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.

Cs-137 γ-선 조사장치의 방사선장 해석연구

전재식,채하석,이철영,오장진,이병영,명동범 충남대학교 기초과학연구소 1995 忠南科學硏究誌 Vol.22 No.1

In reference to the ISO-4037 and ANSI N13.11, appropriateness of the shielding and collimating system, and suitability of the irradiation and its environmental conditions of a 20 Ci Cs-137 gamma-ray irradiator installed in Korea Institute of Nuclear Safety(KINS) were investigated. Upon the installation of the irradiator, condition of collimator alignment and virtual beam cross section were examined by use of a portable He-Ne laser. In order to evaluate the fitness of the secondary(scattered) to primary ratio of the collimated gamma-ray beam from the irradiator in light of ISO and ANSI requirement, the measurements of the secondary to primary ratio were performed by use of a cavity type ion chamber which had been calibrated in a calibration laboratory that maintains reliable traceability. For the theoretical assessment of the gamma-ray field the collimated beam were divided into fifteen sectors and for each sector the secondary to primary ratio and the gamma-ray spectrum was simulated by means of Monte Carlo method. The outcomes were compared with the experimental results, and cause of scattering and the existence of alleged modifying factors in the irradiator were examined.

모래쥐(Gerbil)에서 지속적 및 간헐적 뇌혈류차단이 뇌부종과 허혈성 신경세포 손상에 미치는 영향

전병윤,주진양,이규창,김태승 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.7

Temporary occlusion of the cerebral blood flow is an effective maneuver to prevent and/or to control excessive bleeding during neurosurgical operations. Many studies have been reported employing single occlusion of various durations. However, there has been only a few studies examing the consequences of repeated occlusions on the development of cerebral edema and neuronal injury in the gerbil. Three separate episodes of 5-minute ischemia spaced at varied time interval was produced in Mongolian gerbils by occlusion of bilateral common carotid arteries. Quantitative estimates of cerebral edema and neuronal injury were obtained 24 hours after the third occlusion. The result was compared to that of single 15-minute occlusion. In gerbils with three 5-minute occlusions at 10-minute intervals. cerebral edema was not significant. However, the animals killed 24 hours after three 5-minute occlusions at 1-hour intervals or single 15-minute occlusion showed severe cerebral edema. Such animals showed significantly more neuronal injury than in animals with three 5-minute occlusions at 10-minute intervals. These results suggest that ischemic brain damage may be reduced with repeated vascular occlusions spaced at short intervals.

이면성 및 도플러 심초음파도를 이용하여 진단한 선천성 거대 좌회선지-좌심실 관동맥루

진승원,박준철,이영중,유병현,박현옥,김용주,윤호중,김재형,홍순조,최규보,권종범,원용순,박건 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

솔-젤공정에 의한 한외알루미나 여과막의 기공보정에 관한 연구

채만병,조원준,정은정,이진휘,서동호 서울産業大學校 1996 논문집 Vol.44 No.1

서로 다른 입자 크기의 3층 구조를 갖는 튜브 형태의 한외 알루미나 분리막은, 일반적으로 제조공정중 분리층에 결손부분이 발생하기 때문에 낮은 선택도 및 제거율을 보인다. 이와같은 결손부분을 보정하기위하여 습도조절에 의한 선택적 적심(alternative wetting by controlled humidity)을 한 수 colloidal silical 솔을 적용하여 처리하고 특성을 평가 하였다. Sealing처리한 분리막에 대한 누수여부를 평가하기 위하여 3가지의 염료로 조사하였고, 보정전분리막과 보정후분리막에 대한 SEM, 액체으 투고도, 선택도 및 P.E.G./물 혼합물의 제거율을 측정하였다. P.E.G 2000, 12000 및 35000에 대한 제거율은 각각 약 0.6, 18 및 17% 향상된 결과를 보였으나 colloidal silica 솔의 deposition에 기인하여 투과율의 감소는 77%였다. 이상의 결과에서 보면 습도조절에 의한 선택적 적심법은 비록 deposition에 의한 문제점을 내포하고 있으나 액체분리를 위한 알루미나 한외여과막의 보정에 효과적인 방법이다. The 3-layer type alumina membrane consisting of different pore size shows the decreased selectivity and rejection because of cracks in the separation layer generally occurred during the manufacturing process. To modify these cracks, the colloidal sol is applied by sol-gel process after treating by alternative wetting method using controlled humidity(Alternative Wetting Method by controlled humidity) and evaluated the characteristics. For the evaluation of the leakage for the sealed membrane, the sealed membranes were tested by 3 kinds of dyes. For the comparing of native and modified membranes, the modified membranes for the cracks treated by Alternative Wetting Method by controlled humidity were also tested by SEM, permeability by liquid equipment, selectivity and rejection of the P.E.G./water mixtures. The results showed that the rejections were increased ca. 0.6, 18 and 17 % for the P.E.G. polyethyleneglycol 2000, 12000 and 35000 individually. The permeabilities are decreased, however, 77% for the pure water caused by deposition of colloidal silica sol after caulking. In conclusion, the Alternative Wetting Method by humidity control had the effect for the modification of ultrafiltration alumina membrane for separation of liquids and gases, though having problem of deposition.

