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.

관상동맥내 스텐트 삽입후 발생한 관상동맥류 2례

제인수,허민영,문치숙,이재호,정수룡,조길현,이영민,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3

Coronary artery aneurysms are detected with increasing frequency because of the routine use of coronary angiography in the diagnosis and management of coronary artery disease. Although some coronary artery aneurysms are congenital or inflammatory, most are atherosclerotic. The prognosis of atherosclerotic coronary artery aneurysm may depend on the morphology of the aneurysm or the presence of coexisting obstructive disease. Coronary artery aneurysms have been also reported to occur after ballon angioplasty, directional athrectomy, laser angioplasty, and stent implantation with a frequency of 2% to 4%. The long-term outcome of post-intervention coronary artery aneurysm is unknown. We report two cases of the development of a coronary aneurysm 6 months after stent implantation as a treatment of severe obsructive coronary artery disease.

전격성 경과를 취한 만성 호산구성 폐렴 환자 1예

윤호상,진춘조,유광하,이상엽,이수인,정상만,김선두,이순제,이길도,전혜정 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Chronic eosinophilic pneumonia(CEP) is a rare disease of unknown etiology characterized by chronic infiltration of the lung with eosinophils. It presents with profound systemic symptoms comprising fever, night sweats, weight loss, dyspnea and blood eosinophilia with nonsegmental air-space consolidation confined to the outer third of the lung, the "photographic negative of pulmonary edema". Histopathologic features of chronic eosinophilic pneumonia are intraalveolar and interstitial infiltrations with eosinophils, histiocytes, giant cells, scattered lymphocytes and plasma cells. Glucocorticoid therapy cause prompt resolution of symptoms as well as disappearans of blood eosinophils, elevated serum Ig E levels and the roentgenographic lesions. Infrequent radiographic findings include nodular infiltrates, consolidations, cavitations, atelectasis and pleural effusions. Deaths from CEP although rare, have been reported, but the majorities of CEP have benign courses and do not need a therapy with ventilator. We report a case of chronic eosinophilic pneumonia, which had a sudden course associated with diffuse pneumonic consolidations on the both lung and bilateral pleural effusion.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

英國의 保險브러커制度

이두영,崔斗壽 인제대학교 1994 仁濟論叢 Vol.10 No.2

This paper examines a role, legal position and regulation of insurance brokers in England. These are summarized as followings: First, In effect all insurance business is conducted through the medium of agents of one sort or another in London insurance market. Most insurers are and have to be companies or, in exceptional cases, other associations and such bodies can of necessity act only through agents, ranging from directors and senior management down to junior employees. The only category of individual who can be an insurer is a Lloyd's underwriter. Quite apart from the sorts of intermediary above mentioned, much insurance business is transacted through insurance brokers and other independent agencies. Second, as regards a relationship between a broker and the relevant parties to the insurance contract, the broker is the agent of the insured. But in exceptional cases, the broker may act as the agent of the insurer. Finally, Lloyd's broker is largely regulated by the Lloyd's Act 1982 and undertakes a measure of self-regulation in some respect. But insurance brokers are regulated by the Insurance Brokers (Registration) Act 1977 and the Financial Services Act 1986. According to the Act 1977, all brokers should be registered with the Insurance Brokers Registration Council, the body charged with supervising the regulating machinery.

상태천이 행렬의 계층적 접근방법에 의한 대규모 시스템의 최적제어

이한석,이재춘,안두수 成均館大學校 科學技術硏究所 1996 論文集 Vol.47 No.1

This paper presents the modified hierarchical approach which decomposes the state transition matrix into several sub-equations for the optimal control of the large-scale systems instead of decomposing systems directly. The proposed algorithm takes the solutions of the low order matrix differential equation. The algorithm utilizes the modified interaction prediction principle in the upper level and the single term Walsh function in the low level respectively. The employed algorithm whose rationality is checked in the simulation takes a simple form in comparison with the conventional hierarchical optimal control methods.

드릴링 작업중의 切削速度制御에 관한 연구

이수한,안두성 釜山水産大學校 1985 釜山水産大學 硏究報告 Vol.25 No.1

드릴링 작업주의 제어변수와 제한조건들 사이의 수학적 모델을 결정하였고 절삭속도를 제어변수로 선정하였다. 기존의 범용 드릴링 머시인을 속도 가변모우터, 드릴동력계 및 μ-computer를 이용하여 작업중 절삭속도제어가 가능한 시스템으로 변환하였다. 완성된 작업중 절삭속도 제어계에 대해 절삭실험을 실시한 결과, 공절삭시간 및 실절삭시간이 상당히 줄어들어, 드릴링 절삭공정의 효율성 향상이 입증되었으며 기계도 안전영역에서 사용할 수 있었다. In order to improve the efficiency of drilling process, the mathematical model of drilling process is established and conventional upright type drilling machine has been modified as an on-line cutting velocity control system with μ-computer. The machining tests show that the system is very efficient in reducing air cutting time and metal cutting time, and is reliable in several operating conditions.

