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.

우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

최적설계 기법을 적용한 1톤 운반차용 P.T.O축 및 트랜스미션 개발에 관한 기초연구

김재열,심재기,최승현,정효희,김훈조,오현중,박경섭 한국공작기계학회 2007 한국공작기계학회 추계학술대회논문집 Vol.2007 No.-

Now, power tillers and cultivators which are spread among fruit tree households have usage, low application, and high accident risk. Therefore, the development of multi-purpose work vehicles is needed as an alternative for these problems. Especially, easy usage and the ability to easily change gears when driving and the development of the P.T.O for various tasks such as pruning, water lifting, pest control, application and, mowing are needed. In this research, we will develop a transmission with design on P.T.Oaxle for agricultural work vehicles including multi-purpose vehicles. We aim to develop a 4-wheel drive transmission of synchronous contact type for practical use in fruit tree households which is required to be a large-sized agricultural vehicle. Therefore, we have per performed as follows that are composed of load capacity from 500kg to 1,000kg, safety securing for passengers, and drive securing under bad conditions of the topography slope and swampy land and the rest. For this purpose, we have developed a prototype vehicle through strength analysis of transmission design. we have selected optimal design conditions (Optimal RPM and torque according to some works) on the power transmission with multi-purpose vehicle for various jobs: spraying, manure spreading, mowing, brush wood chopping. If development of the P.T.O containing variable RPM and torque is successful, the following tasks can be possible. Air pruning, air maintenance, water lift, pest control, application, mowing, spraying, and brush wood chopping are possible with this developed P.T.O. Methods and contents for research are followed. Therefore, we have achieved performance-tests through the prototype of the multi-purpose work vehicle and have improved on troubles by the analysis of results of R&D. Also, we provided solutions to problems in mass production in the future.

