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.

Esmolo과 lidocaine의 혼합사용시 기관내 삽관에 따른 혈압과 심박수에 미치는 영향

하정량,손용,김태요,윤재승,송윤강 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.1

Background: Ultrashort acting β-adrenergic antagonist, esmolol and local anesthetics, lidocaine are well known about effects of hemodynamic stabilization to tracheal intubation. But, the effects of these drugs are still controversial. The aim of the present study is to assess whether a combination of both drugs are more effective than either drug alone. Methods: Forty eight patients, ASA physical status Ⅰ or Ⅱ, were randomly assigned to one of four groups (n=12 each): control (Group S), esmolol 1 ㎎/㎏ (Group E), lidocaine 1 ㎎/㎏ (Group L) and esmolol-lidocaine combination (Group M). Anesthesia was induced with thiopental 5 ㎎/㎏ intravenously, and then saline, esmolol, lidocaine and combination drug were administered as an intravenous bolus, and immediately followed by succinylcholine 1.5 ㎎/㎏. Tracheal intubation was done 90 seconds after intravenous injection of drugs, respectively. Systolic and diastolic blood pressure and heart rate were measured before induction and every minute for 5 minutes after tracheal intubation. Results: There was a significant attenuation in systolic, diastolic arterial pressure and heart rates after tracheal intubation in esmolol-lidocaine group compared to other three groups. Conclusions: Combination of esmolol 1 ㎎/㎏ with lidocaine 1 ㎎/㎏ seems to be useful for attenuation of the increases in blood pressure and heart rates compare to either drug alone after tracheal intubation.

일 농촌지역의 우울 증상에 관한 역학연구 -위험요인 및 요인구조분석

하양숙,홍진표,김한규,이군희,한경자,조맹제,김용익,송미순,박성애,김창윤 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 세계적으로 널리 사용되는 우울증 척도인 the Center for Epidemiologic Studies Depression Scale(CES-D)을 이용하여 지역사회 주민의 우울증상의 정도를 평가하고, 우울증상의 위험요인을 분석하고, 한국인에서 우울증상의 요인구조를 알기 위해 본 연구를 실시하였다. 방 법 : 경기도 일 농촌 지역의 30세 이상 주민에 대해 무작위 군집 집락 추출을 실시하였고, 훈련된 면담원들이 가정 방문을 통하여 면접 및 자기보고 검사인 CES-D를 실시하였다. 총 1,315명에서 응답을 하였고 응답율은 59.3%이었다. 결 과 : CES-D에 의한 우울증 점수는 0∼5점이 57%정도를 차지하였고, 평균 점수는 남자 7.8점 여자 9.5점으로 비교적 낮은 편이었다. ANCOVA 분석 결과 비결혼, 저학력, 여성이라는 위험요인은 독립적으로 우울증상을 악화시키는 요인이었으나 연령은 통계적으로 유의하지 않았다. CES-D 결과를 요인분석을 시행한 결과 4가지 요인이 추출되었는데 우울증상 및 신체증상이 한 개의 요인으로, 다른 나라에서 보고되지 않는 정서적 고통이 별도의 요인으로 추출되었다. 결 론 : 국내 역학 조사에서도 외국과 유사한 우울점수 및 위험요인이 확인되었으나 우울증의 요인에서는 특이한 요인이 추출되었다. 한국인에 독특한 우울 반응에 관한 추가 연구가 필요하다. Objectives :The rates, correlates, and factor structure of depressive symptoms in a Korean rural sample were examined using Korean version of the Center for Epidemiologic Studies Depression Scale(CES-D). Methods : Door to door visiting survey was conducted by trained interviewers. A random cluster sample of 1,315 respondents, aged 30 and over completed the CES-D scale along with additional sociodemographic questionnaire. Results : In this sample, mean CES-D score of male and female were 7.8 and 9.5, respectively which were lower than those reported previously. Symptoms of depression were most common among the less educated, non-married and female according to ANCOVA. Age was not a significant risk factor for depressive symptoms. Different factor structures emerged from this sample as compared to other studies using this approach. Somatic symptoms and affective symptoms were combined as one factor and emotional hardship emerged as a separate factor. Conclusion : Symptoms scores and risk factors were similar to the results reported in other countries but unique factor structures were found in this study. Further research is needed about the Korean depressive symptomatology and related areas.

