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.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

고분자에 고정된 유기주석 촉매의 합성

徐延穆,吉德洙,孟學永 公州大學校 基礎科學硏究所 1994 自然科學硏究 Vol.3 No.-

공중합체 내의 염소 성분의 함량 변화는 methylal을 용매로 사용하였을때 3% 가교도의 공중합체가 최대이었으며 그 이상의 가교도를 지닌 공중합체에서는 거의 동일하였다. 팽윤율은 Methylal 용매중에서 3% 가교화 ST-DVB 공중합체가 최대로 팽윤되었으며 그 이상의 가교도를 지닌 공중합체에서는 자동가교의 영향으로 인하여 거의 일정하였다. ST-DVB 공중합체의 다공도 변화는 가교도가 5%일때 최대였으며 그 이상에서 거의 일정하였다. Crosslinked ST-DVB Copolymer was Chloromethylated, vinylated, and orgnometalated. When degree of crosslinkage was 3%, the chlorine content and the degree of swel ling of the polymer was highest in methylal solvent. The pore volme is highest in 5%-crosselinked polymer.

소아 악골 골절의 치료에 대한 임상적 고찰 및 증례보고

서창호,김준배,배정수 東國大學校醫學硏究所 1997 東國醫學 Vol.4 No.-

소아에서는 골 및 주위 조직의 특성상 성인의 경우와는 다른 안면골 골절의 양상을 띄며 따라서 치료 방법도 각 증례에 적합한 방법이 선택되어져야 하므로 진단 및 치료계획 수립시 이러한 특징들이 잘 파악되고 있어야 한다. 저자들은 1996년 5월 1일 1997년 6월 30일까지 동국대학교병원에 내원한 3차례의 소아 악골 골절 환자들을 각각의 증례에 적합한 보존적인 방법으로 치료하여 만족할 만한 결과를 얻었기에 임상적 고찰과 함께 각각의 증례들을 보고하는 바이다. Compared to adult facial bones, growing chidren have their unique characters of bone and its surrounding structures in maxillofacial region. SO, in diagnosing, treatment planning and treating the maxillofacial injuries in children, these characters would be fully considered and adapted carefully in each separate cases. We experienced and successfully managed 3 cases of maxillofacial injuries in children during 1 year period (from May, 1996 to June, 1997) and present these cases with clinical considerations.

회장에 장폐색을 유발한 Anisakiasis 1예

박수헌,서정민,문인성,백남종,심규식,김부성 대한소화기내시경학회 1990 Clinical Endoscopy Vol.10 No.2

Anisakiasis refers to the infestation of humans by species of marine nematode larvae belonging to the subfamily Anisakiae. An acute abdominal symptom may occur after ingestion of raw marine fish containing nematode larvae of the genus Anisakis. Migration of the parasite into the wall of gtomach, small intestine or, less commomly, the colon elicits a striking eosinophilic granulomatous tissue response. A 39 year old man was visited St. Vincent Hospital because of abdominal distension and tenderness. The plain abdominal X-ray showed ileus pattern suggesting intestinal obstruction. Hence we presented a case of intestinal Anisakiasis combined with intstinal obstruction.

