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        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.

      • Increased 11β-hydroxysteroid dehydrogenase type 1 contributes to barrier dysfunction in aged skin

        ( Beom Jun Kim ),( Noo Ri Lee ),( Chung Hyeok Lee ),( Young Bin Lee ),( Solam Lee ),( Hyun Jee Hwang ),( Eunjung Kim ),( Eung Ho Choi ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

        Background: 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive cortisone into cortisol, an active form, and is expressed by several tissues including the skin. Excessive active glucocorticoid (GC) deteriorates skin barrier function. Objectives: To find out if 11β-HSD1 affects on the barrier function in aged skin. Methods: We have performed human and in vivo studies. We measured cortisol in stratum corneum (SC) and oral epithelium of the elderly and young. Hairless mice were used for 11β-HSD1 immunohistochemistry staining of skin and measuring skin barrier function and serum cytokines. 11β-HSD1 knock-out (KO) mice and its wild-type were used for measuring lipid synthesis related enzyme. Results: Cortisol levels were elevated in SC and oral epithelium of the elderly rather than young. The 11β -HSD1 expression was increased in immunohistochemistry stain of aged mice skin. Aged mice showed decreased transepidermal water loss (TEWL) and SC hydration, and increased SC integrity than young. Serum inflammatory cytokines including interleukin-1α, -4, -10, -31 and tumor necrosis factor-α were increased in aged mice than young. The expressions of lipid synthesis related enzymes in epidermis were elevated in KO mice and topical 11β -HSD1 inhibitor applied mice. Conclusion: 11β-HSD1 expression is elevated in aged skin. It increases active GC and then deteriorates skin barrier function.

      • 부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

        김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

        The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

      • KCI등재

        Biomass 유래 퓨란계 단량체를 이용한 폴리에스터의 중합 및 특성 연구

        정용석(Yong Seong Chung),이영철(Young Chul Lee),서강진(Kang Jin Seo),김명준(Myeong Jun Kim),정지혜(Ji Hea Jeong),노시태(Si Tae Noh) 한국고분자학회 2011 폴리머 Vol.35 No.6

        바이오매스에서 유래된 2,5-dihydroxymethylfuran(DHMF)을 KMnO4 산화반응으로 furan-2,5- dicarboxylic acid(FDCA)를 합성하였다. 합성한 FDCA와 다이올류를 에스테르화 반응과 축중합 반응을 진행시 켜 폴리에스터를 중합하였다. 폴리에스터는 NMR을 통해 조성을 분석하였고 DSC와 TGA를 통해 열적특성을 분 석하였다. 합성된 폴리에스터의 고유점도는 0.78∼1.2 dL/g으로 상용화된 poly(ethylene terephthalate)(PET) 와 비슷하였다. 다이올의 길이가 증가할수록 Young`s modulus와 strength는 낮아지고 elongation-to-break는 높아지는 경향을 확인하였다. 합성한 poly(ethylene furandicarboxylate)(PEF)의 Young`s modulus는 3551 MPa, strength는 103 MPa로 상용화된 PET와 비슷하였다. Furan-2,5-dicarboxylic acid (FDCA) was synthesized by KMnO4 oxidation of 2,5-dihydroxymethylfuran( DHMF) derived from biomass. Polyesters were synthesized by esterification and polycondensation of FDCA with various diols(ethane-1,2-diol, propane-1,3-diol, butane-1,4-diol, hexane- 1,6-diol, decane-1,10-diol). The composition of polyesters was characterized by using 1H NMR. Thermal properties of the polyesters were characterized by DSC and TGA. Intrinsic viscosities(IV) of the polyesters were measured to be 0.78∼1.2 dL/g comparable with IV of commercial poly(ethylene terephthalate)(PET). As the chain lengths of diols increased, Young`s modulus and strength decreased and elongation-to-break generally increased. Young`s modulus and strength of the polyesters were measured to be 3551 MPa and 103 MPa, respectively, comparable with commercial PET.

      • KCI등재

        야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

        조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

        Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

      • Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

        ( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

        Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

      • CORBA 기반의 분산 통합 망관리 시스템

        정영준,김남호,송화선 강원대학교 정보통신연구소 1999 정보통신논문지 Vol.3 No.-

        This paper analyzes some problems for the architecture of TMN-based integrated network management systems and presents a CORBA-based integrated network management system, which maintains transparency and scalability of distributed managed objects and reliably provides interoperability between heterogeneous networks and systems. In this paper, the proposed system model has been applied to the TMN based management systems and then analyzed for qualitative evaluation of the system performance. To implement the proposed system, two different types of model have proposed: one is a system using a CORBA gateway and the other is a system, which transforms all managed objects into CORBA objects. The former model is adequate for the implementation of a short-term integrated network management system and the latter one is good for a long-term management system.

      • 물체의 3차원 복원을 위한 스테레오 정합에 대한 연구

        정영준,전효병,심귀보 중앙대학교 생산공학연구소 1999 생산공학연구소 논문집 Vol.8 No.2

        스테레오 영상 처리에 있어서 중요한 과정은 왼쪽 영상과 오른쪽 영상의 일치하는 화소를 찾는 스테레오 정합 과정 이다. 정합 방법에는 두 가지 방법이 있다. 한가지는 영역기반의 방법이며 다른 방법은 특징기반 방법이다. 영역기반 방법은 특정기반 방법에 비해서 연산 시간이 많이 소요되며, 특징기반 방법은 연산 시간에 있어서는 장점이 있지만 영상의 모든 화소에 대한 정합을 수행 할 수 없다. 본 논문에서는 영역기반 스테레오 정합 방법으로 후보접합 방법을 제안하였다. 이 방법은 영상의 밝기 정보를 평판화 하고, 정합 후보를 찾은 후 상관도에 의한 방법으로 정합을 수행한다. 본 알고리즘의 효율성을 확인하기 위하여 몇가지 스테레오 영상에 대해서 실험하였다. The most important step in stereo image processing is stereo matching porcess which is conjugate pair of pixel finding process in the left and right image. There are two matching methods. The one is an area based approach and another is a feature based approach. An area based approach needs much calculation time than feature based approach and feature based approach has advantage in calculation time, but can not obtain matched data for all pixels in the image. In this paper, we propose a candidate matching algorithm. This method converts brightness data of image to equalized value and find candidates of matching and find matching point by correlation method. We experiment with some stereo images to validate effectiveness of this algorithm.

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