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.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

농촌경관 중요요소의 조작을 통한 경관평가 : 농촌 문화마을을 대상으로 The case of Rural Culture Village

서주환,심성보,전영임,박태희,조영배 경희대학교 부설 디자인연구원 2002 예술· 디자인학연구 Vol.5 No.1

This study does questionnaire over recognition of landscape, major landscape and impressive site in rural community, and research visual preference through precessing pictures with a computer about major landscape. The landscape with natural fabric generally harmonizing with background is high in preference. Also, though major landscape factors are similar, preference is different according to shape, size, quality and color.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

우리나라 시외통신망의 과부하 통화량 관리 방안에 관한 연구

서영태,박상희 연세대학교 산업기술연구소 1991 논문집 Vol.23 No.2

When the traffic performance begins to decline, to assure the adequate call processing of the toll network, efficient management of overload traffic is needed. In this paper, the generated patterns and managing methods of overload traffic in Korean toll network have been studied and the traffic performance has been analyzed by the result of applying overload traffic managing methods and compared with a traffic performance without this method. When the overload traffic managing method, the obtained results are as follows. 1. When the busy traffic performance is 700,000 houses, good processing of the traffic performance over 95% is obtained, which is the operation target of an automatic trunk call operator. 2. If the busy traffic performance increases above 700,000 houses, the trunk call performance goes down abruptly. 3. When the number of trunk call is 700,000, 665,000 calls are connected and 35,000 calls are not connected.

저손실 스너버 회로를 이용한 유도 전동기의 서지전압 억제

서기영,문상필,김주용,박진민 경남대학교 신소재연구소 2003 신소재연구 Vol.15 No.2

The development of advanced Insulated Gate Bipolar Transistor(IGBT)has enabled high-frequency switching operation and has improved the performance of PWh4 inverters for motor drive. However, the high rate of dv/dt of IGBT has adverse effects on motor insulation stress. In many motor drive applications, the inverter and motor are separated and it requires long motor type. The long cable contributes high frequency ringing at the motor terminal and it results in hight surge voltage which stresses the motor insulation. The inverter output filter and RDC snubber are conventional method which can reduce the surge voltage. In this paper, we propose the new low loss snubber to reduce the motor terminal surge voltage. The snubber consists of the series connection of charging/discharging capacitor and the voltage-clamped capacitor. At IGBT turn-off, the snubber starts to operate when the IGBT voltage reaches the voltage-clamped level. Since dv/dt is decreased by snubber operating, the peak level of the surge voltage can be reduced. Also the snubber operates at the IGBT voltage above the voltage-clamped level, the snubber loss is largely reduced comparing with RDC snubber. The proposed snubber enables to reduce the motor terminal surge voltage with low loss.

갑상선 종양에서 thrombin receptor (PAR-1)의 발현 양상

박지영,목지오,김여주,박형규,김철희,변동원,서교일,유명희,조현득,오미혜,김상진 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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비만 환자에서 비만관련 유전자 다형성에 따른 체중감량차이 : 지방흡수억제제를 복용한 환자를 대상으로 In Cases of Subjects with Orlistat for Weight Reduction

서영성,김대현,이인규,이근미,김영훈 대한비만학회 2003 The Korean journal of obesity Vol.12 No.4

간호사의 임상 실무 경험

서문자,손행미,강현숙,권성복,김주현,박영숙,이은희,임난영,조경숙,지성애 성인간호학회 2002 성인간호학회지 Vol.14 No.4

purpose: This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. Method: Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. Result: The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. Conclusion: Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.

7個 結晶系의 唯一 X-線 回折强度 資料

徐日煥,金光柱,秋錦洪,李珍昊,林星秀,柳保盈,金文執 충남대학교 자연과학연구소 1992 忠南科學硏究誌 Vol.19 No.1

한 結晶의 構造는 唯一單位의 X-線 回折强度資料로부터 決定될 수 있다. Miller指數(hkl)의 函數인 回折强度Ⅰ(hkl)는 異常 散亂(anomalous scattering)이 無視될때 對稱中心點群 卽 Laue群의 對稱性을 나타낸다. 이 論文에서는 모든 結晶系에 對한 回折强度의 唯一單位를 Laue群들의 對稱性으로부터 誘導하여 놓았다. Crystal structures can be determined from the unique data of X-ray intensity. As the X-ray intensity Ⅰ(hkl), which is a function of diffraction plane (hkl), has a center of symmetry assuming anomalous scattering is negligible Ⅰ(hkl) shows the symmetry of a centrosymmetric point group, i.e., a Laue group. In this paper the unique data of the intensity for all crystal systems have been derived from the symmetries of Laue groups.