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.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

고요산혈증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이종은,이준숙,이찬구,이한정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : Serum uric acid has now been identified as a marker for a number of metabolic and hemodynamic abnormalities. The aim of this study is to evaluate risk factors which influence hyperuricemia in the citizens of Asan. Method : The study design was cross-sectional and research subjects were 1086 citizens of Asan. General characteristics, cigarette smoking, alcohol consumption, and past history were obtained by interview using a structural questionnaire. Also, we measured height, weight and blood pressure, and serum uric acid of the subjects. Results : The mean serum uric acid level was 5.27 ㎎/㎗ in men and 4.01 ㎎/㎗, in women, In the multiple logistic regression analysis, statically significant risk factors of hyperuhcemia were gender, body mass index, blood lead concentration, and serum creatinine. Conclusion : Our results suggest that gender, body mass index, blood lead concentration, and serum creatinine might be the most important risk factors of hyperurcemia. Education program as well as routine check-up for serum uric acid was highly recommended for the effective prevention of hyperuricemia.

연폭로 근로자들에서 흡연 및 보건행태학적 변수가 주관적 자각증상에 미치는 영향

이성수,김화성,리갑수,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

To investigate the effect of smoking and drinking habit on the health status of lead workers, 220 male workers in lead using industries and 210 male controls were selected for this study. Selected study variables were lead in blood (PbB), zinc protoporphyrin in blood (ZPP), delta-aminolevulinic acid in urine(DALA), hemoglobin (Hb), and hematocrit (Hct). Questionnaire for lead related symptoms (15 symptoms) and smoking and drinking habit was provided to all the workers and filled up by themselves and reconfirmed by physician. The results obtained were as follows; 1. While smoking and drinking rate of lead exposed group were 77.7% and 75.8%, respectively, those of control group were 53.3% and 35.7%, respectively. 2. Mean values of lead exposed indices of lead workers was significantly different from other group. 3. In exposed workers, there was significant differences of DALA between smoker and non-smoker. 4. The neuromuscular symptom prevalence of lead exposure was higher in lead exposed group than non-exposed group. 5. Symptom prealence of lead exposure were higher in drinking and smoking group than non-drinking and non-smoking group. 6. While logistic analysis of positive neuromuscular symptom with categorized blood lead and age, smoking, drinking as categorized independent variables indicated that only blood lead (>40㎍/㎗) was significantly contributed to dependent variable with 95% significant odd ratio confidence interval, logistic analysis of positive constitutional symptom with same categorized independent variables indicated that only age (>40years) was significantly contributed to dependent variable. And logistic analysis of total symptom with same categorized independent variables indicated that blood lead (>40㎍/㎗) and age (>40years) were significantly contributed to dependent variable.

새로운 연노출의 효과지표로서의 혈장 δ-aminolevulinic acid 측정의 유용성

이금원,황보영,김용배,리갑수,이성수,장봉기,함정오,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

To evaluate the usefulness of the measurement of plasma δ - aminolevulinic acid (ALAP) as a new effect indicator of lead exposure, the association of ALAP with blood lead, DMSA chelatable lead and bone lead with a special emphasis of genetic interaction of ALAD polymorphism was studied with 419 lead exposed workers and 85 non-lead exposed workers. Lead workers were recruited from storage battery industries, secondary smelting industries and other lead using industries and non-lead workers selected from electronic refrigerator manufacturing industry. Blood lead, DMSA chelatable lead and bone lead were chosen for parameters of lead exposure. Plasma and urinary ALA were selected for the effect parameter of lead intoxication. Information for age, smoking, drinking habit and body mass index were also obtained. Job duration for lead workers was also collected. The overall prevalence of the variant allele, ALAD type 1-2 or 2-2(ALAD2) in lead exposed workers was 10.0% (42 out of 419 lead workers) which was not differed from control workers (9.4% : 8 out of 85). The means blood lead and DMSA chelatable lead of lead workers with ALAD 1(ALAD type 1-1) were lower than those of lead workers with ALAD2, but the differences were not statistically significant. On the other hand, the mean of tibia lead of lead workers with ALADI was higher than that of lead workers with ALAD2, but the difference was not statistically significant. DMSA chelatable lead showed highest correlation with log transformed plasma ALA(LALAP)(r=0.682) and blood lead and tibia lead had r=0.650, r=0,402 correlation coefficient with LALAP respectively On the other hand. log transformed urinary ALA(LALAU) had lower correlation coefficient with all three parameters of lead exposure than LALAP. The equation of robustic simple linear regression of blood lead on LALAP was LALAP=2.0439+0.0165PbB in ALADI lead workers and LALAP=2.031+0.0121PbB in ALAD2 lead workers. ALAD genotype in the multiple regression analysis of blood lead with LALAP after adjusting for possible confounders(sex, ago, BMI, smoking and drinking status and job duration) showed significant main effect on LALAP resulting lower LALAP in ALAD2 lead workers than ALADI lead workers. On the other hand, effect modification of ALAD genotype was observed in the multiple regression analysis of tibia lead with LALAP after adjusting for possible confounders, but there was no significant effect of ALAD genotype in the multiple regression analysis of DMSA chelatable lead with LALAP after covariate adjustment. With above results, plasma ALA was found to be a useful effect parameter of lead exposure compared with urinary ALA. It was also observed that ALAD polymorphism made significant effect on the association of blood and tibia lead with ALAP. Thc lower plasma ALA in ALAD2 lead workers suggested supportive effect of ALAD2 in lead exposure.

