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.

Adamkiewicz 동맥의 폐색에 의한 척수경색 1례

이광훈,이종걸,이태연,신동익,이성현,이상수,한설희,차상훈 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

방사선조사에 따른 구개점막상피의 형태학적 변화에 관한 실험적 연구

이강숙,손정익,최갑식,안상희 大韓口腔顎顔面 放射線學會 1994 Imaging Science in Dentistry Vol.24 No.2

The purpose of this study was to investigate the irradiation effects on the palatal mucosa. For this study, Sprague-Dawley strain rats were irradiated to their head and neck region with the dose of 5Gy and 10Gy by 6MV X-radiation and sacrificed on the experimental periods after irradiation. The authors observed the histological changes of the hard and soft palatal mucosae. The results were as follows: In the light microscopic examination, hydropic change on the basal cells, increased cell size of the epithelium, and decreased epithelial cell layers were observed on the 3hours, 6hours, and 12hours groups after irradiation. But, basal cell hyperplasia, increased epithelial cell layers, and elongated rete pegs were observed on the 3days group after irradiation. After then, these changes were recovered in the mucosa of the hard palate on the 7days and 14days groups, and in the mucosa of the soft palate on the 14days and 28days groups after irradiation. And such changes were greater in the mucosa of the soft palate than in that of the hard palate, and more prominent in 10Gy irradiated groups than in 5Gy irradiated groups.

암환자에서 다른 신경학적 증상이 동반되지 않는 두통 : 예비 보고

이성형,안미영,백신혜,이형석,신동익,이상수 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1

연구목적 : 암환자에서 신경학적 결손이나 발작 등이 동반되지 않는 두통의 원인과 이런 경우 심각한 두개내 질환에 의한 이차두통을 의심할 수 있는 소견의 진단적 유용성을 알아보고자 하였다. 대상 및 방법 : 2005년 10월부터 2009년 1월까지 신경학적 결손이나 발작을 동반하지 않는 두통이 발생한 71명의 암환자를 대상으로 하였다. 자세한 병력을 청취하고 신경학적 검사를 하였으며, 환자의 상황에 따라 적절한 조합의 뇌MRI, 뇌CT, 및 뇌척수액 검사를 시행하였고, 최소한 3개월 이상 추적 관찰하였다. 이 소견을 종합하여 두통의 국제분류 기준(The International Classification of Headache Disorders, second edition) 에 따라 두통을 진단하였다. 또한 심각한 두개내 질환에 의한 이차두통을 의심할 수 있는 소견인 있는 환자군과 없는 환자군 사이에 중추신경계로의 전이빈도가 차이가 나는지 알아보았다. 결과 : 71명 중에 8.5%인 6명에서 중추신경계로의 전이가 관찰되었는데 심각한 두개내 질환에 의한 이차두통을 의삼할 수 있는 소견이 있었던 18명 중에 4명(22.2%), 이런 소견이 없었던 53명 중에 2명(3.8%)이었다. (상대위험도 5.89, 95% 신뢰구간 1.18-29.49). 두통의 다른 원인으로는 지주막하 출혈이 1명, 중추신경계 이외의 감염에 의한 두통이 6명, 항암제에 의한 두통이 1명, 고혈압성 두통이 1명, 방사선 치료와 관련된 두통이 1명, 원발성 찌름두통이 3명, 긴장성 두통이 51명이었다. 결론 : 심각한 두개내 질환에 의한 이차두통을 의심할 수 있는 소견의 유무가 암환자에서 발생하는 두통의 감별진단에 유용하며, 이러한 소견이 동반되지 않는 경우의 두통은 대부분 양성이다. 하지만 이러한 결론을 바탕으로 향후 보다 많은 대상 환자군을 통한 연구가 필요할 것이다. Purpose: Headache in patients with systemic malignancy is a great concern to neurologists. We performed this study to investigate the frequency of metastasis as the cause of headache in the patients with systemic malignancy and the usefulness of symptoms suggesting underlying serious pathologies especially when headaches do not accompany any other neurological symptoms. Materials and Methods: From October 2005 to January 2009, we prospectively collected 71 patients with systemic malignancy complaining headache but not having any other accompanying neurological symptoms. After thorough history taking and neurological examination, we performed a neuroimaging (MRI or CT) and CSF study according to the clinical situations of individual patients and followed them at least 3 months and diagnosed headaches according to The International Classification of Headache Disorders, second edition (ICHD-II). We compared the incidence of intracranial metastasis between headaches with symptoms suggesting underlying serious illness and those without. Results: Six (8.5%) out of 71 patients had intracranial metastasis: 4(22.2%) out of 18 patients with symptoms suggesting underlying serious illness, 2(3.8%) out of 53 patients without them (relative risk 5.89, 95% confidence interval 1.18-29.49). Other causes included subarachnoid hemorrhage (1 patient), headache attributed to infection (6), headache attributed to drug (2), hypertensive headache (1), headache attributed to radiotherapy (1), primary stabbing headache (3), and tension headache (51). Conclusion: This study suggests that headache symptoms suggesting underlying serious disorder are valuable in differentiating the causes of headache without any other accompanying neurological symptoms in patients with systemic malignancy and headaches without those symptoms might be usually benign. However, more broad study should be made for these value and relationship.

