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.

경기 일부지역 육용 양돈작업장의 분진 및 내독소 농도

유동호,김형아,허용,성재혁,이한기,박용규 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.1

The aim of this study was to evaluate exposure to dust and endotoxin produced while working at swine confinement buildings. The dusts and endotoxin may cause adverse health effects on humans. Fourteen swine farms located at Yong-In, I-Cheon and Yeo-Ju of onggi-do were investigated. Husbandry workers form the farms were requested to wear personal sampler to measure respirable dust levels. Area samplings for total and respirable dust were also conducted at swine confinements buildings by season (summer under window open, winter under window close.) Gravimetric analyses and Limulus Amebocyte Lysate assay for measu- rement of dust level and endotoxin, respectively. The highest geometric mean (GM) concentration of airbome dusts was 7.47mg/㎡ for area respirable dust. and 10.35mg/㎡ for personal respirable dust. For respirable dust levels, seven farmers exceeded level of ACGIH, 3mg/㎥. The highest GM of endo- toxin was 5745.40 EU/㎥ for personal respirable dust. Significantly increased level of total dust (p〈0.001) and endotoxin in area total dust was observe with winter samples compared with those of summer. Area total dust and area respirable dust (r-0.622, p〈0.0001) was very significantly correlated in winter. Swine husbandry worker may have a considerable risk of ill health whenexposed to level of dust or endotoxin demonstrated at this study.

배자기 중 인간 사지의 형태발생에 관한 연구

박형우,민양기,심용운 대한해부학회 1992 Anatomy & Cell Biology Vol.25 No.1

배드민턴 선수들의 정신력 특성 분석

조용찬,이동수,이재형 한국스포츠리서치 2005 한국 스포츠 리서치 Vol.16 No.2

The purpose of this study was to investigate the mental toughness of Badminton players and suggest way of performance enhancement using Loehr's AET(Athletic Excellent Training) program. Subjects of this study were sampled 243 the badminton players (133 male, 110 female) by the random sampling method. The method of statistics used to analysis the collected data are mean, standard deviation, two-way ANOVA. Based on the procedures and results, the following conclusions were warranted ; 1. Arousal control. Attention control were significant between high school and major badminton players. Major badminton players showed lower score than that college badminton players(p<.05). 2. Positive energy were significant difference a statistics of sex. 3. In general Self-confidence, Arousal control, Attention control level. which are important factors of badminton players. were lower then the norm of AET. 4. Imagery, motivation level. Attitude control level of high school groups showed lower score. 5. Self-confidence, Arousal control, Attention control level, motivation level, Positive energy factors of showed lower score, Imagery, Attitude control level factors of showed higher score.

파라콰트 중독에서의 항산화치료

권운용,조유환,송형곤,김명천,이중의,서길준,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Paraquat causes severe tissue toxicity when ingested, but has no effective treatment modality. We have shown that high dose vitamin C has effective antioxidant activities against the paraquat intoxication in a previous animal experiment. This study was designed to evaluate the effect of antioxidant therapy with high dose vitamin C and vitamin E in human cases of paraquat intoxication. Methods: From August 1999 to August 2001, 19 paraquat intoxication patients who visited the emergency department of the Seoul National University Hospital and the Kyounghee University Hospital were enrolled to this study. They were devided into two groups, a control group(9 patients) and a study group(10 patients). The control group received only conservative managements including gastro-intestinal decontaminati-on. The study group received conservative managements plus the antioxidant therapy which was composed of vitamin C 24 gm/day intravenously and 20 gm/day orally, and vitamin E 1.6 gm/day orally. Results: In the study group, 5 of 10 patients(50%) survived, but all patients of the control group died(p=0.003). There were no significant differences in age, sex, and usage of gastric lavage and activated charcoal between the two groups. Difference in ingested amount of paraquat between the two groups could not be analyzed due to the inexact and subjective measuring methods based on patients' histories. Conclusion: Antioxidant therapy with high dose vitamin C and vitamin E is effective in vival rate in paraquat intoxicated patients.

