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.

외음부의 기저세포암

김보영 ( Bo Young Kim ),황선정 ( Sun Jung Hwang ),박병준 ( Byung Joon Park ),이은실 ( Eun Sil Lee ),한호섭 ( Ho Suap Han ),김용욱 ( Yong Wook Kim ),김태응 ( Tae Eung Kim ),노덕영 ( Duck Yeong Ro ),이안희 ( An Hi Lee ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.9

Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.

정신장애인 치료에 중요 역할 담당자의 정신질환에 대한 태도조사

김병후,정선욱,강연화,김윤,김창엽,홍진표,한오수,조맹제,김용익 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

Objectives : Attitudes of families of mentally ill, health personnels and community leaders to the mentally ill after the development and utilization of the community mental health program and reintegration of the chronically ill patients into society. This study was designed to compare the attitudes toward the mentally ill patient of the persons who have important role in treating the mentally ill and to find the variables influencing the attitudes. Methods : We measured attitudes toward mental illness in psychotic patients' families(N=139), community leaders(N=180) and health personnels(N=324) including mental health personnels before the implementation of community mental health services in Yonchon county and Seodaemun district area. The instrument used to measure attitudes was Opinion about Mental Illness(O. M. I.) scale. Results : 1) Health personnel showed lower Authoritarianism(Factor A) and higher Benevolence(Factor B) scores on the average than community leaders and psychotic patients families. 2) Current residence affect the attitudes in psychotic patients' families, not in community leaders and health personnels. Families in urban area showed lower Authoritarianism(Factor A) and Social Restrictiveness(Factor D) and higher Benevolence(Factor B) scores than in the rural areas. 3) Many patient variables were correlated to the attitudes of families. Duration of illness, number of recurrence, number of admission, age of patient and family burden were positively correlated mainly to Social Restrictiveness(Factor D). 4) Sex and religion of respondents showed no or weak relationship with the factor scores. Conclusions : Education for community leaders and families is required to achieve successful community mental health services. Community support program should be developed for chronic, recurrent and burdensome psychiatric patients in the first place.

중년기 우울증 여성의 생활사건, 대처방식, 사회적 지지 및 가족관계

김동인,이진욱,김임,이선미,은헌정 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

국문초록본 연구는 중년기 우울증 여성의 생활사건 스트레스, 대처 방식, 사회적 지지, 가족 관계 등의 정신사회적 요인들을 알아보기 위한 것으로 각 변인들이 어떻게 우울과 관계가 있는지를 우울증 환자 집단과 정상인 집단으로 나누어서 비교 연구하였다. 이를 위해 35세 이상 64세 이하의 116명의 우울증 환자와 113명의 정상인을 대상으로 Beck 우울 질문지(BDI), 생활사건 질문지, 대처방식 척도, 대인관계 지지 평가척도(ISEL), 가정환경척도 등의 검사를 하였고 다음과 같은 결과를 얻었다. 1) 최고 스트레스는 환자 집단의 경우 결혼생활 스트레스(42명, 36.2%), 정상인 집단의 경우는 가정생활 스트레스(44명, 38.9%)였다. 2) 소극적 대처(t=0.93, p=.35)만을 제외하고 환자 집단과 정상인 집단에서 BDI 우울 점수(t=15.94, p<.0001), 생활사건 스트레스 점수(t=4.73, p<.0001), 적극적 대처점수(t=6.29, p<.0001), 사회적 지지점수(t=7.20, p<.0001), 가족 관계 점수(t=5.75, p<.0001)에서 유의한 차이를 보였다. 3) 우울증 환자 집단에서 BDI 우울 점수는 생활사건 스트레스(r=.24, p<.01) 변인과 유의한 정적 상관을 보였고, 적극적 대처(r= -.22, p<.01) 변인, 사회적 지지(r= -.35, p<.001) 변인, 가족관계(r= -.30, p<.001) 변인과는 유의한 역 상관을 보였다. 4) 우울증 환자 집단에서 BDI 우울에 대한 각 변인들의 중다회귀분석은 사회적 지지(12.3%, β= -.281, T= -3.162, P=.002, 생활사건 스트레스(5.1%, β=.279, T=3.195, P=.002), 적극적 대처(3.5%, β= -.204, T= -2.225, P=.028) 변인이 합하여 20.9%의 설명력을 나타냈다. 5) 중년기 여성에서 생활사건 스트레스는 가족 관계에서 겪는 스트레스가 가장 큰 스트레스였고, 대처방식은 우울과의 관계에서 일관성이 부족하였으며, 사회적 지지는 우울에 영향을 주는 가장 중요한 요인이었고, 가족관계는 양 집단에서 유의한 차이는 있었으나 우울에 대하여 의미있게 설명하지 못하고 있다. ABSTRACTLife Events, Coping Styles, Social Support, and Family Relationships of Middle-Aged Depressed Women Jin-Wook Lee, M.D., Yim Kim, M.D., Sun-Mi Yi, M.S., Dong-In Kim, M.D., Heon-Jeong Eun, M.D. Department of Neuropsychiatry, Presbyterian Medical Center, Chonju The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups : a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows : 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores(t=15.94, p<.0001), life events(t=4.73, p<.0001), active copinig(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationships(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life events(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<.01), social support(r= -.35, p<.001) and family relationships(r= -.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, β= -.281, T= -3.162, P=.002), life events(5.1%, β=.279. T=3.195, P=.002), and active coping(3.5%, β= -.204, T= -2.225, P=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores of the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

