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.

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.

이온빔 보조증착 방법으로 제작된 Al 박막의 특성

손영호,김인수,황도원 경운대학교 산업기술연구소 1999 産業技術硏究論文誌 Vol.2 No.1

Al thin films were fabricated by using vacuum evaporation method and ion beam assisted deposition method. The effects of ion impact on Al thin films were characterized by the surface roughness and the SEM morphology. Al thin films fabricated by vacuum evaporation method were increasing surface roughness as increasing substrate temperature. Al thin films fabricated by ion beam assisted deposition method were decreasing hillock profiles and increasing density as increasing ion arrival ratio comparing to the Al thin films fabricated by vacuum evaporation method.

體內受精된 생쥐胚子의 體外成長을 利用한 培養液 및 培養過程의 精度管理

孫瑛銖 梨花女子大學校 韓國生活科學硏究院 1989 韓國生活科學硏究院 論叢 Vol.44 No.-

체외수정 및 배아의 자궁내 이식(체외수정시술)은 불임증, 특히 난관이 없거나 복구 불가능한 손상을 입은 경우에 임신할 수 있는 유일한 방법으로서 최근 괄목할 만한 발전을 계속하고 있다. 사람에서 체외수정시술이 성공하기 위해서는 실제적으로 각 단계마다 어려운 점이 많으나 특히 난자와 정자를 체외에서 수정하여 적절한 단계까지 분열이 일어난 후에 자궁내로 이식해 주는데 생체외에서 수행되는 체외수정시술과정의 정도관리는 임신성공율의 유지에 필수적이다. 즉 배양액의 선택, 배양액의 적절한 가스처리 및 평형상태의 유지, 시술과정에 사용되는 pipette나 catheter의 이중세척, 배아조작시 5% CO_2 공기상태의 유지 또는 완충배양액의 사용, 배아주변온도의 급격한 변화 방지 그리고 각종 첨가물에 대한 정도관리가 필요하다. 이와 같은 사람의 체외수정시술과정의 정도관리체계로서 생쥐배자의 체외성장의 관찰실험이 적합하다. 본 연구는 사람의 체외수정시술의 정도관리체계 확립과정의 일환으로 배양액 및 배양체계의 적합성에 대한 검증을 목적으로 체외수정시술시 사용되는 다양한 배양액에 대해서 2∼4세포기 ICR계 생쥐배자의 체외성장발달을 관찰비교하여 다음과 같은 결과를 얻었다. 1. 후기 2세포기 생쥐배자를 37℃, 5% CO_2습윤배양기를 이용하여 m-KRB, D-PBS Ham's F-10, 그리고 MEM의 4가지 배양액내에서 70±2시간 배양한 결과 포배형성율은 m-KRB에서 64.3%, D-PBS에서 52.9%, Ham's F-10에서 37.5%, MEM에서 63.2%이었으며 각 군간에 포배형성율의 통계 학적 유의한 차이는 없었다. 2. 초기 4세포기 생쥐배자를 37℃, 5% CO_2 습윤배양기를 이용하여 m-KRB, D-PBS, Ham's F-10, 그리고 MEM의 4가지 배양액내에서 14±2시간 배양시 추가분열이 일어난 배자의 비율은 m-KRB에서 86.4%, D-PBS에서 81.5%, Ham's F-10에서 76.4%, 그리고 MEM에서 65.4%이었으며 각 군간의 차이는 통계학적으로 유의하지 않았다. 한편 14±2시간 배양시 부가증대가 일어난 배자의 비율은 m-KRB에서 54.5%, D-PBS에서 37.0%, Ham's F-10에서 16.0%, 그리고 MEM에서 46.1%로서 Ham's F-10에 비해 m-KRB와 MEM에서 통계학적으로 유의하게 높게 나타났다. 3. 초기 4세포기 생쥐배자를 37℃, 5% CO_2 습윤배양기를 이용하여 m-KRB, D-PBS, Ham's F-10, 그리고 MEM의 4가지 배양액내에서 70±2시간 배양시 추가분열이 일어난 배자의 비율은 m-KRB에서 95.5%, D-PBS에서 100%, Ham's F-10에서 92.0%, 그리고 MEM에서 84.7%로서 각 군간의 차이는 통계학적으로 유의하지 않았으며 또한 포배형성비율도 m-KRB에서 90.9%, D-PBS에서 81.8%, Ham's F-10에서 64.0%, 그리고 MEM에서 65.4%로서 각 군간에 통계학적으로 유의한 차이는 보이지 않았다. 