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.

작은 피질하 병변에 대한 정위적 개두술 및 경-구 접근법

손병철,김문찬,이관성,박춘근,홍용길,강준기 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.12

직류송전계통에 대한 전력조류계산에 관한 연구

손태훈,안병철,이오걸 동의공업대학 1999 論文集 Vol.25 No.1

The active and reactive power transfers to and from nodes connected to H.V.D.C.(High Voltage Direct Current) links do not obey the general rules of a.c. power transmission, the active power is independent of phase angle relationships and the reactive power is not directly related to voltage variation. Under such circumstances it is difficult to visualize H.V.D.C. model compatible with the behaviour of the fact decoupled algorithm. However, acknowledging the general acceptance of fast decoupled programs and the existence of some H.V.D.C. 1inks(particular1y considering their large power-carrying capacitors) a model of the H.V.D.C. transmission link suitable for incorporation with fast decoupled loadflow programs is described in the following sections.

국내 주요호수의 육수학적 조사 (1) : 옥정호

김범철,박주현,이병진,허우명,황길순,최광순,채기숙 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

The limnological survey of Lake Okjong was conducted for one year from June 1993 to May 1994 on the monthly basis. The loading of phosphorus, nitrogen and organic carbon from the watershed into the lake were monitored at the main in flowing sites. Secchi disc transparency , epilimnetic chlorophyll a, total nitrogen, total phosphorus concentration and primary production were in the range of 1.3~4.H m, 2.4~ 18.7 mg Chl/m³. 1.25~2.87 mg N/l, 7~65 mg P/m³, 325~2,113 mg C/m²/day, respectively. TN/Tl atomic ratio varled from 129 to 443. N/P ratio decreased in summer because phosphorus concentration was higher than in winter, while nitrogen did not vary much. The seasonal succession of phytoplankton was distinct. In winter and spring, diatoms, Aulacoseira granulata var. angustissima and Aulacoseira italica were dominant while cyanobacteria, Microcystis sp.,M. ichthyovlabe, Phormidium sp. and P.valderianum var. tenuis were dominant in warm seasons. The dominant zooplankton species were Thertmocyclops taihokuensis in warm seasons while Boosmina longirostris were dominant in cold seasons. The organic carbon, nirtogen and phosphorus content of lake sediment were 8.0~14.8, 0.59~0.71, 1.14~1.87 ng N/g, respectively. The sediment of Lake Okjong can be classified as oligohumic based on C/N ratio. The total phosphorus loading from the watershed and fishfarm were estimated to be 2.7g P/m²/yr, which far exceeded the critical loading for eutrophication. The organic carbon loading from the watershed and primary production were determined to be 998t C/yr, 6,348t C/yr, respectively. Most of organic carbon was contributed by autochthonous primary production of phytoplankton. Trophic state of Lake Okjong can be classified as eutrophic

레이더를 이용한 콘크리트의 두께 측정과 유효 측정범위 설정에 관한 연구

임홍철,이지훈,손병오 한국비파괴검사학회 2000 한국비파괴검사학회지 Vol.20 No.4

콘크리트 구조물의 성능평가 방법의 하나로 최근 들어 레이더가 널리 쓰이고 있다. 콘크리트 구조물 적용에 대한 레이더법의 발전을 위해서는, 콘크리트의 전자기적 재료 특성과 레이더의 작동원리를 이해하고, 활용하는 체계적인 연구노력이 필요하다. 본 논문에서는 레이더법의 유효 측정범위 설정과 레이더를 이용한 콘크리트의 두께측정 방법을 제시하고, 레이더 측정을 통한 콘크리트의 유전상수 계산 방법을 제안한다. 실험에서는 900mm (길이) × 600mm (폭)에 두께 50mm, 100mm, 150mm, 200mm, 250mm의 콘크리트 시편 5개를 사용하였다.

