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.

수산화세륨(Ⅲ)으로부터 질산암모늄세륨(Ⅳ)의 제조

윤호성,김철주,이진영,김성돈,김준수,유승준 한국화학공학회 2003 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.41 No.3

본 연구에서는 수산화세륨으로부터 질산세륨 용액 제조 후 질산암모늄 첨가에 의한 질산암모늄세륨 제조시, 출발용액의 산도와 농도 그리고 질산암모늄 첨가량, 반응온도 및 반응시간이 질산암모늄세륨 합성에 미치는 영향을 고찰하였으며, XRD, SEM 그리고 TGA 분석을 통하여 결정의 형태 및 구조에 대한 고찰을 수행하였다. 4가의 수산화세륨을 질산에 용해한 질산세륨(Ⅳ)수용액으로부터 질산암모늄 첨가에 의한 질산암모늄세륨 제조시 회수율을 고려한 최적 합성조건은 출발물질의 세륨 농도 70-100g/l, 출발용액의 산도 7 mol/l, 질산암모늄 첨가량 2.5당량, 감압·가열온도 65℃ 및 반응시간 15-30min.이었으며, 제조된 질산암모늄세륨의 결정 화학식은 (NH_4)_2[Ce(NO_3)_6) · ×H_2O(x=6-8)인 것을 알 수 있었다. Synthetic process of ammonium cerium nitrate from cerium hydroxide was presented and influences of concentration and acidity of starting solution, addition quantity of ammonium nitrate, reaction temperature, reaction time on the yield of ammonium cerium nitrate are discussed. The shape and composition of crystal were determined by SEM, thermogravimetry differential thermal, x-ray diffraction and chemical analysis. The optimum synthesizing conditions of ammonium cerium nitrate were discribed as follows; rare earth concentration of starting solution 70-100 g/l. acidity of starting solution 7 mol/l, addition quantity of ammonium nitrate 2-3 equivalent, the condition of rotary evaporation 65℃ and reaction time 15-30 min. It was also known that the chemical formulae of ammonium cerium nitrate was (NH_4)_2[Ce(NO_3)_6] ·×H_2O(x=6-8) from TGA.

집단정신치료의 活性化 : For Its Activation of Practical Applications

윤성철,이후경 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

1997년부터 정신보건법이 시행되면서 정신질환자에 대한 관리가 중요한 문제로 대두되었으며, 정신질환자들을 관리할 전문가의 양성이 불가피하게 되었다. 정신질환자에 대한 관리는 질병에 대한 치료 뿐 아니라 삶의 질을 향상시키는데 목표가 있는 것으로 생각된다. 현실을 돌아볼 때 최선의 치료와 관리를 위한 접근 방식에 있어서는, 의료비용의 제한과 관리의 효율성 때문에 일대일로 접근하기는 매우 어렵게 되었고 그 대신 집단으로 접근하여야만 하는 상황이 되었다. 정신질환자의 효과적인 치료와 효율적인 관리를 위해 '집단정신치료의 활성화'가 매우 중요하며, 치료자는 집단정신치료에 대해 잘 알고 적절히 활용할 필요가 있다. 이러한 관점에서 저자들은 본 논문에서 먼저 대표적 유형이라 할 수 있는 Yalom의 대인관계중심의 집단정신치료를 포함한 여러 집단정신치료의 유형들을 전체적으로 소개하였다. 다음으로 집단정신치료들을 간단히 분류하여 그 적용실제를 살펴 보고, 마지막으로 이러한 이해를 바탕으로 정신질환자에 대한 집단정신치료의 활성화 필요성과 그 실제적인 관련 배경에 대해 구체적으로 살펴보았다. In Korea Mental Heath Law came into operation in 1997, and the management of the mentally ills has become an important issue and it is inevitable to train mental health workers for the management of the mentally ills. The purpose of the management seems not only to care the patients' symptoms but also to improve the quality of life. Nowadays, in the best approach of treatment and management it is difficult that one to one management is used because of the cost limitation and management efficacy. So it is highly recommended that the group approach should be used. Hence 'the activation of group psychotherapy' is very important for the effective treatment and efficient management of the mentally ills. And therapists should know group psychotherapy well and to use it properly. In these viewpoints, we first introduced various types of group psychotherapy generally, including Yalom's group psychotherapy which focus on the interpersonal relationship and is the representative type of group psychotherapy. And then we classified group psychotherapy simply, describe the concepts of practical application of group psychotherapeutic approach. And last on the basis of understanding group psychotherapy in this paper, we explored the necessity of its activation on the practical setting and the surrounding circumstances.

