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.

안성시 간이급수시설에 대한 연구

이웅,이상수,이상훈,유원석,박규홍 중앙대학교 건설환경연구소 2001 環境科學硏究 Vol.12 No.1

The condition of operation and maintenance for selected small water systems in An Sung was surveyed. Eight small water systems were selected among one hundred ninety systems in An Sung. The environment, especially contaminant source around the systems was reevaluated. Questionnaire was also conducted to find out the recognition of inhabitants and/or managers for the operational difficulty and management problems of the systems. Twenty percent of the respondents was not satisfied with the flow rates of the supplied water and 16% with the water quality. Eighty percent of the respondents wanted to enhance the existing treatment facilities by installing additional filtration and/or disinfection process. Only 13% of the managers of the small systems were regularly paid. The limit of their role and responsibility seemed unclear and the development of practical and responsible management program for small water systems is expected.

혼합형 자가면역성 용혈성 빈혈을 동반한 전신성 홍반성 루푸스 1예

이승철,김선임,이승훈,이현경,조남국,한성훈,유영진,조종래 인제대학교 2000 仁濟醫學 Vol.21 No.2

A 17-year-women developed mixed warm and cold antibody type autoimmune hemolytic anemia associated with systemic lupus erythematosus. The patients was admitted to our hospital for syncope. Jaundice was observed. Urinalysis revealed protein and hemoglobin. Her hemoglobin was 4.6g/dl and reticulocytes were 10%. Total bilirubin was elevated, while haptoglobin and complement were abnormally reduced. ANA and mitochondrial Ab were detected. The direct and indirect Coombs test were positive. The direct antiglobulin test was positive ; IgG and C3d were detected on the red cell surface. The cold agglutinin(CA) titer was 128. The patients was initially treated with high dose steroid therapy. However the patients did not responded to high dose steroid therapy. We treated the patients with plasmapheresis and synchronized cyclophosphamide therapy. Clinical remission of hematologic complications was achieved in this patients. We report a case of mixed type autoimmune hemolytic anemia with SLE that responded plasma pheresis and synchronized cyclophosphamide therapy.

봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

2자유도 PI 제어기를 이용한 BLDC 전동기의 벡터제어에 관한 연구

이종현,성낙규,이상집,이승환,오봉환,이훈구,한경희 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

This paper describes the speed control method of BLDC Motor using TDOF PI ( Tow-degree of freedom PI ). PI control method generally used has difficulty in efficient speed control because speed response and load torque response interfere each other. It can't decrease the overshoot of motor speed w rm, and shorten the response time of load torque TL, at the same time according to the step alternation of speed reference w rm. Therefore TDOF PI is applied to BLDC Motor in order to supply these weak points of PI control method in this paper. TDOF PI can get the torque characteristic of short response time as well as stable and prompt speed adjustment by separate control for speed response and load torque response. The results from the tests of C program simulation and system construction show that TDOF PI is superior to PI control system in speed adjustment and load torque response.

Adamkiewicz 동맥의 폐색에 의한 척수경색 1례

이광훈,이종걸,이태연,신동익,이성현,이상수,한설희,차상훈 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

봉독약침이 류마티스 관절염 환자의 기능회복 및 삶의 질에 미치는 영향

이상훈,이현종,박상민,김수영,박재경,홍승재,양형인,이재동,최도영,김건식,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective: To evaluate the effects of bee venom acupuncture(BVA) on the rehabilitation and quality of life in rheumatoid arthritis(RA) patients Methods: Patients with RA were treated with the BVA therapy twice a week for 3 months. Tender joint counts, swollen joint counts, morning stiffness, Erythrocyte Sedimentation Rate(ESR), C-reactive protein(CRP), patient global assessment, physician global assessment, Korean health assessment questionnaire(KHAQ) were estimated and analyzed before and after BVA therapy. Results: Tender joint counts, swollen joint counts, morning stiffness showed significant decrease after BVA therapy. But, as acute inflammatory reactants, ESR showed no significant difference and CRP showed significant increase after BVA therapy. Patient global assessment physician global assessment, and KHAQ index showed significant improvement after BVA therapy. Conclusions: BVA therapy can improve rehabilitation and health-related quality of life RA patients as well as clinical symptom and signs. Further study is required in more population with large scale including acute inflammatory reaction of BVA therapy.

