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.

三鍾 黃連類의 氣管支 平骨筋 弛緩效果에 關한 硏究

서영철,임성우,신길조,이원철 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

This study was carried out to investigate the tracheal muscle relaxation of water extracts of three kinds of Coptis thizoma and also compare of Coptis rhizoma, in isolated rat tracheal smooth muscle. As a result, Coptis chinensis showed significant tracheal muscle relaxation on KCI-induced contraction and more markedly on carbachol-induced contraction in close-dependent manner. Coptis japonica exhibited also tracheal muscle relaxation on both contraction with slightly weaker activities than those of Coptis chinensis. The activities of the root hair of Coptis chinensis were the most weakest in three thizomas. Berberine and palmatine had strong tracheal muscle relazation, especially, on carbachol-induced contraction, however, their activities on KCI-induced contraction were weaker than that of Coptis chinensis. The inhibitory effects of three kinds of Coptis rhizoma on the contraction by KCI and carbachol were inbestigated to explain the process of their tracheal muscle relaxation. All rhizomas inhibited the contraction by both agents, among them, Coptis japonica showed the most significant effect, so indicating the tracheal muscle relaxation of Coptis rhizoma may be concerned with the blocking of muscarine receptor and Ca²+ channel.

근적외분광분석법을 이용한 참기름 정량 분석 및 진위 판별

서은정,백주현,우영아,김효진 동덕여자대학교 종합약학연구소 2002 동덕약학연구지 Vol.6 No.-

In this study, sesame oil have been analyzed by near infrared spectroscopy (NIRS). Sesame oil was mixed with the other edible oil. NIR transmittance spectra of sesame oil mixtures were acquired by using a dip probe. Partial least squares regression (PLSR) was applied to develop a calibration model over the spectral range 1100-1750nm. The calibration model predicted the content of sesame oil for validation set with a standard errors of prediction (SEP) of 0.3871%. Soft Independent Modeling of Class Analogy (SIMCA) was used to identify sesame oil and adulteration. This model identified the sesame oil and adulteration for validation set with 100% accuracy. This study showed that the rapid and non-destructive the determination of the quantitative analysis of sesame oil, the identification of sesame oil and adulteration was successfully performed by portable NIR system.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

Agrobacterium transformation 에 의해 Manganese SOD가 과발현된 transgenic tobacco의 개발에 대한 연구

徐廷彬,金榮照,李宇成 성균관대학교 기초과학연구소 1995 論文集 Vol.46 No.2

식물체는 냉해, 가뭄, air pollutants 등과 같은 다양한 외부 환경적인 스트레스에 노출되어짐으로써 매우 활동적인 oxygen radicals 생성을 유도한다. 이러한 활동적인 oxygen radicals 는 식물체 내의 수 많은 생리적 문제를 유발시킨다. 이러한 스트레스에 적응하고자 식물체 내에는 다양한 방어 기작이 있으며, 그 중 하나가 superoxide를 Hydrogen peroxide로 바꾸는 효소인 superoxide dismutase (SOD, EC 1.15.1.1)이다. 방어 기작에 있어서 SOD의 역할을 조사해 보고자, 본 실험에서는 담배의 엽록체에 완두의 manganese SOD를 과발현시킨 형질 전환 식물체를 개발하였다. Northern hybridization과 SOD activity gel staining을 해 본 결과, 이러한 형질 전환된 담배 엽록체 내에서 완두의 manganese SOD가 안정적으로 발현되고 있음을 확인할 수 있었다. Upon exposure of plant to diverse environmental stress such as chilling, drought, and air pollutants, the activated oxygen radicals are actively produced. These reactive oxygen species are associated with a number of physiological disorders in plant. One of the enzymes involved in the defense is superoxde dismutase (SOD, EC 1.15.1.1) which converts superoxide into hydrogen peroxide. To test the role of SOD in the defense system, We produce transgenic plants which are overexpressed Mn SOD of pea (Pisum sativum L.) in chloroplasts of tobacco (Nicotiana tabacum L. cv Xanthi). Using Northern hybridization and SOD activity gel staining, it was confirmed that these transgenic plants overexpressed the introduced gene.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

Thrombopoietin이 제대혈의 CD34 양성 조혈모세포의 거핵구계 세포분화에 미치는 영향

서진태,조경삼,윤휘중,김시영,이우인 경희대학교 2000 慶熙醫學 Vol.16 No.2

발작을 동반한 뇌스파르가눔증 1예

서환조,고경식,양 익,최태열,최우석,신선영 대한감염학회 1993 감염 Vol.25 No.4

Human sparganosis is a rare infection caused by a tape worm larva, the genus Spirometra. Most infection occurs in the soft tissue, and sparganosis of the brain is very rare. There is no effective chemotherapy, and the best treatment for cerebral sparganosis is surgical removal of the worm, as in the case of the noncerebral form. A 40 year-old Korean man presented a 10 year history of episodic confusion followed by grand malseizure. He also had a history of consuming snake meat. Computed tomography and magnetic resonance imaging of the brain showed a lesion of the right temporoparietal lobe. Micro-ELISA test for sparganum specific antibody revealed high anitbody levels of absorbance 0.39 in serum, and 0.53 in cerebrospinal fluid. He refused operation, and a single maximal 50 Gy dose of irradiation by gamma knife was done. After 6 months, the lesion had no interval change on brain CT.

작업구역의 합리적 분할에 의한 택트공정관리 개선

정영권,윤유상,서상욱,신동우,김창덕,김경래 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The purpose of this study is to increase the operational efficiency of Tact Planning and Scheduling through effective labor control based on fairly reasonable creation of work area. The main result of the study are as follows: 1) Specific section of work area for electric work lead to no division of zone between internal residence area and bathroom. And designate the work area of each floor so that it would manage labor control effectively. 2) When it comes to equipment work. It set up work area according to "floor" taking account into more frequent unit work comparatively than floor work. The study recommends that. As a future research, eventually aims at establishment of integrated system of labor control Tact Planning and Scheduling by combining respectively divided system into one.

폐농양 및 복부농양을 일으킨 Eikenella corrodens 감염 2예 : Two Case Reports and Review

정용희,류미숙,김영식,이우인,이희주,서환조 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

Eikenella corrodens is a slowly growing, facultative anaerobic gram-negative bacillus. It is a normal inhabitant of the human upper respiratory tract, and it is recognized as an infrequent cause of invasive disease. To date, a few cases of E. corrodens infection were noted from all other organ. We report herein two cases of E. corrodens infection. In one case E. corrodens was isolated in the lung abscess and in the other case it was in the appendiceal abscess. The patients were treated empirically with penicillin G. The results of the bacterial culture and sensitivity test were available with it. The patients were discharged 15 days later with marked improvement after treatment. Our report clearly demonstrates that E. corrodens can be the pathogen of lung abscess and intraabdominal abscess. We reviewed descriptions from the literature of infections caused by E. corrodens.