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.

사면의 안정도 해석을 위한 입체투영법

이성대,이철우,이동우,이성규 公州大學校 基礎科學硏究所 1996 自然科學硏究 Vol.5 No.-

암반 사면의 안정성을 해석하는데 입체투영기법을 이용하였다. 안정도에 영향을 미치는 요인으로는 절리의 경사, 암석의 밀도, 내부마찰각등이 있으나, 가장 중요한 요인은 절리면의 경사이다. 이 연구에서는 암석의 점착력은 무시하고 단지 내부마찰각과 절리의 주향 및 경사만을 이용하였다. 그 결과 입체투영도에서 나타나는 암반사면의 안정도는 이동력과 저항력의 상대적인 크기에 의하여 좌우되는 것으로 나타났다. 동시에, 지반진동에 의한 영향도 입체 투영기법으로 찾아낼수 있다는 것이 밝혀졌다. Stereographic projection technique was used to analyze rock slope stability. Strike and dip of joints, rock strength, and internal frictional angle are major factor on slope stability. Among them, the most important factor is strike and dip of joints. In stereographgic projection technique, only internal frictional angle, and strike and dip of joints were used to interprete slope stability. Cohesion of rock was not considered. It is suggested that the rock slope stability on stereographic projection depends upon only the differential stress between driving and resisting force. At the same time, Stereographic projection technique on seismic loading was proposed in this study.

혼성제 직립 케이슨의 활동에 대한 부분안전계수 산정

이철응(Lee, Cheol-Eung),박동헌(Park, Dong-Heon),권혁재(Kwon, Hyuk-Jae),이선용(Lee, Sun-Yong) 한국해안해양공학회 2009 한국해안해양공학회 논문집 Vol.21 No.4

혼성제 케이슨의 활동파괴모드에 대한 목표파괴수준에 따른 저항 및 하중 그리고 신뢰함수의 부분안 전계수를 산정하였다. 이를 위해 파력의 편이를 고려한 혼성제 케이슨의 활동파괴모드에 대한 신뢰함수를 수립하 고, 관련 확률변수의 불확실성에 대해 분석하였다. Level II AFDA 해석법을 이용하여 여러 수심조건 및 단면조건 그리고 파랑조건에 대해 신뢰성 해석을 수행하였다. 특히 대산항, 동해항 그리고 포항항의 실제 혼성제 케이슨의 활동파괴에 대한 신뢰성 해석도 수행하였다. 마지막으로 목표수준에 따른 혼성제 케이슨의 최소 소요 폭을산정하는 방법으로 본 연구에서 산정된 부분안전계수에 대한 비교 평가를 실시하였다. 비교 결과, 목표수준 1%에서는 약간의 차이를 보이고 있으나 다른 모든 수준에서는 비교적 잘 일치하고 있다. Partial safety factors of the load, resistance, and reliability function are evaluated according to the target probability of failure on sliding mode of monolithical vertical caisson of composite breakwaters. After reliability function is formulated for sliding failure mode of caisson of composite breakwaters regarding bias of wave force, uncertainties of random variables related to loads, strengths are analyzed. Reliability analysis for the various conditions of water depth, geometric, and wave conditions is performed using Level II AFDA model for the sliding failure. Furthermore, the reliability model is also applied to the real caisson of composite breakwaters of Daesan, Dong- hae, and Pohang harbor. By comparing the required width of caisson of composite breakwater according to target probability of failure with the other results, the partial safety factors evaluated in this study are calibrated straightforwardly. Even though showing a little difference on the 1% of target probability, it may be found that the present results agree well with the other results in every other target probability of failure.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

