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.

방진마스크의 Stainless steel arc 용접흄 여과효율에 관한 연구

송경석,권용식,한규태,정규혁,이용묵,유일재 한국산업위생학회 2001 한국산업보건학회지 Vol.11 No.1

The purpose of this study was to investigate for filtration efficiency of several dust masks, comparing with filtration efficiency certified by KOSHA(Korea Occupational Safety & Health Agency), and to require of the right use of protective respirator. Using a welding fume generator and chamber, several dust masks, which were widely used in the workplaces in korea, were tested for their filtering efficiency for stainless steel are welding fume. The filtration efficiency testing system consisted of a welding fume generator, a chamber and a filtration unit. The filtration unit was made of a mask which was inserted into the sampling cassette and another sampling cassette, which contained mixed cellulose ester filter paper. These two cassettes were connected with tubing. Stainless steel arc welding fume generator was delivered into an chamber. The welding fume in the chamber was passed into the filtration unit with flow rate of 30 liter/min. The welding fume filtration efficiency was evaluated by gravimetric measurement. Metal concentrations in the welding fume before and after filtration were measured with inductive coupling plasma analyzer. Following results were obtained: Filtration efficiency of welding fume for comm hygienic mas was 63.82% and the average efficiencies for A, B, C, D, E, F and G masks were 94.62% 96.58%, 83.20%, 82.76%, 77.25%, 86.55% and 93.22%, respectively. Our results indicate that dust masks used widely in the welding workplaces in korea are not proper for protecting worker's health and then the use of fume mask should be required.

알쯔하이머형 치매와 혈관성 치매환자에서의 ALDH2와 APOE 유전자의 다형성에 관한 연구

김동홍,김영돈,이창화,엄기춘,김은식,윤경식,김동희 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

연구목적: 본 연구는 국내 치매환자들을 대상으로 치매발병의 위험요소가 될 수있는 ALDH2와 APOE 유전자형이 어떤 양상으로 나타나는지 알아보기 위하여 시행되었다. 방 법: 충남 부여군에 위치한 부여노인병원에 입원중인 65세 이상의 알쯔하이머형 치매와 혈관성 또는 혼재성 치매환자 59명(남:19, 녀:40)을 대상으로 ALDH2와 APOE 유전자형을 제한효소법에 의하여 조사하였고 치매유형에 따른 유전자형과 대립유전자의 빈도를 비교하였다. 결 과: 1) 알쯔하이머형 치매환자군에서 혈관성 또는 혼재성 치매환자군보다 ALDH2*(-/2)유전자형의 빈도가 높았으나 통계학적으로 의미있는 차이는 없었다. 2) 알쯔하이머형 치매화자군에서 혈관성 또는 혼재성 치매환자군보다 APOE*(-/ε4) 유전자형의 빈도가 높았으나 통계학적으로 의미있는 차이는 없었다. 3) APOE*ε4와 ALDH2*2를 알쯔하이머병의 균등한 위험대립유전자로 가정하고 각 유전자형의 대립유전자의 수를 점수화하여 각 치매환자군의 위험유전자 전체점수를 비교한 결과 알쯔하이머형 치매환자군에서 점수가 더 높게 나왔으나 통계학적으로 의미있는 차이는 없었다. 결 론: 알쯔하이머형 치매환자군에서 혈관성 또는 혼재성치매치매환자군보다 ALDH2*2와 APOE*ε4 대립유전자의 빈도가 높게 나왔으나 통계학적으로 의미있는 차이는 없었다. A study on gene polymorphism of ALDH2 and APOE in patients with alzheimer's disease and vascular or mixed dementia. Objective : This study was designed to investigate gene polymorphism of ALDH2 and APOE, reported the risk factor of Alzheimer's disease, in korean dementia patients. Method : 59 Patients(male:19, female:40) with dementia, aged 65 and older in Buyeo geriatric hospital located in Buyeo-gun, chungnam, were finally included in this study. gene polymorphism of ALDH2 and APOE was typed with polymerase chain reaction in patients with Alzheimer's desease and vascular or mixed dementia. Results : 1) There was no difference in allelic frequency of ALDH2 gene polymorphism between patients with Alzheimer's disease and vascular or mixed dementia. 2) There was no difference in allelic frequency of APOE gene polymorphism between patients with Alzheimer's disease and vascular or mixed dementia. 3) Supposing APOE*ε4 and ALDH2*2 were equal risk allele of Alzheimer's disease, the sum of score by counting each risk allele was higher in patients with Alzheimer's disease than vascular mixed dementia, however there was no significant difference. Conclusion : The genotype frequency of ALDH2*(-/2) and APOE*(-/ε4) was higher in patients with Alsheimer's disease than vascular or mixed dementia, however there was no significant difference in allelic frequency of gene polymorphism of ALDH2 and APOE between patients with Alzheimer's disease and vascular or mixed dementia.

