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.

새로운 항암성 백금(Ⅱ) 착체류의 in vivo 독성연구

정광원,임종석,정세영,노영수,최병기 한국환경독성학회 1995 환경독성보건학회지 Vol.10 No.2

The general toxicological study of new platinum(Ⅱ) compounds, KHPC-002, KHPC-005 and KHPC-006 were investigated in rats. The effects of these Pt(Ⅱ) complexes on renal, hematopoietic and hepatic system in rats showed lower toxicity compared with cisplatin. In the consideration of the maximal dose of these Pt(Ⅱ) complexes using in this experiment is 4-8 times higher than cisplatin, these novel compounds will have the less general toxicity in vivo.

Matti-Russe술식을 이용한 주상골 불유합의 치료

안상로,정진선,박원,우영길 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

13 Cases of scaphoid nonunion had been treated by original Matti-Russe procedure and followed up more than 2 years, from September 1990 to September 1993, at the Department of Orthopedic Surgery, Chung Nam National University Hospital. The results were as follows ; 1. Scaphoid nonunion occurs between 21 to 40 years of age( 13 cases ) and 13 cases were all male. 2. Most commonly, the site of fracture were confined to middle one third in 9 cases( 69 %), and fracture line were transverse in 6 cases( 46% ). 3. Radiological union was obtained with DISI deformity correction and normalization of intrascaphoid angle in all cases. 4. The result of treatment were excellent in 8 cases( 61%), good in 4 cases( 31%) and fair in 1 case( 8%)

영아기 호흡기 질환의 이환요인에 관한 연구

신상원,김은영,노영일,양은석,문경래,박상기,박영봉 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Purpose: Respiratory tract infections are common in the first year of life. Severity of respiratory tract infection in infants is associated with early-life environmental factors, In recent, genetic studies suggest a role of heredity in susceptibility to severe respiratory tract infection(RTI) in infants. We designed a case control study to further investigate relative importance of familial influence in risk of respiratory tract infection in infants compared to environmental factors. Methods: We selected 126 children(44 cases; 82 controls) that admitted or visited to Chosun University Hospital. Cases were infants under age 1 year admitted to hospital with severe respiratory tract infection. Familial history and other factors were recorded in cases and controls by questionnaire. Results: Out of 126 infants, Patients admitted with severe respiratory tract infection are 44 cases. Diagnosis of patients with RTI are acute bronchitis 15 cases(34.1%), pneumonia 12 cases (27.3%), acute nasopharyngitis 7 cases (15.9%), acute bronchiolitis 5 cases (11.4%), infantile asthma 3 cases (6.8%), and croup 2 cases (4.5%). The crude odd ratio of repiratory tract infection of parental smoking is 3.35 and cow mik feeding 3.13, Prematurity & low birth weight 2.39, maternal allergic disease 2.13, and child allergy 1.92. Conclusion: Maternal allergic disease, parental smoking, Prematurity and low birth weight, and Allergic diseases increased the risk of respiratory tract infection in infants. Breast milk feeding decreased that. These results support the possibility that genetic factors play an important role in susceptibility to recurrent and severe respiratory infections in early life.

