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      • 干拓地의 農業開發을 위한 綜合硏究 : IV.界火島 干拓地의 土壤微小動物相에 관한 연구 -

        金泰興,蘇仁永,郭晙洙,金俊範 전북대학교 농업과학기술연구소 1987 農大論文集 Vol.18 No.-

        This study was carried out to investigate the soil arthropods and nematodes fauna, population density, biomass, vertical distribution, seasonal fluctuation , and the relationship between the density of soil inhabiting animals and some edaphic factors such as organic matter , pH, temperature, moisture, and salt concentration at reclaimed paddies Samples were taken on January 25, April 5, July 9, and October 4 in1986 from three sites of Gyehwado reclaimed land and one paddy field of Ch?nmidong ,n Ch?n Buk province, southern part of Korea. The results were as follows : 1. Soil arthropods consisted of Diptera (41 .2% ), Collembola(36%), Acarina(21.1%). and etc .. but the proportion in biomass of Diptera(90.5%) showed the highest of all, Nematodes fauna was composed of free living type(55.7 %), p.edato.5(33.') %), and plant parasites(11 .1 %). 2. Density and biomass of arthropods were highest In Ch?nmldong site(35.4 %), and of nematodes highest in the Gyehwa Ⅲ slte. 3. Arthropods(83.4%) and nematodes(65%) were found the most In the first layer. subsoil, i.e., 0-5in and 0-10 in, respectively but the density of arthropods was higher than that of nematodes 4. The population density of arthropods showed highest in April lowest In July, slightly increasing in October. And of the nematodes showed highest in October, lowest in January. 5. Density of arthropods In the first layer decreased gradually from January to July, and slightly increased in October. Of the nematodes. the highest In July and the lowest in April. 6. The correlations between arthropods and organic matter, pH, and temperature were significant , respectively but those of nematodes were significant In case of temperature only.

      • 사회적 변화에 따라 정신질환자들의 피해망상 속에 나타난 박해자 유형변화

        강승범,황인복,김한석,김승곤,김학렬,박상학,김상훈,황걸 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

        Objective: The authors investigated the frequency of persecutors in persecutory delusions of the psychiatric patients who didn't undergo the arrest or traumatic injury, reside in Gwangju Jeonnam area, and were admitted to the hospital after the 5.18 prodemocracy movement in Gwangju in 1980 upward 10 years. Also this study investigated the frequency of the persecutors before and after the prodemocracy movement and in capital and Gwangju Jeonnam area. Subjects and Methods: Among the 896 patients who were admitted to department of psychiatry, Chosun University Hospital from Jan. 1. 1989 to Dec. 31. 1991, we choosed 144 patients with persecutory delusion who had lived in Gwangju Jeonnam area for 10 years after 5.18 prodemocracy movement as subjects. Persecutors were classified into 7 class: unspecified, family, neighbors, communist or spy, police or army or secret agent, impersonal, others. Results: 1) In our study, the frequency of persecutors was family, unspecified, neighbors, police or army or secret agent, impersonal, others, communist or spy in descending order. As compared to previous studies (1956-2003) including our study about frequency of persecutor at capital area and Gwangju Jeonnam area, and before and after 5.18 prodemocracy movement, 2) At capital area, in the early 1980s, police, family, neighbors, unspecified person was frequent in descending order. In the both of early 1970s, 1990s, neighbors, family, unspecified person, police was frequent in descending order. 3) At Gwangju Jeonnam area, in the early 1970s, family, unspecified person, neighbors, police was frequent in descending order. In the early 1990s, unspecified person and family, neighbors, police was frequent in descending order. 4) The police class was most frequent at capital area in the early 1980s. Conclusions: We suppose that class of persecutor in persecutory delusions of psychiatric patients are changing according to social change, and frequency of police class was decreasing in both of capital and Gwangju, Jeonnam area.

      • SCOPUSKCI등재

        Original Article : Geographic difference of epidemiological features of HCV infection in Korea

        ( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

        Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

      • 유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

        신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

        Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.

      • 한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

        최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

        The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

      • KCI등재

        류마티스 관절염 환자의 T세포 수용체 Vβ 유전자 레퍼토리 분석

        정성수 ( Sung Soo Jung ),황관표 ( Kwan Pyo Hong ),김동욱 ( Dong Yook Kim ),김태환 ( Tae Hwan Kim ),이인홍 ( In Hong Lee ),전재범 ( Jae Bum Jun ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),김성윤 ( Seong Yoon Kim ),이은영 ( 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1

