정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

고압전류 감전자에게서 나타난 말초신경병증 증례보고

손준석,김영욱,채창호,민경범,이철호 대한산업의학회 2006 대한직업환경의학회지 Vol.18 No.4

Background: With increasing industrial development, opportunities are growing to contact electricity in the workplace or home. Therefore, the risk of electrical accident has been increased gradually. In general, electrical injuries involve the extremities and result in amputation or severe disability of limbs. Delayed spinal cord injury and peripheral neuropathies following electrical accidents are extremely rare. Case report: A 32-year-old man with 10 years working experience at a CRT-monitor manufacturer with repetitive exposures to high voltage current visited our hosipital. He complained of left leg weakness and atrophy, and intermittent pain. The symptoms were progressive. Other symptoms occurred such as nocturia, hesitancy, and weak urinary stream. We examined the patient and conducted EMG, L-spine MRI, neurometer test, isokinetic strength test, and physical examination. The results showed neural injuries due to anterior horn lesions or compression of the left femoral nerve pathway, with a consequent diagnosis of neurogenic bladder.

(Tl0.6+x Pb0.2Bi0.2)(Sr1.0Ba0.2)Ca₂+y Cu₃O9+δ명목조성에서의 TI-1223/Ag복합선재 제조연구

손영국,김형욱 釜山大學校生産技術硏究所 1999 生産技術硏究所論文集 Vol.56 No.-

(Tl0.6+x Pb0.2Bi0.2)(Sr1.0Ba0.2)Ca₂+y Cu₃O9+δ명목조성(x=0 또는 0.2, y=0 또는 0.2)으로부터의 다결정 Tl-1223 상을 합성할 때 열처리온도와 상생성가의 관계를 연구하였다. 단일상 Tl-1223분말을 합성한 후 Tl-1223/Ag 복삽선재를 제조하였다. 열처리과정에 따른 Tl-1223/Ag선재의 특성변화를 관찰하였다. Bulk상은 잘 연결된 판상이였으나 선재에서는 그렇지 못하였다. 선재에서의 전류밀도는 낮았고 주요요인은 Tl의 증발로 생각되며 ICP분석이 이를 확정하였다. 그러므로 향상된 Tl-1223/Ag복합선재를 제조할 때는 과량의 Tl을 함유한 green powder mixture을 사용하였다. Tl-1223/Ag복합선재를 제조하고 열처리한후 전류밀도를 측정하였다. 관측된 grain은 잘 연결된 판상이였으며 topotactic성장을 하였다. 전류밀도는 OT, 77K에서 9.6×10³A/㎠이였다. 그리고 복합선재의 초전도특성과 제조조건, 미세구조와의 관계도 조사하였다. The phase formation relationship with heat-treatment temperture of Tl-1223 phase poly-crystalline bulk from (Tl0.6+x Pb0.2Bi0.2)(Sr1.0Ba0.2)Ca₂+y Cu₃O9+δ nominal composition (y=0 or 0.2) was investigated. And a single-phase Tl-1223 powder has been prepared and used to produce Tl-1223/Ag composite tape. The change of characteristics of Tl-1223/Ag compostie tape according to heat-treating procedure was observed. The bulk was found to have well-linked and platelike morphology but the tape was not. Transport current density of the tape was low. The evaporation of Tl was regareded as main factor, and ICP analysis confirmed it. Therfore, Tl rich green powder mixture was used to fabricate improved Tl-1223/Ag composite tape. Tl-1223/Ag composite tape was produced and heat-treated. Transport current density of heat-treated tapes was measured. The morphology of grains was platelike and well-linked. Topotactic grain growth was observed. A trasnport current density of 9.6×10³A/㎠ was obtained at 77K OT. The relationship between processing condition, microstructure, and superconducting properties of the tape were also investigated.