정신분열병 환자의 인식유발전위에 관한 연구

이상익,김종성,김용식 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.6

To investigate the characteristic features and the diagnostic meaning of the cognitive evoked potential in schizophrenics, the authors performed the auditory evoked potential to the schizophrenic patients(n=34) who were admitted to Seoul National University Hospital and the normal controls(n= 19) from the 15th, Feb. 1988 to the 24th, Aug. 1989. The latency and peak-to-peak amplitudes of the cognitive evoked potentials were compared with student t-test between schizophrenic group (n=19) and control group who was age-and sex-matched by one to one. Also, the correlations between 12 items of clinical characteristics, and latency and peak-to-peak amplitudes were studied in schizophrenic group(n=34). The schizophrenic group showed longer latencies in N₂and P₃and smaller amplitude in P₃-N₃than the control group, and there were the statistically significant correlations between age of onset and P₂-N₁amplitude, between number of the electroconvulsive therapy and P₃-N₃amplitude, between the presence of the auditory hallucination and the P₁-N₁amplitude, between the medication dosage at test and amplitudes of P₃-N₂, P₃-N₃ and N₁latency, and between years of education and amplitudes of P₁-N₁, P₂-N₂and P₂-N₁. We confirmed that there were some differences of the cognitive evoked potentials between schizophrenic patients and normal controls. Also there were some clinical characteristics which had influences on the cognitive evoked potentials. We discussed the possibility of cognitive evoked potentials as diagnostic utility For that, study condition needs to be controlled and standardized, and the basic psychophysiological study of cognitive evoked potentials should be preceded.

정신분열병환자에서 Haloperidol 투여에 따른 치료반응과 혈장 Homovanillic Acid 농도 및 혈장 Haloperidol과 Reduced Haloperidol농도와의 관계에 대한 연구

이상익,권준수,우종인 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.3

In order to develop a more effective therapeutic guidelines for haloperidol treatment, the authors measured plasma haloperidol(HP), reduced haloperidol (RH) and homovanillic acid (HVA) levels in 14 schizophrenic patients and analyzed their relationship to therapeutic response. The plasma homovanillic acid levels were further evaluated to see whether it can be adopted as a predictive biological marker reflecting therapeutic response of haloperidol. The measurement of plasma haloperidol, reduced haloperidol and HVA levels were carried out with high performance liquid chromatography(HPLC) and the therapeutic reponses were assessed with Brief Psychiatric Rating Scale(BPRS) every week before and during the administration of haloperidol for 5 weeks. The results of this study are as follows. 1) There was no significant changes on the plasma HVA levels after haloperidol administration as a whole. But in higher pHVA group(baseline plasma HVA level≥4.5ng/ml), the plasma HVA levels were significantly decreased after haloperidol administration, and in lower pHVA group(baseline plasma HVA level〈4.5ng/ml), the plasma HVA levels were significantly increased compared to baseline plasma HVA levels. 2) Total BPRS scores were continuouly and significantly decreased from 1st week to 3rd week after haloperidol administration not only in total subject, but also in higher pHVA group and lower pHVA group. 3) There was significant correlation between baseline plasma HVA levels and clinical improvement(percentile improvement) at 3rd week in higher pHVA group. But no significant correlation was found between baseline plasma HVA levels and clinical improvement in total subject or in lower pHVA group. 4) Hyperbolic correlation was observed between plasma haloperidol level and plasma RH level(Km=33.11ng/ml). 5) There were no statistically significant correlations between clinical improvement and plasma haloperidol level, plasma RH level and RH/HP ratio in any of the total subject, higher pHVA group and lower pHVA group. 6) The changes of plasma HVA levels after haloperidol administration were not significantly correlated with plasma haloperidol level, plasma RH leel and RH/HP ratio in any of the total subject, higher pHVA group and lower pHVA group.