일부 부인과 양성 질환자의 지방조직 및 혈청의 PCBs와 DDE 농도

박성균,이강숙,노영만,구정완,민선영,한진구,고원경,김미란,정재근,이종승,김진홍 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 본 연구는 지방조직과 혈청의 PCBs와 DDE 농도를 측정하고, 이에 영향을 미치는 것으로 알려진 요인들과의 관련성을 평가하고자 하였다. 방법 : 유방암, 자궁내막증 등 유기염소계 화합물의 영향이 있는 것으로 알려진 호르몬 관련 질병을 제외한 부인과 환자 52명을 대상으로 지방조직과 혈청을 분석하였으며, 설문조사를 통하여 연령, 교육수준, 직업, 비만도, 흡연과 음주, 출산력, 수유력등을 조사하였다. 지방조직과 혈청의 PCBs와 DDE 농도는 가스크로마토그래피를 사용하여 측정하였다. 결과 : 지방조직의 경우, 13개 PCBs congeners 농도의 합은 중앙값이 48.29 ng/g, 기하평균값이 56.78 ng/g이었고, DDE 농도는 중앙값이 142.89ng/g, 기하평균값이 117.06 ng/g이었으며, 혈청의 경우는 PCBs congeners 농도의 합은 중앙값이 4.67 ㎍/L, 기하평균값이 4.85 ㎍/L이었고, DDE 농도는 중앙값이 1.75 ㎍/L, 기하평균값이 2.09 ㎍/L로 나타났다. 지방조직과 혈청의 DDE 농도 사이는 높은 상관성을 보였으나(r²=0.310, p=0,0002), PCBs는 상관성이 약한 것으로 나타났다(r²=0.029, p=0.2582). 영향요인을 범주화한 후 로그변환 시킨 지방조직과 혈청의 PCBs, DDE 평균의 차이를 분석한 결과, 지방조직의 DDE만이 출산자녀수(p=0.015), 초산연령 (p=0.014), 비만지수(p=0.035)와 연관성이 발견되었다 다중회귀분석의 결과 지방조직의 DDE는 출산자녀수가 적을수록, 초산연령이 늦을수록 증가하는 경향을 보였다. 결론 : 출산자녀수와 초산연령, 비만도가 지방조직의 DDE와 관련성을 보였으며, 또한 유기염소계 화합물의 장기간의 노출에 의한 영향을 평가하는데 있어서 혈청보다 지방조직이 더 유용한 생물지표임을 알 수 있었다. Objectives : This study was purposed to determine the levels of PCBs and DDE in adipose tissue and serum and to evaluate the relations with factors affecting these levels. Methods : We analyzed adipose tissues and sera from 52 gynecologic benign disease patients aged 27-78 years, except hormonal diseases such as breast cancer and endometriosis. We also surveyed age, education, occupation, body mass index (BMI), smoking, drinking, number of children, and duration of breastfeeding by questionnaires. Tissue and serum levels of PCBs and DDE were measured using gas chromatography. Results : The median and geometric mean levels of PCBs were 48.29 ng/g, 56.78 ng/g for adipose tissue and 4.67 ㎍/L, 4.85 ㎍/L for serum, and those of DDE were 142.89 ng/g, 117.06 ng/g for adipose tissue and 1.75 ㎍/L, 2.09 ㎍/L for serum, respectively. Adipose tissue and serum levels for DDE showed high correlation (r²=0.310, p=0.0002), but those of PCBs didn't (r²=0.029, p=0.2582). In analyses of the differences of the means of log transformed adipose tissue and serum PCBs and DDE levels for groups of potential covariates, only adipose tissue DDE levels were significantly associated with number of children (p=0.015), age at first birth (p=0.074) and BMI (p=0.035). In multiple regression analysis, adipose tissue DDE levels were significantly increased with decreasing number of children and increasing age at first birth. Conclusions : This study suggested that parity and adiposity were associated with levels of DDE in adipose tissue, and adipose tissue is a better biomarker than serum for evaluating the long-term exposure of organochlorines.

혈청 Fructosamine에 대한 임상적 유용성에 관한 연구

김철,김용태,노상현,홍순표,김미송,장숙진,박희완,문대수 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

Diabetes mellitus is a universal health problem and may occur at any age. The traditional biochemical measurements for initially detection patients with diabetes mellitus are random estimations of blood and urine glucose concentrations. Despite their common use both tests are fairly non-specific, being influenced by wide variety of condition. Measurement of the HbA_(1c) in a random blood specimen is a more simple screening test for diabetes, and widely used as an index of diabetic control. But unfortunately, it has difficulties with methodology. Fructosamine has been described as a new parameter for the estimation of glycosylated protein, It is based on the reduction potential of ketoamines in an alkaline medium and measures colorimethcally the concentration of all glycosylated semm proteins belonging to the class of fructosamine. It reflects the time-integrated glucose concentration over the previous 1 to 3 weeks and can be used for the follow up of diabetes mellitus. We measured serum fructosamine concentration and compared with any other items. The results are summehzed as follows : 1. Within-run and between-run imprecision were assessed by 20 analysis of 3 differential fructosamine concentration in control sera. The respective coefficients of variation were 2.9%, 6.6% in low concentration, 2.2%, 5.1% in medium concentration and 3.3%, 4.7% in high concentration. 2. The serum fructosamine concentration were 2.26±0.21 mmol/L in normal control subjects(n=29) and 3.35±0.65 mmol/L (n=62) in patients with diabetes mellitus (p<0.001). 3. In diabetic patients (n=62), the serum fructosamine concentrations correlated less significantly with glucose (Y(fructosamine) = 0.01×(glucose)+2.52, r=0.54, P<0.001) and more significantly with HbA_(1c) (Y(fructosamine) = 0.22×(HbA_(1c))+1.71 , r=0.63, P<0.001). 4. The concentrations of fructosamine in serum and EDTA plasma were not significently diferent (P<0.01). So, Plasma is as well suited to fructosamine determinations as serum(Y(serum) = 0.95×(Plasma)+0.25, r=0.96). 5. No interference was observed with lipemic sera (cholesterol) in detection of serum fructosamine(P=0.393).

圓光醫大 附屬 第2病院 神經精神科 患者에 對한 統計的 考察(Ⅱ)

박민철,장광철,김상원,김한주,유미경,김훈,유용진,김현정,박남진,오상우,이귀행,노승호,백영석 圓光大學校 醫科大學 神經精神科學敎室 1992 圓光精神醫學 Vol.8 No.1

