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.

두개강내 유표피종의 수술적 치료성적

김종수,정희원,이선호,정영섭,김현집,최길수,한대희 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.8

Fifteen patients with intracranial epidermoid cysts underwent microsurgical resection between January, 1980 and June, 1994. The average age of the patients was 38.9 years and the male to female ratio was 3 : 2. The most frequent location was the cerebellopontine angle(9) and other locations included parasellar(2), sylvian fissure(1), paratrigeminal(1), pineal(1) and parasagittal(1). Common clinical presentations were cranial nerve impairment and mass effect. Gross total removal was possible in 8 cases. During 57.9 months of mean follow up period there were 5 recurrences, one of which occurred after a complete surgical resection and the others were symptomatic recurrences after incomplete removal. The mean duration from the first operation to reoperation was 8 years and 3 months(2^(+10)-13^(+8) years). In every case of incomplete removal or even in complete removal cases, regular MRI follow up should be done for early detection of recurrence.

측뇌실내 종괴의 감별진단 및 수술적 치료

김동규,김봉수,이상형,심기범,왕규창,정희원,김현집,조병규,최길수,한대희 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

We present a series of 42 patients with the lateral ventricular mass lesions who underwent operative removal between 1979 and 1992 at the Seoul National University Hospital. These lesions included 29 tumors, 10 benign cysts and 3 arteriovenous malformations. There were 20 lesions in the trigone, 14 in the frontal horn, 6 in the body, and 2 in the temporal horn. Together with the age of the patient, the location in the lateral ventricle and the CT or MR patterns, the range of the differential diagnosis of the lesions can be narrowed. The mass were removed by various surgical approaches ; 11 by the middle frontal gyrus, 10 by the superior parieto-occipital, 13 by the middle temporal gyrus, 4 by the anterior transcallosal, 2 by the posterior transcallosal and 3 by the combined approaches. The superior parieto-occipital approach left postoperative morbidities in 64% and other approaches in 20 to 25% of the cases. These morbidities included hemiparesis, hemianopsia, aphasia, memory distubance and seizure. Most hydrocephalus disappeared without the shunting procedure after removal of the lateral ventricular mass. The high frequency of postoperative complications in the superior parieto-occpital approach require meticulous consideration in the selection of this approach.

성인에서 발병한 지역사회폐렴의 원인으로서 호흡기 바이러스의 역할

김지희,곽영호,나병국,이주연,신구철,정혜선,홍정연,오명돈,정희진,김민자,배현주,김양리,신완식,강재명,우준희,어수택,이환종 대한감염학회 2001 감염 Vol.33 No.1

Purposes : To investigate the viral etiology of community-acquired pneumonia in Korean adults, we have detected respiratory viruses (Respiatory syncytial virus, adenovirus, influenza virus and parainfluenza virus) in the way of prospective, multi-center study. Methods : From July 1997 to April 2000, nasal aspirates or sputum were obtained from adults patients with community pneumonia admitted to the participating hospitals and transferred immediately to the central laboratory at the Seoul National University Children's Hospital. The specimens were divided into three parts. One part was used for indirect immunofluorescent test for respiratory viruses, the other part for the culture of RSV and adenovirus in HEp-2 cell monolayer. The other part was used for the culture of influenza virus and parainfluenza virus in MDCK or LLC-MK2 cell monolayers. Results : Of 317 samples, 32 (10.1%) specimens were positive for viral agent by indirect IF staining or culture, including one dual-infected specimen (adenovirus and parainfluenza virus). Influenza virus was most commonly detected (16 specimens). Parainfluenza virus, adenovirus and RSV were detected in 10, 4 and 3 patients, respectively. All isolated influenza viruses were type A (H3N2 in 9 patients, HIN1 in 2 and unspecified in 5), and 8 out of 10 parainfluenza virus isolates were type 3. Conclusion : Similar to previous reports from other countries, a significant portion of community-acquired pneumonia in Korean adult is caused by respiratory viruses. (Korean J Infect Dis 33:8~14, 2001)

급성심근경색후 발생한 심실중격결손 2례

김태희,이재호,김애란,허민영,문치숙,정수룡,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Ventricular septal defect remains an infrequent but devastating complication of acute MI. Approximately 1∼3% of cases of acute myocardial infarction are complicated by ventricular septal rupture in the prethrombolytic era and the incidence has decreased to 0.2% with reperfusion therapy. This mechanical complication usually occurs within the first 10 to 14 days when necrotic tissue is most abundant and the collateral coronary circulation is not well developed. This lesion is generally associated with complete coronary obstruction rather than severe stenosis. Rupture of the ventricular septum is a severe mechanical complication of acute myocardial infarction, usually resulting in death unless surgical repair is performed. The bad prognosis of this event within the first 2 weeks indicates the need for early surgical rapair. This complication is more frequent after the first acute myocardial infarction in the elderly and secondary to a transmural myocardial infarction. We report two cases of ventricular septal rupture after acute myocardial infarction.

