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.

Evans 증후군 1례

장성익,이의재,황성수,이경일,이원익,이준성 최신의학사 1990 最新醫學 Vol.33 No.1

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.

고등부 유도 지도자의 지도행동 유형분석

이준희,윤익선 龍仁大學校 武道硏究所 1997 武道硏究所誌 Vol.8 No.2

In this assentation I tried to investigate and analyze the actual behaviors of the coaches of the high level male and female team and the behaviors that the players of the team prefer. I came to conclude like the followings through the analysis of 432 Leadership scale for sports from 30 coaches and 432 players in the 30 teams which is constitute of the 20 coaches and 309 players in 20 male high level teams and the 10 coaches and 123 players in 10 female high level teams. 1) The coaches in the male teams are better in efficiency of teaching because the male team coaches are better in the background variables of age, career, and the career of winning the prize. 2) In the assentation on the actual of coach the male team coaches have the strongest disposition of behavior that influence on the advancement of the game, whereas the female team coaches the strongest disposition of democratic behavior. Considering such the differences of leadership behaviors, the coaches of male team have the disposition of emphasis of the task, whereas the coaches of female team emphasis of the relations. 3) In the research of leadership scale among the teams, the male players prefer behavior of training and indicating, positive reward, social support, democratic, and then authority behavior whereas the female players positive reward, social support, democratic, training and indicating and then authority. 4) In the research of preferable behavior, male players prefer the training and indicating, positive reward, social support, and then authority behavior, whereas the female players positive reward, social support, democratic behavior, training and indicating and then authority behavior. The male players were found to prefer such behaviors as influence the advancement of the game power directly, whereas the female players most prefer such behaviors as reward the results of the game. 5) In the comparison of the leadership behaviors that male and female players prefer, the male players have stronger disposition to want training and indications, authorities than female players,, whereas the female players prefer the democratic behaviors, social supports, positive rewards. 6) In the differences of the actual behaviors the players want from the coach, the male players differs in the democratic behaviors most, whereas the female players in the authority behaviors. 7) In the research on the differences of the behaviors the coach actually do and the players expect, ·in the training and indications, the male team players were a little more satisfied than the female team players. ·in the democratic behaviors, the male team players were more unsatisfied. ·in the authority behaviors, the female team players want more authorities from the coaches. ·in the social supports, the female team players were more unsatisfied. ·in the positive rewards, the female team players were more unsatisfied.

동종 골수이식을 시행받은 환자에서 폐색성 세기관지염에 의하여 발생한 자발성 기종격동과 피하 기종

이병환,이제중,이연경,안재숙,김여경,황호인,박무림,조상희,정익주,김형준 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.2

저자들은 만성골수성백혈병으로 동종 골수이식과 이식편 부전으로 인하여 추가적인 말초혈액 조혈모세포이식을 시행 받은 환자에서 만성 이식편대숙주질환과 그 폐 합병증인 폐색성 세기관지염에 동반된 자발성 기종격동과 피하 기종이 병발한 1예를 경험하였기에 이를 보고하는 바이다. Obstructive lung disorders following after allogeneic bone marrow transplantation (BMT) in association with graft- versus-host disease (GVHD) contribute significant morbidity and mortality. We report a case of a 28-year-old man who developed spontaneous pneumomediatinum and subcutaneous emphysema complicating bronchiolitis obliterans after allogeneic BMT. He received an allogeneic BMT for chronic phase of chronic myeloid leukemia. Five months after BMT, he was boostered by allogeneic peripheral blood stem cells from the same donor due to graft failure. One month after the boostering, chronic GVHD developed and were treated with cyclosporine and steroid. The patients developed spontaneous pneumomediatinum and subcutaneous emphysema secondary to severe bronchiolitis obliterans 4 months after boostering donor cells. The air-leak syndromes were recovered by conservative management, including high-flow oxygen.

복압성요실금(Stress urinary incontinence)과 절박성요실금(Urge incontinence)환자에서 TVT 수술 결과의 비교

이경구,이준호,권용욱,정태융,심희영,이상익 관동대학교 의과대학 의과학연구소 2005 關東醫大學術誌 Vol.9 No.1

Tension-free vaginal tape(TVT) has been widely used in the management of stress urinary incontinence(SUI), and has been applied to urge incontinence (UI). We evaluated and compared the outcomes between SUI and UI for patients who had undergone TVT. Patients were categorized into SUI(33 patients) and UI(26 patients). Before treatment, we asked about LUTSs using female bladder questionnaire. And we asked about sexual function. After treatment, the same questionnaires were repeated. During the postperative period, the objective and subjective success rate were evaluated. For operation outcome results, in SUI group there were 29 cases of cure (87.9%)and 2 of improvement(6.1%), and in UI group there were 20 cases of cure(76.9%)and 3 of improvement(11.5%) (p>0.05). The operation satisfaction rate of patients was 90.9% in SUI group and 84.6% in UI group(p>0.05). Improvement of sexual satisfaction occurred in 6(20.0%) of SUI group, and 3 (18.8%) of UI group, respectively(p>0.05). The objective success rate, satisfaction rate and sexual satisfaction of SUI patients did not significantly differ from the women with UI. Also, these results shows that TVT procedure improves some LUTSs in both groups. We consider the TVT procedure to be an effective treatment not for stress urinary incontinence but also urge incontinenece.

