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.

전기자극 스트레스 또는 심리갈등 스트레스가 흰쥐 비장 임파구 증식과 Interleukin-2 생산능에 미치는 영향

한상진,김정목,양병환 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

The purpose of this study was to examine the relastionship between stress and immunologic function as a possible mechanism of stress and disease process. The authors investigated how the psychological stress induced by avoidance-avoidance conflict model or physical stress of electric shock do impact the immune function, measuring proliferation and interleukin-2(IL-2) production of rat splenic lymphocytes stimulated with various mitogens such as concanavalin-A(Con-A). phytohemagglutinin-M(PHA) and phorbol 12-myristate l?-acetate+calcium inophore A23187(PMA+A23187). In this experiment, female Sprag-Dawley rats were used an subjects. Animals were separated into 4 group according to different stress conditions. Conflict group received psychological conflict stress with electric shock depending on the coping behaviour and Yoked group was not in psychological conflict situation but received as same amount of electric shock as conflict group. Skinner-Box control group was immobilized without electric shock and Home-cage control group had no stress condition. The results are as follows : 1) There is significant difference in lymphocyte proliferation in case of Con-A and PMA+A 23187 between Skinner-Box control group and Yoked group at the high current condition. 2) There is significant difference in IL-2 production in case of PHA and PMA+A23187 between Skinner-Box control group and Yoked group. 3) There is more significant difference in lymphocyte proliferation in case of all of mitogens, Con-A. PHA and PMA+A23187 between Yoked group and Conflict group regardless of high or low current condition. 4) There is significant difference in IL-2 production in case of PMA+A23187 between Yoked group and Conflict group. This results suggest that psychological stress could reduce the immue function more profoundly than physical stress and also means the importance of coping and appraisal in the stress-immunology relationship.

직업적 연폭로에서 혈중 연량 수준에 따른 선별검사로서의 혈중 ZPP 검사의 타당도

한구석,안현철,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to evaluate the validity of current screening criteria of lead exposure and to provide effective information for the better health management of lead workers, author investigated the interrelationship between blood lead and blood zinc protoporphyrin(ZPP) and evaluate the validity of blood zinc protoporphyrin as the screening test and blood lead as gold standard of diagnostic test. The total of 2245 lead workers (male workers: 1982, female workers : 263) from 12 lead using industries were studied. Blood lead, ZPP, hemoglobin and hematocrit were selected as lead exposure variables. Personal information on sex, age and work duration were also checked. Blood lead was measured with flameless atomic absorption spectrometry (model: Hitachi 8100) using standard addition method. Blood ZPP was measured with portable hematoflurometer (model: Aviv 206). The results obtained were as follows: 1. The mean blood lead of all lead workers were 0.7±14.3㎍/㎗(Male: 31.0±14.4㎍/㎗, Female: 28.2±12.9㎍/㎗), whereas the mean blood ZPP of those were 68.1±47.5㎍/㎗(Male: 63.9±43.7㎍/㎗, Female: 100.1±61.0㎍/㎗). The mean value of hemoglobin and hematocrit of all lead workers were 14.5±1.5g/㎗(Male: 14.7±1.3g/㎗, Female: 12.3±1.2g/㎗) and 45.4±3.6(Male: 46.2±2.8, Female: 39.5±3.1) respectively. 2. Validity of test using blood zinc protoporphyrin as screening test for blood lead levels of 30㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 50 and 90 ㎍/㎗ of ZPP respectively, showing 50 and 60 ㎍/㎗ of ZPP for all lead workers. While those test for blood lead levels of 40㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 and 90 ㎍/㎗ of ZPP respectively, showing 60 ㎍/㎗ of ZPP for all lead workers, those test for blood lead levels of 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 or 70 and 100 ㎍/㎗ ZPP respectively, showing 60and 70 or 80 ㎍/㎗ of ZPP for all lead workers. 3. Predictive value of test using blood zinc protoporphyrin as the screening test for different blood lead levels of 30, 40, 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that positive predictive value of screening test were decreased by the increase of blood lead level regardless of csreening criteria value ZPP and negative predictive value of screening test were increased accordingly regardless of screening criteria value of ZPP. On the other hand, within same blood lead level as a gold standard positive predictive values were inceased by the increase of screening criteria value of ZPP, whereas the negative predictive value were decreased accordingly by the the increase of screening criteria value of ZPP. 4. The correlation analysis of all lead workers among study variables revealed that CPbB and natural log transformation ZPP(LZPP) were better correlated with other variables and found to be better estimate than PbB and ZPP themselves. The age was correlated with all other variables, but the work duration was not. The correlation analysis of male and female workers among study variables revealed the same results with all lead workers. 5. The slope of simple linear regression of CPbB (independent variable) with ZPP in female workers(3.223)was steeper than in male workers(2.144). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But there was no slope difference between two groups divided by their work duration of 2 years less and more. The slope of simple linear regression of CPbB lead (independent variable)with ZPP in lead workers whose blood lead were higher than 30㎍/㎗and 40㎍/㎗ were steeper than those whose blood lead were less than 30㎍/㎗ and 40㎍/㎗. 6. The slope of simple linear regression of CPbB (independent variable) with ZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead. 7. The slope of simple linear regression of CPbB (independent variable) with LZPP in female workers(0.0308was steeper than in male workers(0.0253). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But where was no slope difference between two groups divided by their work duration of 2 years less and more. While the slope of simple linear regression of CPbB lead (independent variable) with LZPP in lead workers whose blood lead were hogher than 30㎍/㎗ was not steeper than those whose blood lead were less than 30㎍/㎗, there was no slope difference between two groups whose blood lead were less than 40㎍/㎗ and more than 40㎍/㎗. 8. The slope of simple linear regression of CPbB (independent variable) with LZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead, but the difference was not significant then that of CPbB and ZPP. With above results, it is recommended that the screening criteria value of ZPP should be down to 60-70㎍/㎗ from 100㎍/㎗ for male lead workers and screening criteria of ZPP for female lead workers was all right with current value of 100㎍/㎗. So it is recommended to make different screening criteria of ZPP for male and female workers like the hemoglobin and hematocrit screening criteria. It is also preferable to use CPbB and LZPP rather than uncorrected PbB and ZPP in the evaluation of lead exposure for lead workers.

