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.

전립선암에서 TGFβl, TGFβ2 발현과 Ki-67 표지지수의 예후적 가치

장혁준,김기권,이경섭 大韓泌尿器科學會 1999 Korean Journal of Urology Vol.40 No.5

MaxEnt 모델링을 이용한 기후변화 시나리오에 따른 서어나무 (Carpinus laxiflora)와 개서어나무 (C. tschonoskii)의 분포변화 예측

이민기 ( Min-ki Lee ),천정화 ( Jung-hwa Chun ),이창배 ( Chang-bae Lee ) 한국농림기상학회 2021 한국농림기상학회지 Vol.23 No.1

Hornbeams (Carpinus spp.), which are widely distributed in South Korea, are recognized as one of the most abundant species at climax stage in the temperate forests. Although the distribution and vegetation structure of the C. laxiflora community have been reported, little ecological information of C. tschonoskii is available. Little effort was made to examine the distribution shift of these species under the future climate conditions. This study was conducted to predict potential shifts in the distribution of C. laxiflora and C. tschonoskii in 2050s and 2090s under the two sets of climate change scenarios, RCP4.5 and RCP8.5. The MaxEnt model was used to predict the spatial distribution of two species using the occurrence data derived from the 6^th National Forest Inventory data as well as climate and topography data. It was found that the main factors for the distribution of C. laxiflora were elevation, temperature seasonality, and mean annual precipitation. The distribution of C. tschonoskii, was influenced by temperature seasonality, mean annual precipitation, and mean diurnal rang. It was projected that the total habitat area of the C. laxiflora could increase by 1.05% and 1.11% under RCP 4.5 and RCP 8.5 scenarios, respectively. It was also predicted that the distributional area of C. tschonoskii could expand under the future climate conditions. These results highlighted that the climate change would have considerable impact on the spatial distribution of C. laxiflora and C. tschonoskii. These also suggested that ecological information derived from climate change impact assessment study can be used to develop proper forest management practices in response to climate change.

Comparison of controlled ovarian stimulation outcomes for fertility preservation in women with breast cancer according to KI-67, histologic grade, pathologic type, and cancer stage

( Eun Ji Oh ),( Yeon Hee Hong ),( Seul Ki Kim ),( Jung Ryeol Lee ),( Byung Chul Jee ),( Chang Suk Suh ),( Seok Hyun Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: This study aims to analyze that specific prognostic factors such as Ki-67 value, histologic grade, pathology type, and cancer stage can affect controlled ovarian stimulation outcomes(COS) for fertility preservation in women with breast cancer. Methods: This retrospective cohort study included 92 patients with breast cancer aged 21-44 who underwent COS from August 2012 to April 2020, excluding patients with previous gonadotoxic therapy history. All COS cycles were conducted letrozole-combined random start GnRH antagonist protocol. COS outcomes were compared according to prognostic factors;Ki-67 (< 30% vs. ≥ 30%), histologic grade (low vs. high), and pathologic type (intraductal carcinoma(IDC) vs. triple-negative breast cancer(TNBC)), and cancer stage (early (I, II) vs. advanced (III, IV)). Multivariate analysis was also conducted to find any parameter that can impact over 10 mature oocytes acquisition. Results: Among the 92 patients, 42 were Ki-67≥30% compared to 49 of Ki-67<30%. The number of oocytes, and initial mature oocytes were comparable between Ki-67<30% and ≥30 group. The maturation rate was significantly higher in Ki-67≥30% group than Ki-67<30% group (57.4±36.8% vs. 44.8±28.3%, p=0.041). The same results were drawn when divided according to IDC or TNBC. The maturation rate was significantly higher in TNBC than the IDC group (73.0±17.6% vs. 47.0±28.1% p=0.001). However, the histologic grade or stage did not show any difference in COS outcomes between high and low grade or early and advanced stages. With multivariate analysis, age and AMH are parameters associated with the acquisition of over 10 mature oocytes (OR 0.863, 95% CI [0.755-0.987], OR 1.408, 95% CI [1.145-1.732], respectively). Conclusion: Either Ki-67 or pathologic type can be a potential reliable marker for predicting COS outcome, especially maturation rate. Further study with larger sample size with specific conditions is necessary to clarify the correlation between breast cancer prognostic factors and COS outcomes.