초피나무 樹皮의 脂質成分에 관한 硏究

申秀澈,徐在信,鄭賢淑 順天大學校 1983 論文集 Vol.2 No.1

초피나무 樹皮에 含有된 一般成分과 脂質成分의 構成 및 脂肪酸의 組成을 分析한 結果를 要約하면 다음과 같다. 1. 一般分析値는 水分이 61.09%, 組蛋白質이 12.18%, 組脂質이 5.89%, 조섬유가 11.66%, 회분이 9.18%였다. 2. 脂肪質의 構成은 中性脂質이 64.77%, 糖脂質이 27.2%, 燐脂質이 7.58%였고, 中性脂質成分은 hydrocarbon, esterified sterol, triglyceride, free fatty acid, free sterol diglyceride 및 monoglyceride의 成分으로 分離 同定하였다. 3. GC에 의하여 7가지 脂肪酸이 檢出되었는데 주요 脂肪酸은 palmitoleic acid, oleic acid, linoleic acid, linolenic acid의 不飽和 脂肪酸이었고, myristic acid, palmitic acid, stearic acid의 飽和脂肪酸은 소량 含有되어 있었다. The lipid components and fatty acid composition of crude lipid in bark of Xanthoxylum piperitum were determined by the methods of thin layer chromatography and gas liquid chromatography. The results were summerized as follows: 1. Proximate components of the bark were shown to be 61.09% moisture, 12.18% crude protein 5.89% crude lipid, 11.66% crude fiber, 9.18% ash. 2. Lipid components were 64.77% neutral lipid, 27.2% glycolipid and 7.58% phospholipid The neutral lipids were fractionated and identified as hydrocarbons, esterified sterols, triglycerides free fatty acid, free sterols, diglycerides and monoglycerides. 3. Lipids of the bark of X. piperitum contained 7kinds of fatly acid as constituent by gas liquid chromatography anlysis. The main fatty acides in the lipids were unsaturated fatty acids(palmitoleic acid, oleic acid, linoleic acid, linolenic acid), and saturated fatty acids(myristic acid, palmitic acid, stearic acid) were as minor components.

횡 요천골부 후피부판 (Transverse Lumbosacral Back Flap)을 이용한 천골부 욕창 치험례

전건수,김유승,하재성,박준용,서정오 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.3

Pressure sore is an area of ischemic tissue loss resulting from prolonged or often repeated pressure, usually over a bony prominence of body. Recently, the prevalence of pressure sore is major clinical problem, due to the increased number of patients with spinal cord injuries or longterm comatous patient after traffic, industrial accidents. The surgical principles in the treatment of pressure sores are total excision of the ulcer, scartissue, bursae, complete removal of all infected bone with recontouring of bony prominences to alleviate discrete pressure points and resurfacing and padding of the defects with healthy and well vascularized tissues. The sacral sore is the most common site for the development of pressure sore in Korea. We had experienced 14 cases who had received surgical treatments for sacral sores with transverse lumbosacral back flap. We obtained the following conclusions. Advantages 1)It is quick and easy procedure 2)The flap elevation itself is relatively bloodless 3)The donor defect is in a non-weight-bearing area 4)Muscle is not sacrified(possibly of importance in the ambulatory patient) 5)Surgical options are preserved in cases of recurrence(the flap itself may be reelevated and inset in some cases of recurrence) Disadvantages 1)It is lacking the bulky padding afforded by alternative musculocutaneous flaps 2)The vascularity of the flap tip is empirically less dependable than that of a musculocutaneous flap 3)The donor defect is large, cannot usually be closed primarily, and may prove of cosmetic concern

인공위성영상과 NDVI를 이용한 피복분류 : 동국대학교 운길산연습림을 중심으로 Focus on Mt. Ungil Experiment Forests belong to Dongguk University

원명수,서정수,김창호 동국대학교 생명자원과학대학 연습림 2000 연습림논문집 Vol.- No.6

Recently, Satellite image data is applied in many fields. Spatially, NDVI(Normalized Difference Vegetation Index) is widely using as a indicator for vegetation environment assessment and utilized to measure quantities of forest resources and vegetation vitality. In this study, it is introduced to perform land use classification for each land cover condition and NDVI using Landsat-5 Thematic Mapper imagery data acquired in 1997. Also this study is aimed at organizing base data to manage and use forest rationally with focus on Mt. Ungil Experiment Forest belong to Dongguk University in Namyangju, Kyounggi Province. Land cover is classified into total seven categories as water body, urban area, barren area, agriculture area, grass land, forest and etc.

