• Journal of Nutrition and Health
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• 제41권2호
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• pp.147-155
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• 2008

우리나라의 경제적 발달과 문화 수준의 향상으로 질병 양상과 사망 원인에 많은 변화가 있는데, 그 중에서도 최근 당뇨병의 유병률의 상승 현상이 두드러지게 나타나고 있으며, 사망 원인의 수위를 차지하고 있다. 그러므로 이를 예방하고 당뇨병 합병증을 예방하기 위한 구체적이고 근거중심인 영양치료 방법의 제시가 절실한 실정이다. 미국영양사협회에서는 지속적으로 증가하는 당뇨병 유병율을 낮추기 위하여 생활습관의 개선을 목표로 임상영양치료의 표준화 지침을 제시하고 이에 따른 치료 효과 연구가 활발히 진행되고 있으나, 아직 국내에서는 많은 연구가 진행되고 있지 않은 현실이다. 따라서 본 연구에서는 이미 국외에서 사용되고 있는 지침에 근거하여 심층영양교육 방법을 실시하여 그 효과를 1회 교육만으로 시행되는 기본교육 방법과 비교하여 다음과 같으나 결과를 얻었다. 심층 및 기본영양교육 즉, 두 가지 교육 방법을 비교하였을 때 심층영양치료 방법을 실시한 경우 기본영양교육을 실시한 경우보다 혈당, 혈압 및 체중 강하 효과 면에서 유의적으로 개선효과가 있는 것으로 나타났다. 비용효과 면에서 장기간의 혈당변화 상태를 알 수 있는 당화혈색소의 경우 1%를 낮추기 위하여 소요되는 비용은 심층영양교육군에서 더 적었으며, 교육의 잠재 효과를 고려하였을 경우, 모든 혈당 검사 지표의 영양치료 비용 대비 효과 면에서 심층영양교육 방법이 기본영양교육 방법보다 앞서는 것으로 나타났다. 저비용 고치료 효과를 보여주고 있는 임상영양치료는 당노병과 같은 만성질환의 중요한 기본치료로 주목되고 있는 현 시점에서 영양치료행위의 의료 보험 급여화는 국민의 건강을 증진시키고, 국가적으로는 의료비 지출을 감소시키며 국민의 건강을 증진시키는데 큰 기여를 하는 합리적인 방안이라 생각된다. 따라서 현 비급여 수가로 되어 있는 교육수가를 급여화하여 많은 환자들에게 의료 혜택을 주는 일이 필요하리라 사료된다.

• Journal of Acupuncture Research
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• 제24권3호
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• pp.215-229
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• 2007

Objectives : Placebo phenomena have been considered as a confounding factor of clinical trial. Expectancy and belief of acupuncture have not been evaluated quantitatively. The present study was performed to analyze the emotional and cognitive factor .of acupuncture and investigate whether the expectancy of acupuncture treatment is associated with the cognition of acupuncture. Methods : The expectancy and the perception of bodily sensation (PBS) of 22 participants were assessed using self-reported questionnaire. The subjects used the self assessment manikin (SAM) to rate each of the standard affective image of the international affective picture system (lAPS) and other acupuncture-related image. Based on the degree of expectancy, the high expectant (HE) and the low expectant (LE) group were classified. The thermal and pressure pain threshold was objectively evaluated using radiant-heat device and algometer. The degree of expected pain of acupuncture and the actual pain of painful stimulation was subjectively evaluated using facial pain scales (FPS). Results : Using SAlVI analysis, we identified the negative correlation between hedonic valence and arousal dimension on acupuncture-related visual cue. The degree of the PBS and general pain threshold did not show any significant difference between the HE and the LE group. The HE group rated the acupuncture images as more pleasant, more arousing, than the LE group. In addition, we also found that the higher expectancy marked the lower FPS of the expected pain of acupuncture, but not of the actual pain of painful stimulation. Conclusions : Our preliminary study identified the psychological dimensions of acupuncture-related visual cue. These findings indicate that the expectancy of acupuncture could affect the cognition of acupuncture.

