정신분열병 환자의 우울증에서 Paroxetine과 삼환계 항우울제 병용치료

심주철,공보금,박정환,윤영란,신재국,김정익,안동성,김용관,차인준,김영훈 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 마산동서병원에 입원중인 우울증이 동반된 정신분열증 환자 10명을 대상으로 사용중인 항정신병약물에 paroxetine과 저용량의 삼환계 항우울제를 6주간 병용투여한 후 우울증상에 대한 효과와 치료의 안전성 및 약물상호작용을 알아보았다. Paroxetine은 고정량의 항정신병약물과 삼환계 항우울제에 부가하여 일일 20㎎을 6주간 병용하게 하였으며, 임상상태는 HDRS, HARS, UKU Side Effect Rating Scale등의 평가척도를 사용하여 평가하였다. 또한 약동학적 약물상호작용은 삼환계 항우울제들의 혈장농도를 HPLC로 측정하여 분석하였다. 결과는 다음과 같다. 1) 10명의 전체 대상환자에서의 HDRS 평균점수는 TCA와 paroxetine 병용투여 6주후에 통계적으로 유의하게 감소되었다. 이중 40%의 환자에서는 병용투여 6주후에 HDRS 점수상 50% 이상의 감소를 보여, 일부의 환자들에서는 정신분열병에 동반된 우울증상의 치료에 소량의 삼환계 항우울제와 paroxetine의 병용치료가 효과가 있음을 확인하였다. 2) 두 명의 환자에게서 심각한 약물독성이 발생하였다. 이중 한 명은 삼환계 항우울제의 높은 혈중농도로 인한 항콜린성 위기(anticholinergic crisis) 소견을 보였으며, 다른 한 명은 인지기능 및 의식수준은 명료하였으나 망상과 환각증상이 약화되는 소견을 보였다. 따라서 본 연구에서 시도된 복합적 약물치료의 경우, 삼환계 항우울제의 혈중농도의 측정을 포함한 세심한 임상적 추적이 필요하다고 생각된다. 3) 기저치의 amitriptyline과 그 대사물인 nortriptyline의 농도합. imipramine과 대사물인 desipramine의 농도합은 각각 47.8-226.5ng/㎖. 80.5-395.6ng/㎖였으며 일반적으로 이들 약물들의 단독사용시에 문헌에 보고된 혈중농도를 훨씬 상회하고 있었다. 이는 병용투여된 항정신병 약물 약시 강력한 CYP2D6 효소억제제로서 기저치의 삼환계 항우울제들의 혈장농도를 이미 상당히 증가시켰던 것으로 판단되며, 그러한 결과로 인해 본 연구에서는 paroxetine이 이전의 문헌보고들과는 달리 뚜렷하게 삼환계 항우울제들의 혈장농도를 증가시키지 못하였다. 본 연구는 SSRI와 삼환계 항우울제의 병합 투여가 우울증의 개선 효과를 빠르게 하고, 치료역을 넓히고, 약물상호작용의 결과 paroxetine이 삼환계 항우울제의 혈중농도를 증가시킨다는 기존의 연구결과를 이용하여 정신분열병 우울증상의 치료에 parotextine과 소량의 삼환계 항우울제를 병용하는 방법을 시도해 본 연구이다. 저자들은 이러한 약물치료가 일부의 환자들에게서 효과가 있음을 관찰하였으나, 항정신병약물과 삼환계 항우울제를 병용투여 할 경우는 물론 이에 paroxetine과 같은 선택적 세로토닌 재흡수 억제제를 병용할 경우 복합약물상호작용의 결과로 약물독성의 위험성이 크며 세심한 주의가 필요함을 경험하였다. Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly. Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained : 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was found in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYP2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant in our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.

산모가 인지하는 배우자의 지지와 출산경험과의 관계 연구

김인숙,박공례 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2

This study explored the relationship between women's perception of husband's support and of childbirth experience. The subjects of this study were a sample of 66 women who delivered at "C" University Hospital and OB clinics in Kwang Ju city, between January 26 and March 3, 1990. The instruments used in this study were the husband's support scale developed by an and the in strument measuring perception of childbirth experience by women, which was developed by the researcher, and available information from several reference was utilized. Data were analyzed by S.P.S.S. package including Frequency, tUtest, ANOVA Pearson's Correaltion Coefficient. The results are as follows: 1. The hyphothesis that as the degree of the husband's support perceived by the women increases, the higher is the woman's perception of childbirth experience was supported(r=0.2904, P< 0.05). 2. According to the analytic results cencerning the relationship between the general backgrounds and obstetric characteristics of subjects and the husband's support, there was a statistically significant difference in the period of marriage(F=4.598, P< 0.05), Para(F=8.405, P< 0.05), and the frequency of antepartal care(F=3.439, P< 0.05). 3. Results from analyzing the relationship between general backgrounds, obstetric characteristics and the perception of childbirth experience of subjects are as follows: there was a statistically significant difference in the condition of health (F=3.357, P< 0.05), helping person of after-childbirth (t=-1.22, P< 0.05) and para(F=3.37, P< 0.05). Therefore, nurses working in the obstetric field must try to develop an educational program to inform women and there husbands of the importance of the husband's support to the women's positive perception of childbirth experience.