본 연구는 1986년 7월 11일부터 1991년 7월 10일까지 원광의대 부속 제2병원 신경정신과에서 의래 및 입원치료를 받았던 6,072명의 환자를 대상으로 병원 역학조사를 실시하고 그 결과를 1차조사 (박민철 등1986)와 비교했다. 1.전체 환자 중 남자가 54.4%로 여자보다 많았고, 이리와 이리 인접지역이 84.0%로 대부분의 지역을 나타났다. 의료보장상태는 보험환자가 57.1%, 의료보호환자21.8%, 일반환자 21.1%였으며 연령별로는 20대 24.6%, 30대 22.8%로 20대 30대가 절반정도를 차지했다. 2.외래환자에서는 신경중성장애가 46.0%로 가장 많고 정동장애, 경련성장애 순이며, 입원환자에서는 정신분열증이 30.5%로 가장 많고 기질성정신장애, 정동장애의 순이었다. 3.남자는 신경증성쟝애(23.4%), 정신분열증, 기질성정신장애 순이고 여자는 신경증성장애(39.9%), 정동장애, 정신분열증의 순이었다. 남자가 여자보다 많은 진단은 알코올정신장애(94.6%), 기질성정신장애, 소아정신장애 순이고, 여자가 남자보다 많은 진단은 정동장애(64.5%), 신경증성장애였다. 4.진단별 연령분포에서 신경증성장에는 30대(25.3%), 20대, 40대 순이고, 정신분열증은 20대(40.5%), 30대, 40대 순이며, 정동장애는 20대, 30대, 50대 순이나 비교적 비슷한 융이었다. 5.진단별 발병연령에서 신경증성장에는 20대, 30대가 절반이고,정신분열증은 20대(51.3%), 10대, 30대 순이며 정동장애는 20대(30.7%), 30대, 50대 순이었다. 진단별 평균 발병연령은 신경증성장애 32.7세, 정동장애 36.1세, 정신분열증 23.6세였다. 6.진단별 이병기간은 2년이상이 신경증성장에 28.3%, 정신분열증 68.5% 정동장애 43.9%인데 전체적으로 41.0%였다. 진단별 평균 이병기간은 정신분열증 73.2개월, 정동장애 45.5개월, 신경증성장애 29.5개월이었다. We examined epidemiologic study of 6,072 patients who visited Wonkwang Neuropsychiatric hospital since July 11 of 1986 until July 10 of 1991 and compared this results with previous study(Park et al 1986). The study revealed as follows:1. Of total patients males visited this hosptial more than females as 57.1%, Most of them(84.0%) resided Iri and neighbouring Iri. In the point of insurance, insured patients, medicaid patients and uninsured patients were 57.1%, 21.8% and 21.1% respectively. On the distribution of age, the twenties, the thirties were 24.6%, 22.8% respectively and twenties and thirties were about half of total patients. 2. Of outpatients neurotic disorder was the most as 46.0%, secondly mood disorder and thirdly convulsive disorder, but of inpatients schizophrenia was the most as 30.5%, secondly organic mental disorder and thirdly mood disorder. 3. Of males neurotic disorder was the most as 23.4%, secondly schizophrenia, and thirdly organic mental disorder, but of females neurotic disorder was the most as 39.9%, secondly mood disorder and thirdly schizophrenia. alcoholic mental disorder(94.6%), organic mental disorder, child mental disorder were mostly found in males,but mood disorder(64.5%) and neurotic disorder were mostly found in females. 4. On the distribution of age neurotic disorder was found the most in the thirties(25.3%), next in the twenties and in the forties, and schizophrenia was found the most in the twenties(40.5%), next in the thirties and in the forties, but mood disorder was found the most in the twenties, next in the thirties and in the forties but revealed similar rates relatively. 5. On the distribution of age of onset neurotic disorder developed nearly half during the twrnties and the thirties, schizophrenia developed mostly during the twenties (51.3%), secondly the teens and thirdly the thirties, but mood disorder developed firstly the twenties(30.7%), secondly the thirties and thirdly the fifties. on the average age of onset of illness neurotic disorder, mood disorder and schizophrenia were 32.7 years, 36.1 years and 23.6 years respectively. 6. On the duration of illness more than two years was 28.3% in neurotic disorder, 68.5% in schizophrenia and 3.9% in mood disorder and on the average duration of illness schizophrenia, mood disorder and neurotic disorder were 73.2 months, 45.5 months and 29.5 months respectively.

The Prevalence of Metabolic Syndrome in Patients with Gout :A Multicenter Study

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Case Reports : A Case of Spontaneous Pneumomediastinum and Pneumopericardium in a Young Adult

Young Jung Lee,Seung Won Jin,Sung Hee Jang,Yi Sun Jang,Eun Kyoung Lee,Yong Joo Kim,Man Young Lee,Jun Chul Park,Tai Ho Rho,Jae Hyung Kim,Soon Jo Hong,Kyu Bo Choi 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

Spontaneous medialstinal emphysema (pneumomediastinum) and pneumo-pericardium may be defined as the presence of free air or gas in the mediastinal structures and in the pericardial sac without an apparent precipitating cause. It most frequently occurs in y

Prevalence of the Metabolic Syndrome in Gout Patients

Young Hee Rho,Seong Jae Choi,Young Ho Lee,Jong Dae Ji,Kyung Mook Choi,Sei Hyun Baik,Seung Hie Chung,Chae Gi Kim,Jung Yoon Choe,Sung Won Lee,Won Tae Chung,Gwan Gyu Song 대한내과학회 2004 대한내과학회 추계학술대회 Vol.2004 No.1