위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

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.

위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

한국의 정신분열병 외래 환자의 직ㆍ간접비용

박종익,송선희,서동우,장현종,이종국,장안기,김윤,이철,홍진표 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

연구목적 : 정신분열병 외래 환자의 직접 비용과 간접 비용을 추산해 보고, 의료 자원의 적절한 운용과 효과적인 배분을 위한 보건 정책의 기초자료로 사용하고자 한다. 방 법 : 정신분열병 진단을 받은 289명의 환자를 대상으로 6개월간 외래를 방문하면서 사용한 의료비와 시간을 조사하여 직접 비용을 추산하였고, 이 기간 동안 소실된 생산성을 간접 비용으로 환산하였다. 만성질환인 관상동맥 질환을 앓고 있는 환자 82명을 대조군으로 하여 비용을 비교하였다. 결 과 : 정신분열병 환자의 실업률은 72.1%였으며, 직장을 가지고 있는 경우에도 단순노무직의 비율이 64.5%로 매우 높았다. 정신분열병의 직접 비용은 평균 81.5만원으로 관상동맥 질환의 평균 71.5 만원보다 상대적으로 많이 추산되었으나 유의하지는 않았다. 간접 비용은 평균 645.6만원, 258.9 만원으로 정신분열병군이 2.5배 정도 높았다. 결 론 : 정신분열병은 다른 만성질환에 비하여 상대적으로 매우 고비용이 요구되는 질환이며, 보다 체계적인 비용의 추산을 통하여 양질의 정신 보건 서비스를 제공할 수 있는 토대가 마련되어야 할 것이다. Objectives : We have aimed to estimate the direct and indirect costs of treating out-patients with schizophrenia in Korea, to use this fundamental data for the effective management and proper distribution of the medical resource. Method : To estimate the direct cost, we surveyed the medical cost and time of two hundred and eighty-nine out-patients with schizophrenia for six months. And the lost productivity as many months was converted into the indirect cost. Those of eighty-two coronary heart disease patients were also estimated as a comparison group. Results : An unemployement rate of schizophrenic patients was 72.1 percent. Moreover the ratio of the laborer in the sample was, even if employed, 64.5 percent. The mean direct cost of schizophrenic patients was, about 815,000 won, higher than that of coronary heart disease, 715,000 won however it was not statistically significant. The former was also estimated 2.5 times more than the latter for the indirect cost, or 6,456,000 won versus 2,589,000 won. Conclusion : Schizophrenia is a relatively costly illness compared to other chronic illness, so the systematic estimation of the cost is necessary to provide mental health service of high quality.

침 치료가 오십견(五十肩) 환자의 적외선 체열촬영에 미치는 영향

김건형,이로민,남동우,김종인,임사비나,이두익,최도영,이윤호,이재동 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To observe the effect of acupuncture treatment on Digital Infrared Thermographic Imaging(DITI) in frozen shoulder patients. Methods : 17 voluntary patients received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwanand Gyun-joong, twice a week for 4 weeks. The patients were instructed to practice self exercise during their daily lives. Evaluations were made before treatment, after 1 week of treatment, after 2 weeks, 3 weeks and after 4 weeks of treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). DITI was measured before treatment and after 4weeks of treatment. The obtained data was analyzed. Results : CSA, SPADI, VAS, adduction and extension showed significant(p<0.05) improvement. Abduction and flexion both improved after 4 weeks of treatment, but the improvement was statistically insignificant(p>0.05). DITI showed improvement but the improvement was insignificant(p>0.05). Conclusion : 4 weeks of acupuncture treatment significantly improved CSA, SPADI, VAS, adduction and extension in frozen shoulder patients(p<0.05). The improvement of abduction and flexion after 4 weeks of acupuncture treatment was insignificant(p>0.05). DITI results improved after 4 weeks of acupuncture treatment. But the change of thermal difference was insignificant(p>0.05).

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.

한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

열충격이 작용하는 세라믹구조의 신뢰성 평가

이치우,장건익,김종태 慶南大學校 附設 工業技術硏究所 1997 硏究論文集 Vol.15 No.1

본 연구에서는 열충격이 작용하는 세라믹 구조의 신뢰성 평가 방법을 제시하였다. 어떤 확률분포함수를 갖는 균열의 크기를 구조의 단위 체적당 밀도가 랜덤하게 분포되는 것으로 가정하였다. 크랙이 불안정한 조건은 일반적인 열응력하의 취성체로써 유도될 수 있다. 확률 고장 모델은 불확실한 크기의 크랙을 함유한 취성체에 대한 크랙 불안정의 확률을 연구하기 위해 제시하였다. 취성구조의 신뢰성은 어떤 미소체적의 크랙이 불안정하게될 때 그 구조는 파괴되는 것으로 하여 취약 링크의 가설 모델을 기초로 평가하였다. 그리고 수치 해석적 예제를 통하여 제사한 방법의 유용성을 증명하였다. An analysis method for the reliability of ceramic structures subjected to thermal shocks is presented. Flaws with the size of given probability distribution function are assumed to be distributed at random with a certain density per unit volume in the structures. Criterions for crack instability are derived for brittle solids under general thermal stresses. A probabilistic failure model is presented to study the probability of crack instability for brittle solids containing cracks with uncertain crack size. The reliabilities of brittle structures are evaluated based on the weakest-link hypothesis, which states that a structure fails when the cracks in any differential volume become unstable. A numerical example is given to demonstrate the application of the proposed method.

임신중 뇌동맥류의 외과적 치료 : 증례보고 A Case Report

이익모,김상진,박순필,도종웅,주양자 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.1

A multiparous 28-year-old woman, suffering ruptured intracranial aneurysm during pregnancy is presented. Clipping of the aneurysm was performed in 32 weeks of gestational age. Three weeks after operation, she delivered vaginally without complication. Delivery may be managed according to obstetrical indication following surgical correction of the aneurysm. The authors reviewed the literature, and discussed the neurosurgical and obstetric management of such patients.