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.

기준모델 적응제어에 의한 유도 비행체의 자동조종장치설계에 관한 연구

林虎,朴正一,金元圭,朴鍾國 慶熙大學校 1989 論文集 Vol.18 No.-

This paper is concerned with the stability analysis and the design of an autopilot using direct model reference adaptive control for BTT missile with unknown dynamics when subjected to the longitudinal and lateral gusts. A motion of BTT missile can he seperated into the longitudinal and lateral motions, but there exist cross - coupling. The proposed algorithm is introduced different leakage terms about each motion into adaptation law so as to prevent drift of the adaptive gain and alleviate gust effects and cross - coupling. The algorithm is applied to the 6-DOF motion of an EMRAAT missile.

동종 골수이식 후 만성 이식편대숙주질환과 동반되어 신증후군으로 발현된 IgA 신병증 1예

정철권,김현수,박준성,정성현,조도연,최진혁,남동기,임호영,김명성,신규태,임현이,김효철 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

동종 골수이식 후 발생하는 신기능부전은 원인이 다양하여 감별에 어려움이 있다. 만성 GVHD는 흉선의 기능저하에 따른 면역관용의 실패로 발생되는 자가면역현상에 의해 발생되는 것으로 알려져 있으며 드물게 신장을 침범하여 신증후군을 일으키기도 한다. CaA의 용량을 줄이거나 투약중지 후 발생한 만성 GVHD에 동반된 신증후군의 경우 조기에 신조직검사를 시행하여 감별진단하고 CsA의 용량을 증량하거나 재투약하여 좋은 치료 결과를 보일 것으로 기대된다. 저자들은 문헌고찰을 통해 동종 골수이식 후 발생된 신증후군이 유사한 임상양상을 보이며 발생기전에 만성 GVHD와 자가면역현상이 연관되어 있음을 확인하였으며 동종 골수이식 후 신증후군의 임상양상을 보이는 환자에서 병리조직학적으로 lgA 신병증을 진단하고 이러한 lgA 신병증이 발생기전에 만성 GVHD와 자가 면역현상이 연관되어 있을 가능성을 최초로 확인하였으며 CsA를 이용하여 성공적으로 치료한 경험을 하였기에 보고하는 바이다. Renal insufficiency is occasionally encountered in allogeneic bone marrow transplantation and its cause is difficult to ascertain. Chronic graft-versus-host disease (GVHD) related to thymic dysfunction is immune-mediated and involves autoreactivity of T-lymphocytes derived from donor marrow to recipient's major histocompatibility complex(MHC) minor antigens. The clinical mainifestations of chronic GVHD are similar to those of autoimmune disease but kidney involvement is rare. Few cases of nephrotic syndrome with membranous nephropathy or minimal change nephrotic syndrome have been reported to be associated with chronic GVHD in allogeneic bone marrow transplant recipient especially after cyclosporine A(CsA) withdrawal, and these cases have responded well to CsA. Therefore, it is prudent to differentiate the cause of post-transplant renal insufficiency using renal biopsy and to start CsA in a case of nephrotic syndrome associated with chronic GVHD as early as possible. We report a case who had a massive proteinuria during the post-allogeneic marrow transplantation period. The cause of nephrotic syndrome was diagnosed as IgA nephropathy by renal biopsy. The patient was successfully treated with reintroduction of CsA.

소비자 문제에 대한 대응행동 : 여자대학생을 중심으로

임정빈,이영호,조미환,강은주 漢陽大學校 韓國生活科學硏究所 2000 韓國 生活 科學 硏究 Vol.- No.18

The purpose of this study was to provide with the basic research to aid to establish in the direction of consumer education, which investigate the actual condition of consumer complaining behavior according to consumer problems. Content analysis method was used and the sample 624 case was taken from report about experienced according to consumer problems by university of women. The major results are as follows: They have much more consumer complaining behavior, when they experience the problem about non-durable goods, and less experience them in case about durable goods. But they need to knowledge(information) about the durable goods and a way of settlement when they experience problems after service and structural problems.