두개하악장애환자의 임상적 평가를 위한 컴퓨터적외선체열검사 : CLINICAL EVALUATION

조익주,홍정표,이상래 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.2

The purpose of this study was to assess the thermographic differences of craniomandibular area between normal indivisuals and patients with craniomandibular disorders and to compare the differences between clinical and thermographical assessment. The author had used 50 subjects as materials for this study, which was divided into 2 groups (first group included 15 healthy subjects and second group included 35 patients) with craniomandibular disorders; 17 subjects had normal disc-condyle relationship, 13 subjects had disc displacement with reduction and 5 subjects had disc displacement without reduction. Agema870 thermovision(D.I.T.I.) was used to take thenuographs with 0.1t difference of gradual temperature shift. The. results were as follows 1. Of 34'patients with craniofacial pain, 15(44.1%) subjects showed hyperthermia on the pain site in the theiniography, 8(23.5%) exhibited hyperthermia on the site opposed to the pain site, and 11(32.4%) did not show any significant thermal change. One patient without craniofacial pain showed hyperthermia on the site opposed to the site of disc displacement without reduction. 2. Of 35 patients with craniofacial pain or disc dispalcement, 24(68.6%) subjects showed a significant thermal difference between symptomatic and asymptomatic sides of the face, but 11(31.4%) did not show any difference. 3. Of 17 patients with pain but with normal disc-condyle relationship, 8(47.1%) subjects- showed hyperthermia on the pain site, 4(23.5%) showed on the site opposed to the pain site, and 5(29.4%) did not show any significant thermal change. 4. Of 13 patients with pain and disc dispacement with reduction, 6(46.2%) subjects showed hyperthermia on the pain site, 3(23.1%) showed on the site opposed to the pain site, and 4(30.8%) did not show any significant thermal change. 5. 15 healthy subjects did not show any thermal differences between the both sides of the face.

혈액투석기간에 따른 불안의 변화

한상익,이성필,유태열 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.4

Hemodialysis has become one of the indispensible choice of treatment for the patients with chronic renal failure and also has become popular and practical in the clinical field. However, it has been know that during hemodialysis most patients develop various neuropsychiatric problems, of which depression and anxiety are the most fequent and serious responses to the situation of survival dependent on dialysis machine. Most of the reports about the change of depression according to the period of time of hemodialysis has been consistent but that of anxiety has been controversial. This study was designed to evaluate whither there are change of severity of anxiety following hemodialysis. Subjects were consisted of 17 short-term hemodialysis patients, 18 mid-term hemodialysis patients and 19 long-term hemodialysis patients who were undergoing maintenance hemodialysis at Kangnam St. Mary's hospital, St. Vincent hospital and Holy family hospital from March to July 1987. Two different self-rating scales, Spielberger's state-trait anxiety inventory and Zung's self-rating anxiety scale, were applied to the subjects for elucidating the change of severity of anxity according to the period of time on hemodialysis. The results were as following: 1) On Spielberger's state anxiety inventory, the scores of short-term hemodialysis patients was 41.8±2.1, mid-term hemodialysis patients was 41.1 ±2.0 and long-term hemodialysis patients was 44.9±2.1 There were no statistically significant differences among 3 groups. 2) The scores of Spielberger's trait anxiety inventory for short-term, mid-term and long-term hemodialysis patients were 41.9±2.4, 44.8±2.3 and 48.7±2.4 respectively. 3 patient groups did not showed statistically significant differences. 3) The scores of Zung self-rating anxiety scale were 40.0±2.1 in short-term hemodialysis patients, 43.6 ±2.0 in mid-term hemodialysis patients and 46.6±1.9 in long-term hemodialysis patients. They also had no significant differences in statitics. 4) But all the scores of 3 sets of psychological tests were similar to those of Korean high school students, chronic medical patients and cancer patients but lower than those of the anxiety disorder patients. In conclusion, it was implicated that most of hemodialysis patients have mild to moderate anxiety with superimposed transient episodic severe fear for death during maintenance hemodialysis, which appeared to be not significantly changed during the course of hemodialysis.

