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.

레이저 스페클간섭법에 있어서 스페클크기와 측정 한계에 관한 연구

윤성운,김경석,양승필,정현철,김정호,이도윤 한국공작기계학회 1996 한국생산제조학회지 Vol.5 No.1

The high coherence of laser beam has made it possible to observe interference effects even in the light scattered from rough surfaces. That's why, when object with a scattering surface is illuminated with laser light, we do see a speckled appearance due to random interference. This sort of unique property of laser speckle has brought into existence the new noncontacting techniques such as speckle metrology method of measuring deformation, displacement, and vibration etc of objects with high optical sensitivity. The measurable range of speckle metrology especially used to measure in-plane information, however, is limited by some factors, the so-called strain, rotation, tilt of surface and out of displacement perpendicular to the plane of analysis. This restrictions severly limits the measurable range of speckle metrology by causing the decorrelation of speckle patterns. It is the purpose of this paper to give a survey on the measurable limitation of speckle photography method that is one of speckle metrology. Namely we will discuss the mutual relationships and problems of each limitations adding the restriction of the largest and smallest displacement measurable with speckle methods.

드레인 전류 잡음원만을 고려한 스케일링이 가능한 바이어스 의존 P-HEMT 잡음모델

윤경식,이창석,맹성재,이진희,박철순 대전산업대학교 반도체기술연구소 1999 半導體技術硏究所報 Vol.1 No.-

게이트 길이가 0.2㎛인 P-HEMT에 대하여 드레인 바이어스 전류의 변화 및 게이트 폭에 대해 스케일링이 가능한 잡음모델을 제안하였다. 본 논문에서는 S-파라미터를 정확히 예측하기 위하여 x를 제외한 intrinsic 파라미터는 offset를 도입하여 정규화 한 후 스케일링을 하였다. 드레인 포화전류에 대한 드레인 전류의 비율과 게이트 폭을 변수로 하는 소신호 모델 파라미터의 맞춤함수를 구하였다. 또한, 잡음 파라미터를 정확히 예측하기 위하여 진성저항 잡음 온도 T_g, 게이트 단 전류 잡음원 등가잡음 컨덕턴스 G_ni 드레인 단 전류 잡음원 등가잡음 컨덕턴스 G_no를 잡음 모델정수로 사용하여 그 값을 추출하여 스케일링 하였다. 잡음 온도 T_g는 드레인 전류와 게이트 폭에 거의 추출되었다. 그러므로, G_no만을 잡음 모델정수로 하는 잡음모델과 T_g, G_ni, G_no를 잡음 모델정수로 하는 잡음모델을 측정값과 비교하여 본 결과 G_no만을 갖는 잡음모델도 측정된 잡음 파라미터와 잘 일치하였다. 따라서, 모델 정수 추출이 간단한 G_no 만을 갖는 잡음모델은 게이트 폭과 바이어스 전류에 대해 스케일링이 가능한 실용적인 잡음모델임을 확인하였다. Bias-dependent noise models of 0.2㎛ gate length P-HEMT's which are scalable with gate width are proposed. To predict S-parameters of the P-HEMT's the intrinsic parameters except for x subtracted the offsets introduced in this paper are normalized to the gate width and then scaled. The small-signal model parameters are expressed as fitting functions of the drain current to I_dss ratio and gate width. In addition, to estimate accurately noise parameters the noise temperature T_g of the intrinsic resistance, the equivalent noise conductance G_ni of the gate current noise source, and the equivalent noise conductance G_no of the drain current noise source are adopted as the noise model parameters. The extracted values of T_g are nearly independent of drain current and gate width and their average is arou

부산시 상업중심지의 공간적 분포특성

윤철현,이상현,박봉진 동아대학교 건설기술연구소 2000 硏究報告 Vol.24 No.2

Spatial distribution of centeral places in one of key factors to find out internal structure of the city. However, there has not been, still now, even basic study or survey on the commercial centers in Pusan. Thus, this paper has the purpose to discover the spatial structure of the commercial centers of Pusan. For that, this paper has defined functions by the statistical data of 1981 and 1998 and has made Z-score by functions. As a result, enormous change has been discovered in the spatial distribution as well as hierachy of the commercial centers of Pusan between early '80s and late '90s, according to Z-score>1.

