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.

HPLC/FLD를 이용한 성별·연령별 혈장 homocysteine 정상치 조사

이경옥,류광석,이규범,이경옥,류광석,이규범 대한임상검사정도관리학회 1999 臨床檢査와 精度管理 Vol.21 No.1

The First Case of Pure 3D Laparoscopic Living Donor Hepatectomy in Kazakhstan

( Kyung Chul Yoon ),( Kaliev Aset ),( Zhanadil Almyrzauly ),( Yerlan-sultangereyev ),( Bazylbek Zhakiev ),( Kwang-woong Lee ),( Kyung Chul Yoon ),( Kaliev Aset ),( Zhanadil Almyrzauly ),( Bazylbek Zha 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Laparoscopic living donor hepatectomy is performed selectively in some countries because of the small sized structures and anatomic variations which requires more precise technique. In Kazakhstan about 200 cases of living donor liver transplantation were performed starting from December 2011.We now present the first case of laparoscopic living donor hepatectomy in Kazakhstan using a 3D laparoscopic device with colleagues from Seoul National University Hospital, Korea by professor KwangWoong Lee. Methods: A 23-year-old male volunteered for living donor to his older brother who had combined hepatitis B, D and C related cirrhosis without any history of antiviral treatment. The recipient age was 36 and His model for end-stage liver disease score was 22. Brief morphologic characteristics of donor and recipient were as follows: donor - height 177 cm, weight 74 kg, BMI 23.64 kg/m²standard liver volume 1348 ml; recipient - height 172 cm, weight 78 kg, BMI 26.44 kg/m², standard liver volume 1350ml.Donor graft volume was 820ml and left remnant liver volume was 32%. Results: The surgery was performed in October 2016 with 5 port insertion using an ultrasonic dissector, Cabitron Ultrasonic Aspirator, and clips. The liver was extracted via 10 cm sized suprapubic incision. V5 and V8 were reconstructed to the right hepatic vein using the PTFE graft. The Donor’s operation time was 295 minutes and estimated bleeding was 700ml. The recipient had sanguinous drain and bleeding control was performed postoperative day 1 due to bleeding from hilar plate. Both donor and recipient were discharged after 15 and 28 days and the donor was not eventful. Conclusions: 3D laparoscopic hepatectomy has been progressively developed along the past decade. High quality studies allied with high-level surgical training are required to base surgical practice and to disseminate the benefits of to many centers as possible. Future applicability of new technologies such as robot assistance and 3D surgery is still under investigation in Kazakhstan.

한국재래흑염소에서 발정 및 과배란 유도와 외래유전자 주입에 적합한 1세포기 수정란의 채취

신상태,이두환,김명철,이운규,이철상,한용만,이경광 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Three different treatments for induction of estrus in Korean native black goats were compared: follicle stimulating hormone(FSH, FSH-p^TM), FSH combined with MAP(intravaginal impregnated sponges, Veramix^ⓡ, containing 60 ㎎ medroxy progesterone acetate for 14 days), and FSH combined with progesterone(Ovaron^ⓡ, 10 ㎎ IM for 10 days) and PGF_2α(Lutalyse^ⓡ, 3 ㎎ IM at first FSH injection). FSH for inducing estrus and superovulation was given a total 20 ㎎ intramuscularilly in decreasing dosage injections twice daily over 4 days. The MAPs were withdrawn at the 3rd day of FSH injection. Estrus observations were conducted every 6 hours from last FSH injection for 24 hours by placing the does with fertile male goats. Estrus and superovulation were more successfully induced with treatment of MAP + FSH than other treatments(FSH only, or progesterone + PGF_2α + FSH) (estrus induction; 100 vs 42.8 and 71.4%, ovulation points; 11.4 vs 5.4 and 4.4, respectively). The effect of gonadotropin releasing hormone(GnRH) on the ovulation rate was also examined. However, no difference was observed for inducing ovulation with treatment or dosage(100 ㎍ 200 ㎍) of GnRH. Low midline laparotomies were performed, and then ovarian responses (ovulations and follicular development) were examined by exteriorization of the reproductive tracts. Ova were recovered from oviducts by retrograde flushing 60-146 hours after MAP removal, and were classified the developmental stages. Overall 66.1% (236/357) of recovery rate was obtained from 30 superovulated does. The optimal recovery time of microinjectable 1-cell zygotes was approximately 72-76 hours after MAP removal.

