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.

운동부하양식에 따른 심폐 능력의 비교분석

전태원,우재홍,신창호,이기봉,이광희,박익렬,박성태,강현주 서울대학교 체육연구소 2000 서울大學校 體育硏究所論集 Vol.21 No.1

The purpose of this study this study was to comparative analysis the V02max and HR through arm ergometer exercise, bicycle ergometer exercise, and treadmill exercise and to propose correct data of aerobic ability according to GXT. Subjects for study were 8 healthy male students. The process of the test were performed maximal GXT on arm ergometer exercise, bicycle ergometer exercise, and treadmill exercise and measured V02max, max heart rate and recovery time of 3 VO2 and heart rate respectively. The conclusions were supported by the findings of this study: 1.There were significant differences between test style and V02/kg/min(p<.05). 2.There were significant differences between test style and test stage at heart rate(p<.05) There were no effect of reciprocal action. Therefore, V02/kg/min should be on individual exercise prescription guiedlines for health promotion should be provided proper GXT which are arm ergometer exercise, bicycle ergometer exercise, and treadmill exercise.

전류모드방식 적분기의 구조개선을 통한 성능비교

이근호,조성익,방준호,김동용 全北大學校 論文集 Vol.42 No.-

In this paper, a CMOS fully-differential complementary current-mode integrator adequate to design low-voltage, low-power and high frequency application circuit. The designed fully-differential complementary current-mode integrator has a new architecture. When the improved integrator is compared with proposed current-mode integrator, the new integrator has lower power dissipation and higher frequency range. The small signal analysis results are showed in table.1 with several improved characteristics. And the results of PSPICE simulation using ORBIT company's 1.2㎛ CMOS n-well processing parameter shows fig. 3.

풍력발전단지의 임계제거시간 고찰

김세호,양익준 제주대학교 공과대학 첨단기술연구소 2004 尖端技術硏究所論文集 Vol.15 No.2

Generation of electricity using wind power has received considerable attention worldwide in recent years. In addition, the concern about the stability of wind power increases more and more, because most of the wind generators are induction generators that have shorter critical clearing times than those of synchronous generators. This paper investigates factors influencing the transient stability of the system connected to wind generation system.

제주한경 풍력발전시스템에 연계된 가정의 전압품질 분석

김세호,양익준 제주대학교 공과대학 첨단기술연구소 2004 尖端技術硏究所論文集 Vol.15 No.1

Operation of wind turbines has impacts on the voltage quality at the connected electricity network. Increasing penetration of wind energy makes necessary to study the power quality regarding voltage variations(sag, swell, interruption) and presence of harmonics in the grid. This paper investigates the voltage quality of low voltage customers connected to wind generation system. To study the influences of wind power generation to low voltage power system, voltage data are collected in three house using PQM(Power Quality Monitoring) equipment during one month and analyzed regarding voltage variation and harmonics.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

