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        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.

      • SCOPUSKCI등재
      • KCI등재

        Paraquat 중독환자의 초기검사로서 sodium dithionite를 이용한 소변내 paraquat검출의 임상적 의의

        윤갑준,임경수,이진웅,김영식,이부수,박덕우,김선만,이강현,황성오,안무업 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

        Background : Mortality from paraquat intoxication depends upon plasma paraquat concentration. To know the severity of paraquat intoxication is important for directing therapeutic modality and predicting prognosis. Sodium dithionite test for urinary paraquat provides an easy and simple method to determine the severity of paraquat intoxication in emergency department. purpose : To determine whether the result urinary paraquat test by sodium dithionite can predict outcome in patients with paraquat intoxication in emergency department. Subjects : 48 patients(male 31, female 17, mean age 37 years) who had exposure to paraquat and presented within 24 hours after exposure. Result : Thirty five patients were positive in paraquat urine test and thirteen patients were negative. Clinical manifestations were more severe in positive patients than in negatives. Complication was much more in positives than in negatives. 28 of 35 patients(80%) in positives and 2 of 13 patients(15%) in negatives died. Conclusion : Positive test for urinary paraquat is associated with high mortality and morbidity from paraquat intoxication, and qualitative test for urinary paraquat by sodium dithionite is an useful method to determine the severity of paraquat intoxication in emergency department.

      • 유도선수들의 개인별 특성에 따른 성취동기에 미치는 영향 : mainly university students

        윤익선,김진표,권성준 龍仁大學校 武道硏究所 2002 武道硏究所誌 Vol.13 No.1

        This investigation used questionnaire which amended and made up for TSMI(Taikyo Sport Motivation Inventory) to verify what effect judo champions personal trait has on accomplishment motive. The subject of the study was 406 men, women judo champion's in Seoul and Kyung-Ki province. The personal trait which is an independent variation was set up as sexual distinction, grade, athlete career, economic standard, record of winning a prize and weight. According to this, the dependent variable for accomplishment motive to find out about accomplishment motive was foxed as competition, ambition, effort and self-confidence and the result of the research is followed as below. Firstly, there seemed to exist a significant difference in competition(p<.001), standard of ambition(p<.006) and self confidence(p.006) in accomplishment motive according to sexual distinction. Secondly, a significant difference in standard of ambition(p<.001) existed among the dependent variable of accomplishment motive according to grade. Result of Scheffe's pre-verification was that significant difference seemed to exist in 4th grade with the 1st and 3rd grade. Thirdly, all of the dependent variable; competition(p<.001), standard of ambition(p<.001), effort(p<.003) and self confidence(p.006) showed significant difference in accomplishment motive according to athlete's career. Scheffe's pre-verification showed that significant difference in competition existed in between 5-8 years and 8-10 years, and significant difference in standard of ambition in between 3-5 years and 8-10 years and also 3-5 years and 5-8년 and over 10 years group existed. Also significant difference in effort showed in 5-8 years and 8-10 years. Fourthly, the accomplishment motive according to the economic levels showed significant difference only in standard of ambition(p<.05) which is a dependent variable. Fifthly, The accomplishment motive according to the career of winning a prize showed a significant difference in competition(p<.01), ambition(p<.01) and effort(p<.05) among the dependent variable, and also Scheffe's pre-verification showed a significant difference in more than 7 times, less than 3times and less than 7 times in ambition. Sixthly, the accomplishment motive according to weight showed a significant difference in competition(p<.001) and effort(p<.05) among the dependent variable, and Scheffe's pre-verification showed significant difference in middle weight class with the lightweight and middle lightweight class in competition.

      • 忠南地域住民의 開發要求分析에 關한 硏究

        윤준상,이창식 公州大學校 産業開發硏究所 1997 産業開發硏究 Vol.5 No.-

        This study aims to analyze the need assessment of development in Chungnam west-coast people and to search implication of ploicy and planning that induses inter-regional balanced development. The major findings of this study could be follows; 1) The most positive development in industry of all researching area was tourist business. And the most negative industry was forestry. 2) The most positive Social Overhead Capital(SOC) business was education, and the most negative business was electric. 3) The most positive development method was the sustainable development and the third sector types. 4) The lack of capital was the most important factor of barrier of development. The followings implications were suggested for more efficient inter-regional balanced development; 1) making the development circumstance of the low developed area 2) planning of development from bellow, 3) getting rid of the barrier of development, 4) selecting the sustainable development method and the third sector, 5) investing inter-regional balanced development.

