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.

호주의 유전자변형생물체(Genetically Modified Organisms) 안정성 심사절차 및 유전자변형식품의 표시제도

김태산,김영미,손성한,김용환,박용환 한국국제농업개발학회 2002 韓國國際農業開發學會誌 Vol.14 No.1

1. 호주는 GMO의 실험 및 상업화를 규제하는 신법 "유전자기술에 관한 법(Gene Technology Act 2000)을 제정 운영중임 2. GMO를 관리 감독하기 위하여 보건후생성산하에 유전자기술 감독국(Office of the Gene Technology Regulator)이 신설됨 3. GMO를 취급(dealings)형태에 따라서 면제(exemption), 위험이 매우적은 취급(notifiable low risk dealing), 면허(licensing), 등록(register)의 4가지로 분류하여 감독함 4. GM식품의 안전성 심사는 호ㆍ뉴식품청(Australia New Zealand Food Authority, ANZFA)에서 관장하며 호주식품 강령 기준 18(Standard A18 of the Australian Food Standards Code)이 근거 법임 5. ANZFA에서는 제초제 저항성 콩, 옥수수, 면화, 감자, 카놀라 등 6작물 12종의 GM작물에 대하여 식품안정성 확인을 완료함 6. 호주에서는 2001년 12월 7일부터 유전자변형식품의 의무 표시제를 시행하고 있으며 비의도적 혼입 허용치는 1%로 설정함 As Australia's new national gene technology regulatory system began on 21 June 2001, the Office of the Gene Technology Regulator (OGTR) was newly established to regulate GMO related research and GM products throughout the nation. "Gene Technology Act 2000" is the statutory basis the new regulatory system. The OGTR is within the Commonwealth Department of Health and Aged Care, responsible for overseeing the gene technology research and development including the GMO field trials across Australia. For the regulation of genetically modified food, the Australia New Zealand Food Authority(ANZFA) is responsible for developing and reviewing national food standards. All foods available for sale in Australia and New Zealand must comply with the relevant national food standards. ANZFA also responsible for carrying out safety assessments of GM foods on behalf of the Commonwealth, State and Territory Governments of Australia and the Government of New Zealand. The ANZFA's safety assessment process for GM foods is based on concepts and principles that have been developed through international organizations such as the World Health Organization(WHO) and the Food and Agriculture Organization(FAO) and the Organization for Economic Co-operation and Development(OECD). Mandatory labelling of GM foods containing either introduced DNA or protein in the final food came into effect on 7 December, 2001.

결장 직장암 환자에서 근치적 절제술 후 혈청 CEA치의 변화에 대한 임상적 의의

김영훈,배병노,김기환,한세환,김홍주,김영덕,김홍용 대한대장항문학회 2003 Annals of Coloproctolgy Vol.19 No.6

장기간 항갑상선제 투여 후 임의 중단 뒤 재복용시 발생한 무과립구증 1 예

김승만;김태영;박수영;배영환;서영경 정은주;김태균;권민정;박정현;이순희 인제대학교 2011 仁濟醫學 Vol.32 No.-

Agranulocytosis, one of the major side effects of antithyroid a gents, probably occurs in less than 0.25% of cases treated with antithyroid agents. It usually occurs within the first several weeks or months after the initiation of therapy, when drug dosage is higher. Most reported cases of agranulocytosis have occurred during the first 3 months of therapy. We describe here a rare case that did not experience the side effect for 6 years of antithyroid agent treatment but presented with agranulocytosis in one month after re-exposure. It suggests that the major side effect such as agranulocytosis can occur in patients who had undergone prior uneventful antithyroid drug therapy.

