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.

韓國人血液群 A,B,및 AB 赤血球의 被疑集性에 關한 硏究

梁學道,李楨浩,尹秉文,芮薰海,全東雨,李文玉,金晉郁 醫藥係社 1955 綜合 醫學 Vol.12 No.8

VDRL 硝子板法 陰·陽性 血淸에 對한 Waaler-Rose 反應

梁學道,李楨浩,尹秉文,芮薰海,全東雨,金晋郁,玉東石 醫藥係社 1954 綜合 醫學 Vol.11 No.12

한국인 인슐린비의존형 당뇨병환자에서 엔지오텐신 1-전환효소 유전자의 다형성과 당뇨병성 만성합병증 및 관상동맥질환과의 관계

정민영,천남일,이창훈,조동혁,강호철,정동진,정명호,강정채,박종태,양승원 全南大醫大 2001 전남의대학술지 Vol.37 No.3

세균독소로 자극시킨 사람 섬유아 세포에서의 Interleukin-6와 Interleukin-8의 생성

정인교,양동규,홍시영,이성근,김욱규,김광혁,김종렬 大韓顎顔面成形再建外科學會 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.4

Cytokines are hormone-like proteins which mediate and regulate inflammatory and immune responses. Interleukin-6 (IL-6) is involved in the final differentiation of B cells into antibody-producing cells. Interleukin-8 (IL-8) is a neutrophil chemotactic factor that plays an important role in the recruitment of neutrophil to inflammatory loci. Inflammatory mediators by cells in the gingiva have been implicated in the initiation and progression of periodontitis and oral infection. The purpose of this study was conducted to investigate the effect of lipopolysaccharide (LPS), staphylococcus enterotoxin B (SEB) on production ofIL-6 and IL-8 by human gingival and facial dermal fibroblasts. Primary cultured human gingival and facial dermal fibroblasts were incubated with LPS(0.01, 0.1, 1.0㎍/ml), SEB (0.01, 0.1, 1.0㎍/ml) or LPS (0.1㎍/ml) plus SEB (0.1㎍/ml). Culture supernatants were collected at 24, 48, and 72 hrs and assessed for IL-6 and IL-8 production by enzyme-linked immunosorbent assay. IL-6 production in gingival fibroblasts stimulated with LPS was higher than that with SEB. IL-6 production by double exposure with LPS plus SEB was amplified in comparison with single exposure of LPS or SEB. IL-6 production in facial demal fibroblasts was increased only by stimulation with a high concertration of LPS (1.0㎍/ml). Its production in facial dermal fibroblasts by exposure with SEB was decreased in comparison with control, nontreated cells. Therefore, gingival fibroblasts showed higher sensitivity than facial dermal fibroblasts in response to low concentration of LPS. Also, IL-6 production by double exposure with LPS plus SEB was amplified in comparison with single exposure of LPS or SEB.IL-6 production in facial dermal fibroblasts was increased only by stimulation with a high concentration of LPS(1.0㎍/ml). Its production in facial dermal fibroblasts by exposure with SEB was decreased in comparison with control, nontreated cells. Therefore, gingival fibroblasts showed higher sensitvity than facial dermal fibroblasts in response to low concentration of LPS. Also, IL-6 production by double exposure with LPS plus SEB was amplified in comparison with single exposure of LPS or SEB. IL-8 production in gingival fibroblasts was enhanced greatly only by stimulation of high concentration of LPS (1.0㎍/ml). That by exposure with SEB was increased only in 24 hrs cultivation. IL-8 production by double exposure with LPS plus SEB was amplified in comparison with single exposure of LPS or SEB. IL-8 production in facial dermal fibroblasts was decreased by LPS and increased only in 48 hrs cultivation by SEB. IL-8 production by double exposure with LPS plus SEB was enhanced only in 48 hrs cultivation in comparison with single exposure of LPS or SEB. therefore, IL-6 and IL-8 production were released at various quantities according to bacterial toxin applied and site of fibroblast harvested. These results suggest that gingival fibroblasts may be concerned with IL-6 and IL-8 related inflammatory response more than facial dermal fibroblasts.

