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.

소규모사업장 보건기술지원사업에 대한 보건관리자의 경험 : Focus Group Interview Use of Focus Group Interview

한영란,김수근,하은희 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.4

목적: 소규모사업장 보건기술지원사업에 참가한 보건관리자들을 대상으로 그동안 수행한 보건기술지원사업의 경험에 대해 focus group interview를 이용한 개방적 논의를 실시하여 본 사업의 내용과 효과, 진행과정에서의 어려움 그리고 평가 및 대안을 체계적으로 분석, 제시하여 보다 충실한 개선 전략을 모색할 수 있는 기초자료를 제시하고자 시도되었다. 방법: 포커스 그룹방법론을 이용하였다. 즉 포커스그룹인터뷰를 통해 자료를 수집하고 Strauss와 Corbin(1990)이 제시한 근거 이론 방법으로 자료를 분석하였다. 연구대상자는 총 20명으로 의사 6명, 간호사 14명이었다. 결과: 최종 분석 결과 총 69개의 개념이 도출되었으며 이 개념들로부터 28개의 하위범주와 5개의 상위범주가 도출되었다(Table 2). 상위범주는 사업목표, 다양한 사업, 사업진행 시 어려움, 사업평가 및 대안모색 등 5개이다. 첫째 상위범주인 사업목표에는 사업목표 1과 2가 하위범주로 포함되었고 둘째 상위범주인 다양한 사업내용이 하위범주에는 집단보건교육, 건강상담 및 개별교육, 건강증진사업, 건강검진, 유소견자 관리, 작업환경관리, 응급처치 및 구급함과 성공전략이 하위범주로 포함되었다. 셋째 상위범주인 사업진행시의 어려움에는 보건관리의 중요성에 대한 인식부족, 보건관리에 대한 사업주의 비협조적 태도, 본 사업에 대한 사업주의 부정적 인식, 짧은 사업기간과 방문횟수 부족, 유소견자에 대한 부당한 처리, 비효과적인 사업의 지침, 모니터 요원의 능력 및 연계성 부족, 보건관리자의 자존감 저하, 기타 어려움이 하위범주로 나타났다. 넷째 상위범주인 사업평가에는 사업에 대한 총평, 건강관리 및 작업환경관리 사업장의 구분, 팀 방문, 기관평가인 하위범주가 포함되었다. 다섯째의 상위범주인 대안모색에는 효과적인 사업을 위한 전제, 현 사업의 활성화 방안, 사업장 특성에 맞는 자율적인 사업구축, 기본모형구축, 기타 대안이 포함된다. 결론: 본 연구결과 보건기술지원사업을 받은 소규모사업장은 사업장 보건관리의 중요성을 다소 인식하여 보건관리를 시행할 가능성은 높아졌으나 자율적 보건관리능력개발을 위한 변화는 아직 요원한 것으로 나타났다. 본 사업이 성공하기 위해서는 대상자의 특성과 요구를 반영하는 현실적 사업을 제공하고 기준 이상의 방문과 서비스 제공, 업무의 지속성 유지를 위해 대상자와의 신뢰감을 형성하는 것이 중요한 것으로 나타났다. 또한 서비스기관이 질적 향상과 보건관리자의 전문성향상 그리고 권한강화가 선행되어야 하고 노동부/공단, 서비스 기관과 사업장의 삼자구조가 보다 적극적인 의미에서 협조적 관계가 되어야 하는 것으로 나타났다. 마지막으로 사업장 특성에 맞는 자율적 사업구축을 위한 프로그램 다양화, 시범사업 사업장 특성별 모형구축과 보건관리자 역할모델등이 대안으로 나타났다. Objective: This study was conducted to provide the fundamental information to prepare better strategies based on the experiences of occupational health care providers who are involved in the Government-funded subsidized occupational health programs for small scale industries. Methods: The focus group methodology was used in this study. The data was collected using focus group interviews and analuzed in the framework of the Grounded theory method as mapped by Strauss and Corbin(1990). The subjects enrolled in this study included 20 occupational health care providers in the Government- funded subsidized occupational health program for the SSI: 6 doctors and 14 nurses. Results: We indentified 69 concepts, 28 sub-categories and 5 categories(Table 2). The categories were the Program's Goals, Various Services, Difficulties in Implement Services, Program Evaluation, and Suggestions for Alternative Plans. Conclustions: This program showed that autonomous health management ability has not changed altouugh the possibility for small scale industries to start the health management arose by acknowledging the importance of the health management in the workplace. A successful program should provided a practical service that is planned by the characteristics and the requirements of the workers, a better service than the standaed, more visiting times, and a trusting relationshop among workers. The occupational health agency's quality and the health manager's specialty needs to e improved and the health magager's authority should be consolidated. And actively cooperative triangular relation among the Labor Department/KOSHA, service organizations, and the workplace is required. In addition, alternative plans were suggested. These included various programs for planning an autonomous service suitable for the quality of the workplaces, a model set-up suitale for the quality of the workplaces, and a role model set-up for the health manager.

