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.

임신부의 인플루엔자 백신 접종률 및 관련요인

김미정,이승연,이광수,김아름,손동욱,정문현,박신구,박지현,이병익,이진수 대한감염학회 2009 감염과 화학요법 Vol.41 No.6

Background : During seasonal influenza epidemics and previous pandemics, pregnant women have been at increased risk for complications related to influenza infection. Although influenza vaccination has been widely recommended to pregnant women and immunocompromised hosts, the vaccination rate is presumed to be low in pregnant women. This study was aimed to evaluate the vaccination rate and factors associated with Influenza vaccination among pregnant women, who are at high risk for developing complications from the influenza. Materials and Methods : This study was carried out by telephone survey from April, 2007 to August, 2007. Women who were in their second trimester of pregnancy or above,- during October, 2006 and February, 2007, the recommended vaccination period, and had given birth at Inha University Hospital were selected as the study population. Immunization status, general understanding, and factors associated with vaccination were evaluated. Results : Among a total of 506 eligible pregnant women, 227 (44.8%) responded to the questionnaires. The influenza vaccination rate among the pregnant women was only 4% (9/227). Major reasons for not receiving vaccination were first, not awaring the necessity of immunization during pregnancy (48.5%, 110/227) and second, misunderstanding that it is prohibited during pregnancy (36.1%, 82/227). The major factors that influenced the compliance of vaccination were correct understanding and doctor's recommendation on the influenza immunization during pregnancy. Conclusions : The influenza vaccine coverage on pregnant women was very low and the awareness of influenza vaccination during pregnancy in general was inaccurate. Shift in perception is required and this can be achieved by educating the pregnant women on the safety and efficacy of vaccination. In addition, doctors' active encouragement to vaccination is highly recommended.

21세기 새로운 시대를 준비하는 원광대학교 의과대학의 교육목표 개정과정

이학승,김요식,송윤강,오재민,양연식,정선관 원광대학교 의과학연구소 2009 圓光醫科學 Vol.24 No.1

교육목적은 대학의 교육이 지향하는 대전제이다. 그러므로 대학교육 목적과 목표가 어떤가에 따라 교육과정과 교육방법이 달라진다. 원광대학교 의과대학의 교육목표는, '지덕겸수'로 요약되는 '과학과 도학을 겸비한 전인교육'의 건학정신과 '학술탐구'와 '덕성함양'의 원광대학교 교육목표와 일치하게 현재까지 유지되었다. 그러나 현행 교육목표의 여러 문제점이 발견되었고, 시대상의 변화에 따라 원광대학교 의과대학에서도 사회적 변화 빛 의료인에 대한 시대적 요구에 걸맞은 의학교육의 목적 및 목표의 재설정 과정을 시작하게 되었다. 그 결과 개정 작업을 통해 새로운 교육목표를 설정하게 되었으며 그 내용은 다음과 같다. 1. 기본진료능력을 지닌 의사를 양성한다. 2. 원불교 교리 이념을 반영한 윤리적, 도덕적인 의사를 양성한다. 3. 평생 학습하는 연구하는 의사 혹은 의과학자를 양성한다. 4. 사회적 책무를 수행하는 리더십을 갖춘 의사를 양성한다. 5. 지역 사회에 공헌하는 봉사정신을 갖춘 의사를 양성한다. Purpose : With the changes to the medical environments and to the medical educational systems, we aimed to evaluate the current mission statement of the School of Medicine, Wonkwang University, and to revise it. Methods : To establish the new goal and mission statement, a Special Committee for the Revision of Medical School Mission and advisory group were organized in 2008. This special committee conducted through five steps of action, which are composed of investigation, education, development, surveillance of various opinions, and announcement. Results : For the development of new goal and mission, the revised, final goal and mission statements decided through the five steps of action. The new mission of Wonkwang University School of Medicine was as follows; 1. Doctor who can diagnose and treat easily 2. Ethical and moral doctor who practice Won Buddhism 3. Doctor or Medical Scholar who studies lifelong study 4. Doctor who has leadership to social responsibility 5. Doctor who goes into service to a local community. Conclusion : The authors expect that the new goal and mission of Wonkwang University School of Medicine would be helpful in giving the guideline on the educational process of medical school and will give the information to reform the medical school system according to the rapidly changing educational environment.

