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.

작업장 특성에 따른 톨루엔 노출 근로자의 마뇨산 배출 특성

박흥재,김형준,정성욱,이병호 한국환경과학회 2005 한국환경과학회지 Vol.14 No.2

This study was carried out to investigate the correlation between toluene in air and hippuric acid in human urine, which is based in the results of the health check-in and measure of working environment, was investigated for five years. Toluene in air and hippuric acid in urine were checked 116 workers who exposed to toluene in five type of industry. The Mean concentration of toluene in air by type of industry and every year and sex distinction, had positive correlation.(p<0.01) The Mean concentration of hippuric acid in urine by type of industry, every year, sex distinction, disparity of age and term of duty had positive correlation.(p<0.01)

AZO 투명전도막의 전기 광학적 특성에 미치는 PET 기판 표면처리 효과

박병욱,김지훈,성열문,추영배,곽동주 경성대학교 공학기술연구소 2008 공학기술연구지 Vol.15 No.-

In this paper aluminium-doped zinc oxide(ZnO:Al) conducting layer was deposited on polyethylene terephthalate(PET) substrate by r. f. magnetron sputtering method PET substrate was modified by a DBD(dielectric barrier discharge) plasma before sputtering to improve the electric and optical properties of ZnO:Al film and to increase also the deposition rate The effect of heat treatment time on the dectrical, optical, chemical and structural properties of ZnO:Al thin film were investigated experimentally The PET films modified with the DBD plasma showed a significant decrease in water contact angle The deposition rate of ZnO:Al film in the case of the plasma-treated substrate was also increased by around 2 times compared to the untreated substrate The minimum resistivity of about 28×10-3 Ω-cm and transmittance of about 83.3% were obtained under the experimental condition of 6min of heat treatment time.

이황화탄소 폭로 남성 근로자의 진동감각 역치에 관한 연구

박승희,이은일,천병철,염용태,최재욱 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.1

This study was conducted on 367 male workers to evaluate the change of vibration perception threshold(VPT) according to exposure degree to carbon disulfide. VPT was measured on both metacarpal bones of index and little fingers and on fibular malleoli by Vibrometer(Rion, on 125Hz). The exposure degree was classified by the name of department. Workers in department 2 had been exposed to carbon disulfide, those in department 3 had been exposed to undetectable concentration of carbon disulfide. The results were as follows: 1. The mean values of VDT of metacarpal(MC) bones showed dose-response pattern, i.e., the mean values of VPT at department 1 were highest, and those of VPT at department 3 were lowest with similar work duration or age. But the mean values of VPT of fibular malleoli(FM) showed dose-response patter only in workers having above 5 years of work duration or whose age were above 30. 2. The mean values of VPT of MC bone of workers increased by age. 3. There were statistically significant difference in mean values of VPT of MC bone only in workers having 5-10 year work duration. And there were statistically significant difference of mean values of VPT of left 2nd and 5th MC bone in workers whose age was 30's, of right 2nd MC bone in those whose age was 40's, and of left 2nd MC bone in those whose age was 50's. 4. The variables affecting VPT significantly were department and age(or age group) both in multiple regression and general linear model. The department showed to have more effect to VPT than age in multiple regression, but age group showed to have more effect to VPT than department in general linear model. 5. The variables were transformed to indicator variable to do logistic regression analysis. department 1, 2, 3 were classified into high exposure(spinning department) and low duration was classified into long(above 10 years) and short. The exposure and age were significant variables by logistic regression analysis. Odds rations of department and VPT on metacarpal bones or malleoli were 2.7-3.2 and VPT those were 2.6 or 2.7. Odds ratio of age and abnormality of VPT on any point was 3.3(1.59-6.8), and that of department and VPT was 2.8(1.5-5.5). We concluded that exposure of carbon disulfied was significantly associated with reduction of VPT regardless of age; and that the test of VPT would be useful tool for screening and early detection in neuropathy by carbon disulfide or other neurotoxic chemicals, even though it is simple and cheap.

필름형 염료감응태양전지용 AZO 투명전도막의 개발

박병욱,성열문,추영배,곽동주 경성대학교 공학기술연구소 2008 공학기술연구지 Vol.15 No.-

Recently, much interest has been paid in using plastic materials for replacing glass substrates with increasing applications for large scale flexible flat panel display and flexible film-typed dye sensitized solar cell(DSCs) In particular, flexible film-typed dye sensitized solar cell(DSCs) has attracted much interest because it can be applied to a smart window, a wearable PC as a supplementary power supplier and a winter clothes In this paper ZnO:Al thin film, which serves as a transparent conducting layer, was deposited on the polyethylene terephthalate(PET) substrate by the capacitively coupled r. f. magnetron sputtering method The effect of r. f. discharge power on the morphological, electrical and optical properties of ZnO:Al thin film were studied The film deposited on the PET substrate at r. f. discharge power of above 200 W and gas pressure of 5mTorr showed the minimum resistivity of about 2×10-3 Ω-cm, a transmittance of about 87% and optical band gap of 3.56 eV.

