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.

주요우울증에 대한 벤라팍신의 효과 및 안전성

이민수,남종원,강성민,연병길,오병훈,이철,정인과,채정민,백인호 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요우울증 환자에서 벤라팍신의 치료 효과와 안정성을 조사하기 위해 다기관 개방연구를 시행하였다. 방 법 : DSM-IV 진단 기준에 의거하여 주요우울증으로 진단된 환자중 벤라팍신 투여에 동의한 환자를 대상으로 하였다. 선택된 환자에서 다른 항우울제를 복용하고 있는 경우 14일 이상의 약물 배설기간을 가진후 벤라팍신을 6주간 투여하였으며, 기준점, 1주, 2주, 4주, 6주 후에 HAM-D, MADRS, 그리고 CGI등을 사용하여 평가하였다. 본 연구기간중 발생된 모든 부작용은 부작용의 발생 및 소설 시기, 심한 정도, 발생 빈도, 벤라팍신과의 관련성, 관련 조치 및 결과에 대하여 증례기록서에 기록하도록 하였다. 결 과 : 총 141명을 대상으로 하였으며, 이중 94명(66.7%)이 6주간의 연구를 완결하였고, 47명(33.3%)이 중도탈락하였다. HAM-D총점수는 벤라팍신 투여 1주후부터 유의한 감소를 나타내었으며, 2주,4주, 6주후에도 지속적인 감소를 보였다. MADRS의 총점수도벤라팍신 투여 1주 후부터 유의한 호전을 나타내었으며, 2주, 4주, 6주 후에도 지속적인 감소를 보였다. CGI에서도 기준점, 1주, 2주, 4주, 6주 후 각각의 시점 사이에 유의한 호전이 보였다. 활력징후, 일반 혈액학, 생화학, 심전도 검사 등에서 유의한 변화는 없었다. 벤라팍신과 관련된 부작용으로 흔히 보고한 증상은 오심(10.6%), 소화불량(9.5%), 변비(8.5%), 현기증(8.5%)등 이었다. 결 론 : 다기관 개방연구를 통해 주요우울증 환자에 대한 벤라팍신의 투여는 우울증상의 호전에 효과적이었으며 안전하였다. Objective : A Multicenter open-label study was conducted to evaluate the clinical efficacy and safety of venlafaxine for the tretment in patients with major depression. Method : The study was done in patients with major depression diagnosed by DSM-IV who accepted venlafaxine medication. In cases of the patients taking other antidepressants, 6 weeks of venlafaxine medication was carried out after 14 days of drug excretion period and evaluation using HAM-D, MADRS, and CGI was done at baseline, and after 1, 2, 4, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, relationship with venlafaxine, managements and results have been putted into the records. Results : A total of 141 patients were enrolled. Among 94 of them finished the 6 weeks of research and 41 of them did not make it through the research. Total HAM-D scores showed significant decrease after 1 week of venlafzxine medication and continous decrease through the study period. Total scores of MADRS also showed significant improvement after 1 week and continuous decrease through the study period. Similarly, CGI showed significant improvement between baseline, 1, 2, 4, and 6 weeks. There were no significant changes in vital sign, CBC, chemistry, and EKG. The commonly reported side effects of venlafaxine were nausea(10.6%), indigestion(9.5%), constipation(8.5%), and dizziness(8.5%). Conclusion : According to the results, venlafaxine was effective and safe in the treatment of patients with major depression.

