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.

범법 정신 장애자와 일반 정신 장애자의 약물 사용 양상에 관한 비교 분석

이길홍,박두병,나철,이재광,기백석,이재우,유영식,이영식,이헌재 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.1

범법정신장애자의 정신의학적 특성분석

이길홍,이재광,박두병,나철,기백석,이재우,유영식,이영식,이헌재 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.1

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

전통서정시의 위상과 1950년대 박희진의 시

李秉憲 대진대학교 1993 大眞論叢 Vol.1 No.-

Park Hee-Jin entered upon a literary career in the latter half of 1950's. The Korean poetry in the latter half of 1950's is classified into traditional lyric poetry and modernism poetry. The time when traditional lyric poetry led poetical circles is the same period when modernism was prevalent and when the attempt of formal revolution was going down In the latter half of 1950's, traditional lyric poetry that matched modernism poetry was vigorously created. It seems that they filled the vacuum of thought of that time. Park Hee-Jin's poetry started from the purpose of recovering the vitality which was suppressed by the shock from the outer world His integrity forced him to seek for a certain whole Beauty or an eternal life. He realized that it is possible to do so only in the clear spiritual condition. Therefore we named his poetic world the poetics of transparency. Park Hee-Jin's poems that we looked into are also a model of traditional lyric poetry which contains the connotation of what is called pure poetry

한국 현대소설의 문체 분류 시론

이병헌 고려대학교 민족문화연구원 한국문학연구소 2002 한국문학연구 Vol.- No.3

This is an attempt to set up the new criteria for classifying the style of the whole Korean modern novel.With the help of text liguistics, I set up the two dimensional standards which are 'presentation and expression' according to the functions of sentences and 'moderation and emission' according to the aspects of subject treatment, and looked into the characteristic of each style. As for the styles classified by the function of sentence, the style of 'presentation' is to write at a distance from the emotion, feeling and intention of the text maker or writer in describing the story, background and events of the novel and the characters' psychology. Whereas the style of 'expression' gives priority to the manifestation of the feeling and attitude of the writer and to the dealing with the text marker as a subject matter over the uninvolved netural writing.So the phrase which is intruded by the writer's judgement and the sentence which has the device that attracts the reader's attention are the style markers of the 'expression'. As for the styles classified by the aspects of subject treatment, the style of 'moderation' is the statement and expression which restrains the desire for using words and keeps the virtue of harmony and proportion in managing the subject of the novel.It's influence reveals when it shows the circumstances explicitly and makes clear the message that the writer wish to convey through a few proper words.The style of 'emission' is the narrator's attitude of saying freely and fully what he want to say in easy and relaxed stste with confidence. It is the style in which any circumstance and psychology is told fully by means of the rhetorical devices or the effect of communication can reach to the maximum by mean of eloquence, pungent colloquialism or unconstained sentence.

申石艸의 詩意識 硏究 : 「돌팔매」를 중심으로 Mainly with Dolpalmal

李秉憲 대진대학교 1993 大眞論叢 Vol.1 No.-

Shin Seok-Cho's poetical style is deeply effected by Paul Vale´ry Though Vale´ry appreciated the Oriental thoughts, his thought was based on the Western rationalism Shin didn't regard the Western rationalism as the best He was saturated with the Eastern thoughts. However, because he was always conscious of Vale´ry, he could not free from the influence of Vale´ry. Anyway Shin's Dolpalmae is similar to Vale´ry's Le Vin Perdu But the poetical idea of the former is simpler and is organized more properly than the latter. In this writing, Shin's view of poetry was pursued through the analysis of "Dol Palmae" and other works. We bacame to aware that he was looking for the world like endless waves that have primitive vitality and change continuously as Ocean waves It is where the East and the West, Classics and Modernity, the finite and the infinite, spirit and body, participation and purity are originally one The poetry he was looking for was as such.

