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.

계층적인 탐색점 배치와 화소 간축을 이용한 움직임 추정 기법

박준호,류명춘,김준한,김신희 경운대학교 산업기술연구소 1999 産業技術硏究論文誌 Vol.1 No.1(B)

In motion estimation of moving pictures compression, fast block matching method using hierarchical search point displace and the pixel decimation is supposed. The method is based on TSS(Three step Search) method and pixel decimation. This method improves image quality and local minima by increasing search points, but operation counts that resulted from increasing search points are reduced by the pixel decimation method. So, the method can improve image quality and operation counts are nearly the same with TSS. MP@ML video is simulated by this method, which shows good results compared with TSS.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

항균성 동치미액의 첨가에 의한 냉면국물 중의 Listeria monocytogenes 및 Escherichia coli O157:H7 생육억제

소명환,박상희,조신호,황한준,성낙주 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.2

동치미액은 전통적으로 냉면국물로 이용되어왔다. 냉면국물의 미생물 오염문제를 해결하기 위하여 항균활성이 높은 김치 젖산균 Lactobacillus homohiochii B21과 Leuconostoc mesenteroides subsp. mesenteroides C16을 스타터로 혼합사용하여 동치미액을 제조하고, 이를 냉면국물에 100%, 50%, 10% 및 0% 첨가하여 20℃ 및 10℃에서 보관할 때에 동치미액의 항균력으로 인하여 의도적으로 첨가한 Listeria monocytogenes와 Escherichia coli O157:H7의 증식이 억제되는 정도를 조사하였다. 동치미액 100%인 냉면국물은 20℃에서 보관할 때에 Listeria monocytogenes는 8시간만에, Escherichia coli O157:H7는 40시간만이 10^6CFU/ml에서 10^0CFU/ml로 각각 급격히 사멸하였고, 10℃에서 보관할 때에도 시간경과에 따라 생균수가 급격히 감소하였으나 감소속도는 20℃에서 보관할 때보다 느렸다. 동치미액을 50% 첨가한 육수에서도 Listeria monocytogenes와 Escherichia coli O157:H7는 시간경과에 따라 급격히 감소하였으며, 감소속도는 동치미액 100%일 경우보다 느렸다. 동치미액을 10% 첨가한 육수는 20℃에서 보관할 때는 초기에 Listeria monocytogenes 및 Escherichia coli O157:H7의 균수증가가 약간 있었으나 동치미액 무첨가에 비하여 현저히 억제되었으며, 16시간 이후부터는 균수가 서서히 감소하였다. 동치미액을 첨가하지 않은 육수는 20℃에서 보관할 때는 초기부터 Listeria monocytogenes 및 Escherichia coli O157:H7의 균수증가가 급격히 이루어졌으며, 10℃에서 보관할 때는 24시간 이후부터 서서히 증가하였다. Listeria monocytogenes 및 Escherichia coli O157:H7에 대한 본 동치미액의 항균활성은 후자의 미생물보다 전자에 대하여 더욱 강하게 나타났다. 본 연구의 동치미액을 육수에 50% 첨가하여 냉면국물을 제조한다면 보관중의 미생물 오염문제 해결에 큰 도움이 될 것으로 판단된다. Juice of Dongchimi, a Korean traditional vegetable food fermented with lactic acid bacteria has been traditionary used as broth for Naengmyon, a Korean cold noodles with broth. This study was carried out to demonstrate the growth inhibition of two food born pathogens, Listeria monocytogenes and Escherichia coli O157:H7, in Naengmyon-broth containing Dongchimi-juice fermented with high antibacterial lactic acid bacteria, Lactobacillus homohiochii B21 and Leuconostoc mesenteroides C16. Naengmyon-broths were made with beef broth and Dongchimi-juice fermented with lactic acid bacteria, and the changes in viable cell counts of the inoculated pathogens in Naengmyon-broths were investigated during storage at 20℃ and 10℃. In Naengmyon-broth of 100% Dongchimi-juice stored at 20℃, the numbers of Listeria monocytogenes and Escherichia coli O157:H7 were rapidly decreased from 10^6CFU/ml to 10^0CFU/ml in 8 hours and 40 hours, respectively. In Naengmyon-broth containing 50% Dongchimi-juice, their numbers were also rapidly decreased, though the decreasing rates were not so fast as those in 100% Dongchimi-juice. In Naengmyon-broth containing 10% Dongchimi-juice, the growths of the two pathogens were markedly inhibited, compared with those in 100% beef broth, though some growths were occurred in early phase. But in Naengmyon-broth of 100% beef broth, their growths were very fast from early. Antibacterial activity of the Dongchimi-juice was more distinct at 20℃ than at 10℃, and was more active against Listeria monocytogenes than against Escherichia coli O157:H7.

