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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

한약에 의해 유발된 급성 간질성 신염 2례

김덕윤,박동건,김응석,강영모,양창헌,이정호,이동철,이영현,김정란 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

간질성 신염은 신장의 간질을 선택적으로 침범하는 염증성 질환으로 여러가지 원인에 의해 유발되며, 이 중 약물에 의한 경우는 각종 항생제, 비스테로이드성 진통제, 항경련제, 이뇨제, 면역억제제등에 의한 증례들이 보고되고 있다. 현재 각종 질환-특히 만성질환-의 치료에서 한약이 차지하는 비중이 적지 않으나, 그 각각의 성분들이 유발할 수 있는 부작용들에 대한 연구는 거의 없는 실정이다. 저자들은 관절염 치료를 위해 중국산 한약을 복용한 후 복통, 피로감 및 육안적 혈뇨를 주소로 내원한 두 환자에서, 단백뇨와 신기능 장애를 보여 시행한 신조직 생검상 급성 간질성 신염에 합당한 병리학적 소견을 보이고, 한약 복용 중지 후 급속한 회복을 보여, 한약에 의해 유발된 것으로 사료되는 급성 간질성 신염 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Acute interstitial nephritis is a disease characterized by renal interstitial inflammatory cell infiltration and acute renal functional deterioration. This is caused mainly by antibiotics, NSAID and diuretics such as thiazide, but cases induced by herb medication are rare. We experienced two cases of acute interstitial nephritis after treatment with herb medication. One 71-year-old female patient and the other 60-year-old female were admitted to the hospital because of general weakness and gross hematuria. Microscopic hematuria, pyuria, and proteinuria were presented. After definitive diagnosis with a renal biopsy, we noted rapid recovery of renal function by drug withdrawal and steroid therapy. We report these cases with a review of the referenced literatures. Key Words : Herb medication, Acute Interstitial nephritis.

유제놀에 의한 즉시형 알레르기 반응의 억제

김상현,신태용,김형룡,이영미,이은희,신보경,김윤철,안년형,김형민 우석대학교 의약품개발연구소 1996 藥學硏究誌 Vol.1 No.-

The current study evaluates the capacity of eugenol to regulate immediate allergic reaction by control of histamine release. Administrations of eugenol (1 M/kg. i.p.) at 60 min before and 5.10 min after the compound 48/80 treatment (8 mg/kg.i.p.) were shown the mortality rates as 0.44.4. and 77.8%. respectively. A 60 min before administered group revealed a singificant inhibition of serum his-tamine release compared with those of 5 and 10 min after the compound 48/80 injection. Eugenol (6-48mM) was also showed a dose-dependent activity on the compound 48/80-induced histamine release from the highly purified population of Alcian Blue-positive peritoneal mast cells. These results indicate that in vitro treatment with exogenous eugenol inhibited the active response of mast cell populations and modulated its characteristics.

