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.

미세채널 구조물 상부의 초정밀 연마 기술 연구

강정일,이윤호,안병운,윤종학 한국공작기계학회 2003 한국공작기계학회 추계학술대회논문집 Vol.2003 No.-

Micro-Channel ultra-precision polishing is a new technology used in magnetic field-assisted polishing. In this paper, an electromagnet or the jig of test system was designed and manufactured. A size of magnetic abrasive is used on 25~75μm and for the polish a micro-channel upper part. A surface of channel which is not even is manufactured using magnetic abrasive finishing at upper surface of micro-channel. As a result, the surface roughness rose by 80% after upper surface of micro- channel was polished up 8 minutes by polishing.

말기신부전 환자에서 혈액투석 전후의 QT간격분산 비교

강대웅,정지용,윤나라,안치용,김종오,신병철,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Background: Some cases of QT interval, corrected QT interval (QTc), QT dispersion (QTd) and corrected QT dispersion (QTcd) have been reported in ESRD, but these results are variable and the influence of a hemodialysis is still controversial, In this study, we investigated the effect of hemodialysis on QT and QTc interval and QT and QTc dispersion in patients with ESRD 15 min before and 15 minute after each hemodialysis. Methods: Sixty-seven patients with ESRD (men 33 & women 34) on three-times stable hemodialysis (>3 months) were randomly enrolled. Fifty control subjects with a similar age and normal renal function were enrolled from this hospital. Routine biochemical studies were measured pre- and post dialysis, at the time of the ECG. Plasma Na+, K+, BUN, creatinine, ionized calcium and phosphate were checked. Twelve-lead electrocardiographs were performed at 10㎜/mv and 50㎜/s using a HewIett-Packard Pagewriter 100, before and after a single hemodialysis session.The QT interval was measured from the onset of the QRS complex to the end of the T wave. If the end of the T wave was not clear in a particular lead then it was excluded from analysis. When U waves were present, the end of the T wave was taken as the nadir between the T and U waves. Each QT interval was corrected for heart rate using Bazett's formula (QTc==QT/√(RR)) (ms). The difference between maximal and minimal QT interval duration was defined as QT dispersion (QTd) in each of the 12 leads. Result: This study demonstrates that QT, QTd, QTcd is higher in hemodialysis patients compared with control subjects, and QT and QTd rise postdialysis to levels comparable to those seen acutely following myocardial infarction, when patients are at greatly increased risk of potentially fatal ventricular arrhythmias, Conclusions: QT interval and QT dispersion, markers of risk for arrhythmias and sudden death, are elevated in hemodialysis patients, and rise postdialysis. QT interval and QT dispersion is an easily obtainable, noninvasive, simple, inexpensive, and widely available method of risk stratification in uremic patients receiving chronic dialysis. Additional studies are needed to clarity whether increased postdialysis QT dispersion results in an increased occurrence of arrhythmias.

하악에 발생한 횡문근육종

윤숙자,강병철 대한구강악안면방사선학회 2004 Imaging Science in Dentistry Vol.34 No.2

Rhabdomyosarcoma, when it occurs in the head and neck, is primarily found in children. Alveolar rhabdomyosarcoma is rarely seen in the oral lesion, comparing to the embryonal and the pleomorphic variants. This is a report of a case of alveolar rhabdomyosarcoma in the mandible in a ten-year old girl who complained of a non-painful swelling on the right cheek. The right lower 1st molar was mobile. Her radiographs revealed an extensive radiolucency with somewhat irregular border on the right mandibular ramus. The right mandibular 1st and 2nd molars lost their lamina dura and were floating. CT images revealed smooth-outlined soft tissue mass occupying the pterygomandibular space, the infratemporal space, and the masseteric muscle with thinning and perforation of the right mandibular angle and ramus. Histopathological and immunohistochemical findings established the final diagnosis of alveolar rhabdomyosarcoma.

제산제를 이용한 자두와인의 감산처리

강병태 ; 김순희 ; 윤옥현 김천대학교 2006 김천대학교 논문집 Vol.27 No.-

To decrease the acid quantity of the plum wine, we have treated the plum wine aged 3 months with calcium carbonate and potassium bicarbonat as antacids. Total acid contents of plum wine was drastically reduced and the pH was increased, rel-atively to concentrations, in the calcium carbonate treated group. But there was not consistent with results in the potassium bicarbonate treated group. However, Both of antacids did not affect the contents of total phenolics. Color changes were mon-itored by the CIELAB space, using the D65 illuminent and 10° observer. Redness (a) was significantly decreased in the plum wine treated with antacids. The chroma(C) and hue (H) parameters was also changed as a result of the dis-coloring process since they are combinations of the a and b parameters.

