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.

지난 4년간 학회지 "신경정신의학" 심사 평가보고

오병훈,권준수,남궁기,김승현,지익성,김창윤,하규섭,박원명,김성곤,오강섭,김정범,이수정,정한용,이창욱,박용천,이영문,김세주,이병욱 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation Processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.

Hepatic Cirrhosis Occurring in a Young Woodchuck(Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus(WHV)

Kyu-shik Jeong,정원일,Jae-yong Chung,Mi-young An,Chae-yong Jung,Gyoung-jae Lee,Jong-soo Kang,Byeong-cheol Kang,Young-heun Jee,Bruce H Williams,Young-oh Kwon,Da-hee Jeong 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

Cirrhosis Occurring in a Young Woodchuck (Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus (WHV)Da-hee Jeong, Won-il Jeong, Jae-yong Chung, Mi-young An, Chae-yong Jung, Gyoung-jae Lee1, Jong-soo Kang1, Byeong-cheol Kang2, Young-heun Jee3, Bruce H Williams4, Young-oh Kwon5 and Kyu-shik Jeong*College of Veterinary Medicine, Kyungpook National University, Daegu 702-701, Korea1Shinwon Scientific Co., LTD, Research Institute, Suwon, Korea2Clinical Research Institute, Seoul National University, Seoul 110-744, Korea3College of Veterinary Medicine, Jeju National University, Jeju 690-756, Korea

垂直平板과 斷熱壁이 이루는 모서리에서의 自然對流

權純錫,徐龍權,鄭永和,金善政 동아대학교 공과대학 부설 한국자원개발연구소 1989 硏究報告 Vol.13 No.1

Natural convection heat transfer from the corner between a vertical flat plate and adiabatic wall has been studied for various inclination angles of the adiabatic wall and Rayleigh numbers by using Mach-Zehnder interferometer in air. Natural convection heat transfer is increased with increasing the inclination angle of the adiabatic wall. The local Nusselt number is increased to x/L=1/18 and then decreased at θ=30° And 60°, but decreased at θ=90°, 120°, 150° And 180° as the dimensionless plate length increases. The mean Nusselt number at θ=30° Shows minimum and at θ=180° Maximum for constant Rayleigh numbers.

MR Angio영상의 Ray Casting 가속화 Algorithm에 관한 연구

정용규,권영만,김욱동 凡石學術奬學財團 2001 凡石學術論文集 Vol.5 No.1

Volume render is to visualize 3D (3 Dimension) information, which is used in diverse applications, such as medical imaging, fluid dynamics, meteorology, failure analysis, and molecular modeling. Medical applications are mainly diagnosis. virtual surgery. image guided surgery and others. Most widely used 3D method in MR and CT Images is Ray Casting, It has some shortcomings of the slow rendering speed. In this reason, many 3D volume visualization methods have been developed. General methods are surface and volume rendering. This paper intends to, show that the job related 3D volume visualization let' us be capable of displaying more realistic images than surface rendering. Proposed method is Ray Casting witch Octree algorithm, Which follows as bellow steps. First of all, depth information is made by threshold segmentation. Secondly, depth range is adjusted. Finally, area within specified depth range is processed to produce the result image. In this step, sampling point which is acquired by interpolating voxel is blended as. semitransparent material. Using blending operation, overlapped objects can be displayed correctly. It accelerates the job more than general Ray Casting.

