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.

전기자극이 건의 치유에 미치는 영향에 관한 실험연구

홍성철,김덕래,김태연,정전은,박길홍 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

The mechanism of tendon healing has been a controversial issue. Although there seems to be a dipolarizing opinion regarding the tendon healing, it is well known to us that the tendon has both intrinsic and extrinsic healing capacity which has proved in vivo and in vitro studies. Tendon adhesion is a common sequella after tendon repair, particularly after the ling period of immobilization. This can be explained by one wound concept or extrinsic tendon healing. If we can modify the natural healing process of the tendon by augmenting the intrinsic capacity, we can reduce the period of immobilization to allow early motion for better gliding. in this study, we used the electrical stimulation technique, which has been known to have good growth stimulatory effect on the living cells, to investigate its effect on tendon healing in organic culture for 6 weeks. Total 64 flexor tendons were harvested from 8 rabbit paws and they were cultured in separate petri-dishes.: 32 tendons were used for the control group and the rest 32 were used for the electric stimulation group. Tendons through which a continuous 7 μAmp current was passed at the repair site were compared with the non stimulated controls. In reference to the histologic study with Hematoxylin ?? Eosin stain and van Gieson stain, the following results were obtained. 1. There was found no necrosis in the specimens of the control as well as the elctrical stimulation group during 6 weeks' culture period. 2. Starting from 1 week, there was prominent increase of fibroblastic proliferation and collagen production in electrical stimulation group and these active repair processes persisted up to 6 weeks. Accordingly, I conclude that the intrinsic tendon healing capacity can be enhanced by the electrical stimulation in vitro.

태권도 품새 수련이 아동의 심박수, 심근산소소비량, 에너지 대사에 미치는 영향

정성태,전태원,박익렬,정덕조,우재홍,이광희,이동기,강현주 서울대학교 체육연구소 2000 서울大學校 體育硏究所論集 Vol.21 No.1

The Taegeuk Poomse 1 through 8 of Taekwondo are based upon eight major branches of philosophical theories. The propose of this study was to investigate the nfluence of Taekwondo poomse trainning on heart rate, MVO2, energy metabolism in primary school students. Subjects for this study were eight male the fifth∼sixth grades students who participated in exercise program consist of Taekwondo poomse trainning in dojang which is located in Shinlim-2dong, Kwanak-Gu, Seoul(12.7± 0.5years, 150.8 ±4.6cm, 45.1 ± 9.4kg, 24.9 ± 9trainning length). The results of thet this study are as follows: 1) The average of heart rate was Taegeuk Poomse 1 through 8 of Taekwondo 90.57± 4.gbeats/min in rest and 139.7 ± 17.5beats/min in exercise. The minimum heart rate was 89.0±2.8, peak heart rate was 167.1 ±6.4 in exercise. It was ranged from 42% to 80% 2) of the max heart rate and ranged 42 to 65%HRmax. Taegeuk 1 Jang was differenced with others Jangs significantly(p<0.05), 2) The time of the Taegeuk 1 through 8 Jang of Taekwondo was 5minutes 12seconds. Heart rate was ranged from 90.6 ± 7.85beats/min to 171.8 ±8.Ibeats/min and increased linearly. 3) The average of the MVO2 was 11.1 ±0.78mmHg · bpm-3 in rest and 19.1 ± 1.2mmHg ㆍbpm-3 in exercise. MVO2 was ranged from 10.5mmHg · bpm-3 to 20.3mmHg · bpm-3. There were not difference between Taegeuk Poomses(p<0.05). 4) The energy metabolism was as follows: Mean VO2 Respiratory exchange ratio, energy consumption were 0.51(V02L/min),0.71(RQ),2.32Ckca1/min) in rest respectively. but In exercise Mean VO2 Respiratory exchange ratio, energy consumption were 0.89 ± 0.18( V 02L/min), 0.79±0.08(RQ), 4.26±0.51(kcal/min) respectively . The difference was only between Taegeuk 1 Jang and Taegeuk 3 Jang(p<0.05). This study showed that the Taekwondo Poomse trainning was proper exercise for fitness, body composition and weight control in normal, abnormal(obese) children because the Taekwondo trainning are dynamic and exciting sport.

퍼지제어를 이용한 유도전동기 드라이브의 효율 최적화

정동화,이정철,박기태,이홍균 순천대학교 1999 순천대학교 자연과학논문집 Vol.18 No.2

Efficiency optimization of an indirect vector controlled induction motor drive is proposed. The loss models are used in the validation of the fuzzy logic based on-line efficiency optimization control. At steady state, the fuzzy controller adaptively changes the excitation current on the basis of measured input power, until the maximum efficiency point is reached. The pulsating torque, due to flux reduction, has been compensated by an ingenious feedforward scheme. During transient state, rated flux is established, to get the best transient response. Through a comprehensive simulation study, the results confirmed the validity of the proposed method.

