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한국형 양극성 장애 약물치료 알고리듬의 적용 가능성(Ⅱ):약물의 선택
신영철,박원명,김찬형,민경준,윤보현,조현상,권준수,전덕인 대한정신약물학회 2005 대한정신약물학회지 Vol.16 No.4
Objective : The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean algorithm project for bipolar disorder to aid clinical decisions. The purpose of this study was to investigate the prescribing tendency of psychopharmacological agents such as mood stabilizers and antipsychotics according to the Korean Medication Algorithm for Bipolar Disorder(KMAP-BP) in clinical settings. Methods : Ninety-two patients were treated according to the algorithm. Among them the selection and dose of drugs were investigated in 71 patients whose precise medication records were available. Results : Lithium(n=37) and divalproex(n=33) were used as mood stabilizers and combination treatment with both medications was done for one patient. Carbamazepine was not used. During the maintenance period, dosage of mood stabilizer was higher for mixed and psychotic mania compared with euphoric mania. Antipsychotic drug was co-administrated with a mood stabilizer from the beginning of the treatment in 62 of 71 patients and risperidone(69.4%) was the most preferred drug. Of those 62 patients who were treated with antipsychotics, 24 patients were initially taking anti-parkinsonian agents. Conclusion : This study investigated the prescribing tendency of clinicians who practiced according to the KMAP-BP. Considering the results of this study, further research is needed to revise KMAP-BP. 목 적:저자들은 한국형 양극성 장애 약물치료 알고리듬의 적용 가능성을 평가하기 위해 다기관 조사를 실시하였고, 알고리듬 적용 시 어떤 약물을 사용하는지, 특히 기분조절제 및 항정신병약물의 선택 경향에 대해 조사하여 향후 개정판의 기본 자료로 활용하고자 하였다. 방 법:알고리듬을 따라 치료한 92명 중 양극성 장신영철 등 291 애의 아형, 약물의 사용 경향, 용량 등이 정확히 기재된 경우는 71명이었고 이들을 대상으로 약물의 사용 경향을 조사하였다. 결과:기분조절제는 lithium(37명)과 divalproex (3명)를 사용하였고 carbamazepine을 사용한 경우는 없었다. 기분조절제의 평균 용량은 유쾌성 조증에 비해 혼재성, 정신병적 조증의 경우가 더 높았으나 세 군간에 통계적 차이는 없었다. 대상환자 71명 중 62명에서 처음부터 기분조절제와 함께 항정신병약물을 사용하고 있었는데 risperid one(69.4%)을 사 용하는 경우가 가장 많았다. 또한 risperidone을 사용하는 경우 항파킨슨약물을 사용하는 비율이 가장 높았다(48.8%). 결 론:저자들은 양극성 장애 환자의 알고리듬에 따른 치료 시 약물의 사용 경향에 대해 조사하였고 이 결과가 추후 알고리듬 개정 시 참고 자료가 될 수 있고자 하였다.
愼英喆 진주산업대학교 1982 論文集 Vol.20 No.-
This study aimed to get basic for the purpose of searching improvement about the instruction of hydraulic subject from student's characteristics in junior college. First of all, Elements of education were analyzed with each of parts, which were student's characteristics, interpretation of textbook and the methods of teaching-learning. The result obtained by analysis were summarized as follows. It ought to establish instructional model by means of student's characteristics and educational materials. In order to understanding about student's characteristics, system of diagnosis-treatment and program of teaching ought to be pruduced. Learning of subject ought to be connected with instruction for the announcement and test of project work. For elevation of interesting and participation in learning. The method of teaching have to be various. The formation of the learning process need to employ the module unit. A vailable using methods of the audiovisual mathines were influenced by the operating and the various program production.
신영철,Shin, Young-Chul Korean Society of Electron Microscopy 1998 Applied microscopy Vol.28 No.1
본 연구에서는 박절편과 동결할단복제법을 이용하여 흰쥐 간세포에서 dehydrocholic acid가 수송되는 경로를 전자현미경적으로 조사하고자 하였다. 정상군이나 dehydrocholic acid 투여군에서 대부분의 Golgi 장치는 형성면을 담세관으로 향하고 있었다. Dehydrocholic acid 투여 20분 후에 세포질내세망과 Golgi 장치 및 소포 등이 담세관 주위에 증가되어 있었는데 특히 Golgi 장치 형성면에서는 소포가 될 것으로 추정되는 싹이 돌출되어 있었으며 소포들은 담세관에 융합된 것들도 관찰되었다. 이러한 소견으로 미루어 담즙산의 분비는 Golgi 장치 형성면의 쌀이 유리되어 형성된 소포가 담세관막에 융합되므로서 이루어질 것으로 추정된다. The pathway of intracellular transport of dehydrocholic acid was investigated in the hepatocytes of rats by transmission electron microscopy with conventional and freeze fracture methods. Both in normal and experimental groups, the cis Golgi cisterns were sacculated and faces toward the bile canaliculus. In the experimental group, however, the cis Golgi cisterns showed buds, which were probably separated to be vesicles. Some of the buds were connected to the cisterns with the narrow neck. The vesicles were increased in the vicinity of bile canaliculi. The fusion between vesicles and bile canaliculus were frequently observed in the experimental group. This was particularly well shown in the freeze fracture replica. In the thin section, the vesicles were devoid of visible contents as seen in the bile canaliculli. The evidence suggests that the vesicles are derived from the cis Gogi cistern in the way that buds pinch off, serve as vehicles to transport dehydrocholic acids and fuse to bile canaliculi for exocytosis.