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.

Elderly kidney transplant recipients have favorable outcomes but increased infection-related mortality

임정훈,Lee Ga Young,Jeon Yena,Jung Hee-Yeon,Choi Ji Young,CHO, JANG-HEE,Park Sun Hee,김용림,Kim Hyung-Kee,Huh Seung,유은상,Won Dong Il,Kim Chan-Duck 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.3

Background: The number of elderly patients with end-stage kidney disease has been increasing, but the outcomes of kidney transplants (KT) remain poorly understood in elderly patients. Therefore, we evaluated the clinical outcomes of elderly KT recipients and analyzed the impact of elderly donors. Methods: This retrospective cohort study included patients who underwent KT between 2000 and 2019. KT recipients were divided into four groups according to a combination of recipient and donor age (≥60 or <60 years); elderly recipients: old-to-old (n = 46) and young-to-old (n = 83); young recipients: old-to-young (n = 98) and young-to-young (n = 796). We compared the risks of mortality, graft failure, and acute rejection between groups using Cox regression analysis. Results: The incidence of delayed graft function, graft failure, and acute rejection was not different among groups. Annual mean tacrolimus trough level was not lower in elderly recipients than young recipients during 10-year follow-up. Mortality was significantly higher in elderly recipients (p = 0.001), particularly infection-related mortality (p < 0.001). In multivariable Cox regression analysis, old-toold and young-to-old groups had increased risk of mortality (adjusted hazard ratio [aHR], 2.89; 95% confidence interval [CI], 1.14– 7.32; p = 0.03; aHR, 3.06; 95% CI, 1.51–6.20; p = 0.002). However, graft failure and acute rejection risks were not increased in elderly recipients. Conclusion: In elderly recipients, graft survival and acute rejection-free survival were not inferior to those of young recipients. However, mortality, especially risk of infection-related death, was increased in elderly recipients. Thus, low immunosuppression intensity might help decrease mortality in elderly recipients.

방사선 조사에 의한 흰주 난포의 퇴축과 난포세포의 방사선 감수성

김수일,한승로,조근자,허대영,이영호,조문준,김무강,김원식 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

The aim of this study were to investigate radiation-induced atresia and radiation susceptibility in the rat ovary morphologically. Female rats (Sprague Dawley strain) of 4 weeks old were irradiated with dose of 4 Gy and 8 Gy, and sacrificed at hour 6, 12, and 24 after radiation. The H & E stain, the TUNEL method (ApopTag kit) and transmission electron microscopy (TEM) were used. In light microscopic observation, the number of atresia of ovarian follicles were increased significantly at 6h after irradiation (p<0.01). There was no significant difference between 4 Gy and 8 Gy irradiated groups. In TEM observation, granulosa cells in radio-sensitive follicles were characterized by several structural features including condensation of nuclear chromatin granules, nuclear fragmentation and apoptotic body formation. An apoptotic cell is observed to have been phagocytosed by a normal granulosa cell. Granulosa cells in radio-resistant follicles were characterized by several structural features including nuclear indentation, partial condensation of chromatin granules, mitochondrial swelling, dilatation of RER cisterns, accumulation of dense irregular masses, accumulation of lipid droplets, and increased lysosomal bodies. Number of gap junctions between granulosa cells were decreased, and intercellular space were widen than that of control animals. These findings were prominent at 6h after irradiation and were diminished at 12h and 24h after irradiation. With these results, it was concluded that radiation-induced follicular cell apoptosis and ovarian follicular atresia in rat ovary increased considerably at 6h after irradiation. Further studies are needed to reveal the more extensive differences between radiosensitive and radioresistant follicular granulosa cells.

소아 야뇨증에 대한 임상적 고찰

김승수,곽병곤,김영대,김우경,김영균,이종국 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objectives: The aim of this study was to describe the clinical characteristics of enuretic children and to evaluate the efficacy of treatments. Methods: Our study subjects enrolled were 52 children with nocturnal enuresis, who visited outpatient clinic of pediatrics in Seoul Paik Hospital and Ilsan Paik Hospital, during the period from October 1998 to August 2004. The data of gender, age, family history, symptom, clinical type of enuresis and drug therapy were collected and analyzed retrospectively. Results: The male : female ratio was 2.25 : 1. The mean age at diagnosis was 6.8 years with an age range from 4.3 years to 12.5 years. Fourty five cases(86.5%) were diagnosed as primary enuresis and 7 cases(13.5%) were diagnosed as secondary enuresis. A family history of enuresis was noted in 5 cases(9.6%) including 4 cases with parental enuresis history. The accompanying urinary symptoms were urgency(11.5%), frequency (7.7%), and dysuria(2.0%). Conclusion: We found frequent occurrences of enuresis in boys and primary type and an occasional association with a family history of enuresis. The two main treatment modalities were behavior control with an alarm system and drug therapy with imipramine, desmopressin, or oxybutynin. We recommend continuous drug medications to control nocturnal enuresis along with encouragement.

