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.

한국인 인슐린 비의존형 당뇨병 및 이차성 당뇨병 환자에서 글루코키나제 유전자 변이

남재현(Jae Hyun Nam),이현철(Hyun Chul Lee),김연의(Youn Euy Kim),권석호(Suk Ho Kwon),윤용석(Yong Suk Yoon),박석원(Suk Won Park),원영준(Young Jun Won),차봉수(Bong Su Cha),송영득(Young Duk Song),이은직(Eun Jig Lee),임승길(Sung Kil Lim) 대한내과학회 1998 대한내과학회지 Vol.54 No.6

N/A Objectives: Mutations in the glucokinase (GCK) gene are considered a possible cause of maturity-onset diabetes of the young. The purpose of this study was to evaluate the contribution of this gene to the development of non insulin dependent diabetes mellitus (NIDDM), gestational diabetes mellitus (GDM) and post-renal transplantation diabetes mellitus (PTDM). Method: Identification of GCK mutation was attempted on 39 NIDDM patients, 2 GDM patients and 58 selected renal allograft recipients with PTDM and 45 normal controls. The exons in the GCK gene were examined by polymerase chain reaction (PCR), followed by analysis of single-stranded DNA conformational polymorphism (SSCP). The abnormal bands were also confirmed by DNA sequencing analysis. The exons of affected family members were also investigated for mutations of the GCK gene. Results: Two of the 58 PTDM patients (3.4%) were found to have CKK mutations. One had the mutation on exon 5 and the other on intron 7. One control subject had the mutation on intmn 9. The mutation of exon 5 was identified as a substitution of CCT (proline) for CTT (leucine) at codon 164, which has not ever reported before. The family members of the PFDM patient with mutation of exon 5 were analyzed by PCR followed by SSCP, and two of them revealed the same mutation. The abnormal band on the SSCP analysis of exon 7 was identified as the insertion of base C/T at the 39th nucleotide in intron 7. Two family members of this patients also had same band on SSCP. The one mutation of 45 normal controls was CT located at the 8th nucleotide in intron 9, which was a common polymorphism. Conclusion: We found GCK mutations in subjects with PTDM and we speculate that these mutations may be one of the contributing cause of PTDM.

성남시 지역주민의 정신질환에 대한 태도 연구

고영,신수경,황태연,이충순,박연수,김인숙,황은숙,정원재 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.1

환자 이송에 관한 소고 : 2명의 가정의 협동개업병원을 중심으로

윤방부,원영주 대한가정의학회 1984 Korean Journal of Family Medicine Vol.5 No.12

규칙적 장기간 운동이 성인여성의 골밀도 함량, 최대 산소섭취량과 각신전력 변화에 미치는 영향

윤성원,강영석,나윤수 서울여자대학교 자연과학연구소 1996 자연과학연구논문집 Vol.7 No.-

The purpose of this study was to examine the effect of organized walking (n=9) and badminton exercise (n=9) on bone density, maximal oxygen consumption, and leg extensor intake during 6-month period of experiment with middle-aged women(48-56 years). Subjects (n=18), regularly participating to a social sport oenter, were practiced an assigned exercise 3 times a week and measurements were taken every 3-month. after the program being initiated Bone density was measured by DEXA method, VO?? by a rpogressive work load exercise, and leg extensor by isokinetic equipment. The following results were obtained from data analyses : 1. For walking group, the 6-month exercise with a regular time interval resulted in an increase in the bone density of back lumber (L1-L4). On the other hand, for badminton group, an increase was shown in the bone density of head of thigh. 2. For both groups, les extensor was significantly increased over the 6-month experimental period. 3. Subjects in walking exercise group showed an significantly increased VO?? over the experimental period while badminton group did not. These conclusions suggest that an exercise prescriptor should design an exercise program such a way that it includes both a resistance training and aerobic exercise in order to increase bone density, which has a prevention effect against aging and bone fracture, as well as to enhance strength of leg muscle and VO??.

