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.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

데이터 마이닝 접근방법에 의한 기업 도산 예측

정병화,지원철 弘益大學校 科學技術硏究所 2000 科學技術硏究論文集 Vol.11 No.-

Bankruptcy Prediction is a noble application of data mining. We attempt to analyze korean companies which were bankrupted or in financial insolvency after IMF is introduced, using Frailty Model. Frailty model has the advantage that it can consider multiple observations over some periods, while neither MDA nor Logit analysis can. Firstly, we build the model according to frailty analysis, and remodel the prediction model to estimate the parameters using hierarchical generalized linear model. The model select the ratio of interest over sales volume as a most influential factor in predicting bankruptcy.

장기간 수영운동에 참가한 중년여성의 신체구성과 건강체력 특성에 대한 연구

전종귀,성민철,이창규,현광석,조병준 충남대학교 체육과학연구소 2000 體育科學硏究誌 Vol.18 No.1

The purpose of this study was to identify the effects of swimming exercise career on the middle-aged women. The number of sujects were 44 postmenopausal women(45-60 age group). The number of exercise group were 27(3 years average career) and that of control group were 17, Percent body fat physical development score, back strength, grip strength, trunk flexion, endurance were measured. The results were as followings; 1. The percent body fat, physical development score, back strength, grip strength, endurance of swimming exercise group was higher than that of control group. The difference showed the statistical significance. The trunk flexion and grip strength of swimming exercise group were lower than that of control group. The difference didn't showed the statistical significance. 2. The back strength, muscle endurance, endurance of swimming exercise 7 years average career group was higher than that of 3 years average career group. The difference showed the statistical significance. As the above, the regular participation of swimming exercise help the middle-aged women to promote their health-related fitness. Also the exercise prevent obesity, back pain.

분자선 Epitaxy법에 의해 MgO(100) 및 MgO/Si(111) 기판위에 증착된 YBa_2Cu_3O_7-x 박막의 초전도 및 결정특성(Ⅰ)

장호정,김병철 단국대학교 신소재기술연구소 1993 신소재 Vol.3 No.-

분자선 Epitaxy법에 의해 MgO(100) 및 MgO/Si(111) 기판위에 기판온도 590℃, chamber압력 9.5×10^-5 Torr의 증착조건에서 YBA_2Cu_3O_7-x (YBCO)박막을 제작하여 초전도 및 결정특성을 조사하였다. MgO(100) 단결정 기판위에 증착된 YBCO박막은 초전도 전이온도 Tc_zero 86K의 표면이 거칠은 단결정 박막을 재현성있게 얻을 수 있었다. 또한 MgO/Si(111)기판위에 증착된 박막시료의 경우 Tc_zero 75K의 다결정의 결정특성을 나타내었다. XRD분석결과 양쪽시료 모두 기판위에 수직한 c축 배향구조를 나타내었고, rocking curve의 FWHM(Full width at half maximum) 값은 MgO(100)기판위에 증착된 박막이 0.65°로써 더 작은 값을 나타내어 c축 배향성이 개선되었음을 알 수 있었다. SEM에 의해 표면조직을 관찰한 결과 박막표면에 과성장 핵(outgrowth nuclei)이 관찰되었으며, 이는 증착중 a, b축과 c축의 결정성장 속도의 차이에 기인하는 것으로 사려 되었다. MgO(100) 기판위에 증착된 Tc_zero 83K의 YBCO박막시료의 임계전류밀도(Jc)값은 온도 4.2K 1 Tesla 자장하에서 5.1×10^6A/㎠이었다. The YBa_2Cu_3O_u-x(YNCO) thin films were grown on MgO(100) and MgO/Si(111) substrate at the substrate temperature of 590℃ and the chamber pressure of 9.5×10^-5 Torr by a molecular beam epitaxy method. The superconductivity and crystalline quality were investigated. The YBCO film on MgO(10)substrate showed Tc zero 86K with single crystal phase in RHEED observation. Whereas, the YBCO film deposited on the MgO/Si(111) substrate was Tc zero 75K with polycrystalline nature under the same deposition condition. The X-ray diffraction (XRD) analysis for the both samples showed preferentially c-axis oriented superconducting phases perpendicular to the film surface. The FWHM (Full Width at Half Maximum) of (005) rocking curve for the YBCO film on MgO(100) substrate was 0.65° and was increased to 1.72° when the YBCO film was deposited on MgO/Si(111) substrate. This large value of FWHM means that the degree of preferred orientation was lowered. The critical current density (Jc) for the films deposited on MgO(100) substrate was found to be 5.1×10^6 A/㎠ at 4.2K and 1 Tesla in applied magnetic field.

함수정방형내에서 과냉각 현상에 관한 실험적 연구

김병철,신현성,정홍철 조선대학교 동력자원연구소 1996 動力資源硏究所誌 Vol.18 No.2

Supercooling phenomena with pure water in freezing process was studied experimentally from -5℃ to 0℃. Temperature distribution and heat transfer were analyzed on the supercooling phnomena, according as the initial temperature, inclied angle and temperature of cooling-well were varied. When the water was cooled from the cooling surfacee, a supercooling phnomena was appered. After a while, dendritic ice grew suddenly and spread over the supercooled region. Then the dendrite began to melt again from the bottom at the same time and dense ice layer began to grow from the surface. The supercooling phenomema duration was the longers with decreasing the inclined angle and initial temperature than those of increasing the inclined angle.