수직냉각면을 가진 함수정방형내에서 초기온도가 동결량에 미치는 영향에 관한 실험적 연구

김병철,주동인,손정배,박영훈 조선대학교 에너지.자원신기술연구소 1997 에너지·자원신기술연구소 논문지 Vol.19 No.2

The effect of initial temperature on freezing with vertical cold wall in rectangular cavity was studied. When the initial temperature was below the 4℃, the frozen thickness in the upper part was thicker than that of lower part from the beginning of freezing and above the 4℃, at beginning the frozen thickness in the upper part was thinner than that of lower part but with time the frozen thickness in the upper part was thicker than that of lower part. And when it was above the 8℃, at the beginning of freezing the upper part of frozen thickness was thinner than that of lower part with concave but with time the concave in the upper part became thicker and the frozen thickness in the upper part was thicker than that of lower part too. The effect of initial temperature had no effect on the increasing of ice volume with time because in the beginning of freezing the more initial temperature was low, the more frozen thickness grew but the heat resistance increased in proportion as the frozen thickness grew.

국내 주요 호수의 육수학적 조사(4): 주암호

김범철,박주현,허우명,임병진,황길순,최광순,최종수 江原大學校 附設 環境硏究所 2001 環境硏究 Vol.18 No.-

In this study limnological characteristics of Lake Juam was surveyed from June 1993 to May 1994 in order to provides important information regarding water resources. Seschi disc transparency, epilimnetic chlorophyll a(chl-a), tatal nitrogen(TN), total phosphorus(TP) concentration and primary productivity were in the range of 2.0~4.5 m, 0.9~13.6 mgChl/㎥, 0.78~2.32N/l, 11~56 mgP/㎥, 270~2,160mgCm^(-2)day^(-1), respectively. On the basis of TP, Chl-a and Secchi disc depth, the trophic state of Lake Juam can be classified as mesotrophic lake. The phosphorus inputs from non-point sources are concentrated in heavy rain episodes during the monsoon season. As a result, phosphorus concentration are higher in summer than in winter. TP loading from the watershed were estimated to be 0.9 gPm^(-2)yr(-1), which correspond to a boundary of the critical loading (1.0 gPm^(-2)yr(-1), which correspond to a boundary of the critical loading (1.0 gPm^(-2)yr(-1)) for eutrophication. From the results of the algal assay, both phosphous and nitrogen act as limiting nutrients in algal growth. The seasonal succession of phytoplankton community structure in Lake Juam was similar to that observed in other temperate lakes. Diatoms(Asterionella formosa and Aulacoseira granulata var. angustissima) were dominant in spring and winter, cyanobacteria (Microcystis aeruginosa, M. sp. and M. viridis) were dominant in warm season. The organic carbon, nitrogen and phosphorus content of lake sediment were 9.5~14.0 mgC/g, 1.01~1.82 mgN/g, and 0.51~0.65 mgP/g, respectively. The allochthonous organic carbon loading from the watershed and autochthonous organic carbon loading by primary production of phytoplankton were determined to be 1,122 tC/yr and 6,718 tC/yr, respectively. To prevent eutrophication of Lake Juam, nutrient management of watershed should be focus on reduction of fertilizer application, proper treatment of manure, and conservation of topsoil as well as point source.

