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.

Caffeine이 지구성 운동 수행능력에 미치는 영향과 억제성 아미노산에 의하여 활성화되는 이온통로의 조절작용

김은경,김영표,천병옥,이계영,김연정,임백빈,조영욱,김창주,김성수 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

To investigate the effect and mechanism of caffeine on endurance exercise, two experiments were performed. First, to test caffeine effect on aerobic exercise, 200-300g Sprague-Dawley rats were used and three groups, control group, low caffeine injection group and high caffeine injection group, were divided. Blood smpling by heart puncture were done at rest, after 30 min treadmill exercise, and after maximal exercise. Blood glucose, free fatty acid concentration were detected and following results were obtained. Glucose concentration showed significant difference between groups(p=0.0305) and also significant changes were exhibited between time(p=0.0004). Free fatty acid concentration had no difference between groups. but had significance between times(p=0.00065). Exercise endurance performance time showed significant difference(p=0.02350 in high caffeine injection group compared to control group. In this experiments, endurance exercise capacity was increased by caffeine injection. Therefore, second experiment was performed to investigate the effect of caffeine on ion current induced inhibitory amino acid neurotransmitter. GABA and glycine. Single periaqueductal gray neuron was acutely dissociated and nystatin perforated patch clamp was performed under voltage clamping condition. Caffeine evoked outward current in PAG neuron dose dependent manner. 1mM of caffeine application had no response. but 3mM caffeine evoked about 32.5±8.539pA outward ion current and 10mM caffeine evoked about 215.46±19.4pA outward current. 10^-2mM GABA activated Cl￣current and recorded by inward current. Caffeine inhibited GABA activated Cl￣ current concentration dependent manner. 10^-2mM of caffeine had no effect on 1-^-2mM of GABA response. but 10^-1mM caffeine inhibited GABA activated Cl￣ current about 5.74±2.13%, 1mM caffeine inhibited about 17.25±2.70%, 10mM caffeine inhibited GABA response about 45.31±7.71%. 10^-1mM of glycine activated Cl￣ current and also recorded by inward current. Caffeine inhibited glycine activated Cl￣ current concentration dependent manner. 10^-2mM caffeine decreased glycine activated Cl￣ current about 4.61±1.650%, 10^-1mM caffeine decreased about 6.49±2.24%, 1mM caffeine decreased about 26.82±4.27%, and 10mM caffeine decreased glycine response about 94.47±1.39%. These results suggest that caffeine inhibite inhibitory amino acid, GABA and glycine, this response causes excitation of CNS and this seems to be the basic mechanism of increasing effect to aerobic exercise performance by caffeine.

동영상 프로그램과 구조화된 면담이 내시경 점막 하 박리절제술 환자의 수술 전 불안에 미치는 효과

김서영(Seo Young Kim),이영휘(Young Whee Lee),김화순(Hwasoon Kim),임지영(Ji Young Lim) 한국콘텐츠학회 2022 한국콘텐츠학회논문지 Vol.22 No.11

