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.

대학생 흡연자의 금연경험에 따른 건강신념차이

구정일,김민정,김동희,백정희,안현실,은가희,우혜령,이명희,이수현,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

It has been generally known that smoking is one of the worst factor increasing disease and mortality in human health since in 1950's and nowadays. But regardless of various proofs about social or economical problems due to smoking, current smoking rate has not been decreased in our country. Until now, most of tobacco use and its addiction researches have been focused on the adolescent or adult women smokers not on the university students. Therefore, the purpose of this study was to investigate smoking cessation of university smokers and analyze the health belief-perceived sensitivity, severity, benefits and barriers- difference, then to provide basic data for effective smoking cessation strategy for university smokers. The subjects were comprised of 181 university smokers from 15 universities in Seoul. The data were collected by structured questionaires. The questionaires were designed to measure general characteristics, smoking cessation and health belief, based on Ahn(2003)'s result on the Study of Smoking attitude, Behavior and Smoking Cessation of Adult Male and Lee(1987)'s result on Relationships Between the Health Belief Model and Smoking Habits. The data were collected from May 5 to 16. The collected data were analyzed by SPSS program. The actual number, percentiles, means, standard deviation, t-test and ANOVA were done. The result of this study were as follows; 1. The general characteristics of the subjects of this study The range of age was from 18 to 34 and the averaging age was 23. The subjects of this study were 141 males and 40 females. The religions were Christianity 25.4%(46), Buddhism 12.7%(23), Catholic 23.2%(42), no religion 37.0%(67). The residential forms were living with family 59.1%(107), cooking food for oneself 28.7%(52), dormitory 5.0%(9), boarding house 1.7%(3). Smoking starting age were university 43.1 %(78), high school 29.8%(54), middle school 14.9%(27), in the army 6.1 %(11), elementary school 1.1 %(2). 2. The smoking cessation of the subjects 80% of current smokers showed quitting smoking decision and 20% have not tried. The frequency of quitting smoking decision were from 1 to above 8 and mean was 3.06. As for smoking cessation plan, 54.7%(99) current smokers answered yes, 3.9%(7) said no, 35.4%(64) had no idea and 6.1 %(11) didn't answer. As for the reason of never quitting smoking decision, 71.42%(25 among total 35) have no need to quit smoking and the others said difficulty of smoking cessation. As for the main reason of smoking cessation decision, 54.7%(99) answered for the health, 7.2%(13) family advice, 15.5%(28) girl/boy friend's advice, 1.7%(3) to save money. As for the reason to fail smoking cessation, 56.7%(68) were will-lack, 17.5%(21) stress, 15%(18) smoking mood, 10%(12) withdrawl symptom. As for the smoking cessation method, 85.0%(125) were oneself-will, 2.7%(4) way acquired by mass-media, 2%(3) doctor's prescription, 2%(3) religion's help, 0.7%(1) smoking cessation school. As for the difficulty in smoking cessation, 42.2%(62) were drinking meeting, 23.1 %(34) no alternative of stress release, 12.2%(18) withdrawl symptom, 11.6%(17) having nothing to do, 7.5%(11) friend's encouragement. As for the most difficult cigarette to quit, 67.8%(99) were all-day smoking except the first smoking in the morning, 32.2%(47) the first smoking in the morning. 3. Health belief as for general characteristics Gender - The total point in benefits showed higher in male(28.5177) than female(26.6750). There was significant difference(t=.778, p<.05). The total point in health belief showed higher in male (105.8298) than female(l00.5000). So there was significant difference(t=.345, p<.05). Age - There was significant difference in benefits between age(10's-25.83, 20's-28.39, 30's-32.00)(F=3.73, p<.05). Smoking starting age - There was significant difference in total point of sensitivity and health belief(sensitivity F=4.00, p<.Ol, health belief F=2.843, p<.05). As for sensitivity, subjects who started smoking in the army showed the highest(33.36) and ones in high school showed the lowest(26.96). The total point in health belief showed the highest in elementary school(l19.00) and the lowest in high school(100.98). 4. Health belief as for smoking cessation There was significant difference in health belief as for smoking cessation(t=0.189, p=0.OO2). Sensitivity point showed higher in smoking quitting trial smokers(29.2) than non-trial smoker (26.9). Severity point showed higher in trial smokers (30.7) than non-trial smokers(28.9). Benefit point showed higher in trial smokers(28.6) than non-trial smokers(26.2). There was no significant difference in barriers point.

