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.

위암의 연령에 따른 차이

김영재(Young Jae Kim),이영철(Young Chul Rhee),이만길(man Kill Lee),차호(Ho Cha),정영채(Young Chae Jung) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A Comparative analytic review on clinical, endoscopic and histopathological findings was done in 13 cases of young age (under 29), 446 cases of mid age (30~69) and 39 cases of old age (above 70) stomach cancer who were visited Department of Internal Medicine of Masan Koryo General Hospital from March 1981 to July 1985. The following results were obtained: The peak of age incidence was the 5th decade amounting to 36.8%. The ratio between male and female was 2.6:1. The main chief complaint of each group was epigastric pain and it was followed by epigastric fullness. The most patient had the duration of symptom from 3 months to 6 months. For old-age group, mid-age group, major site of lesion in the antrum, meanwhile body for young-age group. The most frequent type of gastric cancer was type III in each group by Borrmanns classification. For each group, adenocarcinoma was major cases in the view of histopathological findings, and incidence of well differentiated type adenocarcinoma were lower in young-age group than others.

형상기억복합재료에 대한 온라인 모니터링 시스템 개발

이동화,박영철,이민래,이동화,이규창 한국비파괴검사학회 2003 한국비파괴검사학회지 Vol.23 No.1

형상기억복합재료를 제조하기 위하여 핫프레스 방법을 이용하여 최적의 제조조건을 도출하였으며 냉간압연에 의해 기지재와 강화재의 계면접합을 강화하여 강도를 증가시켰다. 이러한 방법에 의해 제조된 형상기억복합재료에 대하여 외부 하중에 의한 손상정도와 균열의 발생을 감지하여 균열 발생 및 진전을 억제하는 온라인 모니터링 시스템을 개발하고자 한다. 이를 위하여 음향방출 신호의 파라미터를 이용하여 손상에 따른 최적의 AE 파라미터를 도출하였으며 가열시스템을 이용하여 형상기억합금을 가열함으로써 형상기억합금의 수축에 의한 복합재료 내부에 균열진전을 억제시키는 시스템을 개발하였다. A hot press method was use for the optimal manufacturing condition for a shape memory alloy(SMA) composite. The bonding between the matrix and the reinforcement within the SMA composite by the hot press mothod was strengthened by cold rolling. In this study, the objective was to develop an on-line monitoring system for the prevention of the crack initiation and propagation by shape memory effect of SMA composite. Shape memory effect was used to prevent the SMA composite from cracking. For the system to be developed, an optimal AE parameter should be determined based on the degree of damage and crack initiation. When the SMA composite was heated by the plate heater attached at the composite, the propagating cracks appeared to be controlled by the compressive force of SMA.

FET형 CO₂센서의 제조 및 감응특성

이은숙,이영철,정지영,윤종훈,김창수,손병기,이흥락 경북대학교 센서기술연구소 1995 센서技術學術大會論文集 Vol.6 No.1

A FET type micro CO_(2) sensor based on a Severinghaus type arrangement has been prepared and its response characteristics were examined. The sensor was fabricated by formation of hydrogel layer containing bicarbonate/chloride ions on the PH-ISFET and the Ag/AgCl reference electrode prepared by the thermal evaporation and chemical chloridation methods. And then gas-permeable membrane was dip-coated on the hydrogel layer of the sensor. Gas-permeable membranes were fabricated with silicon rubber and polyurethane dissolved in toluene and THF, respectively. The CO_(2) sensor with the silicon rubber membrane showed better sensitivity and lower detection limit than the CO_(2) sensor with the polyurethane membrane for dissolved CO_(2). The sensor with silicon rubber membrane at optimal conditions showed a good response: linear range of 1.60X10^(-4) ~ 4.40X10^(-2) M CO_(2), sensitivity of 57.30 mV/decade, and detection limit of 7.50x10^(-4) M.

