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.

흉요추 방출성 골절의 방사선학적 소견

오연희,이현경,이원재,이성우,박수성 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

A retrospective review of 22 burst fractures of the thoracolumbar spine was performed to define the radiographic features found on CT and plain radiography. Characteristic components of the injury include : 1. Male to female ratio was 2.7 : 1, and the most prevalent age was 21 to 40 years. 2. Multiple level injuries were 6 cases (27.3%), and the most common cause of injury was fall down(14 cases, 63.6%). 3. The most cammon location was L1(45.5%) 4. The most common pattern of the retropulsed fragment in burst fracture was single midline fragment type(14 cases, 63.6%) and the most common type of burst fracture was classical form(10 cases, 45.5%). 5. Posterior element involvement of vertebra was seen in Ⅱ cases(50%) and the most common finding was laminar fracture in 9 cases. 6. The degree of anterior wedging above the 50% in height of vertebral body was in 4 cases (18.2%). 7. Degree of spinal canal narrowing and degree of neurological impairment is not directly correlated.

후부비동에 관한 시신경의 해부학적 관계 : Ostiomeatal Unit CT상 연구 Ostiomeatal Unit(OMU)CT Anatomic Study

오연희,이성우 동국대학교 경주대학 1998 東國論集 Vol.17 No.1

PURPOSE : To delineate the relationship between the optic nerves and the posterior paranasal sinuses using CT data. MATERIALS AND METHODS : Direct coronal CT scans of 93 consecutive patients with chronic inflammatory sinus disease were reviewed two radiologist. The direct relationship between the optic nerves and the posterior ethmoid and sphenoid sinuses was recorded, as were indentations into the sinus wall, course of the nerve through the sinus region and bone dehiscence. RESULTS : A total of 186 optic nerves were evaluated in 93 patients. The relationship of the optic nerve to the posterior paranasal sinus fell into one of four discrete categories, type 1 through type 4. In most common form, type 1 nerves, course adjacent to the sphenoid sinus without indentation of the wall(153 nerves, 82%). Type 2 nerves course adjacent sphenoid sinus, causing indentation of the sinus wall (20 nerves, 16%). Type 3 nerves course through the sphenoid sinus(3 nerves, 2%). Type 4 nerves course immediately adjacent to the sphenoid sinus and posterior ethmoid air cell(0 nerves, 0%), Boone dehiscence was present in 11% of type 1 nerves, in 57% of type 2 nerves, and in 100% of type 3 nerves. CONCLUSION : The type 1 nerves were the most common form of the relation of the optic nerve to the posterior paranasal sinus and we had no case in contact with the posterior ethmoid sinus. Anatomic configurations that predispose the optic nerve to injury include type 2 or 3 optic nerves, bone dehiscence over the nerve. These configurations are common and should be routinely sought out so that devastating complications from surgery can be avoided.

의예과 학생들의 성격유형검사(MBTI)의 특성

오윤경,장진영,박상학,류소연 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Pmpose: To investigate the characteristics of Myers-Briggs Type Indicator (MBTI) in premedical students of one medical college and to compare the personality profiles of them with those of other studies which involved the K-orean university students and other country population. Mateiials and Methods: The MBTI was used to measure the personality profiles of premedical students at the Center for Teaching & Leaming of Chosun University. One hundred and twenty five premedical students participated in this study and the MBTI profiles of them were compared to those of K-orean university students (1,441 persons), i.e. their potential patients and those of the United Kingdom (UK.) Population (1,634 persons) and a sample of UK- doctors (313 persons) of one medical college involved in other studies. Results: The premedical students had a preference for Introversion (62%) rather than Extraversion (38%), Sensing (70%) rather than Intuition (30%), Thinking (66%) rather than Feeling (34%), and Judging (57%) rather than Perceiving (43%). There were more Thinking (66% vs 57%, p=0.071) in the premedical students than in K-orean university students with borderline significance. There were significantly more Thinking (66% vs 46%, P=0.000) and more Introversion (62% vs 48%, p=0.002) than in UK- adult population. Also there were significantly more Sensing (62% vs 48%, p=0.002), significantly less Judging (57% vs 68%, P=0.034), and more Introversion (62% vs 53%, 0=0.094) with borderline significance than in UK doctors. But no difference was shown in Thinking between the premedical students and UK- doctors, Conclusion: The personality profiles of the premedical students in this study differed in Thinking with borderline significance from K-orean university students and significantly differed from the UK adult population in Thinking and Introversion showing the cultural difference. No difference of Thinking between the premedical students and UK doctors despite of cultural difference suggests the correlation between the Thinking and medical professional choice.

고해상도 CT상 측두골의 다양한 정상 변이 : 발생빈도와 임상적 유의성 Incidence and Clinical Significance

오연희,이성우 동국대학교 경주대학 1999 東國論集 Vol.18 No.-

Purpose: We evaluated normal variation of the temporal bone on high-resolution CT and investigated their incidence and clinical significance. Materials and methods: High-resolution CT scans of the temporal bone of 74 patients were retrospectively reviewed. Six groups of variants were evaluated. These were group1 ; an incomplete bony covering of a jugular bulb, group2 ; a severe asymmetry of the jugular foramen, group3 ; an anteriorly; located sigmoid sinus, group4 ; a deep sinus tympanum. group5 ; a large internal auditory canal, group6 ; a large cochlear aqueduct, Contiguous axial secans parallel to Reid's base line were obtained. Patients with symptoms which could possibly be related to the location of variants were excluded from the group. Patients with tumors or inflammatory masses surrounding the jugular bulb, the sigmoid sinus, or sinus tympani were excluded. Patients with middle ear anomalies were also excluded. Finally patients with abnormal audiograms or congenital anomalies in the inner ear were excluded. Results: The incidences of the variations were as follows: group1; 5 cases(3.4%), group 2; 3 cases(2.0%), group3; 2 cases(1.4%), group4; 7 cases(4.7%), group5; 1 case(0.7%), group6;8cases(5.4%). A large cochlear aqueduct is the most common normal variation of temporal bone detected on high resolution CT. Other group is descending order of frequency, group4, group1, group2. Conclusion: Normal anatomical variations of the temporal bone are not rare and awareness of the possible variations in necessary before surgery on the inner ear, middle ear and posterior fossa.

췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

유한요소법에 의한 영구자석 전동기의 정특성 해석

오연호,한성진,주수원 동아대학교 공과대학 부설 한국자원개발연구소 1993 硏究報告 Vol.17 No.2

There are increasing needs for high performance small motors using permanent magnets. In this paper, the static characteristics of pm dc motor has been analyzed by finite element method. In the air gap, magnet flux densities due to only field magnet have been calculated, and the effect of armature reaction has been investigated. For torque calculation two dimensional F.E.A. with the integration of Maxwell stress tensor has been applied and show good agreement with experimental result.

Morgagni 탈장 : 1례 보고

오연희,이창욱,김승현,이성우,정병욱,이준희,박동일,권영무,신현종 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

Morgagni 탈장은 횡격막의 전내측 부위의 발달이상으로 열공을 통하여 장관이나 대망과 같은 복강내 구조물이 흉곽내로 빠져나가는 드문 질환으로 알려져 있다. 저자들은 호흡곤란을 주소로 내원하여 방사선학적 검사와 수술로 확진된 1례를 보고한다. Morgagni hernia is improperly located abdominal viscera into the thoracic cavity through the foramen of Morgagni which is a congenital defect at the anterornedial portion of diaphragm. We report a case of Morgagni hernia diagnosed by radiologic examination and operation.

Natto의 텍스쳐 및 관능적평가

오성천,서연희,조정순 명지대학교 자연과학연구소 1997 자연과학논문집 Vol.16 No.-

To make Natto, traditional Japanese food fermented by Bacillus natto, acceptable to Koreans, garlic(2%) and ginseng(2%) were added. General soybean Natto(S₁), 2% garlic Natto(S₂), 2% ginseng Natto(S₃) and black soybean Natto(S₄) were prepared. The proximate composition revealed the most moisture content in S₂ among the all samples. The most cmde protein, crude fat and ash were found in S₄. The non-fibrous and fiber contents were the most in S₁ and S₃. In the texture characteristics, hardness and gumminess were the highest in S₄. The highest springness and cohesiveness were found in S₁. Adhesiveness and chewing were the best in S₂ and S₃. In the sensory evaluation, S₃ showed the best preference, appearance and color. In the aspects of taste and texture, S₄ was mostly prefered. Flavor and viscosity of S₂ were the best among the all samples. The general soybean Natto(S₁) without any addition showed low values in most examinations and tests. In the sensory evaluation, S₃ has the best overall acceptability among the all experimental Nattos.

경동맥 죽종의 색혈류 도플러 초음파 소견

오연희,김승현,이성우,어경윤 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

한국인의 뇌경색의 가장 중요한 원인은 경동맥 죽종으로 알려져 있다. 저자들은 경동맥 죽종의 복식 초음파 및 색혈류 도플러 초음파영상을 비교·분석 하였다. 죽종 침범의 범위는 총경동맥+내경동맥+외경동맥 혹은 분지부 47.9%, 총경동맥 24.4%, 총경동맥+분지부+내경동맥 11.1%등이었다. 경동맥 협착은 중등도 53.6%, 경도 26.1%, 중도 16.3%, 위험도 3.1%, 완전폐쇠 0.9%. 표면의 형태는 매끄러운 경우 53.1%, 경도 불규칙 41.3%, 심한 불규칙 3.9% 그리고 표면 궤양이 동반된 경우 1.7%였다. 또한 죽종 내부구조의 음영도상 균일한 경우 90.5% 였고 죽종의 음영은 등에코성 40.2% 석회화 25.1%, 저에코서 22.3%등이었다. 결론적으로 복식 초음파와 색혈류 도플러 영상은 경동맥 죽종 진단에 있어서 정확하고 안전한 비침습적인 진단방법이다. Several reports have been documented that carotid atheroma presented as the mostimportant cause of cerebral infarction in Korea. Authors analysed the atheroma imaging of the carotid artery in the patients with cerebral infarction patients using duplex sonography and color flow imaging. The atheroma extents were CCA(common carotid artery)+ICA(intemal carotid artery)+ECA(external carotid artery) or BIF(bifurcation) 47.9%. CCA(common carotid artery) 24.4%, CCA(common carotid artery)+BIF(bifurcation)+ICA(lntemal carotid artery) 11.1 %. The percents of stenosis of carotid arteries were moderate 53.6%, mild 26.1 %. severe 16.3%, critical 3.1 % and occlusive 0.9%. The surface characters were smooth 53.1 %, mild irregular 41.3%, severe irregular 3.9% and ulcerated 1.7%. The atheroma texture was homogenous 90.5%, and the echogenicities of atheroma were isoecboic 40.2%, calcification 25.1 %, hypoechoic 22.3%. We concluded that duplex sonography and color flow imaging were accurate and safe non-invasive method detecting of carotid atheroma.