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        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.

      • 관상동맥내 스텐트 삽입후 발생한 관상동맥류 2례

        제인수,허민영,문치숙,이재호,정수룡,조길현,이영민,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3

        Coronary artery aneurysms are detected with increasing frequency because of the routine use of coronary angiography in the diagnosis and management of coronary artery disease. Although some coronary artery aneurysms are congenital or inflammatory, most are atherosclerotic. The prognosis of atherosclerotic coronary artery aneurysm may depend on the morphology of the aneurysm or the presence of coexisting obstructive disease. Coronary artery aneurysms have been also reported to occur after ballon angioplasty, directional athrectomy, laser angioplasty, and stent implantation with a frequency of 2% to 4%. The long-term outcome of post-intervention coronary artery aneurysm is unknown. We report two cases of the development of a coronary aneurysm 6 months after stent implantation as a treatment of severe obsructive coronary artery disease.

      • 전격성 경과를 취한 만성 호산구성 폐렴 환자 1예

        윤호상,진춘조,유광하,이상엽,이수인,정상만,김선두,이순제,이길도,전혜정 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

        Chronic eosinophilic pneumonia(CEP) is a rare disease of unknown etiology characterized by chronic infiltration of the lung with eosinophils. It presents with profound systemic symptoms comprising fever, night sweats, weight loss, dyspnea and blood eosinophilia with nonsegmental air-space consolidation confined to the outer third of the lung, the "photographic negative of pulmonary edema". Histopathologic features of chronic eosinophilic pneumonia are intraalveolar and interstitial infiltrations with eosinophils, histiocytes, giant cells, scattered lymphocytes and plasma cells. Glucocorticoid therapy cause prompt resolution of symptoms as well as disappearans of blood eosinophils, elevated serum Ig E levels and the roentgenographic lesions. Infrequent radiographic findings include nodular infiltrates, consolidations, cavitations, atelectasis and pleural effusions. Deaths from CEP although rare, have been reported, but the majorities of CEP have benign courses and do not need a therapy with ventilator. We report a case of chronic eosinophilic pneumonia, which had a sudden course associated with diffuse pneumonic consolidations on the both lung and bilateral pleural effusion.

      • SCIESCOPUSKCI등재
      • 한국개비자(Cephalotaxus koreana)의 Harringtonine 과 Homoharringtonine에 관한 연구

        이연,박두천,박호일,주우홍,이현채,신동수 昌原大學校 基礎科學硏究所 1996 基礎科學硏究所論文集 Vol.8 No.-

        한국산 개비자로부터 alkaloid계통의 성분인 harringtonine과 homoharringtonine의 혼합물을 추출하여 한국산 개비자의 잎, 줄기, 뿌리에서의 harringtonine과 homoharringtonine의 함량은 고속 액체 크래마토그래피에 의해 결정하였다. 두물질의 함량은 서식지, 식물의 부위에 따라 상이하였다. Harringtonine의 함량은 줄기보다 잎과 뿌리에서 높았고, homoharringtonine의 함량은 harringtonin 함량보다 낮았다. 팔공산, 덕유산, 백양산, 지리산 및 남해에서의 잎의 homoharringtonine 함량은 줄기와 뿌리에서 높게 나왔으며, 조계산과 진도에서는 잎의 함량이 뿌리와 줄기에서 보다 낮았다. Harringtonine and homoharringtonine known as anti-cancer agents were isolated from Korean native plumyew (Cephalotaxus koreana). The contents of harringtonine and homoharringtonine in the needles, stems, and roots of Korean native plumyew were determined by high performance liquid chromatography (HPLC). The contents of both compounds varied with the site of location and the part of plant. The content of harringtonine was higher in needles and roots than in stems, whereas the content of homoharringtonine was lower than harringtonine. Homoharringtonine contents in needles at Mt. Palgong, Mt. Dukyu, Mt. Baekyang, Mt. Jiri, and Namhae were higher than in stems and roots. But homoharringtonine contents in needles at Mt. Jokye and Jindo were lower than in stems and roots.

      • 한우 Stearoyl-CoA Desaturase의 cDNA 단편 클로닝 및 mRNA 발현양상

        이창수,윤두학,이승환 건국대학교 자연과학연구소 1999 建國自然科學硏究誌 Vol.10 No.1

        Single-strand cDNA was prepared from total RNA in liver of Hanwoo cattle using the random primer. A fragment of 675 bp coding for part of the Hanwoo stearoyl-CoA desaturase(SCD) gene was amplified by Reverse Transcriptase-Polymerase Chain Reaction(RT-PCR) using primers based on published rat cDNA sequence. The amplified DNA product was cloned into the pGEM-4Z vector. The insert DNA was sequenced by the Saneer's method. The homology of Hanwoo SCD cDNA sequence was shown to be 98%, 85% and 84% to that of rat, ovine and human, respectively. When the Hanwoo SCD cDNA sequence was translated into peptide. the similarities with rat, ovine and human SCD were 98%, 83% and 87%, respectively. Southern anaiysis of Hanwoo genomic DNA with Hanwoo SCD cDNA generated a single hybridization fragment that was observed in size 2.Okb or 1.Okb by EcoR Ⅰ or Hind Ⅲ digestion. The level of SCD mRNA in Hanwoo cattle was low in liver and high in adipocyte and muscle tissues.

