안병호,임성규,윤일희,김중욱,강동진 경북대학교 과학교육연구소 1996 科學敎育硏究誌 Vol.20 No.-

The status of facilities, management of the experiment, practices, and Science education teaching method in middle school have been investigated. The present status and reasonable management of middle school science education have been grasped from the questionaires. The results are as follows : The reasonable management for expeiments and practices of science education were scanty in the middle school around the urban and rural schools owing to the shortage of facilities and equipments, crowded class, excessive classes, work for teachers, excessive contents of present textbook and insufficience of administrative support etc. The current teaching method of middle school science has emphasized knowledge. This fact does not satisfy the objective of learning due to lack of teaching method. Desirable directions for the improvement of present status of middle school science education were proposed in this paper.