다양한 치근단공 크기와 근관단면의 형태를 가지는 치아에서 taper의 정도가 미세누출에 미치는 영향

김정희,이경하,이세준,유미경,이광원 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.2

The aim of this study was to evaluate the microleakage of teeth according to root canal preparation with & without apical enlargement in various size of apical foramen. 60 extracted one canal roots were cross-cutted at 5 mm from root apex and divided into two groups according to their apical foramen size of large (L) and small (S). Each group was subdivided into two groups accordance with their cross-sectional configuration at 5 mm from apex, round (R) and ovoid (O); SR Group, SO Group LR Group, LO Group. Each group was shaped in .02 taper by Quantec series Nickel-Titanium (NiTi) rotary file, obturated by lateral condensation method. Leakage was measured using a fluid transport model under 40cmH₂O pressure. After the leakage test, blocks which had showed the leakage retreated with .04 taper and ,06 taper and evaluated the degree of fluid filtration in each group. The data was analysed statistically using chi-square test and fisher's exact test. The results obtained were as follows : 1. Significant difference in leakage was found in groups which had different apical foramen size in .02 taper instrumentation (p < 0.05), but not in .04 taper instrumentation (p > 0.05) 2. The difference in microleakage according to the shape of canal was not evident at 5 mm from apex (p > 0.05). 3. There was correlation between .02 taper instrumentation and .04 taper instrumentation in LR group, LO group (p < 0.05). 이 연구의 목적은 근단공의 크기가 다양한 치아에서 근단공 확대의 유무에 따른 근관성형시 치아의 미세누출을 평가하기 위함이다. 1근관 치아 60개를 치근첨 상방 5mm에서 절단후 각 치아의 근단공 크기에 따라 큰 근단공 (L) 작은 근단공 (S)으로 나누었다 이 두 군을 치근첨 상방 5mm의 횡단면상 근관의 형태로 원형 (R)과 난형 (O)으로 나누었다(SR, SO, LR, LO). 각 군은 Quantec series Nickel-Titanium (Ni-Ti) rotary file을 이용하여 .02 taper로 성형 후 측방가압법으로 충전하였다. 누출은 40cmH₂O 압력하에 fluid transport method로 측정하였다. 측정 후 누출이 있는 시편은 .04 taper와 .06 taper로 재근관치료 하여 다세 미세누출을 평가하였다. 통계학적으로 chi-square test와 fisher's exact test를 이용하였다. 결과는 다음과 같다. 1. .02 taper로 성형한 군에서는 근단공의 크기에 따른 미세누출은 통계적으로 유의성이 있었고 (p < 0.05) .04 taper로 성형한 군에서는 통계적으로 유의한 차이를 보이지 않았다 (p > 0.05). 2.근첨 상방 5 mm에서 근관단면의 형태에 따른 미세누출은 통계적으로 유의하지 않았다 (p > 0.05). 3. LR group과 LO group에서는 .02 taper로 성형한 군과 .04 taper로 성형한 군사이에 유의한 차이를 보였다 (p < 0.05).