      • 複合運送條件의 등장에 따른 貿易慣習의 發展展望

        李龜喚,崔斗壽 新羅大學校 1987 論文集 Vol.23 No.-

        After world war Ⅱ, with the container revolution the combined transport system appeared, then many problems were brought out in the field of transportation of goods which had no great significance in the earlier times. To cope with them the International Chamber of Commerce (ICC) has come to codify 「Incoterms 1980」after many times amendments, which includes trade terms-FRC·DCP·CIP, used for the contracts of Sale based on the combined transport system. In this thesis, I lightened the essence of FRC·DCP·CIP contracts, the main issues in the performance of the contracts, that is, property transfer and passing of risk from view point of jurisprudence. Under FRC contract the seller and buyer become exporter and consignor respectively, under DCP·CIP contract the seller becomes exporter and consignor, arranges the contracts of transport and insurance, and pays freight and insurance costs as under CFR·CIF contracts. But the characteristics of FRC·DCP·CIP contracts in the light of transport system depended upon the course of contacts performance. Under the former contracts the extent of obligation on all costs and the time of property transfer and passing of risk are defined by the concept-under the custody of the first carrier, which is compared with that-ship's rail under the latter contracts. The amounts of trade by the combined transport system is on the increase, but the adoptation of FRC·DCP·CIP terms is seldom, therefore the countermeasures and improvements are required. Firstly, the United Nations Convention in International Multimodel Transport of Goods(1980) should come into effect and new insurance system for the combined transport system be enacted. Secondly, combined transport document, insurance policy should be characterized by negotiability and document of title, which enable the buyer to the price of goods by documentary bill of exchange. Then the benefit of finance would be guarantees /by use of the evidential documents. Thirdly, the FRC·DCP·CIP usages should be developed with the accumulation of trade customs and juridical precedents.

      • 계면활성제의 체인길이에 따른 구형 MCM-41의 합성

        이두형,최병열,장원철,서길수,이태진 영남대학교 공업기술연구소 1999 工業技術硏究所論文集 Vol.27 No.1

        Mesoporous MCM-41 exibits a hexagonal arrangement of uniform mesopores whose dimensions may be engineered in the range of ∼20Å to greater than 100Å. The MCM-41 typically have high surface areas above 1000m2/g, and then capacities of MCM-41 to accommodate the larger hydrocarbon is still higher than the general molecular sieve. At the present, many surfactants as organic templates have been proposed for various formations of these MCM-41. In this study, we synthesized mesoporous MCM-41 which has a spherically hexagonal structure. Also, the pore size of MCM-41 could be changed by the control of alkyl chain length of surfactants.

      • 데이타플로우 컴퓨터에서 Sparse한 행렬과 벡터의 내적 수행시 성능 평가

        李暻敏,李龍頭,蔡洙煥 한국항공대학교 1992 論文集 Vol.30 No.-

        실 시간 처리 분야에서 요구하는 컴퓨터 시스템의 성능을 만족시키기 위하여 병렬처리 시스템에 대한 연구가 활발히 진행되고 있다. 본 연구에서는 병렬처리 시스템들 중에 병렬성 구현 정도가 뛰어난 정적 데이타플로우 컴퓨터의 구조에서 최대의 병렬성, 적정 프로세서의 수, 대기 행렬의 수, 속도 향상등을 평가하기 위해 시뮬레이터를 구성하였다. 병렬로 처리될 수 있는 부분들이 많이 존재하는 sparse한 행렬로 벡터의 내적을 구하는 문제들을 시뮬레이션 하였다. 시뮬레이션에 있어서, 필요한 명령들의 처리 시간을 8086프로세서를 기준으로 한 실제적인 경우로 주었다. Research on parallel processing systems is very active to satisfy the computer performance required in real-time processing fields. In this research, a simulator is implemented to evaluate the maximum parallelism, the proper number of processors, the size of queue and the speed up factor on static dataflow computer architectures which can be expressed parallelism naturally. Inner product of sparse matrices and vectors is chosen to evaluate the performance of static dataflow architectures. In the simulation, ideal execution times and real execution times based on the 8086 processor are applied.

      • 하드 실시간 처리에서 보장 알고리즘에 관한 연구

        李滿熙,李龍斗,蔡洙煥 한국항공대학교 1994 論文集 Vol.32 No.-

        실시간 타스크가 어떤 분산처리시스템의 한 노드에서 발생했을 때, 만약 그 타스크가 주어진 시간 내에 수행이 보장되지 않는다면, 타스크의 전이가 이루어져야 한다. 그런데 불행히도 타스크 전이는 많은 통신시간을 요구한다. 본 논문에서는 하드 실시간 타스크의 특성을 더 잘 반영하는 요소들을 제안하고 이들을 이용하여 타스크의 보장률을 높힘으로서 가능한 한 타이스 전이를 줄이는 알고리즘을 제안했고 이 알고리즘을 시뮬레이션하였다. When a hard real-time task occurs at a node on a distributed system, if the task is not guaranteed to be executed within given deadline, it should be migrated to other nodes. Unfortunately, the task migration requires much communication overhead. We suggest some factors which can represent the characteristics of hard real-time tasks, propose a guarantee algorithm for reducing the number of task migration by increasing the local guarantee ratio, and simulatethe algorithm.

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