워터스, 파노라마 방사선사진과 Scanora 방사선사진의 상악동 점막비후 진단 결과의 비교

윤숙자,강병철,정현대 大韓口腔顎顔面 放射線學會 1995 Imaging Science in Dentistry Vol.25 No.2

The purpose of this study was to compare the diagnostic performance of Waters' and panoramic view ; maxillary sinus posteroanterior and lateral scanography of ?? for mucosal thickening of maxillary sinus as well as to identify the utility of ?? for the detection of maxillary sinus disease. The assessment was done at 66 maxillary sinuses in 45 patients and the results were as follows ; 1. Estimation of presence or absence of mucosal thickening. The sensitivity, specificity, and positive and negative predictive value of maxillary sinus posteroanterior and lateral scanography were 0.865, 0.860, 0.921, and 0.805 respectively and slightly higher than those of Waters' and panoramic views, which were 0.832, 0.835, 0.903, and 0.728 respectively. However, paired t-test showed no significant differences in the diagnostic performance of the two pairs of imaging modalities. 2. Estimation of the types of mucosal thickening. The diagnostic accuracy for type Ⅰ, Ⅱ, Ⅲ was 75.3% on Waters' and panoramic view ; 77.9% on maxillary sinus posteroanterior and lateral scanography. It was higher on the latter, but showed no significant differences from that on the former. 3. Reliability of interpretation. In intraobserver and interobserver agreement, both overall rates of agreement and kappa-value were slightly higher on maxillary sinus posteroanterior and lateral scanography than on Waters' and panoramic views. There was no significant differences between the two pairs of imaging modalities. These results suggested that scanogram is a useful diagnostic radiography as well as Waters' and panoramic views for detection of maxillary sinusitis.

MAN 급의 망에서 공정성 개선에 관한 연구

강상욱,윤정오,최병진 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(C)

In this paper we introduce a solution to improve the unfairness problem and to remove the waste of bandwidth in the distributed queue dual bus system. This solution requires only a minor modification of the current protocol and further shows no bandwidth wastes when we try to resolve the unfairness problem occurred in current DQDB protocol. There has been many problem in DQDB system in terms of fairness of sending message in each node. In order to solve this problem, Bandwidth Balancing technic and proportional assignment technic have been introduced. It is, however, to note that the waste of bandwidth problem is still existing in those technics, even though there has been significant improvement as to the fairness problem. In this paper we introduce a new solution to remove the waste of bandwidth problem while we are still obtaining the improved fairness of the network. By following this new solution, the simulation result shows higher throughput and lower message delay than previously proposed technics.

안면비대칭 3차원 CT 분석

윤숙자,임회정,강병철,황현식 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.36 No.1

Purpose : This study aimed to identify the range of normal facial asymmetry using three-dimensional CT and to develop a simple method of diagnosis of facial asymmetry. Materials and Methods : Twenty eight adults with normal occlusion (16 males and 12 females; mean age 24 years and I month) were selected, whose faces were assessed to be symmetric by an orthodontist. Three-dimensional reconstructions were obtained utilizing spiral CT scans and an oral and maxillofacial radiologist, evaluated nineteen anatomic landmarks in three-dimensional coordinates. Facial asymmetry index of each landmark was caluculated. Results : The range of normal facial asymmetry of each landmark was identified using mean and standard deviation of facial asymmetry index. Conclusions : The range of normal facial asymmetry identified in this study may be used as a diagnostic standard for facial asymmetry analysis. (Korean J Oral Maxillofac Radiol 2007; 37: 45-51)

신경회로망 예측기법을 이용한 Variable Rate Leaky Bucket 알고리즘의 구현에 관한 연구

강상욱,윤정오,최병진 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(B)

ATM (asynchronous transfer mode)을 이용한 B-ISDN의 출현은 다양하고 새로운 멀티미디어 서비스를 가능하게 하였다. 그러나 다양한 트래픽 자원들의 버스트성 때문에 이들 트래픽을 동시에 서비스하는데 혼잡제어 (congestion control)라는 새로운 문제에 당면하고 있다. 이를 위하여 UPC/NPC (user parameter control/network parameter control)에 대한 여러 연구가 활발히 진행되고 있는데, 트래픽 상태와 버퍼의 점유 상태에 따라 토큰 생성율을 동적으로 변화시키는 VRLB(variable rate leaky bucket) 알고리즘이 UPC/NPC 메커니즘의 좋은 예가 될 수 있다. 그러나 VRLB 알고리즘과 같은 기존의 UPC/NPC 메커니즘의 단점은 토큰 생성율이 현재 망의 상태에 기반을 두고 있기 때문에, 버스티한 성격을 지닌 트래픽 자원 하에서는 효율성이 떨어진다는 것이다. 본 논문에서는 토큰 생성율을 현재 상태에 기반을 두고 결정하는 VRLA 알고리즘의 단점을 개선하기 위해서 신경회로망의 예측기법을 이용하여 토큰 생성율을 미리 예측하여 보다 유연하고 효율적으로 혼잡제어를 수행하는 새로운 알고리즘을 제안하고, 이의 성능을 컴퓨터 시뮬레이션을 통하여 확인하였다.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.