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.

Pretreatment with Lycopene Attenuates Oxidative Stress-Induced Apoptosis in Human Mesenchymal Stem Cells

( Ji Yong Kim ),( Jai Sung Lee ),( Yong Seok Han ),( Jun Hee Lee ),( Inhyu Bae ),( Yeo Min Yoon ),( Sang Mo Kwon ),( Sang Hun Lee ) 한국응용약물학회 2015 Biomolecules & Therapeutics(구 응용약물학회지) Vol.23 No.6

Human mesenchymal stem cells (MSCs) have been used in cell-based therapy to promote revascularization after peripheral or myocardial ischemia. High levels of reactive oxygen species (ROS) are involved in the senescence and apoptosis of MSCs, causing defective neovascularization. Here, we examined the effect of the natural antioxidant lycopene on oxidative stress-induced apoptosis in MSCs. Although H2O2 (200 mM) increased intracellular ROS levels in human MSCs, lycopene (10 μmM) pretreatment suppressed H2O2-induced ROS generation and increased survival. H2O2-induced ROS increased the levels of phosphorylated p38 mitogen activated protein kinase (MAPK), Jun-N-terminal kinase (JNK), ataxia telangiectasia mutated (ATM), and p53, which were inhibited by lycopene pretreatment. Furthermore, lycopene pretreatment decreased the expression of cleaved poly (ADP ribose) polymerase-1 (PARP-1) and caspase-3 and increased the expression of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax), which were induced by H2O2 treatment. Moreover, lycopene significantly increased manganese superoxide dismutase (MnSOD) expression and decreased cellular ROS levels via the PI3K-Akt pathway. Our findings show that lycopene pretreatment prevents ischemic injury by suppressing apoptosis-associated signal pathway and enhancing anti-oxidant protein, suggesting that lycopene could be developed as a beneficial broad-spectrum agent for the successful MSC transplantation in ischemic diseases.

Pretreatment with Lycopene Attenuates Oxidative Stress-Induced Apoptosis in Human Mesenchymal Stem Cells

Kim, Ji Yong,Lee, Jai-Sung,Han, Yong-Seok,Lee, Jun Hee,Bae, Inhyu,Yoon, Yeo Min,Kwon, Sang Mo,Lee, Sang Hun The Korean Society of Applied Pharmacology 2015 Biomolecules & Therapeutics(구 응용약물학회지) Vol.23 No.6

Human mesenchymal stem cells (MSCs) have been used in cell-based therapy to promote revascularization after peripheral or myocardial ischemia. High levels of reactive oxygen species (ROS) are involved in the senescence and apoptosis of MSCs, causing defective neovascularization. Here, we examined the effect of the natural antioxidant lycopene on oxidative stress-induced apoptosis in MSCs. Although $H_2O_2$ ($200{\mu}M$) increased intracellular ROS levels in human MSCs, lycopene ($10{\mu}M$) pretreatment suppressed $H_2O_2$-induced ROS generation and increased survival. $H_2O_2$-induced ROS increased the levels of phosphorylated p38 mitogen activated protein kinase (MAPK), Jun-N-terminal kinase (JNK), ataxia telangiectasia mutated (ATM), and p53, which were inhibited by lycopene pretreatment. Furthermore, lycopene pretreatment decreased the expression of cleaved poly (ADP ribose) polymerase-1 (PARP-1) and caspase-3 and increased the expression of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax), which were induced by $H_2O_2$ treatment. Moreover, lycopene significantly increased manganese superoxide dismutase (MnSOD) expression and decreased cellular ROS levels via the PI3K-Akt pathway. Our findings show that lycopene pretreatment prevents ischemic injury by suppressing apoptosis-associated signal pathway and enhancing anti-oxidant protein, suggesting that lycopene could be developed as a beneficial broad-spectrum agent for the successful MSC transplantation in ischemic diseases.

