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.

저지방 프레스햄의 제조와 안정성

정인범,문윤희 慶星大學校 1998 論文集 Vol.19 No.2

This study was conducted to investigate the possibility of production for low fat pressed ham which was made without fat added. Four kinds of pressed ham were manufactured as the A(pork 70%, fat 0% : low fat pressed ham), B(pork 60%, fat 10%), C(pork 55%, fat 15%) and D(pork 50%, fat 20%). The pressed ham samples were stored at 4±2℃. The storage stability of pressed hams were analyzed during storage 60 days at 4℃. The pH of low fat pressed ham was a little higher than others, and increased in all products for 60 days, but it was not significantly different. The volatile basic nitrogen content of low fat pressed ham was higher than other products, and the thiobarbituric acid values of all samples were below 10⁴/g meat, the coliform bacteria were showed to be negative until 60 days.

저지방 프레스햄의 제조와 품질특성에 관한 연구

정인범,정인철,문윤희 한국식품영양학회 1998 韓國食品營養學會誌 Vol.11 No.5

돈육의 적육을 70%로 하여 등지방을 첨가하지 않고 저지방 프레스햄(A)을 제조하고, 또 돈육과 등지방 배합비를 각각 60%와 10%(B), 55%와 15%(C) 및 50%와 20%(D)로 하여 모두 4종류의 프레스햄을 제조하였다. 이 때에 적육과 등지방 이외의 모든 재료와 제조 조건은 동일하게 하였다. 제조된 프레스햄의 일반성분, 보수력 및 기호성을 비교하고, 이것을 4℃에서 60일간 냉장하면서 10일 간격으로 조직특성의 변화 정도를 비교하였다. 저지방 프레스햄(A)은 수분 71.3%, 조단백질 함량 23.4%로 다른 제품보다 높았으며, 저지방 함량은 2.8%로 현저히 낮았다(p<0.05). 저지방 프레스햄의 보수력은 74.5%로 다른 제품보다 높았다. 저지방 프레스햄의 표면색도 중 명도(L)는 61.6 황색도(b)는 5.9로 다른 제품보다 높게 나타났다. 저지방 프레스햄은 경도가 70,.2, 탄성 85%, 씹힘성 0.49㎏, 뭉침성 2.0% 및 파쇄성이 0.7㎏으로 다른 제품보다 높은 편이었고 응집성의 경우 D제품보다 낮은 값을 보였다. 저지방 프레스햄의 향과 조직감은 다른 제품보다 열등하였으나 맛이 우수하였으며 기호성도 좋은 편이었다. This study was conducted to investigate the possibility of production for low fat press ham which was made without fat added. Four kinds of press ham were prpared ; A(pork 70%, fat 0% : low fat press ham), B(pork 60%, fat 10%), C(pork 55%, fat 15%) and D(pork 50%, fat 20%). The press ham samples were stored at 4±2℃. The physico chemical properties of press hams were analyzed during storage 60 days at 4℃. The contets of moisture(71.3%) and crude protein(23.4%) of low fat press ham were higher than those of other products, and crude fat content(2.8%) was remarkably lower(p<0.05). The water holding capacity of press ham was higher than other products. Hunter's L(61.6) and b-value(5.9) of low fat press ham were lower than other products, but a-value(11.7) was higher. Hardness(70.2dyne/㎝), springiness(85%), chewiness(0.49㎏), gumminess(2.0㎏) and brittleness(0.7㎏) of low fat press ham were higher than those of other products, but cohesiveness was lower than D product. Aroma and texture of low fat press ham were inferior to other, but taste and palatability of that were superior.

대퇴사두근 테이핑이 근력 및 근지구력에 미치는 영향

윤범철,홍혜정 高麗大學校 倂設 保健大學 保健科學硏究所 1999 保建科學硏究論集 Vol.8 No.1

This study was investigated the effect of the Kinesio taping on muscle power and muscular endurance in quadriceps femoris. Twenty-three subjects, 14 male and 9 female, were included in this study. Peak torque et al at 60℃/sec, average power and average power to BW ratio et al at 180℃/sec were neasured by using a Cybex 1000(Orthotron KT2) and compared between before- and after-taping. The results were as follows; 1. Isokinetic muscle power measures-peak torque, peak torque to BW ratio, work/repetition, work/repetition to BW ratio, average power/repetition, average power/repetition to BW ratio-, in total was increased following kinesio taping. 2. There were significant differences in the isoisokinetic muscle power measures-peak torque, F/E ratio, work/repetition, work/repetition to BW ratio- of male, and F/E ratio of female. 3. isokinetic muscular endurance measures-initial peak torque, initial peak torque to BW ratio, total work done-, in total was increased following kinesio taping. 4. There weren't significant differences in the isokinetic muscular endurance measures of male, but there were significantly in the initial peak torque, initial peak torque to BW ratio, total work done, total work done to BW ratio, average power, average power to BW ratio of female. 5. There were significant differences in the isokinetic muscle power measures among sex groups. 6. There were significant differences in the isokinetic muscular endurance measures among sex groups. This study showed that the application of the Kinesio taping in quadricepsfemris enhanced muscle power and muscular endurance.

