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.

ECAP 공정을 거친 1050 Al 합금 판재의 전기화학 특성에 관한 연구

정민경,최윤석,김정구,김영만,이재철,석현광 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.8

The effect of equal channel angular pressing (ECAP) pass number on the electrochemical properties of AA 1050 (UNS A91050) in 0.1M Na₂SO₄ solution containing 100 ppm chloride were investigated by electrochemical techniques (potentiodynamic test, potentiostatic test, electrochemical impedance spectroscopy (EIS) and surface analyses (OM, SEM, EDS). The ECAPed specimens that have a various numbers of passes from N=l to N=5 were selected for electrochemical experiments in this study. The results of potentiodynamic test indicated that the breakdown potential increased with increasing the ECAP pass number. EIS measurements also showed that the corrosion resistance of the AA 1050 increased with increasing the ECAP pass number at the passivation and breakdown states. The results of surface analyses (SEM, EDS) showed that silicon-containing impurities were observed on the surface of the alloy. It was found that the size of these Si-containing impurities decreased with increasing the ECAP pass number. The Si-containing impurities induced the microgalvanic reaction(i) between the Al matrix and the Si-containing mixed oxide and (ii) between the Al matrix and the Si-containing impurities. Due to its ultrafine-grained microstructure, ECAPed AA 1050 had smaller Si-containing impurities, and reduced microgalvanic currents. Thus, in the case of ECAPed AA 1050, it has increasing corrosion resistance with increasing ECAP pass number because of its small cathodic impurities.

두개인두종과 동반한 다발성 특발성 치근 외흡수

정원균,윤정훈 대한치과보존학회 2001 Restorative Dentistry & Endodontics Vol.26 No.2

Idiopathic external root resorption is an apparently infrequently occurrence involving single or multiple teeth. Presented is an unusual case of multiple external root resorption associated with craniopharyngioma. Although the cause of this resorption was not determined, several possibilities are discussed. The literature to a systemic etiology for external root resorption is briefly reviewed.

남조류 Microcystis aeruginosa의 증식에 미치는 중금속의 영향에 관한 실험적 연구

정용태,윤정로 順天靑巖大學 1992 論文集-順天靑巖大學 Vol.16 No.-

Microcystis aeruginosa의 증식에 미치는 중금속 첨가실험을 하여 조류증식에 미치는 중금속의 영향과 제거되는 중금속의 량을 조사하였다. 조류의 양은 건조중량법으로 중금속의 양은 원자흡광분석기로 분석하였다. 인제한실험에서 Monod type의 동력학적 해석으로 부터 μ_max=0. 6 day^-1이고 Ks=0. 06 mg/L의 값을 얻었다. 중금속이 저농도로 첨가되면 증식촉진효과를 나타냈고, 한계증식촉진농도 이상이 되면 증식저해를 나타냈다. 한계증식촉진농도는 크롬은 극미량이며, 구리와 카드뮴은 0. 2 ㎎/L이고, 코발트는 0. 4 ㎎/L이었다. Microcystis aeruginosa에 중금속을 첨가하면 증식저해는 비길항적 저해로 나타났고, 증식저해상수는 크롬은 0. 85 ㎎/L, 구리는 3. 23 ㎎/L, 코발트는 10. 53 ㎎/L를 나타냈다. 첨가된 중금속은 구리의 경우 5-10%정도 제거가 되고, 크롬이나 코발트는 거의 제거되지 않았다. The effects of heavy metals on Microcystis aeruginosa and quantity of heavy metals removed were experimentally investigate with adding heavy metals to CB media. The algal mass was determied by suspeded solids deried at 103-105℃ ad heavey metals determined by Atomic Absorption Spectrometry. Under the Phosphate-limiting culture condition, the kinetics coefficient of Monod equation, μ_max and Ks, calculated form the least-square method, were 0. 6 day^-1 and 0. 06 ㎎-P/L. The growth of Microcystis aeruginosa was accelerated at low concentration of heavy metal but inhibited above the critical growth-accelerating concentration. The critical growth-accelerating concentration was on the very low level;Cu and Cd was about 0. 2 ㎎/L and Co was 0. 4 ㎎/L respectively. When adding heavy metals to the culture media of Microcystis aeruginosa, the type of growth inhibition was turned out by noncompectitive-inhibition. The growth inhibition consatnat of Cr, Cu and Co was 0. 85 ㎎/L, 3. 23 ㎎/L and 10. 05 ㎎/L respectively. Cr and Co added to CB media was little removed but Cu removed at 5-10%.

건선 병변부 및 병변주위부 피부의 Cytokines 유전자 발현

윤기성,김도원,정상립,김문규,김정철 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

It has been proposed that cytokines may be involved in mediating the characteristic pathological changes in psoriasis, including epidermal hyperplasia, compromised keratinocyte differentiation, and dermal and epidermal infiltration by polymorphonuclear leukocytes and mononuclear cells. The purpose of this study os to assess the pattern of cytokine gene expression in psoriatic skin lesion. To investigate the cytokine expression pattern, we examined the transcripts of cytokine genes using reverse transcription and polymerase chain reaction (RT-PCR) method with 13 cytokine-specific primers. The Results were as follow; 1. Only the TGF-β gene was expressed in the normal skin. 2. IL-1α, IL-1β, IL-8, and TGF-β were detected in both lesional and perilesional psoriatic skin. The lesions showed more prominent expression. 3. IL-10 and GM-CSF were weakly detectable in three lesional psoriatic skin respectively, and IL-2R in two lesional psoriatic skin. 4. IL-2,IL-4,IL-5,IL-6 TNF-α, IFN-γ were not detectable on both lesional and perilesional psoriatic skin. Therefore, distinct differences in the cytokines gene expression were noted between normal and psoriatic skin. The patterns of cytokines gene expression in perilesional skin were similiar to those of lesional psoriatic skin.

