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.

급성 충수염으로 내원한 환자에서의 충수 방선균증

임수경,최희정,손효문,최윤이,조민선 이화여자대학교 의과학연구소 2014 EMJ (Ewha medical journal) Vol.37 No.S

방선균증은 그람양성 혐기성 세균인 Actinomyces에 의해 유황 과립을 함유하는 특징적인 종괴나 농양을 형성하는 만성 화농성 및 육아종성 감염으로 경부-안면 감염이 흔하며, 복부-골반 감염, 흉부 감염이 나타날 수 있고, 복부-골반 방선균증은 복부수술, 난관-난소 농양, 자궁 내 삽입장치와 관련이 있다[1]. 방선균증은 미생물학적 배양검사와 조직학적 검사를 통해 진단하지만, 세균의 동정이 어려워 진단은 주로 현미경적 검사를 통하여 유황 과립의 존재에 의존하게 된다. 방선균증 중에서 복부-골반 감염은 이전에도 다수 보고된 바이며, 자궁 내 삽입장치를 가지고 있던 경우 복부 방선균증이 확인된 증례나[2], 장 점막의 약화를 유발할 수 있는 복부 수술 이후 발생한 방선균증의 증례는 보고되었으나[3], 방선균증을 일으킬 수 있는 수술 병력이나 유발요인이 없는 환자에서 일차적으로 충수의 방선균 감염이 발견된 경우는 드물다. 저자는 병력상 장 점막의 약화로 인한 방선균증의 침범을 유발할 수 있는 복부 수술력 없이, 급성 충수염으로 내원한 환자에서 충수절제술 시행 후 진단된 충수 방선균증증례를 4예 경험하여 문헌 고찰과 함께 보고하고자 한다.

Porphyromonas endodontalis 의 Lipopolysaccharide가 섬유아세포의 세포막 투과성에 미치는 영향

윤수한,김민겸,김재희 大韓齒科保存學會 1999 Restorative Dentistry & Endodontics Vol.24 No.3

유무선 통합을 고려한 무선 인터넷산업 발전전략

윤문길,허희영,윤수현 한국항공대학교 경영연구소 2002 경영연구 Vol.9 No.1

The rapid adoption of PCs and accessibility of Internet infrastructure has accelerated the use of high-speed Internet access services, and people want to use it for various broadband multimedia services with regardless of the wired or the wireless networks. Delivering such broadband multimedia services to end users, it is required to integrate or to interface the wired and the wireless networks. There are several alternative technologies for integrating the two networks for providing broadband multimedia services efficiently. In this paper, we survey the alternative technologies for integrating the two networks to deliver the mobile internet service, and analyze the business strategies for the mobile internet service.

시론으로서의 시 : 월러스 스티븐즈의 「푸른색 기티를 든 남자」 Wallace Stevens's "The Man with the Blue Guitar"

윤희수 釜慶大學校 1999 釜慶大學校 論文集 Vol.4 No.1

This paper aims to examine Stevens's reflections on the relationship between reality and imagination which is the persistent theme of his poetry, based on one of his major poems as poetic theory. "The Man with the Blue Guitar." Critics on Stevens's poetry are roughly divided into two groups: one who views him as the poet of reality searching for things as they are or pure reality, and the other who labels him as the poet of imagination in pursuit of the supreme fiction without which men are unable to conceive of life and reality. In this regard, this poem which contains the poet's desire to gaim access to things as they are and his will to create believable fictions through imagination at the same time could be a good example which supports the grounds of each critical pole simultaneously. In this set of thirty-three variations as if plated on the guitar as a symbol of the imagination, through the arrangement of audience's requests and speaker's replies. Stevens dramatizes the tension between his desire to reveal things as they are and his will to transform reality through imagination and create the supreme fiction. Although he does not liberate himself from the awareness that his imagination can not represent reality as it is due to the will to change, the shows a dim vision that he can create more credible fictions based on the interdependence of reality and imagination which will be more clarified in one of his canonized pieces. Notes toward a Supreme Fiction."

관용어의 굳은 정도

윤희수 金烏工科大學校 1990 論文集 Vol.11 No.-

The purpose of this study is to examine the gradience in idiomaticity, This study is based on the framework of traditional grammar through the so-called Chonsky's Standard Theory. The results of the study are as follows: First, idioms vary in the degree to which their meaning is a compositional function of the meanings of their constituents, and these variations constitute the following continuum from completely opaque to near-transparent: -------------------------------------------------------------------------------- Completelty Opaque Semi-opaque Semi-transparent Near-transparent -------------------------------------------------------------------------------- queer the pitch, burn one's bridges, be on thin ice have a kick the bucket be tarred with the add fuel to the fire give a smile same brush -------------------------------------------------------------------------------- least compositional <-------------------------------------> most compositional -------------------------------------------------------------------------------- Second, several linguists examined the degrees of transformations in idioms. The most systematic is Frasser's hierarchy of frozenness. There are some problems in hisn analysis, but it is very useful in foreign laguage teaching. Third, the graduence of translatability is divided into four types; (1) idioms which have direct word-for-word translations in other languages without losing their idiomatic meanings ; (2) idioms which have similar word-for-word translations in other languages ; (3) idioms which have semantic counterparts but are worded differently ; (4) idioms which can be only paraphrased in other languages. This classification shows both the linguistic and cultural relationship between one's native language and target language, which is conducive to language teaching.

