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.

BMB Reports : Binding model for eriodictyol to Jun-N terminal kinase and its anti-inflammatory signaling pathway

( Eun Jung Lee ),( Ki Woong Jeong ),( Areum Shin ),( Bong Hwan Jin ),( Hum Nath Jnawali ),( Bong Hyun Jun ),( Jee Young Lee ),( Yong Seok Heo ),( Yang Mee Kim ) 생화학분자생물학회 2013 BMB Reports Vol.46 No.12

The anti-inflammatory activity of eriodictyol and its mode of action were investigated. Eriodictyol suppressed tumor necrosis factor (mTNF)-α, inducible nitric oxide synthase (miNOS), interleukin (mIL)-6, macrophage inflammatory protein (mMIP)-1, and mMIP-2 cytokine release in LPS-stimulated macrophages. We found that the anti-inflammatory cascade of eriodictyol is mediated through the Toll-like Receptor (TLR)4/CD14, p38 mitogen-activated protein kinases (MAPK), extracellular-signalregulated kinase (ERK), Jun-N terminal kinase (JNK), and cyclooxygenase (COX)-2 pathway. Fluorescence quenching and saturation-transfer difference (STD) NMR experiments showed that eriodictyol exhibits good binding affinity to JNK, 8.79 × 105 M-1. Based on a docking study, we propose a model of eriodictyol and JNK binding, in which eriodictyol forms 3 hydrogen bonds with the side chains of Lys55, Met111, and Asp169 in JNK, and in which the hydroxyl groups of the B ring play key roles in binding interactions with JNK. Therefore, eriodictyol may be a potent anti-inflammatory inhibitor of JNK. [BMB Reports 2013; 46(12): 594-599]

고환수염전과 동반된 고환미석증 1예

양상국,신현준,김홍섭,정상원,노용수,김상윤 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Testicular microlithiasis is a rare disease characterized by calcifications within the seminiferous tubules. Testicular microlithiasis has been found with a wide variety of testicular pathology, but to our knowledge its association with torsion of appendix testis has been reported only one case. Therefore, we report on an 13-year-old boy with torsion of testis appendix and bilaterally diffusely echogenic testes on sonography.

충격하중을 받는 Al 박육부재의 에너지흡수 제어특성

양용준,황우채,서현경,김정호,심재기,양인영 한국공작기계학회 2007 한국공작기계학회 추계학술대회논문집 Vol.2007 No.-

In this study, concerns the crashworthiness of the widely used vehicle structure, square thin-walled tubes, which are excellent on the point of the energy absorbing capacity. An experimental investigation was carried out to study the energy absorption characteristics of thin-walled square tubes subjected to dynamic crushing by axial loading to develop the optimum structural members. The impact velocity was tested in the rage 4.698~8.2m/s. To efficiently review the collapse characteristics of these sections, the simulation have been carried out using explicit FEM package, LS-DYNA. The solutions compared with results the impact collapse experiment. Here, the controller are introduced to improve and control the absorbed energy of thin-walled square tubes in this paper. To predict and control the energy absorption, we designed it in consideration to the it's influence, height, thickness, wide ratio in this study. When the controller used, the experimental results of crushing of square tubes controlled by the controller's elements showed a good candidate for a controllable energy absorption capability in impact axial crushing.

공조시스템을 적용한 석실 고분내 온ㆍ습도 분포

전용두,이금배,박진양,고석보,전희호 公州大學校 工學硏究院 生産技術硏究所 2005 論文集 Vol.13 No.-

Although the importance of good conservation of historic sites including ancient royal tombs is well aware, still not much attention has been paid for the facilities and systems to preserve those historic sites, which includes precious artifacts as wall paints and carved works, etc. Even the general understanding about the environment of the underground space of tombs is not satisfactory. In Korea, researchers have recently begun addressing the above issue and are making efforts to develop suitable HVAC(heating, ventilating and air-conditioning) systems for conservation of tombs. An experimental investigation was carried out to study the behavior of the HVAC system installed for a tomb. This tomb resembles in size and shape the original stone built tomb of Baek-je Dynasty, which dates back to 6th Century in southwest part of Korean peninsula. In this study, an HVAC system for a tomb(D×W×H=1.3m×3.0m×1.2m) was installed to maintain sui표 indoor conditions for conservation of tomb. The temperature and humidity inside the tomb were measured different of the setting. Finally, performance of the HVAC system is presented and discussed.