본 연구의 결과로 미루어 보아 현재 이화대학병원 산부인과 체외수정쎈터에서 사용하고있는 배양액 및 배양체계는 일차적으로 적합한 것으로 사료되며, ICR계 생쥐배자의 체외성장발달에는 초기에는 m-KRB가 가장 적합하고, Ham's F-10이 가장 부적합하며, 후기에는 4가지 배양액 간에 차이가 없는 것으로 추정되어 향후 ICR계 생쥐배자를 이용한 체외수정시술과정의 정도관리체계에는 m-KRB를 배양액으로 사용하는 것이 적절할 것으로 사료된다. This study was carried out to investigate the effect of various kinds of culture media on in vitro development of mice preimplantation embryo and to establish quality control system for the basic culture procedure adopted in human IVF & ET program. Using ICR mice, culture of preimplantation embryos in four different kinds of media(modified Kreb's Ringer Bicarbonate, Dulbelcco's Phosphate Buffered Saline, Ham's F-10, and Minimum Essential Medium) from late 2-cell or early 4-cell stage to blastocyst were done. The following results were obtained. 1. When late 2-cell stage mice embryos had been cultured at 37℃, in 5% CO_2, humidified atmosphere for 70±2hours, the blastulation rates in the various media were 64.3% in m-KRB, 52.9% in D-PBS, 37.5% in Ham's F-10, and 63.2% in MEM, respectively. The differences of blastulation rates among four different media groups were statistically insignificant. 2. When early 4-cell stage mice embryos had been cultured at 37℃, in 5% CO_2 humidified atmosphere for 14±2 hours, the cleavage rates in the various media were 86.4% in m-KRB, 81.5% in D-PBS, 76.4% in Ham's F-10, and 65.4% in MEM, respectively. The differences of cleavage rates among four different media groups were statistically insignificant. However the apposition rates in the various media were 54.5% in m-KRB, 37.6% in D-PBS, 16.0% in Ham's F-10, and 46.1% in MEM, respectively. The apposition rates in m-KPB and MEM were significantly higher than that in Ham's F-10. 3. When early 4-cell stage mice embryos had been cultured at 37℃, 5% CO_2 humidified atmosphere for 70±2 hours, the cleavage rates in the various media were 95.5% in m-KRB, 100% in D-PBS, 92.0% in Ham;s F-10 and 84.7% in MEM, respectively. The differences of cleavage rates among four different media groups were statistically insignificant. And the blastulation rates in the various media were 90.9% in m-KRB, 81.8% in D-PBS, 64.0% in Ham's F-10 and 65.4% in MEM, respectively. The differences of blastulation rates among four different media groups were also statistically insignificant. It was concluded that the media and culture procedures adopted in human in vitro fertilization & embryo transfer program were adequate, and m-KRB media had a valuable place for the quality control system using ICR mice embryos.

