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.

사후분해 시체에 대한 법의학적 접근

최영식,이상용,김유훈,조갑래,이봉우,양경무,정낙은,서중석,이한영,이원태,강현욱 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.

Escherichia coli B가 생산하는 글라이코겐의 특성

양지영,이양봉 釜慶大學校 1998 釜慶大學校 論文集 Vol.3 No.2

The bacterial glycogen was prepared from the cultural broth of E. coil B. Glycogen-produing bacteria could be detected with iodine staining method. E. coli B in stationary phase was stained brown due to glycogen accumulation. But purfied glycogen from E. coli B had a different parrern in iodine reaction. While rebbit glycogen was dark brown in color, bacterial glycogen was yellow and then disappeared. This phenomenum suggested that it may have different structures between glycogen of rabbit and E. coli B. In enzymatic reaction with β-amylase, bacterial glycogen produced maltose. Rabbkt glycogen had α-1,,4 linkage but bacterial glycogen had α-1,4 and α-1,6 linkagte in methylation analysis.

우리나라 제약산업의 경쟁력 강화

양봉민,이모세 서울大學校 保健大學院 1998 보건학논집 Vol.35 No.1

With economic crisis in 1998, Korean pharmaceutical industry faces a new challenge for a change. The challenge began in 1987, when the IPR (intellectual property right) was enforced in the area of pharmaceutical products by the developed countries. Domestically, the challenge is related with the cost containment of pharmaceutical industry, analyzes problems that the industry is facing these days, and suggests future strategies for the industry to be competitive in the international market. Efforts to increase M&A among pharmaceutical firms are recommended as potential strategies.

배추흰나비 食道下神經節의 神經細胞에 관한 形態學的 硏究

梁熙永,李鳳熙,金宇甲 순천향대학교 1985 논문집 Vol.8 No.1

The study on the nerve cells in the subesophageal ganglion of adult cabbage butterfly (Pi-eris rapae L.) was performed to observe their structural characteristics. The subesophageal ganglion which had been associated to rear part of brain in the process of metamorphosis of larva to pupa was consisted of neuropile in the central region and nerve cell bodies in the rind. The nerve cell bodies were divided into three types on basis of their shapes, sizes and presence of neurosecretory granules, etc. In type I nerve cells the sizes of their cell bodies were 9.5 to 14.5μm in diameter and those of their nuclei were 7.0 to 12.0μm. The type I nerve cells which were the most typical neurons of brain nerve cells from cabbage butterflies had round or ellipsoid shapes. The type Ⅱ nerve cells had a variety of shapes, i.e., round, ellipsoid or triangle, and their sizes were 14.5 tp 20.0μm in diameter. The type Ⅱ nerve cells which included a number of neurosecretory granules were considered neurosecretory cells. The type Ⅲ nerve cells had the smallest sizes of approximately 4.5μm in diameter and their nuclei were about 2.5μm. These cells had no secretory granules in their cell bodies.

나비目 終齡幼蟲의 血球에 關한 電顯的 硏究

梁凞永,李鳳熙,鄭啓憲 순천향의과대학 1979 Journal of Soonchunhyang Medical Science Vol.2 No.1

Morphological studies on larval hemocytes of varioius insects were performed in two ways of research. Ⅰ. Finestructures. An electron microscopical study on hemocytes of last instar larvae of 12 species of Lepidoptera was performed to observe cell types, structrues, raions, relationships and their origins. The results are as follows; 1) Prohemocytes are the smallest round cells with large numlesus, poorly developed cytoplasmic organelles and lower composition ratio, accounting for less than 5% of all cell types. Little remarked differences were revealed among prohemocytes of varous insects and they are thought to be the origins of other cell types. 2) Palsmatocytes are relatively large cells with higher composition ration, accounting for about 40%. They could be subdivided into two forms, oval and spindle. Oval cells are rich in cytoplasmic projections and organelles. But the spindle cells include few of them, while nearly all of the spindle cells possess some microtubules as their cytoskeletons. Some marked difference were revealed among different insects. The most exceptional structure was the fibrous bundles located in both nucleus and cytoplasm in Sericinus telamon Donovan. 3) Granular cells are characterized by various granules in cytoplasm, and by higher composition ration, accounting for about 50% of all numbers. They could be subdivided into three forms, oval, round and spindle with fully developed cytoplasmic organelles and Projections. Cellular fractions were often noticed to be enclosed by granular cells, indicating some activities of phagocytosis. Granular cells are the most pleomo rphous of all cell types, and the most exceptional structures are the bundles of microfibrils in Phalerodonta manleyi Leech. 4) Adipohemocyte were found only in Plodia interpunctella Hubner. They are somewhat oval with few cytoplamic projections and less developed organelles. Some granular cells were found to accumulate lipid droplets into the cytoplasm by trapping floating lipid droplets, adn the adipohemocytes are believed to be originated from formers. 5) Sperule cells were found nearly in all specimens and characterized by sperules composed of flocculent materials. They are round or oval with few cytoplasmic organelles. The most conspicuous spherulesof all sperule cells were radial arrangement of sperules in Adristyrannus amurensis Staudinger and presence of the specific granules in Mamestra illoba Butler. Young sperule cells resembled the granular cells and it is possible that they originate from granular cells. 6) Oenocytoids are large cells and were found nearly in all specimens. They could be subdivided into 3 types according to their inclusions, such as microfibrils, microtubules and none of them. Young Oenocytoids resemble the giant plasmatocytes, perhaps in dicating to be originated from the latters. Ⅱ. Composition ratios of cell types from mid 5-instar to late prepupa. Composition ratios of cell types were investigated in phalerodonta manley; Leech and could be summarized as follows; 1) Prohemocytes disappeared from the stage of early prepupa. 2) Plasmatocytes increased in number at mid stages of each inster and decreased nearing to pupal stage. 3) Granular cells reached peak at early prepupal stage. 4) Adipohemocytes heavily increased at late prepupal stage. 5) Sperule cells increased at late stage of each instar and reached peak at late prepupal stage. 6) Oenocytoids increased at late stage of each instar and reached peak at early prepupal stage.

