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.

산화구리에 의한 배기 가스 중의 아황산 가스 제거 : 반응속도에 관한 연구 A Kinetic Study

신창섭,노용우,이태희 연세대학교 산업기술연구소 1985 논문집 Vol.17 No.2

The reaction of cupric oxide powder with 2% sulfur dioxide was investigated over a temperature range of 300-500℃ and over a particle size range of 0.051-3㎜. The experimental data were correlated well by the shrinking unreacted core model and the optimal reaction temperature was found to be 450℃. With average particle diameter less than 1㎜ and superficial gas velocity higher than 8.8 ㎝/sec, the reaction of cupric oxide powder with sulfur dioxide was found to be controlled by the chemical reaction and the intrinsic rate constant was k=8987 exp(-8134/RT).

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

Pyridostigmine과 Neostigmine의 골격근이완계 길항 효과에 관한 연구

우현제,신용섭,김태관,이정은,최세진 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

This present study was undertaken to observe the effects of pyridostigmine and neostigmine of heart rate and it's antagonistic effect on pancuronium in 62 patients during general anesthesia. We obserived the effect of pyridostigmine and neostigmine with atropine and glycopyrrolate of heart rate, appearance of arrhythmia, time required for returning of spontaneous breath an sustained tetanic response and effect on the amount of secretion in oral cavity and trachea. The result are as follows: 1. The incidence of bradycardia was the highest in the group of atropine and neostigmine i. v. administration together, and the lowest in the group of glycopyrrolate and pyridostigmine i. v. administration together. 2. The incidence of tachycardia was the highest in the group of atropine and pyridostigmine i. v. adminstration together, and the least in the group of glycopyrrolate and pyridostigmine i. v. administration together. 3. Among the experimental cases, only one showed arrhythmia which is PVD. 4. The time required for returning of spontaneous respiration was 4.6-6.1 minutes range in all groups. 5. The group of glycopyrrolate administrated showed the greates antisialogue effect.

증후성 단일 소심부뇌경색의 임상적 및 방사선학적 양상

신원철,이태규,노용우,오재욱,장대일,정경천 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3

웨이브렛 계수 Zero Crossings를 이용한 영상의 잡음제거 및 압축

신재호,이용준,은종숙,이성우 동국대학교 산업기술연구원 1997 산업기술논문집 Vol.10 No.-

윤곽선이나 에지같은 영상 데이터의 중요한 성분들은 웨이브렛 계수의 zero crossings를 통해 검출할 수 있다. 이런 방법은 영상의 패턴 인식에 관한 연구에서 sharp variation points를 검출하는데 사용되었다. 웨이브렛 변환과 zero-crossings를 거쳐 국부 극치의 위치를 검출하는데 이 방법을 적용하여서 영상의 잡음제거에 사용하도록 개선하였다. 더욱이 영상 데이터에서 전체 영상의 픽셀과 정보를 저장하는 대신, 대부분의 중요한 성분을 효과적으로 몇몇 국부 극치값으로 압축하였다. 그 결과 새로 개선된 기법은 패턴 인식 분야에서만 아니라 높은 압축률의 잡음 제거에도 사용될 수 있다. The important image data components such as contours and edges could be detected by zero crossings of wavelet coefficient. This method has been used for the studies on pattern recognition of images to detect sharp variation points. We have applied it to detection of the position of local maxima through zero-crossings and wavelet transform, so that it is improved to be used for noise-eliminating of image. In addition it could compress the image data into a few of local maxima which held the most of important component efficiently without saving All image pixels and information. As the result, the newly improved method could be implemented not merely for the field of pattern recognition but for that of noise removal at the higher compression ratio.

영구자석 동기발전기의 정주파수 정전압 출력에 관한 연구

우정인,조용길,황정원,송호신 동아대학교 공과대학 부설 한국자원개발연구소 1994 硏究報告 Vol.18 No.2

The permanent magnet machines have the advantages of high efficiency and power density, features very improtant for air-borne applications with their requiement of no external dc supply for rotor excitation, in addition, a very lower synchronous reactance thus making it a stiff source of power with a higher steady state and more transient capability than ist counterpart, the wound rotor type. In this paper, The permanent magnet synchronous machine is taken as a power source in the variable speed constant frequency power conversion scheme with converter-inverter system. All digital routines are excuted in the sampling time of 100 micro second by a DSP Board (TMS320c25) with A/D converters, which is detect the load current, capacitor current and DC link voltage at a sudden load change and to compute the predicted current. In one sampling interval, two optimal space voltage vectors as well as tow zero voltage vectors are employed so that the capacitor current may follow the reference. As a result, sinusoidal output constant voltage is obtained while swiching frequency is constant, and experimental results are presented, which shows the effectiveness of the proposed control method.

반송용 편측식 선형기기의 추력제어에 의한 특성해석

우정인,신동률,조용길,노태균 東亞大學校 大學院 1999 大學院論文集 Vol.24 No.-

본 논문에서는 PWM 인버터 구동 편측식 선형유도 전동기(이하 SLIM)의 공간백터 제어와 PI 제어를 통한 추력 제어를 행한다. 1차측 권선과 SLIM의 2차측 구조 사이에서 발생하는 공극길이의 떨림은 빠른 응답특성을 얻기위해서 최소화 되어야 한다. 먼저, SLIM의 전압방정식이 추력과 수직력 특성을 해석하기 위하여 d-q축 등가회로로서 나타내어진다. 또한, d-q축 등가회로의 모델링과 해석은 등가회로상에서 전류변동에 따른 강인한 과도 추력특성을 얻을 수 있다. 지령속도와 추력에 의한 SLIM의 직접구동 결과는 실험을 통해서 확인된다.

Managing Cultural Diversity by Effective Human Resource Management of International Trade: Focus on Asian Perspectives

Shin,Soo Yong,Pak,Myong Sop,Cho,Sung Woo 한국무역상무학회 2012 貿易商務硏究 Vol.56 No.-

Changes in the global business environment continue at an accelerated pace. The 21st century maybe remarked, perhaps, for its hot issues on globalization and diversity. Diversity may arise in terms of ethnic, gender, age and culture. Cultural diversity out of all stands out in front in modern times as more multinational companies operate internationally resulting more people to start living abroad and work with people from different cultures. In recent years, these multinational companies realized the important roles human resource management play in international trade since cultural diversity is very influential on their work performance. A well-managed human resources will ensure organizations' success to a great extent. This paper touches the field of cultural diversity and introduces human resource management of international trade as a way to handle diversity matters faced by international organizations.

가치경영 특질에 관한 탐색적 연구

申鉉佑,徐傭準 慶一大學校 1999 論文集 Vol.16 No.4

The purpose of this study is to specify about value management. Fundamental concepts of this research presents a perceived value approach to the determination of price in comsumer's decision making. I defined about value management more clearly that will be contributed to macimize business process performance. Environmental pressures and the development of radical information technologies are convergeing to create on impetus for major change in the structure, function and process of business organizations. A key componenet of these research effect factors has been the rethinking of perceived valye enlargement for meet customer's needs. So as to meet internationalized business environment and maximize business process performandce found out the correlated loops with value management, through these interactive process loops made model of SEV(shdow effect of value model). Use the SEV model to radically redesign our business processes in order to achieve dramatic improvements in their performance.