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.

치환용매 변화에 따른 비대칭 Ceellulose Acetate 막의 기체투과특성

정광보,장승현,남석태 한서대학교 산학협력연구원 부설 환경연구소 2000 환경연구소 논문집 Vol.3 No.-

Gas permeation behavior was examined for asymmetric cellulose acetate membrane prepared by changing the acetone evaporation time and drying solvent. By changing the acetone evaporation time, the gas permeation rate decreased for the first 2 minutes and then increased gradually for the membrane of i-PrOH exchange drying. Gas permeation rate was in the order of He>N₂>O₂ and separation factor was about 1.9 for the membrane of 9 minute acetone evaporation. The permeation mechanism appears to be the combination of Knudsen flow and viscous flow. The effect of Knudsen flow was increased with acetone evaporation time, while the effect of viscous flow increased for the membrane of EtOH exchange drying.

한국인 인슐린비의존형 당뇨병환자에서 엔지오텐신 1-전환효소 유전자의 다형성과 당뇨병성 만성합병증 및 관상동맥질환과의 관계

정민영,천남일,이창훈,조동혁,강호철,정동진,정명호,강정채,박종태,양승원 全南大醫大 2001 전남의대학술지 Vol.37 No.3

급성 심근경색 : Gd-DTPA 조영증강 자기공명영상 Gd-DTPA Enhanced Magnetic Resonance Imaging

정경일,김제현,이창호,이영주,김한수,소동문,이영돈,박경주,왕희정,탁승제,이철주,김선용,김옥화,임태환,문창현,최병일,서정호 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

This study was undertaken to determine the value of gadolinium dimeglumine (Gd-DTPA) enhanced MRI in the diagnosis of acute myocardial infarction. Seven cats were subjected to 2 hours of left anterior descending coronary arteryocclusion (group 1) and 8 cats to 1 hour of occlusion (group 2). Reperfusion was followed by taking Tl-weighted MR images at 5, 15, 30, 45, 60 minutes after Gd-DTPA (0.2 mmol/kg) injection. Myocardial enhancement patterns were categorized into three zones (central ischemic, peripheral ischemic, and normal) or two zones (ischemic and normal) and the presence of injured myocardium in each zone was confirmed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Signal intensity (SI) of each zone was evaluated relative to back muscle in regard to its chronological changes and difference among the zones. Group 1 displayed three zones of enhancement in 6 cats whereas 1 cat in group 1 and all in group 2 showed two zones of enhancement. Intermediate SI central zone was compatible but smaller than TTC nonstained area, and determined to be a persistently occlusive injury. High SI peripheral zone in group 1 and high SI ischemic zone in group 2 were stained and determined as reperfused injury although reversibility was not definite. The peak SI, occurring 15 minutes after Gd-DTPA injection, of 2.47±0.48 at peripheral zone was greater than that of 1.66±0.36 at central zone in group 1 and of 1.81±0.41 at ischemic zone in group 2 (p < 0.05). SI of injured myocardium increased more rapidly and decreased more gradually than that of normal myocardium. That the features of SI change with time in injured myocardium was compatible with the results of other studies using different contrast agents. Gd-DTPA enhanced MRI differentiated persistently occlusive injury as central intermediate SI, and reperfused injury as homogenous high SI, with the maximal contrast between the two at 15 minutes after contrast injection, thus indicating the value of Gd-DTPA enhanced MRI in the diagnosis of acute myocardial infarction.

급성 췌장염으로 발현된 부갑상선 선종

유태양,박종빈,류한승,조미영,노혜정,박병현,조정구 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.1

저자들은 급성 훼장염 환자에서 심한 고칼슘혈증을 동반한 부갑상선 선종에 의한 원발성 부갑상선 기능항진증을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Primary hyperparathyroidism is characterized by hypercalcemia and hypophosphatemia induced by an increased level of parathyroid hormone(PTH). Patients with primary hyperparathyroidism are usually asymptomatic, but can present with symptoms of renal stones, peptic ulcer disease, muscle weakness and depression. In addition, primary hyperparathyroidism-related with hypercalcemia is considered to represent a risk factor for the development of pancreatitis. We report a case of a 66-year-old woman with primary hyperparathyroidism who was accompanied with acute pancreatitis. The chief complain was abdominal pain and general weakness. The serum levels of amylase, lipase, calcium and intact PTH were 17391U/L, 4160IU/L, 21.2mg/dL and 1836pg/mL. A parathyroid mass was detected by neck computed tomography, ultrasonography and 99m-Tc sestamibi scintigraphy. After the surgical procedure, the symptoms were improved and the calcium level was normalized.

