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.

TFT LCD 공장의 Array 공정에 대한 생산 계획 수립

백종관,김성식 한국경영과학회 2001 한국경영과학회 학술대회논문집 Vol.- No.1(2)

This paper focuses on scheduling problem in a TFT LCD array, generally considered as bottleneck processes, producing multiple products that have different due dates and different process flows. Most of the previous research focuses on semiconductor wafer fab, similar to TFT LCD array, on throughput rate or cycle time without considering due dates. We provide a new scheduling architecture for meeting a due dates of products with different due dates and process flows on array process.

低週期 疲勞壽命評價 시스템의 開發

박종주,서상민,김영진,최용식 成均館大學校 科學技術硏究所 1994 論文集 Vol.45 No.1

This paper describes the development strategy and contents of a fatigue life evaluation system, FLEVA. The system is comprised of 4 parts ; Material properties, load histories, cycle counting and life prediction. The cycle counting is based on the rain -flow counting method and peak counting method, and the life prediction is performed based on the linear damage rule. Material properties( static, fatigue) are also provided as a database obtained by a computer aided test system. Case studies are performed to verify the developed program.

CT型 多段 變厚部在內의 Mode I 龜裂에 대한 龜裂成長擧動 硏究

崔鎔湜,梁源鎬,金永鎭,朴鍾桂 成均館大學校 科學技術硏究所 1992 論文集 Vol.43 No.1

A plate with multi-step varying thickness is widely used in a variety of machine components. In order to provide design data required for damage tolerant design for such components, fracture mechanics analysis was performed. Compact tension specimens with thin-to-thick geometry were used for analysis models. Three-dimensional finite element analysis was performed, and stress intensity factor was obtained by crack opening displacement extrapolation method. Analysis parameters were λ (dimensionless crack length), β(thickness ratio) and ω(width ratio). Dimensionless correction factor F values decreased rapidly as λ approached 1(thickness interface). And effect of front step was more pronounced than that of rear step.

