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.

치료저항 만성 정신분열증 환자에서 Clozapine과 Haloperidol의 치료효과에 대한 비교

이홍식,김찬형,이희상,남궁기,송동호,이영문,한은선 大韓臨床藥理學會 1993 臨床藥理學會誌 Vol.1 No.2

Butt 용접재의 피로균열성장거동 및 ΔK_th 결정에 관한 연구(Ⅰ) : 피로균열성장거동 Fatigue Crack Propagation Behaviour

최용식,김영진,우흥식 成均館大學校 科學技術硏究所 1987 論文集 Vol.38 No.2

Threshold stress intensity factor range (ΔK_th) and fatigue crack growth behaviour were investigated for transverse submerged butt-welded joints of SM 50A steel with compact-tension type specimens. It was found in every case that welding induced stresses in center portion of specimen and compressive residual stresses near the edges. The fatigue crack grew in the field of compressive residual stresses. Additional effect of postweld heat treatment was examined. As a result, the fatigue crack growth rates of the weld metal and the HAZ metal in the state as weld were slower than those of the base metal. The ΔK_th value of the weld metal is smaller than those of both the base metal and the HAZ metal in the state of as weld. And the ΔK_th value of the HAZ metal is the largest among those of them. In the state of PWHT, the fatigue crack growth rates of the weld, HAZ metal were similar to those of the base metal and the threshold stress intensity factor range (ΔK_th) of the weld metal is similar to the value of the base metal.

光彈性實驗에 依한 直四角形板材內의 中央貫通傾斜龜裂에 대한 應力擴大係數 K_Ⅰ, K_Ⅱ 解析

崔鎔湜,權永顔 成均館大學校 科學技術硏究所 1985 論文集 Vol.36 No.1

There can be several types of crack geometry in practical materials. But among the several types of crack geometry which can influence S.I.F. K, the oblique crack seems to have much influence. Analyses on S.I.F. K_I,K_II for such an oblique crack were studied in numerical methods by M. Isida and many other researchers. But experimental attempts for the studies of oblique crack have been rarely made. A specimen used in this study was Epoxy-Resin plate of 40mm width, 60mm height, 3mm thickness. And by using this specimen S.I.F. K_I,K_II were obtained with photoelastic experimental procedure. Conclusions obtained from experimental results are as follows. 1. When λ equals to 0. 2∼0. 7, S.I.F. K_I,K_II and F_I,F_1 increase with increase of λ in the whole range of oblique angle(β). But when β equals to 60˚, F_I decreases with increase of λ and when equals to 75˚ F_II decreases with increase of λ. 2. When the oblique angle β equals to 15˚ and 45˚ increasing rate of K_II, is larger than that of K_I, and increasing rate of F_t is larger than that of F_II. When Q equals to 45˚ and 60˚ increasing rate of K_11 is larger than that of K_I, and increasing degree of F_II is larger than that of F_I. 3. There are differences between experimental results of this study and numerical analysis results of M. Isida for the oblique center crack in rectangular plate. It shows that when λ equals to 0.2∼0. 4, the differences between the two results are -7%∼17% in the whole range of β, and when λ equals to 0.5∼0,7, the differences between the two results are -5%∼40%. 4. It shows that when β equals to 15˚,30˚, the differences between the two results of K_I are 3%∼14%, and when β equals to 60˚,75˚ the differences between the two results of K_I,K_1,F_I,F_II are 4%∼9% 5. When the oblique angle(β) equals to 15˚S.I.F. K_I has maximum value, and when β equals to 45λ S.I.F. K_11 has its maximum value.

단독표면균열재의 피로수명 예측 해석

최용식,양원호,김영진,김재원 成均館大學校 科學技術硏究所 1990 論文集 Vol.41 No.1

Recent studies have shown that the fatigue growth behavior of semi-elliptical surface crack cannot be adequately predicted solely by the stress intensity factor analysis. The variation in constraint along the crack border, from plane stress condition at the plate surface to plane strain condition at the point of maximum crack depth, must be an important factor affecting the fatigue crack growth behavior. In this paper, an analysis on the fatigue life prediction of a semi-elliptical surface cracked body was performed, accounting for the variation in constraint along the crack border. That is, the fatigue life for a surface cracked body was predicted using linear elastic fracture mechanics concepts that were modified to account for crack closure behavior. The model for the fatigue life prediction in consideration of crack closure phenomenon was developed, and then the predicted fatigue lives using the model were compared with test data from PMMA specimens. The predicted results appeared to be conservative.

