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.

Study on Reliability Improvement of Voltage Transformers by Increasing Voltage Factor

Tae‑Sik Kong,Hee‑Dong Kim,Hung‑Sok Park,Soo‑Hoh Lee,Soon‑Yong Kim,Pil‑Bum Joung,Jin‑Yeub Park 대한전기학회 2020 Journal of Electrical Engineering & Technology Vol.15 No.3

Voltage transformers (VTs) must be highly reliable as they are essential components of the electric power industry. VT failures can cause a signifcant impact for important facilities such as nuclear power plants. In fact, VTs which passed the international standard, were damaged and sometimes resulted in the shutdown of the nuclear power plants. In order to improve the reliability, VTs with various iron core was studied. The electromagnetic feld simulation, a saturation characteristics test, and an overvoltage breakdown test were conducted. The result shows that the magnetic fux density signifcantly afects the reliability of VTs. To increase the reliability of VTs, it is required to reduce the magnetic fux density by increasing the knee-point and voltage factor. Owing to limited installation space, increasing the size of the iron core is difcult. Instead, VT by decreasing the thickness of the conductor and increasing the number of turns, it was possible to reduce the magnetic fux density without the size change. Therefore, improved VTs were obtained by decreasing the thickness of the conductor and increasing the number of turns, and the improved reliability was verifed through a comparison test with existing VTs. The fabricated VTs shows a signifcantly higher saturation voltage and breakdown time than existing VTs. Thus, by proposed VTs can contribute the stable operation of the nuclear power plant and improve the manufacturer’s quality.

하악골에 발생한 골막 골육종

김태우,김승범,권혁찬,문선재,윤정훈,김형준,차인호,육종인,김진 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Periosteal osteosarcoma is a distinct entity of malignant bone tumor with characteristic clinical, morphological, and histological features within the group of juxtacortical osteosarcoma. Periosteal osteosarcoma is predominantly located in the tubular long bones, and extremely rarely involving the jaws. A case of periosteal osteosarcoma of the right mandible is presented. A 27-year-old woman complained of the gingival swelling and bleeding tendency of the right posterior mandible. Clinical examination revealed a reddish brown strawberry-like swelling on the affected mucosa, which measured 1.5㎝×1.5㎝. The tumor was located on the lingual cortex of the mandible and extended into the surrounding soft tissues. Microscopically, the tumor consisted exclusively of atypical chondroblastic cells with a small osteoblastic area. A minimal bone marrow involvement was noted and the adjacent cortex was free of tumor. These findings suggested that the tumor originated from the periosteal cambium layer, which lies between the periosteal fibrous layer and the cortex of mandible.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

忠北大學校 附設 平生體育硏究所

金泰完,金昌範,張鳳愚,金奎鎭 忠北大學校 平生體育硏究所 1985 平生體育硏究所 論文集 Vol.1 No.-

This study is based on the written inquiry about STAI as a measuring tool, which spielberger developed as a anxiety measure to examine what relationship is between the ability in athletic sports and anxiety. The female or male 153 players 918 to 21 years old) became the subject of this written inquire. Trait anxiety was measured by Form x-2 of STAI (State-Trait Anxiety Inventory) while state anxiety was measured by Form x-1. And then, we compared the records in everyday practices with those in games, and used these records as an ability in games. We tried to clarify the relationship between the ability in games and the anxiety. The subjects for the measurement is divided in the three groups of the athletics track sports; a short, a middle, a long-distance race, and the three groups of the athletics field sports; running, jumping and throw. Analysis-the correlation with the state-trait anxiety we measured the records of athletic sports, examined the influence that anxiety exerts on the ability in game, and compared and analyzed the level of anxiety in each event. We have received these results as the following. 1. The influence that anxiety exerts on the athletics records. The events of athletic sports the relation between the anxiety in everday life and the records in that time shows its correlation(r=-0.374, r=-0.361) only in 100m running, but this is not connected with the other events. But except the midium distance events all of the women and men players are connected with the relation detween the anxiety in game and the records. So, because the level of anxiety in the game affects the records in the game, the players need to practice the psychological control of themselves and a little anxiety is needed as a stimulant in everyday practices. 2. Anxiety and records in usual time and game. In events of athletic track sports there was a deep relation, except the event of women distance running (r=0.365), between the anxieties in normal times and in game; (0.50,r<0.70). And the event of men 100M running practicing records in normal times and those in games was not considered here. Therefore, the higher anxiety one has in normal times, the higher his anxiety tends to go up in games; the records in practicing times generally corespond to those in games though such relation is not always applied to the event of 100M running. 3. Anxiety in track and field athletic sports. There was no difference of anxiety in the events of track and field athletic sports between men and women players. Anxiety in games showed the difference in the mean value in all games and their players.

폐쇄성 황달로 내원한 담관내 증식을 동반한 간세포암 1예

김승범,김태년,이호찬,박재현,은종렬,장병익,이헌주,윤성수,배영경 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7 -9% The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth A 46-year-o1d woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filhng defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.

응급실내 중환자의 단기간 진정을 위한 Midazolam의 지속적 정주

김범주,정태오,진영호,이재백 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: The mechanically ventilated patient's stay in the emergency department(ED) is brief but ventilatory management and intervention must be optimal. Agitation, anxiety, distress, and discomfort are common complications for the ventilated patient. So, sedation is necessary to reduce these complications. Methods: Patients were monitored and mechanically ventilated. Midazolam was intravenously administered as loading dose(3-5mg), followed by continuous infusion at a rate of 0.06mg/kg/hr, titrated to achieve a predetermined sedation level(Ramsay's sedation score: 2-5 points, Glasgow coma score scale: 8-11 points). Results: After onset of predetermined sedation, systolic and diastolic blood pressure and heart rate remained stable during continuous infusion when compared with those of the initial state. Arterial blood gas and peak inspiratory pressure remained unchanged but respiratory rate was decreased to allowable ranges. Conclusion: A short-term continuous infusion of midazolam was a safe and effective method for sedation of ventilated patients in ED.

수술의 함정 : 중심성 신경세포종 2례 2 Cases of Central Neurocytoma

김범태,주교성,장채칠,신원한,최순관,변박장 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.3

흉부자상에 의한 심실중격결손 및 승모판 부전증 치험 1예

김범식,조순걸,곽영태,조규석,박주철,유세영 慶熙大學校 1985 論文集 Vol.14 No.-

A 34-year-old man was stabbed with knife in the left fourth intercostal space. He was admitted to Kyung Hee University Hospital Emergency room with Cardiac tamponade state. Through a left anterior thoracotomy, a tense hemopercardium was released. A 2㎝ wound of right ventricle was sutured with 3-0 prolein. Seven month after the injury he was readmitted for cardiac catheterization. Cardiac catheterization confirmed the presence of an interventricular septal defect in the membranous septum with left ventricle to right ventricle shunt. A laceration of the septal leflet of mitral valve was also demonstrated. The pulmonary blood flow as 1.22 times the systemic flow. A longitudinal incision was made on the right atrium on the cardiopulmonary bypass. An 1×0.5㎝ interventricular septal defect was found in the membranous septum. In order to achieve and adequate repair interventricular spetal defect and mitral insufficency. The ventricular septal defect was repaired 3-0 prolein plegeted suture with interrupted. Artifical atrial septal defect was made and the septal leflet defect(1.5㎝) was reattached with 3-0 prolein plegeted suture interrupted. The partient had and uneventful post operative recovery and was discharged the Hospital on the 24day post operative day.

探討買辦

金泰範 順天鄕大學校 人文科學硏究所 1998 순천향 인문과학논총 Vol.6 No.-