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.

석탄 가스화를 통한 전력 생산과 DME 병산 공정에 대한 기초 경제성 분석

유영돈 ( Young Don Yoo ),김수현 ( Su Hyun Kim ),조원준 ( Won Jun Cho ),모용기 ( Yong Gi Mo ),송용택 ( Tae Kyong Song ) 한국화학공학회 2014 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.52 No.6

석탄가스화를 기반으로 한 발전(IGCC 발전) 및 화학원료 제조공정의 상업화 관건은 화석연료인 원유 또는 천연가스를 기반으로 생산되는 경우와 비교하여 경제성을 확보할 수 있는지 여부이다. 경제성 확보를 위한 가장 현실적인 방법으로는 석탄 가스화를 통해 얻어진 합성가스로부터 2개 이상의 생산물(예: 발전과 화학원료를 동시 생산)을 병산(coproduction또는 poly-generation)하는 것이다. 본 연구에서는 석탄 가스화를 기반으로 하여 발전과 수송용, 발전용 및 가정용 연료로 사용이 가능한 DME(dimethyl ether)를 병산하는 공정에 대한 경제성 분석을 실시하였다. 경제성 분석을 위한 병산 공정에서는 250 MW 전력생산 연간 30만 톤의 DMZ 생산을 기준으로 하였다. 병산 공정에서 DME 판매가격이 50만원/ton인 경우, 전기 생산원가는 34.8~58.4원/kWh으로 SMP(계통한계가격) 가중평균인 150.69원/kwh(2013년 1월~12월까지의 평균값)의 33~58% 수준으로 산정되었다. 따라서, DME 판매가격이 적정하게 유지될 경우 석탄IGCC+DME 병산공정은 IGCC 단독 발전과 비교하여 경제성을 확보할 수 있을 것으로 판단된다. 현재 중국에서 DME판매가격이 900,000원/톤 내외이므로, 전력과 DME를 병산할 경우, IGCC 단독으로 전력을 생산할 경우와 비교하여 전력 생산 원가를 월등하게 낮출 수 있음을 알 수 있다. 이와 같이 석탄 가스화를 기반으로 한 병산 공정을 통해 전력과 DME를 병산하는 시스템에서, 시장 여건에 따라 전력과 DME 생산비율 제어가 가능하고, 석탄 가스화기 및 정제 시스템을 공통 설비로 활용함으로써, 개별적으로 생산하는 것보다 생산 원가를 낮출 수 있다는 결과를 얻었다. The key for the commercial deployment of IGCC power plants or chemical (methanol, dimethyl ether, etc.) production plants based on coal gasification is their economic advantage over plants producing electricity or chemicals from crude oil or natural gas. The better economy of coal gasification based plants can be obtained by co-production of electricity and chemicals. In this study, we carried out the economic feasibility analysis on the process of co-producing electricity and DME (dimethyl ether) using coal gasification. The plant’s capacity was 250 MW electric and DME production of 300,000 ton per year. Assuming that the sales price of DME is 500,000 won/ton, the production cost of electricity is in the range of 33~58% of 150.69 won/kwh which is the average of SMP (system marginal price) in 2013, Korea. At present, the sales price of DME in China is approximately 900,000 won/ton. Therefore, there are more potential for lowering the price of co-produced electricity when comparing that from IGCC only. Since the co-production system can not only use the coal gasifier and the gas purification process as a common facility but also can control production rates of electricity and DME depending on the market demand, the production cost of electricity and DME can be significantly reduced compared to the process of producing electricity or DME separately.

손자병법을 통한 디지털 경영전략

송경용,김원철 東新大學校 2003 論文集 Vol.13 No.-

This research investigated about business strategy spread variously by compare 5 principle in art of war and is grafted together with administration strategic theory digital age. Infinity age that 21th century digital age is fast is coming. Keyword of 21th century administration is game plan, information, info, change, being etc. In 21th century, corporation formation's environment change is unforeseeable effectively. It is important that approach in strategic administration to do so that formation may can achieve result that want in these environment. Leader who retain strategic thoughtway examines together two faces of pros and cons necessarily when begin action that is new. Deflective thinking to lean on which one during work that is worth getting into gains and work that see damage must not have. Only so, can enjoy much successes keeping away miss beforehand. Principles that say in art of war called art of business strategy ever for these as necessary main principles to business strategy development in administration as well as war. Corporation must apply digital business strategy system properly taking a triangular position at early time because collect and uses value creation and great many information for customer.

