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.

SELDI-TOF MS를 이용한 유방암 환자 진단을 위한 새로운 혈청 표지자의 개발

정용식,김호승,윤태일,전미선,윤용달,이용성,이기환,김혜진,김명욱,박희붕 한국유방암학회 2004 한국유방암학회지 Vol.7 No.1

전염소 투입 및 정수지 구조가 정수장 총소독능에서 갖는 중요성 평가

윤제용(Je Yong Yoon),변석종(Seok Jong Byun),최유식(Yu Sik Choi) 한국물환경학회 2001 한국물환경학회지 Vol.17 No.3

Disinfection is one of the most important processes in water treatment plants since it protects consumers from waterborne diseases. In Korea, chlorine which is most frequently used as a disinfectant is generally applied in two ways: prechlorination and postchlorination. Postchlorination is to supply chlorine to the influent of a clearwell. While, prechlorination is to add chlorine to rapid mixing chamber or water intake in plants. Major disinfection reaction occurs in the step of post chlorination. Therefore, frequently, prechlorination is not counted on in evaluating disinfection credit. This study was conducted to evaluate the importance of prechlorination and the existence of baffling wall in clearwell with the United States disinfection requirement(Surface Water Treatment Rule). Eight water plants were considered. Yoon`s classification(1997) was selected in classifying the prechlorination practice in water treatment plant. It was found that most of the prechlorination practices performed in water plants(three out of four types) were not important in gaining any significant disinfection credit. One prechlorination practice conducted to remove ammonia in raw water became significant in meeting the disinfection requirement. Despite the existence of baffling walls of clearwell, T_(10)/T varied considerably in the range of 0.3-0.6, indicating that the existence of baffling wall itself does not guarantee the goodness of plug flow characteristics. For some plants, T_(10)/T were lower than that of US-EPA conservative recommendation which is considered when tracer test could not be performed.

데오도라이트 시스템의 측정 정확도에 대한 연구(Ⅰ) : 데오도라이트 시준 거리에 따른 측정 정확도 A Measurement Accuracy According to a Theodolite Collimation Distance

윤용식,이동주 한국공작기계학회 2004 한국생산제조학회지 Vol.13 No.2

A non-contact precision measurement system is a theodolite system, a laser tracker and a photogrammetry system. etc. Nowadays, the system reaches to a limit of measurement accuracy required from industrial product of middle and large scale. The one of the solutions for this problem is to maximize the accuracy of the existing measurement system. According to it, we performed the study for a measurement accuracy of theodolite system when the distance between two theodolites is changed lm to 5m We could know that the changes of distance affect the measurement accuracy of theodolite system and that the maximum measurement accuracy is ± 0.02 mm on theodolite distance 3~4 m.

진균성 부비동염 환자의 상악동내 농성 분비물에 대한 세균 배양 및 항생제 감수성 결과

이윤식,김용재,김재호,정유삼,이봉재 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.10

터보過給 가솔린機關의 에너지損失에 關한 硏究

尹健植,金容鎭 國立 昌原大學校 産業技術硏究所 1995 産技硏論文集 Vol.9 No.-

In this study, the performance tests for gasoline engine were carried out in order to analyze the energy losses in the cases of a naturally aspirated engine and a turbocharged engine. The test engine was domestic 4-cycle 3-cylinder gasoline engine of a light passenger car. The variation of cylinder pressure with crank angle was measured by piezoelectric pressure transducer in order to examine the variation of the indicated work and pumping loss. The mechanical losses were obtained by the comparison of the indicated work and brake work measured using engine dynamometer. The energy losses to cooling water and exhaust gas were also measured. These tests were carried out over the wide range of operating conditions to give a consideration of energy losses in gasoline engine with respect to the variations of engine speed and boost pressure.

데오드라이트 시스템의 측정 정확도에 대한 연구(Ⅲ) : 시준거리 3m에서 기준자 거리에 따른 측정 정도 A Measurement System Accuracy depending on a Distance of Scale Bar on the Distance 3m between two Theodolites

윤용식,이동주,윤인진 한국공작기계학회 2005 한국생산제조학회지 Vol.14 No.2

The theodolite system consists of two theodolites, a scale bar and a target bar. A measurement accuracy of theodolite system is affected by a measurement distance of each equipment. This study was performed for measuring an accuracy when the distance from theodolite to scale bar was changed 2~6 m on two theodolites distance 3 m. The results showed that the measurement accuracy could be ±0.021 mm when the distance from theodolite to target was 2, 3 and 6 m. Specially, it was found that the maximum measurement accuracy was ±0.017mm on theodolite collimation distance 3m and the distance 4 m of the theodolite and scale bar.

데오도라이트 시스템의 측정 오차 요인에 대한 연구

윤용식,이동주 한국공작기계학회 2003 한국생산제조학회지 Vol.12 No.4

Theodolite measurement system is non-contacted 3-dimensional measurement system. The system accuracy is ±0.5mm or better for distance 0~100m. And the system is used for the measurement of a product of middle and large scale. This study is performed for the measurement error factors of the system. We could know that the main measurement error factors are temperature, illumination and skill. Also, we performed the study for the effect according to the height difference of scale bar.

데오드라이트 시스템의 측정 정확도에 대한 연구(Ⅱ) : 기준자 측정 높이에 따른 측정 정확도 A Measurement Accuracy for a Height of Scale Bar

윤용식,이동주,정종길 한국공작기계학회 2004 한국생산제조학회지 Vol.13 No.4

A measurement accuracy of theodolite system may be affected by a measurement environment, a measurement distance change and so on. This study was performed for measuring an accuracy when the height of scale bar is changed 0.05m, 0.5m, 1m and 1.5m under the distance 3m between two theodolites, the distance 4m from the theodolite system to scale bar and the distance 5m from the thodolite system to the horizontal target bar. And we could know that the best height is 0.05m and 1m.

데오도라이트를 이용한 위성체 얼라인먼트 측정에 관한 연구

윤용식,이동주 한국공작기계학회 2003 한국생산제조학회지 Vol.12 No.6

A measurement of spacecraft alignment is an important process of spacecraft assembly, integration and test because it is necessary that a ground station controls the precise positions of on-orbit spacecraft by using the alignment data of attitude orbit control sensors(AOCS) on spacecraft. In addition, accuracy of spacecraft alignment requirement is about 0.1°- 0.7°. The spacecraft alignment is measured by autocollimation of theodolite. This paper describes the measurement principle and method of spacecraft alignment. The result shows that all of the AOCS on the spacecraft are aligned within the tolerance quired through the alignment measurement.