우울증 환자 치료에 있어서 Tianeptine과 Sertraline의 효과와 안전성 비교

이민수,강성민,기백석,연병길,오병훈,이철,채정민,백인호 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: 주요 우울증의 치료에 있어서 티아넵틴과 써트랄린의 임상적 효과와 안정성을 비교하기 위하여 연구를 시행하였다. 방법: DSM-IV 진단 기준에 의거하여 주요 우울증의 진단기준에 부합되고 17항목 해밀턴 우울척도 점수가 14점 이상인 환자를 대상으로 하였다. 총 40명의 환자를 무작위적 방식에 따라 티아넵틴 치료군과 써트랄린 치료군으로 분류하였다. 선탠된 환자에서 다른 항우울제를 복용하고 있는 경우 7일 이상의 약물 배설기간을 가진 후 티아넵틴과 써트랄린을 각각 6주간 투여하였으며, 기준점, 1주후, 2주 후, 4주 후, 6주 후에 HAM-D, MADRS, 그리고 CGI, COVI 등을 사용하여 평가하였다. 본 연구기간 중 발생된 모든 부작용은 부작용의 발생 및 소실 시기, 심한 정도, 발생 빈도, 관련 조치 및 결과에 대하여 증례기록서에 기록하도록 하였다. 결과: 30명(티아넵틴군 15명 ; 써트랄린군 15명)이 6주간의 연구를 완결하였고 티아넵틴 치료군에서는 1일 37.5mg을 투여하였으며 써트랄린군에서는 1일 평균 64.0±22.5mg을 투여하였다. 본 연구 결과 HAM-D, MADRS, CGI 상에서 두 군 모두에서 치료 1주 후부터 유의한 감소를 나타내었으며 이는 2주 후, 4주 후, 6주 후에도 지속적인 감소를 보였고 두 군간에 항우울 효과의 차이는 없었다. 활력징후, 일반 혈액학, 생화학, 심전도 검사 등에서는 두 군 모두 유의한 변화는 없었다. 티아넵틴과 관련된 부작용으로 흔히 보고한 증상은 오심(33.3%), 복부 불쾌감(26.7%), 구강 건조(20.0%), 두통(13.3%)등 이었고 써트랄린 치료군에서는 구강 건조(53.3%), 두통(46.7%), 오심(33.3%), 그리고 식욕 부진(33.3%)등으로 티아넵틴군에서 보다 적은 발현빈도를 보였다. 결론: 티아넵틴은 우울증의 치료에 있어서 효과적이고, 내약성이 우수한, 안전한 항우울제이다. Objective: This study was designed to evaluate the efficacy and safety of tianeptine and sertraline in the treatment of patients with depression. Method: The study was done on the patients with major depression diagnosed by DSM-IV, who had aHamilton Rating Scale for Depression(HAM-D) score ≥ 14 on the first 17 items of the HAM-D. A total of 40 patients were randomly assigned to tianeptine group and sertraline group. Tianeptine and sertraline were prescribed to each group. 6 weeks of each medication was carried out after 7 days of drug excretion period. Evaluation using 17 item HAM-D, Montgomery and Åsberg Depression Rating Scale(MADRS), Clinical Global Impression Scale (CGI), and Covi Scale was done on the baseline and after 1 week, 2 weeks, 4 weeks, and 6 weeks. Regrding all side effects that had occurred during the period of our study such as their developed/disappeaed time, severitien, incidences, managements and results have been recorded. Results: A total of 30 patients(tianeptine group 15 ; sertraline froup 15) finished the 6 weeks of research. 37.5mg of the daily dose was regularly prescribed to the tianeptine group, the average amount of 64.0±22.5mg of the final daily dose was prescribed to the sertraline group. Total 17 item HAM-D scores, total points of MADRS and CGI showed significant decrease after 1 week in each treatment froup and continous decrease after 2, 4 and 6 weeks ; and no difference was found between tianeptine group and sertaline group in the antidepressant efficacy. Also there were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The common reported side effects of tianeptine were nausea(33.3%), epigastic distress(26.7%), dry mouth(20.0%), headache(13.3%) and those of sertraline were dry mouth (53.3%), headache(46.7%), nausea(33.3%), anorexia(33.3%). Conclusion: According to the results, tianeptine was effective in improvement of depressive symptoms and was well tolerated and safe in patients with depression.