진행 위암환자에서 Lymphokine-Activated Killer (LAK) 활성의 저하

홍원선,김영환,송재관,강윤구,이진오,강태웅,김정룡 대한내과학회 1990 대한내과학회지 Vol.38 No.3

Natural killer(NK) and lymphokine-activated killer(LAK) activities were determined in 31 patients with unresectable stomach cancer before and immediately after chemotherapy with 5-fluorouracil, adriamycin and mitomycin C(FAM) and 31 healthy volunteers. The major purposes of the study were focused on whether peripheral blood lymphocytes(PBL) in stomach cancer patients had a similar ability in the generation of LAK activity to those in healthy volunteers and what the effect was of chemotherapy with FAM on the generation of LAK activity. LAK cells were generated in vitro by culturing human PBL with 100 U/㎖ of recombinant human interleukin-2(rH-IL-2) for 72 hours. K562(human myelogenous leukemia cell line) and MKN-45(human stomach adenocarcinoma cell line) were used as target cells for NK and LAK activities. NK activity against K562, a sensitive line, was significantly depressed in patients with stomach cancer compared with that in healthy volunteers(p<0.01). However, LAK activity against K562 was similar to that of the controls. Age, sex and performance status(ECOG 0-2 and 3-4) did not have an influence on both NK and LAK activities. LAK activity was significantly higher than NK activity, either against K562 or MKN-45, in both healthy volunteers and patients with stomach cancer(p<0.001). NK and LAK activities against MKN-45, a NK-resistant line, in patients with stomach cancer showed significantly lower levels than those in healthy volunteers. We also analyzed the effect of chemotherapy with FAM on NK and LAK activities, with no suppression of NK and LAK activities being observed. In this study, we have demonstrated that PBL of stomach cancer have a reduced ability to generate LAK activity in response to rH-IL-2. However, LAK activity generated from PBL receiving chemotherapy with FAM was similar to that of PBL without chemotherapy.

한국어판 예일 틱 증상 평가척도 : 신뢰도 및 타당도 연구

정선주,이정섭,유태익,구영진,전성일,김봉석,홍강의 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 틱 증상의 심한 정도를 평가하기 위한 도구인 예일 틱 증상 평가척도(Yale Global Tic Severity Scale)를 한국판 가정 평가용 설문지 및 임상 평가용 척도로 개발하기 위하여 본 연구를 시행하였다. 방 법 : 예일 틱 증상 평가척도는 뚜렛 장애 및 기타 틱 장애에서 나타나는 운동틱과 음성틱 각각의 증상의 수, 빈도, 심한 정도, 복합성, 방해 정도 및 장해도를 포괄적으로 평가하도록 고안되어져 있다. 틱 증상을 주소로 정신과외래를 방문한 만 4.3세에서 19세까지의 100명의 환아 및 부모들을 대상으로 한국어로 번역한 예일 틱 증상 평가척도의 가정평가용 설문지를 평가전에 완료하도록 한 후, 면담을 통한 임상평가용 척도를 실시하였으며 수렴타당도 및 변별타당도의 검증을 위해 총괄적인 임상 인상척도-뚜렛 증후군, 강박장애, 주의력결립/과잉운동장애(Clinical Global Impression-TS, OCD, ADHD)를 시행하였다. 결 과 : 자료분석결과 내적일치도, 수렴타당도, 변별타당도 및 검사자간 신뢰도 모두 매우 높게 나타났으며 요인분석상 전 항목척도와 장해도는 운동틱과 음성틱에 해당하는 2개의 요인으로 묶여졌다. 결 론 : 본 연구결과 한국판 예일 틱 증상 평가척도의 높은 타당도 및 신뢰도가 입증되었으며 이는 향후 틱 증상의 객관적인 평가 및 정량화를 위해 유용하게 사용되어질 수 있을 것이다. Objectives : This study was carried out to develop the Korean form of Yale Global Tic Severity Scale(YGTSS)-family & clinical rating version. The severity of motor and phonic tics was rated according to five separate dimensions : number, frequency, intensity, complexity, and interference. Methods : The Korean form of YGTSS was applied to 100 children who visited psychiatric outpatient clinic with chief complaints of tic symptom. Together with YGTSS, Clinical Global Impression for Tourette's syndrome(CGI-TS), Obsessive-Compulsive disorder(CGI-OCD), Attention-Deficit/Hyperactivity Disorder(CGI-ADHD) were administered to all subjects for examining convergent and discriminant validities. Results : We could confirm high internal consistency, convergent and discriminant validities and interrater reliability of YGTSS by analysing data from 100 children with tic disorder. In factor analysis, items were clustered to 2 factors which were identical to motor and phonic tic subscales. Conclusion : The results of this study indicate the Korean form of YGSS is a reliable and valid rating scale for rating tic symptom severity. It can be used to evaluate tic symptom objectively and to quantify the tic severity in the studies for tic disorder.

