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.

저에너지 사료 급여가 거세 비육돈의 성장과 도체 품질에 미치는 영향

이철영,이희포,이진희,박만종 진주산업대학교 농업기술연구소 2000 農業技術硏究所報 Vol.13 No.-

Barrows eat excessively more feed than gilts and as a result, their carcass grades are, in general, lower than those of the latter. The present study was conducted to investigate the effect of a low-energy diet on growth and carcass quality in finishing barrows and thereby to draw a guideline for the usage of it. In experiment I(Exp. I), 60 LYYD cross-bred barrows weighing ~70kg were randomly assigned into four pens and fed ad libitum either of two finishing diets containing 103%(control diet) and 87%(low-energy diet) of the NRC digestible energy(DE) requirements, respectively, up to slaughter at ~105kg. Exp. Ⅱ was same as Exp. Ⅰ except that average initial weight of the barrows(48 heads) was ~60kg and feed intake was measured. In Exp. I, by feeding the low-energy diet, average daily gain(ADG) was decreased(P<0.05); backfat thickness corrected for 110kg of live weight tended to be decreased(P=0.11); and the ratio of A,B grade carcass was not apparently affected[93%(low-energy diet) vs 90%(control)]. In Exp. II, as in Exp. I, ADG was decreased by feeding the low-energy diet vs control, which is interpreted to have resulted primarily from a 14% decrease in total DE intake. Compared with control, low-energy diet group had a similar average daily feed intake(3.10 vs 3.04kg) and a 14% higher feed/gain. In somewhat contrast to the result of Exp. I, backfat thickness corrected for the live weight was not different between the two groups in Exp. II, which is presumed to have resulted mainly from a genetic ununiformity of the animals with respect to this trait. The A,B carcass ratio, on the other hand, was not appreciably different between the two groups(73 vs 83%). In summary, under the current domestic carcass grading system allowing a relatively wide range of backfat thickness for A and B grades, a low-energy diet is considered to be useful only for a barrow population where the A, B carcass ratio is too low for excessive fackfat. More studies are needed, however, to determine whether a low-energy diet will be useful under the situation of international pork market demanding a higher lean meat ratio.

도시 개발에 따른 기상장 변동의 3차원 수치해석에 관한 연구

이희철,이범주,이도훈,이은태 경희대학교 산학협력기술연구원 1999 산학협력기술연구논문집 Vol.5 No.-

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

에탄올을 장기간 섭취한 백서에서 Acamprosate 투여가 Nitric Oxide Synthase 발현에 미치는 영향

정홍경,이기철,이정호,이승휘,이희제,정주호 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

에탄올이 백서의 해마에서 Neuropeptide Y 발현에 미치는 영향

정홍경,이기철,이정호,이희제,정주호,이주영 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

전류 비유 모델에 의한 초등학생의 전류 개념 변화 분석

유병길,강인석,김병철,남만희,박선희,소하연,윤희정,이영아,이하룡,전병문,정승호 부산교육대학교 과학교육연구소 2000 科學敎育硏究 Vol.25 No.-

There exists a major impediment to learning electricity which may illuminate why direct presentation of scientists' ideas is too aggressive a strategy. This impediment lies in thinking that electricity is used up and in envisaging the light bulb as a consumer. This view is based on a powerful idea which summarises much of our experience; it declares that 'things get used up', 'you cannot get something for nothing', and 'intuitive thinking'. To replace this view with scientific view, we made the analogy model. It is suggested that the analogy model is more effective in teaching electricity circuits than conventional teaching method.

조혈모세포이식을 받은 급성 골수 백혈병 환자에서 발생한 cyclosporine에 의한 양측 시신경병증

정진권,김한조,박명진,하승주,최경식,이성진,박성희,이상철,이남수,박희숙,원종호 순천향대학교 의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

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Cyclin-dependent kinase(CDK)와 세포주기(cell cycle)조절을 통한 새로운 항암제의 개발 현황

이철훈,조율희 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1

The cell-division cycle is a tightly controlled process that is regulated by the cyclin/CDK family of protein kinase complexes. Stringent control of this process is essential to ensure that DNA synthesis and subsequent mitotic division are accurately and coordinately executed. There in now strong evidence that CDKs, their regulators, and substrates are the targets of genetic alteration in many human cancers. As a result of this, the CDKs have been targeted for drug discovery and a number of small molecule inhibitors of CDKs have been identified. Our attempt here is to illustrate the potential for development of therapeutics to treat human cancers by interfering with cell-cycle progression. Because of the central role that they play in advancing the division cycle, CDKs have been targeted for drug discovery and a number of small molecule compounds have now been identified as CDK inhibitors. These strategies and other targets of intervention within the cell cycle are discussed in our review.

Lyo-Dura를 이용한 Orbital Floor Fracture의 정복술

이희철,이희원 인제대학교 1982 仁濟醫學 Vol.3 No.4

최근 우리나라는 물론이고 전세계적으로 교통사고등 현대산업사화에서 빈발하는 각종사고로 인하여 악안면 부위의 골절환자가 점증하고 있는 바 이에 대한 적절한 진단과 처치가 구강외과 영역에서 중요한 문제로 대두되고 있다. 이에 본 논제에서는 facial bone fracture가 있을때에 orbital floor를 Lyodura를 이용해서 reconstruction 하는 방법에 대해서 논하고자 한다. Orbital bone trauma, maxillofacial bone fracture, and soft tissue injury are often progressive components of a single or multiple injury pattern. Facial lacerations associated with underlying skeletal damage have been described previously; but its diagnostic significance seldom has been appreciated. Blunt trauma to the region of infraorbit may result in a spectrum of injuries, ranging from minor lacerations or eccymosis to compound fractures. The extent of soft-tissue and skeletal damage is related to the force and direction of impact; a relatively large force seems to be required to produce a infra-orbital-floor fracture, whereas lesser impacts generally result only in soft-tissue injury. When the facial bone is fractured, especially commiunted fracture of the orbital-floor, the bony surface is lost and opened to the maxillary-sinus cavity. Therefore the orbital fascia, the periosteum and the muscle is herniated partially into the cavity. If oral-surgern did not reconstruct the area perfectly, the permanent diplopia is caused by compress the oblique inferior muscle and the rectus inferior muscle. Then we reconstruct the fractured orbital-floor by use of the LYO-DURA effectively. This report describes representative patients with fractures of the infraorbital floor and of the maxillo-facial bone secondary to maxillo-facial-region trauma and suggests a protocol for efficient diagnosis and surgical new technique.