낭성법랑모세포종, 함치성낭, 치성각화낭의 방사선소견과 Ki-67, PCNA, Cytokeratin 발현과의 연관성에 관한 연구

송만용,이삼선,이진구,이원진,허민석,이재일,민병무,최순철 대한구강악안면방사선학회 2004 Imaging Science in Dentistry Vol.34 No.2

Purpose : To compare the proliferation potential of the epithelial cells between unicystic ameloblastoma (UA), dentigerous cyst (DC), and odontogenic keratocyst (OKC) and to correlate this proliferation potential with the radiographic features of these three pathoses. Materials and Methods : Immunohistochemical expression of PCNA, Ki-67, and cytokeratin as a proliferation marker were assessed for 15 cases of UA, 15 cases of DC, and 15 cases of OKC. The degree of immunochemical expression of three proliferation markers were correlated with the radiographic features, especially cortical expansion (negative and positive) and shape of border (scalloped and round). Results : Using PCNA and Ki-67, OKC showed the highest proliferation potential and UA the lowest. Statistically significant differences were found between the OKC and the UA (p.0.05). However, no statistically significant difference was present according to the radiographic features in all pathoses. Using cytokeratin, there was no significant differences of proliferation potential among three pathoses. Conclusions : OKC epithelium has the most intense proliferation potential, followed by the dentigeous cyst and then unicystic ameloblastoma. There is no significant relation between the radiographic features and the proliferation potential of epithelium of these three pathoses.

병식 평가 척도-한국판(SUMD-K)의 신뢰도와 타당도 검증

송지영,김기태,이서경,김용희,노준호,김종우,장환일,반건호,강원섭 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : This study was conducted to evaluate the reliability and the validity of the Korean version of the Scale to Assessment Unawareness of Mental Disorder (SUMD-K). Methods : The subjects were 55 schizophrenic patients between ages of 26 and 58 who were recruited from the psychiatric unit of the university hospital and the out-patient clinic. The SUMD-K and insight scale of PANSS were applied to the patients. Results : The range of inter-rater (Spearman's rho) of the general items of SUMD-K were .97-.98 on the current illness and .58-.98 on the past illness. The correlation coefficient between the sum and the general items of the SUMD-K showed high scores. The concurrent validity between SUMD-K and insight item of PANSS was high (scores between .59-.96). However,the reliability and the validity of the attribution items of symptoms showed low scores compared to the current symptoms. Conclusion : The SUMD-K was confirmed in its reliability and validity. It can be a useful clinician-rating scale for evaluating insight in schizophrenic patients as well as patients with other neuropsychiatric conditions.

대전지방 도시단독주택 지붕ㆍ현관ㆍ창호의 형태에 관한 조사연구

宋容浩,金尙謙,趙原德 忠南大學校 産業技術硏究所 1986 산업기술연구논문집 Vol.1 No.2

Roof, porch and window are important exterior elements which constitute the building envelope. This is a research on these elements of urban detached houses in Taejon area to suggest the basic data for housing design. The research is executed by enquete survey, photographs, sketch, measurement of size and survey sheets. By analyzing the elements according to the building ages, type, size, materials and color, and then comparing them with the traditional elements, the findings extracted the following criteria; 1) the inclination of roof type/color. 2) the tendency of establishing porch. 3) the changing aspects of window type/materials/color as well as those of entrance door.