외상성 고관절 아탈구의 원인과 치료 : 2 Cases Report

문명상,옥인영,염공섭 최신의학사 1980 最新醫學 Vol.23 No.9

파쇄대에 접근하는 터널의 내공변위 변화 해석

이인모,이승주,이주공,이대혁,Lee, In-Mo,Lee, Seung-Ju,Lee, Joo-Gong,Lee, Dae-Hyuck 한국터널지하공간학회 2002 터널기술 Vol.4 No.3

The purpose of this study is to figure out the tendency of tunnel convergence during excavation and to present a methodology for the prediction of a fault zone ahead of a tunnel face by analyzing three dimensional displacements in various ways. 3-D numerical analysis was performed to investigate changes of tunnel convergence vectors near a fault zone and to propose a flow chart for predicting fault zones. Results of the site investigation and results of trend line analysis of in-situ data were compared to verify the usefulness of a trend line analysis. It is concluded that the orientation of faults can be predicted by using stereonets and the direction of initial stresses can be predicted from the arm length of a displacement vector as a tunnel approaches fault zones. The results of the trend line analysis coincided with those of the site investigation, and a methodology for the prediction of a fault zone was proposed. 본 연구는 터널 굴착시 막장 전방의 지반변화를 사전에 예측할 수 있는 방법을 제시하고자 하였다. 이를 위하여 막장 전방에 파쇄대가 방향성을 가지고 존재 할 때 터널의 3차원 해석을 통하여 터널의 내공변위의 변화 경향을 살펴보았으며, 이를 통하여 막장전방의 지반 변화를 파악하고자 하였다. 이러한 터널의 내공변위의 변화는 경향선과 영향선을 이용하여 표현할 수 있으며 이를 이용하여 막장 전방에 존재하는 파쇄대를 예측하고자 하였다. 수치해석 결과에 의하면 막장전방에 파쇄대가 존재 할 경우 막장이 파쇄대에 접근할 수록 급격한 경향선의 변화가 나타난다. 또한 파쇄대가 방향성을 가지고 있는 경우에는 경향선의 급격한 변화 외에 측벽부의 변위 경향이 비대칭을 이루므로 인하여 평사투영도 상에 나타난 변위가 비대칭을 형성하는 것으로 파악되었다. 이러한 수치해석결과에 의한 내공변위 해석결과를 현장 계측 자료와 비교하였으며, 현장에서 계측한 오차를 줄일 수 있도록 계측데이터가 정규분포 한다고 가정하여 현장데이터를 분석한 결과 막장전방의 파쇄대의 존재 유무를 파악할 수 있는 것으로 나타났다.

잇꽃 Carthamin의 초임계 추출 및 농축

이종민,마상동,한태룡,김공환,임상빈,정인식 경희대학교 생명자원과학연구원 1997 遺傳工學論文集 Vol.9 No.-

Supercritical fluids (SCF) are useful substances that are recently used in bioseparation process. Extraction of carthamin from safflower using supercritical carbon dioxide were examined at various conditions of temperature (35∼40℃), pressure (3000∼5000 psi) and CO₂ flow rate (900∼1200 m/hr). SCF was less effective than solvent methods in carthamin extraction from safflower. Concentration of carthamin was 50% more efficent at the use of alginate beads with 35 g cellulose per column loadings compared to the control (15g cellulose per column loadings).

Year-to-Year and Inter-Decadal Fluctuations in Abundance of Pelagic Fish Populations in Relation to Climate-Induced Oceanic Conditions

Gong, Yeong*,Young-Sang Suh,In-Seong Han,Ki-Tack Seong 한국생태학회 2008 Journal of Ecology and Environment Vol.31 No.1