우울증 환자 치료에 있어서 Tianeptine과 Sertraline의 효과와 안전성 비교

이민수,강성민,기백석,연병길,오병훈,이철,채정민,백인호 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: 주요 우울증의 치료에 있어서 티아넵틴과 써트랄린의 임상적 효과와 안정성을 비교하기 위하여 연구를 시행하였다. 방법: DSM-IV 진단 기준에 의거하여 주요 우울증의 진단기준에 부합되고 17항목 해밀턴 우울척도 점수가 14점 이상인 환자를 대상으로 하였다. 총 40명의 환자를 무작위적 방식에 따라 티아넵틴 치료군과 써트랄린 치료군으로 분류하였다. 선탠된 환자에서 다른 항우울제를 복용하고 있는 경우 7일 이상의 약물 배설기간을 가진 후 티아넵틴과 써트랄린을 각각 6주간 투여하였으며, 기준점, 1주후, 2주 후, 4주 후, 6주 후에 HAM-D, MADRS, 그리고 CGI, COVI 등을 사용하여 평가하였다. 본 연구기간 중 발생된 모든 부작용은 부작용의 발생 및 소실 시기, 심한 정도, 발생 빈도, 관련 조치 및 결과에 대하여 증례기록서에 기록하도록 하였다. 결과: 30명(티아넵틴군 15명 ; 써트랄린군 15명)이 6주간의 연구를 완결하였고 티아넵틴 치료군에서는 1일 37.5mg을 투여하였으며 써트랄린군에서는 1일 평균 64.0±22.5mg을 투여하였다. 본 연구 결과 HAM-D, MADRS, CGI 상에서 두 군 모두에서 치료 1주 후부터 유의한 감소를 나타내었으며 이는 2주 후, 4주 후, 6주 후에도 지속적인 감소를 보였고 두 군간에 항우울 효과의 차이는 없었다. 활력징후, 일반 혈액학, 생화학, 심전도 검사 등에서는 두 군 모두 유의한 변화는 없었다. 티아넵틴과 관련된 부작용으로 흔히 보고한 증상은 오심(33.3%), 복부 불쾌감(26.7%), 구강 건조(20.0%), 두통(13.3%)등 이었고 써트랄린 치료군에서는 구강 건조(53.3%), 두통(46.7%), 오심(33.3%), 그리고 식욕 부진(33.3%)등으로 티아넵틴군에서 보다 적은 발현빈도를 보였다. 결론: 티아넵틴은 우울증의 치료에 있어서 효과적이고, 내약성이 우수한, 안전한 항우울제이다. Objective: This study was designed to evaluate the efficacy and safety of tianeptine and sertraline in the treatment of patients with depression. Method: The study was done on the patients with major depression diagnosed by DSM-IV, who had aHamilton Rating Scale for Depression(HAM-D) score ≥ 14 on the first 17 items of the HAM-D. A total of 40 patients were randomly assigned to tianeptine group and sertraline group. Tianeptine and sertraline were prescribed to each group. 6 weeks of each medication was carried out after 7 days of drug excretion period. Evaluation using 17 item HAM-D, Montgomery and Åsberg Depression Rating Scale(MADRS), Clinical Global Impression Scale (CGI), and Covi Scale was done on the baseline and after 1 week, 2 weeks, 4 weeks, and 6 weeks. Regrding all side effects that had occurred during the period of our study such as their developed/disappeaed time, severitien, incidences, managements and results have been recorded. Results: A total of 30 patients(tianeptine group 15 ; sertraline froup 15) finished the 6 weeks of research. 37.5mg of the daily dose was regularly prescribed to the tianeptine group, the average amount of 64.0±22.5mg of the final daily dose was prescribed to the sertraline group. Total 17 item HAM-D scores, total points of MADRS and CGI showed significant decrease after 1 week in each treatment froup and continous decrease after 2, 4 and 6 weeks ; and no difference was found between tianeptine group and sertaline group in the antidepressant efficacy. Also there were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The common reported side effects of tianeptine were nausea(33.3%), epigastic distress(26.7%), dry mouth(20.0%), headache(13.3%) and those of sertraline were dry mouth (53.3%), headache(46.7%), nausea(33.3%), anorexia(33.3%). Conclusion: According to the results, tianeptine was effective in improvement of depressive symptoms and was well tolerated and safe in patients with depression.

임상가검물에서 분리된 효모의 임상적 의의

유병용,이원길,김재식,전효진,노략균,이장백,김중명 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.4

