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.

정확한 완충기체효과가 적용된 질량분석원리에 대한 다중입자 분석 전산시늉

이유용,이원욱,오차환,김필수,송석호 한양대학교 자연과학연구소 2001 自然科學論文集 Vol.20 No.-

질량분석기로 사용되는 폴 트랩 내에서 보다 실제적인 이온운동을 예측해내기 위하여 약 2천 개의 다중입자의 궤적에 대한 계산을 실시하였다. 보다 정확한 질량 분석스펙트럼을 얻기 위하여 충돌확률에 대한 보다 정확하고 실질적인 함수 값을 도입하였다. 계산된 전산시늉의 결과들로부터 특히 작은 질량의 영역에 대한 분석을 할 경우 본 논문에서 제시된 바와 같이 매우 정확한 충돌확률이 고려되어야 함을 확인할 수 있었다. To predict the practical characteristics of ion motion in the paul trap as a mass spectrometer, the ion trajectories of the multi-particle(over than 2000 particles) were calculated. In order to expect more practical mass spectrum, the exact expressions for the collision probability was adopted. From the simulation result, we found that the exact collision probability has to be considered to analyze the materials existed in the low mass region.

RS 및 GIS를 이용한 지형변화분석

김용인, 이승기, 조의환, 최석근 충북대학교 건설기술연구소 2009 충북대학교 건설기술연구소 논문집 Vol.28 No.2

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표재성 방광암에서 Bacillus Calmette-Guerin 방광 내 주입요법 : 장기적 추적결과 Long-term Follow up Results

김용웅,왕세환,육승모,한동석,노안식,나용길,설종구 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

To evaluated the results of long-term follow up of superficial bladder cancer patients who were treated with transurethral resection and intravesical BCG therapy. Between April 1989 and December 1997, 65 patients with superficial bladder cancer were treated with TUR-B(Transurethral resection of bladder tumor) and intravesical BCG instillation, and follow-up was performed for 5 years longer, and the mean follow-up duration was 82 months. Of 65 patients, pathologic stage were Ta in 17 cases and T1 in 48 cases and grade were G Ⅰ in 22 cases, G Ⅱ in 35 cases and G Ⅲ in 8 cases. The tumor recurred in 22(33.8%) at the median of 21.8 months and the tumor progressed in 9(13.8%) at the median of 20.8 months. Most of the recurrences and progression were within 3 year(838 and 77%). Progression is more likely in higher grade(G Ⅱ, G Ⅲ) and higher stage(T1). The complete response rate after first and second courses of BCG therapy were 53% and 73% and the 5 and 10 year disease specific survival rates were 89.5 and 78% respectively. The complete response rate after first and second courses of BCG therapywere 53% and 73%. Most of recurrences and progressions were within 3 years of the BCG therapy, but some cases occured after 5 years. Therefore, close long-term follow up is needed.

煙草의 折衷被覆栽培에서 着根肥 施用이 初期生育에 미치는 影響

張鎔煥,石泳善,裵吉寬 충북대학교 엽연초연구소 1999 煙草硏究 Vol.17 No.-

This experiment was conducted to investigate the effects of starter solution on the growth responses of flue-cured tobacco at the transplanting time, which had been cultivated with compromised mulching culture system, and to find out the ways to reduce the damages at the early growth stage due to low temperature and drought. The results were summarized as follows. 1.Soil moisture content of the compromised mulching plot at the early growth stage after transplanting was lower, 2∼4%, than that of the pit-covered mulching culture. 2.The growth of flue-cured tobacco during early growth stage in compromised mulching culture plot were delayed about 5 days compared to those of the pit-covered mulching culture. 3.200ppm of (NO4)2SO4, NH4NO3 and KNO3 application had accelerating effects on the early growth of tobacco. 4.By applying 200 and 300ppm of KNO3 and 100 and 200ppm of NH4NO3 as starter solution, the growth of length and width of largest leaf, plant height, weight of top and roots, root length were accelerated during early growth stage.

운동형태의 차이가 Alloxan유발 당뇨쥐의 혈당 및 인슐린 농도에 미치는 영향

윤진환,정일규,김종오,이희혁,지용석,오봉석,채정룡 대한스포츠의학회 2003 대한스포츠의학회지 Vol.21 No.1

The Purpose of this study was to investigate the effect of exercise intensity on blood glucose and insulin levels in diabetic rats with alloxan. Twenty sprague-dawley male rats were assigned to power training groups(n=10) and endurance training groups(n=10). Diabetes was induced by single injection of alloxan(50 mg/kg B.W) Blood glucose and insulin were determined every week for 4-weeks. The conclusion of this study follows as below: 1) There was significantly different on blood glucose levels in two groups. 2) There was significantly different on insulin levels in two groups These results suggest that proper exercise intensity in diabetic rats can significantly decrease blood glucose and insulin level and make good glycemic control. In conclusion, it has been found that regular prolonged endurance training with diabetic rats, improves insulin and blood glucose.

