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.

파킨슨씨병 환자에 있어서 자가부신수질 이식술

정상섭,박상근,오성훈,김선호,윤도흠,박정수,양우익,최인준,안영수,김경환,박창일,김진수,이현철 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.6

Recent experimental studies and clinical cases have suggested that grafting tissue from the adrenal medulla into the brain may alleviate the symptoms of Parkinson's disease. Autologous adrenal medullary grafts into the striatum was performed stereotactically in two patients with Parkinson's disease. Both patients were bedridden preoperatively, but 4 months after the surgery both became ambulatory and one was even capable of returning to his job. Even though the number of cases was small⑵ and the follow-up period was short, this study shows that adrenal medullary transplantation into the striatum may have some beneficial effects in patient with Parkinson's disease. Further experimental and clinical trials are necessary to see whether this procedure will be a recommendable surgical treatment for patients suffering from Parkinson's disease.

I-Beam연속교 내측지점의 소성변형에 관한 연구

정경희,김진성,양승이 한국산업안전학회 2002 한국안전학회지 Vol.17 No.4

The steel shows plastic deformation after the yield point exceeds. Because of overloads, the plastic deformation occurs at the interior support of a continuous bridge. The plastic deformation is concentrated at the interior support, and the permanence deformation at the interior support remains after loads pass. Because local yielding causes the positive moment at the interior support, it is called "auto moment". Auto moment redistributes the elastic moment. Because of redistribution, auto moment decreases the negative moment at the interior support of a continuous bridge. In this paper, the moment-rotation curve from Schalling is used. The plastic rotation is computed by using Beam-line method, and auto moment is calculated based on the experiment curve. The design example is presented using limit state criterion.

공공정보화사업의 사전평가 모형 구상 : 예산과의 연계와 사업 실효성 확보방을 중심으로

양재진,정명주,정진우 한국정보사회진흥원 2003 정보화정책 Vol.10 No.3

공공정보화사업은 다른 사업보다 파생효과가 큼 국가적으로 중요한 사업이나, 생애주기가 짧고 변화가 심한 정보기술을 활용하는 특성을 가지고 있어, 사업 실패의 가능성이 큰 문제를 안고 있다. 그리고 업그레이드 비용 등 유지비가 많이 소요되는 특징을 가기고 있다. 따라서 예산편성시부터 사전평가의 강화를 통해 국가자원의 낭비를 막고 동시에 사업의 효과성을 높이는 과제를 안고 있다. 이러나 인식하에, 본 논문은 사후평가 위주의 현행 한국 정보화사업평가체제의 문제점을 지적하고, 사전평가 도입의 필요성을 제기하였다. 구체적으로 정보화사업 2 단계 사전평가 모형을 제시하였는데, 제 1 단계 사전평가는 국가과학기술위원회의 국가연구개발사업 사전조정 모형을 바탕으로 예산과정과의 연계를 담보할 수 있는 제도화 방안을 다루었고, 제 2 단계 ㅅ전평가는 정보화지원사업의 구체화 단계에서 한국전산원의 역할을 바탕으로 사업계획서 검토와 사업자 선정에 관련된 제도화 방안을 다루었따. 제 1 단계 사전평가의 실효성 확보를 위하여 본 논문은 정보화추진위원회를 대통령 산하로 개편하고 정보화 예산심의 권한을 법제화할 것을 주장하였고, 기타 사전평가와 조정의 합리화 방안 등을 제시하였다. 제 2 단계 사전평가와 관련하여서는 대상사업과 전문기관의 인증문제 그리고 그리고 사업계획서 검토와 계약관련 사항에 대해 논의하였다. Public informatization projects(PIPs) are strategically important government's works due to their far-reaching spon-off effects. But PIPs have inherent shorcomings since they have to rely on information technolgies characterized by short life cycle and barely predictable developmental path. Moreover, PIPs once in place require a high level of maintenance costs incurred by continuous upgrades and operation staffs. Therefore, a systematic ex-ante evaluation of PIPs should be built-in in the budgeting process. With this point in mind, this paper prposes a two-step ex-ante evaluation model. Based on the national R&D budget prescteening by the National Science and Technology Council the first step pre-screens competing PIP proposals and notifies the results to the national budgetary agency. The second step seeks to maximizes funded PIPs' performance by doing front-end analyses and providing technical assistanies before the launch of PIPs, as seen in the National Computerization Agency's activities for PIPs funded by the information promotion fund.

