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.

원격 영상 정보 시스템의 개발

김선호,유선국,김용구,박성욱,김성림,김남현 대한의료정보학회 1996 Healthcare Informatics Research Vol.2 No.1

김밥과 그 재료의 세균수 측정

강국희,김혜란,고애경,김경민,최선규 성균관대학교 생명과학자원연구소 1994 生命資源科學硏究 Vol.1 No.2

We have investigated the distribution of bacteria in kimbab and its materials. The total bactria counts were over 3×10 exp(6)/g(n=30) when the kimbabs were delivered to restaurant and it exceeded the prieliminary legal level 1 × 10 exp(6)/g even though it should be negative for coliforms. In order to look into the cause of bacterial contamination in kimbabs, we examined the content materials of kimbabs. The bacterial counts were founded 10^4-10^8/g for Kim, 10^4-10^8/g for sausage, 10^4-10^6/g for spinach, 10^3-10^7/g for carrot, and 10^3-10^6/g for danmugi, respectively. From these results it could be concluded that the bacterial contamination in Kimbabs are due to kim, spinach, carrot, and sausage. Therefore, so as to reduce the bacterial contamination for kimbab, the sanitary manufacture and storage of kim and the refrigeration of content materials should be went abreast.

중합효소연쇄반응법을 이용한 급성 치수 및 치근단 질환의 병원성 세균의 동정

김지훈,유소영,임선아,국중기,임상수,박슬희,황호길 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.2

The purpose of this study was to investigate the frequency of 7 putative pathogens in endodontic infections. The specimens were collected from infected pulpal tissue of patients who were referred for root canal treatment to the department of conservative dentisty, Chosun University. Samples were collected aseptically using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ml of 1 X PBS. DNAs were extracted from the samples by direct DNA extraction method using lysis buffer (0.5% EDTA, 1% Triton X-100). Identification of 7 putative pathogens was performed by PCR based on 16S rDNA. The target species were as follows: Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Bacteroides forsythus, Actinobacillus actinomycetemcomitans, and Treponema denticola. Our data revealed that the prevalence of P.endodontalis was found in 88.6% (39 / 54), P.gingivalis 52.3% (23 / 44), P.nigrescens 18.2%(8 / 44), P.intermedia 15.9% (7 / 44), B.forsythus 18.2% (8 / 44), A.actinomycetemcomitans 2.3% (1 / 44), T.denticola 25% (11 / 44) of the samples. The high prevalence of P. endodontalis and P.gingivalis suggests that they may play an important role in the etiology of endodontic infections.

빌트인 모터를 이용한 2축 제어 미세 가공기 개발

김건희,김효식,양순철,이상용,국명호,이선규,김윤중,홍권희 한국공작기계학회 2007 한국공작기계학회 추계학술대회논문집 Vol.2007 No.-

This paper describes development of low cost precision machine that has combined the Build-in Motor with a vacuum chuck. This study mainly aims to find out a cutting condition for maintaining optimum surface condition and to examine cutting characteristics of the precision machine that is equipped by diamond bites. The cutting materials is Al alloy. Several experiments were carried out to find out the main factors that affect the surface roughness such as principal axis RPM(rotation per minute), feeding speed, and cutting depth. As a result, we obtain The optimum cutting condition of the developed precision machine.

악교정 수술에서 모의 조종된 3차원 전산화 단층촬영상의 응용

김형돈,이경상,유선국,박창서 大韓口腔顎顔面 放射線學會 1998 Imaging Science in Dentistry Vol.28 No.2

In orthodontics and orthognathic surgery, cephalogram has been routine practice in diagnosis and treatment evaluation of craniofacial deformity. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. Therefore, it is desirable that three dimensional object is diagnosed and evaluated three dimensionally and three dimensional CT image is best for three dimensional analysis. Development of clinic necessitates evaluation of result of treatment and comparison before and after surgery. It is desirable that patient that was diagnosed and planned by three dimensional computed tomography before surgery is evaluated by three dimensional computed tomography after surgery, too. But Because there is no standardized normal values in three dimension now and three dimensional Computed Tomography needs expensive equipments and because of its expenses and amount of exposure to radiation, limitations still remain to be solved in its application to routine practice. If postoperative three dimensional image is constructed by pre and postoperative lateral and postero-anterior cephalograms and preoperative three dimensional computed tomogram, pre and postoperative image will be compared and evaluated three dimensionally without three dimensional computed tomography after surgery and that will contribute to standardize normal values in three dimension. This study introduced new method that computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms, and for validation of new method, in four cases of dry skull that position of mandible was displaced and four patients of orthognathic surgery, computer-simulated three dimensional image and actual postoperative three dimensional image were compared. The results were as follows. 1. In four cases of dry skull that position of mandible was displaced, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -1.8 mm to 1.8 mm and 94% in displacement of all co-ordinates values was from -1.0 mm to 1.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). 2. In four cases of orthognathic surgery patients, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in coordinates values was from -6.7 mm to 7.7 mm and 90% in displacement of all co-ordinates values was from -4.0 to 4.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). Conclusively, computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. Therefore, potentiality that can construct postoperative three dimensional image without three dimensional computed tomography after surgery was presented.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