Comparison of Proliferative Activity in Each Histological Subtypes of Benign and Atypical Intracranial Meningiomas by PCNA and Ki-67 Immunolabeling

최승진,장은덕,권성오,계대곤,박춘근,이상원,강준기,Choi, Seung Jin,Chang, Eun Deok,Kwon, Seung Oh,Kye, Dae Kon,Park, Choon Keun,Lee, Sang Won,Kang, Joon Ki The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.9

목 적 : 양성 뇌수막종에 비하여 이형성 및 악성 뇌수막종이 나쁜 임상적인 예후 및 양상을 보이는 것은 잘 알려져 있으나, 양성 뇌수막종에 있어서 각각의 병리조직학적 아형에 따른 생물학적 양상의 차이에 대해서는 잘 알려지지 않거나 일부 논란이 되고있다. 본 연구에서는 이형성 뇌수막종 및 양성 뇌수막종의 각각의 병리조직학적 아형에 따른 증식능의 차이여부를 알아보고자 PCNA와 Ki-67표지지수를 분석하였다. 방 법 : 본원에서 뇌수막종으로 수술을 시행하여 얻은, 재발을 보여 재수술을 시행한 2례를 포함하여, 파라핀에 포매시킨 27개의 조직을 대상으로 병리학적인 증식능을 분석하기 위해, PCNA에 대한 단일항체 및 MIB-1 단일항체를 이용한 면역조직화학적 염색을 시행하였다. 조직학적 분류상 meningothelial type이 8례, transitional type이 9례, fibroblastic type이 5례였으며, 이형성 수막종이 5례였다. 결 과 : PCNA표지지수의 평균값은 양성 수막종에서 meningothelial type이 $4.82{\pm}5.10%$, transitional type이 $9.01{\pm}4.25%$, fibroblastic type이 $5.66{\pm}5.32%$를 보였으나 이형성 수막종에서는 $27.62{\pm}19.67%$의 높은 지수를 나타냈고, Ki-67 표지지수의 평균값은 양성 수막종의 아형에서 각각 $0.43{\pm}0.85%$, $0.44{\pm}1.08%$, $0.24{\pm}0.18%$를 보이고, 역시 이형성 수막종에서는 $0.84{\pm}0.59%$의 높은 지수를 보였다. 즉, 양성 수막종에서 각각의 아형에 따른 PCNA 및 Ki-67 표지지수는 통계학적으로 의미있는 차이는 없었으나(p>0.05), 이형성 수막종에서는 의미있는 높은 표지지수를 보여(p<0.05) 양성 수막종에서 보다 높은 증식능을 보임을 알 수 있었다. 결 론 : PCNA 및 Ki-67 표지지수를 이용한 증식능의 비교결과, 양성 뇌수막종에서는 각각의 아형에 따른 생물학적 양상이나 예후는 차이가 없을것으로 생각되나, 이형성 수막종에서는 높은 증식능을 보여 이에 대한 예후를 예상할 수 있을것으로 생각되며, 또한 이러한 표지지수가 병리조직학적으로 양성과 이형성의 감별에 많은 도움이 될것으로 사료된다. Objective : The clinical prognosis and biological behavior of atypical and especially malignant meningiomas are well known to be worse than benign meningioma, but the degree of biological aggressiveness in each classical subtypes of benign meningioma is controversy. This study was performed to see whether there is a difference in the proliferative activity between each different histological subtypes of benign meningioma as well as atypical meningioma. Methods : Paraffin-embedded surgical specimens of 27 meningiomas, including two recurrent tumors, were studied to evaluate proliferative activity by immunohistochemical method with monoclonal antibodies to proliferating cell nuclear antigen(PCNA) and MIB-1. The specimens consisted of 8 cases of meningothelial, 9 cases of transitional, 5 cases of fibroblastic subtypes and 5 cases of atypical meningiomas. Results : Mean PCNA labeling indices of meningothelial, transitional and fibroblastic meningiomas were $4.82{\pm}5.10%$, $9.01{\pm}4.25%$ and $5.66{\pm}5.32%$, but that of atypical meningiomas was $27.62{\pm}19.67%$, noting a higher value compared to all three subtypes of benign meningiomas. Mean Ki-67 labeling indices of the above 3 subtypes were $0.43{\pm}0.85%$, $0.44{\pm}1.08%$ and $0.24{\pm}0.18%$, and that of atypical meningiomas was also revealed to be of higher value ($0.84{\pm}0.59%$). PCNA and Ki-67 labeling indices were not statistically different between histological subtypes of benign meningioma(p>0.05), but the differences of both immunolabeling between benign and atypical meningiomas were statistically significant(p<0.05). Conclusion : Immunolabeling of PCNA and Ki-67 in intracranial meningiomas reveals no prognostic difference between meningothelial, transitional and fibroblastic subtypes in classical benign meningiomas by measuring expression of PCNA and Ki-67, but it seems to be helpful in differentiating benign and atypical meningioma, later showing more proliferative activity and biological aggressiveness.

