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.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

데이터 마이닝 접근방법에 의한 기업 도산 예측

정병화,지원철 弘益大學校 科學技術硏究所 2000 科學技術硏究論文集 Vol.11 No.-

Bankruptcy Prediction is a noble application of data mining. We attempt to analyze korean companies which were bankrupted or in financial insolvency after IMF is introduced, using Frailty Model. Frailty model has the advantage that it can consider multiple observations over some periods, while neither MDA nor Logit analysis can. Firstly, we build the model according to frailty analysis, and remodel the prediction model to estimate the parameters using hierarchical generalized linear model. The model select the ratio of interest over sales volume as a most influential factor in predicting bankruptcy.

장기간 수영운동에 참가한 중년여성의 신체구성과 건강체력 특성에 대한 연구

전종귀,성민철,이창규,현광석,조병준 충남대학교 체육과학연구소 2000 體育科學硏究誌 Vol.18 No.1

The purpose of this study was to identify the effects of swimming exercise career on the middle-aged women. The number of sujects were 44 postmenopausal women(45-60 age group). The number of exercise group were 27(3 years average career) and that of control group were 17, Percent body fat physical development score, back strength, grip strength, trunk flexion, endurance were measured. The results were as followings; 1. The percent body fat, physical development score, back strength, grip strength, endurance of swimming exercise group was higher than that of control group. The difference showed the statistical significance. The trunk flexion and grip strength of swimming exercise group were lower than that of control group. The difference didn't showed the statistical significance. 2. The back strength, muscle endurance, endurance of swimming exercise 7 years average career group was higher than that of 3 years average career group. The difference showed the statistical significance. As the above, the regular participation of swimming exercise help the middle-aged women to promote their health-related fitness. Also the exercise prevent obesity, back pain.

ECAP 강가공에 의한 5083 Al 합금의 초소성 변형

이정국,서창우,김병철,신동혁 漢陽大學校 工學技術硏究所 2000 工學技術論文集 Vol.9 No.1

초기 결정립 크기가 200 μm인 상업용 5083 Al 합금에서 equal channel anglar pressing(ECAP) 강가공에 의하여 결정립을 초미세화 시킬 수 있었다. ECAP는 200℃에서 수행되었고, 반복 passes시 180˚ 회전을 주면서 같은 시편에 8 passes까지 강가공을 가하였다. 미세조직 특징은 1 pass후 평균 0.2 μm의 폭과 0.8 μm의 길이를 갖는 연신된 평행한 bands가 균일하게 형성 되었고, 4 passes후 결정립 크기가 약 0.3 μm인 등축의 초미세 결정립이 얻어졌다. 이러한 초미세 결정립을 갖는 5083 Al 합금에서 저온 초소성 성질이 얻어졌는데, 약 0.5 μm의 결정립 크기를 갖을 때 250℃이하의 온도에서 연신율이 200 %이상인 초소성 거동을 나타내었다. An ultrafine grained structure was introduced into a commercial 5083 Al alloy with the initial grain size of ∼200 μm using the equal channel angular pressing technique. Equal channel angular pressing was successfully conducted at 200℃ and the results showed that the microstructure was reasonably homogeneous after single passage and consisted of parallel bands of elongated substructure having the average width of 0.2 μm and the average length of 0.8 μm. Repetitive passes were conducted on the same sample up to total 8 passes through the die so that the sample was rotated 180˚ around its longitudanal axis between passes. An equiaxed ultrafine grained structure of ∼0.3 μm was obtained in the present alloy after 8 passes. It was found that a 5083 Al alloy with the grain size of ∼ 0.3 μm exhibited a superplastic-like behavior with elongation to failure in excess of 200% below.

