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.

각화극 세포종, 기저세포암과 편평상피암에서 p21과 p53의 표출 양상

윤성웅,조현득,양승하,김의한 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background: The function of the p53 protein was known to regulate cell proliferation by inhibiting cells in S phase, so DNA damaged cell proliferation was not occured by apoptosis. p21 is a cyclin dependent kinase inhibitor induced by wild type p53. p21 is thought to mediate the signal of p53 induced by DNA damaged agents and to arrest the cell cycle in G1 phase. p21 and p53 were expressed in many malignant tumors, and its role in oncogenesis, tumor progression and prognosis were important. The authors analyzed immunohistochemical expression of mutant p53 and p21 protein in keratocarcinoma, squamous carcinoma and basal cell carcinoma. Method: Eight cases of keratocarcinom, fifteen cases of squamous cell carcinoma and twenty cases of basal cell carcinoma were immunohistochemically stained with p21 and p53 monoclonal antibodies. Results: 1. The positive reaction of p21 protein and p53 protein in keratocarcinoma were samely observed In 7/8 cases(87%) and the positive reaction of p21 and p53 protein in squamous cell carcinoma were samely observed in all cases(100%) 2. The reaction pattern of p21 protein and p53 protein showed that positive reaction in both basal layer and keratinocytes concomitantly were more common observed than that in basal layer only. But the case of positive reaction in only keratinocytes was not observed. 3. In basal cell carcinoma, the positive reaction of p21 protein werw seen in 5/20 cases(25%) and that of p53 were positive reaction in 15/20 cases(75%). p21 protein also showed positive reaction in cases of p53 protein positive cases. 4.The reaction pattern in basal cell carcinoma showed more intense reaction in peripheral portion than central portion of tumor nests, which suggested that tumor cells in the peripheral portion was composed of less mature cells than that of contal portion. The mutant p53 protein had lost of capability of inducing p21 protein, So in cases of p53 protein wae negative, the p21 protein theoretically showed negative reaction. But the p21 protein positive cases were observed in p53 positive cases, which was suggested that the p21 protein was induced by the p53 independent pathway. The prognosis appeared to be good in cases of both p21 protein (+)and p53 protein(+) cases than that of p21(-) and p53(+).

만성부비동염 환자에서 부비동 단순 X-선 사진과 전산화 단층(CT) 사진 소견의 비교

선동일,윤선호,신민호,서병도,양일권 釜算慶南耳鼻咽喉科學會 1993 임상이비인후과 Vol.4 No.1

자궁 경부의 편평상피 화생, 이형성과 콘딜롬에서 p53, Ki-67 및 HPV의 발현 양상

윤성웅,오미혜,양승하,김의한 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

To observe the expression of p53, Ki-67 and HPV type in the uterine cervical lesions, such as 11 cases of squamous metaplasia, 6 cases of CIN Ⅱ and 14 cases of condyloma accuminatum and to evaluate the correlationship between the results, the author has been carried out immunohiostochemical staining for monoclonal antibodies to p53, Ki-67 and in situ hybridizatiion of HPV nucleic acid. So, following results are obtained. 1. The HPV type 6 and 11 are negative in all cases of suamous metaplasia and CIN Ⅱ. 2. In condyloma accuminatum, the HPV type 16 and 18 are negative in all cases, but HPV 6 and 11 are positive in 9 cases out of 14 (65%). 3. The stain patterns of p53 in squamous metaplasia and CIN Ⅱ show similar findings but the areas of basal and reserve cell layers show more strong stain. 4. The stain pattern of Ki-67 in squamous metaplasia and CIN Ⅱ show high prolliferatlion. 5. In condyloma accuminatum, the expresseion of p53 show weakly reaction in general, but in cases of present nuclear enlargement and atypia, the stain degree show more stronger than only koilocyte presence. 6. The Ki-67 in condyloma accuminatum show high proliferation in all cases.

