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.

현대음악 앙상블의 리허설 담론 분석

손민정(Son, Min-Jung) 한국교원대학교 교육연구원 2020 敎員敎育 Vol.36 No.2

본 연구는 2012년에 결성된 한국 현대음악 단체 project21AND의 제4회-제6회 정기연주회(2016-2018년) 리허설 담론을 분석함으로써 한국 현대음악의 의미생성 과정의 현장을 질적으로탐구하고자 하였다. 연구의 목적은 한국 현대 음악 전반의 흐름을 분석하는 것이 아니라, 일부일지라도 현재 활발하게 작품 활동을 하고 있는 음악인들의 역동적인 음악 만들기 과정을 심층적으로해석하는 것이다. 연구에서 취했던 방법론은 현장중심의 인류학적 연구이며, 본 논문에서는project21AND의 상임 작곡가 김정훈의 <Chorus (2016)>와 공모 작곡가 전현석의 <De Tuin derLusten (2018)> 리허설 담론을 집중적으로 분석하였다. <Chorus>는 제4회 정기연주회(2016년)를위한 작품으로서 project21AND의 설립자이자 상임 음악감독인 김승림과 김정훈이 지휘자와 작곡가의 역할로 음악 만들기에 공조했는가 하면, <De Tuin der Lusten>의 경우는 제6회 정기연주회(2018년)를 위한 공모에서 선정된 작품이었기에 project21AND의 내재적인 특성을 드러내기에 적합하였다. 분석의 틀은 긴스보르와 킹의 리허설 담론 연구와 고든의 현대음악 리허설 논의를 기본으로 했으며, 질적연구 소프트웨어 <NVivo12>를 활용하여 코딩하였다. 이 때, 제4회-제6회 정기연주회에 참가한 총 13인의 작곡가와의 개별면담을 통해 ‘음악적 실험’을 추구하고자 하는 공통적인 인지적 맥락을 도출하였으며 이를 리허설 담론 분석의 근거로 삼았다. 실제로 리허설은 연습리허설과 공연 리허설로 구분되었으며, 연구자는 리허설 내내 작곡가, 연주자, 지휘자 간의 대화를녹취 및 녹화를 실시했다. 두 경우의 리허설에서 기록된 대화를 전사하여 코딩한 결과로 도출된코드는 ‘작곡가의 작품에 대한 성찰’, ‘악보 보완 및 수정’, ‘악기 주법’, ‘연주자의 물리적 배치’, ‘공연에 대한 설명’ 등이었다. 이는 작곡가 면담에서 도출되었던 ‘음악적 실험’에 관한 가치관과 일맥상통한 것을 확인했으며, 작곡가, 지휘자, 그리고 연주자 간의 민주적인 상호관계가 형성되어 있음을 알 수 있었다. The purpose of this study was to qualitatively explore the musical meaning generation process of Korean contemporary music by interpreting the rehearsal discourse of a Korean contemporary musicgroup project21AND (est. 2012), focusing on the 4th~6th periodical concert (2016~2018). This research was not geared to analyze the entire spectrum of Korean contemporary music, but to interpret the dynamic music-making process of certain active a vant-garde musicians. The researcher has not only been participating in their music-making process as a music critic since the foundation of the organization, but also established a strong rapport with the members. The method ologyutilized in this study is field-oriented anthropological research, and the analyzed pieces in this article include Kim Jung-hoon s <Chorus (2016)> and Jeon Hyun-suk s <De Tuin der Lusten (2018)>. KimSeung Lim and Kim Chunghoon, the two key members of project21AND collaboratively worked as a conductor and a compsoer respectively in the music-making of <Chorus>, while Chun as anofficially chosen composer by the group realized his work, <De Tuin der Lusten>. The framework of the analysis was based on Ginsborg and King s research on rehearsal discourse and Gordon s discussion on contemporary music rehearsal, with the help of the qualitative research software NVivo12. In addition, 13 composers were interviewed who participated in the 4th to 6th regular concerts, and this research found their common cognitive ground, ‘musical experiment’ to contextualize the rehearsal discourse of the two exemplary cases. Rehearsals were divided intopractice-rehearsals and performance-rehearsals, and conversations were recorded between composers, performers, and a conductor throughout the rehearsals. The codes resulted from the interpretation of the dialogue recorded in the rehearsals in both cases include the following:‘composers contemplations on their works; ‘editing and changing the acoustic details; ‘instrumental renditions; and ‘physical arrangement of the performers. In conclusion, the rehearsal discourses of project21AND emphasized the search for new sounds and unveiled the values of the ‘musical experiment derived from the composer interview, and the discourses that were produced through the dynamic interrelationships between the composers, the conductor, and the performers.