        목적: 류마티스 관절염(rheumatoid arthritis; RA)의 병인에 있어 중추적인 역할을 하는 것으로 알려진 T세포에 관한 연구가 최근에 관심의 초점이 되고 있으나, 현재까지 한국인을 대항으로 시행된 보고는 없다. 한국인 류마티스 관절염 환자의 관절병변부위에서 T세포 수용체(TCR)의 Vβ유전자 사용의 빈도를 검색하여 한국인 류마티스 관절염 환자에서 사용되는 빈도가 높은 유전자계를 찾는데 목적을 두었다. 방법: 이에 저자는 T세포에 관한 연구의 일환으로 류마티스 관절염 환자 3명과 정상인 4명을 대상으로 말초 혈액과 활액 T세포로부터 추출한 RNA를 이용하여 cDNA를 합성한뒤 cDNA를 주형을 Vβ family specific oligonucleotide를 시발체(primer)로하여 반정량적 역전사 연쇄중합반응(semiquantative RT-PCR)을 시행하여 T세포 수용체(T cell receptor; TCR) Vβ 레퍼토리를 분석하여 다음과 같은 결과를 얻었다. 결과: 1. 정상인 4명의 말초혈액에서 T세포 수용체 Vβ유전자 평균사용빈도는 Vβ7(8.68±3.20%), Vβ3(7.83±2.03%), Vβ(6.74±1.43%)의 순서로 빈도가 높았으며, HLA-DR4 양성군(3명)에서는 Vβ8(7.39±1.71%), Vβ2(7.31±2.30%), Vβ1(7.22±1.54%)의 순서로 빈도가 높았고, HLA-DR4 음성(1명)에서는 Vβ3(17.79%), Vβ4(11.41%), Vβ24(9.8%)의 순서로 사용빈도가 높았다. 2. 류마티스 관절염환자 3명의 말초 혈액에서는 Vβ16(6.90±1.81%), Vβ18(6.89±0.80%), Vβ14(6.58±0.65%)의 순서로 빈도가 높았다. HLA-DR4 양성 환자군에서는 Vβ16(7.52±2.06%), Vβ14(6.96±0.04%), Vβ22(6.78±0.18%)의 순서로 빈도가 높았다. 각각 환자의 결과를 보면 첫번째 환자(HLA-DR4 양성)는 Vβ16(8.98%), Vβ14(6.99%), Vβ22(6.91%)의 순서로 빈도가 높았고, 두번째 환자(HLA-DR13 양성)는 Vβ18(7.79%), Vβ20(5.98%), Vβ24(5.90%)의 순서로 빈도가 높았다. 이를 종합해 보면 류마티스 관절염 환자의 말초혈액에서 Vβ16, Vβ20, Vβ14, Vβ18유전자계가 제한되어 사용되었다. 3. 류마티스 관절염환자의 활액의 T세포에서 Vβ유전자 평균발현빈도는 Vβ20(7.39±1.77%), Vβ18(5.60±1.31%), Vβ12(5.56±1.77%)순으로 높았으며, HLA-DR4양성인 환자군에서는 Vβ12(6.56±0.58%), Vβ20(6.44±0.94%), Vβ4(5.30±0.49%)순으로 빈도가 높았으며, HLA-DR4음성 환자에서는 Vβ20(9.29%), Vβ19(7.57%), Vβ18(7.07%)의 순서로 빈도가 높았다. 각각 환자의 결과를 보면 첫번째 환자(HLA-DR4 양성)는 Vβ12(6.15%), Vβ20(5.77%), Vβ7(5.74%)의 순서로 빈도가 높았고, 두번째 환자(HLA-DR4 양성)는 Vβ20(7.10%), Vβ12(6.98%), Vβ24(5.83%)의 순서이었고, 세번째 환자(HLA-DR13 양성)는 Vβ20(9.29%), Vβ19(7.57%), Vβ18(7.06%)의 순서로 빈도가 높았다. 활액 T세포에서는 Vβ20, Vβ12유전자계가 제한되어 사용되었다. 4. 말초 혈액에 비해 활액 T세포에서 TCR Vβ유전자 사용빈도가 1.5배 이상인 경우는 Vβ5.2, Vβ9, Vβ23 이었으나, 이들 유전자계가 활액 T세포 전체에서 차지하는 사용빈도에 있어서는 각각 Vβ5.2는 1.07±1.26%, Vβ9는 2.17±1.42%, Vβ23는 3.84+1.97%로 낮은 수치를 나타내었다. 각각 환자에서 비교했을때에 첫번째 환자(HLA-DR4 양성)는 Vβ23(3.69%:1.12%), Vβ5.1(3.51%:1.40%), Vβ12(6.15%:3.29%), Vβ6(3.35%:2.10%), Vβ2(5.74%:3.73%)의 유전자계에서, 두번째 환자(HLA-DR4 양성)는 Vβ9(3.58%:0.74%), Vβ19(4.67%:1.52%), Vβ5.2(2.52%:0.87%), Vβ10(4.25%:1.75%), Vβ1(5.74%:2.35%)의 유전자계에세, 세번째 환자(HLA-DR13 양성)는 Vβ6(2.68%:0.15%) Vβ9(2.17%:0.73%), Vβ11(2.30%:1.10%), Vβ20(9.29%:5.98%)의 유전자계에서 활액에서 말초혈액보다 1.5배이상 증가되어 사용됨을 볼수 있었다. 즉 활액에서 말초혈액보다 의미 있게 편향되어 사용되는 Vβ 유전자계는 각각 환자마다 다른 결과를 나타내었다. 5. 류마티스 관절염환자의 말초 혈액과 정상인의 말초 혈액의 T세포의 Vβ 유전자 사용빈도를 비교했을때 류마티스 관절염 환자의 말초혈액 T세포에서 Vβ16(6.90±1.81%:3.23±1.21%), Vβ18(6.89±0.80%:2.72±0.70%) 유전자계가 2배 이상으로 빈도가 높았고, HLA-DR4양성군만 비교하였을때도 Vβ16(7.52±2.06%:3.69±1.46%), Vβ18(6.45±0.28%:2.61±0.86%) 유전자계가 2배 이상 사용이 많았다. 결론: 이상의 성적으로 미루어 보아 류마티스 관절염 각각 환자마다 다른 Vβ 유전자계의 제한적 사용과 편향됨을 볼 수 있었으나, 공통된 유전자계의 증식은 볼 수 없었다. 