항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

증후성 단일 소심부뇌경색의 임상적 및 방사선학적 양상

신원철,이태규,노용우,오재욱,장대일,정경천 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3

여성 요도증후군에서 Terazocin의 효과에 대한 연구

우승효,신관희,한광희,정원일,이형래,이상철,김용태,김원재 충북대학교 의학연구소 2000 忠北醫大學術誌 Vol.10 No.2

연구목적: 여성 요도증후군을 보이는 환자에서 교감신경차단제인 terazocin을 복용한 후 치료 효과에 대한 각 증상의 변화와 부작용을 알아보고자 하였다. 대상 및 방법: 1997년부터 1999년까지 충북대학교병원 비뇨기과에 내원한 35명의 여성 중 요검사 및 요배양 검사, 그리고 다른 이학적 검사에서 이상이 없는 요도증후군 환자를 대상으로 간질성방광염 증상점수(ICSS)를 terazocin (3mg/day for 3 months) 투여 전후에 조사하였고, 치료 후 3개월과 1년에 Likert scale 점수를 조사하였다. 결과: ICSS는 비치료군은 18.3±5.9점, 치료군은 16.5±6.8점으로 두군간의 차이는 없는 것으로 나타났다(p=0.52). 치료군은 치료 후 3개월에 시행한 ICSS가 9.9±7.8점으로 치료 전에 비해 현격히 증상이 호전되는 것으로 나타났다(p=0.0001). 특히 3개월에 시행한 Likert scale에서는 주간 및 야간빈뇨, 절박뇨, 배뇨통의 횟수 및 강도, 그리고 전체적인 증상정도에서 40-70% 가량 호전된 것으로 밝혀졌으며 이는 1년 후에도 증상의 호전이 지속되는 것으로 나타났다. 비치료군에서의 1년 후 Likert scale은 6명 중 2명이 전체적인 증상의 호전이 있는 것으로 나타났다. 결론: Terazocin은 환자의 약 70%가량에서 증상의 호전을 가져왔고, 비치료군에서도 환자의 33%가 저절로 증상이 좋아진 것으로 보아 Terazocin은 여성 요도증후군에서 분명히 효과가 있으나 증상이 심할 경우 보조적인 치료로 이용되는 것이 바람직할 것으로 사료된다. Purpose: We performed to assess the effects and complications of terazocin in women with chronic female urethral syndrome. Materials and Methods : Thirty-five women with chronic female urethral syndrome were studied from March 1997 to August 1999. The subjects exhibited normal findings without the pyuria and bacteriuria in urinalysis and urine culture and were invested the interstitial symptom score(ICSS). 29 subjects of them took a terazocin 1-4 mg/day for 3 months. They were reevaluated for the ICSS and Likert scale after 3 months and for Likert scale after 1 year. Results: The ICSS before treatment were showed 18.3±5.9 in the untreated patient group and 16.5±6.8 in the treated patient group, and no statistically difference between both patient groups(p=0.52). In the treated patient group, the ICSS after treatment were showed 9.9±7.8, significant difference between before and after treatment(p=0.0001). The Likert scale was showed at 3 months after treatment that frequency, nocturia, urgency, pain frequency, pain intensity, daily activities, and overall symptoms were improved in 65.5%, 55.2%, 24.1%, 41.4%, 41.4%, 70%, 70%, and 70% of 29 subjects, each other. Overall symptom score assessed at 1 year were showed that 3 subjects was aggravated. In untreated patient group, 2 of 6 was improved in overall symptom score. Conclusion: Terazocin was effective above 70% in the treated group, and symptoms were improved spontaneously in a third of the untreated group. So, we thought that terazocin would be useful as supportive treatment in period of severe symptoms.

전력선 통신(PLC)을 위한 모뎀 개발에 관한 연구

신관우,김용태,이윤섭 공주대학교 생산기술연구소 2001 論文集 Vol.9 No.-

PLC (Power Line Communication) is the communication method using the existing power line installed in houses and offices to convert and transmit high frequency communication signal from tens of KHz to tens of MHz, and receive the filtered signal using high frequency filter. The advantage of PLC is that PLC uses the existing power line installed in houses and offices so it does not require separate power line. Easy and convenient access using electric outlets is another advantage of PLC. However, PLC has some disadvantages such as limited transmission power, high load interference and noise, variable signal attenuation, characteristic of impedance, selective possibility of frequency property. This study designed the boiler temperature control system by unit using the modem designed on the basis of technology used for PLC modem. After conducting experiments with systems, it was possible to control stably. By commercializing this product, we can avoid unnecessary heating of separate temperature control unit, and save the cost accordingly.

