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.

피로와 의료이용, 업무상 사고 및 질병결근

장세진,고상백,강동묵,김성아,정진주,이철갑,강명근,현숙정,조정진,차봉석,박종구 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study examined the relationship of fatigue to medical utilization, occupational accident and sickness absence. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002~2004). A total of 30,146 employees categorized within the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were recruited. A structured-questionnaire was used to assess the participants' sociodemo-graphics, job-related factors, health-related behaviors, personality trait, self=perceived fatigue (MFS) and the frequency of medical utilization, occupational accident and sickness absence. Data on medical utilization and occupational accident were confirmed from company health records. Chi-square test and logistic regression analysis were used to elucidate the relationship of self-perceived fatigue to medical utilization, occupational accident and sickness absence. Results: In logistic regression analyses, self-perceived fatigue was associated with medical utilization (outpatient), occupational accident and sickness absence although the strength of the associations was higher in the blue collar workers except for medical utilization. For medical utilization, the white collar worker's adjusted odds ratios of outpatient utilization for workers scoring in the third quartile and the highest quartile, compared to workers scoring in the lowest quartile were 1.50 (95% CI: 1.20-1.87) and 2.16 (95% CI: 1.69-2.75), respectively. The blue collar workers' adjusted odds ratios of outpatient utilization for workers scoring in the second (OR: 1.23, 95% CI: 1.06-1.43), third (OR: 1.42, 95% CI: 1.22-1.66) and highest quartile (OR:1.83, 95% CI: 1.55-2.17), respectively, compared to workers scoring in the lowest quartile were statistically significant. However, no associations were found between fatigue and inpatient utilization for either the white or blue collar workers. The blue collar workers' adjusted odds ratios of being injured for workers scoring in the second, third and highest quartile were 1.41 (95% CI: 1.00-2.00), 1.57 (95% CI: 1.10-2.22) and 2.41 (95% CI: 1.69-3.44), respectively, compared to those scoring in the lowest quartile, but, those of the white collar workers were not significant. There was more likely to an increased risk of sickness absence in workers scoring in the second, third and highest quartile compared to those scoring in the lowest quartile in both white and blue collar workers, but the magnitudes of risk were higher in the blue collar workers than the white collars workers. Conclusion: This result suggests that fatigue is a determinant predictor of medical utilization, occupational accident and sickness absence, and that the pattern of risks for the three outcomes differs according to the occupational type. Some limitations of this study and considerations for future study were also discussed.

고속 머시닝센터의 진동특성 및 가공성 평가

강익수,강명창,김정석,김기태 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

The high speed machining center(HMC) has been widely applied to manufacture a die and trial product in many machine industry. Because the evaluation for HMC is not sufficiently performed and the efficient cutting conditions can't be selected, a great loss has been caused in the cost aspect. In this study, the need of preliminary running time and unstable spindle speed is presented by the analysis of acceleration in idling. The Machinability for the TiAIN coated flat end mill and STD11(H_(R)C60) is evaluated from the trends of tool wear and cutting force according to cutting conditions. The resonance spindle speed is identified through the tool wear and natural frequency test.