ECAP 강가공에 의한 5083 Al 합금의 초소성 변형

이정국,서창우,김병철,신동혁 漢陽大學校 工學技術硏究所 2000 工學技術論文集 Vol.9 No.1

초기 결정립 크기가 200 μm인 상업용 5083 Al 합금에서 equal channel anglar pressing(ECAP) 강가공에 의하여 결정립을 초미세화 시킬 수 있었다. ECAP는 200℃에서 수행되었고, 반복 passes시 180˚ 회전을 주면서 같은 시편에 8 passes까지 강가공을 가하였다. 미세조직 특징은 1 pass후 평균 0.2 μm의 폭과 0.8 μm의 길이를 갖는 연신된 평행한 bands가 균일하게 형성 되었고, 4 passes후 결정립 크기가 약 0.3 μm인 등축의 초미세 결정립이 얻어졌다. 이러한 초미세 결정립을 갖는 5083 Al 합금에서 저온 초소성 성질이 얻어졌는데, 약 0.5 μm의 결정립 크기를 갖을 때 250℃이하의 온도에서 연신율이 200 %이상인 초소성 거동을 나타내었다. An ultrafine grained structure was introduced into a commercial 5083 Al alloy with the initial grain size of ∼200 μm using the equal channel angular pressing technique. Equal channel angular pressing was successfully conducted at 200℃ and the results showed that the microstructure was reasonably homogeneous after single passage and consisted of parallel bands of elongated substructure having the average width of 0.2 μm and the average length of 0.8 μm. Repetitive passes were conducted on the same sample up to total 8 passes through the die so that the sample was rotated 180˚ around its longitudanal axis between passes. An equiaxed ultrafine grained structure of ∼0.3 μm was obtained in the present alloy after 8 passes. It was found that a 5083 Al alloy with the grain size of ∼ 0.3 μm exhibited a superplastic-like behavior with elongation to failure in excess of 200% below.

