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.

지난 4년간 학회지 "신경정신의학" 심사 평가보고

오병훈,권준수,남궁기,김승현,지익성,김창윤,하규섭,박원명,김성곤,오강섭,김정범,이수정,정한용,이창욱,박용천,이영문,김세주,이병욱 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation Processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.

Hepatic Cirrhosis Occurring in a Young Woodchuck(Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus(WHV)

Kyu-shik Jeong,정원일,Jae-yong Chung,Mi-young An,Chae-yong Jung,Gyoung-jae Lee,Jong-soo Kang,Byeong-cheol Kang,Young-heun Jee,Bruce H Williams,Young-oh Kwon,Da-hee Jeong 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

Cirrhosis Occurring in a Young Woodchuck (Marmota monax) Due to Vertical Transmission of Woodchuck Hepatitis Virus (WHV)Da-hee Jeong, Won-il Jeong, Jae-yong Chung, Mi-young An, Chae-yong Jung, Gyoung-jae Lee1, Jong-soo Kang1, Byeong-cheol Kang2, Young-heun Jee3, Bruce H Williams4, Young-oh Kwon5 and Kyu-shik Jeong*College of Veterinary Medicine, Kyungpook National University, Daegu 702-701, Korea1Shinwon Scientific Co., LTD, Research Institute, Suwon, Korea2Clinical Research Institute, Seoul National University, Seoul 110-744, Korea3College of Veterinary Medicine, Jeju National University, Jeju 690-756, Korea

유전체 공진기를 이용한 개인휴대 통신용 대역통과 필터의 설계 및 구현

권정열,이헌용,홍성용,윤중락 明知大學校 産業技術硏究所 1996 産業技術硏究所論文集 Vol.15 No.-

In this paper, the band pass filter for personal communication services was constructed and designed using λ/4 TEM mode dielectric resonators with a (Zr0.65,Sn0.35)ATi1.04O4.04 ceramic of dielectric constant εr=37.8, Qxfo=48.600 temperature coefficient of resonant frequency rf=7ppm/˚C, and Unloaded-Q (Qo) of λ/4 TEM mode dielectric resonator with inner hole size 0.9㎜ and external size 3㎜ using silver electrode is 354.5 at 1950MHz. For the band pass filter design and construction, the design theory and simulation results of band pass filter using J-inverter theory have been studied. The parameters which are evaluated by design theory are practically applied to the filter construction and the simulation results are in agreement with the measured results after fine tunnings.

MR Angio영상의 Ray Casting 가속화 Algorithm에 관한 연구

정용규,권영만,김욱동 凡石學術奬學財團 2001 凡石學術論文集 Vol.5 No.1

Volume render is to visualize 3D (3 Dimension) information, which is used in diverse applications, such as medical imaging, fluid dynamics, meteorology, failure analysis, and molecular modeling. Medical applications are mainly diagnosis. virtual surgery. image guided surgery and others. Most widely used 3D method in MR and CT Images is Ray Casting, It has some shortcomings of the slow rendering speed. In this reason, many 3D volume visualization methods have been developed. General methods are surface and volume rendering. This paper intends to, show that the job related 3D volume visualization let' us be capable of displaying more realistic images than surface rendering. Proposed method is Ray Casting witch Octree algorithm, Which follows as bellow steps. First of all, depth information is made by threshold segmentation. Secondly, depth range is adjusted. Finally, area within specified depth range is processed to produce the result image. In this step, sampling point which is acquired by interpolating voxel is blended as. semitransparent material. Using blending operation, overlapped objects can be displayed correctly. It accelerates the job more than general Ray Casting.

경피적 자궁동맥 색전술로 치료한 산후 출혈 1례

정명철,김호성,김경철,노지현,고재환,김용봉,권동일 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Postpartum hemorrhage remains one of the leading causes of maternal deaths. The major causes of postpartum hemorrhage include uterine atony, retained placental fragment, placenta accreta, and lower genital tract lacerations. Conservative treatment is based on administration of uterotonic drugs, vaginal packing, and surgical repair of genital tract lacerations. When bleeding fails to respond to conservative treatment, surgical ligation of uterine vessels or hemostatic hysterectomy is performed. We present a case of postpartum bleeding treated by selective uterine arterial embolization with a brief review of previous literatures of postpartum hemorrhage & uterine arterial embolization.