葡萄(Campbell Early)의 結實에 미치는 GA 및 覆袋의 影響

權相洙,具禹書,朴正璂,權五昌,李容門 東亞大學校 1983 東亞論叢 Vol.20 No.3

葡萄 Campbell Early 의 無核果 生成 및 成熟促進을 위하여 GA₃ 濃度別 그리고 몇 가지 覆袋處理를 한 實驗結果는 다음과 같다. 1. 果房重과 果粒數는 滿開 8日前 處理가 適期로서 果房重은 無處理에 비해 76.4%, 果粒數는 80.6%였다. 2. 1果房當 無核粒率(92%)과 100粒中 種子數(12個)는 滿開 18日前, Gibberellin 處理+cellophane紙 覆袋區가 가장 良好하였다. 3. 果粒數와 種子數(r=0.826) 또한 種子數와 果重間에는 정의 相關關係(r=0.841)를 나타내었다. 4. 糖度는 無處理區보다 cellophane紙 覆袋區가 9.34% 로서 높았다. 含水量과 灰分은 無處理와 新聞紙 覆袋區가 높았고 cellophane 紙 覆袋區가 낮았다. 5. vitamin C 含量은 Gibberellin 處理時期가 빠르고 無核率이 높을수록 낮은 傾向이엇다. 處理間에 있어서는 無處理와 parchment紙 袋覆區 많았고 cellopnane紙 袋覆區가 含量이 적었다. 6. Gibberellin 處理時期를 앞당기고 cellophan紙 袋覆를 하면 無核率이 높은 反面 果粒數 果重이 減少되고, Gibberellin 處理時期를 늦추고 新聞紙 覆袋를 하면 果粒數 果重은 增加하지만 無核率이 낮아졌다. The results obtained by the Gibberellin and bagging treatment on the Campbellearly grape are as follows: 1. The suitable period of treatment for cluster weight and number of berry are to be before 8 days of full bloom. The cluster weight was 76.4% and number of berries were 80.6% compared with control. 2. The ratio seedless berries of 92% per cluster, and number of 12 seedss in 100 beries were showed the best on before 18 full bloom at the bagging plots of Gibberellin treatment+cellophane paper. 3. Number of berry and number of seed (r=0.826) also were showed mutual relation of plus between the number of seed and fruit weight. 4. Soluble solid was showed higher of 9.3% at the cellophane paper bagging plot and 9.34% at the parchment paper bagging plot than the control. Juice content and ash were showed high at the conthol and newspaper bagging plot, and low at the cellophane paper bagging plot. 5. The content of vitamin C was showed low tendency at the higher of the seedless ratio with the quick Gibberellin treatment period. At the betweentreatment, the control and parchment paper bagging plot were showed much, and showed less content at cellophane paper bagging plot. 6. In advance the period of Gibberellin treatment and had cellophane paper bagging then the ratio of seedless would be high, but on the contrary, the number of berry and fruit weight decreased, and had delay the period of Gibberellin treatment and had the newspaper bagging, the number of berry and fruit weight would be increased but the ratio of seedless was low.

발열이 있는 호중구 감소증 환자에서의 위험도 예측인자

정중식,권운용,김규석,임용수,이중의,서길준,윤여규 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. Methods: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. Results: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17,2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr < 75㎖/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). Conclusion: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-prediction factors in febrile neutropenia at the time of visiting the emergency department.

정상교합자의 치열궁 형태

권용철,성정옥,권오원,성재현 대한치과교정학회 1989 대한치과교정학회지 Vol.19 No.1

This study was designed to investigate dental arch shapes buccally and lingually at Bracket Level of Koreans. This involved studying 63 inviduals (37 males, 26 females) with normal occlusion ranging in age from 17 to 24 yesrs old. The landmarks were digitized and measurements and statistical analysis were performed by NEC 9801 V-M computer. The Results were as Follows: Bicanine width, Bipremolar width and Bimolar width were larger in males than in females. Buccal and lingual arch form and coordination form were obtained by NEC 9801 V-M computer. The parabolic equations which represents buccal and lingual arch form were obtained.

경피적 자궁동맥 색전술로 치료한 산후 출혈 1례

정명철,김호성,김경철,노지현,고재환,김용봉,권동일 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Postpartum hemorrhage remains one of the leading causes of maternal deaths. The major causes of postpartum hemorrhage include uterine atony, retained placental fragment, placenta accreta, and lower genital tract lacerations. Conservative treatment is based on administration of uterotonic drugs, vaginal packing, and surgical repair of genital tract lacerations. When bleeding fails to respond to conservative treatment, surgical ligation of uterine vessels or hemostatic hysterectomy is performed. We present a case of postpartum bleeding treated by selective uterine arterial embolization with a brief review of previous literatures of postpartum hemorrhage & uterine arterial embolization.

BAF 공정을 이용한 제직폐수의 재이용

정용준,배종홍,권구호,민경석 한국물환경학회 2004 한국물환경학회지 Vol.20 No.6

An upflow BAF(Biological Aerated Filter) equipped with an expanded clay media was applied to reuse weaving wastewater of water jet loom. The performance of lab-scale biofilter was investigated by the adjustment of EBCTs(Empty Bed Contact Time) and the packing ratio of media, which were changed 1.1 to 3.7hr and 38 to 63%, respectively. In most conditions except 1.1hr of EBCT, BOD, CODcr, SS and Turbidity of the effluent were 1∼4㎎/L, 7∼16㎎/L, 1∼5㎎/L and 5∼14NTU, where their removal efficiencies were 76∼95%, 82∼93%, 63∼94% and 59∼81%, respectively. From the observation of SEM(Scanning Electron Microscope) photographs of porous clay media, it was revealed that this media provided good performance of retaining microbes effectively. In addition, 0.44∼0.49㎏VSS/㎏BOD_(rem). of low sludge reduction was expected. The most efficient back washing cycle and procedure were once per 4 to 9 days and air including collapse-pulsing method, respectively. Therefore, this system can be of use as an weaving wastewater treatment for reuse