단일 밴드 중적외선 영상으로부터 표면온도 추정을 위한 기초연구

박욱 ( Wook Park ),이윤경 ( Yoon Kyung Lee ),원중선 ( Joong Sun Won ),이승근 ( Seung Geun Lee ),김종민 ( Jong Min Kim ) 大韓遠隔探査學會 2008 大韓遠隔探査學會誌 Vol.24 No.2

3~5μm 파장대의 중적외선 영상은 화산 활동이나 산불과 같이 고온 현상을 관측하는데 효과적이다. 그러나 중적외선 영역은 지표의 복사율과 대기의 영향으로 인한 변화가 매우 심하고, 특히 낮 영상의 경우 태양 복사량에 의한 영향도 고려해야 하는 어려움이 있다. 따라서 단일밴드인 중적외선 영상을 이용하여 표면온도를 얻기 위해서는 영상이 취득된 시간과 장소에서 관측된 태양 복사량 및 여러 가지 대기 변수가 필요하다. 이 연구는 기존의 다중밴드 기반의 중적외선 영상 활용방법과 달리 단일 밴드 중적외선 영상을 이용하여 표면온도 측정을 위한 기초연구에 그 목적이 있다. 이를 위하여 MODIS 영상을 대상으로 MODTRAN을 사용하여 중적외선 영역의 대기보정 기법을 적용 한 뒤 복사전달 모델을 이용하여 지표의 온도를 측정하였다. 획득된 온도 영상의 정밀도를 측정하기 위해 기존의 온도 알고리즘인 MODIS Sea Surface Temperature 알고리즘에 의해 얻어진 해수온도와 비교를 통하여 오차 원인에 대해 분석을 실시하였다. 두 결과의 온도 차는 낮 영상의 경우 0.89±0.54℃ 밤 영상의 경우 1.25±0.41℃로 비교적 긍정적인 결과를 보였다. 그러나 낮 영상의 육지의 경우 대기에 의한 영향보다 태양빛의 반사가 주된 오차의 원인이 되며 이는 지표 복사율에 의한 영향이 매우 크게 작용하고 있음을 추정할 수 있다. 이 연구는 현재까지 해수에 대한 적용에 국한된 것으로 육상의 경우 복사율 변화가 매우 크기 때문에 중적외선 단일밴드에 의한 온도추정이 매우 어려울 것으로 예상된다. Middle-infrared (MIR) spectral region between 3.0 and 5.0 μm in wavelength is useful for observing high temperature events such as volcanic activities and forest fire. However, atmospheric effects and sun irradiance in day time has not been well studied for this MIR spectral band. The objectives of this basic study is to evaluate atmospheric effects and eventually to estimate surface temperature from a single channel MIR image, although a typical approach utilize split-window method using more than two channels. Several parameters are involved for the correction including various atmospheric data and sun-irradiance at the area of interest. To evaluate the effect of sun irradiance, MODIS MIR images acquired in day and night times were used for comparison. Atmospheric parameters were modeled by MODTRAN, and applied to a radiative transfer model for estimating the sea surface temperature. MODIS Sea Surface Temperature algorithm based upon multi-channel observation was performed in comparison with results from the radiative transfer model from a single channel. Temperature difference of the two methods was 0.89±0.54℃ and 1.25±0.41℃ from the day-time and night-time images, respectively. It is also shown that the emissivity effect has by more largely influenced on the estimated temperature than atmospheric effects. Although the test results encourage using a single channel MIR observation, it must be noted that the results were obtained from water body not from land surface. Because emissivity greatly varies on land, it is very difficult to retrieval land surface temperature from a single channel MIR data.