흉통의 양상에 따라 분류한 불안정형 협심증 환자의 임상적 소견의 비교

김명수,김성구,정호석,온영근,신원용,김철현,최태명,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background and aims : The clinical syndrome unstable angina pectoris that encompasses a variety of symptoms and clincal presentations of transient episode of myocardial ischemia, was devided to several subgroups. Also, it has variable pathophysiologic factors to cause myocardial ischemia. According to clincal presentation, coronary angiographic finding and prognostic factor, the result of unstable angina pectoris is variable. In fact, there were a few data reported on the prognosis of wide spectrum of patients with unstable angina. However, the precise risk of subgroups according to classitication has not been established because it was difficult to compare between studies. We classified unstable angina pectoris by clinical nature of chest pain, and performed to establish and compare the clinical presentations, coronary angiographic findings, treatement and prognosis of patients with unstable angina within subgroups of classification. Methods : Retrospenctive data for 164 unstable angina pectoris patients admitted to the Internal Cardiology Division of Soon Chun Hyang University Hospital from May 1996 to July 1999 was analyzed. The patients were classified into one of the following categories: Class I, new onset of severe angina; Class II, acceleration of previous chronic stable angina; Class III, angina at rest. Clinical presentations, echocardiographic findings, coronary angiographic findings, treatment and prognosis were compared. Results : From the total 164 patients, the subjects of classes were as follows : Class I, 46 cases (28.1%); Class II, 74 cases (45.1%); Class III, 44 cases (26.8%). In view of age distribution, the 7th decade had the highest incidence, and then, 6th, 8th decades were followed. There was no baseline differences among the 3 classes with respect to gender, number of risk factors. Significantly, class II showed more severe findings in abnormal Q wave 15 cases (20.8%), total occclusive lesion 10 cases (20.8%) and three vessel coronary disease 11 cases (22.9%) than other classes. The change of ST segment was significantly apparent (p<0.02) among class I 28 cases (60.8%), class III 26 cases (59.0%), comparing with class II 30 cases (40.5%). Class III had the higher incidence of one vessel coronary artery disease than class I and III. The heparin treatment was performed in 99 cases (60.1%). The incidence of nonfatal myocardial infarction was much more in class I and III, each 4 cases (8.7%, 9.8%) than in class II 1 cases (1.4%). In-Hospital death was occurred in class I and II, each 1 case. Conclusion : The patients with the acclerated angina from chronic stable angina had more severe coronary artery disease than other classes, but they had better in-hospital prognosis.

TiAIN을 코팅한 WC공구의 절삭성능에 관한 연구

김현자,최현철,김영대,김일선,노태영,이규용 釜慶大學校 2001 釜慶大學校 論文集 Vol.6 No.-

Thin film of TiAlN was deposited onto ISO P20 tungsten carbide cutting insert tip substrate specimen using the FVAS (filtered vacuum arc system) at the substrate temperature of 80℃. Cutting and wear tests have been performed to the TiAlN coated and uncoated WC specimen, respectively under the same cutting conditions for the comparison. Cutting forces and tool wear of coated and uncoated carbide cutting tools were investigated by means of cutting length and cutting forces. Also tool wear and tool life were analyzed using the 3ch tool dynamometer amp lifier and oscilloscope. In this study cutting tests for the cutting performance of TiAlN coated WC-Co P20 to the steel alloy of SNCN420 have been curried out. Through the comparisons of cutting forces during the cutting tests and tool wear, we got the conclusions as follows.; ① In usual cutting conditions, main cutting force component showed higher value than the thrust force normal to the cutting direction especially cutting forces in the of early stage on cutting tests. But, after loosing the protective hard thin film on substrate or insert tip, the thrust force normal to the cutting direction showed much higher than main cutting force component. ② Within the range of 0.3㎜ build up edge in P20 insert tip, TiAlN coated tip was evaluated more stable in flank wear and less in crater wear than the uncoated specimen. ③ Through the wear growth curve of the specimen, tool life differences of uncoated and TiAlN coated tip at high speed (V=250[m/min]) was higher than the low speed(V=200[m/min]) case, compared to the average but the tool wear was almost same in both specimen for the case of normal wear occurred.

