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.

자가 두개골 이식을 이용한 단중족골증의 치료

손윤호,박재우,변진석,백봉수 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.1

Brachymetatarsia frequently affects the fourth toe, and is more common in females, The etiology is obscure but the premature closure of epiphysis results in early union and cessation of metatarsal growth. The abnormally short metatarsus is both clinically and radiographically evident with an associated shortened and contracted toe. The deformity is usually asymptomatic but produces a serious cosmetic and psychological problems. For the corrction fo brachymetatarsia, many different surgical alternatives have been presented. We adopted the modified Jinnaka's method : interposing the autogeneous cranial bone graft within the metatarsophalangeal joint of the metatarsophalangeal joint for reducing the tension dorsally on the digit. Postoperatively the short leg splont was removed two weeks after the operation. During the next four weeks, the walking cast was applied and weight bearing was begun. During recent 4 years, 9 brachymetatarsia developed in the 4th toe in 5 patients were treated with this technique and good postoperative results were achieved in cosmetic and functinal aspects. This method has following merits. 1. The cranial bone is less absorbable than the rib or iliac crest. 2. The lengthening of the dorsal skin is easily obtained by means of Z-plasty over the dorsal skin of the metatarsophalangeal joint. 3. By interposing a bone graft within the metatarsophalangeal joint, bone lengthening of two centimenters or more could be achieved and the patients could walk without fracture of the grafted bone except one toe, in which pseudojoint is formed with normal gait.

우리나라 주택공간구성에서 보이는 전이적 연속성에 관한 연구

손세관,이수진 中央大學校 建設環境硏究所 1997 環境科學硏究 Vol.8 No.-

The purpose of this study is to grasp the peculiarities of spatial sequence and transition expressed on modern residential space of Korea. For the analyses, 8 famous house designed by Korean architects were selected. Three aspects of spatial sequence such as spatial composition, visual sequence, and visual changes of space were analyzed. In the spatial composition of houses, the linear composition was emphasized to arrtact the sequential visual experience. And the characteristic spatial composition to induce the conversion of direction and the intended sequential movement were used variously. And the inductive walls, change of level of floor and height of ceiling, and various use of corridor or stairs were intentionally emphasized. Change of visual scene according to spatial experience in each stage of spatial connection were also stressed. Based on the above analyses, 14 'patterns' of spatial composition were extracted as a set of language for design of houses.

FET형 반도체 마이크로센서 개발(Ⅱ)

손병기,이흥락,박이순,조진호,이성필,최평,서화일,고성택,박재윤,서장수,김창수 경북대학교 센서기술연구소 1994 연차보고서 Vol.1994 No.-

현재 의료진단, 화학공정의 모니터링이나 환경공학적 감시 및 제어 등의 분야에서 사용되고 있는 기존의 센서는 고가이며 용적이 클 뿐만 아니라 분석시간이 길고 사용하기 까다로운 것 등 여러 가지 문제점이 있다. 또한 측정환경에 영향을 주지 않을 만큼 충분히 작으며 빠른 분석시간을 가진 센서를 필요로 하고 있다. 본 연구에서는 기존의 센서들의 난점을 극복할 수 있는 새로운 형태의 FET형 전해질(electrolyte : H^+, K^+, Ca^2+, Na^+)분석 시스템, 용존가스(O_2, CO_2)분석 시스템의 개발을 중점적으로 추진하며, FET형 압력센서, 습도센서, 방사형 온도센서 등의 개별 FET형 센서에 관한 연구도 병행하고자 한다. Recently various kinds of sensors have been developed, being applicated to their own purpose. There are lots of difficulties to apply them to measurements in which the real-time monitoring is required without disturbing the surrounding environment. FET type semiconductor sensors, fabricated by the semiconductor integration technologies, have many advantages for their miniaturization, standardization, mass-production and in vivo/in situ monitoring. They also hold a very proper configuration for multi-functional sensors or integrated smart sensors, and wide availability by forming various kinds of physical or chemical sensing materials onto their sensing gates.