The 13-year experience of performing pancreaticoduodenectomy in a mid-volume municipal hospital

Hongbeom Kim,Jung Kee Chung,Young Joon Ahn,Hae Won Lee,In Mok Jung 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.2

Purpose: Pancreaticoduodenectomy (PD) is a complex surgery associated with high morbidity, mortality, and cost. Municipal hospitals have their important role in the public health and welfare system. The purpose of this study was to identify the feasibility as well as the cost-effectiveness of performing PD in a mid-volume municipal hospital based on 13 years of experience with PD. Methods: From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government – Seoul National University Boramae Medical Center.. Retrospectively collected data were analyzed, with a particular focus on complications. Hospital costs were analyzed and compared with a national database, with patients divided into 2 groups on the basis of medical insurance status. Results: The percentage of medical aid was significantly higher than the average in Korean hospitals. (19.1% vs. 5.8%, P = 0.002). Complications occurred in 88 patients (44.3%). Postoperative pancreatic fistula (POPF) occurred in 113 cases (61.7%), but the clinically relevant POPF was 24.6% (grade B: 23.5% and grade C: 1.1%). The median hospital stay after surgery was 20 days (range, 6–137 days). In-hospital mortality was 3.8% (n = 7), with pulmonary complications being the leading cause. During the study period, improvements were observed in POPF rate, operation time, and hospital stay. The mean total hospital cost was 13,819 United States dollar (USD) per patient, and the mean reimbursement from the National Health Insurance Service (NHIS) to health care providers was 10,341 USD (74.8%). The patient copayment portion of the NHIS payment was 5%. Conclusion: Performing PD in a mid-volume municipal hospital is feasible, with comparable results and cost-effectiveness.

소아에서 발생한 골수이형성 증후군 2례

홍성진,윤석중,김성우,조형구,오명호,김기혁,이인성 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

Myelodysplastic syndrome(MDS) is a group of acquired conditions characterized by progressive bone marrow failure associated with normocellular or hypercellular bone marrow that cannot be attributed to nutritional deficiency, chronic infection, or other chronic systemic illness, and cannot be reversed by the successful treatment of those conditions. Whereas the cases of secondary MDS occur at all ages, primary MDS is essentially a disease of elderly, though no age group is exempt and predomonant in men. The MDS is fundamentally clonal disorders at the level of the haemopoietic totipotent stem cell. Clinically, they are characterized by varing degrees of peripheral cytopenia(s) with morphological and functional abnormalities of blood elements. We have experienced two unrelated pediatric cases, who showed pancytopenia on admission and the characteristic marrow findings of MDS. The first case, a 12 months-old girl, showed increased reticulin with abnormal localization of immature precursor cells(ALIP) in her bone marrow, in addition to dysplastic features such as bi-and multi-nucleation of late normoblasts and internuclear bridging. She also showed 22% of blasts in her bone marrow cells thus classified in the category of RAEB-t after FAB classification. Also found were a chromosomal abnormality namely 46 XX t(14q21q), which was an unusual one. Her family brought her home and, 4 month later, she deceased. The second case, a 12 year-old boy, showed pancytopenia with Pseudo-Pelger-Huet anomaly in neutrophils but no blasts in the peripheral blood. Bone marrow of this case also showed the picture of dyserythropoiesis with binuclearity, internuclear bridging, nuclear fragments, multinuclearity of late normoblasts, in addition to megaloblastoid change in the normoblasts and increased mitosis in granulocytic series. No chromosomal abnormality was found. Classified as RA after FAB classification of MDS. Showed good response to conservative management for anemia for more than one year.

Application of Cubic Spline Synthesis in On-Line Core Axial Power Distribution Monitoring

In, Wang-Kee,Yoo, Hyung-Keun,Auh, Geun-Sun,Lee, Chong-Chul,Kim, Si-Hwan Korean Nuclear Society 1991 Nuclear Engineering and Technology Vol.23 No.3

The Core Operating Limit Supervisory System (COLSS) is digital computer based on-line monitoring system that is designed to assist the operator in monitoring of the Limiting Conditions for Operation. A current COLSS calculates axial power distribution based on in-core detector signals using 5th order Fourier series method. It was found that the 5th elder Fourier series method was not accurate for certain axial power shapes, especially saddle power shapes, resulting in thermal margin decrease. A cubic spline synthesis was applied to the COLSS in order to improve the axial power distribution monitoring for the various axial power shapes. The results showed that the cubic spline synthesis simulated more accurately the axial power shapes, up to 5% in RMS errors, compared to those of the Fourier series.