정신병환자에서 집단정신치료와 싸이코드라마의 치료요인 비교

윤성철,이후경,정인과,이규항,함 웅,차정화 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

목 적 : 본 연구에서는 정신병환자를 대상으로 실시한 집단정신치료와 싸이코드라마에 작용하는 치료요인을 조사하여, 그 치료적 특성들을 비교하기 위한 목적으로 이루어졌다. 방 법 : 1996년 9월부터 1997년 5월까지 낮병원에 참여한 환자를 대상으로 하였다. 대상자는 총 35명의 정신병환자로 남자 22명, 여자 13명이었다. 동일한 낮병원 환자들에게 집단정신치료와 싸이코 드라마를 각각 시행한 후, 13가지 치료요인 척도를 사용하여 집단정신치료의 구성원, 싸이코드라마의 주인공, 싸이코드라마의 관객에 작용하는 치료요인의 순위를 각각 조사하였다. 이 세 집단을 모두 상위기능 집단과 하위기능집단으로 나누어 치료요인을 비교하였다. 상위와 하위기능집단은 낮 병동에서의 생활, 치료 프로그램에 참여하였을 때의 태도, 치료자와 면담하였을 때의 모습을 기준으로 하여 낮병원 치료팀 모임에서 치료자들의 합의에 의해 결정하였다. 각각의 치료 요인은 평균점수를 산출하여 치료 요인의 순위를 매겼으며, 이 순위에 의해 집단정신치료, 싸이코드라마의 주인공, 싸이코드라마의 관객에 작용하는 치료요인의 특징을 비교하였다. 결 과 : 본 연구에서 나타난 치료요인에 대한 특정적인 결과는 다음과 같다. 1) 싸이코드라마에서 주인공은 기능수준에 관계없이 모두 “카타르시스”와 “일차 가족 집단의 교정적 감정 경험”을 매우 중시하였다. 2) 싸이코드라마에서 주인공은 상위기능집단의 경우 “치료자의 조언”을 하위기능집단의 경우 “구성원의 조언”을 중시하였다. 3) 싸이코드라마에서 관객은 기능수준에 관계없이 모두 “치료자와의 동일시” 와 “구성원과의 동일시”를 매우 중시하였으며, 또한 보편성을 중시하였다. 4) 상위기능집단의 경우 집단정신치료 싸이코드라마의 관객 및 주인공에서 “대인관계학습”을 중시하였으며, 특히 집단정신치료에서 “대인관계학습”을 매우 중시하였다. 5) 하위기능집단에서 싸이코드라마의 주인공과 집단정신치료에서 모두 “사회화 기술의 발달”을 중시하였다. 결 론 : 본 연구의 결과를 종합하여 다음과 같이 제안할 수 있다. 먼저 집단정신치료나 싸이코드라마를 환자에게 시행할 때 치료자가 치료요인을 고려하여 치료를 진행하는 것이 효과적일 것으로 생각된다. 다음으로 집단정신치료와 싸이코드라마는 모두 동일하게 중요한 치료법으로 실제 임상에서 널리 이용하는 바람직한 것으로 생각된다. 마지막으로 집단정신치료와 싸이코드라마의 기법을 서로 혼합하여 사용한다면 매우 효과적인 치료법이 될 수 있을 것으로 생각된다. Objective : This study was performed to investigate the therapeutic factors of group psychotherapy and psychodrama which were applied to psychotic patients, and to compare the therapeutic characteristics of two therapies. Methods : The subjects of this study were patients of a day hospital from September 1996 to May 1997. The subjects were composed of 35 psychotic patients(22 males, 13 females). Both of group psychotherapy and psychodrama were done to the patients of the day hospital. After these therapeutic factors were checked by the members of group psychotherapy, the protagonists of psychodrama, and the audience of psychodrama using 13 therapeutic factors scale. All three groups divided into higher functioning group and lower functioning group by mutual consent of the therapists in the treatment team meeting according to the patient's life of the day hospital, the attitude in programs, and the state during the interview with the therapist. And then therapeutic factors of higher and lower functioning group were compared. By the mean score of each therapeutic factor the rank of therapeutic factors was decided. By these ranks we compared the important therapeutic factors on the members of group psychotherapy, the protagonists, and the audience. Results : The results were as follows : 1) The protagonists of psychodrama set a very high value on “catharsis” and “the corrective recapitulation of the primary family group”, regardless of their functional level. 2) The protagonists with a higher function set a higher value on “guidance of therapists”, while those who had a lower function set a higher value on “guidance of members”. 3) The audience of psychodrama set a very high value on “identification with therapists”, “identification with members”, and set a high value on “universality”. 4) The higher functioning group of the group psychotherapy, the audience, and the protagonists set a high value on “interpersonal learning”, especially the patients of group psychotherapy set a very high value on “interpersonal learning”. 5) The lower functioning group of the protagonists and the group psychotherapy set a high value on “development of socializing techniques”. Conclusion : From the results of this study, we can draw some suggestions. First, if therapists take the above-mentioned therapeutic factors into consideration during the sessions of group psychotherapy or psychodrama, they can obtain more effective therapeutic outcome. Second, it is desirable that both group psychotherapy and psychodrama should be used more extensively as important methods of treatment in clinical settings. Third, the combination group psychotherapy and psychodrama would be more effective than the separate application of each therapy.

