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.

Clinical Significance of Classification of Graves` Disease According to the Characteristics of TSH receptor Antibodies

(Won Bae Kim),(Hyun Kyung Chung),(Young Joo Park),(Do Joon Park),(Hong Kyu Lee),(Bo Youn Cho) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

N/A Background:It has been widely accepted that the epitope (s) and/or functional characteristics of thyrotropin receptor antibodies (TSHRAb) from Graves` patients are heterogenous among patients. However, the clinical significance of such heterogeneity has not been systematically evaluatedyet. We were to elucidate and find the clinical significance of heterogeneity for TSH receptor antibodies in Graves` disease. Methods:We measured stimulating TSHRAb (TSAb) activities using CHO-hTSHR cells, FRTL-5 cells and chimeric receptor expressing cells (Mc1+2 and Mc2), specific blocking TSHRAb (TSBAb) activities using Mc2 cells and TBII activities using porcine thyroid membrane in 136 patients with untreated hyperthyroid Graves` disease. Results: Based on various TSHRAb activities from each patient, the patients could be categorized into 7 subgroups by cluster analysis; 1) Group 1 (n=41) was characterized by moderate TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, typical TSAb epitope, rare blocking antibodies and high TBII activities. 2) Group 2 (n=16) was characterized by the presence of blocking TSHRAb in most patients, albeit the other characteristics were the same as those in Group 1. 3) Group 3 (n=19) patients had low TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, seldom had blocking TSHRAb, but they had high TBII activities. 4) Group 4 (n=30) could be categorized as `mild disease` group, as they had low activities in all kinds of TSHRAb assay and had low antim icrosomal antibody activities. 5) Group 5 (n=14) was characterized by moderate TSAb activities with atypical epitope (s), rare blocking TSHRAb and moderate TBII activities. 6) Group 6 (n=10) patients had veryhigh TSAb activities with typical epitopes, seldom blocking TSHRAb and low TBII activities. 7) Group 7 (n=6) was characterized by very high TSAb activities with atypical epitopes and high TBII activities. Pretreatment serum thyroid hormone level was low only in group 4 patients compared to the other 6 groups (p<0.05). The size of goiter was significantly larger in those in group 1 and group 3 (p<0.05) compared to the other 5 groups. The prevalence of clinically significant ophthalmopathy was higher in group 2 patients than the other 6 groups (50%vs.27.5%,p=0.06). Among 6 kinds of TSHRAb activities, only the blocking TSHRAb activity was significantly associated with the presence of ophthalmopathy in multivariate analysis. Conclusion:These results suggest that the differences inepitopes for TSAb or the presence of blocking TSHRAb is not a major factor in determining the degree of thyrotoxicosis in Graves` disease. Although the pathogenic mechanism is not clearyet, we suggest that patients with ophthalmopathy have different TSHRAb repertoire from those without ophthalmopathy in Graves` disease.