BAF 공정을 이용한 제직폐수의 재이용

정용준,배종홍,권구호,민경석 한국물환경학회 2004 한국물환경학회지 Vol.20 No.6

An upflow BAF(Biological Aerated Filter) equipped with an expanded clay media was applied to reuse weaving wastewater of water jet loom. The performance of lab-scale biofilter was investigated by the adjustment of EBCTs(Empty Bed Contact Time) and the packing ratio of media, which were changed 1.1 to 3.7hr and 38 to 63%, respectively. In most conditions except 1.1hr of EBCT, BOD, CODcr, SS and Turbidity of the effluent were 1∼4㎎/L, 7∼16㎎/L, 1∼5㎎/L and 5∼14NTU, where their removal efficiencies were 76∼95%, 82∼93%, 63∼94% and 59∼81%, respectively. From the observation of SEM(Scanning Electron Microscope) photographs of porous clay media, it was revealed that this media provided good performance of retaining microbes effectively. In addition, 0.44∼0.49㎏VSS/㎏BOD_(rem). of low sludge reduction was expected. The most efficient back washing cycle and procedure were once per 4 to 9 days and air including collapse-pulsing method, respectively. Therefore, this system can be of use as an weaving wastewater treatment for reuse

신경회로망 제어기를 이용한 PID 파라미터 추정에 관한 연구

權重東,裵銀敬,金恩基,全基英,李承桓,吳鳳煥,李勳九,金容珠,韓慶熙 明知大學校 産業技術硏究所 2006 産業技術硏究所論文集 Vol.25 No.-

In this paper, supposed to solve these problem to PID parameters controller algorithm using ANN. In the proposed algorithm, the parameters of the controller were adjusted to reduce by on-line system the error of the speed of IM. In this process, EBPA NN was constituted to an output error value of an IM and conspired an input and output. The performance of the self-tuning controller is compared with that of the PH) controller tuned by conventional method (Ziehler-Nichols). The effectiveness of the proposed control method is verified thought the Matlab Simulink and experimental results.

정상교합자의 치열궁 형태

권용철,성정옥,권오원,성재현 대한치과교정학회 1989 대한치과교정학회지 Vol.19 No.1

This study was designed to investigate dental arch shapes buccally and lingually at Bracket Level of Koreans. This involved studying 63 inviduals (37 males, 26 females) with normal occlusion ranging in age from 17 to 24 yesrs old. The landmarks were digitized and measurements and statistical analysis were performed by NEC 9801 V-M computer. The Results were as Follows: Bicanine width, Bipremolar width and Bimolar width were larger in males than in females. Buccal and lingual arch form and coordination form were obtained by NEC 9801 V-M computer. The parabolic equations which represents buccal and lingual arch form were obtained.

음속의 열역학

권영중,이준용,G. Ali Mansoori 江原大學校 産業技術硏究所 1997 産業技術硏究 Vol.17 No.-

음속에 대한 실험값은 보통의 PVT 측정값보다 훨씬 정확하게 얻을 수 있고 또한 정적,동적 성질을 동시에 얻을 수 있으므로 유체의 구조를 이해하는 방법으로 간주되어 오고있다. 본 연구에서는 음속의 열역학적 성질에 대한 여러 이론을 기술하고 측정된 음속의실험값들로 부터 열역학적 성질을 추출해내는 여러 방법들에 대해 검토한다. The sound velocity measurements can permit much higher precision than that obtainable in the direct PVT experiments in addition to producing static and dynamic properties simultaneously, and thus the study on the sound velocity has been considered as another important approach to a fundamental understanding and description of the structure of fluids. This review deals with what have been done on studies of the sound velocity for evaluating thermodynamic properties with an emphasis on the development of the methods to extract the thermodynamic properties from the experimental data on sound velocity.