NOD/SCID 마우스 모델을 이용한 인간 제대혈 혼합이식에서의 생착 양상 분석

정양조,김동욱,조빈,강영주,박보배,김혜정,김태규,오일환 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.2

연구배경: 제대혈은 골수에 비해 많은 장점을 가지고 있음에도, 이식 후 성적에 있어 총세포수에 의해 좌우되며, 한 개의 태반으로부터 얻을 수 있는 총세포수의 한계가 있어 주로 소아에 국한되고 있다. 따라서 제대혈 응용의 확대를 위해 생착량을 늘이기 위한 방법으로 다중공여자에 의한 제대혈 혼합이식을 늘일 수 있는지 연구하기 위하여, 본 연구에서는 주조직적합성 형별로 조합된 제대혈을 NOD/ SCID 생쥐에 이식하는 방법으로, 혼합생착의 가능성을 연구하였다. 방법: 조합된 2개 공여자로부터 얻어진 제대혈들을 단일이식 및 혼합이식하여, 혼합이식된 숙주에 생착된 세포를 PCR-SSOP 방법을 사용하여 공여자 별로 추적하였다. 또한 각 공여자세포의 상대적 생착비율을 대조군인 단일제대혈 이식에서 얻어진 생착량과 비교하는 정량적 비교도 함께 하였다. 결과: 총단핵구를 혼합이식한 실험군에서는 주조직적합성의 일치도에 관계없이 한쪽공여자의 세포가 다른쪽에 비해 우세한 편향생착을 보였다. 그러나 임파구를 비롯한 Lineage 양성세포를 제거한 실험군에서는 주조직적합성의 불일치에도 불구하고 뚜렸한 생착의 공존이 관찰되었다. 결론: 본 연구는 제대혈의 생착량을 증가를 목적으로 총단핵구를 혼합이식할 경우 한쪽공여자의 세포에 의해 편중되며, 이것을 이식 후 생착과정에서의 두 종류의 세포의 경쟁에 의해 초래된다는 것을 보이고 있다. 또한 이러한 경쟁은 제대혈에 포함되어 있던 임파구들에 의한 것이며, 생착공존을 위하여는 공여자간 주조직적합성의 일치도 보다, 임파구의 제거가 더 중요하다는 것을 보여주고 있다. Background: Although umbilical cord blood (UCB) has been an attractive alternatives for bone marrow cells, application is limited to pediatric case due to limitation in total number of nucleated cells, that is a single most important factor for outcomes of UCB transplantation. Therefore, increasing overall engraftment by mixed transplantation of UCB derived from multiple donor should comprise one strategy to circumvent the posed limitation of UCB transplantation. In order to investigate the feasibility of establishing co-engraftment by multi-donor UCB cells, we carried out a xenotransaplantation study using NOD/SCID mice for systemic analysis of results on the input-based control of single unit transplantation. Methods: UCB units with various extent of HLA-matchings were co-transplanted into NOD/SCID mice along with single unit transplantation control. The relative contributions of engraftment by cells from each donor-derived were analyzed by HLA polymorphism using PCR-SSOP. Results: In all HLA-based mixed transplantation of total nucleated UCB cells, engraftment of one donor predominated over the other despite that equivalent amount of engraftments were achieved by single donor transplantation. When lineage depleted UCB units were co-transplanted, significant degree of co-engraftments were observed regardless of HLA disparity. Conclusion: Our result show that one donor cells dominate over the other in mixed UCB transplantation and that it is due to competition between donor cells during post-transplantation process. Our results suggest that immune cells contained in UCB unit mediate such competitioin and that 6 locus HLA matching would not be sufficient to prevent the competition.