Lesch-Nyhan syndrome 환아의 oral self-mutilation 에 대한 증례보고

최병재,최형준,이제호,전진용 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.1

1. 하순에 심한 self-mutilation wound를 야기한 Lesch-Nyhan Syndrome 환아에서 상하악 유전치에 치관부 절단 및 치수 절세술을 시행하여 치아에 의한 자해를 방지하였다. 2. 장치를 이용한 치료가 어려운 경우 발치가 고려되기도 하나 본 증례에서는 발치보다 보존적인 술식으로 만족할 만한 결과를 얻었다. Self-injurous behavior is defined as deliberate harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, skin cutting, or finger biting and includes ocular, genital and oral self-mutilation. Lesch-Nyhan syndrome is a rate X-linked recessively inherited disorder, caused by complete absence of hypoxanthin-guanine phosphoribosyl transferase(HPRT) activity. Clinical presentation is characterized by mental retardation, chorea, athetosis, hyperuricemia, uricosuria and self-mutilating behavior. In these patients, the most typical feature is loss of tissue from biting themselves, even though they are not insensitive to pain. The dental management of self-mutilation includes treatment with appliances such as soft mouthgrard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a 25-month-old boy who was a known case of Lesch-Nyhan syndrome and presented with severe self-mutilation wound on his lower lip. Vital pulpectomy and coronal resection was done as a more conservative approach than extracting all primary anterior teeth. Due to maintaining the root portion of the teeth in the bone, it is expected that the normal growth of the alveolar bone will be achieved.

복부 외상에 의한 위장관 손상

안진홍,소병준,이정균 圓光大學校 醫科學硏究所 1998 圓光醫科學 Vol.14 No.2

Purpose: We performed this study to evaluate certain factors and events contributing to the overall profile of the victim of abdominal trauma. Methods: 73 cases were analysed retrospectively who underwent operation for gastrointestinal injury from abdominal trauma at Wonkwang University Hospital from january 1995 to June 1998. Blunt injury account for 59 cases( 80%) and penetrating injury for 14 cases(20%) of the victims. Results: 1) The sex distribution was 62 males(85%) and 11 females(15%) with ratio of 5.6:1 and the age distribution revealed a high incidence in forths and fifth decades. 2) The causes of blunt trauma were traffic accidents (39 cases, 68.4%), violence (10 cases, 17.5%), and fall down (5cases, 8.8%),. The causes of penetrating trauma were stab injury (14 cases, 87.5%) and others (2 cases). 3) The clinical manifestations were abdominal tenderness (71.2%), abdominal pain(68.5%), rebound tenderness(52%), decreased bowel sound(38.3%), and abdominal distention(15%). 4) The plain films of abdomen showed free air under the diaphragm in 13 cases(17.8%) among the 73 cases of hollow viscus ruptures. Abdominal paracentesis was performed in 54 cases among 73 cases of hollow viscus rupture, of which 32 cases(59.3 %) revealed positive findings. 5) The peritoneal lavage was valuable in diagnosis, positive findings was 16 cases(84.2%) among 19 cases. 6) The injuried organs were small intestine (53 cases, 72.6%), colon(21cases, 28.8%). 7) The commonly associated extraabdominal injury were extremity fractures (38.2%), chest trauma(29.4%) and soft tissue injury(11.7%). 8) Postoperative complication were developed in 34 cases(46 %), which were intestinal obstruction (10 cases), pulmonary complication (7 cases), wound infection (6 cases), intraabdominal abscess (4 cases). 9) The overall mortality rate was 5.4 %. The causes of death were sepsis (2 cases), hypovolemic shock (1 case), and renal failure (1 case). The deaths and complications were increased by severe associated injuries(1 death in 28cases of 2 organ injury and 2 death in 11 casess of 3 or more organ injury) and diagnostic delay (1 death in 6cases of delayed operation). Conclusions: Repeated physical examinations, tests, and careful attention will be required in abdominal injury to avoid complicaton and mortality.