DIF와 시토키닌의 상호작용이 포도의 기내생장에 끼치는 영향

김선규,김승희,조현정 충북대학교 첨단원예기술개발연구센터 1999 연구보고서 Vol.4 No.-

주야간 온도 변화(DIF)와 시토키닌의 상호작용이 포도의 기내생장에 끼치는 영향을 구명하여 포도의 기내 대량증식체계를 확립하기 위하여 유럽종 양조용 품종 'Cabernet Sauvignon'과 생식용 구미잡종 'Campbell Early' 포도를 공시하여 metal halide lamp와 형광등으로 210μmolㆍm-2ㆍs-1의 광량자속밀도, 상대습도 70±5%, 16시간 광주기로 조절된 생육상에서 일련의 시험을 수행하였다. 주야간 온도는 25/25, 25/18, 18/25℃로 설정하였고, 시토키닌은 zeatin, kinetin, 2ip, BA및 TDZ를 단용 처리하였다. 모든 시험은 3반복으로 실시하였으며, 4주 후 생장과 분지, 그리고 생체중을 조사하였다. Cabernet Sauvignon 에서는 DIF처리와 상관없이 대조구가 신초의 생장이 가장 좋았는데 -7DIF에서 생장이 전반적으로 나빴다. 그리고 BA와 TDZ처리는 DIF에 영향을 크게 받지 않은 것으로 나타났다. 0DIF는 시토키닌의 농도가 높을수록 생장이 다소 좋은 경향을 나타냈고, kinetin 10mM은 87mm로 대조구를 제외한 시토키닌 처리구 가운데에서 가장 높았다. Campbell Early 에서 -7DIF에서는 Zeatin 5mM처리가 162mm로 대조구의 112mm 보다 생장이 좋았으며 +7DIF에서 kinetin 5mM처리가 110mm로 가장 좋았다. 0DIF에서는 Zeatin 5mM 처리가 162mm로 대조구보다 약 2배 정도 높은 생장을 보였다. Cabernet Sauvignon에서 분지수는 DIF처리와 관계없이 대조구는 1개가 분지 되었으며 모든 DIF처리에서 신초의 생장이 적었던 BA와 TDZ처리에서 분지가 많았다. 0, +7DIF에서는 BA 10mM처리가 약 4개로 나타났으며 -7DIF처리는 TDZ 5mM처리에서 가장 많았다. Zeatin, 2ip와 kinetin 처리는 분지가 되지 않은 것으로 나타났다. Campbell Early 에서도 같은 결과였다. 총절편체수는 Cabernet Sauvignon에서는 모든 DIF처리에서 BA 10mM 처리가 가장 많았다. 신초생장이 좋았던 CT와 Zeatin, 2ip, kinetin 보다 생장은 적었지만 분지수가 많았던 BA와 TDZ처리에서 총절편체수가 많은 것으로 나타났다. Campbell Early 역시 Cabernet Sauvignon과 비슷한 경향을 나타냈으며, 0DIF처리가 -, +7DIF처리보다는 절편체수가 많은 것으로 나타났다. Cabernet Sauvignon에서는 -7DIF처리에서 대체로 200mg 이하로 적었으며 시토키닌의 종류에 차이도 크지 않았다. 0DIF처리는 2ip 10mM 처리가 가장 높았으며, +7DIF에서는 TDZ 5mM이 대조구와 비슷하게 380mg을 나타냈다. Campbell Early는 +7DIF처리에서 BA 5mM을 제외한 나머지 모든 처리구에서 대조구보다 높게 나타났고 2ip 10mM이 410mg으로 가장 높았다. 0DIF처리는 Zeatin 5와 2ip 10mM처리가 900, 840mg으로 대조구의 약 8배에 달했으며, kinetin 10mM처리가 가장 낮게 나타났다. -7DIF처리에서 모든 처리구가 대조구보다 높았으나 다른 DIF처리보다는 낮았다. Shoot growth, number of shoots and fresh weight of Vitis vinifera L.'Cabernet Sauvignon' and Vitis labruscana B. 'Campbell Early' explants under three DIF levels, -7, 0 and +7, 210μmolㆍm-2ㆍs-1 provided by metal halide and fluorescent lamps, under 16hㆍd-1 photoperiod were studied. Basal MS media were supplemented with 5 and 10 mM BA, TDZ, Zeatin, 2ip, kinetin, respectively. In all media, 2.1gㆍL-1 gelite and 3% sucrose were used and cultured for 4 weeks. Shoot growth was significantly increased by control regardless of DIF in Cabernet Sauvignon and was suppressed by -7DIF. Effects of BA and TDZ were not affected by DIF. 0DIF enhanced the growth with increasing cytokinin level. Kinetin at 10 mM was most effective for shoot growth with 87mm among cytokinins used except for control. Zeatin and kinetin each at 5 mM significantly increased shoot growth to respective 162 and 110mm. In 0DIF, double increase of 162 mm was obtained by 5 mM zeatin. In control, no further shoot proliferation was observed in Cabernet Sauvignon regardless of DIF. In 0 and +7DIF, 4 shoots were observed with 10 mM BA. Zeatin, 2ip, and kinetin resulted in poor shoot proliferation. BA at 10 mM resulted in profuse branching in all DIFs.

상악동에 발생한 거대한 Cholesterol 육아종 1례

김승찬,박형욱,김용기,나한조,도남용 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

The cholesterol granuloma is not a specific clinical or pathologic entity but merely a term used to describe a tissue response to cholesterol crystal. The cholesterol granuloma in paranasal sinuses is rare disease. Recently the authors had experienced a case of huge cholesterol granuloma, which involved the right maxillary sinus. The cholesterol granuloma was removed successfully by mean of enucleation through the Caldwell-Luc approach. So, we report a case with brief review of the literature.

조팝나무 揷木時期 및 揷床土의 種類가 發根에 미치는 影響

趙鎭泰,尹汰,金泰重,洪承敏,白基燁 한국화훼연구회 1995 화훼연구 Vol.4 No.1

Cutting experiment was conducted to develop a mass propagation method for Spiraea prunifolia var. simpliciflora Nakai. The optimum season for hardwood cutting was between December and early April, but cutting could be done year-round by using rhizome. NAA treatment (100 ppm) was the most effective as rooting promoter. IBA and IAA were also found to be effective. The effect of sand, red clay, loam, silty loam and vermiculite had little differences in rooting especially when cuttings were done earlier than April 5.