귀리 수용성 추출물의 성분과 점도특성

정헌상,강태수,박희정,정익수,이항영 한국산업식품공학회 2004 산업 식품공학 Vol.8 No.1

귀리 단백 다당체의 산업적 활용 가능성을 검토하고자 추출온도(40~60℃), 에탄올 농도(0~20%0 및 pH(5~9) 조건을 조합하여 중심합성계획법에 따라 얻은 귀리 추출물의 이화학적 특성을 분석하였다. 귀리 추출물의 수율은 6.4~17.9% 범위로 추출온도는 증가할수록 에탄올 농도는 감소할수록 증가하였고 중성일 때 보다 알칼리성이나 산성일 때 수율은 증가하는 경향을 보였다. β-glucan 및 단백질 함량은 각각 21.8~38.3% 및 23.8~29.0% 범위였고 추출온도는 낮을수록 에탄올농도는 높을수록 증가하는 경향을 보였으나 pH에 의한 영향은 없는 것으로 나타났다. 귀리 추출물 수용액은 저온 및 고농도일수록 점도가 증가하였으나 일반적으로 낮은 범위였으며, 전단속도에 따라 감소하는 의소성을 나타내었다. 본 연구결과 저농도 에탄올을 용매로 사용하여 귀리 추출물중의 단백 다당체 함량비를 조절할 수 있었고, 그 수용액 또한 식품용으로 적합한 유체 특성을 갖는 것으로 나타나 산업적인 활용가치가 높을 것으로 기대된다. To examine the utilization of the soluble proteoglucan in oats as a nutraceutical ingredient, soluble components were extracted from Oat Bran Concentrate (OBC) by varying the experiment factors such as temperature (40∼60℃), ethyl alcohol concentration (0∼20%), and pH (5∼9), and then analzed gor their compositions and viscosity. The total yield of iat solube extracts ranged between 6.4∼17.9 and the contents of β-glucan, protein, lipid, and ash in oat extracts were 21.4∼38.3%, 23.2∼29.0%, 8.3∼11.8%, and 5.9∼7.9%, respectively. The exreaction yield increased with the extraction temperature, but decreased with the alchohol concentration and pH. The β-glucan and protein contents increased with increasing temperature and decreasing ethaol concentration. However, the pH level did not influenced those contents. The viscosity of 2% oat extract solution ranged between 8.6∼83.1 cp at different share rates, showing the pseudo-plastic flow properties. Results suggested that extraction condition could be controlled the purity of β-glucan and protein and applied commercially to the large-scale process.

5종의 치주질환균에 대한 프로폴리스의 항균효과

이은지,김소민,박소민,박복리,홍성익,김현정 순천향대학교 기초과학연구소 2022 순천향자연과학연구 논문집 Vol.28 No.1,2

Since the oral cavity is directly connected to the outside, it is an important site for microbial invasion, and since it is an environment that is nutritionally and physiologically easy to multiply bacteria, many bacteria always form bacteriological flora in the oral cavity. And propolis is a natural treatment used in many health food stores in various forms for local treatment. This study analyzes the changes in the activity of five oral microorganisms before and after consumption of propolis for various age groups to find out how propolis, which shows the efficacy of anti-inflammatory, antibacterial, and immune sensitization, affects oral microorganisms. Five types of bacteria possessed by periodontal disease patients were specified and digitized targeting the public person, and then before and after propolis intake was compared, and the levels of periodontal disease bacteria in the intake group and the non-consumption group were compared. As a result of comparing the patterns before ingestion (0 week) and after ingestion (3 week) in the oral bacteria analysis, it was confirmed that the bacteria decreased overall except for the five populations in the propolis intake group. In contrast, in the comparative group that did not intake propolis, the bacteria of five periodontal disease increased except for the four populations. What can be seen from this result is that propolis is effective in reducing bacteria in five types of periodontal disease. In order to use propolis as a food for preventing periodontal disease and to get a better effect, further research is needed to find out the mechanism of antibacterial action in propolis compounds.