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.

해도분석을 통한 낙동강 하구 사주 면적의 시ㆍ공간 변화

유창일(CHANG-ILL YOO),윤한삼(HAN-SAM YOON),류청로(CHEONG-RO RYU),이인철(IN-CHEOL LEE) 한국해양공학회 2006 韓國海洋工學會誌 Vol.20 No.6

This study discusses characteristic of spatiotemporal changes of the sand barrier in the Nakdong estuarine for the last century, focusing on geomorphologic evolution and mobility of sand barriers in the view of coastal engineering. The Nakdong estuarine, the research subject, has a complexly changing natural environment by interaction between ground and marine elements such as ocean wave, tidal current, sediment, etc. Moreover, recently, unnatural geomorphologic changes (e.g., seaside reclamation, new harbor construction, etc.) has been radically increased in this area with increasing desire for coastal development. Because of this, its sand barrier has developed quite unstable condition. Therefore, to identify the development process of geomorphologic changes in this area, required is a close examination on historical characteristics of spatiotemporal changes of the sand barrier in relation to surrounding seaside reclamation and physical environmental changes. This study, based on the marine charts published in between 1927 and 1995 year, analyzes the length and area of the sand barrier for the last hundred years, and investigates the cause of the changes by looking into the change of water depth for the last two years and doing ocean-physical site observations. In conclusion, the sand barrier of the Nakdong estuarine expands toward the open sea by 7.4~26 m in annual average, maintaining a fixed distance of 1,241~1.279 m, and its area is expected to increase about 2.8 k㎡ annually. This is characterized by the wocean wave from the open sea and the discharge of Nakdong River.

만성 두부외상 환자에서 99mTc - HMPAO Brain SPECT의 임상적 유용성

서정호(Jung Ho Suh),김동익(Dong Ik Kim),정태섭(Tae Sub Chung),이종두(Jong Doo Lee),박창윤(Chang Yoon Park),정진일(Jin Ill Chung),김영수(Young Soo Kim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1

N/A Minima1 deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using Tc-99m-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with Tc-99m-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using Tc-99m-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

山火跡地의 植物群集 構造 및 植生 變化分析

李敏渟,尹相旭,金昌浩 동국대학교 농림과학연구소 1988 農林科學 論文集 Vol.12 No.-

This study is carried out to clarify the changes in the forest vegetational structure as time goes by after the fire. The results obtained are as follows; 1. The Soil pH decreased, the soil organic matter and water content increased, and the soil structure was hardly changed as time goes by after the fire. 2. By analyzing the soil profile, the soil deepness was shallow in general, and the formation of the organic matter was gradually increased. nced. 3. In relative density, relative cover, relative frequency, Quercus spp., Alnus hirsuta, Lespedeza spp. showed the high value, but that of Lespedeza was decresed as time goes by, and for herbaceous plants Cymbopogon tortilis, Festuca ovina was very high value over all the plot. 4. Importance value of Quercus spp. and Alnus hirsuta was gradually increased, and that of herbaceous plants - Cymbopogon tortilis, Festuca ovina, and Pteridium aquilinum - also was gradually increased, but was decreased in the fifth year. 5. The species diversity showed the low value shortly after the fire, but was increased after the second year, and the eveness index was decreased as time goes by.

신장수여자의 수술경과시간에 따른 자기존경감, 희망감, 염려 및 스트레스원의 차이

이 철,김창윤,한오수,박인호,유희정,한덕종 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.2

This study attempted to examine the differences of self - esteem, hopes, concerns and total stress scores of 110 kidney recipients in before(N=32) and fellowing kidney transplantation [1 to 6 months(N=29), 6 to 12 months(N=23), 12 to 36 months(N=26)] and utilizing severity rating scale of 44 potential stressors on a 5-point scale of 110 kidney recipients in before(N=32) and following kidney transplantation operation [1 to 6 months(N=29), 6 to 12 months(N=23), 12 to 24 months(N=15) and 24 to 36 months(N=11)]. On scores of hopes and total stress, pretransplant group exhibited significantly higher scores than three posttransplant recipient groups. But, it was found that there was no significant differences among four transplant kidney recipient groups on the scores of self - esteem and concerns. In the pretransplant group, craving for foods was identified as the most stressful event, on the contrary, changes in friends was identified as the lowest stressful events. In the 1 to 6 months posttransplant group, side effect of medications was identified as the most stressful event, however, loss of contact with dialysis patients was identified as the lowest stressful event. In the 6 to 12 months posttransplant group, cost of medication, changes in body appearance were identified as the most stressful event, on the other hand, managing of medications at home was identified as the lowest stressful event. In the 12 to 24 months posttransplant group, cost of medication and insurance coverage were identified as the most stressful event, but possibility of dying and competence of nursing staff were identified as the lowest stressful event. In the 24 to 36 months posttransplant group, changes of body appearance was identified as the most stressful event, on the contrary, possibility of infection was identified as the lowest stressful event. Insurance coverage was a continuing concern throughout posttransplant period.