태권도 경기중 고난도 공격기술에 관한 연구

강명덕,이창준 濟州大學敎 體育科學硏究所 1999 체육과학연구 Vol.5 No.-

This paper is to survey the attack times played in the games, to compare the score ratio in accordance with the attack techniques and the counterattack techniques respectively. and to analyzed their relation to Down or K.O. This paper is restricted to the 357 games the Taekwondo participants played in the 79th National Meeting. The results are followed. 1) attack times In total the players most frequently used the attack technique of Momtong-Dolrye Chagi(53.70 %). The heavy weight players used this technique 5,447 times(21.6 %). and the light weight players used this technique 8.520 times(32.76 %). These data show us that the players depended on a techmique for playing Momtong-D olrye Chagi when they attacked each other. 2) score ratio (1) the score ratio as the attack: The score ratio during the attack times is represented low only when the players used Momtong etc. Both light weight players and heavy weight players got the technique which would need the difficult attack techniques. But when they used the body attack techniques. not the light weight players but the heavy weight players got high score ratio. which they used Dye Chagi technique 176 tirnes(17.00 %) and Narae Chagi technique 205 tirnes(17.00 96). As a result. the score ratio is proved to be high when the players attack the face. (2) the score ratio by the countearattack: The counterattackers used Olgul Dolrye Chagi technique 56 times(27.45 %). used Zzige Chagi technique 57 tirnes(26.51 %). used Dye Chagi technique 321 tirnes(17.15 %). used Dye Huryae Chagi 11 tirnes(14.29 %). used Zumug Zirgi technique 34 times(6.79 %). used Narae Chagi technique 85 times(5.55 %). and used Momtong Dolrye Chagi 351 times(4.689 %). The conclusion is that the counterattackers got the high score ratio. when they attacked the face. However when they used the turning body kick technique. they got the very low score ratio(351 times. but 4.68 %) The light and the heavy weight players got the low score ratio(repective1y 4.69) when they used the turning body attack technique. But when they used the turning gace kick technique. they got a high score ratio. The light weight players used Dolrye Chagi technique 34 times(27.38 %). using Zzige Chagi technique 25 times(26.32 %). and using Dye Huryae Chagi 5 times(15.15 %). Mean while the heavy weight players used Olgul Dolrye Chagi 33 times(27.5 %). using Zzige Chagi technique 32 times(26.67%). and using Dye Huryae Chagi technique 6 times(13.64 %). (3) Down or K.O. The occurrence of Down is owing to Zzige Chagi technique (9 times. 33.33 %). Olgul Dolrye Chagi technique(7 times, 25.93 %). Momtong Dye Chagi technique(5 times, 18.52 %) . and Dye Hurye Chagi technique(4 times, 11.81 %) respectively. And the occurrence of K.O. is owing to Zzige Changi technique(3 times, 60 % ). Olgul Dolrye Changi technique(once. 20 %). and Dye Hurye Chagi technique(once. 20 %) respectively. This result implies that the occurrence of Down or K.O. is not influenced by body attack technique but by influenced by Zzige Chagi technique, Olgul Dolrye Chagi technique. and Dye Hurye Chagi technique which need the difficult attack techniques.

항이뇨호르몬 부적절분비증을 동반한 결핵성 기흉

강영희,김경수,강창일,정정명,최하진 인제대학교 1983 仁濟醫學 Vol.4 No.3

A case of pulmonary tuberculosis associated with syndrome of inappropriate secretion of antidiuretic hormone in 39-year-old female is presented. Although proper treatment including the closed thoracotomy for her pneumthorax was preformed, generalized convulsion, mental deterioration and polyuria occurred. On laboratory examination, the hyponatremia in her serum and increased urinary excretion of sodium were noticed, accordingly the osmolality of urine was higher than that of plasmas. The syndrome of inappropriate secretion of antidiuretic hormone was diagnosed and treated with intravenovous hypertonic saline and water restriction for 35 days c satisfactory improvment.

KAL기 추락에 의한 대량재해의 개인식별

강신몽,이원태,고영창,최상규,김윤희,이홍석,서재관,윤중진,이혜경,최득린,김종열,윤창육,변명식,이장홍 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

Individual identification is an important part in medicolegal field especially in mass disaster. At July, 27, 1989, KAL KE-803 was crashed on landing at Tripoli International Airport, Liba. The plane was caught in fire and sixty eight Koreans were sacrified. The majority of victims were severely charred and injured. The authors examed all dead bodies and successfully identified all the cases through visual, anthropological, odontological, radiological and pathological methods including fingerprint and blood typing.

