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.

성상세포종의 MIB-1, AgNORs 및 PCNA 발현에 대한 비교연구

최양문,김태영,김종문,윤기중,문형배 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.4

아리스톨로크산 함유 생약제에 대한 안전성평가연구 : 3개월간 반복투여독성시험을 통한 신장독성평가

황명실,박미선,문지영,이지선,염영나,이효민,신동환,강진석,윤은경,최미나,육미영,장동덕,길광섭,김승희,양기화 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

본 실험에서는 아리스톨로크산을 함운하고 있는 생약제중 하나인 마두령(.4risfoforfioe JTurruf)의 90일 반복투여독성시헌을 실f,」하였다. 마두령에서 아리스톨로크산을 정량분석한 결과 마두령 단일 건조븐말의 경운 2.112mg/g, 잉상에서 처방되고 있는 마든령복방 (마두령외 9가지 생약제 복합처방) 건조분말꼭 경무에는 0.066m9/5으로 각각 검출되었다. 본 실험에서 용량설정은 마두령 처리군 (저용량 군; 21.3m9/k9/day (임상용량), 중용량군; 2t3mgfg/day, 고용량군; 2430mg딘g b.w./day), 마두령복방 처리군 (427mg/kg b.w./da?; 임상용량) 및 positive control (아리스톨로크산) 처리군 (저용량군;0.05mgag/da17, 중용량군; 0.Smg/kg/day, 고용량군; 5mg./kg/dal·1으료 하여 랫드에게 경구투여하였다. 마두령단방 처궈근 및 마두령복방 처리군에서 저용량군과 중응량군에서는 잉상관찰 및 생화학적 분석에서 패조군과 유의적인 차이가 없었다. 그러나 마두령단방 고용량근에서는 간, 신장의 상대적인 무계가 증가되었고, 신장의 유두이행상피증식 및 암종이 관찰되었으며, 위에서는 편평세포암종이 관찰되었다. 하자만 간손상이나 간암은 유발하지는 않는 것으로 판단되었다. 결론끌으로 본 실험의 결과에서는 아리스톨로크산 함유 생약제인 마두령이 임상용량인 저응량 처리군에서는 독성을 나타내지 않았으나, 고용쏭으로 장기 복용시켰을 깅우 설치류의 전위부위 및 신장에서 독성이 있음을 알 수 있었다. Chines herbs nephropathy (CHN) has been described in young women who had taken a slimming pills containing some chines herbs. Aristolochic acid (AA), suspected substance as the causal factor of CHN, is known a carcinogen. The Aristolochiae fructus (fruit of Aristolochia contorta) was used in Korean Traditional Medicine consists of appropriate amounts of mixed natural products. Subchronic toxicity of A. furctus containing aristolochic acid was investigated in SD rats. The body weight and clinical signs were observed after orally administration of A. futctus at doses of 21.2, 213, and 2130 mg/kg/day; mixture (including 9 other herbs) at dose of 427 mg/kg/day; aristolochic aicd (Ⅰ+Ⅱ) at doses of 0.05, 0.5, and 5 mg/kg/day for 3 months. At the end of the treatment, high dose treated animals revealed a deficit in final body weight about 25% compared with that of control. Organ weights of kidney, liver, testis, or ovary were increased with dose dependent manner. No changes considered to be due to the administration of A. furctus, mixture or aristolochic acid were in hematological and clinical study. However, significant changes at histopathological study of kidney and stomach were boserved in high-dose treated groups. In conclusion, for human health safety it needs appropriate regulatory actions regarding the use of natural herbal medicines known or suspected of containing aristolochic acid.

이차 전기영동을 이용한 프로테오믹 접근을 통한 정맥 압박이 혈장 프로테옴에 미치는 영향

양광익,박선아,오형근,정두신,박형국,성기범,안무영,홍세용 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

The human proteomics-based approaches, which examine the expressed proteins of a tissue or cell type, are increasingly being used. Venous occlusion is commonly employed for stimulating tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) release from venous endothelial cells, and this has been regarded as a parameter of the individual fibrinolytic capacity of plasma. The present work involved a detailed investigation of the plasma proteome and fibrinolytic activity in normal subjects, with the aim of determining whether correlations exist between various parameters of the fibhnolytic system before and after venous occlusion. We analyzed fibhnolytic parameters and plasma proteome before and after 15-min periods of venous occlusion in the forearm in 10 healthy 3rd-decade volunteers. Proteome analysis was performed using two-dimensional gels. The tryptic digests of some proteins were confirmed by MALDI-TOF and the MS-Fit algorithm. The fibrinolytic response as measured by the absolute amount of t-PA after venous occlusion was increased by venous occlusion (5.5 vs 9.6 ng/㎗, p<0.05), as was PAI-l (46.8 vs 56.1 ng/㎗, p<0.05). However, two-dimensional electrophoresis finding was virtually nonspecific and inconsistent after venous occlusion in healthy male subjects. Venous occlusion does not influence plasma proteome in healthy males. Although the fibhnolytic response to venous occlusion is attributed to an increase in free tUPA antigen, this change is not correlated with plasma proteome.