1988년 1월부터 동년 12월말까지 경북대학교병원 임상병리과에 의뢰된 가검물 중에서 효모가 분리되었던 환자는 159명이었고, 남자와 여자의 비율은 1.8이었으며 1세 이하와 30세 이상에서 많았다. 또 분리 동정된 효모 총 159주 중 객담에서 78주(49.1%), 요에서 64주(40.3%), 복막액 5주(3.1%) 편도와 대변 각각 4주(2.5%), 농에서 3주(1.9%) 뇌척수액에서 1주(0.6%) 순으로 분리되었다. 분리된 효모로는 Candida albicans가 68주(42.8%), Candida tropicalis 33주(20.8%) Torulopsis glabrata 20주(12.6%), Candida parapsilosis 17주(10.7%), Trichosporon beigelli 7주(4.4%), Torulopsis candida 5주(3.1%), Torulopsis inconspicua와 Saccharomyces cerevisiae가 각 4주(2.5%), Candida guilliermondii 1주(0.6%) 순으로 있었다. 환자들의 기존질병은 폐질환이 70예, 요로질환이 40예 악성종양 및 당뇨병이 각 22예, 간질환 16예, 순환기 질환이 12예 등으로 나타났으며, 유인중 항생제 사용은 114예(80.0%), 수술 49예(34.3%), 카테터 46예(32.2%), 스테로이드사용 28예(19.6%) 악성종양과 당뇨병이 22예(15.4%), 항암제 사용이 10예(7.0%)로 나타났다. 유인이 2개 중복된 경우는 43예, 3개 중복은 38예, 4개는 11예, 5개는 2예로 나타났다. Yeast infection is commonest fungal infection of human. And their incidence becomes to be increased as the frequency of altered host immune system is increased. Antibiotics, cytotoxic drug, malignancy, diabetes mellitus, operative procedures and catherizations are predisposition of fungal infection. Since antifungal drug within a selective or narrow range of activity are available, it is important that speciation of yeast in routine clinical microbiology practice should be effected rapidly and reliably. Author isolated 159 strains of yeast and that were identified by API 20C Auxanogram®. Patient charts were reviewed retrogradely in order to find predisposing factors of isolated yeast cells. Yeast isolation is 1.8(102:57) of male to female rtio and is more frequently below 1 year-old and above 30 year-old in both sexes. Septum(49.1%). urine(40.3%) were major specimens in which yeast isolated. Candida albicans(42.8%), Candida tropicalis(20.8%), Torulopsis glabrata(12.6%), Candida parapsilosis(10.7%) were frequently identified species in order. Candida albicans and Candida parapsilosis were frequently isolated species among various specimens. Pulmonary diseases, urinary tract diseases, malignancy, and diabetes mellitus were major underlying diseases. And antibiotic(80.0%), operative procedure(34.3%), catherterization(32.2%), steroid(19.6%), malignancy(15.4%), diabetes mellitus(15.4%) and cytotoxic drug(7.0%) were predisposed in order.

폐FRP 미분말을 재활용한 PAE 폴리머 모르타르의 물리적 특성

황의환,길덕수,노재성,이병기 공주대학교 자원재활용 신소재 연구센터 2002 센터사업 성과집 Vol.- No.1

In order to recycle the FRP wastes from SMC bathtubes, polymer-modified mortars containing a fine powder of fiber-rainforced plastics(FRP) as a part of the sand were prepared with various FRP replacements for sand and polymer cement rations. The polymer modifier used was polyacrylic ester(PAE) emulsion. The FRP waste fine powder was obtained by pulverizing FRP wastes. The water-cement ratio, compressive and flexural strength, water absorption and hot water immersion of the mortar were tested and the results compared to those of ordinary cement mortal and polymer-cement mortal. As the results, compressive and flexural strengths of ordinary portland cement mortars containing FRP wastes fine powder were remarkably decreased with an increase of a content of FRP wastes fine powder. But those strengths of ordinary portland cement mortars were greatly improved by adding PAE emulsion. When the replacement ratios of FRP wastes fine powder and adding rations of PAE emulsion were 5, 10, 20wt% and fine powder were showed as much those strengths of ordinary portland cement mortar. Otherwise heat curing of PAE-modified mortar containing FRP wastes fine powder accelerated the improvement of early compressive and flexural strengths. But the compressive and flexural strengths of PAE-modified mortar containing FRP wastes fine powder were remarkably decreased after hot water immersion test.

노안수술후 각막형태검사 변화

박근성,고길환,김용선,이재림,민병무,최시환 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

We prospectively analyzed the corneal topography of 26 eyes in 26 patients who had undergone scleral expansion for correcting presbyopia. We examined 26 eyes of 26 patients which were devided into 2 groups (mean age: 51 years, range 40-60 years) according to type of scleral expansion band, with computerized corneal topographic analysis system. Preoperatively and 5 times postoperatively (1day, 1week, 2weeks, 1month, 2months), quantitative descriptors of corneal topograpgy such as Sim K (simulated keratometry value), SRI(surface regularity index), and SAI(surface asymmetry index) were measured at each visit. The mean follow-up period was 43 days. Sim K of the operative eyes ranged from 0 to 2.5 (mean, 0.93) before operation, and mean 2.24 at postoperative 1 day in group Ⅰ. In group Ⅱ, Sim K was mean 2.20 at postoperative 1 day and decreased thereafter. SRI was from 0.54 to 1.39 and SAI was from 0.09 to 0.45 before operation. After operation, mean SAI was maximum at postoperative 2 week and mean SRI was maximum at postoperative 1 day and decreased thereafter. After two months, it became minimum. This study demonstrates that quantitative topographic change after scleral expansion for correcting presbyopia were great during first 1 week after surgery but this change diminished thereafter. Further long studies are in progress to evaluate the long term effects of this procedure.

