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.

설갑상선 : 1 예 보고 A Case Report

한기석,배일헌,차상훈,김성진,박길선 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

갑상선 조직 전체가 설기저부에 발생한 이소성 설갑상선 증례를 경험하였기에 그 방사선학적 소견을 문헌고찰과 함께 보고하고자 한다. 증례는 59세 여자 환자로 40 일전부터 발생한 음성 변화를 주소로 내원하였다. 이학적 검사에서 설 기지부 중앙에 회백색의 격막에 둘러 쌓인 3 cm 가량의 종괴가 있었으며, 종괴는 내장으로 돌출하여 구인두를 막고 있었다. 경부 전산화 단층촬영 측면 정찰 촬영에서, 설 기저부에 후방으로 돌출하여 구인두를 막고 있는 경계가 분명한 연부조직 종괴가 보였으며, 전산화 단층촬영 동맥기와 정맥기에 주변의 혈관과 비슷한 강하고 균일한 조영증강을 보이는 장경 2.5 cm의 원형 종괴가 있었다. 또한 갑상선이 있어야 할 경부 전방 공간에서 정상 갑상선 조직은 전혀 보이지 않았다. 설 기저부의 종괴에서 생검을 시행하였으며 병리 검사에서 갑상선 조직으로 진단되어 설갑상선으로 확진되었다. The authors report a case of ectopic thyroid that whole thyroid tissue was replaced by lingual thyroid. A 59-year-old female presented with dysphonia duration of 40 days. On physical examination, there was a 3 cm sized well encapsulated whitish mass protruding to oral cavity in milline of tongue to base. Computerized tomography of neck revealed homogeneously enhancing well marginated 2.5 cm sized round mass in the cecum of tongue base on arterial and venous phase. And there was no normal thyroid gland in lower anterior neck.

백서 중대뇌 동맥의 폐쇄에 따른 경색의 시간적 변화

정진명,정영섭,박인성,이상형,김현집,최길수,한대희 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.3

For the assessment of clinical management, for the confirmation of clinical findings, and also for the evaluation of new diagnostic techniques to determine the location as well as the extent of area of infarction on evolution in cerebral tissue is essential. Sequential evolution of infarction in 2% 2, 3, 5-triphenyltetrazolium hydrochloride(TTC) staining and its concomitant neurological changes were investigated in the rat following left middle cerebral artery occlusion(MCAO). In addition, the pathological evaluation was performed in the same coronal cut slice of each TTC staining. The results were : 1) In the TTC staining method, the cerebral infarction was not found in the 2 hour group rats, and appeared as white or pink color after 4 hours. 2) The size of infarction was significantly correlated with time of occlusion before sacrifice(p<0.05). The size increment was most obvious between 8 hour and 24 hour groups. 3) The time evolution of cerebral infarction was most prominent in the cerebral cortex, and was minimal in the basal ganglia which are supplied by the 'end artery'. 4) The cerebral infarction appeared first in the coronal cuts at the 4, 6, and 8㎜ from the frontal pole, which is the main territory of MCA. 5) The cerebral infarction, mainly presented in the 4, 6, and 8㎜ coronal cuts from the frontal pole, extended from the pyriform cortex to the fronto-parietal cortex. It also appeared at 2, 10㎜ coronal cuts from the frontal pole in 24 hour group. 6) The neurologic sign was not correlated to the time of MCAO and the size of infarction on evolution. Therefore, the prediction of location and size of area of infarction on evolution was impossible by the neurological status. 7) The histopathological change was detected as early as in 2 hours. However, hematoxylin and eosin(H & E) stained sections showed only subtle changes, such as small irregular areas of cortical spongiosis and neuronal shrinkage up to 8 hours. There was no significant difference between lesion areas of 2 hour and 8 hour groups. The pathological findings of 24 hour group rats was definite and appeared as a central area of coagulation necrosis and rare faction surrounded by a zone of peripheral spongiosis.

