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        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.

      • 서울의 PPNG 발생 빈도(1991-1992)

        김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

        The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

      • Validity and Reliability of Cognitive Assessment Using Virtual Environment Technology in Patients with Stroke

        Ku, Jeonghun,Lee, Jang Han,Han, Kiwan,Kim, Sun I.,Kang, Youn Joo,Park, Eun Sook Wolters Kluwer Health, Inc. All rights reserved. 2009 AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITA Vol.88 No.9

        Ku J, Lee JH, Han K, Kim SI, Kang YJ, Park ES: Validity and reliability of cognitive assessment using virtual environment technology in patients with stroke. OBJECTIVES:: We assessed the validity and reliability of a virtual environment technology (VET)-based cognitive assessment program that was developed as a measurement tool of cognitive abilities in patients after a stroke. DESIGN:: Twenty participants diagnosed with stroke caused by unilateral brain lesions were enrolled to assess the VET program’s validity and test-retest reliability. Participants underwent evaluation by paper-based neuropsychological tests including the Korean Mini-Mental Status Examination, the Korean-Wechsler Adult Intelligence Scale, the Motor Free Visual Perception Test, Rey-Kim Memory Test, and Kim’s Frontal-Executive Neuropsychologic Test as well as the VET-based cognitive assessment. Major variables and indices of the VET program were calculated. The VET program validity was evaluated using a simple correlation analysis between variables from the VET program and conventional paper-based neuropsychological measurements, and the reliability was evaluated by investigating the test-retest correlation coefficients. RESULTS:: Major variables and indices of the VET program in patients with stroke correlated significantly with the related scores of paper-based neuropsychological tests. In addition, the test-retest reliability analysis revealed that the correlation coefficients ranged from 0.528 to 0.926. CONCLUSION:: The VET-based cognitive assessment program showed adequate reliability and validity as a method of cognitive assessment in patients after stroke.

      • 해면의 Lipid 성분 연구

        김인규,최병래,박선구 성균관대학교 기초과학연구소 1990 論文集 Vol.41 No.1

        한국 남해안 소흑산도에서 채집한 미동정된 해면(동정을 의뢰중임)으로부터 일반적인 tetradecanoic, hexadecanoic methyl ester 이외에 탄소수가 홀수인 pentadecanoic, heptadecanoic와 가지가 달린 12-methyltetradecanoic, 14-methylpentadecanoic, 15-methylhexadecanoic, 14-methylhexadecanoic methyl ester가 발견되었으며, 주 sterol 성분으로는 cholesterol과 소량의 ergost-25-ene-3,5,6-triol이 검출되었다. The Korea sea unknown marine sponge was shown to contain odd-numbered pentadecanoic, heptadecanoic, and branched 12-methyltetradecanoic, 14-methylpentadecanoic, 15-methylhexadecanoic, 14-methylhexadecanoic methyl ester, in addition to tetradecanoic and. hexadecanoic methyl ester. Futher elution with more polar solvent gave 5α-cholest-3β-ol along with minor amount of ergost-25- ene-3,5,6-triol.

      • Lutembacher 증후군 환자 증례 보고

        김성범,서정주,곽철훈,김상민,이보라,민선경,황은구,김용인,조욱현,최석구 인제대학교 2008 仁濟醫學 Vol.29 No.-

        Lutembacher's syndrome is rare combination of mitral stenosis (MS) and atrial septal defect (ASD). The hemodynamic interplay between the MS and ASD leads to wide variation of clinical presentation. Here we describe a 43-year-old female with Lutembacher's syndrome and tricuspid regurgitation with pulmonary hypertension, who underwent direct closure of ASD and tricuspid valvuloplasty successfully. We also reviewed other literatures in an effort to increase awareness of this condition.