혈행화된 두개골 피판을 이용한 안와저 및 안와하연의 재건술 치험례

정윤규,이훈범,김석원,봉정표,김균태,김주봉 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.5

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.

일부 지하철 근로자와 소방공무원의 직무 스트레스 요인 비교

윤석환,최숙정,신동훈,정인성,하정숙 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.3

개 소뇌겉질에서 calbindin D-28k와 parvalbumin 함유신경세포에 관한 면역세포화학적연구

정해만,김종중,정윤영 대한췌담도연구회 2000 대한췌담도연구회지 Vol.5 No.3

중추 신경계를 침범한 전신성 홍반성 낭창의 임상적 연구

정윤석,박석원,이돈행,김시찬,박중원,홍천수 대한내과학회 1992 대한내과학회지 Vol.42 No.1

1987년 7월부터 1990년 6월까지 연세의대 세브란스 병원에 입원한 전신성 흉반성 낭창 환자 103예를 대상으로 조사하여 신경학적 증상과 징후가 있거나 뇌 전산화 단층 촬영상 또는 뇌파 검사상 이상이 있는 경우, 또는 정신병적 증상과 징후가 나타난 경우를 중추 신경계 낭창이라고 정의하였을때 다음과 같은 결과를 얻었다. 1) 전체 103예중 43예(41.7%)에서 중추 신경계 침범을 보였다. 2) 중추 신경계 낭창군은 비 중추 신경계 낭창군에 비하여 높은 초기 사망률을 나타내었다. 3) 중추 신경계 낭창군은 비 중추 신경계 낭창군에 비하여 신장 기능이 의의 있게 저하되어 있었다. 4) 중추 신경계 낭창군과 비 중추 신경계 낭창군 사이에 유병기간, 침범된 장기, 자가면역 항체 등에 있어서는 유의한 차이를 보이지 않았다. 결론적으로 전신성 홍반성 낭창환자, 특히 신장 기능이 저하되어 있는 환자는 중추 신경계 침범 여부를 조심스럽게 관찰하여 조기에 진단하고, 중추 신경계 침범이 확인된 경우는 사망률을 저하시키기 위하여 보다 적극적인 치료를 요할 것으로 사료된다. Central nervous system involvement in systemic lupus erythematosus (CNS lupus) is characterized by difficulty in it's proper diagnosis, treatment, and poor prognosis. We analyzed 103 systemic lupus erythematosus patients who have admitted to Severance Hospital, Yonsei University, from July 1987 to June 1990. The results were as followed: 1) 43 cases out of 103 systemic lupus erythematosus patients had central nervous system involvement. 2) Immediate mortality in CNS lupus was significantly higher than non-CNS lupus group. 3) Renal functions in CNS lupus were more significantly impaired than non-CNS lupus group. 4) There was no significant difference in duration of disease, number of organ involved, autoantibodies between CNS and non-CNS lupus group. These results suggest that patients with imparied renal function should be carefully followed up for early detection of central nervous system involvement. And, if central nervous system involvement is suspected, then more aggressive treatment may be required to reduce high mortality rate.

톨루엔 취급 근로자의 ALDH2 Genetic Polymorphism에 따른 뇨중 마뇨산 배설량

김창윤,정종학,권오춘,김성용,이중정,주리 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.2

In this study we evaluated the effects of the genetic polymorphism of aldehyde dehydrogenase2 (ALDH2) on the toluene metabolism and determined biological exposure indices(BEIs) for toluene by the genotypes of ALDH2. The study subject were 77 men workers who are handling toluene in a video tape manufacturing factory and a textile company. Through the face-to-face interview, the information about smoking and drinking behavior was obtained. For determination of ALDH2 polymorphism, 5ml of venous blood sample was obtained from each subject after informed consent. DNA was extracted from the buffy coat and ALDH2 genotyping were performed using a polymerase chain reaction(PCR) method. The genotype of ALDH2 was classified into the homozygous genotype of normal ALDH2(NN), and the heterozygous genotype of normal and inactive ALDH2(ND), and homozygous genotype of an inactive ALDH2(DD). The concentration of hippuric acid (HA), the main metabolite of toluene, was determined in urine specimens collected at the end of shift, corrected with creatinine(HA/C), and compared with BEI for toluene, which is 2.5 g/g creatinine. The personal exposure level of toluene were monitored, using personal air sampler and analyzed by gas chromatography. The frequencies of the three genotypes in this study subject were, NN : 45 (58.4%), ND : 26 (33.8%) and DD : 6 (7.8%), and frequencies of the genotypes in the middle or heavy toluene exposure workers were not significantly different from those in the mild toluene exposure workers. The frequencies of the DD type of ALDH2 was lower among alcohol drinkers than among non-drinkers. The urinary HA concentration of DD group was significantly lower than that of the NN or ND group, which suggests that the HA formation from toluene decreased in DD group. Regression lines were used to estimate the BEIs of the NN, ND, and DD groups. NN : y = 0.0085x + 0.23, r = 0.90 ND : y = 0.0074x + 0.21, r = 0.85 DD : y = 0.0041x + 0.82, r = 0.83 The three regression lines revealed that the estimated urinary HA concentration of NN, ND, and DD groups at 377 mg/㎥ toluene (TLV-TWA) exposure were 3.43, 3.00, and 2.37g/g than that of the ACGIH BEI (2.5 g/g creatinine) ; however, the HA level of DD group was lower than the BEI. These results suggest that the ACGIH BEI is not adequate to estimate the toluene exposure of the NN, ND and DD groups at the same time. Based upon these results, a new BEI for ALDH2 deficient workers may be necessary.