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.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

부산지역 수돗물과 지하수의 중금속 농도

김준연,손지언,김형수,김두희,원미숙,김인식,이혜령 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

This study investigated mean airborne CO concention of 15 workplaces, suspected of CO exposure and conducted self-reported questionnaire completion and indirect COHb concentration measure using Micro II Smokerlyzer to healthy 702 adult subjects from 1999 May to 1999 September in order to find a relation of CO exposure and occupational factors, socioeconomic factors, and health related behaviors and confirm the related conditions in the screening test for CO exposure. The results of this study were summarized as follows : 1. In the CO exposed and non exposed group, COHb concentrations of the smokers were 2.55±0.96% and 2.21±0.97% and that got a statistically significant difference, There were not statistically significant differences in the age and total smoking index. Passed times after the last smoking, Working time/day, and working duration were statistically significant difference (p〈0.05). 2. In the CO exposed and non exposed group, COHb concentrations of non-smoking group were 0.94±0.35% and 0.68±0.47% and that got a statistically significant difference. There were not statistically significant differences in the age and working duration but Working time/day was a statistically significant difference(p〈0.05). 3. In the CO exposed group, r-square of multiple regression of the smokers was 38.5 % and passed time after the last smoking, working time/day, and job category were statistically significant differences (p〈0.05). And r-square in the CO non-exposed group was 38.3 % and age, passed time after the last smoking, and total smoking index were statistically significant difference. 4. In the CO exposed group, r-square of multiple repression of the non-smokers was 66.3% and job category and airborne CO concentration were statistically significant differences(p〈0.05). But r-square of non-smokers in the CO non-exposed group was 1.0% and there was not a statistically significant difference(p〈0.05). 5. In the smokers of CO exposed and non exposed groups, relation of COHb concentration and passed time after the last smoking was expressed as exponential function, Y = 2.9182e-0.0083x and r-square of this function was 37.4%. Therefore it was more than 150 minutes that passed time after the last smoking was when COHb concentrations were measured as less than 1%. In conclusion, variable, that was statistically significant to COHb concentraion in the both CO exposed and non-exposed smokers, was a passed time after the last smoking. We suggest that you have to restrict the smoking of smokers at least 150 minutes in the exposed and non exposed group before COHb concentration measure in order to exclude smoking effects

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

HPLC를 이용한 농약 Carbendazim의 측정법에 관한 연구

김준서,조만희,이상한,김창세 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

The measurements of pesticide Carbendazim were studied and following conditions were proposed as a most good methods; 1. There were detected at 204 nm by means of Hitachi 200-20 spectrophotometer. 2. Pesticide Carbendazim mesurement was performed by menas of ISCO model 2350, spherisorb ODS column, 70% acetonitrile as a solvent phase, flow rate 0.5 ml/min, chart speed 0.5 cm/min, and 25℃ oven temperature. 3. The relationships between the concentration and absorbance of pesticide Carbendazim were linear from 2.5 to 15 ppm. 4. It showed stable result in Folin-Wu, and the recovery rate was also good.

