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.

만성정신분열병의 우울증상에 대한 Nortriptyline의 효과

崔龍成,金容植,趙斗英 大韓神經精神醫學會 1985 신경정신의학 Vol.24 No.3

Authors studied the antidepressant effect of nortriptyline on depression and withdrawal in admitted male chronic achizophrenic patients by dcuble blind method for 5 weeks of duration at Yong-In Mental Hospital. Sample size was forty one cases consisting of 21 nortriptyline group and 20 placebogroup. The results were as follows: 1) In nortriptyline group, there were no signif-icant change in mean BPRS scores, compared with those of placebo group. However decrease of mean BPRS score irom 11.50 to 6.54 was observed. 2) There were no significant change in mean BDI scores in nortriptyline group compared with those of placebo group but also decrease of mean BDI score from 40.90 to 35.23 was observed. 3) In nortriptyline group there were no signif-icant change of total DOTES scores throughout the study. None of total DOTES scores was found to be significantly different from those of placebo group.

난소절제가 흰쥐 대동맥의 미세구조에 미치는 영향

최용귀,전영희,백태경,백두진,정호삼 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.2

Alprazolam함유 poly(D,L-lactic acid) microsphere의 제조 및 평가

용철순,오두만,권미라,박새해 영남대학교 약품개발연구소 1996 영남대학교 약품개발연구소 연구업적집 Vol.6 No.-

Poly(D.L-lactic acid)(PLA) microspheres containing alprazolam(APZ) were prepared by a solvent-emulsion evaporation method and their release patterns were invostigated in vitro. Various batches of microspherss with different size and drug content were obtained by changing the ration of APZ to PLA, PLA concentration in the dispersed phase and stirring rate. Rod-like APZ crystals on microsphere surface, which were released rapidly and could act as a loading dose, were observed with increasing drug content. The release rate was increased with increase in drug contents and decresase in the molecular weight of PLA. The release rate of APZ for long-acting injectable delivery system in vitro, which would aid in predicting in vivo release profile, could be controlled by properly optimizing various factors affecting characteristics of microspheres.

덱사메타손 21-아세테이트를 함유한 콘드로이틴 설페이트/젤라틴 마이크로스피어의 제조 및 평가

용철순,김영주,오두만 영남대학교 약품개발연구소 1997 영남대학교 약품개발연구소 연구업적집 Vol.7 No.-

Chondroitin sulfate/gelatin microspheres containing dexamethasone 21-acetate were prepared by complex coacervation method and their release patterns were examined in vitro. Microspheres prepared with a small amount of crosslinking agent had smooth surface and few pores, but those with a large amount of crosslinking agent were more porous and less spherical. In vitro release patterns were varied by changing polymer/drug weight ratio and amount of crosslinking agent. The release rate of dexamethasone 21-acetate in the presence of collagenase was faster than that in the absence of collagenase. Anti-inflammatory effect of dexamethasone 21-acetate microspheres was more efficient than that of dexamethasone 21-acetate solution in carrageenan-induced arthritis in the rat. On the basis of the above results. we might expect the degradation and drug release rate of these microspheres to be regulated by the degree of crosslinking and the level of enzymes. In patients with sever rheumatoid arthritis who have high concentration of collagenase, more drug would be released from the microspheres. An intra-articular injection therapy of rheumatoid arthritis with desired release kinetics could be developed to enhance patient compliance and therapeutic index.

HrSOD-폴리에칠렌 접합체의 아세트아미노펜 간독성에 미치는 영향

용철순,박경아,오두만 영남대학교 약품개발연구소 1996 영남대학교 약품개발연구소 연구업적집 Vol.6 No.-

The covalent conjugation of human recombinant superoxide dismutase (hrSOD) with trichloros-triazine activated polyethylene glycol (PEG) 5000 formed soluble conjugates with molecular weight of 92KD, which retained 90~98% of original activity with a markedly prolonged plasma half-life of enzyme activity. The effect of hrSOD-PEG conjugates on acetaminophen (ACP)-in-duced hepatotoxicity was tested in male rats which were pretreated with 3-methylcholanthrene. HrSOD-PEG conjugates inhibited the hepatotoxicity produced by ACP, on the other hand, native hrSOD had no protective effect. The above results indicated that oxygen radicals might participate in the mechanism of the ACP-induced hepatotoxicity and that polymer conjugated-protein drugs with prolonged half-lives could be employed as an effective therapeutic agent.