연구개 및 구개수에 발생한 편평세포암종

이승호,이성훈,김기영,김창룡,박문성,류선열,조규승 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Carcinoma of the mouth accounts for approximately 5% of all carcinomas occurring in man. Carcinoma of the oral cavity develops as a result of invasion of malignant epithelial cells through the normally intact basal cell layer into subcutaneous and submucosal tissuse. The sofe palate and uvula may be involved in oral cancer but are not common sites. Early lesions of soft palate carcinoma appear as red, white, or mixed changes in the mucosa. The earliest symptom is mild sore throat. Advanced lesions interfer with swallowing and may cause a voice change. Although surgical method of soft palate carcinoma is successful, prognosis is relatively poor to swallowing and speech problem. Occasionally marginal recurrence may be developed. This article reports a case of squamous cell carcinoma occurred unusually in the soft palate and uvula. The case was treated with neoadjuvant chemotherapy, local radicalexcision and postoperative irradiation. Patient was followed up for 2 years. There was no tumor recurrence. The overall result including function was satisfactory.

A Comparison Between Stroke Patients Admitted to Oriental Hospital in the Years 1987 and 1994

Lee Kyung-sup,Cho, Ki-ho,Kim, Young-suk,Ko, Chang-nam,Moon Sang-kwan,Bae Hyung-sup INSTITUTE OF ORIENTAL MEDICINE KYUNG-HEE UNIVERSIT 1998 JOURNAL OF ORIENTAL MEDICINE Vol.3 No.1

The characteristics of stroke slightly vary as time changes. To compare the characteristics of stroke between the 1980s and 1990s we investigated the clinical records of stroke patients in 1987 and 1994. The subjects of this study consisted of the 1971 patients who were admitted as stroke patients to the Kyunghee University Oriental Medicine Hospital during these two years. There were 1092 stroke patients admitted from May, 1987 to April, 1988 and 879 stroke patients admitted between May, 1994 and April, 1995. The results were as follows. The frequency of cerebral infarction was 77.9% in 1987 and 79.9% in 1994. The male to female ratio of stroke patients was 1.4:1 in 1987 and 1.6:1 in 1994. The occurrence rate of stroke in both 1987 and 1994 were highest in patients in their 60s, followed by those in their 50s, 70s and older, in their 40s, and finally their 30s and below. We especially found that the rate of patients in their 70s and over increased from 17.8% in 1987 to 25.3% in 1994, which was remarkable in cerebral infarction patients. The most common disease preceding a stroke was hypertension, followed by heart disease and diabetes in 1987, and in 1994 hypertension was the most common, followed by diabetes and heart disease. The rate of recurrence among cerebral hemorrhage, that was 12% in 1987 and 24.7% in 1994. The most frequent complications of stroke in 1987 and 1994 were pneumonia and urinary tract infection, respectively. The prescriptions used most frequently during admission were Chungpaesagan-tang followed by Sunghyangjungki-san, Yangyeksanhwa-tang etc. in both 1987 and 1994. When patients were getting better, prescriptions for invigorating Qi and enriching the blood(補氣血) were used more frequently. In conclusion, the most remarkable change of stroke patients from 1987 to 1994 was an increase in occupancy rate of aged patients, especially those in their 70s and older. So we suggest that more research are needed on the stroke of aged man, along with many other subjects on stroke.

