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.

고령자 급성 췌장염의 임상적 고찰

백용한,서정훈,송건훈,이진헌,송시영,정재복,강진경,박인서,이수진 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

Increased 11β-hydroxysteroid dehydrogenase type 1 contributes to barrier dysfunction in aged skin

( Beom Jun Kim ),( Noo Ri Lee ),( Chung Hyeok Lee ),( Young Bin Lee ),( Solam Lee ),( Hyun Jee Hwang ),( Eunjung Kim ),( Eung Ho Choi ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive cortisone into cortisol, an active form, and is expressed by several tissues including the skin. Excessive active glucocorticoid (GC) deteriorates skin barrier function. Objectives: To find out if 11β-HSD1 affects on the barrier function in aged skin. Methods: We have performed human and in vivo studies. We measured cortisol in stratum corneum (SC) and oral epithelium of the elderly and young. Hairless mice were used for 11β-HSD1 immunohistochemistry staining of skin and measuring skin barrier function and serum cytokines. 11β-HSD1 knock-out (KO) mice and its wild-type were used for measuring lipid synthesis related enzyme. Results: Cortisol levels were elevated in SC and oral epithelium of the elderly rather than young. The 11β -HSD1 expression was increased in immunohistochemistry stain of aged mice skin. Aged mice showed decreased transepidermal water loss (TEWL) and SC hydration, and increased SC integrity than young. Serum inflammatory cytokines including interleukin-1α, -4, -10, -31 and tumor necrosis factor-α were increased in aged mice than young. The expressions of lipid synthesis related enzymes in epidermis were elevated in KO mice and topical 11β -HSD1 inhibitor applied mice. Conclusion: 11β-HSD1 expression is elevated in aged skin. It increases active GC and then deteriorates skin barrier function.

Biomass 유래 퓨란계 단량체를 이용한 폴리에스터의 중합 및 특성 연구

정용석(Yong Seong Chung),이영철(Young Chul Lee),서강진(Kang Jin Seo),김명준(Myeong Jun Kim),정지혜(Ji Hea Jeong),노시태(Si Tae Noh) 한국고분자학회 2011 폴리머 Vol.35 No.6

바이오매스에서 유래된 2,5-dihydroxymethylfuran(DHMF)을 KMnO4 산화반응으로 furan-2,5- dicarboxylic acid(FDCA)를 합성하였다. 합성한 FDCA와 다이올류를 에스테르화 반응과 축중합 반응을 진행시 켜 폴리에스터를 중합하였다. 폴리에스터는 NMR을 통해 조성을 분석하였고 DSC와 TGA를 통해 열적특성을 분 석하였다. 합성된 폴리에스터의 고유점도는 0.78∼1.2 dL/g으로 상용화된 poly(ethylene terephthalate)(PET) 와 비슷하였다. 다이올의 길이가 증가할수록 Young`s modulus와 strength는 낮아지고 elongation-to-break는 높아지는 경향을 확인하였다. 합성한 poly(ethylene furandicarboxylate)(PEF)의 Young`s modulus는 3551 MPa, strength는 103 MPa로 상용화된 PET와 비슷하였다. Furan-2,5-dicarboxylic acid (FDCA) was synthesized by KMnO4 oxidation of 2,5-dihydroxymethylfuran( DHMF) derived from biomass. Polyesters were synthesized by esterification and polycondensation of FDCA with various diols(ethane-1,2-diol, propane-1,3-diol, butane-1,4-diol, hexane- 1,6-diol, decane-1,10-diol). The composition of polyesters was characterized by using 1H NMR. Thermal properties of the polyesters were characterized by DSC and TGA. Intrinsic viscosities(IV) of the polyesters were measured to be 0.78∼1.2 dL/g comparable with IV of commercial poly(ethylene terephthalate)(PET). As the chain lengths of diols increased, Young`s modulus and strength decreased and elongation-to-break generally increased. Young`s modulus and strength of the polyesters were measured to be 3551 MPa and 103 MPa, respectively, comparable with commercial PET.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

