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.

프로스타글란딘 E₁에칠에스테르의 외용 리오겔 제제 설계

양성운,이진교,이지은,김희규,박혜숙,김종석,최한곤,용철순,최영욱 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.2

External lyogels containing prostaglandin E₁ethyl ester(PGE₁-EE), a produrg of prostaglandin E₁(PGE₁) as a therapeutic agent for erectile dysfunction, were formulated to overcome the aqueous instability and enhance the percutaneous absorption. Lyogels of PGE₁-EE were prepared with ethanol (EtOH)/proplyene glycol (PG) cosolvent system as a vehicle, cineol as an enhancer, and hydroxypropylcellusose as a gelling agent. In vitro percutaneous absorption studies were performed to determine the rate of PGE₁ absorption through rat or hairless mouse skin. The permeability of PGE₁-EE lyogel with enhancer was 16-fold greater than that of lyogel without enhancer. Cosolvent produced 9-fold increase in percutaneous absorption. Pharmacodynamic effects of lyogels were evaluated in mature male cats in terms of intracavernosal pressure (ICP). Lyogles containing 0.01% of PGE₁-EE showed higher ICP compared to intraurethral preparation of PGE₁(1%) and enhancer-free control lyogel. The shelf-life (t_(10%) of lyogel at refrigerated condition (4℃) was calculated as 928 days, which is 4.2 times longer than that of control hydrogel. As a result, PGE₁-EE was formulated successfully to a lyogel system with a selective enhancer and cosolvent system for the topical delivery of PGE₁.