침자가 성장기 및 성숙기 웅성 흰쥐의 혈액성분에 미치는 영향

윤범철,이성동,류정록,최태암 高麗大學校 倂設 保健大學 保健科學硏究所 2001 保健科學論集 Vol.27 No.2

Acupuncture, an over 2500 years old therapeutic method stemming from traditional oriental medicine, is nowadays wide open to modern medical science. With the widespread usage of acupuncture, the number of article about biomechanical or therapeutic effects of acupuncture from animal experiments and clinical trials is largely reported. In a previous study, we have reported that Joksamlee(ST36) acupuncture increases serum protein and glucose but decrease serum lipid and cholesterol. For further study, we was examined effects of Shenshu(B23) and Samumgyo(SP6) acupuncture stimulation on differential blood components in growing and adult male rate. 24 male Sprague-Dawley rats were randomly assigned into three groups; A1 (B23 and SP6 acupuncture in adult rats) group, A2 (B23 acupuncture in growing rats) group, and control group. The results obtained were as follows; 1. Body weight was significantly decreased in A1 and A2 groups. 2. Serum TP level was not changed, but albumin level was significantly increased in A2 group. 3. Serum glucose level was significantly increased in A1 group. 4. Serum TG level was significantly decreased in A2 group: PL level was significantly decreased in both A1 and A2 groups; FFA level was not changed. 5. Serum T.CHO, HDL-C and LDL-C levels were not changed in both A1 and A2. 6. Serum amylase activity was significantly increased in A1 group.

유리피판을 이용한 하인두-식도 재건 치험례

봉정표,정윤규,이훈범,김주봉,이재화,나동균,김석원 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Hypopharyngo-esophageal cancer is usually found at late stage. Its main treatment is surgical intervention and it often requires radical resection. Reconstruction of the hypopharyngo-esophageal defect after the resection of carcinomas of the hypopharynx and the cervical esophagus has traditionally been carried out with deltopectoral or musculocutaneous flap. Another approach is to reconstruct the defect with the colon or stomach. Recent advances in microvascular surgical techniques have resulted in one stage reconstruction with free flap. Both jejunal free flap and radial forearm free flap is a good alternative for the reconstruction of hypopharyngo-esophageal defect. Six cases of the radial forearm flap and nine cases of the jejunal flap were used to reconstructed the hypopharyngo-esophageal defect in 15 patients. In jejunal free flap, upper margin was reconstructed with end to side anastomosis and lower margin with end to end anastomosis. In radial forearm free flap, we used trapezoid shaped flap and tubed by complete or partial tubing according to the condition of the defects. Stricture and fistula are troublesome complications. The complications were peritonitis(n=1) and fistula(n=1). We concluded that both forearm and jejunal free flap is a useful alternative in reconstruction of hypopharynx and cervical esophagus.

공동주택의 에너지 절약 및 공기환경개선을 위한 열교환기의 성능평가

김범석,정용호,박병윤,손장열 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

This study was aimed to suggest the appropriate residential heat and moisture recovery ventilation systems(HRVs) in order to maintain an acceptable indoor air quality for the climatic conditions of Korea. This study was developed from experimental data on HRV Performance specifications and HVAC system. Results show that total heat exchangers of rotary type is applied on HVAC system that is possible to conserve energy and improve indoor air quality.

