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.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

관상동맥질환 환자에서 스텐트 시술 후 재협착에 관한 연구

강진환,권영주,박상호,한대희,이상철,김명구,변정득,최병조,심규혁,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and aims : In the coronary artery disease, a rate of restenosis was much decreased by placement of coronary stent than when percutaneous transluminal coronary angioplasty has been applied, but there are still important clinical problems of restenosis. There has been many progressive studies about various factors contributed to this restenosis. So, we studied a relation between restenosis after placement of coronary stent in the coronary artery disease and many clinical factors, characteristics of stenotic lesion and procedural factors, and also assessed the restenosis rate of various coronary stents. Methods : Total 58 lesions(46 cases of patients ; man 30, woman 16) were evaluated, which has been performed a follow-up coronary angiography after 6 months (mean 188 days) since coronary stent had been placed. Various stents were implanted and assessed a relation between restenosis and many factors. Results : Of 58 lesions were target stenotic studies, there were 22 of restenotic lesions(37.9%), and the restenosis rate wes statistically significant difference in the relation with diabetes mellitus(p<0.05), group of acute myocardial infarction(p<0.05) among clinical diagnosis of ischemic heart disease(stable angina, unstable angina and acute myocardial infarction) in clinical factors and with high dilation pressure of stent(p<0.05) in procedural factors. When the rate of restenosis was evaluated among implanted stents, it was lowest in the Multilink^(®) stent and highest in the Nir Royal^(®) stent(60%). Conclusion : In this study of restenosis and various factors after placement of stents in the coronary artety disease, factors such as diabetes mellitus, group of acute myocardial infarction and a dilation pressure of stent were significant related with restenosis and the restenosis rate of Multilink^(®) stent was lowest and the highest restenosis rate was of Nir Royal^(®) stent.

과수 조류피해 방지에 관한 연구

김영호,윤철구,임상철,손인창,박재혁,김동환,김선규 충북대학교 한국과학재단 지정 첨단원예기술개발 연구센터 2002 연구보고서 Vol.6 No.-

새로운 저비용 고효율 조류 피해 방지법의 개발을 위한 기초자료를 얻기 위하여, 현재 사과, 배 과수원에서 사용되고 있는 조류피해 방지 방법들의 정확한 효과를 서로 비교 검토하고, 아울러 충북지역 과수 재배 농가들을 대상으로 유해조류에 의한 피해 실태와 경제성 있는 조류 피해방지 방법에 대한 설문조사를 병행 실시한 결과는 다음과 같다. 1. 조류피해는 방조망 설치에 의해서만 완전히 방지할 수 있었으며, 조류 피해율별 손익계산 결과를 참고하여 이익이 있을 때는 표준방조망을 설치하고, 그렇지 않을 경우에는 설치비가 저렴하며 농가에서 간단히 시공할 수 있는 간이방조망 설치가 더 경제적인 것으로 판단되었다. 도내 과수 농가의 조류피해는 지역 간에 큰 차이가 있었으며, 음향적 방제인 버드가드와 보호봉지인 망사봉지에 의한 방제가 가장 효과적이었다. 그러나 버드가드는 높은 설치비용이 문제되므로, 퇴치 효과가 비슷하거나 더 우수하면서 저렴한 한국식 음향 기구를 개발할 필요가 있는 것으로 판단되었다. 보호봉지인 UV 봉지와 플라스틱 보호캡 및 망사봉지 처리는 품종에 관계없이 피해를 현저하게 감소시켰으나, 과실의 착색 등 품질에 미치는 영향에 대해서 추가적인 연구와 검토가 필요한 것으로 생각되었다. To obtain basic data for low cost-high efficiency control methods for bird damage, the available control methods currently in use mostly in Chungbuk Province were tested on site, and the control efficiency was compared. Also, a comprehensive survey of actual bird damage and the control methods on model apple and pear growers in Chungbuk Province was conducted. The results are summarized as follows. The perfect control for bird damage was possible only through bird net, it was recommended that profit-and loss account must be considered before installing bird net, and when the 'standard bird net' does not come up to break-even point, more economic and convenient 'simplified bird net' should be a alternative. Actual extent of bird damage varied according to the locality, and imported acoustic apparatus BirdGard^R, development of our own system with superior or same quality and reasonable price is necessary. Fruit bags such as UV bags, plastic protective caps, and net bags were highly effective for bird damage control, irrespective of fruit species and cultivar, but further study to resolve some problems such as poor coloration caused by bagging is necessary.