Silorane-based 복합레진의 색안정성에 관한 연구

손유진,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

본 연구의 목적은 silorane-based 복합레진의 색안정성을 기존의 methacrylate-based 복합레진과 비교하여 평가하는 것이다. Silorane-based 복합레진인 P90(3M ESPE, USA), methacrylate-based 복합레진인 Tetric Ceram(Ivoclar Vivadent, Liechtenstein), Z250, Z350(3M ESPE, USA)을 이용하여 시편을 제작하고, 증류수, 커피, 레드 와인, 카레 용액에 담가 1일, 3일, 7일, 14일, 21일, 28일 후 색 변화를 분광광도계로 측정하고 실험 전후의 색상차이(ΔE*_(ab))값을 산출하여 다음과 같은 결과를 얻었다. 1. 카레 용액 > 레드 와인 > 커피 > 증류수의 순으로 레진 시편의 변색이 크게 나타났다. 2. 네 가지 종류의 레진을 비교하였을 때, Z350 > Z250 > Tetric Ceram > P90의 순으로 변색이 크게 나타났다. 3. 카레 용액의 경우 네 종류의 레진 모두에서 침지 1일 이후 수용도 역치 이상(ΔE*_(a)b>3.3)의 변색이 나타났다. 4. 레드 와인의 경우 Z350, Z250, Tetric Ceram에서 침지 1일 이후, P90에서는 침지 28일 이후에 수용도 역치 이상의 변색이 나타났다. 5. 커피의 경우 Z350에서 침지 1일 이후, Z250에서 침지 3일 이후, Tetric Ceram에서 침지 7일 이후에 수용도 역치 이상의 변색이 나타났으나 P90에서는 침지 28일 이후에도 수용도 역치 이상의 변색이 나타나지 않았다. The objective of this study was to evaluate the color stability of new silorane-based composite resin compared with methacrylate-based composite resins after immersion in 3 staining solutions. One silorane-based composite(Filtek P90) and 3 methacrylate -based composites(Filtek Z250, Filtek Z350, Tetric Ceram) were evaluated. Twenty disk-shaped specimens(10×2mm) of each of 4 composite resins were prepared. The specimens were then divided into 4 groups of 5 specimens each and immersed in 3 staining solutions( coffee, red wine, curry solution) or distilled water(control) for 28-day test period. Color of the specimens was measured with a spectrophotometer(Color Eye 7000A) using CIE L*a*b* color space relative to CIE standard illuminant D65 at baseline, 1day, 3days, 7days, 14days, 21days and 28days after staining. The color differences( ΔE*_(ab)) were calculated. The results were obtained as follows ; 1. The mean color changes(ΔE*_(ab)) of the composites were greatest in curry solution, then red wine, coffee and distilled water, in decreasing order. 2. The mean color changes(ΔE*_(ab)) of the composites were greatest in Z350, Z250, Tetric Ceram and P90, in decreasing order.

최근 8년간(2001-2008) 서울대학교치과병원 소아치과의 진료현황 및 수익분포 변화에 대한 조사

손유진,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008. 소아치과 전문 지역 의원의 증가, 소아치과에 대한 보호자의 인식 변화, 치의학의 발전, 소아치과 진료 범주의 확대 등에 의해 최근 소아치과의 진료 양상이 크게 변화하고 있다. 이러한 변화 양상을 파악하고 앞으로의 대학병원 소아치과 및 소아치과 전문 지역 의원의 진료분담에 대한 방향성을 제시하고자 본 연구를 시행하였다. 2001년 1월 1일부터 2008년 12월 31일까지 서울대학교치과병원 소아치과에 내원한 모든 초진 및 재진 환자를 대상으로, 서울대학교치과병원 종합의료정보시스템(OCS)을 통하여 1년간의 외래환자집계 및 수가코드별 진료 행위 건수 및 수익 분포를 조사하여 다음과 같은 결과를 얻었다. 1. 내원환자의 수는 2001년부터 2005년까지 대체로 증가하다 2006년에 감소하였으며 그 이후에는 2006년도와 별다른 변화가 없었다. 2. 2001년에는 예방치료가 6.84%, 수복치료가 49.96%, 치수치료가 9.64%, 외과치료가 10.78%, 교정치료가 22.78%를 차지하였으나, 2008년에는 예방치료가 15.40%, 수복치료가 28.97%, 치수치료가 3.28%, 외과치료가 14.83%, 교정치료가 37.52%를 차지하여 수복치료와 치수치료의 비율은 감소하고 예방치료와 교정치료는 증가하였다. 3. 수복치료의 비율에 있어서 아말감과 글라스 아이오노머 수복 및 기성금관수복의 비율은 감소하였고, 레진의 비율은 증가하였다. 4. 진정요법하 치과치료는 2005년까지 증가하다 2006년, 2007년에는 감소하였고, 2008년에 다시 증가하였다. 5. 전신마취하 치과치료는 2001년부터 2008년까지 꾸준히 증가하였다.

