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.

cDNA array 방법을 이용한 망간에 노출된 흰쥐 뇌기저핵의 유전자발현 분석

이채관,노성민,문덕환,,김정호,손병철,김대환,이창희,김휘동,김정원,김종은,안진홍,이채언 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study investigated the gene expression profile in basal ganglia of manganese-exposed rats based on cDNA array analysis. Methods: For cDNA array, 25 male Sprague-Dawley rats (250±25 g) were intraperitoneally injected with 25 ㎎/㎏ B. W./day of MnCl2 (0.3 ㎖) for 10 days. For dose-related gene expression analysis, rats were intraperitoneally injected with 0.2, 1.0, and 5.0 ㎎/㎏ B. W/day of MnCl2 for 10 days. Control rats were injected with an equal volume of saline. RNA samples were extracted from brain tissue and reverse-transcribed in the presence of [α^(32)P]-dATP. Membrane sets of the Atlas Rat 1.2 array Ⅱ and Toxicology array 1.2 kit (Clontech, Palo Alto, CA) were hybridized with cDNA probe sets. Northern blot hybridization method was employed to assess the dose-related gene expression. Results: Fifty-two genes showed significant changes in expression of more than two-fold. Twenty-eight were up-regulated and 24 were down-regulated in the manganese-exposed group compared to the control. Among the 52 genes, 28 genes including nuclear factor I-X1 (NF1-X1), neuroligin 2 and 3, mitochondrial stress-70 protein (MTHSP70), neurodegeneration-associated protein 1 (Neurodap 1), multidrug resistance protein (MDR), and endoplasmic reticulum stress protein 72 (ERP72), were reported for the first time related to the manganese-induced neurotoxic-metabolism in the rat basal ganglia. According to the dose-related gene expression analyses, MTHSP70, Neurodap 1 and ERP72 genes were up-regulated compared to the control even in the group exposed to low manganese dose ( 0.2 ㎎/㎏ B.W./day). Conclusions: Twenty-eight genes detected for the first time in this study were closely related to the manganese-induced neurotoxic-metabolism in the rat basal ganglia and further study of these genes can give some more useful information about the manganese metabolism.

大邱地域 地殼 γ-線의 照射線量率 測定

이모성,김위수,강희동,최문규,장시호,정춘균 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.2

본 연구는 대구지역의 지각 r-선에 의한 조사선량율을 측정하고 그에 따른 성분별 공간선량율 및 지역적 분포 등의 환경방사선 특성을 조사하였다. r-선 스펙트럼의 측정에는 4"ø ×4"Nal(Tl) 계측기와 휴대용 다중파고분석장치를 이용하여 이 지역내의 28개 지점에서 in-situ spectrometry를 수행하였으며, 측정된 스펙트럼으로부터 조사선량율을 환산하여 지각 r-선의 총선량율과 일반적으로 자연방사능의 주종이 되는 ?K, ?U계열 및 ?Th계열의 성분별 조사선량율을 구하였다. 조사결과 대구지역의 지각 r-선에 의한 평군조사선량율은 9.4 μR/h였으며 지점별 분포는 7.6∼11.0 μR/h범위로 다소 차이를 보였다. 측정시에 수반되는 기후나 우주선 등에 따른 일변화폭을 고려한다면 지점간의 차이는 주로 표토층의 자연방사성핵종인 ?K, ?U계열 및 ?Th계열의 핵종에 기인함을 알 수 있었으며, 성분별 선량율은 ?K2.9∼4.6 μR/h, ?U계열1.2∼3.1 μR/h, ?Th계열2.5∼5.0 μR/h의 분포를 나타냈다. This study concerns about the measurement and the investigation of environmental radiation characteristics which the components and the distribution of exposure rates by terrestrial r-rays in Taegu area. A 4"ø ×4"Nal(Tl) scintillation detector with a multichannel analyzer was used in the measurement of r-rays as a part of in-situ spectrometry at twenty eight different locations in this area. The conversion into the exposure rate from the measured r-rays spectrum has been carried out leading to a net exposure rate and component ones by ?K, ?U series and ?Th series products which are known by the major parts in the terrestrial r-rays generally. As a result, the average exposure rate by the terrestrial r-rays in Taegu area is 9.4 μR/h and the distribution of individual exposure rates shows more or less differences between these locations even after the consideration of diurnal and rearly variations which are always involved in these measurements. The component parts of exposure rates are distributed ?k2.92.9∼4.6 μR/h, ?U series1.2∼3.1 μR/h and ?Th series 2.5∼5.0 μR/h over the measured locations.