정신병환자에서 집단정신치료와 싸이코드라마의 치료요인 비교

윤성철,이후경,정인과,이규항,함 웅,차정화 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

목 적 : 본 연구에서는 정신병환자를 대상으로 실시한 집단정신치료와 싸이코드라마에 작용하는 치료요인을 조사하여, 그 치료적 특성들을 비교하기 위한 목적으로 이루어졌다. 방 법 : 1996년 9월부터 1997년 5월까지 낮병원에 참여한 환자를 대상으로 하였다. 대상자는 총 35명의 정신병환자로 남자 22명, 여자 13명이었다. 동일한 낮병원 환자들에게 집단정신치료와 싸이코 드라마를 각각 시행한 후, 13가지 치료요인 척도를 사용하여 집단정신치료의 구성원, 싸이코드라마의 주인공, 싸이코드라마의 관객에 작용하는 치료요인의 순위를 각각 조사하였다. 이 세 집단을 모두 상위기능 집단과 하위기능집단으로 나누어 치료요인을 비교하였다. 상위와 하위기능집단은 낮 병동에서의 생활, 치료 프로그램에 참여하였을 때의 태도, 치료자와 면담하였을 때의 모습을 기준으로 하여 낮병원 치료팀 모임에서 치료자들의 합의에 의해 결정하였다. 각각의 치료 요인은 평균점수를 산출하여 치료 요인의 순위를 매겼으며, 이 순위에 의해 집단정신치료, 싸이코드라마의 주인공, 싸이코드라마의 관객에 작용하는 치료요인의 특징을 비교하였다. 결 과 : 본 연구에서 나타난 치료요인에 대한 특정적인 결과는 다음과 같다. 1) 싸이코드라마에서 주인공은 기능수준에 관계없이 모두 “카타르시스”와 “일차 가족 집단의 교정적 감정 경험”을 매우 중시하였다. 2) 싸이코드라마에서 주인공은 상위기능집단의 경우 “치료자의 조언”을 하위기능집단의 경우 “구성원의 조언”을 중시하였다. 3) 싸이코드라마에서 관객은 기능수준에 관계없이 모두 “치료자와의 동일시” 와 “구성원과의 동일시”를 매우 중시하였으며, 또한 보편성을 중시하였다. 4) 상위기능집단의 경우 집단정신치료 싸이코드라마의 관객 및 주인공에서 “대인관계학습”을 중시하였으며, 특히 집단정신치료에서 “대인관계학습”을 매우 중시하였다. 5) 하위기능집단에서 싸이코드라마의 주인공과 집단정신치료에서 모두 “사회화 기술의 발달”을 중시하였다. 결 론 : 본 연구의 결과를 종합하여 다음과 같이 제안할 수 있다. 먼저 집단정신치료나 싸이코드라마를 환자에게 시행할 때 치료자가 치료요인을 고려하여 치료를 진행하는 것이 효과적일 것으로 생각된다. 다음으로 집단정신치료와 싸이코드라마는 모두 동일하게 중요한 치료법으로 실제 임상에서 널리 이용하는 바람직한 것으로 생각된다. 마지막으로 집단정신치료와 싸이코드라마의 기법을 서로 혼합하여 사용한다면 매우 효과적인 치료법이 될 수 있을 것으로 생각된다. Objective : This study was performed to investigate the therapeutic factors of group psychotherapy and psychodrama which were applied to psychotic patients, and to compare the therapeutic characteristics of two therapies. Methods : The subjects of this study were patients of a day hospital from September 1996 to May 1997. The subjects were composed of 35 psychotic patients(22 males, 13 females). Both of group psychotherapy and psychodrama were done to the patients of the day hospital. After these therapeutic factors were checked by the members of group psychotherapy, the protagonists of psychodrama, and the audience of psychodrama using 13 therapeutic factors scale. All three groups divided into higher functioning group and lower functioning group by mutual consent of the therapists in the treatment team meeting according to the patient's life of the day hospital, the attitude in programs, and the state during the interview with the therapist. And then therapeutic factors of higher and lower functioning group were compared. By the mean score of each therapeutic factor the rank of therapeutic factors was decided. By these ranks we compared the important therapeutic factors on the members of group psychotherapy, the protagonists, and the audience. Results : The results were as follows : 1) The protagonists of psychodrama set a very high value on “catharsis” and “the corrective recapitulation of the primary family group”, regardless of their functional level. 2) The protagonists with a higher function set a higher value on “guidance of therapists”, while those who had a lower function set a higher value on “guidance of members”. 3) The audience of psychodrama set a very high value on “identification with therapists”, “identification with members”, and set a high value on “universality”. 4) The higher functioning group of the group psychotherapy, the audience, and the protagonists set a high value on “interpersonal learning”, especially the patients of group psychotherapy set a very high value on “interpersonal learning”. 5) The lower functioning group of the protagonists and the group psychotherapy set a high value on “development of socializing techniques”. Conclusion : From the results of this study, we can draw some suggestions. First, if therapists take the above-mentioned therapeutic factors into consideration during the sessions of group psychotherapy or psychodrama, they can obtain more effective therapeutic outcome. Second, it is desirable that both group psychotherapy and psychodrama should be used more extensively as important methods of treatment in clinical settings. Third, the combination group psychotherapy and psychodrama would be more effective than the separate application of each therapy.

