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.

초월성의 부재와 그 극복의 한 방법:스티븐즈의「일요일 아침」

윤희수 釜慶大學校 1997 釜慶大學校 論文集 Vol.2 No.1

This paper aims to examine a mode of response to the age of religious skepticism based on one of Stevens's major poems. "Sunday Morning." In this poem, by using a woman protagonist as a spokeswoman for post-Christian mind. Stevens raises successive questions about the presence of divinity and heavenly paradise. And he cautiously explores the possibility of a mancertered,earthly paradise which can be substituded for the abstract and impalpable Christian paradise. As a mode of existence in this human world deprived of transcendence. Stevens suggests that we should cherish our vivid feelings evoked by our contacts with physical and concrete world instead of adhering to abstract religious experience. Of course, he acknowledges our experience of physical reality is so fluctuating that it is does not guarantee "imperishable bliss." However, if we accept our fate which is inescapably free from and "unsponsored" by any transcendental presence, and if we are bound together by the awareness of the very mortality, human world can be another kind of paradise, a substitute for an abstract paradise far beyond our reach. Stevens once remarked the role of poetry in the age of disbelief as life's redemption. In this sense, "Sunday Morning" can be regarded as a starting point of this quest for the life-redeeming "poetry of the earth." In addition, when we pay attention to his incessant effort to solve man's problem within man's capability, without any recourse to transcendental presence, this poem can be an example which distinguishes his poetry from Eliot's theocentric, that is, God-centered poetic world.

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.

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

최소이론에서의 주격자질 점검

윤희수,김형덕 金烏工科大學校 1998 論文集 Vol.19 No.-

In this paper, I have presented Chomsky's(1992) Minimaalist theory and provided solutions to its problems. The Minimalist takes the interface levels,PF and LF, to be the only significant linguistic levels : hence D-and S-structures are eliminated.If an array of items is selected from the lexicon by select-α,then SATISFY presents it ina format satisfying the conditions of the X-bar theory. SATISFY can apply at different positions in a derivation. Computation selects from the lexicon freely at any point. We have assumed that weak features of an inflectional element cannot attract a heavy element such as a main verb. though it attract a light element such as an auxiliary. while strong features attract any element. I have seen that Wh-movement and I to C raising are two separate operations. he motivation for I to C is to check the 〔+ Q 〕feature. while Wh-movement is triggered by 〔+Op 〕. Our basic assumption is that no feature can move alone without being supported by an overt element. If there is no modal or auxiliary. do must be inserted under T in order to bear the features of T. One of the major characteristics of Minimalist theory is that it is a morphological feature-centered theory. Therefore, we can say that all grammatical operations must be driven only to satisfy the requirements of the morphological properties of functional heads or lexical items.

백서의 적출된 기도평활근에서 Ketamine의 이완효과

윤석화,김윤희,김상수,이상묵 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The effects of anesthetics on airway smooth muscle tone are important in the management of patients with asthma. Airway epithelial cells and vascular endothelial cells modulate the tone of the underlying smooth muscle by releasing relaxing factors such as prostanoids and nitric oxide (NO). Ketamine, at concentrations achieved with the usual clinical doses, has a direct relaxant effect on airway smooth muscle. In the present study we evaluated whether the relaxant effect of ketamine depend on any of the epithelium-derived relaxing factors. Isolated rat tracheal preparations mounted in water-jacketed organ baths filled with modified Tris Tyrode buffer solution with 100% oxygen at 37˚C for recording isometric contractile force. In the first experimental step, Tracheae, in the absence and in the presence of epithelium, were contracted with acetylcholine(10^-8M-10^-3M), and we plotted concentration -response curve for the Ach. And then we examined the inhibitory effect of ketamine(10^-5 and 10^-4M) on the concentration-response curve for Ach. In the second experimental steps, we studied the effect of N-omega-nitro L-arginine methylester(L-NAME) on the relaxant activity of ketamine(10^-6-10^-3M) on trachea contracted by 10^-5M Ach. In the result, 1) Removal of the tracheal epithelium did not change the response to Ach. 2) 10^-5M ketamine not significantly changed, but 10^-4 M ketamine shifted to the right the concentration-response curves for Ach in both intact and denuded epithelium rings. 3) L-NAME did not influence the relaxant effect of ketamine on trachea contracted by 10^-5 M Ach. These results indicate that ketamine-induced tracheal smooth muscle relaxation is epithelium-independent and may be is mediated by inhibition of Ca^++ influx in nonspecific way.