개 대뇌겉질에서 Platelet-Derived Growth Factor α-Receptor의 출생 후 발달에 관한 면역조직화학적 연구

윤영,안병수,김인정,양경철,박선홍,김기훈,박도영,김장만,문정석,장인엽,조하영 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background and Objectives : The localization of platelet-derived growth factor-α receptor (PDGF-α R) was commonly restricted to oligodendrocyte progenitors during late embryonic and postnatal development. However, several studies recently demonstrated that mature neurons could also synthesize PDGF-α, Materials and Methods : In the present study, to analyze the distributional pattern of PDGF-αR during postnatal development of the canine cerebral cortex, we used immunohistochemistry on sections of canine brain tissue. Results : We found that neurons of various regions of cerebral cortex exhibited the immunoreactivity to PDGF-αR as early as postnatal day 0, and slightly decreased after postnatal day 14. Whereas neuronal PDGF-αR were maintained at all ages, the oligodendroglia-like expression of PDGF-αR could not be confirmed. Conclusion : The localization of PDGF-αR in immature and mature neurons supports the several roles of PDGF during development, protection and survival of neurons.

성인 막성신병증의 임상적 고찰

양종오,이상주,박기현,장윤경,이강욱,서광선,신영태 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Membranous nephropathy (MN) is a glomerular disease characterized by diffuse thickening of the glomerular basement membrane without significant mesangial proliferative change and is usually manifested by the nephrotic syndrome. To evaluate the clinical and pathologic characteristics of this disease in adults, we analyzed 65 patients with primary membranous nephropathy who were diagnosed at Department of Internal Medicine, Chungnam National University Hospital from February 1986 to February 2001. The results are as follows: 1) Of total 96 patients with membranous nephropathy, 67.7% was primary MN. Hepatitis B-associated MN and lupus MN were 22.9%, and 9.4%, respectively. Median duration of follow-up was 35.1 months(0.3∼177) in primary MN, 49.6 months(2.5∼103) in lupus MN, and 35.6 months(0.5∼108) in hepatitis B-associated MN. 2) Mean age of the patients with primary MN at the time of diagnosis(43.3 years) was significantly higher than that of lupus MN(30.4 years) and HBV-associated MN(36.2 years). Male to female ratio of primary MN was 1.03:l. 3) At the time of diagnosis, 89.2% of primary MN was presented with nephrotic syndrome. Twenty seven percent of patients showed hypertension. Hematuria was found in 58.5% of primary MN patients. Azotemia was noted in 3.1 %. 4) Global sclerosis, tubular atrophy and interstitial fibrosis were noted in 39.8, 16.1 and 11.3% of primaty MN, respectively. IgG and C3 were deposited on the glomerular capillary loop in 92.7% and 29% of primary MN patients. There was no significant correlation between the electron microscopic pathologic stage and clinical findings. 5) Of 56 patients with primary MN followed more than 6 months, 50(90.9%) patients were treated with prednisolone, cyclophosphamide or cyclosporin. Complete remission was obtained in 29 patients(51.8%), partial remission in 6 patients(10.7%), and no response in 18 patients(32.1%). Of 6 patients who were not treated with immunosuppressive drugs, 3 patients showed spontaneous complete or partial remission. Three patients who did not show clinical improvement progressed to end-stage renal failure. There were no significant clinical difference including renal pathology at the time of diagnosis between the patients who showed complete or partial remission and patients who did not. In conclusion, it was difficult to predict the long-term prognosis of primary MN at the time of diagnosis, clinically. The response to therapeutic modality would be the most important to predict long-term prognosis of primary MN.

군복무 청소년의 인권과 복지에 관한 연구

양철호,권순철,박순희,서현미,윤종성,이용교 동신대학교 2005 論文集 Vol.15 No.-

This study focuses on the human rights and welfare of adolescents who are in the military service. An adolescent should have rights of care, autonomy and participate. In Korea, mandatory military service is required for men. Thus their rights can be violated in the military. In this study, the rights of adolescents were categorized as the right to live, protection, develop and care, and the ways of providing those rights in the military were discussed.

