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.

스테인레스강 절삭가공에서 공구의 온도 특성에 대한 실험적 연구

권용기,오석형,김동현 한국공작기계학회 1996 한국생산제조학회지 Vol.5 No.1

This is an experimental investigation of the temperature generated in a cutting tool during the machining of stainless steel. The temperature results from the wear of the cutting tool are considered in order to investigate the relation between cause and effect of these factors. This possibility has been tested using a thermocouple technique to record temperature vs. time curves for a variety of cutting conditions. This is done by employing a thermocouple inserted on the tool tip near the major cutting edge. Temperature distributions are calculated using finite element method and compared to the contour maps measured by an optical system. It suggests that the temperature gradients and the tool performance will be dependent on certain factors in tool geometry when cutting this material.

수용성 키틴이 백서 창상치유에 미치는 영향

강장석,조용남,정상훈,유 결,임진수,권 호,조용우,고석원 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.1

녹색교통수단 이용 활성화 방안 연구

권용석,장세봉 전주대학교 공학기술종합연구소 2002 전주대학교 공학기술종합연구소 학술논문집 Vol.8 No.1

Transportation modes have provided with both affirmative effect of convient movement and negative effects of traffic accident, environmental pollution, and so on. Recently Koreans come to hope their lives in clean environment with their economic richness. As result, the transportation policy in Korea is required to be environmentally sound. This environmentally sound transportation is called as Green Transportation. This paper contains present conditions and problems, and activation schemes of Green Transportation Modes

겨울철 강풍시 교통통제 방안 연구

권용석 전주대학교 공학기술종합연구소 2003 전주대학교 공학기술종합연구소 학술논문집 Vol.9 No.1

This study presents a traffic control strategy for driving stability in winter storm on the Kumgang bridge Vehicle driving stability level is derived from the lateral deviation and reduction of side friction factor caused by cross wind on the icy road. In the case study, the relationship between windy days and rainfall days are studied by using the weather data of the Gunsan Standard Meterological Station. From the measured data, traffic control strategy in winter storm is proposed The strategies are divided into five-step freeway speed limits of small passenger vehicles

제6차 교육과정에 따른 고등학교 화학Ⅰ 교과서의 STS 내용 분석

이석희,김용권,문성배 부산대학교 사범대학 과학교육연구소 2001 科學敎育硏究報 Vol.28 No.-

The STS contents, emphasized in the 6th curriculum, in the chemistry Ⅰ textbooks were analyzed. The STS contents of textbooks showed average of 10.7%. The Chapter in "water and air" were included 34.8% in STS contents, 11.0% in "metal and nonmetal", 9.7% in "organic compound" and 15.1% in "our livelihood and medicine goods". When the STS contents were analyzed by STS topics of Piel, the results are as follows; 51.1% on environmental quality and utilization of natural source, 38.6% on effect of technological developments. 9.5% on energy, 0.8% on sociology of science. However, there were no topics on human engineering, population, space research and national defense. When the STS contents were analyzed by student activities of SATIS, most of the activities were research study and case study. There were few field activities of practical investigation, role play, simulation, and research design.

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

초인지 수업 전략을 적용한 과학수업이 초등학교 아동들에게 미치는 효과

김용권,김병렬,이석희 한국초등과학교육학회 2003 초등과학교육 Vol.22 No.2

In this study, the effects of metacognitive teaching strategy on the students' scientific inquiry ability and scientific attitude were investigated. For the study, two classes of fourth grade from an elementary school in Busan were chosen. Each class was assigned to the experimental group which metacognitive teaching strategy was applied to and the comparative group that traditional teaching method was applied to. The tests of scientific inquiry ability and scientific attitude were administered before and after the instruction period. The results of this study were as follows. There were significant differences between the experimental group and comparative group in scientific inquiry ability and scientific attitude. It was concluded that metacognitive teaching strategy was more effective in the improvement of students' scientific inquiry ability and scientific attitude.

