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.

分割法에 依한 電力潮流計算에 관한 硏究

鄭亨煥,周秀元,禹靖仁 동아대학교 공과대학 부설 한국자원개발연구소 1979 硏究報告 Vol.4 No.1

The Newton-Raphson Method has now gained widespread popularity in Load-Flow calculation. In this paper programming is developed with aims to improve the covergence characteristic, speed and memory requirements in the above method.

Helicobacter pyloir 양성 소화성 궤양에서 lansoprazole 포함 삼제요법의 제균율 및 제균판정에 있어서 요소호기검사의 유용성

정혜경,곽재진,유민아,배기선,권정미,이종수,김도영,문일환 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

목적 : 본 연구는 Helicobacter pylori (이하 H. polyri) 양성인 소화성 궤양 환자에서 lansoprazole 포함 삼제요법의 제균율을 알아보고, 제균 치료 후 제균 판정에 있어서 요소 호기 검사(Urea breath test, 이하 UBT) 및 신속요소분해(rapid urease test, 이하 RUT test)와의 일치율에 대하여 알아보고자 하였다. 방법 : 상부위장관내시경 검사에서 H. polyri 양성인 소화성 궤양환자에서 lansoprazole 60㎎+amoxicillin 2g+clarithromycin 1g의 약제를 2회 분복하여 1주간 복용하는 삼제요법을 실시하였다. 최소 4주후 추적 상부위장관내시경을 실시하였고, 전정부와 체부에서 각각 RUT를 실시하였으며 UBT(5분, 20분)를 시행하였다. 결과 : 대상환자는 총 46명으로 남자 34명(48±13세), 여자 12명(53±14세)이었다. LAC 삼제요법의 제균율은 40/46명(87.0%)이었고, 궤양의 치유율도 42/46명(91.3%)이었다. RUT와 20분 UBT 결과가 모두 음성이었던 경우는 41예, 모두 양성이었던 경우는 4예로 RUT와 UBT는 97.8% (45/46)의 일치율을 보였고, 1예는 UBT는 음성이었으나 체부에서 시행한 RUT가 양성이었다. 5분 UBT 검사가 양성이었던 예는 14/34 (41.2%) 이었고, 이 14예 중 12예(85.7%)는 20분 UBT 검사 음성, RUT 음성이었다. 결론 : Lansoprazole과 amoxicillin, clarithromycin 1주일 병합요법은 H. polyri 양성인 소화성 궤양 환자에서 87.0%의 제균율을 나타내어 우수한 효과를 보였고, 요소호기검사는 제균 치료 후 제균 판정에 유용한 비침습적인 방법임을 확인할 수 있었다. Background : There are only a few studies on Helicobacter pylori (H. pylori) for its eradication rates of lansoprazole-based triple therapy in Korea, and the results are controversial. Therefore, we undertook to investigate the eradication rate of lansoprazole-based triple therapy, and compare the concordance rate of urea breath test (UBT) and rapid urease test (RUT) in evaluating H. pylori eradication. Methods : Patients with acute peptic ulcer who were H. pylori-positive were recruited by prospective, consecutive manner. They received lansoprazole 30 ㎎ b.d., amoxicillin 1 g b.d. and clarithromycin 500 ㎎ b.d. for 1 week. Upper endoscopy was performed after 4 weeks to check for ulcer healing, and UBT and RUT were performed to evaluate H. pylori eradication status. Results : A total of 46 patients were recruited, and they were all compliant. H. pylori eradication rate was 87.0% (40/46) and ulcer healing rate was 91.3% (42/46). Forty one patients showed negative in both UBT and RUT, and 4 patients revealed positive in both tests, therefore, the concordance rate of UBT and RUT was 97.8% (45/46). Conclusion : Our study showed that 1-week lansoprazole-based triple therapy was effective in H. pylori eradication and ulcer healing. UBT can be an effective, noninvasive method for evaluating H. pylori status after H. pylori eradication.

