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.

Paraquat 중독 환자에서 전폐 방사선치료의 효과

이창걸(Chang Geol Lee),김귀언(Gwi Eon Kim),서창옥(Chang Ok Suh) 대한방사선종양학회 1995 Radiation Oncology Journal Vol.13 No.4

목적 : 제초제로 사용되는 Paraquat(Gramoxone??)는 10cc미만의 소량복용으로 사망이 가능하여 자살목적 혹은 사고로 복용한 후 응급실로 내원하게 되는데 적극적인 치료방법으로 신장 및 간장에 대한 독성은 가역적으로 회복이 가능하나 폐에 대한 독성은 가장 치명적으로 초기에 폐부종, 폐출혈등의 성인형호흡곤란증후군의 양상을 보이며 더욱 진행하면 폐섬유화를 초래하여 궁극적으로 사망하게 된다. 1984년 Webb등이 폐부종이 진행되는 paraquat중독환자에서 전폐방사선치료를 시행, 폐섬유화로의 진행을 억제하여 생존시킨 예를 보고한 이래 전폐 방사선치료가 paraquat에 의한 폐독성을 방지할 수 있는 가에 대한 연구가 시도되었다. 저자들은 연세의대 치료방사선과에서 paraquat중독으로 전폐방사선치료를 시행받은 환자들을 후향적으로 분석하여 폐섬유화 예방에 대한 효과 및 궁극적으로 생존율 향상에 기여하였는지 보고자 하였다. 방법 : 1987년 6월부터 1993년 8월까지 paraquat중독으로 연세의료원에 내원하여 치료하였던 30명의 환자들을 대상으로 분석하였다. 이 중 14예에서 전폐방사선치료를 시행받았다. 환자들의 특성을 보면 남녀비가 12:18 이었고 3-76세의 연령에서 20-30세사이가 가장 많았고, 자살목적이 22예, 우발적인 사고로 복용한 예가 8예였다. 환자 및 보호자의 진술에 따라, 복용한 양을 소량(<5cc), 한모금(5-50cc) 그리고 과량(>50cc)군으로 세 군으로 나누어 분석하였다. 방사선치료는 응급실에 도착하여 적극적인 치료와 함께 24시간 이 내 시작하였고 방사선량은 10Gy/5ft/1주으로, 전폐를 범위로 폐밀도 보상 없이 전후 2문 대향조사하였다. 3예에서 방사선치료도중 중단하였는데 치료거절(2Gy) 및 사망(2Gy, 6Gy)이 원인이었다. 결과 : 소량복용군에서는 방사선치료와 상관없이 7예 전원이 생존하였고 대조군에서 2예의 경미한 폐부종이 나타났으나 방사선치료군에서는 나타나지 않았다. 한모금 복용군의 경우 15예 전예에서 폐독성이 나타났는데, 대조군에서는 7예중 1예(14%0에서만 회복된 반면 방사선치료군에서는 8예중 4예(50%)에서 폐독성에서 회복되었다. 한모금 복용군에서 음독후 4일이내에 방사선치료를 받은 경우 5예중 4예(80%)에서 폐독성이 회복된 반면 5일 이후에 치료한 3예에서는 전원(100%)이 호흡부전으로 사명하여 차이를 보였다. 4일이내 방사선치료군에서 2Gy 조사 후 치료를 거절한 1예를 제외하면 4예 전원(100%)에서 폐섬유화를 예방할 수 있었다. 과량복용군에서는 방사선치료와 상관없이 8예 전원이 다기관 손상과 함께 호흡부전으로 사명하였는데 방사선치료는 3예 모두 음독2일 이내에 시행되었지만 모두 폐섬유화로 진행되어 사망하였다. 결과 : Paraquat중독으로 궁극적인 사망의 원인이되는 폐섬유화를 방지하기 위한 방법으로 전폐방사선치료는 비록 복용량이 정확하지는 않으나 약 한모금(5-50cc)정도 복용한 경우 paraquat배설을 위한 적극적인 치료와 함께 조기에(적어도 4일 이내에) 시행될 경우 폐섬유화로의 이행을 방지하여 궁극적으로 생존이 가능함을 알 수 있었고, 소량복용의 경우와 과량을 복용한 경우 전폐방사선치료는 필요가 없을 것으로 생각되었다. 향후 음독후 정확한 혈중 paraquat농도를 측정하여 대조군과 비교하여 전폐방사선효과를 규명하는 임상실험이 필요하리라 사료된다. Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993. thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients were managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal <about 5cc. B: mouthful 5-50cc. c: large>50cc). Pulmonary irradiation was strated within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using Co-60 teletherapy machine. A total of 10Gy(2Gy/fr. x 5days) was delivered without correction of lung density. Results : In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due to multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group, six of 7 patients(86%) with no RT were died due to respiratory failure, but 4 fo 8 patients with RT were alive and 4 of 5 patients who were received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary change. One patient who refused RT after 2Gy died due to pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity Conclusion : It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggresive supportive treatment appears to decrease pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.