韓國의 肝吸蟲症에 관한 臨床的 硏究

金名世,李駿商,林漢鍾 고려대학교 의과대학 1982 고려대 의대 잡지 Vol.19 No.1

For understanding of the significance on clinical features of clonorchiasis, the authors carried out the examinations for hematology, blood biochemistry and clinical symptoms on the patients whose stools were positive eggs of clonorchis sinensis in several endemic areas in Korea. A total of 287 clonorchiasis patients were examined with the stools by Stoll's egg counting method for the intensity of infection. The patients were divided into light, moderate Ⅰ & Ⅱ, heavy and very heavy infection groups depending upon the number of eggs per gm, of feces(EPG). All the calculated mean values for each items with standard deviation of hematological and blood bichemical tests were compared with those of the normal values and the detailed clinical symptoms according to the intensity of infection were analyzed. The results obtained are as follows: 1. The mean values of hematologic findings in each group of infection were within the normal limit except eosinophil counts. In the changes of hematological values by means of intensity of infection, the mean values of hemoglobin, hematocrit, RBC, WBC and eosinophil counts were increased in accordance with the intensity of infection. 2. To observe the occurrence of anemia in the patients infected with C. sinensis, the mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) were compared in each group of infection. But all the values were shown within normal value. 3. All the mean values of blood biochemistry in each group of infection were within the normal limit. However the mean values of GPT, GOT, alkaline phosphatase, bilirubin and cholesterol were increased in accordance with the intensity of infection. Whereas, the mean values of total protein, albumin and A/G ratio were decreased. 4. The subjective symptoms of human clonorchiasis were increased by the higher intensity of infection. Among chief complaints, asthenia, lassitude and mental depression were most common as generalized symptoms, but as gastrointestinal symptoms, abdominal discomfort, epigastric pain and indigestion were most frequent. In physical examination, hepatomegaly, epigastric tenderness and jaundice were found most frequently. Even in the light infection group, over 60 per cent of patients complained the subjective symptoms. 5. With the above results, the changes in the fields of hematology, blood biochemistry and the clinical symptoms by means of intensity of infection were discussed for the specific clinical features of clonorchiasis.

肝吸蟲症에 있어서 국산 praziquantel(Distocide^(�))의 治療效果

林漢鍾,李駿商,朱炅煥,扈宗秀,鄭明淑 최신의학사 1985 最新醫學 Vol.28 No.7

膝關節腔 二重造影劑撮影法에 關한 硏究

金漢錫,趙明俊,李昌惠 최신의학사 1976 最新醫學 Vol.19 No.1

For last 3 years (1973-1975), Double contrast knee arthrography has been performed in 40 patients in the Radiologic department of the National Medical center. The results were as followings: 1) Sex distribution was male 25, female 15, and age ranged from 10 to 49. High incidence was noted in the 3rd decade. 2) In the majority, clinical symptom was knee joint pain. 3) The lesion was more frequent on the Right knee than on the left. 4) lateral meniscus tear (19 cases) was more frequent than the medical one (3 cases). 5) Double contrast Knee arthrography can disclose those lesions of the menisci, the articular cartilages, the synovium, and ligaments. 6) Diagnostic accuracy of double contrast knee arthrography is more than 95%, but authors obtained about 80%, probably due to unskillful technique and inaccurate interpretation. Batter technique and interpretation are necessitated.