Methicillin-내성 황색포도상구균의 각종 항균제에 대한 내성양상과 Plasmid DNA의 특성

정선식,신종희,류필열,안태휴,양동욱,김영일,이준행,김영휴 대한감염학회 1995 감염 Vol.27 No.1

광주지역의 A병원과 B병원에 입원한 환자의 각종 임상가검물로 부터 분리동정한 황색포도상구균 251주를 19종의 항균제에 대한 감수성 검사를 실시하고 내성인자를 조사하여 다음과 같은 결과를 얻었다. Oxacillin에 대한 내성빈도는 A병원에서 74.2%로 B병원의 46.1% 보다 약 30% 정도가 높았다. 또한 cephalosporine계 항균제와 aminoglycoside계 약제에 대한 내성빈도는 A 병원 분리균주에서 높은 경향을 보였으며, ampicillin(Amc), tetracycline(Tc), chloram-phenicol(Chp), ciprofloxacin(Cpfx)등의 항균제에 대한 내성빈도는 A병원와 B병원에서 분리된 균주간에 유사하였다. 그러나 fosfomycin(Fom)에 대한 내성빈도는 오히려 B병원 분리균주에서 높았다. 10가지 이상의 약제에 내성을 갖는 다제내성균의 출현율은 B병원에서 보다 A병원에서 높았다. A병원와 B병원에서 분리된 MRSA 대부분이 cefamandole(Cmdl)을 제외한 cephalosporin계 약제와 aminoglycoside제제에 대해 내성을 나타내었으며, netilmicin(Net) 과 rifampin(Rfp)에 대한 내성빈도는 A병원에서 분리된 균주에서 높았으며 Fom, Tc, Chp에 대한 내성빈도는 오히려 B병원에서 분리된 MRSA 에서 높았다. 다제내성균의 출현율은 두 병원간에 큰차이가 없었다. MRSA 의 다제내성양상은 Fom, Net, Chp 및 Rfp에 대한 내성에 따라 A병원와 B병원에 서 분리된 균주간의 차이가 관찰되었는데, A병원에서 가장 많이 나타난 내성유형은 AmcCtxCzolLmoxGmTobLcmAmkNetTcEmRfp 및 AmcCtxCzolCmdlLmoxFomGmTobLcmAmkNetTcEmRfp에 중복내성을 갖는 균주가 각각 12균주로 가장 많았으며 B병원에서 분리된 균주에서 많이보이는 내성유형은 AmcCtxCzolLmoxFomGmTobLcmAmkChpTcEm에 중복내성은 갖는 균주가 11주로 가장 많았다. 두 병원에서 분리된 균주 모두 β-lactam계 약제와 aminoglycoside계 약제간의 교차내성을 가지고 있었다. MRSA균주에서 분리한 plasmid DNA profile은 A병원와 B병원에서 분리된 균주에서 약제에 대한 다제내성양상에 따라 차이가 있었으며, A병원 분리균주에서는 108kb, B병원 분리균주에서는 2.8kb의 plasmid를 보유하는 차이가 있었다. Background: Increased isolation of methicillin-resistant Straphylococcus aureus has become one of the important problem in treating staphylococcal infections. The aim of the study was to investigate the epidemiological characteristics of antimicrobial resistance of MRSA's isolated in the Kwangju area. Methods: 251 strains of S. aureus were isolated from various specimens from A-hospital and B-hospital and there resistance patterns against 19 antimicrobial agents and plasmid profiles studied. Results: Methicillin resistance was detected in 74.2% and 46.1% of A-hospital and B-hospital isolates, respectively. Resistance to cephalosporins and aminoglycosides was more frequent in the A-hospital isolates than in the B-hospital isolates, whereas fosfomycin resistance was more frequent in the B-hospital isolates than in the A-hospital isolates. Frequency of resistance to ampicillin, tetracycline, chloramphenicol, ciprofloxacin in A-hospital isolates was similar to B-hospital isolates. Strains with multiple resistance to more than 10 drugs were more frequent in the A-hospital isolates than that in the B-hospital isolates. Among MRSA strains, resistance to netilmicin and rifampin was more frequently encountered in A-hospital isolates, while resistance to fosfomycin, tetracyclin, and chloramphenicol was more frequent in B-hospital isolates. No differences in resistance patterns against other cephalosporins and aminoglycosides were observed between the two hospitals. Fosfomycin, netilmicin, chloramphenicol and rifampin resistances were different between the hospitals in strains with multiple resistance. The most frequently observed multiple resistance patterns observed among A-hospital isolates were AmcCtxCzoILmoxGmTobLcmAmkNetTcEmRfp and AmcCtxCzolCmdlLmoxFomGmTobLcmAmkNetTcEmRfp. Among B-hospital isolates, AmcCtxCzolLmoxGmTobLcmAmkChpTcEm pattern was the most frequent. Conclusion: MRSA strains from both hospitals showed cross-resistance to β-lactams and aminoglycosides. Plasmid profiles from MRSA strains were different, according to the multiple resistance patterns. Characteristically, 108 kb plasmid was detected only in A-hospital-MRSA strains, while 2.8 kb plasmid was detected only in B-hospital-MRSA strains.

시각의 노화를 고려한 노인종합복지관의 색체계획에 관한 연구

정준수,임환준,이현희,박용환 대한건축학회 2003 대한건축학회논문집 Vol.19 No.7

As human become aged, he become color weak due to yellowed eye sight. The 87% of information for human behavioral decisions are visually perceived. Therefore, the color weakness will affect his behaviors in many ways. Most of previous research regarding color planning for the aged people focuses on discovering their preferred colors and reflecting the colors on facility color planning. But these research failed to identify confused range of color cognitions due to the color weakness of the aged. In this research, targeting the aged in multi-purpose senior centers, we analyze their color distinctions and confusions using computer graphic tools. Our research discovers several important points. First, there are differences in color cognitions between the young facility designers/staffs and the aged facility residents. Second, these differences lead to the differences in the abilities of spatial cognitions between the young and the aged. Third, the difference in the spatial distinctions if mainly caused not by color itself but by color adjacencies. Based upon these findings, we propose that color planning of facilities for the aged be made not from the view of the designers but from the view of the aged, considering yellowed eye sight of the aged.

Water-soluble Genistin Glycoside Isoflavones Upregulate Antioxidant Metallothionein Expression and Scavenge Free Radicals

Chung, Mi-Ja,Kang, Ah-Young,Jun, Hee-Jin,Kim Sang-Yeon,Moon, Tae-Hwa,Park, Kwan-Hwa,Lee, Sung-Joon 생명자원연구 2005 생명자원연구 Vol.13 No.-