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.

Characterization of cricket song patterns and the behavior observation of Teleogryllus emma (Orthoptera:Grylloidea)

Ji Chang Woo,Kim Nam-Jung,Lee Sang-Guei,Hwang-Yong Kim,Choi Hoon-Sik,Song In-Sun,Ko Jee Sun 한국응용곤충학회 2010 한국응용곤충학회 학술대회논문집 Vol.2010 No.05

We analyzed the chirp sound and behavior of Teleogryllus emma with observation system, which was consisted of computer, ccd-camera and microphone. Computational methods of wavelet transformation and Self-Organizing Maps (SOM) were utilized to characterized the chirp sound of insect species for automatic counting in this study. Wavelets were initially applied to feature extraction of the chirp sound. Wavelet coefficients were accordingly calculated based on the basis function (e.g., Morlet). The obtained coefficients were subsequently provided to count number of chirps in each song. Sound structure of insect specimens consisted with long chirp and short chirp and the patterns of song were grouped by frequency of long chirp and short chirp. The song patterns of insect specimens were divided by Self-Organizing Map (SOM) that was used number of chirp as input data. Application of computational methods to automatic detection of chirp sound was further discussed for obtaining objective assessment in behavior science.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

체육인복지제도와 국가보훈제도의 비교 연구

이용식,조송현 서울대학교 체육연구소 2000 서울大學校 體育硏究所論集 Vol.21 No.1

The propose of this study was to compare national veterans system and sports welfare system in Korea. In the results of this study, existing sports welfare system in Korea is like to national veterans system. Resemblance point between national veterans system and sports welfare system in Korea as follows. First, in the purpose of system, existing sports welfare system in Korea is like to national veterans system in the point of compensation about merits. Second, in the application target, existing sports welfare system in Korea is like to national veterans system in the point of a person of merits. Third, in the allowance type, sports welfare system rely on money and have no opportunity supply program like protection of adoption of a profession or loan support in which national veterans system have. Fourth, in the allowance supply period, existing sports welfare system in Korea is like to national veterans system in the point that supplied when became the target through an application reception and qualified examination. Fifth, in the allowance supply level, an amount of supply money of existing sports welfare system in Korea is low than national veterans system. Sixth, in the finance supply method. existing sports welfare system in Korea is like to national veterans system in the point of public fund. Sports welfare system have to involve program which involved national veterans system in order to strengthen sports welfare system's welfare character. First, senior sportman support program is needed. Second, vocational education for retired athlete is needed. Third, establishment of sports hospital is needed. Fourth, many welfare program like protection of adoption of a profession or loan support is needed at sports welfare system.

맨손무예의 변천사를 통한 태권도의 미래발전에 관한 연구

김응식,송용성 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

"Taekwondo" was originated from "Soo Bakh", a sport widely prevalent in the period of the Three States. It was called Taekkyon in the Chosun Dynasty, then only after the independence of the nation it has named as "Taekwondo." And after the modern, this traditional martial art has divided into Taekwondo and Taekkyon but this separation brought about some historical errors. Now, they are very crucial cultural assets that conveys the historical traces of our ancestors This research is so written as to provide some light to the direction for future development. The conclusion is followings: First, in philosophy, Taekwondo has been influenced by a diversity of religions and they are "Idea Han"(harmony and union), "Hongikingan"(Humanism), Confucianism, Buddhism and Taoism. Thus, these stand on the basis of nature accommodation Second, in the principle, it's the nature accommodation which is achieving spiritual enlightenment by special breathing and motion training. Taekkyon has a intangible principle, while Taekwondo has tangible. Third, in the history and characteristic, Both has similar history but a little differences. Taekkyon is martial arts and kind of light dancing, which has unique characters. On the other hand, Taekwondo has functions of both martial arts and sports ,which is linear and shapely. It's almost the national sport. Fourth, in a match, they usually use feet rather than hands. However Taekkyon use the method of knocking someone down without a protection belt, while Taekwondo use the way of kicking quickly with a protection belt. Finally I think Taekwondo should be developed in the programs : showing an excellent example, curing diseases of adult people etc at the same time. Now, I think Taekwondo of acquiring arts in Korea should change into what everybody can feel, see, and be touched. After all this will make Korea culture spread widely and help the national image and tourism marketing advance.

