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.

한국의 한 농촌 지역에 거주하는 노인에서의 치매의 유병률

우종인,이정희,유근영,홍진표,김창엽,김용익,이강욱 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.1

본 연구는 한국의 농촌지역인 경기도 연천군에 거주하는 65세 이상 노인인구를 대상으로 치매의 유병률을 산정하였다. 선별검사로서 MMSE-K를 실시한 후 NINCDS-ADRDA 기준에 따라 치매의 임상 진단을 확정하였고, 치매의 정도는 DSM-Ⅲ-R 기준에 의하여 평가하여 다음과 같은 결과를 얻었다. 1) 치매의 유병률은 9.5%로 추산되었으며, 알쯔하이머병과 혈관성 치매의 유병률은 각각 4.5%와 2.5%이었다. 2) 치매의 유병률은 연령증가에 따라 증가하는 소견을 보였으며, 성별차이는 알쯔하이머병의 경우 여자에서 유병률이 더 높았으나 혈관성 치매는 남자에서 더 높았다. 3) 치매의 정도에 따른 유병률은 경도의 치매는 6.2%, 중등도 및 중증 치매가 3.3%이었다. 이상의 결과에서 본 연구는 한국에서의 치매의 유병률 양상이 종래의 북미나 유럽에서와 유사하고, 중국이나 일본 등 다른 아시아권의 국가에서와는 차이를 보이는 소견을 나타냈다. The authors investigated the prevalence and risk factors of dementia among 1,674 elderly residents in Yonchon county of Kyonggi-do, a rural area of Korea who were above 65 years of age, in 1993. The primary screening was done with MMSE-K(Korean version of Mini-mental State Examination), and the final diagnoses of dementia for 436 subjects were made by NINCDS-ADRDA criteria. The prevalence of total dementia was 9.5%, and it increased with advancing age. Particularly, it rapidly increased in the elderly above 75 years of age. The prevalence of dementia in female as a whole was higher than in male, but this was not shown in each age group. The prevalences of Alzheimer's disease and vascular dementia were 4.5% and 2.5%, respectively. Assessing the degree of dementia with DSM-Ⅲ-R criteria, the prevalence of moderate and severe dementia was 3.3%. Our result showed the similar finding to the prevalence of dementia in western countries, but was different from those of the previous studies in other Asian countries, China and Japan.

洛東江河口의 鳥類相에 관한 硏究 : 第三次年度 調査

禹龍泰,洪淳福 慶星大學校 1993 論文集 Vol.14 No.2

The third annual observation on the avian fauna around the Nakdong River Estuary were surveyed from January to December, 1991 by strip intersect method. The result were analysed to clarify appearance number of species and individuals in each month, percentage of appearance, percentage of individuals, dominance index. 1) In the surveyed, the total individuals (57741) which consisted of 96 species were recorded. 7683 individuals were increased, but 11 species were reduced to the last year. 2) A total of 96 species were showed 49 species of winter visitors (51.04%), 23 species of passage migrants (23.96%),12 species of summer visitors(12.50%),9 species of Residents (9.38%),3 species of Vagrants (3.12%). These species nearly equals the last year. 3) In each month, these species were recorded a large number of species in March (50),February(45)and a small number of species in June(17).August(24) but, These species were a little differenced between the last year. 4) In each month, these individuals were recorded a large number of individuals in november (10508), February (9675) and a small number of individuals in June(765),July(1373)but these individuals were a little differenced between it, too . 5) In the surveyed, the species which showed 100 percentage of appearance were Gray Heron, spot-billed Duck, Black-tailed Gull. Those which showed above 50 percentage of appearance were 30 species. But in the 100 percentage of appearance, species of this year show a decrease of 3 species as compared with last year. And In the 50 percentage of appearance, species of this year show a decrease of 17 species as compared with last year. 6) In the surveyed, those showing above 10 peroentage of individuals was only one, Dunlin (13.6%). In the this result, species of this year show a decrease of 3 species as compared with last year. And above 577 individuals (percentage of individuals) were 18 species. Species of this year show a decrease of 1 species as compared with last year. 7) the species which showed dominance index above 0.5 percentage were 18 species. Species of this year show a increase of 1 species as compared with last year.

