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.

난소의 성국 낭성기형종에서 관찰된 전립선 조직 - 1예 보고 -

홍승모,최미선,한은미,이현경,노재윤 대한병리학회 1999 Journal of Pathology and Translational Medicine Vol.33 No.7

유화확산법을 위한 유화제로서의 수용성 mPEG-PLGA 공중합체의 사용

한승훈,손서연,김중현 한국공업화학회 2004 응용화학 Vol.8 No.1

Drug carrier formed by a poly(ethylene glycole) (PEG) corona, sterically protects the carrier, avoids their interaction with plasma proteins and phagocytic cells, and thus significantly increase the circulatory blood half-lives of these carrier. Poly(D,L-lactide-co-glycolide) (PLGA) is biodegradable and biocompatible. Non-biodegradable surfactant, such as poly(vinyl alcohol) (PVA), remains in the final composition of the particles. Residual PVA amounts as high as 52%. BiodegradableSurfactant would replace the commonly non-bidoegradable surfactant. In this study, PEG-PLGA di/block copolymer with different HLB was synthesized by ring-opening polymerization. CMC was determined by surface0tension meter. Drug loaded nanoparticles were prepared by emulsification0diffusion method. The size and zeta potentialof the nanoparticles were determined using photo correlation spectroscopy (PCS) and microelectrophoresis.

하악골 후방이동시 중안면부 연조직의 변화양상에 대한 임상통계학적 연구

한대희,김수남,민승기,김태성,성헌모 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalo-metrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1.There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2.There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3.The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4.The upper lip length was increased and moved posterior direction after mandibular setback surgery 5.The lower lip was moved posterior direction by posterior movement of the mandibular structure 6.Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

강진만 해역의 다모류 군집의 종조성 및 계절변동

윤성민,김춘철,서원일,황선영,이성훈,한경호,이우범 國立麗水大學校 環境問題硏究所 2004 環境硏究論文集 Vol.6 No.-

To detemine seasonal fluctuations in abundance and speices composition, polychaete samples were collected by Van Veen grab form March to November 2003 in Kangjin Bay. A total of 25,119.3 ind./㎡ polycaete were sampled and identified into 48 species. 25 families and 10 orders. Of the 10 orders. Phllodocida, Spionida, Eunicida and Sabellida accounted for approximately 79.9% of the polychaete fauna in this area. Phyllodocida, Nereidae, Nephtyidae ans Spionidae were dominant representing every moment 4 species. Of 48 species identified Neanthes japonica, Prionospio pinnate, Cirratulus cirratus and Palola siciliensis for 54.0% individuals collected. Season succession of dominant species was evident in study area: Neanthes japonica, Prionospio pinnata. Cirratulus cirratus. Nephtys oligobranchia in March, Neanthes japonica, Lumbrineris japonica. Cirratulus cirratus, Prionospio pinnata in May, Ncanthes japonica, Cirratulus cirratus, Lumbrineris nippnica. Lumbrineris japonica in August and Neanthes japonica, Prionospio pinnata, Laonice cirrata, Palola siciliensis in November, respectively. The diversity index was the highest value in March(H'=3.0059) and the lowest value in May(H'=2.7305). The eveness index was the highest in August(J=0.9184) and lowest in May(J=0.8524). The dominance index was the highest in May(D=0.3843) and the lowest in March(D=0.2275).

소뇌에 발생한 과립구성 육종 : 증례보고

윤승환,변진수,홍순기,김헌주,한용표,양재승,조미연 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.8

Granulocytic sarcoma, a rare extramedullary solid tumor arising from early myeloid precursors, is capable of invading the meninges or the brain parenchyma. The tumor may occur during or after the onset of systemic myelogenous leukemia. On rare occasions, the tumor may evolve before the onset of systemic myelogenous leukemia. Children are affected more often than adults, but sex is not related. Although no definite target area of the brain can be demonstrated, there may be some predilection of the tumor for the posterior fossa. The authors report a case of 4-year-old-boy with granulocytic sarcoma occuring in the posterior fossa presenting with gait disturbance and torticollis. The patient was treated by surgical removal of the tumor, thereby avoiding the potentially lethal complication of a posterior fassa mass. This rare case is reported together a review of the literature.