주요 우울증에서 종양괴사인자-베타 유전자의 다형성

전태연,배치운,김영호,장계호,이정태,박원명,김광수 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요 우울증은 역학적 유전연구 등을 통하여 유전적 영향이 높은 것으로 알려져 있으며 최근에는 분자 유전학적 연구로 유전자 다형성과 질병의 연관성을 밝히는 것이 정신질환의 유전학적 연구에서 중요한 부분을 차지하고 있다. 이에 본 연구는 중추신경계와 면역계간의 상호작용에 관여하는 싸이토카인 중 TNF-β 유전자의 다형성을 분석하여 주요 우울증과의 유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-IV에 의하여 주요 우울증으로 진단된95명을 환자군으로 선정하였고 가톨릭조혈모세포정보은행에서 보유하고 있는 정상 한국인 202명의 자료를 정상 대조군으로 사용하였다. 전혈에서 DNA를 추출하고 TNF-β 유전자 부위를 증폭한 후 제한효소 Nco Ⅰ으로 절단하여 555bp와 185bp의 절편을 갖는 TNFB*1과 Nco Ⅰ절단부가 없는 740bp의 절편 TNFB*2등 2가지 대립유전자의 제한효소절편길이 다형성을 조사하였다. 모든 자료의 분석은 x²검증을 이용하였다. 결 과 : 1) 주요 우울증과 정상 대조군 간에 TNFB유전자인 TNFB*1/1, TNFB*1/2 및 TNFB*2/2의 발현 빈도에는 유의한 차이가 없었다. 2) 두 군 간에 TNFB*1 과 TNFB*2 두 대립유전자의 빈도에는 유의한 차이가 없었다. 결 론 : 본 연구에서는 주요 울울증군과 정상 대조군 간에 TNFB*1과 TNFB*2의 두 대립유전자 발현 빈도에 유의한 차이를 발견하지 못하였다. 따라서 TNFB 유전자다형성과 주요 우울증과의 유전학적인 연관성이 없었다. 향후 연구에서는 다양한 임상변인을 포함하여 보다 통합적이고 체계적인 연구가 이루어져야 할 것으로 생각되었다. Objective : Major depressive disorder is known to have high genetic predisposition and the main focus of recent genetic studies in major depressive disorder has been concentrated on association studies between genetic polymorphism and disease, since molecular genetic methods have been developed. This study was designed to investigate the relationship between major depressive disorder and immunogenetic influences by analyzing polymorphism of TNFB gene, which is involved in interaction of immune system and CNS. Method : 95 persons who had been diagnosed of major depressive disorder were assigned as patient group and, 202 data obtained from Catholic hemopoietic stem cell bank, College of medicine, the Catholic University of Korea, were used as normal controls in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by Nco Ⅰ.After that procedure, we obtained and assessd restriction fragment length polymorphism of two alleles, TNFV*1 which has 555bp and 185bp fragments and carries the Nco Ⅰ restriction site, and TNFB*2 of 740 bp fragment lacks the Nco Ⅰ restriction site. All data were analyzed by x²test with two-tailed Fisher's exact test. Results : 1) The frequencies of TNFB*1/1, TNFB*1/2, and TNFB*2/2 were not statistically different between major depressive disorder patients and control group. 2) The frequencies of TNFB*2 and TNFB*1 were not statistically different between major depressive disorder patient group and normal control group. Conclusion : We did not verified the differences of frequency in TNFB*1/TNFB*2 gene between the major depressive disorder and normal controls, respectively. Consequently, there is no genetic relationship between major depressive disorder and gene polymorphism of TNFB. We do suggest that further systematic studies including various clinical variables should be conducted.

