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.

알쯔하이머형 치매와 혈관성 치매환자에서의 ALDH2와 APOE 유전자의 다형성에 관한 연구

김동홍,김영돈,이창화,엄기춘,김은식,윤경식,김동희 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

연구목적: 본 연구는 국내 치매환자들을 대상으로 치매발병의 위험요소가 될 수있는 ALDH2와 APOE 유전자형이 어떤 양상으로 나타나는지 알아보기 위하여 시행되었다. 방 법: 충남 부여군에 위치한 부여노인병원에 입원중인 65세 이상의 알쯔하이머형 치매와 혈관성 또는 혼재성 치매환자 59명(남:19, 녀:40)을 대상으로 ALDH2와 APOE 유전자형을 제한효소법에 의하여 조사하였고 치매유형에 따른 유전자형과 대립유전자의 빈도를 비교하였다. 결 과: 1) 알쯔하이머형 치매환자군에서 혈관성 또는 혼재성 치매환자군보다 ALDH2*(-/2)유전자형의 빈도가 높았으나 통계학적으로 의미있는 차이는 없었다. 2) 알쯔하이머형 치매화자군에서 혈관성 또는 혼재성 치매환자군보다 APOE*(-/ε4) 유전자형의 빈도가 높았으나 통계학적으로 의미있는 차이는 없었다. 3) APOE*ε4와 ALDH2*2를 알쯔하이머병의 균등한 위험대립유전자로 가정하고 각 유전자형의 대립유전자의 수를 점수화하여 각 치매환자군의 위험유전자 전체점수를 비교한 결과 알쯔하이머형 치매환자군에서 점수가 더 높게 나왔으나 통계학적으로 의미있는 차이는 없었다. 결 론: 알쯔하이머형 치매환자군에서 혈관성 또는 혼재성치매치매환자군보다 ALDH2*2와 APOE*ε4 대립유전자의 빈도가 높게 나왔으나 통계학적으로 의미있는 차이는 없었다. A study on gene polymorphism of ALDH2 and APOE in patients with alzheimer's disease and vascular or mixed dementia. Objective : This study was designed to investigate gene polymorphism of ALDH2 and APOE, reported the risk factor of Alzheimer's disease, in korean dementia patients. Method : 59 Patients(male:19, female:40) with dementia, aged 65 and older in Buyeo geriatric hospital located in Buyeo-gun, chungnam, were finally included in this study. gene polymorphism of ALDH2 and APOE was typed with polymerase chain reaction in patients with Alzheimer's desease and vascular or mixed dementia. Results : 1) There was no difference in allelic frequency of ALDH2 gene polymorphism between patients with Alzheimer's disease and vascular or mixed dementia. 2) There was no difference in allelic frequency of APOE gene polymorphism between patients with Alzheimer's disease and vascular or mixed dementia. 3) Supposing APOE*ε4 and ALDH2*2 were equal risk allele of Alzheimer's disease, the sum of score by counting each risk allele was higher in patients with Alzheimer's disease than vascular mixed dementia, however there was no significant difference. Conclusion : The genotype frequency of ALDH2*(-/2) and APOE*(-/ε4) was higher in patients with Alsheimer's disease than vascular or mixed dementia, however there was no significant difference in allelic frequency of gene polymorphism of ALDH2 and APOE between patients with Alzheimer's disease and vascular or mixed dementia.

Cadmium에 대한 Metallothionein 및 Free Radical Scavenger에 관한 최근의 연구 동향

김영숙,유대식 동아시아식생활학회 2001 동아시아식생활학회지 Vol.11 No.1

Since the Industrial Revolution, people have enjoyed an abundant life, owing to the technological innovations of science. However, because of changes in the environment or polution to the environment, it has brought on many chronic diseases. Especially, even though it may be a small amount, if cadmium gets into a human body, because its biological half life is long, it fatally causes a kidney disease and damage to human organisms. It was reported that Metallothioneins(MT), a substance that is closely related with a free radical that comes from environmental pollution and the course of which cadmium, which causes chronic addiction in the body, is formed, along with harmful metals, make the toxicity reduce. MT compound led into the body by cadmium indirectly functions as an antioxidation, supplied adequate amount of vitamin E. and suppresses the accumulation of cadmium in heart, liver and blood. Cadmium content found in Korean soil according to the test conducted from 1992 to 1996 was 0.02~0,03㎎/㎏ in cereals, pulses, and potatoes. Free radical scavenger, finding solution for metal substance that comes from environmental pollution from food and natural substances implicates a better future for the study of food science.

