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.

다단계 임계치를 이용한 패턴 디지털 워터마킹

김현환,김용민,김두영 東亞大學校 附設 情報通信硏究所 1999 情報通信硏究所論文誌 Vol.7 No.1

Digital Watermarking is a research area which aims at hiding secret information in digital multimedia contents such as image, audio, and video. In this paper, we propose a new watermaking method with visually recongnizable pattern into the digital image using wavelet transform, spread spectrum method and multilevel threshold value in considering the wavelet coefficients. The watermark information can be extracted by subtracting wavelet coefficients between the origitnal image and orginal image and the watermarked image. The esperimental results show that the prosposed technique is invisible watermarking and robust to JPEG lossy compression, resizing, masking, and filtering.

항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

조발성 우울증과 만발성 우울증의 임상적, 생물학적인 차이

김문두,박용진 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

이동국의 클래스를 갖는 CDMA 시스템의 성능 분석

김두용 순천향대학교 부설 산업기술연구소 1995 순천향 산업기술연구소논문집 Vol.1 No.2

Mobile stations can be classified with the transmission power level in CDMA system. The different performance parameters will be give to the each class of mobile stations so that the varied quality of services can be provided. In this paper, two classes of mobile stations will be assumed. With the classification of mobile stations, the reverse link capacity are evaluated. It is shown that the reduction of 1 dB of Eb/Io Allows the capacity to increase by 25% and also the data transmission rate and the power control accuracy have a significant effect on the reverse link capacity. Finally, the effect of the variation of the reverse link cell size is evaluated.

연속형 프리플렉스 합성교량의 시공관리에 관한 연구

김종인,김두기,임병용 국립7개대학공동논문집간행위원회 2004 공업기술연구 Vol.4 No.-

This paper presents a procedure for the quality control of continuous preflex composite girder bridges through camber measurements during construction. The construction stages which require welding, balanced preflexion loads at the ends, etc. may cause unexpected large deformation of preflex girders. Furthermore, these defects can be detected by the measurements and analyses of the girder behavior, which is sometimes time-consuming. In the present study, preflex girder's camber dta at equally spaced nodes in each construction stage are obtained and analyzed for the quality control of thee span continuous preflex girder composite bridge.

노인우울증에서 Methylphenidate 강화요법의 조기 반응 효과 예측인자

김문두,박용진 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

인터넷 쇼핑몰의 웹사이트 평가요인

김두경,채용원 제주대학교 관광과경영경제연구소 2004 産經論集 Vol.20 No.-

導痰湯이 家兎의 高脂血症 및 血栓症에 미치는 影響

金然斗,文炳淳,朴暎淳,金世吉 圓光大學校 韓醫學硏究所 1994 원광한의학 Vol.4 No.1

The present experiment was designed to investigate the effects of Dodamtang(導痰湯) on the hyperlipidemia and intravasculr coagulation induced rabbits. In order to control the precise condition, the experimental rabbits were sypplied with calorie limited food. The hyperlipidemia was induced by oral administration of cholesterol(500㎎/㎏) for 4weeks and the intravascular coagulation was induced by indotoxin injection(0.15㎎/㎏). The therapeutic effects of Dodamtang (250㎎/㎏ and 500㎎/㎏) on the lipid metabolism, histological changes of fat deposition in tissues, and the FDP were studied. The results were summurized as followings : 1. The food efficiency rate was decreased significantly with the increased concentration of Dodamtang. 2. The concentration of the serum glucose and total lipid decreased significantly with the increased concentration of Dodamtang. 3. The arteriosclerosis index for phospholipid (triglyceride/phosphokipid) decreased with the increased concentration of Dodamtang. 4. The concentration of the serum total cholesterol, free cholesterol and the arteriosclerosis index for HDL-cholesterol(LDL, VLDL-chloesterol/HDL-cholesterol) decreased with the increased concentration of Dodamtang. 5. The concentration of the serum total protein decreased significantly with the increased concentration of Dodamtang, however, the metabolic rate of albumin/globulin increased with the increased concentration on Dodamtang. 6. The concentration of the serum creatinine decreased significantly with the increased concentration of Dodamtang. 7. The activities of GOT, GPT, and LDH decreased significantly with the increased concentration of Dodamtang. 8. The fat deposition in tissues decreased significantly with the increased concentration of Dodamtang. 9. The concentration of FDP decreased significantly with the increased concentration of Dodamtang. According to the above results, Dodamtang is assumed to have a curative effects against hyperlipidemia and intravascular coagulation.

一部 小規模 産業場勤勞者의 一次診療 實態

金容球,金斗熙 慶北大學校 産業開發硏究所 1981 硏究報告 Vol.9 No.-

The present study was conducted to investigate the status of primary health care in small industrial companies with 500 or less employees. I chose 2 dispensaries that were operated by a registered nurse. I studied 2,119 patients (male: 996, famale: 1,123) who visited dispensaries during one calendar year, from December-1979 to November-1980 and the results obtained are as follows. The average frequency of visits to the dispensaries per year was 3.6 times, whith the average visits of males as 4.0 and females as 3.1. Of the total number, 27.3% were injuries and poisonings (XVII of international classification of disease), 19.5% were symptoms, signs and ill-defined conditions (XVI), 17.5% were diseases of the digestive system (Ⅸ), 17.1% were diseases of the respiratory system (Ⅷ). Of the patients who were injured and poisoned, 24.6% were abrasions, 19.9% were open wounds, and 18.5% were contusions. Of 408 cases of the symptoms, signs and ill-defined conditions, 76.2% were headaches. Of the diseases of the digestive system (Ⅸ), about 65% were indigestion and 15% were diseases in the oral cavity. Of the diseases of the respiratory system (Ⅷ), about 86% were common colds. It was possible to treat about 92% of all the cases within 7 days. Monthly distribution of frequency of visits to dispensary showed relatively unique from 8 to 12%. Of the day of a week, monday had the highest number of patients(22%) and sunday, the lowest. More than half of the patients (51.9%) were between the ages of 20 and 24. But the frequency distribution by age group was higher in 20-34 years old group with average three to five times of visits in a year. As educational level is higher, visiting time to dispensary is more frequent. The highest number of injury occurred between second and third hour following each resting period.