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      • 급성 골수성 백혈병 환자에서 관해 유도 항암 화학요법 후 발생한 베르니케 뇌증

        황진원,정재현,서광원,최병진,송영진,김종윤,이은지,임홍규,이상민 인제대학교 2009 仁濟醫學 Vol.30 No.-

        Wernicke's encephalopathy is characterized by the triad of ocular symptoms, ataxia, and mental confusion and neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, hyperemesis gravidarum, anorexia nervosa, hemodialysis, uremia, and acquired immunodeficiency syndrome(AIDS). Chemotherapy in patient with malignanacy and long term total parenteral nutrition following bone marrow transplantation are related with Wernicke's encephalopathy. A 48-year-old woman had been treated with Daunorubicin and Cytarabine for remission induction chemotherapy of acute myeloblastic leukemia and intravenous hyperalimentation due to persistent hematochezia and ileus caused by infiltration of leukemic cell in terminal ileum. She suddenly complained of diplopia, tremor, and mental confusion at 32th day after chemotherapy and generalized tonic-clonic seizure at 34th day after chemotherapy. The diagnosis of Wernicke's encephalopathy was made with clinical presentations and brain MRI. Brain MR T2-weighted & Flair image revealed a high signal intensity lesions bilaterally at the medial thalamus and peri-acueductal grey matter of the midbrain. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after remission induction chemotherapy followed by intravenous hyperalirnentation in a patient with acute myeloblastic leukemia.

      • KCI등재

        주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

        김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

        Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

      • KCI등재

        배구 서브리시브에 따른 팀 간 공격 차이 분석

        김종원 ( Jong Won Kim ),김주학 ( Joo Hak Kim ),김진환 ( Jin Hwan Kim ),홍성진 ( Seong Jin Hong ) 한국스포츠정책과학원(구 한국스포츠개발원) 2011 체육과학연구 Vol.22 No.3

        이 연구는 국내 남자프로배구경기에서 나타난 서브리시브에 따른 팀간 공격 차이를 서브리시브의 유효성, 세터/비세터에 의한 세트, 세터의 위치, 공격형태, 공격결과를 기반으로 어떠한 차이가 있는지를 알아보기 위하여 NH농협 2009~2010 V리그 남자프로배구경기 126경기를 대상으로 하였다. 분석된 요인들을 기반으로 팀간 공격형태별 빈도, 대전팀간 교차분석, 공격형태별 성공 비율 차이를 분석하여 다음과 같이 나타났다. 첫째, 요인에 따른 공격형태별 빈도를 분석한 결과, 서브리시브가 성공하였을 경우 7개팀 중 5개팀이 속공공격, 실패하였을 경우 7개팀 모두가 오픈공격의 빈도가 높게 나타났다. 둘째, 요인에 따른 대전팀 교차분석의 차이를 검증해 본 결과 차이가 나타났다. 시즌 1위팀인 S팀은 7위팀인 A팀보다 서브리시브 성공률에서 10%이상의 차이가 나타났으며, 서브리시브의 성공·실패와 상관없이 7개팀 모두 96%이상의 세트가 세터에 의해 이루어지는 것으로 나타났다. 또한, 공격결과 성공률 평균에서는 상위팀인 S팀·H팀(56.9%), 중위팀인 D팀·L팀(54.7%), 하위팀인 W팀·K팀·A팀(47.7%)로 나타나 상위팀일수록 더 높은 공격결과 성공률 평균이 나타났다. 셋째, 공격형태별 성공 비율 차이를 분석한 결과, 이동공격을 제외한 모든 공격형태에서 차이가 나타났다. 오픈공격에서는 S팀이 D팀은 제외한 모든 팀보다 높은 오픈공격 성공 비율의 차이가 나타났으며, A팀은 W팀을 제외한 모든 팀에게 높은 오픈공격 성공 비율의 차이를 나타내주는 특징을 보였다. 시간차공격에서는 K팀이 A팀을 제외한 모든 팀에게 높은 시간차공격 성공 비율의 차이를 나타내주었으며, 속공공격에서는 H팀이 D팀을 제외한 모든 팀에게 높은 속공공격 성공 비율의 차이가 나타났다. 후위공격에서는 하위팀인 W팀·K팀·A팀에서 상위팀들에게 높은 후위공격의 성공 비율의 차이를 나타내주는 특징을 보였다. 퀵오픈공격에서는 A팀이 K팀은 제외한 모든 팀에게 높은 퀵오픈공격 성공 비율을 나타내주는 특징을 보였다. 서브리시브에 따른 팀 간 공격에서 서브리시브의 유효성, 세터/비세터에 의한 세트, 세터의 위치, 공격형태, 공격결과에 따라 팀 간 차이가 나타났다. 안정된 서브리시브와 세트는 여러 공격형태와 높은 공격성공률과의 관계가 매우 높다고 볼 수 있다. 대부분의 기록에서 승리한 팀이 패배한 팀보다, 시즌 순위 기록으로 상위팀이 하위팀보다 우위를 나타내 여러 요인들의 안정 및 높은 성공률을 위하여 꾸준한 연습과 대전팀의 경기기록에 대한 연구가 필요하다. The study was to compare the differences of attacking patterns related to serve receives basing on effectiveness of serve receives, setter/non-setter, location of setter, type of attacks and outcomes of attacks. The subjects were 126 games in 2009~2010 Korean NH Nonghyub V-league men`s championships. The analysed factors were considered on frequencies of type of attacks by each team, cross comparisons between teams played and a ratio of successful outcome by the type of attacks. The results were found as following belows; Firstly, in the comparisons of frequencies on the type of attacks, 5 teams among 7 teams shown greater frequencies on counter-attacks while the teams were winning. Secondly, there were significant differences of types of attacks between teams. The championships` winner, team S was greater than other teams about 10 % of successful serve-receives and 96% of sets were done by setter without the relationships of successful or unsuccessful serve-receives. Also, the successful percentage of attacking outcomes were ordered by ranks such as superior team S and H (56.9%), mid-ranks team D and L (54.7%) and inferior team W, K and A (47.7%). Thirdly, in the comparisons of successful ratio of type of attacks, there were significant differences between the type of attacks except moving-attacks. In the open-attacks, the ratio by team S was greater than team D. In addition, there was significant difference on the ratio by team A excepted the comparing with team W. In the time difference attacks, the ratio by team K was different comparing to other teams excepting team A. In the counter-attacks, team H were greater ratio excepting to team D. In the backward-attacks, the inferior teams (W, K and A) made greater successful ratio of attacks against the superior teams. In the quick-attacks, there was grater ratio by team A against others excepted to team K. There were differences of the effectiveness of serve-receives, sets by setter/ non-setter, location of setter, type of attacks and outcome of attacks depending on the teams. The stable serve-receives and sets were highly relevant to the various types of attacks and greater ratio of successful attacks. The continuous practice and study on oppositional data are required in order to enhance their performances because the winning and superior teams were stable ratio of successful attacks rather than the losing and inferior teams.