      • 민챙이(Bullacta exatrata)의 화학성분 연구

        김인규,최병래,박선구,박성혜,명승운 성균관대학교 1990 論文集 Vol.41 No.2

        한국 서해 상낙월도에서 채집한 연체 동물인 Bullacta exatrata 로부터 통상적인 9-hexadecenoic ethyl ester 이외에 불포화된 5, 8, 11, 14-eicosatetraenoic, 7, 10, 13-hexadecatrienoic, 10-13-octadecadienoic ethyl ester 및 상당량의 glyceryl ether인 chimyl alcohol이 검출되었다. 주 sterol 성분인 cholesterol이었으며 지방산 ester 형태로도 소량 존재하였다. Unsaturated 5, 8, 11, 14-eicosatetraenoic, 7, 10, 13-hexadecatrienoic, 10, 13-octadecadienoic ethyl ester and a lot of chimyl alcohol were isolated along with common 9-hexadecenoic ethyl ester from marine mollusca Bullacta exatrata collected from sangnackworl island of the Korea sea. In addition, cholesterol and its fatty acid ester were obtained by futher elution in more polar solvent. Their structures were deduced from ^1H-and ^13C-NMR, GC-ms, FT-IR spectra.

      • 해면의 Lipid 성분 연구

        김인규,최병래,홍종기,박선구 성균관대학교 기초과학연구소 1989 論文集 Vol.40 No.2

        일반적으로 해양생물에는 육지 생물에 비해 훨씬 다양하고 특이한 구조의 sterol과 지방산이 나타나고 있다. 본 연구에서는 한국 여수 돌산도 해안에서 채집한 미동정된 해면(동정을 의뢰중임)으로부터 wax성분으로 tetradecanoic acid tetradecyl ester 및 hexadecyl ester을 분리하였다. 또한 지방산으로는 palmitoleic acid ethyl ester가 주성분으로 얻어졌으며 myristoleic acid, oleic acid ethyl ester가 소량으로 발견되었다. There has been a continuing interest in the sterols and fat related compounds of marine organism. The Korea sea unknown marine sponge was shown to contain tetradecanoic acid tetradecyl ester and hexadecyl ester. Futher elution with more solvent gave palmitoleic acid along with minor amount of myristoleic acid, oleic acid ethyl ester.

      • 수중운동이 경련성 뇌성마비의 신체구성 및 체력에 미치는 영향

        김선호,구민 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

        The purpose of this study was to evaluate the effect of aquatic exercise on body composition and physical fitness. The subjects for this study were seven spasticity cerebral palsy(18-20years). The aquatic exercise program consisted of 11 items, and performed for 30-40mins in a bout, 4 times a week at the intensity of HRmax(40-65%) for 12 weeks. And the change of body weight, %fat, fat mass, hand grip, sit up, sit and reach, close eyes foot balance and side step have been measured before and post exercise 12 weeks. Paired t-test was performed for data analysis at the 0.051evel of significance. The following results as; The first, body composition(body weight, %fat and fat mass) were decreased significantly after 12 weeks(p<0.05). The second, muscle strength, agility were showed a case of increasing after 12 weeks, but there was no significant difference. The third, muscle endurance, balance and flexibility were increased significantly after 12 weeks(p<0.05, p<0.01), respectively. These results suggest that the aquatic exercise programs are applicable to the spasticity cerebral palsy with abnormal movement.

      • KCI등재

        한국판 임상가용 아동 및 청소년을 위한 외상후 스트레스장애 척도의 신뢰도 및 타당도 연구

        구정일,김태형,은헌정,최말례,이선미,조수진,송옥선,김형욱 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

        Objectives : This present study was conducted to explore the reliability and the validity of Clinician Administered PTSD Scale for Children and Adolescents Korean version (CAPS-CA) Mcthods : The Subjects were children and adolescents (8-13yrs) from different places: a certain elementary school, three orphanages, a general hospital, and two neuropsychiathc local clinics. Only subjects who experienced a catastrophic traumatic event were tested by CAPS-CA, CDI, RCMAS, and TSC. Rcsults : The range of correlations between item-criterion were .67-.84. The coefficients of internal consistency were .87. and test-retest reliability was .90, were all the coefficients in the proper range. Inter-correlations of CAPS-CA, CDI, RCMAS, and TSC scale showed significant correlation. TSC showed the highest correlation coefficient. CAPS-CA can be a useful clinician-administered diagnostic instrument for children and adolescents PTSD symptoms. Conclusion : The reliability and the validity of CAPS-CA were confirmed. CAPS-CA could be applied for diagnostic purposes of PTSD in children and adolescents.

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