정신과 의약분업에 대한 5년 후 추적조사

박정수,정재열,홍진표,백기청,박영현,박종익 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : This study is designed to discuss the pros and cons related to the 'separation of drug prescription and dispensation' system when 5 years have passed by since the introduction of this system. Methods : The 592 psychiatrists from 1,107 working places took part in nationwide survey by mail or E-mail from June to September, 2005. The response rate was 23.8%, most of respondents came from private clinics. Results : The average age of psychiatrist was 44.6 years old, ranging from 25 to 75, most of them was predominantly male. The main results were as followings : 1) The ratio of psychiatric prescription out of hospital based on out-patients departments was the lowest in clinics, following by hospitals, general hospitals and university hospitals by order. 2) The main reasons of customer's preference for out of hospital prescription were economic advantage and self-awareness of prescription. As for the disliking for it, the most complaints were the anxiety about disclosure of psychiatric treatment, in convenience for delay and concern about drug change. Conclusion : Five years didn't seem to give a change on how the psychiatrists perceive the 'separation of drug prescription and dispensation' system at all. The confidentiality and human right issues on the part of psychiatric patients should never be ignored in order to manage this system successfully.

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.

NH₃가스 미량첨가 분위기에서의 CO-H₂혼합가스에 의한 과탄화철의 합성

정성실,정우창,강흥원,박응열,정원섭,박익민 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.11

The synthesis process of iron carbide was proceeded in two stages of reduction of hematite fines by H₂ gas, and carburization of the reduced metal by CO-H₂ gas mixture at 600℃. The surface of reduced iron was pre-treated with an addition of 0.05 vol% NH₃-Ar before carburization. The synthesized iron carbides were comprehensively explored by C/S analyzer (Low C/S determinator), Mossbauer spectroscopy, X-ray diffraction patterns (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and Raman spectroscopy at various reaction times of 5, 10, 15, 20, 25, 30, and 35 min. By addition of a small amount of NH3 gas, the super iron carbides contained 10 wt% carbon were made, and such addition stabilized iron carbides. It was found that addition of NH3 gas played a major role in the formation of iron carbide without decomposition (Fe₃C→ 3Fe+C) of iron carbides and precipitation of free carbon. From these results, we succeed in synthesis of super iron carbide, Fe_(5)C₂, with a stable single phase without Fe and Fe₃C phases. (Received August 2, 2004)

가네트를 활용한 고강도콘크리트의 고온수열 후 잔존압축강도특성

김동익,윤요현,박정민,김화중 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

The study which it describes the high concrete which industrial by-product used garnet powder was quality of residual strength after heating. The test unit water content 160kg/m', water reunion ratio did with 30%, 35% and the aggregate ratio is 40%, 42%, 44%, displacement ratio admixture is 0%, 10%, 20%. Admixture garnet powder, fly ash, blast-furnace slag and it was compared with the residual strength of concrete after was heated to normal temperature, 50℃,100℃, 150℃, 200℃, 350℃, 500℃, 600℃, 800℃.With this test was got the next conclusion. To previously 350℃, the weight reduction was not big, it was visible the weight reduction which was sudden from 350℃, and it showed the aspect which also the compressive strength reduction is identical. It compared with admixture nothing replacement concrete, garnet replacement concrete relatively weight reduction and compressive reduction appeared small. Like this tendency recording where the replacement ratio will be increased the tendency which appeared relative small.

진행성 비호지킨 림프종 환자에서 ICE 구제 요법에 의한 조혈모세포 가동화 후 자가 말초혈액 조혈모세포이식

이제중,이병환,김여경,변정래,이일권,박무림,정익주,김형준 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.1