A proposal of the Optimal Angle of Standing Assistant Chair for the Elderly by Comparing of Pressure Distribution on Hip

Sung-Ho Chang(장성호),Ji-Hoon Baek(백지훈),Jung-Eon Lee(이중언),Nematov Mirazamjon(Nematov Mirazamjon),Seok-Wan-Kang(강석완),Wang-Bum Lee(이왕범) 한국산업경영시스템학회 2018 한국산업경영시스템학회지 Vol.41 No.3

One of the most performed action in daily life is standing up from sitting position. As the population of the world is aging at the high rates, people may face problems with reduced muscle strength as well as psychological changes. This can lead elderly people having difficulties with standing up from chair. Now, with the aging trend worldwide, products are being developed that can support the lives of the elderly. This study examines the distribution of hip pressure in relation to the seating positions of the standing assistance seats under development to prevent standing up accidents in older adults. The currently developing standing assistant chair designed to tilt to a maximum angle of 25 degrees. At over 25°, design considers that older people are at risk of thrown back out of that force and that the forces exerted on their arms and legs can be a significant burden to older people. By considering danger of higher than 25° for older people which is experimented in the basis of static capturing approach in previous papers, it is experimented people with age group of 20~60 on 0° to 25° tilting angle on the basis of dynamic capturing method in order to pick convenient angle of inclination. Moreover, tried to find the optimum angle by comparing the hip pressure distribution when seated at the edge of the seat and at the center of the seat with the pressure distribution sensor.

직경 1˝ 자성관에서의 원격장와전류 탐상 실험 빛 결함신호 특성

신영길,이창준,이정호,이윤태,장권규,송성철,송성진,정태언 국립7개대학공동논문집간행위원회 2002 공업기술연구 Vol.2 No.-

In this study, a remote field eddy current testing system is built to inspect 1˝ diameter ferromagnetic tubes and resulting experimental signals are investigated. To decide the operating frequency, the emf of sensor coil is monitored while the sensor coil is moved away from the exciter. At proper frequency, sudden change would occur in the signal pattern. This also indicates the location of remote field region, so that the distance between coils can be decided. The defect signal contains two defect indications, each appears as the sensor and exciter coil passes a defect. Experimental results show that defect depth can be estimated by comparing the two indications. Also, linear relationship between defect depth and phase signal strength is observed.

열교환기 위치에 따른 NOx 및 CO 생성특성

김종민(Jong-Min Kim),이승로(Seungro Lee),금성민(Sung-Min Kum),이호연(Ho-Yeon Lee),윤희중(Hee-Jung Yun),이창언(Chang-Eon Lee) 한국연소학회 2009 KOSCOSYMPOSIUM논문집 Vol.- No.38

Recently, strict pollutant regulations of NOx emission and increasing awareness of the environmental damage stimulated interest in research to obtain useful information regarding CO and NOx reductions at the same time. In this study, Premixed flame was experiment to reduce CO and NOx emission level by heat exchanger location in which burner and first heat location distance(L₁) and first and second heat location(L₂) changed. To reduce the NOx emission, first heat exchanger location(L₁) was decided near the flame. After first heat exchanger(L₁) was decided for the optimal NOx emission(about 30 ppm), in order to decide the optimal CO emission(about 30ppm), seocond heat exchanger location(L₂) was tested and decided for several cases. Finally, the optimal location of heat exchanger for minimal CO and NOx emission simultaneously was determined and suggested.