삼중시기 나선형 CT를 이용한 간경변증 환자에서의 결절성 간세포암의 조영증강양상

김영화,윤종필,김형환,이상진,이혜경,김일영,장유진 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

We evaluated the contrast enhancement pattern of nodular hepatocelluar carcinoma in liver cirrhosis patients by using three phase spiral CT. We anlayzed 34 nodular hepatocelluar carcinonmas in 11 patients with liver cirrhosis. Three phase spiral CT were obtained at 30(arterial phase), 60(portal phase), 180seconds(delayed phase) after initiation of contrast injection in the rate of 3ml/sec. Nodules are classified according to size, as group A(below 1cm, n=11), group B(1 - 3cm, n=15), group C(above 3cm, n=8). Enhancement pattern of the nodule was analyzed comparing to normal liver parenchyme in each phase., as total high, central high, peripheral high, iso, low, mixed density. We also analyzed the detection rate of the nodules. As a whole the nodules show high density in arterial phase(76%), high density in portal phase(47%) and low density in delayed phase(56%). In group A, the nodules show high(100%) in arterial phase, iso(54%) or high (46%) in portal phase, iso(82%) in delayed phase. In group B, the nodules show high(100%) in arterial phase, high(74%) in portal phase, mixed (60%) in delayed phase. In group C, the nodules show mixed density in all three phase. The most common enhancement pattern in each group was high(arterial phase) - iso(portal phase) - low (delayed phase) in group A(6/11, 54%), high - high - low in group B (5/15, 33%), mixed - mixed - mixed in group C(5/8, 63%). The detection rate of the nodule was highest in arterial phase, and the usefulness of arterial phase comparing to portal or delayed phase was higher in smaller size. In conclusion, hepatocelluar carcinomas show different enhancement pattern according to the size on three phase spiral CT, and this may be helpful in diagnosis of them.

초임계 이산화탄소로 추출한 유자껍질의 향기성분

김영언,김인환,김흥만,이영철 한국식품영양학회 1996 韓國食品營養學會誌 Vol.9 No.4

초임계 이산화탄소를 이용하여 유자(Citrus junos)껍질의 향기성분을 추출하기 위해 동결건조한 유자과피분말을 4,000psi와 40 에서 운전하면서 이산화탄소의 소비량에 따라 4단계로 분획하여 분획별 향기성분의 특성을 조사하였다. 초임계 이산화탄소에 대한 유자의 향기 성분의 수율은 0.011g/CO_2(L)였으며, 최대추출수율은 8.812g/kg이었다. 초임계 이산화탄소로 추출한 유자과피의 주요향기성분은 dl-limonene, γ-terpinene, linaollo, sabinene, β-myrcene, α-pinene, β-farnesene, α-terpineol 과 terpinolene 등 9종이었다. 분획별 향기성분은 휘발성이 높은 α-pinene, β-myrcene과 dl-limonene은 추출시간이 길어짐에 따라 함량이 감소하였으며, 이와 반대로 휘발성이 낮은 α-terpineol과 β-farnesene은 추출시간이 길어짐에 따라 함량이 증가하였다. 따라서 초임계 이산화탄소로 유자의 향기성분을 추출할 경우 추출시간에 따라 얻어지는 분획의 향기 성분 조성이 서로 다른 것으로 나타났다. Volatile compounds were extracted from freeze-dried citron peel(Citrus junos) using supercritical CO_2 under 4,000psi at 40℃. Four fractions were obtained with consumption of CO_2. Volatile compounds of extracts were analyzed by GC-MSD. Yield of volatile compounds from citron peel was 0.11g/CO_2(l) and maximum yield was 8.812g/kg. Major volatile compounds of extracts were dl-limonene, γ-terpinene, linalool, sabinene, β-myrcene, α-pinene, β-farnesene, α-terpineol and terpinolene. α-Pinene, β-myrcene and dl-limonene in the fractions decereased gradually, while α-terpineol and β-farnesene increased as the consumption of CO_2 increased.

급성신부전을 동반한 알콜성 횡문근융해증 2례

김영민,오동렬,이원재,김형국,황두영,이환,최경호,정시경,김세경,김영옥 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Rhabdomyolysis is a biochemical and clinical syndrome caused by lysis of skeletal muscle cell and release of muscle cell contents into the circulation. In addition to traumatic cause, various nontraumatic causes have been reported. Rhabdomyolysis has frequently been associated with seamy aspects of life and society: alcoholic abuse, drug addiction, sadistic drill exercise, war events and attempted suicide. The abuse of alcohol causes many hazards in many organs. One of these is acute alcoholic myopathy that may present as a fulminent syndrome of muscle pain and tenderness associated with rhabdomyolysis and acute renal failure. Because the prognosis of adequately treated rhabdomyolysis is excellent, early recognition and prompt management are essential in emergency situation. We experienced two typical cases of alcohol-induced rhabdomyolysis with acute renal failure and report these cases with literature review.

