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.

우심방을 침범한 거대 비호지킨씨 림프종 1예

강상범,진승원,이은경,박용현,최용호,김용주,박준철,김재형,홍순조,최규보,권종범,원용순,박건,이은희 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

유약 영구 전치의 함입성 탈구에 관한 고찰과 치험례

전경현,김용기,김종수 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.2

In the Pediatric Dentalc profession the occurrence rate intrusion of young permanent teeth is rather low, and the treatment method varies from one another. Intrusion of the teeth bring complications to the pulp and periodontal ligament, and thus the possibility of endodontic treatment increases. For the formation of calcific barriers, calcium hydroxide is used in young permanent teeth and this makes the final canal filling possible. In this case report, we will show two cases of young permanent teeth intrusion and the treatment methods to help assess the recognition of treatment for young permanent teeth intrusion.

정신과 입원환자에서의 혈청 콜레스테롤 농도와 공격행동

전태연,도규영,정종현,권용실,김석범 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 혈청 콜레스테롤 농도와 자살 등의 공격행동간의 연관성에 관한 여러 연구가 있었으나 일치된 결과를 보이고 있지 못하다. 이에 저자들은 다양한 진단의 정신과 입원 환자들 중 공격행동을 보인 환자의 콜레스테롤 농도를 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추어 공격행동 및 자살시도와 혈청 콜레스테롤 농도간의 연관성을 알아보기 위하여 본 연구를 시행하였다. 방 법 : 본 연구는 1994년 1월 1일부터 1995년 6월 31일까지 18개월간 카톨릭대학교 의정부성모병원 정신과 병동에 입원하였던 환자 중 콜레스테롤 농도를 얻을 수 있었던 127명을 대상으로 하였다. 대상 환자는 공격행동의 유무에 따라 공격군과 비공격군으로 분류하여 공격군 35명과 비공격군 92명의 자료를 얻었으며, 공격군은 Overt Aggression Scale을 사용하여 평가하였다. 측정된 각 환자의 콜레스테롤 농도는 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추어 4개의 군으로 나눈 후 공격행동 발생비율, 자살시도간의 차이를 알아보았다. 또한 공격행동을 보인 군에서도 각 콜레스테롤군 간의 총 공격 점수를 비교하였다. 결 과 : 1) 각 콜레스테롤군 간의 공격행동 발생비율에는 유의한 차이가 없었다. 2) 공격군에서 각 콜레스테롤군 간의 총 공격 점수는 유의한 차이를 보이지 않았다. 3) 각 콜레스테롤군 간의 자살시도 빈도는 유의한 차이가 없었다. 결 론 : 정신과 입원 환자의 혈청 콜레스테롤 농도를 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추었을 때 혈청 콜레스테롤 농도와 공격행동 및 자살시도에 유의한 연관이 없었다. Objectives : An association between serum cholesterol concentration and violent behavior has been suggested, but has not been consistently demonstrated. This study was conducted in order to evaluate the relation between serum cholesterol concentration and violent behavior in psychiatric inpatients who had been admitted at Uijongbu St. Mary's Hospital, the Catholic University of Korea from January 1994 to June 1995. Methods : We divided the 127 subjects into violent(35 subjects) and non-violent group(95 subjects). According to the percentile distribution of serum total cholesterol in healthy Korean adults, the subjects were classified into four subgroups : Group 1, subjects Whose cholesterol concentrations were below 26% of percentile distribution, Group 2, from 26% to 50%, Group 3, 51% to 75% and Group 4, above 75%. In the four cholesterol subgroups, the authors examined the incidence of violent behaviors and suicidal attempts. Within the violent group, total aggression score of four cholesterol subgroups was compared. Results : 1) Among the four cholesterol subgroups, there were no significant differences in the violent behavior. 2) Within the violent groups, total violent score of the four cholesterol subgroups showed no significant difference. 3) Among the four cholesterol subgroups, there were no significant differences in suicidal attempt. Conclusion : When the serum cholesterol concentrations of psychiatric inpatient applied to the percentile distribution of serum total cholesterol in healthy Korean adult, no association was found between serum cholesterol concentration and violent behavior and suicide attempt.

유치와 영구치에 수복된 레진과 글라스 아이오노머 수복물의 미세누출 양상에 관한 비교연구

전경현,김종수,김용기 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.1

The purpose of this study was to compare the microleakage pattern of glass ionomer with resin restoration in microleakage pattern of primary and permanent teeth. Micreoscopical observation of interface between tooth structure and restoration was also performed. 80 and 8 sound molar teeth were used for the microleakage test and SEM study respectively. Data were analyzed statistically using ANOVA test and/or t-Test. The results of the present study were as follows: 1. According to the result of microleakage pattern between primary and permanent tooth, primary tooth generally showed more microleakage than permanent tooth in all groups(p<.05). 2. In the resin-filled groups, occlusal margin was shown to have more micreliakage than gingival margin(p<.05). Whereas the glass ionomer-filled groups showed no statestically significant differences between them(p>.05). 3. No statistically significant differences in microleakage could be found between two different resin groups(p>.05). while FujiⅡ LC group showed less microleakage than Ketac-Fil group(p>.05). 4. The various type hybrid layer was evident under SEM in resin-filled groups both in primary and permanent teeth with generally thicker layer in primary group. Among glass-ionomer group, FujiⅡ LC group showed more intact adhesion to tooth surface than Ketac-Fil group.