전해방전을 이용한 유리 미세가공의 정밀도 향상

한민섭,민병권,이상조 한국공작기계학회 2009 한국공작기계학회 춘계학술대회논문집 Vol.2009 No.-

Electrochemical discharge machining (ECDM)process is one of spark based micromachining methods especially for microstructuring of nonconductive materials such as glass and ceramics. In ECDM process spark discharge is produced by the dielectric gas film which formed by the coalescence of electrochemically generated gas bubbles. ECDM process has been suffered from achieving uniform geometry of microstructures because of the irregular gas film characteristics. In this study various technical approaches, pulse voltage, side insulated electrode and ultrasonic vibrated electrolyte are proposed to improve the geometric accuracy of ECDM process. Side insulated electrode helps improve the spark discharge uniformity by localizing the electrolysis at the tool tip, while ultrasonic vibrated electrolyte enhances the flushing effects at the gap between the tool and the workpiece. Experimental investigation demonstrates that geometric accuracy of microchannel and microhole is improved by using the proposed methods.

Tabes Dorsalis의 핵자기공명영상 및 전기생리학적 소견

권기한,김성민,권석범,이병철,조광호,주정희 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

복부 결핵으로 발현된 후천성 면역 결핍증 1예

고병성,김상중,유경화,이경한,노기탁,허원석 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.3

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.

당뇨병 환자에서 뇌간 청각신경 유발전위 잠복기의 연장- 기질적? 또는 대사성?-

김성민,권기한,이병철,엄근용,배종석 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

NW6005를 이용한 발신자 번호 추적 장치 개발

이다한,박찬진,박찬국,이성철,박민경,윤병우 경성대학교 공학기술연구소 2012 공학기술연구지 Vol.18 No.-

NW6005의 칩을 이용하여 발신자 번호 데이터를 추적하는데 성공하였고 그 뿐만 아니라 두 개 이상의 전화에서 발신자 번호 데이터를 수신하더라도 데이터가 깨지지 않고 제대로 수신하는 알고리즘을 구상하였고 그에 대한 실험은 성공적이었으며 또한 전화 통신중의 오류에 대한 문제도 해결하였다. 최종적으로 4개의 전화선에서 하나 또는 동시에 발신자 번호를 추적하여 시리얼 통신으로 데이터를 전송시키는 장비를 개발하였다.

Timoshenko 보 이론을 이용한 층상균열이 있는 보의 진동해석 및 비파괴적 평가

韓秉基,李晟熙,柳澤仁 弘益大學校 科學技術硏究所 1994 科學技術硏究論文集 Vol.5 No.-

A study of the natural vibrations of Timoshenko beam with a split is presented. An analytic model, based on the transverse and longitudinal vibration of beams is employed to determine the natural frequencies. The variations of natural frequencies with the changes of size and location of laminar tear are plotted for several thickness ratio. A specific example are given to show the effects of rotary inertia, and shear deformation on the natural frequencies of the beam with a split. A new skill for the presentation of relationship between the size and location of laminar tear and natural frequencies is presented.

(p,p') 반응에서 핵자쳐내기 기여의 Q-의존도

한성희,金柄澤 성균관대학교 기초과학연구소 1985 論文集 Vol.36 No.2

We studied Q-dependence of knockout contribution to the (p, p') reaction in the plane wave approximation with the delta interaction. The differential cross sections are calculated at several different Q-values for the ^54Fe(p, p') reaction at 62MeV. We found that the knockout reaction is proceeded by the quasi-free elastic scattering mechanism.