초등학교 저학년용 영양교육 소책자 개발 및 효과 분석

손민정(Min Jung Son),조영숙(Young Sook Cho),김세나(Se Na Kim),서혜지(Hye Ji Seo),김숙배(Sook Bae Kim) 대한지역사회영양학회 2011 대한지역사회영양학회지 Vol.16 No.6

The purpose of this study was to investigate effects of nutrition education program and pamphlet for the lower grades elementary students focused on individual daily needed food exchange units using Food Exchange System. Program consisted of four lessons (40 min/lesson), 5 major nutrients & function, 6 food group and sources, daily needed food exchange units for normal body weight, and smart snack choice and exercise. Pamphlet as activity book was developed for the program. The subjects were 3rd grade elementary students (educated group, 31 vs. non-educated group, 31). Educated group were lessoned as group and/or individual. We examined the differences in nutrition knowledge, dietary attitudes, dietary intakes and satisfaction of the program and pamphlet. In educated group, there were positive improvements on nutrition knowledge score function and foods of 5 nutrients and on dietary attitudes type of breakfast and snacks. In the evaluation of dietary intakes according to KDRI, there were positive improvements on intakes level of riboflavin, vit. C, folate, Ca, P, Fe and Zn in educated group. In satisfaction with the program and pamphlet, contents, font size, visual, figure, difficulty and program curriculum were over 2.90/3.0. It showed that the developed nutrition education program and pamphlet focused on individual daily needed food exchange units using Food Exchange System improved nutrition knowledge, dietary attitudes and nutrients intake level in the lower grades elementary students. (Korean J Community Nutr 16(6) : 647~660, 2011)

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

C-반응성단백과 가장 관련 있는 대사증후군 대사이상 항목

손중천,김범택,이득주,최현국,정현주,김광민 대한비만학회 2003 The Korean journal of obesity Vol.12 No.1

연구배경: C-반응성단백 (이하 CRP)은 심혈관질환의 예후인자 및 독립적 위험인자이다. 대사증후군은 복부비만, 고혈압. 당대사이상 및, 지질대사이상과 같은 관상동맥질환 위험인자들이 동시에 나타나는 증후군을 말한다. 저자들은 18세 이상의 성인 남녀에서 CRP와 대사증후군 대사이상 항목과의 상관관계를 연구하였다. 방법: 2002년 4월부터 10월까지 일개 대학병원 건강증진센터에 내원한 수진자 2772명 중 염증성질환이 의심되는 577명을 제외한 총 2195명을 대상으로 하였다. 신체계측과 혈압측정, 혈액검사를 실시하였다. 통계적 분석은 남녀를 구분하여 대사증루군의 대사이상 항목의 군집성에 따른 CRP값에 대해 ANOVA 검정을 시행하였고, 각 대사이상 항목들과 연령을 독립변수로 하여 회귀분석을 실시하였다. 결과: CRP는 남성에서 0.10 (±0.004) mg/dL, 여성에서 0.08 (±0.003) mg/dL로 남성이 여성보다 유의하게 높았다(p<0.001). 남녀 모두에서 CRP가 대사증후군 군에서 대사증후군이 없는 군보다 유의하게 높았다. 대사증후군의 대사이상 항목 수가 증가할수록 CRP값이 증가하는 양상을 보였다(P for trend<0.001). 남녀 모두에서 허리둘레 (남성 R²=0.132, 여성 R²=0.166)가 가장 높은 설명력을 보였다. 결론: 18세 이상의 성인 남녀 모두에서 CRP는 대사증후군 대사이상 항목들과 유의한 상관관계를 보였다. 대사이상 항목중 허리둘레가 CRP 수치와 상관관계가 가장 높았다 Background: C-reactive protein has been known as an independent risk factor and prognostic factor for cardiovascular diseases. Metabolic syndrome is a sum of coronary risk factors such as abdominal obesity, elevated blood pressure, hypertension, glucose intolerance and abnormalities in lipid level. The previous studies showed limited relationships between CRP and the risk factors in metabolic syndrome. We investigated the relationships between CRP and the risk factors in metabolic syndrome in adult men and women over 18 years old. Methods: This study included 2772 people. 577 people of them found to have inflammatory disease excluded. The anthropometry and blood pressure were measured. High sensitive CRP, Lipid profiles, WBC, and ESR were assessed. Results: CRP in Men (0.10 (±0.004) mg/dL) was significantly higher than that in women (0.08 (±0.003) mg/dL)(P<0.001). In both genders, CRP was significantly higher in people who have metabolic syndrome than in people who don't. As the number of risk factors increased, CRP was significantly increased (P for trend < 0.001). Waist circumference showed the greatest correlation with CRP in men and women (men; R²=0.132, women; R²=0.166) Conclusion: CRP was correlated with risk factors in metabolic syndrome in men and women over 18 years old. Of the risk factors waist circumference was most correlated with CRP.

