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.

5세 남아의 Influenza 종격동기종 및 대엽성 폐렴 1례

오희성,한유진,연은경,선동신,송준환,박경배,박준수,김영통,남해선,최영진,김용배 순천향의학연구소 2009 Journal of Soonchunhyang Medical Science Vol.14 No.3S

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Pristinamycin(Pyostacine®)의 methicillin-resistant Staphylococcus aureus,Penicillin-resistant Streptococcus pneumoniae, Haemophilus influenzae 임상균주에 대한 시험관내 항균력

박정원,송준영,김철현,정희진,김우주,김민자,박승철 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.4

목적 : 국내 및 전세계적으로 methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae(PRSP), β-lactamase 생성 H. influenzae 등의 항균제 내성 감염증이 증가되고, 이에 대한 효과적인 항생제 요법에 대한 필요성이 증가되고 있다. Streptogramin 계열의 경구 항생제인 pristinamycin의 임상검체에서 분리된 균주에 대한 시험관내 항균력을 검사함으로서 이러한 감염증에 대한 임상적 사용의 유용성여부를 알아보고자 하였다. 방법 : 1999년 8월1일부터 2000년 1월 1일까지 호흡기 감염, 피부 및 연조직 감염환자로부터 분리된 MRSA 60주, PRSP 50주, H. influenzae 40주를 대상으로 pristinamycin을 비롯한 8-9종 항생제의 시험관내 항균제 감수성을 측정하였다. 결과 : Pristinamycin은 MRSA에 대한 MIC 범위가 0.125-1㎎/L로서 100%의 감수성을, PRSP에 대한 MIC 범위가 0.125-1㎎/L로서 100%의 감수성을, β-lactamase를 생성하는 H. influenzae에 대해서도 MIC 범위가 0.25-2㎎/L, 96% 감수성으로서 다른 항생제들에 비하여 우수한 시험관내 항균력을 나타내었다. 결론 : 국내에서 문제가 되고 있는 MRSA, PRSP, β-lactamase 생성 H. influenzae에 대하여 pristinamycin은 우수한 시험관내 항균력을 나타내어, 이들 항생제 내성균들에 의한 감염증의 치료에 효과적으로 사용될 수 있을 것으로 생각된다. Background: Pristinamycin(Pyostacine®) is a natural antibacterial combination of compounds Produced by Streptomyces pristinaespiralis. It has been marketed in European countries over 30 years as an oral anti-stphyhcoocal agent. Because of the increasing prevalence microorganisms that are resistant to multiple antimicrobial agents in Korea. there are demand of noble antibiotics like pristinamycin against these resistant organissms. Methods The one-hundred and fifity bacterial strains which were collected from Korea University Guro hospital included sixty methicillin-resistant S. aurous (MRSA) , fifty penicillin-resistant S. pneumoniae (PRSP) and forty H. infuenzae clinical isolates. Using an microbroth dilution or agar dilution technique, we compared the antimicrobial activities of pristinamycin and other usual antibiotics against the studmicroorganisms. Results: All sixty MRSA strains were multiply resistant to other antimicrobial agents, but 100% of MRSA strains were susceptible to pristinamycin (MIC range: 0.125-1㎎/L). All of fifty PRSP strains were multiple resistant to other antimicrobial agents but 100% PRSP strains were susceptible to pristinamycin (MIC range: 0.125-1㎎/L). Twenty-seven strains of forty H. influenzae strains were β-lactamase positive, and 95% (38/40) of H. influenzae strains were susceptible to prisitinamycin (MICrange : 0.015-4㎎/L) . Conclusion : Pristinamycin demonstrated the highly active. in vitro antimicrobial activities against MRSA. PRSP. and H.influenzae isolated so it might be an effective oral therapeutic agent for treating patients with mild infection due to those organisms or on the outpatient setting.

대학의 교수학습 개발에 대한 요구분석 연구 : 동국대학교 교수집단을 중심으로 focusing on Faculties of the Dongguk University

