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.

Comparison of controlled ovarian stimulation outcomes for fertility preservation in women with breast cancer according to KI-67, histologic grade, pathologic type, and cancer stage

( Eun Ji Oh ),( Yeon Hee Hong ),( Seul Ki Kim ),( Jung Ryeol Lee ),( Byung Chul Jee ),( Chang Suk Suh ),( Seok Hyun Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: This study aims to analyze that specific prognostic factors such as Ki-67 value, histologic grade, pathology type, and cancer stage can affect controlled ovarian stimulation outcomes(COS) for fertility preservation in women with breast cancer. Methods: This retrospective cohort study included 92 patients with breast cancer aged 21-44 who underwent COS from August 2012 to April 2020, excluding patients with previous gonadotoxic therapy history. All COS cycles were conducted letrozole-combined random start GnRH antagonist protocol. COS outcomes were compared according to prognostic factors;Ki-67 (< 30% vs. ≥ 30%), histologic grade (low vs. high), and pathologic type (intraductal carcinoma(IDC) vs. triple-negative breast cancer(TNBC)), and cancer stage (early (I, II) vs. advanced (III, IV)). Multivariate analysis was also conducted to find any parameter that can impact over 10 mature oocytes acquisition. Results: Among the 92 patients, 42 were Ki-67≥30% compared to 49 of Ki-67<30%. The number of oocytes, and initial mature oocytes were comparable between Ki-67<30% and ≥30 group. The maturation rate was significantly higher in Ki-67≥30% group than Ki-67<30% group (57.4±36.8% vs. 44.8±28.3%, p=0.041). The same results were drawn when divided according to IDC or TNBC. The maturation rate was significantly higher in TNBC than the IDC group (73.0±17.6% vs. 47.0±28.1% p=0.001). However, the histologic grade or stage did not show any difference in COS outcomes between high and low grade or early and advanced stages. With multivariate analysis, age and AMH are parameters associated with the acquisition of over 10 mature oocytes (OR 0.863, 95% CI [0.755-0.987], OR 1.408, 95% CI [1.145-1.732], respectively). Conclusion: Either Ki-67 or pathologic type can be a potential reliable marker for predicting COS outcome, especially maturation rate. Further study with larger sample size with specific conditions is necessary to clarify the correlation between breast cancer prognostic factors and COS outcomes.

니트로글리세린 투여 Tc-99m-MIBI 정량 게이트 심근SPECT를 이용한 관상동맥우회로술 후 심근 기능 회복 예측

이동수,김유경,천기정,팽진철,이명묵,김기봉,정준기,이명철 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