最近 8年間의 精神神經科 入院 外來 및 患者에 對한 統計的 考察(1960年∼1967年)

李哲奎,盧英一,張煥一,金明源,任允明,韓東洙,吳承煥,金光日 大韓神經精神醫學會 1969 신경정신의학 Vol.8 No.1

1) The number of the out-and in-patients had increased year after year (Table Ⅰ & Ⅲ). 2) Schizophrenia was the greatest number of the in-patients and its rate to whole was 49.1 percent, and neurosis was the greatest number of the out-patients and its rate to whole was 41.66 per cent (Table Ⅰ & Ⅶ). 3) In in-patients, hysteria revealed relatively large in percentage as 11.8% than the other groups (Table Ⅰ). 4) The rate of the male hysteria patients to all male patients was 3.5 per cent and the rate of female hysteria was 20.5 per cent (Table Ⅱ). 5) In in-patients, all the patients of general paresis and alcoholism were only males in sex(Table Ⅱ). 6) In in-patients of schizophrenia, the ratio of the male patients to the female patients was 57.0 : 43.0, but the each rate of each total numbers of the all diseases of the both sexes was almost same (Table Ⅲ). 7) The largest age group of the all patients was between 21∼30 years old, and the next was between 31∼40 years in in-patients (Table Ⅲ). 8) The largest age group of schizophrenia patients was between 21∼30 years and that of M.D.R patients was between 31∼40 years in in-patients (Table Ⅲ). 9) In in-patients of hysteria, the largest age group was between 31∼40 years, and the next was between 21∼30 years (Table Ⅲ). 10) The results of treatment in in-patients were as followings; Recovered; 27.6% Much improved; 43.1% Slightly improved and no changed; 28.2% (Table Ⅳ) 11) The results of treatment in schizophrenia of the in-patients were as followings; Recovered; 19.1% Much improved; 48.3% Slightly improved and no changed; 32.1% (Table Ⅴ) 12) The mode of treatment had been somewhat changed during last 8 years from 1960 to 1967 in treatment of the in-patients (Table Ⅵ). (1) The combined therapy of tranquilizers and EST had been increased, but the therapy of tranquilizer alone or EST alone had been decreased, compared to 1960. (2) The therapy of ICT in the treatment of in-patients had been much decreased.

급성 췌장염으로 발현된 낭성 변화를 이릉킨 종격동 부갑상선 선종 1예

이준호,최영식,박진홍,허갑도,윤설영,최소진,권태헌,이창렬,손성표,박영효 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.3

Hypercalcemia due to hyperparathyroidism is rarely associated with acute pancreatitis. But, the relationship between hypercalcemia and pancreatitis still remains controvesial. Ectopic parathyroid adenoma with cystic change is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. We report a case of mediastinal parathyroid adenoma with cystic change associated with acute pancreatitis. A 54-year-old male presented with epigastric pain for 3 days. The serum calcium, phosphate, elastase were 16.8mg/dL, 1.1 mg/dL, 2772.0 ng/mL respectively and his parathyroid hormone level in serum was 651.84 pg/mL. Chest CT showed a mediastinal mass with well defined inhomogenously enhanced density located between SVC and aorta. The patient was diagnosed to hyperparathyroidism with acute pancreatitis due to mediastinal parathyroid adenoma with cystic change, and was surgically removed. The surgical biopsy showed parathyroid adenoma with cystic change. After operation his general condition was improved and serum calcium, phosphate, amylase, lipase level were normalized (J Kor Soc Endocrinol 13:473-479, 1998).