진폐진행정도에 따른 혈청내 구리와 아연 농도의 변동

박정래,박종욱,이수일,이철호,오차재,김창원,조병만,김돈균 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.3

목 적 : 진폐증은 분진으로 인해 인체의 면역기전이 작용하여 폐섬유화가 진행되는 질환으로, 인체의 면역기전에 작용하는 구리와 아연은 진폐증의 병리적인 진행과정인 폐섬유화에 관여한다. 본 연구의 목적은 초기진폐증 유소견자와 진행된 진폐증 환자의 혈청 구리와 아연의 농도를 정상인과 비교함으로써 체내 구리와 아연의 농도가 진폐증의 섬유화의 진행정도에 따라 변동함을 밝히고, 이를 이용하여 폐섬유화의 진행정도를 추정할 수 있는 지표를 제시하고자 한다. 방 법 : 진폐정밀기관에 내원한 초진내 원자 100명과 진폐요양기관에 입원한 진폐증 환자 100명을 선정한 후 흥부사진소견을 ILO 분류법의 진폐진행정도에 따라 각각 세 군(Stage Vl, V2, V3 & Stage Pl, P2, P3)으로 구분한 후 각 군의 혈청구리와 아연의 농도를 비교분석하였다. 대조군으로는 폐결핵, 심근경색, 뇌경색을 경험한 적이 없는 일반인 100명을 선정하였다. 결 과 : 초진내 원자군의 혈청 구리농도는 섬유화의 진행단계에 따른 유의한 차이를 보였으며, Stage V3에서 가장 높았다. 입원환자군에서는 혈청 구리농도가 대조군과 유의한 차이를 보이지 않는데 (p=0, 152), 이는 입원환자의 불량한 영양상태와 건강상태 때문인 것으로 추정된다. 초진내원자군과 입원환자군의 혈청 아연농도는 섬유화의 진행에 따라 통계적인 차이를 보였으며, Stage V2와 Stage P2, P3에서 각각 대조군에 비해 유의하게 낮았다. 혈청 아연과 구리농도의 비또한 양군에서 섬유화의 진행에 따라 의미있게 높았는데, 섬유화가 현저히 진행된 단계 (Stage V3, Stage P2, P3)에서 대조군과 의미있는 차이를 보였다. 결 론 : 초진내 원자와 입원환자의 혈청 Cu/zrl 비는 섬유화의 진행정도가 현저할수록 대조군에 비해 유의하게 높게 나타났다. 진폐증 환자들의 혈청 Cu/zn 비는 진폐증의 폐섬유화의 진행정도를 추정함에 있어 상당히 유용한 지표로 이용될 수 있으며, 폐섬유화의 진행과정에서의 혈청 구리와 아연의 작용기전을 이용한 치료방법의 마련에도 도움이 될 것으로 판단한다. Objectives : Copper and Zinc, the trace elements of a living body, take a part in immunologic mechanism and induce the pulmonary fibrosis which is the pathologic progress of pneumoconiosis. This study was performed to assist the identification of the pathologic process of pulmonary fibrosis in pneumoconiosis. Methods : The subjects of thls study was 200 diagnosed persons as pneumoconiosis, of whom 700 persons was the visitors in the outpatients departments of pneumoconiosis and 100 admissive pneumoconiosis patients. The serum copper and zinc are measured and compared. Results : The mean serum copper concentration of visitor group was significantly higher than that of control group, and that of stage V3 subgroup of visitor group was highest because of their advanced fibrosis. But, there was not the difference of serum copper concentration between patient and control group. We thought that the reason was poor nutritional and health status of the patient. The mean of serum zinc concentration of visitor and patient control was lower than that of control group. As the degree of pulmonary fibrosis was more severe from stage Vl, V2, V3 of visitor to stage Pl, P2, P3 of patient, the mean of serum zinc concentration was lower. The ratio of serum copper/zinc of visitor and patient was higher than that of control, and that of patient was higher than that of visitor. Those results showed that the ratio of serum copper/zlnc ratio more greatly expressed the degree of progression of pneumoconiosis than only copper or zinc concentration by adjustment of nutritional and health status of the patient. Conclusions : As above study results, the degree of pulmonary fibrosis of pneumoconiosis could be estimated by means of serum copper/zinc ratio.