      • KCI등재후보

        비복신경이식을 이용한 긴 거리의 말초신경 결손부 수복

        이종호,이세영,김명진,이은진,안강민,김성민,최원재,명훈,황순정,서병무,최진영,정필훈 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2

        The surgery of oral and maxillofacial area poses the risk of cranial nerve damage such as trigeminal nerve or facial nerve. Inferior alveolar nerve is prone to damage in the third molar extraction, implant installation, orthognathic surgery, open reduction and rigid fixation, and tumor ablation surgery. On the other hands,facial nerve is likely to be damaged or sacrificed with trauma or parotidectomy. In case of inferior alveolar nerve injury, the incidence is reported to be about 1.3%. The nerve function will almost recover in minimal damage, but it won't recover at last in total damage of a part of nerve unit. In latter cases, nerve regeneration in intended by allograft as nerve substitute or various route of merve condit. But the recovery with autograft is believed to be most relialbe mrthod in the rapair of long-span(longer than 15㎜)nerve defect. We have performed autologous sural nerve graft in the repair of nerve defect, which is caused by resection of benign or malignant tumor. Hereby we report the method of nerve harvesting, recovery of defected peripheral nerve and the complications of donor site with the discussion of sural nerve anatomy.

      • KCI등재

        야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

        조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

        Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

      • KCI등재

        2010 파주, 안산지역 갈대, 억새 등 야초류의 이용실태와 사료가치 평가

        서성(Sung Seo),김원호(Won Ho Kim),정민웅(Min Woong Jung),박형수(Hyung Soo Park),심재진(Jae Jin Shim),박진길(Jin Gil Park),성하균(Ha Guyn Sung),김종덕(Jong Duk Kim),이종경(Joung Kyong Lee) 한국초지조사료학회 2011 한국초지조사료학회지 Vol.31 No.2

