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.

금식시 흰쥐 소장 점막 유당분해효소에 대한 갑상선 호르몬의 영향 및 이의 유전적 조절 기전

이국래,이동호,이한주,윤정환,김재규,정운태,정현채,송인성,김정룡 大韓消化器病學會 1996 大韓消化器病學會誌 Vol.28 No.6

새로운 연노출의 효과지표로서의 혈장 δ-aminolevulinic acid 측정의 유용성

이금원,황보영,김용배,리갑수,이성수,장봉기,함정오,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

To evaluate the usefulness of the measurement of plasma δ - aminolevulinic acid (ALAP) as a new effect indicator of lead exposure, the association of ALAP with blood lead, DMSA chelatable lead and bone lead with a special emphasis of genetic interaction of ALAD polymorphism was studied with 419 lead exposed workers and 85 non-lead exposed workers. Lead workers were recruited from storage battery industries, secondary smelting industries and other lead using industries and non-lead workers selected from electronic refrigerator manufacturing industry. Blood lead, DMSA chelatable lead and bone lead were chosen for parameters of lead exposure. Plasma and urinary ALA were selected for the effect parameter of lead intoxication. Information for age, smoking, drinking habit and body mass index were also obtained. Job duration for lead workers was also collected. The overall prevalence of the variant allele, ALAD type 1-2 or 2-2(ALAD2) in lead exposed workers was 10.0% (42 out of 419 lead workers) which was not differed from control workers (9.4% : 8 out of 85). The means blood lead and DMSA chelatable lead of lead workers with ALAD 1(ALAD type 1-1) were lower than those of lead workers with ALAD2, but the differences were not statistically significant. On the other hand, the mean of tibia lead of lead workers with ALADI was higher than that of lead workers with ALAD2, but the difference was not statistically significant. DMSA chelatable lead showed highest correlation with log transformed plasma ALA(LALAP)(r=0.682) and blood lead and tibia lead had r=0.650, r=0,402 correlation coefficient with LALAP respectively On the other hand. log transformed urinary ALA(LALAU) had lower correlation coefficient with all three parameters of lead exposure than LALAP. The equation of robustic simple linear regression of blood lead on LALAP was LALAP=2.0439+0.0165PbB in ALADI lead workers and LALAP=2.031+0.0121PbB in ALAD2 lead workers. ALAD genotype in the multiple regression analysis of blood lead with LALAP after adjusting for possible confounders(sex, ago, BMI, smoking and drinking status and job duration) showed significant main effect on LALAP resulting lower LALAP in ALAD2 lead workers than ALADI lead workers. On the other hand, effect modification of ALAD genotype was observed in the multiple regression analysis of tibia lead with LALAP after adjusting for possible confounders, but there was no significant effect of ALAD genotype in the multiple regression analysis of DMSA chelatable lead with LALAP after covariate adjustment. With above results, plasma ALA was found to be a useful effect parameter of lead exposure compared with urinary ALA. It was also observed that ALAD polymorphism made significant effect on the association of blood and tibia lead with ALAP. Thc lower plasma ALA in ALAD2 lead workers suggested supportive effect of ALAD2 in lead exposure.

전자부품 제조업 근로자들의 시력변화에 대한 연구

이용만,안규동,이성수,함정오,김화성,리갑수,이병국 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

