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한국형 우울장애 약물치료 알고리듬 2021 (V) : 안전성, 부작용, 동반 신체질환을 고려한 항우울제 선택 및 치료저항성 우울증의 임상적 정의
정명훈(Myung Hun Jung),이정구(Jung Goo Lee),박원명(Won-Myong Bahk),우영섭(Young Sup Woo),왕성민(Sheng-Min Wang),정종현(Jong-Hyun Jeong),김원(Won Kim),심세훈(Se-Hoon Shim),서정석(Jeong Seok Seo),장승호(Seung-Ho Jang),양찬모(Chan-Mo Y 대한신경정신의학회 2021 신경정신의학 Vol.60 No.4
Objectives To revise Korean Medication Algorithm Project for Depressive Disorder 2017 (KMAPDD 2017) guidelines by revising antidepressant choices based on their safety, adverse effects, comorbid physical illnesses, and the clinical definition of treatment-resistant depression (TRD). Methods A 33-item questionnaire comprised of six parts was developed. A 65-expert consensus (65/97, 67.0%) was obtained on pharmacological treatment strategies regarding antidepressant choice with respect to safety, adverse effects, and comorbid physical illnesses. Multiple response sets were subjected to statistical analysis. Results The results obtained showed that first-line pharmacotherapeutic strategies based on various clinical considerations were as follows: mirtazapine (for patients with increased suicidality, Gastrointestinal discomfort, and insomnia), bupropion (for patients with orthostatic hypotension, history of a safety accident, serotonin syndrome, sedation, sexual dysfunction, and weight gain), and escitalopram (for patients with anticholinergic side effects). For patients exhibiting comorbid conditions, duloxetine was the first line pharmacotherapeutic strategy for chronic pain, escitalopram was the first-line pharmacotherapeutic strategy for diabetes, hypertension, liver disease, Parkinson’s disease, renal disease, epilepsy, and thyroid disease, and sertraline was a first-line pharmacotherapeutic strategy for arrhythmia and cardiovascular disease. Conclusion Pharmacological treatment strategy of KMAP-DD 2021 is similar to that of KMAPDD 2017. Additional study is required to determine antidepressant choices for TRD and cancer patients with depression.
PHC 파일 두부정리 자동화를 위한 파일롯타입 장비의 개발
이정호,박상준,정명훈,김영석,Lee Jeong-Ho,Park Sang-Jun,Jeong Myung-Hoon,Kim Young-Suk 한국건설관리학회 2003 건설관리 : 한국건설관리학회 학회지 Vol.4 No.4
기성 콘크리트 파일(PHC파일)은 대규모 건축공사 및 토목공사에서 주로 사용되며, 최근 건축물이 중량화, 대형화, 고층화됨에 따라 그 수요가 지속적인 증가 추세에 있다. 이와 같은 PHC파일은 건물 구조체의 기초와 연결되어 지지력을 확보하기 위해 두부정리 작업이 반드시 요구된다. 두부정리 작업은 800$\cal{kg}f/cm^2$이상으로 압축된 기성 콘크리트 파일의 두부를 파쇄하고 약 30-40cm 정도의 강선을 남겨놓아 구조체의 기초와 정착시킬 수 있도록 하는 작업이다. 국내 재래식 두부정리 작업은 노동 집약적이면 노무자간의 숙련도 차이에 의해 품질 및 작업 생산성이 크게 영향을 받고 있다. 또한, 백호에 연결된 크러셔에 의한 무리한 작업으로 인해 PHC파일 그라인딩면에 다량의 균열이 발생됨으로써 구조체의 지지력 확보에 문제점이 있는 것으로 분석되었다. 따라서 본 연구에서는 재래식 두부정리 작업의 문제점을 해결하고 두부정리 작업을 자동으로 수행학 수 있는 자동화 장비를 개발하고자 기존 문헌 고찰 및 국내외 치신기술 동향, 현장조사를 바탕으로 개념디자인을 제시하고 두부정리 자동화 장비의 파일롯타입을 제작$\cdot$실험함으로써 제안된 개념 디자인의 기술적 타당성 제시 및 자동화 장비 개발을 위해 요구되는 설계파라미터를 도출하였다. During the last few years, the use of Pre-tensioned spun high strength concrete piles(PHC pile) has been gradually increased in many construction sites. Cutting work of the concrete pile is an important task to crush a part of pile head which is compressed with more than 800$\cal{kg}f/cm^2$. It is usually performed by a crusher and three to four skilled workers. Recent analysis results of the pile cutting work reveal that it frequently makes a lot of cracks which significantly reduce the strength of the pile and is labor-intensive work. The primary objective of this study is to propose conceptual designs for developing an automated pile cutting machine. It is anticipated that the development of the automated pile cutting machine would be able to bring improvements in safety, productivity, quality as well as cost saving.