당류 첨가가 김치 성분 및 관능검사에 미치는 영향

권동진,장영상,조길석,강윤한 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.6

김치의 단맛을 내기 위하여 일반 제조에 이용되고있는 sucros 대신 xtevioside나 sorbitol과 같이 당의 종류를 달리하여 제조한 김치의 이화학적 성분, 미생물의 변화 및 관능적 특성에 미치는 영향을 조사하였다. pH와 적정산도는 stevioside와 sorbitol이 첨가된 처리구가 sucrose가 첨가된 처리구보다 산의 생성 억제 효과가 있는 것으로 나타났다. 총균수의 경우 전반적으로 당의 종류와 저장온도와는 관계없이 미생물의 생육 억제효과가 없는 것으로 나타났으나 젖산균의 경우 10℃에서는 균의 생육 억제 효과는 없는 반면 5℃에 저장한 김치의 경우 stevioside와 sorbitol이첨가된 김치는 젖산균의 생육에 억제효과가 있는 것으로 나타났다. 관능검사를 실시한 결과 stevioside 첨가된 김치 sucrose 첨가구에 비하여 기호도에서는전적으로 우수한 것으로 나타났다. Effects of sugars addition in Kimchi preparation on physiochemical characteristics, sensory evaluation of Kimchi were investigated. Sugar sources added were sucrose, stevioside and sorbitol. Changes of pH and titratable acidity in Kimchi with addition of stevioside or sorbitol were similar to ones of control Kimchi with addition of sucrose during storage at 10℃, while ones of Kimchi with addition of stevioside or sorbitol were different from control during storage at 5℃, Comparison with control Kinich, addition of stevioside or sorbitol was inhibited acid production in Kimchi during storage at 5℃. Total number of viable cells were not significantly different among those of Kimchi samples during storage at 5 and l0℃ The number of lactic acid bacteria were not significantly different among those of Kimchi samples during storage at 10℃, but ones of Kimchi with addition of stevioside or sorbitol were less than those of Kimchi with addition of sucrose during storage at 5℃. Among sweetness, taste, flavor, color, texture and overall acceptability, the results of sensory evaluation except sweetness were showed that Kimchi added with stevioside or sorbitol was superior to ones added with sucrose.

폐혈관상이 유지된 선천성 낭성 선종양 기형

배일헌,한기석,차상훈,김성진,박길선,이건국,홍장수 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

선천성 낭성 선종양 기형은 태생 16주 이후 말단세기관지의 형성이 중단되어 미성숙기관지들과 중배엽성분들이 과도하게 증식하여 발생하는 드문 선천성 폐질환이다. CT소견은 낭종의 크기 숫자, 내용물 등에 따라 다양하나, 병변내에 정상적인 폐혈관이 보인 예는 전세계적으로 보고된 적이 없었다. 저자들은 역동적 흉부 CT상 균일한 저음영의 병변내에 정상 폐혈관상이 유지된 선천성 낭성 선종양 기형 1예를 경험하였기에 보고한다. Congenital cystic adenomatoid malformation(CCAM) is a rare pulmonary disease that is thought to be developed by abnormal proliferation of immature alveoli and other mesenchymal component from the abrupt halting of the terminal alveoli formation after 16 weeks of gestation. On CT scan, there are no consistencies regarding to size, numbers, and its contents but no cases were reported in past showing normal pulmonary vascularities. We reports a case of CCAM that showed normal pulmonary vascularities within the hypodense lesions on a dynamic chest CT

기흉 후 발생한 뇌동맥 공기 색전증 : 1예 보고

배일헌,한기석,차상훈,김성진,박길선,홍장수 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

뇌혈관내 공기 색전증은 뇌혈관 조영술, 혈관내 도자술 시행시 발생하여 매우 심각한 합병증을 유발할 수 있다. 그러나 기흉의 합병증으로 발생한 경우는 보고된 적이 없다. 저자들은 기흉에 의하여 발생한 뇌혈관내 공기 색전증 1예를 경험하였기에 보고한다. Cerebral arterial air embolism is a potentially fatal event that may occur during the cerebral angiography and intravascular catheterization. The CT findings of cerebral arterial air embolism following pneumothorax have not been reported. We report a case of cerebral arterial air embolism following pneumothorax, and describe the CT findings.

兒童의 造形能力(繪畵, 彫塑)과 他 敎科成積과의 相關에 關한 硏究

金正熹,韓進九,李吉鍾,金相俊 春川敎育大學 1985 論文集 Vol.25 No.-

The main purpose of this sutdy is ultimately to help improve art education by clarifying and interpreting the correlation of modeling ability to that of other subjects taught in primary schools. This research covered a total of 600 children of two schools : one in Chunchon city and the other in Chunsong county. As the marks of all the subjects are scaled by the absolute achievement evaluation method, the average of the tatal subjects showed a high mark of 4.23. But our research team, having measured their modeling ability in relative evaluation method, marked only 3.31 point in average. Notwithstanding this discrepancy, the correlation between the marks of the toal subjects and the drawing revealed a strikingly low coefficient of 0. 18 and 0.23 between the total and sculpturing ; and 0.20 between the tatal and modeling as a whole. Thus, it is definite that any argument for high correlation among achievements in subjects cannot apply to art subject. The result of this research may be revised by drawing data from markings of identical evaluation method, but the difference will be of little consequence.