彈塑性破壞靭性値 J_IC 決定에 관한 硏究(Ⅳ)

崔鎔湜,梁源鎬,金永鎭,石昌星 成均館大學校 科學技術硏究所 1990 論文集 Vol.41 No.1

The objectives of this study are to determine whether the J_lC approach could be used to evaluate the ductile to brittle temperature performance of A516 Gr70 steel and to evaluate the J_lC value as a function of temperature. Fracture toughness J_lC and K_iC tests were performed on A516 Gr70 carbon steel plate and test results were analyzed according to ASTM E 813 and ASTM E 399 at temperatures ranging from -160℃ to room temperature (20℃). It may be recognized in this study that the temperature ranging from -15 to 20℃ is the upper shelf region of ductile-brittle transition temperature. In this temperature range, the elastic plastic fracture toughness J_lC values decreased with increasing temperature, however, it was insignificant. The transition temperature may be -30℃. In the transition region near -30℃, the tendency of J_lC decrease with decreasing temperature was significant. At temperatures ranging from -160℃ to -50℃, the relation between the J_lC value and the test temperature was obtained.

對稱 二重 板狀 表面龜裂의 相互干涉에 對한 硏究

崔鎔湜,梁源鎬,金永鎭,金在元 成均館大學校 科學技術硏究所 1988 論文集 Vol.39 No.2

In this paper, the authors experimentally investigated interaction effects of twin surface cracks on crack growth rate in the process of fatigue fracture. Because of convenience of measuring crack length toward the thickness direction, transparent PMMA plate specimens with twin circular arc type notches were used for the experiments. Fatigue tests were performed on the specimens with crack aspect ratio b/a=0.267 varying the width and thickness of the specimen. From the test results, the interaction effects of twin surface cracks on fatigue crack growth rate were evaluated, and crack growing aspects during fatigue crack growth process were examined as well. The followings were obtained fromm the experimental analyses. Regardless of the specimen thickness, it was found that the crack growth rate around the surface crack tip increased in the region of crack distance ratio λ{=(a + a*) /e} ≥ 1.0 according to the interaction effect of the twin surface cracks. The magnitude of the fatigue crack growth rate became larger in the following order; (1) the internal crack-tip points, (2) the deepest points of the crack-tip, and (3) the external crack-tip points. During the fatigue process, the varying crack aspect ratios (b/a) of colinear surface cracks appeared to be smaller than those of the single surface crack.

CT型 多段 變厚部在內의 Mode I 龜裂에 대한 龜裂成長擧動 硏究

崔鎔湜,梁源鎬,金永鎭,朴鍾桂 成均館大學校 科學技術硏究所 1992 論文集 Vol.43 No.1

A plate with multi-step varying thickness is widely used in a variety of machine components. In order to provide design data required for damage tolerant design for such components, fracture mechanics analysis was performed. Compact tension specimens with thin-to-thick geometry were used for analysis models. Three-dimensional finite element analysis was performed, and stress intensity factor was obtained by crack opening displacement extrapolation method. Analysis parameters were λ (dimensionless crack length), β(thickness ratio) and ω(width ratio). Dimensionless correction factor F values decreased rapidly as λ approached 1(thickness interface). And effect of front step was more pronounced than that of rear step.

용접 잔류응력장 중에서의 Aluminum-Alloy 용접재의 피로균열 성장거동 연구(Ⅱ) : 잔류응력 재 분포 Redistribution of the Residual Stress

최용식,정영석 成均館大學校 科學技術硏究所 1988 論文集 Vol.39 No.1

It is well known that welding residual stress has a great influence on fatigue crack growth rate in welded structure. In the general area of fatigue crack growth in the presence of residual stress, it is noted that the correction of stress intensity factor(K) to account for residual stress is important for the determination of both stress intensity factor range(ΔK) and stress ratio (R) during a loading cycle. The superposition technique can be applied generally for determination of K. The crack growth rate of the welds correlated with the effective stress intensity factor range, ΔK_eff, which was estimated by superposition of the respective stress intensity factors for the residual stress fields and for the applied stresses. However, redistribution of residual stress occurs during crack growth and its effect is not negligible. In this study, fatigue crack growth characteristics of the weld joint were examined by using superposition of redistributed residual stress and examined in comparison with that of the initial residual stress superposition.

탄소성파괴인성치 J_IC 결정에 관한 연구(Ⅰ)

최용식,양원호,김영진,석창성 成均館大學校 科學技術硏究所 1988 論文集 Vol.39 No.2

Elastic-plastic fracture toughness J_IC can be used as a design criterion of elastic-plastic fracture mechanics. The test methods for J_IC were approved by ASTM in America and JSME in Japan, but there are many differences between the two. In this paper, the J_IC test methods recommended by ASTM were compared with the JSME method for multiple- specimen technique using A516 Grade 70 pressure vessel steel plate. As the result of the experimental study, we discussed the difference of J_IC values due to the difference of the test methods. According to the test method, the definition of J_IC the region of valid data, the method of curve fitting of R-curve, the slope of blunting line and the method of Δα measurement are different from each other. So that the differences of J_IC values due to them were considered. The J_IC value by ASTM E813-81 can be converted to the one by ASTM E813-87.