        본 연구는 부존 조사료자원의 이용을 활성화하여 수입사료를 줄이고 가축 사료비를 절감하고자 2010년도에 경기 파주 (민통선 지역)와 경기 안산 (시화지구)에서 갈대와 억새 등 야초자생지를 탐색하고, 수확?이용실태 조사와 함께 사료가치를 분석하였다. 파주 민통선 내억새 (Miscanthus sinensis)와 갈대 (Phragmites communis) 혼합 자생지는 90~100 ㏊ 규모로, 1차 곤포작업으로 사일리지 520톤 (㏊당 6톤), 2차로 380톤 (㏊당 4톤)을 조제하여, 연 사일리지 900톤 (㏊당 10톤)을 생산하였다. 곤포의 유통가격은 롤당 52~55천 원으로 ㎏당 130~137.5원이었다. 곤포는 자가소비 50~70%, 판매유통 30~50%로, 수익성은 인건비 정도로 추정되었다. 초장 70 ㎝의 재생 억새는 조단백질 9.6%, 상대사료가치 82.4 (건초 4등급), 건물 소화율 67.7%, 초장 70 ㎝의 재생 갈대는 각각 13.8%, 84.3 (4등급), 67.9%로 사료가치는 높았으며, 수확이 늦어짐에 따라 사료가치는 크게 낮아졌다. 안산 시화지구 (3공구)의 갈대 등 야초류자생지는 100 ㏊ 정도로 2009년도에는 50 ㏊에서 사일리지 550톤 (㏊당 11톤)을 생산하여 롤당 50천 원에 유통하였으며, 2010년도는 잦은 강우와 장마로 부분 이용에 그쳤다. 고초기의 갈대는 건물률 89.8%, 조단백질 2.2%, NDF 80.6%, ADF 55.4%, 상대사료가치 52.9 (5등급), 건물 소화율 36.4%로 볏짚에 비해서도 사료가치는 크게 낮았다. 초장 80 ㎝의 재생 갈대는 조단백질 12.9%, 상대사료가치 99.8 (3등급), 건물 소화율 66.6%로 사료가치는 양호하였으며, 개화기의 초장 150 ㎝ 갈대는 조단백질 4.5%, 상대사료가치 59.9 (5등급), 건물 소화율 42.2%로 볏짚의 사료가치와 비슷하였다. 이상의 결과를 종합하여볼 때, 갈대, 억새 등 야초류는 현 상태에서 최대한 수거?이용하되, 사료가치를 유지하고 가축 기호성을 고려한 시기에 수확하는 것이 중요하며, 최소한 볏짚과 비슷하거나 그 이상의 사료가치를 기대하기 위해서는 7월 중순 이전 (늦어도 7월까지)에 수확?이용하는 것이 권장된다. 본 연구에서 조사된 대부분의 야초류는 상대사료가치가 75 이하인 건초 5등급으로 사료가치는 매우 낮았으며, 키가 작은 영양생장기에 수확한 경우에만 4등급으로 나타났다. 부존 조사료자원의 이용은 양질의 사료작물 생산과 병행하여 추진하는 것이 바람직하였다. This study was carried out in 2010 to investigate the utilization and nutritive value of native grasses, such as Phragmites communis and Miscanthus sinensis which might reduce the cost of feeding domestic cattle. The regions within the Civilian Control Line in Paju and Sihwa region in Ansan were surveyed. In Paju, the yearly silage production was 900 MT harvested from 90 ha (10 MT/㏊). About 30~50% of these were sold out at the marketing price of 52,000~55,000 Won per roll (130~137.5 Won/㎏). Regrown Miscanthus sinensis of 70 ㎝ in length contained 9.6% of crude protein (CP), 82.4 of relative feed value (RFV), and 67.7% of in vitro dry matter digestibility (IVDMD). Regrown Phragmites communis of 70 ㎝ in length contained 13.8% of CP, 84.3 of RFV, and 67.9% of IVDMD. As harvesting was delayed, the quality was decreased dramatically. In Ansan region, Phragmites communis plantation covers 100 ha. The silage production was 550 MT from the area of 50 ha (11 MT/㏊) in 2009. And the marketing price was 50,000 Won per roll. But in 2010 only a small amount of grasses could have been baled due to frequent and much rainfall from spring to summer season. However, the good forage quality was observed from regrown Phragmites communis of 80 ㎝ in length, 12.9% CP, 99.8 RFV and 66.6% IVDMD, while that of late matured grasses was very low, 2.2% CP, 52.9 RFV and 36.4% IVDMD, greatly lower than forage quality of rice straw. The quality of grasses at bloom stage of 150 ㎝ in length was similar to that of rice straw, showing 4.5% CP, 59.9 RFV and 42.2% IVDMD. In conclusion, the overall quality of most native grasses in this survey were very poor. Therefore, we recommend that Phragmites communis and Miscanthus sinensis should be harvested during June or July to obtain better forage quality which is richer in forage values than rice straw. Production of high quality forage crops was also desirable for self sufficiency of forage.

      • KCI등재

        한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

        조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

        Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

      • KCI등재

        한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

        조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

        Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

      • 포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

        황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

        Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

      • KCI등재

        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.

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