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.

Accuracy on the Edge Detection of Topography for Digital Map Manufacture

Park, Woon-Yong,Song, Youn-Kyung,Bae, Kyung-Ho,Kim, Yong-Suk 東亞大學校 建設技術硏究所 2005 硏究論文集 Vol.28 No.2

Currently, digital maps in the metropolitan area are supposed to be revised and renewed every two years, but it is difficulty for the renewal of current information to keep pace with the quickly changing society and so, one of the alternative methods being discussed is a digital map produced using high resolution satellites. The biggest problem in the production of digital maps using high resolution satellite images is the difficulty of production in vector resource format through edge detection of satellite images, a Raster data. In this study, topographical boundaries were detected through edge detection of the satellite image, and after vectorliezing using the screen digitizing method, the results were evaluated and compared to the digital map from the NGII(National Geographic Information Institute) for accuracy.

ERK1/2 activation in quercetin-treated BEAS-2B cell plays a role in Nrf2-driven HO-1 expression

이윤진,Jun-Hwan Song,Myung-Ho Oh,Yong-Jin Lee,김용배,Jae-Hyuk Im,이상한 대한독성 유전단백체 학회 2011 Molecular & cellular toxicology Vol.7 No.4

Quercetin, a member of the flavonoids,has been heralded as chemopreventive agent, generally because of its free radical-scavenging and antiproliferative activities. In this process, NF-E2-related factor-2 (Nrf2) plays a role in protecting cells from oxidative damage; however, the exact mechanisms in which bronchial epithelial cells respond to quercetin by activating Nrf2 are not fully understood. Here, we report the role of extracellular signal-regulated kinase (ERK) activation in response to quercetin. Quercetin treatment decreased the viability of human bronchial epithelial BEAS-2B cells in a dose- and time-dependent manner. ERK1/2 was activated within 10 min of quercetin addition and then remained increased above control level throughout 48 h, whereas AKT phosphorylation was suppressed from the first 1 h of quercetin treatment. Inhibition of Erk1/2 phosphorylation attenuated quercetin-induced loss of cell viability. Nrf2levels in both nuclear and whole cell lysates increased after quercetin treatment and was accompanied by the increase of heme oxygenase-1 (HO-1) protein level,indicating that increased HO-1 expression is Nrf2-mediated. Activation of the Nrf2/HO-1 system after quercetin treatment was suppressed by the pretreatment with MEK inhibitor, PD98059. Also, silencing Nrf2 with siRNA decreased cell viability and augmented cytotoxic effect of anticancer drug LBH589. Overall, our results indicate that quercetin induces the up-regulation of Nrf2-mediated HO-1 expression, at least in part, via MEK/ERK1/2 signaling, as an adaptive mechanism which may provide advantages for cell proliferation and enhance survival despite endogenous and/or exogenous oxidative insults.

Stain improvement in the white button mushroom ‘Seolgang’ and its varietal characteristics in Agaricus bisporus

Byung-Joo Lee,Mi-Ae Lee,Yong-Gyun Kim,Kwang-Won Lee,Yong-Pyo Lim,Byung-Eui Lee,Ho-Yeon Song 한국버섯학회 2012 한국버섯학회지 Vol.10 No.4

The button mushroom (Agaricus bisporus) is one of the most widely cultivated important edible mushroom species. In the breeding of new button mushroom, ‘Seolgang’ was developed by crossing two monokaryons ‘CM020913-27’ and ‘SSU423-31’. Because of the secondarily homothallism, only a small percentage of the basidia produce 3 or 4 spores, which are mostly haploid (n) and do not fruit. Single spore cultures derived from these types of spores produce a vegetative mycelium that also contain a variable number of genetically identical nuclei per cell called monokaryon. The lack of clamp connections between monokaryon and dikaryon required a series of mycelial culture and fruiting test. After crossing, hybrids were cultivated on a small scale and on a commercial scale at a farm. For this, the spawn was made by a commercial spawn producer and the spawned compost by a commercial compost producer. Mycelial growth of ‘Seolgang’ on CDA was better at 20℃ and 25℃ when it was compared with that of ‘505 Ho’. The mature cap shape of new strain ‘Seolgang’ is oblate spheroid and the immature cap shape is round to oblate spheroid. The cap diameter was 41.2 mm on average. In comparison with white strain ‘505 Ho’, the strain had a yield that was 9% higher. It produced fruiting bodies which had a higher weight on average per fruiting body and were 19% firmer with a good shelf life. Days of fruiting body were 3-4 days later than those of ‘505 Ho’. The physical characteristics such as elasticity, chewiness, adhesiveness were better than that of ‘505 Ho’. Genetic analysis of the new strain ‘Seolgang’ showed different profiles compared to ‘505 Ho’, CM02913-27, SSU413-31, when RAPD primers A02 and O04 were used.