비혈연간 동종골수이식에 의해 치료된 중증 재생불량성빈혈 1예

김현중,이홍기,이방훈,이창근,이종태,정현식,김원석,윤성수,강원기,박근칠,김대식,고영혜,박찬형 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

비혈연간 동종골수이식은 혈연간 동종골수이식이 불가능한 환자에서 기존의 면역역제요법으로 효과가 없었던 경우나 재발한 경우에 적응증이 될수 있다. 이식 거부와 이식편대숙주병의 발생이 골수 이식의 성공률을 감소시키므로, 보다 강력한 conditioning regimen의 사용과 T cell이 제거된 골수를 사용하는 것이 필요하다. 기존의 high dose corticosteroid나 cyclosporine에 대하여 불응성인 이식편대숙주병의 치료를 위해서 ATG와 Mycophenolate mofetil (Cellcept®) 의 사용이나 Tacrolimus, Methotrexate와 같은 다른 면역억제제치료를 고려해 볼 수 있다. It is known that allogenic bone marrow transplantation is the most effective treatment for aplastic anemia. However, this treatment is only applicable to a minority of patients because the proportion of patients who have HLA-matched siblings about 25% to 30% of all the aplastic anemia patients. In the case of the absence of HLA-matched donor, unrelated allogenic bone marrow transplantation is considered. However, (because of severe acute and chronic GVHD and graft failure) the success rate of this approach is only 20~30%. Recently, it was reported that increased immunosuppressive condition combined with T cell depletion of the marrow graft would result in greater success. There was no case of successfully treated aplastic anemia patient by unrelated allogenic bone marrow transplantation in Korea. Here, we report a case of severe aplastic anemia successfully treated with unrelated allogenic bone marrow transplantation.

치료저항 만성 정신분열증 환자에서 Clozapine과 Haloperidol의 치료효과에 대한 비교

이홍식,김찬형,이희상,남궁기,송동호,이영문,한은선 大韓臨床藥理學會 1993 臨床藥理學會誌 Vol.1 No.2

對稱 二重 板狀 表面龜裂의 相互干涉에 對한 硏究

崔鎔湜,梁源鎬,金永鎭,金在元 成均館大學校 科學技術硏究所 1988 論文集 Vol.39 No.2

In this paper, the authors experimentally investigated interaction effects of twin surface cracks on crack growth rate in the process of fatigue fracture. Because of convenience of measuring crack length toward the thickness direction, transparent PMMA plate specimens with twin circular arc type notches were used for the experiments. Fatigue tests were performed on the specimens with crack aspect ratio b/a=0.267 varying the width and thickness of the specimen. From the test results, the interaction effects of twin surface cracks on fatigue crack growth rate were evaluated, and crack growing aspects during fatigue crack growth process were examined as well. The followings were obtained fromm the experimental analyses. Regardless of the specimen thickness, it was found that the crack growth rate around the surface crack tip increased in the region of crack distance ratio λ{=(a + a*) /e} ≥ 1.0 according to the interaction effect of the twin surface cracks. The magnitude of the fatigue crack growth rate became larger in the following order; (1) the internal crack-tip points, (2) the deepest points of the crack-tip, and (3) the external crack-tip points. During the fatigue process, the varying crack aspect ratios (b/a) of colinear surface cracks appeared to be smaller than those of the single surface crack.

