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.

SSC 앵커의 인발특성에 관한 연구

洪碩佑,朴承一,林鐘鐵 釜山大學校生産技術硏究所 1995 生産技術硏究所論文集 Vol.49 No.-

SSC(strong and Simple Compressive Anchor) 앵커는 진행성파괴의 영향을 줄일 수 있고, 시공이 간단하며, 경제성이 있고, 내구성이 우수한 특징을 갖고 있다. 본 연구에서는 SSC앵커의 현장인발실험과 실내요소시험의 결과를 분석해 정리했다. SSC 앵커의 특성을 요약하면 다음과 같다. (1) 앵커의 인발에 의한 앵커체의 소성변위가 매우 작다. (2) 앵커의 자유장을 줄임으로서 전체 앵커장을 줄일 수 있다. (3) 진행성파괴의 영향이 줄어든다. (4) 앵커의 시공후 시간이 경과함에 따라 인발저항에 대한 안전률이 증가한다. The SSC anchor (Strong and Simple Compressive Anchor) is characterized by decreasement of progressive failure, simple site work, economy and durability. In this study, the result of field pullout test and laboratory element test of SSC anchor are analysed. The characteristics of SSC anchor are summarized as follows: (1) The plastic displacement of anchor body is very small by pullout of anchor. (2) Total anchor length decreases by the shortening of free length. (3) The progressive failure is decreased. (4) The safety factor for pullout resistance increases according to time after construction of anchor.

Web Server의 원활한 운용을 위한 Data Structure 구성에 관한 연구

홍창호,이승철 중앙대학교 기술과학연구소 2000 기술과학연구소 논문집 Vol.30 No.-

근래 Web Server의 안정된 운용의 중요성이 급증하는 Network Traffic과 더불어 점차 증대되고 있다. 기본적인 Network 구성망은 Ethernet으로 표준적인 프로토콜은 TCP/IP로 기반을 잡고 있다. 날로 증가하는 Network Traffic을 효과적으로 처리하기 위해서는 Network의 Bandwidth 및 서버가 처리할 수 있는 데이터 양을 분석하여 병목현상을 줄이고 데이터의 흐름을 원활히 하기 위한 데이터 buffer들의 설치와 적절한 운영 방법에 관한 연구가 필요하다. 본 논문에서는 Web Server로부터 image 데이터를 전송 받아 이를 원활히 display하기 위한 Application Layer에서의 buffer 크기 및 제어방법에 관한 연구를 수행하고 특히 연속적인 이미지의 전송과 재생에 관한 buffer management에 관하여 고찰한다. Providing a satisfactory multimedia application service in networking environments requires an effective media delivery mechanism. However, a common network such as the Internet does not provide a guaranteed network bandwidth to accommodate multimedia service in a reliable fashion. A typical approach to assist multimedia delivery is via buffer management in the end system. Buffer management techniques are classified into two categories: one is adapting the changes in network load and the other is smoothing the bandwidth requirement. The former may cause a serious loss of service quality and the latter is not able to adapt to the dynamic network condition. The authors propose bandwidth adaptive smoothing which is adaptive to the dynamic networks and also supports better quality of service by smoothing the bandwidth requirement.

동아의 체중조절 효과

홍석산,이승환,김철용,권석형,황보식 한국식품영양학회 2002 韓國食品營養學會誌 Vol.15 No.4

본 연구에서 선발된 17종의 천연물을 Sprague- Dawley rat에 급여한 결과, 체중 증가, 에너지 소비, fat pads 중량, 간의 triglyceride 함량, atherogenic index 그리고 혈중 글루코오스의 함량 등이 감소하는 경향을 나타내었다. 특히 동아를 구강으로 섭취시킨 결과, 체중 증가, 에너지 소비, fat pads 중량, 그리고 혈중 글로코오스의 함량등이 감소하였으나, 간의 triglyceride 함량은 오디와 송엽의 열수 추출물보다 적게 감소하였다. 동아, 오디, 그리고 송엽을 혼합하여 사용한 결과, 각각의 원료를 사용할 경우보다 비만이 개선되는 것으로 나타났다. This study attempted to evaluate the effectiveness of function of Wax Gourd for obesity and the related disease of adult people can be developed by the combination of the 17 food materials screened in this study. The experiments using Sprague-Dawley male rats show that seventeen kinds of food material inhibited the increase of body weight gain, energy intake, fat pads weight, liver triglycerides content, atherogenic index, and blood glucose concentration induced by cafeteria diet. Oral administration of wax gourd decreased most body weight gain, energy intake, fat pads weight, and blood glucose concentration induced by cafeteria diet. Oral administration of wax gourd decreased most body weight gain, energy intake, fat pads weight, and blood glucose concentration. Liver triglycerides content was the lowest in the group administered mulberry stem extract and the group administered pine leaves showed the lowest atherogenic index. The combined administration of wax gourd, mulberry stem extract and pine leaves improved more the obesity and related symptoms than the individual administrations.