전자상거래에 데이터마이닝 기술 적용

김종완,진승훈,김병익,김태균,김영순 대구대학교 과학기술연구소 2001 科學技術硏究 Vol.8 No.1

The definition of data mining is the non-trivial extraction of implicit, previously unknown and potentially useful knowledge from data. Also, data mining has been worked on various fields such as database, machine learning, statistics, expert systems, and data visualization, and is a process consisting of these techniques. In many E-Commerce applications, it is important to build personalized profiles of individual users from their transaction histories. These profile constitute models of individual user behavior and can be specified with sets of rules learned from user transactional histories using various data mining techniques. In this paper, we present a MAS (multi-agent system) for customer management which maintains personal user information automatically, commands retrieval of products according to user preference, and builds personalized profiles of user.

^(7)Li, ^(87)Rb과 ^(27)Al NMR을 이용한 (K_(1-x)Li_(x))_(2)SnCl_(6), (K_(1-x)Rb_(x))_(2)SnCl_(6)와 K_(2)SnCl_(6):Al^(3+)의 상전이 근처에서의 결정 동력학 연구

김복수,김영훈,강재필,백아영,차유정,김민경,서용문,송승기 명지대학교 자연과학연구소 2004 자연과학논문집 Vol.23 No.-

K_(2)SnCl_(6)는 antifluoride계에 속하는 결정으로서 K_(2)SnCl_(6)에 Li^(+)를 첨가하여 ^(7)Li 핵자기공명(NMR)을 측정하여 동형(isomorphic) 혼합결정(K_(1-x)Rb_(x))_(2)SnCl_(6)와 비동형(nonisomorphic) 혼합결정 K_(2)SnCl_(6):Al^(3+)에서의 핵자기공명(NMR), ^(87)Rb NMR과 ^(27)Al NMR의 측정값과 비교하였다. Rb^(+) 이온은 K_(2)SnCl_(6)의 K^(+)이온을 대신해 동형 결정을 이루며, Al^(3+)이온은 Sn^(4+)이온을 대치하면서 비동형 결정을 이루는데 Li^(+)이온 또한 K^(+)이온을 대신하는 동형 혼합결정과 유사한 결과 값을 얻을 수 있었다. 이 연구 결과는 종래의 Cl-NQR 연구 결과와 비교함으로서 K_(2)SnCl_(6)의 동력학적 특성과 구조 상전이 근처에서의 임계현상을 새로운 관점에서 볼 수 있는 가능성을 보여주었다. ^(7)Li, ^(87)Rb and ^(27)Al NMR have been investigated in the isomorphic and nonisomorphic impurity doped crystals (K_(1-x)Li_(x))_(2)SnCl_(6), (K_(1-x)Rb_(x))_(2)SnCl_(6) and K_(2)SnCl_(6):Al^(3+) as a supplementary to the previous Cl NQR studies in these crystals. The results yielded that the features of NMR spectra for both types of crystals are roughly in line with the systematic trends shown in the Cl NQR in these crystals, though the outstanding characteristics exhibited in the Cl NQR become in the case of the NMR of the doped impurities in crystals somewhat weakend. This is due to the degradation of the role of the local field from the main hamiltonian in NQR to the subsidiary in NMR. Each NMR result of the iso/nonisomorphic crystals has been analyzed in terms of the 'impurity induced dynamic lattice defects' for K_(2)SnCl_(6):Al^(3+) and the 'static primary impurity effects' for (K_(1-x)Rb_(x))_(2)SnCl_(6) and (K_(1-x)Li_(x))_(2)SnCl_(6) respectlvely.

Densification and Thermo-Mechanical Properties of Al₂O₃-ZrO₂(Y₂O₃) Composites

Kim, Hee-Seung,Seo, Mi-Young,Kim, Ik-Jin The Korean Ceramic Society 2006 한국세라믹학회지 Vol.43 No.9

The microstructure of $ZrO_2$ toughened $Al_2O_3$ ceramics was carefully controlled so as to obtain dense and fine-grained ceramics, thereby improving the properties and reliability of the ceramics for capillary applications in semiconductor bonding technology. $Al_2O_3-ZrO_2(Y_2O_3)$ composite was produced via Ceramic Injection Molding (CIM) technology, followed by Sinter-HIP process. Room temperature strength, hardness, Young's modulus, thermal expansion coefficient and toughness were determined, as well as surface strengthening induced by the fine grained homogenous microstructure and the thermal treatment. The changes in alumina/zirconia grain size, sintering condition and HIP treatment were found to be correlated.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

직장 Dieulafoy 병변으로 다량의 혈변을 보인 1 예

김태영;이상헌;김지현;배영환;정은주;김승만;지삼룡;설상영 인제대학교 2011 仁濟醫學 Vol.32 No.-

Dieulafoy’s lesion is very rare cause of gastrointestinal bleeding, Deiulafoy’s lesion is exposure of non ulcerative, abnormally large tortuous, thick- walled artery in the muscularis mucosa through a small submucosal defect. It is usullay found on stomach antrum and lesser curvature side of the proximal body, and possibly found on any sites throughout whole gastrointestinal tract, but rarely on rectum. The principal of treating Dieulafoy’s lesion was the surgical resection of lesion, but recently remarkable advances in endoscopic technique make endoscopic approach more popular. We report a case of rectal Dieulafoy’s lesion successfully treated with endoscopic hemoclipping in an elderly female patient.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.