이러한 결과는 다른 연구보고와는 다른 결과를 보였고, 이것은 대상 환자의 질병의 유병기간이 다르고, 또 유전적인 배경, 생존 환경, 적용된 방법의 차이로 기인한다고 하는 기존의 보고와 부합된다고 사료되는데 질병의 진행단계에 따라 주로 면역반응을 일으키는 항원의 에피토프가 달라짐에 따라 여기에 대항하는 T세포들의 수용체도 이들 에피토프에 반응할 수 있는 수용체를 가진 코론들이 증식하게 된다는 epitope spreading theory에 부합되며, 이는 아주 초기에 질병을 시작하게 유도하는 항원의 특성을 규명하기 위해서는 환자선택이 연구결과에 결정적인 역할을 할 것으로 사료된다. 또 다른 가능성은 각각 환자마다 다른 Vβ유전자계의 증식된 클론들의 CDR3 연기 서열을 규명하여 비록 유전자 서열이 다를 지라도 항원과 결합하는 같은 성상을 갖는 아미노산 motif를 가질 가능성에 대해서도 연구가 필요하리라 사료된다. Objectives: Polymerase chain reaction (PCR) technology was eamine synovial fluid and peripheral T cells in patients with rheumatoid arthritis (RA) to determine the preferential usage of the T cell receptor(TCR) variable region (V) gene. Methods: Oligonucleotide primers specific for individual TCR Vβ gene families were used to amplify the TCR gene products in a semiquantitative assay of their relative utilization in unselected T cell populations. Results: The result of Vβ utilization was generally heterogenous, similar with previous reports. However, the mean expression of Vβ16 and Vβ18 in RA was more preferentially utilized compared to normal donors. The usage of Vβ in peripheral blood from 3 patients with RA demonstrated restrictions in Vβ16, Vβ20 and Vβ18 genes, respectively. Analyses of synovial fluid resulted in restriction in β12, Vβ20 and Vβ20, respectively. Although there was no significant pattern of skewed Vβ gene mean usage when comparing the synovial fluids with the peripheral blood T cells from RA patients, there were significant biased Vβ genes, Vβ12, Vβl and Vβ20, each 3 patients. As the HLA type is a determining factor in shaping TCR repertoire of peripheral T cells, we compared the Vβ utilization in HLA-DR4 expressing groups that have susceptibility and gene dosage effect in disease progression. It was a little different that comparing the pattern of Vβ usage in peripheral blood and synovial fluid from RA patients between HLA-DR4 positive and negative group. Conclusion: The results were consistent with the conclusion that the increased Vβ family T cells infiltrate synovium and are dependent on each patient and may be involved in inducing and maintaining the synovitis that characterizes RA The different outcome of each patient may be due to the difference in disease duration, genetic background and geographic region. A more important factor may be the stage of disease, because epitope induced immune reaction may change over time. Therefore, selecting patients early in the course of disease may be important and may facilitate the need for more in-depth TCR analysis in the future.