집단정신치료의 내용과 과정

윤성철,이후경 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

Objectives : The purpose of this study was to investigate important therapeutic factors in encounter group and compare these therapeutic factors with those in long-term outpatient group psychotherapy, to understand the content and process in real cases for facilitation of interpersonal learning which is important for long-term outpatient group psychotherapy, and to acquire basic data of long-term outpatient group psychotherapy on the basis of this understanding. Methods : The subject was 7 encounter groups, composed of 41 persons. We used short from of Yalom's Q-sort to find important therapeutic factors in encounter group. We selected 2 cases for analying the process and content in these cases. Results : Three of the most important therpeutic factors were existential factors', 'self understanding', and 'interpersonal learning(input)'. Conclusion : We suggest that interpersonal learning is the most important therapeutic factor in encounter group.

정신분열병의 양성아형과 음성아형에 따른 사회적 지지망의 차이

윤성철,이규항,양익홍 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.2

In this study, positive versus negative symptoms of schizophrenia were examined in relation to social networks. The subjects consisted of 36 positive symptom(PS) and 35 negative symptom(NS) groups of schizophrenics admitted to the Anyang Neuropsychiatric Hospital. There was no significant difference in sociodemographic data(ie. sex, age, education etc) between the two groups. Structurally, the social network of NS group was smaller and contained lesser number of friends and family members than PS group. Furthermore, with respect to the functional aspect of social network. 1) The frequency of contact, comfortability, and material support given by the patients were much less in NS group. However, there was no difference in emotional, material, and informative support between the two groups. 2) In contrast with the PS group, in the 'most important person' category of social network in the NS group, the proportion of 'other people' (fellow patients, hospital staff etc) was much higher than that of friends and family members. 3) All negative symptoms correlated negatively with the size of social network. However, no such relationship existed among PS group. These results indicated close relationships existing between different types of schizophrenic symptoms and the structural and functional aspect of social network.

집단정신치료와 싸이코드라마

윤성철,이후경 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

In this paper, first of all we compared psychoanalysis with psychodrama by a historical point of view. Next, we reviewed group psychotherapy generally and considered the position of psychodrama through the comparison with various types of group psychotherapy. On the basis of this consideration, we compared Yalom's group psychotherapy as a typical type of group psychotherapy with psychodrama. Lastly, we discussed the application of group psychotherapy and psychodrama to each other. Psychoanalysis, psychodrama, and group psychotherapy developed separately at similar times in different fields. Finally, these three fields met with one another in the field of psychiatry. Each of these three fields changed itself as a result of absorbing various things from one another. Therefore, nowadays these fields became to have a close relation with one another. Psychodrama is in a position as a type of group psychotherapies, so it is important to understand group psychotherapy generally for understanding psychodrama. Psychodrama has similar aspects to other group psychotherapies, but also has different aspects from other group psychotherapies. When we understand these aspects, we can conduct therapeutic works effectively in practice. Psychodrama's methods can be applied to group psychotherapy and group psychotherapy's theories can applied to psychodrama. When psychodrama and group psychotherapy takes good points from the other side they can make progress.

NDRG2 is one of novel intrinsic factors for regulation of lL-10 production in human myeloid cell

최승철,김광동,김종태,오상석,윤선영,송은영,이희구,조영경,최인표,임종석,김재화 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

댐 건설전후 유역의 장기유출특성변화의 분석 : I.GIS를 이용한 NWS-PC 모형의 매개변수 추정

윤용남,유철상,안재현,양인태,고덕구 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

본 연구에는 CIS를 이용하여 장기유출 해석 모형의 하나인 NWS-PC모형의 매개변수를 얼마나 적절히 추정할 수 있는가에 대해 알아보았다. 수치표고모형, 수치토양도 및 인공위성영상을 분석하여 얻은 토지이용도 등을 기본 자료로 이용하였고 소유역별 특성값을 GIS를 이용하여 추출하였다. 이러한 특성치들은 Amstrong(1978)에 의거하여 소유역별 모형의 매개변수를 추정하는데 직접이용된다. NWS-PC 모형의 경우 추정된 매개변수는 가능한 값의 범위로 주 This study is to see how effectively the NWS-PC model parameters can be estimated using GIS. Basic informations such as DEM(Digital Elevation Model) ,digital soil map, land use information from satellite image are provided and analyzed for estimating the sub-basin characteristics in GIS. These charcateristics are used to estimate the model parameters for each sub-basin. The model parameters estimated based on Amstrong(1978) are given as a possible range, which will be fixed through the calibration procedure. In this study, we used the1974 data for calibration and the 1979 event for verification. From the calibration procedure, we could find that the parameters related with infiltration and water tend to have the minimum value of the range and that the parameters related with exfiltration of water tend to have the maximum value of the range This result seem to reflect the hydrologic characteristics of Keum-river basin, which could be used to fix the model parameter without difficult calibration procedure. The simulation results show that the relative error of calculated discharge to observed discharge to be within approximately 10% . Therefore, the model with the parameters calibrated was considered to be adaptable for long-term runoff analysisf or Keum-river basin.