본 연구는 내시경 점막 하 박리술을 시행할 예정인 대상자에게 동영상 프로그램과 구조화된 면담을 통한 간호정보 제공이 내시경 점막 하 박리 전 불안에 미치는 영향을 알아보고자 하였다. 비동등 대조군 사전-사후 실험 설계를 사용하였다. 대상자는 실험군 58명, 대조군 61명으로 총 119명이었다. Kim과 Shin이 개발한 한국어판 Spielberger의 State-Trait Inventory와 연구자가 개발한 Knowledge Scale을 사용하였고, 혈압과 맥박을 측정하였다. 데이터 분석은 기술통계, χ²-검정 및 t-검정을 이용하였다. 실험군은 대조군에 비해 상태불안이 유의하게 낮았다(t=3.60.p <.001). 실험군은 대조군 보다 수축기 혈압(t=5.85, p <.001), 이완기 혈압(t=5.53, p <.001), 맥박(t=2.59, p =.011)의 변화가 적었다. 이상의 결과로부터 내시경 점막 하 박리술을 시행하는 대상자의 수술 전 불안을 감소시키기 위해 본 연구에서 적용한 동영상 프로그램과 구조화된 면담 중재를 활용할 필요가 있겠다. The purpose of this study was to investigate the effect of providing nursing information through a video program and structured interview on anxiety before endoscopic submucosal dissection. A non-equivalent control group pretest-posttest experimental design was used. A total of 119 subjects were participated, of which 58 were assigned to the experimental group and 61 were assigned to the control group. Spielberger’s State-Trait Inventory in Korean version and Knowledge Scale were used. Also, blood pressure and pulse were measured. Data analysis was performed using by descriptive statistics, χ²-test and t-test. The experimental group was a significant lower in state anxiety than control group (t=3.60.p <.001). The experimental group showed less changes in systolic blood pressure (t=5.85, p <.001), diastolic pressure (t=5.53, p <.001), and pulse (t=2.59, p =.011) than the control group. From the above results, it is necessary to apply the video program and structured interview intervention which was applied in this study to reduce preoperative anxiety in subjects undergoing endoscopic submucosal dissection.

Optimizing the Hospital Blood Bank Stock in Korea: A Comparative Analysis of the Uniform 5-Day Stock Index and a Novel Blood Stock Index

Park Seo-Jin,Lim Young Ae,Kim Kyung-Hee 대한진단검사의학회 2024 Annals of Laboratory Medicine Vol.44 No.3

Background: Maintaining optimal blood inventory levels in hospitals is important to prevent blood shortage and wastage. We aimed to provide an efficient blood inventory management strategy for hospital blood banks nation-wide by comparing the current use of 5-day issuable stock (IS) with Lim’s IS as a novel target IS. Methods: The average and CV of daily usage (DU) were calculated from information entered into Korea’s Blood Management System by 194 participating hospitals in 2019 and 2020. Using these data, Lim’s IS was calculated by determining the simulated annual average blood shortage day nearest to 1 for each blood group in each hospital. The 5-day IS (5IS) was estimated by multiplying the average DU in 2018 by five to count the shortage days in 2019. Results: The average DU (0.3–231.3 units) and corresponding CV (0.33–7.14) in the participating hospitals were inversely proportional (r=–0.699 to –0.695). The hypothetical averages of 5IS and Lim’s IS were 27.0±41.2 and 24.7±20.8, respectively (P=0.006). The shortage days for 5IS and Lim’s IS were 8.9±22.7 and 1.0±1.9, respectively (P<0.001). Conclusions: While 5IS was unacceptable for universal application, Lim’s IS remained near one shortage day and is considered more efficient than 5IS. Hospitals should implement indicators that consider DU and its variations. This is the first study to introduce Lim’s IS as an indicator of optimal blood inventory, and the data are expected to provide guidance for effective blood inventory management nationwide, particularly during blood shortages.

Are Adolescents with Internet Addiction Prone to Aggressive Behavior? The Mediating Effect of Clinical Comorbidities on the Predictability of Aggression in Adolescents with Internet Addiction

Lim, Jae-A,Gwak, Ah Reum,Park, Su Mi,Kwon, Jun-Gun,Lee, Jun-Young,Jung, Hee Yeon,Sohn, Bo Kyung,Kim, Jae-Won,Kim, Dai Jin,Choi, Jung-Seok Mary Ann Liebert 2015 CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING Vol.18 No.5

