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.

Immobilization with Ketamine HCI and Tiletamine-Zolazepam in Cynomolgus Monkeys

Myung-cheol Kim,Sung-hyeok Hong,Soo-jin Lee,Young-suk Kim,Jae-il Lee 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

with Ketamine HCl and Tiletamine-Zolazepam in Cynomolgus MonkeysJae-il Lee, Sung-hyeok Hong, Soo-jin Lee, Young-suk Kim and Myung-cheol Kim*Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, KoreaReceived March 4, 2003 / Accepted July 2, 2003J. Vet. Sci. (2003), 4(2), 187-191JOURNAL OFVeterinaryScience*Corresponding author: Myung-cheol Kim Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, Korea Tel: +82-42-821-6757, Fax: +82-42-822-4216 E-mail: mckim@cnu.ac.kr

개에서 결직장 연접부의 림프종 1례

이재일,이수진,김영석,김명진,조성환,신상태,이영원,김명철 충남대학교 수의과대학 동물의과학연구소 2003 動物醫科學硏究誌 Vol.11 No.-

A five years old female Shih-tzu was referred to the veterinary medical teaching hospital at Chungnam national university with soft bloody diarrhea and tenesmus. On rectal palpation, solid mass was palpated in colorectal region. In radiographs, small intestine was deviated cranially, descending colon and rectal junction were deviated caudoventrally in lateral projection of the abdomen. In ultrasonographs, hypoechoic nodulation of mesenteric lymph node in colorectal junction, mixed echoic thickening of colorectal wall and irregular margination were observed. Rectal endoscopy revealed that colorectal men was partially obstructed due to compression of the mass. Also, severe ulceration, inflammation and hemorrhage were also observed in descending colon. The mass was resected through the laparotomy. In histopathology, it was diagnosis of lymphoma in the colorectal junction.

생약제제인 이공산(異功散)의 Cisplatin 유도 신장독성 보호 및 항산화 효과

Lee, Kyung-Tae,Ahn, Kyoo-Seok,Chang, Sung-Goo,Oh, Soo-Myung,Jung, Jee-Chang 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Kyung-Tae Lee, Kyoo-Seok Ahn¹, Sung-Goo Chang², Soo-Myung Oh²and Jee-Chang Jung²¹College of Pharmacy, ²Oriental Medicine and ³College of Medicine, and East-West Medical Reserch Institute, Kyung Hee University, Seoul, Korea. Preventive and Antioxidative Effects of Crude Drug Preparation(E-kong-san) on Cisplatin Induced Nephrotoxicity. Proceedings of International Symposium on East-West Medicine, Seoul. 201-211, 1999. -Nephroprotective effects of a crude drug-prearation (E-kong-san) were determined from cisplatin on rabbit kidney proximal tubule and human renal cortical cells by MTT assays and sustained glucose consumption on ciplatin-induced human renal cortical tissue. Levels of creatinine and blood ure nitrogen(BUN) in serum after administration of cisplatin(0.75mg/kg,i.p.) to E-kong-san(0.75g/kg/day,p.o.)-pretreated rats were markedly lower compared to those of cisplatin-treated rats. Moreover, the administration of E-kong-san significantly inhibited the loss of body weight of cisplatin injected rts. These findings suggest that E-kong-san on the cisplatin induced nephrotoxicity led us to investigate whether the effect of this water extract was a result of anti-oxidation. E-kong-san showed strong free radical scavenger activities on 1,1-dipheny1-2picrylhydrazil(DPPH) radical and xanthine/xanthine oxidase(XOD) generated superoxide anion radical(O2-). We further studied the effects of E-kong-san on lipid peroxidation in rat liver microsomes induced by enzymatic and nonenzymatic methods. E-kong-san exhibited significant inhibition on both ascorbic acid/Fe2+and ADP/NADPH/Fe3+ induced lipid peroxidation in rat liver microsomes. Based on these results, we suggest that-E-kong-san attenuate the cisplatin induced cytotoxicity and its mechanism can be eplained by antioxidant.

