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.

소아의 연령별 Propionibacterium acnes에 대한 균체응집항체 및 동종혈구응집항체간의 비교연구

정화영,정상인,최철순,양용태 중앙대학교 의과대학 의과학연구소 1984 中央醫大誌 Vol.9 No.3

In general, the concentration of maternal IgG globulin in serum of the neonates falls rapidly within the first few months after birth and the production of IgM globulin develops in the maturing infants during the course of exposure to various antigens in the environment. The development of natural antibodies, ie., isohemagglutinins, IgM class, to ABO blood group substances and agglutinins, Ig class, to normal flora, in the early stage of life is important since not only they may act as bactericidal substances in nonspecific manners, but also could be immunological barometers on the normal function of humoral immune system. The high concentration of isohemagglutinins to human A or B blood group antigens and agglutinating antibodies to some of normal flora such as Propionibacterium acnes or Staphylococcus aureus were observed in normal human sera. It has been known that the serum concentration of IgM globulin usually reached adult levels by one year of age, while that of IgG globulins by five to six years of age. However, the levels of isohemagglutinins to A and B group substances and agglutinating to Propionibacterium acnes in children's sera and the ages in which the concentrations of their antibodies reached to abult levels are not clarified. In this study, the concentrations of isohemagglutinins to A and B blood group antigens and agglutinating antibodies to P.acnes serotype Ⅰ and serotype Ⅱ in the sera of 163 normal children, ranged from 0 day to 15 years of age, were measured by means of microtitration technique. The results obtained are as follows: 1. In the sera of 163 children under 15 years of age, there observed no significant difference in the titers of agglutinating antibodies to P. acnes serotype Ⅰ andⅡ. 2. Of 75 sera of children under one year of age, the numbers of sera in which agglutinating antibodies were not detectable or less than 1:4 to P. acnes serotype Ⅰ were 67(89.6%) and to serotype Ⅱ 53(70.7%), respectively. 3. Agglutinating antibody to P. acnes serotype Ⅰ in the children's sera reached adult levels by 7 years of age, but 100 percentages of antibody detection was observed only in the age group of 15 years old, whereas the adult levels of isohemagglutinins to A and B blood group antigens were observed in the age group of 6 months old. 4. No correlation were observed in normal children's sera between agglutinating antibody titre to P. acnes serotype Ⅰ and isohemagglutinin titre. These results indicated that the isohemagglutinins to ABO blood substances appeared in the earlier stage of life than did agglutinating antibodies to P. acnes.

중증 장애환자의 구강위생과 치은건강

양충용,주민철 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.1

뇌졸중 환자의 한방 및 보완 대체요법 이용실태

양충용,신용일,주민철,길은영 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.2

알쯔하이머병 환자의 뇌혈류 장애 : Statistical Parametric Mapping을 이용한 Tc-99m ECD SPECT 분석 Statistical Parametric Mapping analysis of Tc-99m ECD SPECT

양동원,김범생,손영민,박정욱,정용안,손형선,김상윤 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.2

Background and Objectives . Alzheimer's disease (AD) is the most common cause of the dementia Pathologic and functional changes of AD are known to be unevenly distributed in the brain. This study investigates changes of cerebral blood flow (CBF) in patients with AD to determine brain regions with hypoperfusion that reflects progression of disease. Methods. Tc-99m-ECD single photon emission computed tomography (SPECT) was performed to measure regional CBF and statistical parametric mapping (SPM) 99 soft ware was used for the automated and objective approach to analyze SPECT image data. Twenty-five patients with mild to moderate dementia who met NINCDS-ADRDA critena for AD (male 11 female 14) and 17 age-matched normal control subjects were studied. The severity of AD was measured by clinical dementia rating (CDR) scale Results. SPM analysis of SPECT images revealed that CBF in the anterior cingulate gyrus left superior panetal cortex left medial frontal cortex left infenor temporal cortex. right thalamus and left hippocampus was significantly decreased in AD patients compared with normal controls (corrected p<0.05). The reduction of CBF according to CDR was localized in the left hippocampus and infenor temporal cortex right antenor and postenor ciagulate cortex and right superior panetal cortex (uncorrected p<0.01). Conclusions : Our data suggest that the cognitive dysfunction of AD is strongly related with functional abnormality in discrete brain areas 99m-Tc ECD SPECT with SPM analysis could be used as a useful functional imaging tool in AD study.