상피성 암세포주에 대한 녹차 Catechin의 효과

박정현(Jeong Hyun Park),김대중(Dae Joong Kim),한장희(Jang Hee Hahn),김홍태(Hong Tae Kim),정용욱(Yong Wook Jung),성훈기(Hoon Ki Sung),김주영(Joo Young Kim),송인환(In Hwan Song),성언기(Eon Gi Sung),이융창(Yung Chang Lee) 대한해부학회 2001 Anatomy & Cell Biology Vol.34 No.5

Catechin은 녹차에서 추출되는 폴리페놀의 주요성분으로 고혈압 및 동맥경화의 예방효과, 당뇨억제효과, 항산화작용, 항암작용 등에 직접 관여하는 물질이다. 본 연구에서는 태평양에서 제공받은 녹차 catechin을 이용하여 상피성 암세포주인 A549 (폐암)와 EATC (복수암)세포에 투여한 후 처리농도와 시간에 따른 변화를 비교, 관찰함으로써 녹차의 효과와 작용기전을 밝혀내는데 목적이 있었다. 본실험은 A549 세포와 EATC 세포를 배양한 후 녹차 catechin을 1, 10, 100, 500 μg/ml의 농도로 48시간 동안 처리하였고, 광학현미경, 공초점현미경, 전자현미경 등을 이용하여 세포의 구조적 변화를 확인하였으며 MTT분석, 전기영동, 유세포분석기 등을 사용하여 세포 손상정도를 파악하였다. A549 세포에서는 catechin 1 μg/ml와 10 μg/ml 농도에서는 대조군에 비하여 큰 변화를 관찰할 수 없었다. 100 μg/ml catechin을 처리하였을 때 세포내의 검은 과립들의 수가 증가하였고 층판소체의 손상이 나타났다. 세포주기의 장애가 나타나 DNA 합성전기에 있는 세포들의 수가 급격히 증가하였다. 500 μg/ml 농도에서는 층판소체와 사립체의 파괴가 심하게 나타났으며 세포생존율이 감소하였고 세포주기의 장애도 관찰되었다. EATC 세포에서는 catechin의 농도가 A549 세포의 경우보다 낮은 농도에서도 세포증식 억제 및 세포손상 효과가 나타났다. 10 μg/ml 농도에서도 세포의 위축과 생존율의 감소가 일어났으며 전기영동상에 괴사되는 세포들이 파악되었다. 100μg/ml catechin을 처리하였을 때 자연사의 형태학적 관찰, 전기영동, 유세포분석 등에서 자연사 과정에 있는 세포들이 많이 나타났다. 결과적으로 녹차 catechin을 배양한 상피성 암세포에 투여함으로서 세포의 생존율과 증식이 억제되었고 그 과정에서 괴사, 자연사, 세포주기의 장애 등이 관여하는 것으로 생각된다. 그러나 일련의 세포손상과정을 유도하는 데 있어 세포의 종류, 처리 시간, 농도에 따라 다소 차이가 있음을 확인하였다. Catechin is main component of polyphenol extracts from green tea, it is associated with prevention of hypertension and atherosclerosis, anti-diabetic effect, antioxidant, antitumor. The purpose of this research is to investigate the effect and its mechanism of green tea catechin on epithelial cancer cell lines in various concentrations and durations. For this study, epithelial cancer cell lines, A549 (lung cancer), EATC (Ehrlich-Lettre ascites tumor cell) were used. Inverted, light, confocal and electron microscopes were applied to find morphological changes. MTT assay, flowcytometric analysis, gel electrophoresis were used to compare severity of cellular damages to control after exposure to 1, 10, 100 and 500 μg/ml catechin for 48 hours. In the A549 cells, after 1 μg/ml and 10 μg/ml catechin treatments, there was no notable changes. However, exposure to 100 μg/ml catechin induced increase of cytoplasmic granules, destruction of lamellar body, inhibition of cell cycle, especially G0/G1. In the early phase of 500 μg/ml catechin administration, decrease of cell population, severe destruction of lamellar bodies and mitochondria, derangement of cell cycle were shown. In the EATC, such as those effects occurred after exposure to lower concentration of catechin than in that of A549 cells. After exposure of 10 μg/ml catechin, rounded-up cells and necrotic cells were found. Whereas, most of cells were under apoptotic changes-cytoplasmic condensation, nuclear fragmentation, cellular shrinkage, ladder pattern in the electrophoresis, when administrated 100 μg/ml catechin. These results suggested that exposure of catechin induced severe cellular damage and growth inhibition in dose- and time-dependent manner. And we confirmed that these effects of catechin were involved with apoptosis, necrosis and cell cycle arrest and were quite different according to cancer type. Therefore, much more research would be demanded before clinical application of catechin to human cancer therapy and this study would be the basic source for further study of green tea.