학생청소년의 불안성향과 문제행동 유형간의 상관분석

김헌수,이재우,나철,김영돈,김민호,김은희,권지란,박광식,이길홍,민병근 중앙대학교 의과대학 의과학연구소 1987 中央醫大誌 Vol.12 No.4

The purpose of the present study was to examine the relationship between their problem behavioral pattern and anxious trends among Korean student adolescent. Zung's measurement of anxiety level undergone through used of the self-rating anxiety scale. the data were collected through the questionaire survey which was conducted on Dec.1, 1983. Subjects served for this atudy consisted of 1,404 syudents in Korea, randomly sampled from Korean student population by means of census method. The data were analysed by CDC-174 computer of KAIST, using SPSS pogram. Statistical methods empoyed were χ^2 test and Eta measures. the results of this study were as follows. 1. It showed that students psychological anxious trends had greatest significant correlation with adolescent student's problem brhavioral pattern, but the cardiovascular, respiratory, gastrointestional and genitourinary anxious trends has not significantly related with student's problem behavioral pattern. 2. Students group with undersocialized aggressive, undersocialized nonaggressive,undersocialized school-norm avoidant, or socialized nonaggressive behavioral patterns were less anxious, whereas those with socialized latent aggressive, socialized sexual, or socialized modellong behavioral patterns were higher anxious.

하지방사통을 동반한 성인 협부결손성 요추전방전위증의 후방요추간유합술 및 추경나사고정술후 추적결과

최철,김근수,최하영,김철진,김형일,이정청 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.4

초임계 이산화탄소로 추출한 유자껍질의 향기성분

김영언,김인환,김흥만,이영철 한국식품영양학회 1996 韓國食品營養學會誌 Vol.9 No.4

초임계 이산화탄소를 이용하여 유자(Citrus junos)껍질의 향기성분을 추출하기 위해 동결건조한 유자과피분말을 4,000psi와 40 에서 운전하면서 이산화탄소의 소비량에 따라 4단계로 분획하여 분획별 향기성분의 특성을 조사하였다. 초임계 이산화탄소에 대한 유자의 향기 성분의 수율은 0.011g/CO_2(L)였으며, 최대추출수율은 8.812g/kg이었다. 초임계 이산화탄소로 추출한 유자과피의 주요향기성분은 dl-limonene, γ-terpinene, linaollo, sabinene, β-myrcene, α-pinene, β-farnesene, α-terpineol 과 terpinolene 등 9종이었다. 분획별 향기성분은 휘발성이 높은 α-pinene, β-myrcene과 dl-limonene은 추출시간이 길어짐에 따라 함량이 감소하였으며, 이와 반대로 휘발성이 낮은 α-terpineol과 β-farnesene은 추출시간이 길어짐에 따라 함량이 증가하였다. 따라서 초임계 이산화탄소로 유자의 향기성분을 추출할 경우 추출시간에 따라 얻어지는 분획의 향기 성분 조성이 서로 다른 것으로 나타났다. Volatile compounds were extracted from freeze-dried citron peel(Citrus junos) using supercritical CO_2 under 4,000psi at 40℃. Four fractions were obtained with consumption of CO_2. Volatile compounds of extracts were analyzed by GC-MSD. Yield of volatile compounds from citron peel was 0.11g/CO_2(l) and maximum yield was 8.812g/kg. Major volatile compounds of extracts were dl-limonene, γ-terpinene, linalool, sabinene, β-myrcene, α-pinene, β-farnesene, α-terpineol and terpinolene. α-Pinene, β-myrcene and dl-limonene in the fractions decereased gradually, while α-terpineol and β-farnesene increased as the consumption of CO_2 increased.

HID 램프용 디지털제어 전자식 안정기에 관한 연구

김영동,강원찬,김남오,김형곤,김병철 조선대학교 에너지.자원신기술연구소 2004 에너지·자원신기술연구소 논문지 Vol.26 No.1

In this paper, digitally controlled electronic ballast for the HID lamps driven by proposed frequency conversion method is described. This electronic ballast consists of a buck converter, a low frequency square wave full bridge inverter, a high voltage pulse generator for the lamp ignition, an over current protection circuit and an 8-bit microcontroller. The fuzzy logic digital control operation is carried out by the 8-bit microcontroller. In spite of the limited control bandwidth caused by low operation speed of the 8-bit microcontroller, the good control performance for the constant lamp current in the warm-up period is obtained using the proposed frequency conversion driving method. The HID lamp is controlled in a constant current mode during the lighting warm up process and is controlled in a constant power mode during lighting steady state. A controlled variable power mode is used to extend the lamp lifetime.