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.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

合成酸性, 鹽基性 Flux에 의한 鋼의 精鍊

李成龍,黃龍吉 東亞大學校 大學院 1988 大學院論文集 Vol.13 No.-

This study has been carried out to investigate into the reaction effect of fluxes with respect to various basic and acidic synthetic fluxes from the solidification and dephosphorization process at 1200℃ and 1400℃, respectively, and refining of steel with the high frequency induction furnace. The results obtained from the experiments are as follows; 1. The basic synthetic flux dispersed along solid surface while the acidic synthetic flux formed spherical drop during the solidification of melt at 1200℃. 2. The dephosphorization processes have shown that the magnetic and non-magnetic materials from the synthetic flux with 10% Fe₃P at 1400℃ were the calcium ferrite type and calcium phoshate type. respectively, and SiO₂ component of the synthetic fluxes formed the calcium ferrite, whereas the CaCl₂ and Na₂O₂ compounds formed the calcium phosphate. 3. The results fo high frequency induction melting have shown that the solution rate of synthetic flux was twice as fast as that of mixed flux in the acidic based flux and three to five times as fast as that of mixed flux in the basic based flux and therefore, the solution rate of basic based flux was twice to three times as fast as that of acid based flux.

스웨덴의 近代發展史

李吉鎔 동국대학교 유럽문화연구소 1983 유럽硏究 Vol.1 No.-

The Swedes, living on the outlying northern peninsular, thrust upon the south and helped shape the European history. Between 800 and 1050 A.D., the Vikings, who formed last phase of the Germanic invasions, pushed themselves to the east and south, and thus left profound historic marks on Russia through Black Sea as well as Western Europe. The Swedes' second outward thrust occured during the first half of the 17th century in the form of the Swedish intervention of the thirty-year War, and the Swedish leaders fought for the protestant causes and territorial gains. Meanwhile, Sweden as a whole remained largely secluded, backward and agricultural a society being unaffected by the dynamic changes occurring in the Western Europe during this period. However, the nation has emerged in the twentieth century as an ideal state of peace loving, neutral, welfare minded and most progressive kind. How did this great conversion come about beginning 1870's? What factor contributed to the rapid development that has been much faster than other Western European countries? A process which has taken more than centuries in other societies that the process of industrialization, urbanization democratization and social reform have been achieved in Sweden within the span of half a century. For many centuries, the Swedes were known for adventure and violence; and then the present Sweden is known for the homeland of Nobel prize, great artworks and one of the most advanced technology. How has this come about? The key task ahead is to assess the national accomplishment as a whole, the achievements of individual endeavor and concerted effort on the part of the nation. The Swedes learned the necessity of compromise and adjustment. Competition and burst of energy are channeled toward positive national goals instead of strife and violence. Taking into account that the nation is small and backward, the country was united in striving for independence and excellence. The descendents of the Vikings realized that they form homogeneous community and they are indeed in the same boat, and that a driving for excellence and originality since became national obssession. The success story of modern Sweden would be a major examplar which worth careful examination as well as thoughtful analysis. It should also be noted that the Swedish model could serve as a lesson to other developing countries.

2지역 연계 전력시스템의 뉴로-퍼지제어기 설계

이오걸,이용길,김상효 동의공업대학 2001 論文集 Vol.27 No.1

This paper proposed a optimal scale factors technique of a neuro-fuzzy controller for a load frequency control of two areas power system. The optimal scale factors control technique is optimize from an initial fuzzy logic control rule, and then is learned with an error back propagation learning algorithm of the neuro-fuzzy controller. In application two areas the load frequency control of the power system, it hopes to have response characteristic better than the conventional control technique.

우리나라 청정지역에서 측정한 PM_(2.5) 입자의 특성

이종훈,김용표,문길주,김희강,정용승,이종범 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

Atmospheric fine particles (PM_(2.5)) were collected at the background sites, Kangwha, Taean, and Kosan and characterized to understand their behaviors at the sites. Daily samples of PM_(2.5) mass were measured and ionic species, carbonaceous species, and gaseous species were analyzed. Four-daγ backward trajectory analysis was also carried out. The mean concentrations of anthropogenic species were highest at Kangwha among three sites, while contributions from sea salts were highest at Taean during the measurement period due to higher wind speed at Taean. Major chemical components in fine particles were sulfates organic carbon, nitrate, and ammonium. Most of the non-sea-salt (nss) sulfates in PM_(2.5) might be present as ammonium sulfates at these sites. Most air parcels arriving at Kangwha and Taean were from northern China. Therefore, both sites were thought to be affected by the same air parcel. At Kosan, during the measurement period, air parcels were from either northern China or southern China. The nss sulfate concentration in the air parcels from southern China was higher, while the nss calcium nitrate, and ammonium concentrations were higher when the air parcels were from northern China.

이동 로봇의 지능 경로 계획에 대한 연구

李基聖,김용길 弘益大學校 科學技術硏究所 1998 科學技術硏究論文集 Vol.9 No.2

During the navigation of a mobile robot, one of the essential task is to plan the optimal path from a starting point to a destination point. This paper describes the global path planner using HNN(Hopfield Neural Network) which can be realized in real time and with a high reliability. Using Hopfield type neural network, it is needed to choose the energy coefficient. Usually, it is determined by trial and errors. In this paper, in the beginning of the simulation the weight factor is selected as a large value, and the factor is diminished. The simulation results show accuracy and efficiency of the proposed algorithm.

건축물 붕괴사고의 원인 분석을 통한 제도적 개선방안

이인영,김학길,김용수 중앙대학교 건설산업기술연구소 2003 건설산업기술연구소 논문집 Vol.4 No.-

The objective of this study is to suggest regulation improvements through the analysis of causes of building collapse incidents. The research method involves statistical data analysis, case studies of incidents and analysis of problems related to construction regulations. The results of this study are as follows: (1) The investigated problems are carelessness of supervision, insuffiency of designers' responsibility, insuffiency of structure specialist's joinning throughtout the project. (2) The regulation improvements are suggested to be rainforcing supervision, reinforcing of qualification of structure specialists' and increasing of structure specialist's joinning throughtout the project.

구조용 세라믹재료의 피연삭성에 관한 연구

이종찬,강용구,이태원,전영길,하상백 金烏工科大學校 1998 論文集 Vol.19 No.-

Structural ceramics have been widely used in engineering parts. It, however, is very difficult to grind the ceramics with desired shape and dimensional accuracy because of their high hardness, strength, and brittleness. Grindability of structural ceramics are quite different as they have different mechanical and physical properties. This paper compares the grindability of structural ceramics such as Al₂O₃Si₃N₄and SiC. The grinding experiments include the measurement of grinding force, surface roughness. and SEM observation. The experimental results indicate that Si₃N₄consumes the highest specific grinding energy among the three kinds of ceramics. It was also found that there is no corelationship between grindability and surface roughness of ground surface.