목적: 생존심근 진단에 있어 니트로글리세린 투여 Tc-99m-MIBI 게이트 심근SPECT의 진단성능을 휴식/지연재분포 Tl-201 심근SPECT와 비교하였다. 대상 및 방법: 22명의 관상동맥질환에서 Tl-201휴식/디피리다몰 부하 Tc-99m-MIBi 게이트/ 지연재분포 Tl-201 심근SPECT를 시행하였다. 이 때 게이트SPECT 시행 후 니트로글리세린 0.6mg을 설하 투여하고 연이어 그 자리에서 게이트 SPECT를 1회 더 반복 시행하였다. 환자들에서 관상동맥우회로술을 시행하고 3개월 후 게이트 심근SPECT를 추적검사로 시행하였다. 20 분절 모델을 이용하여 각 분절에서 휴식, 지연재분포, 기저상태와 니트로글리세린 투여 후의 심벽운동 및 수축기비후화 등을 정량하였다. 정량화된 생존심근 예측지표들 중, (1) 휴식기 Tl-201 섭취, (2) Tl-201 지연재분포, (3) 기저상태의 수축기비후화, (4) 니트로글리세린 투여 후의 수축기비후화, 네 가지의 예측성능을 평가하고 비교하였다. 결과: 총 100개의 분절이 분석에 포함되었으며, 이 중 66개(66%)의 분절이 재관류 후 기능 회복을 보였다. 최적 기준점인 50%를 기준으로 하였을 때, ROC 곡선 분석에서 휴식기 Tl-201 섭취와 Tl-201 지연재분포의 민감도, 특이도는 각각 79%와 44%, 그리고 82%와 44%였다. 또한 15%를 기준으로 하여, 기저상태 수축기비후화와 니트로글리세린 투여후 수축기비후화의 민감도, 특이도는, 각각 49%, 50%와 64%, 65%였다. ROC 곡선의 AUC는 니트로글리세린 투여 후 수축기비후화가 기저시 수축기비후화에 비하여 유의하게 높았다(p=0.004). 결론: 니트로글리세린 투여 Tc-99m-MIBI 정량적 게이트 심근SPECT는 기능이상 심근에서 기능 회복을 예측하는데 유용한 검사이다. The performance of nitroglycerin-challenged Tc-99m-MIBI quantitative gated SPECT for the detection of viable myocardium was compared with rest/ 24-hour redistribution TI-201 SPECT. Materials and Methods: In 22 patients with coronary artery disease, rest Tl-201/ dipyridamole stress Tc-99m-MIBI gated/ 24-hour redistribution TI-201 SPECT were performed, and gated SPECT was repeated on-site after sublingual administration of nitroglycerin (0.6 mg). Follow-up gated SPECT was done 3 months after coronary artery bypass graft surgery. For 20 segments per patient, perfusion at rest and 24-hour redistribution, and wall motion and thickening at baseline and nitroglycerin-challenged state were quantified. Quantitative viability markers were evaluated and compared;(1) rest thallium uptake, (2) thallium uptake on 24-hour redistribution SPECT, (3) systolic wall thickening at baseline, and (4) systolic wall thickening with nitroglycerin-challenge. Results: Among 100 revascularized dysfunctional segments, wall motion improved in 66 segments (66%) on follow-up gated myocardial SPECT after bypass surgery. On receiver operating characteristic (ROC) curve analysis, the sensitivity and specificity of rest and 24-hour delayed redistribution TI-201 SPECT were 79%, 44% and 82%, 44%, respectively, at the optimal cutoff value of 50% of Tl-201 uptake. The sensitivity and specificity of systolic wall thickening at baseline and nitroglycerin-challenge were 49%, 50% and 64%, 65% at the optimal cutoff value of 15% of systolic wall thickening. Area under the ROC curve of nitroglycerin-challenged systolic wall thickening was significantly larger than that of baseline systolic wall thickening (p=0.004). Conclusion: Nitroglycerin-challenged quantitative gated Tc-99m-MIBI SPECT was a useful method for predicting functional recovery of dysfunctional myocardium.