• 대한중풍순환신경학회지
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• 제6권1호
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• pp.25-32
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• 2005

Background and purpose: Arterial stiffness is an important, independent determinant of cardiovascular risk. Pulse wave velocity (PWV) has been used as a valuable index of arterial stiffness and as a surrogate marker for atherosclerosis. The Framingham risk score was developed using categorized risk factors to predict the 10 year absolute risk of developing coronary heart disease (CHD). This algorithm is established using recommended guidelines for blood pressure, total cholesterol, and high density lipoprotein cholesterol in addition to age, smoking history and history of diabetes. Tongxinluo(TXL) has been shown to have anti hyperlipidemic activity and anti atherogenic effects. To determine its efficacy and safety, we examined whether TXL improves PWV, ABI, Framingham score, blood pressure, and lipid profile in high risk group of cardiovascular diseases. Subjects and methods: 49 subjects with the high risk of cardiovascular diseases were recruited. Subjects were administered TXL with the dose of 1110mg three times a day for 8 weeks. baPWV, ABI, Framingham risk score, Blood pressure and serum lipid profile were assessed at baseline and after 4 and 8weeks. Results: Total cholesterol, LDL cholesterol, triglyceride, total lipid and phospolipid significantly decreased after 4 weeks of medication. Total cholesterol, total lipid and phospolipid significantly decreased after 8 weeks of medication. There were no significant changes in Framingham risk scores, ABI, PWV and blood pressure. On safety assessment, there were no adverse effects, hepatic or renal toxicity. Conclusion: We suggest that TXL is a safe and useful herbal medicine for hyperlipidemia and as for anti-atherognic effects, further research would be necessary.

• Journal of Nutrition and Health
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• 제44권5호
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• pp.428-442
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• 2011

본 연구의 목적은 한국 일부 여대생 978명 대상으로 로마진단기준에 의한 변비 실태를 조사하고, 변비증상을 가진 자와 정상배변 습관을 가진자들의 생활습관, 배변상태, 월경불편감, 의생활, 주거생활, 식습관 및 식이섭취실태 등을 조사하여 변비와 관련성을 살펴보고 이를 영양교육 자료의 기초를 삼고자 실시하였다. 조사대상자는 인구비례에 근거한 전국 5개지역 소재 (서울/경기, 경상, 충청, 전라, 강원지역) 4년제 대학에 재학 중인 여대생 978명을 대상으로 2008년 5월부터 6월까지 조사를 실시하였다. 1) 조사대상자의 평균연령은 21.6세로 로마기준 II에 의한 변비실태 조사는 정상배변군과 변비군 각각 714명 (73.0%)과 264명 (27.0%)로 나타나 변비유병률은 27.0%로 나타났다. 2) 변비군에서 체중 (p < 0.05)과 체질량지수 (p < 0.05)는 정상배변군보다 더 높게 나타났고 비만도가 높을수록 변비발생 (p < 0.01)과 배변장애요인수 (p < 0.01)가 높았다. 3) 변비군의 경우 기능성대장질환 (p < 0.001)과 과민성대장질환 (p < 0.001), 치질 (p < 0.01)발생률과 대변모양이 비정상적 (p < 0.05)비율이 정상배변군보다 더 높게 나타나 배변상태와 변비여부와 관련성이 있는 것으로 나타났고 속쓰림증과 상복부 통증증상은 정상배변군에서 변비군보다 더 높게 나타났다 (p < 0.001). 4) 배변상태에 이상이 있고 변비가 있을 때 월경불편감을 느끼는 정도가 더 크게 나타났다. 5) 의류 (속옷류) 착용 시 인체에 나타나는 불편한 증상은 정상배변군보다 변비군에서 유의적으로 더 높았고, 의류착용시 편안함이 높을수록 변비 (p < 0.01), 배변장애요인수 (p < 0.01), 기능성대장질환 (p < 0.01), 과민성대장질환 (p < 0.01) 및 월경불편감 (p < 0.01)은 유의적으로 낮았다. 6) 조사대상자의 평상시 식사의 규칙성 조사결과 변비군에서 아침식사가 불규칙적인 경우는 30.3% (p < 0.05), 점심식사와 저녁식사의 불규칙적인 경우는 각각 33.3% (p < 0.05)와 30.8% (p < 0.05)로 나타나 정상배변군보다 더 높게 나타났다. 또한 규칙적인 식사를 할수록 변비증세 (p < 0.01), 배변장애요인수 (p < 0.01), 기능성대장질환 (p < 0.01), 월경불편감 (p < 0.01), 음주률 (p < 0.01) 및 외식률 (p < 0.05)이 낮았다. 7) 식품군다양성점수 (DDS)는 정상배변군에서 4.22점인 반면 변비군에서는 4.12점보다 더 높게 나타나 (p < 0.05) 변비군의 경우 식사의 다양성이 낮았다. 8) 조사대상자의 주생활 요인 인자와 변비여부와의 관련성은 나타나지 않았다. 9) 변비상태와 건강관련 항목과의 관련성을 조사결과 변비가 있을수록 배변장애요인수 (p < 0.01),기능성대장질환 (p < 0.01), 과민성대장증후군 (p < 0.01) 및 월경불편감(p < 0.01)이 높은 것으로 나타났다. 본 연구결과 여대생들의 변비 증세를 감소시키기 위해서는 식생활습관의 정정과 함께 규칙적인 하루 3끼 식습관유지가 중요하고 식품 선택 시 다양하게 골고루 규칙적으로 섭취하는 것이 필요하다. 의류 착용 시 편안한 옷차림을 유지하고 속옷착용 시에도 편안하고 쾌적함을 유지를 통해 신체증후에 나타는 증상을 최소화하는 것이 변비 개선에 중요할 것으로 사료된다. 추후, 가임기 성인여성 변비 예방을 위한 올바른 생활습관을 유지 및 개선 할 수 있는 실생활 교육지침과 기초자료 제공이 필요하다.