교통사고후 정신과로 장애감정 의뢰된 환자의 임상적 특징

김병철,김성곤,박제민,김명정,정영인 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

1994년 1월부터 1996년 12월까지 3년간에 걸쳐 교통사고후 법원으로부터 장애감정 의뢰되어, 부산대 학교병원 정신과에서 정신장애감정을 받았던 88명의 환자를 대상으로 임상적 특징을 조사하였던 바. 그 결과를 다음과 같이 요약할 수 있었다 1) 대상 환자 88명 가운데 58명(65.9%)이 남자, 30명(34.1%)이 여자였다. 낮은 교육과 사회경제적 수준을 가진 환자가 많았으며, 21세에서 50세까지의 사회 활동층이 과반수를 넘었다. 2) 수상당시 환자의 71.6%에서 뇌37상이 있었고, 다음으로 두개골 골절(36.4%), 뇌출혈(33.7%), 뇌혈종(26.1%). 뇌진탕(12.6%) , 축삭손상(10.2%) 등이 있었으며. 대상 환자의 9.1%에서는 뇌손상의 증거가 없었다. 3) 환자나 환자의 보호자가 주관적으로 호소하는'자각적 증상은 인지증상이 가장 많아 전체 대상 환자의 85.2%에서 있었고. 다음으로 신체증상(83.0%), 행동증상(69.3%), 정서증상(58.0%) 순이었던 반면에, 감정의가 판단한 탄각적 증상은 정서증상(80.7%7)이 가장 많았고, 다음으로 행동중상(77.3%). 인지 증상(63.6%), 신체증상(40.9%) 순이었다 4) 대상 환자의 48.8%에서 수상후 1개월과 6개월 사이에 정신의학적 증상이 발현하였고.6개월 이후에 나타난 경우는 9.1%에 불과하였다. 또한, 대상 환자의 61.4%에서는 증상이 있음에도 불구하고 감정 당시까지 정신의학적 치료를 받은 적이 없었고. 정신의학적 치료를 받았던 환자의 23.5%에서는 증상 발현 후 6개월이 경과한 뒤에야 치료를 받았다. 5) 감정시 모든 대상 환자에서 뇌영상겋사와 뇌파검사가 실시되었고, 이들 가운데 47.7%에서 비정상적인 뇌영상 소견을 보였다. 이상소견으로서는 뇌연화증이 가장 많았고, 다음으로 뇌위축, 축삭손상. 낭종 등의 순이었다. 뇌파는 환자의 86.4%에서 정상소견을 보였고, 뇌파 소견과 뇌영상 소견간에는 유의한 상관관계가 있었다. 6) 감정당시 대상 환자의 95.5%에서 최종적으로 정신장애가 확인되었고, 이중 두부외상에 의한 인격 변화가 가장 많았으며, 다음으로 두부외상에 의한 치매, 적응장애, 두부외상에 의한 우울장애, 뇌진탕후장애. 외상후 스트레스 장애 등의 순으로 많았다. 정신장애가 확인되었던 환자의 38.1%에서는 추후 계속적인 정신의학적 치료의 필요성이 인정되었다. 7) 외상 후유증으로 인한 지능의 변화 정도에 있어서 두부외상 관련인자 유무간에 차이가 있는지를 알아본 결과. 수상당시의 의식소실 유무간이나 외상후 섬망 유무간에는 차이가 있었고, 감정당시 실시되었던 뇌 영상검사상의 이상소견 유무간에도 차이가 있었다. In an attempt to obtain the basic data for mental disability evaluation in psychiatric casualties by traffic accidents,88 cases referred from the court for the purpose of mental disability evaluation for 3 years from 1974 to 1996 were surveyed. The results are summarized as fellows : 1) Among the 88 cases, 58 cases(65.9%) were male and 30(34.1%) were female. Cases with low educational and socioeconomic levels outnumbered those with high educational and socioeconomic levels. More than half of the cases were in socially active group with ages of 21 to 50years. , 2) At the time of accidents,11.6% of the whole cases were diagnosed as cerebral contusion, Which was the most common diagnosis. The next common diagnoses were skull 7acture(36.4%), brain hemorrhage(33.0%), brain hematoma(26.1%), cerebral concussion(12.6%), and axonal injury(107%) in order of frequency. In 9.1% of the cases there was no definite evidence of head injury was found. 3) During talc period of mental disability evaluation, the most common symptom was cognitive symptom(85.2%), and the next common symptoms were somatic(83.0%), behavioral(69.3%), and affective(58.0%) ones in order of frequency. On the other side, the most common psychopathology recognized by talc psychiatrists was affective symptom, which was present in 80.7% of the cases manifested during the period of evaluation, and the next common psycho-pathologies were behavioral(77.3%), cognitive(63.6%), and somatic(40.9%) symptoms in order of frequency. 4) Nearly half(48.8%) of oft whole patients manifested psychiatric symptoms such as cognitive, affective, behavioral, and somatic symptoms between the first and sixth months after traffic accidents. Only 9.1% of the cases developed psychiatric symptoms after six months of traffic accidents. Meanwhile,61.4% of the cases were never given psychiatric treatments despite the presence of psychiatric symptoms, and 23.5% of the cases given psychiatric treatments visited psychiatrists after six months of symptom development. 5) All of the cases took neuroimging studies such as brain CT or MRI and EEG during the period of mental disability evaluation. In 47.7% of the cases there were abnormal findings in neuroimaging studies among which encephalomalacia was the most frequent. The next abnormal findings were brain atrophy, axonal injury, cyst, and so on in order of frequency. On file other hand, in 86.4% of the cases EEG findings were within normal limit. 6) In 95.5% of the cases, mental disorders were confirmed, among which personality change due to head trauma was the most common, and the next common mental disorders were dementia due to head trauma, adjustment disorder, depressive disorder due to head trauma, postconcussional disorder, posttraumatic stress disorder, and so on in order of frequency. Mere than one third of the casts(38.1%) given psychiatric diagnoses were considered to need continuous psychiatric treatments at the time of mental disability evaluation. 7). Posttraumatic decline in intelligence tended to be affected by loss of consciousness and delirium, but not b? skull fracture and brain surgery. In brain imaging .and EEG studies performed during the period of mental disability evaluation, posttraumatic decrease in intelligence tended to be influenced by abnormal findings on brain imaging, but not EEG findings.

프레탈정 (실로스타졸 100mg)에 대한 실로스탄정 (한국유나이티드 제약)의 생물학적 동등성

용철순,이경희,최진석,박병주,정세현,김용일,박상만,유봉규,이종달,최한곤 한국병원약사회 2003 병원약사회지 Vol.20 No.2

Bioequivalence of one cilostazol tablets, the Pletaal^(R)(Korea Otsuka Pharmaceutical Co., Ltd.) and Cilostan^(R)(Korea united Pharmaceutical Co., Ltd.), was evaluated according to the guideline of KFDA. Sixteen normal male volunteers(age 20~30 years old)were divided into two groups and a randomized 2×2 cross-over study was employed. After one tablet containing 100㎎ of cilostazol were orally administered, blood was taken at predetermined time intervals and the concentration of cilostazol in plasma was determined with an HPLC method using UV detector. The pharmacokinetic parameters(C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameter. The results showed that the differences in C_(max), T_(max) and AUC_(t) between one tablet were 16.08%, 18.88% and 17.57%, respectively. The powers (1-β) for C_(max), T_(max) and AUC_(t) were 85.03%, 83.92% and 80.12%, respectively. Detectable differences(Δ) and confidence intervals were all less than 20%, and confidence interval of all the parameters were also less than 20% at the significance level(α) of 0.05. All of these parameters met the criteria of KFDA for bioequivalence, indicating that Cilostan^(R) tablet is bioequivalent to Pletaal^(R) tablet.