VLSI의 收率增大를 위한 PMOS IC 프로세스 진단에 관한 연구

홍완희,김창민,김철주,노승용,김성환 서울市立大學校 1987 論文集 Vol.21 No.2

In this paper, the PMOS IC process check through various fabrication processes were dicussed. The Si water used process was estimated by the surface cleanness and bulk crystalline properties. For the photolihography process and photomask fabrication, the process cleanness was estimated. The control technology of process parameters from process cleanness in oxidation, CVD(chemical vapor diposition), diffusion and Al evaporation process was described. To estimate synthetically the process, the MOS and planar diode and PMOS transistor array were fabricated, and then the maximun yield of IC was assumed by the minimum number of bad transistor and diode.

정신분열증 환자의 음성증상과 혈청 Prolactin 값

홍승철,이철,백인호 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.5

With the development of radioimmunoassay method, one of the improved investigative laboratory tools available today, many investigators have begun to examine relationship of prolactin(PRL) to clinical features in schizophrenia. However, the reports of relating PRL to negative symptoms in schizophrenia have been scarce. This study was designed to find whether serum PRL levels measured before antipsychotics administration are related to negative symptoms. The subjects were consisted of 36 male schizophrenia by Diagnostic and Statistical Manual of Mental Disorder-Ⅲ, who were admitted to the Department of Neuropsychiatry, Dae-Gu Catholic Hospital from Sep. 1, 1986 to Mar. 31. 1987 and 17 normal men (control group). The results were as follow ; 1) Before antipsychotics administration, the serum PRL levels of a high negative symptom group(9.18±6.46ng/ml) were significantly lower than a low negative symptom group(21.81±16.22ng/ml) and control group (16.01±5.49ng/ml) (p<0.005). 2) The reciprocal correlation between serum PRL levels and negative symptoms was statistically significant(r=-0.50, p<0.001). In the light of these results, it seems that the measurement of serum PRL as a biological marker could be used in evaluating negative symptoms of schizophrenia.

제주도 고등학교 학생들의 비만 정도, 심혈관 위험인자, 소아시 비만과의 관련성

홍성철,황승욱,현인숙 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.2

Background: Recently, adolescent obesity was increased and tended to become obese adults, facing increased risk for diabetes, cardiovascular disease. Even before reaching adulthood, adolescent obesity already was experiencing hypertension, dyslipidemia, and diabetes mellitus. The purpose of this study was to find prevalence of obesity of high school students in Jeju island and association between obesity and cardiovascular risk factors and association between childhood obesity and adolescent obesity. Method: The study subjects were 6,064 students of twenty-two high school in Jeju island and health survey data was gathered from high school health examination data and hospital health examination data from Aug. 1999 to Dec. 1999. Adolescent obesity was evaluated by ideal body weight method in 1998 and body mass index. Cardiovascular risk factors were checked total cholesterol, systolic and diastolic blood pressure, fasting blood sugar. In 1,534 students, obesity at primary school is checked by primary and middle school health record. Results: Prevalence of obesity in Jeju island high school students is 12.6% in male students, 13.3% in female students by ideal body weight method and 8.7% in male students, 8.5% in female students by body mass index. Prevalence of obesity of male students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 14.2% and not significantly different. Prevalence of obesity of male students in general and commercial school group were each 13.9%, 10.3% and that of general school group was significantly higher. In female students, Prevalence of obesity general and commercial school group was not significantly different. Total cholesterol, systolic and diastolic blood pressure were significantly associated with degree of obesity in male and female students(P<05) and fasting blood sugar was only significantly associated with degree of obesity in male students(P<05). In 1,514 students checked by health record, Odds ratio of obesity at primary and middle school that at high school were 12.96~22.77 and was significantly associated. Conclusion: Prevalence of obesity of high school students in Jeju island is very high and adolescent obsity was significantly associated with cardiovascular risk factors. Mostly childhood obesity tended to become adolescent obsity and program of control of obesity at childhood and adolescence is required.

Creutzfeldt-Jacob병 1례

홍승철,한진희,정종현,김소양,허균,이성필 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

저자들은 Creutzfeldt-Jacob병 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 약 4개월에 걸친 비교적 짧은 기간 동안 중증의 인지 기능 장애와 시각 장애, 보행장애와 하지의 약화, 불수의적 운동 등과 함께 섬망상태에까지 이르게 되어 본원 정신과에 입원하게 되었다. 정신상태 검사상, 반응시간의 지체, 언어장애와 보속증, 시간에 대한 지남력 장애, 주의 집중력 장애, 단기 및 장기 기억 장애, 추상적 사고능력 장애 등의 소견을 보였고, 이러한 증상들은 입원후 치료에도 불구하고 빠르게 악화되었다. 뇌파검사상 지속적인 다발초점성 서파가 모든 전극에서, 특히 우측 전두부에서 현저하게 나타나는 소견을 보였고, 병리조직학적 검사상 대뇌 피질에 신경손실을 동반한 해면화와 신경교 증식증을 나타냈다. 이상의 소견들은 모두 CJD의 진단에 합당하였다. We report a case of Creutzfeldt-Jacob disease and review the relevant literatures. This 56-year-old male patient was admitted to our hospital with a history of rapidly progressing cognitive dysfunction, visual disturbance, gait disturbance, weakness, involuntary movement of lower extremities, and the symptoms of delirium. On mental status examination, he showed psychomotor retardation, speech disturbance, perseveration, disorientation, impairment of short-term and long-term memory, and inability of abstract thinking. He had a rapid downhill course, along with shakiness of trunk, rigidity of the limbs, myoclonus, confusion, and finally, inability to speak or move on the bedside. On electroencephalogram(EEG), continuous multifocal show delta activities were found in all leads, especially in the right frontal areas. Brain biopsy showed, spongiosis with neuronal loss and gliosis noted at the cerebral cortex. These findings were compatible with Creutzfeldt-Jacob disease.