베체트병에서 보이는 혈관질환

박우일,김동익,조진현,이병붕,신성욱,도영수 대한혈관외과학회 2003 Vascular Specialist International Vol.19 No.2

유동요소모델을 이용한 대공간 건축물의 실내 기류 예측에 관한 연구

박선효,안병욱 대한건축학회 2004 대한건축학회논문집 Vol.20 No.2

Flow element model is used for predicting indoor air distribution. The greatest assets of the flow element models are the facts that they are relatively easy to use, they require only a few input parameters, they are not very timeconsuming and they do not demand any investments of importance. Because the flow elements such as supply air jets, exhaust flows, thermal plumes, boundary layer flows, infiltration and gravity currents are controlled by the restricted number of parameters, the flow element model will be useful at the first stage of design process. Air distribution with inclined jets is widely used in large rooms of industrial and commercial buildings when chilled air is supplied through the grilles and nozzles. In this paper, Basic principles of air distribution with inclined jets through grilles and nozzles are discussed. In this study, computer program is developed to evaluate the dimensions of the occupied zone effectively ventilated by the jets through the studies of airflow parameters after impingement of inclined jets with surface.

일기엔트로피 및 정보비에 의한 장마기의 일기대표성 설정 : 서울, 대구, 광주, 충주, 부여를 중심으로 Focused on Seoul, Taegu, Gwangju, Chungju, Puyo

박현욱,문병채 한국환경과학회 2003 한국환경과학회지 Vol.12 No.4

The seasonal variation and frequency of rainfalls of Korea peninsula in Changma period show strong local weather phenomenon because of it's topographical and geographical factors in Northeast side of Asia. Based on weather entropy(statistical parameter)-the amount of average weather information-and information ratio, we cal define each area's weather representativeness, which can show us more constant form included topographical and geographical factors and seasonal variation. The data used for this study are the daily precipitation and cloudiness during the recent ten years(1990-1999) at the 73 stations in Korea. To synthesize weather Entropy, information ratio of decaying tendency and half-decay distance, Seoul's weather representativeness has the smallest in Summer Changma period. And Puyo has the largest value in September.

합성수지 반제품 생산 공장에서 발생한 반응성 기도과민 증후군

박소영,이종성,김부욱,이정오,박규철,최병순 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.4

배경 직업성 천식 감시체계의 활성으로 국내 직업성 천식의 보고가 증가하였음에도 불구하고 전체 직업성 천식의 약 5-18%를 차지한다고 알려진 반응성 기도과민증후군의 보고는 많지 않다 이에 저자들은 합성수지 반제품을 생산하는 사업장에서 발생한 반응성 기도과민 증후군 사례를 발견하였기에 이를 보고하는 바이다 증례 평소 건강하던 61세 남자 환자는 40세 때인 1987년부터 약 20년 간 합성수지 반제품을 생산하는 사업장에서 배합작업을 하였다 2007년 8월 PVC(polyvinyl chloride) DEHP (d₁-(2-ethylhexyl)phthalate) dibutyl tin maleate epoxidized soybean oil 등의 원료를 혼합하는 기계의 가열로 작업장내 연기가 자욱하게 된 사고가 발생한 직후 환자는 기침 콧물 호흡곤란 천명 등의 증상을 보였다 폐기능 검사에서는 FEV₁ 1.63 L(50%) FVC 3.81 L(82%) FEV₁/FVC 43% 소견을 보였으며 기관지 확장제 투여 후 FEV₁은 1.80 L로 투여 전에 비해 170 ml 10.4% 증가하였다 흡입용 스테로이드 및 기관지 확장제를 포함한 치료 시행 7개월 후에는 FEV₁ 3.21 L(99.3%) FVC 6.56 L(143.5%)로 회복되었으며 메타콜린 기관지 유발검사에서는 음성이었다 결론 혼합기 가열로 인해 발생한 원료물질 자체 또는 이들의 열분해산물에 고농도로 노출되면서 RADS가 발생한 것으로 판단된다. Background Reactive airways dysfunction syndrome (RADS). which represents between 5% and 18% of new-onset, work-related asthma remains underreported in spite of increasing reports of occupational asthma cases through occupational asthma surveillance in Korea We report a 61-year-old male who developed RADS after exposure to a high level of toxic gases from a workplace accident. Case The patient who had worked for 21 years at a PVC manufacture factory and had retained good health until Aug 22, 2007, when he was exposed to PVC (Polyvinyl chloride) DEHP (D₁ (2-Ethylhexyl) Phthalate) dibutyl tin maleate and epoxidized soybean oil gases from a heated mixer. Within several minutes of exposure, he developed coughing rhinorrhea dyspnea and wheezing. Pulmonary function tests (PFTs) showed an FVC of 3.81 L(82% of predicted) FEV₁ of 1.63 L/s (50% of predicted) FEV₁/FVC% of 43 % and FEV₁ of 1.80 L/s that increased by 170 ml and 10.4% in response to bronchodilator. After 7 months of treatment with inhaled steroids and bronchodilators, repeat PFTs showed an FVC of 6.56L(143.5% of predicted) FEV₁ of 3.21 L(99.3% of predicted) and FEV₁/FVC% of 48.9%. A methacholine challenge test was negative at a concentration of 25 ㎎/ml. Conclusion RADS occurred due to exposure to raw material vapors or their thermal decomposition products.