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.

정신분열증의 역학

韓辰熙 大韓神經精神醫學會 1990 신경정신의학 Vol.29 No.1

Current knowledges on epidemiology of schizophrenia were briefly reviewed with respect to basic rates(prevalence and incidence) and risk factors(demographic correlates, antece-ding and precipitating factors, genetic factors, and other factors). To date, it seems that epidemiological researches on schizophrenia were hampered by definitional ambiguity and some methodological problems, which, in turn, made the compa-rison across the studies more difficult. Despite these limitations, there have been emerging new trends in both descriptive studies and exploration of risk factors of schizophrenia. Ge-netic epidemiology could be one of such powerful strategies in the epidemiologic research of schizophrenia. It is necessary that future epidemiological research of schizophrenia should incorporate current laboratory measures of vulnerability into field survey studies.

사람 갑상선자극호르몬 수용체를 발현하는 Chinese Hamster Ovary(hTSHR-CHO)세포를 이용한 자극형 갑상선자극호르몬 수용체 항체 활성 측정의 임상적 유용성

한희정,원진호,채수홍,김현진,송민호,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Detection of thyroid stimulating hormone receptor(TSHR) autoantibodies has clinical value in establishing the diagnosis of Graves ' disease, and in predicting its clinical course with high sensitivity and high specificity. Especially, TBII using radioreceptor assay has been widely used. Recently, for detecting thyroid stimulating antibody(TSAb), a sensitive method using human TSH receptor-transfected Chinese Hamster Ovary(CHO) cells has been developed and clinically used. The aims of this study are to determine the change and discrepancy of 2 TSHR autoantibodics in clinical course and to evaluate the correlation between 2 autoantibodies. We measured TSAb and TBII in 30 newly diagnosed and untreated patients and in 73 previously diagnosed as Graves ' disease and treated with antithyroid drug. Also we compared the changes of the antibodies in clinical course and correlation between 2 antibodies. Thes results are summarized follows. 1. In newly diagnosed patients, all of the 30 patients had positive TBII and/or TSAb. None of them had negative TBII and negative TSAb. And in newly diagnosed patients, mean TBII and mean TSAb values are 46.8% and 361%, respectively. In 73 treated patients mean values are 18. 7% and 196% each other. Therefore, newly diagnosed group has significant greater TBII and TSAb than antithyroid drug-treated group. 2. TBII was significantly different between euthyroid group and thyrotoxic group in antithyroid drug-treated patients, but TSAb was not. 3. TBII was sequentially decreased as increased medication duration, but TSAb was not shown sequential decrease as increased medication duration. 4. There was significant negative correlation between cumulative doses of antithyroid drug and TBII, but no significant correlation between cumulative doses and TSAb. 6. There was significant positive correlation between TBII and TSAb in total patients group and in antithyroid drug medication group, but not in newly diagnosed group. In conclusion, in Graves ' disease patients, detection of TSHR antibodies are clinical values in establishing the diagnosis and prediction of clinical course. A method detecting TSAb using hTSHR-CHO cells should be further studied for standardization of measurement, and for detecting the changes of TSAb in clinical course, long-term follow-up of patients are important.

單症性 健康念慮症의 臨床經驗

韓辰熙,柳太烈,趙伯紀,李鍾六 서울醫大 1990 精神醫學 Vol.15 No.2

골프선수들의 심리적(PSIS) 비교 분석에 관한 연구

한정훈,배진희,최영수 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

The purpose of this study was to compare the PSIS factors and to development the norms of golf players in competition. Subjects were 180 golf players. For PSIS adopted Mahoncy(1989) was used in this research. The main findings of this study were as follows. First, there was significant mean difference in the confidence factor between university and business players, however there were no differences in other factors. Second, there was significant mean difference in the confidence factor among under 3.48th, 3.49th~9.65th years by career, however there were no differences in other factors. Third, there was significant mean difference in the confidence factor between one and none by representative career, however there were no differences in other factors. Fourth, there were 11~26 norm scores of university players and 17~28 norm scores of business players in the anxiety factor. Fifth, there were 6~20 norm scores of university players and 7~18 norm scores of business players in the concentration factor. Sixth, there were 12~27 norm scores of university players and 16 ~27 norm scores of business players in the confidence factor. Seventh, there were 4~20 norm scores of university players and 10~23 norm scores of Eighth, there were 9 ~23 norm scores of university players and 10~23 norm scores of business players in the motivation factor. Ninth, there were 5~18 norm scores of university players and 9~18 norm scores of business players in the team emphasis factor.