妊娠嘔吐에 關聯된 心理的 要素

李東洙,趙斗英 大韓神經精神醫學會 1983 신경정신의학 Vol.22 No.4

Forty-two postpartum women who were admitted at the Seoul National University Hospital Obstetric ward from September 21, 1982 to October 15, 1982 were subjects of this study. Twenty were vomiters who were regarded as an experimental group and twenty-two were non-vomiters being regarded as a control group. They were interviewed for the purpose of investigating the related psychological factors of the vomiting in pregnancy. Semistructured psychological interview were performed(by the auther) and several suspected items were rated. The results are as follows: 1. Verbally expressed ambivalency whether she wants her baby or not was much related to the vomiting in pregnancy. That means there could be some more emotional conflict than just mere rejection of pregnancy. 2. Poor mother image such as 1) an anxious, dependent or rather domineering type in reering her child, 2) early childhood loss or separation of her mother, 3) previous traumatic about being pregnant was one of the important related psychological factors of the vomiting in pregnancy. 3. Marital problem, especially husband's concern and understanding was expressed as possible related factors by the statistics. 4. Other factors such as psychosexual disturbance, socio-economic problems and psychosomatic symptoms were not shown as the respectable factors in this study when compared with those of the other studies. 5. There were no difference between vomiters and non-vomiters in their characteristics of age, parity, economic status, educational level and having a job.

데이타플로우 컴퓨터에서 Sparse한 행렬과 벡터의 내적 수행시 성능 평가

李暻敏,李龍頭,蔡洙煥 한국항공대학교 1992 論文集 Vol.30 No.-

실 시간 처리 분야에서 요구하는 컴퓨터 시스템의 성능을 만족시키기 위하여 병렬처리 시스템에 대한 연구가 활발히 진행되고 있다. 본 연구에서는 병렬처리 시스템들 중에 병렬성 구현 정도가 뛰어난 정적 데이타플로우 컴퓨터의 구조에서 최대의 병렬성, 적정 프로세서의 수, 대기 행렬의 수, 속도 향상등을 평가하기 위해 시뮬레이터를 구성하였다. 병렬로 처리될 수 있는 부분들이 많이 존재하는 sparse한 행렬로 벡터의 내적을 구하는 문제들을 시뮬레이션 하였다. 시뮬레이션에 있어서, 필요한 명령들의 처리 시간을 8086프로세서를 기준으로 한 실제적인 경우로 주었다. Research on parallel processing systems is very active to satisfy the computer performance required in real-time processing fields. In this research, a simulator is implemented to evaluate the maximum parallelism, the proper number of processors, the size of queue and the speed up factor on static dataflow computer architectures which can be expressed parallelism naturally. Inner product of sparse matrices and vectors is chosen to evaluate the performance of static dataflow architectures. In the simulation, ideal execution times and real execution times based on the 8086 processor are applied.

複合運送條件의 등장에 따른 貿易慣習의 發展展望

李龜喚,崔斗壽 新羅大學校 1987 論文集 Vol.23 No.-

After world war Ⅱ, with the container revolution the combined transport system appeared, then many problems were brought out in the field of transportation of goods which had no great significance in the earlier times. To cope with them the International Chamber of Commerce (ICC) has come to codify 「Incoterms 1980」after many times amendments, which includes trade terms-FRC·DCP·CIP, used for the contracts of Sale based on the combined transport system. In this thesis, I lightened the essence of FRC·DCP·CIP contracts, the main issues in the performance of the contracts, that is, property transfer and passing of risk from view point of jurisprudence. Under FRC contract the seller and buyer become exporter and consignor respectively, under DCP·CIP contract the seller becomes exporter and consignor, arranges the contracts of transport and insurance, and pays freight and insurance costs as under CFR·CIF contracts. But the characteristics of FRC·DCP·CIP contracts in the light of transport system depended upon the course of contacts performance. Under the former contracts the extent of obligation on all costs and the time of property transfer and passing of risk are defined by the concept-under the custody of the first carrier, which is compared with that-ship's rail under the latter contracts. The amounts of trade by the combined transport system is on the increase, but the adoptation of FRC·DCP·CIP terms is seldom, therefore the countermeasures and improvements are required. Firstly, the United Nations Convention in International Multimodel Transport of Goods(1980) should come into effect and new insurance system for the combined transport system be enacted. Secondly, combined transport document, insurance policy should be characterized by negotiability and document of title, which enable the buyer to the price of goods by documentary bill of exchange. Then the benefit of finance would be guarantees /by use of the evidential documents. Thirdly, the FRC·DCP·CIP usages should be developed with the accumulation of trade customs and juridical precedents.