複數表面龜裂의 疲勞成長壽命豫測

崔鎔湜,金永鎭,李鎭鎬 成均館大學校 科學技術硏究所 1991 論文集 Vol.42 No.1

The objective of this paper is to develop a computational model and a software for predicting fatigue growth life of collinear multiple surface cracks under constant amplitude loadings and variable amplitude loadings. After examining crack growth rate data for CT specimens and surface crack specimens, empirical equations for surface crack geometry are proposed to predict the crack growth rate. In order to verify the proposed algorithm, a life prediction program has been developed. Several case studies were performed to check the accuracy of the proposed model and to verify the usefulness of the developed program. A good agreement was observed between the numerical results based on the proposed model and the published experimental data.

흰쥐에서 출혈량에 따른 비장세포 증식력과 말초임파구 아형의 변화

이한식,정성필,김욱진,조영순,장석준 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Hemorrhage itself has been shown to produce abnormalities in immunity, particularly depression of the lymphocyte function. In order to better examine the amount of hemorrhage required to suppress the lymphocyte function, we determined the effect of graded fixed-volume hemorrhage on splenocyte proliferation and the lymphocyte subpopulation. Methods: Male Sprague-Dawley rats(weight,350∼400 g) were anesthetized, subjected to hemorrhages of 7.5 ㎖/㎏, 15 ㎖/㎏, and 22.5 ㎖/㎏ by percutaneous cardiac puncture with ㎖/㎏ needles, After 1, 2, 4, and 7 days, animals were killed to obtain the blood and spleen. The splenocyte proliferative capacity was measured by using the tritiated thymidine incorporation technique, and the peripheral lymphocyte subpopulation was determined using flow cytometry with the following monoclonal antibodies: T cell(CD3+), T helper cell(CD4+),7 cytotoxic cell(CD8+), and B cell(CD45RA+). Results: Hemorrhage of 7.5 ㎖/㎏ did not induce depression of splenocyte proliferation. However, for hemorrhage greater than 15 ㎖/㎏, the splenocyte proliferative capacity was significantly depressed at 2 days after hemorrhage and recovered at 4 days. Hemorrhage induced no changes in the relative percentage of lymphocyte subpopulations and in the number of each cell in peripheral blood. Conclusion: This study suggests that cellular immunity is depressed at 48 hrs after a hemorrhage greater than 15 ㎖/㎏ without any change in the peripheral lymphocyte subpopulation.

彈塑性破壞靭性値 J_IC 決定에 관한 硏究(Ⅳ)

崔鎔湜,梁源鎬,金永鎭,石昌星 成均館大學校 科學技術硏究所 1990 論文集 Vol.41 No.1

The objectives of this study are to determine whether the J_lC approach could be used to evaluate the ductile to brittle temperature performance of A516 Gr70 steel and to evaluate the J_lC value as a function of temperature. Fracture toughness J_lC and K_iC tests were performed on A516 Gr70 carbon steel plate and test results were analyzed according to ASTM E 813 and ASTM E 399 at temperatures ranging from -160℃ to room temperature (20℃). It may be recognized in this study that the temperature ranging from -15 to 20℃ is the upper shelf region of ductile-brittle transition temperature. In this temperature range, the elastic plastic fracture toughness J_lC values decreased with increasing temperature, however, it was insignificant. The transition temperature may be -30℃. In the transition region near -30℃, the tendency of J_lC decrease with decreasing temperature was significant. At temperatures ranging from -160℃ to -50℃, the relation between the J_lC value and the test temperature was obtained.

CT型 多段 變厚部在內의 Mode I 龜裂에 대한 龜裂成長擧動 硏究

崔鎔湜,梁源鎬,金永鎭,朴鍾桂 成均館大學校 科學技術硏究所 1992 論文集 Vol.43 No.1

A plate with multi-step varying thickness is widely used in a variety of machine components. In order to provide design data required for damage tolerant design for such components, fracture mechanics analysis was performed. Compact tension specimens with thin-to-thick geometry were used for analysis models. Three-dimensional finite element analysis was performed, and stress intensity factor was obtained by crack opening displacement extrapolation method. Analysis parameters were λ (dimensionless crack length), β(thickness ratio) and ω(width ratio). Dimensionless correction factor F values decreased rapidly as λ approached 1(thickness interface). And effect of front step was more pronounced than that of rear step.