인터넷을 활용한 원격교육에서 자기 규제 학습 유형이 학습자-자료 상호작용에 미치는 영향

강명희,장선 이화여자대학교 사범대학 교육과학연구소 1998 교육과학연구 Vol.27 No.-

본 연구의 목적은 인터넷을 활용한 원격교육에서 학습자의 자기 규제 학습 유형(자기 규제 학습자, 정보관리형 학습자, 과제중심형 학습자)에 따른 학습자-자료 상호작용의 양과 학습결과를 평가하는 데 있다. 연구 결과, 자기 규제 학습 유형별 학습자-자료 상호작용의 양은 통계적으로 유의미한 차이를 보이지 않았으나, 학습결과는 유의도 수준 10에서 유의미한 차이를 보였으며, Scheff 사후 검증 결과 정보관리형 학습자와 자기규제적 학습자 집단간에 유의미한 차이를 보였다. 이러한 결과는 인터넷을 활용하여 많은 정보를 제공하는 원격교욱의 환경에서는 정보관리형 학습자가 다른 유형의 학습자보다는 효과적인 학습을 할 수 있다는 가능성을 제공한다는 것을 제시하고 있다. Due to the radical development of technology, many changes have been made in our society, not to mention the educational area. First, the traditional media has changed into technomedia such as satellite broadcasting, VTR, audio, computer, beam projector, etc. They provide an environment that makes education more interesting and exciting. Learning is extended to the life education, telecommunication, and professional education from school education, and many researches are focused on this new area of learning. But most researches focused on Network system application, comparison with other media, and user interface. And few studies focused on the type of the interaction in the distance education, the comparison with other traditional instruction, and the degree of satisfaction in using the distance education. These do not show the instructional strategies which make more various interaction of the distance education. This study will focused on the different effects of learner-content interactions based on the learner cognitive engagement. To elucidate these areas of study, 78 sophomores who were taking classes related computer from E University were selected as the participants. And one recipience was excluded because of sample size. For quantitative data anlaysis except recipience, statistical methods of ANOVA and Scheffe were used. This study found following conclusion. Analysis on the difference of the learner-content result showed no significant statistical differences between the cognitive engagement of amount of references. But, with task performance, there is significant differences between the self-regulated learner and resource management(p = .0533, p<.10). From the above results, this study would propose that resource management showed high task performance. So the distance education using Internet can provide better environment to the resource management. Finally, there are three types of interaction in distance education: learner-instructor interaction, learner-learner interaction, and learner-content interaction. This study focused on the learner-content interaction. However, more research should be conducted on other areas such as the influences of the four forms of cognitive engagements on learner-instructor or learner-learner interaction in the distance education using Internet, the fluences of the other learner characteristrc like MBTI on interaction in distance education, etc.

고속 머시닝센터의 성능평가 기술에 관한 연구

강익수,강명창,김정석,김기태 한국공작기계학회 2004 한국공작기계학회 추계학술대회논문집 Vol.2004 No.-

The high speed machining center(HMC) has been widely applied to manufacture a die and machine elements product in industrial field. Because the evaluation for HMC is not sufficiently performed, ineffective machining is occasionally conducted in machining industry. In this study, the dynamic characteristics of newly developed machining center is evaluated under running condition and the machinability is investigated experimentally. Also, the in-process measuring instrument which can measure the tool wear on the machine were developed by using the CCD and exclusive jig and calibration instrument for tool wear measurement.

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.

Purge & Trap-GC를 이용한 의약품 필름코팅 정제 중 잔류용제에 관한 연구

장준식,이명자,소유섭,문춘선,이주헌,박희라,김진숙,강경모,이선옥,방성연,유미자,유문균,금오성,이병욱 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

의약품은 약물을 생체에 적풋하기 위하여 유효성분의 효과가 언제나 일정하게 확보되고 사응에 편리하도록 만들어지는 것이므로 유효썽분 이외에 약효에 영향을 주지 않는 성분이 첨가되는 경운가 많다. 이 때 사용되는 용매들은 제피의 광택 및 건쪼시간의 단축 등을 위하여 휘발점이 낮을 용매들이 주로 사용되어진다. 본 연구는 의약품 필름코팅정제 중 잔류용매 4종(chlorofonr benzen, trichloro ethylen, 1,4-dioxane)에 대한 변형된 pirge & trap-GC 장치를 이용한 동시분석방법을 개발하였으며, 각 표준품의 RSD 값은 chloroform 3.03%, benzen 3.17%, trichloroethylen 3.69% and 1,4-dioxane 3.41%였다. 또한 시중 유통중인 의약품 50종에 대하여 잔류웅매 양을 측정하였으며, 검출되는 잔류용매는 한 건도 없었다. This study nras carried out to develope the analytical method for the mixture of chlorefonn, benzen, trichloroethylen and 1,4-dioxane simultaneously and determine the remainingorgauic solvents in coating tablets by Purge & Trap-GC. The results were as follouFs ; 1. Chloroform, benzen, trio:tloroethylen and 1,4-dioxane separated by tenax #5 trap by HP-624GC column by terrlperature programming. The peaks were separated completely at retentiontime of 6.88min for chloroform, 8.21min for benzen, 10.38miu for trichloroethylen and 11.95minfor 1,4-dioxane. 2. Standard RSD were individually chloroform 3.03%, benzen 3.17%, trichloroethylen 3.69%and 1,4-diorane 3.41%. 3. 60 samples were not detrcted chloroform, benzen, trichloroethylen and 1,4-dioxane.