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.

직업적 연폭로에서 혈중 연량 수준에 따른 선별검사로서의 혈중 ZPP 검사의 타당도

한구석,안현철,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to evaluate the validity of current screening criteria of lead exposure and to provide effective information for the better health management of lead workers, author investigated the interrelationship between blood lead and blood zinc protoporphyrin(ZPP) and evaluate the validity of blood zinc protoporphyrin as the screening test and blood lead as gold standard of diagnostic test. The total of 2245 lead workers (male workers: 1982, female workers : 263) from 12 lead using industries were studied. Blood lead, ZPP, hemoglobin and hematocrit were selected as lead exposure variables. Personal information on sex, age and work duration were also checked. Blood lead was measured with flameless atomic absorption spectrometry (model: Hitachi 8100) using standard addition method. Blood ZPP was measured with portable hematoflurometer (model: Aviv 206). The results obtained were as follows: 1. The mean blood lead of all lead workers were 0.7±14.3㎍/㎗(Male: 31.0±14.4㎍/㎗, Female: 28.2±12.9㎍/㎗), whereas the mean blood ZPP of those were 68.1±47.5㎍/㎗(Male: 63.9±43.7㎍/㎗, Female: 100.1±61.0㎍/㎗). The mean value of hemoglobin and hematocrit of all lead workers were 14.5±1.5g/㎗(Male: 14.7±1.3g/㎗, Female: 12.3±1.2g/㎗) and 45.4±3.6(Male: 46.2±2.8, Female: 39.5±3.1) respectively. 2. Validity of test using blood zinc protoporphyrin as screening test for blood lead levels of 30㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 50 and 90 ㎍/㎗ of ZPP respectively, showing 50 and 60 ㎍/㎗ of ZPP for all lead workers. While those test for blood lead levels of 40㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 and 90 ㎍/㎗ of ZPP respectively, showing 60 ㎍/㎗ of ZPP for all lead workers, those test for blood lead levels of 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 or 70 and 100 ㎍/㎗ ZPP respectively, showing 60and 70 or 80 ㎍/㎗ of ZPP for all lead workers. 3. Predictive value of test using blood zinc protoporphyrin as the screening test for different blood lead levels of 30, 40, 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that positive predictive value of screening test were decreased by the increase of blood lead level regardless of csreening criteria value ZPP and negative predictive value of screening test were increased accordingly regardless of screening criteria value of ZPP. On the other hand, within same blood lead level as a gold standard positive predictive values were inceased by the increase of screening criteria value of ZPP, whereas the negative predictive value were decreased accordingly by the the increase of screening criteria value of ZPP. 4. The correlation analysis of all lead workers among study variables revealed that CPbB and natural log transformation ZPP(LZPP) were better correlated with other variables and found to be better estimate than PbB and ZPP themselves. The age was correlated with all other variables, but the work duration was not. The correlation analysis of male and female workers among study variables revealed the same results with all lead workers. 5. The slope of simple linear regression of CPbB (independent variable) with ZPP in female workers(3.223)was steeper than in male workers(2.144). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But there was no slope difference between two groups divided by their work duration of 2 years less and more. The slope of simple linear regression of CPbB lead (independent variable)with ZPP in lead workers whose blood lead were higher than 30㎍/㎗and 40㎍/㎗ were steeper than those whose blood lead were less than 30㎍/㎗ and 40㎍/㎗. 6. The slope of simple linear regression of CPbB (independent variable) with ZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead. 7. The slope of simple linear regression of CPbB (independent variable) with LZPP in female workers(0.0308was steeper than in male workers(0.0253). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But where was no slope difference between two groups divided by their work duration of 2 years less and more. While the slope of simple linear regression of CPbB lead (independent variable) with LZPP in lead workers whose blood lead were hogher than 30㎍/㎗ was not steeper than those whose blood lead were less than 30㎍/㎗, there was no slope difference between two groups whose blood lead were less than 40㎍/㎗ and more than 40㎍/㎗. 8. The slope of simple linear regression of CPbB (independent variable) with LZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead, but the difference was not significant then that of CPbB and ZPP. With above results, it is recommended that the screening criteria value of ZPP should be down to 60-70㎍/㎗ from 100㎍/㎗ for male lead workers and screening criteria of ZPP for female lead workers was all right with current value of 100㎍/㎗. So it is recommended to make different screening criteria of ZPP for male and female workers like the hemoglobin and hematocrit screening criteria. It is also preferable to use CPbB and LZPP rather than uncorrected PbB and ZPP in the evaluation of lead exposure for lead workers.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