Methylation Status and Expression of E-cadherin in Oral Squamous Cell Carcinomas Compared to Benign Oral Epithelial Lesions

Son, Hyun-Jin,Chu, Jung-Youb,Cho, Eui-Sic,Lee, Dong-Geun,Min, Myung-Gee,Lee, Suk-Keun,Cho, Nam-Pyo The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Expression of invasion/metastasis suppressor, E-cadherin, is reduced in many types of human carcinomas. Although somatic and germline utations in the CDH1, which encodes the human E-cadherin, have frequently been reported in cases with diffuse gastric and lobular breast ancers, irreversible genetic inactivations are rare in other human carcinomas. Recently, it has been well documented that some genes in human cancers may be inactivated by altered CpG methylation. Herein, we determined the expression and methylation status of E-cadherin in oral squamous cell carcinoma (SCC) by immunohistochemistry and methylation-specific PCR. The expression of E-cadherin was significantly higher in the well-differentiated oral SCCs than the moderately or poorly differentiated ones. None of eight tested benign pithelial hyperplasias showed aberrant methylation, whereas five of 12 oral squamous cell carcinomas showed aberrant methylation. When we compared E-cadherin expression with methylation status, oral SCCs with normal methylation showed a higher expression of E-cadherin than those with methylation. These findings suggest that aberrant CpG methylation of CDH1 promoter region is closely associated with transcriptional inactivation and might be involved in tumor progression of the oral mucosa.

함입된 상악 중절치의 외과적 재위치 후 예후

민성진,최형준,류정아,김성오,이제호,최병재,손흥규 대한소아치과학회 2006 大韓小兒齒科學會誌 Vol.33 No.3

Surgical Outcomes of Adrenocortical Carcinoma; 20 Years of Experience in a Single Institution

Min Jhi Kim,Eun Jeong Ban,Soo Jung Jung,Hai Young Son1,Cho Rok Lee,Sang-Wook Kang,Jong Ju Jeong,Kee-Hyun Nam,Woong Youn Chung,Cheong Soo Park 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4