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.

접착제와 와동형성의 차이에 따른 5급 복합레진 수복의 전향적 임상연구

이경욱,정세준,한영철,손호현,엄정문,오명환,조병훈 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.4

본 연구의 목적은 복합레진을 이용한 비우식성 치경부 5급 병소 수복에 있어서, 3가지 다른 접착제를, 유지구를 부여한 치아와 부여하지 않은 치아에 적용하였을 때의 임상적인 효능의 차이를 비교하기 위함이다. 총 150개의 치아를 각각 25개씩 6개의 군으로 나누었다. A군 Scotchbond Multi-Purpose (SBMP, 3M ESPE, St, Paul, MN, USA, 4세대 접착제)를 사용하고 유지구를 부여하지 않음. B군: SBMP를 사용하고 유지구를 부여. C군: BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5세대 접착제)를 사용하고 유지구를 부여하지 않음. D군: BC Plus를 사용하고 유지구를 부여. E군: Adper Prompt (3M ESPE, Seefeld, Germany, 6세대 접착제)를 사용하고 유지구를 부여하지 않음. F군: Adper Prompt를 사용하고 유지구를 부여. 모든 치아는 복합레진인 Denfil(Vericom Co., Anyang. Gyonggido. Korea)을 이용하여 충전하였다. 수복 직후와, 수복 6개월 후에 modified USPHS (United States Public Health Service) criteria에 따라 수복물을 임상적으로 평가하였다. 추가적으로 임상사진을 촬영하였으며, 에폭시 레진을 이용하여 복제한 후 주사전자현미경을 이용하여 이를 관찰하였다. 6개월 후 관찰 결과. alpha rating의 수가 각 실험군마다 동일하지는 않았지만, 통계적으로는 3가지의 접착제간에 유의할만한 차이는 없었고, 기계적인 유지구를 부여한 군과 부여하지 않은 군 간에도 유의할만한 차이는 없었다 (p > 0.05). 그러나 6개월의 관찰 기간은 일반적으로 기대되는 레진의 수명보다 짧기 때문에, 각 실험군 간의 차이를 알아보기 위해서는 추후 더 오랜 기간의 관찰이 요구된다. The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty nine healthy adults who had at least 2 NCCLs in their promolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups; (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St, Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves: (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves: (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin, Denfil (Vericom Co., Anyang, Gyeonggido, korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United states Public Health Service) criteria, Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpah ratings, there was no significant difference among the 3 adhesive systems (p > 0.05). There was also no significant difference between the groups with or without mechanical retention (p > 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves. 〔J Kor Acad Cons Dent 31(4):300-311, 2006〕

지속성 외래 복막투석 환자의 복막염

신영태,황평주,김종학,강민규,구영선,양종오,장윤경,이강욱 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