日本 엔貨換率의 自己相關條件附異分散(GARCH)에 관한 硏究

李潤九,李相根 明知大學校 附設 日本問題硏究所 1997 日本硏究 Vol.5 No.-

장기 구매력평가 가설의 공적분 분석

李成九 明知大學校 經濟硏究所 1995 경영연구 Vol.12 No.1

7분 선별검사(7 Minute Screen Test) 각 하위 척도의 임상적 유용성

구형모,김지혜,고선규,고혜정,이형석,김상윤,김도관 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : We aimed to provide standard data of the individual tests in 7MS that could generalized for Korean elderly accor-ding to age and education. We also evaluated diagnostic efFicacy of each test in 7MS. Methods : Data on demographic characteristics of 311 normals were gathered for comparison. We also assessed two differences between normal and dementia group in individual tests of 7MS. Results : All individual tests of 7MS showed significant differences in sex, age, and education, except for ECR. But there were no significant differences in sex controlling age and education. As a result of ROC curve, the ability of the ECR test to discriminate between AD and normal subject appeared superior. The scores of the individual tests of 7MS among CDR 0.5 and 1 group and normal group were compared. It was also found that the ECR test stands out among 7MS tests. Conclusion : The 7MS, Particularly ECR, had the highest sensitivity and specificity for diagnosis of AD as well as early de-mentia. It suggests that the individual tests of 7MS are useful to predict early dementia, without using the complex logistic re-gression equation.

결절성 및 괴상성 간세포암에서 역동적 전산화단층촬영 소견에 따른 경동맥화학색전술결과의 예측

이성문,김홍,지성우,우성구,이정형,서수지,손철호 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.2

Purpose: To evaluate retrospectively whether it is possible to predict the transarterial chemoembolization(TACE) result with the pre-TACE dynamic CT findings. Materials and Methods: The dynamic CT findings of 33 patients with 35 nodular and 8 massive hepatocellular carcinoma(HCCs) who was taken follow up CT after TACE, were reviewed retrospectively. After excluding the diffuse or infiltrative HCCs, the mass was classified into two groups of nodular and massive types. The size, location, degree of enhancement, pseudocapsule, portal vein(PV) thrombosis and arterioportal(AP) shunt were evaluated on the dynamic CT scans. The vascularity, multiple or parasitic blood supply, AP shunt and the possibility of superselection were considered on the angiography. After TACE, the pattern of lipiodol uptake and residual enhancing nodules were evaluated on the follow-up CT scans. Results: The good TACE results could be obtained in 18 of 35 nodular HCCs with dynamic CT findings of small size(mean=2.94cm), peripheral location, hyper-or iso-enhancement, and absence fo PV thrombosis, with angiographic finding of possible superselection, but the pseudocapsule did not give important effect on the result. Most of the massive HCCs had poor TACE results. Conclusion: The prediction of the TACE results of nodular and massive HCCs was possible with dynamic CT findings. If the good prognostic factors were not observed on the pre-TACE dynamic CT, the multiple TACE and/or combination therapy with percutaneous ethanol injection(PEI), surgical resection or others should be considered for the effective control of the HCCs.

알칼리성 폐수를 중화제로 사용하기 위한 처리방법 연구

구민희,이찬원,문성원 경남대학교 환경문제연구소 2002 환경연구 Vol.25 No.-

A cleansing wastewater which comes from operating water-purifying machine is classified as a strong alkaline wastewater. When this alkaline wastewater was directly applied to the neutralization of acidic wastewater, there were several problems such as increasing the coagulant amount, reaction time, and floating of sludge in the neutralizing tank. Thus, the goal of this study is to fix the problems in utilizing the alkaline wastewater as a neutralizing agent by introducing a new method to the first pre-treatment process. A cleansing wastewater was characterized by pH 12.3, COD 28mg/L, and SS 25mg/L. Without any treatment, there would be some difficulties in treating in the following physicochemical sewage treatment facilities. When seawater or bittern was added to the alkaline wastewater, the solids were coprecipitated with Mg(OH)₂. Use of alkaline wastewater after removing some contaminants and color made it possible to treat wastewater effectively and economically in the next step of wastewater treatment.

地方自治를 위한 基層組織으로서의 洞會의 機能開發模型

李南久,琴鍾友,鄭三澤,全相恒 경북대학교 1991 새마을 硏究論叢 Vol.12 No.-

장애인생활시설의 교육서비스 요구 분석

이상복,김춘희,유은정,이원령,구원옥 대구대학교 특수교육재활과학연구소 2004 특수교육재활과학연구 Vol.43 No.1

The purpose of this study was to provide suggestions for the future 2year educational services based on the on-going education services for the persons with disabilities in the facilities. The results of the study were as follows. First, the facilities manly provided the persons with disabilities with the educational programs for improving basic functional skills in their daily living lives. Second, the recording data showed that average 2 out of 10 short-term plans were reached to above 80% of successful performance levels, and the rest of the 8 plans were reached to between 11% and 79% of the unsatisfactory levels.