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.

Tetrahydroisoquinoline Alkaloids가 쥐의 동맥과 뇌균등질의 α-Adrenoceptors에 미치는 영향

이현석,백선하,황수현,박인성,김은상,정진명,한종우,장기철,장기철 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.1

外國人力의 추진과 活用에 따른 問題點과 改善方案에 關한 硏究

韓奇洙 대불대학교 1997 論文集 Vol.3 No.1

Employment of foreign workers has been a common issue in the advanced countries for a long time period. In Korea, the issue emerged for the first time when Korea imported mining workers in 1991. Taking into consideration many hot debates by industrial, labor, and political sectors about the effect of overseas workers' employment on the society, it is a very delicate and important matter, not one to be considered simply economically. Since the employment of foreign workers in the industrial production sector has become a reality, which we can not deny or refuse, without dramatic change of the labor related policy, or preparaton of a fundamental problem solving method, the inflow of those workers will continue, and will cause a lot of social problem. Therefore, more active approaches mentioned below, far from current passive and temporary remedy, are required to solve the problem. First, in case the authorities concerned permits a partial import of foreign workers, our government should provide the foreign workers with the same status and treatment as local workers receive, but the permit should be given to the foreign workers only for a short term period. Second, the government should expand the present technical trainee program aiming at relieving the shortage of labor supply, and at the same time actively prevent employers from hiring illegal foreign workers. Third, even though a partial supply of foreign workers is permitted, the government should prepare for ways against any negative effect caused by the import. To do this, government to consider policies like fun-allotment or deposition systerm. Fourth, the government needs to consider installing a new agency to be in charge of and effectivelt manage foreign workers' employment on the base of the prospect of local labor supply and demand.

공포로 상승된 경악반응에서의 편도체 노어에피네플린의 역할

한정수,신선희,김기석 한국심리학회 한국심리학회지 생물 및 생리 Vol.4 No.1

편도체가 공포나 불안을 담당하는 신경구조물임을 밝힌 많은 연구가 있다. 본 연구에서는 상승된 경악반응을 이용해, 편도체의 어떤 전달물질이 공포의 표현에 관여하는 지를 밝히기 위해 노어에피네플린만 선택적으로 감소시키는 DSP-4(30㎍/2.5㎕)를 조건화 후에 편도체에 주입하였다. 그리고 요힘빈에 의한 불안이나 공포의 증가가 편도체의 노어에피네플린 감소 후에도 나타나는지를 밝히기 위해, 경악반응을 측정하기 전에 체순환적으로 요힘빈(1.25㎎/㎏)을 주입하였다. 조건화 후에 DSP-4만을 주입받은 동물과 조건화 후에 DSP-4을 주입받고 나서 일주일 후에, 경악반응을 측정하기 전에 요힘빈을 체순환적으로 주입받은 동물은 상승된 경악반응을 보이지 않았다. 이 결과로 편도체의 노어에피네플린이 상승된 경악반응이 나타나기 위해서 필요하고, 요힘빈에 의한 상승된 경악반응의 촉진효과는 편도체에 노어에피네플린을 증가시킴으로써 나타났다고 할 수 있다. In many studies, amygdala is considered to be the neural structure that is involved in fear or anxiety, in human and mammals. This paper, using fear-potentiated startle responses as a measure of fear, was to see whether noradrenergic receptors in the amygdala are involved in the expression of fear Rats were implanted with bilateral cannulae aimed at the amygdala. After the conditioning, DSP-4(30㎍/㎕) was injected to the amygdala, DSP-4 selectively produces the degeneration of the noradrenergic receptors only. In addition, we tried to find out whether or not yohimbine, which is known to increase fear and/or anxiety, can produce the potentiated startle responses even after the degeneration of noradrenergicr receptors in the amygdala. For this, before test, yohimbine(1.25㎎/㎏) was injected systemically. Results showed that animals injected with DSP-4 did not show the potentiated startle responses, and neither did the aniamls with DSP-4 plus yohimbine before test. It may thus be concluded that the no epinephine in the amygdala is necessary for the expression of fear.

중국진출기업의 인사관리향상전략에 관한 연국

한기수 대불대학교 2003 大佛大學校大學院 硏究論文集 Vol.2 No.1

The Purpose of this paper has two objectives. The first is to develop and enhance the understanding through examples by examples by examining the theoretical background related to the international personnel management(labor mana-gement)and to analyze the cases of labor managements by examing the investment climate of China and by and by analyzing the practical problems through a more systematic and logical rewearch.

국내기업의 팀제 도입에 따른 효율적 운영방안에 관한 연구

한기수,윤광심 대불대학교 1999 論文集 Vol.5 No.1

In this study, team organizational effectiveness and effectiveness and efficiency of team was analyzed and how to grade it in company K was suggested. First, definition, purpose, precondition and management method of teams organization was explained, and then theatrical consideration was made on putting the team organization management into practices. Second, problems was explained based on that analysis. Third, methods were suggested how to cope with the situation. Major finding and some suggestion of the study in the field of management of team in company K as follws : Teams develop direction, momentum, and commitment by working to shape a meaningful purpose. Management is responsible for clarifying the charter, retionale, and leave enough flexibility for the term to develop commitment around its own spin on that purpose, set of specific goals, timing, and approach. Effective teams develop strong commitment to a common approach, that is to how they will work together to accomplish their purpose. team members must agree on how will do particular jobs, how schedules will be set and adhered to, what skills need to be developed, how continuing membership in the team is to be earned, and how the group will make and modify decisions.

