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.

미국의 이혼법에 관한 연구

鄭光洙 江原大學校 比較法學硏究所 2005 江原法學 Vol.20 No.-

Divorce is the legal termination of a marriage in the United States. But in some states, divorce is called dissolution or dissolution of marriage. A divorce or dissolution servers a marriage. This discussion refers to civil annulments; within the Roman Catholic Church, a couple may obtain a religious annulment after obtaining a civil divorce, in order for one or both spouses to remarry. It has now been more forty years since California, in late 1960s, launched the modern-day reform movement in divorce laws by adoption the first no-fault divorce law in the United States and eliminating the concept of fault in marriage dissolution actions. The no-fault movement was premised on the idea that the removal of fault as a basis for divorce would significantly reduce the amount of personal animosity and bitterness typically associated with divorce. While the actual terminology of no-fault grounds may vary from state to state, they share a common theoretical basis allowing for the dissolution of marriages deemed no longer viable, regardless of cause, rather than requiring that dissolution be granted only if based on the fault of one of the parties. Following California's lead, in August, 1970, the Uniform Marriage and Divorce Act (UMDA) was proposed by the National Conference of Commissioners on Uniform State Laws, recommending that the sole ground for divorce should be a finding of irretrievable breakdown of marriage. Delays in obtaining an endorsement of the UMDA by the American Bar Association meant that states eager to reform their divorce laws to the California legislation or early versions of the UMDA for guidance. The focus of this article is to examine the historical development and current status of one particular no-fault divorce issue associated with the dissolution of a marriage. A comparison of approach to no-fault divorce law in the United States with fault divorce law in the Korea should highlight the debate on these important issues of public policy.

전자근관장측정기 Root ZX의 정확도에 관한 실험적 연구

강대훈,정관희,윤수한,배광식 大韓齒科保存學會 1998 Restorative Dentistry & Endodontics Vol.23 No.1

The purpose of this study was to evaluate the in vitro accuracy of Root ZX(Torita Co., Japan) which is the ratio type electronic apex locator. The 86 extracted human palatal roots of maxillary molar with fully formed apices were used. File lengths with the file tip just visible at the foramen were compared to those measured with Root ZX. For length measuring with Root ZX, saline test model with which the apical 1/3 of each root was submerged into normal saline were designed. The root canal lengths were determined with Root ZX and the radiographs were taken with a file in the canal. The distances from file tips of Root ZX lengths to apecies in radiographs also were measured with Profile projector PJ311(Mitutoyo Co., Japan). The results were as follows : 1. The root canal length determined with electronic apex locator was 0.78±0.53 mm shorter than the length with visual measurement. 2. The file tip of Root ZX lengths was located at 0.85±0.49 mm away from the apex in radiograph. 3. The accuracy of the Root ZX was 79.1% within 0.5mm of visual working length and 96.5% within 1.0mm.

이소매복된 하악 제2소구치의 자가치아이식을 이용한 치험례

정윤주,궁화수,최성철,김광철,박재홍 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.4

악골내 이소매복된 치아로 인해 유치의 만기잔존, 교합이상과 같은 교정적인 문제가 발생할 경우 그 해결책으로 주기적 관찰, 최소한의 개입, 교정적 견인, 발치, 그리고 환자 자신의 매복치아를 이용하는 자가이식술 등을 들 수 있다. 자가치아이식은 치아를 구강내의 한 위치에서 다른 발치와나 외과적으로 형성된 치조와로 이동시키는 술식으로, 치아가 교정력을 가할 수 없는 위치에 존재하거나 치아 이동에 제한이 있어 통상적인 치료가 불가능할 경우에 발거에 앞서 고려할 수 있는 방법이다. 자가치아이식은 치료기간을 단축시키고, 치근 형성이 완료되지 않은 어린 환자의 경우 이식된 새로운 위치에서 치근 형성이 이루어지며, 새로운 치조골의 형성을 유도할 수 있다. 본 증례는 하악 우측 제2소구치의 매복과 하악 우측 제2유구치의 만기잔존을 주소로 본원에 내원한 11세 여아로, 하악 우측 제2소구치의 매복의 깊이가 깊고, 방향이 교정적 견인에 불리하다는 점, 미성숙 치근 발육 상태와, 만기잔존한 유구치로 인해 공간 상실이 없다는 점 등을 고려하여 자가치아이식을 시행한 뒤, 1년간의 주기적 관찰 결과, 양호한 결과를 얻어 이에 보고하는 바이다. In the case of the impacted teeth, the clinician has to consider development of tooth, site of impaction, eruption path, and cooperation of patient. Treatment options for the management of impacted teeth are separated into four categories: observation, intervention, orthodontic or surgical relocation and extraction. Autotransplantation may be defined as the transplantation of embedded, impacted or erupted teeth, from one site to another in the same individual into extraction site or surgically prepared sockets. Autotransplantation ensures preservation of natural tooth, induction of alveolar bone growth and root development, offers one of the fastest and most economically feasible means in the replacement of young patients' missing teeth. This case presents a malpositioned impacted mandibular premolar of an 11-year-old girl. It was thought that orthodontic traction was difficult because of its unfavorable impacted position. Therefore the tooth was treated by autotransplantation, we can observe good healing pattern during 12 months.