Doppler 및 심초음파도에 의한 운동선수의 운동 전후 좌심실 기능 평가에 관한 연구

배종화,조정휘,최철준,김권삼,김명식,송정상 대한내과학회 1992 대한내과학회지 Vol.42 No.1

저자들은 지속적 운동이 심장의 형태 및 기능에 미치는 효과를 알아보기 위하여 정상 대조군 10명과 등력성 운동선수 22명(마라톤 선수 10명, 축구선수 12명)과 등장성 운동선수 25명(레스링선수 10명, 역도선수 10명, 투원반선수 3명, 투창선수 2명)등 총 57명을 대상으로 안정시와 최대 운동부하 후에 Doppler 심초음파도 검사를 실시하여 다음과 같은 결과를 얻었다. 1) 안정시 등력성 운동선수의 좌심실 무게는 대조군보다 증가되어 있었고 등장성 운동선수의 좌심실 무게도 대조군 보다 증가하였다. 안정시 양군의 구획 단축률, 구혈률, 수축기 속도적 및 최대 가속도가 대조군보다 유의하게 증가하였다. 2) 안정시 등장성 운동선수에서 좌심실 확장기말 내경은 등력성 운동선수와 차이가 없었으나 좌심실 수축기말 내경은 유의하게 감소되고 구획 단축률, 구혈률 및 최대 가속도가 유의하게 증가되어 있었다. 3) 최대 운동부하 후의 좌심실 확장기말 내경은 양군에서 모두 대조군보다 증가되어 있었고 수축기말 내경은 등력성 운동선수에서는 증가되어 있었으나 등장성 운동선수에서는 대조군과 차이가 없었다. 또한 등장성 운동선수에서 구획 단축률과 구혈률이 대조군보다 유의하게 높아 대조군보다 수축기 기능이 증가된 것을 알 수 있었다. 4) 최대 운동부하 후의 좌심실 확장기말 및 수축기말 내경은 등장성 운동선수에서 등력성 운동선수보다 유의하게 감소되어 있었고 구획 단축률, 구혈률 및 최대 가속도는 유의하게 증가되어 있어 등장성 운동선수에서 좌심실 수축기능이 좀 더 증가되어 있었다. 이상의 결과로 보아 운동선수에서는 좌심실 무게가 대조군보다 증가되어 있고 이것은 등력성 운동선수에서는 좌심실 내경의 증가로, 등장성 운동선수에서는 좌심실 내경의 증가 및 좌심실벽 두께의 증가로 기인하였다. 최대 운동부하 후에는 등장성 운동선수에서 좌심실 수축기 내경이 감소하고 좌심실벽의 두께와 최대 가속도도 증가하여 수축기 기능이 더욱 항진되는 것을 알 수 있었다. To evaluate the left ventricular structure and function in athletes before and after maximum exercise, we studied 57 males (average age: 20 years) by Doppler and echocardiography, which consisted of 10 normal controls, 22 dynamic exercise athletes (10 marathon runners, 12 soccer players) and 25 static exercise athletes (10 wrestlers, 10 weightlifters, 3 discus throwers, 2 javelin throwers). These athletes were trained regularly for more than 5 years, and the results were as follows: 1) Before exercise, the left ventricular mass of athletes increased more significantly than in the controls, with increased left ventricular end-diastolic dimensions. Left ventricular wall thickness also increased in static exercise athletes. Before exercise, the fractional shortening, ejection fraction, systolic velocity integral, and peak acceleration of aortic flow increased more significantly in athletes than in the controls. 2) There were no differences of left ventricular enddiastolic dimension between the dynamic and static groups of athletes before exercise, but the left ventricular end-systolic dimensions decreased significantly in static exercise athletes, and the fractional shortening, ejection fraction, and peak acceleration of the aortic flow increased more significantly in static exercise athletes than in the dynamic exercise athletes. 3) After maximum exercise, the left ventricular enddiastolic dimensions increased more in both groups of athletes than in the controls, and the left ventricular end-systolic dimensions decreased more in the static exercise athletes than in the controls. 4) The left ventricular end-diastolic and end-systolic dimensions after maximum exercise decreased more significantly in the static exercise athletes than in the dynamic exercise athletes, but the fractional shortening, ejection fraction, and peak acceleration of the aortic flow increased more significantly in the static exercise athletes than in the dynamic exercise athletes. These results suggested that the left ventricular mass in athletes increased due to increased left ventricular end-diastolic dimensions in the dynamic exercise athletes and to the increased left ventricular end-diastolic dimensions and wall thickness in the static exercise athletes. After maximum exercise, the left ventricular end-systolic dimensions of the static ercise athletes were more decreased with increased left ventricular wall thickness than in the dynamic exercise athletes resulting in augmented left ventricular systolic function in the static exercise athletes.

웨이블렛 영역에서 Interleaving을 이용한 Gray-level Image Watermarking

이종원,고성식,김정화 조선대학교 전자정보통신연구소 2001 電子情報通信硏究所論文誌 Vol.4 No.2

Watermarking is an emerging technology that is claimed to have an important application in copyright protection. Compared with existing watermarking method, the size of watermark image is not only smaller than that of original image, but data quantity of watermark image is restricted. Thus in this paper, we propose a new watermark method which can embed a 256 Gray-Scale watermark invisibly in wavelet transform domain and enhance image quality by interleaving to keep robustness. Also, it used Median Filter with after control, it improved an image quality. Using the interleaving proposed in this paper, experimental results demonstrate that high quality recovery of the watermark is possible to operations such as LPF or JPEG lossy compression.

정신분열병 환자의 인지과제수행에서 삼차원적 시공간-운동 방해자극 처리의 특성

정혜정,김재진,박성혁,전종희,김지혜,염태호,이장한,김선일,구정훈,조원근,안석균,이홍식 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : Abnormalities of cognitive responses to verbal and visual distracter in schizophrenia have been demonstrated in numerous studies but little is known about three dimensional visuospatial-motor distracter processing. The purpose of this study was to investigate the vulnerability of patients with schizophrenia to three dimensional visuospatial-motor distracter. Methods : 14 patients with schizophrenia and 14 normal volunteers were assessed on three dimensional maze tasks requiring on working memory and reasoning ability in the virtual reality environment. Performances were compared according to with- or without-distracter conditions. Results : Patients with schizophrenia showed significantly lower performances than normal control group on cognitive flexibility, simple motor function or motor control and motor coordination, working memory span and delayed performance times. The performance index tended to be more deteriorated, but not significantly, in with-distracter condition than in Without-distracter condition in schizophrenia. Conclusions : Patients with schizophrenia tend to be vulnerable to visuospatial-motor distracter which simulate the real world of three dimensional environment.