UV/TiO_(2) 수처리 공정에서의 살균에 관한 연구

이규환,이상진,이용재,이동석 강원대학교 산업기술연구소 2007 産業技術硏究 Vol.27 No.A

This study investigated disinfection effect by general water purifier and water purifier with UV light disinfection. The results are as follows : (ⅰ) The general bacteria existed plentifully in a storage tank before treatment (ⅱ) Water treated in water purifier did not meet the water treatment regulation standard since the presence of bacteria, whereas with UV light application the regulation standard is totally satisfied. (ⅲ) Photocatalytic disinfection process with UV light in the presence of TiO_(2) more effectively killed general bacteria than UV light only.

운동 강도의 차이가 흰쥐의 혈액 성분과 적혈구의 형태에 미치는 영향

김부환,김종오,지용석,최대원,윤진환,정일규,김영욱,오봉석 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.4

This study was to investigate the effects on hematological indices and heinz body formation in various intensity, Male Sprague-Dawley rats were randomly divided into the control group, the low-intensity exercise group, nigh-intensity exercise group (n=7 in each group). Animals of the low-intensity exercise groups were put on exercise 30 min per 1 day, 5 days per week for 6-weeks. Animals of the high-intensity exercise groups were put on exercise 120 min per 1 day, 5 days per week for 6-weeks. Red blood cell count (RBC), hemoglobin (Hgb), hematocrit (Hct), mean ceil volume (MCV), mean hemoglobin corpuscular (MCH), mean hemoglobin corpuscular concentration (MCHC) were analyzed in automated hematology analyzer (ABX Hematology MICROS 60) from 10㎕ of whole blood. Erythrocyte morphology were evaluated in super vital (Brilliant cresyl blue stain) stained blood films. In the present results, Hg, MCHC in the high-intensity exercise group was significantly decreased compared with the different exercise intensity and the control group. MCV in the high-intensity exercise group was significantly increased compared with the different exercise intensity end the control group. Heinz body formation in the high-intensity exercise group was significantly increased compared with the different exercise intensity and the control group. In the present study, it can be suggested that intensity of exercise can influence hematological variables and heinz body formation. These findings suggest that high intensity exercise induces oxidative damage to erythrocyte.

토끼에서 Etofenprox와 Spinosad 합제의 국소자극성 시험

황윤환,김명석,송인배,박병권,양승호,임용현,송치용,안성한,남현수,임정교,정상일,명노일,윤효인 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2008 動物醫科學硏究誌 Vol.15 No.1

This study was performed to evaluation the skin and eye irritation of etofenprox 8% and spinosad 4% combination in male New Zealand White rabbits. In skin irritation test, the combination of etofenprox and spinosad did not showed any change of body weight but caused slight skin irritation with the P.I.I. (primary irritation index) value 0.25. The etofenprox and spinosad combination showed severe eye irritation 1 h, 24 h, 48 h, and 72 h after ocular treatment, having the A.O.I. (acute ocular irritation) value of 37.3. Therefore, these result indicated that the combination of etofenprox and spinosad might be irritant formulation on eye and skin.

장기간 운동이 노인들의 심혈관계 기능 변화에 미치는 효과

지용석,김동진,유신환 대한스포츠의학회 2004 대한스포츠의학회지 Vol.22 No.1

The purpose of this study was to investigate the change of related factors in cardiovascular function variables after long duration regular exercise programs. The subjects of this study were 40 older man and women residing Seoul-Seniors-Tower. All of subjects divided to four groups, exercise group 20(man = 10, women = 10) was participating in an exercise program for 3 years, and the other group or non-exercise group 20(man = 10, women = 10) was not in that program. In the results, Changes of cardiovascular function were significantly improved in peak oxygen uptake, ventilation, rest blood pressure of cardiovascular function variables in male or female exercise groups after 3 years' exercise program. Also, we have been known to the facts that although the cardiopulmonary variables of men are superior to those of women, if being exercised for a long time, the women's cardiopulmonary variables(e.g. Endurance time, HRrest, SBPrest, SBPmax, DBPrest, RPPrest, and RPPmax) would not different from those of the men especially in old ages. As a conclusion, we could know that not only the regular exercise might increase or change almost the cardiovascular function variables except for V ˙O2max, Ventilation, and HRmax of elderly people, but also the sex's differences were vanished in endurance time, HRrest, SBPrest, SBPmax, DBPrest, RPPrest and RPPmax between males and females. Therefore, we might tell that exercise programs could provide an excellent parameters for enforcing or keeping the cardiovascular functions of elderly people.