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.

석면에 장기간 노출된 퇴직한 수리조선업 근로자의 폐영상 : 단순흉부촬영 및 고해상전산화단층촬영 소견과 그 유병률 Lung and Pleural Diseases Prevalence on Chest Radiograph and HRCT

김기남,김정일,,이기남,정갑열,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 장기간 석면에 노출되었던 퇴직한 조선소 근로자에서 단순흉부촬영과 고해상 CT소견 및 그 유병률을 알아보고자 하였다. 대상 및 방법: 수리조선소에서 배관공 또는 영선반에서 근무한 후 퇴직한 근로자 18명을 대상으로 하여 후전면 및 측면 단순흉부촬영과 고해상 CT를 시행하였다. 이들은 모두 조선소에서 사용하는 단열재 사용 작업 중에 석면에 노출되었다. 결과: 단순흉부촬영에서 총 18례 중 12례(66.7%)에서 흉막병변이 관찰되었다. 흉막플라크의 위치는 횡경막 단독으로 비후된 경우가 5례로 가장 많았으며, 외측흉벽 흉막플라크의 두계는 a가 3례, b가 1례에서 보였고, 길이는 1이 4례, 2가 1례에서 보였다. 흉막플라크를 가진 12례 중 2례는 미만성 흉막비후를 동시에 보였다. 흉막플라크의 석회화는 횡경막에서만 4례 관찰되었다. 석면과 관련된 폐실질병변이 의심되는 소견은 관찰되지 않았다. 고해상 CT에서는 16례(88.9%)에서 흉막비후가 관찰되었으며, 위치는 척추 주위 13례, 횡경막 11례 등이었다. 동반된 석회화는 7례에서 보였다. 두께는 1 mm부터 1cm까지 이었고, 길이는 2cm부터 47cm이상까지 매우 다양하였다. 3명(16.7%)에서 흉막비후 근처의 하폐 기저부에 흉막하 곡선이 나타나는 석면폐증의 초기 소견이 보였다. 결론: 장기간 석면에 노출된 근로자의 석면 관련 흉막병변의 유병률이 매우 높아 장기적인 추적검사가 필요하다고 사료된다. Purpose: To determine imaging findings among retired workers who were long-term exposed to asbestos. Lung and pleural diseases prevalence were studied on chest radiograph and HRCT. Materials and Methods: Eighteen workers who were long-term exposedto asbestos occupationally in shipyards were examined by chest radiographs (PA and lateral view) and HRCT (high-resolution computed tomography). Results: In 12of 18 subjects (66.7%), asbestos-related pleural abnormalities were evident in diaphragmatic, lateral chest wall and costophrenic angle of the pleura on chest radiographs. The thickness of pleural plaques at the lateral chest wall varied. Diffuse pleural thickening was evident in 2 workers. Parenchymal abnormalities were not found on chest radiographs. On HRCT, pleural thickening wasobserved in 16 of 18 subjects (88.9%), in the areas of juxtavertebral, diaphragmatic, anterior, lateral, mediastinal and fissural pleura. Curvilinear subpleural lines representing early parenchymal asbestosis were found in the lower posterior lung in three of 18 subjects (16.7%). Conclusions: In long term asbestos-exposed workers, the asbestos-related pleural disease was 66.7% on chest radiographs and 88.9% on HRCT. The authors suggest that this group should be followed up periodically

판별분석법을 이용한 관상동맥질환 고위험군의 예측

김성률,김기현,정갑열,김정만,박경일,김준연,이상주,김원술 동아대학교 부설 산업의학연구소 1995 산업의학연구소 논총 Vol.- No.2

The objective of this study is to predict the high risk group of coronary artery disease from body mass index, blood pressure, fasting blood sugar and serum lipids level using the method of discriminant analysis. Variables with significant difference between coronary artery disease group and normal group were HDS-C, LDL-C/HDL-C, LDL-C, and TG. But the acuity did not exceed 70% in any single variable. As the results of discriminant analysis, statistically significant discriminant variables were HDL-C, T-chol, FBS and TG. The discriminant equation was(Y) = -0.06759(HDL-C) + 0.01498(T-chol),+0.01923(FBS) - 0.01421(TG) + 0.5187, and the overall discriminant power using the above 4 variables was 79.3%

Ki-67 Expression Gives Additional Prognostic Information on St. Gallen 2007 and Adjuvant! Online Risk Categories in Early Breast Cancer

Jung, So-Youn,Han, Wonshik,Lee, Jong Won,Ko, Eunyoung,Kim, Eunkyu,Yu, Jong-Han,Moon, Hyeong-Gon,Park, In Ae,Oh, Do-Youn,Im, Seock-Ah,Kim, Tae-You,Hwang, Ki-Tae,Kim, Sung-Won,Noh, Dong-Young Springer - Society of Surgical Oncology 2009 Annals of Surgical Oncology Vol.16 No.5

