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.

강원도 화천군 수달(Lutra lutra) 서식지의 식생 구조

서형수 ( Hyung Soo Seo ),신영섭 ( Young Seob Shin ),이경은 ( Kyung Eun Lee ),김윤미 ( Yoon Mi Kim ),전미나 ( Mina Jeon ),남택우 ( Taek Woo Nam ),한성용 ( Sung Yong Han ),정연숙 ( Yeonsook Choung ) 한국하천호수학회 2014 생태와 환경 Vol.47 No.special

In order to determine whether vegetation would be one of the factors for the selection of otter home range, vegetation structure and other potential factors were studied in Hwacheon, Korea. Thirteen sites, otter’s activity found and not found, were investigated in North Han River and connected tributary streams of Hwacheon-gun. Three types of vegetation were classified by cluster analysis, which is short grass, tall grass and shrub type. Vegetation zone of each channel is composed of either one type, or mosaic of tall grass and shrub type. Short grass type is common in Lake Paro and upper North Han-river where water level is highly variable throughout a year. Therefore, annual species such as Persicaria nodosa, Fimbristylis dichotomam and Chenopodium ficifolium are the most dominant. Shrub type is common at the downstream sites of Jichon stream and along mainstream of North Han River down Lake Paro. A shrub species, Salix koreensis, is the most common. Tall grass type is dominant occupying the most vegetation zone of the tributary channels. Phragmites japonica is absolutely dominant. Due to its dense cover, a few plant species are co-existed. Otter activity was found in all three vegetation types and no marked activity was found at some sites of tall grass type. There is no difference in species composition and physiognomy between tall grass sites with and without otter activity, while it shows significant difference in fish availability between two groups. Overall we found that home range of otters in the region is along the mainstream and downstream of tributary streams with high fish availability in all vegetation types and in various human activity levels.

EXPERIMENTS ON THE INTERACTION OF WATER SPRAYS WITH POOL FIRES

Han,Yong-Shik,Kim,Myung-Bae,Shin,Hyun-Dong 한국화재소방학회 1997 한국화재소방학회 학술대회 논문집 Vol.1997 No.-

A series of measurements and visualization to investigate the interaction of water sprays with pool fires is presented. Fire source is a small-scale pool burner with methanol, ethanol and gasoline. Measurements of temperatures, <TEX>$O_2$</TEX>, <TEX>$CO_2$</TEX>, and CO concentrations along the plume centerline are carried out to observe pool fire structures without water sprays. Visualization by the Ar-ion laser sheet shows flow pattern of droplets of the sprays above the pool fires. It is observed that in the case of methanol and ethanol, water sprays continuously penetrate into the center of fuel surfaces. The gasoline pool fire allows intermittent penetration of water sprays because of pulsating characteristics of the gasoline flame. To evaluate the cooling effect of the fuel surface by the sprays, the temperature was measured at the fuel surface. As soon as the mists reach the fuel surface of methanol and ethanol, the temperatures of the fuel surface decrease rapidly below the boiling point, and then the fires are extinguished. Due to the application of mist upon the gasoline fire, though the fuel temperature decrease abruptly at the time of the injection, such a rapid decrease do not continue till the extinction point.

Pool 화재에서의 표면 냉각에 의한 소화

한용식,김명배,신현동 (社團法人) 韓國火災 ·消防學會 1997 한국화재소방학회논문지 Vol.11 No.4

고무질 보강 식품포장용 LDPE필름의 기계적 강도와 기체투과 선택성

한신,강용구,박찬영 전남대학교 촉매연구소 2000 觸媒硏究 論文集 Vol.21 No.-

To improve the mechanical strength of the functional LDPE packaging film that has deficiency in the strength, though the film is active in vitality and has selective permeability for specific gases such as ethylene and carbon dioxide, this work blends a rubbery polymer, ethylene propylene monomeric rubber(EPM), in the LDPE film, and examines the mechanical strength and the permeability to assess preserving the functionality of freshness keeping of product. Overcoming the defect of incomplete coupling of the ceramic powder to the LDPE film is to use a coupling agent KBM-503( γ -methacryloxy propyl trimethoxy silane) of Shinetsu company in Japan. The optimum blending ratio of the EPM was about 5 percent in weight. The blended film reserves the selective gas permeability in relatively equivalent capacity of the non-rubbery film. The 5 percent EPM blended film has stronger mechanical strength than that made without the EPM, The strength approaches to the pure LDPE film. In conclusion, this work presents the method of improving mechanical strength without any depression in its freshness keeping functionality of the conventional packaging film.