쾌적한 도시환경 조성을 위한 어메니티자원 조사 및 발굴에 관한 연구 : 부산광역시 서구를 중심으로

김승환,박승범,강영조,남정칠,도창희 東亞大學校 1997 東亞論叢 Vol.34 No.-

This study tries to survey and extract amenity resources for the creation of urban amenities Seo-Gu at Pusan city was selected due to abundant amenity resources in the region. The process of research methodology as follows; Firstly, various types of amenity resources were collected by literature and preliminary survey. The resources were classified into 5 categories as park and greenery, natural, historic, cultural and life resources. These were reclassified such three types of detailed frames existing, potential and extractable forms. Secondly, the detailed information on amenity resources in the site was gathered by visiting all Dongs in Seo-Gu. Furthermore, careful amenity watching survey was carried out to extract potential in citizen`s common behavior. Then, amenity resources was evaluated through the assessment survey of landscape architects and other professionals. Finally, amenity resources maps were produced based on the evaluation of the selected amenity resources. The total amenity resources in Seo-Gu amount 169, which comprised of 81 existing resources, 22 potential resources, and 66 extracted resources. In order to create and maintain the best quality of urban amenity, it`s important to have this kind of amenity resources map. Citizen, planners and policy makers can use these to make better urban environment by providing the information of existing, potential and extractable amenity resources which may enhance the pride and affection for the citizen.

晉州 附近 新洞層群(下部 白堊系)에서 産出되는 化石 Stromatolite의 生堆積 構造 및 古環境

金榮汶,白光錫,徐承祚 晋州敎育大學校 科學敎育硏究所 1998 科學敎育硏究 Vol.24 No.-

For the purpose of clarifying the organosedimentary structure and paleoenvironment of stromatolites from the southem part of the Kyongsang Basin, the study was carried out both through the field works and chemical analysis of samples. Obtained data were compared with the repotred ones from areas in North Kyongsang Province, additionally. Through this study, the paleaoenvironments of these areas were summarized as follows: 1. Laminations of stromatolite are consist of algal-rich and sediment-rich laminae altemately. The content of calcite, main component of stromatolite, has less Magnesium value. Thus, it seems to have formed under the fresh water environment. 2. The almost of the stromatolites have very irregular shapes which has been caused by disturbed and divided algae from microbial activities. Therefore, it can be inferred that the lake was calm. 3. It seems to have been shallow lacustrine environment and intermittent dry season.