사람 갑상선자극호르몬 수용체를 발현하는 Chinese Hamster Ovary(hTSHR-CHO)세포를 이용한 자극형 갑상선자극호르몬 수용체 항체 활성 측정의 임상적 유용성

한희정,원진호,채수홍,김현진,송민호,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Detection of thyroid stimulating hormone receptor(TSHR) autoantibodies has clinical value in establishing the diagnosis of Graves ' disease, and in predicting its clinical course with high sensitivity and high specificity. Especially, TBII using radioreceptor assay has been widely used. Recently, for detecting thyroid stimulating antibody(TSAb), a sensitive method using human TSH receptor-transfected Chinese Hamster Ovary(CHO) cells has been developed and clinically used. The aims of this study are to determine the change and discrepancy of 2 TSHR autoantibodics in clinical course and to evaluate the correlation between 2 autoantibodies. We measured TSAb and TBII in 30 newly diagnosed and untreated patients and in 73 previously diagnosed as Graves ' disease and treated with antithyroid drug. Also we compared the changes of the antibodies in clinical course and correlation between 2 antibodies. Thes results are summarized follows. 1. In newly diagnosed patients, all of the 30 patients had positive TBII and/or TSAb. None of them had negative TBII and negative TSAb. And in newly diagnosed patients, mean TBII and mean TSAb values are 46.8% and 361%, respectively. In 73 treated patients mean values are 18. 7% and 196% each other. Therefore, newly diagnosed group has significant greater TBII and TSAb than antithyroid drug-treated group. 2. TBII was significantly different between euthyroid group and thyrotoxic group in antithyroid drug-treated patients, but TSAb was not. 3. TBII was sequentially decreased as increased medication duration, but TSAb was not shown sequential decrease as increased medication duration. 4. There was significant negative correlation between cumulative doses of antithyroid drug and TBII, but no significant correlation between cumulative doses and TSAb. 6. There was significant positive correlation between TBII and TSAb in total patients group and in antithyroid drug medication group, but not in newly diagnosed group. In conclusion, in Graves ' disease patients, detection of TSHR antibodies are clinical values in establishing the diagnosis and prediction of clinical course. A method detecting TSAb using hTSHR-CHO cells should be further studied for standardization of measurement, and for detecting the changes of TSAb in clinical course, long-term follow-up of patients are important.

RS232C직렬통신을 이용한 다중접속 패킷 접속 장치

한경호,곽희수 단국대학교 1999 論文集 Vol.34 No.-

In this paper, The multiple access of serial communication, by applying Collision Sensing Multiple Access(CSMA) Protocol to RS232C communications systems. Multiple access is implemented by assigning a unique ID to each controller. The multiple access control operation starts by sending a command packet from a host to another host and the command packet is composed of ID bytes of source and destination controller, data bytes and the check sum byte. A source controller sends the command packet to the destination controller via two-wire communication channel and the transmitted data is fed back to detect the collision. The feedback data from the channel is compared with the transmitted data to detect the collision. The unequal data means that the transmitted data is collided with other transmitted data from other controller and the controller retries the transmission. The packet communication of the controller enables the multiple access of the controller through the common serial data link. The application of the CSMA protocol to two-wire serial communication by using two wires has an effect on saving the wires and convenient of layout work.