전선 : 사학분쟁조정위원회의 대법원 판례 해석과 정이사 선임원칙 등의 문제점 -상지학원의 정이사 선임 사례를 중심으로-

송기춘 ( Ki Choon Song ),김명연 ( Myoung Youn Kim ) 민주주의법학연구회 2011 민주법학 Vol.0 No.46

2010년 사학분쟁조정위원회(이하 "사분위")는 상지학원의 ``정상화``를 위하여 과거 교육비리로 이사에서 해임되었고 형벌까지 받았던 김문기 씨쪽이 추천한 인사를 정이사로 선임하고 교육과학기술부는 이를 승인하였다. 사분위는 이 결정이 대법원의 판결을 충실하게 따른 것이라고 강변하고 있지만, 사분위가 만든 정이사 선임기준은 이 대법원 판결을 자의적으로 왜곡한 것일 뿐 아니라 사립학교법이나 민법의 일반원칙에 비춰 봐도 받아들이기 힘든 것이다. 사분위의 결정은 대법원의 다수의견이 아닌 다수의견에 대한 보충의견을 다수의견인 양 인용하면서 자신들의 정이사 선임원칙을 정당화하고 있을 뿐이다. 또한 사학의 정상화를 위한 기준은 심의 당시의 민법, 사립학교법 등의 일반원칙에 따라 결정되어야 한다는 판결에도 불구하고 현행 사립학교법의 취지와 전혀 반대되는 결정을 하고 있다. 이 글은 사분위가 대법원 판결을 어떻게 왜곡하고 있는지, 정이사 선임원칙은 어떠한 문제가 있는지를 종합적으로 평가하고 아울러 사분위의 권한남용의 원인이라 할 수 있는 사립학교법의 사분위 심의기준에 대한 입법적 보완 또는 사분위의 폐지를 주장하고 있다. The Private School Dispute Resolution Committee has the power to appoint the ad-hoc directors, discharge them or appoint the regular directors to normalize private schools. It made a decision regarding Sangji Educational Foundation last year. The decision is to appoint the directors recommended by the ex-director Moonki Kim who was discharged because of his crime regarding illegal operations of the Foundation as a director. The Committee says that the decision is based on the judgement of the Supreme Court relating to the Sangji Educational Foundation in 2007. But the Committee distorted the judgement to justify its own decision. It regards the concurring opinion of two Associate Justices as the binding opinion of the Supreme Court. Only the opinion of the Court has the binding power, but the concurring one does not. The Committee even made its decision arbitrarily because there is no regulation on the way and scope to normalize private schools. The power of regulation is delegated to the Committee too comprehensively. It`s the defect of the legislation which should be corrected by the legislative body. It was wrong for the Committee to appoint the crime-related people as directors of Sangji Educational Foundation. It should have considered the moral aspects of the ex-director Kim. He has the critical defect to become an educator.

중소기업 CRM시스템의 조직특성과 성과에 대한 인식-중요도-성취도 평가

윤기호,김성환 東亞大學校 經營問題硏究所 2003 經營論叢 Vol.24 No.-

상악 측절치의 치내치에 대한 증례보고 : REPORT OF 2 CASES

윤석희,이재천,김영재,장기택,한세현,김종철 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

치내치(dens invaginatus)는 치아 발생 과정 중 경조직이 석회화되기 전에 법랑질 상피가 함입되어 생기는 치아 기형이다. 치내치는 함입된 정도에 따라다양한 형태학적 변이를 보이는데 이러한 기형은 미생물이 침입할 수 있는 통로가 될 수 있어 치수조직의 괴사와 치근단 농양 또는 치은 농양의 원인이 된다. 이러한 경우 근고나의 복잡한 해부학적 형태 때문에 근관 치료가 매우 어렵다. 본 증례는 상악 좌측 측절치의 동통을 주소로 내원한 두 명의 환아들에 관한 것이다. 첫 번째 증례는 수산화 칼슘제재를 이용한 근관치료를 시행하여 양호한 결과를 얻었고 두 번째 증례는 치아를 발거하였다. 발거된 치아는 미세전산화 단층촬영을 이용하여 해부학적 형태를 살펴보았기에 보고하는 바이다. Dens invaginatus is a malformation of tooth resulting from an infolding of the enamel epithelium during tooth development. This malformation shows a broad spectrum of morphologic variations. This invagination frequently allows the entry of irritants and microorganism, which usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscess. Root canal treatment of such tooth is often difficult because of the unusual form and complicated pulpal space. This article reports 2 cases of dens invaginatus in maxillary lateral incisors. The first case was successfully treated with Ca(OH)₂. In the second case, involved tooth was extracted and this extracted tooth was observed using the micro-computed tomography.

