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.

현행 중등학교 과학 실험 , 실습 교육 실태 조사 및 그 운영 진단 (Ⅱ) : 고등학교 과학 실험 , 실습 교육을 중심으로

김영호,이윤종,정원우,강용희,양승영,윤성효,안병호,윤일희,권용주,임성규,오철한,기우항,전명남,김중욱 한국과학교육학회 1998 한국과학교육학회지 Vol.18 No.3

본 연구는 96년도에 실시한 우리 나라 중학교 과학 실험·실습 교육의 실태 조사 연구에 따른 계속 연구의 일환으로 고등학교 과학 실험·실습 교육의 실태를 조사하기 위한 것이다. 연구내용은 고등학교 과학 교과서의 분석, 실험·실습 실시 현황 분석, 현행 실험·실습 교육의 문제점 분석, 현행 학교 구성원들의 실험·실습 교육 운영 실태 조사 및 현행 실험·실습 교육의 개선을 위한 연구과제 도출을 주요 연구내용으로 다루었다. 연구방법은 전국의 고등학교 80개교를 대상으로 이들 학교의 학생 1,977명, 교사 165명, 학교장 80명에게 적용하였다. 본 연구에서 밝혀진 결과를 중심으로 우리 나라 고등학교 과학 실험 실습 교육의 정상화를 위한 실험 내적인 연구과제를 제시하면 다음과 같다. (1)교재 개발에 대한 연구, (2)실험 킷트 개발에 대한 연구, (3)교사교육 및 재교육 프로그램 개발에 대한 연구, (4)교실 밖 실험·실습 활동 프로그램 개발에 대한 연구, (5)과학 실험·실습 소재의 개발에 대한 연구. This study was accomplished to analysis and survey on the experimental and practical science education of high school in korea for the consecutive study of the an analysis and survey on the experimental and practical science education of middle school in korea(Lee, Yoon-Jong et al., 1997). The status of facilities, management for the experiment, practices, teaching methods in high schools have been investigated. The present status and reasonable management of the high school science education have been grasped from the questionaires. To do this 165 high school science teachers, 1977 students and 80 principals of high schools in Korea are administered questionaires of Science Education Research Institute of Kyungpook National University(1997). The results of this study are as follows : The reasonable management for experiments and practices of science education were scanty in the high school around the urban and rural school owing to the shortage of facilities and equipments, crowded class, excessive class works for teacher, excessive contents of present textbooks and insufficiency of the administrative supports etc. The current teaching method of high school science has emphasized knowledge. This fact does not satisfy the objective of learning due to lack of the teaching method. Desirable directions for the improvement of present status of high school science education were proposed in this paper.

하악골 골절 환자에 있어 수술후 합병증으로 발생한 골수염의 치험례

윤규호,전인성,신용길,박준호,허남오,방석준 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

The term osteomyelitis literally means inflammation of bone marrow. It is described as an inflammatory condition of bone primarily engaging the medullary Following circulatory collapse and ischemia, the involved portions of the bone become necrotic. Cellulitis and osteomyelitis are the most frequent complications of fractures of the mandible and maxilla, because there is an abscessed tooth in the line of fracture. Since most fractures are compound fractures, infection may develop because of contact with oral secretions or outside air. The treatment of chronic osteomyelitis is still under debate. Some authors rely on antibiotics alone, while others advocate combination with surgery. But when infection occurs, establish proper drainage and administer antibiotics. Author treated a case of infected mandibular fracture with mandibular osteotomy, sequestrectomy, iliac bone graft and hyperbaric oxygen therapy, who had suffered suppurative osteomyelitis and mandibular nonunion following the open reduction of the mandibular fracture.

소화관내 이물에 대한 고찰

윤한덕,류진호,박주경,허탁,조석주,김성근,민용일 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

We analyzed records at Chonnam university hospital from Sep. 1. 1993 to Aug. 31. 1996 to assess clinical significance of the foreign body in the gastrointestinal tract. There were 133 episodes consisting of 79 pediatric and 54 adult patients as possible to review. In the pediatric patients, the coin was the most common cause of foreign body ingestion, while adult patients were usually caused by bones and meat. We removed foreign bodies in the oral cavity and oropharynx in 12 cases using direct laryngopharyngoscpy and forcep. Endoscopy was performed successfully in 47 of 51 patients in which was attempted; there were two complications composed of an aspiration pneumonia and a mediastinitis due to esophageal perforation. There were spontaneous passage of foreign bodies in 48 cases. We observed complications in 6 cases in which 4 cases needed operations due to complications. Foreign bodies which pass into the stomach can be observed for development of complications, as 94% of foreign bodies which reach the stomach spontaneously pass. Only 4 patients required interventions, which was done without mortality.