綜合炳院 精神科諮問의 現況과 轉歸 : 서울大學校病院의 경우

韓辰熙,趙斗英 大韓神經精神醫學會 1984 신경정신의학 Vol.23 No.1

In an attmpt to characterize psychiatric consultations in the areas of referral rates, psychiatric diagnoses, and consultees' concordance with consultant's recommendations in Korea, the medical records of 583 psychiatric consulations done from March 1. 1983 to Feb. 28, 1983 at a large university hospital were reviewed. Overall referral rate rod psychiatric consultation was 1.5% for inpatients population, and the rates were 3 times greater from the medical services as compared with the surgical services. The frequency of current use of psychotropic drugs prior to consultations was 44%. Depression(23.5%) was the most common psychiatric diagnosis, followed by organic brain syndrome, hysteria, psychophysiological disorders and adjustment reactions, successivele Among various concordance rates with consultants' recommendations, that of psychotropic drug recommendations was the highest(89.5%) and that of diagnostic representation the lowest(44.6%). Surgeons particularly showed the lowest concordance(24.4%) in diagnostic representation. Following numbers of variales were frond to be significantly related to each category of concordances- 4 variables (current use of psychotropic drugs, specification of starting dosage, recommendation of same drugs as the consultee prescribed prior to the consultation, and concordance with further follow-up ward visit recommendations) to the concordance with phychotropic drug recommendations : 8 variables(previous psychiatric illness, current use of psychotropic drugs, psychiatric diahnosis by the consultee prior to the consultation, duration of hospitalization, concordance with further follow-up ward visit recommendations) to the concordance with diagnostic representation : and 2 variables(current use of psychotropic drugs, and concordance with psychotropic drug recommendations).

他科醫師의 精神科 諮問에 대한 期待度

韓辰熙,柳太烈,李秀晶 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.1

To investigate physicians' expectations to the role of psychiatric consultation, the authors conducted 18-item questionnaire on 117 nonpsychiatric physicians of two university affiliated general hospitals(St. Mary's Hospital and Kang Nam St. Mary's Hospital) in Seoul. The results were as follows : 1) Physicians rated, in general, high scores on items related with `evaluation function ' and `direct service function' of psychiatric consultation, whereas they rated low on `mediating function' items. 2) `Evaluate mental status', `Help physicians understand psychological aspects of a patient's illness', ` Arrange to transfer patient to psychiatric ward', `Evaluate psychogenesis' and `Make suggestions about management of patient on the ward' are those which phisicians valued most important of all 18 items. 3) There was a tendency that resident group manifested low item scores compared to faculty members, and items of `Arrange to transfer patient to psychiatric ward' and `Recommand additional diagnostic work-up' showed significant difference in mean scores between groups. 4) Physicians in medical services showed significant high mean scores on items such as `Arrange to transfer patient to psychiatric ward', `Make suggestions about management of patient on the ward', `Evaluate psychogenesis' and `Work with patient's family' as compared to surgeon group.

재료의 흡수상태에 따른 콘크리트의 물리적 변화에 관한 기초적 연구

한다희,황병준,박희곤,이영도,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

Most concrete is recently made of an aggregate which is properly absorbed, and carried in it in order to do capability at every fields. We have been close to demand new capability of high flowing and enduring for specific concretes. That is difficult to cope with claiming the efficiency on deterioration from lack of a high quality aggregate. Therefore, For solving the problems we apply to a packing method for using dried materials. That is to say it is a kind of making into an instant. In this study, There is a purpose to present fundamental data, comparing and analyzing a phenomenon about aggregate's absorption following the rate of adding water, for using existing materials.

대량의 각혈로 사망한 장티푸스 1예

한상우,유진홍,권순석,김성훈,박지찬,홍은정,최경성,박용완,장준희,안지원,박유경,강지영,박상미,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

건조 재료를 사용한 콘크리트의 포장화에 관한 실험적 연구

한다희,박희곤,백민수,김성식,이영도,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

Most concrete is recently made of an aggregate which is properly absorbed, and earned in it in order to do capability at every fields. We have been close to demand new capability of high flowing and enduring for specific concretes. That is difficult to cope with claiming the efficiency on deterioration from lack of a high quality aggregate. Therefore, For solving the problems we apply to a packing method for using dried materials. That is to say it is a kind of making into an instant. In this study, There is a purpose to present fundamental data, comparing and analyzing a phenomenon about aggregate's absorption following the rate of adding water, for using existing materials.