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.

폐결핵 환자의 우울 상태

홍정표,최선희,조만종,이성주,박종,김기순,김양옥 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.1

The main purpose of this study is to identify and evaluate the depressive states for the patients with chronic pulmonary tuberculosis. A questionnaire(Self-rating Depression Scale, SDS) survey was performed toward 57 pulmonary tuberculosis patients with initial treatment who started chemotherapy and 53 pulmonary tuberculosis patients with retreatment, admitted to one tuberculosis-centered hospital and two general hospital. Fifty three healthy persons as control group were investigated with the same questionnaire for comparison. The survey was performed from July to August 1996. The results are as follws : 1. The patients had significantly high scores in the depression than control and the patient with retreatment showed significantly high scores in the depression than the patient with initia1treatment(P<0.01). 2. The depressive levels of the patients were associated with duration of admission and the expectancy of recovery (P<0.05). 3. The percentage of the subjects with 40 or more scores tentatively classifiable as psychologically depressed was 67.1% of the total subjects, 48.4% of the control groups, 75.0% of the patient with initial treatment and 84.1% of the patient with retreatment. Because patient with pulmonary tuberculosis with initial treatment showed higher depression scores than normal persons, and patients with retreatment due to failure of initial treatment showed higher depression scores than initial treatment, it is necessary to give attention to depression of the patients during treatment of pulmonary tuberculosis.

한국산 꿩 Sertoli 세포의 계절적인 변화

양홍현,백영기,김인식 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.1

이상와 누공(piriform sinus fistula)에 기인한 재발성 화농성 갑상선염 1예 : A Route of Infection in Recurrent Suppurative Thyroiditis

양근호,김홍주,김기환 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Piriform sinus fistula, believed as an embryonic remnant of the third or forth pharyngeal pouch, is an extremely rare and newly recognized entity that lead to acute suppurative cervical infection. Recently, reports of acute suppurative thyroiditis and anterior neck abscess due to piriform sinus fistula have been increasing in number, though an extensive review of the literature reveals that about 60 cases of this condition have been reported. The sinus may be overlooked for years and the patient may undergo multiple procedures before the diagnosis is properly made and treated. We have experienced such a case of recurrent suppuative thyroidits in which coexisting piriform sinus fistula was identified by intra-operative endoscopic examinaton. This report reviews the embryological development of the sinus and the clinical symptoms and treatment of this condition.

스노젤렌공간이 정신지체아동의 문제행동에 미치는 영향

양복욱,김기홍 용인대학교 특수체육연구소 2011 특수체육연구 Vol.8 No.-

본 연구의 목적은 스노젤렌 공간이 정신지체 아동의 문제행동에 미치는 영향을 알아보는데 있으며 이를 위해 특수학교에 재학 중인 학생 2명을 대상자로 선정하였다. 단일대상연구 중 A1-B1-A2-B2-A3 설계로 15주, 총 45회기 동안 측정하였고, 스노젤렌공간에서 별다른 중재 없이 문제행동을 측정했으며 분석결과는 다음과 같다. 학생1은 손을 빠는 문제 행동을, 학생2는 웅웅거리는 소리를 내는 문제행동을 관찰했고, 스노젤렌공간 적용 초기에는 장애 정도가 다른 두 학생의 문제행동이 감소했다. 하지만, 점차 새로운 환경에 적응 하면서 문제행동이 기초선 수준으로 회복되었다. 본 연구의 결과를 종합해 볼 때, 장기간 스노젤렌공간의 적용이 정신지체 아동의 문제행동 감소에 유의한 효과를 보이지 않는 것으로 나타났다.

師範系 體育敎育科 志望生의 一般運動能力檢査 基準値 設定에 關한 硏究

梁點紅,高基俊,黃喆文,金泰運,金重雄,白永鎬,表內淑,黃太相,徐國雄 釜山大學校 附設 體育科學硏究所 1989 體育科學硏究所 論文集 Vol.5 No.-

This study was analyzed the validity and the reliability of evaluation norm. which was used in choosing and grading events of the General Motor Ability Test. The General Motor Ability Test has been done for applicants for entrance to the department of physical education, college of education, Pusan National University. The subjects of this study were 433 applicants(men :387, women :46) for three years. They were tested in seven events : 1) 100m Dash, 2) 1500m Run(man), 800m Run (woman), 3) Throwing Hand-Ball, 4) Broad Jump, 5) Chinning(man), Flexed-Arm Hang(woman), 6) Zig-Zag Run, 7) Trunk Flexion. The results could be summerized as follows ; 1. In 100m Dash, 1500m Run, and Throwing Hand-Ball, man's average records were shown normal distribution which was inclined toward low ll grade. Therefore, the interval size of those three events must be regulated to lower. 2. Average records of Broad Jump in man were distributed into high (1) grade. So, the interval size must be adjusted to higher. 3. In Chinning, Zig-Zag Run, ad Trunk Flexion, man's average records were shawn normal distribution, and the interval size was similar to present records. 4. For woman, it was impossible to analyze correctly in all seven events because of the small number of subjects. So, it was for the sake of the reference. 5. The record of applicants for three years were operated to the variable quantity analysis. And the restults were these ; 100m Dash was F=3.0865(p<0.05), Chinning F=3.9309(p<0.05), Broad Jump F=14.7338(p<0.001), Throwing Hand-Ball F=4.9716(p<0.01), and Zig-Zag Run F=6.8297(p<0.001). Then, it was shown statistical meaningful difference in three groups. 6. In investigating the validity in choosing seven events, it was concluded that the events have been chosen reasonably. Because all events except for 100m Dash, and Zig-Zag Run in man were independent. From the analysis of the General Motor Ability Test, we could realized the necessity of regulating the standard and the interval size in several events. Then, we proposed the new evaluation norm which was suitable to present situation.