두부손상시 발견된 뇌혈관질환

윤승환,변진수,홍순기,김헌주,한용표 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.10

Five separate incidences of patients with cerebrovascular disease(CVD) were revealed among 555 craniocerebral traumatic victims between 1991 and 1992. The 5 cases of with cerebrovascular disease revealed included 3 aneuryms. 1 arteriovenous malformation and 1 spontaneous intracerebral hematoma caused by angiographic study. The frequent use of computerized tomographic scans in the evaluation of head-injured victims can well demonstrate an intracerebral hemmorrhage, but may not get able to direct the associated cerebrovascular disease;whereas the efficacy of angiography, on the contrary, has been losing its popularity as diagnostic armamentarium. The importance of angiographic study should be considered, if clinical signs and/or brain CT ideate the possibility of cerebrovasular disease even during the course of head injury management.

진피내 모반, 경계 모반 및 악성 흑생종에서 p53과 Ki-67의 발현 양상

이정훈,양승하,오미혜,김의한 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

The authors analyzed immunohistochemical expression of mutant p53 and Ki-67 in eleven cases of intradermal nevus, 7 cases of junctional nevus and 6 cases of malignant melanoma, so following results were obtained. Results: 1. The positive reaction of p53 protein was 0%(0/11) in intradermal nevus, 43%(3/7) in junctional nevus and 83%(5/6) in malignant melanoma. 2. The positive reaction of Ki-67 was 9%(1/11) in intradermal nevus and 14%(1/7) in junctiona nevus, but the labelling index were below 10% in both nevi. In malignant melanoma, the positive reaction of Ki-67 was appeared in 50% (3/6). but the labelling index were below 20% in all positive cases Above results suggested that the p53 expression was stronger in poor differentiated tumors, so the p53 protein expression appeared to be related to the histological differentiation degree. But the Ki-67 expression appeared to be more related to the prognosis according to tumor growth rate than histological differentiation degree Because the Ki-67 labelling index was low in malignant melanoma as expected, it was difficult to justify the idea that the growth and prognosis of malignant melanoma were justified only by the Ki-67 positive reaction and labelling index. But the Ki-67 positive cells were not almostly observed in intradermal nevus and junctional nevus, So the differnetial diagnosis between benign and malignant melanocytic tumors were appeared to be possible by Ki-67 positive reaction and labelling index.

호산구성 육아종에 병발된 동맥류성 두개골 골낭종 : 증례보고 Case Report

길승배,허철,변진수,한용표,김헌주,홍순기,김명순,홍순원,김윤미 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

A case of aneurysmal bone cyst(ABC1 secondary to eosinophilic granuloma of the skull is reported. In the skull the presence of ABC secondary to eosinophilic granuloma is rare. We reviewed the clinicopathological and radiological features of this type of eocinophilic granuloma at the cranium.

외상성 뇌지주막하출혈을 동반한 두부외상 환자의 예후인자

길승배,김헌주,허철,한용표,홍순기,변진수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

The presence of traumatic subarachnoid hemorrhage on the initial computerized tomographic scans has been known to be associated with worse results. By means of a simple and reliable computerized tomographic grade system proposed by Greene and his colleagues, prognostic factors of the traumatic subarachnoid hemorrhage was significantly related to clinical outcome at the time of discharge from acute hospitalization. Between February 1992 and August 1995, 3975 patients were admitted to our department of neurosurgery due to head injury. Clinical data were retrospectively reviewed to ascertain the relationship of the thickness of traumatic subarachnoid hemorrhage, its location, evidence of mass lesion(s), midline shift, obliteration of the basal cistern, and cortical sulcal effacement to outcome. Additionally initial Glasgow coma scale score, arterial gas study systemic blood pressure and prothrombin time were also analyzed for the same purpose. Among 3975 head-injured patients. 213 patients were identified to have traumatic subarachnoid hemorrhage on the initial computerized tomographic scan. Among 213 traumatic subarachnoid hemorrhage patients, the patients treated with calcium channal blocker(32 patients) and 3 patients lost to follow-up were excluded from this study for a total of 178. The computerized tomographic scan findings were divided into a 3 grade system : Grade 1 indicating only traumatic subarachnoid hemorrhage. Grade 2 indicating traumatic subarachnoid hemorrhage with mass lesion(s). Grade 3 indicating traumatic subarachnoid hemorrhage with mass lesion(s) and midline shift. All these data were compared to Glasgow outcome scale on discharge, and arbitarily these were divided into the good(good recovery and moderate disability) and the bad(severe disability, vegetative state and death). The authors conclude that the contributing factors to outcome at discharge were as follows : 1 midline shift(p=0.002), PT≤70%(p<0.001), obliteration of the basal cistern(p=0.001) and cortical sulcal effacement(p=0.001) were shown to the statistically significant. 2. initial computerized tomographic grade contributed to outcome at discharge.