觀光情報案內所(TIC) 外來 利用者의 滿足度

孫大鉉,羅珍琇 한양대학교 사회과학대학 2001 社會科學論叢 Vol.20 No.-

본 연구는 관광정보 안내소가 외래 관광자의 첫 관문으로서 체재기간을 연장하고 추가적인 소비를 이끈다는 것과 이용자의 특성에 따라 필요한 정보와 서비스 요구가 달라지고 지역마다 또한 연구결과마다 차이가 있다는 기존연구를 바탕으로 한국에서 TIC를 이용하는 외래 관광자의 필요 정보와 서비스를 이용자의 특성, 즉 국적별, 여행형태별, 방한체재기간별에 따라 차이가 있는지를 분석하고 이용하기 전 기대정도와 이용한 후의 만족정도를 파악하여 한국에서 TIC가 나아가야 할 방향을 제시하고자 하였다. 실증조사결과 한국의 TIC에서 원하는 정보의 순은 지역정보, 교통정보, 쇼핑정보, 숙박정보, 식·음료정보의 순으로 나타났고 이것은 국가마다 다소 차이를 보였다. 특히 국적별로 원하는 정보와 서비스에 있어서 통계적으로 유의한 차이를 명확하게 보여 주었는데 이런 결과는 한국의 TIC가 이용자의 특성에 맞게 전략을 조정할 필요가 있음을 보여준다. Recently, the role of information in tourism sector is very important. Especially, based on the previous studies of Tourist Information Center(TIC), it seems that the information you have obtained on your trip makes travelers' behavior increase the number of days spent in a destination as well as the level of visitors expenditures. Considering these, the goal of this research is to know clearly what the traveler really needs in TIC in Korea and to verify whether there are significant difference by TIC user' distinction (as variables) such as nationality, type of travel and length of stay in this trip. The result of this research gives us useful informations. 1) when traveler use TIC in Korea, the order of information they need is the following ; ① sightseeing information including map in each local area ② transportation information ③ shopping information ④ accommodation information ⑤ restaurant·food Information 2) significant differences are found by TIC user's distinction, especially, nationality clearly. Based on these findings, the conclusion section of this research includes suggestions for improvement about TIC in Korea.

FET형 반도체 마이크로센서 개발(Ⅲ)

손병기,이흥락,박이순,조진호,이성필,최평,서화일,박재윤,송경은,김창수 경북대학교 센서기술연구소 1995 연차보고서 Vol.1995 No.-

현재 의료진단, 화학공정의 모니터링이나 환경공학적 감시 및 제어 등의 분야에서 사용되고 있는 기존의 센서는 고가이며 용적이 클 뿐만 아니라 분석시간이 길고 사용하기 까다로운 것 등 여러 가지 문제점이 있다. 또한 측정환경에 영향을 주지 않을 만큼 충분히 작으며 빠른 분석시간을 가진 센서를 필요로 하고 있다. 본 연구에서는 기존의 센서들의 난점을 극복할 수 있는 새로운 형태의 FET형 전해질(electrolyte : H^+, K^+, Ca^2+, Na^+)센서소자 및 분석 시스템, 용존가스(O_2, CO_2)센서의 개발을 중점적으로 추진하였으며, FET형 압력센서, 습도센서 둥의 개별 FET형 센서에 관한 기초연구도 병행하였다. The conventional sensors have many problems such as high cost, large dimension, long analysis time and troublesome handling to apply to the fields of medical diagnosis, monitoring of chemical process and environmental monitoring/control. The main objects of this research are to develope a new FET type electrolyte(H^+, K^+, Ca^2+, Na^+)sensors, analysis system, and dissoved gas(O_2, CO_2)senors that can overcome the problems of the conventional sensors, and parallel basic researches on FET. type sensors such as pressure and humidity are also in progress.

十二指腸憩室에 關한 臨床的 觀察

孫宜錫,崔振學,韓昇洙,安炳善 대한내과학회 1964 대한내과학회지 Vol.7 No.12

In medical practice, it is generally believed that duodenal diverticulum is symptomless. However, surprisingly enough more cases of duodenal diverticulum with various gastrointestinal symptoms are encountered in our clinic in recent years and this paper presnts the results of our recent clinical observation of duodenal diverticulum in 29 cases. The incidence of duodenal diverticulum among 515 X-Ray examinations of the upper gastrointestinal tract was 5.6% (29 Cases). Sex distribution was 31% (9 cases) in male and 69% (20cases) in female. In regards to the age distribution, the highest incidence was found in 4 th decade of life (72.4 %). The duodenal diverticulum was found most frequently among the inner aspect of the duodenum (94.4%), and in 80.5% it was located in the seond portion of the duodenum. The single diverticulum was found in 86.2% of cases. and multiple diverticuli was found in 13.8% of cases. The size of diverticulum was various ranging between 3 ㎜, and 97 ㎜, in longitudinal diameter. 30.6% of cases showed 20-29 ㎜, in diameter. The shape of the diverticulum was round in almost all the cases. Complications were found in 10.3% of the diverticulum and associated diseases other than diverticulum were found in 62.1% of cases. General symptoms of gastrointestinal tract were found in most of the cases of duodenal diverticulum in contrast to the general believe that duodenal diverticulum is symptomless, and hunger pain, epigastric discomfortness, nausea and vomiting, which are prominent in peptic ulcer, were noted in highest proportion. Gastric juice analysis showed various results ranging between low acidity and high acidity but the high acidity was found more frequently in duodenal diverticulum when it is compared with results found in peptic ulcer.

