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.

Pulmonary Inflammatory Pseudotumor with Solitary Plasmacytoma of Bone Mimicking Advanced Lung Cancer

( Chang Hoon Kim ),( Jae Seok Jeong ),( Yong Chul Lee ),( So Ri Kim ),( Yeong Hun Choe ),( Seung Yong Park ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Lung cancer has been the most commonly diagnosed type of cancer and the leading cause of cancer related mortality in Korea and worldwide. Although it is fatal, most of the lung cancer patient are asymptomatic at the time of diagnosis. Therefore, radiologic screening by chest low-dose computerized tomography (LDCT) has been recommended by lung cancer specialists for early detection and improving survival. However, clinical suspicion of lung cancer by radiologic screening is quite challenging because of its high false positive rate. A wide range of benign pulmonary diseases could be misinterpreted as lung malignancy on LDCT, including infection, benign mass-forming lesion, and inflammatory changes. Therefore, physician should consider the possibility of the benign disease entities when radiologic features suggest lung malignancy. Herein, we report a case of a 50-year-old man presenting a 4.5-cm lung mass in the right upper lobe with solitary osteolytic lesion of the right 8th rib. Under the suspicion of metastatic lung cancer, the lung mass and the right 8th rib were surgically resected for the diagnostic and curative purpose. After the tissue biopsy, unexpectedly, the lung mass was diagnosed as inflammatory pseudotumor. Furthermore, histopathology of the resected rib showed solitary plasmacytoma of the bone. Our experience highlights the importance of clinical suspicion that in patients with radiologic features compatible to advanced lung cancer could be caused by coexistence of unrelated two uncommon disease entities, which can be completely treatable with surgical resection.

출산에 따른 그레이브스병의 재발 및 관련이자

임창훈,최현아,한승석,김해성,이창욱,정호연,한기옥,장학철,박원근,윤현구,한인권 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2

Background: Pregnancy affects the course of Graves' Disease (GD), and patients who initially maintain euthyroid function into their middle trimester with minimum doses of antithyroid drugs become exacerbated after delivery. Even patients who are completely cured, requiring no treatment during pregnancy, can relapse after delivery. In this study, we examined the postpartum changes in the thyroid functions of patients with GD, and attempted to determine the factors contributing to these changes. Methods: The study subjects were recruited from pregnant women visiting our outpatient clinic for routine prenatal evaluations. 45 women previously diagnosed with GD, who had been treated and cured with hyperthyroidism, and were no longer taking any thyroid medications, were evaluated for 1 year post delivery. Results: Among 45 patients, 20 (44.4%) developed thyroid disorders following delivery. Postpartum thyroiditis (PPT) developed in 8 patients (17.8%), and GD developed in 12 (26.0%). The onset of the PPT disease 3.1 ± 1.4 months following delivery, which was significantly earlier than the 6.7 ± 2.7 months required for the post delivery onset of GD (p=0.003). The TBII values, measured during the thyrotoxic state in each womaen, were negative in women with PPT and positive in 71.4% of women with GD (p=0.030). The duration of treatment for hyperthyroidism prior or pregnancy, the number of recurrences, and the time interval without treatment, were not associated with the development of postpartum thyroid disorders. Whereas, the mean number of past pregnancies for women who developed PPT was 3.9 ± 2.1, and was significantly higher than the 2.2 ± 1.7 for women developing no thyroid dysfunctions (p=0.044). In 13 women their initial onset of GD occurred within one year postpartum, 7 (53.8%) having had a recurrence, which was significantly higher than in women whose disease onset occurred unrelated to delivery (5 of 32 women: 15.6%). Conclusion: Women with GD developed postpartum thyroid dysfunctions in 44.4% of cases. Women whose initial disease onset occurred within one year postpartum had higher recurrences of GD, and women who developed PPT had a history of higher gravidity compared to the euthyroid women postpartum. Therefore, if women with GD develop postpartum thyroid dysfunctions, the diagnosis should be made, and a treatment modality planned, following careful considerations of the patients' past obstetric history, changes in clinical manifestations and the TBII values

