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        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.

      • 서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

        김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

        Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

      • 청소년기 태권도 수련생들의 체격 및 체력 요인별 발달 비교

        김동제,권창기,가경환 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

        This study was intended to investigate changes in the physique and fitness by age in adolescence. For this purpose, it attempted to make the first measurement in June, 2001 and the second measurement in 2002 for a total of 15 persons(seven middle school students aged 13 to 14 years and 8 high school students aged 16 to 17 years) practicing Taekwondo at 'S' and 'C' Drill Centers located in South Kyungsang Province. Both measures were conducted over the 2-day period. An attempt was made to compare and analyze the growth rate of physique and fitness factors by age based on data from measurement. As a result, the following conclusion was drawn: First, it was found that there was a statistically significant difference in the change of height, weight and body fat percent before and after measurement in order to investigate the change of physique(P<.05). Among other things, it was found that there was a statistically significant difference in the change of height, weight between the period of middle school days(13 to 14 years old) and the period of high school days(16 to 17 years old)(P<.05). It was found that Taekwondo trainees grew more over the period of middle school days(13 to 14 years old) than over the period of high school days(16 to 17 years old). But it was found that there was not a statistically significant difference in body fat percent between both groups(P<.05). But body fat percent reduced over the period of middle school days{13 to 14 years old) but did remain almost unchanged. Second, an attempt was made to measure power(high jump test), agility(side step test), muscular endurance(sit-up) and cardiopulmonary endurance(1500-meter run) to investigate the change of physique. It was found that there was not a statistically significant difference in the change of power(high jump test) and muscular endurance(sit-up) before and after measurement(P<.05). But it was found that there was a statistically significant difference on agility(side-step test) and cardiopulmonary(1500-meter run)(P<.05). It was found that there was a statistically significant difference in agility(side-step test), muscular endurance(sit-up) and cardiopulmonary endurance(1500-meter run) except power(high jump test) between he period of middle school days(13 to 14 years old) and the period of high school days(16 to 17 years old)(P<.05). The high jump test was conducted to investigate the change of power. As a result, it was found that power increase the period of middle school days(13 to 14 years old), whereas it decrease over the period of high school days(16 to 17 years old). On the other hand, the side-step test was conducted to investigate the change of agility. It was found that agility increased in Tawekwondo trainees over both the period of middle school days(13 to 14 years old) and the period of high school daysd(16 to 17 years old), the latter of which it was more or less improved. This study conducted the sit-up test to investigate the change of muscular endurance and the 1500-meter run test to investigate the change of cardiopulmonary endurance. In case of the 1500-meter run, cardiopulmonary endurance decreased over the period of middle school days(13 to 14 years old) but increased over the period of high school days(16 to 17 years old).

      • SCOPUSSCIEKCI등재

        Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

        Kim, Chang-Wook,Hyun, Seung-Jae,Kim, Ki-Jeong The Korean Neurosurgical Society 2021 Journal of Korean neurosurgical society Vol.64 No.6

        The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

      • SCIESCOPUSKCI등재
      • SCISCIESCOPUS

        Expression of Wnt Target Genes in Solid Pseudopapillary Tumor of the Pancreas: A Pilot Study

        Kang, Chang Moo,Kim, Hyun Ki,Kim, Hoguen,Choi, Gi Hong,Kim, Kyung Sik,Choi, Jin Sub,Lee, Woo Jung Lippincott Williams Wilkins, Inc. 2009 PANCREAS Vol.38 No.2

        OBJECTIVES:: Solid pseudopapillary tumor (SPT) of the pancreas is very rare. This study was performed to analyze the expression of Wnt signal target genes (matrix metalloproteinase-7 [MMP-7], cyclin-D1, and c-myc) and Ki-67 in resected SPTs to determine their clinicopathologic characteristics according to their expression. METHODS:: From January 1995 to December 2005, 23 patients underwent pancreatic resections for SPT of the pancreas. Among 23 formalin-fixed, paraffin-embedded tissues, 12 were evaluated as a pilot study. Immunohistochemistry was performed using various detection and antigen retrieval methods to detect MMP-7, cyclin-D1, c-myc, and Ki-67. The expression of Wnt target genes was correlated with clinicopathologic features of the patients. RESULTS:: Solid pseudopapillary tumors of the pancreas always showed cytoplasmic/nuclear accumulation of &bgr;-catenin, frequent expression of cyclin-D1, and low proliferation index. MMP-7, cyclin-D1, c-myc, and Ki-67 were not correlated with microscopic features suggesting malignant potential (P > 0.05). Tumor size was closely related to microscopic features of malignant potential and apparently has an inverse relationship with the expression of cyclin-D1 and Ki-67 (P < 0.05). CONCLUSIONS:: Low proliferative index and associated MMP-7 expression may cause an unpredictable clinical course in this tumor. Subtle changes in the intracellular environment, not pathologic (morphologic) changes, may elucidate the unpredictable clinical course of this tumor.