低溫 鹽素化 反應에 依한 Silicon 製造

尹秉河,林龍進,金大龍,金圭鎬 경북대학교 공과대학 1980 工大硏究誌 Vol.9 No.-

The preparation of high purity silicon by the hydrogen reduction of sicl_4 which producted from the chlorination of commercial ferrosilicon was carried out. The chlorination rates and reaction ratio of ferrosilicon were increased with inoreasing of temperature and Cl_2 flow rate. The optimum Cl_2 flow rate and particle size of ferrosilicon was about 50ml/min and 30-40mesh, respectively. Reaction rate and reaction ratio were increased in the presence of NiCl_2, but CaCl_2, znCl_2, Cu powder and Cu-turnings were acted as an acticatalystic effects. By the addition of 10% NiCl_2 catalysis at 250℃, 66% reaction ratio for four hours was obtained. Silicon chlorides products were purified by the combination of the fractional distillation and silica gel adsorption techniques, and, using these purification techniques, all metallic and nonmetallic impurities were eliminated to unit ppm purified SiCl_4 was reduced in a graphite tube by hydrogen in the temperature range of 900-1200℃, The yields of the silicon products were increased with increasing of temperature and H_2/SiCl_4 mole ratio, and yields at 1100℃ and 1200℃ with mole ratio of 50 was 30% and 43%, respectively. Growth morphologies of silicon crystal were fine needle or cobweblike growth up to 1100℃ and coarse needle or sawtoothlike at 1200℃. These growth morphologies were little changed with precipitation substrates. The purity of silicon product which was analyzed after etching of HF and hydrochloric acid was higher than 99.99%.

경기북부지역에 잘 적응하는 콩 품종 선발

윤성탁,주용하 한국국제농업개발학회 2003 韓國國際農業開發學會誌 Vol.15 No.4

경기도 북부지방의 환경조건에 적응하는 콩 품종을 선발하고자 13개 품종을 공시하여 생육 및 수량특성을 조사ㆍ검토한 결과는 다음과 같다. 1. 성숙기에 13개 품종의 경장은 74.4~134.9㎝의 분포를 보였으며, 가장 경장이 큰 품종은 송학콩으로 134.9㎝이었으며, 가장 작은품종은 대황콩으로 74.4㎝이었다. 2. 주당협수는 47.1~62.4개의 분포를 보였으며, 협수가 가장 많은 품종은 장수콩으로 62.4개이었으며, 가장 적은 품종은 대황콩으로 47.1개이었다. 3. 협당립수는 신팔당콩2호가 2.73개로 가장 많았으며, 그 다음은 송학콩 및 대황콩으로 각각 2.3, 2.2개이었다. 4. 등숙률은 소담콩, 황금콩, 장수콩이 각각 91.1, 90.7, 90.3%순으로 높았다. 100립중은 13개 품종이 20.8~38.2g의 분포를 보였으며, 대황콩이 38.2g으로 가장 컸다. 5. 종실수량은 신팔달콩2호가 272.6㎏/10a으로 가장 높았으며, 다음은 장원콩(255.7㎏/10a), 태광콩(250.9㎏/10a), 송학콩(249.3㎏/10a) 순이었으나, 이들간에 유의한 통계적 차이는 나타나지 않았다. 6. 13개 품종에 대한 병충해 발생정도를 보면 자반병에 이병율이 적은 품종으 장엽콩, 장수콩, 장미콩, 소담콩, 대황콩이 0.11%로 적었으며, 미이라병은 신팔달콩2호, 장미콩이 SMV 감염율은 신팔달콩 2호, 태광콩이 이병률이 적었다. 7. 수량은 주당협수, 주당립수, 주당립중과 정의 상관관계를 보여 주당협수, 주당립수, 중당립중이 많을수록 수량이 많음을 알 수 있었다. 8. 결론적으로 본시험의 결과를 종합해 보면 공시된 13개 품종 중 수량 면에서 보면 신팔달콩 2호가 272.6㎏/10a로 가장 많았으며, 병충해도 비교적 적고, 경장도 크지 않아 도복저항성도 클 것으로 판단되어 경기북부지역에서 재배하기에 적합한 품종으로 판단되었다. This experiments were carried out to evaluate the growth and yield characteristics of 13 soybean varieties and select the optimum varieties for Gyeonggi northern areas. Stem length of 13 varieties ranged from 74.4㎝ to 34.9㎝. The highest stem length was shown in Songhakkong with 134.9㎝ and the lowest was shown in Daehwangkong with 74.7㎝. Number of pods per plant of 13 varieties ranged from 47.1 to 42.4. The highest number of pods per plant was seen in Jangsukong with 62.4 and the lowest was seen by Daehwangkong with 47.1. Shinpaldalkong #2 showed the highest seeds per pod, and the next was in oredr of Songhakkong and Dashwangkong with 2.3 and 2.2 seeds, respectively. Sodamkong, Hwangkeumkong and Jangsukong showed higher ripened seed ratio by 91.1, 90.7, and 90.3% respectively among 13 varieties. One hundred seed weight ranged from 20.8 to 38.2g, and Daehwangkong showed the highest one hundred seed weight by 38.2g. Shinpaldalkong #2 showed the highest seed yield by 272.6㎏/10a, and next was in order of Jangwonkong, Taekwangkong and Songhakkong by 255.7㎏/10a, 250.9㎏/10a and 249.3㎏/10a, respectively. Purpura infection rate was the lowest in Jangyeobkong, Jangsukong, Jangmikong, Sodamkong, Daehwangkong, and Shinpaldalkong #2, Jangmikong were the lowest phomopsis seed decay caused by phomopsis spp. Low infection of SMV(Soybean Mosaic Virus) were observed in Shinpaldalkong #2, Taekwangkong. Seed yield showed positive coefficients with pods per plant, seeds per plant and seed wight per plant, showing that it is profitable to increase these characteristics for improving seed yield. In conclusion, the optimum soybean variety at Gyeonggi northern area was thought to be Shinpaldalkong #2, because it showed the highest seed yield and low damage by plant disease and insect.