한국 대표팀과 세계 상위 랭커의 핸드몰 경기 분석에 관한 연구

두만균,오용기,박종하 圓光大學校 附設 體力科學硏究所 2005 體力科學硏究 Vol.28 No.-

The subjects of this study are the female handball players of 7 high ranking countries and Korea who participated in the Sydney Olypics 2002 in Australia. Upon closing of the Olympics, an analysis was conducted into the data which were released by IHF in connection with the outcomes of the games between the Korean female handball team and other seven participating countries. The results of the analysis by item are shown below-. 1. From the comparison of attacking power by type and position of each Korean female handball player, no significant difference was found generally except for 6M shoots and feint shoots in a 1 to 1 confrontation, which showed a slight difference(p<.05). In terms of the outcomes by position, players in R·B position were analyzed to record high average in 6M and 9M shoots. while players in C·B position scord high average in 7M shoots. As regards pointw. players in R·W position yielded average points. The speedy attacks appeared to record generally higher scores than other attacks. The players in R·W position scored high points in average. In regard of shoots and scores by feint attack in 1 to 1 confrontation, the players in P·V position showed fairly high average points. The players in C·B position scored higher points while those in R·W position demonstrated higher scording ratio in average. 2. From the analysis into the outcomes of the female handball games between Korea and 7 countries(Norway, Denmark, Rumania, Brazil, Angola, France and Hungary) at Sydney Olympics 2000, there was somewhat significant in terms of attacking position, while there was somewhat significant difference in scording by speedy attacks(p<.05). In detail, Rumanian team recorded higher average in 6M shoots while Danish team showed higher average in 9M position. Angola and Denmark yielded similar average scores in 9M attacks whereas Hungary showed generally low average in 7M Shoots and scores by wing attacks. Denmark got on scores by wing attacks. Hungary proved to be fairly good in feint attack in 1 to 1 confrontation and Brazil harvested a little higher shoots and scords in average.

養鷄經營診斷에 關한 硏究

金容斗 東亞大學校 1966 東亞論叢 Vol.3 No.-

本調査硏究는 養鷄經營의 合理化를 위하여 簡易한 經營診斷의 方法을 究明하고 經營의 改善点을 發見하여 具體的 合理化方案을 摸索하고자, 釜山市內 養鷄農家중에서 400首 以上 飼育하고 있는 農家 32個所를 選定하여 1965年 10月 1日부터 10月 31日까지 實態調査를 하고 硏究分析을 하였는데 그 結果를 要約하면 다음과 같다. (1) 1日 1首 平均 飼料給與量은 131g 平均 飼料費는 2.06원이었으며 平均 産卵率은 53% 販賣鷄卵의 單價는 平均 8.7원이었다. (2) 總支出중의 飼料費比率은 平均 83% 總收入중의 卵代比率은 平均 86%를 차지하고 있었으며, 産卵鷄 100首當 年平均 收益은 約 10萬원이었다. (3) 簡易한 經營診斷의 方法으로 다음과 같은 採算指數를 求하여 採算指數가 100% 以上이면 黑字經營으로 看做하였는데 調査結果 平均採算指數는 216%었다. 鷄卵 1個代金×産卵率÷總收入중의 卵代比率 採算指數(%) = ----------------------------------------- 1日 1首 飼料費÷總支出중의 飼料費比率 8.7×0.53÷0.86 ×100 = --------------------- ≒ 216% 2.06÷0.83 (4) 經營의 合理化를 위하여 施設의 改善, 優良鷄 普及, 飼養의 啓蒙, 自給飼料(牧草)의 生産 및 徹底한 防疫이 要望된다. (5) 經營의 安定化를 위하여 飼料의 適切한 需給調節 및 飼料價의 安定과 卵價安定이 要望된다. This report aims to get a simple method of the management test for the retaionalization of poultry management and improvement. In order to gain a rationalized plan, the test has selected 32 farm-houses which hold over 400 chickens in the Pusan city. Then the actual condition of chickens was investigated from 1 Oct. 1965 to 31 Oct. 1965. The summalized results of the research are as follows; 1. Average 131 gr. of feed for poultry per a chicken are a dosage of a day, the average feed costs 2.06 won, the average laying rates 53 per cent, and the average price of each egg is 8.7 won. 2. This management test demonstrated that the feed cost rate in the total expense was 83 per cent, the egg cost rate in the income was 86 per cent, while the profits per 100 chickens were 100 thousands won annually. 3. According to the method of a simple management test, an index of the commercial profit has got the results as follows; As the commercial profit index exceeds 100 per cent, the poultry raising management is calculated by a benifit management. The average commercial profit index showed 216 per cent in the results of this management test. commercial price of an egg×laying rate÷egg price rate in the total income profit = --------------------------------------------------------------------- index(%) feed cost per a chicken in a day÷feed cost rate in the total expense 8.7×0.53÷0.86 ×100× = ----------------- ≒ 216% 2.06÷0.83 4. All of the farm houses want the improvement of facilities, the spread of well-bred chickens, the enlightenment of feeding, much production of self supply feed (pustures), and the exhaustive preventive of epidemics for the rationalized poultry management. 5. For stabilizing the poultry management, all of the farm houses need for an adequate control of demand and supply of feeds, and a stability of feed and egg prices.

