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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.
질소 가스 내에서의 전자 수송계수에 대한 몬테칼로 해석
심재학,정운관 조선대학교 에너지.자원신기술연구소 2003 에너지·자원신기술연구소 논문지 Vol.25 No.1
In this paper, electron swarm parameter is calculated by Monte-Carlo method in nitrogen gas. Under the uniform electric field, the motion of electron which depends on the electric field is calculated by time of flight(TOF) method, and the type of collision between electron and nitrogen molecule are determined by the comparison between collision cross section of nitrogen gas and random number. On the assumption that nitrogen pressure is 200[Torr] and 50≤E/p≤700[Vcm^(-1)Torr^(-1)], we calculate the ionization coefficients, drift velocity, energy distribution and diffusion phenomena, and compare these values with experimental values.
정운관,심재학,김영진 조선대학교 에너지.자원신기술연구소 2004 에너지·자원신기술연구소 논문지 Vol.26 No.2
This paper describes experimental evaluation of exposure dose algorithm for film badge and the results of the personnel dosimetry performance test. Reference radiations irradiate seven categories, except the neutron category prescribed in the ANSI N13.11-1993. The performance criterion in a given category, sum of the absolute value of the bias and the standard deviation of the performance quotient, was estimated by the use of film badge algorithm and dose equivalents according to the standard method. As a result, the performance index in a given category showed a good agreement less than tolerance level, for the deep and shallow dose equivalents or absorbed dose, and this study is satisfied with quality decision cnterion of the film badge personnel dosimeter and intercomparison results.
景觀的 側面에서 照明한 主要寺刹 內 庵子의 創建 年代 建物의 形態 主佛 및 庵子 名稱的 特性
裵貞寬,沈載成 배재대학교 자연과학연구소 2005 自然科學論文集 Vol.16 No.1
This study was conducted under the theory of hermitage ever built from Buddhist belief. Directing to hermitages within temples of Korea Jogye Order, we focused on the layout correspondence relationship among them. and 161 hermitages were the first object of the investigation. For the accomplishment of the research purpose, the general epitome and spatial specification through various literature studies, on-the-spot survey and personal communications with a lot of priests were made. As one of the basic surveys, the foundation year were thoroughly investigated, followed by the form of building, main buddha and hermitage name. The results obtained were summarized as follows : Forty five hermitages which are equivalent to twenty eight percent of total hermitages within the parish-level temples of Korea Jogye Order, were built in Shilla Dynasty and twenty hermitages that are 12.4 percent of the total were constructed in Koryo Dynasty and thirty seven percent of the total were founded during both of dynasties. This fact makes us to consider that many of hermitages in those days were constructed with the simultaneity of principal temple foundation which means hermitage had responded the spirit of the times. Every hermitage has its main Buddha and this thing happened that each hermitage enshrines its main Buddha according to the thought which was developed with the Buddhism expansion and sutra that is in accordance with their own intention. Basically a capital temple has differed in its central sanctum in accordance with resourceful sutra, and, at the same time, twenty seven in avatamsk Sect enshrine for Sakyamuni as their sanction and eight for the Merciful Goddess and 42.7 percent for Chajang's hermitages. The name of hermitage not only represents its symbol but comprises the characteristic meaning of ascetic practice. 31.7 percent of the hermitages studies was found to have the names of relating to 'ascetic practice' or 'thought' followed by the 'nature' or 'environment' to 21.7 percent.