      • 지역사회교육을 위한 농촌폐교시설의 활용방안에 관한 연구

        윤준상,이창식 公州大學校 産業開發硏究所 1998 産業開發硏究 Vol.6 No.-

        Because of reduction of population in rural area, primary schools in that area are exposed to many problems and the environment of education of rural area has been deterrioration. In this situation, many cases of mergeer and abolition(M&A) of primary school in rural area were reported. The aims of this study were to define the concept of Community Education and to review, factors and method, the situation and problems of M&A and to suggest the policy direction to the M&A in rural area for the Community Education. This study was carried out through review of literature an statistical data collected from varioous sources. The major findings of this study were as follows: 1) The M&A of primary school is inevitable for change of placement standard to primary school and qualitative improvement of environment of education in rural area. 2) By the mobility of modern industrial society and the inequality between urban area and rural area in developing stage, necessity of M&A is increasing. 3) In this consequence, the number of abolished school is also increasing, and the relevant plan of utilization of facilities of abolished school is needed. Based on the results of the study, it was recommended that the M&A of primary school of rural area be changed to the Community Education Center. And comprehensive policy community education directions which include educational inevestment, public relation and gross social welfaree are to be formed.

      • 西海岸 綜合開發計劃 樹立을 爲한 關聯計劃 分析

        윤준상 公州大學校 産業開發硏究所 1997 産業開發硏究 Vol.5 No.-

        This study aims to investigate the related planning for the establishing of integrated development of west coast area and to suggest more efficient planning and policies to archive balanced regional development. In detail, this study reviewed the central and local government policies and planning. The major findings and suggestions of this study could be follows; 1) Recently, the west coast of chungnam, one of the typical lagging regions in the country draws a nationwide attraction for a base of West-Sea Rim. Thus, many a projects are being suggested and attempted. However, the region has serious limitations in structural rather than quantitative terms to be tackled. Those are concerned with ① poor endowment of hard and soft infrastructure, ② increasing intraregional disparity. 2) The top-down development strategy employed by the central government, in which development effects of centers has not contributed much to improving inequality structure. Since chungnam has been always least benefited from the fruit of high economic development and SOC development. 3) By the plannings and reports, the development potential of west coast of chungnam is very high and varius. So, planning and ploicy of this area must be setting up many-sided diversity. The development plan could be seperately presented as follows: ① west-north part of this area(Chonan, Asan, Tangjin, Soesan) - manufacuring industry area ② west coast area(Seochon, Hongsung, Taechon) -tourist area ③ west-south part of this area(Seochon, Janghang) - large industrial complex. 4) The central government as a coordinator and a cooperator with local governments provides directions of each region's development and assists large scale projects through financial supports, while local government prepares and implements its plans as a main body of regional development. And people's participation of planning should be widen.

      • 용융염 합성법에 의한 strontium barium niobate의 분말제도 및 소결성

        윤상옥,전종호 강릉대학교동해안지역연구소 1990 東海岸硏究 Vol.1 No.2

        NaCl-KCl 용융염 합성법에 의해 strontium barium niobate분말을 제조하여 합성온도에 따라 그 특성을 열분석, X-선 회절분석, 전자현미경 관찰, 선수축율 및 유전상수 측정을 통하여 조사하였다. 용융염 합성법에 의하면 650℃ 부터 pyrochrole상이 적은 strontium barium niobate분말의 제조가 가능하며 분말의 형상은 침상이다. 또한, 합성온도가 올라감에 따라 입자성장이 일어나 선수축율은 감소하는 반면 이방성이 증가하여 유전상수는 증가 하였다. Strontium barium niobate powders were prepared by NaCl-KCl molten salt synthesis method and their characteristics were evaluated by thermal analysis, X-ray diffraction analysis, SEM observation, and measurements of linear shrinkage and dielectric constant as a function of synthesis temperatures. The needle like strontiun barium niobate powders having low content pyrochrole phase could be prepared at 650℃ by the molten salt synthesis method. As the synthesis temperature increased, the linear shinkage decreased due to the growth of particles but the dielectric constant increased by the increase of anisotropic.

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