CAPD has established itself as an effective method maintaining the patients with end stage renal disease. CAPD peritonitis is one of the most important complication of peritoneal dialysis. We analyzed the incidence, pathogens, and outcome of the peritonitis, of the 95 patients who underwent CAPD at CNUH from January 1993 to July 1998. The result were as follows : 1) A total of 72 episodes of peritonitis occurred during this periods. The incidence of peritonitis were 0.64/patient/year. 2) The first episode of peritonitis was occurred within a year in 75%, within two year in 95.8%. 3) The rate of positive and negative culture were 27.8% and 72.2% respectively. Gram positive organisms were cultured in 60%, Gram negative organisms in 40%. S. aureus were most prevalent organisms(30%). 4) The cure rate were 83.3% in Gram positive organisms and 62.5% in negative organisms. 5) Peritoneal catheter were removed in 18 cases. Among them, 7 cases are due to peritonitis. In conclusion, improved technology and increasing patients' effort to careful management of catheter will reduce the incidence of peritonitis.

하악 대구치 근심근관에 대한 전자근관장 측정기의 정확도

조영린,손욱희,황호길 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.6

근단부위 형성이 완료되고 우식이 없는 하악 대구치 근심치근 50개를 대상으로 주파수 의존형 전자근관장 측정기를 이용하여 측정한 근관장의 정확도를 평가하기 위해 치수강 개방 후 동일한 치아에서 방사선 사진으로 확인한 실측 근관장을 대조군, 각종 전자근관장 측정기로 측정한 근관장을 실험군 (Ⅰ군: Root-ZX, Ⅱ군: Bingo, Ⅲ군: Propex, Ⅳ군: Diagnostic)으로 분류하여 근심협측과 설측의 근관장을 근관의 입구 측으로부터 치근단 1/3까지 확대여부 및 서로 다른 측정시기에 비교 평가한 결과 다음과 같은 결론을 얻었다. 하악 대구치 근심치근의 협측과 전자근관장은 측정기의 종류, 근관의 입구 측으로부터 치근단 1/3까지의 확대여부 및 측정시기에 상관없이 0.5 ㎜ 이내의 오차범위를 나타내었으며, 근관치료시 오차한계인 ± 1 ㎜ 에서 정확성은 근관의 입구 측으로부터 치근단 1/3까지 미리 확대한 후에 근관장을 측정할 경우와 측정시기가 반복될 경우에 증가되는 경향을 보여 임상에 유용하게 활용할 수 있을 것으로 사료된다. The aim of this study was to compare the length between the mesio-buccal and mesio-lingual canal of the mandibular molars before and after early coronal flaring at the different measuring time using several electronic apex locators. Fifty mandibular molars with complete apical formation and patent foramens were selected. After establishing the initial working length of the buccal and lingual canal of the mesial root using a surgical microscope (Carl Zeiss Co. Germany) at 25X with #15 K-file tip just visible at the foramen, radiographs were taken for the working length. After measuring the length of mesio-buccal and mesio-lingual canal (control group), the electronic lengths were measured at different times using several electronic apex locators (experimental groups; Ⅰ-Root ZX, Ⅱ-Bingo, Ⅲ-Propex, Ⅳ- Diagnostic). After early coronal flaring using the K^(3) file, the additional electronic lengths were measured using the same manner. The results were as follows: One canal has a correct working length for the mesial root of the mandibular molar, it can be used effectively for measuring the electronic working length of another canal when the files are superimposed or encountered at the apex. In addition, the accuracy of the electronic apex locators was increased as the measurement was accomplished after the early coronal flaring of the root canal and the measuring time was repeated.

地震波를 받는 基礎-地盤 相互作用계에서의 波消散 效課

金宗周,孫榮浩,崔鎭旭,崔光圭 東亞大學校 海洋資源硏究所 1992 硏究論文集 Vol.5 No.2

In this study , the dynamic analysis procedure of foundation -soil interaction system subjected to seisemic wave is presented . The foundation is placed on a linear elastic , isotropic and homogeneous half space representing the soil medium. The boundary element model of half space and the finit element model of foundtion are coupled together by enforcing compatibility condition of displacements and equilibrium condition of traction on the contact surface. The acuuracy of the proposed method si vertified throough the conparison studies with results reported method is that it provides directly the transient response unlike the frequency domain techniques.