광장공포증 유무에 따른 공황장애 환자의 공존병리와 증상 심각도의 비교 연구

임경희,장은진,김정범 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

연구목적 : 본 연구에서는 광장공포증을 동반하지 않은 공황장애 환자들(이하 비광장공포증군)과 광장공포증을 동반한 공황장애 환자들(이하 광장공포증군)의 공존병리와 증상의 심각도를 조사하여 두 질환의 본질을 규명하고 치료계획을 세우는데 도움을 얻고자 한다. 방 법 : 연구대상은 1998년 3월부터 2001년 7월까지 계명대학교 동산의료원 정신과에서 외래치료를 받아온 환자들로 비광장공포증군 26명, 광장공포증군 44명으로 구성된 총 70명이다. 평가도구는 9개의 증상차원을 평가하는 90문항으로 구성된 간이정신진단검사(SCL-90-R)와 공황장애의 필수적이고 전반적인 7가지 영역의 심각도를 평가하는 한국판 공황장애 심각도 척도를 사용하였다. 통계적 분석은 ANOVA, Chi-square test, student t-test, person correlaiton을 시행하였고, 통계적 유의수준은 p<.05로 하였다. 결 과 : 1) 광장공포증군의 광장공포증적 두려움과 회피의 정도는 경도에서 중등도 사이에 해당되는 것으로 나타났다(PDSS점수 : 1.46±0.94). 2) 인구통계학적 특성에 대해 광장공포증군과 비광장공포증군을 비교해 보면, 연령, 성별, 교육정도, 직업유무, 병력, 발병연령에서는 두 집단 간에 유의한 차이가 없었다(표 1). 3) 세 집단의 공존병리의 유형을 분석해 본 결과, 광장공포증군은 모든 증상차원에서 정상대조군 집단보다 유의하게 높은 점수를 얻었다. 비광장공포증군은 불안, 공포불안, 정신증 척도에서 정상대조군 집단 보다 유의하게 높은 점수를 얻었다(표2). 4) 광장공포증군은 비광장공포증군에 비해 신체화, 강박증, 적대감, 공포불안, 편집증척도에서 유의하게 높은 점수를 보였다(표 2). 5) 광장공포증군과 비광장공포증군의 심각도 비교에서는 내적감응적 두려움과 회피, 직무수행의 장해/고통, 사회적 기능의 장해/고통에서는 두 집단 간에 유의한 차이를 보이지 않았느아, 심각도 총점, 복합점수, 공황발작의 빈도, 공황발작 동안의 고통, 예기불안, 광장공포증적 두려움과 회피에서는 광장공포증군이 비광장공포증군에 비해 유의하게 높은 점수를 보였다(표 3). 6) 광장공포증군내에서 광장공포증적 두려움과 회피항목은 SCL-90-R의 정신증 척도를 제외한 신체화, 강박증, 대인민감성, 우울, 불안, 적대감, 공포불안, 편집증 척도와 유의한 정적상관관계를 보였다(표 4). 결 론 : 광장공포증군이 비광장공포증군에 비해 대부분의 필수증상의 심각도가 높을 뿐만 아니라 더 다양한 공존병리를 가지고 있음이 밝혀져 기본적으로 더 심한 질환임이 시사된다. 따라서 공황장애의 치료와 평가에 있어서 공존병리와 증상의 심각도를 함께 고려하고 공황장애에서 광장공포증이 동반되는 경우 이에 대한 더 적극적이고 집중적인 치료가 필요하겠다. Objectives : In this research comorbidity and severity of symptom of patients that have panic disorder without agoraphobia(PD) and with agoraphobia(PDA) were examined in order to study their nature more closely and also to help set up therapy plans. Method : 70 patients were diagnosed with PD(N=26) and PDA(N=44) by DSM-Ⅳ. SCL-90-R was administered to panic subjects and normal control subjects. PDSS were administered to panic subjects, the statistical analysis was conducted using ANOVA, Chi-square test, student t-test, Pearson Correlation analysis. statistical signifi-cance was p<.05. Results : 1) The degree of agoraphobic fear/avoidance of PDA indicated the level to from moderate(PDSS score 1.46 0.94). 2) There was no significant difference between the two groups(PD/PDA) in there sex, age, education level, occupation, duration of illness, onset of age. 3) After analyzing the comorbidity pattern of the three groups, PDA was significantly higher score than normal control group in all symptom level. PD had higher score than normal control groups in anxiety, phobic anxiety and psychotism. 4) PDA showed much a significantly higher score in Somaatization, Obsessive-Compulsive, Hostility, Phobic Anxiety, Paranoid Ideation when compared to PD. 5) There was no significant difference between the two groups(PD/PDA) in there interoceptive fear/avoidance, PDA had significantly higher scores than PD. 6) The agoraphobic fear/avoidance item within PDA had significant correlation with Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Idation except significant correlation with psychoticism. Conclusion : As it is shown clearly in all the results, PDA had a higher level of severity than PD. It was also clarified that PDA had a variety of comorbidity. Therefore when evaluating the treatment of Panic Disorder, One has to consider the comorbidity and severity. A more positively and concentrated treatment will be needed when panic disorder is accompanied by agoraphobia.

內障疾患에 對한 丹梔逍遙散의 치료효과에 關한 임상적 분석

김성범,홍성민,임승환,김경준 대전대학교 한방병원 2002 惠和醫學 Vol.11 No.1

Because their severity of the symptom and influence in visual loss, suitable prevention and treatment to internal optic disease are required. Representative disease belonging to category of internal optic disease is separation of the retina, retinnitis pigmentosa, glaucoma, cataract, uveitis and corneitis and vitreous opacity myopia etc.. Caused by stress specially in internal optic disease are induction factor that's frequency is increasing on modern industrial society, so we must handle this problem by alleviation of fever and make digestion strong. "Danqi-Soyosan" is the representative prescription which can apply in the internal optic disease by stress. We adding some drugs to "Danqi-Soyosan" and got significant result in the internal optic disease which caused by stress, so we reporting.