염기성 섬유아세포성장인자가 치주인대세포 및 치은섬유아세포의 증식능에 미치는 영향

조영준 경북대학교치과대학 1995 慶北齒大論文集 Vol.12 No.2

염기성 섬유아세포성장인자가 치주인대세표 및 치은섬유아세포의 증식능에 미치는 영향

조영준 慶北大學校 齒科大學 1995 慶北齒大論文集 Vol.12 No.2

미분화중배엽세포에 강력한 유사분열효과가 있다고 알려진 염기성 섬유아세포성장인자를 초기배양한 치주인대세포와 치은섬유아세포에 각기 다른 농도와 시간에 따라 주입했을때 두 세포의 세포증식능에 미치는 영향을 알아보고 각 조건에 따른 두 세포간의 증식능을 상호 비교해 보고자 본 실험을 실시하였다. 교정치료를 목적으로 내원한 환자의 제 1 소구치 부위의 정상치은을 절개하고, 건강한 제 1 소구치를 발거하여 치은섬유아세포와 치주인대세포를 분리, 배양하여 염기성 섬유아세포성장인자를 주입시키지 않은 군을 대조군으로 하고, 염기섬 섬유아세포성장인자를 각각 0.1, 1, 10, 50, 100ng/ml로 주입시킨 군을 실험군으로하여 24시간, 48시간 , 72시간 동안 배양하였으며, 각 시간별 배양6시간 전에 10㎕/200㎕의 5-Bromo-2'-deoxy-uridine을 첨가하여 5-Bromo-2'-deoxy-uridine이 DNA내로 편재되는 양으로써 두세포군의 증식능을 측정하여 다음과 같은 결과를 얻었다. 치은섬유아세포에 염기성 섬유아세포성장인자를 주입후 24, 48, 72시간 동안 배양시 각시간별로 농도의존형으로 증가하는 경향을 보였으며 24, 48 시간 배양시 세포의 증식능은 유사하였으나, 72시간 배양시에는 24, 48시간 배양시에 비해 증식능이 전반적으로 감소라는 경향을 보였다. 24시간 배양시에는 모든 실험군에서 , 48시간 동안 배양시에는 1ng/ml를 제외한 모든 실험군에서 , 72시간 배양시에는 1, 10ng/ml를 제외한 모든 실험군에서 대조군에 비해 통계적으로 유의한 차이(P<0.01, P<0.05)를 나타내었다. 치주인대세포에 염기성 섬유아세포성장인자를 주입후 24, 48, 72시간 동안 배양시 각시간별로 50ng/ml 주입군까지 농도의존적으로 증가하였다가 100ng/ml 주입군에서 감소하는 경향을 보였으며, 48시간 배양시까지 증가하다가 72시간 배양시에는 24, 48시간에 비해 증식능이 다소 감소하는 경향을 보였다. 24시간 동안 배양시에는 0.1ng/ml를 제외한 모든 실험군에서, 48시간 동안 배양시에는 모든 실험군에서, 72시간 동안 배양시에는 0.1, 10ng/ml를 제외한 모든 실험군에서 대조군에 비해 통계적으로 유의한 차이(P<0.01, P<0.05)를 나타내었다. 치주인대세포와 치은섬유아세포의 증식능을 비교해 보면, 24시간 배양시에 0.1, 1, 100ng/ml 주입군에서 치주인대세포가 치은섬유아세포보다 조금 더 낮은 경향을 나타내었고, 두 세포 상호간에 0.1, 1ng/ml 투여한 실험군에서 통계적으로 유의한 차이(P<0.01)를 나타내었다. 48시간 배양시에는 100ng/ml 주입군을 제외한 모든 실험군에서 치주인대세포가 치은섬유아세포보다 증식능이 더 높은 경향을 나타내었으며, 두 세포 상호간에 10, 50ng/ml에서 통계적으로 유의한 차이 (P<0.01, P<0.05)를 나타내었다. 72시간 배양시에는 10ng/ml까지 비슷한 경향을 보이다가 50, 100ng/ml에서 치주인대세포가 치은섬유아세포보다 그 증식능이 더 높은 경향을 나타내었으며, 두 세포 상호간에 1, 10ng/ml를 제외한 모든 실험군에서 통계적으로 유의한 차이(P<0.01, P<0.05)를 나타내었다. The use of basic fibroblast growth factor which function as potent biologic mediators regulating numerous activities of wound healing has been suggested for the promotion of periodontal regeneration. The mitogenic effects of basic fibroblast growth factor on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of 5-Bromo-2'-deoxy-uridine into DNA of the cells in a dose-dependent manner. The cells which were prepared were the primary cultured gingival fibroblasts and periodontal ligament cells from human the fourth or sixth subpassages were used in the experiments. The cells which were seeded DMEM contain 10% FBS. The added concentrations of basic fibroblast growth factor were 0.1, 1, 10, 50, 100ηg/ml and basic fibroblast growth factor were added to the quiescent cells for 24 hours, 48 hours and 72 hours. They were labeled with 10μl/200μl 5-Bromo-2'-deoxy-uridine for the last 6 hours of each culture. The results of the five determinants were presented as mean and S.D.. The results were as follws : The DNA synthetic activity of human gingival fibroblasts was increased dose dependently by basic fibroblast growth factor at 24 hours, 48 hours and 72 hours. The similar mitogenic effects were at the 24 and 48 hours of basic fibroblast growth factor, but the DNA synthetic activity of human gingival fibroblasts generally decreased at 72 hours. The DNA synthetic activity of human periodontal ligament cells was increased dose dependently to 50ηg/ml by basic fibroblast growth factor at 24, 48 and 72 hours, but the DNA synthetic activity decreased at 100ηg/ml of each hour. Generally the maximum mitogenic effects were at the 48 hours application of basic fibroblast growth factor. The DNA synthetic activity of human periodontal ligament cells generally decreased lower at 72 hours than at 24, 48 hours the application of basic fibroblast growth factor. In the comparison of DNA synthetic activity between human gingival fibroblasts and human periodontal ligament cells human periodontal ligament cells had slightly higher proliferation activity than human gingival fibroblasts for a longer time at the high dosage of the basic fibroblast growth factor. In conclusion, basic fibroblast growth factor have important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, and thus may be useful for clinical applications in periodontal regenerative procedures.

