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.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

부산지역 수돗물과 지하수의 중금속 농도

김준연,손지언,김형수,김두희,원미숙,김인식,이혜령 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

This study investigated mean airborne CO concention of 15 workplaces, suspected of CO exposure and conducted self-reported questionnaire completion and indirect COHb concentration measure using Micro II Smokerlyzer to healthy 702 adult subjects from 1999 May to 1999 September in order to find a relation of CO exposure and occupational factors, socioeconomic factors, and health related behaviors and confirm the related conditions in the screening test for CO exposure. The results of this study were summarized as follows : 1. In the CO exposed and non exposed group, COHb concentrations of the smokers were 2.55±0.96% and 2.21±0.97% and that got a statistically significant difference, There were not statistically significant differences in the age and total smoking index. Passed times after the last smoking, Working time/day, and working duration were statistically significant difference (p〈0.05). 2. In the CO exposed and non exposed group, COHb concentrations of non-smoking group were 0.94±0.35% and 0.68±0.47% and that got a statistically significant difference. There were not statistically significant differences in the age and working duration but Working time/day was a statistically significant difference(p〈0.05). 3. In the CO exposed group, r-square of multiple regression of the smokers was 38.5 % and passed time after the last smoking, working time/day, and job category were statistically significant differences (p〈0.05). And r-square in the CO non-exposed group was 38.3 % and age, passed time after the last smoking, and total smoking index were statistically significant difference. 4. In the CO exposed group, r-square of multiple repression of the non-smokers was 66.3% and job category and airborne CO concentration were statistically significant differences(p〈0.05). But r-square of non-smokers in the CO non-exposed group was 1.0% and there was not a statistically significant difference(p〈0.05). 5. In the smokers of CO exposed and non exposed groups, relation of COHb concentration and passed time after the last smoking was expressed as exponential function, Y = 2.9182e-0.0083x and r-square of this function was 37.4%. Therefore it was more than 150 minutes that passed time after the last smoking was when COHb concentrations were measured as less than 1%. In conclusion, variable, that was statistically significant to COHb concentraion in the both CO exposed and non-exposed smokers, was a passed time after the last smoking. We suggest that you have to restrict the smoking of smokers at least 150 minutes in the exposed and non exposed group before COHb concentration measure in order to exclude smoking effects

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

운동선수 모델의 광고에 대한 청소년소비자의 인식과 효과에 관한 연구

김상대,이준희 한국스포츠산업경영학회 2001 한국스포츠산업경영학회지 Vol.6 No.1

본 연구는 운동선수가 광고의 주 모델로 등장할 경우 청소년 소비자들은 그 광고모델을 통하여 가지게 되는 신뢰성과 광고의 효과가 어떠한 변화를 나타내는가를 알아보고 이것을 통하여 운동선수의 광고모델 효용성을 규명하는데 그 목적이 있다. 이러한 목적으로 부산광역시와 경상남도 김해시 소재 고등학교와 대학교에 재학 중인 남·녀 학생 905명을 대상으로 자기평가기입법에 의한 설문조사를 실시하였다. 본 연구에 사용된 조사도구는 Ohanian(1990), 김형준(1995), 박영묵(1993), 김재영(1995), 오인숙(1997), 임용덕(1990)의 연구에서 사용된 설문지를 2차에 걸친 예비조사를 실시한 후 수정 보완하여 사용하였다. 통계분석은 SPSS Win V8.0 프로그램을 이용하여 t-test와 삼원분산분석, 상관분석 및 희귀분석을 실시하여 분석한 결과 다음과 같은 결론을 도출하였다. 1) 운동선수 모델의 신뢰도는 여자에 비하여 남자가, 대학생보다 고등학생이 높게 나타났으며, 여자 고등학생과 남자 대학생은 연예인 모델에 대한 신뢰도가 가장 높게 나타났다. 2) 운동선수 모델의 광고에 대한 인식은 전체적으로 남자가 가장 긍정적인 것으로 나타났으며, 여자는 연예인 모델의 광고에 대한 인식의 정도가 가장 긍정적이며 운동선수는 다음으로 나타났다. 3) 운동선수 모델의 신뢰도와 광고효과에서는 전체적으로 남자에서 상관관계가 가장 높게 나타났으며, 여자는 고등학생집단에서는 연예인 모델과 가장 상관관계가 높고 대학생은 전문인 모델이 광고효과와의 상관관계가 가장 높은 것으로 나타났다. The purpose of this study was to analyze the confidence of youth consumers according to the adventising models and the changes on the effect of advertisement from the athlete models, and to examine the effectiveness of the athlete models. The subjects recruited for the study were composed with 905male and female students in high school and university in Busan city and Gimhae city. This survey was conducted by self-administration. The data collected were analyzed in t-test, three-way ANOVA. Pearson's correlation coefficient, and regression analysis using SPSS Win V8.0 program. The .05 level was initially established in significance. The results of this study are as follows: 1. In the confidence of the athlete models, male and high school students were significantly higher the female and university students, in the confidence to the entertainer models, female high school students and male university students were highest among all subjects. 2. Tee recognition of the athlete models in male students were firstly positive in all aspects, and in the degree of recognition, the entertainer models in female were firstly positive and the athlete models were secondary. 3. In the confidence of athlete models and effect of advertisement, male students were the most highly correlated to all aspects, female high school students were highly correlated to the entertainer models, and the university students were highly correlated to the professional model with the effects of advertisement.