디지털 시대의 사회운동과 이미지의 관계에 대한 연구 -중동 및 북아프리카 시민혁명을 중심으로-

장철규 ( Chul Kyu Chang ),양종훈 ( Jong Hoon Yang ) 한국사진학회 2011 AURA Vol.0 No.25

``Jasmine Revolution`` started in Tunisia in 2011, spreading across the Middle East and North Africa. The long-ruling dictatorship, repressive and undemocratic society has been called for change. Poverty and unemployment demanded to transform the social situation. Social Media such as Twitter and Facebook played important role in the process of civil revolution. Citizens combined with social media networks in cyber space has changed political power and social structure in the real space. The distinct feature of social movement in the digital age is that everyone can exchange information and opinion, and voluntary participation is possible owing to the development of information technology. The social movements gained international public opinion and support by spreading the photos and videos using Social Media. The power of images are more immediately acceptable than the text which requires reading and complex thinking. Images combined with social network services serve as a powerful weapon to change social structure as well as personal transformation.

The Korean Academy of Tuberculosis and Respiratory Diseases : Slide Session ; OS-053 : COPD ; Factors Associated with Smokers` will for Smoking Cessation in Korea

( Ah Young Leem ),( Chang Hoon Han ),( Chul Min Ahn ),( Tae Hoon Jung ),( Yu Il Kim ),( Jae Yeol Kim ),( Sang Haak Lee ),( Eun Mi Chun ),( Kwang Ha Yoo ),( Ji Ye Jung ),( Korean Smoking Cessation Stud 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Smoking is known to increase the risk of chronic disease. Understanding of factors that contribute to smoking cessation may help to develop strategies for smoking behavior change. Methods: Pooled cross-sectional data of 11,924 subjects from the Korea National Health and Nutrition Examination Survey II-V were analyzed. The stages of change in smoking cessation were categorized into pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological characteristics, and tobacco-related factors were compared between the groups. Results: The study population consisted of 32.4% in pre-contemplation, 54.4% incontemplation, and 13.1% in preparation group. While the proportion for pre-contemplation group (37.4% to 28.4%) tended to decrease from 2001 to 2012, that of preparation group (6.4% to 18.1%) tended to increase. The mean age of pre-contemplation group (48.4±16.2) is higher than comtemplation and preparation group (42.2±13.9 and 44.4±15.3; P=0.02). As levels of education and income status increased, the proportion of pre-contemplation tended to decrease, and that of preparation tended to increase. Proportion of blue collar job in pre-contemplation group was higher than in preparation group (67.9% vs 58.1%; P<0.001). In pre-contemplation group, percentage of suicidal ideation within 1 year was higher than contemplation and preparation group19.3% vs 16.0% and 16.1%). Upon adjusting analysis, the proportion of pre-contemplation group increased with increasing age (OR=1.01; 95%CI 1.01-1.02), and smoking amount (OR=1.04; 95%CI 1.03-1.05). People of pre-contemplation group (vs. preparation) are be less educated (OR=1.99; 95% CI 1.51-2.62), are in single marital status (OR=1.25; 95%CI 1.04-1.50), have lower prevalence of cardiovascular disease OR=0.48; 95%CI 0.31-0.76), and do less exercise walking (OR=1.36; 95%CI 1.09-1.69)and weight training (OR=1.59; 95%CI 1.35-1.85). Conclusions: We demonstrated a signifi cant association between the stages of changesmoking cessation and age, education, marital status, cardiovascular disease, and amount of exercise.

Free Paper Presentation : OS-53 ; Factors Associated with Smokers` will for Smoking Cessation in Korea

( Ah Young Leem ),( Chang Hoon Han ),( Chul Min Ahn ),( Tae Hoon Jung ),( Yu Il Kim ),( Jae Yeol Kim ),( Sang Haak Lee ),( Eun Mi Chun ),( Kwang Ha Yoo ),( Ji Ye Jung ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-