범법정신장애자의 정신의학적 특성분석

이길홍,이재광,박두병,나철,기백석,이재우,유영식,이영식,이헌재 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.1

기종성 신우신염 1례

이재욱,구정태,서정일,양창헌,이정호,이동철,이영현,이활,이경섭 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

기종성 신우신염은 주로 당뇨병환자나 폐쇄성 요로질환을 가진 환자에 발생하며 특징적으로 신실질 및 그 주위조직에 가스를 형성하면서 심한 조직괴사를 일으키는 매우 드문 급성 화농성 신감염으로 사망률이 높은 질환이다. 이 질환은 1989년 Kelly와 MacCallum에 의해 처음 보고된 이래 외국문헌에 약 90례 정도가 보고되어 있으며 국내에는 28례가 보고되어 있다. 수액 및 전해질 보충, 인슐린 투여를 통한 적절한 혈당조절 및 항생제 투여등의 내과적 치료와 절개배농 및 신적출술등의 수술적 치료 방법이 있다. 내과적 치료로 가스의 감소가 없는 경우에는 즉각적인 수술적 치료를 시행하여야하므로 이 가스변화에 대한 추적관찰이 중요하다 하겠다. 본 저자들은 당뇨병환자에서 발생한 기종성 신우신염 1례를 내과적 요법을 치험하였기에 문헌고찰과 함께 보고하고자 한다. Emphysematous pyelonephritis is rare, life-threatening infection of the renal parenchyma and perirenal tisseue. This disease is characterized by the production of intrarenal and perirenal gas and is frequently encountered in patients with diabetes mellitus or urinary obstruction. We experienced a case of emphysematouse pyelonephritis in a 62 years old women with poorly controlled diabetes mellitus who had been managed with medical theraphy. So we report this case with a review of the referenced literatures.

의사소통과 언어중재 프로그램의 일반화 향상 방안

이영철 국립특수교육원 1996 특수교육연구 Vol.3 No.-

Generalizaion is an interative process between the children, his comunication and language skills, and totaly of the children's environment. This study was to review related articles and suggest relevant strategies that programming communication and language intervention to facilitate generalization. Milieu language intervention was reviewed as a communication and language intervention that effected to the developmental disabilities with relatively low receptive and expressive language levels(Yoder et al., 1995). Milieu language intervention executes in the natural environment, modeling, mand-modeling, time-delay, and incidental teaching methods are used only or combined by multiple settings and interventionists according to the children's different language levels. The common results of milieu language intervention were reported as follows; first, remakbly increased frequences of the utterance, second, increased language responses to the adults and peers, third, increased use of elaborate vocabulary and sentence, fourth, increased the MLU(mean length of utterance in morphemes), fifth, increased language generalization. The various generalization effects of milieu language intervention were reported across settings, across persons, and across settings and across persons. The results of generalization across settings were effected four studies(Carr and Kologinsky(1983), Charlop, Schriebman and Thilbodeau(1985), Charlop and Walsh(1986), Giumento (1990)) of five stuies, the results of generalization across persons were affirmative effected four studies(Carr and Kologinsky(1983), Halle et al.(1979), Hart and Risley(1975), Oliver and Halle(1982)). And the results of generalization across settings and across persons were effected five studies(Charlop et al.(1985), Halle et al.(1979), Lee, Young-chul(1995), Warren and Gazdag(1990), McGee, Krantz and McClannahan (1985)) of seven studies. Four aspects have to be considered in the development of an active communication and language intervention generalization program; first, programming multiple exemplars, second, programming loose training, third, programming common stimuli, fourth, programming natural maintaining consequences.

Fluoxetine이 Schedule-Induced Polydipsia가 유발된 백서 뇌에서 Tyrosine Hydroxylase 발현에 미치는 영향