하악골 후방이동시 중안면부 연조직의 변화양상에 대한 임상통계학적 연구

한대희,김수남,민승기,김태성,성헌모 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalo-metrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1.There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2.There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3.The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4.The upper lip length was increased and moved posterior direction after mandibular setback surgery 5.The lower lip was moved posterior direction by posterior movement of the mandibular structure 6.Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

他科醫師의 精神科 諮問에 대한 期待度

韓辰熙,柳太烈,李秀晶 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.1

To investigate physicians' expectations to the role of psychiatric consultation, the authors conducted 18-item questionnaire on 117 nonpsychiatric physicians of two university affiliated general hospitals(St. Mary's Hospital and Kang Nam St. Mary's Hospital) in Seoul. The results were as follows : 1) Physicians rated, in general, high scores on items related with `evaluation function ' and `direct service function' of psychiatric consultation, whereas they rated low on `mediating function' items. 2) `Evaluate mental status', `Help physicians understand psychological aspects of a patient's illness', ` Arrange to transfer patient to psychiatric ward', `Evaluate psychogenesis' and `Make suggestions about management of patient on the ward' are those which phisicians valued most important of all 18 items. 3) There was a tendency that resident group manifested low item scores compared to faculty members, and items of `Arrange to transfer patient to psychiatric ward' and `Recommand additional diagnostic work-up' showed significant difference in mean scores between groups. 4) Physicians in medical services showed significant high mean scores on items such as `Arrange to transfer patient to psychiatric ward', `Make suggestions about management of patient on the ward', `Evaluate psychogenesis' and `Work with patient's family' as compared to surgeon group.

PLD 박막의 물리적 성질

한용진,조봉균,정재훈,이수빈,박해윤,이태기,채희백,홍진수 순천향대학교 기초과학연구소 1998 순천향자연과학연구 논문집 Vol.4 No.2

Thin amorphous carbon films were deposited by a Q-switched Nd;YAG 532nm with beam power density of ?? on the high purity graphite (99.7%). The pressure of vacuum chamber was ?? Torr. In order to estimate the quality of the Pulsed Laser Deposition films one of the most important optical properties, bandgap energy, was characterized by transmission and reflection in the range of the visible, and an optical direct bandgap energy of 2.45eV and indirect bandgap energy 0.36eV were obtained. Surface morphology of amorphous film was investigated by AFM (Atomic Force Microscopy). Its surface roughness is 70nm. Comparing our results with the published values in the literature we have confidence that our films show the good quality for optical properties.

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

고추 풋마름병ㆍ역병 복합 저항성 계통육성

한정혜,김주영,황희숙,김병수 경북대학교 농업과학기술연구소 2000 慶北大農學誌 Vol.18 No.-

풋마름병과 역병에 복합저항성인 계통을 육성하기 위한 노력으로서 앞서 역병 저항성으로 육성한 계통(16-2-2-3-2 = 역병 저항성 '칼미초', 19-1-3-7-1-1, 19-2-4-5-3-2 = 역병 저항성 '수비초', 김 등, 1996)과 풋마름병 저항성 계통(KC350 = MC 4, KC353 = PBC631)을 교배하여 육성한 F5와 BC1F4, F6와 BC1F5 세대에 대해 1999년과 2000년에 각각 풋마름병과 역병에 대한 복합저항성을 검정하였다. 풋마름병과 역병에 복합 저항성을 보인 개체를 선발하여 다음 세대의 종자를 채종하였다. In an effort to breed lines resistant to both bacterial wilt and Phytophthora blight, F5 and BC1F4, and F6 and BC4F5 generations of the crosses between the lines previously bred for resistance to Phytophthora blight ((16-2-2-3-2 = Phytophthora-resistant 'Kalmi', 19-1-3-7-1-1, 19-2-4-5-3-2 = Phytophthora-resistant 'Subi', Kim et al., 1996) and sources of resistance to bacterial wilt (KC350 = MC-4 or KC353 =PBC631, Kim et al., 1998) were evaluated for resistance to both bacterial wilt and to Phytophthora blight in 1999 and 2000, respectively. Plants which were highly resistant to both bacterial wilt and Phytophthora blight were selected for development of the next generations.

인터넷 전자상거래에 의한 관세인하 효과 연구

한억수,이상규,구희조 한국정보전략학회 1999 추계공동학술대회 논문집 Vol.- No.01

This study firstly aims to review the discussions among major nations and international organizations on removal of tariff wall in EC. Secondly, it is analyzed how the trend of tariff reduction of removal will affect an individual economy in a partial balance analysis model on an assumed small-size economy. In closing, political implication for removal of tariffs in EC will be presented. The study concluded that tariff removal on Internet EC has both positive and negative effects on the importing economy. It can improve the efficiency in utilization of economic resources by the importing economy in the long term while cut the financial revenue and aggravate the trade balance of importing country. It is inferred from such a conclusion that tariff removal can lead to trade imbalance between the Information haves and the have-nots.