석면관련 폐질환의 진단에 있어서 흉부고해상도전산화단층촬영검사(HRCT)의 유용성

이현재,손지언,,홍영습,,이영일,예병진,유창훈,정갑열,김상훈,임형준,장은철,김정만,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 석면에 노출된 근로자에서 석면관련 폐질환의 양상을 분석하고 진단에 있어 HRCT의 유용성을 연구하여 석면에 대한 의학적 감시프로그램의 개발에 기여하고자 하였다. 방법: 석면에 직접 노출되는 작업자 68명과 간접 노출되는 작업자 94명 등 총 162명에 대해 OSHA 석면 표준, 의학적 감시 프로그램에 따라 단순 흉부방사선검사, 폐활량검사 및 우리나라 실정에 맞게 일부 수정한 의학적 설문지를 통해 면접조사의 방식으로 환자에 관한 정보를 수집하였으며, 자료의 신뢰성을 확보하기 위하여 면접조사는 1달 이상의 기간을 두고 2차례에 걸쳐 실시된 후 확인, 수정하였다. 또한, 석면관련 폐질환을 확진하기 위하여 HRCT를 추가적으로 실시하였다. 결과: HRCT결과 석면관련 폐질환의 유병율은 162명의 근로자중 17명으로 10.5%였는데, 직접 노출군에서 10명 (14.7%), 간접 노출군에서 7명 (7.4%)이었다. HRCT와 비교할 때 단순 흉부방사선검사의 민감도와 특이도는 각각 70.6%와 98.6%이었고, 양성 예측도와 음성 예측도는 각각 85.7%와 96.6%으로, HRCT는 단순흉부방사선검사에 비해 민감도가 높아 초기 석면관련 폐질환을 진단하는데 효과적이었다. 석면관련 폐질환의 진단에 있어 HRCT와 폐활량검사 사이에 유의한 관련성이 관찰되었다. HRCT 결과 석면관련 폐질환의 유무와 의학적 설문조사 결과의 빈도분석을 실시한 결과, 유의한 변수는 작업기간, 흡연량, 호흡기질환의 과거력, 기침, 호흡곤란이었다. 결론: HRCT는 석면관련 폐질환의 진단에 있어 단순 흉부방사선검사와 비교하여 민감도가 높아 초기 진단에 유용하므로 단순 흉부방사선선검사 결과 석면관련 폐질환소견을 보일 때뿐만 아니라, 정상소견을 보이더라도 폐활량 검사결과와 근무력, 흡연력, 호흡기질환의 과거력, 기침, 호흡곤란 등의 호흡기 증상을 참고하여 HRCT검사를 고려해야 한다. 또한, 본 연구에서 관련성이 없었던 요인들에 대해서도 향후 연관성을 규명하는 광범위한 전향적 연구가 필요하다. Objectives: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. Methods: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveilance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveilance program consists of simple chest x-ray, spirometry and medical questionnarie. Results: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT, HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. Conclusions: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

American Medical Association 5판을 근거로 한 한국형 말초신경계 장애 평가기준 개발

박동식,김병조,황선철,송인욱,손병철,장성호,정두신 순천향대학교 의학연구소 2009 Journal of Soonchunhyang Medical Science Vol.14 No.3

.

용접공들의 망간 폭로와 건강장해에 관한 연구

문덕환,강동묵,손병철 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the degree of manganese exposure and its health hazards effect on welders in manufacturing industry. Methods : The author measured airborne, blood and urine concentrations of manganese and blood chemistry, and also observed clinical symptoms and signs on 60 welders for case and 60 non-welders for control working in manufacturing industry by age maching method. Results : The geometric means of blood and urine concentrations of manganese were 1.13±1.38 ㎍/㎗ and 2.52±1.37㎍/ℓ for Welders group, 1.09±1.68 ㎍/㎗ and 1.86±1.34 ㎍/ℓ for Non-welders group. Airborne concentration of manganese was 0.15±1.66㎎/㎥ for exposured group, and the urinary mean concentration of manganese was statistically significant difference between exposured and non-welders group (P<0.05). Clinical signs in welders group were palmomentle reflex(23.3%), tremor(20.0%) and grabellar sign(5.0%). Symptoms in welders group were fatigue(66.7%), amnesia(66,7%), excessive sweating(51.7%), nervousness(51.7%), general weakness(48.3%) and arthralgia(46.7%) and so on, and there was statistically significant difference compared to non-welders group(P<0.05). Manganese effects on blood chemistry were not observed. There were statistically significant correlation between manganese concent- ration in blood and urine(r=0.269), airborne and urine(r=0.601) and airborne and blood(r=0.268). Conclusion : The author suggest that further studies are followed to evaluate the health status of welders whose blood and urine manganese concentrations were below normal reference level, and to establish the questionnaire and the diagnostic tools for early detecting the chronic manganese poisioning on welders.