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.

넙치 및 조피볼락용 습사료의 보관조건에 따른 안정성 평가

안창범,주용석,정관식,서경란,신태선 여수대학교 1998 論文集 Vol.13 No.2

본 실험은 습사료를 대상으로 보관조건(온도별, 시간별)에 따른 지질의 산화진행 정도를 파악하여 사료의 효율적인 이용성을 구명하고자 산가(acid value, AV), 과산화물가(peroxide avlue, POV) 및 비타민 함량을 분석하였다. 생사료와 분말배합사료를 혼합하여 제조한 습사료는 혼합비가 8:2 사료에서 5:5 사료보다 높은 AV와POV를 나타내었고, 보관기간이 경과함에 따라 보관조건과는 상관없이 8:2 사료에서 빠른 산패를 보였다. 산화진행속도는 4℃ 보관조건하에서는 48시간째, -15℃ 보관조건하에서는 72시간째에서 빠르게 일어났다. 60,000 Lux이상의 직사광선 노출하에서의 AV,POV는 노출시간이 길어질수록 증가하였고, 8:2사료에서 빠르게 변화하였다. This experiment was conducted to investigate rancidity in moist pellet(MP) during various practical condition of handling and storage conditions. The experimental moist pellet diets were prepared by mixing frozen raw fish (FRF) and commercial compound meal (CCM) in ratio of 8:2 and 5:5, respectively. Immediately before and after manufacturing of MP, the MPs were stored at 4℃ and -15℃, and exposed under the sunlight(30±2℃, 60000Lux). The rancidity of each MP was determined from 1 to 96 hours after pellting. The acid value (AV) and peroxide value (POV) in the diets stored at 4 and -15℃ increased rapidly after 48 and 72 hours, respectively. For the sample exposed sunlight, AV and POV were slightly increased with the exposed time. The rancidity increased in the 8:2MP(FRF : CCM) than in the 5:5MP(ERF : CCM) at all storage condition and the amount of vitamin E in MPs decreased rapidly as AV and POV increased.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

흰쥐 해마에서 경련에 의해 발현 유도된 MKP-1에 의한 MAPK 활성 조절

유범희,강웅구,안용민,정선주,전송희,박주배,김용식 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.4

연구목적 : 전기경련 충격(Electroconvulsive shock, ECS) 및 카이닌산(kainic acid)에 의한 경련은 흰쥐 해마에서 mitogen activated protein kinase(MAPK)를 활성화시키며, 동시에 MAPK 불활성화 효소인 MAPK phosphatase-1(MKP-1)의 발현을 일으킨다. 이 연구의 목적은 경련에 의해 발현된 MKP-1이 역시 경련에 의해 활성화된 MAPK의 불활성화에 관여하는지를 알아보고자 하는 것이다. 방 법 : 흰쥐에 ECS를 가하여 해마에서 MKP-1 발현을 일으킨 뒤 다시 ECS를 가하고, 두 번째 ECS에 의한 MAPK의 일시적 활성화가 MKP-1의 발현상태에 의해 영향받는지를 알아보았다. 또한 흰쥐에 지속적인 MAPK 활성화 및 MKP-1 발현을 일으키는 카이닌산을 투여한 뒤 해마에서 MKP-1의 발현과 MAPK 활성과의 관계를 알아보았다. 결 과 : ECS후 해마에서 타이로신 인산화 면역블롯 및 효소활성으로 측정한 MAPK의 인산화 및 활성은 MKP-1의 발현이 일어나 있는 경우와 그렇지 않은 경우 사이에 차이를 보이지 않았다. 카이닌산의 투여에 의해 MAPK 활성화가 일어나는 경우, 뒤이어 MKP-1 발현이 일어나지만, 이렇게 발현된 MKP-1은 MAPK 활성을 충분히 감소시키지 못하였다. 결 론 : MKP-1은 흰쥐 해마에서 ECS 및 카이닌산에 의한 MAPK의 활성화를 차단하는데 큰 역할을 하지 않는다. Objectives : Both electroconvulsive shock(ECS)- and kainic acid-induced seizures activate mitogen-activated protein kinases(MAPKs) in rat hippocampus. They can also induce the expression of MAPK phosphatase-1(MKP-1) in rat hippocampus. MKP-1 is known as a specific MAPK deactivator. This study aimed to elucidate the role of MKP-1 in the deactivation of MAPKs in rat hippocampus. Methods : In order to induce MKP-1 in the hippocampus, ECS was given to the rats. At the time points when MKP-1 was sufficiently induced, the second ECS was given to them and the subsequent phosphorylation or activation of MAPKs were measured in the hippocampus. A second group of rats were injected with kainic acid and the relationship between MKP-1 expression and MAPK phosphorylation was examined in their hippocampi. Results : The expression of MKP-1 did not influence the phosphorylation or activation of MAPKs following ECS in rat hippocampus. Kainic acid-induced expression of MKP-1 did not significantly reduce the phosphorylation of MAPKs. Conclusion : MKP-1 did not play a significant role in the deactivation of MAPKs which were activated by ECS or kainic acid in rat hippocampus.