수돗물염수액 전기분해에 의한 살균소독

박준오, 김완석, 최영기, 이영민, 김형규, 차은종, 김석용 충북대학교 동물의학연구소 2008 Journal of Biomedical and Translational Research Vol.9 No.2

본문참고

비화농성 삼출성 복수를 동반하는 질환에서 복막 침생검의 진단적 의의

정종훈,서용태,오덕환,채종구,정춘해,조건국 朝鮮大學校 附設 醫學硏究所 1986 The Medical Journal of Chosun University Vol.11 No.1

Percutaneous needle biopsies of peritoneum with Abrams needle and Cope needle were done un 64 patients with non-purulent exudative ascites, who was admitted to the department of internal medicine, Chosun University hospital, from January 1978 to Deccmber 1983. The diagnostic significance and safety of the needle biopsy was estimated. The results were as follows. 1. Adequate peritoneal tissue for pathological diagnosis was obtained in 53 cases(82.8%) among 64 cases. (Abrams needle 84.8%, Cope needle 80.6%) 2. Definitive diagnosis was obtained in 31 cases among 53 cases (58.6%). (Tuberculosis 23 cases, malignancy 8 cases). 3. As compared final diagnosis with biopsy result, the rate of final diagnosis corresponding with biopsy diagnosis was 58.8% in tuberculosis and 26.3%, in malignancy, but the rate of biopsy diagnosis corresponding with final diagnosis was 100% in both tuberculosis and malignancy. 4. Cases of chronic non-specific inflammation which were diagnosed by biopsy were 13cases(24.5%)among 53 cases, and among these cases, tuberculosis was 69.2% and malignancy 30.8% on final diagnosis and among 53 cases, histologically normal was 9 cases(16.9%) of which 33.3% was tuberculosis and 66.7% was malignancy on final diagnosis. 5. Of the malignant cases on final diagnosis, Positive cytologic examination of ascitic fluid was 16.7% 6. Primary losions of cancerous peritonitis were stomach cancer (38.9%) hepatocellular cancer(22.2%) colon cancer (11.1%) ovarian cancer (11.1%) Pancreatic cancer (5.6%). 7. Complication of percutaneous peritoneal biopsy was local swelling with leakage of ascitic fluid and the accident rate were 36.4,% in Abraham needle and 3.2% in Cope needle.

횡류팬 유로최적화를 위한 수치실험

전용두,이종수 공주대학교 생산기술연구소 2002 論文集 Vol.10 No.-

Cross flow fan system is widely used for various applications, especially for the air-moving device of heaters, air-conditioners, and air-curtains. Although there are efforts for the optimization of cross-flow fan flow path with different methods of approach, it is still being investigated by many researchers through experimentally and/or theoretically, because the flow pattern of the cross flow fan is not stereotyped. This paper presents some results from numerical experiments for optimization of the flow path through a cross-flow fan to be applied to indoor wall-mounted room heater. Two dimensional analysis has been applied to a specific fan system including inlet and diffuser outlet. Flow characteristics are presented and discussed for two different flow path at three different operating conditions represented by rotational speed(800, 1,000, 1,200 rpm) of the fan. According to the simulated results for the specific fan system under consideration, it could be found that the flow pattern resembles each other at different rotational speed (to say from 800 rpm to 1,200 rpm) for a fixed flow path, while the secondary flows mostly absorbs the speed effects. By changing the flow path significant increase in volume flow rate is estimated upto 2.65 at the same rotational speed. According to the present experience, fan flow path design can be performed more efficiently by incorporating this type of numerical experiments combined with the model tests.

환경교육을 위한 웹 기반 프로젝트 학습 시스템의 설계 및 구현

전우천,정효숙,김동용,엄종진,정성모,최수경 서울교육대학교 2001 한국초등교육 Vol.12 No.2

The use of the Web (World Wide Web) has been changing roles of traditional education style. Especially, the Web can overcome time and space limitations in the traditional schools. Teachers and students are now using the Web to access vast amounts of information and resources on cyber space. Also, the learning via the Web enables both synchronous and asynchronous communication. Despite of many benefits of the Web, it may weaken students motivation due to lack of face-to-face communication. In this paper, we provide a learning model called Web Project Learning, which is based on the contructivism, to provide motivation and collaborative learning for students in the Web environment. The model is based on the Project-Based Learning model and is revised for use in the Web. The model can also encourage the participation of parents as well as students, and be applied to any subject. We implement our model and show that the model can be used for environmental education as an instance.

인슐린 비의존성 당뇨병에 동반된 심상성 천포창 1 례

이상준,박진용,임태형,윤영호,권순대,남창욱,허규찬,박근용,구본식,김상표,장종억 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

저자들은 인슐린 비의존형 당뇨병 환자에서 통증성 구강내 미란 및 전신성 수포성 미란을 동반한 심상성 천포창 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Various skin conditions such as diabetic dermopathy, necrobiosis lipoidica diabeticorum, bullosis diabeticorum, granuloma annulare occur frequently in diabetes, although common lesions may be associated by chance. Pemphigus vulgaris(PV) is a blistering skin disease seen predominantly in elderly patients. This disorder is characterized by the loss of cohesion between epidermal cells with the resultant formation of intraepidermal blisters. These blisters rupture easily, leaving denuded areases that may crust and enlarge peripherally. In half or more of patients, lesions begin in the mouth: approximately 90% of patients have oromucosal involvement at some time during the course of their disease. But the relationship of this disorder with diabetes is not clear. We experienced a case of pemphigus vulgaris associated with NIDDM in 67 years old woman who was admitted due to painful oral ulcer and control of blood glucose, so we present this case with a review of literatures.