葡萄(Campbell Early)의 結實에 미치는 GA 및 覆袋의 影響

權相洙,具禹書,朴正璂,權五昌,李容門 東亞大學校 1983 東亞論叢 Vol.20 No.3

葡萄 Campbell Early 의 無核果 生成 및 成熟促進을 위하여 GA₃ 濃度別 그리고 몇 가지 覆袋處理를 한 實驗結果는 다음과 같다. 1. 果房重과 果粒數는 滿開 8日前 處理가 適期로서 果房重은 無處理에 비해 76.4%, 果粒數는 80.6%였다. 2. 1果房當 無核粒率(92%)과 100粒中 種子數(12個)는 滿開 18日前, Gibberellin 處理+cellophane紙 覆袋區가 가장 良好하였다. 3. 果粒數와 種子數(r=0.826) 또한 種子數와 果重間에는 정의 相關關係(r=0.841)를 나타내었다. 4. 糖度는 無處理區보다 cellophane紙 覆袋區가 9.34% 로서 높았다. 含水量과 灰分은 無處理와 新聞紙 覆袋區가 높았고 cellophane 紙 覆袋區가 낮았다. 5. vitamin C 含量은 Gibberellin 處理時期가 빠르고 無核率이 높을수록 낮은 傾向이엇다. 處理間에 있어서는 無處理와 parchment紙 袋覆區 많았고 cellopnane紙 袋覆區가 含量이 적었다. 6. Gibberellin 處理時期를 앞당기고 cellophan紙 袋覆를 하면 無核率이 높은 反面 果粒數 果重이 減少되고, Gibberellin 處理時期를 늦추고 新聞紙 覆袋를 하면 果粒數 果重은 增加하지만 無核率이 낮아졌다. The results obtained by the Gibberellin and bagging treatment on the Campbellearly grape are as follows: 1. The suitable period of treatment for cluster weight and number of berry are to be before 8 days of full bloom. The cluster weight was 76.4% and number of berries were 80.6% compared with control. 2. The ratio seedless berries of 92% per cluster, and number of 12 seedss in 100 beries were showed the best on before 18 full bloom at the bagging plots of Gibberellin treatment+cellophane paper. 3. Number of berry and number of seed (r=0.826) also were showed mutual relation of plus between the number of seed and fruit weight. 4. Soluble solid was showed higher of 9.3% at the cellophane paper bagging plot and 9.34% at the parchment paper bagging plot than the control. Juice content and ash were showed high at the conthol and newspaper bagging plot, and low at the cellophane paper bagging plot. 5. The content of vitamin C was showed low tendency at the higher of the seedless ratio with the quick Gibberellin treatment period. At the betweentreatment, the control and parchment paper bagging plot were showed much, and showed less content at cellophane paper bagging plot. 6. In advance the period of Gibberellin treatment and had cellophane paper bagging then the ratio of seedless would be high, but on the contrary, the number of berry and fruit weight decreased, and had delay the period of Gibberellin treatment and had the newspaper bagging, the number of berry and fruit weight would be increased but the ratio of seedless was low.

각종 골대체물질들의 골형성능에 관한 비교연구

설정현,최원희,김정철,홍정수,서동보 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.4

We studied the bone forming capacity of the various bone substitute materials for the confirmation of bone regeneration with each case i.e Hydroxyapatite(SURGIBON), kiel obne, B.O.P. and bone dust. The bone dust was used for control. In 18 New Zealand white rabbits, four partial thickness bone defects were created on the outer table of parietal bone, which were measured 1.5mm in depth x 8mm in diameter. Bone substitute materials were filled in each bone defect. The animals were sacrified at 2, 4, 6, 8 weeks after taking a plain skull film, and then both macroscopic and microscopic examinations were done. The results were as follows : 1. Hydroxyapatite : good bone regeneration with moderately increased eosinophil. 2. KIEL BONE : no bone regeneration and markedly increased eosinophil. 3. B.O.P. : no evidence of bone growth during postoperative 8 weeks. 4. BONE DUST : persistent osteoblast existed during experimental period, more likely as own bone. We summarized that the hydroxyapatite is a biocompatible matrix implantable as a bone graft substitute and more bone regeneration than other bone substitutes during the experimental period.