지속형 항응고성 살서제 중독에 기인한 뇌실질출형 1예

양충용,이진훈,이서울,정복희,노상균,신용일 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

저자들은 brodifacoum성분의 지속형 효과를 갖은 항응고제인 쿠마린계 살서제를 정확한 용량을 추정할 수는 없지만 다회의 약물 복용 17일 후 뇌실질출혈이 발생한 증례를 문헌 고찰과 함께 보고하는 바이다. 지금껏 쿠마린계의 지속형 항응고성 살서제의 약물 중독이 알려져 있다. 이러한 약물은 vitamin K₁ 2,3-epoxide 환원효소를 억제하여 vitamin K₁과 연속적으로 vitamin K₁ 의존성 응고인자 Ⅱ, Ⅶ, Ⅸ, Ⅹ의 합성을 억제하고 이로써 출혈 경향을 증가시킨다. 이 증례를 토대로 향후 출혈성 환자 특히 선행 질환이 없는 젊은 뇌실질출혈 환자에서 원인을 감별진단 함에 있어 환자의 약물 중독 가능성과 치료에 대한세심한 주의가 필요할 것으로 생각한다. Spontaneous intracerebral hemorrhage is one-tenth of all strokes and represents relatively high frequency and morbidity. Hypertension is the most common cause of spontaneous intracerebral hemorrhage and other causes are vascular malformation, intracerebral amyloid angiopathy, hemorrhagic infarction, blood diseases and drug abuse. Some peoples have the intoxication of drug such as long-acting anticoagulant of rodenticides, family of cumarin, that inhibit vitamin K₁ 2,3-epoxide reductase, the synthesis of vitamin K₁ and subsequently vitamin K₁ dependent clotting factors Ⅱ, Ⅶ, Ⅸ, and Ⅹ. Finally these make prolonged PT, INR and aPTT, which are prone to trigger bleeding tendency. We report a rare case of intracerebral hemorrhage maybe caused by after frequent intended ingestion of long-acting anticoagulant rodenticide(brodifacoum) for suicide.

급성충소돌기염의 임상 : 병리학적 고찰

양기화,조준필,하영천,한진우,정학재,손수창,이성희,황재훈,신철호 최신의학사 1989 最新醫學 Vol.32 No.4

무우자갈버섯(Hebeloma crustulineforme)을 위시한 한국산 담자균류 46종의 용혈활성 검색

양희정,정수현,김진향,정경수 충남대학교 약학대학 의약품개발연구소 1997 藥學論文集 Vol.13 No.-

To elucidate the hemolytic toxicities of Korean basidiomycetes, the cold-water extracts of 46 wild mushrooms were tested for hemolytic activity on mouse erythrocytes. Twelve species including Amanita esculenta, A. griseofarinosa, A. longistriata, A. melleicepe, A. phalloides, A. rubescence, A. spissacea, A. vaginata, Hebeloma crustuliniforme, Lepiota cygnea, Macrolepiota procera, and Oudemansiella platyphylla showed strong hemolytic activities. Of these, A. griseofarinosa and H. crustuliniforme showed no decrease in their hemolytic activity even after five minutes' boiling.

구강으로부터 분리한 Micromonospora aurantiaca 인공치태 형성에 미치는 영향

정진,양규호,오종석,박진경,김선미 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

The critical etiologic factor in the development of dental caries is dental plaque. The main component of dental plaque is the mutan produced by streptococcus mutans. The following results were obtained by using blue mutan to assess the factors affecting the mutan-digesting activity of micromonospora aurantiaca isolated from oral cavity. Micromonospora aurantiaca digested more blue mutan in the minimal essential broth at pH 7.0 than at pH5.5 or 8.5, and at 37℃ than at 32℃ or 42℃. Blue mutan was similarly digested at the range of lmM to 16mM of CaCl₂and 0.1mM to 6.4 mM of MgCl, while being significantly digested at the concentration of 2.5mM of KCL. When the concentration of glucose was decreased in the minimal essential broth, the digestion of blue mutan was increased, When the culture supermatant of Micromonosoira ayrabtiaca in the broth with 1% glucose or 0.5% mutan was mixed with 2× BHLYS broth containing 0.5% yeast extract and 10% sucrose, the formation of artificial plaque on the orthodontic wires by streptococcus mutans was inhibited(p<0.05). These results indicated that the production of mutanase was identified in the culture supernatant of Micromonospora aurantiaca, suppressing the formation of artificial plaque by streptococcus mutans.

과량의 방사선에 노출된 흰쥐 소뇌외측핵의 미세구조

정재삼,양남길,안의태,고정식,박경호,김진국 대한해부학회 1992 Anatomy & Cell Biology Vol.25 No.3

해결중심 집단상담이 학교부적응 청소년의 학교생활태도와 자아존중감 및 희망에 미치는 효과

김수진,이정숙,양미화 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Purpose : This study was designed to examine the effects of solution-focused group counseling on the school attitude, self-esteem and hope in school maladjusted adolescents. Methods : The research design of this study was a non-equivalent control group pre-post test design. Thirty middle school students referred to a community mental health center in G city for school maladjustment from a school and welfare center were assigned to the experimental group and thirty middle school students in care for school maladjustment at a welfare center were assigned to the control group. The solution-focused group counseling for the experimental group was conducted once a week for 90 minutes during 6 weeks. The data were collected from December 10, 2003 to May 23, 2004. The data was analyzed by χ2-test, t-test and paired t-test using the SAS program. Results : 1) School attitude increased significantly after solution-focused group counseling (t=6.036 p=.001). 2) Self-esteem increased significantly after solution focused group counseling (t=2.705, p=.010). 3) Hope increased significantly after solution-focused group counseling (t=3.671, p=.001). Conclusion : Solution-focused group counseling appears to be a very effective intervention for school maladjusted adolescents by increasing self-.esteem, positive school attitude, hope and coping with problems.