전자부품 제조업 근로자들의 시력변화에 대한 연구

이용만,안규동,이성수,함정오,김화성,리갑수,이병국 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

근접작업이 시력약화의 원인이 될 수 있는가를 알아보기 위하여 전자부품을 제조하는 2개 사업장에서 1991년에서 1993년까지 입사한 근로자들 중에서 근접작업으로 인정되는 마이크로칩을 조립하는 근접작업자 306명을 조사군으로, 대조군은 세탁기 타이머 및 일반 기계기구를 조립하는 작업자 154명, 계 460명을 선정하였다. 이들 대상자는 1991년 입사자는 1993, 1994, 1995년 시력을 조사하였으며, 1992년 입사자는 1993, 1994, 1995년 3년동안 조사를 하였으며, 1993년 입사자는 1994, 1995년 2년간 시력을 조사하였다. 대상자 중에서 입사시 안경을 착용한 근로자는 82명(17.8%)이었다. 따라서 남자 근로자와 안경착용자를 제외한 여성 근로자들 335명만을 추적 조사하여 다음과 같은 결론을 얻었다. 조사군에서 입사시 시력 1.0 이상이었던 근로자의 분포는 취업 1년 후 약 25-35% 정도 감소하였으며, 2년후에는 약 40-60% 정도의 감소를 나타내었고, 3년 후 약 50-65% 정도로 감소하였고 4년후에는 약 65% 이상 감소하였다. 그러나 대조군에서는 1.0 이상의 시력을 보였던 근로자들의 비율이 취업 1년 또는 2년 후 15-30%의 감소를 보이고 있으나 그 이후에는 큰 변동이 없었다. 이들의 시력변화를 근무년수에 따라 알아보기 위하여 조사된 시력을 순위변수로 하여 Kruskall-Wallis 검정을 시행한 결과 조사군, 대조군 모두에서 근속년수에 따른 순위의 합의 평균이 년차적으로 유의하게 감소하였으나, 입사시부터 근속년수에 따른 조사군과 대조군과의 순위합의 평균에 의한 시력차 비교에서 입사시 조사군의 순위합의 평균이 유의하게 높았던 것이 근무기간에 따라 대조군의 평균이 높아지면서 통계적 유의성이 없고 대체적으로 1년 이후부터 변화가 적은 것으로 나타나 근접작업으로 인한 시력약화를 추정할 수 있었다. This study was carried out to investigate that the close distance works were associated with decreased visual acuity. 306 workers were subjects who had been recruited from 1991 to 1993 in two electronic parts manufacturing factories, and 154 workers were controls who had been employed from 1991 to 1993 in launder machine timer and general machine assembly factories. Subjects who had been employed in 1991 and 1992 were follow up from 1993 to 1995, and subjects who had been employed in 1993 were from 1994 to 1995. The male workers as well as glasses wearing workers were excluded. Only 335 female workers were followed up to study the change of visual acuity. The results were as follows; The rate of workers with visual acuity over 1.0 at recruit year in subjects group was decreased about 25-35% after 1 year, 40-60% after 2 years, 50-65% after 3 years, and 65% after 4 years. While, the rate of workers with visual acuity over 1.0 at recruit year in control group was decreased about 15-30% after 1 or 2 years, and there was no more additional visual acuity reduction after then. Kruskall-Wallis test was performed to investigate the change of visual acuity in subject and control group by work duration. The means scores of ranks in both group were significantly decreased by work duration. The mean scores of ranks in subject group at recruit year were significantly higher than those in control group at recruit year, but these differences were disappeared after 1 year work. Therefore, this suggest that close distance workers may be affected their visual acuity.