6-hydroxydopamine에 의한 Synaptosome의 Na^+-K^+ ATPase 및 Mg^++ ATPase의 비활성화에 대한 Cu^++의 역할

이경용,이정수,정명희,이광수 중앙대학교 의과대학 의과학연구소 1985 中央醫大誌 Vol.10 No.4

6-Hydroxydopamine(6-OHDA) is selectively accumulated in catecholamine-containing neurons and causes degeneration of nerve terminals when injected into animals. However, the exact molecular mechanism of toxicity remains uncertain. 6-OHDA is an unstable compound which autoxidizes extremely rapidly. Among the various metal ions, Cu^++ is an extremely reactive cation which is known to stimulate the autoxidation of several autoxidizable compounds, among them catecholes and hemoglobin. In the present study, role of Cu^++ was observed on both the production of reactive oxygen species and the inactivation of rat brain synaptosomal Na^+-K^+ ATPase and Mg^++ATPase caused by 6-OHDA. Synaptosomal Na^+-K^+ ATPase and Mg^++ATPase activities were significantly reduced by 6-OHDA. In reaction medium of pH 7.4 6-OHDA is autoxidized rapidly and during this process H_2O_2 and superoxide radical(o^1_2) were formed. Thus, the observed findings suggest that inactivation of these ATPases may be caused by reactive oxygen species. Cu^++ stimulated the rate of autoxidation of 6-OHDA in a dose dependent manner and this stimulation of the autoxidation of 6-OHDA by Cu^++ was prevented by EDTA, penicillamine, catalase and histidine. Effect of Cu^++ was also observed with Na^+-K^+ ATPase and Mg^++ ATPase activities. Inhibition of Na^+-K^+ ATPase and Mg^++ATPase activities by 6-OHDA was further enhanced by Cu^++ and these effects were effectively prevented by catalase and histidine. From the results obtained, it is suggested that Cu^++ stimulates the autoxidation of 6-OHDA and enhances the inactivation of synaptosomal Na^+-K^+ ATPase by 6-OHDA. Also, the inactivation of these ATPase may be attributed to singlet oxygen (O^1_2).

[18F]FDG PET을 이용한 강박증 환자에서 뇌 포도당 대사의 이상에 관한 연구

권준수,이동우,이재성,최정임,이동수,정준기,조맹제,이명철,류인균 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 강박증에 대한 기능적 뇌영상 연구들에서 강박증 환자들의 안와전두엽과 미상핵의 대사율 증가 소견이 비교적 일과되게 발표되어 왔으며, 전두-피질하 회로의 이상이라는 이론이 수립되기도 하였다. 그러나 기존의 연구들은 강박증의 유병기간에 따른 구분없이 시행된 연구였고, 영상분석 방법에 있어서도 관심영역 방법을 이용했다는 한계를 지니고 있다. 본 연구의 목적은 첫째, 강박증의 유병기간에 따라 환자군을 구분하여 PET 영상소견을 분석함으로써 유병 기간에 따른 차이가 있는지를 조사하였으며, 둘째, 강바증 환자의 포도당 양전자방출 단층촬영(18-Fluor-deoxyglucose Positron Emission Tomography : FDG-PET) 영상분석에 통계적 매개변수 지도법(Statistical Parametric Mapping : SPM)을 이용함으로써 강박증의 병인기전 및 강박증상과 뇌기능 간의 관계를 명확히 규명하고자 하였다. 방법: 구조적 면담도구(Structured clinical interview for DSM-IV : SCID-IV)를 적용하여 진단된 12명의 강박증 환자들과 10명의 정상 대조군에 대해 FDG-PET을 촬영하여 SPM으로 분석하였다. PET 촬영 전 적어도 4주 동안에는 약물복용을 하지 않은 상태였다. 결과: 1) 환자군과 대조군의 비교 : 강박증 환자군은 대조군에 비해 양측 두정 영역의 대사율이 유의하게 감소되어 있었으며(P<0.01). 대사증가를 보인 영역은 없었다. 강박증의 유병기간이 10년 이상인 만성강박증 환자 4명은 양측 안와전두엽에서 유의한 대사증가 소견을 보였으며(P<0.01), 양측 두정영역에서 유의한 대사감소 소견을 보였다 (P<0.01), 유병기간이 10년 이하인 환자에서는 전체 환자군의 분석에서와 마찬가지로 대조군에 비해 유의한 대사증가 소견을 보인 영역은 없었으며, 양측 두정엽 부위에서 유 의한 대사 감소 소견을 보였다.(P<0.01). 2) 강박증상의 심각도와의 상관관계 분석 : 우측 두정엽의 대사율은 강박장애 척도 점수와 유의한 음의 상관관계를 보였으며(p<0.01), 양측 시상 영역의 대사율은 예일-브라운 강박장애 척도의 강박장애척도 점수와 유의한 양의 상관관계(p<0.01)를 보였다. 결론: 본 연구는 결과는 기존의 연구들에서 보고된 안와전두엽의 대사 증가 소견이 강박증의 만성화로 인해 나타나는 2차적 장애이며, 두정엽의 대사 저하가 보다 1차적인 장애일 가능성을 시사한다. Baxter가 수립한 전두-피질하 회로 이론은 두정엽의 이상을 포함하는 전두-두정엽 복합체 이론으로 확장되어야 할 것이다. Objectives: Functional imaging studies on obsessive-compulsive disorder(OCD) subjects have repeatedly reported increased metabolism in orbitofrontal lobes and caudate nucleus, resulting in the "frontal-subcortical" circuit abnormality theory. Limitations of the previous studies to date include little consideration for the duration of illness, and the use of regions of interest methods, as an image analysis method. Our study objectives are 1) to include the duration of illness as an important study variable, and 2) to use Statistical Parametric Mapping(SPM) method in order to tap relations between the brain function and the psychopathology and symptoms of OCD. Methods: The [18] fluorodeoxyglucose positron emission tomography(FDG-PET) scans of OCD subjects and normal comparison subjects, as diagnosed by the Structured Clinical Interview for DSM-IV(SCID-IV), were analyzed using SPM. Results: 1) Comparison of OCD and control groups : OCD subjects had significantly decreased metabolism in both parietal lobes and didn't have any areas of increased metabolism in comparison to comparison subjects(p.<0.01). four OCD subjects with the illness duration of 10 years or longer, had significantly increased metabolism in both orbitofrontal lobes<p<0.01). OCD subjects whose illness duration is shorter than 10 years didn't have any areas of increased metabolism and had significantly decreased parietal lobe metabolism, as in the analyses of all subjects(p<0.01). 2) Correlation analysis between areas and symptom severity : Metabolism of both thalamic sreas showed significant positive correlation with Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) scores(p<0.01). Metabolism of right parietal area showed significant negative corre lation with Y-BOCS scores(p<0.01). Conclusions: The current findings suggest that the increased metabolism in orbitofrontal lobe, previously rported, may be a secondary phenomenon due to the extended illness dur- ation and that decreased metabolism in the parietal lobes are primary abnormality in OCD subjects. Thus Baxter's fronto-subcortical circuit theory should be extended into "fronto-pari-etal" complex theory, which includes the parietal lobes.