GPS/GLONASS 위성항법시스템에 의한 차량의 이동궤적

이기부,이인수 영남이공대학 2001 論文集 Vol.30 No.-

Nowadays Multi-sensor such as GPS(Global Positioning System), GLONASS(GLObal Navigation Satellite System), CCD(Charge Coupled Device), IMU(Inertial Measurements Units), etc are integrated. And information about road, etc is acquired and the Digital Map is upgraded from these. Expecially, GPS in U.S.A is popular in the integrated land navigation system, and also GLONASS in RUSSIA is expected to play an important key as a complementary device of GPS, but now it is not working perfectly because of a life cycle and a budgetary deficit. So In this study, moving trajectory of vehicle with the integrated GPS/GLONASS satellite navigation system is measured. and as a result, it was shown that GLONASS play an important key in the navigation of vehicle.

주정박 사일리지 제조시 인삼박의 혼합이 사일리지의 품질에 미치는 영향

이수기,이인덕,김용국 충남대학교 농업과학연구소 2001 농업과학연구 Vol.28 No.1

본 연구에서는 타피오카 주정박에 인삼박을 혼합하여 사일리지를 제조하였을 때, 사일리지의 품질(실험 Ⅰ)과 건물 섭취량 및 소화율 (시험 Ⅱ)에 미치는 영향을 조사하였다. 사일리지 조제시 수분함량을 낮추기 위하여 소맥피를 10% 수준으로 첨가하였으며, 인삼박의 혼합비율은 원물기준으로 0, 15 및 30% 수준 (3 처리)으로 하였다. 처리당 5반복으로 20㎏ 씩 비닐백에 넣고 공기를 배제하여 포장한 후 20∼25℃에서 30일간 숙성시켜 공시하였다. 시험 Ⅱ의 소화시험에서는 10개월령의 재래산양 수컷12두 (평균체중 14㎏)를 공시하여서 처리당 4반복이 되게 하였다. 7일 동안의 적응기간을 거친 후, 5일간 소화율을 조사하였던 바, 얻어 진 결과를 요약하면 다음과 같다. 1. 인삼박의 혼합 비율이 증가함에 따라 조단백질, NDF 및 ADF의 양이 증가하는 경향을 나타내었으며, 특히 인삼박 30% 첨가구는 인삼박 무첨가구와 인삼박 15% 첨가구에 비하여 유의하게 높은 결과를 나타내었다 (P<0.05). 그리고 조지방 함량과 hemicellulose 함량은 처리구간에 유의한 차이가 인정되지 않았다. 2. pH는 인삼박을 혼합하므로서 유의하게 감소하였으며, 인삼박 처리구간에는 유의한 차이가 인정되지 않았다. 젖산 함량은 인삼박 혼합비율이 증가함에 따라 유의하게 많아졌으며 (P<0.05), 총산도 인산박 첨가구가 무첨가구에 비하여 유의하게 많은 결과를 나타냈다. 초산은 인삼박 30% 첨가구가 유의하게 적었다. 한편 낙산은 인삼박 첨가구가 무첨가구에 비하여 유의하게 적었다(P<0.05) 3. 사일리지의 섭취량은 인삼박 첨가구가 무첨가구 보다 유의하게 많았다. 건물 소화율은 인삼박을 많이 혼합할수록 증가하였다. 위의 결과로 볼 때 주정박에 인삼박을 혼합하여 사일리지를 조제하는 것은 주정박 안으로 조제할 때 보다 더 좋은 품질의 사일리지를 만들 수 있으며, 기타 유사 재료에 대해서도 광범위한 적용이 가능할 것으로 사료된다. Two experiments were conducted to investigate the effects of the addition of ginseng meal to distillers feed on the silage quality, and feed intake and matter (DM) digestibility in goats In Experiment I , three levels of ginseng meal (0, 15, and 30%) were added to the distillers feed to make three types (treatment) of distillers feed silages (DFS). There were five replicates per treatment. Samples of 20 kg each were put into vinyl bag and vacuumed by an air compressor Vinyl bags mere kept at 20-25℃ for 30 days before being analyzed In Experiment Ⅱ. 12 male Korean native goats were employed to investigate the DM intake and digestibility of silages from Experiment I There n-ere 4 replicates per treatment. Daily feed intakes and fecal excretion were measured In Experiment I. the silage pH decreased and the lactic acid increased significantly by the addition of ginseng meal (P<005) In Experiment Ⅱ, the feed intake and DM digestibility increased significantly by the addition of ginseng meal It appears that the quality of distillers feed silages could be improved by the addition of ginseng meal at the level of 15 to 30%.

