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.

매독의 혈청학적 검사에 대한 연구 : 특히 FTA-ABS test와 타 검사와의 비교검토

金宗琪,鞠泓一,禹泰河 대한의학협회 1973 대한의학협회지 Vol.16 No.4

요관결석 환자에서 강성요관경하 제석술과 요관절석술에 대한 임상적 고찰

김홍섭,황선태,노용수,양상국,박치영 건국대학교 의과학연구소 1995 건국의과학학술지 Vol.5 No.-

Patients with ureteral calculi may be managed by expectant, invasive, or noninvasive treatments, depending on the stone composition, size and location, expectations of the patients, and experience of the surgeon. Currently ureteroscopic removal of stone(URS) has been popularly used for the treatment of ureteral calculi. From January 1992 to December 1994,we retrospectively compared the clinical results of 87 URS's to those of 31 ureterolithotomies and analysed the factors that affect the result of URS. The clinical results of two groups were summarized as follows The mean stone size was 7.6㎜ in URS group and 12.1㎜ in ureterolithotomy group. In 81.6% of URS group, the stone was located in the lower ureter and 71% of ureterolithotomy group in the upper ureter. The mean operation time, hospital stay and costs of the URS group, 96.6% of the stone were removed or disintegrated. There was no statistical significance in the success rate of URS along the sex difference, the location and size of stone. However, the higher the location of stone was, the more operation time spent. The complication rate of URS was estimated 26.5% but most of complications were resolved by conservative management. We conclusively suggest that the URS is the acceptable alternative modality of the ureterolithotomy for the treatment of the ureteral calculi.

수면관련 호흡장애 환자의 MMPI 및 SCL-90-R 반응 특성

김경우,윤석준,양창국,한홍무 한국정신신체의학회 2002 정신신체의학 Vol.10 No.1

사구체 수의 증감을 비교할 수 있는 기준 개발

김용진,이지은,이국주,최영호,홍정석 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.1

Background: The number of glomerulus has been considered one of the etiologic factors especially for focal segmental glomerulosclerosis. However, glomeruli are too many to calculate them correctly. Although the fractionator method has became convinced, in which they used selected sections, not whole kidney sections, with same intervals, it is also very hard to get good results. Because it is still very time-consuming and laborous work which leads to make big observers' biases. Methods and Materials: We designed the index for glomerular number to estimate the tendency of increase or decrease of the number of it in different kidneys and which was evaluated by other conventional methods including fractionator method. Index was based upon the theory by Nyengaard; "the number of glomerulus correlates with the weight of kidney, which is positively correlated with body weight". Calculating formula is the number of glomeruli/surface areas of cortices, which contain calculacted glomeruli multiplies by kidney weight/body weight. Results: We applied this index to kidneys of FGSKist mouse and those of RFM/Nga mouse. The former is spontaneous glomerulosclerosis model with heavy protein uria and renal faille and the latter is the mother side of FGS/Kist mouse but has no glomerular disease or protein aria. The number of glomerulus of FGS/Kist mouse was decreased by 30% to those of RFM/Nga mouse. Conclusion: This index was useful and reliable for estimating the relative glomerular number between two groups.

DESMOPLASTIC AMELOBLASTOMA의 치험 1례

김성국,신홍인,박희경,장현중,김영미,김진수 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

Ameloblastomas are benign epithelial neoplasm of the jaw comprising approximately 1-3.3% of all odontogenic cysts and tumors. Although most are microscopically benign, they are generally considered to be locally aggressive and destructive, exhibiting a high rate of recurrence. Treatments of them contain the conservative treatments on unilocular types and radical treatments on multilocular types. Classifications based on the histologic features of ameloblastoma generally included the follicular, plexiform, acanthomatous, basal cell, uncystic types. However, recantly a new and unusual variant has been added by Eversole et. al in 1984, the histologic features of which are characterized by marked stromal desmoplastic proliferation. This is a case report of desmoplastic ameloblastoma in the anterior maxilla of 63 year-old female treated by block excision. THis provides a brief review of the literature because of the rarity and unusual radiographic-histologic features of desmoplastic ameloblastoma.