만성 심부전환자의 혈액에서 측정한 Tumor necrosis factor-α 및 Interleukin-6의 임상적 의의

김명구,김성구,박상호,한대희,강진환,변정득,심규혁,최병조,방덕원,온영근,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and objectives: Many conditions are responsible for the pathophysiology and progressive mechanisms of congestive heart failure. More recently, it has also become evidence that another class of biologycally activated molecules generically reffered to as cytokine these are also over expressed in congestive heart failure. Therefore, the purpose of this study was to measure concentrations of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) in mild to severe symptoms of heart failure and compare their values with those found in normal control and analysed correlation relationship between cytokine level, clinical findings and hemodynamic indicies. Subjects and Methodology: Levels of TNF-α and IL-6 were measured on pulmonary artery during cardiac catheterization in heart failure patients(n=32) and normal subjects(n=8) as well as physical examination and echocardiogram. Cytokines assay were performed on plasma using commercially available ELISA(Enazyme-Linked Immunosorbent Assay) kits. Results: Although the levels of TNF-α and IL-6 tend to increase in congestive heart failure group, the cytokines level was not made significantly statistical difference between congestive heart failure group and controls. When analyzing the correlation between the levels of PCWP(pulmonary capillary wedge pressure) and cytokines(TNF-α, IL-6), respectively, there were statistically significant correlation coefficient 0.32,(p<0.05), 0.39(p<0.01). The cytokine IL-6 and pressure of pulmonary artery were significant correlation.(correlation coefficient 0.36, p<0.02) More significantly, there was correlated with TNF-α and IL-6.(correlation coefficient 0.57, p<0.001) Conclusions: There was tended toward high concentration of TNF-α & IL-6 in congestive heart failure and significant difference for PCWP between TNF-α & IL-6, thus may be correlated with development and progression in congestive heart failure.

광선각화증, 각화극세포종과 Bowen's병에서 p53과 p21의 표출 양상

조명구,조현득,양승하,김의한 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background The function of the p53 protein was known to regulate cell proliferation by inhibiting cells entering Sphase. So DNA damaged cell proliferation was inhibited by apoptosis. P21 is a cyclin dependent kinase inhibitor induced by wild type p53, not mutant p53. Thus p21 is thought go mediate the signal of p53 induced by DNA damaged agents to arrest the cell cycle in G1 phase. p53 and p21 were expressed in many malignant tumors, and its role in oncogenesis, tumor progression and prognosis were important. The authors analyzed immunohistochemical expression of mutant p53 and p21 protein in some skin tumors. Method Thirteen cases of actinic keratosis, 7 cases of keratoacanthoma and 8 cases of Bowen's disease were immunohistochemically stained with p53 and p21 monoclonal antibodies. Results; 1. In cases of positive p53 protein and negative p21 protein, the expressed p53 protein was suggested as mutant form. 2. Positive expression of p53 protein and p21 protein in prickle cell layer of actinic keratosis and Bowen's disease was suggesded that the composing cells of prickle cell layer were transformed into the proliferated cell. The p21 protein expression was suggested to be induced by the p53 independent pathway. 3. Negative expression of p53 protein and p21 protein in prickle cell layer of keratoacanthoma was suggested that the composing cells of prickle cell layer were completely mature cells, so the keratoacanthoma had good prognosis.

近代化 過程에 있어서의 福祉問題 : A Case Study in Korea

孫明子,朴慶九,金福圭 啓明大學校 社會科學硏究所 1986 한국사회과학연구 Vol.4 No.-

데이터 마이닝에서 교사학습에 의한 속성 가중치 최적화

강명구,김명원 崇實大學校 2000 論文集 Vol.30 No.1

Custering and dassification are important methods of dada mining which is raw widely applied to various problem. However, feature weighting and feature selection are important in those methods because features may differ in importance and such differences need to be considered in data mining, otherwise the data mining results may not be useful or sometimes it can be harmful. In addition using the whole set of features will slow down the data mining process significantly. Recently, attempts have been made to investigate methods of feature weighting and feature selection. Algorithms have been proposed to determine the significance of features simply based on the relationship between data without consideration of user's intention. In such a case the user is left uncertain of the reliability of the result. In this thesis, we propose a semi-supervised learning method for determining feature weights. In our method feature weights are determined in such a way that a certain user-intended classification performance is optimized. The user selects a set of training data each of which is associated with its cluster or class as the user intends. Given the training data feature weights are iteratively updated using genetic algorithm to optimize Cramer's V² function as a measure of classification performance. We have experimented our method with several benchmark data including the iris data, the wine data, the glass data, and an e-commerce data and the experimental results have shown that our method is promising.