도시 거주 노인 수면 습관 및 불면증상의 요인 : 인구학적,질병 및 정신증상의 관련성

홍진표,안준호,윤영국,박종익,이소영,함봉진,김장규,한오수,조맹제 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 본 연구는 국내 노인의 습관을 조사하고 불면 증상과 연관 있는 인구학적, 질병학적 요인을 알고자 했다. 방 법 : 1997년 12월부터 1998년 1월까지 약 1개월에 걸쳐 2단계 층화집락표본추출의 역학조사법을 통해 선정된 3개 4개동 거주의 만 65세 이상 노인을 대상으로 수행되었다. 대상자 중 723명에서 등답을 받았으며 응답률은 73.8였다. 대학생인 설문조사요원들을 훈련시킨 뒤, 이들로 하여금 대상지역의 노인거주가정을 방문하여 개개 노인을 대상으로 반구조화된 면담으로 수면습관 및 불면증상 설문을 실시하였으며 그 외 한국어판 노인정신장애평가척도, 삶의 질 척도를 이용한 설문조사와 과거 질병력을 청취조사하게 하였다. 결 과 : 국내 노인들은 평균 오후 10시 16분에 자리에 누워 오전 5시22분에 일어나서 총 7시간 6분의 수면시간을 보였다. 노인의 11.7%가 거의 매일 밤 불면증을 14.8%가 간헐적 불면증을 호소하였다. 남자에서는 연령이 증가할수록 침상에 누워있는 시간이 증가하고, 또, 입면시까지 소요되는 시간과 수면 중의 각성회수가 증가되었으나 여성에서는 명확하지 않았다. 단변수 분석에서 요통, 중풍 병력의 환자에서 불면증상이 심했다. 다변량분석 결과 불면 증상과 관련 깊은 요인으로 남자에게서는 고령과 우울증상이 여자에게서는 남자의 위험요인에다 신체통증과 피부병력이 추가로 관련이 있었다. 결 론 : 지역 거주 노인에서 불면 증상은 매우 흔한 증상이며 우울증상과 명확한 상관관계를 보이고 있었다. 불면증을 극복하기 위해 불면증 위험요인의 인과관계에 대한 추후 연구가 필요하다. Objectives : The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly Method : A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale(PAS), the short form Quality of Life Scale (SF-36) and etc. Results : The mean scores are as follows : retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. Conclusions : The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.

대장내시경검사에서 비특이적 염증형태로 나타난 대장선암 1예

박재현,장병익,이호찬,김성준,박준석 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.2

Colon cancer is the second most common malignancy in Korea. It is classified as superficial type, the mass type, the ulcerative type, the ulceroinfiltrative type, the diffuse infiltrative type and the unclassified type according to the colonoscopic findings. We report here on a case of colon cancer that was initially misdiagnosed as acute infectious colitis at the initial presentation. A 64-year-old man visited to Yeungnam University Hospital for watery diarrhea and lower abdominal pain. Colonoscopy revealed long segmental edematous mucosa and hyperemic mucosa with stenosis in the transverse colon. He was diagnosed as having acute infectious colitis according to the colonoscopic finding. However, two days later after colonoscopy, he visited the emergency room for hematochezia. We performed computerized tomography (CT) and obtained blood samples to find the origin of the bleeding. We found thickening of the transverse colon lumen and ascites on the CT finding and an elevated level of tumor markers; we also obtained the results of the colonoscopic biopsy that was done via colonoscopy. He was finally diagnosed as having colon cancer with carcinomatosis, a poorly differentiated adenocarcinoma.

마이크로그로브 형태에 따른 평활근 세포 운동 측정

유소영,박찬영,정석,김동익,이병붕,허세호,한동철,장준근 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.2

Purpose: The spreading, orientation, and chemotaxis the gradient of a chemoattractant of smooth muscle cells (SMCs) were studied on the micro-grooved substrata by the light, fluorescence and scanning electron microscopy. Method: Vertical-walled grooves were produced in silicon wafers by the micromachining technique. All grooves were 4~20㎛ deep and 10~80㎛ wide, SMCs were cultured on each microgroove and examined under stereo-microscope. Result: Cell clusters were markedly oriented by all the grooved substrata examined. Tim-lapse images acquired from CCD (Charge Coupled Device) showed that the grooves directed the migration of SMCs. There was no prominent difference in the migration speed of SMCs according to the grooves. All the cytoskeletal fibers were reoragnized in the same direction with grooves. Especially the alignments of microtubule and intermediate filaments were distinguished in the SMCs on the micro grooves. Conclusion: These results could be applied to the analysis of vascular restenosis and the development of artificial blood vessels.

간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과

김금래,김주형,박원규,장재천,조재호,김태년,김준화,장병익 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: The purpose of this study was to determine the effectiveness of percutaneously place self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self-expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cased of Bismuth type Ⅱ,21 cases of Bismuth typeⅢa 8 cases of Bismuth type Ⅲb and 15 cases of Bismuth type Ⅳ. Stent placement was technically successful in all patients All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage of 91.9% There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60 ~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method of palliation of patients with hilar cholangiocarcinoma.