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.

간암 환자에 합병된 Citrobacter braakii 패혈증 1례 보고

이해미,배성하,이수남,이정우,신아영,류시영,이수연,윤문희,한선영,한남익,이영석,유진홍 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Citrobacter species is a gram-negative bacilli that can cause opportunistic infections in immunocompromised hosts. Citrobacter braakii refers to the genomospecies 6 of the Citrobacter freundii complex. There are no detailed studies on infections caused by this newly identified specific genetic species in Korea. We herein report a case of a patient with hepatocellular carcinoma who, after undergoing transcatheter arterial chemoembolization, developed biloma which later progressed to C.braakii sepsis and did not respond to treatment. To our knowledge, this is the first reported case in Korea on C. braakii infection resulting in septic shock in a patient with malignancy in Korea.

지역사회 정신의학 전공의 교육과정 실태조사

홍진표,황순찬,이영문,이선형,신나리,이종일,박종익,장동원,정인원 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. Methods : Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. Results : Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs, Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. Conclusion : Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

알쯔하이머병 환자의 혈소판 아밀로이드 전구단백질 이상

이애영,조은경,김건익,김선국,손은희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Background:Although Alzheimer's disease (AD) is a progressive neurodegenerative disorder without any truly effective pharmacological treatment at present, early accurate diagnosis is important for the delaying of disease progression and proper management It would be desirable to have a peripheral biological marker to identify patients affected by AD Amyloid β-peptide originates from a larger precursor, the amyloid precursor protein (APP). which can be seen in the platelet of its equivalent to those found in brain. To investigate if there is a correlation between level of platelet APP isoform and AD, we evaluate a cohort of subjects including patients affected by sporadic AD, vascular dementia, and controls Subjects & Methods :Thirty-five patients with sporadic AD diagnosed according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Relatec Disorders criteria (NINCDS-ADRDA) and 26 vascular dementia patients diagnosed by the Diagnosis and Statistical Manual of Mental Disorders, Fouth Edition (DSM-Ⅳ) criteria and 12 controls were included Blood sample were drawn from fasting state and collected into 3 mL of 3.8% sodium citrate. Platelets were collected by centrifugation at 500 g for 20 minutes and washed. and the platelet pellet was stored at -80℃ until used APP was assessed by western blot analysis and quantified by densitometry using Image Analyzer Results:In platelets densitometer as well as the result of Western blot was higher compared with those of patients with non-Alzheimer dementia and controls We observed statistically significant reductions in the ratio of 120 kDa to 130 kDa APP to 110 kDa APP (APPr) for patients with probable AD compared with control subjects and patients with vascular dementia APPr levels in AD correlated with the severity of dementia measured by CDR. Accuracy levels measured by Receiver Operating Curve analysis showed that a cut-off level of 0.45 resulted in a sensitivity of 71% and a specificity of 74%, with an area under the curve of 0 793 Conclusion:Platelet APPr allowed to differentiate AD from normal aging and vascular dementia with high sensitivity and specificity These findings suggest that platelet APPr may be a helpful peripheral marker for diagnosis and clinical progression of Alzheimer disease.

달리기 운동 프로그램이 시각장애인의 건강관련 체력에 미치는 영향

이명수,양점홍,홍순미,최재현,박원익,이창준 釜山大學校 附設 體育科學硏究所 2004 體育科學硏究所 論文集 Vol.20 No.-

The purpose of this study was to find out the effect of jogging(LSD ; Long Slow Distance) and walking training on health-related fitness of the blind.....

Pedunculagin(Purified tannin)의 BRM Response

이도익,장재권,이민원,홍순각 중앙대학교 약학연구소 1998 약학 논총 Vol.12 No.-

Pedunculagin, an ellagitannin from Alrus hirsuta var. microphylla, Betulaceae was evaluated on the antitumor activity. To investigate cytotoxicity of pedunculagin on tumor cells, the effect of the substance on three cell lines(P815, Yac-1, B16-F20) was examined. And the result was somewhat different among three cell lines. The growth-rate of P815 was not cut down significantly, but in contrast, the inhibitory activities on Yac-1 and B16-F10 were effective. ED_50s of pedunculagin against P815, Yac-1 and B16-F10 were 12.16, 1.89, 3.30㎍/㎖ respectively.

Diarylheptanoid의 일종인 Oregonin의 항암효과

이도익,장재권,이민원,홍순각 중앙대학교 약학연구소 1988 약학 논총 Vol.12 No.-

Oregonin, a diarylheptanoid derivative from Alrus hirsuta Turcz, Betulaceae was evaluated on the antitumor activity. Oregonin, a diarylheptarioid zyloside is a novel immunomodulator augmenting macrophage and natural killer cell activity related anti-tumor functions. To investigate cytotoxicity of oregonin on tumor cells, the effect of the substance on three cell lines(P815, Yac-1, B16-F10) was examined. The result was somewhat different between suspension and adhesion cells. The growth-rate of suspension cells(P815, Yac-1) was not cut down significantly, but in contrast, the inhibitory activity on adhesion cell(B16-F10) was effective. Its ED50 is 20.09㎍/㎖(4.19×10^-5mol/l)