겔화 반응 및 열처리한 금속염화물의 결정 및 구조특성

김인태,박환서,유승곤,김환영,김준형 한국공업화학회 2003 응용화학 Vol.7 No.2

A new concept for the stabilization and solidification of volatile radioactive wastes via gelation in a simple material system is introduced in this paper. Using sodium silicate as a reaction module and phosphoric acid as a catalyst or stabilization agent. CsCl is chemically converted to thermally stable compounds. The heat-treated product at 1000℃ contained a cristobalite crystalline framework and a glassy phosphorus-rich phase with a high Cs content. The morphology looked like honey flowing on the honeycomb. From TG/DT analysis, Cs could not be vaporized below 1300℃ by changing the aging conditions and molar ratio of Si/p. As a new concept, GRSS(gel-route stabilization and solidification) could give us the chance to make the high temperature waste conditioning process more stable and economical.

A LONG-TERM FIELD TEST OF A LARGE VOLUME IONIZATION CHAMBER BASED AREA RADIATION MONITORING SYSTEM DEVELOPED AT KAERI

Kim, Han-Soo,Ha, Jang-Ho,Park, Se-Hwan,Kim, Jung-Bok,Kim, Young-Kyun,Jin, Hyung-Ho The Korean Association for Radiation Protection 2009 방사선방어학회지 Vol.34 No.2

An Area Radiation Monitoring System (ARMS) ionization chamber, which had an 11.8 L active volume, was fabricated and performance-tested at KAERI. Low leakage currents, linearities at low and high dose rates were achieved from performance tests. The correlation coefficients between the ionization currents and the dose rates are 1 at high dose rate and 0.99 at low dose rate. In this study, an integration-type ARMS ionization chamber was tested over a year for an evaluation of its long-term stability at a radioisotope (RI) repository of the Young-gwang nuclear power plant. The standard deviation of dose rate of 1 day data and over a 100-days mean value were 6.2 $\mu$R/h and 2.9 $\mu$R/h, respectively. The fabricated ARMS ionization chamber showed stable performance from the results of the long-term tests. Design and performance characteristics of the fabricated ionization chamber for the ARMS from performance-tests are also addressed.

정상과 갑상선 종양조직에서 사람 IGF-I 유전자의 발현

김성운,장현하,박상미,김덕윤,우정택,양인명,김진우,김영설,김광원,고석환,홍성화,최영길 경희대학교 유전공학연구소 1993 遺傳工學論文集 Vol.5 No.-

Many of the growth-promoting properties of growth hormone(GH) are mediated by insulin-like growth factor-I(IGF-I), a highly conserved circulating 70-amino acid peptide. Recent studies have shown that multiple mechanisms influence IGF-I gene expression, including transcription from two promoters, alternative RNA splicing, and variable polyadenylation. In thyroid tissue, thyroid stimulating hormone(TSH) and IGF-I are the most possible candidates for follicular cell proliferation and hypertrophy. Actually IGF-I had autocrine and paracrine effect for tissue growing. We prepared thyroid tumor tissue mRNAs using single step method for detecting IGF-I levels according to different tissues, i.e., thyroid adenoma or papillary thyroid carcinoma. We used Northern blot analysis for IGF-I mRNA and RNase protection assay (RPA) for IGF-I transcription start sites. For Northern blot, we used whole human IGF-I cDNA as a DNA probe and for RPA, we used IGF-I exon 1 containing noncoding promoter 1 as a riboprobe. We got good RNA bands from Northern blot analysis around 1 kb (IGF-IA) and 7.5 kb (IGF-IB) region. To clarify the amount of both IGF-IA and IB mRNAs, we measured autoradiographied signal of IGF-I mRNAs bands using densitometer. In IGF-IA signals, there's no change among liver and thyroid tissues, but in case of IGF-IB mRNA bands, the signal was markedly increased in thyroid carcinoma tissues than that of normal thyroid tissue (85% vs 14%). In the study of RPA, all thyroid tissues used the same transcription start sites as those of liver's. We concluded that that this different regulation of IGF-I mRNA was originated from tissue specificity. That meant some tissue specific transcription factor/s were related to tissue IGF-I expression.