알쯔하이머병 환자의 뇌혈류 장애 : Statistical Parametric Mapping을 이용한 Tc-99m ECD SPECT 분석 Statistical Parametric Mapping analysis of Tc-99m ECD SPECT

양동원,김범생,손영민,박정욱,정용안,손형선,김상윤 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.2

Background and Objectives . Alzheimer's disease (AD) is the most common cause of the dementia Pathologic and functional changes of AD are known to be unevenly distributed in the brain. This study investigates changes of cerebral blood flow (CBF) in patients with AD to determine brain regions with hypoperfusion that reflects progression of disease. Methods. Tc-99m-ECD single photon emission computed tomography (SPECT) was performed to measure regional CBF and statistical parametric mapping (SPM) 99 soft ware was used for the automated and objective approach to analyze SPECT image data. Twenty-five patients with mild to moderate dementia who met NINCDS-ADRDA critena for AD (male 11 female 14) and 17 age-matched normal control subjects were studied. The severity of AD was measured by clinical dementia rating (CDR) scale Results. SPM analysis of SPECT images revealed that CBF in the anterior cingulate gyrus left superior panetal cortex left medial frontal cortex left infenor temporal cortex. right thalamus and left hippocampus was significantly decreased in AD patients compared with normal controls (corrected p<0.05). The reduction of CBF according to CDR was localized in the left hippocampus and infenor temporal cortex right antenor and postenor ciagulate cortex and right superior panetal cortex (uncorrected p<0.01). Conclusions : Our data suggest that the cognitive dysfunction of AD is strongly related with functional abnormality in discrete brain areas 99m-Tc ECD SPECT with SPM analysis could be used as a useful functional imaging tool in AD study.

표상전략교수와 직접교수가 수학학습부진아의 문장제 해결력과 자기효능감에 미치는 효과 비교

양문창,정동영 韓國敎員大學校 敎育硏究院 2009 敎員敎育 Vol.25 No.3

본 연구는 표상전략교수와 직접교수가 수학학습부진아의 문장제 해결력과 자기효능감에 미치는 효과의 차이를 비교하는데 그 목적을 두고 있다. 본 연구는 제주도 A초등학교에 재학 중인 5학년 297명 중에서 수학학습부진아 30명을 연구대상으로 선정하여 실험집단과 통제집단에 각각 15명씩 배정하고,실험집단에 주 3회씩 5주 동안 총 15회기의 표상전략 교수를 시행하고,통제집단에 같은 회기 동안 직접교수를 시행하였다. 연구결과 표상전략교수를 실시한 실험집단이 직접교수를 실시한 통제집단보다 문장제 해결력과 자기효능감이 더 많이 향상되었다. 이를 통해 표상전략교수는 직접교수보다 수학학습부진아들로 하여 금 문장제를 해결하는데 더욱 효과적인 교수전략임과 동시에 수학학습부진아들이 문장제를 성공적으로 해결하는 경험을 통해 수학에 대한 자기효능감을 증진시키는데도 적합한 교수전략이라 할 수 있다. The purpose of this study was to compare the effects of representation strategy instruction and direct instruction on the mathematical underachiever's word-problem solving and self-efficacy. In order to accomplish such purpose, the research questions were established that is how much different effects are made by representation strategy instruction and direct instruction on the mathematical underachiever's word-problem solving? and how much different effects are made by representation strategy instruction and direct instruction on the mathematical underachiever's self-efficacy? In order to resolve the above questions, 30 students with mathematical underachievement were selected among 297 5th graders of primary school located in Jejudo. After, the experiment group of 15 students were treated with the representation strategy instruction during 15 periods third on a week and the control group of 15 students were treated direct instruction. The data were treated to obtain mean and standard deviation as descriptive statistics and perfomed ANCOVA to verify the difference of the effect. The results of this study are as follows. First, the experiment group that participated in the sessions of representation strategy instruction was proved to be more effective on enhancing the mathematical word-problem solving rather than control group that participated in the sessions of direct instruction. Second, the experiment group that participated in the sessions of representation strategy instruction was proved to be more effective on enhancing the self-efficacy rather than control group that participated in the sessions of direct instruction. As above, representation strategy instruction is not only more suitable teaching strategy to enhance the mathematical underachiever's mathematical word-problem solving but also to enhance the self-efficacy rather than direct instruction.

