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.

Disulfiram유발 정신증 1례

김석범,이정태,김광수 한국의학사 1993 診斷과治療 Vol.13 No.1

에코뮤지엄 개념에 기초한 지역문화재의 보전 및 이용현황에 관한 실태분석

김선화,문동기,박광범 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(계획계)

Recently an inhabitants participation campaign that utilize cultural inheritance to place of history education in area rescue regional quality is implemented in advanced countries. The purpose of this study is aimed to investigate the conservation present condition and utilization present condition cultural assets in chongju city, Korea. This study is grope possibility that do cultural assets being in area throught ecomuseum theory as can do function by area people's lifelong education.

대장암환자에서 자연살해세포의 변화

김광호,심강섭,박응범,강은숙,홍기숙 대한대장항문학회 1998 Annals of Coloproctolgy Vol.14 No.3

불소의 종류 및 도포방법에 따른 치면에의 침착농도 비교

김도훈,박광범,박준봉 慶北大學校 齒科大學 1990 慶北齒大論文集 Vol.7 No.1

치주과적 시술후 빈발되는 병발증중 하나인 지각과민증을 치료하는 방법인 불소도포후 그 종류 및 처리방법에 따라 무기이온의 용출량을 측정함으로써 불소이온이 치근면에 함유되는 양을 역으로 추정하고자 부분적 혹은 완전히 매복된 상, 하악 제3대구치를 이용하여 본실험을 실시하였다. 발거된 치아의 연조직을 제거하여 건조시킨 후 증류수, 2% NaF, 10% SnF_2등의 용액을 국소도포만 시행한 군과 inotophoresis를 병행하여 시행한 군으로 분류한 후 1, 2, 3회 도포를 시행하였다. 무기이온의 용출량을 관찰하고자 처치된 치근면을 노출시킨후 pH5.0으로 적정된 0.5M acetate buffer solution에 2시간 처리하여 각군에서 용출되는 칼슘 및 무기인의 양을 측정하여 상대적으로 치면에 함유된 불소량을 역으로 추정 하였으며 그 결과는 다음과 같다. 대조군, 2% NaF, 10% SnF_2도포군을 비교시 국소도포만 시행한 경우는 도포군사이에 용출량의 유의한 차이를 보였으며, SnF_2군에서 칼슘이온의 용출이 5.69ppm으로 최소였고 NaF군은 이 보다는 효과가 적었으나 대조군에 비해서는 효과가 있었다(p<0.05). Iontophoresis를 병행한 경우도 대조군, NaF군, SnF_2군의 순서로 용출량이 감소되었다(p<0.05). 국소도포만 시행한 경우와 iontophoresis를 병행한 경우에서의 칼슘용출량을 비교해보면 iontophoresis를 병행한 경우가 NaF에서 2.2-11.7배의 감소로 더 우수한 효과를 나타내었으며 NaF보다는 SnF_2가 약 2-4배 정도 더 용출역제효과가 높았다. 도포회수 증가에 따른 칼슘의 용출량은 국소도포만을 시행한 경우 유의성이 없었으나 iontophoresis를 병행한 경우는 대부분에서 유의성 있게 나타났으며(p<0.05) SnF_2의 경우 2회와 3회 시행에서 서로간의 유의성이 없었다(p>0.05). 국소도포만을 시행한 경우 및 iontophoresis를 병행한 경우에서 양자 모두 대조군, 2% NaF, 10% SnF_2의 순서대로 유의성 있게 무기인의 용출이 억제되었다(p<0.05). 국소도포만을 시행한 경우와 iontophoresis를 병행한 경우 무기인의 용출량을 비교해 보면 국소도포만 시행한 군에서 유의성이 있게 감소되었으나(p>0.05) SnF_2의 1회 도포에서 군소판을 시행한 경우에는 iontophoresis가 더 효과가 있었다. 도포회수 증가시 국소도포만을 시행한 모둔 경우 유의성이 없게 나타났으며(p<0.05). iontophoresis를 병행한 후 경우는 SnF_2군은 1회에 비해 2, 3회가 유의성이 있었다(p<0.05). This experiment was designed to measure inversely the amount of fluoride deposited on the partially or completely impacted upper and lower 3rd molars through measuring the amount of the released inorganic ions after application of fluoride, which is one of the therapies for the hypersensitive root that is a frequent complication of periodontal therapies. After debrided and dried, the root surfaces were divided into control group, 2% NaF, 10% SnF_2 topical application group, 2% NaF and 10% SnF_2 iontophoresis group and each of them was treated once, twice, 3 times. To find out the amount of the released inorganic ion the treated root surface was exposed and shaken for 2 hours in the 0.5 M acetate buffer solution (set for pH 5.0) and then the amount of fluoride deposited on the tooth surface was estimated inversely through the measurement of the amount of calcium and phosphorous released. the results were as follows: The amount of calcium released after topical application of fluoride was significantly different among the control, 2% NaF, 10% SnF_2 group. The least amount of them was SnF_2 group, which was 5.69 ppm and that of NaF group was less than SnF_2 group, but more than that of the control group(p<0.05). The same results was found in the iontophoresis groups. When compared the amount of calcium released after topical application and iontophoresis group, the amount of iontophoresis group was more than that of the topical group and the rate of reduction of NaF group was 2.2-11.7 times more than that of the control group. The rate reduction of SnF_2 was 2-4 times more than that of NaF. As the application frequency was increased, the amount of calcium released was not changed significantly in case of topical application, but changed significantly in case of iontophoresis (p<0.05) except twice, 3 times of application(p>.05). In case of phosphorus both topical application and iontophoresis showed significant reducation in the order of control, 2% NaF, 10% SnF2 group(p<0.05). when compared the amount of phosphorous released after topical application and iontophoresis, topical application group showed significant reduction in case of once application of naF, once and 3 times application of SnF2. As the application frequency was increased, the amount of calcium released was not changed significantly in case of topical application, but changed significantly in case of iontophoresis (p<0.05) except twice, 3 times of application(p>0.05). In case of phosphorous both topical application and iontophoresis showed significant reduction in the order of control, 2% NaF, 10% SnF_2 group(p<0.05). When compared the amount of phosphorous released after topical application and iontophoresis, topical application group showed significant reduction in case of once application of NaF, once and 3 times application of SnF2. As the application frequency was increased, the amount of phosphorous released was not changed significantly in case of topical application and significant difference was found between once and twice, 3 times application in case of iontophoresis. J. Kyungpook Univ. Sch. Dent. Vol.7,No.1,169∼181,1990

