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.

고요산혈증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이종은,이준숙,이찬구,이한정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : Serum uric acid has now been identified as a marker for a number of metabolic and hemodynamic abnormalities. The aim of this study is to evaluate risk factors which influence hyperuricemia in the citizens of Asan. Method : The study design was cross-sectional and research subjects were 1086 citizens of Asan. General characteristics, cigarette smoking, alcohol consumption, and past history were obtained by interview using a structural questionnaire. Also, we measured height, weight and blood pressure, and serum uric acid of the subjects. Results : The mean serum uric acid level was 5.27 ㎎/㎗ in men and 4.01 ㎎/㎗, in women, In the multiple logistic regression analysis, statically significant risk factors of hyperuhcemia were gender, body mass index, blood lead concentration, and serum creatinine. Conclusion : Our results suggest that gender, body mass index, blood lead concentration, and serum creatinine might be the most important risk factors of hyperurcemia. Education program as well as routine check-up for serum uric acid was highly recommended for the effective prevention of hyperuricemia.

압출성형에 의한 국산 무연탄 활성탄의 세공구조 변화

이송우,문장천,김도한,이창한,최동훈,류동춘,송승구 부산대학교 환경문제연구소 2000 環境硏究報 Vol.18 No.-

The purpose of this study is to investigate the variation of pore size distribution of the coal-based extruded activated carbon. The extruded activated carbon was prepared by extruding the mixture of coal powder and coal tar. Pore size distribution of the extruded activated carbon was compared with that of the extruded coal and the extruded char. Also it was compared with that of the crushed activated carbon, raw coal and char. The extruded coal had coarser surface than that of raw coal. Macropores of the extruded coal were funned near 10,000Å in diameter during carbonization process and steam penetrated easily between particles and were growing between 3,000Å and 20,000Å in diameter during activation process.

Adamkiewicz 동맥의 폐색에 의한 척수경색 1례

이광훈,이종걸,이태연,신동익,이성현,이상수,한설희,차상훈 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

중소규모 사업장 근로자의 직무스트레스로 인한 결근, 조퇴 현황과 한국형직무스트레스 하부요인과의 관련성

김정훈,박신구,김동현,김환철,임종한,이의철,이동훈,이지영 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

목적: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴의 현황과 한국형 직무 스트레스 하부 요인과의 관련성을 알아보고자 하였다. 방법: 중소규모 사업장 83곳 근로자들에 대해 한국형 직무스트레스요인 평가도구-단축형(KOSS-SF)과 사회 일반적 특성, 직업적 특정 및 직무스트레스로 인한 결근이나 조퇴 경험여부 등을 묻는 구조화된 자가 기입식 설문을 실시하였고, 응답한 4,350명에 대해 최종 분석을 시행하였다. 직무스트레스로 인한 결근, 조퇴와 한국형 직무스트레스 하부 요인들과의 관련성을 확인하기 위하여 로지스틱 회귀분석을 시행 하였다. 결과: 직무 스트레스로 인한 결근, 조퇴를 한 근로자는 남자에서 7%(196명), 여자에서 8%(113명) 로 조사되었고 한국형 직무 스트레스 하부요인과의 관련성에서는 남, 여 모두 직무요구, 관계갈등, 조직체계, 보상부적절, 직장문화 영역의 스트레스가 높은 군에서 통계적으로 의미있게 직무스트레스로 인한 결근, 조퇴율이 증가하였다. 결론: 중소규모 사업장 근로자들의 직무 스트레스로 인한 결근, 조퇴와 한국형 직무 스트레스 하부요인과의 관련성은 남자에서는 조직체계 영역이 가장 높았고, 여자는 직장문화 영역에서 가장 높은 관련성을 보였다. Objective: The aim of this study was to examine the actual conditions of absence and early leave due to job stress of 4,350 workers in 83 small and medium scale industries, and its relationship to job stress factors using Korean Occupational Stress Scale-Short Form (KOSS-SF). Methods: A structured self-reported questionnaire was used to assess each respondent's Sociodemographics, job stress, experience of absence and early leave due to job stress. Seven KOSS-SF domains of job stress were used. We estimated the relation of absence and early leave due to job stress and job stress factors using logistic regression analyses. Results: Absence or early leave due to job stress occurred in 7% of male workers and 8% of female workers. Multiple regression analysis revealed a significantly positive association job stress-related absence/early leave and job demand, interpersonal conflict, organizational system, lack of rewards and occupational climate. Conclusions: Absence and early leave due to job stress is significantly attributed to organizational System and lack of reward for men, and occupational climate and organizational system for women.