Clonidine의 투여가 수술 후 통증 조절에 필요한 morphine 요구량에 미치는 효과

신용섭,한규철 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

To investigate the effect of intravenous clonidine on morphine requirements in the postoperative period, 20 ASA physical status 1 patients who had undergone spinal surgery were studied. Clonidine group (10 patients) received clonidine 3 ㎍/kg intravenously 30 min before endotracheal extubation and received morphine infusion through a patient-controlled analgesia device (bakground infusion, morphine 10 ㎍/kg/hour ; subsequent dose, morphine 20㎍/kg on demand ; lockout time 10 minutes). The control group (10 patients) received only morphine with same device. At the following times : 30 min, 1, 3, 5 and 24 hour after endotracheal extubation, pain intensity and sedation score were evaluated. Also, arterial blood pressure, respiratory rate and any side effects were recorded. There were no significant differences between the clonidine and control groups with respect to postoperative pain. The amount of morphine delivered was lower in the clonidine group compared to the control group, but there was no significant difference between clonidine and control groups. The clonidine group was accompanied by sdation and decreased arterial blood pressure 30 min after endotracheal extubation. There was no significant difference in respiratory rate at any time interval. These results suggest that during the 24 hours following spinal surgery, postoperative morphine requirements could not be reduced significantly by single intravenous administration of clonidine 3 ㎍/kg.

니트섬유강화 복합재료의 기계적 성질에 관한 연구

한길영,이동기,최병기,오환교,신용욱,전수영 조선대학교 에너지.자원신기술연구소 1999 에너지·자원신기술연구소 논문지 Vol.21 No.2

Using conventional textile techniques such as weaving, braiding, knitting and stitching it is possible to produce a wide range two and three dimensional fiber preforms. However, so far only a limited attention has been given to knitted fabrics in composite industry. This is mainly due to the opinion that knitted fabric reinforced composites posses low mechanical properties owing to their looped fiber architecture. But it is possible to obtain desired mechanical properties by selecting proper knitted fabric structure. In this paper, tensile failure load and displacement of one yarn, four yarns and knitted fabrics of ten yarns of kevlar fiber were determined experimentally in the unidirection. Mechanical properties of plain weft knitted fabrics reinforced composite intrusion beam for car side door application were investigated experimentally, which compared with desire value of American Fedral Motor vehicles Safety Standard (FMVSS) and presented the results.

대량의 각혈로 사망한 장티푸스 1예

한상우,유진홍,권순석,김성훈,박지찬,홍은정,최경성,박용완,장준희,안지원,박유경,강지영,박상미,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

구리의 전기석출시 젤라틴이 물성에 미치는 영향

신석재,강현춘,안형환,강안수,김용렬,한성만,이한섭 明知大學校 産業技術硏究所 1995 産業技術硏究所論文集 Vol.14 No.-

In the electrodeposition of copper foil for preparing printed circuit boards, a little amount of gelatin as a addition agent has been used for the better characteristics of a coat of electroplating. Gelatin modifies the physical properties such as mechanical strength, matte-side roughness, ultimate tensile strength(U.T.S), and elongation of copper foil, furthermore gelatin have influence on the structure of electrodeposits and the cathode polarization. The electrolyte used was of a composition; CuSO₄·5H₂O 300g/ℓ, H₂SO₄ 100g/ℓ, NaCl 10 ppm as a brightner, and was gelatin 0-7 ppm as a addition agent. Current density was 50 A/dm², and the temperature of electrolytic bath was 50 to 52 ℃. Experiments showed that the optimum gelatin concentration was 5 ppm with the consideration of the numbers of electrodeposited nuclei. And the nuclei numbers was sharply increased under 5 ppm, but was almostly constant above 5ppm. Average matte-side roughness by Surfcorder was gradually increased with the increasing gelatine concentration up to 2 ppm, and maximum roughness was observed at 2ppm. The roughness showed gradual decrease within the concentration range of 2 to 4 ppm, and was almost constant above 4ppm . Within the gelatine concentration range of 0 to 7 ppm, as the concentration increased, UTS was increased and elongation was decreased logarithmically. Also, in comparison between UTS and elongation, gelatin was identified as an addition agent acting inversely.

社會體育 活動의 滿足度 評價

한이석,신용업 龍仁大學校 1991 용인대학교 논문집 Vol.7 No.-

The purpose of this study was to examine and explicate the concept of Recreation satisfaction and to describe the development and adequacy of an instrument to measure it. Examination of the concept of Recreation satisfaction is relatively new and research reports on the topic only recently have begun to appear fine the literature. yet, despite the recent and increasingly frequent research efforts, knowledge of this subject remains limited. A major goal of recreation services and Leisure service is to contribute to individuals' satisfaction and pursuit of happiness. In addition, researchers have expressed the importance of Recreation as an aid in the process of "need gratification". However, the research of Recreation satisfaction as a concept has had little attention. Recreation satisfaction, therefore, appears to be a potentially important concept for Recreation researchers as well as practitioners.