흄관매설 자동화 장비의 성능분석을 위한 평가모델의 개발
유연택,박상준,이정호,정명훈,김영석,Ryu Yeon-Taek,Park Sang-Jun,Lee Jeong-Ho,Jeong Myung-Hoon,Kim Young-Suk 한국건설관리학회 2004 건설관리 : 한국건설관리학회 학회지 Vol.5 No.1
건설 자동화 장비 개발의 성공여부를 판단하고 이를 실용화하기 위해서는 개발 장비의 성능평가 및 분석을 통해 재래식방식과 비교하여 자동화 방식을 도입함으로써 얻을 수 있는 기대효과에 대한 검증이 이루어져야 한다. 본 연구에서는 최근 국내에서 개발된 흄관매설 자동화 장비의 성능분석을 위한 평가모델 및 방법론을 구축하고 수차례의 현장실험(field trials)을 통해 수집된 실험 데이터를 바탕으로 재래식 흄관매설 방식과 자동화 방식의 성능을 종합적으로 비교$\cdot$분석함으로써 재래식 방식에 비해 자동화 방식의 도입을 통해 얻을 수 있는 정성적 $\cdot$정량적 기대효과를 제시하였다. 흄관매설 자동화 장비의 성능분석을 위해 본 연구에서 제시한 성능평가 모델 및 방법론은 향후 건설자동화 관련 기술개발 시 자동화 장비의 성능평가 및 분석 모델을 개발함에 있어 기본적 틀(framework)을 제공할 수 있을 것으로 기대된다. In developing an automated construction system, it is essential to propose a performance evaluation model and methodology, which can measure productivity, quality, safety and economic feasibility in order to verify its superiority. Recently, a tele-operated hume concrete pipe laying machine has been developed to solve several problems related to safety, quality, productivity in conventional method. The primary objective of this study is to propose a model and methodology for the performance evaluation of the developed tele-operated hume concrete pipe laying machine. Furthermore, this study evaluates the automation machine's performance compared with the existing hume pipe laying work by using data which obtained in many field trials. It is anticipated that the proposed model and methodology might be effectively used in analyzing the performance of other automation robots.
한국형 우울장애 약물치료 알고리듬 2021 (II) : 임상 아형
박영민(Young-Min Park),서정석(Jeong Seok Seo),우영섭(Young Sup Woo),박원명(Won-Myong Bahk),김원(Won Kim),정종현(Jong-Hyun Jeong),심세훈(Se-Hoon Shim),이정구(Jung Goo Lee),장승호(Seung-Ho Jang),왕성민(Sheng-Min Wang),정명훈(Myung Hun 대한신경정신의학회 2021 신경정신의학 Vol.60 No.3
Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) was developed in 2002 and revised in 2006, 2012, 2017. In 2021, the fifth edition was published. This edition reflected new findings and the latest trends in the areas of pharmacological treatment. The aim of this study is to present strategies and treatment options according to the subtype of depression using data from the KMAP-DD-2021. Methods Ninety-seven psychiatrists with clinical experience in depressive disorder were selected. The questionnaires for KMAP-DD 2021 were sent to participants via mail. KMAP-DD 2021 consists of overall treatment strategies and treatment options under specific circumstances. Each treatment strategy or treatment option was evaluated with an overall score of nine and was divided into the three phases of recommendation that include primary, secondary, and tertiary. Results For persisting depressive disorder, antidepressant monotherapy including selectiveserotonin reuptake inhibitor (SSRI) (escitalopram, fluoxetine, sertraline, paroxetine), serotoninnorepinephrine reuptake inhibitor (SNRI) (desvenlafaxine, venlafaxine, duloxetine, milnacipran), vortioxetine, and mirtazapine, was recommended as first-line medications. For melancholia of major depressive disorder, SSRI, SNRI, vortioxetine, and mirtazapine also were recommended as first-line medications. For mixed features, SSRI, bupropion, mirtazapine, SNRI, except for duloxetine, and milnacipran were recommended as first-line medications. For anxious distress, SSRI, mirtazapine, and SNRI, except milnacipran, were recommended as first-line medications. Conclusion The preferences of antidepressants by experts differed according to the subtype of depression. These findings suggest that experts treat patients with a major depressive disorder after considering the subtype of depression involved.
한국형 우울장애 약물치료 알고리듬 2021 (I) : 주요우울삽화의 치료 전략
우영섭(Young Sup Woo),박원명(Won-Myong Bahk),서정석(Jeong Seok Seo),박영민(Young-Min Park),김원(Won Kim),정종현(Jong-Hyun Jeong),심세훈(Se-Hoon Shim),이정구(Jung Goo Lee),장승호(Seung-Ho Jang),왕성민(Sheng-Min Wang),정명훈(Myung Hun 대한신경정신의학회 2021 신경정신의학 Vol.60 No.3
Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) is a consensus-based medication guideline. To reflect advances in pharmacotherapy for depressive disorders, we have undertaken a fourth revision of the KMAP-DD. Methods The review committee for the new version of the KMAP-DD (KMAP-DD 2021) included 143 Korean psychiatrists with clinical experience in the field of depressive disorders. Each treatment strategy or treatment option was evaluated with an overall score of nine, and the treatment option was categorized into the three levels of recommendation of primary, secondary, and tertiary. Results The first-line pharmacotherapeutic strategy for mild to moderate major depressive episodes (MDE) was antidepressant (AD) monotherapy. For severe MDE without psychotic features, AD monotherapy or the combination of AD and atypical antipsychotics (AAP) was the first-line strategy. The combination of AD and AAP was recommended as the first-line for the MDE with psychotic features as well. When treatment response to initial AD monotherapy was insufficient, a combination of AAP or another AD was recommended. In the case of unsatisfactory response to initial treatment with an AD and AAP combination, switching to another AAP or adding another AD was recommended. Conclusion Generally, there were no significant changes in the recommendations for MDE management in the KMAP-DD 2021 compared to previous versions. However, it was notable that the preference for the use of AAP and AD with the novel mechanism of action including vortioxetine and agomelatine increased.