Background: Smoking is known to increase the risk of chronic disease. Understanding of factors that contribute to smoking cessation may help to develop strategies for smoking behavior change. Methods: Pooled cross-sectional data of 11,924 subjects from the Korea National Health and Nutrition Examination Survey II-V were analyzed. The stages of change in smoking cessation were categorized into pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological characteristics, and tobacco-related factors were compared between the groups. Results: The study population consisted of 32.4% in pre-contemplation, 54.4% in contemplation, and 13.1% in preparation group. While the proportion for pre-contemplation group (37.4% to 28.4%) tended to decrease from 2001 to 2012, that of preparation group (6.4% to 18.1%) tended to increase. The mean age of pre-contemplation group (48.4±16.2) is higher than comtemplation and preparation group (42.2±13.9 and 44.4±15.3; P=0.02). As levels of education and income status increased, the proportion of pre-contemplation tended to decrease, and that of preparation tended to increase. Proportion of blue collar job in pre-contemplation group was higher than in preparation group (67.9% vs 58.1%; P<0.001). In pre-contemplation group, percentage of suicidal ideation within 1 year was higher than contemplation and preparation group (19.3% vs 16.0% and 16.1%). Upon adjusting analysis, the proportion of pre-contemplation group increased with increasing age (OR=1.01; 95%CI 1.01-1.02), and smoking amount (OR=1.04; 95%CI 1.03-1.05). People of pre-contemplation group (vs. preparation) are be less educated (OR=1.99; 95% CI 1.51-2.62), are in single marital status (OR=1.25; 95%CI 1.04-1.50), have lower prevalence of cardiovascular disease (OR=0.48; 95%CI 0.31-0.76), and do less exercise walking (OR=1.36; 95%CI 1.09-1.69) and weight training (OR=1.59; 95%CI 1.35-1.85). Conclusions: We demonstrated a significant association between the stages of change in smoking cessation and age, education, marital status, cardiovascular disease, and amount of exercise.

상백피봉약침요법(桑白皮蜂藥鍼療法)을 포함한 한방치료(韓方治療)로 증상(症狀)은 소실(消失)되었으나 CT추적관찰상(追跡觀察上) 변화(變化)가 없는 요추(腰椎) 추간판(椎間板) 탈출증(脫出症) 1예(例)

이병훈,김철홍,서정철,윤현민,송춘호,안창범,장경전,Lee, Byung-Hoon,Kim, Cheol-Hong,Seo, Jung-Chul,Youn, Hyoun-Min,Song, Choon-Ho,Ahn, Chang-Beohm,Jang, Kyung-Jeon 대한약침학회 2001 Journal of pharmacopuncture Vol.4 No.2

By process of treatment for a case which diagnosed as HNP of left posterolateral aspect of L4/5 disc and treated from the 10th, May 2001 to the 23rd, Jun 2001, the results are as follows. Method & Results : This patient was medicated Hwallaktang-gami, taken acupuncture, phototherapy, TENS, electric acupuncture, exercises, Mori Cortex-bee venom acupuncture. As a result, the patient's clinical symptom were improved but a computed tomagraphy confirmed L4/5 and L5/S1 HNP was not changed as seen on repeated CT scanning. Conclusion : These results suggest that among conservative therapies the oriental medical treatments including Mori Cortex-bee venom acupuncture improve clinical symptom effectively. But in this case, the structure of herniated disc was not changed.

PET/CT 검사에서 환자체형에 따른 적정검사 프로토콜에 관한 고찰

조석원,함준철,강천구,반영각,이승재,임한상,이창호,박훈희,Cho, Seok Won,Ham, Joon-Chul,Kang, Chun Goo,Bahn, Young Kag,Lee, Seung Jae,Lim, Han Sang,Lee, Chang-Ho,Park, Hoon-Hee 대한핵의학기술학회 2013 핵의학 기술 Vol.17 No.2