• 동의생리병리학회지
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• 제22권6호
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• pp.1611-1620
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• 2008

This clinical research was conducted to test patients with Atopic Dermatitis by external application with Hwangryeonhaedok-Tang in cosmetics. We gave scores to 31 patients who visited the Dept. of Oriental Medical Opthalmology & Otolaryngology & Dermatology of Semyung University Jecheon Oriental Medical Hospital from May 15th, 2008 to June 26th. Fifteen patients were treated with the ointment that contain Hwangryeonhaedok-Tang (experimental group) and sixteen patients were treated with normal ointment that doesn't have Hwangryeonhaedok-Tang (control group) for 4 weeks. We observed change of total IgE, eosinophil count, Skin Temperature, Transepidermal Water Loss(TEWL), Skin Hydration and Skin pH. Also Clinical Index of Atopic Dermatitis(SCORAD Index) and global assesment of efficacy were used to evaluate the effects of Hwangryeonhaedok-Tang. Statistical analysis was performed by using frequency analysis and descriptive analysis. Statistical significance was achieved if the probability was less than 5%(p<0.05). After 4 weeks of external application treatment, SCORAD Index in experimental group was significant statistically decreased compared with control group. After 4 weeks of external application treatment, total IgE of both groups were decreased and eosinophil count in control group was decreased but experimental group was unstatistically decreased. Unstatistically, both groups didn't showed significant effect on Skin Temperature. Transepidermal Water Loss(TEWL) in both groups were increased but experimental group was significant decreased compared with control group. Skin Hydration in experimental group was significant statistically increased compared with control group. Statistically, both groups didn't showed significant effect on Skin pH. Only experimental group showed little increase. After 4 weeks of external application treatment, experimental group showed significant effect on global assesment of efficacy. Considering the above results, we can speculate that cosmetics with Hwangryeonhaedok-Tang has some therapeutical effects in mitigating the symptoms of Atopic Dermatitis.

• 대한임상독성학회지
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• 제11권1호
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• pp.9-18
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• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권2호
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• pp.279-285
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• 2005