농어촌 생활하수처리를 위한 수초·골재 하수처리장의 특성

정동양 한국교원대학교 환경과학연구소 2004 환경연구논문집 Vol.- No.8

A sewage treatment plant built with water plants and gravels in an open field has been operated for 3 years with a daily average flow of 50 m. The quality of treated water was regularly analysed and the economic assesment of the process has been investigated. Seasonal performance of the plant has been investigated with emphasis on treatment efficiency, shock loading responses, effects of sewage evaporation rate, effects of high and low ambient temperature, long term shutdown and start-up. Analyses of sewage indicated that the quality and quantity of the sewage generated in farming and fishing villages depend mainly on the life pattern of the residents. A sewage treatment plant with mechanical equipments may have high operating costs and low treatment efficiency to treat this type of sewage. However, the sewage treatment plant suggested in this study employs natural purification processes and has showed stable long term treatment efficiency even with shock loading and ambient temperature variation. Treatment of phosphorus with mechanical processes may need high operating costs but the suggested processes using water plants and gravels removes phosphorus in natural ways resulting in high removal efficiency and low costs. The natural sewage treatment plant showed good efficiency for all year around to meet the discharge guide-lines of drinking water protection area with respect to BOD, COD, TN. TP and SS. The high treatment efficiency may be due to the action of microorganisms living attached on the surface of the gravels. However, the water plants showed limited treatment performance.

수도수중 염소 소독부산물로 인한 건강위해성 평가에 관한 연구 : 서울시 수도수중 Trihalomethanes 및 Haloaceticnitriles을 중심으로

정용,신동천,양지연,박연신,김준성 한국환경독성학회 1997 환경독성보건학회지 Vol.12 No.2

Public concerns about hazardous health effect from the exposure to organic by-products of the chlorination have been increased. There are numerous studies reporting that chlorination of drinking water produces numerous chlorinated organic by -products including THMs, HAAS, HANs. Some of these products are known to be animal carcinogens. The purpose of this study was to estimate health risk of DBPs by chlorinated drinking water ingestion in Seoul based on methodologies that have been developed for conducting risk assessment of complex-chemical-mixture. The drinking water sample was collected seperately at six water treatment plant in Seoul at March, April, 1996. In tap water of households in Seoul, DBPs were measured with the mean value of 36.6 μg/L. Risk assessment processes, which include processes for the estimation of human cancer potency using animal bioassay data and calculation of human exposure, entail uncertainties. In the exposure assessment process, exposure scenarios with various assumptions could affect the exposure amount and excess cancer risk. The reference dose of haloacetonitriles was estimated to be 0.0023 mg/kg/day by applying dibromoacetonitrile NOAEL and uncertainty factor to the mean concentration. In the first case, human excess cancer risk was estimated by the US EPA method used to set the MCL (maximum contaminant level). In the second and third case, the risk was estimated for multi-route exposure with and without adopting Monte-Carlo simulation, respectively. In the second case, exposure input parameters and cancer potencies used probability distributions, and in the third case, those values used point estimates (mean, and maximum or 951!!i) upper-bound value). As a result, while the excess cancer risk estimated by US EPA method considering only direct ingestion tended to be underestimated, the -risk which was estimated by considering multi-route exposure without Monte-Carlo simulation and then using the maximum or 95% upper-bound value as input parameters tended to be overestimated. In risk assessment for Trihalomethanes, considering multi-route exposure with adopting Monte-Carlo analysis seems to provide the most reasonable estimations.