Purpose: Whole-body PET using radiopharmaceutical is one of the imaging study methods for physiological changes of body. High specificity of the PET-CT examination is used to detect an early stages of cancer and metastatic cancer by imaging a physiological changes. During the imaging process, PET image has been characterized by a relatively low image quality due to its low sensitivity and the acquisition of random and scatter coincidences as well as patients figure. Therefore, the image quality as the changes of the acquisition times of patient weight was evaluated in this study. Materials and Methods: Thirty patients who presented to our hospital were enrolled. They were divided to normal, overweight, and obese group using BMI index, respectively. The patients with a liver disease and diabetes were excluded. $^{18}F-FDG$ was administered to the patients as 5.2 MBq per kg. After an hour from an injection, image acquisition was obtained as List mode in a part of liver in 1 bed. SNR (signal-to-noise ratio) of each groups acquisition times were confirmed from the calculated radiation counts and random fractions. The statistical significance of three groups was confirmed through one-way ANOVA test. On the basis of the counts of 2 minutes on normal group, the SNR of overweight group and obese group were compared. Results: The SNR were increased with loger aquisition time in 3 groups. In the condition of same acquisition time, the SNR had a statistical significance (P<0.05). The SNR were decreased to the normal, overweight, and obese, respectively. Liver activity had no significance difference on each group and RF had the significance differences (P<0.05). On the basis of the counts of 2 minutes on normal group, there were no statistical significance in a three minute acquisitions of overweight group and two minute acquisitions of obese group (P=0.150). Conclusion: In this study, the administrated amount of radiation dose did not adjust as the change of the patients weight. Increasing the acquisition time when the administration of the same amount of dose was able to get a good result of SNR. When the Based 2 minute on normal group, if overweight and obese case the increased acquisition time of 3 minute was able to obtain a similar SNR. On the basis of the normal group, the acquisition times of overweight and obese group were increased to 3 minutes per bed and the SNR were similar to the normal group.

토끼의 협골궁을 이용한 유경골이식과 유리골이식의 비교연구

장가용,한상훈,정복성,박철규 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.1

The membranous bone is new used frequently to fill the defect made during the craniofacial osteotmy. The membranous bone is resolved less than the endochondral bone after the free graft, and maintains its greater preportion when it is transfered with its vascular pedicle. It is also known that there is less resorption in the orthotopic graft than in the heterotopic graft. We have stuided the amount of resorption of the orthotopically grafted bone in the vascularized and nonvascularized model. A zygomatic arch of the rabbit was resected completely and was fixed orthotopically using a wire. The contralateral one was resected and fixed with its muscle attachment(masseter). After 8 weeks the animals were sacrificed. The volume of the grafted bone was compared. There 10±2% volume loss in the vascularized modol and 18±4% volume loss in the free graft model with a statistically significant difference(P<0.001). Histologically, in the vascularized graft, primary bony union was observed and the original architecture was preserved well and the periosteal activity way great. The free graft was also healed by bony union except in 1 case. But the architectural irregularity was more prominent in the free graft than in the vascularized graft.

GF(2m)상의 타원곡선 암호 프로세서 설계

김상철,이동호,최현민,김창훈,남영진,홍춘표 대구대학교 정보통신연구소 2008 情報通信硏究 Vol.5 No.1

This paper presents a high-performance elliptic curve cryptographic processor over GF(2m). The proposed design adopts L&oacute;pez-Dahab Montgomery algorithm for elliptic curve point multiplication and uses polynomial basis for GF(2m) field arithmetic operations. We select m=163 which is the smallest value among five recommended GF(2m) field sizes by NIST. The proposed elliptic curve cryptographic processor consists of host interface, data memory, instruction memory, control, and ALU. We simulate the proposed design using Xilinx XCV2000E hardware platform. Simulation result, we can see that our design is high flexibility and requires significantly less hardware resource compared with the previously proposed hardware implementation. 본 논문에서는 GF(2m)상의 고속 타원곡선 암호 프로세서를 제안한다. 제안한 암호 프로세서는 타원곡선 정수 곱셈을 위해 L&oacute;pez-Dahab Montgomery 알고리즘을 채택하고, GF(2m)상의 산술 연산을 위해 다항식 기저(Polynomial Basis: PB)를 이용한다. 본 논문에서 구현한 타원곡선 암호 프로세서는 m=163을 선택하였으며 NIST(National Institute of Standard and Technology)에서 권고하는 5개의 GF(2m) 필드 크기 중에서 가장 작은 값이다. 제안한 암호 프로세서는 Host Interface, Data Memory, Instruction Memory, Control, AU(Arithmetic Unit)로 구성되어 있으며 Xilinx XCV2000E 하드웨어 플랫폼으로 시뮬레이션을 한다. 그 결과 제안된 암호 프로세서는 기존의 연구 결과에 비에 높은 확장성과 낮은 하드웨어 복잡도를 가진다.