K 강선 및 긴장대 강선을 이용한 원위 쇄골 제 2형 골절의 치료

정환용,이우석,전택수,김대환,김광균,임재우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 윈위부 제 Ⅱ형 골절의 치료에 있어 견봉 쇄골 관절을 통과하지 않고 직접 골편을 고정시키는 K 강선 및 긴장대 강선을 이용한 고정술로 치료한 환자에서 임상 결과를 후향적으로 분석하여 보고하고자 한다. 대상 및 방법: 2000년 5월부터 2001년 5월까지 쇄골 원위부 제 Ⅱ형 골절로 관혈적 정복술 및 K 강선 및 긴장대 강선을 이용한 고정술을 실시한 12례 중 최소 1년 이상 추시가 가능한 11례를 대상으로 하였다. 임상적 평가를 위해 최종 추시에서 변형된 견관절 기능 평가법을 사용하여 결과를 분석하였고 골유합 상태, 합병증, 견관절 운동범위를 측정하였다. 결 과: 전례에서 골유합을 얻었으며, 수술 후 골 유합까지의 기간은 평균 10주 (8~12주)였다. 최종 추시 상 견관절의 운동범위는 모두 정상 소견이었고, 변형된 견관절 기능 평가상 우수 9례, 양호 2례였다. 결 론: 쇄골 원위부 제 Ⅱ형 골절에서 K 강선 및 긴장대 강선을 이용한 고정술은 좋은 치료 방법 중 하나로 사료된다. Purpose: This is retrospective study to analyze the clinical results of the usefulness of K-wires and tension band wiring that fix the fracture fragment directly without passing the acromioclavicular joint in distal clacivle type Ⅱ fractures. Materials and Methods: From May 2000 to May 2001, eleven patients with distal clavicle type Ⅱ fracture were treated by open reduction and internal fixation with K-wires and tension band wiring. The clinical results were analyzed according to modified shoulder rating scale for distal clavicle freacture. Radiological union, complication, and range of motion of the shoulder were assessed. Results: All fractures were united at 10 weeks (8~12 weeks) in average. Finally, full range of motion of the shoulder joint was achieved in all patients. No complication was found and the modified shoulder rating scale for distal clavicle fracture were as follows: excellent 9 and good 2. Conclusion: K-wires and tension band wiring can be a good treatment method for distal clavicle type Ⅱ fractures.

녹농균 외독소에 반응하는 단일클론항체의 생산과 특성

정용훈,조양자,박장환,한왕수,김광남 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.2

Exotoxin A from Pseudomonas aeruginosa is known to be the most lethal and the most extensively studied product among its virulence factors. Hybridomas secreting monoclonal antibodies against exotoxin A from Pseudomonas aeruginosa PA 103 were derived from the fusion of myeloma cell with spleen cells from mice immunized with purified exotoxin A. Total of 582 hybridomas were screened and selected by using an enzyme-linked immunosorbent assay. Among these 39 clones positive for binding to exotoxin A were obtained and fusion-specific efficiency was turned out to be 6.7%. All antibody isotypes were represented (immunoglobulins G, and M) as determined by sandwich enzyme-linked immunosorbent assay. Hybridomas were selected and cloned by limiting dilution and agarose methods, obtaining 1 IgG? and 11IgG? clones. The specificity of the monoclonal andtidodies for exotoxin A was demonstrated by the immunoblotting technique. They bound 66kilodalton (KDa) exotoxin band and 45KDa fragment B portion. The protective ability of anti-exotoxin A monoclonal antibody was demonstrated in vitro by toxin neutralization. Ascitic fluid of monoclonal antibody producing hybridoma was able to neutralize at maximum 100 dilution to CHO cell cytotoxicity by 2ng of Pseudomonas ceruginosa exotoxin A and 60% increase in survival rate has been obtained through passive immunization by using anti-exotoxin A monoclonal antibody (IgG?) in mice injected 300ng of exotoxin A. And its in vivo and in vitro protective activities were appeared to reside in tis selective affinity and specificity to fragment B of Pseudomonas aeruginosa exotoxin A.