근접작업이 시력약화의 원인이 될 수 있는가를 알아보기 위하여 전자부품을 제조하는 2개 사업장에서 1991년에서 1993년까지 입사한 근로자들 중에서 근접작업으로 인정되는 마이크로칩을 조립하는 근접작업자 306명을 조사군으로, 대조군은 세탁기 타이머 및 일반 기계기구를 조립하는 작업자 154명, 계 460명을 선정하였다. 이들 대상자는 1991년 입사자는 1993, 1994, 1995년 시력을 조사하였으며, 1992년 입사자는 1993, 1994, 1995년 3년동안 조사를 하였으며, 1993년 입사자는 1994, 1995년 2년간 시력을 조사하였다. 대상자 중에서 입사시 안경을 착용한 근로자는 82명(17.8%)이었다. 따라서 남자 근로자와 안경착용자를 제외한 여성 근로자들 335명만을 추적 조사하여 다음과 같은 결론을 얻었다. 조사군에서 입사시 시력 1.0 이상이었던 근로자의 분포는 취업 1년 후 약 25-35% 정도 감소하였으며, 2년후에는 약 40-60% 정도의 감소를 나타내었고, 3년 후 약 50-65% 정도로 감소하였고 4년후에는 약 65% 이상 감소하였다. 그러나 대조군에서는 1.0 이상의 시력을 보였던 근로자들의 비율이 취업 1년 또는 2년 후 15-30%의 감소를 보이고 있으나 그 이후에는 큰 변동이 없었다. 이들의 시력변화를 근무년수에 따라 알아보기 위하여 조사된 시력을 순위변수로 하여 Kruskall-Wallis 검정을 시행한 결과 조사군, 대조군 모두에서 근속년수에 따른 순위의 합의 평균이 년차적으로 유의하게 감소하였으나, 입사시부터 근속년수에 따른 조사군과 대조군과의 순위합의 평균에 의한 시력차 비교에서 입사시 조사군의 순위합의 평균이 유의하게 높았던 것이 근무기간에 따라 대조군의 평균이 높아지면서 통계적 유의성이 없고 대체적으로 1년 이후부터 변화가 적은 것으로 나타나 근접작업으로 인한 시력약화를 추정할 수 있었다. This study was carried out to investigate that the close distance works were associated with decreased visual acuity. 306 workers were subjects who had been recruited from 1991 to 1993 in two electronic parts manufacturing factories, and 154 workers were controls who had been employed from 1991 to 1993 in launder machine timer and general machine assembly factories. Subjects who had been employed in 1991 and 1992 were follow up from 1993 to 1995, and subjects who had been employed in 1993 were from 1994 to 1995. The male workers as well as glasses wearing workers were excluded. Only 335 female workers were followed up to study the change of visual acuity. The results were as follows; The rate of workers with visual acuity over 1.0 at recruit year in subjects group was decreased about 25-35% after 1 year, 40-60% after 2 years, 50-65% after 3 years, and 65% after 4 years. While, the rate of workers with visual acuity over 1.0 at recruit year in control group was decreased about 15-30% after 1 or 2 years, and there was no more additional visual acuity reduction after then. Kruskall-Wallis test was performed to investigate the change of visual acuity in subject and control group by work duration. The means scores of ranks in both group were significantly decreased by work duration. The mean scores of ranks in subject group at recruit year were significantly higher than those in control group at recruit year, but these differences were disappeared after 1 year work. Therefore, this suggest that close distance workers may be affected their visual acuity.

리스페리돈과 올란자핀이 투여된 정신과 환자들에서 간 효소 변화에 대한 후?적 연구

임현국,배치운,박석준,김정진,이창욱,이수정,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

大田 3大 河川의 自然河岸과 人工河岸의 植物相과 植物群落의 比較

이정하,조국연,김성덕,이남주 忠南大學校 環境問題硏究所 1998 環境硏究 Vol.16 No.-

The phytosociological investigation was carried out at natural and artificial streamsides over 3 main streams located in Taejeon, by Braun- Blanquet's method for the comparative study of the flora and vegetation from May to October, 1998. On the natural streamside, total number of vascular plant species were 142 species and hydrophyte of them was 27 species, while on the artificial streamside the former species number was 138 species and hydrophyte was 21 ones. The plant communities in the natural streamside were classified into 17 groups, such as Zizania latifolia community, Typha orientalis community, Phragmites communis community, Phragmites japonica community, Miscanthus sacehariflorus-Hemarthria sibirica community, Leersia japonica community, Trapa japonica-Trapa pseudo-incisa community, Marsilea quadrifolia community, Hydrilla verticillata-Myriophyllum verticillatum community, Vallisneria asiatica-Potamogeton malaianus var. latifolius community, Myriophyllum verticillatum community, Spirodela polyrhiza- Lemna paucicostata community, Salix glandulosa-Salix koreensis community, Salix gracilistyla community, Salix koreensis community, Phalaris arundinacea community, Persicaria hydropiper community. On the other hand, the plant community in the artificial streamside was classified into 14 communities, such as Zizania latifolia community, Typha orientalis community, Miscanthus sacchariflorus - Hemarthria sibirica community, Phragmites japonica community, Leersia japonica community, Hydrilla verticillata-Myriophyllum verticillatum community, Vallisneria asiatica- Potamogeton malaianus community, Paspalum distichum community, Phalaris arundinacea community, Persicaria hydropiper community, Zoysia japonica-Digitaria sanguinalis community, Panicum dichotomiflorum-Persicaia lapathifolia community, Echinochloa crusgalli- Setaria viridis community, Artemisia princeps community, Rumex crispus- Rorippa islandica community, Portulaca oleracea community, Potentilla paradoxa community, Panicum dichtomiflorum community. Number of species and plant communities were variously distributed over the various sites in the natural streamside, it is more than in the artificial streamside was distributed. These results mean that the distribution of plant community and number of species in the wild plant were more closely to be related to the human impacts or one's disturbance.

