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.

彈性抵抗 Tubex 運動이 腕回轉 파워에 미치는 效果

蔡鴻遠,金柄斗,李敏炯,林銖遠 慶北大學校 體育科學硏究所 1990 체육과학연구지 Vol.6 No.-

The purpose of this study is to analyze the effect of elastic recoil tubex exercise for development of shoulder rotation power, 9 male players were selected out of the volleyball players in kpu. The experiment was focused on full swing, half swing, chest full and pull down with tube(1 Tubex tension-1½ Tubex tension). The exercise duration was 8 weeks, and it's frequency was 4-5 times or 5-6 times a week, and they got tests twice : one at the begining of the experiment, and the other 8 weeks later. The test was measured at 60°/sec, 180°/sec and 240°/sec using cybex 340 system, the result of which are as follows : ① Peak torque The wrist showed significant (P<.01, P<.05) increases in the extension at 60°/sec, 180°/sec and 240°/sec, and only the flexion at 240°/sec (P<.05). In the elbow, only extension, was significant (P<.05) increase at 240°/sec. Also in the shoulder, only extension was significant (P<.01, P<.05) increase at 60°/sec, 180°/sec and 240°/sec. But in te shoulder, the adducation and abduction appears nonsignificant. ② Muscle endurance ratio The result of the test upon both the flexion and the extension in the wrist were statistically significant (P<.01) at 240°/sec. ③ Flexion / extension ratio The ratio of Flexion and extension apperar nonsignificant decrease after experiment. but there was only significant (P<.05) decrease in wrist at 180°/sec.

가족성 고콜레스테롤혈증 유병자에서 HMG Co-A Reductasen Inhibitor 및 Bile Acid Resin의 투여로 인한 아킬레스건 황색종의 감소

채인호,한기훈,박영배,조주희,김효수,손대원,김철호,오병희,이명묵,최윤식,서정돈,이영우 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

社會體育振興을 위한 國民意識 再考方案

金柄斗,蔡鴻遠,安禹洪,李敏炯,申榮吉,金基學,鄭相澤,林銖遠 慶北大學校 體育科學硏究所 1987 체육과학연구지 Vol.3 No.-

The purpose of this paper is to investigate and analyze the nation's consciousness about the social physical education by regional groups(big cityes, middle cityes, farm village, fishing villge). And the researchers are to find a way to populize this movement. These subjects for this investigation were chosen at random among the citizens in four region. 4,450 sheets of questionnaire were given to the citizen. And 3,587(81%) sheets of them were received from male(2,582) and female(975) citizens. The results of this investigation are as follows: 1. The nation's consciousness has not been still modernized and the nation tend to depend on their doctors rather than on the new active leisure sports, which is a passive and conventional way, to keep their health. 2. Most people have spent their leisures on nonactive hobby such as reading, listening to music, and watching TV rather than sports. 3. Most residents pointed out lack of facilities, and needed professional directors and various programs they could participate. 4. The opening of citizen athletic field and the gymnasiums to citizens was needed to recruit the lack of facility, and the participation to commercial sport ws differed by economical status and leisure time, however, they usually participated such activities as table-tennis, swimning and tennis. 5. To activate social physical education, first of all, an expansion of the facilities such as athletic fields and gymnasium is needed under the active support of government. 6. The facilities for young men and the handicapped is insufficient, and to prevent juvenile delinquency and guide them into the right way, we should lead them out to participate sports activity. And the facility for the handicapped is needed too.

사다리형 Pt 엑츄에이터를 가진 FET형 포도당센서

이채향,서화일,김창수,손병기 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

An ISFET glucose sensor employing a ladder-type Pt actuator is proposed and its characteristics were investigated. Compared with rectangular-type Pt actuator, the sensor showed better characteristics such as rapid response, high sensitivity, and wide dynamic range. These improved characteristics result from reduced distance between the Pt actuator and the ISFET gate region.

전거근 유리피판 및 복합피판을 이용한 다양한 크기의 연부 및 복합조직결손의 재건

백봉수,조병채,이정형,정호윤 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.3

A wide variety of free muscle or composite flaps have been used clinically for the reconstruction of soft tissue or compound tissue defects since introduction of the microsurgical technique but there were still difficulties in their application due to donor site morbidity and flap bulkiness. Free serratus anterior muscle flap and free composite flap, including serratus anterior muscle have been applied to 17 patients with small or medium sized tissue defects or large sized compound tissue defects from June 1995 to July 1997. There were 11 male cases and 6 female. Average age was 27 years. Defect sites were the anterior tibial area in 6 cases, the dorsum of foot in 6, the medial malleolar area in 1, the heel area in 1, the foot in 2, and the thumb and 1st web space in 1. There were 12 free muscle flaps, 2 free serratus anterior and rib composite flaps, 2 free serratus anterior and latissimus dorsi combined muscle flap and 1 free serratus anterior and latissimus doris and rib composite flap. The average follow up period was 14 month. The survival rate was 100% in 16 cases, 80% in 1 case. There was no remarkable donor site morbidity and operative results were satisfactory in all cases. The advantages of this flap are consistent and reliable flap with minimal donor site morbidity, long constant large caliber pedicle, taking a thin flap, excellent malleability allowed a broad of range of inserting technique, and additional possibility of a composite flap.