미만성 대형 B-세포 림프종에서의 예후인자에 관한 연구

김삼용,곽승근,박상은,윤환중,조덕연,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

미만성 대형 B-세포 림프종은 가장 흔한 악성 림프종의 한 종류로서 우리나라에서는 전체 비호지킨 림프종의 50%를 차지한다. 비호지킨 림프종에서 병기는 호지킨병과는 달리 예후 인자로서의 유용성이 적다. 따라서 병기만을 예후 인자로서 평가하는 한계를 극복하기 위해 국제예후지표(International Prognostic Index)가 도입되었다. 특정 환자에서 IPI 점수와 함께 그 환자의 림프종의 생물학적 특성을 분석한다면 예후 예측에서 정확도가 높아질 것이다. 본 연구에서는 미만성 대형 B-세포 림프종에서 국제예후지표의 유용성을 확인하고자 하였으며, 각종 생물학적 지표의 면역화학염색을 통하여 이들을 배세포 중심 아형(germinal center subgroup : 이하 GC양 아형으로 약함)과 활성화 B-세포 아형(post-germinal center subgroup; 이후 pGC양 아형으로 약함)으로 분류하고 이들의 예후 예측에 대한 적절성을 평가하였다. 결과는 다음과 같다. 1. 연령분포는 37세에서 69세로 중앙치는 56세이었으며, 남자는 17예(65.4%), 여자가 9예(34.6%)였다. 병기는 Ⅰ, Ⅱ, Ⅲ, Ⅳ기가 각각 2예(7.7%), 11예 (42.3%), 5예(19.2%), 8예(30.8%)였다. 'B'증상은 5예(19.2%)에서 양성이었다. 진단 당시 혈청 LDH치가 상승한 경우가 11예(42.3%)였고, 거대종양(직경이 10㎝이상)을 갖는 경우가 5예(19.2%)이었다. ECOG 수행등급은 0이 2예(7.7%), 1이 18예(69.2%), 2가 5예(19.2%), 3이 1예(3.8%)이었다. 2. 면역조직화학염색 상 bcl-2의 양성은 17예(65.4%), bcl-6의 양성이 20예(76.9%)이었다. CD10이 양성인 경우가 5예(19.2%)이었다. IRF-4가 양성인 경우는 8예(30.8%)였다. 26명의 환자에서 bcl-6, CD10과 IRF-4를 이용하여 GC양 아형과 pGC양 아형으로 분류 하였는데, GC양 아형은 14예(53.8%)이었고, pGC양 아형은 7예(26.9%), 분류가 되지 않는 경우가 5예(19.3%)이었다. 3. 평균 48개월 동안 추적한 결과 중앙생존기간은 44개월이었고 생존기간은 1~100+개월에 분포하였다. Kaplan-Meier법에 의한 5년 누적 생존률은 32%이었다. 4. 병기, 'B' 증상, 혈청 LDH 농도, ECOG 수행등급, 거대종양유무가 통계학적으로 의미있는 임상적 예후 인자였다. 5. 면연조직화학염색에서는 bcl-2만이 통계학적으로 유의한 예후인자였다. 6. GC양 아형은 pGC양 아형에 비해 생존기간은 좋았으나, 통계학적 유의성은 없었다. 7. 다변량 분석결과 bcl-2 발현과 혈청 LDH치만이 예후에 영향을 미쳤다. Clinical Significanceof Expression of Biomarkers in Patients with Diffuse Large B-cell Lymphoma Diffuse large B-cell lymphoma(DLBL) is the most common type of lymphoma in Korea, representing about 50% of non-Hodgkin's Lymphomas. Although DLBL is usually considered as a specific category, the diversity in clinical presentation, morphology, genetic and molecular alterations strongly suggest that these tumors represent a heterogeneous group of neoplasia rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embraces patients with heterogeneous prognoses. It is likely that the prognostic assessment of patients with DLBL might be improved by using biological features. During the last decade, most studies dealing with the heterogeneity of DLBL have focused on individual protein expression and molecular alterations. The expression of individual antigens related to different stages of B-cell differentiation, including CD10, bcl-6, and IRF-4, may help to define groups of tumors with different clinical and pathological characteristics. To determine the clinical significance and prognostic value of individual biomarker expression and the biomarker expression patterns according to germinal center subgroup or post-germinal center subgroup of DLBL as defined by a relatively small number of single antigens, we studied 26 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for CD10, bcl-6, IRF-4, bcl-2 antigens. Two immunophenotyping profiles were distinguished according to the pattern of differentiation; germinal center(GC;CD10/Bcl-6+/IRF-4-) subgroup or postgerminal center (pGC ; CD10/bcl-6/IRF4+) subgroup. The results are as follows; 1) Baseline characteristics of patients were ; median age of patients was 56(range ; 37-69). 17 patients(65.4%) were male. 5 patients(l9.2%) had 'B' symptoms. Stages were as follows ; stage Ⅰ2 patients(7.7%), stage Ⅱ 11 patients(42.3%), stage Ⅲ 5 patients(l9.2%), stage Ⅳ 8 patients(30.8%). 11 patients (42.3%) had elevated LDH levels. 25 patients(96.2%) had ECOG performance grade 0-Ⅱ and 1 patient had grade Ⅲ. 5 patients(l9.2%) bad bulky disease. 2) The results of immunohistochemical study were as follows ; positive bcl-2 staining in 17 patients(65.4%), positive bcl-6 in 20 patients(76.1%), positive CD10 in 5 patients(l9.2%), positive IRF-4 staining in 8 patients (30.8%). 3) After a median follow up duration of 48 months, the median survival duration was 44 months with a range of survival of 1-100+ months. 5-year overall survival rate was 32% by Kaplan-Meier method. 4) The clinical factors affecting survival were elevated serum LDH level, B symptoms, bulky disease, stage at diagnosis and ECOG performance status 5) Among the biomarkers, only bcl-2 expression affected survival of DLBL patients 6) The germinal center like subgroup had superior survival than post-germinal center like subgroup but had no statistical significance. 7) Multivariate analysis showed that bcl-2 and serum LDH level had siginificance on survival Conclusion In addition to the known clinical prognostic factors, immunohistochemically defined characteristics such as bcl-2 expressionin DLBL is important and subgroups(germinal center or post-germinal center subgroup) of DLBL may have importance in predicting prognosis of DLBL patients

부가가치생산성 측정법의 기업단위 적용방식에 대한 새로운 접근

조승제,김승용 조선대학교 경영경제연구소 2000 經營經濟硏究 = Management and economics research Vol.23 No.2