정신분열병의 양성아형과 음성아형에 따른 사회적 지지망의 차이

윤성철,이규항,양익홍 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.2

In this study, positive versus negative symptoms of schizophrenia were examined in relation to social networks. The subjects consisted of 36 positive symptom(PS) and 35 negative symptom(NS) groups of schizophrenics admitted to the Anyang Neuropsychiatric Hospital. There was no significant difference in sociodemographic data(ie. sex, age, education etc) between the two groups. Structurally, the social network of NS group was smaller and contained lesser number of friends and family members than PS group. Furthermore, with respect to the functional aspect of social network. 1) The frequency of contact, comfortability, and material support given by the patients were much less in NS group. However, there was no difference in emotional, material, and informative support between the two groups. 2) In contrast with the PS group, in the 'most important person' category of social network in the NS group, the proportion of 'other people' (fellow patients, hospital staff etc) was much higher than that of friends and family members. 3) All negative symptoms correlated negatively with the size of social network. However, no such relationship existed among PS group. These results indicated close relationships existing between different types of schizophrenic symptoms and the structural and functional aspect of social network.

레이저 스페클간섭법에 있어서 스페클크기와 측정 한계에 관한 연구

윤성운,김경석,양승필,정현철,김정호,이도윤 한국공작기계학회 1996 한국생산제조학회지 Vol.5 No.1

The high coherence of laser beam has made it possible to observe interference effects even in the light scattered from rough surfaces. That's why, when object with a scattering surface is illuminated with laser light, we do see a speckled appearance due to random interference. This sort of unique property of laser speckle has brought into existence the new noncontacting techniques such as speckle metrology method of measuring deformation, displacement, and vibration etc of objects with high optical sensitivity. The measurable range of speckle metrology especially used to measure in-plane information, however, is limited by some factors, the so-called strain, rotation, tilt of surface and out of displacement perpendicular to the plane of analysis. This restrictions severly limits the measurable range of speckle metrology by causing the decorrelation of speckle patterns. It is the purpose of this paper to give a survey on the measurable limitation of speckle photography method that is one of speckle metrology. Namely we will discuss the mutual relationships and problems of each limitations adding the restriction of the largest and smallest displacement measurable with speckle methods.

개에서 이중 결찰법을 통한 동맥관 개존증의 완치 예

윤헌영,정순욱,박희명,박철,정만복,김준영,한현정,황민,노병국,박상혁,장하영,박정윤 한국임상수의학회 2004 한국임상수의학회지 Vol.21 No.1

A ten months old, female Yorkshire terrier weighing 2.88 kg referred to veterinary teaching hospital of college of veterinary medicine, Konkuk University because of syncope, cough and dyspnea. First hematological and serum chemical test revealed thrombocytopenia, mild anemia, and increase of concentration of ALP (195 U/L). On 57 days later, second hematological and serum chemical test revealed polycythemia, increase of concentration of ALP (211 U/L), and Tchol (387 mg/dl). Right atrium enlargement, main pulmonary artery bulge and cardiomegaly (VHS = 11.5) were observed in radiographic findings. Ultrasonographic images showed both right and left ventricular dilation and turbulent flow between the descending aorta and the main pulmonary artery in color Doppler imaging. ECG showed left ventricular enlargement, SA block, and electrical alternant. Thoracotomy was performed through left fourth intercostal incision under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. Cough and dyspnea disappeared on 5 days after operation. Turbulent flow was not found in color doppler imaging of ultrasonography on 10 days after operation. Ten months later after the operation, syncope could not exist any more.

부산시 상업중심지의 공간적 분포특성

윤철현,이상현,박봉진 동아대학교 건설기술연구소 2000 硏究報告 Vol.24 No.2

Spatial distribution of centeral places in one of key factors to find out internal structure of the city. However, there has not been, still now, even basic study or survey on the commercial centers in Pusan. Thus, this paper has the purpose to discover the spatial structure of the commercial centers of Pusan. For that, this paper has defined functions by the statistical data of 1981 and 1998 and has made Z-score by functions. As a result, enormous change has been discovered in the spatial distribution as well as hierachy of the commercial centers of Pusan between early '80s and late '90s, according to Z-score>1.