박명희,김성훈,박명숙,이중권,박종호,이성림 동국대학교 교육연구원 2005 교육문제연구 Vol.16 No.-

본 연구의 목적은 동국대학교의 교수들이 수행하고 있는 교수학습 방식을 파악하고 각 방법들의 효과성을 교수들이 어떻게 인식하고 있는지를 알아 보고자 하였으며 창의적 교수학습방법개발에 대한 교수들의 요구를 파악하여 교수학습개발센터의 프로그램개발을 위한 기초자료로 삼고자 하였다. 수업방식에 있어서 전공, 교양을 막론하고 대부분이 강의식 수업방식이 높았으며(80.9%, 86%), 발표식, 토론식이 (14%, 18.6%) 실험실습 등이 그 다음으로 나타났다. 교수들은 전공과목보다는 교양수업에서 학생들의 요구에 맞는 수업 수업방식을 고려하고 있는 반면 수업방식의 효과에 대해 53%만이 효과적이라고 보고하고 있다. 교수들도 효과적인 강의방법 등 교수법에 대해 체계적으로 학습할 필요성을 느끼고 있었다. 강의 기술(교수방법)과 토론 중심 수업 방법에 대한 워크샵에 대한 요구가 가장 높게 나타났고 발표수업과 프로젝트수업 방법 등 강의식 수업 이외의 다른 수업방식에 대한 워크샵 요구도가 높았다. 그 외에 학교의 지원에 대해서는 첨단 수업 기자재 활용을 위한 보조자(조교)에 대한 요구도가 가장 높고 강의 운영을 위한 보조금, 개인별 상담 지원 순으로 요구도가 높게 나타났다. The purpose of this study was to comprehend the methods of teaching and learning carried out by the teachers of Dongguk University, and to find out how the professors found those methods effective. This research was also used to serve as a basis for the development of a more creative teaching-learning system to enhance better programs for the Professor Teaching-Learning Development Center. In teaching methods, regardless of classes for majors or for cultural enrichment, most of the courses were in the form of lectures (80.9%, 86%) followed by research and discussion (14%, 18.6%), with experiment and practical training coming in third. Although professors tend to choose a more student-oriented class method in distribution courses more than in major courses, it was reported that only 53% of the faculty claimed this class method to be effective. The faculty felt the need for professors to have more constructive learning in incorporating more effective teaching methods. The demand for professor workshops on teaching skills (teaching methods) and discussion oriented classes proved to be high, as well as the need for workshops on teaching methods other than lectures, such as research courses and project oriented class methods. Regarding other demands for university support, the demand for an assistant (assistant teacher) to help with the new technology equipment was the highest, followed by subsidies for course management and support in individual counseling.

自由中國 就學前 敎育政策 樹立過程의 敎育人類學的 理解

朴俊熙 이화여자대학교 한국문화연구원 1981 韓國文化硏究院 論叢 Vol.38 No.-

In the late of the 18th century, the Republic of China was becoming aware of necessity for educational modernization with concern in the educational system, facility, materials and the methods of teaching. Also, she tried to reorganize and change from the traditional situation to the modernized European nations models for the making the so-called developed and modernized one. The purpose of the transition from the traditional situations of education to modernized, was to assure that she was going to make her country a new nation through education. First of all, for the accomplishment of the purpose, she tried to study the educational systems, facilities, materials and methods of teaching of the advanced countries like England, France, Germany and America. Then she tried to reorganize the educational system of her own country and at the same time, she never has forgotten but rather as an informal or very fundamental education in relation to home education in early childhood, especially and traditional carried out by herself from the ancient. Therefore, the present educational system which she has developed is mostly, in its frame, imitated from the systems of advanced countries. And so, nowadays the pre-school education in the Republic of China has been well developed in comparison with the pre-school education of Korea and Japan. In Taiwan, for instance, the private pre-school education institution reaches almost one thousand and one-third in its ratio. This number and ratio shows a much more advanced situation in comparison with Korea and Japan in relation to the total population, the scale of the land and at the same time the wealth of those countries. The reason why and how she could make that development of the pre-school education and at the same time emphasize so much importance of its is very interesting from the standpoint of educational anthropology and so it might be deeply considered. Historically and culturally it can be classified into two categories, One is that is has come from the value of education the Chinese people have stressed due to their traditional Confucian way of thinking. The other is from the characteristics of the Chinese culture which they also has built based on the same way of life as follows; 1. Historically, from the first, most of the Chinese people have emphasized home education for children to promote the development of a nationalistic ethical idea and personality, and they thought of the home education as the foundation of the nationalistic development of the people. At the same time, they thought of the home education as the foundation of all kinds of educational systems and activities. 2. From the standpoint of the Chinese culture, there are these kinds characteristics: (1) The Chinese culture has both characteristics of conservativeness and innovativeness. (2) The Chinese personality is very continental and they could well accommodate foreign culture or values without feeling any anxiety about it. (3) The Chinese language is, in its structure from the standpoint of grammar, very similar to the western language and thus they have similar ways of thinking. (4) The style of living of the Chinese people is also similar, in many ways, to the style of western people. (5) The Chinese people are excellent in their economic idea for the making of the wealth for their living and at the same time their skills for their commercial activities in their personality.