사염화탄소 투여 흰쥐에서 간섬유화 진행에 따른 Propranolol 의 약동학적 지표들의 변화

이민호,강주섭,강문수,윤병철,이오영,함준수,변재원,윤창옥 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.2

Background/Aims : This study was designed to determine the effect of hepatic fibrotic severity on pharmacokinetics of propranolol in CC1q - treated rats. Methods - 1 mL/kg of 10% CC14 in olive oil was injected intramuscularly to rats twice weekly for 4, 6, 8 and 10 weeks, respectively (n=6). Control (n=6) was a sham - injected equal dose of olive oil for 10 weeks. After intravenous bolus injection of 2 mg/kg propranolol to rats, the serum propranolol concentrations were analyzed for 4 hours at various time points by a HPLC - fluorimetric system, and pharmacokinetic parameters such as Co, MRT, AUC, Vdss, tl/2(p) and CLp were determined. Then, a small amount of hepatic tissue was obtained and subjected to determination of the hepatic 4 - hydroxyproline content, which confirmed the hepatic fibrotic severity. Results : The serum concentrations of propranolol at 0.5, 1, 2 and 4 hours were significantly increased in CC1q-treated rats (p$lt;0.01). In proportion to the duration of CC4 treatment, Co and AUC were significantly increased, and Vdss and CLp were significantly decreased (p$lt;0.001). But MRT and t1/2(β) were not significantly changed. The hepatic 4 -hydroxyproline content was gradually increased in CC4-treated rats (p$lt;0.001). Conclusion - Gradual changes in pharmacokinetic parameters of propranolol were seen to be dependent on the hepatic fibrotic severity. We suggest that gradual dosage modification, according to their hepatic fibrotic severity, is necessary for many drugs administered to patients with chronic liver disease.(Korean J Hepatol 2001;7:181-188)

Near-Normalized Gene Expression Profiles in Bladder With Detrusor Overactivity in Rats With Bladder Outlet Obstruction After Deobstruction

Lee, Tack,Lim, U-Sung,Kang, Dong Hyuk,Jung, Hae-Do,Kim, Hyunzu,Choi, Bo-Hwa,Kang, Ju-Hee,Yoon, Sang-Min,Park, Chang-Shin Korean Continence Society 2017 International Neurourology Journal Vol.21 No.4

<P><B>Purpose</B></P><P>The pathophysiological role of detrusor overactivity (DO) in the bladder, which is commonly observed in various bladder diseases, is not well understood. DO appears in bladder outlet obstruction (BOO), and may continue even after subsequent deobstruction. DO therefore provides an excellent opportunity to observe molecular biological changes.</P><P><B>Methods</B></P><P>In this study, to understand the molecular effects of persistent DO after BOO induction and deobstruction, we performed awake cystometry on female Sprague-Dawley rats divided into 4 groups: a sham group, a BOO group, a deobstructed group with DO after BOO (DDO), and a deobstructed group without DO after BOO (non-DDO). Total RNA was extracted from the bladder samples, and gene expression profiles were compared between the sham and model groups.</P><P><B>Results</B></P><P>DO was observed in 5 of the 6 rats (83%) in the BOO group, and in 6 of the 13 rats (46%) in the deobstructed group. The non-DDO group showed a significantly greater residual volume than the DDO group. Through a clustering analysis of gene expression profiles, we identified 7,532 common upregulated and downregulated genes, the expression of which changed by more than 2 fold. In the BOO group, 898 upregulated and 2,911 downregulated genes were identified. The non-DDO group showed 3,472 upregulated and 4,025 downregulated genes, whereas in the DDO group, only 145 and 72 genes were upregulated and downregulated, respectively.</P><P><B>Conclusions</B></P><P>Abnormal function and gene expression profiles in bladders after BOO were normalized in the BOO rats with DO after deobstruction, whereas in those without DO, abnormal function persisted and the gene expression profile became more abnormal. DO may play a protective role against the stress to the bladder induced by BOO and deobstruction as a form of adaptive neuroplasticity.</P>

Injecting NMDA and Ro 25-6981 in insular cortex induce neuroplastic changes and neuropathic pain-like behaviour

Yoon, M.S.,Koh, C.S.,Lee, J.,Shin, J.,Kong, C.,Jung, H.H.,Chang, J.W. Wiley (John WileySons) 2018 European journal of pain Vol.22 No.9

<P>SignificanceThis article represents that the CPR model can mimic the neuropathic pain derived by neuroplastic changes. Our findings indicate that the CPR model may aid the development of novel therapeutic strategies for neuropathic pain and in elucidating the mechanisms underlying pain induced by central sensitization and neuroplastic changes.</P>