법랑질 형성 부전증에 대한 증례보고

이승영,백병주,이지연 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.1

Amelogenesis imperfecta(AI) is defined as a genetically determined effect affecting enaml formation and may be associated with other ectodermal or systemic disorders. It is entriely an ectodermal disturbance, since the mesodermal components of the teeth are basically normal. The presentation of diverse clinical manifestations in thought to result from the heterogeneous structural and chemical defects. The anomaly occurs in the general population in the range of 1 n 14,000 to 16,000, to 1.4 in 1000, depending on the specific population studied. Classification of the AI types considers mode of inheritance and clinical manifestations. The most widely accepted classifi-cation system recognizes three major groups ; i.e., hypoplastic(thin enamel), hypocalcified (primary mineralization defect), hypomaturation(defect in enamel maturation). Delineationg speific AL types can be confusing given the phenotypical similarity of many forms and that the most recent classification lists 14 different AI types. A 8-years-old female patient with complaint of abnoraml crown shape and discoloration of maxillary anterior tooth and excessice wear of posterior dentition of both arch.came to Dept.of pedodontics, College of Dentistry, Chonbut National University for rahabilitation. The treatment depends on its severity and the demands of esthetic improvement. In this case, resin veneer crown of maxillary anteiror tooth and composite resin restoration of mandibular anterior tooth showed good esthetic result. Restoration of Mx. and Mn. 1st first molar with stainless steel crown rehabilitated the masticatory function and estabilished the vertical dimension of occlusion. But futher care is needed for estabilishment of final vertical dimension of occlusion after completion of permanent dentition.

미약한 경부기종에 의해 발생된 개의 부분적 기관협착

이성호,박영석,박병권,김병수,정지윤,박창식,김상기 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

A 10-year old male Pomerarian was presented with about a ten day history of stridor and severe paroxysmal honkinglike coughing which were aggravated with excitement and exercise. Auscultation revealed prominent inspiratory and expiratory crackles and wheezes over the caudal cervical trachea which were heard equally over both side of the chest, and a hemogram showed mild leucocytosis with mild dehydration. On the lateral radiographs of the neck and thorax, the cervical trachea was displaced ventrally by the air trapped between fascial planes of the cervical area near the thoracic inlet. It also revealed a marked narrowing of the tracheal lumen extending from the level of the fifth cervical to the second thoracic vertebra, and the lung field was judged to be within normal limits. There was no evidence of pneumomediastinum. A diagnosis of segmental tracheal stenosis was made. The emphysema of the retrotracheal area was thought to be a traumatic origin. The dog was treated successfully with strict cage confinement for a week. The tracheal stenosis caused by mild emphysema between the soft tissue of the cirvical area or mediastinum in the dog is very rare.

유구치 치근분지부 병소의 치수절제술과 소파술에 의한 골재생

이승현,우연선,김재문,정태성,김신 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.4

유구치의 깊은 우식은 치수병소을 유발하고 이를 조기에 치료하지 않을 경우에는 치수강저의 수많은 부근관을 통하여 치근분지부 병소로 이어진다. 지금까지 대부분의 교과서나 문헌에서는 이와 같은 경우를 발치의 적응증으로 기술하여 왔고 임상에서도 상례적으로 발치를 흔히 시행하였다. 그러나 유구치의 조기 상실은 수많은 부작용을 낳는 것이 필연적이다. 어린이의 골재생 능력이 우수하며, 치수강저와 치근분지부를 잇는 많은 부근관이 있음을 생각해 볼 때 유구치 치수 내의 감염원을 치수절제술로 제거하고, 이미 발생한 치근분지부 병소에 대해서는 소파술을 시행한다면 치근분지부 골조직의 신속한 재생이 가능하지 않을까하는 의문이 제기되었다. 본 중례는 3~6세 어린이에서 유구치 치근분지부 방사선 투과상이 2~4mm 정도의 깊이를 보이는 비교적 경미한 수준이면서, 연조직 누공을 보이는 10개 중례를 선별하여 치수절제술과 치근분지부 소파술을 시행한 결과, 모두에서 방사선적으로 골재생이 관찰되었다. 이를 통하여 유구치 치근분지부 병소나 누공을 보이는 모든 경우가 발치의 적응증은 아니며, 이 방법이 치근분지부 병소를 가진 유구치를 잔존시킬 수 있는 하나의 대안이 될 수 있음을 알 수 있었다. 그러나 이 방법이 객관적인 타당성을 얻기 위해서는, 병소의 크기와 진행정도, 계승 영구치의 성숙도, 환아의 연령 등 적응증에 대한 보다 심층적인 검토와 연구가 필요할 것으로 사료되었다. Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent furcation lesion with fistulous openings. Up to now, majority of the textbooks on pediatric dentistry and literatures have described that extraction of the inflicted teeth is indicated for these cases and in reality these teeth have usually been extracted in the dental clinics. However, when we recognize the excellent capacity of bone regeneration in children and the presence of numerous accessory canals at furcation areas, the removal of infection source in pulp by pulpectomy and inflammatory granulation tissues at furcation areas by furcal curettage might open the possibility of rapid healing at the furcation region. In this report. 10 cases of primary molars in 3 to 6-year-old children with fistulous openings and furcation lesions in moderate size of 2 to 4mm in depth radiolucency at furcation lesion have been chosen. After pulpectomy and furcal curettage, evident bone regeneration was detected rediographically in all cases. Through the cases, we came to realize that all the cases previously described are not the indications of extraction and this approach could make many cases with pulp and furca combined lesions survive and remain healthy in the children's dental arches. However, in order for this approach to acquire objective appropriateness. it is thought that more scrupulous evaluation is desirable on the various factors regarding the indication such as the extent of furcation, absorption status of teeth, amount of covering bone on succeeding teeth and so on.