특징적인 다방성 소견을 보이는 치성 점액종의 증례보고

이병도,이완,팽준영,손현진 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.1

Although odontogenic myxoma (OM) has various radiographic appearances, the characteristic features of OM are the multilocular radiolucent lesion, straight bony septa along the margin forming either square or triangular spaces. We present a case of OM in a 25-year old-male patient. Multilocular radiolucent lesion on the left mandible body showed tennis racket appearance. Cone beam computed tomography (CBCT) showed straight bony septa along the margin and cortical perforation. This CBCT features would have significantly contributed to allowing a diagnosis of OM. We think that this case shows characteristic radiographic features of odontogenic myxoma.

상악 구개측 중앙부에 매복된 과잉치

민성진,최형준,,김성오,이제호,곽지윤,최병재 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.4

과잉치는 치배 형성기에 정상 치판의 과도한 증식의 결과로 발생하며 산발적일 수도 있고 유전적일 수도 있다. 발생 빈도는 1~3%이며,2:1의 비율로 남아에게 호발한다. 주로 상악 전방부에서 많이 발견되며, 매복, 영구치의 위치 이상, 정중부 이개, 낭종, 비강으로의 맹출 등과 같은 다양한 합병증을 나타낼 수도 있다. 상악 전방부에서 발견되어지는 과잉치는 치축방향에 따라 위치가 결정되며 상악 전방부 과잉치의 1/3 정도는 역위 매복되어 맹출의 가능성이 없지만, 치낭의 치관 부위가 정상적인 관계로 존재하는 한 과잉치의 이동이 일어날 수 있다. 치아의 이동은 경구개, 소구치 부위, 비강까지도 일어날 수 있다. 또한 전상악 수직고경의 성장으로 시간이 지남에 라 외과적 접근이 어려워질 수 있다. 이에 본 두 증례에서는 역위 매복된 상악 전방부의 과잉치가 구개 측 중앙부까지 이동된 것을 발견하여 외과적으로 제거하였다. Supernumerary tooth develops as a result of abnormal proliferation of the dental lamina during the initiation stage of dental development. It could be a sporadic occurrence or a hereditary transmission. Supernumerary tooth occurs with a frequency of 1 to 3%, Generally, there is a 2:1 preference for boys. It is usually found in the anterior portion of the maxilla and may be associated with complications such as impaction, malposition of permanent teeth, formation of diastema, cysts and eruption into nasal cavity. The position of supernumerary tooth found in the anterior portion of the maxilla is determined by the axis of the tooth. One third of supernumerary tooth in the anterior portion of the maxilla has no possibility of eruption due to its invertedly impacted position. However, as long as the coronal part of the follicle remain intact, migration of supernumerary tooth is possible. The migration may occur into the palate, the premolar region, the sinus or the nasal cavity. Also, growth of vertical dimension of maxilla could make surgical approach difficult as time goes by. For this reason, we have found invertedly impacted mesiodens moved to the vault of the palate in the two cases, and extracted supernumerary tooth surgically.

하악 전치부에서 발생한 선양치성종양의 증례보고

이병도,이완,권경환,팽준영,손현진 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.2

Adenomatoid odontogenic tumor(AOT) is a tumor of odontogenic epithelium with varying degrees of inductive changes in the connective tissue. The common radiographic appearance of AOT is a unilocular radiolucency associated with an unerupted tooth. Detectable radiopacities have been reported in many cases. We present a case of AOT in a 9-year old-female patient. Cystic lesion with numerous, punctuate radiopaque foci was observed on the anterior region of the mandible. These radiopacities were situated mostly on the buccal side of impacted tooth on the multi-planar images of cone beam computed tomograph. Characteristic duct like structures and amyloid like material were observed on histopathologic finding.