배관 검사용 Radiometric Scanning System 제작 및 시험

김용균,홍석붕,정종은,이정기,이윤호,정용하 한국비파괴검사학회 2002 한국비파괴검사학회지 Vol.22 No.5

필름을 사용하지 않는 방사선투과검사 시스템인 1차원 Radiometric scanning system을 개발하여 부식 및 침적물이 있는 배관의 두께평가에 적용해 보았다. 개발된 시스템은 단일 방사성 동위원소에서 나오는 방사선을 선형으로 접속하여 시험체를 투과시킨 방사선을 한개의 섬광형 검출기인 BGO를 사용하여 검출하는 single source - single detector alignment system을 제어하는 기계주사 시스템과 제어 프로그램을 개발하였다. 개발된 시스템의 성능을 GEANT4 프로그램을 사용하여 예측하여 보았다. 그리고, 인공결함을 제작하여 넣은 시편과 두께 변화를 준 시편에 적용하여 실제 성능을 평가하였다. 이 시스템은 방사성 동위원소를 이용하여 배관의 부식과 침적물에 의한 두께 변화에 대하여 실시간으로 필름을 사용하지 않고 평가할 수 있는 가능성을 알 수 있었다. One dimensional Radiometric scanning was fabricated and tested as a filmless radiographic inspection system, which could be applied to the evaluation of the corrosion and deposits in the pipeline. This system is composed of the single radioactive source of the collimated focusing beam, and single scintillation detector of BGO, and the mechanical scanning system to transport and align the source and detector, and the operating software to automatically control the mechanical scan system. The performance of the system was simulated using GEANT4 software. This system is applied to one specimen having an artificial flaw(flat bottom hole) in the pipe and other specimen with thickness variation. For the inspection by using the radioactive source in the pipeline, it is possible to evaluate the corrosion and deposits in real time and without film.

아고용한 Zr-Nb 2원계 합금의 미세조직 및 부식특성

林潤洙,崔洋鎭,河憲永,魏明鏞 大田産業大學校 2000 한밭대학교 논문집 Vol.17 No.1

Effect of niobium content on the microstructure and corrosion characteristic of hypo-solubility in binary Zr-Nb alloys were studied. The specimens with 0.2 and 0.4wt.% of niobium were prepared under various annealing temperatures from 400℃ to 800℃ and times from 30 to 5.000 minutes after vacuum arc remelting. The microstructures behavior was observed by a polarized optical microscope. TEM and micro-vickers hardness tester. The recrystallization temperature of the alloys slightly increased with niobium content due to increase of activation energy. The grain growth of the alloys more 0.2 than 0.4 wt.% of niobium occured rapidly. The specimens for corrosion test were prepared by annealing with 590℃ for 2hr to be recrystallized and performed in distilled water at 360℃ using a static mini-autoclave and the corrosion characteristic was measured by weight gains with exposure time. With increasing Nb content from 0.2 to 0.4wt.% the corrosion resistance in Zr-xNb binary alloys decreased an d oxide structure was slowly transformed from tetragonal -ZrO2 to monoclinic-ZrO2.

