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.

HPLC에 의한 혈청 Haloperidol 분석에 관한 연구

楊秉煥,延炳吉,韓圭熙,感喆珪,金光日 漢陽大學校 精神健康硏究 1985 精神健康硏究 Vol.3 No.-

일개 종합병원 입원환자의 낙상 실태 및 관련요인

양화미,천병철 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

Background: Toestimate fall incidence rate and associated factorsin inpatients from a generalhospital. Method: The data werecollected from 104 fall incident reportsdeveloped by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristicsof patients, factors related to fall, types, places,circumstances and outcomes of fall. Result: The incidence rate of fall, which was 4.4 per 1,000 total dischargedpatientsand 0.5 per 1,000 patientdays, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting systemof each hospital. Fall-pronepatients were, in general, ~65 years of age, had an alert mental status, were ambulatory with some a ssistance, and were dependenton and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall event susually occurredin bed orat the bedsidein thepatient's room, and occurred more of tenduring the night than during the day or evening. Risk factors of fall wereuse of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly highbed height, surrounding objects, inadequate fitnessshoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injuryand treatmentsuchas suturing. Riskfactorsforrepeatedfallswereuseofa neuropsychiatric drug (oddsratio=13.9) and gait disturbance (oddsratio=91.2). Risk factors for fall-related injurywerealert mental status(oddsratio=3.3 timesmore likelyto fall than thosewhoweredrowsyor ina stupor) and general weakness(odds ratio=3.3 times more likelyto fall than thosewhowerenot generally weak). Conclusion : Medicaland nursing staff shouldbe awareof the fall risk factorsof hospitalized patientsand should intensively pursue preventative strategies. Development of fall prevention education based on these resultsis recommended.

정신분열병환자의 혈소판막과 ³H-spiperone결합에 관한 연구

양병환,박응철,정하승 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.5

This research was to determine whether changes of dopamine receptors on the platelet membrane of schizophrenics could be used as a biological marker for schizophrenia. ³H-spiperone binding to platelet membranes was carried out in 22 schizophrenic patients who fulfilled DSM-ⅢR criteria and 14 age-matched control subjects. ³H-spiperone specifically binds to dopamine D2 receptor with high affinity. Increased Bmax can suggests increase in the number of dopamine receptors on the platelet membrane. The results are as follows ; 1) Bmax of the patient group was significantly higher than that of control group(p<.05). 2) Kd was not significantly different between the two groups. 3) Bmax of the positive and the negative symptom groups were significantly higher than the control group when the patient group was subdivided into the positive, the negative and the mixed symptom groups(p<0.5). 4) Kd of the positive symptom groups, the negative symptom groups and the control group were not significantly different among each other. 5) Bmax and Kd of the positive and the mixed and the negative symptom groups were not significantly different among each other. This results shows that increase in the number of depamine receptors on the platelet membrane of schizophrenics would be a part of disease process in schizophrenia.

발치 직후 시행된 즉시 임플란트 식립술에 관한 임상적 평가

양은영,천상득,노재환,이승은,송재철,진병로 영남대학교 의과대학 2003 Yeungnam University Journal of Medicine Vol.20 No.1

Background: Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. Materials and Methods: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. Results: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. Conclusion: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.

탄화수소에 의한 NO의 선택적 촉매 환원 반응에서 Pt/MCM-48 촉매의 반응 메커니즘에 관한 연구

양재승,이성철,장재훈,이병용,정석진 한국화학공학회 2003 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.41 No.4

기본형의 Si-MCM-48에 알루미늄 치환량과 귀금속 담지량의 변화에 따라 다양한 촉매를 제조하였고, 이를 탄화수소에 의한 선택적 촉매 환원(HC-SCR)반응에 적용하여 각각의 NO 환원반응 특성을 비교 고찰하였다. Pt/MCM-48 촉매의 NO 환원 활성을 고찰한 결과, 문헌상 보고 되고 있는 Pt/ZSM-5 촉매를 이용한 NO의 제거 활성과 비교하여 매우 우수한 결과를 보였다. 또한 5 vol% 이하의 산소 조건에서 그 활성이 현저하였으며, 특이하게 최고 활성에 도달한 후에 반응온도가 600℃까지 증가하여도 계속하여 그 활성을 유지하였다. XRD, TPD, TGA, XPS 등의 특성화를 통해 촉매의 표면 특성 및 반응 mechanism에 관한 연구를 수행하였으며, 이러한 결과로부터 Pt/MCM-48 촉매가 기존 촉매보다 일정 산소 조건에서 우수한 성능을 보이는 것은 담체의 표면 산특성과 촉매 고유의 redox mechanism에 기인한 것으로 해석하였다. Pt supported on MCM-48 was tested as a new catalyst for hydrocarbon-SCR process. MCM-48 is a new support material of the catalyst for SCR. Characterization and de-NO, activity test were performed for the newly synthesized MCM-48-supported catalysts. Pt(l wt%)/MCM-48 showed 90% of NO reduction at 250-500℃. It should be concluded, from what has been said above, that Pt/MCM-48 catalysts showed higher NO reduction conversion than zeolite based catalyst, and it was not affected by 5 vol% O₂ concentration and water vapor addition. It would be supposed that sustention of activity in that oxygen condition might be caused by surface acidic characteristic and its characteristic redox mechanism.