목적 : 이 연구에서는 장시간 약물작용이 지속되는 MPH-OROS를 주의력결핍과잉운동장애 아동에게 투여하여 그 효용성과 안전성 및 부모 만족도를 평가하려고 하였다. 방법 : 연구대상은 DSM-IV의 진단기준을 이용하여 임상적으로 ADHD로 진단 받은 569명의 아동으로 하였다. 이미 약물을 복용중이거나 약을 복용한 적이 없는 아동을 대상으로 이전 약물에서 MPH-OROS로 약물을 바꾸거나 처음으로 MPH-OROS를 복용하였다. 증상의 정도는 MPH-OROS 약물 사용 전과 사용 1주 및 3주에 한국어판 Conners 부모용 평가척도를 사용하여 평가하였다. 임상 호전은 Clinical Global Impression Severity of illness(CGI-S)를 사용하여 MPH-OROS 약물 복용 전과 복용 1주 및 3주에 임상가가 평가하였고 Clinical global impression severity of improvement(CGI-I)로 약물 복용 1주 및 3주에 호전 정도를 평가하였다. 약물 복용 3주에는 약물 복용에 따른 부모 만족도를 설문 조사하였다. 결과 : MPH-OROS의 1일 평균 복용량은 기저선 $25.3{\pm}11.2mg$ 1주 $28.9{\pm}12.7mg$, 3주 $31.3{\pm}13.2mg$이었다. 시간에 따라 용량이 유의하게 증가하였고, 성에 따른 차이는 없었다. 전체의 $13\%$가 중도 탈락했으며, 그 원인으로는 부작용이 가장 많았다. CGI-I의 변화는 시간에 따라 유의하게 감소하는 모습을 보였고, 성에 따른 호전 정도의 차이는 나타나지 않았다. CGI-I에 의한 호전평가에서 MPH-OROS 치료 1주에 호전은 $72.3\%$이고 치료 3주에는 $87.4\%$였다. 한국판 Conners부모용 평가척도 합계 점수는 시간에 따라 유의하게 감소하였다. 한 가지 이상의 부작용을 경험하였던 환자는 119명으로 $20.7\%$에 달하였으며, 가장 많은 빈도로 나타난 것은 식욕부진이고, 불면, 두통, 오심의 순이었다. 기존에 속효성 메틸페니데이트를 사용하던 군과 약물을 처음 사용하는 군을 나누어 부작용 빈도를 살펴보았을 때 크게 차이가 나지 않았다. 부모만족도 설문 결과에서 MPH-OROS 약물치료에 대해 $94\%$의 부모는 전반적으로 만족한다고 응답하였다. 또한 부모가 보고하는 MPH-OROS 의 가장 큰 장점은 오후까지 약물효과 지속, 학교생활 및 수업태도, 가정생활 및 숙제, 과잉행동 개선의 순이었다. 결론 : MPH-OROS는 주의력결핍과잉운동장애의 치료에서 효과적이며 충분히 안전하다.

• 대한기관윤리심의기구협의회지
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• 제2권2호
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• pp.37-48
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• 2020

Purpose: The purpose of this study is to assess the operational status and level of understanding among IRB and HRPP staffs at a hospital or a research institute to the HRPP guideline set by the Ministry of Food and Drug Safety (MFDS) and to provide recommendations. Methods: Online survey was distributed among members of Korean Association of IRB (KAIRB) through each IRB office. The result was separated according to topic and descriptive statistics was used for analysis. Result: Survey notification was sent out to 176 institutions and 65 (37.1%) institutions answered the survey by online. Of 65 institutions that answered the survey; 83.1% was hospital, 12.3% was university, 3.1% was medical college, 1.5% was research institution. 23 institutions (25.4%) established independent HRPP offices and 39 institutions (60.0%) did not. 12 institutions (18.5%) had separate IRB and HRPP heads, 21 (32.3%) institutions separated business reporting procedure and person in charge, 12 institutions separated the responsibility of IRB and HRPP among staff, and 45 institutions (69.2%) had audit & non-compliance managers. When asked about the most important basic task for HRPP, 23% answered self-audit. And according to 43.52%, self-audit was also the most by both institutions that operated HRPP and institutions that did not. When basic task performance status was analyzed, on average, the institutions that operated HRPP was 14% higher than institutions that only operated IRB. 9 (13.8%) institutions were evaluated and obtained HRPP accreditation from MFDS and the most common reason for obtaining the accreditation was to be selected as Institution for the education of persons conducting clinical trial (6 institutions). The most common reason for not obtaining HRPP accreditation was because of insufficient staff and limited capacity of the institution (28%). Institutions with and without a plan to be HRPP accredited by MFDS were 20 (37.7%) each. 34 institutions (52.3%) answered HRPP evaluation method and accreditation by MFDS was appropriate while 31 institutions (47.7%) answered otherwise. 36 institutions answered that HRPP evaluation and accreditation by MFDS was credible while 29 institutions (44.5%) answered that HRPP evaluation method and accreditation by MFDS was not credible. Conclusion: 1. MFDS's HRPP accreditation program can facilitate the main objective of HRPP and MFDS's HRPP accreditation program should be encouraged to non-tertiary hospitals by taking small staff size into consideration and issuing accreditation by segregating accreditation. 2. While issuing Institution for the education of persons conducting clinical trial status as a benefit of MFDS's HRPP accreditation program, it can also hinder access to MFDS's HRPP accreditation program. It should also be considered that the non-contact culture during COVID-19 pandemic eliminated time and space limitation for education. 3. For clinical research conducted internally by an institution, internal audit is the most effective and sole method of protecting safety and right of the test subjects and integrity for research in Korea. For this reason, regardless of the size of the institution, an internal audit should be enforced. 4. It is necessary for KAIRB and MFDSto improve HRPP awareness by advocating and educating the concept and necessity of HRPP in clinical research. 5. A new HRPP accreditation system should be setup for all clinical research with human subjects, including Investigational New Drug (IND) application in near future.