서울시 대기오염과 일별 사망의 상관성에 관한 시계열적 연구 (1998~2001년)

조용성,이종태,김윤신,홍승철,김호,하은희,박혜숙,이보은 한국대기환경학회 2003 한국대기환경학회지 Vol.19 No.6

This study was performed to examine the relationship between air pollution exposure and mortality in Seoul for the years of 1998~2001I. Daily counts of death were analyzed by general additive Poisson model, with adjustment for effects of seasonal trend, air temperature, humidity, and day of the week as confounders in a nonparametric approach. Daily death counts were associated with CO (current day), 0₃(current day), PM_(10) (current day), NO₂, (1 day before), SO₂, (1 day before). Increase of 41.711㎍/㎥ (interquartile range) in PM_(10) was associated with 1.3% (95% CI = 0.7~1.9%) increase in the daily number of death. 0₃concentrations resulted in an increased risk of 1.3% for 23.86 ppb in all-aged mortality [RR = 1.013 (1.004-1.023)]. This effect was greater in children (less than 15 aged) and elderly (more than 65 aged). After ozone level exceeds 25 ppb, the dose-response relationship between mortality and ozone was almost linear. We concluded that Seoul had 1~5% increase in mortality in association with IQR (interquartile range) in air pollutants. Daily variations in air pollution within the range currently occurring in Seoul might have an adverse effect on daily mortality. These findings also support the hypothesis that air pollution, at levels below the current ambient air quality standards of Korea, is harmful to sensitive subjects, such as children or elderly.

『金匱要略』의 重要 註釋書에 대한 硏究

廉龍河,河基泰,玄東煥,尹相柱,金俊錡,崔達永 동국대학교 한의학연구소 2000 東國韓醫學硏究所論文集 Vol.9 No.-

「금궤요약」은 韓醫學 最高의 雜病專門書로서 그 중요성이 널리 인정되고 있지만, 우리나라에서는 그에 대한 註解나 연구가 미흡한 실정이다. 따라서 著者는 앞으로의 硏究와 敎育의 基本資料로 삼기 위하여 本書의 重要 註繹書에 대하여 정리하였다. 「금궤요약」에 대한 최초의 注繹은 元明間趙良仁의 「금궤요약연의」「개정금궤요약주」等이 유명하다. 日本에서는 「금궤요약주해」을 효시로 「금궤요약방론친주」, 「良沙正經證匯」, 「금궤요약집성」, 「금궤요약집의」, 「금궤옥함요약술의」등의 注本이 있다. Jinguiyuolue(금궤요약), written by Zhong-Jing Zhang(張仲景) in late Han(漢) Dynasty, is very foundamental Cannon of Oriental Medicine. Many Doctors commented on the book from Yuan(元) Dynasty ir! Chian and from Edo(江戶) Period in Japan, but there are a few studies in Korea. So we studied on the commentaries of the book, which published in the three countries, for improving research and education of it in our country.

Escherichia coli(M15)을 이용한 serotonin N-acetyltransferase 유전자의 발현

김용만,정미영,윤경식,진병관,백행운,조용호,백형환 慶熙大學校 1997 論文集 Vol.26 No.-

AA-NAT cDNA was obtained by RT-PCR technique from total RNA of rat sacrified at night(02:00am). pCRNAT was cloned using the pCRII vector with insertion of AA-NAT cDNA(about 1.4 kb) at EcoRI site. For the expression of the gene, pQECNAT was subcloned, in which the coding region of AA-NAT was inserted into expression vector pQE30 at BamHI and HindIII sites. According to the experimental results, Escherichia coli strain M15, transformed by the expession vector pQECNAT, was selected as a host to express AA-NAT gene with the induction of isopropyl β-D-thiogalactoside(IPTG). Optimal condition for the expression of AA-NAT gene was achieve from the experimental results, showing that the expression of the protein was inducible much 19.800 ± 2,200 dpm per ml of culture volume in 4 hours at the concentration of 2 mM IPTG. Partial purification through the affinity column(Ni-NTA agarose) binding to the continuous 6 histidine residues of protein resulted in 5 times more increase in the specific activity of AA-NAT than that of the homogenate of bacterial pellet. These experimental results will provide basic data in further study for the enzymatic kinetics and antibody production of AA-NAT.