모 축전지 회사 근로자들의 연폭로 지표에 대한 경시적 관찰

강명식,김용배,이용진,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

Lead poisoning is still prevalent and one of important occupational disease in Korea. To prevent undue high lead burden and maintain good health condition of lead workers in lead using industries, periodic health examination and regular biological monitoring of lead workers are often required in addition to the fundamental improvement of their working condition. To evaluate the effect of comprehensive occupational health program with regular biological monitoring on the level of lead exposure of lead workers in lead using industries, 11 year database from 1983 to 1994 of one storage battery factory was reviewed. From 1983 to end of 1986 only periodic health examination was provided to the lead workers, but from 1987 comprehensive occupational health program with regular biological monitoring was provided to maintain better health condition of lead workers. Selected study variables for lead exposure were blood lead(PbB), zinc protoporphyrin in blood(ZPP), δ-aminolevulinic acid in urine(ALAU), hemoglobin(Hb), hematocrit(HCT). Information on sex, age and work duration was also reviewed. 5 years data from 1983 to 1987 and 3 years data from 1990, 1993 and 1994 were available for all lead exposure indices except ALAU which has only 5 years data from 1983 to 1997. The results of 11 years longitudinal observation of lead indices are all follows: 1. The mean value of ZPP of lead workers in 1983 was 148.7±73.1 ㎍/㎗(Male: 145.5±72.3, Female: 168.1±79.1), whereas that of ZPP of lead workers in 1994 was decreased to 64.3±32.7 ㎍/㎗(Male: 60.2±28.8, Female: 95.2±43.4). 2. The mean value of PbB of lead workers in 1983 was 56.4±18.8 ㎍/㎗(Male: 55.59±19.1, Female: 59.6±19.1), whereas that of PbB of lead workers in 1994 was dcreased to 35.4±11.9 ㎍/㎗(Male: 35.7±12.0, Female: 32.8±10.8). 3. The mean value of Hb of lead workers in 1983 was 14.1±1.4 g/㎗(Male: 14.4±1.1, Female: 11.7±0.8), whereas that of Hb of lead workers in 1994 was increased to 15.6±1.5 g/㎗(Male: 15.9±1.2, Female: 12.9±1.1). 4. Blood lead is most highly correlated with ZPP(r=0.522, male:0.54 and female:0.50) and also correlated with ALAU and work duration also. 5. The simple regression analysis of PbB and ZPP showed different coefficient of regression by the measurement year, but there was no difference of coefficient of regression between sex. The slope of equation of pooled data for 1983-1986 without comprehensive occupational health program was 2.16 and differed from that of pooled data for 1987-1994(1.25). This difference suggests that the unit effect of blood lead on ZPP was relatively smaller in later period of comprehensive occupational health program than carly period without comprehensive program. The slope change in the analysis of linear regression of PbB on ZPP in lead workers can be used to evaluate the possible effect of health intervention to prevent undue high lead absorption in lead using industries. 6. 11 years occupational health service in this storage battery factory brought out considerable improvement of health status of lead workers in terms of decrease of PbB and ZPP and increase of Hb and the improvement was more remarkable after the introduction of comprehensive occupational health program.