• Clinical and Experimental Reproductive Medicine
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• 제19권2호
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• pp.169-174
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• 1992

Previous studies have indicated that immunological factor is responsible for the infertility. We have detected sperm antibodies in ZIFT patients which grouped as fertilization failure (A; n=18) and low fertilization rate (${\leq}50%$)(B; n=20). Patients, however, had normal oocytes and sperms. We collected serum from wives and semen from husbands and donors (fertile sperm), if it was needed. We examined class, binding patterns and amounts of antisperm antibodies(ASA) by direct and indirect immunobead binding assay. In group A, 11 husbands were ASA positive showing 62.2% and 61.1% binding with IgA and IgG, respectively, and two wives were ASA positive showing 70.0% and 71.0% binding with IgA and IgG, respectively. Binding sites were mainly at the head of sperms (84%). In group B, 8 husbands were ASA positive showing 37.5% and 40.0% binding with IgA and IgG, respectively, and two wives were ASA positive showing 41.3% and 42.0% binding with IgA and IgG, respectively. Binding sites were also mainly at the head of sperms (78%). For the treatment of ZIFT patients who had fertilization failure at the first trial, we used albumin fractionation method and dilution method with 30% fetal cord serum (FCS) to reduce the titer of ASA. We used partial zona dissection (P.Z.D.) method for wives who have antisperm antibodies in their serum. According to represented method, we could inhance the fertilization rate to 60.0% by albumin fractionation and 20.0% by P.Z.D., respectively. We concluded that the use of micromanipulation like P.Z.D. or the other sperm processing methods is required to increase a chance of fertilization. This result suggested that it should be a prerequisite to test antisperm antibodies prior to entering assisted reproductive technologies (ART) programs.

• 정신신체의학
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• 제13권2호
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• pp.85-94
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• 2005

연구목적 : 본 전향적 개방형 연구는 섬망에 대한 quetiapine과 haloperidol의 효과와 안전성을 평가하기 위하여 시행되었다. 방법: DSM-lV에 의하여 섬망으로 진단된 40명(quetiapine군 19 : haloperidol군 21)을 대상으로 순차적으로 quetiapine과 haloperidol을 투여하였다. 약물의 1차적 효과를 평가하기 위하여 한국판 섬망 평가 척도를 매일 일주일간 시행하고, 약물에 의한 2차적 효과와 안전성을 평가하기 위해 전반적 임상 인상-심각도, 한국판 간이정신상태검사, 약물에 의한 추체외로 증상 평가 척도를 각각 연구 시작시와 7일째에 시행하였다. 자료의 수집은 2004년 11월부터 2005넌 6월까지 이루어졌다. 결과: 연구 기간 동안 두 군 모두 한국판 섬망 평가 척도의 점수가 유의하게 감소하였으며, 두 군간의 평균 척도점수는 유의한 차이가 없었다. 두 약물에 대한 치료 반응율에서도 유의한 차이가 없었다. 연구 기간 동안 임상적으로 심각하거나 위험한 부작용은 관찰되지 않았다. 결론: 본 연구 결과 섬망의 치료에 있어서 quetiapine은 haloperidol과 대등한 효과와 안전성을 보였다. 기존의 연구에서 haloperidol은 장기 복용시 운동성 부작용을 유발할 가능성이 크다고 알려져 있으므로, 그러한 부작용이 적다고 알려진 quetiapine이 장기간 지속될 수 있는 섬망의 치료에 있어 haloperidol을 대체할 수 있을 것으로 기대된다.