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.

Tabes Dorsalis의 핵자기공명영상 및 전기생리학적 소견

권기한,김성민,권석범,이병철,조광호,주정희 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

정신분열병 환자 자녀에서의 주의력 장애

김철권,조현기,장정희,강동호,조진석,김명정,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

본 연구의 목적은 정신분열병 환자의 자녀들과 알코올 의존증 환자의 자녀, 그리고 정신과학적으로 건강한 부모의 자녀들을 대상으로 연속 작업수행력 검사를 이용한 정보처리 과정에서의 지속적 주의력에 관한 사항과 정보 감지능력 검사를 이용한 정보 처리과정에서의 감각등록에 관한 사항을 측정하고 세 군간에 그 결과를 서로 비교하여 차이 유무를 검증하기 위함이다. 연구 대상은 정신분열병 환자의 자녀 28명을 대상군으로 그리고 알코올 의존증 환자의 자녀 18명과 정신과학적으로 건강한 부모를 둔 중고등학생 41명을 대조군으로 하였다. 연구 방법은 대상군 및 두 대조군 모두에게 연속 작업수행력 검사와 정보 감지능력 검사를 순차적으로 시행한 후 그 결과를 서로 비교하였다. 그 결과는 다음과 같다. 1) 연속 작업수행력 검사에서는 대상군이 두 대조군에 비해 맞춘 횟수와 비율이 유의하게 낮았고 놓친 횟수는 반대로 유의하게 높았다. 가장 중요한 변인인 민감도는 대상군이 두 대조군에 비해 유의하게 낮았다. 2) 연속 작업수행력 검사에서 시간 경과에 따른 각 변인의 변화를 보면 맞춘 횟수와 비율에서 대상군이 두 대조군에 비해 시간이 경과할수록 유의하게 감소하였다. 민감도 역시 시간이 경과할수록 대상군이 두 대조군에 비해 유의하게 감소하였다. 3) 연속 작업수행력 검사의 민감도, 정보 감지능력 검사에서의 정답반응 횟수에서 정상 대조군의 분포 곡선중 하위 10% 수치를 절단점으로 잡아 그 수치 이하를 보이는 대상 숫자를 비교해 보면 연속 작업수행력 검사에서만 정신분열병 환자의 자녀군과 정상 대조군 사이에 유의한 차이를 보였다. 4) 대상군, 정상 대조군, 대상군중 연속 작업수행력 검사의 민감도가 하위 10% 이하에 속하는 군의 MMPI를 서로 비교한 결과 세 군간에 MMPI의 모든 변인에서 유의한 차이를 발견할 수 없었다. 5) 정보 감지능력 검사에서는 대상군이 두 대조군에 비해 정답반응과 오답반응을 보이기까지 걸린 평균 시간이 유의하게 길었다. 이상의 연구결과를 통해 저자들은 정신분열병의 발병 위험성이 높은 정신분열병 환자의 자녀군이 알코올 의존증 환자의 자녀군이나 정신과학적으로 건강한 부모를 둔 대조군보다 지속적 주의력에서 결손이 있음을 발견하였고 나아가 이와 같은 지속적 주의력에서의 결손이 정신분열병의 한 가능한 취약지표가 될 수 있을 것으로 사료된다. In order to study the possible vulnerability in the markers of schizophrenia, offsprings of the schizophrenic parents(n=28), offsprings of the alcohol dependent parents(n=18), and offsprings of the psychiatrically normal persons(n=41) were examined for their sustained attention and sensory register by means of Continuous performance test(CPT) and Span apprehension task(SPAN) respectively. The results were as follows : 1) The offsprings of the schizophrenic parents showed a significant deficit in the sustained attention as manifested in the data of CPT by significantly lower hit rate and sensitivity, compared with the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the false alarm rate and response bias among three groups. There was no difference in all variables of the CPT between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. 2) The deficit in the sustained attention as revealed by lower hit rate and sensitivity was not apparent in the first part of the CPT. However it emerged and aggravated itself as the test continued in the offsprings of the schizophrenic parents only. 3) Proportion of subjects falling in the extreme low sensitivity of lower 10% of the normal controls was significantly higher in the offsprings of the schizophrenic parent group as compared with the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons with a rate of 29%, 17%, and 10% respectively. 4) No significant difference was noted in all variables of MMPI among normal controls, index group, and the extreme low CPT sensitivity subgroup of index group. 5) The offsprings of the schizophrenic parents showed a significantly delayed response in the time to correct and incorrect response in SPAN compared to the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the number of correct response, number of incorrect response, and number of no response among three groups. There was no difference in all variables of the SPAN between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. These results suggest that a subgroup of the offsprings of schizophrenic parents may suffer from the deficit in the sustained attention which may be a vulnerability marker of schizophrenia.