들잔디 성숙종자로부터 캘러스배양 및 식물체 재분화에 미치는 몇 가지 요인의 영향

이상훈,김범수,원성혜,조진기,김기용,박근제,성병렬,이효신,이병현 Plant molecular biology and biotechnology research 2004 Plant molecular biology and biotechnology research Vol.2004 No.-

In an effort to optimize tissue culture responses of zoysiagrass (Zoysia japonica Steud.) for genetic transformation, factors affecting callus induction and plant regeneration were investigated. MS medium containing 3 ㎎/L 2,4-D was optimal for embryogenic callus induction from mature seed. The plant regeneration frequency of 73.3% was observed when embryogenic calli induced in this medium were transferred to N6 medium supplemented with 0.1 ㎎/L 2,4-D and 5 ㎎/L BA. Among several basic media, MS and N6 medium were optimal for callus induction and plant regeneration, respectively. Regenerated plants were grown normally when shoots transplanted to the soil. A rapid and efficient plant regeneration system established in this study will be useful for molecular breeding of turfgrass through genetic transformation.

납 폭로 근로자에서 δ-aminolevulinic acid dehydratase 유전형질이 zinc protoporphyrin 및 δ-aminolevulinic acid에 미치는 영향

이병국,황규윤,장봉기,김용배,리갑수,안현철,김화성,이성수,안규동,박종범 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

The inhibition of δ-aminolevulinic acid dehydratase (ALAD) in the heme synthetic pathway results in increased protophoryphyrin (ZPP) and δ-aminolevulinic acid (ALA) and is responsible for some of toxicological effects of lead. This enzyme is coded by the ALAD gene containing 2 co-dominant alleles. The polymorphisms of ALAD gene may be related to differential effects of lead on ZPP and ALA, ALAD genotype was measured in 975 Korean male lead workers, of whom 897 were homozygous for ALAD1 (ALAD 1-1 genotype) and 96 were heterozygous for ALAD2 (ALAD 1-2 genotype). Blood lead in subjects with ALAD1 was significantly higher than those with ALAD2 (p = 0.01). No difference between ALAD genotypes was found for age, exposure duration, ZPP, ALA, hemoglobin, hematocrit, body mass index, tobacco and alcohol use. After adjustment for possible confounders, ALA and ZPP became significantly elevated in ALAD1 subjects (p = 0.004 and 0.055, respectively). This result suggests that ALAD1 subjects may be more susceptible to the hematotoxicologic effects of lead than ALAD2 subjects.

연작업자들의 신기능 평가에서 요중 δ-aminolevulinic acid 측정의 의의

이병국,이숙,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

To clarify the effect of occupational lead exposure on renal function 241 lead workers working and 56 non lead workers were studied in 5 lead acid battery industries. Study variables for renal effect were urinary N-acetyl-β-D-glucosaminidase(NAG), urinary total protein(U-TP), blood urea nitrogen(BUN), serum creatinine(S-Cr), and serum uric acid(S-Ua). On the other hand, blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), and delta-aminolevulinic acid in urine(δ-ALA) were selected for the variables of lead exposure. Information on age, work duration, smoking and drinking history were also obtained. The results obtained were as follows. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of BUN, U-TP and S-Cr of renal function indicators of exposed were also different from non-exposed. BUN, U-TP and NAG showed statistically significant correlation with PbB and ZPP, and NAG revealed also statistically strongly significant correlation with δ-ALA. On multiple regression using renal fuction indicators as a dependent variable and δ-ALA, age, work duration,lead exposure,smoking and drinking as independent variables, only δ-ALA contributed to NAG.

Impedance를 이용한 전도성고분자 센서의 가스감응특성

이경문,유준부,이병수,전희권,이상태,이덕동,허증수 경북대학교 센서기술연구소 2002 센서技術學術大會論文集 Vol.13 No.1