볼베어링 설계를 위한 접촉기구 규명에 관한 연구

임재환,이기형,정인성 全北大學校 1994 論文集 Vol.37 No.-

The performance of ball bearing is evaluated by both the lubrication between ball and race and the condition of the contact mechanism. The contact between ball and race of bearing is considered as point contact, and point contact generally occurs in the condition of the contact between two spheres or between sphere and plane which is basic form. Therefore, first we have to define the contact mechanism of ball and race to know the performance of the ball bearing. By this reason, in the paper we defined the contact mechanism by using the actual surface parameters.

建築物 監理의 改善에 관한 硏究

이재인,김억,김기철 대한건축학회 2004 대한건축학회논문집 Vol.20 No.8

It is prescribed in the provision of Article 2 of Architects Regulation that the definition of "Field Administration" is: to supervise and affirm whether the building, architectural equipment, or structure is being constructed in accordance with contract documents to guide and direct quality and progress of work, and its safety management. Since the "Provision of Architects Regulation" was enacted in 1962, it has been compulsory to conduct field administration for any building of certain size by a qualified licensed architect to affirm whether the building was constructed in accordance within the legal parameters of the contract documents. However, the intention of the above legislation has become nominal since the government mitigated provisions for duties and requirements of construction engineers, construction progress and safety in October 1998. There have been constant disputes among many parties since the limitation of responsibility for field administration was never clearly established legally even after the enactment of provisions on field administration. The objective of this study is to build transparency in the construction process by clarifying the limit and extent of field administration. I hope that this study can establish a basis to promote national competitiveness in the construction industry.

정신병적 우울증과 비정신병적 우울증의 몇가지 임상변인 및 갑상선 기능에 관한 비교조사

이철,백인호,이충기 대한신경정신의학회 1994 신경정신의학 Vol.33 No.3

The nosological status of major depression with psychotic features has been a matter of considerable controversy during the last 2 decades. To date, two hypotheses have been put forward : 1) that this condition represents a separate diagnostic entity : 2) that it is a more severe but not qualitatively different clinical form with respect to nonpsychotic depression. The validity of these hypotheses has been tested by comparing psychotic and nonpsychotic depressive patients with regard to a number of variables or biological meaures. The results obtained have not been consistent. With these aspects in mind, we studied clinical variables and thyroid function in 46 psychotic and 76 nonpsychotic hospitalized depressives to elucidate whether psychotic depression represents a distinct subtype. The results were as follows : 1) The psychotic and nonpsychotic depressives did not differ significantly with respect to sex, age, marital status, family history, past history, bipolarity, and suicide attempt. However, psychotic depressives had a lower age of onset than nonpsychotic patients. Also, psychotic patients had more past episodes than nonpsychotic patients. 2) The psychotic depressives had a significantly higher total score for Hamilton Depression Scale. A comparision of individual Hamilton item scores showed the psychotic group was significantly more depressed, guilty, suicidal and likely to complain of early insomnia. 3) There were no significant differences in mean serum levels of T3, T4, and TSH between psychotic depression and nonpsychotic depression. The psychotic and nonpsychotic depressives did not differ significantly with respect to TSH blunting. In light of our data, it seems less likely that psychotic depression is a separate diagnostic entity.

질화 분위기에서 결정화 된 Fe_(73.5)Si_(13.5)B_(9)Cu₁Nb₃ 연자성 합금의 자기적 성질

이기선,박인수,이기안,김문철,장석훈 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.11

Amorphous Fe_(73.5)Si_(13.5)B_(9)Cu₁Nb₃ alloy was crystallized in nitriding atmosphere of mixture gas of NH₃ and hydrogen. The crystallization at 823K showed the high electrical resistivity ranging from 494 to 538 mW-cm, which was higher level compared with nano-crystalline Fe_(73.5)Si_(13.5)B_(9)Cu₁Nb₃ alloy with a resistivity of about 110 mW-cm. Through the nitridation treatments, the amorphous alloy was transformed into nano-sized crystalline Fe3Si including iron nitrides such as γ' -Fe₄N phases. EPMA-concentration depth profiles confirmed an existence of nitrogen-rich region on the surface of the alloy ribbon, leading to the preferential formation of g -Fe4N phase. The formation of γ' -Fe₄N phase leaded to an increase of the resistivity and provided stable permeability and a low core loss at high frequency.