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.

상악 측절치의 치내치에 대한 증례보고 : REPORT OF 2 CASES

윤석희,이재천,김영재,장기택,한세현,김종철 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

치내치(dens invaginatus)는 치아 발생 과정 중 경조직이 석회화되기 전에 법랑질 상피가 함입되어 생기는 치아 기형이다. 치내치는 함입된 정도에 따라다양한 형태학적 변이를 보이는데 이러한 기형은 미생물이 침입할 수 있는 통로가 될 수 있어 치수조직의 괴사와 치근단 농양 또는 치은 농양의 원인이 된다. 이러한 경우 근고나의 복잡한 해부학적 형태 때문에 근관 치료가 매우 어렵다. 본 증례는 상악 좌측 측절치의 동통을 주소로 내원한 두 명의 환아들에 관한 것이다. 첫 번째 증례는 수산화 칼슘제재를 이용한 근관치료를 시행하여 양호한 결과를 얻었고 두 번째 증례는 치아를 발거하였다. 발거된 치아는 미세전산화 단층촬영을 이용하여 해부학적 형태를 살펴보았기에 보고하는 바이다. Dens invaginatus is a malformation of tooth resulting from an infolding of the enamel epithelium during tooth development. This malformation shows a broad spectrum of morphologic variations. This invagination frequently allows the entry of irritants and microorganism, which usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscess. Root canal treatment of such tooth is often difficult because of the unusual form and complicated pulpal space. This article reports 2 cases of dens invaginatus in maxillary lateral incisors. The first case was successfully treated with Ca(OH)₂. In the second case, involved tooth was extracted and this extracted tooth was observed using the micro-computed tomography.

수종의 desensitizing agent가 상아질 투과도에 미치는 영향

윤태철,정일영,전영의 大韓齒科保存學會 1999 Restorative Dentistry & Endodontics Vol.24 No.2

부하순환 하에서 제V급 복합레진 수복물의 미세변연누출에 대한 재접착제의 효과에 관한 연구

윤연희,김영재,김정욱,장기택,이상훈,김종철,한세현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

저점도의 레진을 복합레진 수복물 위에 도포하는 것은 미세누출방지와 변연 완전성(integrity) 유지를 위한 한 방법이다. 하지만 장기간 관찰하면, 수복물은 저작압에 의한 영향을 받게 되는데, 저점도의 레진으로 수복물 변연부를 재접착(rebonding)하였을 때 저작압에 의한 응력에 견디면서 계속하여 수복물에 긍정적인 영향을 주는지에 대한 연구는 미흡한 실정이다. 본 연구는 부하순환(load cycling) 하에서 제Ⅴ급 수복물의 미세변연누출에 대한 재접착제 (rebonding agent)의 효과를 알아보고자 하였다. 40개의 건전한 소구치의 협면에 제Ⅴ급 와동을 형성하고 제조사의 지시대로 광중합복합레진으로 수복하였다. 20개씩 무작위로 나누어 표면전색을 하지 않는 Ⅰ군과 표면을 산부식 후 재접착한 Ⅱ군으로 설정하였다. 열순환 후 각 군에서 10개씩의 하위군 (A군=No load cycling군, B군=Load cycling군)으로 나누어 이중 B군의 시편에 1 Hz의 속도로 수직력이 4-100까지 100,000회의 부하순환을 가하였다. methylene blue용액에 침윤시켜 변연의 미세누출릉도를 평가하여 다음과 같은 결과를 얻었다. 1. 교합변연에서는 재접착과 무관하게 유의한 차이가 없었다(ⅠA-ⅡA군, ⅠB-ⅡB군) (p>0.05). 2. 치은변연의 경우는 부하순환을 하지 않은 군의 경우 재접착을 한 군(ⅡA군)이 재접착을 하지 않은 군 (ⅠA군)에 비해 더 적은 미세누출결과를 보였다(p<0.05). 3. 치은 변연에서 부하순환을 시행한 군의 경우에는 재접착을 한 군(ⅡB군)과 재접착을 하지 않은 군 (ⅠB군)과 유의차가 없는 비슷한 미세누출의 결과를 보였다(p>0.05). One clinical technique recommended f3r improving marginal integrity is "rebonding" or application of unfilled resins to the surface of composite restoration. But continuously the restorations are affected with occlusal load. There is room for doubt that the rebonding agent has the positive effect on microleakage in spite of the stress generated by the occlusal load. This study determined the effect of rebonding on microleakage of Class Ⅴ resin composite restorations under load cycling. Class Ⅴ cavities were prepared on the buccal surface of 40 sound extracted premolars and restored with a hybrid light-cured resin composite according to manufacturers' directions. They wert randomly divided into two groups consisting of 20 samples a control(group Ⅰ), without surface sealing, and the other group (group Ⅱ) in which margins were etched and rebonded. After thermocycling, each of groups was divided into subgroups (group A, B), and load cycling(total 100,000 cycles with 4-100N load at a rate of 1 Hz) were applied on the group B. Assessment of microleakage utilized methylene blue dye penetration. The following results were obtained : 1. In the occlusal region, no significant difference was noted in the scores regardless of whether or not the rebonding agent was used (group ⅠA-ⅡA, ⅠB-ⅡB) (p>0.05). 2. In the cervical region, the control group with rebonding (group ⅡA) showed the better result than the group without rebonding (group ⅠA) (p<0.05). 3. In the cervical region, the rebonded group with load cycling(group ⅡB) showed similar results to the groupf·ithout rebonding(group ⅠB) and no significant difference was noted(p>0.05).

