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.

초음파 수침법을 이용한 터빈베어링 Babbitt 금속 박리 검사 기술

정계조,박상기,조용상,박병철,길두송 한국비파괴검사학회 2004 한국비파괴검사학회지 Vol.24 No.4

이 연구는 터빈베어링의 신뢰성을 평가하기 위하여 초음파 C-Scan 방법을 적용한 기술이다. 수침법에 관한 연구는 실험실과 현장검사 적용에 광범위하게 사용되는 기술이다. 여기에서는 C-Scan 방법을 이용하여 베어링의 모재와 Babbitt 금속간 경계부의 상태를 평가하였다. 수침법 C-Scan 방법에 의한 초음파 영상은 베어링 경계부의 상태를 확인하는데 효과적인 방법으로 사용될 수 있었다. 초음파 영상의 분해능을 높이기 위하여 집속형 탐촉지를 사용하고, Babbitt 금속과 베어링 모재간의 접합경계면에서 발생하는 초음파 음압 반사율을 측정하여 결함의 검출과 면적을 추정할 수 있었다. 초음파 수침법은 베어링 접합부의 박리위치와 박리면적의 경계면을 결정하여 크기를 계산하는데 아주 유용하게 사용될 수 있는 기술이며, 이 연구에서 개발된 기술은 화력발전소에서 사용되고 있는 터빈베어링의 건전성을 확보하는데 적용되었다. This study is aimed for the implementation of ultrasonic method to assess the reliability of turbine bearings. A modified ultrasonic immersion technique was carried out in both laboratory experiment and field application. From the laboratory results, we confirmed that the condition of interface layer between the babbitt and base metal be monitored by the C-Scan. The C-Scan image by the ultrasonic immersion test can be used successfully to observe the condition of interface layer. The testing with a focused transducer provides a promising approach for estimating the extent of the damaged region and observing the interface layer effectively. The difference of the ultrasonic reflection ratio between the bonding and debonding area at the interface layer is one of the key parameters for assessing the extent of the damaged area; additionally, the reflection amplitude exhibits a favorable correlation with the overall damage level. The technique developed in this study was applied to the inspection of the turbine bearings at several power plants in Korea whereby the applicability in the filed can be ascertained.

군병원 간호장교 근무의욕 향상 요인 분석 연구

정두채,정용남 남서울대학교보건의료개발연구소 2004 보건복지 연구 논집 Vol.1 No.1

The purpose of this study is to analyze the morale of military nurse officers by finding out the level of their job satisfaction and organizational commitment. The level of morale and its affecting factors were measured with structured questionnaire. The difference in the level of morale by personal characteristics variables and by job related variables was analyzed with statistical methods such as T=test, F-test, X^(2)-test, and ANOVA. The result of this study can be used improve nurse officer'spersonnel management and to improve the quality of nursing care inmilitary hospitals. Data were collected by questionaries of 287 nurseofficers work in the military hospital in March, 2003. The main results of this research are follows; First. The morale of military nurse officers was high in general. The level of job satisfaction was measured as high in job itself and human relationship factors. The level of morale was measured as high in high rank group, corps-supporting hospital, high school career and married group of nurse officers. While the level of morale was measured as low in the lieutenant rank and in the field army-supporting hospital. Second. The major factors influencing the morale are as follows · Increasing factors ; inner compensation level, human relationship, outer compensation level. · Decreasing factors ; human relationship, outer compensation level, leadership The frequencies of increasing factors and decreasing factors are not different at 5% significant level by the level of morale. Third. The degree of the morale, job satisfaction, organizational commitment are significantly inter-related(+). The factors such as rank, marriage status and service period are significantly related. As a result of this study, we would rather concern about of the morale of low rank nurse officers whose morale level is especially lower than other groups, and also we would rather improve the service condition of the army-supporting hospital by facility modernization. The limitation of this research are the subjective answers of the respondents and the differences of sample size of hospitals in which generalizing of the conclusion may be reserved in some aspects. Accordingly we need mord in-depth studies on human relationship factors influencing the morale of military nurse officers ar required.