니세틸 정(아세틸-엘-카르니틴 500 mg)에 대한 뉴로세틸 정의 생물학적 동등성

조혜영,김은아,정현철,심영순,임동구,오인준,문재동,이용복 전남대학교 약품개발연구소 2001 약품개발연구지 Vol.10 No.-

Acetyl-L-carnitine (ALC), an endogenous component of the L-carnitine family, is naturally occurring molecule synthesized from L-carnitine (LC) by carnitine acetyl transferase. ALC has been shown to improve the cognitive performance of patients suffering from dementia of the Alzheimer's type and proposed for treating Alzheimer's disease in pharmacological doses. The purpose of the present study was to evaluate the bioequivalence of two ALC tablets, Nicetiler^TM (Dong-A pharmaceutical Co., Ltd.) and Neurocetil^TM (Kyung-Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration. Twenty six normal male volunteers, 22.80±2.76 year in age and 63.07 7.98㎏ in body weight, were divided into two groups and a randomized 2×2 cross-over study was employed. After one tablet containing 500㎎ of ALC was orally administered, blood was taken at predetermined time intervals and the concentrations of ALC in serum were determined using HPLC with fluorescence detector. Because of the presence of endogenous ALC, the calibration was performed using dialyzed serum. Pharmacokinetic parameters such as AUC_t, C_max and T_max were calculated and ANOVA was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC_t, C_max and T_max between two tablets were 2.72%, -0.65% and -8.42%, respectively, when calculated against the Nicetile^TM tablet. The powers (1-β) for AUC_t and C_max were 94.87% and 87.17%, respectively. Minimum detectable differences (Δ) at α=0.05 and 1-β=0.8 were less than 20% (e.g., 15.58% and 19.16% AUC_t and C_max, respectively). The 90% confidence intervals were within ±20% (e.g., -11.84∼6.41 and -10.57∼11.88 for AUC_t and C_max, respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that Neurocetil^TM tablet is bioequivalent to Nicetile^TM tablet.

중소규모 사업장 근로자의 직무스트레스로 인한 결근, 조퇴 현황과 한국형직무스트레스 하부요인과의 관련성

김정훈,박신구,김동현,김환철,임종한,이의철,이동훈,이지영 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

목적: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴의 현황과 한국형 직무 스트레스 하부 요인과의 관련성을 알아보고자 하였다. 방법: 중소규모 사업장 83곳 근로자들에 대해 한국형 직무스트레스요인 평가도구-단축형(KOSS-SF)과 사회 일반적 특성, 직업적 특정 및 직무스트레스로 인한 결근이나 조퇴 경험여부 등을 묻는 구조화된 자가 기입식 설문을 실시하였고, 응답한 4,350명에 대해 최종 분석을 시행하였다. 직무스트레스로 인한 결근, 조퇴와 한국형 직무스트레스 하부 요인들과의 관련성을 확인하기 위하여 로지스틱 회귀분석을 시행 하였다. 결과: 직무 스트레스로 인한 결근, 조퇴를 한 근로자는 남자에서 7%(196명), 여자에서 8%(113명) 로 조사되었고 한국형 직무 스트레스 하부요인과의 관련성에서는 남, 여 모두 직무요구, 관계갈등, 조직체계, 보상부적절, 직장문화 영역의 스트레스가 높은 군에서 통계적으로 의미있게 직무스트레스로 인한 결근, 조퇴율이 증가하였다. 결론: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴와 한국형 직무 스트레스 하부요인과의 관련성은 남자에서는 조직체계 영역이 가장 높았고, 여자는 직장문화 영역에서 가장 높은 관련성을 보였다. Objective: The aim of this study was to examine the actual conditions of absence and early leave due to job stress of 4,350 workers in 83 small and medium scale industries, and its relationship to job stress factors using Korean Occupational Stress Scale-Short Form (KOSS-SF). Methods: A structured self-reported questionnaire was used to assess each respondent's Sociodemographics, job stress, experience of absence and early leave due to job stress. Seven KOSS-SF domains of job stress were used. We estimated the relation of absence and early leave due to job stress and job stress factors using logistic regression analyses. Results: Absence or early leave due to job stress occurred in 7% of male workers and 8% of female workers. Multiple regression analysis revealed a significantly positive association job stress-related absence/early leave and job demand, interpersonal conflict, organizational system, lack of rewards and occupational climate. Conclusions: Absence and early leave due to job stress is significantly attributed to organizational System and lack of reward for men, and occupational climate and organizational system for women.