「面」制度의 變遷과 現行 「面」行政 實態에 關한 硏究

김연기 대구대학교 새마을지역사회개발연구소 1981 지역사회개발논총(地域社會開發論叢) Vol.4 No.-

The importance of the Myeon administration is stressed as it administers various national polioies ultimately and comprehensively and adjusts policies to each region's characteristics. While the improvement on the local administration system, as the terminal offices, is urgently needed, the purpose of this paper is to review our past local government system and develop it suited to our situation. Our Myeon system's history is as follows; 1. The Myeon system had developed as autonomous regional organization until the end of Lee dynasty and played a key role of government orders, public morals and maintenance of law and order. 2. In 1895 the Myeon meeting was adopted, in 1910 got the legal basis as the lowest office of local government, and in 1930 was recognized as the juridicial body. 3. After the independence of Japan, the self-government system of Myeon council was formed, but abolished by provisional orders pertaining to local government after the military revolution in 1961. It is now sustained just as a sub-administrative organization for County. Viewing the aforementioned facts, the Myeon system was under great change in the aspects of qualities and quantities. Among those changes are included as follows; 1. Development, production and welfare administration is necessarily demanded. Those contents are now much colorful. 2. The much authority of central government has been transferred to local government. 3. As the result of population increase and more demand from people, the function of public administration has been expanded. The problems of current Myeon system and the methods of improvement on those problems are as follows; 1. Compared with its over-burdened business, the Myeon office is lack of manpower and facilities. As a result, it gets stereotyped and its efficiency has lowered drastically. As soon as possible, proper reinforcement of manpower and modernized equipments are seriously needed. 2. Because of frequent supervision of the upper organization, the Myeon has low morale. It is desirable that the administrative area of province be sub-divided into smaller size. County be abolished Myeon system be readjusted and the function of the local administration be focused on it. For that readjustment, we should considere the economic area, community develoment area, population number and traffic network. 3. Introduction of computerized communication sostem is urgently required to exchange speedier message between the upper and the lower sides of public administration. 4. Even though Myeon system is established as an organ toward people, it is required that more residents participate in the activities of the system. The participation should be expanded for the realization of democracy and desirable public administration. In conclusion, for the activation of local government, local government should start from the self-sufficient areas such as larger cities and spread into another smaller cities and towns. I suggest that more attention be payed to local government, especially Myeon system for the normalization and activation of our local self-government system.

비ST분절상승 급성관동맥 증후군 환자에서 N-terminal Pro B-type Natriuretic Peptide(NT-proBNP)를 이용한 관동맥 협착의 중증도 및 초기 위험도 평가

김기석,한혜숙,황경국,연태진,김동운,조명찬 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

地方自治實施를 위한 與件 助成 方案에 관한 硏究

김연기 대구대학교 법정연구소 1987 法政論叢 Vol.2 No.-

The republic of Korea has adopted the democratic political system since 1948 and from 1952 to 1961 local councils were constructed by citizen and local governments were enfroced all over the country. After the 5.16 military revolution in 1961, the military regime disorganized the local councils and local government has been withheld up to now. But in 1984, the ins and the outs agreed to partially construct local councils and enforce local government from the first half of 1988. Central government set its prior goal in the econmic development since 1960 and operated the national policy by putting its efficiency before its democracy for ideology of administration, As the result of it the government accomplished ahigh degree of economic growth, but major fowers in political administrative were concentrated in the central government. The result this prefereatial policy about aconomic growth broght about unblance between its regions, classes and urbenrural. Korean people now claim entensive and variable political participation, their powers being delegated from Centrad government to local government. The purpose of this thesis is to present a geneal plan for the preparation of conditions for the constructiong of local councils and enforcement of local government asneeded. At first, the past 10 year's of local government experience (1952―1961) and present local government realities are analized and evaluated. Because the past experiences present good instructive examples for the enforcement of future rational local government. Durinng the 10 years local governments (1952―1961) were politically exploited by the party in power because of the low concern and participation of citizens about democracy and local govermments. That is local government and local councils were used for keeping the ruling part in power. Also, local government and local councils were politically influenced by central government that bringing about excessive conflict and many problems. That the realities of present local government and central government is that both have excessive powers in function and finance. Therfore local government is degraded by the local agent of central government. In addition, the local governments were unblanced in reltionship to the local population, size of area, financial independence ratio, and GDP, etc. In order to improve the present unreasonable situations for the enforcement of local autonomy system Central government has to reallocate power for their functions, reform the local financial system for financial independene abjust the service area between the governments, reform control partterns and mitigate control from the central government to local government, etc. Also, concern and participation of citizens are most important factors for the desirable local government. Government is only effective with the participation of the governecl citizens.