비정상 질확대경검사 소견을 보이는 환자에서 환상투열요법의 직접적 적용에 관한 연구

우헌탁,이철민,박교훈,조용균,최훈,김복린,이홍균 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2

Objective: Large Loop Excision of the Transformation Zone (LLETZ) has been widely used for evaluating cervical dysplasia/cancer. We performed this study to evaluate if colposcopically suspected cervical high-grade dysplasia or cancer could be directly evaluated and treated with LLETZ. Methods: 93 women who were scheduled for colposcopic evaluation because of an abnormal cervical cytology report were included in the study in Sanggye Paik Hospital from Jan to Dec 2001. Mean age of the study population was 38.6±9.0. colposcopy directed punch biopsy was not performed and histologic diagnosis was made by LLETZ. Sensitivity and specificity of colposcopic evaluation was calculated and compared with those of cervical cytology. Results: On histopathological examination by LLETZ, 11(11.8%) patients had invasive cancers including 3(3.2%) adenocarcinomas. The sensitivity and specificity of colposcopy for the detection of cervical dysplasia or cancer was 71.7% and 72.3% respectively, wile those of cytology was 56.5% and 74.5% respectively. Conclusion: LLETZ may be adequately performed for the diagnosis and treatment of cervical dysplasia/cancer based on the results of pap smear and colposcopy without punch biopsy. Cost benefit might be anticipated while cost-effectiveness analysis is necessary in the future.

Genome-wide investigation of a Korean synthetic breed, Woori-Heukdon using the Illumina PorcineSNP60K BeadChip

Yong‑Min Kim,Ha‑Seung Seong,Jung‑Jae Lee,Da‑Hye Son,Jin‑Su Kim,Soo‑Jin Sa,Young‑Sin Kim,Tae‑Jeong Choi,Kyu‑Ho Cho,Joon‑Ki Hong,Jung‑Woo Choi,Eun‑Seok Cho 한국유전학회 2020 Genes & Genomics Vol.42 No.12

Background: Woori-Heukdon (KWH) is a Korean synthetic pig breed generated using Chookjin-Duroc (KCD), Chookjin-Chamdon (KCC), and their crossbreds. Currently, there is a severe lack of studies investigating the Korean breed populations including wild boars (KWB) throughout the genome. Objective: This study was performed to investigate the genetic characteristics of Korean pig populations at the genome-wide level. Methods: Using the SNP dataset derived from genotyped and downloaded datasets using the Illumina PorcineSNP60K BeadChip, we compared the genomes of 532 individuals derived from 23 pig breeds to assess the genetic diversity, inbreeding coefficient, genetic differentiation, and population structure. Results: KWB showed the lowest average expected heterozygosity (HE = 0.1904), while KWH showed the highest genetic diversity (HE = 0.02859) among Korean populations. We verified that the genetic composition of KWH, showing USD of 74.8% and KCC of 25.2% in ADMIXTURE analysis. In population structure analyses, KCC was consistently shown to be separated from other pig populations. In addition, we observed gene flow from Western pigs to a part of Chinese populations. Conclusion: This study showed that Korean native pigs, KCC have genetic differences in comparison with Chinese and Western pigs; despite some historical records and recent genetic studies, we could not find any clear evidence that KCC was significantly influenced by Chinese or Western breeds in this study. We also verified the theoretical genomic composition of KWH at the molecular level in structure analyses. To our knowledge, this is the first genomic study to investigate the genomic characteristics of KWH and KCC.

國立大學 敎育施設의 維持管理 및 改善方案

홍세현,이용우,이훈 충북대학교 산업과학기술연구소 2002 산업과학기술연구 논문집 Vol.16 No.1

Since 1980s, the educational facilities of university are getting explosive, because of enlargement of entering high-level education. Consequently, the new educational buildings of university are constructed, but the management of existing facilities is superannuated. And this problem makes difficult to serve amenity spaces for education. In this thesis, I will find out the efficiently management for the educational facilities of university. I will make the problems clear and suggest the improvement by investigating and analyzing the existing state of the facilities, and the appropriation of the budget, in the there national universities in Chungbuk province.