니세틸 정(아세틸 - 엘 - 카르니틴 500mg)에 대한 뉴로세틸 정의 생물학적 동등성

조혜영,오인준,이용복,임동구,문재동,심영순,김은아,정현철 한국약제학회 2001 Journal of Pharmaceutical Investigation Vol.31 No.1

Acetyl-L-carnitine (ALC), an endogenous component of the L-carnitine family, is naturally occurring molecule synthesized from L-carnitine (LC) by carnitine acetyl transferase. ALC has been shown to improve the cognitive performance of patients suffering from dementia of the Alzheimer's type and proposed for treating Alzheimer's disease in pharmacological doses. The purpose of the present study was to evaluate the bioequivalence of two ALC tablets, Nicetile^(TM) (Dong-A pharmaceutical Co., Ltd.) and Neurocetil^(TM) (Kyung-Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration. Twenty six normal male volunteers, 22.80±2.76 year in age and 63.07±7.98 ㎏ in body weight, were divided into two groups and a randomized 2 × 2 cross-over study was employed. After one tablet containing 500 ㎎ of ALC was orally administered, blood was taken at predetermined time intervals and the concentrations of ALC in serum were determined using HPLC with fluorescence detector. Because of the presence of endogenous ALC, the calibration was performed using dialyzed serum. Pharmacokinetic parameters such as AUC_t, C_(max) and T_(max) were calculated and ANOVA was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC_t, C_(max) and T_(max) between two tablets were 2.72%, -0.65% and -8.42%, respectively, when calculated against the Nicetile^(TM) tablet. The powers (1-β) for AUC_t and C_(max) were 94.87% and 87.17%, respectively. Minimum detectable differences (△) at α=0.05 and 1-β=0.8 were less than 20% (e.g., 15.58% and 19.16% AUC_t and C_(max), respectively). The 90% confidence intervals were within ±20% (e.g., -11.84∼6.41 and -10.57∼11.88 for AUC_t and C_(max), respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that Neurocetil^(TM) tablet is bioequivalent to Nicetile^(TM) tablet.

복강경담낭절제술에서 수술전 간담도신티그라피와 경구담낭조영술의 의의

문대혁(Dae Hyuk Moon),양승오(Seoung Oh Yang),이희경(Hee Kyung Lee),원경숙(Kyoung Sook Won),류진숙(Jin Sook Ryu),한동복(Dong Bok Han),박철민(Cheol Min Park),이문규(Moon Gyu Lee),박광민(Kwang Min Park),이승규(Sung Gyu Lee) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1

N/A 131I-6β-iodomethyl-19-norcholesterol(NP-59) has an advantage to assess adrenal dysfunction caused by adrenal cortical disorders. The aim of this study is to evaluate the clinical usefulness of NP-59 scintigraphy in each adrenral disease. Ten patients who did eleven NP-59 adrenal scintigraphies at Dong-A University Hospital from March 1990 to December 1996 were selected as the subject. Among the subject there were 5 cases of Cushing's syndrome, 2 cases of incidentaloma, 1 case of metastatic adrenal tumor, liver cirrhosis with hirsutism and hypertension respectively. Among 5 case of Cushing's syndrome, there were 2 cases of Cushing's disease, 2 cases of adrenal adenoma and 1 case of adrenal carcinoma. There are no disagreement between clinical diagnosis and scan finding in Cushing's syndrome. In 2 incidentaloma cases, even though one is interpretated as a functioning tumor, both of 2 cases could avoid unnecessary biopsy according to scintigraphy result. One case of hirsutism, clinically adrenal originated, revealed the normal scintigraphic hirsutism was extra-adrenal origin. One case of hypertension took the study to exclude the possibility of primary aldosteronism. Normal suppression scan finding revealed that primary aldosteronism did not exist in this case. In conclusion, NP-59 scintigraphy was very useful in diagnosis and differential diagnosis of Cushing's syndrome and it could avoid unnecessary biopsy in the incidental adrenal tumor.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

악관절 급성 손상시 관절강 세척술의 효과에 관한 연구

이동근,문철,김장현 원광대학교 생체재료·매식연구소 1996 원광생체재료·매식 Vol.4 No.3

This study has demonstrated the efficacy of arthrocentesis of upper temporomadibular joint (TMJ) compartment in cases of severe pain and limited maximum mouth opening (MMO) in traumatic hemarthrosis of TMJ. Thirteen patients complaining of severe pain and limited MMO were treated by irrigation of the upper compartment of the affected TMJ with lactated Ringers solution. This treatment was found to be effective in reestablishing normal mouth opening and relieving pain within I week in postoperative. It is suggested that arthrocentesis simple, less invasive, inexpensive, and highly efficient procedure, which can be performed under local anesthesia, is used in traumatic hemarthrosis cases with severe pain and limited MMO.