소나무 재생버섯(Fomitopsis pinicola Jeseng) 다당류의 추출 특성

장경호,신진기,이명예,이상일,김정숙,오승희,김순동 동아시아식생활학회 2005 동아시아식생활학회지 Vol.15 No.1

This study was conducted to investigate the extraction characteristics of the polysaccharide from Jeseng mushroom (Fomitopsis pinicola Jeseng). Yields of the polysaccharide extracted from powdered mushroom by autoclaving(120, 30 min) with water at different pH and salt concentration were 8.2~9.2% in pH 5~11, 4.7~5.5% in 1.5% salt solution, respectively. The yield by the 0.05~1.0 N KOH-extraction was ranged 3.45~13.20%, while that by HAS-extraction(homogenizing after KOH swelling) using 1~2.5 N KOH 73.6~78.4%. Content of carbohydrate, protein, lipid and ash of the crude polysaccharide extracted from fruits body and its cultured mycelium by method of water extraction, KOH extraction(0.005~1N) and HAS-extraction were ranged 86.5~92.6%, 2.3~13.1%, 0.1~4.2% and 0.1~1.7%, respectively. The polysaccharide were composed of 62.0~77.8 g/g of pentose, 138.0~187.8 g/g of hexose and 21.2~117.3 ㎎/g of protein. From these results, the polysaccharide extracted was supposed to be a protein-bound polysaccharide.

유기용제 폭로가 여성 근로자들의 월경에 미치는 영향

김대환,이채관,김휘동,강동묵,문덕환,김정호,손병철,이창희,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1

유기용제는 산업장에서 널리 사용되고 있다. 특히 여성근로자들의 폭로기회가 증가하고 있으며 이로 인한 자연유산, 수태능력 감소, 월경이상 등이 보고되고 있다. 따라서 유기용제 폭로가 여성근로자들의 월경에 미치는 영향을 보기 위해 설문조사와 월경주기별 여성생식 호르몬(progesterone, estrogen) 분석을 하였다. 그 결과 폭로군에서 progeterone의 억제효과가 유기용제에 폭로되는 여성근로자들의 다양한 월경이상을 초래할 가능성이 있는 것으로 생각된다. ■ Objectives This study was conducted to evaluate the effects of menstrual function in female workers exposed to organic solvents. ■ Methods Rates of menstrual disorders were studied in 87 female workers with exposure to organic solvents(Cn/Hn-value 0.713) in a factory manufacturing shoes and compared with 83 general female workers who had no exposure to organic solvents, Detailed menstrual and reproductive histories were obtained by personal interview using structured questionnaire, and plasma concentrations of progesterone and estrogen were assayed by radioimmunoassay(RIA). ■ Results The rates for menstrual irregularity, menstrual duration, blood clot in menstrual flow and dysmenorrhea were not significantly different in both groups. Number of using menstrual pad was significantly higher and the plasma level of progesterone during 6-11th day of menstrual cycle was significantly lower in the exposed group compared with non-exposed group(P<0.05). ■ Conclusions It seemed to be suppression effect of organic solvents on the reproductive hormones(progesterone and estrogen) in female workers. But there was no evidence that menstrual disorder was likely to result from exposure to organic solvents, because other behavioral, psychological and work related factors may also affect menstrual function.

