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.

SELDI-TOF MS를 이용한 유방암 환자 진단을 위한 새로운 혈청 표지자의 개발

정용식,김호승,윤태일,전미선,윤용달,이용성,이기환,김혜진,김명욱,박희붕 한국유방암학회 2004 한국유방암학회지 Vol.7 No.1

전염소 투입 및 정수지 구조가 정수장 총소독능에서 갖는 중요성 평가

윤제용(Je Yong Yoon),변석종(Seok Jong Byun),최유식(Yu Sik Choi) 한국물환경학회 2001 한국물환경학회지 Vol.17 No.3

Disinfection is one of the most important processes in water treatment plants since it protects consumers from waterborne diseases. In Korea, chlorine which is most frequently used as a disinfectant is generally applied in two ways: prechlorination and postchlorination. Postchlorination is to supply chlorine to the influent of a clearwell. While, prechlorination is to add chlorine to rapid mixing chamber or water intake in plants. Major disinfection reaction occurs in the step of post chlorination. Therefore, frequently, prechlorination is not counted on in evaluating disinfection credit. This study was conducted to evaluate the importance of prechlorination and the existence of baffling wall in clearwell with the United States disinfection requirement(Surface Water Treatment Rule). Eight water plants were considered. Yoon`s classification(1997) was selected in classifying the prechlorination practice in water treatment plant. It was found that most of the prechlorination practices performed in water plants(three out of four types) were not important in gaining any significant disinfection credit. One prechlorination practice conducted to remove ammonia in raw water became significant in meeting the disinfection requirement. Despite the existence of baffling walls of clearwell, T_(10)/T varied considerably in the range of 0.3-0.6, indicating that the existence of baffling wall itself does not guarantee the goodness of plug flow characteristics. For some plants, T_(10)/T were lower than that of US-EPA conservative recommendation which is considered when tracer test could not be performed.

진균성 부비동염 환자의 상악동내 농성 분비물에 대한 세균 배양 및 항생제 감수성 결과

이윤식,김용재,김재호,정유삼,이봉재 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.10

데오드라이트 시스템의 측정 정확도에 대한 연구(Ⅲ) : 시준거리 3m에서 기준자 거리에 따른 측정 정도 A Measurement System Accuracy depending on a Distance of Scale Bar on the Distance 3m between two Theodolites

윤용식,이동주,윤인진 한국공작기계학회 2005 한국생산제조학회지 Vol.14 No.2

The theodolite system consists of two theodolites, a scale bar and a target bar. A measurement accuracy of theodolite system is affected by a measurement distance of each equipment. This study was performed for measuring an accuracy when the distance from theodolite to scale bar was changed 2~6 m on two theodolites distance 3 m. The results showed that the measurement accuracy could be ±0.021 mm when the distance from theodolite to target was 2, 3 and 6 m. Specially, it was found that the maximum measurement accuracy was ±0.017mm on theodolite collimation distance 3m and the distance 4 m of the theodolite and scale bar.

초음파검사자 기량검증 체제를 위한 다자비교시험

윤병식,양승한,김영호,김용식,양동순 한국비파괴검사학회 2004 한국비파괴검사학회지 Vol.24 No.4

국내 원자력발전소의 Class1과 Class2 배관검사에 적용할 수 있는 초음파탐상 검사자, 장비 그리고 절차서에 대한 한국형 기량검증(KPD) 시스템을 구축하였다. PD 방법을 적용한 검사결과와 전통적인 dB-drop 방법을 이용한 검사결과를 상호 비교하기 위하여 Round Robin Test(RRT)를 수행하였다. RRT 결과는 PD 방법의 신뢰성이 dB Drop 방법보다 우수한 것으로 나타났다. 이러한 결과로부터 원자력발전소 가동중검사에 PD 방법을 적용함으로써 초음파탐상검사 결과의 신뢰성이 더욱 향상될 것으로 기대된다. The Korean Performance Demonstration(KPD) System for the ultrasonic testing personnel, equipments and procedures applicable to the Class 1 and 2 piping examination for nuclear power plant in Korean has been established. A round robin test was conducted in order to compare the examination results by the method of Performance Demonstration(PD) with the traditional dB-drop method. As a result, adoption of the PD method to the in-service inspection of the nuclear power plants will improve the reliability of the ultrasonic test results.

