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.

폐경기증상 치료에서 승마추출물과 호르몬보충요법의 비교연구

이병익(Byoung Ick Lee),고승권(Seung Kwon Koh),황성욱(Seong Ook Hwang),박지현(Jee Hyun Park),김종화(Chong Wha Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.8

목적 : 폐경 증상에 대한 장기간의 호르몬 보충 요법은 유방암에 대한 공포와 부작용으로 말미암아 새로운 대체요법에 대한 관심이 절실히 요구되는 실정이다. 이에 본 연구는 승마추출물이 폐경 여성에 있어서 폐경 증상을 완화시키는데 호르몬 보충 요법의 대체요법으로 사용될 수 있는 지 알아보고자 시행하였다. 연구 방법 : 폐경 증상을 호소하는 폐경 여성 74명을 위약군 (Placebo: 12명), 승마추출물군 (Feramin: 32명), 호르몬보충요법군 (Premarin: 30명)으로 나누어 3개월간 약물을 투여하였다. 총 3회 (약물 투여전, 투여 1개월, 투여 3개월)에 걸쳐 폐경 증상의 변화는 Kupperman index의 변화로, 골대사의 변화는 Osteocalcin과 Deoxrpyridinoline을 측정하여, 지질대사의 변화는 총 콜레스테롤, 중성지방 및 고밀도 콜레스테롤을 측정하여 계량화 하였다. 약물투여에 대한 부작용은 투여 3개월 후 조사하였다. 결과 : 위약군과 비교하여 승마추출물은 Kupperman index를 낮추는데 있어서 호르몬 보충 요법만큼 효과적이었다 (투여 1개월: p<0.05, 투여 3개월: p<0.01). 골대사 및 지진대사의 변화에 있어서 위약군에 비하여 약간의 긍정적인 효과를 보이나 통계학적으로 유의하지 않았다. 부작용은 호르몬보충요법에 비하여 훨씬 적었다. 결론 : 승마추출물은 폐경 증상을 완화시키기 위한 목적으로 호르몬 보충 요법을 대치할 수 있는 안전하고 효과적인 치료제이며 특히 호르몬 보충 요법의 부작용이나 장기간투여에 따른 유방암에 대한 공포로 말미암아 투여를 거부하는 경우 새로운 대체요법으로 생각된다. Objective : The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. Material & Methods : Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRT on Kuppetman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal^??) (n=12), BCRE (Feramin^??) (n=32) and HRT (Premarin^??) (n=30) for 3 months. Kupperman index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, I and 3 months. Side effects were checked at 3 months. Results : BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. Conclusion : BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.

Luncheon Symposium : Overactive bladder

이병익 ( Byoung Ick Lee ) 대한산부인과학회 2005 대한산부인과학회 학술대회 Vol.91 No.-

줄기세포이식 후 여성호르몬치료

이병익 ( Byoung Ick Lee ) 대한폐경학회 2007 대한폐경학회지 Vol.13 No.1

Women undergoing stem cell transplantation (SCT) are mostly young and have more than 90% probability of ovarian failure, which is often permanent. A woman`s age, use of radiotherapy, alkylating chemotherapy, and the allogeneic type of transplant are associated with a higher rate of premature ovarian failure (POF) and worse residual ovarian function. POF has serious systemic and psychological effects that may need treatment and should be managed by practitioners trained to treat this particular population of women. Ultrasonographic evidence of ovarian follicles is often associated with a future resumption of cycles, but there are no serum markers to predict the return of ovarian function in these patients. There are no guidelines on how to manage POF induced by myeloablative treatments followed by SCT. Because of the likelihood of the need for long-lasting estrogen plus progestin therapy (EPT) and the increased risk of secondary neoplasia after SCT, the EPT should be as physiological as possible. The cyclical sequential combination of EPT was associated with excellent compliance because of its simple administration and few adverse effects. Such a treatment led to a dramatic improvement in vasomotor, urogenital, and psychological symptoms related to estrogen deficiency. However, in the allogeneic transplantation setting, up to 25% of women may suffer from gynecological chronic graft-versus-host disease (GVHD), which may become apparent as hematocolpometra after introduction of EPT. Thus, accurate pretreatment evaluation and frequent monitoring during treatment are required. Moreover, EPT absorption may be reduced in patients who received allotransplants and have gastrointestinal or skin chronic GVHD.