Balb/c와 DDY계 생쥐 오금림프절의 구조에 관한 형태학적 연구

이창호,이원규,허영범,김정혜,한희경 慶熙大學校 1993 論文集 Vol.22 No.-

This study was aimed to clarify the distribution of lymph follicles, germinal centers and deep cortex structure in the lymph nodes of the Balb/c and DDY strain mice. Male adult mice were adopted in this study. After mice were sacrifed, the fight popliteal lymph nodes were removed in the popliteal fossa and fixed in Zenker-formol solution for 3 hours and embedded in plastic resin. The cutting thickness was 3㎛ serially and one of every two section was stained in May-Gru¨nwald and Giemsa solution. The results obtained from this study were as follows; 1. The size of lymph node was 0.750 mm in Balb/c mice and 0.968mm in DDY mice. 2. The average number of lymph follicles per popliteal lymph node was 15.5 in Balb/c mice, but 16.0 in DDY mice. The major of the lymph follicles situated in peripheral cortex overlying the uint(PCOU) in Balb/c. 3. The most transverse diameters of each strain lymph follicles was between 0.01 to 0.19mm. 4. The characteristic difference was number of germinal centers, DDY mice lymph follicles contained germinal centers in 13.25/lymph node, but Balb/c mice lymph follicles contained it in 5.75/node. 5. The morphology of deep cortex was not significant between each strain.

질소산화물의 급성 노출로 인한 폐 손상 1례

김정호,김대환,손병철,이창희,김정원,문덕환,이채언,김주인 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Lung injuries due to exposure to nitrogen oxides can occur in various process in industry. We experienced a case of chemical pneumonitis induced by accidental inhalation of nitrogen oxides emitted from the bath in an acid dipping operation. Case : Dyspnea, cough and blood-tinged sputum production, cyanosis, and tachypnea occurred after exposure to oxides of nitrogen. There were bilateral diffuse ground glass opacities in simple chest radiography and high resolutional computed tomography, hypoxemia in arterial blood gas analysis, mixed ventilation defect and reduced diffusion capacity in spirometry. As an oxygen and supportive therapy, after hospitalization, was given, the patient recovered completely from the lung injury on the 8th day after admission. There was no evidence of delayed onset of bronchiolitis obliterance or pulmonary edema in a follow-up for about 6 months. Conclusions : Acid dip operation require more efficient hooding and exhausting system for the prevention of lung injuries caused by inhalation of nitrogen oxides. Also health education for worker need.

항 Vancomycin 내성균성 항생물질을 생산하는 Streptomyces sp.AMLK-335의 배양조건

이기형,임대석,최경희,이경호,김창한,김정환 건국대학교 동물자원연구센터 2000 動物資源硏究誌 Vol.21 No.-

본 연구는 새로운 항 vancomycin 내성균성 항생물질을 개발하기 위하여 실시되었으며, 전국 각지의 토양 시료로부터 분리한 방선균 중 vancomycin 내성균주인 K-98 Enterococcus faecium 642, K-98 Enterococcus faecium 637 균주에 대하여 항생물질을 생산하는 분리균주 AMLK-335를 선정하여 이 균주의 항생물질 생산에 대한 최적 발효 조건을 검토한 결과, 탄소원 첨가로는 glycerol(0.5%), 질소원 첨가로는 yeast extract(0.5%)가 가장 효과적으로 항생물질 생산에 이용되었고, 비타민을 첨가에 따른 항생물질 생산성의 차이는 크게 나타나지 않았으나, calcium pantothenate 첨가시 항균활성이 비교적 높아졌으며, 금속이온의 첨가는 K+, Pb+, Ba²+, NA²+ , Ca²+를 첨가하였을 때는 항생물질의 생산성이 비교적 높아졌으며, 그중 Ca²+ 첨가구가 가장 생산성이 높았으며, Fe²+ , Hg+의 금속이온을 첨가하였을 때는 항생물질 생산성이 감소하였으며, CaCO₃첨가는 비첨가구보다 높은 항생물질 생산성을 보였으나, 첨가량에 따른 영향은 대체적으로 없었다. pH의 변화에 따른 생산성은 전반적으로 pH가 항생 물질 생산에 영향을 미치지 못하였으나, pH 4.5∼6.0 부근에서는 비교적 높은 항생물질 생산성을보였으며, 통기량에 따른 항생물질 생산성은 통기량이 많을수록 항생물질 생산이 좋았다. 한편 배양기간에 따라 항생물질 생산성을 조사한 결과, 5일째에 가장 높은 항생물질 생산성을 나타내었으며, pH의 변화는 배양 초기에 하강하였다가 점차 상승하는 경향을 보였다. This study was carried out for examining antibiotic productivity of the strain Streptomyces sp. AMLK-335 producing anti-VRE antibiotic. According to different condition, the strain was cultured for 4 days at 27℃ and determined cell growth, pH value and antibiotic productivity using disk diffusion method. In the experiment, the strain Streptomyces sp. AMLK-335 was examined various culture conditions which was added 8 carbon sources, 12 nitrogen sources, 8 vitamins and 11 metal ions in each time and controlled concentration of CaCO₃, initial pH and aeration. From the studies of conditions for antibiotic production, antibiotic productivity was the best to use 0.5% glycerol as carbon source and 0.5% yeast extract as nitrogen source. When several vitamins were added to medium, there was little difference in antibiotic productivity. But the addition of calcium pantothenate slightly increased antimicrobial activity. The addition of metal ion, such as K+, Pb+, Ba²+, NA²+ and Ca²+ slightly increased antibiotic productivity except Fe²+ and Hg+. The addition of CaCo₃showed higher than non-addition experiment in antibiotic production, but there wasn't generally influenced at addition concentration. According to pH change, antibiotic productivity was increased at pH 4.5∼6.0, and when there was a lot of aeration, antibiotic productivity was increased.