신경섬유종증 환자에서 상완신경총 병변의 소견을 보인 척추 신경섬유종

양충용,박효인,박순아,박종태,정선관,신용일 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

본 증례는 50세 여성의 제 1형 신경섬유종 환자로서 척추 신경섬유종에 의해 초기 상완신경총 병변 소견을 보였다. 약 4개월 동안 후경부통, 좌측 견관절, 좌측 상완의 마비를 보였으며, 초기 전기진단학적 검사상 경수 5번과 6번 신경근을 중심으로 쇄골상부 신경절전성 상완신경총 병변이 관찰되었다. 그러나, 액와 자기공명영상, 초음파검사, 단순 방사선검사, 골주사 등의 영상학적 검사에서는 심한 흉추 척추 전-측만증과 경수 뇌경막에 확장 소견을 제외하고는 상완신경총 병변의 소견은 관찰되지 않았다. 7개월경과 후, 좌측 상지 및 양측 하지의 근력 저하, 경수 4번이하의 감각 저하, 경도의 흉통을 동반한 호흡곤란이 진행되었다. 응급으로 시행된 경수 자기공명영상에서 좌측 경수 3번과 4번에 경막내 액와-속질의 신경종양이 진단되었다. 수술적 처치를 시행하였으며, 거시적 관찰상 척수 신경섬유종이 진단되었다. 급격히 진행하는 척수 신경섬유종은 초기에 상완신경총의 신경근 병변의 소견을 보일 수 있으므로, 신경섬유종증 환자에서 상완신경총 병변의 진단에 세심한 주의를 요한다. We observed a patient with symptom similar to brachial plexus lesion caused by spinal neurofibroma in a 50-year-old female with a history of neurofibromatosis-1(NF-1). She presented with posterior neck, left shoulder and left upper arm paralysis of 4 months duration. The initial electrodiagnostic study(EDS) revealed supraclavicular preganglionic brachial plexus lesion of mainly involved left C5 and C6 roots. However, radiological imagings including axillar MRI, ultrasonography, cervical plain radiography and bone scintigraphy showed no definitive brachial plexus disease except cervical dural dilation and severe thoracic scolio-Iordosis. On 7 months after the first admission, she had aggravated muscle weakness on the left upper arm and both lower extremities, sensory impairment below C4 and respiration difficulty with the chest pain. Emergency MRI showed intradural axillar-medullary neurogenic tumor at the left C3-C4. Subsequently, the patient was treated with surgical resection. Grossly specimen examination displayed the presence of a spinal neurofibroma. In rapidly progressing spinal neurofibroma represented firstly as root lesion of brachial plexus in EDS, the physician should pay scrupulous care to evaluate the cause.

지속적 교환관계에서 협력에 영향을 미치는 요인

鄭洋一,李鑑鏞 大田産業大學校 1996 論文集 Vol.3 No.-

고등학교 지구과학 실험·실습 요목 비교 분석

정원우,이윤종,기우항,김영호,양승영,강용희,안병호,임성규,윤일희,김중욱,윤성효,강동진 경북대학교 과학교육연구소 1997 科學敎育硏究誌 Vol.21 No.-

The purpose of this study is to investigate the status of the experimental and practical education in high school earth. The present status and reasonable management of the experimental and practical education in high school earth science have been grasped from the questionaires. To do this, eighty eight earth science teachers in Korea are administered questionaires. The frequency of the experimental and practical items in the seven kind of earth science text books were investigated. The problems and the reasonable management for experimental and practical education were proposed in this paper.