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

公共行政에 있어서 市民參與制度의 役割

申容宇 상명대학교 논문집 1986 상명대학교논문집 Vol.17 No.-

1. Introduction 2. The Meaning of Citizen Participation 3. Citizen Participation and Administrative Democracy 4. Citizen Participation and Administrative Efficiency 5. Conclusions The number of administrative agencies and employees grew slowly but steadily during the 19th and early 20th centuries, and then increased explosively on the occasion of World War Ⅰ, the Depression, and World War Ⅱ. Max Weber, after all, warned us that in capitalist and socialist societies alike, bureaucracy was likely to acquire an overtowering power position. To control the high-powered authority of administrative agencies and employees, we can propose Citizen Participation which is the best way to secure Democracy. And, this citizen participation is understood to be a process by which citizens organize into interest groups and lobby, bargain, and otherwise respond to the established program agencies. This thesis focuses on the impact of citizen participation upon the administrative democracy and the administrative efficiency. At first, consideration of the impact of citizen participation upon the administrative democracy propose that citizen participation has a merit which it removes the citizens' disadvantages due to the bureaucrats' professional self-righteousness, hierarchical force of habit, secrecy, etc. Also, consideration of the impact of citizen participation upon the administrative efficiency propose that citizen participation require the high cost at the sides of personal management, economics, planning, and so on. According to these results, we can know citizen participation generally improve the administrative democracy, but decrease the administrative efficiency. Finally, the application of the citizen participation in the administrative process have to be decided by the valuation of the administrative democracy and the administrative efficiency.

산화구리에 의한 배기 가스 중의 아황산 가스 제거 : 반응속도에 관한 연구 A Kinetic Study

신창섭,노용우,이태희 연세대학교 산업기술연구소 1985 논문집 Vol.17 No.2

The reaction of cupric oxide powder with 2% sulfur dioxide was investigated over a temperature range of 300-500℃ and over a particle size range of 0.051-3㎜. The experimental data were correlated well by the shrinking unreacted core model and the optimal reaction temperature was found to be 450℃. With average particle diameter less than 1㎜ and superficial gas velocity higher than 8.8 ㎝/sec, the reaction of cupric oxide powder with sulfur dioxide was found to be controlled by the chemical reaction and the intrinsic rate constant was k=8987 exp(-8134/RT).

반송용 편측식 선형기기의 추력제어에 의한 특성해석

우정인,신동률,조용길,노태균 東亞大學校 大學院 1999 大學院論文集 Vol.24 No.-

본 논문에서는 PWM 인버터 구동 편측식 선형유도 전동기(이하 SLIM)의 공간백터 제어와 PI 제어를 통한 추력 제어를 행한다. 1차측 권선과 SLIM의 2차측 구조 사이에서 발생하는 공극길이의 떨림은 빠른 응답특성을 얻기위해서 최소화 되어야 한다. 먼저, SLIM의 전압방정식이 추력과 수직력 특성을 해석하기 위하여 d-q축 등가회로로서 나타내어진다. 또한, d-q축 등가회로의 모델링과 해석은 등가회로상에서 전류변동에 따른 강인한 과도 추력특성을 얻을 수 있다. 지령속도와 추력에 의한 SLIM의 직접구동 결과는 실험을 통해서 확인된다.

Managing Cultural Diversity by Effective Human Resource Management of International Trade: Focus on Asian Perspectives

Shin,Soo Yong,Pak,Myong Sop,Cho,Sung Woo 한국무역상무학회 2012 貿易商務硏究 Vol.56 No.-

Changes in the global business environment continue at an accelerated pace. The 21st century maybe remarked, perhaps, for its hot issues on globalization and diversity. Diversity may arise in terms of ethnic, gender, age and culture. Cultural diversity out of all stands out in front in modern times as more multinational companies operate internationally resulting more people to start living abroad and work with people from different cultures. In recent years, these multinational companies realized the important roles human resource management play in international trade since cultural diversity is very influential on their work performance. A well-managed human resources will ensure organizations' success to a great extent. This paper touches the field of cultural diversity and introduces human resource management of international trade as a way to handle diversity matters faced by international organizations.

배 농가의 경영효율성 분석 : 비모수적 접근방법에 의한 사례연구 A case study using non-parametric method

우수곤,유진채,강경하,신용광 한국농촌지도학회 2002 농촌지도와 개발 Vol.9 No.2

The objective of this study was to compare the farm efficiency of members of cooperative firms with that of non-members in Korea. Data were collected from 27 farms members of three cooperatives and 13 non-member farms, based on the managerial achievements of 1999. For the analysis, the data were divided into three different farming types: type I and Ⅱ of member farms and non-member farms. Economic analysis were implemented using DEA(Data Envelopment Analysis). Major findings was as follows. Total average technology efficiency was 0.782, which implies that there still remains 21.8% of improvement possibility. Among the time types, type I showed the highest technology efficiency of 0.9055, while " 11 and non-member farms showed 0.7670 and 0.7171, respectively. This means that these farms have relatively high potential improved. Also, comparing technology efficiency by dividing into pure technology and scale efficiency, all type of the farms exhibit a higher pure technology efficiency compared to scale efficiency. Therefore, to improve current technology efficiency, farms need to focus more on pure technology efficiency improvement. Meanwhile, profit analysis based on farm size indicate that most of the farms demonstrated the increasing-return-to-scale, which means it is necessary to extend the farm size to improve technical efficiency. Type I member farms achieve higher profit and efficiency than other two types and relatively higher producer prices through introducing cooperative sorting, grading and packing. Also, these labor saving technologies increased farm size.