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.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

부산지역 수돗물과 지하수의 중금속 농도

김준연,손지언,김형수,김두희,원미숙,김인식,이혜령 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

This study investigated mean airborne CO concention of 15 workplaces, suspected of CO exposure and conducted self-reported questionnaire completion and indirect COHb concentration measure using Micro II Smokerlyzer to healthy 702 adult subjects from 1999 May to 1999 September in order to find a relation of CO exposure and occupational factors, socioeconomic factors, and health related behaviors and confirm the related conditions in the screening test for CO exposure. The results of this study were summarized as follows : 1. In the CO exposed and non exposed group, COHb concentrations of the smokers were 2.55±0.96% and 2.21±0.97% and that got a statistically significant difference, There were not statistically significant differences in the age and total smoking index. Passed times after the last smoking, Working time/day, and working duration were statistically significant difference (p〈0.05). 2. In the CO exposed and non exposed group, COHb concentrations of non-smoking group were 0.94±0.35% and 0.68±0.47% and that got a statistically significant difference. There were not statistically significant differences in the age and working duration but Working time/day was a statistically significant difference(p〈0.05). 3. In the CO exposed group, r-square of multiple regression of the smokers was 38.5 % and passed time after the last smoking, working time/day, and job category were statistically significant differences (p〈0.05). And r-square in the CO non-exposed group was 38.3 % and age, passed time after the last smoking, and total smoking index were statistically significant difference. 4. In the CO exposed group, r-square of multiple repression of the non-smokers was 66.3% and job category and airborne CO concentration were statistically significant differences(p〈0.05). But r-square of non-smokers in the CO non-exposed group was 1.0% and there was not a statistically significant difference(p〈0.05). 5. In the smokers of CO exposed and non exposed groups, relation of COHb concentration and passed time after the last smoking was expressed as exponential function, Y = 2.9182e-0.0083x and r-square of this function was 37.4%. Therefore it was more than 150 minutes that passed time after the last smoking was when COHb concentrations were measured as less than 1%. In conclusion, variable, that was statistically significant to COHb concentraion in the both CO exposed and non-exposed smokers, was a passed time after the last smoking. We suggest that you have to restrict the smoking of smokers at least 150 minutes in the exposed and non exposed group before COHb concentration measure in order to exclude smoking effects

자매에서 발생한 중증 마이코플라즈마 폐렴에서 스테로이드 치료

김도희,이경일,김명숙,윤유숙,황자영,임정우,강진한,이준성 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Numerous evidences support the pathogenesis that M. pneumonias pneumonia is associated with cell-mediat-ed immune reaction. We report 2 cases of severe M. pneumoniae pneumonia in previously healthy sisters, who were both admitted during an epidemic of M. pneumoniae pneumonia. The elder sister, who was 16 years old, was admitted with M. pneumoniae pneumonia. She showed no response to treatment with clarithroycin and levo-floxacin, and eventually progressed to severe ARDS, requiring mechanical ventilation. After treatment with hydrocortisone (200 mg/day), there were rapid improvements in clinical manifestations and chest radiographic findings. The younger sister, who was 14 years old, was admitted 10 days later, Presenting with fever but no pneumonic lesions on chest radiograph. Just like her sister, the infection showed no response to clarithromycin. Fever persisted and pneumonic consolidation with mild pleural effusion was noticed in the left lower lobe on the 5th hospital-day. After treatment with oral prednisolone (1 mg/kg), she showed rapid defervescence and on the 8th hospital day, no pneumonic lesions were detectable on chest radiograph. Given the fact that the pathogenesis of pneumonia and extrapulmonary manifestations in M. pneumoniae infection is immune-mediated, an immuno-suppressive therapy would be validated for selected patients with M. pneumoniae infections.

스타이렌 아이오노머의 기계적인 성질에 미치는 혼합 양이온의 영향

김희석,나연화,이용혁,이법원,유지강,박기주,김준섭 조선대학교 생산기술연구소 1998 生産技術硏究 Vol.20 No.1

The styrene-co-methacrylate ionomers neutralized with Na +, Ba2 +, and mixed cation of both were prepared. The dynamic mechanical properties of two cation-containing ionomers were measured and compared to those of the ionomers neutralized with only one type of cations. We found that in the ionomers with one type of cations the difference in the type of cation does not change the glass transition temperatures. It was found, however, that the cluster Tg of the mixed cation ionomer is lower than that of the single cation ionomers. Thus it was postulated that in the two-cation system the two cations in a solution have sufficient dynamics to form new type of multiplet containing both cations, which may be slightly bigger than that found in the single cation multiplet. The mechanical properties also imply that the strength of ion interactions in the multiplets of the two cation ionomer is thought to be weaker than that of the one cation ionomers. These two effects are believed to contribute the lower in the cluster glass transition of mixed cation system.

과호산구증가증의 원인과 발생율에 대한 임상적 고찰

김봉준,이천우,조은주,김희규 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: Eosinophilia is associated with various primary and reactive conditions. The incidence and causes of eosinophilia might have changed through time according to the changes in the incidence of diseases such as cancer, chronic degenerative diseases, and so forth. This study was sought to investigate the causes and the incidence of hypereosinophilia and compare the results with those obtained by other reports in Korea. Methods: Eosinophilia and hypereosinophilia are diagnosed when the absolute eosinophil count is greater than 500/μL and 1,500/μL, respectively. Patient's clinical records were reviewed to determine the underlying clinical conditions in relation to what causes hypereosinophilia. Results: Out of 18,941 patients who undertook hematology profiles, 1,584 (8.4%) and 143 (0.75%) were found to have eosinophilia and hypereosinophilia, respectively. Among patients with hypereosinophilia, 106 patients (74.1%) had identifiable and/or possible causes. The major causes of hypereosinophilia were malignancy (48.1%), allergy and skin diseases (22.6%), infectious diseases (9.4%), gastrointestinal tract diseases (5.7%), and hepatobiliary diseases (4.7%). Conclusion: We found various causes of hypereosinophilia in this study, and the most common cause of hypereosinophilia was malignancy. Therefore, a thorough study in patients with hypereosinophilia is necessary.