고등부 유도 지도자의 지도행동 유형분석

이준희,윤익선 龍仁大學校 武道硏究所 1997 武道硏究所誌 Vol.8 No.2

In this assentation I tried to investigate and analyze the actual behaviors of the coaches of the high level male and female team and the behaviors that the players of the team prefer. I came to conclude like the followings through the analysis of 432 Leadership scale for sports from 30 coaches and 432 players in the 30 teams which is constitute of the 20 coaches and 309 players in 20 male high level teams and the 10 coaches and 123 players in 10 female high level teams. 1) The coaches in the male teams are better in efficiency of teaching because the male team coaches are better in the background variables of age, career, and the career of winning the prize. 2) In the assentation on the actual of coach the male team coaches have the strongest disposition of behavior that influence on the advancement of the game, whereas the female team coaches the strongest disposition of democratic behavior. Considering such the differences of leadership behaviors, the coaches of male team have the disposition of emphasis of the task, whereas the coaches of female team emphasis of the relations. 3) In the research of leadership scale among the teams, the male players prefer behavior of training and indicating, positive reward, social support, democratic, and then authority behavior whereas the female players positive reward, social support, democratic, training and indicating and then authority. 4) In the research of preferable behavior, male players prefer the training and indicating, positive reward, social support, and then authority behavior, whereas the female players positive reward, social support, democratic behavior, training and indicating and then authority behavior. The male players were found to prefer such behaviors as influence the advancement of the game power directly, whereas the female players most prefer such behaviors as reward the results of the game. 5) In the comparison of the leadership behaviors that male and female players prefer, the male players have stronger disposition to want training and indications, authorities than female players,, whereas the female players prefer the democratic behaviors, social supports, positive rewards. 6) In the differences of the actual behaviors the players want from the coach, the male players differs in the democratic behaviors most, whereas the female players in the authority behaviors. 7) In the research on the differences of the behaviors the coach actually do and the players expect, ·in the training and indications, the male team players were a little more satisfied than the female team players. ·in the democratic behaviors, the male team players were more unsatisfied. ·in the authority behaviors, the female team players want more authorities from the coaches. ·in the social supports, the female team players were more unsatisfied. ·in the positive rewards, the female team players were more unsatisfied.

몇가지 植物의 棲息地 造成에 關한 硏究

윤종선,김익환,신세균,심우경,이철희,신영철 韓國植物ㆍ人間ㆍ環境學會 1999 인간식물환경학회지 Vol.2 No.2

종의 棲息密度가 낮아지고 있는 하늘나리, 섬초롱, 자란 3종의 식물을 인위적으로 棲息地를 造成하기 위하여 국립공원 속리산 등산로변 標高 200m, 400m, 600m 지점에 150주식 종당 450주를 조직배양 및 분주에 의하여 육묘 된 묘를 이식하여 생존상태 및 棲息地 造成의 가능성을 2년에 걸쳐 검토한 결과는 다음과 같다. 1. 造成 棲息地의 토양의 理化學的 造成은 pH 5.2∼5.6, 유기물 함량 29∼54g/㎏, CEC 9.4∼11.5㎝ mol(+)/㎏으로 산성을 띠고 있었으며, 유기물 함량은 높은 편이었고, 염기치환용량은 낮았으나 비교적 우리나라 典型的 山地土壤의 理化學的 造成과 유사하였다. 2. 棲息地內 생장기간의 投光率은 標高 200m 지역은 10.8∼11.6%, 400m lw역은 10.8∼11.4%, 600m 지역은 11.0∼12.8%로 식재식물의 生長環境에 부족한 상태였다. 3. 식재 식물 수는 식재 후 활착율은 3종 모두 양호하였으나, 점차 감소되었으며, 특히 자란의 감소율이 높았다. 감소의 원인을 분석한 결과 하늘나리, 섬초롱, 자란 모두 굴취나 절취의 피해가 많았으며, 특히 자란은 凍害에 의한 枯死가 1년차 72∼86주, 2년 차에서 19∼35주로 조사도어 자연상태에서의 越冬은 어려운 것으로 나타났으며, 집중호우에 의한 流失도 감소의 한 원인이었다. 4. 식재식물의 생장상태는 불량하였는데 이는 投光量 부족으로 판단되어 棲息地造成時에는 錄陰期 投光量에 대한 사전 검토가 중요한 요인으로 나타났다. 5. 개화율은 섬초롱과 자란에서 높았으며 標高가 높을수록 개화기는 2∼4일 늦어지고 휴면기는 빨라지는 경향이었다. 식물 棲息地 造成時에는 造成 식물의 생장에 적합한 토양, 光環境 등을 고려한 위치 선정이 중요하며, 上層林에 의한 遮光으로 下層 초본식물 遷移速度가 빨라짐으로써 光環境 개선을 위한 上層林의 間伐, 周邊樹種의 更新이 요구된다. In order to make the artificial habitats of Lillium concolor, Campanula takesimana and Bletilla striata that the number of plant became sparse, 150 plants per species were transplanted at the region of 200m, 400m and 600m above sea level. And the growth of plants and the potential as habitats creation were analyzed. In the physical and chemical properties of soils in the there, soil pH was 5.2 to 5.6, organic matter content was 29 to 54g/㎏ and cation exchange capacity(CEC) was 9.4 to 11.5㎝ mol(+)/㎏. The transmittance rates of sunlight of the habitats during the growing periods were 10.8 to 11.6% in the 200m region, 10.8 to 11.4% in the 400m region and 11.0 to 12.8% in the 600m region. These transmittance rates were deficient for normal growth of plants. After the plants were transplanted, the survival rates of three species were high in common but the rates decreased gradually. Especially the decrease rate was high in the Bletilla striata. The causes of decrease were digging and cutting by climbers, sweeping asay by rainfall and freezing damage. Especially, the cold tolerance of Bletilla striata was weak in the natural condition. The growth of planted plants was poor, and it was assumed that the reason was shortage of sunlight transmittance. The flowering rates were high in the Campanula takesimana and Bletilla striata. And as the elevations were high, the flowering was later by 2 to 5 days but the dormancy was earlier. In the artificial making of plant habitats, the growth environment of plants have to be considered to choose the suitable region. And, because the habitats are shaded by the trees and bushes, the thinning of trees and the change of species are needs to improve the light transmission.