쯔쯔가무시병의 진단에 사용되는 피동혈구응집법과 간접면역형광법의 비교 연구

이창섭,권근상,나상언,이흥범 대한감염학회 2008 감염과 화학요법 Vol.40 No.1

The gold standard for the serologic detection of scrub typhus is the indirect immunofluorescence assay (IFA), however the passive hemagglutination assay (PHA) is commonly used method in Korea because of its availability, easy handling. We compared the sensitivity of PHA and IFA to compare their effectiveness in diagnosing scrub typhus. Out of 35 patients who were eventually diagnosed of scrub typhus by positive IFA, 19 patients (54%) were also tested positive for PHA during the acute phase (titer=1:80). Whereas 30 patients (85%) were positive in IFA during the acute phase. During the recovery phase 30 (85%) patients were positive in PHA, whereas all patients were found to be positive in IFA. Patients with 4-fo1d or greater rise of antibody were 12 (34.3%) in PHA, and 19 (54.3%) in IFA. We note that IFA has better sensitivity over PHA in detecting scrub typhus.

레이저 인터페로메타를 이용한 드릴링 머신의 틸팅에 관한 연구

이승수,손영지,장성규,전언찬 동아대학교 공과대학부설 생산기술연구소 1996 生産技術硏究所硏究論文集 Vol.1 No.2

This paper describes tilt angle measurement method. This method measures tilt angle of drilling machine using laser interferometer with simple sliding linear bearing. Measurement method is next orders. First, measurement position is considered pointed contact of two probes. And revolution of drill axis deliver pointed contact of probe. Second, so laser interferometer attach on sliding linear bearing, moving of probe influence laser reflector. And laser program displays this vibration of laser reflector. Namely, this vibration is tilt factor. A lot of error factor have an effect on accuracy to measurement of linear, angular, and so on. But this paper ignores some error factor, because these error festor is very smaller than tilt angle factor which we had been measuring values.

구개부에 발생한 다형성선종의 치험례

이창진,김태열,김효언,김희광,전인성,윤규호 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50 per cent of all cases of tumors, and approximately 90 per cent of all benign salivary gland tumors. Since the term mixed tumor' was introduced by Broca for its dual origin of epithelial and mesenchymal elements, the term plemorphic adenoma suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The parotid gland is the most common site but it may occur in any of the salivary glands. It is somewhat more frequent in women and in the fourth to sixth decades, but they are also relatively common in young adult and have been known to occur in children. Treatment of choice is surgical excision. Adequate surgery with safe margin reduce its recurrence rate. We represent a case of pleomorphic adenoma with literature review in 65-year old male occured in the palate. The lesion was successfully treated by surgical excision.

천연한방식물체 추출물의 생리활성에 관한 연구

이진태,아봉전,이창언 경산대학교 생명자원개발연구소 2001 생명자원과 산업 Vol.5 No.-

Physiological activities of extracts of Oldendia diffusa(WILLD.) ROXB., Agrimonia pilosa LEDEB. Var. japonica(MIQ.) NAKAI and Aconitum coreanum (LEVL.) RAIPAICS were investigated, respectively. Electron donating ability of Agrimonia pilosa LEDEB. var. japonica(MIQ.) NAKAI was higher than 60% at concentrations of various diluted solutions. The SOD like activity of 5% extracts of Oldendia diffusa(WILLD.) ROXB. And Agrimonia pilosa LEDEB. var. Japonica(MIQ.) NAKAI were measured as 64.08% and 62.38%, respectively. Tyrosinase inhibition experiment was done as using mushroom tyrosinase. Tyrosinase inhibitory effect of 1% extract of Agrimonia pilosa LEDEB. var. japonica(MIQ.) NAKAI was measured as 89.6%. This result was very higher than 81.5% of Oldendia diffusa(WILLD.) ROXB. at the same concentration.