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.

골격성 Ⅱ급 성인 부정교합자에서 혀와 두개안면골격 및 악간공간과의 상관관계에 관한 연구

강현희,박수병 대한치과교정학회 1999 대한치과교정학회지 Vol.29 No.5

골격성 Ⅱ급 부정교합자 중 성장이 완료되었다고 생각되는 만 18세 이상의 여자 37명, 만 20세 이상의 남자 23명을 선정하여 정상 성인의 안면비를 기준으로 hyperdivergent group(n=30)과 hypodivergent group(n=30)으로 나누어 두부 방사선 규격사진의 투사도를 작성하였으며 두개안면골격 및 혀의 크기, 높이 그리고 자세를 나타내는 항목을 계측하였고, 두 군간의 차에 대한 유의성 검정 및 혀와 두개안면골격 그리고 악간공간 사이의 상관관계를 조사하여 다음과 같은 결론을 얻었다. 1. 두 군의 혀와 악간공간의 계측항목 비교시 악간공간에 대한 혀의 면적비(TS/IS)는 hyperdivergent group에서 더 크게 나타났으며, PIH(posterior intermaxillary height)와 IS(intermaxillary space)는 hypodivergent group에서 더 크게 나타났으나 혀의 높이와 자세를 나타내는 항목에서는 두 군간에 유의할 만한 차이가 없었다. 2. 혀와 두개안면골격의 상관관계 비교시 두 군 모두에서 혀의 면적(TS), 길이(TGL) 그리고 높이(TH)를 나타내는 계측 항목이 전안모고경(AFH)과 가장 높은 상관관계를 나타냈으며, 또한 hypodivergent group에서는 후안모고경(PFH)과도 높은 상관성을 보였다(p<0.01). 3. 혀와 악간공간의 상관관계 비교시 두 군 모두 혀에 관한 대부분의 항목(H-P제외)이 악간공간(IS)과 가장 높은 상관성을 보였으며, 혀의 높이(TGH)와 면적(TS)을 나타내는 항목은 악간공간의 AIH 및 PIH와 높은 상관성을 보였다(p<0.01). This study was designed to evaluate the correlations between tongue with skeletal pattern and intermaxillary space in Class Ⅱ malocclusion adult patients. Craniofacial skeletal pattern was analyzed on the lateral cephalometric radiograph and the subjects were devided two groups by facial ration, the 30 subjects of hyperdivergent group and the 30 subjects of hypodivergent group. The size and posture of tongue and intermaxillary space were measured on the lateral cephalometric radiograph. These data were statistically analyzed to examine significant differences between both groups and compared the correlation between tongue with skeletal measurements and intermaxillary space in each group. The results of this study were as follows.: 1. In comparison of the tongue and intermaxillary space, the measurement of TS/IS showed significantly larger in hyperdivergent group and PIH and IS showed significantly larger in hypedivergent group. There were no statistically significant differences in the measurements of the height and posture of tongue. 2. In correlation between tongue with craniofacial skeletal measurements. the length and height of tongue showed the highest correlation with AFH(anterior facial height) in both groups(p<0.01). And that measurements showed high correlation with PFH(posterior facial height) in hypodivergent group. 3. In both groups, most measurements of tongue showed high correlation with intermaxillary space and the height and space of tongue showed high correlation with AIH and PIH(p<0.01).

소아기 붕괴성 장애 1례

강병구,조수철,홍강의 대한소아ㆍ청소년정신의학회 1996 소아청소년정신의학 Vol.7 No.1

액체식품의 건조시 방향물질의 보존 제1보 : 평판건조시 방향물질의 보존

강안수,이병철 明知大學校 産業技術硏究所 1993 産業技術硏究所論文集 Vol.12 No.-

The aroma retention in the drying of light foods. which is an important factor fur determining the quality of products, was analysed by a theoretical model and was investigated through experiments. Model liquid foods were made of aqueous solutions of sugar, sucrose and maltodextrine, to which fixed ratios of benzaldehyde were added. It was assumed that aroma component and water in drying material were transported by molecular diffusion. The system was treated as a pseudo-binary system when the transport of volatiles is considered and as a binary system of water and sugar when the transport of water is considered. Approximate solutions of the diffusion equation were obtained for the case of fast drying and fur the case of slow drying. In solving the diffusion equation, the shrinkage of the specimen was in proportion to the amount of water evaporated in the slow drying case and that the specimen behaved as a semi-infinite body in the fast drying case. The experimental results showed that the aroma retention was high when the initial concentration of sugar was high. The higher the molecular weight of sugar and aroma components, the lower the diffusion coefficients of aroma in sugar solution, so that the aroma retention was high. And when the concentration of aroma components was below 1.000ppm. it's concentration had no influence on the aroma retention.