만성 심부전환자의 혈액에서 측정한 Tumor necrosis factor-α 및 Interleukin-6의 임상적 의의

김명구,김성구,박상호,한대희,강진환,변정득,심규혁,최병조,방덕원,온영근,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and objectives: Many conditions are responsible for the pathophysiology and progressive mechanisms of congestive heart failure. More recently, it has also become evidence that another class of biologycally activated molecules generically reffered to as cytokine these are also over expressed in congestive heart failure. Therefore, the purpose of this study was to measure concentrations of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) in mild to severe symptoms of heart failure and compare their values with those found in normal control and analysed correlation relationship between cytokine level, clinical findings and hemodynamic indicies. Subjects and Methodology: Levels of TNF-α and IL-6 were measured on pulmonary artery during cardiac catheterization in heart failure patients(n=32) and normal subjects(n=8) as well as physical examination and echocardiogram. Cytokines assay were performed on plasma using commercially available ELISA(Enazyme-Linked Immunosorbent Assay) kits. Results: Although the levels of TNF-α and IL-6 tend to increase in congestive heart failure group, the cytokines level was not made significantly statistical difference between congestive heart failure group and controls. When analyzing the correlation between the levels of PCWP(pulmonary capillary wedge pressure) and cytokines(TNF-α, IL-6), respectively, there were statistically significant correlation coefficient 0.32,(p<0.05), 0.39(p<0.01). The cytokine IL-6 and pressure of pulmonary artery were significant correlation.(correlation coefficient 0.36, p<0.02) More significantly, there was correlated with TNF-α and IL-6.(correlation coefficient 0.57, p<0.001) Conclusions: There was tended toward high concentration of TNF-α & IL-6 in congestive heart failure and significant difference for PCWP between TNF-α & IL-6, thus may be correlated with development and progression in congestive heart failure.

치환된 알킬요드화물 또는 크산테이트 화합물과 에틸 아크릴산 또는 메틸 비닐케톤과의 분자간 라디칼 탄소-탄소 결합형성반응

강석구,박영원,박천호,조일환,오원택 성균관대학교 1992 論文集 Vol.42 No.2

생리활성천연물인 lipoxin A, carpenter bee 페로몬, 뇌염모기 페로몬, exobrevicomin 등의 합성의 주요 키탈 중간체들을 치환된 요드화물 또는 크산테이트 화합물과 에틸아크릴산 또는 메틸비닐케톤과의 분자간 라디칼 탄소-탄소 형성 반응에 의해 합성하였다. The chiral building blocks for the synthesis of biologically active natural products such as lipoxin A, carpenter bee pheromone, mosquito ov-iposition pheromone, and exo-brevicomins were synthesized by intermol-ecular radical C-C bond formation of the appropriate substituted iodides or xanthates with ethyl acrylate or methyl vinyl ketone.

위암 환자에서 위절제술후 나타나는 담도확장의 임상적 의의: 추적 CT 소견을 중심으로

윤구섭,백승연,이문규,김영환,오용호 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

A retrospective review of consecutive 35 patients'pre and post operative abdominal computed tomography was performed to determine frequency and degree of bile duct dilatation following Billroth Ⅱ operation for stomach cancer and it's clinical significance. Degree of intrahepatic biliary dilatation was classified as mild, moderate, marked according to the extension into central, middle and peripheral zone of liver, respectively. Three specialists on the abdominal image participated in analysis of those findings without prior information of the patients. Intrahepatic biliary dilatation was seen in 22 patients(63%) analysed by at least one radiologist, in 13 patients(37%) by at least two radiologists. Bile duct dilatation on CT was common finding and not necessarily meant tumor recurrence. Vagotomy and afferent loop resulted form Billroth Ⅱ were one of possible causes of bile duct dilatation. This study showed in the cases of bile duct dilatation without clinical and other radiological evidence of recurrence, no further study are needed and only enough to follow up study.

허혈성 심질환에서 염증지표에 관한 연구

번정득,권영주,박상호,한대희,이상철,강진환,김명구,심규혁,최병조,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background : Atherosclerosis is the chief underlying cause of ischemic heart disease and there is increasing evidence that inflammation is an important determinant of the development of atherosclerosis. We assessed the levels of inflammatory markers in patients with ischemic heart disease and normal group who has normal coronary angiograms. Materials and Methods : Coronary angiography was performed in 142 patients. 107 patients of ischemic heart disease(stable angina pectoris 58, unstable angina pectoris 30, Acute myocardial infarction 19) and 38 normal control subjects. We assessed the level of inflammatory markers, such as CRP, ESR, fibrinogen and leukocyte. Results : CRP, ESR and fibrinogen values of the patients with stable angina pectoris and unstable angina pectoris were higher than that of normal control group, but there were no statistical significance. Leukocyte value of the patients with unstable angina pectoris(9003.3±701.5/mm^(3)) was significantly higher than that of the patients with stable angina pectoris(6685.5±245.8/mm^(3)) and normal control subjects(6394.3±235.1/mm^(3)). CRP, ESR and fibrinogen values of the patients with acute myocardial infarction were also higher than that of normal control subjects. CRP was 3.88±2.05 mg/dL in acute mocardial infarction group, and 0.29±0.15 mg/dL in normal control subject group(p<0.05). Fibrinogen was 541.6±45.1 mg/dL in acute myocardial infarction group, 321.4±25.6 mg/dL in normal control subject group(p<0.05). Leukocyte was 10942.1±737.6/mm^(3) in acute myocardial infarction group, 6394.3±235.1/mm^(3) in normal control subject group(p<0.05). Conclusions : This study demonstrate that CRP, fibrinogen and leukocyte values of acute myocardial infarction group were significantly higher than that of control group and stable, unstable argina pectoris group. Leucokyte values were significantly elevated in unstable angina group, but CRP values were not in unstable angina group.