제주지역 지표 오존 농도의 시·공간적 분포 특성

이기호,김대준,허철구 한국환경과학회 2004 한국환경과학회지 Vol.13 No.4

This study has been performed to clarify the characteristics of temporal and spatial distribution of surface ozone concentration over Jeju Island, one of the cleanest areas in Korea with low emissions of air pollutants. Ozone data are monitored at four sites in Jeju Island. These monitoring sites are located at two urban area(referred to Ido and Donghong), coastal area(Gosan site) and forest site(Chuna site). Ozone data has been routinely collected at these sites for the late four years. The patterns of seasonal cycle of ozone concentrations at all stations show the bimodal with the peaks on spring and autumn and a significant summer minimum. However, the patterns of diurnal variations at rural station, i.e., Gosan and Chuna sites are considerably different to those at urban stations such as Ido and Donghong sites. The patterns of ΔO₃ variations are very similar with those of monthly mean ozone concentrations and ΔO₃ values are exceeded 30 ppb, at urban stations. This may be that urban stations are more influenced by local photochemical reactions rather than rural stations. In order to assess the potential roles of meteorological parameters on ozone formation, the meteorological parameters, such as radiation, temperature, and wind are monitored together with ozone concentrations at all stations. The relationships of meteorological parameters to the corresponding ozone concentration are found to be insignificant in Jeju Island. However, at Gosan and Donghong stations, when the sea breeze blew toward the station, the ozone concentration is considerably increased.

제주도에 수송되는 황사의 사례분석

이기호,허철구 제주대학교 환경연구소 1995 환경연구논문집 : 제주대 Vol.3 No.1

This study is carried out to investigate the charactexistis of the yellow sand transported to Cheju dand on 1995 and its influence on the concentration of TSP at Cheju area. For this purpose, the collection of TSP is conducted by using a high volume air sampler and the analyses of weather maps is also performed. By the analysis of weather map, it can be seen that the yellow sand ocurred at Cheju area on March 1995 is tramporkd from the upstream of the Yellow River via Shanghai region The duration time far this case is 32 hours at Cheju area. Although the source regions of yellow sand occurred on April are not dearly inferred on the weather map, it can be confirmed that the bend of yellow sand is flowed to Cheju area f&wd by cyclone passage with cold fornt passing the Korean penmda. It can be also confirmes that the of 40-9 knots in the 700hPa layer and southward movement of cold core. circulation associated with the yellow sand is characterizd by the westerly to north-weaskly The concentration of TSP when the yebw sand occurrs is increased over 4 times than normal period.

정신과 입원환자의 서비스 만족척도의 개발

김철권,이지연,송영선,김규호,김경률,김제원,이동기,최병무 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

목적 본 연구의 목적은 국내 정신의료기관(정신병원, 종합병원 정신과)에서 간편하게 사용할 수 있는 신뢰도와 타당도가 검증된 입원환자의 서비스 만족척도를 개발하기 위한 것이다. 방법 여러 단계를 거쳐 국내 실정에 맞는 문항을 개발하였고,정신병원, 종합병원, 대학병원 정신과 병동에서 퇴원하는 348명의 환자들을 대상으로 신뢰도와 타당도를 조사하였다. 요인분석 결과 5개의 요인이 추출되었으며 전체 변량의 63.04%를 설명하였다. 내적 일관성에 대한 신뢰도 계수 (Crohnbach's α)는 0.95로 상당히 높은 수준이었고, 수정된 개별문항-총점 상관계수는 0.50부터 0.72까지의 범위에 속하였다. 요인분석을 통해 추출된 서비스 만족척도의 각 하위척도 점수와 서비스 만족척도에 첨부된 각 영역에 대해 전반적인 만족도를 묻는 세 개의 문항 점수 간의 상관성 역시 유의하게 높았다. 결과 진단명에 따른 서비스 만족척도의 전체 점수에서는 불안/신체형/강박장애 환자군과 기분장애 환자군이 각각 정신분열병 및 기타 정신병 환자군과 알코올중독 장애 환자군에 비하여 유의하게 높은 점수를 보였으며, 입원형태에 있어서는 자발적 입원군이 강제 입원군에 비하여 전체 만족점수가 유의하게 높았다. 그러나 성별, 월수입, 학력, 직업, 종교, 결혼상태 등의 변수에서는 서비스 만족척도의 전체 점수에서 유의한 차이가 발견되지 않았으며, 마찬가지로 연령, 입원일수, 입원횟수, 첫 발병나이, 유병기간 등의 임상적 변수에서도 서비스 만족척도의 전체 점수와 유의한 관계를 보이지 않았다. 서비스 만족척도의 전체점수에서 대학병원 환자군이 정신병원 환자군과 종합병원 환자군에 비하여 각각 유의하게 높았다. 결론 결론적으로 국내 정신의료기관에 입원한 환자들의 서비스 만족을 평가하기 위한 목적으로 개발된 본 척도는 높은 수준의 신뢰도와 타당도를 보였으며, 또 국내 정신의료 환경에 맞는 요인구조를 보였다. 따라서 정신의료 서비스에 대한 정신과 환자의 만족도에 대한 연구가 거의 없는 실정에서 본 척도의 개발은 향후 국내 정신의료의 질과 치료결과를 높이는 도구로 활용될 수 있을 것으로 기대된다. Objectives : To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale : SSS) for routinely assessing the quality of service in psychiatric ward inpatients. Methods : A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and University hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. Results : Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. Conclusion : SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring Satisfaction of psychiatric inpatients in Korea.

