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        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.

      • 퇴행성 슬관절염에 대한 제통단의 안정성과 효능 임상연구

        서병관,류성룡,강중원,안경애,이상훈,최도영,김건식,이두익,이윤호,이재동 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

        Objectives : In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo-controlled randomized clinical trial of patients with osteoarthriotis of the knee was undertaken. Methods : Data were obtained from 80 patients with OA of the knee. After the enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transminase (ALT) level, blood urea mitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results : The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by Jetongdan. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions : Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

      • 퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구

        서병관,류성룡,강중원,안경애,이재동,최도영,김건식,이두익,이윤호,이상훈 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

        Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index, Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ,, VAS were not correlated with the thermal differences of each region. Conclusion : Further study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

      • 제통단이 퇴행성 슬관절염 환자의 삶의 질에 미치는 영향

        서병관,류성룡,강중원,우현수,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

        Objectives : to evaluate the effects of Jetongdan, the newly developed herbal medicine, on the quality of life in patients with osteoarthritis of knee Methods : Placebo-controlled, randomized clinical trial on the 80 patients with osteoarthritis of the knee was fulfilled. After enrollment, they took medication as they enrolled. And they were asked to answer the questionnaires (Korean Health Assessment Questionnaire (KHAQ), Lequesne's functional index (LF1), visual analogue scale (VAS)) and analysed with the erythrocyte sedimentation rate (ESR) at baseline, after 4 weeks and 8 weeks of medication. Results : Total KHAQ score, some categories of KHAQ like hygiene, activities were significantly improved after 8 weeks of medication. And the change of the KHAQ score was significantly correlated with the change of VAS. But LFI, VAS, ESR level was not significantly improved, and it was considered because of the short medication period and small size of study population. Conclusion : In conclusion, Jetongdan could improve the health-related quality of life in patients with osteoarthritis of knee. Further study in the large population, in long period were recommended.

      • 퇴행성 슬관절염 환자 평가 설문도구의 내적 신뢰도, 상관성에 관한 연구

        류성룡,안경애,서병관,강중원,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

        Objective : The aim of this study is to evaluate internal reliability and correlation among assessment instruments of knee OA. Methods : Data were obtained from 85 patients with knee OA. They were asked to answer VAS pain scale, two disease-specific questionnaires (WOMAC and LFI) and one instrument about health-related quality(KHAQ). Reliability was assessed using cronbach's alpha. Correlation was assessed by examining the pearson's correlation coefficients. Results : Cronbach's alpha of all Index except WOMAC stiffness subscale(.6679) exceeded the value of 0.70. A good correlation was obtained between WOMAC Subscale (especially Pain Subscale) and LFI (.726<cronbach's alpha<.791). Also, Correlation between KHAQ and two disease-specific questionnaires (WOMAC and LFI) was good(.612<cronbach's alpha<.662). Conclusions : All used instruments have good internal reliability. also, There are good correlation among them. The treatment of knee OA must be focused on health related quality. For this, we should use proper assessment instruments.

      • KCI등재

        매복된 하악 제1대구치의 맹출 유도

        이두영,송제선,이제호,최병재,김성오 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.2

        영구치의 매복온 다양한 빈도로 보고되며, 인구 집단의 약 5.6~18.8%에서 발생한다. 그 중에서 하악 제2대구치의 맹출장애 빈도는 약 0.06%, 하악 제l대구치는 약 0.01%로 매우 드물게 나타난다. 영구 대구치는 기능적으로 저작을 위한 중요한 교합적 지지를 제공하며 안면의 조화로운 성장발육에 중요한 역할을 담당한다. 영구 대구치의 매복시 발생되는 문제점으로는 구치부의 개방교합과 대합치의 정출, 인접치의 치근흡수와 기울어짐, 낭종의 형성, 심할 경우 하안면고경의 감소 등 여러 가지 문제점이 유발될 수 있다. 매복치의 치료 방법으로는 우선적으로 외과적노출술을 생각해 볼 수 있으며, 외과적노출술 후에 추가적인 인위적 아탈구로 자발적맹출을 기대해 볼 수도 있다. 자발적맹출이 관찰되지 않으면 교정적 강제 견인이나 외과적 재위치술을 고려해 볼 수 있으며, 최악의 경우에는 발치 후 보철치료를 준비해야 할 것이다. 맹출장애를 보이는 치아의 조기진단과 치료는 중요한 의미를 갖는데, 늦은 시기에 발견될 경우 자발적 맹출력이 감소되어 치료의 성공률도 감소하고, 치료기간도 증가하며 임상적으로 다양한 합병증을 야기하기 때문이다. 따라서, 하악 제1대구치의 맹출장애를 조기에 발견할 경우 우선적으로 맹출유도를 고려해 볼 필요가 있다. 다음 두 증례는 매복된 하악 제1대구치에 대하여 외과적 노출술을 시행 후 자발적 맹출을 기대하였으나 상반된 결과를 얻었기에 보고하는 바이다. Incidence of tooth impaction varies from 5.6 to 18.8% of the population. Failure of eruption of the first and second permanent molars is rare; the prevalence in the normal population is 0.01% in case of the first permanent molar, and 0.06% in case of the second permanent molar. Permanent molars are particularly important for providing sufficient occlusal support and co-ordinating facial growth. Failure of eruption of permanent molars may result in various complications such as decrease in vertical dimension, posterior open bite, extrusion of antagonistic teeth, resorption and inclination of adjacent teeth, formation of cyst and so on. Treatment options of impacted teeth are periodic observation, surgical exposure, surgical exposure with subluxation, orthodontic relocation, and surgical extraction before prosthetic treatment. Early diagnosis and treatment are important, because delayed treatment induces various problems such as decreased spontaneous eruptive force, decreased successful percentage, increased treatment period, increased various complications. Prevalence of the failure of mandibular first molars is rare but eruptive guidance before extraction of impacted teeth is necessary due to importance of permanent molars. We reported two cases of surgical exposure of impacted mandibular first molar. In these cases, we could observe different result of the impacted mandibular first molar after surgical exposure.

      • 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.

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