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.

左則 上두骨 및 頰骨에 發生한 殲維性 骨異形成症의 治驗例

梁棟奎,朴相俊,金秉民,金基元,金鍾烈 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.3

Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced and disturbed by poorly organized, structually unsound fibroosseous tissue, which may produce cortical expansion. When facial bones are involed, considerable esthetic deformity may result. The term monostotic fibrous dysplasia has been applied when one bone is involved : when more than one bone is affected, the term polyostotic used. The polyostotic form may be accomplished by pigmented skin lesion (Jaffe type), or by pigmented skin lesions with endocrine disturbance (Albright syndrome). No general agreement exists on the cause of fibrous dysplasia. A few authors have suggested that fibrous dysplasia arises as a resujlt of trauma. It occurs predominantly in infant, adolescent females and runs a variable clinical course. When several bones are involed, it tends to be unilateral. Involements of alveolar bone may produce displacement of teeth with malocclusion, or loss of teeth, or both. Radiographycally, ti shows an indistinctly delimited osteolytic defect with a bubble - like pattern, but without a sclerotic rim. The preferred treatment is almost always surgery. If the lesion is extensive, surgical intervention with use of recontouring procedures aimed at the correction of esthetic or funtional disturbances is preferred treatment. Now, we present a case of fibrous dysplasia on the left maxilla and the zygoma treated by bony contourign via hemicoronal flap and intraoral approach with good results.

時差性 多發病變을 보인 유전성 비용종성 대장암 1예

양동휘,강구정,민중기,김병구,박용기,최창록,지정희 대한대장항문학회 1992 Annals of Coloproctolgy Vol.8 No.3

韓國人血液群 A,B,및 AB 赤血球의 被疑集性에 關한 硏究

梁學道,李楨浩,尹秉文,芮薰海,全東雨,李文玉,金晉郁 醫藥係社 1955 綜合 醫學 Vol.12 No.8

Cardiolipin-Lecithin 抗原과 Reagin間의 沈降反應 및 補體結合反應成績의 比較檢討

梁學道,芮薰海,李楨浩,尹秉文,全東雨,金晉郁,金永洙 醫藥係社 1955 綜合 醫學 Vol.12 No.2

타액 할로페리돌 측정

楊秉煥,吳東烈,鄭恩基,鄭夏承 漢陽大學校 精神健康硏究 1987 精神健康硏究 Vol.6 No.-

DSM-Ⅲ-R 성격장애 진단의 내용타당도

양병환,조연규,김창현,황순택,오동열 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

The purpose of this study was to examine the content validity of DSM-Ⅲ-R personality disorder(PDs). A 3-point rating scale of 150 preliminary diagnostic criteria including 95 DSM-Ⅲ-R PD diagnostic criteria was sent to psychiatrists. Each item in this scale was rated by psychiatrists(n=101) in term of prototypicality to every DSM-Ⅲ-R PD. The results show that each PD criteria set of DSM-Ⅲ-R was registered high level of interrater consistency and items listed in the DSM-Ⅲ-R were, for the most part, rated as very prototypical to their DSM-Ⅲ-R diagnosis. Some criteria were, however, not rated to characteristic features to their DSM-Ⅲ-R diagnosis. 11 items of DSM-Ⅲ-R diagnostic criteria scored high not only to their DSM-Ⅲ-R diagnosis but also other diagnosis. 16 items rated as high prototypicality item of other diagnosis. Another 16 items seemed not to be appropriate to any of DSM-Ⅲ-R PD diagnosis. These results suggest that the content validity of the DSM-Ⅲ-R personality disorder is not so high.

VDRL 硝子板法 陰·陽性 血淸에 對한 Waaler-Rose 反應

梁學道,李楨浩,尹秉文,芮薰海,全東雨,金晋郁,玉東石 醫藥係社 1954 綜合 醫學 Vol.11 No.12

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

측뇌실내 수막종 : 임상분석 및 수술접근법 Clinical Analysis and Surgical Approach

양희진,김동규,정희원,이현구,김현집,조병규,최길수,한대희 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10

The authors present six cases of lateral ventricle meningiomas treated at Seoul National University Hospital between 1979 and 1991. These six cases of lateral ventricular meningiomas constitute 1.8 percent of all intracranial meningiomas and 16.7 percent of mass lesions of the lateral ventricle. The mean age was 29 years ranging from 11 to 50 years, younger than that or intracranial meningiomas with a statistical significance(p<0.01). Four of the patients were women and two were men. All cases were located in the trigonal area. The most common clinical symptoms and signs were related to increased intracranial pressure such as headache, nausea and vomiting. Based on the clinical presentation and radiological features(CT. MRI and angiography), correct preoperative diagnosis was possible in five cases. Gross total removal of the tumor was achieved in all cases. There was no operative mortality. A temporal gyrus approach was used in five cases with good surgical results. The benefits and drawbacks of each surgical approach for meningiomas of the lateral ventricle is discussed with review of pertinent literatures.