한국 소비자원 상담에 나타난 주택유형별 소비자 불만분석

김선욱;신경주 한양대학교 2007 韓國 生活 科學 硏究 Vol.27 No.1

The purpose of this study is to provide basic data for the improvement of residential quality and the protection of consumers by resolving consumer problems in single-family houses, apartments, row houses, multiplex houses, and studio apartments. The analytic data used for the research were 1073 formal complaints filed at the Korea Consumer Agency from January 1 to December 31, 2000. The results are as follows: 1) Consumers in single-family houses complained about housing management such as water leakage, consumers in apartments complained about housing economics which is related to the cancellation of contract, consumers in row houses complained about housing management such as water leakage, consumers in multiplex houses complained about housing economics which is related to the cancellation of contract and consumers in studio apartments complained about housing economics which is related to the cancellation of contract. 2) Complains about housing management highly appeared in all types of houses, especially in single-family houses and row houses, except in studio apartments; complains about housing economics appeared in all types of houses, though less frequent in apartments, multiplex houses, and studio apartments; and complaints about housing environment appeared less in all types of houses, though more frequent in single-family houses than other types of houses. 3) Gonsumer problems commonly founded were problems related to repairing defects, contracts, sale and purchase, and house environment.

2000학년도 입학관련 정책연구

김선형,남상인,엄태준,제갈욱,신현철,권준택 순천향대학교 부설 산업기술연구소 1999 순천향 산업기술연구소논문집 Vol.5 No.1

This paper presents an improved admission policy of 2000 academical year so that more promising students apply for the University. By analyzing the past admission data and the questioned report, a unique admission policy has been suggested as the University feature reflected. One of the major differences compared from the admission policy of the last year is that the entry number limit for the special admission is in creased or newly established such as the entry allocated for recommended students, perfectly attending students, and regionally apportioned students. Also established is the special admission for those licensed students and late educated students.

Lutembacher 증후군 환자 증례 보고

김성범,서정주,곽철훈,김상민,이보라,민선경,황은구,김용인,조욱현,최석구 인제대학교 2008 仁濟醫學 Vol.29 No.-

Lutembacher's syndrome is rare combination of mitral stenosis (MS) and atrial septal defect (ASD). The hemodynamic interplay between the MS and ASD leads to wide variation of clinical presentation. Here we describe a 43-year-old female with Lutembacher's syndrome and tricuspid regurgitation with pulmonary hypertension, who underwent direct closure of ASD and tricuspid valvuloplasty successfully. We also reviewed other literatures in an effort to increase awareness of this condition.

유도 업어치기 패턴에 따른 하지의 운동학적 분석

김의환,정재욱,강선영,윤현 龍仁大學校 武道硏究所 2002 武道硏究所誌 Vol.13 No.1

The purpose of this investigation was to analyze the changes of the lower limbs angle, when performing Morote-Seoinage(M.S.N.:two arm shoulder throw) in judo who was 5 females university representative judokas of light weight category in judo, and filmed on video cameras(60field/s). The data of this study digitizied by KWON3D 2.1 program computed the average and standard deviation calculated individual 5 trials with Programing Lab view 6i. From the data analysis & discussion, the following conclusions were drawn : 1) A pattern : Right vknee angle was flextion and extension Kuzushi phase and flexed in Tsukuri to Kake phase. Light knee angle flexed in the whole phase. Right·Light hip angle weren't difference changle of angle. 2) B pattern : R. knee angle had flextion and extension in Kuzushi phase and flexed in Tsukuri to kake phase. Light knee angle slowly flexed in the whole phase. Suddenly, flexed in Kake 1·2 stage. Right hip angle raised flextion and extension in Kuzushi phase and suddenly flexed in Tsukuri to Kake phase. Light hip angle slowly raised in the whole phase. 3) C pattern : C pattern was larger than A, B pattern's change of Right knee angle, this time angle was 30.4˚. Light knee angle was flextion in the whole phase. Right hip angle flexed in Kuzushi phase and largely extended, again flexed. Light hip angle firstly flexed and extended, flexed on the Tsukuri to Kake phase.