Thioamide와 Benzothiazole 유도체의 합성

정대일,신규하,김인식,김윤영,정두희,이용균 東亞大學校 1998 東亞論叢 Vol.35 No.-

The thioamides; {N-(6-methyl-2-pyridinecarbothionyl)-3-methoxyaminobenzene (27), N-(6-methyl-2-pyridinecarbothionyl)-4-methoxyaminobenzene (29), N-(6-methyl-2-pyridine-carbothionyl)-3-ethoxyaminobenzene (31), N-(6-methyl-2-pyridinecarbothionyl)-4-ethoxyamion-benzene (33), N-(6-methyl-2-pyridinecarbothionyl)-3-bromoaminobenzene (35), N-(6-methyl-2-pyridinecarbothionyl)4-bromoaminobenzene (37), N-(6-methyl-2-pyridinecarbothionyl)-3-chloroaminobenzene (39), N-(6-methyl-2-pyridinecarbothionyl)-4-chloroaminobenzene (41)} were synthesized by the treatment of 2,6-lutidine(22) with sulfur in aniline derivatives (23). The benzothiazole derivatives; {5-methoxy-2-(6-methylpyridy)benzothiazole (46) and 6-ethoxy-2-(6-methylpyridyl)benzothiazole (47)} were respecively synthesized by the treatment of synthesized thioamides; N-(6-methyl-2-pyridinecarbothionyl)-3-methoxy-aminobenzene (27) and N-(6-methyl-2-pyridinecarbothionyl)-4-ethoxyaminobenzene (33) with zirconium (Ⅳ) oxide catalyst in sodium carbonate solution.

CORBA A/V 스트리밍 서비스에 관한 연구

정두용,홍영래 공주영상정보대학 2000 논문집 Vol.7 No.-

OMG에서 제정한 A/V 스트리밍 서비스 사양은 표준 분산객체 미들웨어인 CORBA 환경에서 스트림 제어와 관리 객체에 대한 인터페이스와 각 스트림 단말의 스트림 인터페이스 제어객체에 대한 표준 인터페이스를 정의하고 있다. 그리고, 멀티미디어 데이터의 전송은 CORBA GIOP/IIOP를 사용하지 않고 RTP와 같이 멀티미디어 데이터 전송에 적합한 전송 프로토콜을 사용할 수 있도록 함으로써 CORBA를 사용하지 않은 미디어 스트림 프레임워크와 비슷한 미디어 전송 성능을 발휘할 수 있도록 하였다. 앞으로 더 많은 어플리케이션들이 멀티미디어 서비스를 제공할 것으로 예상됨에 따라 OMG A/V 스트리밍 서비스 사양은 주문형 오디오/비디오 서비스, 영상 회의, 인터넷 방송, 원격 의료 시스템, 대용량 데이터 전송에서 분산 이기종 시스템을 통합하는 핵심 기술이 될 것으로 예측된다.

중학생의 여가만족도가 여가몰입에 미치는 영향

정용각,황두일 부산 외국어 대학교 2003 外大論叢 Vol.26 No.-

This thesis was designed to reveal how the participation in youth group activity affects leisure satisfaction and commitment. The subjects were chosen among middle school students in Pusan using cluster sampling. The total 550 youths were consisted of 300 youths , 25 boys and 25 girls from each six office of education and 250 youths, 50 from each five youth activity group. The researcher visited their schools and the subjects were asked to fill out the distributed questionaries under their consents after enough explanation. The results are as follows. leisure satisfaction by genders does not show remarkable differences in facilities, psychology, rest, sociality satisfaction. Boys show more satisfaction than girls in physicality and interchange satisfaction. Leisure satisfaction by genders does not show remarkable differences in facilities, psychology, rest satisfaction. The attended students in groups showed more satisfaction than non attended students in physicality, interchange, study, and sociality satisfaction. Leisure commitment experience scale by gender does not show differences. The attended students showed higher leisure commitment experience scale than non -attended students in statistics. Statistically, facilities, affiliation, psychology, and study satisfaction have much effect on non-attended students. Generally physicality, facilities, interchange, psychology satisfaction have significant effects on leisure commitment.