급성충소돌기염의 임상 : 병리학적 고찰

양기화,조준필,하영천,한진우,정학재,손수창,이성희,황재훈,신철호 최신의학사 1989 最新醫學 Vol.32 No.4

환경기초시설의 연계 처리

양기섭,이찬원,권영택,김영진 경남대학교 환경문제연구소 1998 환경연구 Vol.21 No.-

This paper presents the optimal treatment procedure and rational of combined wastewater with municipal, night soil, and animal waste, considering influent organic concentration of combined wastewater, sewer line system, and operating efficiency. Results indicate that aerobic digestion of night soil is recommended before combining with wastewater rather than pretreatment of night soil, even though the oxidation ditch operates in an extended aeration mode with long detention and solids retention times. Much attentions should be paid to the corrosive effects of contaminants from animal waste and night soil on the following treatment facilities. It is also expected that discharge standards of nitrogen and phosphorus will be strictly enforced in near future.

본태성 고혈압이 동반된 당뇨병환자의 혈중 인슐린 농도

양동호,홍세용,성기범,안무영,윤신구,박형국,양광익,황주호,신현길 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

Multiple lines of evidence link elevated blood pressure with diabetes mellitus. Specifically, it has been proposed that resistance to insulin-stimulated glucose uptake and hyperinsulinemia may play a central role in the cause and clinical course of hypertension. In diabetes mellitus, insulin resistance and/or hyperinsulinemia is an common finding and it is interesting whether the hyperinsulinemia may play a signigicant role in hypertension with DM in the same way as in essential hypertension without diabetes mellitus. The object of this study was to compare insulin and c-peptide levels between age, sex, and obesity matched two groups(DM with DM without hypertension). Method The study group consisted of 55 male diabetes mellitus patients, aged between 45-55 (years). Patients with obesity (body mass index · 30 ㎏/m2), renal disease (proteinuria · 300 ㎎/24hr urine), and secondary hypertension were excluded. Insulin and c-peptide were measured in overnight fasting state and after oral administration of glucose(75 gm). In the fasting, venous plasma glucose levels were similar in the hypertensive and control group(132 ±7 ㎎/dl vs 135 ±8 ㎎/dl). In the fasting, venous plasma insulin levels were higher in the hypertensive than in the control group (10.9 ±5.3 μIU/ml vs 5.5 ±3.9 μIU/ml, p = 0.0001). After loading with 75 gm glucose, venous plasma insulin level seems to be higher in the hypertensive patients than in the control patients, but the difference was not signigicant statistically (27.2 ±17.5 μIU/ml vs 19.9 ±18.9 μIU/ml, p = 0.1297). The mean insulin concentration of the essential hypertensive patients with diabetes mellitus was twice that of the normotensive patients with diabetes mellitus. In control group, there was a direct relations between insulin level and c-peptide, in both fasting state (R = 0.617, p = 0.0001) and glucose-loaded state (R = 0.531, p = 0.001). But in hypertensive group, there was no relations between insulin level and c-peptide, in both fasting state (R = 0.257, p = 0.2738) and glucose-loaded state (R = 0.307, p = 0.1885).

악교정 수술후 자가통증조절장치(Patient-Controlled Analgesia)의 사용 효과에 관한 연구

양병은,유준영,송상훈,엄기훈 大韓顎顔面成形再建外科學會 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.4

The concept of PCA(Patient Controlled Analgesia) was first described in 1968, by Sechzer. The earliest descriptions of actual self-administered PCA machines were by Forrest et al. In gastric bypass surgery, cesarian section, orthopedic surgery etc, PCA is widely used in the control of postoperative pain. Previous Studies have shown that PCA provides effective pain-control for the postoperative patient. The postoperative pain-control is a problem that should be solved in surgery. Especially in orthognathic surgery, it is not same as in the case of maxillofacial trauma surgery or of tumor surgery : most orthognathic surgery patients are under operation not accustomed to pains, and difficulties in pain-complaint due to IMF(Intermaxillary fixation), postoperative nausea, and vomiting are additional problem. In this study, we have compared PCA and IM analgesics with respect not only to time request but also to the quality of postoperative pain control.

척수 경막에 발생한 Sarcoidosis

김영신,양기화,김병기,김선무 대한병리학회 1991 Journal of Pathology and Translational Medicine Vol.25 No.2

유연한 수리계획 작성을 위한 모형관리자의 설계 및 구현

양영철,장양자,김기동,박진우 한국경영과학회 2001 한국경영과학회 학술대회논문집 Vol.- No.1(2)

Recently, in the competitive environments, every company recognizes the importance of planning models. However, there are so many problems in correctly applying mathematical model to the real world. Because mathematical modeling packages, especially, charge planning managers with understanding the models and responsibility for generating plans, fast and accurate model cannot be generated with ease. In this paper, we design the system that helps planning managers flexibly create and modify mathematical models and manage model versions. Also, we implement this model management system with model base concept.