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.

동종 조혈모세포이식 후 발생한 치명적 홍역 폐렴 1예

백창렬,이동건,최정현,정현화,조유경,박훈준,이승훈,박윤희,이교영,민우성,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

As a result of the enlarging pool of unvaccinated children and young adults, there has been an increase in measles in our countries. In these situation, it has been reported that measles associated pneumoinia is easily complicated with fatal respiratory failure, espycially in immunocompromised patients. Herein we report the case of lethal measles pneumonia after allogenic hematopoietic stem cell transplantation in adults proven by autopsy. Recently, one case of measles was encountered in 39-year-old female patients after allogenic bone marrow transplanted case (chronic myelogenous leukemia), who progressed into interstitial pneumonia pattern, despite treatment including antibiotics, immunoglobulin. The patient died of giant cell pneumonia compatible with that of measles which was comfirmed in the section of necropsy lung specimen. (Korean J Infect Dis 33:301∼309, 2001)

당뇨병 노인환자의 자가간호 지식정도 및 신체적 건강상태와 자가간호 수행정도와의 관계 연구

백훈정 中央醫學社 1993 中央醫學 Vol.58 No.8

This descriptive ?correlationaly study was undertaken in order to examine if there was a relationship between the level of knowledge about self-care and self-care behavior, a relationship between the physical health status and self-care behavior in elderly DM patients. The sampling method was a non-probability purposive sampling technique. The participants of this study were 73 volunteer clients. Data was collected between July 27th and August 1st in E general hospital in Seoul. The instructions used for this study were a knowledge scale about self-care behavior scale developed by researcher. For checking the physical health status of the elderly DM patients, the scale was used that was developed by Choi & Jung. The tool of this research were reviewed its content validity by 1 professor of nursing and 2 nurses. The tool of this research were reviewed its reliability; Cronbach α=0.82,0.85, 0.87. the former was the tool for the level of knowledge, the second was the tool for self-care behavior and the latter was the tool for physical health status. 73 data were analyzed by percentage, mean, t-test, ANOVA and Pearson Correlation Coefficient. The result of study were as follows: 1. There was a relationship between the level of knowledge about self-care and self-car e behavior in elderly DM patients. 2. There was a relationship between the physical health status and self-care behavior. In conclusion, this study revealed that both knowledge about self-care and physical health status of elderly are factors in improving self-care behavior in elderly DM patients. So, in caring elderly DM patient, the knowledge reinforcing education program and health promotion or health maintenance program will be useful.

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.

주요우울증에 대한 Milnacipran의 효과 및 안정성 : Fluoxetine과의 비교

이민수,함병주,기백석,김정범,연병길,오강섭,오병훈,이철,정한용,지익성,최병무,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This 6-week, open label randomized, multicenter study was conducted to evaluate the antidepressant effect and safety of milnacipran and fluoxetine in patients with major depression. Methods : The study was done in patients with major depression diagnosed by DSM-IV who score ≥17 in 17 items Hamilton Rating Scale for Depression (17-item HAM-D) and score ≥25 in Montgomery and Asberg Depression Rating Scale (MADRS). A total of 87 patients were randomized to milnacipran group and fluoxetine group. In cases of the patients taking other antidepressants, 6 weeks of each medication was administered after 7 days of drug excretion period. The evaluation was done using 17 item HAM-D, MADRS, Clinical Global Impression Scale (CGI), and COVI scale after baseline, 1 week, 2 weeks, 4 weeks, and 6 weeks. The side effects that had occurred during the period of our study were put in records by developed/disappeared time, severities, incidences, managements and results. Results : A total of 87 patients were enrolled. 70 (mitnacipran group 39 ; fluoxetine group 31) of them were included for the 6 weeks of research and 17 of them dropped out with in the first week, not due to adverse reactions or deficiency of effects. Total 17 item HAM-D scores, total points of MADRS, and CGI showed significant decrease after 1 week in each treatment group and continued decrease after 2 weeks and 4, 6 weeks. But there was no difference between milnacipran group and fluoxetine group in the antidepressant effect. There were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The commonly reported side elfects of minlacipran were nausea (25.0%), headache (10.7%), vomiting (7.1%),constipation (7.1%), dizziness (7.1%) and those of fluoxetne were GI trouble (11.1%), diarrhea (11.1%), insomnia (11.1%),agitation (5.6%), and dizziness (5.6%). Conclusion : Milnacipran was effective for the improvement of depressive symptoms and was well tolerated and safe in patients with depression.