<P>Previous studies have reported associations between aggression and Internet addiction disorder (IAD), which has also been linked with anxiety, depression, and impulsiveness. However, the causal relationship between aggression and IAD has thus far not been clearly demonstrated. This study was designed to (a) examine the association between aggression and IAD and (b) investigate the mediating effects of anxiety, depression, and impulsivity in cases in which IAD predicts aggression or aggression predicts IAD. A total of 714 middle school students in Seoul, South Korea, were asked to provide demographic information and complete the Young's Internet Addiction Test (Y-IAT), the Buss-Perry Aggression Questionnaire, the Barratt Impulsiveness Scale-11, the State-Trait Anger Expression Inventory-2, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Conners-Wells Adolescent Self-Report Scale. Three groups were identified based on the Y-IAT: the usual user group (n=487, 68.2%), the high-risk group (n=191, 26.8%), and the Internet addiction group (n=13, 1.8%). The data revealed a linear association between aggression and IAD such that one variable could be predicted by the other. According to the path analysis, the clinical scales (BAI, BDI, and CASS) had partial or full mediating effects on the ability of aggression to predict IAD, but the clinical scales had no mediating effect on the ability of IAD to predict aggression. The current findings suggest that adolescents with IAD seem to have more aggressive dispositions than do normal adolescents. If more aggressive individuals are clinically prone to Internet addiction, early psychiatric intervention may contribute to the prevention of IAD.</P>

물질남용 치료프로그램 후 재범여부에 대한 예비적 추적조사 연구

김현수,조선미,오은영,임기영,정영기,윤웅장,이영미 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 물질사범에게 시행되는 수강명령 프로그램의 효과를 재범률을 중심으로 살펴보고자 한 것이다. 방 법: 이 연구의 대상집단은 보호관찰소에서 의뢰받은 물질남용자집단이다. 이들은 법원으로부터 보호관찰, 수강명령, 치료명령, 사회봉사 등을 부과받았다. 총 104명의 대상자집단을 치료프로그램을 이수한 수강군과 비수강군으로 나누었으며 이들에 대한 재범률을 조사하였다. 결 과: 프로그램을 이수한 수강군이 비수강군에 비해 재범률이 낮았다(p<.05). 또한 단기 수강군과 장기수강군의 재범률의 차이를 조사하였는데 대상자 집단의 수가 적기 때문에 장기 수강군의 효과가 통계적으로 입증되지는 않았다. 결 론: 우리는 물질남용자에 대한 정책이 보다 교육적으로 변화할 것을 본 논문을 통하여 제시하려 하였으며 정부 및 법무부는 물질남용자에게 교육과 치료를 제공해주어야만 한다. Objectives: Using recidivism rate, we investigated the outcome after our substance abuse treatment program had been implemented. Methods: Our target population was substance abuse criminals referred by probational office. They either received the parole and probation order, treatment order or social service order from the court. We divided 104 substance abuse criminals into treatment group and non-treatment group. We examined their recidivism rate. Results: We reached a conclusion that treatment group had lower recidivism rate than non-treatment group(p<.0.5). We examined the effectiveness of short-term and long-term programs. However, no effectivess of long-term program was found because the sabject number was too small. Conclusion: We suggest that the strategies for substance abuse should be changed to more educative ones. The Government and Ministry of Justice must provide education and treatment to the substance abuse criminals.