      • 濟州道 改良草地에 있어서 띠(Imperata cylindrica)의 季節的 年次的 變化

        趙南棋,金翰琳,宋昌吉 제주대학교 1983 논문집 Vol.16 No.-

        本 硏究는 濟州道 中山間地帶의 自然草地(Imperata cylindrica/Zoysia japonica type)를 開墾한 後 1 ha當 Dactylis glomerata 17kg, Festuca arundinacea 7kg, Lolium multiflorum 2kg, Trifolium repens 2kg의 導入牧草를 混播(28kg)하여 家畜放牧에 利用되고 있는(1977∼1982年) 改良草地를 對象으로하여, 띠(Imperata cylindrica)植生의 季節的ㆍ年次的變化過程을 調査한 結果를 要約하면 다음과 같다. 1. 每年 季節에 따르는 草長ㆍ收量ㆍ密度ㆍ被度 等 植生의 季節的 變化에 있어서는 秋期에 가장 優勢하였고, 春期에는 低調하게 나타났다. 2. 改良後 年度別 草長의 變化는 1年草地에서 34.26cm이었으나 점차 增加되어 6年草地에서는 49.35cm이었는데, 이 變化狀態의 回歸方程式은 y=-0.13x²+4.41x+28.50이었다. 3. 年數의 經過에 따르는 密度의 變化는 1年草地에서 0.76%였던 것이 年數가 지남에 따라 급격히 增加되어 6年草地에 이르러서는 32.97%로 나타나고 있는데, 이 變化를 y=0.10x²+0.32x-2.30의 回歸方程式으로 表示할 수 있었다. 4. 草地造成 以後 年次別 被度의 變化는 1年草地에서 1.05%, 2年 1.38%, 3年 2.46%, 4年 17.11%, 5年 27.56%, 6年草地에서 36.66%로 每年 增加(y=1.40x²-2.36x+1.39)되었다. 5. 收量의 年次的 變化는 1年草地에서 1.95kg이었으나 年數가 지남에 따라 점차 增加되어 6年草地에서는 1,107.35kg으로 나타났는데, 이 變化狀態를 y=29.11x²+53.52x-154.67로 表示할 수 있었다. This study was conducted to examine the yearly and seasonal changes of Imperata cylindrica on the improved pasture of the mountain districts around Mt. Halla in Cheju Island. For this study, the researcher had investigated for six years from 1977 to 1982 the improved pasture which had been used for grazing from 1977 to 1982. The pasture was reclaimed from native grassland. The mixed seeds of 17kgs' Datylis glomerata, 7kgs' Festuca arundinacea, 2 kgs' Lolium multiflorum and 2kgs' Trifolium repens were sowed per 1 ha. The results of this study are the following : 1. The seasonal changes of Imperata cylindrica : its length, weight, density and coverage are heighest in Autumn, and are lowest in Spring every year. 2. The yearly change in the length of Imperata cylindrica : its length is gradually increased from 34.26 cm in the first year after the reclaimation to 49.35 cm in the 6th year. This change can be represented by the regression equation, Y=-0.13x²+4.41x+28.50. 3. The yearly change in its density : its density is rapidly increased from 0.73% in the first year to 32.97% in the sixth year. The results of this change can be obtained with the regression equation, Y=0.10x²+0.32x-2.30. 4. The yearly change in its coverage : its coverage is increased year by year (1.05% in the 1st year, 1.38% in the 2nd year, 2.46% in the 3rd year, 27.56% in the 5th year, and 36.66% in the 6th year). This change can be calculated with regression equation, Y=1.40x²-2.36x+1.39. 5. The yearly change in its weight : the weight is also increased year after year from 1.95 kg in the first year after reclaimation to 1107.35kg in the sixth year. This change can be calculated with the regression equation of y=29.11x²+53.52x-154.67.

      • SCIESCOPUS

        TRANSIENT ISCHEMIA-INDUCED EXPRESSION AND CHANGES OF TYROSINE KINASE A IN THE HIPPOCAMPAL DENTATE GYRUS OF THE GERBIL

        HWANG, IN,LEE, HYEON,YOO, KI-YEON,KIM, DAE,KIM, JUNG,KIM, CHANG,LIM, BEONG,KANG, TAE-CHEON,BANG, KYUNG,SEONG, NAK,LEE, HAK,KIM, JONG,WON, MOO Taylor Francis 2006 International journal of neuroscience Vol.116 No.8

        <P>The present study examined ischemia-related changes in tyrosine kinase A (trkA) immunoreactivity and its protein content in the dentate gyrus after 5 min of transient forebrain ischemia in gerbils. One day after ischemic insult, cresyl violet-positive polymorphic cells showed ischemic degeneration. The ischemia-induced changes in trkA immunoreactivity were found in the polymorphic layer (PL) and granule cell layer (GCL) of the dentate gyrus. In the sham-operated group, trkA immunoreactivity in the dentate gyrus was very weak. From 30 min after ischemia, trkA immunoreactivity was increased in the dentate gyrus and peaked in the dentate gyrus at 12 h after ischemia-reperfusion. Thereafter, trkA immunoreactivity was decreased time-dependently after ischemia-reperfusion. Four days after ischemic insult, trkA immunoreactivity was similar to that of the sham-operated group. In addition, it was found that ischemia-related changes in trkA protein content were similar to the immunohistochemical changes. These results suggest that the chronological changes of trkA in the dentate gyrus after transient forebrain ischemia may be associated with ischemic damage in polymorphic cells of the dentate gyrus.</P>

      • 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.

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