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.

Effect of Nonviolent Communication Education Program on Nursing Students’ Empathy and Communication Skill

Hae Kyung Jo,Hyun Kyoung KIM,Hye-Kyung Lee 한국성인간호학회 2021 성인간호학회 학술대회 Vol.2021 No.8

Aim(s): Nonviolent Communication (NVC) is an effective program for empathy education; handling of criticism, anger, rejection, and emotional pain; and adjustment of human relationship dynamics (Nosek & Durán, 2017). Thus, it is necessary to conduct studies on how to apply NVC, as one of the various communication methods, specifically to nursing students. The purpose of this study was to investigate whether NVC program deescalate primary anger and secondary anger and enhance empathy and communication skill. Therefore, the hypothesis were as follows: NVC program will increase empathy and NVC program will increase communication skill. Method(s): Researchers used a non-equivalent control group pre-post-test design. The program of non-violent communication was adapted to nursing students for examination of effects on empathy, and communication skill. Convenience sampling was used to source 62 nursing baccalaureate students living at J City and 55 students living at A City, South Korea. Two universities have nursing departments located in J and A city which have similar population and sociocultural background. Empathy means understanding other’s intention, predicting other’s behavior, and experiencing other’s affection. Empathy was measured using Chung & Kim’s(2006) Korean version of Empathy Quotient (EQ). Communication efficacy was measured using Chung’s (2010) Korean version of communication efficacy scale. The effect of non-violent communication program was analyzed using analysis of covariance (ANCOVA) via the Statistical Package for the Social Sciences 24. Result(s): After the intervention, empathy was increased from 79.84 (SD=7.83) to 100.39 (SD=8.76) in the case group, and significant difference between two groups. Communication skill was increased from 46.80 (SD=11.03) to 53.50 (SD=9.53) in the case group, and significant difference between two groups. Conclusion(s): The basic objective of this study was to provide a basis for the development of communication programs that can help improve nursing students’ communication and interpersonal relationship skills based on the NVC program. The findings of this study indicate that nursing students’ empathy and communication skill were improved significantly after the NVC program was implemented.

위전절제술 후 Kim 's Tie 부근 공장에 국소 재발한 위암환자 1예

배병구,서병조,유항종,강윤경,김진복,Bae Byung-Gu,Suh Byoung-Jo,Yu Hang-Jong,Kang Yun-Kyung,Kim Jin-Pok 대한위암학회 2005 대한위암학회지 Vol.5 No.1

위암은 국내에서 발생 빈도가 가장 높은 암으로서 근치적 절제술 및 확대 영역 림프절 절제술의 도입과 더불어 술후 보조 항암화학요법 및 면역요법 등의 이용으로 최근 치료성적의 향상을 보이고 있다. 그러나 수술적 치료를 포함한 치료법의 발전에도 불구하고 다양한 형태의 재발을 경험하게 되고, 대부분의 재발은 3년 이내에 일어난다. 재발양상으로는 크게 국소재발, 원격재발, 복막재발 등이 있으며, 여러 가지 재발양상이 한꺼번에 보이는 경우도 있다. 이 중 국소재발의 호발 부위로는 림프절($48\%$), 문합부($32\%$, 잔존 위($20\%$)의 순으로 보고되고 있다. 증례: 51세의 여자 환자로 1999년 10월 진행성 위암으로 근치적 위전절제술을 시행 받았고, 당시 병기는 T3N1M0(IIIa,AJCC 1997)이었다. 수술 후 10회의 보조적 정맥 주사용 항암화학요법 및 경구용 항암화학요법을 2년간 실시하였고, 외래를 통한 추적검사상 약 5년간 재발을 보이지 않았으나 2004년 9월 시행한 내시경상 Kim's tie 부근공장에서 궤양성 병변을 발견하고 조직검사를 시행, 병리학적으로 낮은 분화도를 보이는 인환 세포암종 형태의 위선암 재발로 진단하고 수술을 시행하였다. 수술 방법은 Kim's tie 위치를 포함해 근위부 6.5 cm, 원위부 4 cm의 절제연을 두고 공장부분 절제술을 시행하였다. 수술 당시 다른 복부장기로 전이는 없었으며 전이성 복수도 없었다. 수술 후 별다른 합병증 없이 회복하였으며 보조 항암화학요법 제제로써 TS-1을 사용하며 외래 통한 추적검사 중이다. Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.

한열변증에 따른 중풍 환자의 제반특성 비교

김민경,이인환,신애숙,김나희,김혜미,심소라,나병조,조승연,박성욱,정우상,문상관,박정미,고창남,조기호,김영석,배형섭,Kim, Min-kyung,Lee, ln-whan,Shin, Ae-sook,Kim, Na-hee,Kim, Hye-mi,Shim, So-ra,Na, Byung-Jo,Cho, Seung-yeon,Park, Seong-uk,Jung, Woo Sang 대한중풍순환신경학회 2010 대한중풍.순환신경학회지 Vol.11 No.1

Object : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we aimed to evaluate the characteristics of acute stroke between heat pattern group and cold pattern group. Methods : We recruited stroke patients from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo medical center, Kyungwon university lncheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university llsan oriental medical center) from April, 2007 until February, 2010. We diagnosed them and selected 463 heat pattern patients and 182 cold pattern patients. Results : We find that the risk factor of smoking, alcohol, diet(prefer to meat) are more associated with the heat pattern group. On the other hand, inflammation history in recent 3 months and diet(prefer to sea food) are more associated with the cold pattern group. RBC, Hg, Hct, TG, CK and Cl are more related to the heat pattern group. CPT, total cholesterol and HDL are more related to the cold pattern group. Tae-eum type takes high distribution of the heat pattern group, and So-eum type takes high distribution of the cold pattern group. Conclusions : This study provides evidence that the heat pattern group have more risk factor than the cold pattern group.