수직냉각면을 가진 함수정방형내에서 초기온도가 동결량에 미치는 영향에 관한 실험적 연구

김병철,주동인,손정배,박영훈 조선대학교 에너지.자원신기술연구소 1997 에너지·자원신기술연구소 논문지 Vol.19 No.2

The effect of initial temperature on freezing with vertical cold wall in rectangular cavity was studied. When the initial temperature was below the 4℃, the frozen thickness in the upper part was thicker than that of lower part from the beginning of freezing and above the 4℃, at beginning the frozen thickness in the upper part was thinner than that of lower part but with time the frozen thickness in the upper part was thicker than that of lower part. And when it was above the 8℃, at the beginning of freezing the upper part of frozen thickness was thinner than that of lower part with concave but with time the concave in the upper part became thicker and the frozen thickness in the upper part was thicker than that of lower part too. The effect of initial temperature had no effect on the increasing of ice volume with time because in the beginning of freezing the more initial temperature was low, the more frozen thickness grew but the heat resistance increased in proportion as the frozen thickness grew.

等電點 電氣泳動에 의한 배추와 양배추 育成系統에서의 自家不和合性 關聯 glycoproteins의 比較分析

이정명,최근원,민병훈,이태진,백남권,이철우 경희대학교 부설 식량자원개발연구소 1994 硏究論文集 Vol.15 No.-

等電點 電氣泳動을 이용하여 배추의 몇 개의 5-allele 造成과 그들의 F₁에서 自家不和合性의 발현과 관련된 glycoprotein의 band 樣相을 비교 분석한 결과는 다음과 같다. 1. 배추의 內婚系와 이들 간의 에서 柱頭內 glycoprotein의 band pattern을 分析한 결과 兩親의 band pattern이 F₁으로 그대로 遺傳되므로 써 명확한 同定 및 區分이 가능하였다. 2. 공시된 배추의 계통 중에서 8개의 等電點을 발견하였는데 대부분의 系統에서 pl 7.0 또는 8.6에서 major band를 보이고 있었다. 따라서 major band만으로는 S-allele genotype의 명확한 동정이 불가능한 경우도 상당히 있었다. 3. 상기 bands (pI 6.8 and 7.7)에서의 glycoprotein의 分子量은 pI 7.0에서 49,000-50,000이었고 pI 8.6에서 59,000으로 推定되었다. 4. 양배추는 배추에 비해서 glycoprotein의 major bands와 minor bands수가 많고 매우 다양하게 나타나므로써 S-allele 동정이 배추보다 매우 용이할 것임을 보여 주었다. Band patterns of glycoproteins associated with the expression of self-incompatibility were examined in the stigmatic extracts of self-incompatible Chinese cabbage inbred lines and the hybrids. Clear relationship in the band pattern could be confirmed in the parents and their hybrid, indicating the inheritance of S-alleles to the progeny. Total of 8 isoelectric points were indentified in the inbreds, with the major bands at pI 7.0 and 8.6. Thereforne, in some genotypes, identification of cultivars or S-allele genotypes were impossible with the major bands only. The molecular weights of the glycoproteins were estimated to be 49,000-50,000 for pI 7.0 and 59,000 for pI 8.6 bands. The stigmatic extracts from cabbages showed numerous major and minor bands so that identification of S-allele genotype will be much easier as compared to chinese cabbage.

유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.

불안정성 흉요추체 방출형 골절 환자에서 기구를 이용한 고정술의 결과

안병조,이정청,김재은,김형일,김철진,최하영 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

Fifty six patients with unstable thoracolumbar bursting fractures were treated using variable internal fixation devices such as the Kaneda Anterior Fixation System(Kaneda device), the Z-Plate-ATL^(TM) Anterior Fixation System(Z-Plate ATL^(TM)device), the Harrington device. Cotrel-Dudousset(CD) or Compact Cotrel Dubousset(CCD) device of Steffee Transpedicular System with or without decompression. Suchy internal fixation devices were grouped into anterior and posterior internal fixation devices and compared with each other in the aspect of the degree of neurological improvement, the changes of the vertebral height and the kyphotic angle, the duration of admission, and postoperative complications. In conclusion, the anterior internal fixation device appears to be of more benefit in the management of patients with unstable thoracolumbar bursting fracture