Revised (2018) COPD Clinical Practice Guideline of the Korean Academy of Tuberculosis and Respiratory Disease: A Summary

( Yong-bum Park ),( Chin Kook Rhee ),( Hyoung Kyu Yoon ),( Yeon-mok Oh ),( Seong Yong Lim ),( Jin Hwa Lee ),( Kwang-ha Yoo ),( Joong Hyun Ahn ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.4

Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients nationally and globally. The Korean clinical practice guideline for COPD was revised in 2018. The guideline was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Health Insurance Review and Assessment Service, Korean Physicians’ Association, and Korea Respiration Trouble Association. The revised guideline encompasses a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We performed systematic reviews assisted by an expert in meta-analysis to draft a guideline on COPD management. We expect this guideline to facilitate the treatment of patients with respiratory conditions by physicians as well other health care professionals and government personnel in South Korea.

Community Attachment & Preferable Development for Regional Tourism

Ahn Bum-Yong 한국관광레저학회 2002 관광레저연구 Vol.14 No.2

임상연구 구연발표 : 임플란트 주위 골결손부의 Gore-Tex membrane을 이용한 Guided bone regeneration

( Yong Bum Ahn ),( Seung Jae Lee ),( Won Jin Lee ),( Jun Ho Oh ),( Eun Sun Lee ),( Sun Young Ko ),( Moon Taek Jang ),( Hyung Seop Kim ) 대한치주과학회 2007 대한치주과학회 학술대회자료집 Vol.2007 No.2

Making Ecotourism a Workable Concept

Ahn, Bum-yong(안범용),Chon, Jin-hyung(전진형),C.Scott shafer 한국관광연구학회 1999 관광연구저널 Vol.- No.11

두경부 편평상피세포암과 절제연에서 Human Telomerase Reverse Transcriptase의 발현

김용범(Yong Bum Kim),노경섭(Kyung Sup Rho),홍남표(Nam Pyo Hong),안회영(Hwoe Young Ahn),이용식(Yong Sik Lee),송영호(Young Ho Song) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.1

Background and Objectives: The expression of telomerase, a ribonucleoprotein complex, has been detected in tissues from many human cancers, but not in the majority of normal tissues except germ cell. It is believed that the activation of telomerase is linked to celluar immortality and may playa role in tumorigenesis. Human telomerase reverse transcriptase (hTERT) has been identified as a putative catalytic subunit of human telomerase and its expression is closely correlated with telomease activity. We studied the expression of hTERT in head and neck squamous cell carcinoma (HNSCC) and resection margin by immunohistochemistry for hTERT and evaluate the correlation between hTERT expression and clinical data in HNSCC. Materials and Methods: We performed a immunohistochemistry in 17 cases of HNSCC and 10 cases of resection margins, histologically normal. The correlations between the hTERT expression and the clinical data in HNSCC were analyzed. Result: hTERT immunoreactivities were detected in 14 of 17 (82.4%) HNSCC, 1 of 10 (10%) resection margin. No correlation was observed between clinical data and hTERT expression in HNSCC. Conclusion: hTERT is activated in HNSCC and its expression is independent from clinical data of patients.

The Evaluation of hES cell-derived Dopaminergic Precursor Cells in MPTP induced Parkinson"s disease model with Common marmoset

Jae-Bum Ahn,Euna Kwon,Jae Hun Ahn,Hyung Woo Park,Yong Hoon Lim,Yona Kim,Jeong-Eun Yoo,Dongjin R. Lee,Jun-Won Yun,Sun Ha Paek,Dong-Wook Kim,Byeong-Cheol Kang 한국실험동물학회 2016 한국실험동물학회 학술발표대회 논문집 Vol.2016 No.2