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.

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

향류식 역삼투공정에 의한 상용막의 에탄올 농축 특성에 관한 연구

진병복,이병철,민병렬 연세대학교 산업기술연구소 1993 논문집 Vol.25 No.2

0The concentration characteristics for reverse osmosis and countercurrent reverse osmosis process with varing concentration of ethanol solution and applied pressure were investigated in this study. Also, the theoretical value derived for countercurrent reverse osmosis(Osmotic sink reverse osmosis) were compared with the experimental results. In RO and CCRO experiments, three kinds of commercial membrane(TFCL, UOP Co., U.S.A./FT-30, Film Tec Co., U.S.A. / Cellulose Acetate blend, UOP Co., U.S.A.), applied pressure of 3.92, 4.9 MPa and feed concentration of 3.9, 10.2 wt% were used. From the results of this study. DC(Degree of Concentration) of ethanol by TFCL membrane was the highest value of three kinds of membrane, and DC of ethanol by OSRO was the highest value of two types of ethanol concentration process. In addition, DC of OSRO more increased greately than that of RO as applied pressure difference increased. In comparison with experimental and numrical results, the numerical results were accorded with experimental results within 5-13% of error.

공기소총 사격시의 생체변화 분석

엄기진,이철규,박장평,이광재,문병용,홍관이,노성규,오수일,박기동 江原大學校附設體育科學硏究所 1985 江原大學校附設體育科學硏究所論文集 Vol.- No.10

This study conducted for analyze the process of physiological variation during shooting, and produce the basic data for training prescription to the performance improvement in Air Rifle Shooting, 9 Elite Rifle shooters )College 3, High School 3, Middle School 3) in GangWeon province were tested the physiological parameter which are Electrocardiograph(E.C.G), Heart-rate(H.R), Respiratory pattern, and Trigger time by polygraph system 8 channel from Sept. 1st to Sept. 10th, 1985. Analyzed experimental results are as follows; 1. Firing at T-P wave in E.C.G, 77.68bpm in H.R)16.68% by resulting H.R), the deep size of inspiration-expiration was low, and 8.34 sec of trigger interval were appeared when the shooter acquired high score. 2. The most effective factor among physiological parameters for excellent shooting score is the inspiratory volume with decresc breathing pattern. 3. Shooting performances correlated with stability and static-dynamic balance, but flexibility effected on negative correlation.

레이저에 의해 손상된 치아경조직 및 치수조직의 치유과정에 대한 연구

김철순,민병순,최호영,박상진,최기운 大韓齒科保存學會 1998 Restorative Dentistry & Endodontics Vol.23 No.1

全國主要 地方의 日射量 分析

김병철,김진흥,하옥남 조선대학교 동력자원연구소 1987 動力資源硏究所誌 Vol.9 No.2

The insolation and meteorological data which were measured in the meteorological observatory in several locations were examined and analysed. Also mean air temperature, wind speed and amount of cloud were examined. Monthly average insolation, clear sky solar radiation, diffuse, direct, global solar radiation and the ratio of the horizontal solar radiation and extraterrestrial solar radiation were observed and analysed to be a useful data in using the solar energy.

중증 만성정신질환자 수의 추산 : Through Two Community Surveys 두 지역사회 조사를 중심으로

홍진표,김윤,배재남,정유진,강영호,양병국,김용익,김병후,이철,조맹제 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

국내 중증 만성정신질환자 수를 추정하기 위하여 일 농촌 및 대도시 지역의 지역의료보험 및 의료보호 대상자 중 1993년 1년간 의료기관에서 정신증 상병(ICD-9 code 상 290-299) 및 알콜 남용/중독, 성격장애 및 정신박약 진단하에 치료를 받은 적이 있는 사람에 대해 설문조사를 실시하였다. 연구자들이 개발한 진단도구를 이용하여 진단을 평가하고, Strauss-Carpenter scale 등을 이용하여 기능 장애를 평가하고 유병기간 등을 조사하였다. 결과를 요약하면 다음과 같다. 1) 진단평가상 정신분열병군(61.1%)이 가장 많았으며, 정동장애군(23.7%), 알콜장애군(11.2%), 기질성 정신장애군(4.0%)의 순서이었다. 2) 직업활동정도는 진단군별로 차이가 많았다. 지난 1년간 직업활동이 6개월 미만이거나 전혀 없는 환자 비율이 정신분열병군은 67.2%, 알콜장애군 52.0%, 정동장애20.8%의 순으로 정신분열병군이 가장 불량하였다. 3) 사회활동도 진단군별로 차이가 많아서 지난 1년간 의도적, 사회활동이 없는 비율이 정신분열병군이 가장 높았고(72.3%), 알콜장애군(32.0%), 정동장애군(20.7%)의 순이었다. 4) 국내 의료보험 및 사회복지시설 이용 자료 등을 토대로 본 조사 결과를 적용한 결과 국내중증 만성 정신질환자의 수는 약 8만 7천명으로 추산되었다. Objectives: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. Methods : Study populations were recruited from medical insurance data of two district areas ; one rural and the other urban areas. Subject were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November,1994. Results : According to diagnostic assessment schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. Conclusions : Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.