Slim Patch Type을 이용한 카페인의 경피흡수에 관한 연구

김정수,권동환,임도형,김구서,강진양 한국약제학회 2006 Journal of Pharmaceutical Investigation Vol.36 No.2

신체접촉을 통한 스포츠마사지가 자폐아의 적응행동에 미치는 효과

김정수,강경환,송명현 한국특수체육학회 2003 한국특수체육학회지 Vol.11 No.1

The purpose of this study was to compare adaptable activities before and after performing sports massage for autistic students. Ten autistic students aged 14~19 years old participated in this study. They were divided into two groups, Group A(experimental group) and Group B(control group). Group A participated in sport massage class, one a week for about 40 minutes for 16 weeks. Both group A and group B took pre-test and post-test. Their adaptable activities was measured by Motivation Assessment Scale(MAS) designed by Mar Durand(1986). Frequency analysis was applied for data analysis. The results showed over maladaptable activities decreased in case 1(0.83%), case 2(0.91%), case 3(0.78%), and case 4(0.94%). However, there was increase of maladaptable activities in case 5(1.04%). These finding suggest that sports massage was effective in improving inappropriate behaviors of autistic students.

안면부에 발생한 비특이성 염증

유동수,박태원,박래정,최순철,정환석,현영민 大韓口腔顎顔面 放射線學會 1997 Imaging Science in Dentistry Vol.27 No.1

Patient with complaints of swelling, pain in the maxillary region and discomfort visited Seoul National University Dental Hospital in August last year. Clinical examination and diagnostic imagings implied he was suffered from fungal hyphal infection but no causative fungus was found by the histopathologic and microbiologic investigation. Therefore he was diagnosed with nonspecific inflammation. But as yet, we do think this case is very similiar to some kinds of mucormycosis. So we presented this case for more thorough discussion. Followings are founded in the examination. 1. Patient had suffered from Diabetes mellitus and complained of stuffness, headache, swelling in buccal checks and paresthesia. And we found more maxillary bony destruction and ulcer with elevated margin in the palate by clinical examination. 2. In the first visit, Plain films revealed general bony destruction of the maxilla, radiopaqueness in the sinonasal cavities. CT and MRI showed soft tissue mass filled in the paranasal sinus except frontal sinus and bony destruction in involved bones. 3. No causative bacteria and fungus was found in the biopsy and microbiologic cultures. 4. Caldwell-Luc operation and curettage were carried and antibiotics were taken for 4 months. But now he was worse than in the past. 5. In the second visit, involvement of orbit, parapharyngeal sinus, clivus, cavernous sinus and middle cranial fossa were seen clearly in the CT and MRI.

Glucocorticoid가 비장세포 임파구의 증식,Interleukin-2(IL-2) 생산 및 말초 혈액 임파구의 IL-2수용체 발현에 미치는 영향

김정목,조양자,이수영,박장환 漢陽大學校 環境科學硏究所 1992 環境科學論文集 Vol.13 No.-

Glucocorticoids are widely used as therapeutic agents in as variety of allergic and inflammatory diseases and in transplantation rejection. Although glucocorticoids are thought to influence on the immunologic reation, they are not fully known to influence on the immune cell function. In this report, we have studies effects of glucocorticoid. dexamethasone, on porliferation and production of interleukin-2(IL-2) in mouse splenic lymphocytes and on expression of IL-2 production, we isolated C57BL6 mice splenic cells and stimulated with Con-A(5㎍/ml). As the concentration of dexamethasone was increased, the proliferation and the IL-2 production of mouse splenic lymphocytes stimulated by Con-A (5㎍/ml) were decreased. And the expression of IL-2 receptors in human peripheral blood lymphocytes was also decreased in addition of dexamethasone. These findings suggest that proliferation, IL-2 production, and IL-2 receptor expression of immune cells are inhibited by glucocorticoid, dexamethasone.