Laparoscopic single-port access right adrenalectomy using lee's port : A case report

Sung Hoon Choi,Ho Kyoung Hwang,Chang Moo Kang,Woo Jung Lee 대한외과학회 2010 대한외과학회 학술대회 초록집 Vol.2010 No.11

메스암페타민 사용 환자의 정신과적 증상에 영향을 미치는 요인

이춘우,권성민,조성남,권도훈,임효덕,이성국 대한생물치료정신의학회 2004 생물치료정신의학 Vol.10 No.1

목 적 : 본 연구는 메스암페타민 남용 또는 의존 환자의 사회인구학적 특성과 이에 따른 동반된 정신장애를 알아보고, 메스암페타민 사용이 정신과적 증상에 미치는 영향을 알아보기 위함이다. 방 법 : 2002년 7월부터 2003년 7월까지 국립부곡병원 약물중독진료소에 입원한 환자 중 DSM-Ⅳ 진단 기준에 의하여 메스암페타민 남용 또는 의존으로 진단된 44명의 남자 환자를 대상으로 사회인구학적 변인과 물질 의존의 병력, SCL-90-R, BPRS, HRSD, YMRS, Impulsive scale 등을 측정하였다. 결 과 : 메스암페타민 사용 환자들의 93.2%가 우울하였으며, 59.1%는 치료가 필요한 정도의 우울증을 가지고 있었다. 20대 연령층에서는 대인예민성, 적대감 및 공포증에서 유의하게 높았고, 중졸 이하의 교육 수준에서는 대인예민성, 충동성에서 유의하게 높았으며, 무직인 경우는 강박증, 불만, 적대감 및 조중 척도에서 유의하게 높았다. 처음 사용한 연령은 사용 횟수, 유병 기간과 유의한 상관 관계를 보였으나, 수감 횟수와는 낮은 상관 관계를 보였다. 사용 횟수와 적대감, 공포증, 편집증은 서로 유의한 정상관을 보였다. 우울증 척도와 정신병 척도 및 충동성 척도는 서로 유의한 정상관을 보였다. 100회 미만보다 500회 이상 사용했을 경우에 불안, 적대감, 공포증 및 편집증에서 유의하게 높았다. 결 론 : 메스암페타민 남용 또는 의존 환자에서 우울증 유병률이 매우 높게 나타났고, 20대 연령층과 중졸 이하의 교육 수준 그리고 무직인 경우 정신과적 증상이 많이 동반되었으며, 사용 횟수에 따라 불안, 적대감, 공포증, 편집증에서 유의한 차이를 보였다. 그러므로 모든 메스암페타민 사용자에 대해 적절한 정신과적 평가가 필요할 것으로 생각한다. Objectives : The purpose of this study was to examine the sociodemographic characteristics and the comorbid psychiatric disorders and the effect of methamphetamine use on psychiatric symptoms in methamphetamine abuse or dependent patients. Methods : The study subjects were 44 hospitalized male patients who met the DSM-Ⅳ criteria for methamphetamine abuse or dependence. The study included items assessing the sociodemographic profiles, history of substance use, and psychiatric symptomatology. Psychiatric assessments were based on SCL-90-R, BPRS, HRSD, YMRS and Impulsive scale. Results : In methamphetamine use patients, 93.2% were depressed and 59% had moderate to severe depression There were significant differences in interpersonal- sensitivity, hostility and phobia in the 3rd decade age group, interpersonal-sensitivity and impulsive scale in .under the middle school education group, and obsession-compulsion, anxiety, hostility and. YMRS in no-job group, respectively compared to the other groups. Age of the first use was correlated with the frequency of use, and also with the duration of illness, but not with the number of incarceration. There were positive correlations among HRSD, BPRS and impulsive scale. In the above 500 times used group there were significant differences in anxiety, hostility, phobia and paranoia compared to the below 100 times used group. Conclusion : In methamphetamine abuse or dependent patients, the incidence rate of comorbid depression was 93.2%. In the 3rd decade age group, under the middle school education group and no-job group showed higher diverse psychiatric symptoms compared to the other groups. Frequency of use was positively correlated with the symptoms such as anxiety, hostility, phobia and paranoia. We suggest that relevant psychiatric evaluations are needed for all methamphetamine users.

뇌졸중 후 중추성 통증 환자에 대한 동서협진이 진통과 재활에 미치는 영향

이현종,김수영,이상훈,서동민,이두익,김건식,이재동,이윤호,양형인,박재경,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP Patients who were treated with electroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain from stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from 7.7±1.7 to 4.4±2.0 with pain treatment(p<0.05). In accordance with improvement of pain scores, RS and MBI scores were also improved from 2.88±0.95 to 2.13± 1.01 and from 83.0± 16.9 to 94.7±9.5(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.