전기화상후 Prostaglandin F2a와 Thromboxane B2의 증가에 대한 Flurbiprofen, Prednisolone 및 Gabexate mesilate의 억제효과

조병채,김인규,변진석,백봉수 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

This study was conducted to clarify the inhibitory effect of flurbiprofen, prednisolone, and gabexate mesilate on the synthesis of prostaglandin F2a and thromboxane B2 in the tissue of electrical burn. one hundred sixty Sprague-Dawley rats, 250gm of body weight in average, were divided into 4 groups of control, flurbiprofen, prednisolone and gabexate mesilate administred group. Fourty rats of the each group were subdivided into 1st, 2nd, 4th, 7th postburn day with 10 rats in each subgroup. Ten rats were used for normal values of prostaglandin F2a and thromboxane B2. Flurbiprodfen 30mg/kg was given per mouth, and prednisolone acetate 5mg/kg and gabaxate mesilate 50mg/kg were administred intramuscularly 5 minutes after burn injury and then once a day. All but bone tissue of within 2cm area of the current entry were harvested and ground into homogenate. The levels of prostaglandin F2a and thromoboxane B2 were measured by Radioimmunoassay. The results were as followings: In normal rat tissue, the level of prostagland F2a and thromboxane B2 were 15.8±1.8 and 17.6±2.8ng/mg protein in each. In the control group the levels of both prostaglandin F2a and thromboxane B2 increased abruptly to 5 times and 7 thimes in the first day and maintained the same level in the second day. After then they rapidly decreased and returned to a near normal level in the fourth day. The increase of thromboxane B2 was more remarkable than that of prostaglandin F2a. In the flurbiprofen group, the level of thromboxane B2 was not inerease but kept at a normal level. The average level of prostaglandin F2a in the post-burn first and second day was 59.5% lower than of the control group. The average level on the post-burn first and second day was 61% lower in thromboxane B2 and 33% lower in prostaglandin F2a in the prednisolone group, and 68% lower in throboxane B2 and 48% lower in prostaglandin F2a in the gabexate mesilate group, compared to the control group. These findings suggest that electrically injured tissue is vigrously progressive due to rapid increase of thromboxane B2 and prostaglandin F2a, as inflammatory mediators, in the post-burn first and second day, is nonprogressive after the post-burn fourth day. The flurbiprodfen was the most effective of the three drugs(flurbiprofen, gabexate mesilate, prednisolone in order of effectiveness) to suppress the synthesis of thromboxane B2 prostaglandin F2a of the electrieally injured tissue.

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

한국인에서 혈소판 당단백 Ⅲa 유전자 다형성과 급성 관동맥 증후군의 관계

김광일,채인호,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

간암세포에서 저산소증에 의해 유도되는 VEGF의 발현기작에 대한 연구

권유욱,배수경,김정애,김규원,박병채 영남대학교 약품개발연구소 1997 영남대학교 약품개발연구소 연구업적집 Vol.7 No.-

Puropse: Hepatocellular carcinoma (HCC), a typical hypervasculized tumor is very sensitive to hypoxia and vascular endothelial growth factor (VEGF) has previously been identified to be up-regulated in response to hypoxia in several cell types. However, the molecular mechanisms by which hypoxia is sensed by the cells remain enigmatic. To investigate whether calcium and AP-1 are involved in hypoxia-sensing mechanism, we performed following experiments. Materials and Methods: Hep3B cells were grown in hypoxic condition. To assess cell viability, MTT assay was performed. To investigate the effect of calcium and AP-1, northern blot analysis was performed after treatment with BAPTA/AM. Results: The expression of VEGF was significantly up-regulated by hypoxia in Hep3B, hepatocellular carcinoma cell line. The increased expression of VEGF induced by hypoxia was blocked by the addition of BAPTA/AM, a cytosolic calcium chelator to the media. In addition, we found that the expression of c-jun protooncogene was also up-regulated by hypoxia. Hypoxic increase of c-jun expression was also normalized by the treatment with BAPTA/AM. Conclusion: These results suggest that the increased expression of VEGF by hypoxia is mediated through the calcium and c-jun signalling pathway in the Hep3B human hepatoma cell lines.