      • 남자 고등학교 세팍타크로 경기의 공격기술에 관한 분석 연구

        김영호,고문석,제임스전,이영익,차정훈,현종건,김범수,임종만,이석인 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

        This research aims at analysis of attack technique in sepaktakraw games. For this purpose, 3 high school coaches observed and recorded each game Five times in videos of high school male players' thirty games in 2003. The conclusion from the analysis of the recorded data are as follows. 1. Scissors spike was the most popular (favorite) attack technique. Rolling spike, tapping spike and heading spike was popular in order. 2. Heading spike showed the highest success rate (73.5%) in attack technique. And tapping spike (69.5%), scissors spike (57.8%) and rolling spike (67.11) showed a lower success rate in order. In failure rate, heading spike (5.5%), tapping spike (36.5%), scissors spike (32.2%) and rolling spike (32.9%) had a higher percentage in order. 3. When receive was stable, the success rate in attach technique was 47.1%, the failure rate was 20.1%. On the other hand, when receive was unstable, the success rate in attach technique was 16.5%, the failure rate was 14.3%.

      • SCOPUSKCI등재

        소화성 궤양 출혈에 대한 내시경적 순수에탄올 국소주사요법의 치료 효과 및 예후

        김태호,이동호,김유선,정현채,송인성,김용태,이경미,박민정,김정룡,김주성,윤용범,이진혁,이국래,최일주 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

        Background/Aims: Endoscopic injection therapy improves the outcome in bleeding peptic ulcer, but the optimum regimen is unknown. Although endoscopic injection therapy is effective in controlling initial hemorrhage from a peptic ulcer, between 10% to 30% of patients suffer rebleeding. The aim of this study was to evaluate the initial and ultimate success rate of hemostasis, the rebleeding rate, hospital stay (days), and the emergency operation rate in patients who had undergone endoscopic ethanol injection for bleeding peptic ulcer. Methods: Thirty nine patients presented with active bleeding (spurting), visible vessels, or blood clots on endoscopic findings were given an endoscopic ethanol injection with a total of 1.0∼3.0 ml of ethanol. The initial and ultimate success rate of hemostasis, rebleeding rate, and emergency operation rate after the endoscopic injection was evaluated. Results: 1) The initial success of hemostasis was 38/39 (97.4%). 2) The rebleeding rate after ethanol injection was 8/39 (20.5%). ) The success rate of the second trial of ethanol injection was 3/8 (37.8%). 4) Emergency operations were conducted in5/39 (12.8%). 5) The ultimate success rate of hemostasis was 34/39 (87.2%). 6) There were no mortalities [0/39 (0%)] related to the ethanol injections and bleeding peptic ulcers. 7) There were no complications [0/39 (0%)] related to the ethanol injections. 8) The mean duration of hospitalization was 9.5 4.5 days. Conclusions: Endoscopic ethanol injection in the treatment of bleeding peptic ulcers was as effective and safe as any other injection or mechanical hemostatic method. Further prospective studies or endoscopic trials for hemostasis are needed to reduce the rebleeding rate and emergency operation rate of bleeding peptic ulcer.

      • KCI등재SCISCIE

        [Ca(2+)]-dependent generation of intracellular reactive oxygen species mediates maitotoxin-induced cellular responses in human umbilical vein endothelial cells.

        Yi, Sun-Ju,Kim, Kyung Hwan,Choi, Hyun Jung,Yoo, Je Ok,Jung, Hyo-Il,Han, Jeong-A,Kim, Young-Myeong,Suh, In Bum,Ha, Kwon-Soo Korean Society of Molecular Biology 2006 Molecules and cells Vol.21 No.1

        <P>Maitotoxin (MTX) is known as one of the most potent marine toxins involved in Ciguatera poisoning, but intracellular signaling pathways caused by MTX was not fully understood. Thus, we have investigated whether intracellular reactive oxygen species (ROS) are involved in MTX-induced cellular responses in human umbilical vein endothelial cells. MTX induced a dose-dependent increase of intracellular [Ca(2+)]. MTX stimulated the production of intracellular ROS in a dose- and time-dependent manner, which was suppressed by BAPTA-AM, an intracellular Ca(2+) che-lator. Ionomycin also elevated the ROS production in a dose-dependent manner. MTX elevated transamidation activity in a time-dependent manner and the activation was largely inhibited by transfection of tissue transglutaminase siRNA. The activation of tissue transglutaminase and ERK1/2 by MTX was sup-pressed by BAPTA-AM or ROS scavengers. In addition, MTX-induced cell death was significantly de-layed by BAPTA-AM or a ROS scavenger. These results suggest that [Ca(2+)]-dependent generation of in-tracellular ROS, at least in part, play an important role in MTX-stimulated cellular responses, such as activation of tTGase, ERK phosphorylation, and in-duction of cell death, in human umbilical vein endothelial cells.</P>

      • KCI등재

        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.

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