일개대학병원에서 수막알균 백신 사용의 경험

손동욱,이찬우,정영국,조래정,이혜경,김은실,이진수,정문현 대한감염학회 2007 감염과 화학요법 Vol.39 No.6

Meningococcal infection is a life threatening disease that leaves serious sequelae in spite of appropriate treatment, thus vaccination for high risk groups are Important for the prevention of meningococcal diseases. However, the vaccine for Neisseria meningitidis has not been available in Korea until we introduced bivalent (serogroup A and C) polysaccharide vaccine for the first time for relief works in our university hospital. The vaccine was administered from January 2005 to March 2007 to 317 persons. of the groups administered, the largest group among them were 133 (133/317, 42%) students who planned to study abroad and needed the vaccination for secure entrance to school dormitories. This group was followed by health care workers, travellers to the regions of the world with high risks of meningococcal diseases, and splenectomised patients. To ratioalize the domestic use of meningococcal vaccine, the availability of vaccines first needs to be simplified by introducing them to the domestic market; for this to be possible, the approval system for vaccines should be reformed and epidemiogical studies need to be carried out.

생쥐 1-세포기 배아의 체외성장에 미치는 Albumin의 영향

손영수 梨花女子大學校 醫科大學 醫科學硏究所 1992 EMJ (Ewha medical journal) Vol.15 No.4

This study was carried out to investigate the effect of bovine serum albumin on in vitro growth and development of mouse(C57BL×CBA) one-cell stage embryos in simple and complex media. One-cell stage mouse embryos were differentiated to two-cell stage at an identical rate regardless of the nature of the media. simple(m-KRB) or complex(Harn's F-10). When bovine serum albumin was added to the media, one-cell stage embryos were also differentiated to two-cell stage at an identical rate in both simple and complex media. So. therefore, exogenous factors such as the ingredients of media and protein supplementation did not seem to affect the early in vitro growth and development of one-cell stage mouse embryos to two-cell stage. But, the late in vitro growth and development of one-cell stage mouse embryos from two-cell stage through blastualtion in complex medium were superior to those in simple medium. And the late in vitro growth and development in bovine serum albumin supplemented simple medium was better than in bovine serum albumin free simple medium, but the late in vitro growth and development in bovine serum albumin supplemented complex medium was identical to those in bovine serum albumin free complex medium. However, there is no definite conclusion to be made for including or for omitting protein in the preparation of media for the culture of preimplantation embryos. Rather, there may be some specific needs that depend on the species of embryos and on their stage of development, and perhaps on the purity of other ingredients of the media.

수소가 함유된 비정질 탄소 박막의 FTIR 특성 연구

손영호,김인수,황도원 경운대학교 산업기술연구소 1999 産業技術硏究論文誌 Vol.2 No.1

Hydrogenated amorphous carbon(a-C:H) thin films were fabricated by electron cyclotron resonance plasma enhanced chemical vapor deposition method. The carbon and hydrogen structure of the a-C:H thin films have been investigated as functions of ECR power, CH₄/H₂ gas composition and flow rate, deposition time and DC self bias voltage. The bonding characteristics of the a-C:H thin films was analyzed using FTIR spectroscopy. The absorption peaks of the film were observed in the range of 2800∼3000 cm^-1. So bonding structure of a-C:H thin films as a function of the deposition parameter have sp³ bonding mostly and some sp² bonding. The structure of the a-C:H thin films changes CH₃ bonding to CH₂ or CH bonding as increasing deposition time. The reduction of the absorption peaks in the a-C:H thin films fabricated as a function of DC self bias voltage could be the result of dehydrogenation due to the breaking of the C-H bonds caused by increasing ion impact.

심부 매복 정중 과잉치 수술 시 마취방법 선택

민수영,송제선,이제호,최형준,손흥규,김성오 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it’s need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc. 정중 과잉치(mesiodens)는 대개 상악 절치부에서 발견되며, 주로 구개측에 위치하는 경향이 있다. 정중 과잉치의 자연맹 출 가능성이 관찰되면, 주기적으로 검사하여 구강내로 충분히 맹출한 후에 단순발치를 시행한다. 주기적 검사에서 자연맹출 소견이 보이지 않거나, 형태이상 혹은 맹출방향의 이상으로 구강 내로 자연맹출 할 가능성이 없으면, 수술적 제거방법을 고려 해야 할 것이다. 특히, 인접한 중절치나 측절치의 맹출을 방해하고 있는 상황이 관찰된다면, 빠른 시일 내에 과잉치 제거를 위 한 수술적 방법을 시도하는 것이 타당하다. 한편, 외과적 수술의 시기를 늦추는 것을 고려해야 하는 경우도 있다. 정중과잉치가 인접하여 발육중인 정상 치아의 맹출을 방해하지 않는 경우이다. 이때, 삼차원 CT사진을 촬영하여보면, 과잉치 주변으로 영구절치의 치배가 근접하여 성곽처럼 둘러 싸고 있는 것을 볼 수 있다. 미성숙한 치배가 둘러 싸고 있는 상황에서, 무리하게 과잉치를 제거하려고 시도할 경우 인접 치배 를 손상시킬 가능성을 배제하기 어렵다. 이 점을 고려 한다면, 가급적 인접한 치아의 치근이 보다 발육한 후에 수술을 시도하 는 것이 바람직할 것이다. 초등학교 2학년 이상의 어린이들은 외래에서 국소마취하 제거하는 수술방법에 대개 잘 적응하며 고학년이 될수록 보다 수월해진다. 수술시기를 너무 늦추거나, 과잉치가 너무 늦게 발견된 경우 구개측 심부로 깊이 이동한 것을 볼 수 있다. 때로는 과잉치의 위치가 처음부터 심부에 매복되어 있을 수 있다. 이와 같은 경우, 전신마취방법을 생각해 볼 수 있을 것이다. 본 증례는 상악 정중부의 깊은 부위에 역위 매복된 과잉치를 외래에서 국소마취하에 치료를 시도할 때 관찰되는 문제점을 고찰하였고, 전신마취방법을 결정하기 위한 기준을 제시하였다. 심부 매복된 치아의 외과적 발거시 어린이의 행동조절이 가장 큰 문제였으며, 방사선 소견상 과잉치 치관의 위치가 절치의 치근단보다 상방에 위치할 경우 전신마취로 전환 하는 것이 바람직 할 것으로 사료된다.