兩側 및 單側 電氣衝擊療法後의 腦波變化에 對한 硏究

楊秉煥,정경천,李定均,卞容旭 大韓神經精神醫學會 1979 신경정신의학 Vol.18 No.2

Changes on EEG after bilateral and unilateral ECT was studied in 12 young adult schizophrenic patients who were admitted st Seoul Municipal Mental Hospital. Their EEC data were obtained during the interictal period of serial ECT sessions and subjected to global quantitative analysis by visual assessment. Some significant findings are summarizcol as follows: Repeated ECT resulted in increased EEG slow wave activity more see in the frontal and temporal leads which became gradually generalized in forms of occasional burst and run. No spike and focalized activities were seen. The degree of slowing and its amplitude was directly related to the number of ECT sessions. As the successive four to six treatments were administered, the slowing became more persistent and widespreaded with high voltage paroxysmal activities, while the alpha rhythm became disturbed and disappeared. After seven to eight serial treatment, the percent time delta remained constant in plateau or falled off. Fourteen days after the last 10th treatment, 34 percent time of slow wave activities was recorded in frontal lead of bilateral ECT group and 25 percent of unilateral ECT group. Minor lateralized asymmetries of frequancy and amplitude which were predominently right sided, appeared more in the right unilateral ECT group (4 in 6 cases) than the bilateral group (1 in 6 cases). The amount of post-ECT slow wave activity did not revealed major difference between these kinds of ECTs and was closely related to the number of ECT sessions and to the pretreatment EEG with individual variations. No relationship was found between the therapeutic response, degree of amnesia or confusion, and EEG findings after electroconvulsive therapy.

대조 추출물분획이 치은 섬유아세포의 생물학적 활성화에 미치는 영향

양창호,이용무,조기영,배기환,정종평 충남대학교 약학대학 의약품개발연구소 1994 藥學論文集 Vol.10 No.-

Final goal of periodontal treatment is to reconstruct the destructed periodontal tissue as well as to remove the necrotic pathologic elements. The purpose of this study is to investigate on the effect of Zizyphi extract to the inhibitory ability on collagenolytic activity of P gingivalis, biologic activity of gingival fibroblasts and on the collagen and protein synthesis of gingival fibroblasts. Gingival fibroblast from giniva of first bicuspids from patient for orthodontic treatment were used and cultured. For the measurement of inhibitory ability of collagenolytic activity, crude enzyme was extracted and used on the basis of modified Ono's method. On the inhibition of collagenolytic enzyme from herbal extracts, collagenokit CLN-100 were used. The cellular activity of gingival fibroblast, were studied using MTT solution and measured optical density on 570mm by ELISA reader. To measure the effects on the ability of whole protein and collagen synthesis, cell membrane was destructed with ultrasonic grinder after culturing, centrifuged and counted by liquid scintilation counter. The inhibitory effects on producing of IL-1β by monocyte, after promotion of producing IL-1β by LPS, were compared with the mixture of herbal extracts and other drugs using thymocyte stimulation assay. About inhibitory·effects of PGE_2 by gingival fibroblasts, herbal extract was compared with the addition of the other control groups using enzyme immunoassay. On the inhibition of collagenolytic activity by P. gingivalis, benzene extracts showed the most efficient inhibitory effects among the l9㎍/㎖ of the compared extracts and 40.5% by Tetracycline. On the cellular activity promoting effects, compared extracts showed a bit of more effects than PDGF of l00㎍/㎖ concentration and lGF of 20㎍/㎖ concentration. All of the PDGF, 1GF, Zizyphi Fructus extract should increase in collagen synthesis, but especially 70% ethylalcohol extracts of Zizyphi Fructus showed comparably high effects among the compared extracts. Effects on whole protein synthesis were slightly increased on every extract but especially 70% ethylalcohol extract showed significantly effective than any other estract. On the inhibitory effects of Zizyphi Fructus IL-1β production by monocyte, compared extracts showed 70% of highly inhibitory effect than that of 60% inhibition effects on controlled group and each extracts showed no significant difference. In PGE_2 production inhibitroy effect of Zizyphi Fructus gingival fibroblasts, Herbal extracts showed 70% of inhibition comparing with tat of 90.2% of controlled group, but each extracts showed similar effects excluding the H_2O extracts. These results suggested that Zizyphi Fructus might be useful medicine for inhibition of inflammatory mediator including IL-1β and PGE_2·