數種의 市販 淸凉飮料에 依한 琺瑯質 脫灰效果

김영숙,신영림,송근배,김영진 慶北大學校 齒科大學 1992 慶北齒大論文集 Vol.9 No.1

The purpose of this study was to investigate the effects of tooth enamel dissolution by commercial beverages. Five kinds of beverages(cola, cider, aquarius, boribori and sunkist orange) were selected for test medium and sixteen of extracted 3rd molar were used for tooth enamel specimens. The acidity of each beverage was determined with pH meter and the concentration of total glucose was checked with Glucose kit and U-V spectrophotometer. The dissolved calcium was determined by Atomic Absoprtion Spectrophotometer and the change of enamel surfaces were observed with Scanning Electron Microscopy(× 400 & × 1,000 magnification). All collected data were analyzed by one-way & two-way ANOVA in SPSS/PC^+ program. The obtained results were as follows: 1. The major containing acid type of cola beverage was phosphoric acid but the other beverages(cider, aquarius, boribori and sunkist) were citric acid. The pH of each beverage was lowest in cola and sport drink, cider, boribori, fruit juice in ascending order(F=205.85, p<0.001), the average pH of 5 kinds of beverage was 2.84 ±0.04, all beverages used in this experiment were low enough to decalcify the tooth enamel. The total glucose concentration of each beverage was 2.74% in aquarius, 2.78% in cider, 3.96% in sunkist, 4.23% in boribori and 4.27% in cola. 2. The average dissolved calcium concentration in 5cc of beverage was 1.54±0.12ppm/5㎖ of HNO_3 in cola, 1.76±0.38ppm in sunkist, 1.90±0.09ppm in boribori, 3.03±0.09ppm in aquarius, 3.59±0.38ppm in cider and the final calcium contents, which is extrated original calcium contents from total calcium contents after 120 minutes were highest in cola(1.27ppm) and aquarius(1.02ppm), cider(0.58ppm), sunkist(0.45ppm), boribori(0.33ppm) in the order(p<0.05). 3. The direct proportional relationship was not found between the degree of surface change on Scanning Electron Microscopy and the amount of dissolved calcium per immersion time. But the more the immerging time was lengthened, the more surface change was observed. The surface change of 120 minutes group was more remarkable than 30 and 60 minutes immerged group in each beverage.

교정환자의 브라켓과 치아 경계부에 존재하는 치면세균막내 mutans streptococci 종 및 생물형의 식별

김미애,유소영,김화숙,국중기,임성훈,윤영주,김광원 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

본 연구는 교정환자의 브라켓과 치아 경계부 및 브라켓으로부터 2 mm 이상 떨어진 치아 평활면의 치면세근막에 존재하는 mutaus streptococci의 종 및 생물형에 차이가 있는지를 알아보고자 시행되었다. 조선대학교 치과병원에 내원한 13세 이상 35세 미만의 환자 28명으로부터 브라켓을 장착하고 있는 61개 치아에서 치균세균막을 채취하여 mutans streptococci를 MSB 배지에서 선택적으로 분리한 다음, 이들의 지놈 DNA를 추출하여 dextranase 유전자를 표적으로 하는 중합효소연쇄반응법을 시행하고, 그 증폭물을 Hae Ⅲ로 소화하고, 이를 전기영동하여 제한효소절편길이에 따라 그 종을 식별하였다. 또한 생물형을 조사하기 위하여 생화학적 검사를 실시하였다. 그 결과 브라켓과 치아 경계부 및 브라켓으로부터 2 mm 이상 떨어진 평활면의 치면세균막에 존재하는 mutans streptococci 종은 서로 비슷한 검출 빈도를 보이나 두 곳에 존재하는 mutans streptococci 생물형은 서로 차이가 있는 것으로 나타났다. 향후 브라켓과 치아 경계부 및 치아 평활면의 치면세균막의 mutans streptococci 생물형의 차이와 브라켓 주위의 법랑질 탈회 및 치아우식증 발병과의 상관관계에 대한 연구가 필요하다. The aim of this study was to compare the species and biotypes of mutans streptococci isolated from dental plaques sampled from the interfaces between the bracket and tooth surface and smooth tooth surfaces in orthodontic patients. Dental plaque was collected from the interfaces between brackets and teeth (test group), and from smooth tooth surfaces distant from brackets by more than 2 mm (control group). The dental plaque collected by a sterilized curette was transferred into a vial of 1 X PBS. The sample in the vial was vigorously vortexed for1 min and plated on mitissalivarius bacitracin (MSB) agar plate using cotton tips. The agar plates were incubated at 37℃ in a candle jar for 2 days, and again incubated for 1 more day at anambient temperature. Individual colonies were cultured in TH broth at 37℃ CO₂ incubator. The PCR-RFLP based on dextranase gene was performed for the identification of mutans streptococci at the species-level. For biotyping of mutans streptococci, biochemical tests were performed. There was no significant difference of the species of mutans streptococci isolated from both test and control groups. However, the biotypes of the mutans streptococci isolated from test and control groups were different. These results may offer the basic data to verify the relationship between the mutans streptococci biotype and enamel decalcification or dental caries in orthodontic patients with fixed appliances.