근로자의 경영 참가제도에 관한 연구

한기수 대불대학교 1998 論文集 Vol.4 No.1

The purpose of this study is to analysis problems of management participation and to draw out system appropriate for Korean business by investigating actual conditions and recent trends of the existing management participation system in Korean business, carrying out empirical study and literature study. First, It is absolutely needed that the management should consider labor unions as "Harmony" rather than as "power" Second, government should develop systems suitable for our environments and assist enterprisers in enforcing suitable management participation respectively. The third, Positive, continuous enlightening education is needed to make labor unions and the management perceive the good effect of the management participation system. The forth, The current labor-management cooperation system of the labor laws should be revised to adjust to the changing environment.

초음파 진동을 이용한 초정밀 가공에 관한 연구

한복수,김기수 충남대학교 공업교육연구소 1996 論文集 Vol.19 No.1

This paper deals with the ultrasonic vibration cutting for the precision machining of aluminum alloy. When the ultrasonic vibration is applied on the tool, the cutting tool makes periodical contact with workpiece. And, the cutting is performed by vibrating impact force while the cutting tool contacts the workpiece. In this paper, the horn of ultrasonic vibration system were designed and manufactured, to compare the ultrasonic vibration cutting with the conventional cutting, the machined surface roughness of aluminum alloy in turning were experimentally measured. The experiments revealed that the ultrasonic vibration cutting had the best surface roughness than the conventional cutting under the same cutting condition.

하악골 후방이동시 중안면부 연조직의 변화양상에 대한 임상통계학적 연구

한대희,김수남,민승기,김태성,성헌모 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalo-metrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1.There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2.There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3.The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4.The upper lip length was increased and moved posterior direction after mandibular setback surgery 5.The lower lip was moved posterior direction by posterior movement of the mandibular structure 6.Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

전해질 손상 및 Kanic Acid 을 사용한 편도체 중심핵 손상이 공포로 상승된 경악반응에 미치는 효과

한정수,김시현,김기석 한국심리학회 한국심리학회지 생물 및 생리 Vol.4 No.1

본 연구에서는 공포로 상승된 경악반응을 이용해, 공포나 불안을 담당하는 신경구조물인 편도체핵군 중에 하나인 편도체 중심핵의 역할을 알아보고자 하였다. 실험1에서는 조건화 전에 손상용 전극을 심은 후에 이틀에 걸쳐서 조건자극으로 빛(8w, 3700msec)과 무조건자극으로 발바닥 전기충격(1.0㎃, 500msec)을 20번 짝지워 제시한 후에, 편도체 중심핵을 전해질 손상(2.0㎃, 10sec)시켰다. 편도체 중심핵이 손상된 동물은 단순한 경악반응에 의한 반응크기와 조건자극과 경악자극 복합에 의한 반응크기간에 차이를 보이지 않았다. 전해질 손상은 세포체뿐만아니라 축색을 모두 손상하므로, 실험1의 결과는 편도체 중심핵의 세포체손상에 의해서가 아니라, 이 부위를 지나가는 축색의 손상에 의해서 야기된 결과일 수 있다. 그러므로 실험2에서는, 세포체만 손상시키는 카이닌 산(0.1㎍/0.2㎕)으로 조건화 후에 편도체 중심핵을 손상시켰다. 손상을 받은 동물은 조건자극에 대해 상승된 경악반응을 보이지 않았다. 이 결과로 보아, 편도체 중심핵내에 뉴론이 상승된 경악반응에 관여함을 알 수 있다. Of several amygdaloid nucleus, the central amygdaloid nucleus seems to be related to the expression of fear. This experiment is to examine effects of the central nucleus of amygdala on the fear-potentiated startle responses. In experiment 1, monopolar tungsten for lesioning were chronically implanted into the central amygdaloid nucleus in rats. After 7 days, rats received two conditioning sessions on consecutive day, each session consists of 10 light-footshock pairing(light of 8w incandescent bulbs, 3700msec: footshock of 1.0㎃, 500msec: ITI of 4min). After the conditioning, electrolytic lesion(2.0㎃, 10sec) was administered to the central nucleus. One day or seven days later, rats were tested for conditioned fear by comparing the magnitude of the startle reflex to a noise burst presented either alone or in the presence of the previously fear-conditioned light. Results were that the lesioned animals showed no fear-potentiated startle responses. In experiment 2, using kainic acid(0.1㎍/0.2㎕), we lesioned cell bodies without damaging any axons after the conditioning. Results showed that animals lesioned with the kainic acid did not showed potentiated startle responses to the conditioned stimuli. Taken together, it may be said that the intrinsic elements of central amygdaloid nucleus are involved in the expression of fear.