계층적인 탐색점 배치와 화소 간축을 이용한 움직임 추정 기법

박준호,류명춘,김준한,김신희 경운대학교 산업기술연구소 1999 産業技術硏究論文誌 Vol.1 No.1(B)

In motion estimation of moving pictures compression, fast block matching method using hierarchical search point displace and the pixel decimation is supposed. The method is based on TSS(Three step Search) method and pixel decimation. This method improves image quality and local minima by increasing search points, but operation counts that resulted from increasing search points are reduced by the pixel decimation method. So, the method can improve image quality and operation counts are nearly the same with TSS. MP@ML video is simulated by this method, which shows good results compared with TSS.

아동 무용활동이 생활성취도에 미치는 영향

박준희 韓國舞踊敎育學會 1998 韓國舞踊敎育學會誌 Vol.9 No.1

The aim of this study is to find influence of children's participation in dance on their life achievement including character property and life in school. The study is of three groups, experimental group 60, control group 60 and observer group(60 parents of the students) and they responded to my questionnaire on 2 parts including 7 scales. The results of the study are as follows. 1. The experimental group. 1) Their increased mean scores for character property are as follows : stability 2.16, positiveness 1.74, sociality 2.51, responsibiltity 1.24, and self-confidence 2.68. This results show that children's participation in sports have positive effects, especially for self confidence sociality, stability and positiveness. 2) Their increased mean scores for life in school are as follows : adaptation to life in school, 1.60, satisfaction with study in school, 0.49. This results show that children's participation in dance have positive effects to adaptation to life in school, but their is little effect in satisfaction with study in school. 2. The observer group. Their increased mean scores are as follows" Character property part(stability 2.52, positiveness, 1.96, sociality, 1.98, responsibility, 0.92, and self-confidence, 1.75.) Life in school part(adaptation to life in school 1.51, satisfaction with study in school 1.09). The result show that children's participation in dance have good effect to character property and life in school.

길경 Saponin 이 고지방식이를 한 흰쥐의 혈청, 간장 및 분변 지질 함량에 미치는 영향

박무희,이영주,황성원,한준표,배만종 대구효성가톨릭대학교 식품과학연구소 1994 식품과학지 Vol.6 No.-

6주간 고지방식이를 섭취한 흰주에 있어서 길경 saponin이 지방 축적 억제와 대사에 미치는 영향을 검토하고자 혈청과 간장 및 분변 중 지방 성분을 생화학적으로 분석하여 다음과 같은 결과를 얻었다. 1. 혈청 및 간장중의 총지질, 총콜레스테롤 및 중성지방 함량은 길경 saponin군이 대조군에 비하여 유의한 감소를 보였다. 2. 분변 중 총지질 및 총콜레스테롤 함량은 대조군과 비교할 때 길경 saponin군이 다소 배설이 증가되었으나, 유의성은 인정되지 않았다. This study was conducted to investigate the effect of Platycodi radix saponin(PRS) on the reduction of lipid status in rats fed on high fat diet for 6 weeks after which lipid contents were measured in serum, liver and feces. The results obtained from this study are as follows; That the levels of total lipid, total cholesterol and triglyceride in serum and liver were significantly lower in the PRS group as compared with the control group. The contents of total lipid and total cholesterol excreted in the feces were tended to be slightly increase in PRS group compared to the control group, which were not significant.

대구지역 우수의 수소이온농도에 관한 연구(Ⅰ)

박영해,최준호 영남이공대학 1998 論文集 Vol.27 No.-

This study was conducted to investigate the rain acidity(pH) and air qualities in the Taegu area. The datum of rain acidity(pH) and air qualities were collected from in the Taegu office of the Korea Environmental Agency. In Taegu area, the concentrations of sulfur dioxide, carbon monoxide and total suspended particulates were obviously decreased in recent years. These phenomenons were corresponded with the increasement of clean fuel such as. LNG and LPG. But the concentrations of nitrogen dioxide and ozone were increased by the photochemical reaction and exceeded mobiles. The rain acidity(pH) in the Taegu was not serious problem, and the relationship between the concentrations of air pollutants, such as sulfur dioxide and nitrogen dioxide and rain acidity(pH) have no relation. It was considered that suspended particulates and cation, such as K^+, Na^+, Ca^(2+), Mg^(2+) and NH₄^+ were reacted as neutralizers in acid rain.