방사선 치료 중인 암환자의 우울에 대한 연구

김윤원,양창국,최병무,한홍무 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

저자는 1994년 4월부터 9월까지 동아대학교병원 치료방사선과에서 방사선 치료를 받고 있는 암환자 50명을 대상으로 Endicott(1984)의 주요우울증 진단기준에 따른 정신의학적 면담과 HRSD, BDI등의 자가평가척도를 통해 우울증의 빈도, 암환자의 정서상태에 영향을 줄 수 있는 인구통계학적 자료 및 각 변인에 따른 우울의 정도와 특성을 비교 분석하였다. 그 결과를 요약해 보면 다음과 같다. 1) 50명의 환자 중 Endicott(1984) 진단기준으로는 20명(40%)의 환자가 주요우울증에 해당했고 24명(48%)이 경우울증으로 분류되었다. 즉 전체 환자의 88%가 어느정도 이상의 우울증이 동반된다고 판단되었다. 2) 암 자체의 증상이라고도 볼 수 있는 '건강에 대한 염려', '체중감소', '식욕감퇴', '소화기계 증상' 등의 문항이 우울군에서 유의하게 높았다. 이는 암환자의 신체증상이 반드시 암에 이차적인 증상만은 아님을 시사하기 때문에 이러한 증상이 호소될 때 반드시 우울증의 공존에 대한 고려가 필요하다고 생각된다. 3) 학교, 종교, 성별, 연령 등에 따른 BDI 및 HRSD의 평균과 정신의학적 진단은 통계적인 유의성이 없었으나 배우자와 사별한 환자 12명 중 83%가 주요우울증으로 진단되어 암환자에서 배우자로 부터 받는 지지의 경우가 우울증 발생에 중요한 역할을 함을 시사한다. 4) 암의 종류별로는 폐암군에서 높은 우울점수를 보였고 유방암군은 기타암군에 비해서 통계적으로 유의하게 낮은 우울점수를 보였으며 유방암 환자의약 83%가 비우울군으로 나타났다. 폐암군의 경우 신체적 합병증이 많았고 예후가 불량한 경우가 많았던 반면 유방암군은 경과가 양호한 환자들이 대부분이었다. 이로 보아 암의 종류에 따른 우울 정도의 차이가 나는 이유는 병의 치료 상태나, 경과, 예후등의 차이가 우울증에 영향을 끼치기 때문으로 추정된다. Objects : This study was intended to compare the prevalence rate of depression and to investigate the characteristics of depression in cancer patients on radiotherapy. Methods : The authors studied not patterns and prevalence of depression of the 50 cancer patients who were being treated by radiotherapy. Endicott's revised criteria for depression and rating scales for depression, Beck Depression Inventory(BDI) and Hamilton Rating Scale for Depression(HRSD), were used to evaluate depression. Also, the authors compared the mean scores of BDI and HRSD according to each selected variables which might influence on the affective state of cancer patients. Results : 1) According to Endicott criteria for depression, twenty patients(40%) were major depression, twenty-four patients(48%) were minor depression and six patients(12%) were non-depressed. 2) Items of hypochondriasis, weight loss, loss of appetite, and digestive symptoms in both BDI and HRSD, which indicate secondary symptoms induced by cancer itself, were significantly higher in both depressed groups as compared with non-depressed group. This suggests that we should not treat these symptoms simply as secondary symptoms dut to cancer itself but consider presentation of depression when cancer patients complain of these somatic symptoms. 3) Educational level, sex, age, duration of illness did not affect the rate of prevalence of major depression. But the widowed showed significantly higher prevalence of major depression than those who were in the married status(p<0.01). 4) Difference in rates of depression was noted among different cancer groups. The breast cancer group showed significantly lower rate of major depression(p<0.01) and much lower mean scores of BDI and HRSD than the lung cancer or other cancer groups(p<0.01). Conclusion : These above results suggest that depression is very common in cancer patients on radiotherapy and appropriate concerns is needed. The rate of depression was significantly higher in lung cancer group and in the widowed. We have to pay psychiatric concerns about somatic symptoms sush as weight loss, loss of appetite, and digestive symptoms which indicated secondary symptoms induced by cancer itself. Because these somatic symptoms were more prevalent in depressed groups.

Silica Gel-MoO₃觸媒에 의한 Methanol의 酸化反應

김재구,정국삼,홍윤명 연세대학교 산업기술연구소 1983 논문집 Vol.15 No.2

The vapor phase oxidation of methanol to formaldehyde over silica gel supported-MoO₃catalyst was studied at atmospheric pressure as a function of reaction temperature, feed rate and concentration. The silica gel supported-MoO₃catalyst was found very selective in formaldehyde formation but conversion was rather poor. The following rate equation was deduced assuming a steady state with two stage irreversible oxidation-reduction process. γ= ? The rate equation matched experimental data reasonably well and activation energies of the steps were calculated to be 8.345Kcal/g-mole and 7.074Kcal/g-mole respectively.

약물 코팅 스텐트의 후기 재협착

전국진,김준홍,이한철 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

심인성 다음다갈증 2예

양창국,최병무,한홍무,김영대,주승재 동아대학교의과대학 1992 동아의대학술지 Vol.4 No.1