유도 어깨로메치기의 운동학적 특성분석

김의환,김규수,김성섭,박중제 龍仁大學校 武道硏究所 2001 武道硏究所誌 Vol.12 No.1

The purpose of this study was to analyze the kinematic variables when performing Kata-guruma in judo. Yong-In University judo demonstration squad was filmed (30frames/sec.) on 16mm video camera on performing of Kata-guruma in judo. Kinematic variables analyzed here include time, angle and center of gravity. The mean values and the standard deviations for each variables were obtained and used as basic factors for examining characteristic of Kata-Guruma motion. The result of this analysis are ads following. 1) Angle variables From Kumikata to 1st stage in KP, the angle of right elbow in Kata-Guruma was decreased, to 2nd phase and air phase were increased slightly. Lefe elbow angle of Tsukuri motion was decreased from 1st stage in KP to air motion were increased. Kuzushi of right shoulder angle was decreased, Tsukuri of right shoulder was increased, air posture in Kake phase was increased, Kuzushi of left shoulder angle was increased and Tsukuri of left shoulder angle was decreased continually. Both angle of hips were decreased in 1st stage in KP phase. From 2nd stage in KP to air motion were increased slightly. Both angle of Knees were decreased in 1st Kake phase, from 2nd stage KP to air motion were increased again. Left arm obstructs the center of gravity of opposite, extends in order to set the body, and flexes in other to fling the body of the shoulder. Right arm was flexed on order to let the arm in between legs, and flexes on Kake motion and was extended in other to fling the body of the shoulder. According to result of angle variables, deflection of the subject A was of small quantity, and both subject A and B were fixed in view of subject B.

택지개발지구내 도시공원의 분포특성에 관한 연구

김수봉,정응호,김정환,류지원 한국정원학회 2002 한국전통조경학회지 Vol.20 No.2

To generate a suggestion for a better framework especially the distribution and locations of urban parks in residential areas, ‘residential site development districts’ in Daegu city were tested based on the community involvement and user’s demand for visting. Service-range, advantage and disadvantage in use derived from the locations of the parks in the districts were analyzed according to the concept of density,character assessment, structure in the distribution and locations. Suggestions to give residents more friendly surroundings with ’easy access’ and ’friendly characteristics of each parks’ are as follows; ⅰ) Although most of the tested sites are satisfying the legal criterion on the required level of size of urban parks in each district, there are big difficulties to have rich natural environment in the case of extensive size of residential sites due to too low applied-criterion(0.6㎡ per person) which is a minimum requirement. ⅱ) Although the rate of size of parks in the sites were gradually improved recently, the portion for each person had not improved at all. Therefore, it is needed that new detailed criteria in different level rooted in the character of individual sites such as population and characteristics of parks. ⅲ) Although the distance of parks is within the range of use, the locations are on the edge of sites and residential districts where is not on the everyday route. Therefore to give more easy accessibility, the urban parks in the residential sites should be located on the daily life route where is a more common area in future plans.