골격성 Ⅲ급 부정교합자에서 상악골 전방 이동술 후 코의 변화에 관한 연구

강은희,박수병,김종렬 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.5

본 연구는 골격성 Ⅲ급 부정교합 환자에서 상악골 전방이동 수술 후 야기되는 코의 형태변화에 대해 연구하고 이를 예측할 수 있는 요소를 찾아 교정-악교정 수술 복합 치료계획의 수립과 결과의 예측에 이용하고자 시행되었다. 부산대학교병원 치과진료처 교정과에 내원하여 골격성 Ⅲ급 부정교합으로 진단되어 술전 교정치료를 받고 Le Fort I 골절단술로 상악골의 전방 이동시키는 동시에 하악골을 후방 이동시킨 남녀 성인 환자 25명을 대상으로 하였다. 이들의 수술 전, 후 측모두부규격방사선사진과 정모 및 측모 안면사진을 계측, 분석하여 다음과 같은 결과를 얻었다. 1.상악골 전방이동에 따른 비첨의 수직적 위치 변화는 상관성이 높았으며 ANt, SNt에서 A point의 전방이동에 의해 β0는 각각 0.228, 0.257로 나타났다. 2.상악골 전방이동에 따른 비첨의 수평적 위치변화는 상관성이 높았으며 ANt, SNt, Sn point에서 Anoint의 전방이동에 의해 β0는 각각 0.484, 0.431, 0.806으로 나타났다. 3.상악골의 전방이동에 따른 비익부의 확장정도는 A point의 전방이동에 의해 0.002의 β0를 나타내었으나, 임상적으로 유의한 변화는 없었다. 4.수술 후 비첨의 수직적 및 전후방적 위치변화를 예측하는 지표로 사용된 ADV, DRI, Prominence of nose, Pre-OpCA 중 ADV 만이 설명변수로서 유의성이 있었다. The purpose of this study was to evaluate the amount and interrelationship of the soft tissue of nose and maxillary changes and to identify the nasal morphologic features that indicate susceptibility to nasal deflection in such a manner that they would be useful in presurgical prediction of nasal changes after maxillary advancement surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patients (13 males and 12 females) who had severe anteroposterior skeletal discrepancy. The patients had received presurgical orthodontic treatment. They underwent a Le Fort I advancement osteotomy, rigid internal fixation, alar cinch suture and V-Y advancement lip closure. The presurgical and postsurgical lateral cephalograms and lateral and frontal facial photographs were evaluated. The computerized statistical analysis was carried out. Soft tissue of nose change to A Point change ratios were calculated by regression equations. The results were as follows : 1.The correlation of maxillary hard tissue horizontal changes and nasal soft tissue vertical changes were high and the β0 for soft tissue to ADV were 0.228 at ANt, 0.257 at SNt. 2.The correlation of maxillary hard tissue and nasal soft tissue horizontal changes were high and the β0 for soft tissue to ADV were 0.484 at ANt, 0.431 at SNt, 0.806 at Sn. 3.The correlation of maxillary hard tissue horizontal changes and width changes of ala of nose were high and the β0 for alar base width ratio to ADV were 0.002. 4.The DRI, Prominence of nose, Pre-Op CA is not a quantitative measure that can be used clinically to improve the predictability of vertical and horizontal nasal tip deflection. In this study, increases in nasal tip projection and anterosupenor rotation occur when there is an anterior vector of maxillary movement. These nasal changes were quantitatively correlated to magnitude of maxillary(A point) movement.

Trioctylamine에 의한 유기산의 추출

강안수,이병철,이한섭,안형환,이영주,류운형 明知大學校 産業技術硏究所 1993 産業技術硏究所論文集 Vol.12 No.-

For elucidation of various parameter's effect on the reactive extraction of organic acidstrioctylamine(TOA)-diluents system, the association model, equilibrium constants and extraction factors(loading) were investigated . The organic acids rosed were propionic. succinic, masonic, and benzoic acid. Extractant was tertiary amine, TOA and diluents were butylaeohol, hexane, and benzene. It was concluded that the loading of monobasic acid of propionic acid were higher than that of dibasic acids of oxalic, and malonic acid with extranctant TOA. In the extraction of monobasic acid the extraction factor was not affected by the initial concentration of extractant amine, but in the extraction of dibasic acids the extraction factor was getting better with decreasing the initial concentration of amine. There was a strong effect of diluents upon the extractien factor, and the order of these factor was as shown below: xylene<Benzene<butylalcohol<choloroform<methylisobutylketone.