PILOMATRICOMA 치험 1례

김은철,이창우,임창준,이동근,김수남,양희창 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.3

The pilomatricoma (calcifying epithelioma of Malherbe) is rare benign hard, spherical and freely movable cutaneous tumor, which was differentiated from hair cells, particulary hair cortex cells. It is usually occured as a single, asymptomatic, 0.5 cm to 3.0 cm sized, deep seated, firm nodule, covered by normal or pink skin. It arises chiefly in young people, including children, and most often in the head, neck and upper extrimites. The authers experienced a case of pilomatricoma which occured in preauricular region. This case was summarized as follows. 1. 10 years old female has suffered from hard subepidermal mass on preauricular area and she visited our out patient clinic. So we performed surgical extirpation and the excised specimen was pathologically examined. 2. Grossly the tumor measures 2.0 cm in diameter and firm, bosselated, spherical shaped which covered by a thin layer of fibrous tissue. On cut section, it shows spicular gritty surfaces, well encapsulation, interwoven and keratotic lamellae. 3. Histopathologically, the epithelial masses of the tumor are composed of two type of cells, basophilic cells and shodow cells. The basophilic cells resemble hair matrix cells which posses round or elogated, deeply basophilic nuclei and scanty cytoplasm.The shadow cells show a central, unstained shadow at the site of the lost nucleus. Gradual development of basophilic cells into shadow cells can be observed. Foci of calcification are present within the lobule of shadow cells. The stroma of the tumor shows a considerable foreign body giant cell reaction adjacent to the shadow cells. 4. No recurrence was observed until post - operative 40 months.

천연치자색소의 합성색소와의 특성 비교

김희구,김옥도,이상준 한국식품영양학회 1998 韓國食品營養學會誌 Vol.11 No.5

치자를 원료로 천연 치자황색소와 치자황색소를 합성 식용 황색 4호와 ?색 2호와의 대체 가능성을 검토하기 위하여 색차, 내열성 및 내광성을 비교하였으며, ascorbic acid와 dl-α-tocopherol에 의한 내광성 증가효과를 검토하였다. 황색 4호와 치자황색소의 경우 색차는 △E값이 7.55이었다. 내열성 결과는 황색 4호는 80℃×30분과 100℃×30분에서는 pH 2.5∼8.0까지 전 영역에서 99% 이상의 색소 잔존율을 나타내었으며, 121℃×15분 경우에서는 평균 94% 이상의 색소 잔존율을 나타내었다. 치자황색소는 80℃×30분과 100℃×30분의 조건시 pH 7.0부근의 중성영역에서는 약 90% 이상의 잔존율을 보이지만, 121℃×15분에서는 75%의 잔존율을 보였다. 내광성은 황색 4호와 치자황색소의 차이는 약 18%이지만, 비타민 C를 첨가하면 잔존율의 차이는 약 12%로서 6% 정도 내광성이 증가되었다. 청색 2호와 치자청색소의 경우 색차는 △E값이 107로서 다른 보조색의 필요가 있었다. 내열성 결과는 청색 2호는 80℃×30분과 100℃×30분에서는 pH 2.5∼8.0까지 전 영역에서 99% 이상의 색소 잔존율을 나타내었으며, 121℃×15분 경우에서는 평균 95% 이상의 색소 잔존율을 나타내었다. 치자청색소는 80℃×30분과 100℃×30분의 조건시 pH 7.0부터의 중성영역에서는 약 93% 이상의 잔존율을 보이지만, 121℃×15분에서는 90%의 잔존율을 보였다. 내광성은 청색 4호와 치자황색소의 차이는 약 8%이었고, 비타민 E를 0.4% 첨가하면 치자청색소의 내광성이 4%정도 증가되었다. In order to replace systhetic colors by natural colors as food additive, properties of Gardenia yellow color and Gardenia blue color were compared with Food yellow No. 4 and Food blue No. 1. Color difference between Food yellow No. 4 and Gardenia yellow color was 7.55. Thermal stability of Food yellow No. 4 was above 99%. On the other hand, in case of Gardenia yellow color, showed above 90% of residual color units in 80℃×30min and 100℃×30min at pH 7.0 but 75% in 121℃×15min. Difference of light stability between Food yellow No. 4 and Gardenia yellow color was about 18%. Addition of ascorbic acid was increased about 6% in light stability. Color differance between Food blue No. 2 and Gardenia blue color was 107. Thermal stability of Food blue No. 2 was above 99%. But Gardenia blue color showed 92% of residual color units in 80℃×30min and 100℃×30min at pH 7.0 bu 90% in 121℃×15min. Difference of light stability between Food blue No. 4 and Gardenia blue color was 8%. Addition of -tocopherol was increased about 4% light stability of Gardenia blue color.

병력청취에 의한 양성 발작성 체위성 어지럼증의 진단

김병건,배희준,구자성,권오현 대한평형의학회 2003 Research in Vestibular Science Vol.2 No.2