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.

B형 간염 보균산모에서 출생한 신생아에서 수직감염의 기전과 예방

신필진,배종우,정사준,최용묵,김승보 한국의학사 1995 診斷과治療 Vol.15 No.1

반송용 편측식 선형기기의 추력제어에 의한 특성해석

우정인,신동률,조용길,노태균 東亞大學校 大學院 1999 大學院論文集 Vol.24 No.-

본 논문에서는 PWM 인버터 구동 편측식 선형유도 전동기(이하 SLIM)의 공간백터 제어와 PI 제어를 통한 추력 제어를 행한다. 1차측 권선과 SLIM의 2차측 구조 사이에서 발생하는 공극길이의 떨림은 빠른 응답특성을 얻기위해서 최소화 되어야 한다. 먼저, SLIM의 전압방정식이 추력과 수직력 특성을 해석하기 위하여 d-q축 등가회로로서 나타내어진다. 또한, d-q축 등가회로의 모델링과 해석은 등가회로상에서 전류변동에 따른 강인한 과도 추력특성을 얻을 수 있다. 지령속도와 추력에 의한 SLIM의 직접구동 결과는 실험을 통해서 확인된다.

증후성 단일 소심부뇌경색의 임상적 및 방사선학적 양상

신원철,이태규,노용우,오재욱,장대일,정경천 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

전력선 통신(PLC)을 위한 모뎀 개발에 관한 연구

신관우,김용태,이윤섭 공주대학교 생산기술연구소 2001 論文集 Vol.9 No.-

PLC (Power Line Communication) is the communication method using the existing power line installed in houses and offices to convert and transmit high frequency communication signal from tens of KHz to tens of MHz, and receive the filtered signal using high frequency filter. The advantage of PLC is that PLC uses the existing power line installed in houses and offices so it does not require separate power line. Easy and convenient access using electric outlets is another advantage of PLC. However, PLC has some disadvantages such as limited transmission power, high load interference and noise, variable signal attenuation, characteristic of impedance, selective possibility of frequency property. This study designed the boiler temperature control system by unit using the modem designed on the basis of technology used for PLC modem. After conducting experiments with systems, it was possible to control stably. By commercializing this product, we can avoid unnecessary heating of separate temperature control unit, and save the cost accordingly.

교류여자방식 브러시리스 동기전동기의 공간벡터에 의한 토오크제어

우정인,정영일,노태균,조용길,신동률 東亞大學校 附設 情報通信硏究所 1997 情報通信硏究所論文誌 Vol.5 No.1

In the paper, a vector control method for a AC-excited BLSM(Brushless Synchronous Motor) is proposed. The BLSM has a feature that separate exciter is not needed for excitation. The proposed method is described in two parts as follow, one is the design of drive and the other is a modeling for its imlpementation. Rotor flux is estimated using inditect sensing method based on voltage equation in the synchronously rotation reference frame. And rotor position os calculated from rotor angular velocity and stator current. Through computer simulation results of this prorosed system, it is shown that the BLSM drive has a ability of precision torque control from the static and dynamic performances.

韓國 社會福祉 政策에 있어서의 Elite 役割 : 醫療保險 政策을 中心으로 Medical Care Insurance in Korea

申容宇 상명대학교 논문집 1986 상명대학교논문집 Vol.18 No.-

This thesis is intended to apply elite model to policy-making process and discover its character of policy process in Korea. For this aim, policy-making process of Medical Care Insurance is analyzed. Elite Model is based on assumption that society is divided into two part : one is elite who have power, the other is masses who do not. Elite have the power to be able to allocate values for society. The essential argument of elite theory is that it is not the people or the masses who determine public policy through their demands and action. Rather public policy is decided by a ruling class and carried in effect by public officials and agencies. Therefore public policy can be regarded as reflecting the value orientations and preferences of a governing elite and one of which may be a desire to provide for the welfare of masses. Hence masses could not influence policy process or the content. So changes in public policy will be incremental rather than revolutionary, and if elite does not agree to its necessity and relevancy, it is difficult of social need to come into effect as policy or act. If we apply elite model to policy making process of Korean Medical Care Insurance, we refer its characters as follows. First, though socially the necessity of a policy exists, (in this paper, the necessity of Medical Care Policy), if a governing elite did not recognize or agree its necessity or relevancy it is difficult of the demands or action to come into effect. Medical Care Insurance is come into effect when a governing elite recognizes its necessity. Second, the intention of President plays the important role. By the President's directions, then. Medical Care Insurance come into effect. Third, participation of interest group did not appear. This reflects authoritarian politial culture in Korea. Fourth, strong political intention is reflected in the policy making process. That period is characterized by social disorder, and it is recognized that political authority and legitimacy must be preserved and strengthened, anyhow. Fifth, the content of policy reflects the existing conservative character. The primary value of governing elite is in the economic growth. Therefore they consider the convenience of implmentation. Finally, as a result, Korean policy makers have began by introducing health Insurance to relatively small and adventaged segment of the population who are not vulnerable. The poor or economically low c]ass who have the greatest need about Medical Care was excluded. Medical Care Insurance shows inequality of its benefit.

웨이브렛 계수 Zero Crossings를 이용한 영상의 잡음제거 및 압축

신재호,이용준,은종숙,이성우 동국대학교 산업기술연구원 1997 산업기술논문집 Vol.10 No.-

윤곽선이나 에지같은 영상 데이터의 중요한 성분들은 웨이브렛 계수의 zero crossings를 통해 검출할 수 있다. 이런 방법은 영상의 패턴 인식에 관한 연구에서 sharp variation points를 검출하는데 사용되었다. 웨이브렛 변환과 zero-crossings를 거쳐 국부 극치의 위치를 검출하는데 이 방법을 적용하여서 영상의 잡음제거에 사용하도록 개선하였다. 더욱이 영상 데이터에서 전체 영상의 픽셀과 정보를 저장하는 대신, 대부분의 중요한 성분을 효과적으로 몇몇 국부 극치값으로 압축하였다. 그 결과 새로 개선된 기법은 패턴 인식 분야에서만 아니라 높은 압축률의 잡음 제거에도 사용될 수 있다. The important image data components such as contours and edges could be detected by zero crossings of wavelet coefficient. This method has been used for the studies on pattern recognition of images to detect sharp variation points. We have applied it to detection of the position of local maxima through zero-crossings and wavelet transform, so that it is improved to be used for noise-eliminating of image. In addition it could compress the image data into a few of local maxima which held the most of important component efficiently without saving All image pixels and information. As the result, the newly improved method could be implemented not merely for the field of pattern recognition but for that of noise removal at the higher compression ratio.

산화구리에 의한 배기 가스 중의 아황산 가스 제거 : 반응속도에 관한 연구 A Kinetic Study

신창섭,노용우,이태희 연세대학교 산업기술연구소 1985 논문집 Vol.17 No.2

The reaction of cupric oxide powder with 2% sulfur dioxide was investigated over a temperature range of 300-500℃ and over a particle size range of 0.051-3㎜. The experimental data were correlated well by the shrinking unreacted core model and the optimal reaction temperature was found to be 450℃. With average particle diameter less than 1㎜ and superficial gas velocity higher than 8.8 ㎝/sec, the reaction of cupric oxide powder with sulfur dioxide was found to be controlled by the chemical reaction and the intrinsic rate constant was k=8987 exp(-8134/RT).