치은연하 파절로 치조골 소실을 동반한 상악측절치에서 orthodontic extrusive remodeling후 임플란트 식립을 통한 심미수복 : 증례보고

황수연,손원준,한영철,배광식,백승호,이우철,금기연 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.1

심미적으로 중요한 전치부에서 단일 치아 임플란트를 이용한 보철수복은 임상의에게 새로운 도전과제 중의 하나가 되었다. 그러나 전치부에서 single-unit implant는 식립할 부위의 치조골 상태가 양호해야 하는데 치은연하 파절로 인해 치아 주위에 골 손실이 있는 경우 immediate implant는 심미적으로 문제를 야기할 수 있다. 따라서 본 증례는 "orthodontic extrusive remodeling"을 통해 파절치와 주위 조직을 교정적으로 정출시켜 임플란트 식립을 위한 연조직과 경조직을 증대시킨 후 임플란트 식립을 통해 상악측절치에서 성공적인 심미수복을 이룬 증례에 관한 것이다. The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling" was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.

이면성 및 도플러 심초음파도를 이용하여 진단한 선천성 거대 좌회선지-좌심실 관동맥루

진승원,박준철,이영중,유병현,박현옥,김용주,윤호중,김재형,홍순조,최규보,권종범,원용순,박건 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

NC 선반의 직선 사이클 평면 위치결정 정도 측정 및 분석

김영석,정정표,한지희,윤원주 朝鮮大學校 機械技術硏究所 2003 機械技術硏究 Vol.6 No.2

It is very important t o measure linear cycle plane positioning accuracy of NC lathes because the plane positioning accuracy affects accuracy, performance, interchange-ability and quality of machine parts machined by the NC lathes in industries. Until now, linear cycle plane positioning accuracy test of NC lathes has not been carried out because the two axes of NC lathe are moving simultaneously crossing a t right angle each other. while positioning accuracy test of one axis of NC lathe is briskly carried out using a laser interferometer system in industries. So, in this study, a measuring units system to measure simultaneously two axes' plane. positioning accuracy of NC lathe was composed of two optical linear scales installed on the. z and x-axis of work coordinate system on NC lathe and a computer inserted with PC counter card enables to obtain measuring data. Here, ATC(Automatic Tool Changer) and moving part of linear scale are fixed with magnet bases in order to measure displacement of the ATC of NC lathe. And next, computer software was developed in order to measure the lathe under resolution of 0.1㎛ by the linear scales, and also computer soft measuring data could be modeled on plots and be analyzed to numerically.

한랭노출과 고혈압의 연관성

장태원,김윤규,윤동영,이창희,홍영습,신해림,정갑열,김준연 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

Objectives : This study was carried out to suggest preventive methods for hypertension in cold-exposed workers. Methods : In 11 refs·iteration industries, 68 workers working in refrigerated areas more than one time per day were selected as the exposed group, and 68 workers not exposed to cold were selected as the control group. We interviewed the subjects with a questionnaire covering occupational history, and conducted clinical and laboratory tests including measurements of blood pressure and core temperature. Results : The systolic blood pressure in the exposed group(130.0±13.3 mmHg) was significantly higher than that recorded In the control group(118.3±12.1 mmHg), as was the diastolic blood pressure in the exposed group(82.7±8.5 mmHg) versus the control group(77.4±8.7 mmHg). The core temperature in the exposed group(36.1±0.7℃) was significantly lower than that experienced in the control group (36.4±0.5℃). In logistic regression analysis, age, cold exposure severity and milk intake were significant variables, with odds ratios of 5.204(95 % CI 1.440∼18.812), 2.674(95 % CI 1.080∼6.618), and 0.364(95 % Cl 0.141∼0.942) , respectively. Conclusions : Our study suggests that cold-exposed workers have higher a higher risk of hypertension, and that their core temperature is lower. Risk factors affecting hyper-tension of cold-exposed workers include age, cold exposure severity and milk intake. For the prevention of hypertension, cold-exposed workers should minimize cold-exposure time as much as possible.