Plenary Session 2 : PS-2-1 ; Outcomes of hepatitis B virus recurrence after liver transplantation: a multicenter analysis in Korea

( Hee Yeon Kim ),( Jong Young Choi ),( Dong Goo Kim ),( Myoung Soo Kim ),( Soon Il Kim ),( Shin Hwang ),( Sung Gyu Lee ),( Kwang Woong Lee ),( Kyung Suk Suh ),( Young Seok Han ),( Dong Lak Choi ),( Se 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: The outcome of hepatitis B virus (HBV) infection after liver transplantation (LT) was improved by hepatitis B immunoglobulin (HBIG) and nucles(t)ide analogue (NUA). However, HBV recurrence after LT is critical because the recurrence is occasionally accompanied by a progressive destruction of graft and poor survival. The aims of this study were to investigate the significance HBV recurrence and identity factors associated with HBV recurrence. Methods: From October 1999 to February 2011, a total of 2684 consecutive LT recipients who underwent HBV-associated LT were retrospectively enrolled from 7 transplantation centers in Korea. Results: Prophylaxis regimens were HBIG monotherapy (67.7%) or a combination of HBIG with NUA (22.3%). The recurrence rate of HBV was 6.1% (164 recipients) during mean follow-up duration of 10.9 years. The median time from transplantation to recurrence was 2.1 years (0.1-7.9 years). Of the 1,071 patients with hepatocellular carcinoma (HCC) prior to LT, 155 patients (14.5%) had HCC recurrence after transplantation, and 48 patients (31.0%) had HBV recurrence. Of the 48 patients with recurrence of both HBV and HCC, 25 patients (52.1%) experienced HBV recurrence after HCC recurrence. In the multivariate analysis, pretransplant HCC, pretransplant HBV DNA above 5.5 log copies/mL was independent clinical factors influencing HBV recurrence after LT. The mortality rate among the recipients with HBV recurrence was 34.1% (56 recipients). Mean overall survival was 6.4 years in the HBV-recurrence group and 9.9 years in the HBV-nonrecurrence group (p<0.001). HBV recurrence was not an independent prognostic factor for overall survival. HCC recurrence was the most important factor for overall survival. Conclusions: The overall outcome of LT in HBV-related liver disease was excellent with the current prophylaxis regimen Choon Hyuck David Kwon,8 Suk-Koo Lee8 Pretransplant HBV DNA and HCC were important factors for HBV recurrence. HBV recurrence after LT did not significantly influence on the overall survival without combining of HCC recurrence.

복강경담낭절제술에서 수술전 간담도신티그라피와 경구담낭조영술의 의의

문대혁(Dae Hyuk Moon),양승오(Seoung Oh Yang),이희경(Hee Kyung Lee),원경숙(Kyoung Sook Won),류진숙(Jin Sook Ryu),한동복(Dong Bok Han),박철민(Cheol Min Park),이문규(Moon Gyu Lee),박광민(Kwang Min Park),이승규(Sung Gyu Lee) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1

N/A 131I-6β-iodomethyl-19-norcholesterol(NP-59) has an advantage to assess adrenal dysfunction caused by adrenal cortical disorders. The aim of this study is to evaluate the clinical usefulness of NP-59 scintigraphy in each adrenral disease. Ten patients who did eleven NP-59 adrenal scintigraphies at Dong-A University Hospital from March 1990 to December 1996 were selected as the subject. Among the subject there were 5 cases of Cushing's syndrome, 2 cases of incidentaloma, 1 case of metastatic adrenal tumor, liver cirrhosis with hirsutism and hypertension respectively. Among 5 case of Cushing's syndrome, there were 2 cases of Cushing's disease, 2 cases of adrenal adenoma and 1 case of adrenal carcinoma. There are no disagreement between clinical diagnosis and scan finding in Cushing's syndrome. In 2 incidentaloma cases, even though one is interpretated as a functioning tumor, both of 2 cases could avoid unnecessary biopsy according to scintigraphy result. One case of hirsutism, clinically adrenal originated, revealed the normal scintigraphic hirsutism was extra-adrenal origin. One case of hypertension took the study to exclude the possibility of primary aldosteronism. Normal suppression scan finding revealed that primary aldosteronism did not exist in this case. In conclusion, NP-59 scintigraphy was very useful in diagnosis and differential diagnosis of Cushing's syndrome and it could avoid unnecessary biopsy in the incidental adrenal tumor.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

저질에 따른 꼬막(Tegillarca granosa)의 염분내성

한경호,진동수,추은경,이우범,이원교 國立 麗水大學校 環境問題硏究所 2000 環境硏究論文集 Vol.3 No.-

The present study was conducted to know the salinity tolerance of the bloody clam, Tegillarca granosa (Linnaeus) caught in Gang-jin Bay from May to June in 2000. In the experimental groups of sandy-mud, the survival and infiltration rate were not bad at 20~40ppt, but all the bloody clam, Tegillarca granosa died at more than 50ppt and less than 10ppt before the experiment finish. In the experimental groups of muddy, the survival and infiltration rate wrer not bad at 20~35ppt and then 40ppt, 45ppt. All the bloody clam, Tegillarca granosa died at more than 50ppt and less than 10ppt. The infiltration rate was high at 25~35ppt in the both of two experimental groups. In the sandy-mud, the bloody clam, Tegillarca granosa infiltrated less than half of their shells at 25ppt, 30ppt but in the muddy, they infiltrated more than half of their shells at 25ppt, 30ppt, 35ppt.