도말층 존재 유무에 따른 One-step 접착 시스템의 미세인장결합강도

송용범,진정희,이세준,이광원 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.3

The purpose of this study were to evaluate the microtensile bond strength of one-step adhesives according to various dentin surface treatments and to observe the interface between resin(Z-100^™) and dentin under SEM. In this study forty-five non-caries extracted human molars and three adhesive systems were used : All-Bond 2(AB), One-Up Bond F(OU), AQ-Bond(AQ). : In group 1, 2, 3, AB was used and tooth surfaces were treated by smearing(S), ultrasonic cleansing(US), etching(E) respectively. In Group 4, 5, 6, One-Up Bond F was used and tooth surfaces were treated as the same way above. In Groups 7, 8, 9, AQ Bond was used and tooth surfaces were treated as the same way. Each specimen was prepared for microtensile bond testing, and were stored for 24hrs in 37℃ distilled water. After that, microtensile bond strength for each specimen was measured. Specimens were fabricated to examine the failure patterns of interface between resin and dentin and observed under the SEM. The results were as follows; 1. The results(mean±SD) of microtensile test were group 1, 25.69±4.31MPa; group 2, 40.93±10.94MPa; group 3, 47.65±8.85MPa; group 4, 36.98±9.14MPa; group 5, 39.66±8.45MPa; group 6, 43.26±13.01MPa; group 7, 25.07±4.2MPa; group 8, 30.4±4.74Mpa; group 9, 33.61±7.88MPa. 2. One-Up Bond F was showed the highest value of 36.98±9.14MPa in dentin surface treatment with smearing, and there were significant differences to the other groups(p<0.05). 3. All-Bond 2 was showed the highest value of 40.93±10.94MPa in dentin surface treatment with ultrasonic cleansing, but was no significant difference to One-Up Bond F(p>0.05). 4. All-Bond 2 was showed the highest value of 47.65±8.85MPa in dentin surface treatment with etching(10%phosphoric acid), and there were significant differences to the other groups(p<0.05). 5. All-Bond 2 was showed the highest value of 47.65±8.85MPa in dentin surface treatment according to manufacture's directions, but was no significant diference to One-Up Bond F(p>0.05). 6. AQ Bond was showed the lowest microtensile bond strength with various dentin surface treatment. and the were significant differences to the other groups(p<0.05).

1994∼1995년 한국에서 발생한 가을철 열성질환에 대한 혈청역학적 연구

송기준,송진원,백락주,김상현,김세연,이용주 대한감염학회 1998 감염 Vol.30 No.4

목 적 : 최근 우리나라에서 발생했던 금성 열성질환의 전반적인 혈청역학적 양상의 분석을 위해 1994년부터 1995년까지 고려대학교 의과대학 미생물학교실, 바이러스병연구소에 급성 열성질환으로 검사가 의뢰된 환자혈청 5330건을 쯔쯔가무시병, 발진열, 신증후출혈열, 라임병 및 랩토스피라증에 대한 항체를 조사하였다. 방 법 : 1994년부터 1995년까지 2년간 고려대학교 의과대학 미생물학교실, 바이러스병 연구소에 검사가 의뢰된 환자혈청을 주 대상으로 간접면역형광항체법 검사로 쯔쯔가무시병, 발진열, 신증후출혈열 및 라임병에 대한 항체양성 유무를 검색하고 macroscopic agglutination법으로 렙토스피라증에 대한 항체를 조사하였다. 결 과 : 열성질환 환자 혈청 5330건을 대상으로 신증후출혈열, 쯔쯔가무시병, 발진열 및 라임병에 대한 항체검사 결과 쯔쯔가무시 항체양성자가 12% (640/5330)로 항체양성자 중 여자가 60%로 60대가 30% (192명)로 가장 많았다. 월별 분포에서는 대부분의 양성자 (89%)가 가을철에 집중되어 있었다. Richettsia, typhi에 대한 항체를 양성률을 보였다. 발진열 항체 양성자 중 남자가 60% (106/178)로 여자보다 많았으며, 모든 연령 층에서 발견되었으나 40∼50대가 57% (107명)로 가장 많았다. 대부분이 양성자 (44%)가 늦가을 (10∼12월)에 발생하였다. Macroscopic agglutination법에 의한 렙토스피라에 대한 항체률을 조사한 결과 1% (55/5330)의 항체 양성률을 보였으며 연도별로는 1994년 0.4% (11/2799), 1995년 1.7% (44/2531)로 1995년에 더 많은 항체 양성자가 발생하였다. 총 55건의 렙토스피라 항체양성자 중 남자가 71% 였으며, 연령별 분포에서는 60대가 47%로 가장 많았으며 20대 이상의 성인에서만 항체가 발견되었다. 대부분의 항체양성자 (78%)가 8∼10월에 집중되었다. 라임병은 총 5330건 중 항체양성자는 없었다. 결 론 : 1994∼1995년 우리나라에서 발생한 발열성질환환자 중 쯔쯔가무시병, 발진열, 신증후출혈열 및 렙토스피라증 환자가 전체의 29%였으며 항체 양성자수로는 신증후출혈열,쯔쯔가무시병,발진열,렙토스피라증 순이였다. 따라서 위의 4가지 질환이 우리나라에서 특히 가을철에 발생하는 급성열성질환의 주원이으로 생각되나 새로운 질병이나 신종 병원체에 의한 동일한 질환이 존재할 가능성이 매우 높으므로 지속적인 혈청역학적 조사가 수행되어야 할 것이다. Background :The principal acute febrile diseases reported in autumn, Korea, have been hemorrhagic fever with renal syndrome (HFRS), scrub typhus, murine typhus and leptospirosis. Methods : To evaluat the seroepidemiologic patterns of acute febrile illness in Korea, sera were collected from 5330 patients from 1994 to 1995, and examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibidy technique (IFA) and by macroscopic agglutination test for Leptospira interogans. Results : Of 640 seropositive cases against O. tsutsugamushi, 60% were female; age group of the seventh decade occupied 30%; 89% were reported during October and November. By IFA test, the seropositive rate of murine typhus was 3.5% (18/5330) with high incidence rate (44%) in the period from October to December, and males in their forties and fifties were mostly affected. Cases seropositive for leptospirosis consisted 1% of 5330 acute febrile illness cases. Of 55 seropositive cases, 71% were male; 71% were in their sixties; 78% occurred during the period from August to October to January and males in the thirties were mostly infected. No seropositive case of Lyme disease was present. Conclusion : The above results indicate that hantavirus, O. tsutsugamushi, R. typhi, and L. interogans were the main causative agents of acute febrile diseases during autumn season in Korea.