우심방과 우심실의 거대 심장 혈관종 1예

김제열,조상호,김건일,허경림,김현숙,조구영,최영진,이원용,임종윤 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Cardiac tumors, especially the primary tumors involving any part of the heart are extremely rare and its relative incidence has been reported to be approximately 0.02%. We report a patient with huge cardiac hemangioma who complained of shortness of breath, general weakness, and dizziness, Imaging study by echocardiography and computed tomography of thorax revealed a huge lobulating mass like a bunch of grapes in the right chamber of heart. The surgical exploration of thorax was performed and a histological diagnosis of spindle cell hemangioma was obtained by microscopy. The patient was treated by surgical resection of the tumor and doing well after surgery. Our experience indicated that prompt diagnosis and treatment of cardiac hemangioma is imperative for patients' prognosis.

초음파 검사 기반의 용접결함 분류성능 개선에 관한 연구

김재열,윤성운,김창현,송경석,양동조,--,-- 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

In this study, we made a comparative study of backpropagation neural network and probabilistic neural network and bayesian classifier and perceptron as shape recognition algorithm of welding flaws. For this purpose, variables are applied the same to four algorithms. Here, feature variable is composed of time domain signal itself and frequency domain signal itself. Through this process, we comfirmed advantages/disadvantages of four algorithms and identified application methods of four algorithms.

적외선 열화상 카메라를 이용한 Plume 형상에 따른 Nd:YAG 레이저 용접 결함 평가

김재열,유영태,양동조,송경석,노경보 한국비파괴검사학회 2003 학술대회 논문집 Vol.- No.1

In Nd:YAG laser welding, evaluation methods of welding flaw are various. But, the method due to plume shape is difficult to classification of welding flaw. The Nd:YAG laser process it known to have high speed and deep penetration capability to become one of the most advanced welding technologies. At the present time, some methods are studied for measurement of plume shape by using high-speed camera and photo diode. This paper describes the machining characteristics of SM45C carbon steel welding by use of an Nd:YAG laser. In spite of its good mechanical characteristics, SM45C carbon steel has a high carbon contents and suffers a limitation in the industrial application due to the poor welding properties. In this study, plume shape was measured by infrared thermal camera that is non-contact /non-destructive thermal measurement equipment through change of laser generating power, speed, focus. Weld was performed on bead-on method. Measurement results are compared as two equipments. Here, two results are composed of measurement results of plume quantities due to plume shape by infrared thermal camera and inspection results of weld bead include weld flaws by ultrasonic inspector.

문제중심학습(Problem Based Learning; PBL) 패키지 개발 : 지각·조정장애상황을 중심으로

김애리,김영경,송영선,신경림,안혜정,이지순,조계화 성인간호학회 2001 성인간호학회지 Vol.13 No.3

The Purpose of this study is to present an actual example for procedures for developing a PBL package based on philosophical backgrounds derived from Problem-based learning. To perform a systemic study on the operations of an intergrated curricula under multi-disciplines, a research team made up of several professors with different academic backgrounds was formed. Among the four situations for the patients with perception-adjustment disorder, especially a procedure for the development of PBL package which can be used in the emergency room situation has been proposed. The little(2000)'s PBL package model has been applied for this study. Tha package includes course objectives, learning objectives, concept map, situation scenario. tutor guide, and evaluation method. It is believed that learning objectives achievement procedures designed as a part of a problem-based learning package development procedures for the nursing of patients with perception-adjustment can be achieved at the same level as the learning objectives for the science of nursing founded by the Korean Nurses Association.

진공청소기용 팬 모터의 비정상 유동 해석 및 공력소음 해석

김재열,심재기,송경석,오성민,양동조,김우진 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

The vacuum cleaner motor runs on very high speed for the suction power. Specially, the motive power is provided by the impeller being rotate on very high speed. And centrifugal fan consists of the impeller, the diffuser, and the circular casing. Due to the high rotating speed of the impeller and small gap distance between the impeller and diffuser, the centrifugal fan makes very high noise level at BPF and harmonic frequencies. In order to calculate the sound pressure of centrifugal fan, the unsteady flow data is needed. And Noise cause is dividing to fluid noise by exhaust flow of fan and vibration noise by rotational vibration of vacuum cleaner fan motor. Until now, measuring method has been used to measure vibration by the accelerometer; this method has been not measured for the vibration in some parts of brush and commutator because of motor construction and 3-D vibrating mode. This paper was purposed on the accurate analysis, using laser vibration analyzer, By using this measured data of noise cause against the difficult part in old times, we would like to use for the design of silent fan motor.

용접결함의 형상인식을 위한 분류기 알고리즘의 성능 비교

김재열,김영석,김창현,양동조,이창선,송경석 한국비파괴검사학회 2003 학술대회 논문집 Vol.- No.1

In this study, we compared backpropagation network(BPNN) with probabilistic neural network(PNN) as the classification algorithm of welding flaws. For this purpose variables are appied the same to two algorithm. Here, feature variable is composed of time signal itself and frequency signal itself. Those are ultrasonic signals reflected on welding flaws. Through this process, we comfirmed advantages/disadvantages of two algorithms, identified application methods of two algorithms to classification methods of welding flaws. These advantages/disadvantages and application methods are based on theoretical backgrounds.