시선제어 시스템에서의 비선형 토크보상 적용

盧澈均,尹錫榮,金廣泰 慶一大學校 1997 論文集 Vol.14 No.2

Line of sight(LOS) control systems are precision electro-optical-mechanical gimbal assemblies designed to control the angular position of the LOS of a sensor precisely, therefore they are isolated from the base vehicle dynamics and LOS is pointed toward the target in a desired direction. Nonlinear torque disturbances in their systems cause LOS jitter which limit system performance. Major sources of nonlinear disturbance are friction torque by rotation and gimbal imbalance torque by nonlinear environment. This paper describes the compensation technique for reducing LOS jitter due to nonlinear friction coupling of the host vibration. Proposed compensator controls the feedforward torque command of plant adaptively to converge the error between reference model without friction and plant output to zero. Simulation results show that proposed compensator is effective in cancelling the nonlinear torque and improving the stabilization performance.

음식물 쓰레기 퇴비가 오이 발아와 유묘생장에 미치는 영향

박진영,조경철,김희경,지연태,정순주 全南大學校 農業科學技術硏究所 2001 農業科學技術硏究 Vol.36 No.-

This study was conducted to find out toxicity of compost made of food waste to cucumber seed germination and seedlings growth when it was mixed with Mixlite for bed substrate. Mixlite was solely used as bed soil, or mixed with food waste compost ranging 1% to 100% (w/w). Germination percentage and seedling growth of cucumber were examined in 4 weeks after seedling. When cucumber seeds were sowed in Mixlite mixed with food waste compost at 100, 50, 30, 20, 10 or 1%, germination percentages were 30, 36, 38, 46, 74 and 84% compared to with control(100%), respectively. It showed that germination percentage percentage was adversely affected by the amount of food waste composed mixed in the bed substract. Plant height and hypocotyls diameter, root length and root fresh weight, hypocotyls fresh weight and cotyledon fresh weight of cucumber seedling were similarly adversely affected by the amount of food waste compost. Optimum content of the food waste compost for cucumber nursery substrate was found to be 1% of Mixlite.

신 손상 환자의 고식적 요법에 관한 임상적 고찰

김희철,전윤수,김민의,이남규,박영호 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Recently according to the increase of the traumatic patient there is a trent for the prevalence of renal injuries to increase. The key point in managing the renal injuries is that we should make decision the treatment plan after accurate diagnosis from clinical symptoms, physical examination, radiologic studies. The goal of the management is the conservation of the renal function. The management of renal injuries by nonoperative or operative methods has been a subject of controversy for more than 2 decades. A aggressive immediated operative approach is generally advocated in some centers, while a more watchful conservative approach is endorsed in others. From January 1985 to May 1995, 159 patients with renal injury had been managed at Soonchunhyang University Hospital. Among 159 patients, 83 patients were classified with minor renal injury and 76 patients major renal injury. The Computerized Tomography was useful in diagnosing stage of injuries and detecting combined injuries which were not detected in excretory urography. All stabilized patients were managed by careful continuous observation, bed rest, appropriate fluid resuscitation and prophylactic antibiotic coverage, but unstabilized patients(17 cases) were managed by immediate operation. Complications occurred in 10 patients with a major renal injury associated with a devascularized fragment but not in other patients. In conclusion, the accurate diagnosis and treatment plan of renal injury with computerized tomography are important to avoid improper treatment. I conclude that conservative management of minor renal injury and major renal injury associated with vascularized fragment is a proper method of treatment. However, early surgical intervention should be considered in patients with major renal injury associated with devascularized fragment because of high complication rate and delayed surgical intervention rate.