제어기를 이용한 사각 박육부재의 에너지흡수 제어특성

양용준,김정호,박준우,양인영 朝鮮大學校 機械技術硏究所 2007 機械技術硏究 Vol.10 No.1

승객의 안전을 도모하기 위해서는 충돌시 발생하는 구조부재의 에너지홉수특성을 적절히 제어하여 자동차의 구조를 설계해야한다. 현재 차량구조부재의 에너지흡수 능력을 향상시키 기 위해서 여러 가지 형상과 재질에 따른 연구가 활발히 진행되고 있다. 본 연구에서는 자동차 충돌시 에너지 흡수를 적절히 제어하여 승객의 안전을 도모할 수 있는 최적의 구조부재를 개발하고자 한다. 특히 자동차의 전면충돌시 에너지 흡수량이 가장 큰 부재인 사이드 부재의 기본형상인 사각단면부재에 대하여 제어기의 유무 제어기의 두께와 높이에 따른 에너지흡수능력과 평균압궤응력 및 변형모드를 고찰하였다. 에너지 흡수 제어기를 이용하여 에너지흡수량 및 평균압궤하중이 제어기를 사용하지 않은 경우보다 15∼20%정도 증가하였으며, 제어기의 높이와 두께 또한 에너지 흡수에 영향을 미쳤다. The structural members must be designed to control characteristics of energy absorption for protecting passengers in a car accident. Study on collapse characteristics of structural member is currently conducted in parallel with other studies on effective energy absorption capacity of structural members with diverse cross-sectional shapes and various materials. This study concerns the crashworthiness of the widely used vehicle structural members, square thin-walled tubes, which are excellent on the point of the energy absorption capacity. The absorbed energy, mean collapse load and deformation mode were analyzed for side member which absorbs most of the collision energy. To predict and control the energy absorption, controller is designed in consideration to its influence such as height. thickness and width ration in this study. The absorbed energy and mean collapse load of square tubes was increased by 15∼20% in using the controller and energy absorbing capability of the specimen was slightly changed by change of the high controller's height.

하악골 골절의 임상적 연구

양병은,김용관,유준영,장현석 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.2

The mandible plays a crucial role in the vital human functions of breathing, eating, and speaking. No other bone in the body has such a distinctive shape and function. Because of its prominence in the facial structure, the mandible is highly prone to fracture. A chinical study on 122 patients with mandibular fracture who visited Kangnam General Hospital during 4 year(1992-1995) was done by analysing sex, age, cause, fracture site, teeth involvement, treatment method, complication and involvement of other body part. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with the ratio of 5.4 : 1 and most frequently in twenties. 2. Violence was the most common cause of facial mandibular fracture. 3. In mandibular fracture, fracture site was average 1.5 sites, most frequently in symphysis and simple fracture was 86.1%. 4. As treatment methods, open reduction(78.6%) was used more frequently than closed reduction(21.4%) 5. Post-operational complication occurred in 27.0% of the cases. 6. Other injuries that were related to maxillofacial fracture occurred in 25.4%.

쇠고기육중의 방사선 유래 휘발성물질의 분석

차용준,박지영,김훈,박승영,조우진,송양순,유영재 창원대학교 생활과학연구소 2000 생활과학연구 Vol.4 No.-

This study was conducted to identify irradiation-derived volatile components, having positive-correlation with irradiation doses, which may play roles as maker materials for detecting post-irradiation in pork meat. The volatile components of irradiated(0, 1, 3, 5 and 10 kGy doses) pork(Belly) meat was analyzed by liquid liquid continuous extraction(LLCE)/GC/MSD methods. By the results of linear regression analysis between irradiation doses and volatile component amounts in fresh pork, 3 compounds including γ-octalactone(r=0.82), 1-octen-3-ol(r=0.90) and butanoic acid(r=0.81) had high correlations with irradiation doses.

야채결속을 위한 메커니즘의 설계에 관한 연구

김용석,김재준,이창돈,양순용 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

The bundling process is the final step in vegetable manufacturing, however, the process is a little difficult to be automatized, because vegetable has the physical properties of roughness, softness , and fragility etc.. In this paper, we proposed an automatic bundling mechanism for vegetable based on the heat melt joining. The proposed mechanism consists of three modules, one module is the moving part for aligning of the vegetable shape and adjusting of the vegetable tension, second module is the arm driving part for the vegetable binding and the band roll releasing, and third module is band joining, band cutting, and band feeding part for the vegetable binding continuously. Through this research, Using the SMO(SimDesigner Motion) module, we optimize condition of mechanical movement of the bundling mechanism. This bundling system designed in order to binding 2,500 bun-dle at 10 hours.

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.