치과용 금합금과 상변태

김형일,백창준,이경희,이희경 大韓齒科器材學會 2000 대한치과재료학회지 Vol.27 No.3

운동, 흡연, 음주 습관이 운동부하검사성적에 미치는 영향

김희균,강인숙,황은주,배형준 임상병리검사과학회 1998 임상병리검사과학회지 Vol.30 No.3

Although there have been many studies on the risk factors for coronary artery disease, but there have been rare an attempt to examine the effect of risk factors on exercise test The purpose of this study was to research the effects of training, smoking and drinking habit on results of treadmill exercise test. The subject of study was adult patient 530 cases be questionable as coronary artery disease in Dept. of Cardiovascular Center, Kang Dong Sacred Heart Hospital between May 1997 to February 1998. In this study used to modified Bruce protocol(Case 16, Marquette co.). Total positive rate was 30.8%(144 cases) by treadmill exercise test, it was male higher than female(16.3%:14.6%), that was seen significantly differ as increase of age. As training habit, positive rate of nontraining group was higher than training group(18.4%:12.4%), have been no relationship both regularity and frequency between nontraing and traning groups, but performance degree of workload level was high in training group. As smoking habit, positive rate of smoking group was higher than nonsmoking group in males (57.9%:42.1%), 9 cases of total 20 cases in females, there was have been high positive rate(45%). As drinking habit, positive rate of between drinking and nondrinking groups was no significantly differ, but positive rate of drinking group was a few higher than nondrinking group in male and female groups.

ELISA에 의한 뇌척수액내 Fibronectin의 측정과 임상적 의의

김숙희,박충서,이병헌,조준승 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.3

신경계 질환의 진단은 임상 소견과 뇌척수액 검사소견 등을 기초로 하고 있다. 그러나 이들 소견이 각 질환간의 감별에 분명한 도움을 주고 있지는 못하고 있다. 이에 본 연구에서는 뇌척수액 fibronectin을 측정하여 여러 신경계 질환과의 관련을 조사하고 나아가 이들 질환의 감별에 도움을 얻고자 하였다. Fibronectin은 뇌척수액내 미량으로 존재하므로 이의 측정을 위하여 먼저 측정능이 좋은 ELISA를 개발하였다. 그 결과 농도가 10 ng/ml에서부터 100 ng/ml의 범위내에서 뇌척수액 fibronectin 농도를 측정할 수 있었다. 결핵성 뇌막염 9례, 바이러스성 뇌막염 5례, 세균성 뇌막염 2례를 포함한 기타 신경계 질환 8례 및 정상대조군 18례 등 총 40례를 대상으로 뇌척수액내 fibronectin농도를 조사한 결과, 결핵성 뇌막염군은 4.21±2.32 ㎍/㎖, 바이러스성 뇌막염군은 0.9±0.79 ㎍/㎖, 기타 질환군은 2.05±2.48 ㎍/㎖, 그리고 정상대조군은 1.35±0.84 ㎍/㎖의 평균값을 보여 결핵성 뇌막염군이 기타 질환군을 제외한 타 질환군들에 비해 통계적으로 유의하게 높은 값을 보였다(p<0.01). 결핵성 뇌막염의 경우 1례를 제외하고는 모두 2.9 ㎍/㎖ 이상이었고, 3례(38%)에서는 4.6 ㎍/㎖ 이상이었던 반면, 바이러스성 혹은 무균성 뇌막염에서는 1례에서만 2.2 ㎍/㎖이고 나머지는 모두 1 ㎍/㎖ 이하로 나타났다. 이상의 결과로 보아 뇌척수액내 fibronectin농도의 측정은 결핵성 뇌막염과 바이러스성 뇌막염의 감별진단에 유용하리라 생각된다. The diagnosis of neurologic diseases is based on the clinical symptoms and cerebrospinal fluid findings. These findings, however, are often ambiguous. This study aims to evaluate the diagnostic value of cerebrospinal concentration of fibronectin. Fibronectin level in cerebrospinal fuid was measured by ELISA which could detect fibronectin in the range from 10 ng/ml to 100 ng/ml. Nine cases of tuberculous menigitis, 5 cases of viral meningitis, 8 cases of miscellaneous neurologic conditions and 18 cases of normal controls were studied. The mean value of fibronectin level in cerebrospinal fluid in tuberculous meningitis was 4.21±2.32 ㎍/㎖, in viral meningitis 0.9±0.79 ㎍/㎖, in miscellaneous neurologic conditions 2.05±2.48 ㎍/㎖ and in controls 1.35±0.84 ㎍/㎖. The fibronectin level in tuberculous meningitis was significantly higher than in other groups except the miscellaneous neurologic conditon(p<0.01). Cerebrospinal fluid fibronectin level appeared to be useful to differentiate tuberculous meningitis fro viral meningitis. Those levels were higher than 2.9 ㎍/㎖ in all except one case and higher than 4.6 ㎍/㎖ in 38% of tuberculous meningitis cases, but, 2.2 ㎍/㎖ in only one case of viral meningitis and lower than 1.0 ㎍/㎖ in all except one case of viral meningitis. It is suggested that measurement of fibronectin level in cerebrospinal fluid is a useful test for diagnosis of tuberculous meningitis, especially for differential diagnosis between tuberculous and viral meningitis.