수서 환경독성 평가와 어류 Cytochrome P450 1A(CYP1A) 유전자

윤석주,김일찬,윤용달,이재성 한국환경생물학회 2003 환경생물 : 환경생물학회지 Vol.21 No.1

CYP1A 유전자는 cytochrome P450 약물대사효소에 속하며 다이옥신 등의 내분비계 장애물질에 의해 농도 의존적으로 유도되어 환경오염물질에 의해 유도되는 특성을 이용하여 환경오염물질에 대해 반응하는 생물체의 유전자 발현 변화 뿐만 아니라 이를 토대로 특정지역의 환경오염에 관한 정보를 얻을 수 있다. 본 논문에서는 수서환경오염과 관련하여 CYP1A 유전자의 응용성을 다 각도로 논의하였다. The CYPlA gene is one of Cytochrome P450 drug-metabolizing enzymes with dose-dependant manner of gene expression and is useful to get the information of alterations on gene expression upon environmental contaminants as well as the biomarker of environmental contamination at the specific places. In this report, we further discuss the usefulness of CYPlA gene in relation to aquatic environmental contamination at several aspects.

경기북부지역에 잘 적응하는 콩 품종 선발

윤성탁,주용하 한국국제농업개발학회 2003 韓國國際農業開發學會誌 Vol.15 No.4

경기도 북부지방의 환경조건에 적응하는 콩 품종을 선발하고자 13개 품종을 공시하여 생육 및 수량특성을 조사ㆍ검토한 결과는 다음과 같다. 1. 성숙기에 13개 품종의 경장은 74.4~134.9㎝의 분포를 보였으며, 가장 경장이 큰 품종은 송학콩으로 134.9㎝이었으며, 가장 작은품종은 대황콩으로 74.4㎝이었다. 2. 주당협수는 47.1~62.4개의 분포를 보였으며, 협수가 가장 많은 품종은 장수콩으로 62.4개이었으며, 가장 적은 품종은 대황콩으로 47.1개이었다. 3. 협당립수는 신팔당콩2호가 2.73개로 가장 많았으며, 그 다음은 송학콩 및 대황콩으로 각각 2.3, 2.2개이었다. 4. 등숙률은 소담콩, 황금콩, 장수콩이 각각 91.1, 90.7, 90.3%순으로 높았다. 100립중은 13개 품종이 20.8~38.2g의 분포를 보였으며, 대황콩이 38.2g으로 가장 컸다. 5. 종실수량은 신팔달콩2호가 272.6㎏/10a으로 가장 높았으며, 다음은 장원콩(255.7㎏/10a), 태광콩(250.9㎏/10a), 송학콩(249.3㎏/10a) 순이었으나, 이들간에 유의한 통계적 차이는 나타나지 않았다. 6. 13개 품종에 대한 병충해 발생정도를 보면 자반병에 이병율이 적은 품종으 장엽콩, 장수콩, 장미콩, 소담콩, 대황콩이 0.11%로 적었으며, 미이라병은 신팔달콩2호, 장미콩이 SMV 감염율은 신팔달콩 2호, 태광콩이 이병률이 적었다. 7. 수량은 주당협수, 주당립수, 주당립중과 정의 상관관계를 보여 주당협수, 주당립수, 중당립중이 많을수록 수량이 많음을 알 수 있었다. 8. 결론적으로 본시험의 결과를 종합해 보면 공시된 13개 품종 중 수량 면에서 보면 신팔달콩 2호가 272.6㎏/10a로 가장 많았으며, 병충해도 비교적 적고, 경장도 크지 않아 도복저항성도 클 것으로 판단되어 경기북부지역에서 재배하기에 적합한 품종으로 판단되었다. This experiments were carried out to evaluate the growth and yield characteristics of 13 soybean varieties and select the optimum varieties for Gyeonggi northern areas. Stem length of 13 varieties ranged from 74.4㎝ to 34.9㎝. The highest stem length was shown in Songhakkong with 134.9㎝ and the lowest was shown in Daehwangkong with 74.7㎝. Number of pods per plant of 13 varieties ranged from 47.1 to 42.4. The highest number of pods per plant was seen in Jangsukong with 62.4 and the lowest was seen by Daehwangkong with 47.1. Shinpaldalkong #2 showed the highest seeds per pod, and the next was in oredr of Songhakkong and Dashwangkong with 2.3 and 2.2 seeds, respectively. Sodamkong, Hwangkeumkong and Jangsukong showed higher ripened seed ratio by 91.1, 90.7, and 90.3% respectively among 13 varieties. One hundred seed weight ranged from 20.8 to 38.2g, and Daehwangkong showed the highest one hundred seed weight by 38.2g. Shinpaldalkong #2 showed the highest seed yield by 272.6㎏/10a, and next was in order of Jangwonkong, Taekwangkong and Songhakkong by 255.7㎏/10a, 250.9㎏/10a and 249.3㎏/10a, respectively. Purpura infection rate was the lowest in Jangyeobkong, Jangsukong, Jangmikong, Sodamkong, Daehwangkong, and Shinpaldalkong #2, Jangmikong were the lowest phomopsis seed decay caused by phomopsis spp. Low infection of SMV(Soybean Mosaic Virus) were observed in Shinpaldalkong #2, Taekwangkong. Seed yield showed positive coefficients with pods per plant, seeds per plant and seed wight per plant, showing that it is profitable to increase these characteristics for improving seed yield. In conclusion, the optimum soybean variety at Gyeonggi northern area was thought to be Shinpaldalkong #2, because it showed the highest seed yield and low damage by plant disease and insect.

