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.

1,2 디아미노알칸을 포함하는 코발트(Ⅲ)착물의 합성과 분리에 관한 연구

都命基,金奉坤 嶺南大學校府設 基礎科學硏究所 1983 基礎科學硏究 Vol.3 No.-

[Co(en)(pn)₂]I₃ and [Co(Pn)₃]I₃ containing ethylenediamine (en) in EDTA and 1,2-diaminopropane(pN) was isolated from the reaction of [Co(EDTA)]-with 1,2-diamino-propane in aqueous solution by sp-sephadex c-25, cation exchange resin. The structure and composition of these complexes have been determined by means of elemental analysis, ir, electronic absorption spectroscopy. From these results, We have been suggested the new substitution mechanism of the reactions of [Co(EDTA)]-with 1,2-diaminopropane.

Equaatiorial-Skew [Co(TRDTRA)(OH₂)] 착물과 CN, NO₂그리고 NCS 이온간의 치환반응

都命基,趙榮在,李東鎭,吳昌彦,金東曄 嶺南大學校 基礎科學硏究所 1992 基礎科學硏究 Vol.12 No.-

Equatorial-Skew형[Co(TRDTRA)(OH₂)]착물과 ??,?? 그리고 ?? 이온 간의 치환반응결과 생성된 차물의 치환반응성 및 구조를 전자흡수 스펙트럼과 Yamatera 이론에 따라 조사하였다. 속도론적 자료로부터 착물과 ??,?? 그리고 ?? 이온의 반응차수는 각각 1차이며 총괄 반응차수는 2차임을 알 수 있었다. ?? 및 ?? 이온에서 생성된 착물의 구조는 이성질화 반응이 동반된 Polar-Chair 형이며, ?? 이온의 경우에는 이성질화 반응이 동반되지 않은 Equatorial-Skew 형임을 알 수 있었다. The substitution reaction and structrue of products obtained from the reaction of Equatorial-Skew-[Co(TRDTRA)(OH??)](TRDTRA=trimethylenediaminetriacetate) with ??,??, and NCS ions have been investigated by means of electronic absorption spectroscopy and theoretical calculation based on the Yamatera`s theory. According to kinetic data, the substitution reaction order for the complexes such as ??,?? and ?? was the first order, respectively, and overall reaction order was second order. It has been determined that the structure of products having ?? and ?? ions was Polar-Chair type complexes which were accompanying with isomerization and having ?? ion was Equatorial-Skew type complex which was not accompanying with isomerization.

Aminophosphine 류를 포함하는 팔라듐(Ⅱ) 착물 (제3보) : [Pd(L₂)] ?? 의 합성과 적외선 스펙트럼에 관한 연구 Study on the Synthesis and Infrared absorption Spectrum of [Pd(L₂)] ??

都命基,安昌祿,朴商學 嶺南大學校附設 基礎科學硏究所 1984 基礎科學硏究 Vol.4 No.-

New Complexes, [Pd(L₂)] ?? type, have been prepared from the reaction of [Pd(COD)Cl₂] and excess Pi-acid ligands, aminophosphines such as trans-1, 2-bis[(diphenylphosphino)amino]cyclohexane(L₁) and 1, 2-bis[(diphenylphosphino)amino]propane(L₂) in dichloromethane, and the bond character of aminophosphines in the complexes have been investigated by means of infrared and electronic absorption spectroscopy.

에틸렌디아민과 4배위형 에틸렌디아민-트리아세테이트를 포함하는 코발트(Ⅲ)착물에 관한 연구(제2보)

都命基,安昌祿 嶺南大學校附設 基礎科學硏究所 1982 基礎科學硏究 Vol.2 No.-

Octahedral cobalt(Ⅲ) complex containing tetradentate ethylenediamine-triacetate and ethylenediamine was prepared from the reaction of aqua(ethylenediamine-triacetato)cobalt(Ⅲ) with ethylenediamine in dimethylsulfoxide. Red-violet trans(0-0)(1) isomer is the [Co(en)(HEDTRA)]+ was isolated using a column (Φ5×60cm) of Dowex 50W-X8 cation exchange resin in H+ form. The UV, IR, and Circular Dichroism studies indicate that the red-violet complex has trans (0-0)(1) structure and the ethylenediamine-triacetate (EDTRA³-) ligand of [Co(en)(HEDTRA)]+ coordinates to cobalt(Ⅲ) ion as a tetradentate with a free acetate branch.