초음파영상을 이용한 정상 교근의 평가

황형주,김규태,최용석,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.2

Purpose : To assess the internal echo intensity and morphological variability of masseter muscles on ultrasonography and to establish diagnostic criterion of estimation. Materials and Methods : Participants consisted of 50 young adults (male 25, female 25) without pathologic conditions and with full natural dentitions. Sonographic examinations were done with real time ultrasound equipment as Logiq 500 (GE Medical Systems, Seoul, Korea) at 3 parts according to lines paralleling with ala-tragus line as reference line. The thickness and area of masseter muscles according to reference line in cross-sectional images were measured at rest and at maximum contraction. The visibility and width of the internal echogenic intensity of the masseter muscles were also assessed and the muscle appearance was classified into 4 types. Data were statistically analyzed by paired t-test and x²-test. Results : 1. When comparing the thickness and area of masseter muscles concerning with gender, there was few significant difference between right and left sides, however, there were significant differences between males and females except for the greatest thickness of left side. 2. The changes of the greatest thickness and the area between rest and maximum contraction showed that the part of the least thickness manifested more increase at maximum contraction. 3. Each part the manifestations of the internal echogenic intensity of the masseter muscles were different depending on the locations. But there was no statistically significance. Conclusion : Changes of muscles thickness with contraction and internal echogenic intensity with locations showed great disparity within the masseter muscles, which will be diagnostic criteria for pathophysiologic and anatomic changes of masseter muscles.

Cone beam형 전산화단층영상을 이용한 하악과두 위치의 연구

황형주,김규태,최용석,황의환 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.2

Purpose : To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Materials and Methods : Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or prosthodontic treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. Results : In the sagittal views, mandibular condyle within articular fossa was posteriorly located at medial and central sections. In the coronal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Conclusion : Mandibular condyle within articular fossa in an asymptomatic population was observed nonconcentric position in the sagittal and coronal views.

경기도 일부 중학생의 체질량지수 및 성별에 따른 식생활 습관 및 영양소 섭취상태에 관한 연구

전형수;박용순 한양대학교 2007 韓國 生活 科學 硏究 Vol.27 No.1

Aim of this study was to investigate whether middle school students with different body mass index (BMI) and sex were different in their lifestyles and nutrient intake. Middle school students (n=408) in Gyenggi-do were participated in this stsudy. Height, weight and BMI of female students were 159.6㎝, 50.4㎏, and 19.7 ㎏/㎡, and those of male students were 165.5㎝, 57.7㎏ and 20.9㎏/㎡, respectively. Classified by BMI, there were 30% underweight, 51% normal, and 18.9% overweight. Reading time of underweight group was significantly shorter than those of overweight. More underweight students thought themselves healthier and had more appetite than overweight subjects. Male students used computer significantly longer and ate more on time, but had more unbalanced diet than females. Male students consumed more calorie, protein, vegetable protein, vegetable fat, carbohydrate, sodium, vitamin B1. Intakes of fiber and calcium were lower than the Dietary Reference Intakes for Koreans for that age group. Our results suggested that students had meal not on time, unbalanced diet, and meal too fast. Intakes of protein, fat, and sodium were higher, but intakes of calcium and fiber were too low. Those may cause serious health problem. Thus, students and health care providers should recognize the problems and develop education programs to help students to keep proper life style and eating habits.

전상회계 전자교재(e-Textbook) 개발에 관한 연구

김소형,정용화 한국직업능력개발원 2003 직업능력개발연구 Vol.6 No.1

This study researched to apply a accounting education method of the future that to consider college environment. The research model was completed to be analysis a concept, strong-weakness of e-Book & e-Text Book, environment factor for development of accounting e-textbook. The contents development used to the effect of animation and made the simple design. It was to be purposed to study an important accounting knowledge fast. The accounting e-textbook was made to use the PC and internet explore for convenient the students. This method learn anywhere the computer accounting program.

감식초가 고콜레스테롤 식이를 한 흰쥐의 혈중 지질 성분에 미치는 영향

정소형,김주현,정용진,최미자 동아시아식생활학회 1999 동아시아식생활학회지 Vol.9 No.4

This study was performed to evaluate the effect of persimmon vinegar on serum lipid components in the hypercholesterolemic Sprague-Dawley male rats. Forty rats were divided into four groups and fed diets containing 1% cholesterol for 4 weeks. Experimental diets added to distilled water, 1.5%, 3%, and 7% persimmon vinegar(PV) as drinking water. Concentration of total cholesterol, LDL and HDL cholesterol, triglyceride in serum and activity of AST, ALT in serum were assayed. Average food intake, weight gain and FER of experimental rats were not significantly different by contents of persimmon vinegar. Concentration of total cholesterol and LDL cholesterol in serum were lowest in 7% persimmon vinegar group. However concentration of HDL cholesterol in serum was highest in 3% persimmon vinegar group. Concentration of triglyceride in serum was significantly lower in persimmon vinegar group than control group. Activities of AST and ALT in serum were lowest in 7% persimmon vinegar group. The results in this study suggest that persimmon vinegar is effective in lowering serum triglyceride level.