준설수심에 따른 사천만의 해수유동 특성에 관한 연구

강대석,유상호,민일규,이동수,민병형 東亞大學校 海洋資源硏究所 2003 硏究論文集 Vol.15 No.-

This study on the characteristics of the tidal current at the half closed bay selected Sachoˇn Bay located in the western Kyung-nam area as the object location of the study. Then, I analyzed the current with the varying dredging depth after the depth integral of the three Dimensional continuous equation and Navier-stokes equation. The study would get the following results, and the results could be used meamingfully as the analysis material about the dredging depth's influnce on the surrounding ocean when developing the coastal port. 1. When measuring the tidal current, there is a bit dispersion in the current direction of the observed object, but it is the wind effect at the bay. Considering that the calculated result is the shallow-water equation integranted in depth, the results can be concluded to in accored with my expectancy. 2. In case of reclaiming and dredging, the flow velocity and direciton change constantly, compared with the present condition. 3. At the wide bay dredge depth does not arrect the level of the ocean, but in case of inflow from the flood, the increase of the inflow of the river water affects the level of the ocean. 4. As the dredge depth grows deep, the maximum flood tidal current and obb tidal current at the front coast of the reclaimed decreases a little. However, the wide area Pc-7~Pc-9 doesn't show any change. As we saw in the above result, feacturcs of the tidal current as the level of the ocean and the current velocity don't change in the aspect of the ocean engineering even if we increase the degree of the dredge depth up to 6m in Sachoˇn Bay

모 축전지 회사 근로자들의 연폭로 지표에 대한 경시적 관찰

강명식,김용배,이용진,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

Lead poisoning is still prevalent and one of important occupational disease in Korea. To prevent undue high lead burden and maintain good health condition of lead workers in lead using industries, periodic health examination and regular biological monitoring of lead workers are often required in addition to the fundamental improvement of their working condition. To evaluate the effect of comprehensive occupational health program with regular biological monitoring on the level of lead exposure of lead workers in lead using industries, 11 year database from 1983 to 1994 of one storage battery factory was reviewed. From 1983 to end of 1986 only periodic health examination was provided to the lead workers, but from 1987 comprehensive occupational health program with regular biological monitoring was provided to maintain better health condition of lead workers. Selected study variables for lead exposure were blood lead(PbB), zinc protoporphyrin in blood(ZPP), δ-aminolevulinic acid in urine(ALAU), hemoglobin(Hb), hematocrit(HCT). Information on sex, age and work duration was also reviewed. 5 years data from 1983 to 1987 and 3 years data from 1990, 1993 and 1994 were available for all lead exposure indices except ALAU which has only 5 years data from 1983 to 1997. The results of 11 years longitudinal observation of lead indices are all follows: 1. The mean value of ZPP of lead workers in 1983 was 148.7±73.1 ㎍/㎗(Male: 145.5±72.3, Female: 168.1±79.1), whereas that of ZPP of lead workers in 1994 was decreased to 64.3±32.7 ㎍/㎗(Male: 60.2±28.8, Female: 95.2±43.4). 2. The mean value of PbB of lead workers in 1983 was 56.4±18.8 ㎍/㎗(Male: 55.59±19.1, Female: 59.6±19.1), whereas that of PbB of lead workers in 1994 was dcreased to 35.4±11.9 ㎍/㎗(Male: 35.7±12.0, Female: 32.8±10.8). 3. The mean value of Hb of lead workers in 1983 was 14.1±1.4 g/㎗(Male: 14.4±1.1, Female: 11.7±0.8), whereas that of Hb of lead workers in 1994 was increased to 15.6±1.5 g/㎗(Male: 15.9±1.2, Female: 12.9±1.1). 4. Blood lead is most highly correlated with ZPP(r=0.522, male:0.54 and female:0.50) and also correlated with ALAU and work duration also. 5. The simple regression analysis of PbB and ZPP showed different coefficient of regression by the measurement year, but there was no difference of coefficient of regression between sex. The slope of equation of pooled data for 1983-1986 without comprehensive occupational health program was 2.16 and differed from that of pooled data for 1987-1994(1.25). This difference suggests that the unit effect of blood lead on ZPP was relatively smaller in later period of comprehensive occupational health program than carly period without comprehensive program. The slope change in the analysis of linear regression of PbB on ZPP in lead workers can be used to evaluate the possible effect of health intervention to prevent undue high lead absorption in lead using industries. 6. 11 years occupational health service in this storage battery factory brought out considerable improvement of health status of lead workers in terms of decrease of PbB and ZPP and increase of Hb and the improvement was more remarkable after the introduction of comprehensive occupational health program.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

오스테나이트계 TP347 스테인레스강의 파괴저항특성 평가

강병구,김수용,석창성 成均館大學校 科學技術硏究所 1999 論文集 Vol.50 No.1

The objective of this paper is to evaluate the material properties of TP347 stainless steel and their associated welds and the welded joint of the carbon steel and the stainless steel manufactured for primary coolant system of Ulchin 3 & 4 nuclear power plants. The effect of various parameters such as pipe size, welding method, chemical composition, crack plane orientation, metallography and fractography on the material properties were discussed. Test results showed that the effect of pipe size on fracture toughness was negligible while the effect of welding method on fracture toughness was significant. In addition, the drop of fracture toughness in the field fabrication weld of TP347 stainless steel is probably due to the large amount of σ-phase precipitated on the δ-ferrite boundary and the large size dimple.