작물의 수분관계 연구를 위한 pressure chamber 이용 방법

윤태명,최성용 安東大學校 農業科學技術硏究所 1995 農業科學技術 硏究論文集 Vol.2 No.-

Pressure chamber는 식물체의 수분상태를 측정하는 기기로써 식물의 수분관련 생리연구나 생태연구에 광범위하게 이용되고 있다. Pressure chamber의 구조와 측정이론을 개괄·고찰하고 또다른 식물체내 수분포텐셜 측정기기인 thermocouple hygrometer와 비교하여 pressure chamber의 장·단점을 검토하였다. Pressure chamber를 이용하여 포장에서 직접식물의 수분상태를 측정할 때의 주의하여야 할 점과 압력-부피 곡선법을 통한 수분관련 parameter의 산출방법에 대해서도 관련 논문을 종합·고찰하였다. 아울러 pressure chamber의 기타 이용방법으로 식물체의 수분이동저항 측정, 토양수분포텐셜의 간접적 측정, 수액채취, 물관부 emboilsm연구 등에 대하여 언급하였다.

현행 중학교 과학 실험·실습교육에 대한 교사들의 견해와 개선방안

이윤종,기우항,김영호,정원우,양승영,강용희,안병호,임성규,윤일희,김중욱,강동진 경북대학교 과학교육연구소 1996 科學敎育硏究誌 Vol.20 No.-

The status of facilities, management of the experiment, practices, and Science education teaching method in middle school have been investigated. The present status and reasonable management of middle school science education have been grasped from the questionaires. The results are as follows : The reasonable management for expeiments and practices of science education were scanty in the middle school around the urban and rural schools owing to the shortage of facilities and equipments, crowded class, excessive classes, work for teachers, excessive contents of present textbook and insufficience of administrative support etc. The current teaching method of middle school science has emphasized knowledge. This fact does not satisfy the objective of learning due to lack of teaching method. Desirable directions for the improvement of present status of middle school science education were proposed in this paper.

현행 정신과 전공의 교육 과정에 대한 정신과 전문의들의 반응

김성윤,이부영 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.4

A total of 56 psychiatrists with less than 3 years' experience as a specialist were questioned by mail about what they experienced and felt psychiatric residency training. No made of treatment was exclusively preferred or avoided, and there was no significant difference in educational system among the 4 types of training hospitals, psychiatric department of general hospital and psychiatric hospital. The type of disorders experienced, however, was significantly different among the types of training hospitals, especially in the experience of chronic schizophrenias and in somatoform disorders. The experience of neurology rotation was not satisfactory in spite of strong need and positive attitude among the respondents. And more direct, experiential teaching modalities were preferred to didactic, intellectual approach. Several issues in psychiatry, such as board examination, research participation, women psychiatrists, selection of psychiatric residents are also discussed.

임신白鼠의 카드뮴中毒時 마늘의 效果에 關한 硏究

金成淑,徐東允,廉容泰 고려대학교 의과대학 1987 고려대 의대 잡지 Vol.24 No.3

It is revealed in recent studies that the garlic, one of the favorite spice of Korea, which mainly consists of -S-S or -SH radical compound, has protective effect on heavy metal poisoning. This study was conducted to find the effect of garlic on the cadmium poisoning of pregnant rats especially at early stage of organogenesis in fetus. Injections of 4-16 ㎎/㎏ CdCI₂ on 4 consecutive days beginning on day 7 of gestation were done on the back of SD rats subcutaneously. In cadmium-garlic combined treated groups, experimental animals were fed commercial laboratory chow mixed with garlic in 6.4% and water ad libitum from 24 hours before beginning cadmium injection to day 21 of gestation. On day 21 of gestation dams were anesthetised with ether and liver, kidney and blood of dam, placenta and fetus were sampled and measured cadmium levels. Placenta and kidney of fetus were examined microscopically. The results were as follows: 1. Cadmium injected on day 7 of gestation, the early stage of organogenesis, brought about fetal death and/or resorption and the garlic reduced it to 39-56%. 2. The body weight of live fetus was not showed significant difference in 4㎎/㎏ and 8㎎/㎏ cadmium administered groups compairing with control group. Administration of 16㎎/㎏ cadmium significantly reduced fetal weights and garlic inhibited the weight reduction. 3. Although the accumulation of cadmium in fetus and placenta was increased along the dosage of cadium administration, the garlic was not significantly reduced cadmium levels in placenta and fetus. Garlic significantly reduced cadmium accumulation in matrenal liver, kidney and blood. 4. The histopathological findings of placenta and fetal kidney were showed no significant difference between 4㎎/㎏ and 8㎎/㎏ cadmium administered groups, but in 16㎎/㎏ cadmium administered group extensive cell damage in placenta and fetal kidney was shown and garlic reduced the damage.