Lipopolysaccharide(LPS)가 Lymphokine 생산에 미치는 影響에 관한 연구

禹元洪,李鏞柱,韓斗錫 圓光大學校 韓醫學硏究所 1992 원광한의학 Vol.2 No.1

In order to evaluate the effects of LPS on the lymphokine production, the change of the levels of IL-2, γIFN and IL-4 meassured in splenocytes of C3H/HeN mice treated with E.coli LPS, S.abortus equi LPS and heated LPS. The results were as follows; 1. The splenocytes isolated from LPS-injected mice produce greatly reduced levels of the T-cell lymphodine IL-2 and γIFN following activation in vitro with the polyclonal T-cell stimulant anti-CD3 and the production of IL-4 elevated in comparison to normal cotrols. 2. The levels of IL-2 and γIFN in the mice were treated with 5μg-LPS for 3 days elevated and IL-4 reduced continuously from one day later and the levels of 3 kinds lymphokine recovered to a normal value 13 days later. 3. The levels of IL-2 and γIFN in the mice were treated with 5μg-LPS for consecutive 2 weeks reduced and IL-4 elevated greatly at 3 days and the levels of 3 kinds lymphokine recovered to normal value 2 weeks later. 4. In the mice were treated with E.coli LPS and S.aboruts equi LPS, the change of the levels of IL-2, γIFN and IL-4 were not difference between E.coli LPS injected group and S.atortus equi infected group. 5. In the mice were treated with normal LPS and heated LPS, the change of the levels of IL-2, γIFN and IL-4 were not difference between normal LPS injected group and heated LPS injected group.

흉부외상 환자에서 응급 전산화 단층촬영의 효용성에 관한 분석

우건화,김원율,김경환,김홍용,이기재 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.1

Background. Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography(CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest injuries are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. Methods. To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. Results. Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings, Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3% and 45.1% respectively), whereas 65.7%(44/67) of patients had thoracostomy only by CXR. Conclusion. Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.

어음의 善意取得에서 治癒되는 瑕疵의 範圍

禹洪九,鄭容相 건국대학교 1996 學術誌 Vol.40 No.1

In modern society the negotiability of a bill should be guaranteed in order to carry out its native function. There are defence, the institution of the good faith purchase of a bill, and the separate rule of a bill action for it. Because of these institutions, the negotiability of the transactions of a bill is promoted. It's important to protect both the negotiability of a bill and the debtor of a bill. The harmony of interests between the creditor of a bill and the debtor of a bill is guaranteed under the law of Bill. The institution of the good faith purchase of a bill is to harmonize between the creditor of a bill and the debtor of a bill. In Korea the institution of the good faith purrchase of a bio originated from the institution of the good faith purchase of chattel historically. But the good faith purchase of a bill is easier than that of chattel based on Civil law. The conditions of the good faith purchase of a bill are as follows. Firstly a bill should be obtained by the method of the law of a Bill. Secondly the indorsement of a bill should be continued. Thirdly a bill should be acquired by a rightless person. Fourthly the purchaser of a bill should have no bad faith and gross negligence. Fifthly there should be personal economic interests in association with the purchase of a bill. In this thesis a writer is inclined to examine whether a bill is obtained from a rightless person or the good faith purchase of a bill is recognized in case of defect of purchase of a bill(eg.assignor's disability, rightless agency, defect of manifestation of intention)with the exception that an assignor is a rightless person. In this connection there are serious conflicts of theories for it. A writer supports the position to recognize the good faith purchase of a bill restricted a rightless person on the basis of interpretation of the current Law of a Bill, general provision of private law and realization of legal stability The system of this thesis is as follows. 1.Introduction. 2.The controversies concerning scope of defect. A writer briefly introduces legislative examples concerning the good faith purchase of a bill, analyzes the controversies concerning the scope of defect in Korea, Japan and Germany through theories and cases. 3.Conclusion A writer analyzes the basic background of controversies concerning the scope of defect, presents a legal interpretation and legislative opinion.

Cone beam형 전산화단층영상에서 골의 형태와 밀도의 평가

홍상우,김규태,최용석,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.1

Purpose : Diagnostic estimation of destruction and formation of bone has the typical limit according to capacity of x-ray generator and image detector. So the aim of this study was to find out how much it can reproduce the shape and the density of bone in the case of using recently developed dental type of cone beam computed tomography, and which image is applied by new detector and mathematic calculation. Materials and Methods : Cone beam computed tomography (PSR 9000N, Asahi Roentgen Ind. Co., Ltd., Japan) and soft x-ray radiography were executed on dry mandible that was already decalcified during 5 hours, 10 hours, 15 hours, 20 hours, and 25 hours. Estimating and comparing of those came to the following results. Results : The change of inferior border of mandible and anterior border of ramus in the region of cortical bone was observed between first 5 and 10 hours of decalcification. The reproduction of shape and density in the region of cortical bone and cancellous bone can be hardly observed at cone beam computed tomography compared with soft x-ray radiography. The difference of decrease of bone density according to hours of decalcification increase wasn’t reproduced at cone beam computed tomography compared with soft x-ray radiography. Conclusion : CBCT images revealed higher spatial resolution. However, contrast resolution in region of low contrast sensitivity is the inferiority of images’ property.