병식 평가 척도-한국판(SUMD-K)의 신뢰도와 타당도 검증

송지영,김기태,이서경,김용희,노준호,김종우,장환일,반건호,강원섭 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : This study was conducted to evaluate the reliability and the validity of the Korean version of the Scale to Assessment Unawareness of Mental Disorder (SUMD-K). Methods : The subjects were 55 schizophrenic patients between ages of 26 and 58 who were recruited from the psychiatric unit of the university hospital and the out-patient clinic. The SUMD-K and insight scale of PANSS were applied to the patients. Results : The range of inter-rater (Spearman's rho) of the general items of SUMD-K were .97-.98 on the current illness and .58-.98 on the past illness. The correlation coefficient between the sum and the general items of the SUMD-K showed high scores. The concurrent validity between SUMD-K and insight item of PANSS was high (scores between .59-.96). However,the reliability and the validity of the attribution items of symptoms showed low scores compared to the current symptoms. Conclusion : The SUMD-K was confirmed in its reliability and validity. It can be a useful clinician-rating scale for evaluating insight in schizophrenic patients as well as patients with other neuropsychiatric conditions.

대전 기존도심의 보행자 공간 기본 구상

宋容浩,李相이 忠南大學校 地域開發硏究所 1998 地域開發論叢 Vol.10 No.-

This research aims to propose the pedestrian space at old downtown in order to activate the existing CBD in Taejon. The first part reviews the urban problems happened in modern metropolitan and meaning of pedestrian space as an effective & economic method renovating urban environment. The second part reviews the traffics & activities, the traffic control system, and the renovation scheme of the pedestrian space. The conclusions are as follows; 1) To be successful pedestrian space bases on the control of traffics and the resolution of district traffic at the old downtown. 2) The old downtown area needs to be made as a pedestrian zone so that urban activities will be strengthen with new added functions 3) The concept of pedestrian zone based on human life must be adopted to the whole city in the future.

대전지방 도시단독주택 지붕ㆍ현관ㆍ창호의 형태에 관한 조사연구

宋容浩,金尙謙,趙原德 忠南大學校 産業技術硏究所 1986 산업기술연구논문집 Vol.1 No.2

Roof, porch and window are important exterior elements which constitute the building envelope. This is a research on these elements of urban detached houses in Taejon area to suggest the basic data for housing design. The research is executed by enquete survey, photographs, sketch, measurement of size and survey sheets. By analyzing the elements according to the building ages, type, size, materials and color, and then comparing them with the traditional elements, the findings extracted the following criteria; 1) the inclination of roof type/color. 2) the tendency of establishing porch. 3) the changing aspects of window type/materials/color as well as those of entrance door.

코골이 및 폐쇄성 수면무호흡증에서 Laser-assisted Uvulopalatoplasty와 LaserUvulopalatopharyngoplasty의 치료 성적 : 장기추적관찰후 환자 만족도 조사

김재호,이윤식,박형욱,송용진,남순열,김용재,이봉재 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.2

建築 語彙體系를 適用한 都市計劃 事例 分析

송용호 忠南大學校 産業技術硏究所 1993 산업기술연구논문집 Vol.8 No.2

This research aims to analyze the urban pedestrian mall plannings of Frankfurt (a/M) & Venice adapted by the architectural vocabulary system. In order to approach the theme it contains ; 1) To consider the analytical methodology adapted by archtectural vocabulary system. 2) To analyze the pedestrian mall plannings of Frankfurt(a/M) & Venice The results of analysis are as follows. 1) Concerning the urban context, the background of the urban development planning is based on the urban social, economical, and political situation of cities. And the analysis & grasp of these factors are directly relate to the urban planning. 2) Concerning the urban aggregation system, in order to get the comfortable urban built-environment must be controled the urban traffic flow.

성과평가에 관한 연구

송용호 군산대학교 산업개발연구소 1998 産業開發硏究 Vol.17 No.-