유기인제 중독 후 발생한 중간형 마비 증후군

고재욱,박준석,이경룡,정성필,이한식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: Intermediate myasthenia syndrome(IMS) is thought to have clinical importance because it may cause sudden respiratory failure during the recovery phase of a cholinergic crisis of organophosphate poisoning. We designed this study to identify the prevalence, the inducing agent, clinical predictor, and the proposed treatment of IMS. Methods: Patients who had admitted with the diagnosis of acute organophosphate poisoning from 1992 to 1998 at two teaching hospitals were enrolled in this study. We selected the cases of IMS based on a review of medical records using modified He' s criteria. Results: Twelve(12) out of 110 patients with acute organophosphate poisoning were diagnosed for a prevalence at 10.9%. The drug inducing IMS were identified as dichlorvos, fenthion, EPN, methidathion, and phosphamidon. The occurrence of IMS was not related to either the initial treatment with atropine and pralidoxime, or the level of serum cholinesterase. Complications were pneumonia, sepsis, pancreatitis, and pseudomembranous colitis, etc. Eleven(11) patients were discharged without sequelae, and one patient was discharged as a hopeless case. Conclusion: This study suggests that IMS is not rare, so close observation is required to detect IMS in organophosphate-poisoning patients. Also, more studies are required to find predictors and treatments.

관동맥 우회로 이식술후 우회 혈관의 개존 여부 평가에 있어 전자선 단층 촬영을 이용한 3차원 혈관조영술의 유용성

하종원,조승연,심원흠,정남식,이향미,최규옥,장양수,유경종,강면식 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

Genotyping of human papillomavirus with multiplex Liquid bead array system

오은경 ( Eun Kyung Oh ),( Yong Seok Lee ),( Keun Ho Lee ),( Duck Yeong Ro ),( Su Mi Bae ),( Sun Young Kwak ),( Sung Jae Shin ),( Byung Don Han ),( Joon Mo Lee ),( Sung Eun Namkoong ),( Woong Shick Ahn ) 대한산부인과학회 2006 대한산부인과학회 학술대회 Vol.92 No.-

Molecular Cloning of the Arginine Biosynthetic Genes from Corynebacterium glutamicum

Chun, Jae-Shick,Jung, Sam-Il,Ko, Soon-Young,Park, Mee-Young,Kim, Soo-Young,Lee, Heung-Shick,Cheon, Choong-Ill,Min, Kyung-Hee,Lee, Myeong-Sok The Microbiological Society of Korea 1996 The journal of microbiology Vol.34 No.4

Complementation cloning of the argC, E, B, D, F, and G genes in Corynebacterium glutamicum was done by transforming the genomic DNA library into the corresponding arginine auxotrophs fo Escherichia coli. Recombinant plasmids containing 6.7 kb and 4.8kb fragments complementing the E. coli argB mutant were also able to complement the E. coli argC, E, A, D, and F mutants, indicating the clustered organization of the arginine biosynthetic genes within the cloned DNA fragments. The insert DNA fragments in the recombinant plasmids, named pRB1 AND pRB2, were physically mapped with several restriction enzymes. By further subcloning the entire DNA fragment containing the functions and by complementation analysis, we located the arg genes in the order of ACEBDF on the restriction map. We also determined the DNA nucleotide sequence of the fragment and report here the sequence of the argB gene. When compared to that with the mutant strain, higher enzyme activity of N-acetylglutamate kinase was detected in the extract of the mutant carrying the plasmid containing the putative argB gene, indicating that the plasmid contains a functional argB gene. Deduced amino acid sequence of the argB gene shows 45%, 38%, and 25% identity to that from Bacillus strearothermophilus, Bacillus substilus, and E. coli respectively. Our long term goal is genetically engineering C. glutamicum which produces more arginine than a wild type strain does.

공격성 악성림프종 예후인자의 후향적 분석

한지연,최병길,김훈교,이경식,한지연,김훈교,이경식 大韓血液學會 1998 大韓血液學會誌 Vol.33 No.2

악성 흉막삼출액 환자에서 흉막강내 cisplatin 과~cytarabine 복합화학요법의 유용성

김기원,박석영,백종태,이숙경,김선우,이태규,서지원,이경식 대한내과학회 1999 대한내과학회지 Vol.57 No.2

Background: Maligant pleural effusions are common and significant problems in patient with advanced malignancies. In comparison with traditional sclerosing agent, intrapleural chemotherapy has a potential advantage of treating the underlying malignancy in addition to providing local control of th effusion. This study evaluated efficacy of intrapleural chemotherapy with cisplatin and cytarabine in the management of malignant pleural effusion from lung cancer and others. Methods : 29 patients with pathology-proven malig- nant pleural effusion were prospectively analyzed to estimate the effect of intrapleural chemotherapy. A single dose of cisplatin 100mg/m plus cytarabine 1200mg/m in the 250ml normal saline were instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicity and response at 24hours, 1st, 2nd, 3rd week, and monthly interval. No recurrence of the effusion was considered a complete response(CR). Partial responses (PR) was defined as a 75% or greater decrease in the amount of effusion on serial chest radiographs. Results : The overall response rate(CR plus PR) was 93.1% (27 of 29 patients). The median length of response was 7.5 months. Among 17 patients who were assessable until they died, 14 patients(82%) maintained complete response at the last follow-up. One patient experienced reversible grade 4 myelosuppression, 3 patients had grade 3 nausea & vomiting. 2 patients had empyema, and 2 patients had wound infection. Conclusions : The outcome of this trial indicated that the intrapleural chemotherapy with cisplatin and cytarabine with little treatment related mortality and morbidity.

선택적 함구증 환자에서의 Fluoxetine 치험

송동호,박민숙,남수용,육기환,노경선,이홍식 대한소아ㆍ청소년정신의학회 1997 소아청소년정신의학 Vol.8 No.2