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.

급성신부전을 동반한 알콜성 횡문근융해증 2례

김영민,오동렬,이원재,김형국,황두영,이환,최경호,정시경,김세경,김영옥 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Rhabdomyolysis is a biochemical and clinical syndrome caused by lysis of skeletal muscle cell and release of muscle cell contents into the circulation. In addition to traumatic cause, various nontraumatic causes have been reported. Rhabdomyolysis has frequently been associated with seamy aspects of life and society: alcoholic abuse, drug addiction, sadistic drill exercise, war events and attempted suicide. The abuse of alcohol causes many hazards in many organs. One of these is acute alcoholic myopathy that may present as a fulminent syndrome of muscle pain and tenderness associated with rhabdomyolysis and acute renal failure. Because the prognosis of adequately treated rhabdomyolysis is excellent, early recognition and prompt management are essential in emergency situation. We experienced two typical cases of alcohol-induced rhabdomyolysis with acute renal failure and report these cases with literature review.

삼중시기 나선형 CT를 이용한 간경변증 환자에서의 결절성 간세포암의 조영증강양상

김영화,윤종필,김형환,이상진,이혜경,김일영,장유진 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

We evaluated the contrast enhancement pattern of nodular hepatocelluar carcinoma in liver cirrhosis patients by using three phase spiral CT. We anlayzed 34 nodular hepatocelluar carcinonmas in 11 patients with liver cirrhosis. Three phase spiral CT were obtained at 30(arterial phase), 60(portal phase), 180seconds(delayed phase) after initiation of contrast injection in the rate of 3ml/sec. Nodules are classified according to size, as group A(below 1cm, n=11), group B(1 - 3cm, n=15), group C(above 3cm, n=8). Enhancement pattern of the nodule was analyzed comparing to normal liver parenchyme in each phase., as total high, central high, peripheral high, iso, low, mixed density. We also analyzed the detection rate of the nodules. As a whole the nodules show high density in arterial phase(76%), high density in portal phase(47%) and low density in delayed phase(56%). In group A, the nodules show high(100%) in arterial phase, iso(54%) or high (46%) in portal phase, iso(82%) in delayed phase. In group B, the nodules show high(100%) in arterial phase, high(74%) in portal phase, mixed (60%) in delayed phase. In group C, the nodules show mixed density in all three phase. The most common enhancement pattern in each group was high(arterial phase) - iso(portal phase) - low (delayed phase) in group A(6/11, 54%), high - high - low in group B (5/15, 33%), mixed - mixed - mixed in group C(5/8, 63%). The detection rate of the nodule was highest in arterial phase, and the usefulness of arterial phase comparing to portal or delayed phase was higher in smaller size. In conclusion, hepatocelluar carcinomas show different enhancement pattern according to the size on three phase spiral CT, and this may be helpful in diagnosis of them.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

日本의 社會科學 및 體育分野 學問硏究動向에 對한 調査 硏究

金榮秀,崔晄烈,金相漢,金麟坤,金炳斗,金永煥 慶北大學校 經商大學 經濟學科 1981 慶商大學論集 Vol.9 No.-

This paper attempts to review and trace back to, based on the data collected during visits of Japanese universities and research institutes, the organizational characteristics, the structures of curricula and study trends, with regard to the fields of social sciences, especially economics and business administration. One of the most conspicuous characteristics observed in academic organizations was Tsukuba university's system whose academic institution was organized around academic grouping, academic genealogy, and specialty: particularly social economic planning belonged to the genealogy of social engineering, in light of its characteristics in term of curriculum, seems to meet the contemporary need. There found two speciality areas in the Department of Social Engineering at the Graduate School: one is the concentration on Mathematical Planning and the other Management Engineering. Considering that its academic goal is tosys tematically and empirically analyze the human behaviors, and to take interdi-sci plinary approach through a policy-oriented system in doing so, it reflects one of the true natures of the academic trend. Their curricula appear to emphasize on analytical methods under uncertainty, application of mathematical planning techniques, system simulation, and information system design and its application, in the area of economics and business administration. Physical education is believed to require modernized facilities and equipments for its record-breaking and technical enhancement, and so increased investment in physical facilities and policy considerations for the training of physical educators are necessary.

장기간 항갑상선제 투여 후 임의 중단 뒤 재복용시 발생한 무과립구증 1 예

김승만;김태영;박수영;배영환;서영경 정은주;김태균;권민정;박정현;이순희 인제대학교 2011 仁濟醫學 Vol.32 No.-

Agranulocytosis, one of the major side effects of antithyroid a gents, probably occurs in less than 0.25% of cases treated with antithyroid agents. It usually occurs within the first several weeks or months after the initiation of therapy, when drug dosage is higher. Most reported cases of agranulocytosis have occurred during the first 3 months of therapy. We describe here a rare case that did not experience the side effect for 6 years of antithyroid agent treatment but presented with agranulocytosis in one month after re-exposure. It suggests that the major side effect such as agranulocytosis can occur in patients who had undergone prior uneventful antithyroid drug therapy.

수출입 컨테이너 장치장 배정을 위한 소프트웨어의 개발

김갑환,김홍배,홍봉희,김기영,배종욱,최진오,김두열,이영기,박영만,박강태,손행대 한국경영과학회 1995 經營 科學 Vol.12 No.3

The Pusan Container Terminal faces a rapid increase in berthing time of container ships as well as in waiting time of external trucks, which is due to an absolute lack of yard space. This research is focused on the development of a decision support system for the planning of the container terminal yard assignment so that the yard space would be utilized most effectively. Efforts should be given to the reasonable assignment of the yard storage and the dynamic adaptation to the ever changing environment. The software introduced here is based o the know-how of the field exports and its framework takes the approach of the hierarchical decision making.

PVA-ECC를 활용한 Half PC 복합체의 역학적 특성에 관한 실험적 연구

김재환,김영덕,김갑수,조봉석,장종호,김무한 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

ECC represents one particular class of HPFRCC, which are defined by an ultimate strength higher than their first cracking strength and the formation of multiple cracking during the inelastic deformation process. This study is to provide the fundamental data for the development of hybrid construction method such as the half PC(Precast concrete) reinforced by PVA-ECC, the mechanical properties of half PC according to the alteration of properties of PVA-ECC in terms of the type of fiber, Vr, S/M, placing height of PVA-ECC, are experimentally investigated. As the results. it is found that the half PCs of PVA-ECC have very higher mechanical performance in terms of yield load, strain capacity beyond yield point and maximum flexural load than that of mortar. Also, flexural crack in the half PCs of PVA-ECC are not localized at first crack and are growed to many micro crack, especially multiple cracking in specimen of P(12)-30-0.1ㆍ3 occurred.

하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례

김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.

溫室保溫커튼의 材料特性에 따른 保溫效果分析

金榮福,金容換,李昇揆,金成泰,羅又禎,閔永鳳,朴重春,崔東烈 慶尙大學校 1991 論文集 Vol.30 No.2

The effects of the material properties of thermal curtains upon reduction of the greenhouse heat loss were studied. A theoretical analysis procedure with equations and computer programs was developed to estimate them by using energy balance principles. Curtain effectiveness for every three kinds pf value level of the material properties were studied and compared. The results of this study would be useful for the developent and management of greenhouse thermal curtains.