진해지역 근대건축물에 관한 연구

조홍석,구명화,김정동 대한건축학회 2003 대한건축학회논문집 Vol.19 No.4

Jinhae would be a important city of military facilities for naval. Owing to the background of this times, Jinhae focused on military facilities has remained a lot of modern buildings such as government and public offices, stores, house buildings and it has merited the pursuit of learning about the formation of city in modern and the features of modern buildings. Consequently, this paper will be acquired to a first-data about modern buildings under the current situation of loss and transformation and studied to the speciality of the naval city by inquiring the process of formation in Jinhae, executing the literature analysis and the example investigation.

갑상선 초음파검진의 유용성

배오근,김재권,강명순,조영익,김임봉,신유진,임성규,서민호 한국건강관리협회 2000 건협 Report Vol.3 No.-

Sodium molybate가 납중독 랫드의 말초신경내 myo-inositol 인지질 대사 관련 효소에 미치는 영향

박성환,정명규,조해용,최창하,김명녀 대한위생학회 2001 대한환경위생공학회지 Vol.16 No.4

We have previously demonstrated that sodium molybdate(Mo) improved lead-intoxicated status by enhancing the metabolism of myo-inositol-related phospholipids in sciatic nerves isolated from rats. In this study, in order to address the reduction mechanism of Mo for lead toxicity, effects of Mo on cystidine-diglyceride transferase, phosphatidylinositol kinase, and phosphatidyl inositol-4-phosphate kinase, involved in myo-inositol metabolism of nerve, were investigated in vivo and in vitro. Mo significantly increased the activities of cystidinediglyceride transferase and phosphatidylinositol kinase in lead-intoxicated rat, and the pattern of increase was dose-dependent manner. However, Mo did not affect the activity of phosphatidylinositiol-4-phosphate kinase in normal and lead-intoxicated rats. We also found that Mo affected the activities of phopholipid metabolism-related enzymes not by the indirect manner such as activation of another metabolic pathway but by the direct manner. These results suggest that the improvement mechanism of Mo for lead-intoxicated status might be a normalization of the activities of phospholipid metabolism-related enzymes in sciatic nerve.

소아에서 발생한 골수이형성 증후군 2례

홍성진,윤석중,김성우,조형구,오명호,김기혁,이인성 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

Myelodysplastic syndrome(MDS) is a group of acquired conditions characterized by progressive bone marrow failure associated with normocellular or hypercellular bone marrow that cannot be attributed to nutritional deficiency, chronic infection, or other chronic systemic illness, and cannot be reversed by the successful treatment of those conditions. Whereas the cases of secondary MDS occur at all ages, primary MDS is essentially a disease of elderly, though no age group is exempt and predomonant in men. The MDS is fundamentally clonal disorders at the level of the haemopoietic totipotent stem cell. Clinically, they are characterized by varing degrees of peripheral cytopenia(s) with morphological and functional abnormalities of blood elements. We have experienced two unrelated pediatric cases, who showed pancytopenia on admission and the characteristic marrow findings of MDS. The first case, a 12 months-old girl, showed increased reticulin with abnormal localization of immature precursor cells(ALIP) in her bone marrow, in addition to dysplastic features such as bi-and multi-nucleation of late normoblasts and internuclear bridging. She also showed 22% of blasts in her bone marrow cells thus classified in the category of RAEB-t after FAB classification. Also found were a chromosomal abnormality namely 46 XX t(14q21q), which was an unusual one. Her family brought her home and, 4 month later, she deceased. The second case, a 12 year-old boy, showed pancytopenia with Pseudo-Pelger-Huet anomaly in neutrophils but no blasts in the peripheral blood. Bone marrow of this case also showed the picture of dyserythropoiesis with binuclearity, internuclear bridging, nuclear fragments, multinuclearity of late normoblasts, in addition to megaloblastoid change in the normoblasts and increased mitosis in granulocytic series. No chromosomal abnormality was found. Classified as RA after FAB classification of MDS. Showed good response to conservative management for anemia for more than one year.