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.

림프구성 뇌하수체염 - 증 례 보 고 -

임동준,정용구,이훈갑,이기찬,서중근 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.11

외경 0.25 ㎜ 동맥의 단단 및 단측문합법

전대우,정재홍,강진성,한기환 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.3

Microvascular surgery has rapidly developed in the last 30 years and vessels of 1.0 mm can be anastomosed easily with a patency rate over 90 percent and is widely used in clinical practice with remarkable success. To obtain more successful microvascular anastomosis in smaller vessels, the improvement in methods of microanastomosis, the development of microvascular instruments including the operating microscope along with microsutures, and anticoagulants are needed. These improvements made microvascular anastomoses of vessels that are less than 0.5mm in extemal diameter possible. Huang et al.? performed anastomoses of the vessels in rats with an external diameter of 0.2 mm using a high magnification operating microscope, specially designed microinstruments, and fine sutures, and achieved a patency rate of 76 percent in the second postoperative week. However, we tried to anastomose vessels with an external diameter of 0.25 mm with ordinary instruments and 11-0 nylon. Animal studies on 180 rats were carried out by doing end-to-end anastomoses and 180 end-to-side anastomoses. In the end-to-end and end-to-side anastomoses, each 180 rats were then divided into 3 groups each. Group A was the control group. Aspirin and persantin were given orally in group B. Ticlopidine hydrochloride was given orally in group C. The method of end-to=end anastomosis was as follows : A superficial epigastric artery as small as 0.25 mm in diameter was severed transversely and longitudinal incisions, the length of the arterial diameter, were made down opposite sides of each end. Each flared fragment of the proximal end is approximated with each distal end and sutured together by only two stitches. The method of end-to-side anastomosis was as follows. In the side of the femoral artery an elliptical hole was made the same length of the circumference of the superficial epigastric artery, then the superficial epigastric artery was incised in the same manner as the end-to-end anastomosis. The flared ends of the superficial epigastric artery were then inserted into the hole of the femoral artery and sutured by four stitches. Light microscopic and scanning electron microscopic observation was performed serially at 3 days, 2 weeks, 3 weeks after the microvascular anastomosis for studying change of vessel diameter and histopathological changes at the microvascular anastomotic sites. The results were as follows : 1. The patency rate for the end-to-end anastomoses in the third postoperative week was 25% in the control group(A), 35% in the aspirin-persantin group(B), and 40% in the ticlopidine group(C) ; in the end-to-side anastomoses, 45% in group A, 50% in group B, and 60% in group C. 2. In the patency rate, the ticlopidine group is slightly higher than the aspirin-persantin group and even higher than the control group (P<0.05) in the end-to-end and end-to-side anastomoses. However, the end-to side group is higher in all 3 groups than the end-to-end one (P<0.1). 3. The intimal regeneration in all arteries was completed at end of the third postoperative week in the end-to-end and end-to-side anastomoses. 4. Changes of the internal diameter in anastomosed vessels showed luminal narrowing in the vessels at the third postoperative day and still narrowing at the second and third postoperative week in the end-to-end anastomoses. However, initial postoperative widening continued into the third postoperative week in the end-to-side anastomoses. The authors got a high success rate of anastomoses of very small arteries approximately 0.25 mm in external diameter, by developing a method of using an ordinary microscope and instruments, 11-0 nylon suture, and the administration of ticlopidine hydrochloride which is a more powerful anticoagulant than aspirin-persatin.

척수원추내에 발생하여 외장성 성장을 보인 낭종성 기형종 -증 례 보 고-

임동준,박윤관,김애리,정흥섭,이기찬,이훈갑,서중근 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.10

企業結合의 規制에 관한 硏究

鄭世喜,高準基 東亞大學校 1986 東亞論叢 Vol.23 No.1

Monopolistic and oligopolistic through merger is one of the most controversial problems in modern economic life. As a result of Mergers, the economies of large Scale, accumulation of capital, the dispersion of risks and the rationalization of management of firms are brought but the weakness of free competition-one of the fundamental principles of capitalism, the abuse of dominative power in markets, the ineffective of the economy and the inequality of income distribution are caused by monopolization and oligopolization due to mergers. In Korea, according to the constitutional provision "monopolistic and oligopolistic practices shall be properly regulated and coordinate" (Art. 120. (3) of Constitution). The act concerning restriction of monopoly and maintenance of fair trade is enacted in 1980 and put in force from 1981. This law provides that any special firm shall not effect a merger in either of the following cases, "where the effect of a merger may be substantially restrain competition in any particular field of trade" or where unfair methods of practices have been employed in the course of the merger." Here we assume an effective competition, not a perfect competition. Our antitrust policy is not a perfect and satisfactory one but it has a lot of problems. Our legislative policy is the method of post-regulation system and so, to eliminate the evils afferwards if evils accrued from mergers. This policy is reasonable under our industrial structure, I think. But under our Antitrust Act, the conglomerate merger could not regulated. In the legistration to come, this point shall be considered, I believe.

만정 뇌경막하혈종에서 술전 CT음영 및 천두폐쇄배액술후 배액량과 재발과의 상관관계에 대한 연구

임동준,박윤관,정용구,김봉룡,정흥섭,이기찬,이훈갑,서중근 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.10

기저질환이 없는 사람에서 발생한 Campylobacter fetus에 의한 재발성 심내막염 1예

전재범,정진원,김성혜,송문희,오형철,안성기,최상호,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

C. fetus 심내막염은 드물게 발생하는 질환으로 주로 면역능이 저하된 환자에서 발병하고 대동맥판을 침범하는 경우가 많으며 적절한 치료가 되지 않을 경우 치사율이 높다. 저자들은 기저질환이 없던 69세 남자에서 C. fetus 심내막염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 발열로 내원하여 시행한 혈액배양 검사상 C. fetus가 동정되었고 경식도 초음파 검사상 삼첨판에 증식증이 발견되어 심내막염 진단하에 ceftriaxone에 이어 meropenem으로 총 4주간 항생제를 투여받고 호전되었다가 한달 후 다시 재발하였고 판막부전 소견 진행하여 삼첨판 치환술을 시행받고 전신상태 호전되어 퇴원하였다. Campylobacter fetus is a rare cause of endocarditis. To date, only about 30 cases of C. fetus endocarditis have been reported mainly in the elderly with chronic underlying illnesses. Most cases showed tendency to involve aortic valve. This report describes a case of native tricuspid valve infective endocarditis in a 69-year-old man without any underlying disease. Despite adequate antibiotic therapy for 4-weeks, endocarditis recurred and leading to surgical valve replacement.

후방순환계 뇌동맥류의 임상분석

임동준,이훈갑,정흥섭,김봉룡,권택현,이기찬,서중근 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.11

65세 이상 노인 급성 심근경색증 환자의 사망에 영향을 미치는 인자들

정봉기,양금열,손준혁,주시내,남홍우,전용덕,이홍순 대한노인병학회 2001 대한노인병학회지 Vol.5 No.2

旋削作業에서 채터 發生點의 決定

鄭準基,李炯植 연세대학교 산업기술연구소 1981 논문집 Vol.13 No.2

The phenomenon of chatter is a violent relative vibration between workpiece and tool in machining of metals, and is an important limiting factor of production rate and surface quality, and also reduces the life of machine-tool and tool. In this study, for the prevention of chatter, the tendency of vibration of cutting force and horizontal deflection of workpiece at the chatter occurring point was observed, and some methods to determine the chatter occurring point were suggested, and by these methods, the maximum chatter free length of cantilever type workpiece in lathe was determined according to the variation of workpiece diameter and cutting depth.