자매에서 발생한 중증 마이코플라즈마 폐렴에서 스테로이드 치료

김도희,이경일,김명숙,윤유숙,황자영,임정우,강진한,이준성 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Numerous evidences support the pathogenesis that M. pneumonias pneumonia is associated with cell-mediat-ed immune reaction. We report 2 cases of severe M. pneumoniae pneumonia in previously healthy sisters, who were both admitted during an epidemic of M. pneumoniae pneumonia. The elder sister, who was 16 years old, was admitted with M. pneumoniae pneumonia. She showed no response to treatment with clarithroycin and levo-floxacin, and eventually progressed to severe ARDS, requiring mechanical ventilation. After treatment with hydrocortisone (200 mg/day), there were rapid improvements in clinical manifestations and chest radiographic findings. The younger sister, who was 14 years old, was admitted 10 days later, Presenting with fever but no pneumonic lesions on chest radiograph. Just like her sister, the infection showed no response to clarithromycin. Fever persisted and pneumonic consolidation with mild pleural effusion was noticed in the left lower lobe on the 5th hospital-day. After treatment with oral prednisolone (1 mg/kg), she showed rapid defervescence and on the 8th hospital day, no pneumonic lesions were detectable on chest radiograph. Given the fact that the pathogenesis of pneumonia and extrapulmonary manifestations in M. pneumoniae infection is immune-mediated, an immuno-suppressive therapy would be validated for selected patients with M. pneumoniae infections.