잠재적 간성혼수 환자의 인지기능과 양성자 자기공명분광 소견과의 상관관계

김성윤,정범석,서동완,이정희,이 철 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

연구목적 : 잠재성 간성혼수 환자들의 신경인지기능 장애 정도와 기저 핵이나 두정엽 백질부에서의 자기공명분광 (proton MRS)으로 측정한 양성자 함유 화합물의 변화와의 상관관계를 조사하고자 하였다. 방법: 한국판 웩슬러 지능 검사(KWIS) 중 토막짜기나 기호 바꾸기, 그리고 번호잇기 검사를 적용하여 잠재성 간성혼수로 정의된 18명의 간경변 환자를 대상군으로 하고 20명의 정상인을 대조군으로 하였다. 복합주의력과 시각 정보 분석능력 측정을 위해 Vienna 전산화 신경인지기능 검사 중, Cognitrone 검사. 미세 협응 운동능력을 위해 Grooved pegboard 검사를 적용하였단 1.5 Tesla 임상용 자기공명 촬영기를 이용해 자기공련명 분광을 얻었으며 두정엽 백질부와 기저핵의 각각 2×2×2cm3 vocel에서의 myoinositol(ml), N-acetyl-L-aspartate(NAA). creative(Cr), choline(Cho) 등의 농도를 측정하고 Cr 농도에 대한 상대적 농도비율을 구하여 분석하였다. 결과: 1) 잠재성 간성혼수 환자들의 기저핵과 두정엽 백질부에서 Cho/cr 및 ml/Cr 비가 감소하였다. 2) 미세 협응 운동능력을 반영하는 Grooved pegboard 검사의 수행능력이 기저핵의 ml 및 두정엽 백질부의 Cho농도와 유의미한 역상관관계를 보였다(r= -0.59. p<.05). 3) Cognitrone 검사 중 정반응하는데 걸리는 평균시간은 두정엽 백질부의 NAA와 역 상관관계를 보였다(r= -0.55, p<.05) . 결론 : 잠재성 간성혼수 환자들의 특정 신경인지기능의 장애는 양성자 자기공명분광법으로 측정한 기저핵 및 두정엽 백질부의 신경화학적 변화와 상관관계를 보인다. 하지만 이러한 신경화학적 변화가 잠재성 간성 혼수의 근본적 병리 생리인지 2차적 변화인지를 규명하기 위해서는 질병의 경과에 따른 신경인지기능 및 양성자 자기공명분광 소견의 추적연구가 필요하며 비슷한 인지기능의 장애를 보이는 다른 신경퇴행성 질환과의 비교 연구가 필요하다. 0bjectives To investigate the relationship of neurochemical changes of brain in SCHE patients and the level of cognitive function, the authors measured hydrogen containing neurochemicals in two brain regions using 1H MRS, and compared those changes with the level of cognitive performances such as attention, visual analysis, or fine motor function. Methods ; A total of patients with liver cirrohosis were defined as SCHE, for they performed poorly(out of 1 SD of normative data) in more than one neuropsychological tests conventionally used(digit symbol and block design tests in KWIS, trail making test A and B). They were further evaluated in attentional ability and efficacy of visual analysis using Cognitrone subtest in Vienna Neurocognitive Test battery. Fine motor coordination were also measured by Grooved Pegboard test. Patients and 20 nodal controls underwent proton MRS study. Proton containg neurochemirals , such as myoinositol(mI) , N-acetrl-L-aspartate(NAA) , creating (Cr) , choline(Cho) were measured from 2*2*2cm3 voxel of basal ganglia and parietal white matter using 1.5 tesla dinical MRI/MRS system. The ratios of above metabolites to Cr were analyzed. Results : 1) Patients with SCHE showed reductions in Cho/Cr and ml/Cr in both basal ganglia and parietal white matter compared to normal subjects. 2) Performance of Grooved Pegboard test were negatively correlated with ml level of basal gang1ia and with Cho level of parietal white matter(r= -0.59, p<.05). 3) Mean time of correct responses in Cognitrone test skewed negative correlation with NAA level of parietal white matter(r= -0.55, p<.05). Conclusion : Certain neurocognitive disturbances in SCHE patients seemed to be related with neurochemical changes in basal ganglia or parietal white matter. To further elucidate the relationship of focal biochemical changes and neurocognitive deficits in SCHE patients, however, fo11ow-up study according to the illness stage must be performed. Studies on other disorders showing similar cognitive deficit patterns would be helpful.

혈행화된 두개골 피판을 이용한 안와저 및 안와하연의 재건술 치험례

정윤규,이훈범,김석원,봉정표,김균태,김주봉 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.5

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.

성장기 흰쥐의 족삼리(ST-36) 침자가 혈액성분에 미치는 영향

이성동,윤범철,류정록,최태암 高麗大學校 倂設 保健大學 保健科學硏究所 2000 保健科學論集 Vol.26 No.1

Acupuncture, an important branch of oriental medicine, has been practiced for many centuries and has been proved to be an effective treatment for all sorts of disease. However, the exact mechanism on effects of acupuncture was uncertain. Recently investigation for the mechanism of acupuncture has concentrated to human and animals. So, This study was to determine effects of ST-36 acupuncture stimulation on blood component in growing rats. For this study, 24 male Sprague-Dawley rats weighting 159?13g were randomly assigned into three groups; A4 group, A10 group, and control group. In A4 group, four times acupuncture were performed at both ST-36 every other days and in A10 group, ten times acupuncture. The results obtained were as follows; 1. Total protein level was significantly increased, particularly in A10 group; albumin level was also significantly increased. 2. Serum glucose level was significantly increased. 3. Triglyceride level was significantly increased in A4 group; phospholipid level had no changes; free fatty acid level was significantly decreased particularly in A10 group. 4. Total cholesterol level was rarely affected by acupuncture: HDL-C and LDL-C levels were affected by the number of times of acupuncture, that is, HDL-C levels were increased, and LDL-C level decreased in A4 group, while HDL-C level decreased and LDL-C level increased in A10 group. 5. Serum amylase activity was not significantly changed.