배차계획을 위한 대화형 의사결정지원시스템

박양병,홍성철 한국경영과학회 1998 經營 科學 Vol.15 No.2

Truck dispatching is one of the most commonly occurring problems of transport management. We developed an interactive decision support system named IDSSTD, for the truck dispatching problem where two conflicting objectives are treated and travel speed varies depending on the passing areas and time of day. The IDSSTD aids the decision-making process by allowing the user to interact directly the database, to direct data to a decision model, and to portray results in a convenient form. The IDSSTD is consisted of two major interactive phases. The pre-scheduling interactive phase is to reduce the complexity of a given problem before applying the BC-saving heuristic algorithm and the post-scheduling interactive phase is to improve practically the algorithmic solution. The IDSSTD has the capabilities of its own manipulation(analysis and recommendation) and diverse graphic features in order to facilitate a user's interaction.

일간지 생산-배송계획 문제를 위한 혼성유전알고리듬 해법

박양병,홍성철 한국경영과학회 2003 한국경영과학회 학술대회논문집 Vol.- No.1(1)

많은 기업들은 그들의 생산과 배송 기능을 분리하여 각각의 최적화를 꾀하고 있는데, 이러한 접근방법에 의해 이룰 수 있는 절약은 제한적일 수밖에 없다. 최근의 공급사슬경영(SCM)에서는 이들 두 기능의 관련 비용을 총체적 관점에서 잘 조절하면서 동시에 통합 분석하는 것이 더 중요하다고 인식되고 있다. 본 논문에서는 일간지의 생산-배송계획 문제를 다룬다. 일간지는 재고로 유지될 수 없으며, 고객이 정한 시간보다 늦게 배송되면 큰 손실을 야기하는 일종의 단일기간 재고품목이다. 저자들은 일간지 생산-배송의 통합계획을 위한 혼성유전알고리듬 해법을 개발하고 예제를 이용하여 Hurter and Buer의 순차적 분리계획 해법과 성능을 비교한다. 계산실험 결과, 개발된 해법의 성능은 효과적인 것으로 나타난다.

TCD를 이용한 뇌사의 판정기준

권양,김창진,임승철,권병덕,황충진 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.4

It is generally known that demonstration of absence of cerebral blood flow is necessry to confirm brain death. Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels. We performed transcranial doppler(TCD) examinations on 15 patients in brain death. Anterior criculation was examined through the temporal window or transorbiral window and basilar arteries were examined through the suboccipital window. All of the patients fulfilled the criteria for determination of brain death by clinical criteria, EEG and/or Brainstem Auditory Evoked Response(BAER) or clinical criteria alone, were mechanically ventilated. A TCD waveform abnormality consisting of reversed diastolic components was found in all brain death patients. The net flow veloicties of <10 ㎝/sec were present in all brain death patients. TCD may be a rapid and convenient alternative to cerebral angiography for confirming brain death when institutional protocols require such comfirmation.

단일기간 재고품목의 생산/분배계획 문제를 위한 Evolutionary Ant Colony Optimization

홍성철,박양병 한국경영과학회 2003 한국경영과학회 학술대회논문집 Vol.- No.2

일정한 시간이 지나면 제품으로서의 가치가 사라지게 되는 단일기간 재고품목들은 생산된 직후 전량 각 고객들에게 주어진 납기에 맞추어 효율적인 분배가 요구된다. 본 연구에서는 고객들은 다수 종류의 제품을 주문할 수 있으며 제품종류별 분리배송을 허용하는 상황에서 생산비, 수송비, 납기위반비, 차량고정비를 최소화하기 위한 생산순서 및 차량경로를 수립함을 목적으로 한다. 이에 대한 해법으로써 진화개미해법을 개발하였다. 개발된 해법의 성능평가를 위해 각 고개의 위치, 주문 제품 종류, 주문량들을 다르게 하여 구축한 실험문제에 대하여 유전알고리듬해법과 비교실험을 수행하였다