전주산업단지 및 주변지역 VOCs 및 악취물질 모니터링

김용문,박비오,고영삼,심재정,송병식,양고수 전북대학교 공학연구원 ( 구 전북대학교 공업기술연구소 ) 2002 工學硏究 Vol.33 No.-

Important main odorous compounds and VOCs(volatile organic compounds) possibly emitted from the Jeon-Ju Industrial Sites were identified and measured in amount through making air sampling over Jeon-Ju Industrial Sites and analyzing them with the sate of the art analytical instrument. Sampling sites were chosen 8 points by considering the industrial characteristics for the 1,2 Industrial Sites and 2 points for the 3 Industrial. Site Sampling times were two times, the first one was March. 2002 - April. 2002, and the second was May. 2002 - July. 2002. Canister sampling units and polyester bags were used to collect 6 liters air samples during 1hour or 3minutes for VOCs and polyester bags were used to sample 10 - 50 liters of air for 3 minutes depending on analytic characteristics of odor compounds. The important main VOCs were measured as acetone, ethyl benzene, n-hexane, m,p-xylene, toluene, M.E.K.(methyl ethyl ketone), isopropanol, ethyl acetate, o-xylene, n-butyl acetate, ethanol, benzene as in order of average concentration for the Industrial Sites. The main odorous compounds were COS, H2S, CS2, MM(methyl mercaptan), form aldehyde, acetaldehyde for the 1,2 Industrial Sites and COS, H2S, form aldehyde, acetaldehyde were measured as main species for the 3 Industrial Site. NH3 was measured as below the detection limit of the instrument. The concentrations of sulfide compounds for the 1,2 Industrial Sites were relatively higher than ones for the 3 Industrial Site. Among aldehydes, form aldehyde, acetaldehyde were detected very highly as 0.1- 1ppm over all the Industrial Sites.

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.

3-Cyano 및 3-Carbomethoxy Chromone과 Allenylstannane과의 반응

鄭大一,宋有淨,崔舜圭,李龍均,安賢淑,윤구식 東亞大學校附設基礎科學硏究所 1998 基礎科學硏究論文集 Vol.15 No.2

t-Butyldimethylsilyl triflate 존재에서 3-Cyano 및 3-Carbomethoxy Chromone(1a,b)과 Allenylstannane(2) 과의 반응에서 Chromone의 C-2위치에 propargyl기가 도입된 유도체(3a,b)를 합성하였다. 합성한 유도체의 상대적 구조는 ¹H-NMR을 통해 분석하였으며, T.S구조의 모델을 통하여 가능한 메카니즘을 제시하였다. Reaction of 3-Cyano and 3-Carbomethoxy Chromone(1a,b) with Allenylstannane(2) in the presence of tert-butyldimethylsilyl triflate afforded the corresponding the propargylation product(3a,b) in the moderate yield. The relative stereochemistry of 3a,b are obtained on the basis of ¹H-NMR analysis. And the possible reaction mechanism are suggested by the molecular models in the transition state.

Polyozellus multiplex가 생산하는 지질과산화 저해물질

황지숙,송경식,김양섭,석순자,이태호,유익동 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.5

담자균류로부터 지질과산화 저해물질을 탐색하던 중 강원도 오대산 지역에 자생하는 버섯의 한 종류로 부터, Sparague-Dawley계 rat의 간 mirosome 분획의 지질과산화를 강하게 억제하는 물질이 있음을 발견하였다. 이 버섯의 미생물학적 특성을 관찰한 결과 민주름버섯목, 굴뚝버섯과에 속하는 까치버섯(Polyzellus multiplex)으로 동정하였으며 본 버섯의 자실체 methanol 추출물을 benzene, ethylacetate로 순차적으로 추출하고 각종 chromatography를 이용하여 활성물질을 정제한 결과, ethylacetate층으로 부터 황산화활성을 나타내는 PM1을 benzene층으로 부터 지방산 계열의 PM2와 PM3 화합물을 순수하게 분리 정제하였다. PM1은 정색반응 및 각종 기기분석 결과 thelephoric acid계의 화합물로 동정되었으며 PM2 및 PM3는 각각 linoleic acid와 oleic acid로 동정되었다. 지질과산화 활성물질로 분리정제한 PM1 화합물의 IC_50 값은 1.96 ppm이었으며 LD_50 값은 500 mg/Kg 이상이었다. In the course of screening lipid peroxidation inhibitor from basidiomycetes, a mushroom, which was collected at O-Dae mountain in Kangweon-Do, was found to have active compound. The mushroom was identified as Polyzellus multiplex, which belongs to Aphylloporalles Thelephoraceae, on the basis of macroscopic and microscopic characteristics of the fruiting body. The methanol extract of fruiting body was extracted with benzene and ethylacetate, sequentially. By using various kinds of chromatographies, PM1, and PM2 and PM3, were purified from the ethylacetate extract and the benzene extract, respectively. Color reaction and analyses of IR, UV, and NMR spectra indicated that PM1 was a derivative of thelephoric acid, and PM2 and PM3 were linoleic acid and oleic acid, respectively. IC_50 of PM1 for inhibition of lipid peroxidation was 1.96 ppm and LD_50 was 500 mg/kg.