C++를 이용한 통신 시뮬레이터의 설계 및 구현

이광휘,정상국,안정희,김한경,이종근 國立 昌原大學校 精報通信硏究所 1998 精報通信論文集 Vol.2 No.-

In this paper, we are designed and implemented communication simulator, for two systems which communicates in peer-to-peer and simulating for protocol, to verify the interwork not yet designed system Peerl and now being operated Peer2. To begin with, after the investigation in Interworking Standard in Interface Control Document and check the satisfied requirements in each system, the environment of simulator is set up. We examine Interworking Standard in FSM representation. And in protocol design, partial steps follows necessary procedure of protocol engineering. Simulator is implemented in C++ and, to interwork two systems smoothly, the whole system will be merged. Finally, a design and implementation of simulator is completed by confirming simulation results of simulator and Interworking Standard coincide.

중량물 운반시 잡기유형에 따른 근전도 분석

이훈식,강영택,윤양진,정미라,유국종,서국웅,김정태 釜山大學校 附設 體育科學硏究所 1999 體育科學硏究所 論文集 Vol.15 No.-

The purpose of this study was to examine EMG changes of the body according to method the holding during carrying object. The experiments were conducted with utilizing EMG analyses for five male and five female adults as subjects. The results were as followed. 1. The higher muscle action potential of vertical holding was shown than that of right holding when carrying objects in MMH work in proportion to the weight of the object. The came from the subjects using their brachial muscles much to maintain the angles of their wrist joints and elbow joints for keeping their stable postures while walking. 2. The higher muscle action potential of right holding was shown in right and left elector-muscles of their spines(L1-L2, L4-L5) while carrying in all stages of weights except 25kg objects than that of vertical holding. These results were caused from more use of brachial muscles than elector-muscles of spines in carrying weight objects. So vertical holding is more effective in carrying weight objects at a short distance than right holding.

여성 연폭로 근로자들의 연폭로 지표와 자각증상에 관한 연구

이금원,임정규,안규동,이병국 순천향대학교 1994 논문집 Vol.17 No.2

The effect of lead on subjective symptoms of lead exposure was studied with 396 women lead workers in 6 storage battery factories as an exposed group to lead and 166 women workers in general manufacturing industries as a non-exposed group to lead. Zinc protoporphyrin in whole blood(ZPP) was selected as an indicator of lead exposure. SGOT and SGPT were also checked to observe the lead effect on liver function of lead workers. Questionnaires of 15 lead related symptoms were provided to all women workers and filled up by themselves and reconfirmed the symptoms answers by interviewing medical doctor. There was significant mean difference of blood ZPP between exposed group (90.0 ± 86.2 ug/dl) and non-exposed group (33.8 ± 29.9 ug/dl), but there was no differences of means of SGOT and SGPT between exposed and non-exposed group to lead. After age stratification, the symptom prevalences of exposed group were higher than non-exposed group in most cases. This trend was strong in the comparison of symptom prevalence of women worekrs whose ages were under 30 years. The symptom prevalence of women workers who worked in medium sized factories was higher than that of women workers working in small sized factories. While the symptom prevalence of all workers was not dose-dependent to ZPP increase in most symptoms category, there was weak trend of dose-respnse relationship of symptom prevalence with ZPP increase in women workers working in medium sized factories, but not statistically significant.