결함 허용성과 부하 균등화를 위한 프로세스 스케쥴러 연구

임종규,박영진,최길성,김한웅 안성산업대학교 1993 論文集 Vol.25 No.-

A Process Scheduler is designed for load balancing under normal state and for load redistribution under failure in a fail-soft distributed system. The proposed load redistribution algorithm is that if any soft-fault occurs in the local nodes, all the processes in the queue of the failed processor and all incoming processes the failed processor are automatically rescheduled by a certain policy in which we determine to buffer them in the current node or to transfer them to another underloaded node considering criticality and service time of the fault. The proposed load balancing algorthm enhances Soh's model(ESM). Our algorithm eliminates the problems of conventional algorithm which has load tables in each processor. This model provided us with several advantages such as reliability, availability and fault-tolerance.

편측성 하악 과두 과증식으로 인한 안모비대칭의 치험례

김상규,이상한,장현중,우길상,이은진 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Condylar hyperplasia is an uncommon malformation of the mandible created by excessive growth of one of the condyles. Condylar hyperplasia is a self-limiting condition, and treatment is determined by the degree of functional difficulty and aesthetic change. Some patients can be treated with unilateral condylectomy, whereas others require unilateral or bilateral mandibular osteotomies. Our method includes a condylectomy to arrest the continued condylar growth or to excise the neoplastic condyle, unilateral vertical ramus osteotomy to allow horizontal rotation of the mandible without significantly altering the temporomandibular articulations, and an arthroplasty by superior repositioning of the stump of the proximal condylar segment into the condylar fossa. Both the facial asymmetry and the occlusion were corrected by rotation of the mandible around the unaffected condyle.

감자 추출물의 아질산염 소거 및 전자공여 작용

엄미아,강윤한,권동진,조길석 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.5

본 연구는 감자의 활용도 증진을 목적으로 수미와 대서 감자 2품종을 속과 껍질 부위로 나누어 열처리 후 열풍건조 분말을 제조하였고, 70% 아세톤 추출물 을 얻어 페놀성 화합물의 함량과 조성을 조사하고 아질산염 소거 및 전자공여작용 등 기능적 특성을 검토하였다. 분말의 색도는 속부위에서 열처리시 비열처리에 비해 백색도, 황색도 값이 높았고 특히 수미 감자의 색도 개선에 열처리는 효과가 있었다. 수미가 대서보다 총폴리페놀, 클로로겐산 함량이 높은 것으로 나타났으며 열처리로 증가하는 것으로 나타났다. 그러나 플라보노이드는 부위중 껍질과는 달리 속에서 거의 확인되지 않았다. 따라서 생 감자를 전처리시 스팀으로 열처리하더라도 페놀성 화합물의 함량은 감소되지 않았다. 아질산염 소거와 전자공여 작용은 1㎜ 두께의 껍질부위에서 높게 나타났다. 이상의 결과는 감자 품종에 따른 부위별 변색 정도, 페놀성 화합물 함량 등에 차이가 있으며, 부위중 껍질이 속보다 폴리페놀 함량이 높았다. 따라서 스팀으로 5분간 열처리 후 열풍건조한 감자로부터 얻은 껍질 추출물은 아질산염소거와 전자공여 작용 등 기능적 특성이 우수한 것으로 나타났다. This study was conducted to investigate functional properties of 70% acetone extract in different parts of two potato varieties. 'Superior' and 'Atlantic' potato were processed by following method. Potatoes are washed, peeled, sliced and steamed before hot air drying for flesh and peel powder. Hunter's L and b values of flesh powder from blanched 'Superior' potato were higher than flesh powder from fresh 'Superior' potato. Discoloration of 'Superior' potato was inhibited by steam blanching. Contents of total polyphenol and chlorogenic acid in the 70% acetone extract of 'Superior' potato were higher than those of 'Atlantic' potato, paticularly in the blanched flesh and peel. But flavonoid was not detected in flesh extract. The phenolic concentration was not decreased by the heat treatment. The nitrite scavenging and electron donating ability was greatest at the tuber peel, including the skin and cortex tissue 1mm beneath the skin. From the above results, browning reaction and polyphenol contents in different parts of potato slices were dependent on cutivars. Peels contained more polyphenols than those from the flesh. The results indicate that potato peel extract of steam blanched plus hot air dried potato tuber showed the effectiveness as a natural nitrite scavenger and antioxidant.