Ocean climate variables (1900~2005), time series of catches (1910~2005) and body size data were used to assess the year-to-year and decadal scale fluctuations in abundance of the fish populations (Japanese sardine, anchovy, jack mackerel, chub mackerel, Pacific saury and common squid) that have spawning grounds in the East China Sea and its adjacent regions. A negative correlation between the abundance of pelagic fishes (e.g. jack mackerel) in the Tsushima Warm Current (TWC) region and the Kuroshio-Oyashio Current (KOC) region was attributed to the climatic modulation of larval transport and recruitment, which depends on the winter monsoon-induced drift, current systems, and spawning season and site. The changes in abundance and alternation of dominant fish populations in the two regions in the 1930s, 1970s, and late 1980s mirrored changes in the climate indices (ALPI, AOI and MOI). Oscillations in the decadal climate shifts between the two regions led to zonal differences in larval transport and recruitment, and hence differences in the abundance of the pelagic fish populations. During deep Aleutian Lows, as in the 1980s, larval transport from the East China Sea to the KOC region increases in association with the strong winter Asian monsoon, cool regime and increased volume transport of the Kuroshio Current systems, whereas during a weak Aleutian Low (as in the 1990s), larval transport to the TWC region increased in association with a weak winter Asian monsoon, a warm regime, and increased volume transport of the Tsushima current system. We postulate that the increased chub mackerel abundance in the TWC region and the decreased abundance in the KOC region in the 1990s are partly attributed to changes in recruitment and availability to the fishing fleets under the warm regime in the spawning and nursery grounds in the East China Sea in association with the quasi-steady state of mild winter monsoon in the 1990s. The fluctuations in chub mackerel and jack mackerel abundance are under the environment-dependant growth form, although the tropicalization was identified in the TWC region. The density-dependant growth form was found in Japanese sardine populations, but no tropicalization by fishing was identified in the long (10~15 year) periods of abundance despite their short (3~4 year) generation time, suggesting that the environment-dependant growth form drove the changes in abundance. Year-to-year and decadal scale variations in abundance and population structure of the Pacific saury responded to climate regime shifts (1976/1977, 1988/1989), suggesting that the fish is a key bio-indicators for changes in the ecosystem. Ocean climate variables (1900~2005), time series of catches (1910~2005) and body size data were used to assess the year-to-year and decadal scale fluctuations in abundance of the fish populations (Japanese sardine, anchovy, jack mackerel, chub mackerel, Pacific saury and common squid) that have spawning grounds in the East China Sea and its adjacent regions. A negative correlation between the abundance of pelagic fishes (e.g. jack mackerel) in the Tsushima Warm Current (TWC) region and the Kuroshio-Oyashio Current (KOC) region was attributed to the climatic modulation of larval transport and recruitment, which depends on the winter monsoon-induced drift, current systems, and spawning season and site. The changes in abundance and alternation of dominant fish populations in the two regions in the 1930s, 1970s, and late 1980s mirrored changes in the climate indices (ALPI, AOI and MOI). Oscillations in the decadal climate shifts between the two regions led to zonal differences in larval transport and recruitment, and hence differences in the abundance of the pelagic fish populations. During deep Aleutian Lows, as in the 1980s, larval transport from the East China Sea to the KOC region increases in association with the strong winter Asian monsoon, cool regime and increased volume transport of the Kuroshio Current systems, whereas during a weak Aleutian Low (as in the 1990s), larval transport to the TWC region increased in association with a weak winter Asian monsoon, a warm regime, and increased volume transport of the Tsushima current system. We postulate that the increased chub mackerel abundance in the TWC region and the decreased abundance in the KOC region in the 1990s are partly attributed to changes in recruitment and availability to the fishing fleets under the warm regime in the spawning and nursery grounds in the East China Sea in association with the quasi-steady state of mild winter monsoon in the 1990s. The fluctuations in chub mackerel and jack mackerel abundance are under the environment-dependant growth form, although the tropicalization was identified in the TWC region. The density-dependant growth form was found in Japanese sardine populations, but no tropicalization by fishing was identified in the long (10~15 year) periods of abundance despite their short (3~4 year) generation time, suggesting that the environment-dependant growth form drove the changes in abundance. Year-to-year and decadal scale variations in abundance and population structure of the Pacific saury responded to climate regime shifts (1976/1977, 1988/1989), suggesting that the fish is a key bio-indicators for changes in the ecosystem.

Fluctuations of Pelagic Fish Populations in Relation to the Climate Shifts in the Far-East Regions

Gong, Yeong,Jeong, Hee-Dong,Suh, Young-Sang,Park, Jong-Hwa,Seong, Ki-Tack,Kim, Sang-Woo,Choi, Kwang-Ho,Han, In-Seong The Ecological Society of Korea 2007 Journal of Ecology and Environment Vol.30 No.1

Based on a time series of ocean climate indices and catch records for seven pelagic fish species in the Tsushima Warm Current (TWC) and Kuroshio-Oyashio Current (KOC) regions from 1910 to 2004, we detected regional synchrony in the long-term fluctuations of the fish populations and identified alternation patterns of dominant species related to climate shifts. The annual catches of Pacific herring, Japanese sardines, Japanese anchovies, jack mackerel, chub mackerel, Pacific saury and common squid in the TWC region fluctuated in phase with those in the KOC region, which suggests that they were controlled by the same basin-wide climate forcing. After the collapse of the herring fishery, the alternation sequence was: sardines (1930s), Pacific saury, jack mackerel, common squid and anchovies ($1950s{\sim}1960s$), herring ($late\;1960s{\sim}early\;1970s$), chub mackerel (1970s) and then sardines (1980s). As sardine biomass decreased in the late stages of the cool regime, catch of the other four species increased immediately during the warm period of the 1990s. Regional differences in the amplitude of long-term catch fluctuations for the seven pelagic fishes could be explained by regional differences in availability, fishing techniques and activity.