초등영어교실의 효율적 상호작용과 수업 준비의 현실화

윤희백,한문수 부산교육대학교 교육대학원 1999 논문집 Vol.1 No.-

The game and activities discussed here based on some of the skills and instincts a young child brings to learning a foreign at school are all intended to encourage real language use and to develope confidence and willingness to have a go. In Korea where each of elementary school has usually large size of class, the considerations of stir/settle, the concepts of mental engagement and actual occupation will help us to evaluate the game and activities offered in textbooks of elementary English classroom, and to improve the general atmosphere of the classroom. Preparation load by teachers can be lessened through the variety of work, reuse of materials, reuse of a core of ideas, and new verses of chant and song, helping children feel their competence being built up. The follow up study, it is hoped, will be concerned with analyzing the games and activities in the English textbook of Elementary school.

『월든』의 생태주의적 지향성에 관한 연구

윤희수 새한영어영문학회 2001 새한영어영문학 Vol.43 No.2

This paper aims to examine the ecological orientation of Walden, the best-known work by Thoreau. The study will clarify the reason why Walden, founded upon ecocentric view of nature rather than Emerson's anthropocentric one, should be regarded as one of the canonical works in American ecological writing. The reluctance of some critics, including Karl Kroeber, to accept Thoreau as a deep ecologist is based on two reasons, First, Thoreau's focus on nature is a means of purification of the self through a sensual and intellectual confrontation with nature, which means he does not observe and write for others. Second, he is basically a faithful apostle of Emerson who holds a man-centered transcendental view of nature. A close reading of Walden, however, puts the validity of this pejorative view into doubt because the work shows us his deep ecological consciousness founded upon biocentrism which examines the possibility of human existence in harmony with nature. The ecological orientation of Walden is first substantiated through Thoreau's harsh criticism of commercial farming exclusively pursuing human interest and consequently destroying nature. To overcome this human avarice, he suggests the simplicity of life based on self-constraint. Thoreau's ecological inclination also comes from his humble recognition that man is but part and parcel of nature which proves its great life force through the thawing "sand foliage" for instance. Furthermore, using hoeing as an analogy, he seeks for the possibility of an ecological writing which aims to reveal nature as it is rather than impose artificial meanings on it.

쏘로우와 현대 미국 생태주의 시의 상관성에 관한 연구

윤희수 새한영어영문학회 2002 새한영어영문학 Vol.44 No.2

This paper aims to examine the connection between ecological thoughts in Thoreau's Walden and modern American ecological poetry and then discover a continuum of American ecological writings with Thoreau as a starting point. The study is motivated by the skepticism about Karl Kroeber's view that the most important American ecological writing in the 20th century is un-Thoreauvian. Kroeber underestimates Thoreau's nature writings because he believes that they have as a primary goal the purification of his own self through a sensual and intellectual confrontation with nature, which means he does not observe and write for others. However, Kroeber's view is in sharp contrast to that of Quetchenbach who maintains that American poetry, including nature poetry, after the World War Ⅱ has been based on "the quotidian experience of the individual" which can extend to others through analogy. The reflections of the poets who attempt to reestablish the relations between man and nature can be public and universalized in this age of environmental crisis, which is also the reason why Thoreau's writings cannot be easily defined as personal and private ones. The examination of Thoreau's Walden shows that the monumental work serves as a matrix of three primary characteristics of ecological poetry: an emphasis on maintaining an ecocentric perspective that recognizes the interconnection of the world, a need for humility in relationships with both human and nonhuman nature, an indictment of a technologized modern world and a warning concerning the potential for ecological catastrophe. Levertov's "Web" and Roethke's "the Minimal" and "Cuttings" echo Thoreau's reflections on the interconnectedness of man and nature sharing life in the universe. Thoreau's search for the possibility of an ecological writing to reveal nature as it is rather than impose artificial meaning is based on his recognition of the need for human humbleness towards nature. This recognition is also echoed in Ammons' "Corsons Inlet" and Snyder's "Ripples on the Surface" which acknowledge the ontological autonomy of the nonhuman world which exists beyond human language. Finally, Snyder's "Front Lines" and Merwin's "The Last One" remind us of Thoreau's warning against the destruction of nature by human avarice.

시의 추상성과 언어의 본질 : Wallace Stevens의 〈추상화〉에 대한 한 관점

윤희수 신한영미어문학회 1995 새한영어영문학 Vol.33 No.-

This paper aims to reinterpret the meaning of Stevens' first condition for a supreme fiction, "It Must Be Abstract." For this purpose, the paper primarily examines two opposite interpretations of Stevens' abstraction, either as a means of philosophical generalization or as a way to pure reality. And the focus of the re-examination is on the second interpretation suggested by the critics who view him as a poet of reality. As a result, we find their unusual notion of abstraction has possibly been fabricated to support their view. In addition, this finding is proved through investigating in detail the relation between abstraction and "the first idea" in "Notes" which is one of the main sources of their interpretation. Through this process of re-examination, we have reached the assumption that behind Stevens' uncertainty of the capacity of abstraction to grasp the thing itself lies his recognition of the intrinsic abstractness of language. And this assumption is likely supported by the fact that the shift of Miller's view, which represents the second interpretation of abstraction, is influenced by deconstructionists such as Derrida whose main source of inspiration is, in turn, Nietzsche's insight into the arbitrary abstraction of language.