이기철,이정호,최영민,정주호,정홍경,이용민,김도형,이대환 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: Fluoxetine은 serotonin을 매개하여 간접적으로 dopamine 신경전달기능을 억제한다고 추정되고 있다. 또한 운동장애에서 운동기능의 악화를 유발한다고 알려져 있다. 그러나 신경세포체에서 fluoxetine이 dopamine에 어떠한 영향을 주는지는 아직까지 확실치 않다. 저자들은 schedule-induced polydipsia를 유발시킨 백서 뇌의 흑질, 복부피개영역, 미상핵에서 tyrosine hydroxylase(TH) 발현이 저하됨을 발견하였다. 이를 통해서 fluoxetine이 백서 뇌의 dopamine 기능에 긍정적인지 혹은 부정적인지를 규명하고자 하였다. 방법: 4주간의 schedule-induced polydipsia 과정을 거친 백서에서 면역죄치화학적인 방법으로 흑질, 복부피개영역, 미상핵의 tyrosine hydroxylase 발현이 저하됨을 확인한 후, 실험동물들에게 fluoxetine 10mg/kg를 3주간 복강내 주사하였다. 실험백서들을 희생시켜 뇌 조직을 적출하여, TH 면역조직화학 염색법을 이용하여 흑질, 복부피개영역, 그리고 미상핵의 TH 면역반응세포를 관찰하고 이를 정상백서와 비교하였다. 결과: 1) 다갈증이 유발된 백서의 흑질, 복부피개영역, 미상핵에서 tyrosine hydroxylase 발현이 정상백서 보다 저하됨을 관찰하였다. 2) 3주간에 걸친 fluoxetine 투여후 흑질, 복부피개영역, 미상핵의 tyrosin hydroxylase 발현이 다시 증가하는 소견을 보였다. 결론: Fluoxetine 만성투여가 흑질, 복부피개영역 그리고 미상핵의 tyrosin hydroxylase를 증가시키는 소견을 얻었다. 이러한 결과는 임상에서 dopamine 결핍과 연관된 질환들에서 fluoxetine을 만성투여하면 운동기능을 포함한 증상들의 개선을 가져올 수도 있다고 추정된다. Objective: It has been suggested that fluoxetine inhibits the dopaminergic neurotransmission by serotonergic mediation. And also, it has been shown to inhibit synthesis of DOPA in dopamine-rich areas of the rat forebrain. These dopamine-antagonistic capacity of fluoxetine is only supported by anecdotal report that the increased amount of motor disability in patients with idiopathic Parkinson's disease after exposure to fluoxetine. However, there is still no evidence of the direct effect of fluoxetine on dopaminergic neuronal cell body in the substantia nigra, VTA, caudate & putamen. This study was designed to evaluate the effects of fluoxetine in rat brain which showed decreased numbers of dopaminergic neuronal cell body induced by schedule-induced polydipsia(SIP). Method: We incidentally found that 4 weeks of schedule-induced polydipsic rats revealed the suppression of tyrosine hydroxylase expression in the substantia nigra, VTA, caudate & putamen with the immunohistochemistric measures. After 3 weeks of intraperitoneal injection of 10mg/kg of fluoxetine to the schedule induced polydipsic rats, the tyrosine hydroxylase expression was also measured with immunohistochemistry. We compared the tyrosine hydroxylase expression among the normal control, the polydipsic rats, and the rats with fluoxetine treatment. Results: 1) By contrast with the control, the polydipsic rats revealed the evidence of decreased tyrosine hydroxylase expression in the substantia nigra, VTA, caudate & putamen. 2)After daily injection of fluoxetine for 3 weeks, the polydipsic rats showed increment of tyrosine hydroxyase expression in those areas. Conclusions: In previous studies, a great deal of results suggest that fluoxetine negatively influence the dopaminergic systems indirectly via serotonergic activation such as inhibition of dopamine synthesis or transport system. Although our results are obtained from rodents, we suggest that fluoxetine directly and positively enhance the dopamine system in the substantia nigra, VTA, caudate & putamen. The chronic adminstration of fluoxetine may be helpful to dopamine-depleted condition in clinical situations. We anticipate the replication studies of our findings and well-controlled clinical trial.

성인의 급성 설사에 대한 로페라미드 옥사이드의 효과: 위약과의 무작위 이중 맹검 비교 다시설 시험

박영태,정희진,박중원,이계희,김나영,임선희,윤병철,한동수,이오영 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.31 No.5

Food Functionality of Opintia ficus - indica var. Cultivated at Jeju Island

Young-Chul Lee1,Chae-Kyung Ahn 한국식품영양과학회 2004 한국식품영양과학회 학술대회발표집 Vol.55 No.-