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.

토지이용패턴에 따른 하천수질과 식생분포

오영주,강병화,김병우,김성필,한민수,김진호,나영은 한국환경농학회 2006 한국환경농학회지 Vol.25 No.1

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

소아 Henoch-Schonlein 신염의 임상경과와 조직학적 특성 : Renal Outcome and Prognostic Factors

김병목,장창환,조민현,곽정식,고철우,구자훈 대한신장학회 2003 대한신장학회잡지 Vol.22 No.6

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

여드름 환자에서 adapalene 겔과 tretinoin 크림의 split-face 비교 연구

김영조,선정우,정병수,최규철 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background : Adapalene is a new synthetic naphtholic acid derivative with potent retinoid and antiinflammatory properties, developed for the topical treatment of acne vulgaris. Objective : This study was designed to compare the efficacy and safety of 0.1% adapalene gel with tretinoin cream(0.025% and 0.05%) in the treatment of grade I to V facial acne vulgaris. Methods : Forty acne patient volunteers were enrolled in this investigatormasked, left-right comparison, randomized, controlled, intraindividual study. 0.1% adapalene gel and tretinoin cream(0.025% or 0.05%) were applied once a day to one halfface by the volunteers for 30 consecutive days. Efficacy and cutaneous tolerance were accessed at baseline and week 1, 2, 3, and 4. Efficacy was determined by investigator counts of inflammatory papules and pustules, and non-inflammatory open and closed comedones, as well as global improvement. Clinical signs(erythema, desquamation, dryness) and subjective symptoms(pruritus, burning) were evaluated and scored weekly. Result : 0.1% Adapalene gel was more effective in treating acne lesions than tretinoin cream(p<0.05). Cutaneous side effect was limited to a mild retinoid dermatitis occurring in all treatment groups. However, patients treated with adapalene gel tolerated this therapy significantly better than those treated with tretinoin cream. Conclusion : 0.1% adapalene gel applied once daily was significantly more effective in reducing acne lesions and was better tolerated than tretinoin cream in the treatment of acne vulgaris.

고정상태에서 경상용차용 타이어의 진동특성

김용우,최동수,김병삼 순천대학교 2000 순천대학교 자연과학논문집 Vol.19 No.1

To investigate differences between the dynamic characteristics of two kinds of light-duty truck tires, modal testings have been performed on radial tire and bias tire under constrained condition. Through the test, modal parameters, such as natural frequencies, modal decay rates and mode shapes, were obtained. The mode shapes in direction of circumference and of meridian are presented. The test results have shown that the modal frequencies of bias tire are much higher than the corresponding values of radial tire with a similar mode shape, which is in accordance with the fact that the radial rigidity of bias tire is higher than that of radial tire. Most of the modal decay rates of bias tire are larger than those of radial tire within the scope of this experiment. In the frequency domain range of test, the bias tire has extra mode which do not occur in the radial tire. This difference is based on the fact that the circumferential rigidity of the bias tire is quite low whereas that of radial tire is so high that the frequencies of the corresponding modes are out of the frequency range of test. As the inflation pressure increases, the natural frequencies are increased while most of the modal decay rates remain constant or are decreased slightly.

메탈라스와 와이어메쉬로 횡구속된 철근 콘크리트 기둥의 내력 및 연성에 관한 연구

김병철,이우진,정덕우,윤승조,김성수,한천구 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

Generally, transverse steel in reinforced concrete column serves the three-fold function of confining the compressed concrete, preventing lateral buckling of the longitudinal reinforcing steel, and acting as shear reinforcement. However, the amount of confining steel required in the form of rectangular hoops is still argument. This paper summarizes the results of an experimental program where 10 short columns with compressive strength 21MPa are designed with variable lateral confinements such as Metal Lath and Wire Mesh were tested under monotonic axial compression to failure. The columns were 300mm square and 750mm high. The purpose of this study is to investigate the ductility and strength of columns with variable lateral confinement. Test results indicate that specimen confined by metal lath and hoop, and wire mesh and hoop show 1.89 times ductility than NO.I specimen using hoop only. However, effect of lateral confinement by metal lath and wire mesh is how or same than NO.I specimen in maximum strength.

주파수응답함수법에 의한 타이어 반경방향 고유진동수와 감쇠비 측정

김용우,김병삼,최동수 順天大學校 1999 論文集 Vol.18 No.1

In this paper, we have reported fundamental natural frequencies and damping ratios in the radial direction of various tires, from passenger car tires to truck-bus tires, under unconstrained condition. We have determined the radial directional modal parameters of tires, which are subjected to different levels of inflation pressure, by using frequency response function method. The results show that experimental conditions shift the natural frequency and damping ratio.

석탄폐석 및 광재의 유해물질 침출특성 연구

우영국,강성환,임재명,한동준,김병욱 강원대학교 석재복합신소재제품연구센터 1996 석재연 논문집 Vol.1 No.-

광산에서 배출되는 광재폐기물은 산과 계곡에 투기 또는 매립되어 강우등에 의하여 주변 소하천을 오염시키고 있다. 따라서 본 연구는 광재의 물리적특성과 이화학적 특성을 조사하고 회분식과 칼럼식실험을 수행하여 오염물질의 침출특성을 고찰하고자 하였다. 실험결과, 다음과 같은 결론을 얻을 수 있었다. 1) 광재는 점토질 및 실트질의 크기를 지니고 있으나 점착력과 소성적 성질이 없는 사질토의 특성을 지니고 있다. 2) 광재의 투수계수는 대부분 10(???)³-10(???)cm/sec의 범위이며, 일반 사질토의 투수계수보다 낮음을 알 수 있었다. 3) 회분식과 칼럼식 용출시험의 결과, 대상 광산의 광재폐기물 일부에서 기준치 이상의 중금속농도가 침출되었으며, 이에대한 방지대책의 심각성을 알 수 있었다. 4) 광재 폐기물의 칼럼식 용출시험 결과 kg폐기물 당 인공강우 투여량 비가 증가할수록 침출수의 중금속 및 유해물질 농도는 크게 감소되어 어느정도 진행된 이후부터는 대부분 일정한 농도가 유지되나, 산성강우시 침출정도 및 침출시간은 지속되는 것을 알 수 있었다. 5) 광재는 많은 중금속과 유해물질을 함유하고 있으나 양적인면에서 자원화의 가치가 높을 것으로 판단된다. 따라서 광재내의 자원회수, 건설 재료등의 재활용및 자원화 연구가 필요하다. Tailing wastes producedat metal mines have been disposed of by dumping or landfiling in depression. Mine drainage developed at pile of the tailing wastes has high concentrations of various kinds of heavy metals and harzardous materials, and these contaminants are leached out from the tailing wastes by water infiltration or when they collapse. In this study, both batch test and column test were performed in order to investigate the physical and leaching characteristics of tailing wastes. The batch test results were compared with those by EPT and DLT, and column test was carried out at acidic and neutral pH ranges. The results showed that high concentrations of heavy metals and sulfate were contained in the leachate of the some tailing wastes. In column test, levels of heavy metals in the leachate produced during the initial rainfall period were found higher.