명상에 의한 뇌파의 변화 : 스펙트럼 분석 및 시각적 고찰

권준수,함봉진,이부영 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

목적 : 본 연구는 한국의 전통적인 명상법의 하나인 단학수행에 의한 뇌파의 변화를 조사하기 위한 것이다. 방법 : 명상수행자 16명과 대조군 9명을 모집하였다. 명상 및 이완상태에서 측정한 뇌파에 대한 스펙트럼 분석을 시행하여 각 주파수 구간의 절대력(absolute power)과 양반구간 동시성(interhemispheric coherence)을 구하였다. 명상수행군과 대조군의 뇌파변화를 비교하기 위하여, 절대력과 양반구간 동시성의 변화율을 계산하였다. 아울러, 스펙트럼 분석으로 발견되지 않는 뇌파의 특징을 조사하기 위하여 모든 뇌파를 시각적으로 관찰하였다. 결과 : 11명의 명상수행자와 4명의 대조군이 졸음 또는 순응도 불량으로 분석에서 제외되었고, 명상 수행자 5명과 대조군 5명이 실제 분석에 포함되었다. 명상수행군과 대조군 모두 다양한 뇌파의 변화를 보였고, 그 변화의 정도는 대조군에 비해 명상수행군에서 현저하였다. 이러한 차이는 전두엽부위의 알파와 쎄타의 절대력과 베타의 양반구간 동시성 그리고 후두엽부위의 쎄타의 양반구간 동시성에서 현저하였다. 대조군에 비해 명상수행군에서 전두엽부위의 알파와 쎄타의 절대력과 후두엽 부위의 쎄타의 양반구간 동시성이 증가하는 경향이 있었다. 뇌파의 시각적 관찰에서 5명의 명상수행군 중 3명에서 많은 theta burst가 발견되었고, 대조군에서는 1명에서 1개의 theta burst가 나타났다. 결론 : 이상의 결과는 뇌파변화의 다양성과 theta burst의 출현이 대조군과 구별되는 명상수행군의 특징이고, 명상의 상태가 단순한 이완상태에 비해 매우 다양하고 역동적이라는 것을 시사한다. 0bjectives : This study was to investigate the EEG changes induced by Danhak which is one of the Korean traditional meditation. Methods : Sixteen meditators and 9 controls were recruited. Spectral analysis and visual inspection of EEG during meditation(meditators) and relaxation(controls) were performed. The absolute power and interhemispheric coherence in each frequency band were obtained. Ratio of change in absolute power and interhemispheric coherence was calculated to compare the EEG changes between meditators and controls. To evaluate episodic changes of EEG with time, all recorded EEGs were reviewed by visual inspection. Results : Eleven meditators and 4 controls were excluded from the analysis due to drowsiness or poor compliance. Both meditators and controls showed various EEG changes and the degree of variability was more prominent in meditators than in controls. These differences were evident in absolute power of alpha and theta and coherence of beta at frontal, and coherence of theta at occipital. Meditators showed the increase in absolute power of alpha and theta at frontal, and interhemispheric coherence of theta at occipital. In visual inspection, a number of theta bursts were observed in three of 5 meditators and only one theta burst appeared in one control. Conclusion : These results suggest that great variability of EEG change and the appearance of the bursts is the characteristics of EEG change and the appearance of theta bursts is the characteristics of EEG changes of meditators and that th state of meditation is more diverse and than that of relaxation.

BaTiO₃PTC 소자와 진공 열증착된 Al 전극의 접촉 특성

권혁주,전본근,이재성,이용수,이용현 경북대학교 센서기술연구소 1992 센서技術學術大會論文集 Vol.3 No.1

단백뇨를 보이는 사구체 질환 및 당뇨병성 신병증에서의 Lp(a)