IPS-Empress 도재에 대한 콤포짓트 레진의 전단결합강도

윤병식,임미경,이용근 大韓齒科保存學會 1998 Restorative Dentistry & Endodontics Vol.23 No.1

Dental ceramics exhibit excellent esthetic property. compressive strength. chemical durability, biocompatibility and translucency. This study evaluated the shear bond strength of composite resin to the new heat-pressed ceramic material(IPS-Empress System) depending on the surface treatments and bonding agents. The surface treatments were etching with 4.0% hydrofluoric acid, application of silane, and the combination of the two methods. Composite resin was bonded to ceramic with four kinds of dentin bonding agents(All Bond 2, Heliobond, Scotchbond Multi-purpose and Tenure bonding agents). The ceramic specimen bonded with composite resin was mounted in the testing jig, and the universal testing machine(zwick 020, Germany) was used to measure the shear bond strength with the cross head speed of 0.5 mm/min The results obtained were as follows : 1. The mean shear bond strength of the specimens of which the ceramic surface was treated with the combination of hydrofluoric acid and silane before bonding composite resin was significantly higher than those of the other surface treatment groups(p<0.05). 2. In the case of All-Bond 2 and Scotchbond Multi-purpose bonding agent group, the surface treatment methods did not influenced significantly on the shear bond(p>0.05). 3. Of the four bonding agents tested, the shear bond strength of Heliobond was significantly lower than those of other bonding agents regardless of the surface treatment methods(p<0.05). 4. The highest shear bond strength(12.55+-1.92 MPa) was obtained with Scotchbond Multipurpose preceded by the ceramic surface treatment with the combination of 4% hydrofluoric acid and silane.

퍼머제의 중금속 농도에 관한 연구

윤복연,문덕환,박명희,황용식,함성애,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : This study was conducted to prepare the fundamental data on heavy metal concentration in hair permanents agents and to prevent the health impairment due to heavy metal. Methods and Material : The author determined of 5 heavy metals(Pb, Cr, Mn, Ni, and Cu) concentration hair permanent agents in the market with flameless atomic absorption spectrophotometer. Results : The results were as follows: 1. The geometic mean concentrations of total subjects were 0.04㎍/g for Pb, 0.09㎍/g for Cr, 0.06㎍/g for Mn, 0.03㎍/g for Ni, and 0.04㎍/g for Cu. 2. The most highest mean concentrations of heavy metals in hair permanent agents by using type were Cr for wave agent and straight cream agent, Cu for setting iron agent, Cr and Cu for coating perm agent. 3. Metal most hlghest mean concentrations of heavy in hair permanent agents by type of color was green for Cu. 4. The mean concentration of Cu among 5 heavy metals in hair permanent agents by marker was most highest. 5. There was most statistically significant difference on mean concentration in hair permanent agents between domestic and foreign products. 6. The exposure amount of heavy metal concentration by one time using the permanent agent were 4.O㎍ for Pb, 9.O㎍ for Cr, 6.0㎍ for Mn, 3.O㎍ for Ni and 4.0㎍ for Cu. Conclusion : As above results author suggest to prepare the preventive program of health impairment due to heavy metal by long term chronic exposure to who were using the hair permanent agents hair designer and customers.

Plus(+) Point Probe를 이용한 용접부 와전류검사

윤병식,남민우,김석곤,이희종,김용식 韓國非破壞檢査學會 1999 한국비파괴검사학회지 Vol.19 No.6

발전설비를 구성하는 주요 기기중 펌프, 발브, 배관 등의 용접부에 발생할 수 있는 균열 등의 결함을 검출하기 위한 plus-point 와전류검사탐촉자를 설계하여 결함을 검출하고 그 크기를 측정할 할 수 있는 검사기법을 연구하였다. 차동형 모드로 운전되는 plus-point 와전류탐촉자는 2개의 "I"자형 코일 이 십자형태로 교차되어 있으며, 탐촉자와 시험체 표면사이의 lift-off변화에 의한 영향이 재래식 표면 탐촉자에 비해서 작게 발생하는 특징이 있다. 결함에 대한 탐촉자 반응을 평가하기 위해서 304 스텐 인레스강 용접부에 인공결함인 균열성 노치를 방전가공하여 시험편을 제작하였으며, 이를 활용하여 plus-point 와전류탐촉자의 결함 검출, 종류 판별 및 크기를 측정할 수 있는 기법을 연구하였다. A plus-point eddy current test(ECT) probe was developed to examine the defects on the welds of pumps, valves, and pipings which are the major components of the electric power plants. non-destructive evaluation(NDE) techniques for detecting and sizing the flaws were studied adapting this probe. Differential plus-point ECT probe is consists of two "I"-type coils crossed each other and has an advantage having a small influence on the sensitivity by lift-off variation to the conventional types of probe. The specimens with crack-like electro dischrge machining(EDM) notches on the weld of type 304 stainless-steel were fabricated in order to evaluate the plus-point ECT probe response to the flaws. NDE techniques to detect and size the flaws and estimate the flaw type were established with this specimens.

인장력을 받는 CT형강 고력볼트 접합부의 감소계수 U값에 관한 연구

윤성호,김진숙,김원식,신영록,김보영,최문식 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

The purpose of this experimental study is to investigate the validity of code equation and table to calculate the reduction coefficient for effective net area in the limit state design code of steel structure and offer the basic research data for the effective net area of tee shape members in tension. The experimental tests were performed by loading the specimens through the flange with high strength bolt. Length of connection, number of bolt and the eccentricity are the parameters in test. According to result, the failure loads in test is less than predicted loads and it well showed when the predicted loads are based on reduction coefficient of the table in code. The lateral buckling of stem occurred in the members with big eccentricity and it reduce the failure loads. Therefore, we thought that an additional tests and research on the factors of effective net area is required.