Glucagon 및 Cycloheximide 投與에 의한 흰쥐 肝細胞 lysosome의 變化에 관한 超微形態學的 硏究

이진식,김익동,배한익,서인수,김중길,곽정식,손태중 慶北大學校 醫科大學 1983 慶北醫大誌 Vol.24 No.2

저자는 체중 30∼35gm 정도의 ICR계 생쥐에 체중 100gm당 100㎍의 glucagon을 그리고 체중 100gm당 0.15mg의 cycloheximide를 각각 단독으로 또 이들을 같이 복강내에 병합 투여하여, 이때 간세포에 일어나는 형태학적 변화와 아울러 lysosome막의 유래의 일단을 알아보기 위한 실험성적을 요약하면 다음과 같다. 광학현미경적으로는 중심정맥 주위의 간세포이 종창과 한국성 지발변화가 나타났었는데, 그 정도는 glucagon 단독투여군과 cycloheximide와 glucagon을 병합투여한 군에서는 다같이 중등도로 일어났었다. 전자현미경적으로는 glucagon 단독투여 군에서는 간세포에 있어서의 lysosome의 현저한 증가, 특히 autophagic vacuole의 증가, 세포핵의 비대 및 핵소체수의 증가, 그리고 kupffer세포의 탐식 작용의 증가등이고 cycloheximide 단독투여군에서는 경한 lysosome의 증가, RER의 확장, 단열, ribosome의 탈락, free ribosome의 증가, Golgi complex의 위축, SER의 감소, mitochondria의 종창 및 공포화와 lipid droplet의 증가 등이다. 그리고 glucagon과 cycloheximide 병합투여군에서는 상기한 두가지 단독투여군의 소견과 여기에 더하여 peroxisome의 증가가 일어났으며, 이들 변화중 특히 autophagic vacuole의 증가는 glucagon 단독투여군보다 좀더 현저한 경향이었다. 이상의 연구성적으로 보아, glucagon은 간세포에 있어서 autophagy를 증가시킬 뿐 아니라, 핵에도 작용하여 그 비대를 일으키며, 이때 cycloheximide를 투여하여 단백합성을 억제하여도 autophagy를 저해하지는 않는다고 믿어진다. 따라서 autophagic vacuole의 한계막은 새롭게 신생된다기 보다는 세포내의 기존의 막, 예를 들면 SER, RER, Golgi막등 막성 성분에서 유래될 가능성이 지금으로서는 더 많은 것으로 생각된다. Glucagon은 autophagic vacuole을 증가시킬 뿐 아니라, cycloheximide를 투여한 후 glucagon을 투여한 경우에는 autophagic vacuole의 증가와 더불어 peroxisome도 증가시킬 것으로 추정된다. In order to investigate the morphologic changes and origin of membrane of lysosomes, the author administered glucagon, 100㎍ per 100gm of body weight, cycloheximide, 0.15㎎ per 100 gm of body weight and both to the healthy male ICR mice intraperitoncally. Each hepatic tissue was observed by light microscope and electron microscope. The results were summarized as follows. Light microscopically, swelling of heaptocytes and focal fatty change appeared around the-central vein. The severity of these changes was mild in the group administered glucagon and was moderate in groups administered cycloheximide alone, both cycloheximide and glucagon. Electron microscopically, in the group administered glucagon, marked increase of lysosomes, particularly autophagic vaculoles, enlargement of nuclei with increase of nuclcoli in thc hepatocytes and increase of phagocytosis in kupffer cells were appeared. In the group administered cycloheximide, slight increase of lysosomes, dilatation and fragmentation of RER, shedding of ribosomes, increase of free ribosomes, atrophy of Golgi complex, decrease of SER, swelling and vacuolizatlon of mitochondria, and increase of lipid droplets occured. In thr group aiministered both cycloheximide and glucagon, above findings in each group and additional increase of peroxisomes appeared. In these changes, increase of autophagic varuoles was more prominent in the group administered glucagon. From the above results, it is believed that glucagon induces enlargement of nuclei as increase of autophagy in the hepatocytes. At this time, in spite of suppression of protein synthesis by administration of cycloheximide, the autophage was not inhibited. Therefore it is more possible that the limiting membrane of autophagic vacuoles originates from preexisting membrane rather than front de novo synthesis. when glucagon was administered after administration of cycloheximide, peroxisomes as well as autophagic vacuoles were increased.