용기의 크기가 養液栽培 오이의 生長과 收量에 미치는 影響

鄭淳柱,李範宣,朴順基,金光秀 全南大學校 農業科學技術硏究所 1998 農業科學技術硏究 Vol.33 No.-

본 연구는 perlite를 이용한 오이의 양액재배시 적정 배지량과 근권용적을 구명하고자 용기의 크기가 2, 4, 6, 8 및 10ℓ인 플라스틱 포트에 펄라이트를 채워 오이를 양액재배하였다. 근권용적이 증가할수록 초장, 경경, 엽수 및 엽면적이 증가하였고, 과실수와 과실중량에서는 근권용적이 큰 8ℓ와 10ℓ의 처리구에서 가장 양호하였으며 기형과 발생률도 낮은 경향이었다. 근권용적 6ℓ이상으로 하였을 때 경으로의 건물분배가 줄어들고 엽으로의 건물분배가 많았다. NAR과 CGR은 근권용적이 증가함에 따라 증가하는 경향을 보였다. 근권용적에 관계없이 본 실험 범위내에서는 LAI가 증가할수록 NAR과 CGR도 증가하는 경향을 나타내었다. This experiment was carried out to investigate the effect of container size and substrate volume on the growth and fruit yield of hydroponically grown cucumber(Cucumis sativus L.) plant. Seeds were sown in plug tray filled with coir dust on Feb. 13, 1998. Seedlings with 5 to 6 true leaves were transplanted in 2l, 4l, 6l, 8l and 10l plastic pots filled with perlite medium. Cucumber fruits were harvested with 1 to 2 day interval, and fresh weight, number and malform of fruit were recorded. Plant height, stem diameter, number of leaves and leaf area highly depended on the container size. Total fresh weight and the number of fruit were increased as the container size increased. NAR(net assimilation rate) and CGR(crop growth rate) increased with increasing the container size. Optimum container size for hydroponically grown cucumber plant using perlite medium was recommended as 8l per plant.

반복적인 실신 및 실신전환자의 기립경사 검사시 뇌혈류 변화

조수진,김준수,이광호,정진상,송희정,이상철,서정돈,이원로 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

증후성 단독 중뇌동맥협착의 예후

이수주,이광호,정진상,조수진,이원용,이한보 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

생산자책임재활용제도에 관한 고찰

정광수 江原大學校 比較法學硏究所 2005 江原法學 Vol.21 No.-

The object of this paper shall be a study on Extended Producer Responsibility. The concept of this is that the human is the center of solving all the problems and based on the concept of consideration of next generation. This is the meaning of development, which the present generation had been developed natural resources and environment much excessive, hence it must not threaten to the next generation's life. Recently it is the preliminary concept when establish the policy in politic, economy, and social area. In 1992 UNCED(United Nations Conferences on Environmental & Development), which was held in Rio de Janeiro Brazil, had discussed about the imminence problems such as the environment preservation and responsibilities that producers and distributors have previously been assigned (i.e. worker safety, prevention and treatment of environmental releases from production, financial and legal responsibility for the sound management of production wastes) to include management at the post-consumer stage. Many western countries, including Korea, have actively implemented policies and programs to prevent pollution and promote waste minimization. Yet, environmental pressures are still increasing and the generation of wastes and the management of their disposal continues to be a concern. In the face of these challenges, and in the interests of supporting sustainable development objectives, new policies and programs are being evaluated, developed and implemented both by government and by businesses. Key among these approaches are Extended Producer Responsibility(EPR). EPR programs can be best understood as changing the traditional balance of responsibilities among the manufacturers and distributors of consumer goods, consumers and governments with regard to waste management. Today recycling technology has been highly developed in the area of waste paper, solid iron, and waste glasses. Waste plastic of PE, PP and expanded resin is recycling, and research on recycling of fueling is in low development stage. Waste tire's generation is increasing by day-by-day, urgently mandatory to develop the recycling plan. Recycling of the reproduction and the quality of refine oil are inferior level compare to the others. But research of the manure in the organic waste recycling is at beginning.