Cu/Kieselguhr 觸媒에 依한 Acrylonitrile의 水和反應에 關한 硏究

尹奇俊,姜喆象 成均館大學校 科學技術硏究所 1990 論文集 Vol.41 No.2

Catalytic hydration of acrylonitrle over Cu/kieselguhr catalysts was studied at 343K. The catalysts with varying Cu loadings were prepared by the precipitation method using NaOH and K_2CO_3 solutions as the precipitants. The active surface areas were measured by O_2 chemisorption at 77K in order to determine the areal reaction rate constants. Some effects of the precipitant and the Cu loading were investigated. The results were as follows : (1) Only acrylamide was produced over the catalysts prepared using NaOH, whereas ethylene cyanohydrin was also produced over the catalyst prepared using K_2CO_3. (2) The reaction rate for the production of acrylamide was first order with respect to the concentration of acrylonitrile. (3) The areal reaction rate constant. for the catalysts prepared using NaOH decreased significantly with decreasing Cu loading. The constant at 343K for the catalyst having 50% Cu loading was 2.83 x 10 wxp(-6)l/㎡. min.

緯度와 地形에 따른 溫帶中部 溪谷植生의 種多樣性 및 群集構造에 關한 硏究

尹相旭,辛壽哲,郭東勳,金昌浩 동국대학교 농림과학연구소 1994 農林科學 論文集 Vol.18 No.-

This study was Carried out to analyse species composition, species diversity and structure and variation trends of vegetation, of Mt. Odae, Mt. Sobaek, and Mt. Juwang following various latitudes and topographies which were in middle temperate zone in Korea. Obtained results are as follows : 1. As a result of the simple discriminant analysis, soil texture Showed the highest high percent contribution of each environmental factor to the discriminant of Studred area. And Mt. Odae showed high content of sand while Mt. Juwang Showed silt. 2. Mean stem density showed highest value in Mt. Juwang and mean D. B. H. was Mt. Odae, and on phisiographic locations showd high values of stem density and mean D. B. H in slow slope area, nothern aspect area, and high elevation area, in order. 3. Species that showed the highest importance value in each canopy-subtree-shrub layer in study area were Quercus mongolica-Acer pseudo-sieboldianum-Lindera obtusiloba were in Mt. Odae, Betula platyphylla var. japonica-Styrax obassia-Deutzia parviflora were in Mt. Sobaek, and Pinus densiflora-Acer pseudo-sieboldianum-Lindera obrusiloba were in Mt. Juwang. 4. Species that showed the highest importance value in each canopy-subtree-shrub layer on the physiographic location were Quercus mongolica-Acer pseudo-sieboldianum-Lindera obtusiloba in high elevation and southern aspect, Carpinus laxiflora-Acer pseudo-sieboldianum-Lindera obtusiloba in high elevation and southern aspect, Carpinus laxiflora-Acer pseudo-sieboldianum-Lindera obtusiloba in nothern slope, Carpinus laxiflora-Styrax obassia-Lindera obtusiloba in low elevation, and Betula platyphylla var. japonica-Styrax obassia-Deutzia parviflora in high elevation. 5. According to decrease of latitudes with going down from Mt. Odae to Mt. Juwang, the more Number of species and individuals were increased, and the deversity index was the highest value in Mt. Sobaek, the evenness was in southern aspect, and the dominance was in high elevation. 6. As a result of Cluster analysis, the study area were divided into 4 groups, Carpinus laxiflora community, Styurax obassia community, Deutzia parviflora community, and Quercus mongolica community. 7. As a result of COA analysis, communities of the study area were divided into Betula platyphylla var. japonica community, Deutzia parviflora community, Quercus mongolica-Acer pseudo-sieboldianum community, and species were divided into 4 groups as the major, the disturbed, the waterside, and the fertile. 8. As results of the simple discriminant analysis and the linear regression, sand and silt content, slope aspect, total nitrogen content, and elevation among environmental factors had high percent contribution to classification and ordination of vegetation communities of the study area. 9. Major tree species had the unstable layer structure due to lower importance values of canopies and subtrees than those of shrubs, and Pinus laxiflora and Betula platyphylla var. japonica were on the decline phase due to very low dominance and absence of next generation. while, Styrax obassia and Acer pseudo-sieboldianum were sustanable layer structure as being distributed on all the crown layer.