병원과 지역사회에서 메티실린 내성 황색 포도상구균(methicillin-resistant Staphylococcus aureus) 감염의 임상 분자역학 연구

박정원,이종섭,송준영,김철현,엄중식,정희진,김우주,박승철 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.2

목적 : 국내에서 1990년대 이후 중요한 병원균으로 대두되고 있는 methicillin-resistant S. ureus(MRSA)는 주로 입원환자에서만 분리되는 것으로 알려져 있으나, 최근들어 지역사회에서도 퍼져있는 것으로 알려지기 시작하였다. 이에 병원획득 및 지역사회획득 MRSA의 임상역학 및 분자역학적 연구를 통하여 획득요인, 병원과 지역사회 획득 균주간의 교류 양상등을 규명하고자 하였다. 방법 : 1998년 1월부터 12월까지 고려대 부속 구로병원에서 임상검체로부터 분리된 S. aureus 균주중에서 MRSA 균주의 빈도를 구하였고, 이중 1998년 10월 1개월 동안 분리되었던 42균주에 대하여 지역사회획득 균주와 병원획득 균주로 나누고, 임상역학적 조사를 하였다. 지역사회 획득 18주와 병원획득 22주에 대하여 PCR 방법으로 mecA 유전자를 확인하였고, PFGE를 시행하여 균주의 클론형(clonal type)을 결정하고 이 결과에 준하여 덴드로그램 분석을 시행하여 분자적 친밀도를 결정하였다. 결과 : 1998년 1년간 분리된 총 1,587주의 S. aeureus 균주중 73.8%(1,163주)가 MRSA 였다. 1998년 10월 1개월 동안 임상자료의 고찰이 가능하였던 MRSA 감염환자 42명 중 20명이 지역사회획득 환자였고, 병원획득 환자가 지역사회획득 환자보다 항생제사용 과거력(17 vs 5, p=0.001), 기저질환의 존재(18 vs 8, p=0.002) 등이 통계적으로 의미있게 높았다. 지역사회획득환자가 이루(7/20[35.0%] vs 2/22[9.1%] ; p=0.041)와 밀접한 관계가 있음도 확인하였다. 분자생물학적연구가 진행된 40주의 MRSA 균주는 모두 mecA 유전자 양성이었고, 18주의 지역사회획득 균주에서 총 8가지의 PFGE 클론형이 존재하였으며 A형이 가장 많았다(7/18, 38.8%). 22주의 병원획득균주에서는 6가지의 클론형이 존재하고 A형이 가장 많았으며(15/22, 68%), 15주의 지역사회획득 균주(83.3%)가 21주의 병원획득균주와 공통적인 클론형을 공유하고 있었다. 결론 : 지역사회 획득 MRSA는 주로 이루나 창상부위에서 많이 분리되는 반면 병원획득 MRSA는 객담에서 많이 분리되고 또한 당뇨병을 가진 환자에서 감염을 잘 일으키는 것으로 밝혀졌다. PFGE 분석 결과 원내감염은 단일균주에 의한 유행양상을 보였고, 지역사회에서도 같은 형의 균주에 의한 감염빈도가 가장 높음을 보여 MRSA 균주가 지역사회로 유입되어 지역사회내 MRSA 감염의 발생에 기여했을 것으로 사료된다. Background : Until recently, methicillin-resistant Staphylococcus aureus (MRSA) infection has been acquired primarily in hospital settings. During the late 1990s, the incidence of community-acquired MRSA infections has been increased in this university hospital. This retrospective study evaluated the clinical features and risk factors for community-acquired MRSA infection compared with hospital-acquired MRSA infection; and molecular relatedness of MRSA strains determined by pulsed-field gel electrophoresis(PFGE). Method: MRSA isolates collected from patients during October of 1998 were classified as community-acquired("community') or hospital-acquired("hospital") cases. MRSA infections were defined as hospital-acquired if organisms were isolated > 48 hours after admission to the hospital or isolated from patients with a history of admission to a hospital within the last 3 months. A comparative analysis of risk factors for community MRSA compared with hospital MRSA was performed. mecA gene PCR and PFGE of MRSA isolated was used as a tool of strain identification and molecular typing. Result : During one month, there were 42 patients with MRSA infection or colonization. Of 42 patients with MRSA isolates, 22(52%) were hospital cases and 20(48%) were community cases. Previous exposure to antibiotics(17 vs 5, p = 0.001) and presence of underlying diseases (18 vs 8, p = 0.002) were more common in hospital cases than in community cases. MRSA were more frequently isolated in otorrhea specimens from patients with otitis media in community cases compared with hospital cases. Of the 40 MRSA isolates subjected for PFGE typing, 18 were community isolates and 22 were hospital isolates. There were 8 distinct PFGE types among the 18 community isolates and type A was the most common clonal type (7/18, 38.8%). 22 hospital isolates were of 6 distinct PFGE types, and type A was dominant clonal type (15/22, 68%). PGFE subtyping indicated that 15(83.3%) of 18 community MRSA strains were clonally related with that of 21 hospital MRSA strains. Conclusion : Our results suggest that hospital MRSA strains may have disseminated in the community setting. PFGE subtyping support the finding that MRSA is circulating beyond nosocomial settings in the regional community.