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.

직무특성과 조직공정성이 직무만족에 미치는 영향

이종준,최익봉 啓明專門大學 産業開發硏究所 2000 啓明硏究論叢 Vol.18 No.1

본 연구는 인구통계적 변수들(연령, 학력, 직위, 성별)을 통제한 상태에서 직무특성(기술다양성, 과업중요성, 과업정체성, 자율성)과 조직공정성(분배공정성과 절차공정성)이 직무만족에 미치는 영향을 검증하는 데 그 목적이 있다. 실증조사의 자료 수집은 구미에 위치한 H반도체 제조업체를 대상으로 설문조사를 통해 이루어졌다. 다중회귀분석을 통해 분석된 결과들은 다음과 같았다. 인구통계적 변수들을 통제하고서도 본 연구의 주된 연구변수인 직무특성변수(기술다양성, 과업중요성, 자율성)와 조직공정성(분배공정성, 절차공정성)은 직무만족에 정(+)의 유의적이고 중요한 선행변수로 나타났다. 그리고 절차공정성이 분배공정성보다 직무만족에 관한 전반적 공정성 지각에 훨씬 더 큰 영향을 미쳤다. 본 연구의 공헌점은 첫째, 인구통계적 변수들을 통제하고서도 직무특성과 조직공정성은 여전히 중요한 선행변수로 나타나고 있다. 둘째, 직무만족을 위한 기업에서의 인적자원에 대한 효율적 활용을 제시해 주고 있다. 맺는 글 부분에서는 본 연구의 토론, 한계점 및 미래의 연구방향을 제시하였다. The purpose of this study was to find out the effect of job characteristics (skill variety, task significance, task identity, and autonomy) and organizational justice( distributive justice, Procedural justice) on job satisfaction with demographic variables controlled for. Job characteristics and Organizational justice were hypothesized to be positively related to job satisfaction even with age and education level controlled for. This study directly examined these hypotheses, using survey data collected from a sample of employees in an H semiconductor manufacturer. Overall, results revealed that job characteristics such as skill variety, task significance, and autonomy and organizational justice such as distributive and procedural justice were significant and important predictors of job satisfaction, Procedural justice was more powerful in explaining the perception of fairness about job satisfaction. Contributions of this study are as follows: Firstly, it was to confirm that job characteristics and organizational justice were significant and important predictors of job characteristics even with demographic variables controlled for. Secondarily, it also suggested the practical human resource management by improving job satisfaction. Further discussion, limitation of this study and future direction were suggested.

분할 기법을 이용한 3차원 얼굴 형상의 추출

김익동,이준재,심재창 국립7개대학공동논문집간행위원회 2002 공업기술연구 Vol.2 No.-

This paper proposes a 3D facial reconstruction method using segmentation method. 3D laser scanner, which is based on the laser triangulation, projects a sheet beam on the face in horizontal. At the same time, laser profile images are captured by CCD camera. Center profiles should be extracted from the all profile images. And the depths of those profiles are composed as a 3D face. Generally, when we use laser, it must be used with low wavelength to remove the harm to the body, especially eyes, It makes laser occluded at some region such as hair, chin and the edge of the face. It makes 3D reconstruction more difficult. Proposed method segments a 3D face into FSFS, SSFS and IFS depending on laser intensity reflection coefficient. Each segment was extracted with different algorithm. Finally, those are composed of 2D point cloud of facial depth. As a result, we can get a more reliable 3D face.

119구급대를 통한 서울지역 외상환자 진료체계에 대한 통계분석

서길준,이승한,조익준,권운용,송형곤,이중의,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Backgroud: Despite continous efforts to improve the prehospital trauma care system in Korea, the preventable death rate has been reported to be high. The purpose of this study was to evaluate the prehospital trauma care system in Seoul by analyzing 119 rescue databases. Methods: The 119 rescue data bases of 22,275 trauma patients, who were transported to the secondary and tertiary hospital in Seoul by Seoul 119 rescue services from January 1, 2000 to December 31, 2000, were analyzed. Results: The response time(mean 3.7 min.) showed no time, weekly, and regional variations. However, the transport time from field to hospital showed was high in the morning rush hour(7:00 to 10:00 am), and was gradually decreased and the lowest between 10:00 pm and 7:00 am. There was also a regional variation in the transport time, which was short in the central area and long in the peripheral area of Seoul. Prehospital cares were given to the 10,999 trauma patients(49.4%). Of the 464 unresponsive patients(2%), only 236 patients were identified in transported hospitals. The outcomes of these unresponsive patients were DOA(54%), survival(19%), death in ER(14%), transfer to other hospitals(8%), and death after admission(5%) in order. Conclusion: We suggest that this study may be helpful to the establishment and improvement of the prehospital trauma care system as well as the determination of the adequate numbers and locations of trauma center in Seoul.