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.

The Performance Comparison for the Contention Resolution Policies of the Input-buffered Crosspoint Packet Switch

Jung Hoon Paik,Chae Tak Lim 한국정보과학회 1998 Journal of Electrical Engineering and Information Vol.3 No.1

In this paper, an NxN input-buffered crosspoint packet switch which selects a Head Of the Line, HOL, packet in contention randomly is analyzed with a new approach. The approach is based on both a Markov chain representation of the input buffer and the probability that a HOL packet is successfully served. The probability as a function of N is derived, and it makes it possible to express the average packet delay and the average number of packets in the buffer as a function of N. The contention resolution policy based on the occupancy of the input buffer is also presented and analyzed with this same approach and the relationship between two selection policies is analyzed in terms of the occupancy of the input buffer.

Thermal durability and fracture behavior of layered Yb-Gd-Y-based thermal barrier coatings in thermal cyclic exposure

Jung, Sung-Hoon,Lu, Zhe,Jung, Yeon-Gil,Song, Dowon,Paik, Ungyu,Choi, Baig-Gyu,Kim, In-Soo,Guo, Xingye,Zhang, Jing Elsevier 2017 Surface & coatings technology Vol.323 No.-

<P><B>Abstract</B></P> <P>The effects of structural design on the thermal durability and fracture behavior of Yb-Gd-Y-based thermal barrier coatings (TBCs) were investigated through thermal cyclic exposure tests, such as furnace cyclic thermal fatigue (FCTF) and jet engine thermal shock (JETS) tests. The effects of composition in the bond coat and feedstock purity for the buffer layer on its lifetime performance were also examined. To overcome the drawbacks of Yb-Gd-Y-based material with inferior thermal durability due to poor mechanical properties and low coefficient of thermal expansion, a buffer layer was introduced in the Yb-Gd-Y-based TBC systems. In FCTF tests, the TBCs with the buffer layer showed a longer lifetime performance than those without the buffer layer, showing the longest thermal durability in the TBC with the Co-Ni-based bond coat and the buffer layer of regular purity. In JETS tests, the TBC with the Ni-based bond coat and the buffer layer of high purity showed a sound condition after 2000cycles, showing better thermal durability for TBC with the Co-Ni-based bond coat rather than that with the Ni-based bond coat in the single layer coating without the buffer layer. The buffer layer effectively enhanced the thermal durability in slow temperature change (in the FCTF test), while the bond-coat composition and the feedstock purity for the buffer layer were found to be important factor to improve the thermal durability of the TBC in fast temperature change (in the JEET test). Finally, these research findings allow us to control the structure, composition, and feedstock purity in TBC system for improving the thermal durability in cyclic thermal environments.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Thermal durability and interface stability in Yb–Gd–Y-based TBCs was investigated. </LI> <LI> New architectures of TBC were designed and prepared by introducing a buffer layer. </LI> <LI> Cyclic thermal exposure tests were employed in determining thermal durability. </LI> <LI> Buffer layer improved the thermal durability of TBC in slow temperature change. </LI> <LI> TBCs with high purity buffer layer showed partial delamination in fast temperature change. </LI> </UL> </P>

Spatio-Temporally Adaptive Image Sequence Interpolation

Jung Hoon Jung,Jeong Ho Shin,Joon Ki Paik 대한전자공학회 1998 ITC-CSCC :International Technical Conference on Ci Vol.- No.-

The Performance Comparison for the Contention Resolution Policies of the Input-buffered Crosspoint Packet Switch

Paik, Jung-Hoon,Lim, Chae-Tak The Korean Institute of Electrical Engineers 1998 Journal of Electrical Engineering and Information Vol.3 No.1

In this paper, an NxN input-buffered crosspoint packet switch which selects a Head of the Line, HOL, packet in contention randomly is analyzed with a new approach. The approach is based on both a Markov chain representation of the input buffer and the probability that a HOL packet is successfully served. The probability as a function of N is derived, and it makes it possible to express the average packet delay and the average number of packets in the buffer as a function of N. The contention resolution policy based on the occupancy of the input buffer is also presented and analyzed with this same approach and the relationship between two selection policies is analyzed in terms of the occupancy of the input buffer.