廢有機鹽素化合物의 燒却處理

鄭淳亨,李泰鎬,鄭洪基 대구보건대학 1992 대구보건대학 論文集 Vol.13 No.-

The objective of this study was to oxidize chloromethanes waste with pyrolytic incineration unit. This experiment was carried out in actual plant. We have studied incineration temperature VS. removal rate of waste Liquid, removal of Hcl and Cl₂ in the flue gas. The results obtained were as followa : 1) In combustion condition for the temperature of 950℃ and the residence time of 1, 2 seconds, waste chloromethanes and cyan compounds were nearly decomposed. 2) The removal of Hcl and Cl₂ for the use of NaOH in the flue gas was very excellent. 3) The scrubbing of the dust was effected with NaOH solution.

컨버터로 제어되는 유도전동기 드라이브 시스템의 손실 모델링

정동화,이정철,박기태,이홍균 순천대학교 1999 순천대학교 자연과학논문집 Vol.18 No.2

An accurate loss model of induction motor drive controlled by the converter is proposed. Steady state fundamental and hamonics loss characteristics, besides the dynamics of the machine are analyzed and incorporated in the model, resulting in a new synchronous frame dynamics d-q equivalent circuit. The converter system has been modeled accurately for condition and switching losses.

정신분열병 환자의 살인행동과 관련된 임상양상

정석훈,이태경,정재열,장정기,장상현,이미경,강시현,정혜윤,유한익,김창윤,홍진표 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objectives : Recent studies have shown that schizophrenic patients are at increased risk to commit acts of aggression, and aggressive behaviors have severe critical results for the patients and victims. The purpose of the present study is to assess the homicidal behaviors of schizophrenic patients as a extreme case of aggressiveness. Methods : 93 homicidal schizophrenic patients and 93 non-homicidal schizophrenic patients participated in this study. Diagnostic evaluation was made with SCID (Structured Clinical Interview for DSM-IV), and personality trait was evaluated with SIDP (Structured Interview for DSM-IV Personality Disorders). Symptom evaluation was done with PANSS (Positive And Negative Syndrome Scale), and violent behaviors were assessed with LHA (Life History of Aggression) and OAS (Overt Aggression Scale). Results : There were no significant differences in demographic vahables, schizotypal personality trait and antisocial Personality trait between two groups. Mean age at homicidal commitment was 34±8.9 years and 9.8±7.5 years after the onset of illness. The major criminal victims were the parents of the patients (N=49, 53.7%). The aggressiveness was higher in homicidal schizophrenic patients in LHA and OAS scales. There were statistical significances in separate items of the PANSS scale such as excitement (P4), Poor rapport (N3), lack of judgement and insight (G12), disturbance of volition (G13), Poor impulse control (G14) and active social avoidnance (G16), but not in the positive, negative, general subscales and the total scores of the PANSS scale. Conclusion : Excitement and poor impulse control persisted in homicidal schizophrenics, although overt psychotic Symptoms decline after proper treatment. Homicidal behavior can be preventive if proper treatment for excitement and poor impulse control are given.

淡水魚類, 兩域魚類, 海産魚類의 삼透壓調節器宮의 組織學的 比較

鄭泰永,許洪旭 釜山大學校 師範大學 1977 교사교육연구 Vol.4 No.2

1) The salt cells were absolutely absent in the gill of Carassius carassius, a fresh water fish, tut renal capsules, glomerulus, proximal and distal convoluted tubules were well developed in the kidney of the above fish, which continuously excreted out excess water had come through mucous membrane of epithelium from the environment lower osmotic pressure condition than inner body. 2) Anguilla japonica which behaved both of migration, anadromous, catadrorr.ous had well developed salt cells in the gill, and renal capsules in the kidney since they could adapted fairly in the environment. 3Mugil cephalus, Pseudopleuronectes herzensteini, euryhaline fishes, and Astroconger myriasrer, in shore fishes, had developed salt cells in the gill and renal capsules in the kidney so that they could adapted lower salinity environmental condition. 4) Cynias manazo, essential marine elasmobranchii, had rudimental salt cells in the gill, well .developed renal capsules but had poorly developed proximal and distal convoluted tubules in the kidney. They also had well developed rectal gland, salt excretory organ. By the above condition, they could adapted high salinity of the brine. 5) Pagrosomus major, aglomerulus, had fairly developed salt cells in the gill, but no glomeruli in . the kidney. So that they could live pure brine, not influenced from any factor of fresh water.