우리나라 논 관개용 지하수 수질 특성

김진호,조광래,임수정,이경자,경기천,엄미정,김희권,김찬용,이영한,이신찬,윤순강 한국환경농학회 2003 한국환경농학회지 Vol.22 No.4

This study was carried out to evaluate the status of the groundwater quality for paddy fields irrigation in Korea. Water samples were collected at 130 sites throughout the country. Samples were collected at three seasons-April, July and October-in 2000. According to our survey, the groundwater was found to be suitable for irrigation purpose. Average EC was shown 0.286 dS/m. Nitrate-nitrogen and Cl^(-) concentration was 5.6 ㎎/L, 32.95 ㎎/L which satisfied the Korean Standards for Irrigation Water. Nitrate-nitrogen concentration in each province was shown as following orders: Jeju (11.17 ㎎/L) > Chungnam (8.16 ㎎/L) > Gyeongbuk (6.64 ㎎/L) > Gyounggi (5.91 ㎎/L) > Chungnam (4.95 ㎎/L) > Gyeongnam (3.91 mgk) > Jeonbuk (3.50 ㎎/L) > Jeonnam (3.27 ㎎/L) > Gangwon (2.91 ㎎/L). The concentration by sampling seasons were October (6.62 ㎎/L) > July (5.88 mg&) > April (4.78㎎/L). As the soil of Jeju Province is usually derived from volcanic ash soils mainly used for upland drops, it may influence the nitrate-nitrogen concentration of groundwater. The amount of rainfall also influence the water quality. But the COD_(Cr), were shown April (3.17㎎/L) > July (2.91 ㎎/L) > October (2.40 ㎎/L), it is highly related in the basal dose of organic matter fertilizers. This study demonstrated that groundwater quality was suitable for irrigation, but continuous monitoring is recommended for agricultural policy and developing OECD agricultural environment indicators.

‘임상간호연구’ 학술지 게재논문(1995-2008년)의 연구동향 분석

최명애,정재심,임경춘,김주현,김금순,권정순,김성재,김경희,곽찬영,박광옥,이경은,김을순,이경숙 병원간호사회 2010 임상간호연구 Vol.16 No.2

Purpose: The purpose of this study was to identify the research trend of 341 studies published in Journal of Korean Clinical Nursing Research from 1995 to 2008. Methods: This study was conducted from May to November, 2009. The tool for analysis developed through literature reviews and discussions of researchers consisted of 7 categories such as characteristics of researchers, research designs, subjects, data collection methods, ethical consideration, nursing interventions, and dependent variables. Data were analyzed by frequency and percentage. Results: The mean number of author per study was 4.7, and clinical nurses were the most frequent as the first author (79.7%) and as a corresponding author (67.1%). Quantitative study was 97.6% and nonexperimental study was 51.7%. The most frequently used research designs were quasi-experimental study (73.9%) among experimental studies and survey study (79.1%) among nonexperimental studies. Patients were the most frequent subjects for studies (55.8%). 46.1% of studies gathered data with questionnaire, 57.7% of studies had consent from patients, and 44.3% of studies used nursing skills for nursing interventions, and 60.0% of studies used clinical end points for dependent variables. Conclusion: The research trend of clinical nursing studies shows that clinical nurses mostly perform quasi-experimental researches to solve patients' problem and frequently use nursing skills for nursing intervention and explore the effect of nursing interventions on clinical end points.

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

대장게실염 -18 예-

김광연,차귀현,이영희,유경수 대한대장항문학회 1986 Annals of Coloproctolgy Vol.2 No.1

Mycosis Fungoides 治驗 一例 報告

李健英,金漢京,李光錫,李 賢 최신의학사 1973 最新醫學 Vol.16 No.1

A case of mycosis fungoides in a fourteen months old infant originated from left forearm is reported. Mycosis fungoides, although designated a disease entity by Alibert in 1806, remains a variously defined and poorly understood disease. The term orignially was employed to designate a group of skin diseases characterized clinically by pruritus, raised, indurated, mushroom-like skin tumors and a long duration and characterized histologically by an infiltrate of eosinophiles, plasma cells and atypical reticulum cells with clusters of mononuclear cells in the epidermis. The microscopic findings of this case revealed to the hyperkeratosis and moderate acanthosis associa?ted with the papillomatosis in the epidermis, to the uniform edematous picture and the infiltrate of inflammatory cells in the upper dermis, and to the infiltrate of eosinophile, lymphocyte and reticulum cells consisted of the hyperchromatic nuclei and mitosis in the lower dermis.