에틸렌디아민과 에틸렌디아민-N, N'-디아세테이트를 배위한 코발트(III)착물의 분리와 분광학적 성질

都命基,河鏡得,李東鎭 嶺南大學校附設 基礎科學硏究所 1986 基礎科學硏究 Vol.6 No.-

It was reportd that ethylenediamine-tetraacetatocobaltate (Ⅲ), [Co(EDTA)]- ion react easily with ethylenediamine to form tris-ethylenediamine cobalt (Ⅲ) ion at room temperature. However, so far no report has been publihed on the isolation of the cobalt (Ⅲ) complex containing both ethylenediamine-diacetate (EDDA) and ethylenediamine as the intermediate for the replacement of the EDTA from the reactions fo [Co(EDTA)]- ion by ethylenediamine. In this paper, [Co(en) (EDDA)]? containing obth EDDA and ethylenediamine has been isolated from the reaction of [Co(EDTA)]- ion with ethylenediamine by the Dowex 50W-X8, cation exchange resin in H? form. It was found that the EDDA ligand in the [(Co(en) (EDDA)]+ complex has a α-trans (0-0) configuration by means of the electronic absorption spectrum and theoretical calculation on the Yamatera's theory.

광학활성 아미노포스핀류를 포함하는 로듐(Ⅰ) 착물과 합성과 적외선 스펙트럼에 관한 연구

都命基,金奉坤,朴正學 嶺南大學校附設 基礎科學硏究所 1982 基礎科學硏究 Vol.2 No.-

Wilkinson-type Rh(Ⅰ) complexes containing 1,5-cyclooctadiene and optically active aminophosphines such as trans-(1R,2R)-1,2-bis[N-methyl(diphenylphosphino)amino]cyclohexane(L₁), trans-(1R,2R)-1,2-bis[(diphenylphosphino)amino]cyclohexane(L₂), (R)-1,2-bis[N-methyl(diphenylphosphino)amino]propane(L₃),(R)-1,2-bis[(diphenylphosphino)amino]propane(L₄), which were used as homogeneous catalysts with stereoselectivity in asymmetric hydrogenation reaction for olefins, were prepared and the bond character of Rh(Ⅰ) ion and phosphorus atom in aminophosphines and of Rh(Ⅰ) ion and 1,5-cyclooctadiene were studied by means of IR spectroscopy.

아미노포스핀류를 포함하는 팔라듐(Ⅱ) 착물(제2보),【Pd(COD)(L)】??의 합성과 성질

都命基,金奉坤,安昌祿 嶺南大學校府設 基礎科學硏究所 1983 基礎科學硏究 Vol.3 No.-

Several new [Pd(COD)(L]?? complexes have been prepared from the reaction of [Pd(COD)CI₂] and aminophosphines(L) such as trans-1,2-bis-[(diphenylphos-phino)amino]cyclohexane(L₁) and 1,2-bis-[(diphenylphosphino)amino]propane(L₂) containing phosphorus atom as sigma(σ)-donor and pi(π)-electron accepter in dichloromethane, and the bond character of ligand for complexes have been investigated by infrared and electronic absorption spectra.

아미노포스핀류(L)와 β-케톤류를 포함하는 팔라듐(Ⅱ)착물,[Pd(L)(β-kenonate)]의 합성과 성질

都命基,金東曄,金奉坤 嶺南大學校 基礎科學硏究所 1993 基礎科學硏究 Vol.13 No.-

Several new Palladium(Ⅱ) complexes, [Pd(L)(β-kenonate)] {L: L1=(Ph₂PNHCH₂CH(CH₃)NHPPh₂, L2=Ph₂PNHC?H₄NHPPh₂, β-kenonate= acac, etac} were synthesized. The bond character of complexes have been investigated by ir, UV/Visspectroscopy. The trihapto coordination to palladium(Ⅱ) of the β-ketonate in these complexes were deduced mainly by ir and conductometry.

폴리슬피드기가 배위된 Rh(Ⅲ)-포스핀 착물의 합성과 성질

정민호,도명기 嶺南大學校 基礎科學硏究所 1995 基礎科學硏究 Vol.15 No.-

New Rhodium(Ⅲ) complexes with P-P(dppm, dppe, dppp)and dtc were prepared and characterized by ¹H-NMR and absorption spectra. The ¹H-NMR spectra of dtc in ?? complexes shows at 2,5-3,2 ppm in CD₃CN. The dppm in ?? complex forms a four-membered chelate ring upon coordination and ?? ?? complexes forms five- and six-membered chelate ring upon coordination, respectively.