신생아의 치조제에 발생한 양성 종물

이제호,김소화,윤정훈,최병재 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.2

신생아에서 흔히 발생하는 연조직 종양으로는 신생아의 구개 및 치은 낭종(palatal & gingival cyst of the newborn), 선천성 치은종(congenital epulis), 혈관종(hemangioma), 기형종(teratoma), 화농성 육아종 및 자극성 섬유종(pyogenic granuloma & irritation fibroma)이 있다. 이렇게 신생아의 치조계에서 발생한 연조직 종양은 대부분 외과적으로 절제하여 치료하며, 치료하지 않는 경우 흡인(aspiration)으로 인한 기도 폐쇄 및 호흡 곤란, 구강으로 수유시 불편감, 비강으로 수유시 구토가 불가능해 흡인폐렴(aspiration pneumonia) 유발 가능성이 있다. 본 증례는 신생아의 치조제에 발생한 연조직 종양으로, 외과적으로 절제하여 치료하였으며, 조직 검사 소견상 화농성 육아종 및 자극성 섬유종과 유사하였지만 다핵형 거대세포(multinucleated giant cells)가 관찰되었고 선천적으로 발생하였다는 점에서 차이가 있었다. 이 종물의 병리 기전은 아직까지 명확하지 않으며 어떤 특정 질환으로 포함시키는 데 문제점이 있으므로 이에 보고하는 바이다. The soft tissue tumors that occur commonly in newborn infants include palatal and gingival cyst of the newborn, congenital epulis, hemangloma, teratoma, pyogenic granuloma, and irritation fibroma. Such soft tissue tumors in the alveolar ridge of newborns are usually treated by surgical excision. If untreated, they can cause air-way obstruction and breathing difficulty due to aspiration. They also cause discomfort during oral feeding. If nasal feeding is tried, since vomitting is impossible, there is a risk of aspiration pneumonia. In this case, a newborn infant visited our hospital with soft tissue tumor as chief complaint, and the infant was treated by surgical excision. It appeased to be similar to pyogenic granuloma and irrtation fibroma upon histologic exam. However, it was different from those diseases since multinucleated giant cel1s were observed and it was congenital. The pathologic process of this neoplasm is not clear. This case is reported, since it is difficult to classify it as a specific disease.

라미부딘 내성 만성 B형 간염 환자에서의 아데포비어의 치료 효과

이지숙,장리라,이상욱,한병훈,윤병철 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Backgrounds/Aims : Adefovir dipivoxil(ADV) has been shown to be effective against lamivudine resistant strain of hepatitis B virus. But continuation of lamivudine therapy or switching to Adefovir dipivoxil in patients with viral breakthrough after long term lamivudine therapy are controversial. To find efficacy of adefovir dipivoxil, we retrospectively assessed clinical course after lamivudine resistance in patients who changed adefovir dipivoxil and continued lamivudine therapy. Methods : 58 patients with lamivudine resistant HBV mutants after at least 6 months of lamivudine treatment were included in this study. 24 of the 58 patients were treated with ADV and rest of them were continued the lamivudine therapy after lamivudine resistance. The continuous lamivudine treatment group (n=34) was divided into two groups according to ALT count (ALT≧40, n=19 vs ALT<40, n=16) The clinical course and the biochemical and virological response of the switching adefovir group were compared with those of continuing lamivudine group. HBV genotypes and YMDD mutation site was anaylzed by TRUGENE HBV Genotyping. Results : At twelve months, the levels of median serum HBV DNA and ALT was decreased and albumin was improved significantly(P<0.01) in adefovir switching group compared with lamivudine sustained group, especially ALT was elevated more than 40. There is no significant differences between adefovir switching group and lamivudine sustained group (ALT<40, n=15). This study showed that adefovir dipivoxil reduces HBV replication and improves not only biochemical markers of disease activity, but also liver function. HBV genotypes of 58 patients were all C and rtM204I/V mutant was the most common. Conclusion : This study provides an evidence that adefovir dipivoxil can be effective in the treatment of lamivudine-resistant HBV mutants, especially ALT elevated.