미용사들의작업관련성 근골격계 장애에 관한 연구

박수경,최영진,문덕환,전진호,이종태,손혜숙 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.3

목적 : 미용사의 작업관련 근골격계 장애 실태와 관련 요인을 알아보고자 한 것이다. 방법 : 최종 대상이 된 미용사 267명에 대하여 2000년 3월부터 5월까지 Karasek의 J7Q와 N10SH의 표준화 설문지를 이용하여 일반적 특성, 직무관련 스트레스, 근골격계 장애 자각증상 등을 자기 기입식으로 작성하게 하였다. 결과 : N10SH 감시기준에 의한 근골격계 자각 증상 호소율은 전체적으로 94.4%으로 높은 편이었으며, 각 신체부위별로는 어깨 부위(61.0%), 목 부위(59.9%), 허리 부위(53.2%), 손 및 손목 부위(41.6%)의 증상 호소율이 비교적 높게 나타났으며, 상대적으로 무릎 및 허벅다리 부위(36.7%), 발 및 발목 부위(34.8%), 등 부위(28.8%), 팔 및 팔꿈치부위 (28.5%), 종아리 부위 (28.5%), 손가락 (22.8%) 등은 낮았다. 다변량 분석 결과, 미용사들의 WRMDS는 직무 스트레스와 건강관련 습관 등에 영향을 받은 것으로 관찰되었으며, 부위별로 목부위는 직무의 불안정성, 허리부위는 여자, 음주, 결정의 허용범위, 손 및 손목부위는 음주, 무릎 및 허벅다리 부위는 흡연, 발 및 발목부위는 흡연, 결정의 허용범위, 그리고 등부위는 직무의 불안정성 등이 유의한 요인으로 관찰되었다. 결론 : 주관적인 증상 호소만을 이용한 제한점에도 불구하고 산업보건의 명확한 대상이 되지 않고 있는 미용사 등의 서비스업 종사자에 대한 WRMDS 연구의 기초자료로서 활용될 수 있을 것이다. Objectives : To determine the prevalence and related factors of work related musculoskeletal symptoms in hairdressers. Methods : Informations on general characteristics, job strain, and musculoskeletal symptoms were obtained by a self-administered questionnaire, through adopting NIOSH instrument and JCQ (Job content questionnaire) , from 267 hairdressers, between March and May, 2000. Results : The symptom prevalence by N10SH surveillance criteria in total was high as 94.4%; shoulder (61.0%), neck (59.9%), low back (53.2%), hand and wrist (41.6%), etc. In multiple logistic regression, significant factors affecting the symptoms by body region , job insecurity on neck; gender, alcohol, decision latitude on low back; alcohol on hand and wrist; smoking on thigh and knee; smoking, decision latitude on ankle and foot; job insecurity on upper back. Conclusions : Musculoskeletal symptoms of hairdresser were highly prevalent, and associated with job strain and their health habits. This Is a basic data of work related musculoskeletal disorders among hairdressers who are not the subjects of occupational health service at the present time in Korea.

한국의 조기난소부전 환자에서 Inhibin 유전자의 변이 분석

김영진,손인숙,이지영,김수녕 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

The clinical models for studying ovary-determining genes may be premature ovarian failure(POF). POF is a condition causing amenorrhea, hypoestrogenism, and elevated gonadotropins in women under 40 years old. The prevalence of POF among reproductive women is 1%. POF is a highly heterogenous condition, but its etiology remains unknown in approximately two-thirds of cases. Many causes of POF were reported, including Turner syndrome, genetic disease, iatrogenic agents such as chemotherapy or radiotherapy, infection and autoimmune disease. FSH receptor, LH receptor, inhibin, GDF-9(growth differentiation factor), BMP-15(bone morphogenetic protein), DIAPH2(diaphanous gene) and XPNPEP2(X-prolyl aminopeptidase) genes were proposed as a possible candidate gene, but only mutations of FSH receptor, LH receptor, inhibin genes were reported in women with POF. The present study was performed to investigate whether the mutation of inhibin gene is observed in Korean patient with premature ovarian failure and whether mutation of these genes is a likely cause of POF. Eighty-six women with premature ovarian failure were studied and thirty-six normal women were enrolled as control. Mutation screening of these genes were established by denaturing HPLC and were confirmed by automatic sequencing. No mutation of inhibin gene was identified in Korean women with POF. In conclusion, premature ovarian failure was not likely caused by mutations of inhibin gene.