급성충소돌기염의 임상 : 병리학적 고찰

양기화,조준필,하영천,한진우,정학재,손수창,이성희,황재훈,신철호 최신의학사 1989 最新醫學 Vol.32 No.4

大學校 敎職員의 健康實態에 관한 基礎的 調査硏究

양점홍,황철문,남태호,백영호,윤양진,황영성 부산대학교 사범대학 1993 교사교육연구 Vol.26 No.-

The purpose of this study was to analyze the staffs' health of P. University through survey research. Also, the staffs's health problem was analyzed by the regular health test's result and their lifestyle. The results were as following: 1. The analysis of lifestyle (1) A habit of smoking 1. It was presented the male smokers(55.9%) and females smokers(0.6%) of P. university staffs were found in this study. 2. It was presented the male smokers smoked average 18.2 pieces a day. Also, they began to smoke cigarette 21.5 years old. 3. The persistent smokers were 24.6% and 52.2% of smokers be going to quit smoking cigarette someday in the future. (2) A habit of drinking 1. It was presented 85.7% of males and 59.1% of females subject drinking normally. 2. It was presented 3.7% of male subjects were drinking alcohol almost everyday in a week. 3. The most frequent kind of alcohol is as following order a beer(males 67.6% & females 79.6%) and a soju(males 28.3% & females 4.3%). Males drunken average amount of beer was 2 bottles(640ml) and females drunken average amount of beer was 0.8 bottles in a week. (3) A habit of exercise 1. It was presented males (29.0%) and females (15.1%) were exercising regularly, but males (23.3%) and females (38.6%) of staffs were not exercise at all. 2. It was found males' regular kind of exercise was as following order mountain-climbing, tennis, and jogging and females' regular kind of exercise was as order swimming, free handing exercise, and mountain-climbing. 3. It was presented 25.1% of staffs exercised 6 times a week regularly. And each times of exercise, 37.3% of staffs spent less than 30 minutes. 4. It was presented staffs exercised for health (72.4%) and 48.4% of staffs could not exercise as following reasons of not enough times, home work, research.... 5. Male staffs prefer as following order kind of sport tennis, swimming, and golf and female staffs prefer as following order kind of sport swimming, tennis, and bowling in the future. (4) A habit of eating 1. It was presented 5.5% of males and 16.6% of females did not have a breakfast regularly. 2. Concerning balance of food content: do not concerning food (males 34.7% & females 23.8%) and subjects like vegetables 9males 25.7% & females 32.7%) were found. 3. It was presented 8.5% of males and 5.4% of females took the vitamin regularly. (5) Health condition 1. In present evaluation for subject's health condition, very healthy (males 7.5% & females 6.0%) and poor health (males 2.0% & females 1.8%) were found in this study. 2. In present evaluation criterion for subject's health condition, the ability of adaptation on fatigue was appeared the most (males 35.9% & females 40.7%). 3. It was presented subjects have a digestive trouble (males 23.5% & females 33.1%) which were the best health problem in subjects. 2. A analysis of result of regular health test (1) Physique test 1. It was presented height (males 169.5cm & females 158.6cm) and body weight (males 65.9kg & females 53.1kg) were found in this study. 2. According to this study, obesity (males 11.2% & females 5.6%) and low body weight (males 8.8% & females 14.8%) were found in this study. 3. A high blood pressure subject (males 8.7% & females 2.5%) over than a contraction blood pressure 140mmHg and A high blood pressure subject (males 8.5% & females 1.9%) over than a expansion blood pressure 90mmHg were found in this study. (2) A blood test 1. Normal hemoglobin of subject (males 99.8% & females 62.3%) and 37.7% of females less than normal hemoglobin were found in this study. 2. 5.3% of males and 2.5% of females have greater than a concentration of glucose 140mg/dl, but there was anyone less than a concentration of glucose 50mg/dl. 3. The greater than 251mg/dl staff''s T.C.(males 7.1% & females 4.9%) and the less than 130mg/dl staffs' T.C.(males 2.0% & females 3.7%) were found in this study. 4. It was found males 5.3%, 11.6% & females 1.9%, 4.3% were presented greater than GOT and GPT 341U/L. (3) Hepatitis, Urinary Sugar, and Urinary Protein test 1. According to this study result, positive hepatitis was presented males (6.5%) and female(4.3%). 2. Urinary sugar is greater than +- males (1.8%) and females (2.4%) were found in this study. 3. Urinary protein is greater than +- males (1.6%) and females (1.8%) were found in this study. (4) Chest X-ray test 1. It was found male (1.6%) suffered from tuberculosis of the lungs. (5) Dental test 1. It was presented 77.3% of males and 88.9% of females was not existed the upper caries. Also, 75.7% of males and 90.7% of females was not existed the bottom caries. 2. It was presented 96.8% of males and 99.4% of females had the non-deficit of teeth in the upper part of teeth. Also, 93.9% of males and 98.1% of females had the non-deficit of teeth in the bottom part of teeth. 3. It was presented 19% of males and 3.7% of females have the periodontal disease. (6) General report and judgment 1. In general report, it was found 75.3% of males and 91.4% of females were the normal health condition. It was presented 9.1% of males and 4.9% of females were the liver disease, 4.9% of males and 1.2% of females were the sugar diabetes, 4.9% of males and 0.6% of females were the high blood pressure, and 1.4% of males and 1.9% of females were high arrest of bleeding. 2. In general judgment, it was presented 75.5% of males and 91.4% of females were the normal health condition. However, it was presented 17.8% of males and 7.4% of females were required high observation, 6.7% of males and 1.2% of females were required simple observation. As presented P. University staffs' lifestyle, it was found still many staffs have not right living habit. It is necessary to be wellness of lifestyle and satisfaction of life through correction of self responsibility and management in their life. Therefore, it is possible to live with healthy in better quality of life which is high quality of life and new concept of health were offered. Also, researcher expected the regular health examination be more practical contents than informal contents. Researcher recommended that it is necessary to support the university administration to be more flexibility of the regular health examination day than set the certain day of regular health examination and it required to create a way of using the P. university hospital.

수소화된 비정질 규소에서 바이어스에 의한 실리사이드 형성

梁承勳,金鐵河,李原鎭 慶北大學校 1990 論文集 Vol.49 No.-

We show that biased annealing of a-Si:H contacted with metal gives rise to silicide growth and the creation of metastable states that can be to some extent removed by unbiased annealing. This paper gives the first report of a direct correlation of Ⅰ-Ⅴ characteristics to silicide growth in a-Si: H. Variations of Ⅰ-Ⅴ characteristics with annealing biases are analysed by the two series-connected diodes model.