흰쥐 시상하부에서 NMDA에 의한 c-fos의 발현

이영기,최기열,이원돈,유영복,이왕재,황덕호,조사선,장가용 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.3

Effects of aerosol on evaporation, freezing and precipitation in a multiple cloud system

Lee, Seoung Soo,Kim, Byung-Gon,Yum, Seong Soo,Seo, Kyong-Hwan,Jung, Chang-Hoon,Um, Jun Shik,Li, Zhanqing,Hong, JinKyu,Chang, Ki-Ho,Jeong, Jin-Yim Springer-Verlag 2017 Climate dynamics Vol.48 No.3

<P>Aerosol effects on clouds and precipitation account for a large portion of uncertainties in the prediction of the future course of global hydrologic circulations and climate. As a process of a better understanding of interactions between aerosol, clouds and precipitation, simulations are performed for a mixed-phase convective multiple-cloud system over the tropics. Studies on single-cloud systems have shown that aerosol-induced increases in freezing, associated increases in parcel buoyancy and thus the intensity of clouds (or updrafts) are a main mechanism which controls aerosol-cloud-precipitation interactions in convective clouds. However, in the multiple-cloud system that plays much more important roles in global hydrologic circulations and thus climate than single-cloud systems, aerosol effects on condensation play the most important role in aerosol-induced changes in the intensity of clouds and the effects on freezing play a negligible role in those changes. Aerosol-induced enhancement in evaporation intensifies gust fronts and increases the number of subsequently developing clouds, which leads to the substantial increases in condensation and associated intensity of convection. Although aerosol-induced enhancement in freezing takes part in the increases in condensation by inducing stronger convergence around cloud bottom, the increases in condensation are similar to one order of magnitude larger than those in freezing. It is found that while aerosol-induced increases in freezing create intermittent extremely heavy precipitation, aerosol-induced increases in evaporation enhance light and medium precipitation in the multiple-cloud system here. This increase in light and medium precipitation makes it possible that cumulative precipitation increases with increasing aerosol concentration, although the increase is small. It is interesting that the altitude of the maximum of the time- and domain-averaged hydrometeor mass densities is quite robust to increases in aerosol concentration. This is because locations of gust fronts and homogeneous freezing do not vary significantly with changing aerosol concentration and this outweighs aerosol effects on hydrometeor size.</P>

Changes of soil organic carbon and its fractions in relation to soil physical properties in a long-term fertilized paddy

Lee, Seul Bi,Lee, Chang Hoon,Jung, Ki Yuol,Park, Ki Do,Lee, Dokyoung,Kim, Pil Joo Elsevier 2009 Soil & tillage research Vol.104 No.2

<P><B>Abstract</B></P><P>Soil organic carbon (SOC) has an important role in improving soil quality and sustainable production. A long-term fertilization study was conducted to investigate changes in SOC and its relation to soil physical properties in a rice paddy soil. The paddy soils analyzed were subjected to different fertilization practices: continuous application of inorganic fertilizers (NPK, N–P–K=120–34.9–66.7kgha<SUP>−1</SUP>yr<SUP>−1</SUP> during 1967–1972 and 150–43.7–83.3kgha<SUP>−1</SUP>yr<SUP>−1</SUP> from 1973 to 2007), straw based compost (Compost, 10Mgha<SUP>−1</SUP>yr<SUP>−1</SUP>), a combination of NPK+Compost, and no fertilization (control). Soil physical properties were investigated at rice harvesting stage in the 41st year for analyzing the relationship with SOC fraction. Continuous compost application increased the total SOC concentration in plough layers and improved soil physical properties. In contrast, inorganic or no fertilization markedly decreased SOC concentration resulting to a deterioration of soil physical health. Most of the SOC was the organo-mineral fraction (<0.053mm size), accounting for over 70% of total SOC. Macro-aggregate SOC fraction (2–0.25mm size), which is used as an indicator of soil quality rather than total SOC, covered 8–17% of total SOC. These two SOC fractions accumulated with the same tendency as the total SOC changes. Comparatively, micro-aggregate SOC (0.25–0.053mm size), which has high correlation with physical properties, significantly decreased with time, irrespective of the inorganic fertilizers or compost application, but the mechanism of decrease is not clear. Conclusively, compost increased total SOC content and effective SOC fraction, thereby improving soil physical properties and sustaining production.</P>