Gene pyramiding effect of two major bakanae disease resistance gene using qBK1 and qBKWD

Sais-Beul Lee,Tae-Heon Kim,Su-Min Jo,Jun-Hyun Cho,Ji-Yoon Lee,Jong-Hee Lee2,Dongjin Shin,You-Chun Song,Myung-Kyu Oh,Dong-Soo Park 한국작물학회 2017 한국작물학회 학술발표대회 논문집 Vol.2017 No.-

요골동맥을 이용한 관동맥 조영술의 유용성

윤정한,이승환,이한요,김장영,김일회,최윤종,이형준,이명옥,김승년,황성오,홍인수,최경훈 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.10

양전자방출단층촬영을 이용한 초점주의와 작동기억의 뇌 활성화 양상 비교

김재진,조상수,김명선,손정우,이재성,이동수,이명철,권준수 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: 단순 초점주의 과제와 보다 고도의 집중을 요하는 작동기억 과제를 수행하는 동안의 뇌 활성화 양상을 비교하여, 두 인지기능 과정을 매개하는 정상적 신경회로의 특성과 차이를 알아보는 것을 목적으로 하였다. 방법: 정상인 14명을 대상으로 시각처리 대조 과제, 단순 초점주의 과제, 작동기억 과제 등 세 가지 인지과제를 주고, 과제 수행 동안 [□O]H₂O를 추적자로 한 양전자방출단층활영을 실시한 후 감산분석을 통해 초점주의와 작동기억의 신경회로 지도를 작성하여 비교분석하였다. 결과: 초점주의 동안 활성화되는 부위는 좌측으로 편측화되고 산발적으로 분포하는 양상이었고, 특히 전대상이랑과 운동영역을 포함한 전두엽, 일차 및 이차 시각피질 등의 활성화가 특징적이었다. 작동기억 동안의 뇌 활성화 역시 산발적 분포와 좌측 편측화 양상이 관찰되었으나, 시각피질보다는 전두엽의 활성화가 우세하였고, 특히 우측 전대상이랑의 현저한 활성화가 특징적이었다. 결론: 초점주의와 작동기억은 개념적으로 공통점과 차이점을 내포하고 있는 것처럼 매개 신경회로에서도 공통 혹은 특이한 영역을 각각 가지며, 전대상이랑의 역할이 두 기능에 공통적으로 중요하고, 이차 시각피질과 전전두피질이 두 기능 각각에 더 중요하게 작용하는 것 같다. Objectives:This study was undertaken to identify neural substrates for simple focused attention and more highly-focused working memory i normal people and investigate their characteristics and differences. Method: Fourteen normal subjects were studied with [□O]H₂O positron emission tomography during a visual processing baseline task, simple focused attention task and working memory task. Results were analyzed with the subtraction analysis to map the neural correlates of focused attention and working memory. Results: Activated areas during focused attention tended to be lateralized to the left and scattered over various regions including the anterior cingulate, motor area, and primary and secondary visual cortices. While the areas activated during working memory also show the left lateralization and scattered distribution, activation prevailed more in the frontal lobe than in the visual cortex, and was particularly remarkable in the right anterior cingulate. Conclusions: Focused attention and working memory do not have only conceptually commonalities and differences but also have common and specific areas in their neural substrates. The anterior cingulate may commonly play an important role in both cognitive functions, whereas secondary visual cortex and prefrontal cortex seem to be predominantly implicated in each function, respectively.