Medx 운동치료 프로그램이 경추근력과 통증에 미치는 효과

남덕현,이한경,박재우,김명준 龍仁大學校 2000 용인대학교 논문집 Vol.18 No.-

The purpose of this study was to evaluate the improvement of the cervical extensor muscles strength in a 103 patients with laser discectomy using Medex program. 103 Patients was divide into 3 Groups, Study group of 40 patients (M=17, F=23), Control Group of 32 patients (M=17, F=15), Normal Group of 31 patients(M= 19, F= 12) Study and Control group was the patient of Laser discectomy on the cervical disc. Study Group was trained with Medx exercise program for the cervical muscles for 12 weeks after 1 month from cervical Laser discectomy. Control Group was rest at home for 12 weeks after the therapeutic exercise program. Normal group was good condition normal persons in cervical and Lumber spine without lesion, 31 persons was tested cervical extension muscle strength before and after 12 weeks. The results of this study were as follows ; 1. In initial muscle strength. The male was found 34275.95 8546.55(n=20) in study croup, 32279.66 3965.43(n=18) in control group, 54297.42 721,39(n=19) in Normal group. The female was found 24445.25 7360.80(n=20) in study group, 25125.64 4463.65(n=14) in control group, 42829 9649.62(n=12) in normal group. Therefore in a study and control group, It was found that the subjects have similar muscle strength after the 12 weeks with no difference. 2. Between three group, after 12 weeks, improvement of male muscle strength was found 50142.29 13017.37(n= 17, study group), 38973.44 7424.36 (n=18, control group), 55774.41 9268.05 (n=17, Normal group) in male. And improvement of female muscle strength was found 40227.80 6062.89(n= 15, study group), 29777.78 10647.34 (n=14, control group). As a result, muscle strength after 12weeks, it was found a little difference cervical extension muscle strength in control group without therapeutic Exercise program. But study group there was a much difference. 3. Study group was statistically significant difference(P<.05, n=40) after 12weeks. And control group was statistically significant difference, too(P<.05, n=32). But in real value, improvement of muscle strength was 50% improvement in study group more than 19% in control group. 4. After 12weeks in a study and control group, Pain scale shows statistically significant difference in study group than control group(P<.05). 5. After 12Wks, Cervical ROM was increased in a study and control group, each other. In a Study group it was found that there was an increase ROM more than control group(Flexion position; study/control G. =124.6 /118.8, Extension position: =1.68 /8.4, ROM; full Extension=0, full Flexion= 126). In conclusion, After 1 month laser discectomy in cervical HNP, The study group with procedure of Medx therapeutic exercise program was statistically significant increased cervical extension muscle strength more than control group with no therapeutic exercise program. And compared with control group, Study group shows decrease in a pain scale as well as the ROM of cervical mobility. Therefore, during 12 weeks Medx therapeutic Exercise in the cervical spine was effective in cervical muscle strength and for the pain, limited ROM, and dysfunction. And the early recurrent and prevention is positively necessary scientific controlled therapeutic exercise program.

회맹장 판막에 발생한 아니사키스증 1례

이재익,박정하,김준영,조영완,진한영,강명주,정은욱,박석주,양성연 인제대학교 2006 仁濟醫學 Vol.27 No.-

Anisakiasis refers to parasitic infestation by nematode larvae that belongs to the subfamily Anisakinae, and this condition is seen in people who eat inadequately prepared or raw salt-water fish. While gastric anisakiasis is commonly diagnosed by endoscopic technique, intestinal anisakiasis is rare because it is less common and the clinical and radiologic features are poorly understood. The authors report a case of human anisakiasis involving the ileocecal valve in 62-year-old man who had the history of eating raw cuttlefish.

자매에서 발생한 중증 마이코플라즈마 폐렴에서 스테로이드 치료

김도희,이경일,김명숙,윤유숙,황자영,임정우,강진한,이준성 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Numerous evidences support the pathogenesis that M. pneumonias pneumonia is associated with cell-mediat-ed immune reaction. We report 2 cases of severe M. pneumoniae pneumonia in previously healthy sisters, who were both admitted during an epidemic of M. pneumoniae pneumonia. The elder sister, who was 16 years old, was admitted with M. pneumoniae pneumonia. She showed no response to treatment with clarithroycin and levo-floxacin, and eventually progressed to severe ARDS, requiring mechanical ventilation. After treatment with hydrocortisone (200 mg/day), there were rapid improvements in clinical manifestations and chest radiographic findings. The younger sister, who was 14 years old, was admitted 10 days later, Presenting with fever but no pneumonic lesions on chest radiograph. Just like her sister, the infection showed no response to clarithromycin. Fever persisted and pneumonic consolidation with mild pleural effusion was noticed in the left lower lobe on the 5th hospital-day. After treatment with oral prednisolone (1 mg/kg), she showed rapid defervescence and on the 8th hospital day, no pneumonic lesions were detectable on chest radiograph. Given the fact that the pathogenesis of pneumonia and extrapulmonary manifestations in M. pneumoniae infection is immune-mediated, an immuno-suppressive therapy would be validated for selected patients with M. pneumoniae infections.