Effects of I- and W-Phases Under Identical Conditions on Microstructure and Mechanical Properties of As-Cast Mg–Zn–Y Alloys at Room and Elevated Temperatures

Young‑Gil Jung,Wonseok Yang,Jae Ik Hyun,Shae K. Kim,Hyunkyu Lim,Do Hyang Kim 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.12

Three alloys (Mg–6Zn–1.2Y, Alloy I; Mg–3.65Zn–1.65Y, Alloy II; and Mg–4.3Zn–1.4Y, Alloy III) with same volume fractionand grain size were designed to evaluate the effects of the I-phase (Mg3Zn6Y) and W-phase (Mg3Zn3Y2), which are themajor phases in Mg–Zn–Y alloys, on the mechanical properties. The tensile strength of Alloy I with the I-phase at roomtemperature was the highest among the tested alloys because the coherent interface between the I-phase and the α-Mg phasewas more resistant to cracking than the incoherent interface between the W-phase and the α-Mg phase. A cross-sectionalmicrostructure analysis of a sample that was tensile-tested at 423 K revealed that the morphology of the I-phase remainedrelatively stable. In contrast, the W-phase was broken and fragmented during the tensile test at 423 K because it had higherbrittleness under the test conditions. Therefore, the tensile and creep properties of Alloy I at 423 K were better than thoseof Alloys II and III containing the W-phase. According to the results, the I-phase in the Mg-Zn-Y alloy was more beneficialto the mechanical properties at room temperature and 423 K than the W-phase.

심정지환자에서 epinephrine투여시 혈중 catecholamine의 변화

임경수,황성오,이부수,이강현,이진웅,임종천,김영식,김선만,김 현 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Background : Cardiac arrest is a potent stimulus for the release of endogenous catecholamine and high plasma catecholamine concentration has been reported during cardiopulmonary resuscitation(CPR). Few data were present about the clinical effect of high plasma catecholamine and endogenous catecholamine response to exogenous epinephrine administration during CPR. Purpose : This study was designed to evaluate endogenous catecholamine response to cardiac arrest and exogenously administered epinephrine during CPR. Method : In 21 cardiac arrest victims, blood sample for epinephrine and norepinephrine was drawn before and 1 minute after each epinephrine administration during CPR. 1mg of epinephrine was administered immediately after intravenous access and 3 minute interval during CPR. Plasma catecholamines were quantitated by high-performance liquid chromatography. Result : Baseline plasma epinephrine concentraqtion was higher in patients with cardiac arrest than normal controls (985±1627 vs 194±173 pg/ml, p<0.05). Baseline plasma norepinephrine concentration was also elevated in patients with cardiac arrest than normal controls, although statistically insignificnat(1965±4915 vs 360±250 pg/ml). Plasma epinephrine concentration in cardiac arrest patients was significantly elevated after exogenous administration of epinephrine, but its response was blunted after the third does of epinephrine. Plasma norepinephrine concentration in cardiac arrest patients was also elevated, but its response was observed only after the first epinephrine administration. Plasma epinephrine concentration was persistently higher in patients with return of spontaneous circulation (ROSC) than patients without ROSC. there was no significant difference of plasma norepinephrine concentration whether spontaneous circulation was restored or not. Endogenous epinephrine response to exogenous epinephrine was not observed in patients having prolonged arrest time over 20 minutes. Conclusion : Results of this study suggests that significant amount of catecholamine is released by exogenous epinephrine administration in spite of high plasma catecholamine concentration, and degree of endogenous catecholamine response influences resuscitation outcome.