Robert Frost시에 나타난 집의 이미지

김신범,김광선 명지대학교 인문과학연구소 2000 인문과학연구논총 Vol.22 No.-

The thesis is to study on image of home in the poetry of Robert Frost based on the extreme situation of the human being. Frost was concemed with the universal and enduring emotions that run through the contemporary's life in 20th century and all of life and with barriers or problems between man and nature, man and God, man and man. Therefore his poetry is focused on the methods for accepting and overcoming these problems. The purpose of writing of poems, Frost thought is "a momentary stay against confusion" Thus, the main theme in his poetry was the wisdom of coping with the human existential situation-chaos of confusion. Frost regarded this world as a sample for the whole, including his religious belief. On the assumption that all artists need the sample, he attempts to see and understand a piece for the whole. Frost picked the region, New England out of many ones for his various poetic materials and tried to communicate his understandings and truman life displayed in the nature of New England realistically. New England was the archetype of his poetic world. In other words, dwellers in the region were the model of his writing of poems. Because Frost himself once said, "If I must be classified as a poet, I might be called a synecdochist; for I prefer the synecdoche in poetry." In the final analysis, Frost has shown the painstaking and consistent effort to tide over this tragic human existential conditions through his all of life. Faced with the chaos of life, endurance and acceptance are essential sometimes, but for survival man should fight against the tragic elements and conditions with wisdom, courage, meditation about life and effort. Accordingly the study examines the absence of the space among some absurd aspects of life. For these considerations, chapter I deals with the absence of meaningful spaces in life revealed the archetypes of the human absurd elements. The meaning of the space is the external house, the most original cradle and the internal house sharing a love with a family, relatives and strangers. And these absence of meaningful spaces triggered the destruction of each individual identity and falling to pieces of human relations. Chapter Ⅱ treats the acceptance from these absent situations and the conquest pursuing life itself on earth. In conclusion, as Frost speaks in "The Lesson for Today," "I had a lover's quarrel in the world." he presented courage and wisdom to endure life, love through genuine human relationship. In this respect, he is a great poet who tries to come out man's self-recognition through the various conflicts and human absurd components and show unity through acceptance and conquest in his poetry. This lover's quarrel is Frost's poetic subject, and throughout his poetry there are evidences of this view of man's existence in the natural world.

전통조경 건축물의 門·窓 景觀構成 기법에 관한 비교연구 : 중국 강남(소주)지역의 고전원림과 한국민간 전통조경의 사례를 중심으로 Based on the gardens of Suzhou in China and traditional Korean gardens

김학범,임광빈 한경대학교 2005 論文集 Vol.37 No.-

This study analyzed the scenery formation method through doors and windows of traditional landscape structures. For the purpose of understanding the visual effect that was seen from the outside scenery through doors and windows, this was deduced by research into various frames of the designer's plan at that time. For this study, the scenery formation method and character through doors and windows were researched on the gardens of Suzhou in China and traditional Korean landscape structures. Doors and windows became frames that define our sight. This frames are the same as finders in the camera and compared with Chinese drawing papers of oriental painter. Accordingly, doors and windows made sceneries and view factors were arranged moderately in them. This things made special scenes like photos or paintings. In other words, a actual scenery seems like a framed picture on the sensitized paper or drawing paper so a beauty of nature became a beauty of art. The scenery formation method by frames of doors and windows was very similar to drawing, calligraphy and seal engraving. So to speak, the scenery formatioin method contains principal and subordinate, compactness, truth and falsehood in the oriental art of drawing.

에코뮤지엄 실현을 위한 청주시민의 지역유산에 대한 보전의식고찰

김수미,박광범 대한건축학회 2005 대한건축학회논문집 Vol.21 No.1

This research Investigates the residents consciousness about the local heritage In Chongju city In order to explore the possibility of an Eco-museum, It aims show the conditions which form the conservation consciousness of the residents sites, by finding out how often those local heritage site were visited or known Consequently, the relation between local heritage and residents depends on the length of time they have lived there and their age, ate And also changes depending on If residents arc local, or non-participates of local activities And this study find out local values and characteristics, thereby playing the role of improving the sense of preserving them

뇌 아밀로이드 혈관병과 고혈압성 뇌출혈의 감별에 있어서 Apolipoprotein Eε4와 점상 출혈 분포의 유용성

김용범,이광호,이수주,나덕렬,조수진,정진상,이원용 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

김해시 인력ㆍ기구의 적정규모와 효율적 조직체계의 구축

김행범,강성철,이광수 인제대학교 김해발전연구소 1997 김해발전연구 Vol.1 No.1