압축강도 평가를 위한 지능형 응력예측기 구축

박원규,우영환,이종구,윤인식 한국공작기계학회 2001 한국생산제조학회지 Vol.10 No.6

This work is concerned with construction of the intelligence stress predictor for compression strength evaluation using neural network-ultrasonic waves. The contact pressure in jointed plates was measured by using ultrasonic technique. Neural network is used to evaluate and predict contact pressure from the results of the calibration curves. The organized neural system was learned with the accuracy of 99%, as a result of learning the ultrasonic echo ratio to the contact pressure measurement between SM45C and STS410 materials. And it could be evaluated and predicted with the accuracy of 90% in the evaluation of ultrasonic echo ratio difference in the same surface roughness and contact pressure, and 85% in the prediction of virtual ultrasonic echo ratio. Thus the proposed stress predictor is very useful for the evaluation and prediction of the contract pressure between SM45C and STS410 materials.

경주지역 여고생의 초경과 체성장간의 관계

김준섭,권오구,박진석,오종수,박정현,박제식,안세한,이용환,서정호,신태섭,최영배,김덕수,이관,박수경 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

본 연구는 경주지역 1개 고등학교 3학년 여고생을 대상으로 초경 시작 전인 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레 수치와 초경 연령을 파악하여 여성의 초경이 빠를수록 체성장 속도의 변화가 있을 것이라는 가설을 기초로 두 요인간의 관련성을 파악하고자 시행되었다. 경주시 1개 여자고등학교 3학년생 총 317명에 대해 ㅊ경 나이, 초경시 심리 상태, 초경이 시작되었을 때의 상담 여부와 상담하였던 사람, 부모 신장과 초경전후의 식사 규칙성, 다이어트 경험, 수면시간, 스트레스, 음주/흡연 여부, 질병력 등에 대한 설문 조사를 시행하였고, 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레에 대한 정보는 건강기록부에서 확보하였다. 상기 대상자 중 건강기록부가 분실된 39명, 초경나이에 대해 응답하지 않았던 29명 및 결석 등으로 조사를 하지 못하였던 42명을 제외한 조사 대상자는 206명으로 선정하였다. 대상자들의 초경연령 평균값(Mean±SD)은 13.0±1.11이었고, 초등학교 4학년부터 고등학교 2학년까지의 초경 이후 신장 성장률은 감소하였으며, 초경연령이 빠른 군이 초등학교 때는 신장에 있어서 우위를 차지하나 고등학교에 오면서 신장은 비슷한 수준이 되었다. 초경후 1-2년 사이에 체중과 흉위의 증가율은 감소하였고, 초경연령이 빠른 군이 초등학교와 고등학교 사이에 체중과 흉위에서 모두 우위를 차지하였다. 본 연구의 결과는, 흔히 이차 성징의 시작 시점 혹은 사춘기의 시작 시점으로 보고있는 초경 연령이 청소년기의 성장과 밀접한 관련성이 있고, 특히 체중과 흉위의 성장 속도와 밀접한 관련성이 있음을 시사한다. To understand the onset of menarche in relation to changes in physical growth that take place during female adolescence, especially the changes in height and weight velocity. The 207 senior in one women high school of Kyongju were investigated in April 3 to 8, 2001. We collected the information, relation in the age at menarche, height & weight of parents, regularity of eating, and obesity diet, duration of sleeping, sickness & stress near age at menarche, by self-recording. The status of height, weight & chest circumference between the 4th grade of primary school and the junior of high school was collected by individual Health Record. The results were followed; The average age at menarche was 12.95±1.11 years old and the most frequent age of menarche is 13 years. After menarche, the velocity of height, weight and chest circumference were decreased. The most rapid group of menarche hold dominant position in height during elementary school. As time passed, they dont hold dominant position in height. The most rapid group of menarche get an advantage in the weight and the girth of chest after elementary school. The height of subjects is directly proportional to the height of their parents. These results suggest that the starting age at menestuation can be closely associated with physical growth and development.