Microstructure‑Strengthening Interrelationship of an Ultrasonically Treated Hypereutectic Al–Si (A390) Alloy

Soo‑Bae Kim,Young‑Hee Cho,Jae‑Gil Jung,Woon‑Ha Yoon,Young‑Kook Lee,Jung‑Moo Lee 대한금속·재료학회 2018 METALS AND MATERIALS International Vol.24 No.6

Ultrasonic melt treatment (UST) was applied to an A390 hypereutectic Al–Si alloy in a temperature range of 750–800 °Cand its influence on the solidification structure and the consequent increase in strength was investigated. UST at such a hightemperature, which is about 100 °C above the liquidus temperature, had little effect on the grain refinement but enhanced thehomogeneity of the microstructure with the uniform distribution of constituent phases (e.g. primary Si, α-Al and intermetallics)significantly refined. With the microstructural homogeneity, quantitative analysis confirmed that UST was found tosuppress the formation of Cu-bearing phases, i.e., Q-Al5Cu2Mg8Si6, Al2Cuphases that form in the final stage of solidificationwhile notably increasing the average Cu contents in the matrix from 1.29 to 2.06 wt%. A tensile test exhibits an increasein the yield strength of the as-cast alloy from 185 to 208 MPa, which is mainly associated with the solute increment withinthe matrix. The important role of UST in the microstructure evolution during solidification is discussed and the mechanismcovering the microstructure-strengthening interrelationship of the ultrasonically treated A390 alloy is proposed.

언어에 대한 회의와 환경 보존 : 현대 미국 자연시에 관한 연구

윤희수 신한영미어문학회 1998 새한영어영문학 Vol.40 No.-

This paper aims to examine the poetic quest of four modern American poets, including Wallace Stevens, A. R. Ammons, Adrienne Rich and Gary Snyder, which shows the indirect respect for the ontological autonomy of nature on the basis of linguistic skepticism. The skepticism originates from the fact that language is an arbitrary abstraction from the individual differences of things in nature and therefore words are sheer emptiness as compared with the substance of the things they name. However, by emphasizing the essential distinction between things and our words for things, the skepticism acknowledges the ontological autonomy of the nonhuman which is one of the key factors of environmentalism. Stevens's "The Snow Man" and "The Course of a Particular", show the mode of experiencing the dehumanized reality of nature by restraining human consciousness and pathetic fallacy. Ammon's "Corsons Inlet" also concerns the risk of imposing arbitrary order on nature in the process of representing ever-changing natural phenomena. In "Rural Reflections", Rich recommends "Inhuman patience" or rhetorical abstinence which enables us to see and enjoy nature as it is. The environmental or ecological aspect of Snyder's "Ripples on the Surface" lies in his understanding of elusiveness of nature and his effort not to trap it in the prison house of language.

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.

정맥내 통증자가조절법을 이용한 Nalbuphine-Ketorolac과 Butorphanol-Ketorolac의 술후 진통효과 비교

윤석화,이원형,손수창,신용섭,김윤희,양신영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

This study aimed to compare analgegic efficacy, satisfaction score and side effect of nalbuphine-ketorolac and butorphanol-ketorolac by using intravenous patient controlled analgesia(IV-PCA) for postoperative anlgesia following a gastrectomy for stomach cancer. Ninety patients who had undergone gastrectomy for stomach cancer under general anesthesia were randomly divided into two groups. Each group recieived nalbuphine 50mg with ketorolac 150mg(Group 1, n=45) and butorphanol 5mg with ketorolac 150mg(Group 2, n=45) by using IV-PCA during postoperative 48hrs. Assessments for pain with numerical rating scale(NRS), and side effects were evaluated at 2hr, 6hr, 12hr, 24hr, 36hr and 48hr after the operation. There were no significant difference in NRS for pain during rest, but Group 2 requested significantly greater amount of supplementary diclofenac during first 24 hours. Side effects were higher Group 1 in pruritus, nausea and vomiting and Group 2 in sedation, nausea and vomiting. This study suggests that adding ketorolac with intravenous nalbuphine or butrophanol in using an intravenous PCA can decrease analgesics requirement and improve analgesic property without the major morbidity like respiratory depression, but needs for the careful observation and treatment on the side effects like nausea. vomiting, pruritis and sedation...