성인 급성 신부전의 원인 및 예후인자 분석

구영선,장윤경,양종오,강민규,황평주,김종학,나기량,이강욱,신영태 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

Acute renal failure is a frequent complication in hospitalized patients and is strongly related to the mortality. The Clinical outcome and prognostic factors of acute renal failure(ARF) have been analyzed by many authors. The present study describes the etiologic and clinical aspects, as well as other factors related to mortality. All the patients suffering from acute renal failure admitted during the period of January 1993 - August 1998 were included in the study. The average age of the patients was 52±17 years and mortality rate was 24%. The causes of acute renal failure were hemorrhagic fever with renal syndrome(HFRS), sepsis, renal hypoperfusion, urinary tract obstruction, acute tubular necrosis, etc. The etiology of ARF was a significant prognostic factor on mortality in ARF. Other significant prognostic factors were oliguria, organ failure, use of vasoconstrictors, hypotension, serum bicarbonate, premorbid conditions, sepsis, neurologic complications, gastrointestinal bleeding. On the other hands, operation, sex, anemia, thrombocytopenia, hypoalbuminemia, BUN, serum creatinine, and hyperkalemia were not significant factors for the mortality. We conclude that major prognostic factors of acute renal failure arc premorbid conditions, sepsis and multiorgan failure, and they are responsible for persistent high mortality of acute renal failure despite of advances of medical care.

기분, 메세지 틀, 정보처리 유형이 행동의도에 미치는 영향

강선영,양윤 한국방송광고공사 2007 광고연구 Vol.0 No.74

본 연구에서는 긍정적·부정적 기분상태에서 득·실로 틀화된 메시지의 설득효과가 개인의 성격특성인 인지욕구와 감정강도를 결합한 정보처리유형에 따라 어떻게 달라지는지 살펴보았다. 정보처리유형은 인지욕구와 감정강도 각각에서의 고·저에 따라 사고처리자, 수동처리자, 복합처리자, 감정처리자로 분류되었다. 실험결과, 사고처리자에게서 실 틀이득 틀보다 더 효과적인 것으로 나타났고, 수동처리자에게서는 득 틀이 실 틀보다 더 효과적인 것으로 나타났다. 한편 긍정적 기분의 복합처리자에게서 실 틀이 득 틀보다 더 효과적인 것으로 나타났으나, 부정적 기분의 복합처리자에게서는 틀에 따른 효과 차이가 유의하지 않은 것으로 나타났다. 또한 감정처리자의 경우 긍정적 기분에서는 틀의 효과가 유의하지 않은 것으로 나타났고, 부정적 기분에서는 득 틀이 실 틀보다 더 효과적인 것으로 나타났다. 아울러 긍정적 기분에서는 실 틀이 더 효과적이었고 부정적 기분에서는 득 틀이 더 효과적이었다. 본 연구결과에 따르면, 메시지 틀의 효과는 기분 조건과 인지욕구 조건에 따라 다르게 나타난다. 또한 인지처리와 감정처리가 동시에 발생할 때, 둘은 상호작용하여 소비자의 의사결정에 영향을 미칠 수 있다. The purpose of this paper is to investigate the effects of affect and cognition with the effects of frame on behavioral intention. The experimental design of this study is 2(mood: positive/negative)X2(message frame: gain/loss)X4(processing type: cognitive/passive/combination/feeling) 3-way completely randomized factorial design. The results showed that thinking processors who are high in need for cognition assigned greater weight to the negative information which is viewed as more diagnostic as than positive information, so that loss-framed message was more persuasive for them. On the contrary, passive processors who are low in need for cognition accepted the positive information with relatively low effort according to hedonic principle, so gain-framed message was more persuasive for them. When combination processors were in positive mood, loss-frame was more effective than gain-frame, but when they were in negative mood, framing effect was not significant. Besides, in the case of feeling processors under positive mood condition, framing effect was not significant either, but when they were in negative mood, gain-frame was more effective than loss-frame. In result, lossframed message was more persuasive under positive mood condition, and gain-framed message was more persuasive under negative mood condition.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.