KAERI 부지 주변의 환경선량 측정을 위한 온라인 감마선량 감시시스템

이정호,박두원,이원윤,이현덕,최용호,김삼랑,홍광희,이창우 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.2

환경감마선량 변동을 감시하기 위해 한국원자력연구소 부지 주변에 온라인 감마선량 감시망을 구성하였다. 모니터링 포스트에 설치된 전리함 검출기에 의해 측정된 자료는 무선전송방식으로 중앙통제소에 전송되어 실시간으로 감시된다. 무선전송 방식은 자료의 전송, 처리 및 자자에 신뢰도가 높고 경제적이었다. 감시시스템은 급격한 선량증가시 조기경보체제와 연결할 수 있게 하였다. On-line gamma monitoring system around KSERI-site was set up to monitor the radiation fluctuations in environment. Data on gamma exposure rates measured by the ionication chamber in the monitoring posts are transmitted to a computer of central control station with radio telemetry transmission and reliable on handing and storing of data. This monitroing system can triger an early warning system in the event of abnormal radiation levels.

골뱅이(Buccinum Undatum) 알레르기 : 감작률과 다른 음식물 항원과의 연관성 Sensitization rate and its relationship with other food allergens

이재영,윤성호,서유진,최정희,서창희,남동호,김윤근,민경업,박해심 대한천식 및 알레르기학회 2004 천식 및 알레르기 Vol.24 No.1

Background : The common whelk (Buccinum undatum) is one of the largest and most common snails in the North Atlantic. In Korea and Japan, common whelk is a popular eatable shellfish. Although shellfish has been known as the one of the most common causes of food allergy, there has been no published report on allergenecity and clinical significance of this sea snail. In this study, we determined the sensitization rate to common whelk and its relationship with other food allergens in allergy patients. Method : We carried out the skin prick test (SPT) with commonly consumed food stuffs in Korea including common whelk in 1700 patients over 1 year. The specific IgE to common whelk were detected by enzyme-linked immunosorbent assay (ELISA). ELISA inhibition test using sensitized sera was conducted. Results : SPT to common whelk was positive (≥2+) in 83 (4.9%) patients studied. Twenty-four (38.7%) of 62 SPT-positive patients had high serum specific IgE to common whelk. ELISA inhibition test showed significant inhibitions by abalone as well as by common whelk and, minimal inhibition were noted by shrimp. Significant correlation was also noted in specific IgE levels between common whelk and abalone (r=0.58, F<.05). Conclusion : IgE-sensitization rate to common whelk was 4.9% in allergy patients. Further stuides are needed to evaluate the clinical significance of sensitized patients to common whelk, and to confirm a cross reactivity with abalone. (J Asthma Allergy Immunol 24 : 77-84, 2004)