직선화된 와이어의 버 없는 전단기 개발에 관한 연구

조준원,김웅겸,김헌영,김병의 강원대학교 산업기술연구소 2005 産業技術硏究 Vol.25 No.B

Micro wires manufactured by the straightening process are used in the BT(Bio-Technology), IT(Information-technology), NT(Nano-Technology). We have developed a novel wire straightener which uses the direct heating method(DHM) for straightening the micro wire and shearing device for burr-less cutting. In this study, we confirm the tendency of micro wire after the shearing process. It is impossible to remove the burr in the shearing process. However, the embodiment of minimum burr size after the shearing process is the best in-process method. In order to minimize the burr size, we have accomplished the various experiment condition such as the U-groove, the effect of counter punch, the shear angle, clearance.

구개열에서 비인두강의 생리해부학적 구조와 과비음과의 연관성 연구

조준희,표화영,최홍식,최병재,손흥규,심현섭 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

비인강폐쇄란 연구개, 인두측벽 그리고 인두후벽간의 움직임이 서로 조화되어 구강과 비강을 나누어주는 괄약근 기전으로서 연하, 호흡, 발음 등의 생리적기능에 중요한 역할을 한다. 이 기능에 문제가 생긴 경우를 비인강폐쇄부전이라하며 그 원인으로는 (1) 연구개의 길이 및 움직임이상 (2) 비인두강의 해부학적 공간문제 (3) 인두 후벽과 측벽의 기능이상 등이 있다. 본 연구는 구개열 환자의 측면두부방사선계측사진을 통해 비인두강을 생리해부학적으로 분석하였으며 산출된 말소리의 과비음정도를 Nasometer로 평가하였다. 이로부터 얻은 정상군과 구개열환자군의 결과를 각각 비교하였으며, 비인강폐쇄부전과의 연관성을 알아보기 위하여 Anatomic VPI와 Nasalance score의 값을 비교분석하였다. 얻어진 결과는 다음과 같았다. 1. 측면두부방사선계측사진 결과, 연구개 길이, 연구개 두께, 비인강 깊이, 비인강 면적, Adequate ratio에서 두 그룹간 유의한 차이를 나타내었다. 2. Nasometer 결과. 모음/오/와 구강공명음문장, 구강장해음문장에서 두 그룹 간 유의한 차이를 나타내었다. 3. 구개열환자군에서 비인두강의 폐쇄부전 정도를 표현해주는 Anatomic VPI와 Nasalance score는 전반적으로 연관성이 없었다. 다만, 모음/이/와 일부 구강자음으로 이루어진 문장에서 다소의 상관성을 나타내었다. 결론적으로, 측면두부방사선계측사진과 Nasometer 각각의 검사결과에서 두 그룹간 유의한 차이를 찾아볼 수 있었으나, 구개열환자군내에서 비인강폐쇄부전을 표현하는 Anatomic VPI와 Nasalance score는 모음/이/와 구강자음을 포함한 문장을 제외하고는 전반적으로 연관성이 없었다. Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall. The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction. The following results were obtained : 1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups. 2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants. 3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated. In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group. Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.

용융염 LiCl-Li_2O-Li_3N에서 316LN SS의 용접부 부식거동

조수행,홍순석,신영준,박성원 한국공업화학회 2003 응용화학 Vol.7 No.1

In the development of the advanced spent fuel management process based on the molten salt technology, it is essential to choose the optimum material for the process equipment handling molten salt. As a part of assessment and application of the strutural material for the molten salt handling system, corrosion behavior of 316LN ss weld in the molten salts was investigated. In a molten salt of LiCI-Li_2O, the oxide scales of LiCrO_2 and Li_4M_0O_5 were formed at the rate of similar linear kinetics. But in the molten salt of lI-Li_2O-Li_3N, the oxide and nitride scales of Li_4M_0O_5 and M_02N were formed at the rate of simliar linear kinetics. The corrosion rate of 316 LN ss in the molten salt of LiCI-Li_2O was lower than that in the molten salt of LiCI-Li_2O-Li_3N.