치과기공사의 스트레스 증상 관련 요인분석

김지환,이원철,이강숙,이철,진기남 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목 적 : 치과기공사에서의 직무 스트레스 증상과 관련된 요인을 알아보기 위하여 본 연구를 수행하였다. 방 법 : 전국에 등록되어 있는 치과기공사 4861명중 786명을 대상으로 생활습관, 직무에서 오는 스트레스, 사회적 지원, 자아 존중감, 성격 및 스트레스증상 평가를 위한 설문조사를 시행하였다. 결 과 : 스트레스 증상지수는 80 percentile을 기준으로 하위척도들의 절단점을 선정하였으며, Receiver Operating Chacteristic Curve를 그려 민감도 81.5 %, 특이도 86.1 % 되는 55점을 절단점으로 선정하였다. 생활습관 및 상태 항목으로는 흡연자에서 OR=1.49(1.11-2.00), 주관적 건강상태가 좋지 않은 군에서 OR=1,53(1.06-2.21)로 유의하게 스트레스 증상이 높았다. 직업관련 스트레서(stressor)로는 역할 과부하 (OR=6.69, 4.74-9.44), 작업 요구(OR=8.34, 5.82-11.97), 작업과정(OR=9.89, 6.76-14.94), 작업환경(OR=8.27, 5.80-11.79), 대인관계(OR=5.82, 4.04-8.39), 직업갈등(OR=8.34, 5.82-11.97), 봉급(OR=5.70, 4.04-8.04), 역할갈등(OR=7.58, 5.37-10.71) 등이 높은군에서 스트레스 증상이 높았으며, 사회적 지원이 높은 군에서 OR꼰.39(0.27-0.57), 자아 존중감이 높은 군에서 OR=0.41(0.290.60)로 스트레스 증상이 유의하게 낮았다. 결 론 : 직업관련 스트레스 경험을 많이 한 사람일수록 직업성 스트레스 증상의 정도도 높았으며, 사회적 지원을 많이 받고 자아존중감이 높은 사람일수록 스트레스 증상을 느끼는 정도가 낮았다. 직장 내에서는 스트레스를 감소시킬 수 있는 다양한 대처 전략 프로그램의 개발과 개인을 위한 스트레스 관리교육이 필요하며, 전문화된 직장 내에서 근로자가 도움을 받을 수 있는 정보체계와 직장내의 지원이 필요함을 제시하고 있다. Objectives To investigate the factors associated with symptoms from job stress among Korean dental laboratory technicians. Methods : We collected the data of 786 technicians for life-style, job stressor, social support, self-esteem, personality, and various dimension of stress symptoms included roomatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility by self-administerd questionnaire. Global severity index of dental technician (GSID) was calculated by total sum of sub-dimension. Results We used 80 percentile as a cut-off point, and got the 81.5 % of sensitivity, 86.1 % of specificity by receiver operating characteristic curve. The odds ratios of various factors in high group of GSID compared with low group were 1,49(95 % Cl 1.00-2.00) for smoker, 1,53 (1.06-2.21) for unhealthy group, 6,69 (4.74-9.44) for work overload, 8.34(5.82-11.97) for work demand, 9.89 (6.76-74.94) for work process, 8.27 (5.80-11,79) for work environment, 5.82 (4.04-8.39) for interpersonal relationship, 8.34 (5.82-11.97) for occupational conflict, 5.70 (4.04-8.04) for labor remuneration, 7.58 (5.37-10.71) for role conflict, but 0.39 (0.27-0.57) for social support, 0.41 (0.29-0.60) for self-esteem. By multiple logistic regression, factors were significantly associated with GSID were age, working area, role overload, work demand, work procedure, physical environment, occupational conflict, role conflict, social support, personality traits. Conclusions : Factors associated with symptoms from stress were role overload, work demand, work procedure, occupational conflict, interpersonal relationship, labor remuneration and role conflict in Korean dental laboratory technicians. It is suggested that health promotion program to reduce job stress and to enforce social support and self-esteem should be developed.

운동선수의 임장불안에 대한 연구

홍관이,이광재,김두경,부기원,노성규,한상준,박기동,오수일,문병용,이철규,박장평,엄기진,박남환 江原大學校附設 體育科學硏究所 1984 江原大學校附設體育科學硏究所論文集 Vol.- No.9

This study is designed to grasp the elements and situations of stage fright in order to propose a part of ways to cope with it. We make 511 top-class high school players, male and female, in the central districts (Seoul, Inchon, Kyungki, Chungbuk, and Kangweon Province) on object of questionnaire, and get the following results. Through players generally have all-round characters they show weakness in the superiority and emotional stability while showing strength in the sonformity. This fact comes to be related to the elements which cause stage fright. Physiological changes also have many effects on the symptom of stage fright. Especially, stage fright increases when players show sensitive reaction to the self-consciousness of final consequence which comes from the tension or uneasiness of sympathetic nerve, Thus, it turns out that players make use of reducing psychological burden by physical exercise or adjusting the level of demanded result in order to release the stage fright.