비정질 와이어의 자기특성 측정시스템

신용진,정병두,진성빈 明知大學校 産業技術硏究所 1996 産業技術硏究所論文集 Vol.15 No.-

In this paper, we mention the implementation and the experiments of a magnetic properties measurement system about amorphous wire in weak magnetic field. By adding an op-amp of high magnification to a traditional properties measurement system the measurement system fully operates the functions in the weak magnetic field less than 0.1[Oe]. As the result we can find large Barkhausen jump

조산 예측인자로서 Fetal Fibronectin과 자궁경부 개대 및 길이 측정의 임상적 의의

정두용,방세창,유정현,김소정 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Twenty seven pregnant women between 22 and 36 weeks of gestational age presenting with preterm labor, intact membrane and less than 3cm cervical dilatation visited the department of Obstetrics and Gynecology, KonKuk University Medical Center, Choongju Hospital from June 1, 1998 to March 31, 1999. These patients' cervicovaginal swabs were assessed for the presence or absence of fetal fibronectin by means of ROM-CHECK(monoclonal antibody assay) the positivity of which was revealed by a colorimetric reaction. Also cervical parameters such as cervical length, presence of funneling, funnel length and funnel width were measured by transvaginal ultrasonography. We compared the diagnostic performances of these results in the prediction of preterm delivery of patients with preterm labor and intact membranes. The results were as follows; 1. The overall incidence of preterm delivery(< 37 weeks) was 44%; 12 among 27 patients. 2. There were statistically significant differences in the mean Bishop scores(4.58±0.48 vs 2.13±0.36), the mean gestational age at first admission with preterm labor(33.33±0.38 vs 29.47±1.06 weeks), the mean gestational age at delivery(34.92±0.34 vs 38.27±0.34 weeks) and interval from first admission to delivery(284.2±103.1 vs 1,339.2±154.4 hour) and mean birthweight(2,620±100 vs 3,131±100g) between the preterm delivery group and term delivery group. 3. The positive rates of fetal fibronectin in the vaginal fluid of preterm delivery group and term delivery group were 42%(5/12) and 0%(0/15). 4. The mean cervical length, presence of cervical funneling, funnel length and funnel width were 22.25±2.61mm vs 30.67±1.63mm; 75%(9/12) vs 47%(7/15); 11.83±3.40mm vs 4.53±1.64mm; 11.50±2.92mm vs 6.07±1.87mm in preterm delivery group and term delivery group, and there were statistical significances in the mean values of cervical length and funnel length between each group. 5. The sensitivities and specificities of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a predictor of preterm delivery were 42% and 100%; 75% and 80%: 50% and 87%; 33% and 93%. The positive predictive values and negative predictive values of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and funnel width(≥16mm) as a predictor of preterm delivery were 100% and 68%; 75% and 80%; 75% and 68%; 80% and 64%. 6. The sensitivities and specificities of the combined use of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a predictor of preterm delivery were 83% and 67%. The positive predictive value and negative predictive value of the combination of fetal fibronectin, cervical length(≤25mm), cervical funnel length(≥10mm) and width(≥16mm) as a whole as a predictor of preterm delivery were 67% and 83%.

상수처리 시스템에서의 막분리 공정의 개발

오중교,이태진,정두식,이용택 경희대학교 환경연구소 1995 環境硏究 論文集 Vol.6 No.-

Membrane filtration process seems to have many advantages such as improvement of drinking water quality, saving water purification chemicals and operation cost, easier operation and maintenance and saving time and cost for construction of a water purification plant. A study was conducted to optimize the use of a membrane process to produce potable water from Lake water in singal, Kyungkido, South Korea. We try to optimize the process by adjusting different pretreatment, various MWCO(Molecular Weig염(salt), alignate와 같은 천연고분자 또는 ht cut-off), hydrauric conditions.

지지방식에 따른 흙막이벽의 변형거동과 안정성

남정만,윤중만,이용두 제주대학교 해양연구소 2000 해양과환경연구소 연구논문집 Vol.24 No.-

An extensive instrumentation systems are designed on twenty-one anchored excavation sites and twelve braced excavation sites to observe the deformation behavior of the earth retention walls. The excavation sites are divided two cases by construction conditions: one is a stable construction site and the other is an unstable construction site. In this excavation sites, the anchor, strut load and the horizontal displacement of walls were measured from load cell and inclinometer. The different behavior of anchored and braced walls are precisely investigated on the basis of field measurements. And an empirical construction criterion is established to judge and ensure the stability of earth retention wall by the relationship between the earth pressure and the horizontal displacement of wall measured from both stable and unstable construction sites.