삼환계 항우울제(Dothiepin)가 우울증 환자의 수면에 미치는 영향 : 수면 다원 검사에 의한 연구 A Polysomnographic Study

홍승철,한진희,이성필,방승규 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.4

우울증환자군에서 삼환계 항우울제인 dothiepin 투여 후의 수면이 변화양성을 알아보며, 치료 후의 호전정도를 예측할 수 있는 치료 전과 치료 후의 수면변인을 조사하기 위하여 본 연구를 시행하였다. 수면상태는 수면다원검사를 실시하여 평가하였고, 우울증상의 심각도와 임상양상의 정도는 Hamilton 우울척도를 이용하여 평가하였다. 연구대상은 최소 14일 이상 약물을 투여 받지 않은 우울증 환자 16명(남자 7명, 여자 9명, 연령분포 23∼64세)으로 구성되었다. 수면다원검사는 약물을 투여하기 전과 약물투여 후 1주와 3주에 시행하여 다음과 같은 결과를 얻었다. 1) 항우울제 투여 1주와 3주 후 수면 연속성은 기준수면에 비하여 총수면 시간이 유의하게 증가하였고 수면잠재기는 단축되었으며, 수면도중 각성시간은 감소하였고, 수면효율은 증가되었다. 2) 항우울제 투여 1주와 3주 후 수면구조에서는 기준수면에 비하여 2단계 수면이 유의하게 증가하였다. 3) 항우울제 투여 1주와 3주 후 급속안구운동 수면은 기준수면에 비하여 유의하게 감소하였고, 급속안구운동 수면잠재기는 증가하였다. 4) 항우울제 투여 1주 후와 3주 후의 수면을 비교시 수면잠재기가 3주에 유의하게 감소된 외에는 수면 변인의 차이를 보이지 않았다. 5) 우울증상의 평가를 위하여 약물투여 1주 후와 3주 후에 시행한 Hamilton 우울척도 점수는 약물투여 전에 비하여 줄어들어 우울증상이 호전됨을 나타내었다. 6) 항우울제 투여 3주 후 치료반응이 좋았던 군의 수면특징은 기준수면에서 수면도중 각성시간이 증가된 경향을 나타내었고, 약물투여 1주 후의 수면에서는 4단계 수면의 양이 유의하게 감소되었다. 이상의 결과를 볼 때, 우울증환자에서 삼환계 항우울제인 dothiepin 투여 후의 수면변화는 치료초기에 나타났다. 기준수면에서 각성기간의 증가와 1주 후의 수면에서 4단계 수면의 감소는 약물치료에 좋은 반응과 관련된 수면변인으로 생각되었다. Objectives : This study was designed to investigate 1) sleep changes after antidepressant (dothiepin) treatment, and 2) sleep variables which seem to be associated with clinical response in the depressed patients. Methods : The subjects consisted of 16 patients who fullfilled the criteria for major depression by the Diagnostic and statistical Manual, (4th edition). Their sleep was recorded using polysomnography at the baseline and after one week and three weeks of dothiepin treatment. All subjects were further interviewed using Hamilton Rating Scale for Depression (HRSD) to rate the severity of their depression. High response to the drug was defined as a reduction of more than 50% of the HRSD score. Results : The results were as follows : 1) Depressed patients after dothiepin treatment showed more total sleep time(p=0.019), shorter sleep latency(p=0.05), less awake time(p=0.033), more sleep efficiency(p=0.018), more stage 2 sleep(p=0.002), less REM time(p=0.000), and longer REM sleep latency(p=0.004) than before treatment. 2) There were no differences in sleep variables between those who received 1 week and 3 weeks of dothiepin treatment except for the shortening of sleep latency after 3 weeks(p<0.05). 3) Depressive symptom scores on HRSD were reduced after 1 week and 3 weeks of dothiepin treatment as compared with the baseline. 4) High responders showed a tendency of increased wake time(p=0.054), while their stage 4 sleep decreased after 1 week of dothiepin treatment as compared with the low responders(p=0.0136). Conclusion : These results suggest that sleep of the depressed patients after dothiepin treatment tends to be normalized and sleep changes seem to appear early in the treatment phase. In addition, clinical response might be associated with greater wake time at the baseline and lesser stage 4 sleep after 1 week of dothiepin treatment.

잎들깨 수량과 단백질체 발현에 미치는 UV-B의 영향

홍성창,황선웅,장안철,신평균,장병춘,이철원 한국환경농학회 2006 한국환경농학회지 Vol.25 No.1