건축공사시방서에서의 KS규격의 국제인증방안에 관한 연구

김경식,이재섭,김용수,이규진,조용훈,최완철,전재열,이현수,구재동,이기환 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

The purpose of this research is make out construction specifications for International Construction. Using off-shore products incur cost increase and longer delivery term of construction. and inconvenient on International Construction. Expand the range of additional local products conforming to performance. Life Cycle Cost. maintainability. operability. user's acceptability, etc.. And this study is suggest the standard formats and the techniques for construction specification.

지역사회획득 폐렴의 치료지침 권고안

송재훈,정기석,강문원,김도진,배현주,서지영,심태선,안중현,안철민,우준희,이남용,이동건,이미숙,이상무,이영선,이혁민,정두련,지역사회획득 폐렴 치료지침 제정위원회 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial therapy. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

Systemic administration of low dosage of tetanus toxin decreases cell proliferation and neuroblast differentiation in the mouse hippocampal dentate gyrus

Bing Chun Yan,In Hye Kim,Joon Ha Park,Ji Hyeon Ahn,Jeong-Hwi Cho,Bai Hui Chen,Jae-Chul Lee,Jung Hoon Choi,Ki-Yeon Yoo,Choong Hyun Lee,Jun Hwi Cho,Jong-Dai Kim,Moo-Ho Won 한국실험동물학회 2013 Laboratory Animal Research Vol.29 No.3

In the present study, we investigated the effect of Tetaus toxin (TeT) on cell proliferation and neuroblast differentiation using specific markers: 5-bromo-2-deoxyuridine (BrdU) as an exogenous marker for cell proliferation, Ki-67 as an endogenous marker for cell proliferation and doublecortin (DCX) as a marker for neuroblasts in the mouse hippocampal dentate gyrus (DG) after TeT treatment. Mice were intraperitoneally administered 2.5 and 10 ng/kg TeT and sacrificed 15 days after the treatment. In both the TeT-treated groups, no neuronal death occurred in any layers of the DG using neuronal nuclei (NeuN, a neuron nuclei maker) and Fluoro-Jade B (F-J B, a high-affinity fluorescent marker for the localization of neuronal degeneration). In addition, no significant change in glial activation in both the 2.5 and 10 ng/kg TeT-treated-groups was found by GFAP (a marker for astrocytes) and Iba-1 (a marker for microglia) immunohistochemistry. However, in the 2.5 ng/kg TeT-treated-group, the mean number of BrdU, Ki-67 and DCX immunoreactive cells, respectively, were apparently decreased compared to the control group, and the mean number of each in the 10 ng/kg TeT-treated-group was much more decreased. In addition, processes of DCX-immunoreactive cells, which projected into the molecular layer, were short compared to those in the control group. In brief, our present results show that low dosage (10 ng/kg) TeT treatment apparently decreased cell proliferation and neuroblast differentiation in the mouse hippocampal DG without distinct gliosis as well as any loss of adult neurons.

고교생의 체육수업에 대한 자기평가 분석

이기철 釜山外國語大學校 1999 外大論叢 Vol.19 No.5

The purpose of this study is to clarify the self-evaluation method of physical education classes by students. Some efficient instruments for the synthetic evaluation have already been developed. However, the reliable instrument for the self-evaluation seems to be missing. Therefore, we intended to develop a convenient and effective instrument for self-evaluation of physical education class which can be used in each teaching unit. The subjects were 426 students from 4 senior high schools. Factor analysis, multiple regression, and oneway ANOVAis used to estimate relationship between each variables. These results were as follows ; 1) The self-evaluation factors exist three factors representing dimensions of self-evaluation ; motivation of learning, cooperation, and outcome of learning. 2) When the self-evaluation factor scores are compared for differences in each senior high schools, mean scores differ significantly for all. 3) When the self-evaluation factors are compared for the result of practical teaching, three factor scores showed significant and positive relationships with those of the comprehensive evaluation items concerning good or effective instruction. Thus, the factors were interpreted as effective standards for self-evaluation.