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.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

신장조직 손상의 진행에 있어서 Renin-Angiotensin System 의 역할에 관한 연구

이강욱,송정헌,강민규,황평주,김종학,나기량,서광선,박정규,신영태 대한신장학회 2001 대한신장학회잡지 Vol.20 No.3

동구북구산 Mesochorinae 아과(별목 : 맵시벌과)의 계통분류학적 연구 1. : Mesochorinae 속의 재고찰 A Review of the Genus Mesochorus

이종욱,최원영,서경인 고려대학교 한국곤충연구소 1997 昆蟲硏究誌 Vol.23 No.1

동구북구산 Mesochorus속을 재고찰한 결과 4미기록종을 포함하여 총 31종을 확인하였다. 따라서 동구북구산 Mesochorus속은 본 연구에서 확인하지 못한 10종을 포함하여 총 41종이 분포하는 것으로 보고된다. 원기재와의 차이점을 추가하여 기록하였고, 채집지, 분포, 숙주목록 등을 정리하였으며, 확인된 31종에 대한 검색표를 작성하였다. 이 중 Lee와 Suh의 M. sp.1은 본 연구에서 신종임이 확인되어 Mesochorus seorakensis로 새로이 명명하였다. 종목록은 아래와 같다. Aa a result of systematic study of the Mesochorinae, a total of 31 species was confirmed in the Eastern palearctic Mesochorus. Among them, four species, M. confus, M. fuscicornis, M. rubranotatus and M. uniformis are new to Eastern palearctic regional fauna. Mesochorus sp. 1 of Lee and Suh (1991) is confirmed as new species and it named to be M. seorakensis. Thus, the Eastern palearctic Masochorus is composed of 41 species including 10 unconfirmed species in this study. Additional descriptions, collection sites, distributions, host lists, keys are provided for the species.

냉매조건에 따른 열교환기의 성능특성

이종인,권일욱,박찬수,하옥남 朝鮮大學校 機械技術硏究所 2003 機械技術硏究 Vol.6 No.1

These days, an attention of environment has been increasing all over the world. To prevent the green house effect and destruction of an ozone layer, an ozone destruction potential(ODP) be zero and a refrigerant for low global warming potential(GWP) is needed. HFC-134a, in which hydrogen is mixed instead of chlorine is a refrigerant used for automobile conditioners and its destruction potential is ecologically zero. However, it is not considered as a perfect substitutive refrigerant as its GWP is high. It is studied refrigerant mixtures in which HFC-134a, HFX-152a and CF₃I with low GWP and zero ODP are mixed by experimentally and concluded as follows : 1) With the variation of speed of compressor, outdoor air temperature effects the performance of air-conditioner, and the performance characteristics differ from according to the refrigerant. 2) Evaporator capacity is constant, condenser capacity is 6% more HFC-134a than mixed refrigerant. 3) The required power is higher than other mixed refrigerant of HFC-152a.

상부요로계감염 환자에서 Gallium-67 Citrate 스캔 및 Tc-99m Dimercaptosuccinic Acid(DMSA)스캔의 임상적 의의

이강욱,강민규,장윤경,양종오,이상주,박기현,소영,신영태 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

It is often not certain whether the focal defect of renal cortex of Tc-99m Dimercaptosuccinic acid(DMSA) renal scan in patients with acute pyelonephritis means the cortical scar by previous inflammation or recent active inflammatory lesion. Gallium-67 citrate(Ga-67) also has been known to be accumulated at the active inflammatory lesion. In order to evaluate the usefulness of the Ga67 and Tc-99m DMSA renal scan in patients with acute pyelonephritis, we reviewed the results of both study and clinical findings. Nintecn patients with typical clinical findings of acute pyelonephritis and admitted to our institute from Jan. 1998 to Nov. 1998 were included in this study. Tc-99m DMSA and Ga-67 scan were performed mean 3.3 and 7.3 days after admission. Eleven of 19 patients (57.9%) showed abnormally increased focal renal uptake on the Gallium-67 citrate scan and 14 of 19 patients(73.7%) had a cortical defect on the kidneys in Tc-99m DMSA scan. Seven(36.8%) patients had an abnormality in both study. Seven(36.8%) patients had an abnormality only in Tc-99m DMSA scan and 4 (21.1%) patients had an abnormality only in Ga-67 scan. Of 7 patients who had an abnormality on both scan, 5 patients had. an abnormality at same region in both scan and 2 patients had an abnormality at the different sites on the kidneys. With the above results, we speculate that Ga-67 scan and Tc-99m DMSA scan play a complementary role in the patients with upper urinary tract infection.

뭉툭맵시벌아과(벌목:맵시벌과)의 분류와 계통 : Ⅰ. 현상학적 분석 Ⅰ. Phenetic analysis

이종욱,차진열,박원학 嶺南大學校 基礎科學硏究所 1995 基礎科學硏究 Vol.15 No.-

For the phenetic analysis of the subfamily Tryphoninae(Hymenoptera:Ichneumonidae), specimens were collected from March of 1988 to September of 1995 in the southem part of Korean peninsula. Specimens were also obtained from various museums and laboratories both in Korea and other counteries. This research utilized about 1000 domestic specimens and 3010 foregin specimens including 10 specimens from North Korea. Phenetic analysis was performed using these specimens (39 genera 39 species)and the following results were obtained. In the cluster analysis, the ward method is more effective than the average linkage method (within group and between group), while the use of total characteristics was resulted in more stable grouping than only quantitative or qualitative characteristics. The cluster and discriminant analyses suggested that the Townes(1969) and Townes et al.(1992)'s system is well fit for the classification of Tryphoninae. For the subfamiliar classification, the analyses of total characteristics by ward method resulted in the most accetable grouping.

월경주기 증상의 요인 분석

이수일,유태혁,강종선,안석철,이병욱,김헌,석재호 大韓神經精神醫學會 1986 신경정신의학 Vol.25 No.1

404 nurses and nurse-aids rated their experiences of 45 symptoms(Moos' Menstrual Distress Questionnaire) of the menstrual, premenstrual and intermenstrual phase on a 4 point scale separately. The 45 symptoms were inter-related and factor analyzed separately for each phase. six common clusters of symptoms emerged from 3 phases, which were labeled concentration, motor tension, pain, pleasurable affect, autonomic reactions and water retention. Four clusters of symptoms emerged from premenstrual phase. These clusters were labeled instabillity, withdrwal reactions, depression and headache. The factor named unpleasurable affect emerged from intermenstrual and menstrual phase. Above findings were differed from the results of Moos' study in which eight basically replicated clusters of symptoms emerged from three phases. Through discussion of validity of this scale, and differences between results of Moos' and this study, we came to the conclusion that sampling of subjects, prospective longitudinal symptoms reporting, amount of variance in a symptom over the course of menstrual cycle and proper choice of factor analysis method would be salient variables to construct valid scale for measuring menstrual cycle symptoms.