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.

고칼륨혈증에서 심전도의 진단적 의의

윤수영,박원녕,정성필,김승호,이한식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Hyperkalemia is a common and potentially life-threatening metabolic disorder. The electrocardiogram(ECG) is known to be a relatively sensitive diagnostic tool for hyperkalemia. However many exceptions, in which patients showed normal ECG findings even though hyperkalemic, have been reported. The purpose of this study was to determine the extent of correlation between the ECG findings and hyperkalemia and to determine when the ECG has value for diagnosing hyperkalemia. Methods: Patients who had been diagnosed as having hyperkalemia at two university hospitals during three years were enrolled in this study. We reviewed the medical records of the patients and evaluated the following 6 ECG abnormalities: tall T waves, narrow T waves, QRS widening, atrioventricular block, loss of P waves, and sine waves. We defined tall T waves and narrow T waves as 20 percentiles of heights and widths of the T waves from the 100 patients with normokalemia. Results: During the study period, there were 100 hyperkalemic patients, and we analyzed 69 available electrocardiograms. Abnormal ECG findings were revealed in 67%of 69 patients. The higher the serum potassium level, the more abnormal ECG findings. The common ECG abnormalities were tall T waves and loss of P waves. The patients with normal ECGs even though hyperkalemic had relatively low potassium levels. And whether chronic renal disease was not correlated to the ECG abnormality. Conclusion: The electrocardiogram is a good diagnostic tool for hyperkalemia if it is used with accurate diagnostic criteria. Thus, hyperkalemia should be considered when the ECG shows tall T waves or loss of P waves.

폴리에스테르 섬유 고속방사중 필라멘트의 냉각과정 분석

윤문구,박준원,이승윤 건국대학교 산업기술연구원 1998 건국기술연구논문지 Vol.23 No.-

High speed fiber spinning of polyethylene terephthalate(PET) was simulated at take-up speed of 6000m/min utilizing generalized steady state governing equations of melt spinning and some other assumed relationship for structure formation. In the present paper, the effect of changes of quench air temperature on the spinning line were mainly discussed. Distance of necking point and stress from the spinneret was elongated when higher quench air temperature was applied. Changes of necking point and stress may affect the development of PET fiber structure in the high speed threadline.

中國進出을 통해본 大邱地域 纖維産業의 活路方案

尹源湜,裵聖鉉 영남대학교 지역발전연구소 1995 새마을지역개발연구 Vol.17 No.-

This thesis is on the suggestion for the revitalization of the textile industry in Taegu and its vicinities through investment in China. The suggestions were derived from the viewpoints of manufacturing and marketing of textile products, and from the viewpoint of investing in China. The big China comes to us as the industrial partner or the trade rival. It may become as the great crisis to overcome to our country. It is very important for our government, scholar, and labors to overcome this crisis by a sense of union.

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).

Cadmium Sulfate가 肝組織에 미치는 影響에 관한 形態學的 硏究

윤강호,박경란,김수일,노승무,김원식 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

Cadmium is well known toxic heavy metal which has been related with various pathologic conditions of liver, kindney, testis, cardiovascular system and central nervous system etc.. In this experiment, cadmium sulfate (1.2mg/100gm b.w.) was given intravenously into the mouse (Balb - C, b. w. 20 - 25gm) via tail vein for the study on morphological changes of liver. On the 8hours, 16hours and 24hours after administration, mice were sacrificed under ether anesthesia, liver was removed, then, a part of liver was fixed in 10% neutral buffered formalin solution, processed routinely, stained with hematoxylin & eosin, and observed under light microscope. Otherwise, the remainder portion of liver tissue was prefixed in 1.5% glutaraldehyde solution, postfixed in the 1% osmium tetraoxide solution, embedded with Epon 840, and observed under transmission electron microscope(H-7000, Hitachi Co.). The results obtained were as followings ; 1. On light microscopic observation, hemorrhagic necrosis at the zone Ⅰ and zone Ⅱ with congestion of hepatic lobules were found. 2. On transmission electron microscopic observation, cisternal dilation of RER & SER, autophagic vacuoles, myelin figures, and certain electron dense materials within the hepatocytes were found. Although this observations were limited in mice, the above findings of its acute effects on liver morphology will serve morphological basis for the better understanding of toxic effects on liver after chronic exposure or multiple interactions with other toxic substances.

두개외 경동맥 협착증에 대한 스텐트 삽입술의 추적 결과

윤영섭,홍범기,최동훈,김선호,김동익,김승민,장양수,심원흠 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.11

관상동맥 스텐트 삽입술 후 항합요법의 무작위 비교

윤영섭,이두희,편욱범,김인재,장양수,조승연,심원흠 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.7

위암환자에서 BrdU에 의하여 유도되는 Fragile sites의 발현

윤숙자,한승로,정옥,김수일,박경란,이영호,김원식 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1

The expression frequency of BrdU-induced fragile sites was examined in stomach cancer patients to determine whether this parameter could be used as a marker of genetic susceptibility in at-risk individuals. G banding performed to detect fragile sites. No difference was found in expression frequency between the stomach cancer patients and a group of normal individuals(p=0.7). This indicates that the expression frequency of BrdU-induced fragile sites is not a suitable marker for assessing genetic susceptibility in stomach cancer patient.

수술 고위험군에서 양측 내경동맥 협착증에 대한 동시 스텐트 시술

윤영섭,심원흠,편욱범,전국진,박경진,장양수,조승연 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.9