A Robust Indoor Positioning System using Two-Stage EKF SLAM for First Responders in an Emergency Environment

Gong Bo Moon,Sebum Chun,Moon-Beom Hur,Gyu-In Jee 제어로봇시스템학회 2013 제어로봇시스템학회 국제학술대회 논문집 Vol.2013 No.10

A positioning method for a first responder in an indoor emergency environment is needed to strengthen a safety for rescue operation. In Korea, it is focused as one of the national agenda. Though many researches are done in this field, but they still have limitations of system preloading and a poor positioning accuracy depending on an arbitrary situation. This paper presents a robust indoor positioning system for the first responder in the scene of fire. The proposed positioning system consists of a monitoring station outside a building, portable access points (APs), and first responders. In the first place, the first responder measure distances to other first responders and portable APs in the hearable range, and calculates its relative position utilizing the simultaneous localization and mapping (SLAM) method implemented with the Extended Kalman Filter (EKF). In this process, the position information stored in the APs and first responders can serve as a map for the others. Then the initial position guess and distance measurements are delivered to the monitoring station via ad-hoc network by portable APs and first responders to correct position estimates of those in the whole system. The monitoring station also uses EKF SLAM method with all available position estimates and distance measurements. In this paper, the system configuration and positioning method are presented, and the simulation on the positioning of the portable APs and the first responders with respect to the monitoring station is carried out to certify the feasibility of the proposed system.

An Indoor Positioning System for a First Responder in an Emergency Environment

Gong Bo Moon,Moon Beom Hur,Gyu-In Jee 제어로봇시스템학회 2012 제어로봇시스템학회 국제학술대회 논문집 Vol.2012 No.10

An indoor positioning system for a first responder in an emergency environment is focused as one of the national agenda in Korea. In this area, many researches are carried out, still there left limitations of a system installation and an inconsistent positioning accuracy in the arbitrary emergency environment. This paper presents a new indoor positioning system for the first responder, especially firemen in the scene of a fire. The portability and adaptability for the emergency environment are mainly considered for a feasibility of the proposed system. With portable access points (APs), which can measure ranges to the other AP and the firemen based on IEEE 820.15.4a, in an indoor environment and a monitoring station in an outdoor environment, a control unit outside a building in fire can determine the position of the firemen and deployed APs using the Extended Kalman Filter (EKF) and the simultaneous localization and mapping (SLAM) methods. In this paper, the concept and positioning procedure of the proposed system are introduced. An experiment on ranging is done to analyze an error characteristic of measurements, then the result is applied to a simulation for the positioning system to certify the possibility of the system operation in the emergency environment. The simulation result shows that the proposed indoor positioning system can be applied to help the firemen escape from the emergency environment safely.

Low-dose-rate radiation exposure leads to testicular damage with decreases in DNMT1 and HDAC1 in the murine testis

Gong, Eun Ji,Shin, In Sik,Son, Tae Gen,Yang, Kwangmo,Heo, Kyu,KIM, Joong Sun JAPAN RADIATION RESEACH SOCIETY 2014 JOURNAL OF RADIATION RESEARCH Vol.55 No.1

<P>This study examined the effects of continuous low-dose-rate radiation exposure (3.49 mGy/h) of gamma rays on mice testicles. C57BL/6 mice were divided into sham and radiation groups (<I>n</I> = 8 each), and were exposed to either sham irradiation or 2 Gy for 21 days, 0.2 Gy for 2 days, or 0.02 Gy for 6 h of low-dose-rate irradiation. Testicular weight, seminiferous tubular diameter, and seminiferous epithelial depth were significantly decreased in the mice irradiated with 2 Gy at 1 and 9 days after exposure. Moreover, the low-dose-rate radiation exposure induced an increase in malondialdehyde levels, and a decrease in superoxide dismutase activity in the testis of mice irradiated with 2 Gy at 1 and 9 days after exposure. The sperm count and motility in the epididymis also decreased in mice irradiated with 2 Gy at 1 and 9 days after exposure, whereas there was no significant effect on the proportion of abnormal sperm. The expressions of DNA methlytransferases-1 and histone deacetylases 1 in testes irradiated with 2 Gy were significantly decreased compared with the sham group. In conclusion, the damage exerted on the testes and epididymis largely depended on the total dose of low-dose-rate radiation.</P>