척수로 전이된 후두엽 다형성 교아세포종 : 증례보고 A Case Report

윤상민,송재욱,이창훈,조경자,김종현,이승훈 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

The tendency of glioblastoma to metastasize to the cerebrospinal fluid(CSF) is well documented, reaching approximately 20% in autopsy series. Nevertheless, clinical symptoms from spinal seeding seem to be infrequent or are at least rarely diagnosed. The authors report a case of 41-year old female patient with a cerebral glioblastoma multiform who developed paraplegia due to a pathologically confirmed spinal matastasis.

요추부 수술후 통증관리를 위하여 실시한 Morphine Sulfate를 이용한 Caudal Block의 효과

윤승환,박형천,김은영,전병윤,이홍식,이성근 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.6

반려동물의 기생충검사 이론 및 실제

이성호,박영석,박병권,김상기,정지윤,박수진,박창식,김병수 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

The aim of this article is to improve human health and that of companion animals by improving the diagnosis and control of parasitic diseases. This is achieved by research into parasites of veterinary significance including zoonoses and the use of comparative systems to increase our understanding of some human parasitic diseases. We should promotes learning and teaching through knowledge and operates a diagnostic unit that offers a service to pet owner for indigenous and exotic parasitic diseases of companion animals. We must diagnose and treat them early. Zoonotic parasites are very important because many of animal parasites are zoonoses and give pain and death to human. Parasites are divided Protozoa, Helminthes and Arthropods. There are many protozoa, about 65,000 species. Arthropods are the vector of another diseases, such as virus, bacteria, protozoa and nematodes. Helminthes are composed of Trematoda, Cestoda, Nematoda and Acanthocephala. The target of Veterinary Parasitology is to recognize the characteristics of these parasites and subsequently diagnose, treat and control them. This article is intended to familiarize you with the essential facts and concepts of companion animal parasitology. Emphasis is placed on fecal sample techniques (comparison of fecal examination techniques; frequently found artifacts in fecal smears; direct Smear; zinc sulfate flotation; etc.) We recommend that the study be done to more references on animal parasites.

재발한 희돌기 교세포종에 대한 BCNU-CDDP 연속정주 화학요법

윤상민,이창훈,이승훈,송재욱,김종현 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

Eight patients with recurrent oligodendroglioma were treated with 1.3-bis(2-chloroethyl) nitrosourea(BCNU) and CDDP continuous infusion chemotherapy. They were 5 with benign oligodendrogliomas and 3 with anaplastic oligodendrogliomas. All the recurrent tumors had been treated with surgery and radiotherapy. Four patients had already received chemotherapy with ACNU. Seven of them showed response to continuous infusion chemotherapy. The time from the response to progression was 15 to 67 weeks. No severe complication of the chemotherapy was found. In conclusion, BCNU-CDDP continuous infusion chemotherapy is an effective treatment modality in recurrent oligodendrogliomas.