사망 진단서(시체 검안서) 작성의 문제점

김규석,임용수,이중의,서길준,윤여규,어은경,염석란,정연권,이윤성 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates Methods: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. Results: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital,101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). Conclusion: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.

TiN Ion-Plating이 교정용 브라켓의 접착강도에 미치는 영향

김석용,권오원,김교한 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.1

TiN ion-plating이 교정용 브라켓의 접착강도에 미치는 영향을 알아보기 위하여 세 종류의 서로 다른 기저면형태를 가지는 스테인레스 스틸제의 브라켓을 선택하고, TiN ion-plating 된 브라켓과 ion-plating 되지 않은 브라켓을 치아에 접착시켰을 때 초기 및 장기접착강도, 접착계면의 주사전자현미경 관찰, 파단면의 주사전자현미경 관찰을 비교 분석하여 다음과 같은 결론을 얻었다. · TiN ion-plating을 하지 않은 경우 24시간 후의 접착강도는 Micro-Loc형이 5.89±1.77MPa, Foil Mesh형이 4.27±1.12MPa, Undercut형이 2.64±0.58MPa로 Micro-Loc형이 가장 높았고, 그 다음이 Foil Mesh형 그리고 Undercut형의 순으로 나타났다(P<0.05). · TiN ion-plating시 24시간 후의 접착강도는 Micro-Loc형이 6.26±1.51 MPa, Foil Mesh형이 7.45±2.01MPa, Undercut형이 2.93±0.84MPa로 ion-plating 하지 않은 경우와 달리 Foil Mesh형이 Micro-Loc형보다 오히려 높게 나타났고, Undercut형이 역시 가장 낮은 접착강도를 나타내었다(P<0.05). Ion-plating 유무에 따른 24시간 후의 접착강도는 3가지형 모두에서 ion-plating시 증가하였으나 Foil Mesh형에서만 유의한 증가가 있었다(P<0.001). · 장기침적시 ion-plating의 유무에 관계없이 전반적으로 초기(1일)접착강도보다 증가하였으며 접착력의 안정성을 나타내었다. · 접착계면의 주사전자현미경 관찰 결과 브라켓 기저면의 형태나 ion-plating 유무에 관계 없이 레진이 브라켓 기저면으로 잘 퍼져 들어가 브라켓과 치아와의 사이에 견고한 접착면을 나타내었고, 장기침적의 경우도 같은 양상을 나타내었다. · 파단면의 주사전자현미경 관찰에서는 다양한 파괴양상이 나타났다. This study was conducted to see the effect of TiN ion-plating on the bond strength of orthodontic bracket. Three stainless-steel brackets with different base types were chosen; when TiN ion-plated brackets and non ion-plated brackets were bonded to the teeth, initial and long-term bond strength were measures. The observations of bonding surface and failure sites through the scanning electron microscope were analysed and compared. The summary of this study was as follows: · When TiN ion-plating was not applied, the Micro-Loc type was the highest in bond strength after 24 hours as 5.89±1.77MPa, followed by 4.27±1.12MPa for Foil Mesh type and 2.64±0.58MPa for Undercut type(P<0.05). ·Under TiN ion-plating, the bond strength after 24 hours showed: Micro-Loc type 6.26±1.51MPa, Foil Mesh type 7.46±2.01MPa, Undercut type 2.93±0.84MPa. Unlike in the case of non ion-plating, Foil Mesh type showed a higher strength than Micro-Loc type, with Undercut type still showing the lowest bond strength(P<0.05). The bond strength, after 24 hours, increased in case of ion-plated in all 3 types, but a significant increase was shown only in Foil Mesh type(P<0.001). · Under a long-term immersion, regardless of ion or non ion-plating, bond strength in general increased over the initial bond strength(one day), with more stability. · Through scanning electron microscopic observation of bonding surface, it was found that, regardless of the bracket base type or the application of ion-plating, the resin was thoroughly spreaded into bracket base to form a solid bonding surface between the bracket and the tooth. This was also true in case of a long-term immersion. · The scanning electron microscopic observation of failure sites revealed diverse failure patterns.