제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

디자인 실기교육 방법에 관한 연구 : A Vision of 21C展을 통한 작품제시를 중심으로

김태진,김윤희,정승혜,홍철순,양재범 경남정보대학 1999 論文集 Vol.27 No.1

Musgrave變法을 이용한 컵상귀(Constricted Ear)교정

한승규,김태연,정전은 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5

The constricted ears are relatively rare and constitute only 10% of all auricular malformations. whereas the minor forms occur in 2% of the general clinical population. the superior portion of the ear, including the helix, scapha, and posterior crus of the antihelix, are bent over and curl downward. The principles of surgical correction are the straightening of the cupping and the coverage of skin. For the correction of consticted ear, there are numerous techniques but they are relatively extensive, involving cartilage or skin flaps, cartilage graft, multi-stage operations. We adopted a modified Musgrave's technique by multiple radiating cartilage incisions and horizontal mattress sutures. 5 cases with constricted ear were treated with this technique and satisfactory aesthetic results were achieved and no significant postoperative complication was developed. The adventages of the modified Musgrave's technique were as followings : 1. The design was simple. 2. The procedure was easy under local anesthesia. 3. The operation time was short. 4. No donor site sacrifice was required.

동일한 시료에 대한 국내 기관간의 STR 분석결과 비교 : STR 유전자좌 분석법의 표준화 설정을 위하여

박종태,신경진,양윤석,우광만,이숭덕,이승환,이정빈,정연보,조승희,한길로,한면수,홍승범 大韓法醫學會 2001 대한법의학회지 Vol.25 No.1

This paper described a collaborative exercise intended to see what kinds of short tandem repeat (STR) loci are used in different DNA typing laboratories in Korea and to compare their results for the demonstration whether uniformity of DNA profiling results from different laboratory could be achieved in Korea Laboratories were asked to test five tissue DNAs using methods routinely used in each laboratory and to report the results to the coordinating laboratory. The exercise demonstrated that each laboratory was using different STR loci for the typing with different STR numbers,2 VNTRS,36 STRs and amelogenin in total, and the direct comparison of the results from all the laboratory for the 18 loci could not be done as only one laboratory submitted typing results. Among 21 loci for which several laboratories submitted typing results, results for 14 loci were the same and results for the other 7 loci were different depending on the participating laboratory. D1S80, F13A01, D16S539, D21S11, D18S51, D3S1744 were the loci with different typing results. Even in the cases where commercial kits were used, the results were not the same depending on the machines used, that is the capillary electrophoresis or the gel based electrophoresis. The reason for the different results, points about the standardization of the methods arid the profiling data were described.

鐵棒競技의 着地 成功率에 關한 分析

金忠泰,南勝久,韓忠湜 韓國體育大學校 1990 論文集 Vol.13 No.-

The puropse of this study was to analyze the success rate of landing in Horizentar Bar. The subjects were 24 gymnasts who were participated in the 24th world championships, the 25th Olympic game in Seoul and the 25th world-championships especrally who made a good record at fesults were as follows. 1. Landing success rate as the games. The success rate was 77.5% in Olympic and in 25th world championships was 70% and in the 24the world champions was 80% whick was the highest rate. 2. Landing success rate as performances. The skill of Double salto backward stretched art was 9 times, and its rate was 88.8% through the 3 Games. The skill of Double salto backward stretched 1/1 turn to dismount Art was used 7 times, its success rate was 82.2%. 3. Landing success rate as art form. Tucked form was used 7 times and its rate was 57%, stretched form was used 16 times and was 85% (which was performed rather than Tucked formed and picked form).