악교정 수술후에 발생한 술후성 상악낭종의 치험례

김종국,김선용,최용석,이충국 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

The postoperative maxillary cyst develops as a delayed complication after surgical intervention or Caldwell-Luc operation in the maxillary sinus and was also reported that it could occur after Le Fort I osteotomy. This is also called as surgical cliated cyst because of its lining epithelium is usually lined by a pseudo-stratfied ciliated columnar epithelium. This report represents a case of postoperative maxillary cyst which developed within the anterior of maxilla and in association with nasal mucosa 6 years after a Le Fort I osteotomy. In 1989, 26-year-old male complained of his mandibular prognathism and underwent orthogmathic surgery, Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, partial glossectomy.

PQ 처리된 다운증후군 세포에서의 산소대사이상에 대한 항산하적반응의 증가

김선미,문영준,정성국,강윤성,이광호 中央大學校 基礎科學硏究所 1999 基礎科學硏究所 論文集 Vol.13 No.-

To assess an involvement of oxygen free radicals, especially O₂, in the genesis and the increased chromosome damage of the cell lines with Down's syndrome(DS), the level of superoxide dismutase(SOD) activity and chromosome aberration(CA) and sister chromatid exchange(SCE) frequencies were examined in lymphoblastoid cell lines(LCLs) derived from DS, which exposed to paraquat(PQ), an intracellular O₂generator. DS cells, which have been known to have the elevated level of enzymes such as SOD and glutathione peroxidase(GPX) capable of scavenging oxygen free radicals, were found to show a somewhat different mode from control cells in preventing themselves from genotoxicity by PQ-induced perturbation of oxygen metabolism. PQ induced a dose-dependent increase of CA and SCE frequencies in both control and DS LCLs, but PQ at a very high concentration induced a decrease rather than a increase of CuZnSOD activity in control LCLs whereas DS LCLs showed a marked increase of CuZnSOD activity in the same concentration, and the level of CA and SCE induction by PQ was lower in DS LCLs than in controls. Also, SOD induced by external not by the enzymatic response of cells to the increased level of O₂served as a substrate showed a severe inhibitory action to growth kinetics of PQ-exposed control LCLs, but little PQ-induced inhibition of the growth kinetics in DS LCLs. Considering that 3-amino-1H-1,2,4-triazole(AT) capable of inhibiting the activity of catalase(CAT) was effective in CA induction in DS LCLs but not in control and diethyl maleate(DM) assigned to inhibit the activity of GPX induced the marked increase of CA frequency in both control and DS LCLs, we suggest that DS cells could play a protective role against genotoxicity by H₂O₂using both CAT and GPX whereas control cells could do such an action only with GPX. In addition, DM and diethyldithiocarbamate(DC), an SOD inhibitor, appeared to be closely associated with the induction of SCE and CA, respectively. H₂O₂and O₂might, therefore, be causative factors responsible for the formation of SCE and CA, respectively. These findings imply that an excess of O₂due to an altered oxygen metabolism in DS cells may lead to the enhanced chromosome damages in these cells with genetic disorders and may be at least partly responsible for the genesis of DS.

요관결석 환자에서 강성요관경하 제석술과 요관절석술에 대한 임상적 고찰

김홍섭,황선태,노용수,양상국,박치영 건국대학교 의과학연구소 1995 건국의과학학술지 Vol.5 No.-

Patients with ureteral calculi may be managed by expectant, invasive, or noninvasive treatments, depending on the stone composition, size and location, expectations of the patients, and experience of the surgeon. Currently ureteroscopic removal of stone(URS) has been popularly used for the treatment of ureteral calculi. From January 1992 to December 1994,we retrospectively compared the clinical results of 87 URS's to those of 31 ureterolithotomies and analysed the factors that affect the result of URS. The clinical results of two groups were summarized as follows The mean stone size was 7.6㎜ in URS group and 12.1㎜ in ureterolithotomy group. In 81.6% of URS group, the stone was located in the lower ureter and 71% of ureterolithotomy group in the upper ureter. The mean operation time, hospital stay and costs of the URS group, 96.6% of the stone were removed or disintegrated. There was no statistical significance in the success rate of URS along the sex difference, the location and size of stone. However, the higher the location of stone was, the more operation time spent. The complication rate of URS was estimated 26.5% but most of complications were resolved by conservative management. We conclusively suggest that the URS is the acceptable alternative modality of the ureterolithotomy for the treatment of the ureteral calculi.