하수체선종의 α - Subunit 분비

이경미,김영수,이병권,허갑범,이현철,임승길,이은직,김경래,정윤석,박석원,윤도흠 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.2

The pituitary glycoprotein hormones are composed of noncovalently bound and subunit, and the α-subunit is very indistinguishable structure. Hypersecretion of -subunit has been reported in patients with pituitary adenoma, particulary in clinically nonfunctioning adenomas. We evaluated the serum α-subunit levels in 20 normal men, 20 premenopausal women, 20 postmenopausal women and 21 patients with pituitary adenoma(8 acromegalies, 6 prolactinoma, 2 TSH-secreting adenomas and 3 nonfunctioning adenomas) by immunoradiometric assay. Also we measured the α-subunit response to TRH stimulation in 7 patients with pituitary adenoma. The serum α-subunit level in normal men was 0.19±0.17 (mean±SD) mIU/ml; normal preminopausal women, 0.21±0.16 mIU/ml; normal postmenopausal women, 0.61±0.35 mIU/ml. And the normal range of α-submit was 0-0.53 mIU/ml, 0-0.53 mIU/ml and 0-1.31 mKU/ml in men, premenopausal, and postmenopausal women, respectively. Two of 8 acromegalies and 1 of 2 TSH-secreting pituitary adenomas had the level of α-subunit. The α-submit secretion was slightly elevated to the response of TRH administraton in pituitary adenomas. In one patient with TSH-secreting pituitary adenoma, basal serum α-submit was 0.96 mIU/ml, after surgical removal of adenoma, the α-submit level decreased to 0.07 mIU/ml. These results support that α-submit is produced by various pituitary adenomas with or without concomitant production of glycoprotein hormones, and the α-submit is a useful marker for diagnosis and response to therapy in patient with pituitary adenoma. (J Kor Soc Endocrinol 8:127~128, 1993)

A Study on the Road Extraction Using Wavelet Transformation

Lee, Byoung Kil,Kwon, Keum Sun,Kim, Yong Il 대한원격탐사학회 1999 International Symposium on Remote Sensing Vol.15 No.1

Topographic maps can be made and updated with satellite images, but it requires many human interactions that are inefficient and costly. Therefore, the automatizing of the road extraction procedures could increase efficiency in terms of time and cost. Although methods of extracting roads, railroads and rivers from satellite images have been developed in many studies, studies on the road extraction from satellite images of urbanized area are still not relevant, because many artificial components in the city makes the delineation of the roads difficult. So, to extract roads from high resolution satellite images of urbanized area, this study has proposed the combined use of wavelet transform and multi-resolution analysis. In consequence, this study verifies that it is possible to automatize the road extraction from satellite images of urbanized area. And to realize the automatization more completely, various algorithms need to be developed.

[Free Paper] Analysis of Clinicopathologic Factors Correlated with Invasiveness in Ductal Carcinoma in situ

Byoung Kil Lee,Young wook kim,Mi suk Yi,Hyun Jo Youn,Sung Hoo Jung 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.11

A Cost Effective Reference Data Sampling Algorithm Using Fractal Analysis

Lee, Byoung-Kil,Eo, Yang-Dam,Jeong, Jae-Joon,Kim, Yong-Il Electronics and Telecommunications Research Instit 2001 ETRI Journal Vol.23 No.3

A random sampling or systematic sampling method is commonly used to assess the accuracy of classification results. In remote sensing, with these sampling methods, much time and tedious work are required to acquire sufficient ground truth data. So, a more effective sampling method that can represent the characteristics of the population is required. In this study, fractal analysis is adopted as an index for reference sampling. The fractal dimensions of the whole study area and the sub-regions are calculated to select sub-regions that have the most similar dimensionality to that of the whole area. Then the whole area's classification accuracy is compared with those of sub-regions, and it is verified that the accuracies of selected sub-regions are similar to that of whole area. A new kind of reference sampling method using the above procedure is proposed. The results show that it is possible to reduce sampling area and sample size, while keeping the same level of accuracy as the existing methods.