동충하초 투여가 최대하 운동 시 지방연소에 미치는 영향

김철우,이용수,이상현,이상호,하민수,윤영조,이재일 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.4

The purpose of this study was to evaluate effects of Cordyceps militaris on fat oxidation during submaximal exercise. Fifteen healthy male collegiate students(ingestion group, N=7; control group, N=8) participated as subjects after signing an informed consent following overnight, subjects completed maximal graded execise test on treadmill to determine exercise intensity(50%VO2max). To evaluate the fat oxidation using indirect calorimeter, it was performed submaximal treadmill to determine exercise lasting. 40min at 50%VO2max after 5day and consumed Cordyceps militaris on separate days. This study was used 2×4 two way repeated ANOVA to analyze physiological and metabolic variables between two groups and metabolic variables between two groups and four exercise periods(l0min, 20min, 30min 40min), and used Scheffe to post-hoc test. Significance was set at α=.05. The results of this study were as followed: First, there were significantly highest in ingestion group for V02, percentage of fat oxidetion(%fat), fat per kilocarolies(Fkcal), and total per kilocarolies(Tkcal)(p<.05), but respiratory exchange ration(RER) and heart rete(HR) were significantly lower in ingestion group(p<.05). Second, RER, %fat, Fkcal were significantly difference in 10, 20, 30, 40min of exercise period(p<.05). This results suggest that there is the effect of Cordyceps militaris on fat oxidation submaximal exercise. Additionally, to evaluate effect of Cordyceps militaris as ergogenic aid, it should be required the future study that included extend subjects, various dosage, and chronic consumption.

팔체질침을 이용한 반월판 관절경부분절제술 환자의 치험례

강영화,김성욱,손인석,서정철,윤현민,장경전 동의대학교 한의학연구소 2001 동의한의연구 Vol.5 No.-

슬관절은 지속적인 압력을 받거나 충격때문에 동작범위의 한계에 이를 때 손상받기 쉽다. 반월판 파열 환자는 일상생활에 지장을 주는 동통, 정복되지 않는 잠김, locking이나 giving way가 자주 일어나는 경우, 지속적인 신전제한이 있을 때 수술의 적응증이 된다. 반월판 파열 환자의 재활에 있어서 관건은 대퇴사두근의 근력과 ROM의 회복이다. 팔체질침 시술후 반월판 부분절제술을 시행한 환자가 동통의 강도와 동통 재발의 감소, ROM의 개선, 전반적 상태면에서 체침이나 MPS 시술 때보다 더 나은 경과를 얻었다. Knee joints are apt to be injured when they are over the limit of ROM by continuous pressure or impact. The patient of meniscus tear has to be operated in case that he has the symptom of knee pain obstructive to daily life, unreducable locking, frequent locking or giving way, continuous extention limit. In the rehabilitation of the patient of meniscus tear, the key is the progress of musculi quadratus femori's power and ROM. After 8 constitutional acupucture therapies, partial menisectomy patient has the better process about decrease of pain intensity and relapsing pain frequence, development of ROM, general condition more than general acupucture or MPS medical treatment.

Space Supervision을 이용한 치성 정중선 변위의 교정

김수연,최영철,박재홍,최성철,김광철 大韓小兒齒科學會 2007 大韓小兒齒科學會誌 Vol.34 No.4

상하악 중절치 간의 정중선 변위는 골격성 변위,치성 변위 및 골격성과 치성의 복합적 변위 등으로 구분된다. 그 중 치성 정중선 변위는 치열의 발육시기에 따라 다양한 방법으로 치료 방법을 선택할 수 있다. 특히 혼합치열의 초기에는 치열 내에 존재하는 공간의 조건,인접 영구치의 맹출 시기 또는 맹출 방향에 따라 영구 절치들의 위치가 자발적으로 변화,개선될 수 있다. 따라서 이러한 치아의 생리적 이동을 이용하여 특별한 교정장치의 이용 없이 치열 내에서 치아의 배열을 개선시킬 수 있다. 본 증례보고에서는 특히 유견치의 발거 시기 및 좌우 유치의 발거 순서 등을 이용하여 치성 정중선 불일치를 개선시킨 증례틀을 보고하고자 한다. A midline deviation is divided into three types, such as a skeletal midline deviation, a dental midline deviation, and a combination. Among them, the midline deviation which appear in the early mixed dentition without any skeletal problem can be managed differently by the stage of dental development. The location of the permanent incisors can be improved without using artificial force in consideration of the condition of the space, the eruption timing or the eruption path of the adjacent permanent teeth in early mixed dentition, especially when the permanent incisors are erupting. Therefore. the space supervision technique, which can have the teeth align themselves utilizing physiologic events such as sequence or timing of the eruption of permanent teeth, can be an alternative to orthodontic movement. This case report describes midline deviation improvement by space supervision.