만성 부비동염에서 섬모운동과 전산화 단층촬영에서의 상악동 점막비후의 상관관계

민양기,전상준,이재서,이철회,이강수,윤자복,이원진,박광석 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.7

유연한 수리계획 작성을 위한 모형관리자의 설계 및 구현

양영철,장양자,김기동,박진우 한국경영과학회 2001 한국경영과학회 학술대회논문집 Vol.- No.1(2)

Recently, in the competitive environments, every company recognizes the importance of planning models. However, there are so many problems in correctly applying mathematical model to the real world. Because mathematical modeling packages, especially, charge planning managers with understanding the models and responsibility for generating plans, fast and accurate model cannot be generated with ease. In this paper, we design the system that helps planning managers flexibly create and modify mathematical models and manage model versions. Also, we implement this model management system with model base concept.

이면성 및 도플러 심초음파도를 이용하여 진단한 선천성 거대 좌회선지-좌심실 관동맥루

진승원,박준철,이영중,유병현,박현옥,김용주,윤호중,김재형,홍순조,최규보,권종범,원용순,박건 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

정신분열병 환자에서 정신병적 증상과 위스콘신카드 분류검사와의 관계

엄양기,김철권,조진석,변원탄 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

The purpose of this study was to investigate 1) the difference of performance on the Wisconsin Card Sorting Test(WCST) between schizophrenecs and normal controls, 2) and the change of performance while clinically improved. WCSTs were administered in 28 schizophrenics and 32 normal controls. The results were as follows. 1) Schizophrenic patients performed poorly on the WCST compared to normal controls. 2) There was no significant change of performance in WCST as clinical symptoms improved 3) There was no significant correlation between the performance of the Wisconsin Card Sorting Test and age, sex, education level and volcabulary test in both groups. These findings suggest that the WCST mat be an indicator of vulnerability to schizophrenia.

Creutzfeldt-Jacob병 1례

홍승철,한진희,정종현,김소양,허균,이성필 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

저자들은 Creutzfeldt-Jacob병 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 약 4개월에 걸친 비교적 짧은 기간 동안 중증의 인지 기능 장애와 시각 장애, 보행장애와 하지의 약화, 불수의적 운동 등과 함께 섬망상태에까지 이르게 되어 본원 정신과에 입원하게 되었다. 정신상태 검사상, 반응시간의 지체, 언어장애와 보속증, 시간에 대한 지남력 장애, 주의 집중력 장애, 단기 및 장기 기억 장애, 추상적 사고능력 장애 등의 소견을 보였고, 이러한 증상들은 입원후 치료에도 불구하고 빠르게 악화되었다. 뇌파검사상 지속적인 다발초점성 서파가 모든 전극에서, 특히 우측 전두부에서 현저하게 나타나는 소견을 보였고, 병리조직학적 검사상 대뇌 피질에 신경손실을 동반한 해면화와 신경교 증식증을 나타냈다. 이상의 소견들은 모두 CJD의 진단에 합당하였다. We report a case of Creutzfeldt-Jacob disease and review the relevant literatures. This 56-year-old male patient was admitted to our hospital with a history of rapidly progressing cognitive dysfunction, visual disturbance, gait disturbance, weakness, involuntary movement of lower extremities, and the symptoms of delirium. On mental status examination, he showed psychomotor retardation, speech disturbance, perseveration, disorientation, impairment of short-term and long-term memory, and inability of abstract thinking. He had a rapid downhill course, along with shakiness of trunk, rigidity of the limbs, myoclonus, confusion, and finally, inability to speak or move on the bedside. On electroencephalogram(EEG), continuous multifocal show delta activities were found in all leads, especially in the right frontal areas. Brain biopsy showed, spongiosis with neuronal loss and gliosis noted at the cerebral cortex. These findings were compatible with Creutzfeldt-Jacob disease.