천연치자색소의 합성색소와의 특성 비교

김희구,김옥도,이상준 한국식품영양학회 1998 韓國食品營養學會誌 Vol.11 No.5

치자를 원료로 천연 치자황색소와 치자황색소를 합성 식용 황색 4호와 ?색 2호와의 대체 가능성을 검토하기 위하여 색차, 내열성 및 내광성을 비교하였으며, ascorbic acid와 dl-α-tocopherol에 의한 내광성 증가효과를 검토하였다. 황색 4호와 치자황색소의 경우 색차는 △E값이 7.55이었다. 내열성 결과는 황색 4호는 80℃×30분과 100℃×30분에서는 pH 2.5∼8.0까지 전 영역에서 99% 이상의 색소 잔존율을 나타내었으며, 121℃×15분 경우에서는 평균 94% 이상의 색소 잔존율을 나타내었다. 치자황색소는 80℃×30분과 100℃×30분의 조건시 pH 7.0부근의 중성영역에서는 약 90% 이상의 잔존율을 보이지만, 121℃×15분에서는 75%의 잔존율을 보였다. 내광성은 황색 4호와 치자황색소의 차이는 약 18%이지만, 비타민 C를 첨가하면 잔존율의 차이는 약 12%로서 6% 정도 내광성이 증가되었다. 청색 2호와 치자청색소의 경우 색차는 △E값이 107로서 다른 보조색의 필요가 있었다. 내열성 결과는 청색 2호는 80℃×30분과 100℃×30분에서는 pH 2.5∼8.0까지 전 영역에서 99% 이상의 색소 잔존율을 나타내었으며, 121℃×15분 경우에서는 평균 95% 이상의 색소 잔존율을 나타내었다. 치자청색소는 80℃×30분과 100℃×30분의 조건시 pH 7.0부터의 중성영역에서는 약 93% 이상의 잔존율을 보이지만, 121℃×15분에서는 90%의 잔존율을 보였다. 내광성은 청색 4호와 치자황색소의 차이는 약 8%이었고, 비타민 E를 0.4% 첨가하면 치자청색소의 내광성이 4%정도 증가되었다. In order to replace systhetic colors by natural colors as food additive, properties of Gardenia yellow color and Gardenia blue color were compared with Food yellow No. 4 and Food blue No. 1. Color difference between Food yellow No. 4 and Gardenia yellow color was 7.55. Thermal stability of Food yellow No. 4 was above 99%. On the other hand, in case of Gardenia yellow color, showed above 90% of residual color units in 80℃×30min and 100℃×30min at pH 7.0 but 75% in 121℃×15min. Difference of light stability between Food yellow No. 4 and Gardenia yellow color was about 18%. Addition of ascorbic acid was increased about 6% in light stability. Color differance between Food blue No. 2 and Gardenia blue color was 107. Thermal stability of Food blue No. 2 was above 99%. But Gardenia blue color showed 92% of residual color units in 80℃×30min and 100℃×30min at pH 7.0 bu 90% in 121℃×15min. Difference of light stability between Food blue No. 4 and Gardenia blue color was 8%. Addition of -tocopherol was increased about 4% light stability of Gardenia blue color.

한국인 편두통 환자와 미토콘드리아 DNA 11,084 유전자 다형성의 연관성

김병건,배희준,구자성,권오현,김만호 대한두통연구회 2002 두통 Vol.3 No.2