연구배경: 비호지킨 림프종에서 자가 말초혈액 조혈모세포이식술이 폭넓게 이용됨으로 인해서, 높은 치료효과뿐만 아니라 조혈모세포의 가동화 효율이 높은 구제 요법이 요구되었다. 방법: 본 연구에서는 진행성 비호지킨 림프종에서 ICE 요법을 이용하여 조혈모세포를 가동화시킨 후 자가 말초혈액 조혈모세포이식이 시행하였던 환자를 후향적으로 분석하였다. 결과: 대상 환자의 중앙 연령은 38세(범위, 16~61)였으며, ICE 요법은 환자당 4주기(범위, 1~6주기)가 투여되었고, 투여 간격은 중앙값이 24일(범위, 16~36일)이었다. 고위험도 관해군을 제외한 13예의 환자 중 완전반응은 7예(53.8%), 부분반응은 4예(30.8%), 진행성질환은 2예(15.4%)를 보였다. 치료에 따른 3~4등급의 혈액학적 독성은 중성구감소증이 13예(81.3%), 혈소판감소증이 7예(42.8%)에서 관찰되었다. 조혈모세포 채집은 ICE 요법 후 중앙값이 12일(범위, 6~20일)에 시행되었고, 각 ICE 요법당 채집한 단핵구치는 중앙값이 5.75× 10^(8)/체중, CD34^(+) 세포는 중앙값이 1.25× 10^(6)/체중, CFU-GM치는 중앙값이 1.19× 10^(5)/체중이었다. 조혈모세포이식은 11예에서 시행되었고, 중앙 추적기간 401일에 평가한 2년 전체생존율은 70.1±14.7%, 1년 및 2년 무사건생존율은 각각 60.7±15.4%와 32.3±17.1%를 보였다. 결론: ICE 요법은 재발성/불응성 비호지킨 림프종 환자에서 높은 치료 반응률과 만족할 만한 조혈모세포 가동화를 보여 주었지만, 치료에 대한 순응도가 낮아서 투여 간격이 연장되는 문제점을 안고 있어서, 우리나라 환자의 실정에 적합한 구제요법에 대한 연구가 필요할 것으로 생각된다. Background: Due to the extensive application of high-dose chemotherapy with autologous peripheral blood stem cell transplantation (PBSCT), a salvage chemotherapeutic regimen with high response rate as well as effective capacity of PBSC mobilization is needed in non-Hodgkin's lymphoma (NHL). Methods: We analyzed the applicability of ICE (ifosphamide, carboplatin, and etoposide) regimen in NHL patients who underewent autologous PBSCT. Results: The median age was 38 years (range, 16~61 years), the patients received median 4 cycles (range, 1~6 cycles) of ICE regimen, and the median interval between each chemotherapeutic cycle was 24 days (range, 16~36 days). There were 7 (53.8%) complete responses, 4 (30.8%) partial responses, and 2 (15.4%) progressive diseases after ICE regimen. Toxicity included grade 3/4 neutropenia and throm bocytopenia in 13 (81.3%) and 7 (42.8%) patients, respectively. PBSC collection began on median day 12 (range, 6~20 days) after ICE therapy. The median number of mononuclear cells, CD34+ cells, and CFU-GM was 5.75× 10^(8)/kg, 1.25× 10^(6)/kg, and 1.19× 10^(5)/kg, respectively. With a median follow- up of 401 days, the patients who underwent autologous PBSCT had overall survival with 70.1±14.7% at 2 year and event free survival with 60.7±15.4% and 32.3±17.1% at 1 year and 2 years, respectively. Conclusion: ICE chemotherapy is an effective cytoreduction and mobilization regimen in patients with NHL, but profound myelosuppression with delayed recovery might pose difficulties in applying for Korean patients. Further evaluation for appropriate salvage regimens in Korean patients should be needed.

Co(Ⅲ)/Co(Ⅱ) 및 Fe(Ⅲ)/Fe(Ⅱ) 산화환원계에 의한 폴리에틸렌글리콜류의 매개전해산화

김익성,박정훈,박승조 동아대학교 환경문제연구소 2006 硏究報告 Vol.28 No.1

Mediated electrochemical oxidation (MEO) is an aqueous process which oxidizes organics electrochemically at low temperatures and ambient pressures. The process can be used to treat mixed wastes containing hazardous organics. This paper has studied MEO of polyethylene glycols (PEGs) in nitric acids by Fe/Fe(Ⅱ) and Co/Co(Ⅱ) system. It is investigated current density, supporting electrolyte concentration, hydraulic retention time, removal efficiency by PEGs continuous MEO. Removal efficiency of PEGs, electrical charge and reaction time by mediated electrochemical oxidation was excellent in Co/Co(Ⅱ) redox system than Fe/Fe(Ⅱ) redox system, indicating mediated electrochemical oxidation removal efficiency was 100 percent.

회맹장 판막에 발생한 아니사키스증 1례

이재익,박정하,김준영,조영완,진한영,강명주,정은욱,박석주,양성연 인제대학교 2006 仁濟醫學 Vol.27 No.-

Anisakiasis refers to parasitic infestation by nematode larvae that belongs to the subfamily Anisakinae, and this condition is seen in people who eat inadequately prepared or raw salt-water fish. While gastric anisakiasis is commonly diagnosed by endoscopic technique, intestinal anisakiasis is rare because it is less common and the clinical and radiologic features are poorly understood. The authors report a case of human anisakiasis involving the ileocecal valve in 62-year-old man who had the history of eating raw cuttlefish.

國家發展을 위한 意識改革의 基本方向

金益鉉,姜宗煥,朴汶政,李達錫 조선대학교 학생지도연구소 1982 生活指導硏究 Vol.7 No.-

말초부위의 후뇌동맥류의 외과적 치료

이익모,김상진,박순필,정현태,도종웅,주양자 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.1

Advances in microneurosurgical treatment of arterial aneurysm have led to increased interest being focused on aneurysm situated within the posterior cerebral fossa. Despite this, reports of neurosurgical intervention in such cases are still rare and there is no report about the distal posterior cerebral artery aneurysm in Korea. An aneurysm of the posterior cerebral artery has been referred to as a "distinct rarity", making up about 0.26 to 2.7% of all cerebral aneurysms. Especially, the incidence of the distal posterior cerebral artery aneurysm is quite rare and most of them are saccular in shape and single in number. The authors report a case of P4 segment aneurysm of left posterior cerebral artery, successfully treated by clipping cross neck and reviewed the literature, and discussed their anatomy, clinical feature, location, and variable operative methods.

인트라넷 환경하에서의 통합의료정보시스템에 관한 연구

김갑식,박준철,제경성,정익재 대구산업정보대학 2000 논문집 Vol.14 No.2

Now a days, Organizations have become to share unlimited field of information & activity due to growth of internet. As a result, they show a certain trend to integrated information system. This research made former information system of hospital to new integrated information system on intranet environment. This system remotely operate and arrange data base and web server. Therefore, this system is designed to keep consistency among each data, to build up data base system preparing for circumstances of which there are many simultaneous user, to conform with operational process in approaching method of data base. We expect that competency-ability of hospital would become much higher as construction of integrated medical information system made them possible share of medical information among each section, prompt management analysis through smooth operational process.