유치원 행정에서 교사의 의사결정 참여 정도가 직무 만족도에 미치는 영향에 관한 연구

孫英秀 진주여자전문대학 1996 論文集 Vol.19 No.-

Study about the effects that the rate of teacher's participation in the decision of opinions about the administration of a kindergarten has on the grade of satisfaction with thar tasks. Because a kindergarten is a systemic body if we are to achieve the purpose or aim of the institute, we must develop the lobby of the institute. And there are usually some factors that make us determine whether the results of systemic activities are desirable or not. To know the way in which a systemic body is more efficiently operated and it accomplishes, we need to know the effects that the rate of teacher's participation in the decision of opinions, about the administration of s systemic body or a kindergarten. Therefore, it is so rare in the bureaucratic administration that teachers take part in the decision of opinions about the administration of the kindergarten. But now the wind of change blow to the administration of the kindergarten and the attitudes of the chief and teacher's of the kindergarten. In other words, they become open-hearted. Consequently, it is very important that teacher's participation in the decision of opinions about the administration of the kindergarten. Through the theoretic consideration concerning the model of the decision of opinions, the decision course of opinions, the participants who take part in the decision of opinions, the degree of satisfaction with their tasks, we can conclude that most of the kindergarten teachers want to take part in the decision of opinions. But, the administration authorities of the kindergarten doesn't want the unconditional participation in the decision of the opinions of the teachers. Most teachers are satisfied with their participation in the decision of opinions, but some of the teachers feel stressed and are unsatisfied with their task. Accordingly, the problem about teacher's participation has a considerable relationship with teacher's technical knowledge, relationship, career and other factors. When teachers have technical knowledge, relationship and more than 5 years experiences in that field, they usually feel satisfied with their task by taking part in the decision of opinions. But, when they scarcely have technical knowledge, relationship, and less than 3 year experiences, they usually feel stressed (unsatisfied) about their particpation over their ability in the decision of opinions.

유아의 색채 사용을 통한 성격분석 방법에 관한 연구

孫英秀 진주여자전문대학 1994 論文集 Vol.17 No.-

This thesis was aimed at the research of characteristic analysis through the use of colors infants At first, the writer surveyed the differences between the sexes in infants and the development of concept to colors in order to know the mentality about colors in infants. The next, the writer discovered the fact that the preference of colors in infants is caused by the three primary colors through the research of the prefering colors in infants. At third, the writer surveyed that what is the relation of these color preferences to the infants' personaities through the theses of V.Lowenfeld, R.H.Alchuler, Atsuri, and Kim Jae-eun. The writer used the method of unconditioned test by Atsuri of Japan He analized the results to which he made draw the free paintings by presenting the twenty-four color pastel Crayon. And the writer presented the method of surveying the relation of colors to the Personalities of infants through the analystic criteria. The problems wich was presented from the characteristic analysis about the color use are as the followings; the colors which infants use had the tendency of using by impulse not by preference, and as the result, these were often uncertain. Haweve, the writer discovered the fact that the uses by impulse are also related with the personality in infants. As the result, the writer presents the much more studies on this area to the teachers for infants.