蛇行現象과 流路移動에 關한 硏究

宋在偶,丁榕泰,白景元 弘益大學校 1990 弘大論叢 Vol.22 No.2

The results of an analysis of channel characteristics for a river basin were as follows; 1) The concave bank for the downstream of once or twice of river width from the apex of curvature should be destroyed more than enlargement channel width by flood. 2) The bedslope increased because of cut-off and all the more flux flowed if the cross-section area was constant. The results of cut-off decreased the flood-flow-level at the upstream, but the bed was eroded and tended to be deposited at the downstream. 3) Based on the momentum equation for flow in a stream bend, the force per unit area which the flow exerts on the outer of a bend was expressed by the curvature ratio which was in proportion to flow characteristics, sediment characteristics, and bend geometry. 4) Considering the construction of riverbank, the average channel migration ratio had been 4.687m/yr from 1953 to 1967 and 10.485m/yr from 1968 to 1981. Generally a distribution of bed material showed that the grain size decreasd with a flow going downstream, exept nearly after the Pal-Dang Dam, the grain size bigger in 1981 than 1967 because the Dam cut the supply of sediment, so small grains were carried away by a flows.

사람 태아간의 산호성 과립백혈구형성에서 산호성 과립형성에 대한 미세구조 연구

송재섭,김경용,이원복,김동창 중앙대학교 의과대학 의과학연구소 1992 中央醫大誌 Vol.17 No.4

The developmental processes of eosinophilic granule formation were ultrastructural investigation of eosinophilic granulopoiesis in 15 cases of human fetal livers from 8 to 34 weeks of gestation. 1) Numerous vesicles, microgranules and small agranular and granular vacuoles were distributed around the distended Golgi apparatus in myeloblast and eosinophilic promyelocyte. 2) Granular matrix of vacuoles contained small granular vacuoles, serveral vesicles and mutilamellar structures. The granular substance exhibited higher electron density than that of cystic rough endoplasmic reticulum(RER) and was similar partly to that of immature eosinophilic granules. 3) Distended cystic RER was fused to produce matrix of maturing granules with granular vacuoles and immature eosinophilic granules. 4) Immature eosinophilic granule which began to be produced in eosinophilic promyelocyte, had myelin sheath-like structure and debris of vesicles and granular vacuoles and those disappeared immediately. The charicteristic crystalloid inclusions began to develop in immature eosinophilic granule of myelocyte. In summary, it is suggested that vesicles and granular vacuoles as well as RER in the myelocyte and promyelcyte are participating in the formation of immature eosinophilic granules which become mature with the appearance of charicteristic crystalloid inclusion