반응성 가열 증착법에 의한 수소화된 비정질 게르마늄 제작

梁承勳,李原鎭,朴奉斗 慶北大學校 1984 論文集 Vol.37 No.-

The addition of hydrogen during the evaporation of germanium has been shown to improve the electrical properties of the resulting a-Ge film considerably by saturation of dangling bonds, if the dissociation of molecular hydrogen by high voltage AC discharge takes place. Evaporation onto a substrate at 200℃ in the mood of hydrogen plasma has been shown to yield a film which shows a high resistance and an activated type conduction(with an activation energy of 0.38eV) above room temperature.

Blumlein 전송회로에 의해 선전리되는 질소레이저의 동작특성 연구

양준묵,추한태,이봉연,이치원 충남대학교 1990 忠南科學硏究誌 Vol.17 No.2

The design and construction of nitrogen laser preionized with a Blumlein transmission line circuit is described. For the power supply, we have used a pulse type high voltage power source that can be produce 10 joule energy in a pulse. The condition of maximum output power is observed at N_2 gas pressure of 100 torr, spark gap distance of 6.0 mm, repetition rate of 30Hz with preionization, and the stability increases by 0.7%. The maximum increment of output power is achieved at pressure of 200 torr when preionization is used. Finally we can increase the output power by approximately 60% by using this work, and the E/P value is 133 V㎝^(-1) torr^(-1).

飮酒運轉의 最適罰則에 관한 實證的 硏究

이재희,양봉민 서울大學校保健大學院 1995 國民保健硏究所硏究論叢 Vol.5 No.1

The goals of this study are as follows: for establishing the rational and acceptable strategy of controlling drunken-drivings, first, to estimate the social aggregate magnitude of optimal penalties for drunken-driving in order to cutting down the incidence of drunken-driving to the optimal level, for this, to estimate the total sum of social aggregate external costs caused by drunken-drivings, and finally, on the ground of this, to evaluate the current drunken-driving penalty policy. The aggregate monetary sum of personal external costs caused by drunken-drivings, namely, the won-based damages of casualties, are estimated that the monetary cost value of 330 of deaths and 9,035 of the injureds these amonted to about 19.2 billion won. The aggreagate external costs of the insurance administration related to the drunken-driving accidents amounted to 3.6 billion won and that of traffic administration as to about 0.9 billion. Hence, the total sum of social external cost, that is, the social magnitude of optimal penalties for drunke-driving was estimated to 129.0 billion won. 82.787 of drunken-drivers were booked on charge and 7,551 were restricted, through the year of 1992. The total monetary amount of penalties fined by the drunken-drivers is estimated to about 16.3 billion, and thus the current penalties were estimated to the amount of 108.0 billion won. Considering the actual condition of underestimating the cases of drunken-driving accidents from restriction of data and leaving out the gas cost and time cost made by the traffic congestions followed by drunken-driving accidents, the total sum of social external costs by drunken-drivings may be larger than that estimated in this study. Therefore it is concluded that we should augment the penalty levels for drunken-driving in view of optimal penalty. For this goal, there are needs to reinforce supervision levels and punishment levels against drunken-drivings, at the same time, the another expected cost items of drunken-drivings to be more expensive. For example, the perceived risk of drunken-drivings should be more accurately informed and the social atmosphere blaming drunken-drivings be fostered.

나선형 이중 평행판 축전기형 Blumlein 전송회로를 사용한 소형 질소레이저의 동작 특성 연구

양준묵,이치원,조돈수,이봉연 충남대학교 기초과학연구소 1995 忠南科學硏究誌 Vol.22 No.1

The design and performance of a compact nitrogen laser which consists of a Spiral multiple parallel plate capacitor type Blumlein transmission line circuit are described. The laser tube is made by 50 ㎜ long with a 2.5 ㎜ main electrode gap spacing. The output power increased with the spark gap distance. The peak power of 3.0 μJ has been obtained with a spark gap distance of 3.5 ㎜ and a repetition rate of 30㎐. The optimum nitrogen gas pressure was about 60torr independent of the variation of spark gap distance. The laser operates with repetition rate of up to 70 ㎐.