우라늄오염에 의한 신부전증에 미치는 제염제의 방호효과

김태환,정인용,김성호,김경중,방효창,류성렬,진수일 대한방사선 방어학회 1990 방사선방어학회지 Vol.15 No.2

원자력산업의 시설증대로 우라늄 오염의 가능성이 증가되고 있음에도 불구하고 종사자 및 국민에대한 안전대책 및 의료적 처치에 관한 연구가 매우 미흡한 실정에 있어 이에 대한 응급처치방안을 수립코자 우라늄을 투여한 후 제염제를 투여하여 관찰하였던 바 다음과 같은 결론을 얻었다. 1. 우라늄오염에 의한 체중변화에 미치는 제염제의 영향에 있어서 sodium bicarbonate와 생리적 식염수를 병행투여한 군과 우라늄을 투여하고 30분이 지나서 dithiothreitol을 투여한 군에서는 우라늄단독투여군에 비해 체중이 현저하게 증가하였다. (P<0.05). 2. 모든 실험군은 우라늄오염에 의한 음수량과 배뇨량의 변화를 유의성 있게 호전시켰으며(P<0.05), 특히 sodium bicarbonate와 생리적 식염수를 병행투여한 군과 우라늄을 투여하고 30분이 지나서 dithiothreitol을 투여한 군이 가장 높은 증가경향을 나타냈다(P<0.05). 3. 우라늄오염에 의한 BUN농도 변화에 미치는 제염제의 효과는 sodium bicarbonate와 생리적 식염수를 병행투여한 군과 우라늄을 투여하고 30분이 지나서 dithiothreitol를 투여한 군이 공히 우라늄단독투여군보다 BUN농도가 매우 감소되었다(P<0.01). 4. 우라늄을 투여하고 30분이 지나서 dithiothreitol를 투여한 군은 우라늄오염에 의한 serum creatinine의 농도증가를 유의하게 감소시켰으나 (P<0.01), sodium bicarbonate와 생리적 식염수를 병행투여한 군은 다소 감소하는 경향으로 나타났다. 5. 우라늄오염에 의한 urine creatinine농도 변화에 미치는 제염제의 효과에 있어서 sodium bicarbonate와 생리적 식염수를 병행토여한 군과 우라늄을 투여하고 30분이 지나서 dithiothreitol를 투여한 군에서는 우라늄단독투여군에 비해 creatinine의 배설이 상당히 증가하였다(P<0.05). 6. 우라늄오염에 의한 신장의 소견에 있어 우라늄단독투여군은 근위곡세뇨관상피의 공포화 및 종창, microvilli와 brush border의 손실, 세뇨관 상피의 괴사가 관찰되었으며, 간장의 충혈, 중심성 괴사 우라늄을 투여하고 30분이 지나서 dithiothreitol를 투여한 군에서는 우라늄단독투여군에 비해 높은 방호효과가 관찰되었으나 다른 실험군에서는 큰 효과가 없는 것으로 나타났다. 결론적으로 우라늄의 체내오염시에는 sodium bicarbonate와 생리적 식염수를 가능한 빨리 병행투여하거나 dithiothreitol을 체내오염후 30분이 지나서 투여하는 방법이 우라늄오염에 대한 제염에 매우 유효할 것으로 생각되며, 특히 우라늄에 의한 인체장해를 유의하게 경감시켜줄 것으로 사료되었다. Appreciable radiation exposures certainly were occurred m the reactor burn-up, the nuelear fall-out and the surroundings of nuclear installations with radioactive effluents. Therefore ,radioactive nuclides is not only potentially hazardous to workers of nuclear power plants and related industrials, but also the wokers who handle radioactive nuclides in biochemical research and nuclear medicine diagnostics. And in the case of occurring the nuclear accidents, the early medical treatment of radiation injury should be necessary but little is established'medical procedures to decontaminate the victims of internal contamination of radioactive nuclides in korea. Accordingly, to achieve the basic data for protective roles and medical treatment of radiation injury, the present studies were can-id out to evaluate the decontamination of uranium by the chemical drugs. The results observed were summarized as follows : 1. The combined treatmet group of sodium bicarbonate and saline with uranyl nitrate injection simultaneously and the dithiothreitol group that was administered 30 minutes after uranyl nitrate injection were increased significantly in the change of body weight than uranyl nitrate-only group(P<0.005). 2. All the experimental groups were increased the fluid intake and urine volume on the uranyl nitrate-induced acute renal failure, but the combined treatment group of sodium bicarbonate and saline with uranyl nitrate injection simultaneously and the dithiothreitol group that was administered 30 minutes after uranyl nitrate injection have the higher increment of fluid intake and urine volume(P<0.05). 3. When sodium bicarbonate and saline was treated with uranyl nitrate injection simultaneously, and dithiothreitol was administered 30 minutes after uranyl nitrate injection, there was significantly reduced in BUN concentration (P<0.0l). 4. When dithiothreitol was administered 30 minutes after uranyl nitrate injection, there was reduced more significantly on the increment of serum creatinine concentration than that observed in uranyl nitrate-only group(P<O.Ol). but when the combined treatment of sodium bicarbonate and saline with uranyl nitrate simultaneously, there was still, albeit much less marked, decrease in serum creatinine concentration. 5. The sodium bicarbonate and saline was treated with uranyl nitrate simultaneously and dithiothreitol was administered at 30 minutes after uranyl nitrate were excreted markedly higher urine creatinine concentration than the uranyl nitrate-only group. 6. Uranyl nitrate has been used in experimental animals to produce hydropic degeneration and swelling of proximal tubules, disappearance of microvilli and brush border or necrosis in the kidney and centrilobular necrosis, congestion, and telangiectasia of the liver. When the sodium bicarbonate and saline was treated with uranyl nitrate simultaneously, and dithiothreitol was administered 30 minutes after uranyl nitrate, there was more marked the protective effect than uranyl nitrate-only group. Finally, if the sodium bicarbonate and saline may administered as quickly as possible each time that some risk for internal contamination with uranium, and dithiothreitol is administered 30 minutes after uranium contamination, there ameliorates the course of uranyl nitrate-induced acute renal failure,and this effect is assocciated with prevention of uranium (heavy metal) induced alterations in BUN. serum creatinine. urine creatinine. fluid intake, urine volume and body weight.