Purpose: Adrenocortical carcinoma (ACC) is a rare malignant tumor. Early detection is difficult and prognosis is poor. We report on 20 years of ACC surgical experience at our institution. Methods: This study included 32 ACC patients who underwent surgical resection at the Department of Surgery of the Yonsei University Health System in South Korea between January 1990 and February 2012. We reviewed these 32 patients and retrospectively analyzed long-term clinical outcomes and prognosis after radical surgery for ACC. Results: The median age of the 32 patients at diagnosis was 42.25 years (range 3∼81 years). There were 16 (50%) female and 16 (50%) male patients. Mean tumor size was 12.36 cm (range 1.8∼20 cm). Twenty-five patients (78.12%) had nonfunctioning tumors while the other seven patients (21.87%) had functioning tumors. Seventeen patients (53.12%) were classified as stage II, two (6.25%) as stage III, and 13 (40.62%) as stage IV. Fourteen patients underwent radical surgical resection, while 14 patients received adjuvant chemotherapy, two received adjuvant radiotherapy, and two received adjuvant chemoradiation. Four patients were lost to follow-up. Among the remaining 28 patients, 15 patients survived. The 5- and 10-year overall survival was 60.6% and 37.8%, respectively (median survival=85±24.3 months). Seventeen patients (53%) experienced disease recurrence. Five- and 10-year recurrence-free survival was 41.5% and 29.7%, respectively (median survival=18±5.5 months). Conclusion: Early stage at diagnosis and surgical resection were the most important prognostic factors associated with prolonged survival. The role of additional therapy remains controversial and new agents should continually be evaluated for efficacy.

인슐린 치료중인 당뇨병환자에서 일시적 갑상선 기능 저하 상태로 발생된 양측성 전 경골 구획증후군

이정민,손호영,차봉연,윤건호,조유경,정지성,고승현 대한내과학회 2001 대한내과학회지 Vol.61 No.3

Acute compartment syndrome is usually caused by local vascular and traumatic involvement. Thyroid disease is not a common cause of compartment syndrome and only two cases of spontaneous compartment syndrome associated with hypothyroid myopathy have been reported. Diabetic muscular infarction is a rare microvascular complication usually occured in type 1 diabetes patients under pjoor diabetic control and intramuscular volume expansion caused by muscle necrosis and increased tissue fluid can iduce compartment syndrome.We report a case of atypical bilateral anterior tibial compartment syndrome and foot drop in a 51-year-old patient with type 2 diabetes in hypothyroid state.(Korean J Med 61:307-312, 2001)

cDNA array 방법을 이용한 망간에 노출된 흰쥐 뇌기저핵의 유전자발현 분석

이채관,노성민,문덕환,,김정호,손병철,김대환,이창희,김휘동,김정원,김종은,안진홍,이채언 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study investigated the gene expression profile in basal ganglia of manganese-exposed rats based on cDNA array analysis. Methods: For cDNA array, 25 male Sprague-Dawley rats (250±25 g) were intraperitoneally injected with 25 ㎎/㎏ B. W./day of MnCl2 (0.3 ㎖) for 10 days. For dose-related gene expression analysis, rats were intraperitoneally injected with 0.2, 1.0, and 5.0 ㎎/㎏ B. W/day of MnCl2 for 10 days. Control rats were injected with an equal volume of saline. RNA samples were extracted from brain tissue and reverse-transcribed in the presence of [α^(32)P]-dATP. Membrane sets of the Atlas Rat 1.2 array Ⅱ and Toxicology array 1.2 kit (Clontech, Palo Alto, CA) were hybridized with cDNA probe sets. Northern blot hybridization method was employed to assess the dose-related gene expression. Results: Fifty-two genes showed significant changes in expression of more than two-fold. Twenty-eight were up-regulated and 24 were down-regulated in the manganese-exposed group compared to the control. Among the 52 genes, 28 genes including nuclear factor I-X1 (NF1-X1), neuroligin 2 and 3, mitochondrial stress-70 protein (MTHSP70), neurodegeneration-associated protein 1 (Neurodap 1), multidrug resistance protein (MDR), and endoplasmic reticulum stress protein 72 (ERP72), were reported for the first time related to the manganese-induced neurotoxic-metabolism in the rat basal ganglia. According to the dose-related gene expression analyses, MTHSP70, Neurodap 1 and ERP72 genes were up-regulated compared to the control even in the group exposed to low manganese dose ( 0.2 ㎎/㎏ B.W./day). Conclusions: Twenty-eight genes detected for the first time in this study were closely related to the manganese-induced neurotoxic-metabolism in the rat basal ganglia and further study of these genes can give some more useful information about the manganese metabolism.