제주시 대기부유분진 중 수용성 이온성분의 입경별 분포특성

허철구,송정화,이기호 한국환경과학회 2004 한국환경과학회지 Vol.13 No.12

Atmospheric particulate matters were collected by 8-stage non viable cascade impactor from October 2002 to August at Jeju City. Eight water-soluble ionic components (Na^(+), NH₄^(+), K^(+), Ca^(2+), Mg^(2+), Cr^(-) NO₃^(-) and SO₄^(2-)) were analyzed by Ion Chromatography. The concentration of particulate matters and eight water-soluble ionic components were determined to investigate their size distributions. Particulate matters exhibited a tri-modal distribution with peak value around 0.9, 4.0㎛ and 9.5㎛. In summer, the last peak value was lower than other season values likely due to particulate matter scavenged by rain water. Four ionic components (Na^(+), Ca^(2+) Mg^(2+) and Cl^(-)) exhibited a bi-modal distribution in the coarse mode whereas three ionic components (NH₄^(+), K^(+) and SO₄^(2-)) in the fine mode, with maximum peak value around 0.9um. NO₃ was found in both the coarse and the fine mode. The enrichment factor (E.F.) of each ionic components was calculated. Based upon E.F., it is considered that Na^(+), Cr, and K^(+) in coarse paricle mode were delivered form oceanic source, but other components might have other source origins.

주거지역에서의 오수 및 오염부하량 배출 원단위에 대한 조사 연구

방기웅,이준호,이재철 大田産業大學校 1998 한밭대학교 논문집 Vol.15 No.1

The characteristics of domestic sewage discharged from residential area can have a profound effect on the operation and design of sewage treatment plant. In order to improve sewage treatment and disposal alternatives effectively, investigating unit loading factors of pollutant is necessary. Investigating measurements were carried out for two residential area to quantify the unit loading factors of various pollutants. The sewage discharged from the residential areas was sampled two days a week at two sites and during four seasons. The analysis of the pollutant loadings such as BOD, COD, ss, VSS, TKN and TP were made every three hours a day. The results of the study were as follows ; (1) The average unit sewage flowrate 231 L/capita/day, (2) The average unit loadings for BOD, COD, SS, VSS, TKN and TP were computed to be 31.2, 63.9, 21.3, 18.1, 5.5 and 1.5 g/capita/day, respectively.

과학교육 개선을 위한 실험모델 제작에 관한 연구(Ⅰ)

이기종,이광호,이종철,김자홍 全北大學校 基礎科學硏究所 1991 基礎科學 Vol.14 No.1

A curriculum for teaching materials in Science Education was studied as a model for modified xperiment on fundamental courses. Coscious effort can be made to desingn experiments that require minimum apparatus, that require low-cost equipment that can be made to from cheap locally available materials. Computer-aided instruction programs at high school, freshman course level have been developed. The software package was consist of five programs: The program contains explanation and problems for the calculation of resonance energy, molecular structure, mole concept, Rutherford's experiment, thermodynamic processes. Special course equipment package explanation mole concept, Rutheford's experiment, thermo dynamic processes. Special course were designed in Science Education with the understanding that to a certain extent science values would be covered in all of the modified experiments and program models.

중소 로프 제조업체를 위한 종합경영정보시스템 구축에 관한 연구

신철호,주기세 木浦海洋大學校 1997 論文集 Vol.5 No.1

In this paper, a new management information system(MIS) is developed for a small-sized rope manufacturing company. The system consists of two fields such as complex production control, and general control field. The complex production control field is divided into three modules of inventory, production and marketing control. The general control field is divided into two modules of payment and finance control, respectively. This system is developed for the small and medium-scale enterprise which mainly manufactures the rope, as an example, and is furthermore applicable to the computer integrated manufacturing(CIM) in the future. Also, this system is expected to contribute to increasing profits, efficiency of company management and is applicable to various kinds of small and medium-scale manufacturing enterprises by adjusting and costomizing the developed system.