심실 중격 결손에 의한 감염성 심내막염 환자의 치과치료

양정현,현홍근,김영재,김정욱,장기택,이상훈,한세현,김종철 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.3

본태성 고혈압이 동반된 당뇨병환자의 혈중 인슐린 농도

양동호,홍세용,성기범,안무영,윤신구,박형국,양광익,황주호,신현길 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

Multiple lines of evidence link elevated blood pressure with diabetes mellitus. Specifically, it has been proposed that resistance to insulin-stimulated glucose uptake and hyperinsulinemia may play a central role in the cause and clinical course of hypertension. In diabetes mellitus, insulin resistance and/or hyperinsulinemia is an common finding and it is interesting whether the hyperinsulinemia may play a signigicant role in hypertension with DM in the same way as in essential hypertension without diabetes mellitus. The object of this study was to compare insulin and c-peptide levels between age, sex, and obesity matched two groups(DM with DM without hypertension). Method The study group consisted of 55 male diabetes mellitus patients, aged between 45-55 (years). Patients with obesity (body mass index · 30 ㎏/m2), renal disease (proteinuria · 300 ㎎/24hr urine), and secondary hypertension were excluded. Insulin and c-peptide were measured in overnight fasting state and after oral administration of glucose(75 gm). In the fasting, venous plasma glucose levels were similar in the hypertensive and control group(132 ±7 ㎎/dl vs 135 ±8 ㎎/dl). In the fasting, venous plasma insulin levels were higher in the hypertensive than in the control group (10.9 ±5.3 μIU/ml vs 5.5 ±3.9 μIU/ml, p = 0.0001). After loading with 75 gm glucose, venous plasma insulin level seems to be higher in the hypertensive patients than in the control patients, but the difference was not signigicant statistically (27.2 ±17.5 μIU/ml vs 19.9 ±18.9 μIU/ml, p = 0.1297). The mean insulin concentration of the essential hypertensive patients with diabetes mellitus was twice that of the normotensive patients with diabetes mellitus. In control group, there was a direct relations between insulin level and c-peptide, in both fasting state (R = 0.617, p = 0.0001) and glucose-loaded state (R = 0.531, p = 0.001). But in hypertensive group, there was no relations between insulin level and c-peptide, in both fasting state (R = 0.257, p = 0.2738) and glucose-loaded state (R = 0.307, p = 0.1885).

음낭내 낭포성 림프관종 1례

양근호,김홍주,김기환 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Cystic lymphangiomas are congenital lymphatic hamartomas of which half are present at birth, 90% are evident by age 2 years and 95% occur in the neck or axilla. Scrotal cystic lymphangioma is rare with approximately 50 cases reported. The lesion is commonly misdiagnosed as hernia. hydrocele, spermatocele and acute scrotal condition, resulting in improper selection of incision, incomplete excision and recurrence, We present a case of 2 year 9 month old male with the scrotal lymphangioma that have not any connection with the testis or spermatic cord.

이차 전기영동을 이용한 프로테오믹 접근을 통한 정맥 압박이 혈장 프로테옴에 미치는 영향

양광익,박선아,오형근,정두신,박형국,성기범,안무영,홍세용 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

The human proteomics-based approaches, which examine the expressed proteins of a tissue or cell type, are increasingly being used. Venous occlusion is commonly employed for stimulating tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) release from venous endothelial cells, and this has been regarded as a parameter of the individual fibrinolytic capacity of plasma. The present work involved a detailed investigation of the plasma proteome and fibrinolytic activity in normal subjects, with the aim of determining whether correlations exist between various parameters of the fibhnolytic system before and after venous occlusion. We analyzed fibhnolytic parameters and plasma proteome before and after 15-min periods of venous occlusion in the forearm in 10 healthy 3rd-decade volunteers. Proteome analysis was performed using two-dimensional gels. The tryptic digests of some proteins were confirmed by MALDI-TOF and the MS-Fit algorithm. The fibrinolytic response as measured by the absolute amount of t-PA after venous occlusion was increased by venous occlusion (5.5 vs 9.6 ng/㎗, p<0.05), as was PAI-l (46.8 vs 56.1 ng/㎗, p<0.05). However, two-dimensional electrophoresis finding was virtually nonspecific and inconsistent after venous occlusion in healthy male subjects. Venous occlusion does not influence plasma proteome in healthy males. Although the fibhnolytic response to venous occlusion is attributed to an increase in free tUPA antigen, this change is not correlated with plasma proteome.