스포츠시설 불만족 고객의 재구매 보상요인

김상대,이준희 한국스포츠산업경영학회 2000 한국스포츠산업경영학회지 Vol.5 No.1

본 연구는 스포츠시설의 최초 구매활동에서 불만족을 경험한 소비자가 구매단절을 하지 않고 재 구매를 할 경우 불만족에 대한 보상요인으로서 스포츠시설의 3대 구성요소를 스포츠시설의 입지조건, 설비수준, 인적서비스 등으로 분류하여 이것들이 인구통계변수와 이용유형에 따른 변화의 차이를 분석하기 위한 것이다. 이러한 목적에 의하여 부산시내에 소재한 6개 스포츠시설을 3개월 이상 계속하여 이용하고 있는 성인 600명을 대상으로 자기평가기입법에 의한 설문조사를 실시한 후 최초의 구매결과에서 불만족을 경험한 것으로 응답한 남자 105명, 여자 126명의 자료를 SPSS Win 7.5를 이용 통계처리 하였으며, 자료분석을 위하여 사용한 통계분석방법으로는 Pearson의 적률상관분석과 Fisher의 Z-score를 채택하였다. 이상의 연구절차를 통하여 얻은 결론은 다음과 같다. 첫째, 스포츠시설의 입지조건은 인구통계 변수 중 소득수준에서, 참가유형에서는 주로 참가하는 종목에 따라 보상받는 정도가 높게 나타났다. 둘째, 스포츠시설의 설비수준에서는 인구통계변수의 직업군 중 전문직, 학력에서는 대학원을 졸업한 집단을 제외한 나머지 집단에서 유의한 것으로 나타났다. 셋째, 인적 서비스에 의하여 불만족을 보상받는 경우는 인구통계변수 중 대졸집단에서, 이용유형에서는 헬스 및 에어로빅을 주로 하는 집단에서만 유의한 관계를 가지는 것으로 나타났다. 따라서 스포츠시설의 구성요소 중 설비수준이 불만족을 상쇄하는 정도가 전 집단에서 가장 유효한 것을 알 수 있었다. This study was aimed to understand the role in the three component factors of sports facilities as compensation factor for dissatisfaction in the case that customers who were not satisfied in the first purchase are keeping purchase, not stoping purchase. As the same aim, the condition of location . the level of equipment, and man service in the sports facilities are classified into three component factors in sports facilities, these results were analyzed the difference of changes according to statistics variables and using types. The counterparts of this study who have using over 3 months in sports facilities located in Pusan, have been not satisfied with the results of the first purchase, 105 male and 126 female, conducted the inquiries by self-administration method, that is dealt with the statistics package of SPSS Win 7.5. statistics analysis method used for analyzing data adopt Quantities correlation analysis of Pearson and Z-score of R.A. Fisher. The conclusion of this study are showed as followings: First, the degrees of compensation showed that location of sports facilities is affected by the level of income among population statistics condition of sport facilities, joining type is affected by the participating event. Second, the level of equipment showed significantly in professional among the groups of population statistics variables, and the rest group exclude the post graduated university. The last, in the case of having compensation against dissatisfaction owing to man-service, that showed significant relations in graduated university group in population statistics variables and the group which use mainly health center and/or aerobics in using type. In conclusion, the level of equipment in component factors in component factors in sports facilities showed the most significant with the degrees of compensation to decrease of dissatisfaction in every group.

한국인 편두통 환자와 미토콘드리아 DNA 11,084 유전자 다형성의 연관성

김병건,배희준,구자성,권오현,김만호 대한두통연구회 2002 두통 Vol.3 No.2

병력청취에 의한 양성 발작성 체위성 어지럼증의 진단

김병건,배희준,구자성,권오현 대한평형의학회 2003 Research in Vestibular Science Vol.2 No.2

새열기형의 임상적 고찰

김장묵,김대식,백승혁,한동렬,김희중,백병준,오천환 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

Background and Objectives : Branchial cleft anomalies are encountered rarely in clinical practice. We reviewed medical records of branchial cleft anomalies according to age and sex distribution, site distribution, characteristics of mass on physical examination, location of mass, preoperative diagnosis, type of branchial cleft cyst and report our experience with 25 cases of branchial cleft anomalies. Materials and Methods : A review of medical records was performed on 25 cases of branchial cleft anomalies diagnosed in pathologic report from January, 1990 to March, 2000. Result : Sex distribution was 11 male and 14 female, age distribution was most common in third decade which was 8 cases(32%). Site distribution was predominant in left side(13 cases), and in physical examination, the characteristics of the mass was nontender(76%), mobile(60%), soft(80%). The lesion site was submandibular area in 2 cases, upper 1/3 portion of sternocleidomastoid muscle(SCM) in 2 cases, middle 1/3 portion of SCM in 20 cases and parotid area in 1 case. The preoperative diagnosis was branchial cleft cyst in 16 cases, cervical lymphadenitis in 3 cases, tuberculous lymphadenitis in 3 cases, branchial cleft fistula in 1 case, dermoid cyst in 1 case and parotid mass in 1 case. Among 25 cases, first branchial cleft cyst was seen in 4 cases, second branchial cleft cyst in 20 cases and second branchial cleft fistula in 1 case. Conclusion : The clinical history of recurrent neck inflammatory episodes in young patients and nontender, mobile, soft neck mass should raise the suspicion of this entity. Investigation using CT scanning in combination with aspiration is useful. Treatment of all branchial cleft anomalies is complete surgical excision because there is lack of spontaneous regression, a high rate of recurrent infection, the possibility of other diagnosis, and rare malignant degeneration. Complete removal without complications depends on a good understanding of regional embryogenesis, a knowledge of the surrounding structure, and awareness of the different anatomical presentation.