심부전을 주소로 진단된 삼방심 1예

박은경,김석호,강흥선,조정휘,김권삼,김명식,송정상,배종화 대한내과학회 1993 대한내과학회지 Vol.44 No.1

저자들은 분만후 울혈성 심부전으로 인한 심한 호흡곤란을 주소로 내원했던 환자에서 경흉부 심초음파도, 경식도 심초음파도 그리고 심도자술 및 심장조영술로 삼방심을 진단하여 치료하였던 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Cor triatriatum is well konwn rare cardiac malformation consisting of accessory chamber that lie within the left atrium and receives the pulmonary vein. Recently, we have experienced one case of isolated cor triatriatum presenting as congestive heart failure. A 24 years old women was admitted to the hospital because of severe dyspnea. We diagnosed isolated cor triatriatum by the transthoracic and transesophageal echocardiography and cardiac catheterization.

난치성 만성정신분열증 환자의 생활의 질에 미치는 정신사회치료 프로그램의 효과에 대한 예비연구

송동호,배민진,이종호,이홍식,김선경,서호석,김찬형,전지용 大韓神經精神醫學會 1995 신경정신의학 Vol.34 No.4

Objects : Recent studies of psychosocial adjustment after hospitalization have found that the combination of maintenance antipsychotic drug treatment and psychosocial treatment including psychoeducational program are highly predictive of social rehabilitation and reduction of subsequent relapse. Two groups of patients with refractory chronic schizophrenia were preliminarily compared to determine the effect of a psychosocial treatment program on the quality of life in refractory chronic schizophrenics in an open comparative trial. Methods : One group(N=11) was assigned to approximately six months of the psychosocial treatment program(including psychoeducation program and activity program such as interpersonal relationship program, social skill training, self management program, outings, etc), in a group format, twice a week and a fixed maintenance dosage of clozapine ; while scale(QLS) was used to provide an objective measure of changes in patient's psychosocial functioning and a general assessment of psychopathology was made using the Brief Psychiatric Rating Scale(BPRS). Results : Both BPRS total positive score and the QLS total score, especially in the intrapsychic foundation factor of the scale showed a statistically significant improvement in the psychosocial treatment group. But there was no significant change in both BPRS and QLS scores over a 6-month period in the non-psychosocial treatment group. A significant negative correlation was found between the negative symptom and changes of QLS total, instrumental role and common object and activities scores respectively after receiving a 6-month of the psychosocial treatment program. Conclusion : These results suggest that a psychosocial treatment program including the integration of psychoeducation and a skill training oriented activity program serve as an outpatient treatment modality to improve the quality of the life in refractory chronic schizophrenia. To further clarify the effect of psychosocial treatment in chronic schizophrenia, a randomized trial should be done.

Cell adhesion and proliferation evaluation of SFF-based biodegradable scaffolds fabricated using a multi-head deposition system

Kim, Jong Young,Yoon, Jun Jin,Park, Eui Kyun,Kim, Dae Shick,Kim, Shin-Yoon,Cho, Dong-Woo IOP Pub 2009 Biofabrication Vol.1 No.1

<P>Scaffolds composed of biodegradable polymers and biocompatible ceramics are being used as substitutes for tissue engineering. In the development of such techniques, scaffolds with a controllable pore size and porosity were manufactured using solid free-form fabrication (SFF) methods to investigate the effects of cell interactions such as cell proliferation and differentiation. In this study, we describe the adhesion of human bone marrow stromal cells (hBMSCs) and proliferation characteristics of various scaffolds, which consist of biodegradable materials, fabricated using a multi-head deposition system (MHDS) that we developed. The MHDS uses novel technology that enables the production of three-dimensional (3D) microstructures. Fabrication of 3D tissue engineering scaffolds using the MHDS requires the combination of several technologies, such as motion control, thermal control, pneumatic control and computer-aided design/computer-assisted manufacturing software. The effects of a polymer and ceramic on a tissue scaffold were evaluated through mechanical testing and cell interaction analysis of various kinds of scaffolds fabricated using polycaprolactone, poly-lactic-co-glycolic acid and tri-calcium phosphate for bone regeneration applications. Based on these results, the feasibility of application to the tissue engineering of SFF-based 3D scaffolds fabricated by the MHDS was demonstrated.</P>