一部 小規模 産業場勤勞者의 一次診療 實態

金容球,金斗熙 慶北大學校 産業開發硏究所 1981 硏究報告 Vol.9 No.-

The present study was conducted to investigate the status of primary health care in small industrial companies with 500 or less employees. I chose 2 dispensaries that were operated by a registered nurse. I studied 2,119 patients (male: 996, famale: 1,123) who visited dispensaries during one calendar year, from December-1979 to November-1980 and the results obtained are as follows. The average frequency of visits to the dispensaries per year was 3.6 times, whith the average visits of males as 4.0 and females as 3.1. Of the total number, 27.3% were injuries and poisonings (XVII of international classification of disease), 19.5% were symptoms, signs and ill-defined conditions (XVI), 17.5% were diseases of the digestive system (Ⅸ), 17.1% were diseases of the respiratory system (Ⅷ). Of the patients who were injured and poisoned, 24.6% were abrasions, 19.9% were open wounds, and 18.5% were contusions. Of 408 cases of the symptoms, signs and ill-defined conditions, 76.2% were headaches. Of the diseases of the digestive system (Ⅸ), about 65% were indigestion and 15% were diseases in the oral cavity. Of the diseases of the respiratory system (Ⅷ), about 86% were common colds. It was possible to treat about 92% of all the cases within 7 days. Monthly distribution of frequency of visits to dispensary showed relatively unique from 8 to 12%. Of the day of a week, monday had the highest number of patients(22%) and sunday, the lowest. More than half of the patients (51.9%) were between the ages of 20 and 24. But the frequency distribution by age group was higher in 20-34 years old group with average three to five times of visits in a year. As educational level is higher, visiting time to dispensary is more frequent. The highest number of injury occurred between second and third hour following each resting period.

효율적인 통합 업무를 위한 정보관리 시스템 구축

박두순,안종근,공용해,정재헌 호서대학교 반도체제조장비국산화연구센터 2001 반도체장비학술심포지움 Vol.2001 No.-

기업의 효율적인 정보시스템 구축은 정보화 사회에서는 반드시 필요하다.또한 기업의 성장 규모, 기업의 요구 사항, 기업의 보다 향상된 업무를 위해 시스템을 능동적으로 구현, 확장, 재구성되어야 한다.이에 정보의 연계, 최신 정보의 효율적 관리를 이용한 구체화와 정보화를 유지할 수 있다.이를 위하여 중소 업체에서는 한 번에 많은 투자를 해야되는 종합 정보화 시스템보다는 생산 관리, 인사 관리, 회계 관리 등 각각에 대한 정보화를 위해 가장 기본적인 프로그램들을 업체의 특성과 차별성을 고려하여 실용 업무에 보다 적합한 자동화 시스템구성의 필요성이 강조된다.따라서 이들 시스템간에 서로 정보를 교환하고, 의사결정을 하는 종합 관리 시스템을 구축하여야 하는데, 이를 위하여 기존에 개발된 영업관리, 생산 관리, 인사 관리, 회계관리 프로그램들을 통합하는 것이 새로운 시스템을 개발하는 것보다 경제적, 기능적 측면에서 매우 유리하다 할 것이다. 본 연구에서는 (주)두양금속의 기존에 사용중인 영업관리, 생산 관리, 인사 관리, 회계 관리 시스템을 통합하고자 이미 구축된 시스템을 분석하고 각각의 독립된 업무를 연계하여 효율적인 정보 관리 시스템을 구축하는 것에 목적을 두고있다.