해양 레저스포츠 관광상품화 개발을 위한 대학과 지방자치 단체간의 커뮤니케이션 모형개발(Ⅰ)

조재기,신영균,손명준 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

This study utilized antecedent studies and statistics made by local governments and other public organizations in order to obtain objective data necessary for the development of marine-leisure tourism products, and adopted related literature research and descriptive analysis as its primary method of data analysis. Based on the primary research, case study by means of field study in advanced countries was adopted in the stage of the secondary research, which aimed to draw inductive reasoning necessary for understanding the circumstances of commercializing marine-leisure sports tourism. The tertiary analysis intended to understand policies related to marine-leisure tourism product development and to design a tourism product, which takes B! usan as its model. The research results are as follows: 1. It is necessary to construct sustainable and organized policies and systems after the public hearing led by the local government and supported by local universities throughout the whole process of developing a marine-leisure tourism product so that the concept of sustenance can be applied. 2. In order to judge and measure the potential for sustainable development of marine-leisure tourism, an index of sustainable tourism should be developed by academic institutes like universities. 3. An event to publicize investment opportunities in marine-leisure tourism should be held under the joint sponsorship of local governments and universities so that enterprises at home and abroad can take interest in investment and further move on to sign an MOU. 4. As past tourist attraction development caused damage to natural environment and ignorance of profitability, the direction of the future marine-leisure tourism development should be separated into the tourism product developmenmt and tourist attraction development. 5. An academy to train professionals in the field of marine-leisure tourism should be established by the joint supervision of the local government and universities. 6. Korean-style marine-leisure sports should take root in the social system and be standardized. 7. Marine-leisure sports should take root in the social system and be standardized. 8. Tourism products using large-scale cruisers should be developed. 9. Coastal cruise course should be developed.

Southern hybridization에 의한 옥수수α-amylase 遺傳子分析

趙駿衡,金容旭 동국대학교 농림과학연구소 1993 農林科學 論文集 Vol.17 No.-

Total genomic DNA isolation from maize shoot was easier and more efficient than isolation from aleurone layers of seeds. During DNA isolation, it was possible to purify total genomic DNA mays by RNase A and phenol : chloroform extraction without repeated processes. As a result of agarose gel electrophoresis, total genomic DNA of maize was a macromolecule which had more than 23 kilo-base in comparison with the size marker, λ/Hind Ⅲ. DNA fragments digested by BamH Ⅰ, EcoR Ⅰ, and Hind Ⅲ were more than 1 kilo-base and DNA fragments digested with Sau 3A Ⅰ and Taq Ⅰ was less than 1 kilo-base in length. At the same treatment time, the reason of different moving distance of digested DNA fragments, DNA sequance sites recignized and digested with each restriction endonucleases would be specific. DNA fragments by Sau3A Ⅰ and Taq Ⅰ were more migrated than those by BamH Ⅰ, EcoR Ⅰ, and Hind Ⅲ at the same time. Enhanced chemilluminescence (ECL) gene detection system was better than then ^32P― radiolabelling method for α-amylase gene detection. Southern hyridization detection signal was similar to agaross gel electrophoretic band pattern observed. It was observed that binding was specific and α-amylase genes were present in isolate total genomic DNA of maize. Also, maize α-amylase genes might have conserved region which appeared in other cereals, and high level homology would be expected among these genes, maize, and other cereal crops. It seemed that utilization of DNA framents digested by EcoR Ⅰ, Hind Ⅲ, and Sau3A Ⅰ would be mostly efficient in α-amylase genomic DNA cloning.

중환자에서 APACHE Ⅲ score와 사망율과의 관계

조준필,김준식,이영주 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

To evaluate the relationship between APACHE Ⅲ score and mortality in critically ill adult ICU patient, we studied the 548 patients who were admitted to the ICU from June 1, 1994 to January 31, 1995. We did not include patients with burn injuries, patients aged less than 15 years, or chest pain patients, in order to rule out myocardial infarction and unsatisfactory data files. There were 120 multiple trauma patients, 68 sepsis patients, 62 hemorrhagic shock patients, 20 multiple organ failure patients, and 120 patients with, among other conditions, durg intoxi-cation, diabetic ketoacidosis, renal failure, hepatic encephalopathy, and cerebral hemorrhage or infarction. The APACHE Ⅲ scores of survivors and non-survivors were analyzed with Chi-square test and compared. The number of nonsurvivors was 168 patients, and the overall mortality rate was 30.7%. there was a positive correlation between a high APACHE Ⅲ score and mortality ; all patients with more than 90 points expired. The average points of the survivors was 34.52 ±15.48 and of nonsurvivors was 77.74 ±31.37. The difference between each group is significant statistically. The average APACHE Ⅲ points was 47.8. The APACHE Ⅲ score is a good prognostic tool to predict the mortality rate in ICU adult patients, and can be used for selection of patients and for ICU admission/discharge. It can also be used to compare the efficacy of intensive care in different hospitals.