권태환,김준홍,조성,김석재,김용림,조동규,백미영 경북대학교 병원 1998 경북대학교병원의학연구소논문집 Vol.2 No.1

Background: Recently there has been evidences that serum Lp(a), an independent risk factor to atherosclerotic cardiovascular diseases, were increased in proteinuric disorders such as nephrotic syndrome and diabetic nephropathy. Methods: We intended to search of altered concentrations of Lp(a) in proteinuric disorder measuring serum Lp(a) concentrations with ELISA in 44 glomerulonephritic patients(25 nephrotic syndrome(NS), 19 non-nephrotic range proteinuric glomerulonephritis(GN), 25 diabetic nephropathy patients(DN), and 31 healthy controls(HC). Also, we compared Lp(a) concentration between glomerulonephritis patients and diabetic nephropathy patients with proteinuria of similar degree. Results: 1) There were significantly increased levels of total choesterol, triglyceride, and LDL-cholesterol in Ns compared to GN, DN, HC. 2) There were significantly increased concentrations of serum Lp(a) in NS compared to HC, but no signiicant difference in serum Lp(a) among NS, GN, and DN. 3) There was no significant difference in serum Lp(a) concentrations between NS & DN with 24 hour urine protein greater than 3.0g. 4) There was no significant difference in serum Lp(a) concentration between GN with 24 hour urine protein greater than 0.5g and less than 1.5g and DN with proteinuria of simial degree. 5) In glomerulonephritis patients, there was negative correlation between serum Lp(a) concentration and serum albumin level but correlation with 24 hour urinary protein, total cholesterol, Ldl-cholesterol, and HDL-cholesterol was not shown. In diabetic nephropathy, there was no significant correlation among serum Lp(a) concentration and all parameters including serum albumin, 24 hour urinary protein, and other lipid profiles. Conclusion: The present study confirmed that patients with nephrotic syndrome of diverse etiologies have makedly increased plasma level of Lp(a), in conjunction with other lipid abnormalities. However, this study shows no difference in Lp(a) concentrations between diabetic nephropathy and glomerulonephritis with similar degree of proteinuria.

지진격리장치를 사용한 교량의 내진성능 보강방법

권기준,김용길 안성산업대학교 1998 論文集 Vol.30 No.-

In the seismic design of bridges equipped with seismic isolation system, the use of equivalent linear approach method makes it possible to take into account the nonlinearity inherent to seismic isolation system. In this paper, equivalent linear approach methd is developed and applied to aseismic analysis of base isolated bridge. Comparing the response spectrum analyses of bridges equipped with common pot bearing and bridges equipped with seismic isolation system, the effect of seismic isolation systems appears clearly and such equipment strengthen bridges seismic design and their seismic performance.

생명현상의 관찰과 명화 감상에서 나타나는 생물교육학자들의 두뇌활성 : fMRI 연구

권용주,이준기,신동훈,이효녕 경북대학교 사범대학부속 중등교육연구소 2006 중등교육연구 Vol.54 No.3

취학전 아동의 체력 실태와 평가

권영옥,김동권,민춘기,이용인,전종귀,진윤수,홍성표 忠南大學校體育科學硏究所 1995 體育科學硏究誌 Vol.13 No.1

The purpose of this study was analyze children's Physical Fitness and basic rate by observing the change in the heart rate of the 1230 children of five of six years of age. Following conclusions were obtained The muscular strength was relatively low according to places. And the muscular strength of boys was higher than that of girls. The flexibility of girls was higher than that of boys according to places and sexes. The muscular endurance, power, balance and agility of boys were higher than those of girls according to places and sexes. Thus the development of physical fitness was improved with their ages, the physical fitness for physique seemed rather low. So the programs of physical plays for children's physical fitness ought to be developed and physical play showed to be done at kindergarten school.

저수지 경관자원을 활용한 야외수영장 개발사업의 투자효과 분석

권용대,황준우 충남대학교 농업과학연구소 2007 농업과학연구 Vol.34 No.1

This study aimed at analyzing the economic effect of outdoor swimming pool investment using the reservoir's amenity resources. We focused on the identification of the amenity value of reservoir in the rural area and the economic evaluation for establishing infrastructure such as swimming pool based on the reservoir's landscape value. To this end, we have conducted the case study on the outdoor swimming pool in connection with Go-Bok reservoir in Yeon-Gi county, Chungnam Province and estimated its income effect on the rural community by cost-benefit analysis method. The research results are as follows: 1) Outdoor swimming pool participants, with 11,581 visitors totaled to Yeon-gi county every year, was estimated to spend the worth of 58,446 thousand won paid for the agricultural product purchase and etc. 2) Internal rate return of the outdoor swimming pool project was estimated to 16.19%, which considered to be economically feasible comparing with 10% of current capital opportunity cost. Based on the results of this study, we suggest the following strategies for development of amenity value of swimming pool in connected with the reservoir: 1) Reservoir amenities should be well preserved even after construction of swimming pool lest losing amenity values while managing the facilities. 2) Measures to increase the marketing value of intangible reservoir's amenities through promotion should be established. 3) Effective program for more visitors with longer staying and more agricultural products sales should be designed.