곰쓸개 복용 후 발생한 육안적 혈뇨와 신유두부 괴사증 1예

김우진,한민석,김수항,박인형,박진석,선제형,홍세인,박옥영,신정현,이숭,신병철 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Renal papillary necrosis occurs most commonly in association with urinary tract infection, diabetes mellitus, sickle cell disease, vascular disease, and analgesic nephropathy. Clinical presentation may be related to symptoms of pyelonephritis such as flank pain, renal colic, hematuria, Proteinuria, recurrent fever. The necrotic tissue may be sloughed off, and the diagnosis can sometimes be made by finding piece of renal medullary tissue in the urine. Pyelography may demonstrate cavities and sinuses in the resion of papillae. Anuria & oliguria can lead to the acute renal failure, and especially prognosis and progress may be affect influenced by urinary infection. We report a case of renal papillary necrosis with ingestion of bear gallbladder. On pyelography, Persistent contrast is diagnostic clue of renal papillary necrosis. This case is not be related to urinary tract infection, but occurred acute renal failure. Expectant treatment was gone.

태권도 경기규칙 개정에 대한 연구

류병관,윤상화,진중의,강성철 龍仁大學校 武道硏究所 1997 武道硏究所誌 Vol.8 No.2

Taekwondo became one of worldwide famous sport. There are more than tenmillian people learning Taekwondo all of the world. Nevertheless Taekwondo game is not very much papular in spectator because the simplicity of the game. Taekwondo game consist of three round system and take one point system. Each round take Two to three minute and 30 second to 1 minute break will be taken every game. This situation can blocking the spectator´s instret of the game and also they can be feel the game is so loose because of stopping the contiguous. One point system is led the fixation of the skill. There is only one point exist in the match and it doesn´t make any sense to perform any high skilled techniques. Performing the high skilled techniques is may have chance to get disadvantage in get point because of it´s performance time. Therefor one simple and clear techniques are more useful in the match to get a point than high skilled technic. This is the main reason that spectators do not have any excitement about game. The game can´t be interesting. The result of this study shows that the rules of Taekwondo competition should be changed to more excite and interest way for spectators. The multi point system should be acpected and circle ground will be more valuable for improve the techniques. The results are also amphasized that warning and deduction should be lessened for active and dinamic game for the spetators.

우수방사성의약품 생산시설 개발

신병철,정원명,박상현,이규일,박경배,박진호 한국약제학회 2003 Journal of Pharmaceutical Investigation Vol.33 No.2

Manufacturing facilities of the pharmaceuticals must meet certain level of the cleanness required so that foreign substances such as dust, moisture, heat, microorganism, or virus do not contaminate the product. In case of radiopharmaceuticals for medical treatment and diagnosis, not only should the operators and environment be protected from radiation but also need to be isolated from the foreign contaminant. Therefore, manufacturing facilities for radiopharmaceuticals must satisfy the design standards of both hot cell and clean room which are specified by GNP. However, standards of maintaining negative pressure for preventing spread of radioactive contaminant in isolated facilities conflict with the standards of maintaining positive pressure for keeping cleanness. To solve this problem, are pressure of hot cell was designed lower than in the adjacent area to meet standards of the radiation safety. To keep higher cleanness in certain part of the hot cell for filling, minimal relative positive pressure allows. In order to effectively maintain the cleanness that is required for production of Tc-99m generator, which takes 70% of whole demand of radiopharmaceuticals, the rooms placed in each side of production room are used as a buffer area and three lead hot cells are installed in production room. In this research, we established the appropriate engineered design concept for Tc-99m generator manufacturing facility, which satisfies both GMP cleanness standard for preventing particles, bacteria, other contaminants and the regulations of radiation safety for supervising and controlling the amount of radiation exposure and exhausted radioactivity. And the concept of multi-buffer zones is introduced to apply negative air pressure for hot cell with first priority and to continue relative positive air pressure for clean room.