Obstructive hemivagina and ipsilateral renal agenesis (OHVIRA) - a case

( Min Kyung Lee ),( Kyung Jin Lee ),( Ye Jeong Kim ),( Tae Hee Kim ),( Hwa Yeon Choi ),( Shina Jang ),( Bang Hyeon Lee ),( Byoung Ick Lee ),( Sung Ook Hwang ),( Soo Ran Choi ) 대한산부인과학회 2021 대한산부인과학회 학술대회 Vol.107 No.-

세포진 검사상 ASCUS/LSIL이 나온 환자의 치료에 있어서 HPV DNA 검사의 임상적 유용성

이정례 ( Jeong Rye Lee ),송은섭 ( Song Eun Seop ),이정헌 ( Heong Hun Lee ),김세련 ( Se Ryun Kim ),박지현 ( Jee Hyun Park ),황성욱 ( Sung Ook Hwang ),고승권 ( Seung Kwon Koh ),임문환 ( Moon Whan Im ),이병익 ( Byoung Ick Lee ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.2

목적 : PCR을 이용한 HPV DNA 검사법이 비정상 세포진 (ASCUS/LSIL)이 나온 환자에서 고위험 병변을 알아내기 위한 보조적인 수단으로서 임상적인 효용성이 있는지 알아보고자 하였다. 연구 방법 : 1996년 9월 1일부터 2000년 5월 31일까지 인하대병원 산부인과에 내원하여 자궁경부 세포진 검사를 받은 여성 중에서 비정상 세포진 (ASCUS/LSIL)의 결과를 보여 HPV DNA 검사와 질확대경하 조직 생검을 시행 받은 61명을 대상으로 Objective : This study was performed to evaluate the clinical efficacy of high risk HPV DNA test using PCR for the detection of high-grade CIN or invasive cancer from patients with ASCUS or LSIL on Papanicolaou smear. Methods : Sixty one patients with a P

Sublingual compared with intravaginal misoprostol in term Labor induction

이정은 ( Jung Eun Lee ),( Jee Hyun Park ),( Se Ryun Kim ),( Sung Ook Hwang ),( Moon Whan Im ),( Eun Seop Song ),( Byoung Ick Lee ),( Woo Young Lee ) 대한산부인과학회 2003 대한산부인과학회 학술대회 Vol.89 No.-

난소 종양으로 오진된 신장 무형성을 동반한 우측 흔적 자궁각

이기은 ( Ki Eun Lee ),권혜진 ( Hye Jin Kwon ),정현재 ( Hyun Jae Jeong ),박정우 ( Jung Woo Park ),최효성 ( Hyo Seong Choi ),이춘수 ( Choon Soo Lee ),황성욱 ( Sung Ook Hwang ),송은섭 ( Eun Seop Song ),이병익 ( Byoung Ick Lee ),이우 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1

Rudimentary uterus with ipsilateral renal agenesis is a very rare Mullerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An appropriate and prompt diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of rudimentary uterine horn with ipsilateral renal agenesis with a brief review of concerned literatures.

Pareto Optimal Design of the Vehicle Body

Byoung-Gon Kim(김병곤),Tae-Jin Chung(정태진),Jeong-Ick Lee(이정익) 한국생산제조학회 2008 한국생산제조학회지 Vol.17 No.4

비수술적 점진적 확장술을 이용한 선천성 무질증 환자의 치험례

이충재,이세일,길민석,이병익,서영태 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.6

The surgical construction of vagina could certainlty be done by skin grafting or flaps, but it involves hospitalization, discomfort,scarring of donor area and vaginal tract, hygiene problem. The tissues of the vagina are soft and distensible and it is reasonable to assume that these same tissues could be stretched, elongated or dilated with gradual external pressure. So, we performed the expansion of vaginal lining by self designed set of graduated dilators. The patients was a 27-years-old female whose chief complaint is amenorrhea and incapability to engage in sexual intercourse. On physical examination, this patients had a feminine figure with a normal vulva but only a vaginal dimple was observed. The patient was educated to carry out the mechanical dilation of this dimply by pressure 15 minutes twice a day. In the evening, with insertion of a dilator, the patient was asked to sit on a bicycle chair for 10 minutes. After 8 weeks, the overall outcome of vaginoplasty was successful. The vaginal tract was 8 cm in length and the largest vaginal speculum could be passed into vagina. The patient was able to engage in sexual intercourse without lubrication. The progressive dilatation of vaginal lining is non-invasive and probably the simplest way to treat the patients with congential vaginal atresia. So we recommend this method as the first treatment strategy before surgery.