비만여중생에서 에어로빅스 운동에 따른 Leptin 농도와 혈청지질간의 상관관계

김주혁,김종인,김은희,김수진,김도형,장성동 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

The subjects of this study included 7 obese middle school girls aged 14 to 15 whose percent at was 35% or over and who were found having no diseases as a result of medical examinations, There's no significant change in Total Cholesterol between 170.7±34.81 before training and 169.0±32.31mg/㎗ after training Triglyceride was significantly decreased from 125.8±75.41 before training to 111.7±54.72.mg/㎗ after training(p<.01). HDL-C showed no significant change from 49.9±10.37 before training to 42.5±7.64mg/㎗ after training, Free Fat Acid was significantly increased from 623,3±176.07 before training to 695.7± 238.73μUq/l after training, Growth Hormone also showed a significant increase from 6.59± 5.29 before training to 9.17±4.24ng/㎖ after training(p<.05). Insluin showed a significant change from 22.3±6.08 to 16.8±4.84μ[U/㎖ between before and after training Lipoprotein Lipase was changed from 53.3±13.25 before training to 39.1±14.19ng/㎖ after training Finally, Leptin showed a change from 24.1±7.17 before training to 23.3±12.22ng/㎖ after training but with no significant difference. Concerning correlations between leptin and serum lipid, there were high correlations between total cholesterol and HDL-C and low between growth hormone and free fat acid, Lein was highly correlated with free fat acid and low with insulin.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of 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 means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : 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 45.5% in 1997.

대두단백질 가수분해물의 특성

김동수,양승택,문윤희,류병호,김희숙,염동민,김진목 慶星大學校 1998 論文集 Vol.19 No.1

The present study was conducted to elucidate some characteristics of soy protein hydrolysates. The soy protein was obtained from defatted soy power by the treatment of n-hexan. The hydrolysates of soy protein were prepared from hydrolysis by bromelian and pepsin with the two kinds of samples of precooking for 30 min in steam oven and noncooking, and fractionated through Bio-gel P-4 column chromatography. Fractions of hydrolysates separated on the Bio-gel column chromatography were carried out to SDS-PAG electrophoresis, resulting to show some different bends from 66kD to 14.2kD of molecular weight. In addition, the fractions showed different activities of superoxide dismutase. From these results, it was found that the hydrolysates could be available to use in a lot of food industrial fields as new functional food materials because the hydrolysates had different characteristics in electrophoresis and could increase the activity of superoxide dismutase.

ACTH분비 뇌하수체 선종의 진단과 치료결과

김종수,정희원,김현집,조병규,최길수,한대희 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.7

The records of 31 patients diagnosed as having Cushing's disease surgically treated via transs-phenoidal approach at our instituion between March, 1984, and April, 1994, were retrospectively reviewed in order to determine the most ideal method in diagnosing and the treatment outcome of ACTH-producing pituitary adenomas. Preoperative diagnosis was made after evaluating the patients with endocrinological studies including inferior petrosal sinus(IPS) sampling, and high-resolution computerized tomography(CT) and/or high-field magnetic resonance(MR) imaging. The sensitivity of IPS sampling technique used in microadenoma cases was 85.7% and of evaluating with CT and MR imaging, 52.9% and 61.9%, respectively. Of the 31 cases, 22 were microadenomas,6 macroadenomas. 1 hyperplasia, and 2 histopathologically identified as being not a tumor. Microsurgical procedures included 19 selective adenomectomy(SA),7 hemihypo-physectomy(HH), 2 partial adenomectomy(PA), and 3 multiple biopsies(BX). The surgical remission rates of SA group and HH group were 89.5%(17 out of 22) and 71.4 % (5 out of 7), respectively. PA and BX groups showed no remission. Out of 7 patients who underwent radiation therapy after showing no remission postoperatively, 5 demonstrated remission, giving an overall remission rate of 81.1% . It is concluded that IPS sampling and high-field MR imaging(including dynamic MR imaging) procedures are the most ideal methods in evaluating and diagnosing patients with Cushing's disease. Selective adenomectomy via transsphenoidal microsurgery is the most effective treatment modality. but such therapeutic intervention should be used with discretion. The best operative results are obtained in cases in which the margin of the adenoma is clearly visualized grossly, and the frozen bipsy of the resected margin is negative for tumor cells.

신경섬유종증-제 2형의 진단과 치료 : 16례의 임상경험 Experience of 16 Cases

김정은,백선하,김종수,이상형,오창완,김동규,정희원,김현집,조병규,한대희,최길수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

Neurofibromatosis type 2(NF-2) is a dominantly inherited disorder characterized by the occurrence of bilateral acoustic neurinomas and the frequent association of other central nervous system tumors. We present a retrospective review of 16 patients with NF-2 who were treated at our hospital from 1984 to 1995 in 13 cases, the diagnoses of Nf-2 were based on the criteria developed at the Consensus Development Conference of National Institute of Health in the United States, and in another 3 cases. the criterias of NF-2 were not fully satisfied, but the diagnoses of NF-2 were highly suspected. The average age of the patients was 27.6 years, ranging from 13 years to 56 years. The most common symptom was hearing difficulty : intervals between symptom onset and deafness ranged from 8 months to 6 years(mean : 2.9 years) One family of NF-2 was documented consisting of a sister a brother and their mother. Nine patients underwent operations on unilateral acoustic neurinomas : these were subtotally removed in eight patients and totally in one patient Among these patients five were deaf on the ipsilateral side at surgery. Among the other four patients with useful hearing before surgery, hearing was preserved to preoperative status in two patients. Four patients with diagnoses of meningioma, received operations to relieve mass effect with subtotal removal in two patients and total removal in the other two. Early diagnosis and treatment are the most important in the management planning of patients with NF-2 for reasons of early manifestation and rapid progression of the disease.