한국어판 병동매일행동척도 개발

임호섭,신경철,함웅,채정호,김한오,정찬호 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

Objectives : Patient's behavior features are important factors which influences the clinical judgement including diagnosis. However, most psychiatrists build up a picture of patients' behavior from an amalgamation of their own brief observations and nurses' reports, which often lack in the objectiveness. Several behavioral scales have been developed to alleviate this difficulty, but the poor efficiency and reliability of these scales have made them less useful. The recently developed Ward Daily Behavior Scale is an objective tool for evaluating all the daily noteworthy behaviors of patients, and is easily applicable to wide ranges of diagnoses and ages. This study tried to prove the reliability and validity of the Ward Daily Behavior Scale-Korean version. Methods : The 112 patients, 63 males and 49 females, at a chronic psychiatric inpatient ward were selected as subjects. Experienced and unexperienced nurses rated patients' behaviors independently with the Ward Daily Behavior Scale-Korean version, after observing behaviors of subjects for 8 hours during day duty time. And then we tested the inter-rater reliability, internal consistency, and concurrent validity of this scale. Results : The Ward Daily Behavior Scale-Korean version proved to be both reliable and valid for measuring of behaviors of psychiatric inpatients. Conclusions : The Ward Daily Behavior Scale-Korean version will be a valuable tool to observe and quantify patients' behavior in psychiatric wards.

우리나라 지방재정의 활성화 방안에 관한 연구

임해정,황정호 군산대학교 지역개발연구소 1991 地域開發硏究 Vol.3 No.-

유기성자원의 퇴비원료로 활용 가능성 평가방법 개발

임동규,이승환,성기석,소규호,신중두,이정택 한국환경농학회 2006 한국환경농학회지 Vol.25 No.1

상아질 결합제의 종류와 처리방법에 따른 전단결합강도와 상아질-레진 결합계면 미세구조에 관한 연구

임창하,이용렬,정영화,송호준,박영준 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.1

The purpose of this study was to evaluate the dentin bonding agents (DBA) with the variations of the bonding system generations (4^th, 5^th and 6^th) and application methods by comparing the shear bond strengths (SBS) which were determined 24 h after application and dentin-adhesive interface microstructure. It was also aimed to suggest the theoretical clues for the adequate use of each bonding systems. The parameters were 1) generation of bonding systems (one product of 4^th, eight products of 5^th, and three products of 6^th generation), 2) moisture condition of the dentin surface after acid conditioning (moist group vs. dry group), 3) solvent type of the primers (three acetone-based, one acetone/ethanol-based, two water/ethanol-based, four water-based, one ethanol-based, one water/acetone-based), and 4) type of etchants (seven with phosphoric acid, three with self-etching primer, and one with 10-3 etchant). The results were as follows; One-bottle adhesives had comparable shear bond strengths compared to multiple component bonding agents, and some showed even higher results. Single Bond had the highest SBS value (20.6 ㎫) in the moist subgroup. For 4th and 5th generation DBAs, except for Mac Bond Ⅱ, all bonding systems showed lower SBS when dentin became desiccated after the conditioning-rinsing step, and generally shorter resin tags were produced in dry condition. Acetone-based adhesives generally showed better penetrability into dentinal tubules, and tended to be more sensitive to the degree of dentin dampness compared to those of the ethanol- or water-based adhesives. With Mac Bond Ⅱ which uses a self-etching primer, even though the hybrid layer was thin with a thickness of 1∼2 μ m, SBS was comparatively high. In the case of 6^th generation DBAs, Prompt L-Pop showed significantly lower SBS to dentin (7.4 ㎫) compared to those of AQ bond (13.3 ㎫) and One-Up Bond F (13.1 ㎫)(p<0.05). The hybrid layer was thin with a thickness of about 1μ m. In the case of AQ bond and One-Up Bond F, dentinal tubules were relatively well sealed. In the case of Prompt L-Pop, on the other hand, some of the dentinal tubules were not completely sealed, and fractured resin tags and separation between the hybrid layer and composite resin were observed. In the case of AQ bond, about 15μ m-thick resin layer was formed and many of the adhesive resin tags could not penetrate deep into the dentinal tubules. In the case of One-Up Bond F, many resin tags which are more than 50μ m-long were formed, but short penetration was also seen in some tubules. It is concluded that even though resin tag formation contributes in some extent for the bond strength, sufficient penetration of the adhesive resin to the exposed collagen meshwork and complete curing there in, and having sufficient strength to withstand the stress caused by the polymerization shrinkage during the light curing is essential for the success of the bonding procedure.

染色廢水슬러지 再活用의 經濟性 評價에 관한 연구 : B 染色組合을 中心으로

임재호,이정연 한양대학교 서해경제연구소 1999 서해경제연구 Vol.4 No.-

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4