스포츠 외상에 의한 척추·척수손상 분석

김대경,임완기,임정일,김범수,추해광,강은균 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

I have researched 46 examples, 43 are spinal column and cord injury and 3 are thoracic vertebrae and cord injury, of J hospital S health caring center. 46 patients were cured by this J hospital medical staffs, and their external injury were caused by sports accidents. I have acquired next four meaningful conclusions. First, the external injury caused by golf sports are 24 cases, and this is the primary cause of injury. Second, high-rank bonn fracture are 78.8 percent in C4, C5, C6 situation. And the bone-fracture, tear-drop fracture, figure in the activity of gold is 45.8 percent, and fracture dislocation is 63.2 percent in other sports activities. Third, there are twenty six cases of paralysis that links frankel C. Four, the sports injuries such as bone fracture are able to prevent by education and effective learning programs.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

콤포짓트 레진의 중합체계에 따른 중합률 및 잔류단량체 유출

문현정,임범순,이용근,송재경,김철위 대한치과기재학회 2001 대한치과재료학회지 Vol.28 No.2

Newly developed curing units for the dental composite resins are claimed to result in optimum properties and short curing time. The purpose of this study was to detemine the curing effectiveness of the curing units, and to evaluate the relationship between the degree of polymerization and leachability of residual monomer. Three composite resins were tested (Z100; z100, Herculite XRV; HX, Heliomolar; HM). Disk specimens of 2 mm in thickness and 6 mm in diameter were cured with a plasma arc [Apollo 95E; at 1370 mW/㎠, for 5 sec.(A5), 10 sec.(A10), 15sec(A15)], halogen lamp [VIP; at 500 mW/㎠, for 13 sec.(V13), 26 sec.(V26), 40 sec.(V40)] and custom made light emitting diode [LED; at 500 mW/㎠, for 13 sec.(L13), 26 sec.(L26), 40 sec.(L40)]. Specimens were immersed in 75% ethanol for 7 days. Eluates of the composites were analyzed by a high-performance liquid chromatography, and the degree of polymerization of composites were determined by a Fourier transform infrared spectroscopy. To obtain the sufficient curing by a plasma arc, the curing time should be longer than 10 sec. When the same light energy was irradiated, LED showed similar curing performance to halogen lamp. The light energy and the degree of polymerization was not correlated (p>0.05), but the light energy and the leachability of residual monomer was correlated (p<0.05). The leachability of residual monomer (TEGDMA+BisGMA) depended on the degree of polymerization.

만성 신부전증 환자의 중중 고혈당에 따른 의식 변화 결정에 대한 연구

위형중,이창범,박성광,강성귀,임천규,박은주,윤경택,한상웅,안유헌,김호중· 대한신장학회 2000 대한신장학회잡지 Vol.19 No.6

악안면 골결손부의 이종골이식을 이용한 수복에 관한 연구

김경원,조용석,이경호,임현범 충북대학교 의과대학 충북대학교 의학연구소 1998 忠北醫大學術誌 Vol.8 No.2

연구목적 : 구강 및 악안면영역의 소수술시 발생할 수 있는 골결손부에 대하여 이종골을 이용한 골이식을 시행하고 치료결과 및 예후를 평가하고자 하였다. 재료 및 방법 : 1996년 1월부터 1996년 12월까지 내원한 환자중 골결손부에 대힌 골이식이 필요하였던 환자중 이식 후 추적 관찰이 가능하였던 36명에 대하여 의무 기록과 방사선 사진을 이용하여 분석하였다 결과 : 대상 환자중 10대와 20대(72.7%)가 가장 많았으며, 골이식이 필요하였던 질병으로는 낭종, 양성 종양, 매복치, 치근단 질환 등이었으며, 이식후 평균 7개월의 추적 관찰을 시행한 결과 36례중 6례(약17%)에서 술후 경미한 정도의 감염 소견이 있었으며 그 외는 특별한 합병증이 발견되지 않았다. 결론 : 구강 및 악안면영역의 비교적 작은 골결손부에 대하여 이종골이식을 선택적으로 시행할 수 있을 것으로 생각된다. Purpose : We evaluated the result and prognosis of the heterogenic bone graft for restoration of the bone defect in oral and maxillofacial region. Materials and Methods : We collected and analysed the patents who received the heteogenic bone graft from January 1996 to December 1996 in Chungbuk National University Hospital. Results : Prevalent age groups of heterogenic bone graft were 2nd and 3rd decades(72.2%), and cysts and benign tumors, impacted teeth, apical lesions were causative diseases of bone defects. The average period of follow-up was 7 months after operation. Major complications were postoperative infections(17%), but they were not severe. Conclusion : We recommend a heterogenic bone graft for restoration of the relatively small bone defect in oral and maxillofacial region selectively.

두가지 혈류 유발방법에 의한 새로운 심폐소생술(이중 혈류 유발 심폐소생술)장치의 개발

황성오,김현,조준휘,오범진,임종천,최경훈,윤정한,이승환,김영식,이강현,이윤선 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. Methods and results: we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To determine strap width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of strap in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the stemum was depressed to 5 cm. Cardiopulmonary resusciation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal study using two dogs. Conclusion: New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

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.