우울증에서의 Dexamethasone에 대한 반응

정희연,서광윤,이병윤 고려대학교 의과대학 1983 고려대 의대 잡지 Vol.20 No.1

In this study the baseline serum cortisol level and the dexamethasone suppression test was adopted as a measure of the hypothalamic-pituitary-adrenal axis both in the heterogenous groups of depressed patients and the control groups of nondepressed psychiatric patients. The 67 subjects of depression comprised 13 cases of the familial pure depressive disease (FPDD), 19 sporadic depressive disease(SDD), 6 depressive spectrum disease(DSD), bipolar primary depressive illness, and comprised 15 cases of the schizophrenia, 8 anxiety neurosis, 5 hysterical neurosis, and 3 posttraumatic stress disorder. Blood samples for the test were collected for two days, 3 times each at 8 AM, 4PM and 11PM. The first-day collections were obtained without any preparation, and the second-day collections, with dexamethasone administration. Serum cortisol was measured by radiommunoassay. The results of this study were summarized as follows: 1. As a preliminary test, the baseline serum cortisol level and the serum cortisol level of the 10 health normal Koreans after 1 ㎎ overnight-dexamethasone were measured. Normal mean baseline serum cortisol concentrations were 15.0 ± 3.8 ㎍/dl at 8 AM, 5.8±2.3 ㎍/dl at 4 PM, and 2.7 ± 1.3㎍/dl at 11 PM. Normal mean serum cortisol concentrations after 1 ㎎ overnight-dexamethasone were 1.0 ± 0.4㎍/dl at 8 AM, 1.0 ±0.3㎍/dl at 4 PM, and 0.8±0.1㎍/dl at 11 PM. There was no significant sexual difference. 2. The mean ages of each subtype of depression were 41.1 years old in FPDD, 43.2 in SDD, 35.2 in DSD, 26.3 in bipolar PDI, and 36.7 in secondary depression, and the mean ages of onest were 31.8 years old in FPDD, 35.0 in SDD, 31.6 in 25.4 in bipolar PDI, 34.5 in secondary depression. The highest mean age of on set was found in SDD, and the lowest mean age of noset in bipolar PDL. 3. Mean baseline serum cortisol concentrations in the cases of FPDD, bipolar PDI. and SDD were higher than that of controls at 4 PM, and 11 PM, while there was no significant change among DSD, secondary depression and controls. The mean serum cortisol concentrations after 1 ㎎ overnight-dexamethasone in FPDD, bipolar PDI were higher than that of controls at 8 AM, 4 PM, but there was no significnt change among SDD, secondary depression and controls. 4. Nonsuppression of serum cortisol after 1 mg overnight-dexamethasone occured in 5 patients out of patients with bipolar PDI(41.7%), 4 out of 12 FPDD(30.8%), and 4 out of 19 SDD(21.1%), but not occured in the cases of DSD and secondary depression as well as controls. 5. Increase in the serum cortisol concentrations of the depressive patients was detected more frequently at 11 PM before dexamethasone administration, and at 4 PM and 11 PM after dexamethasone administration.

다양한 조직에서 중간엽 줄기세포의 미토콘드리아 비교

정희연,김경은,정수정,최수지,이경석,김완중 순천향대학교 기초과학연구소 2020 순천향자연과학연구 논문집 Vol.26 No.2

Mesenchymal stem cell (MSC) and mitochondria are important materials for cell therapy products. In this study, we carried out to compare yields of mitochondria in mesenchymal stem cell isolated from various tissue. The liver, muscle and adipose tissues were removed from rat. Mesenchymal stem cells were isolated using trypsin. Mitochondria were isolated in cultured MSC by cell fractionation. Absorbance of mitochondrial DNA at 260 nm with spectrophotometer to measure indirectly the amount of mitochondria. In these results, liver tissue contained a lot of MSC and mitochondria compared with other tissues. The liver is an optimized tissue for harvest of mitochondria.

집중이수제에 대한 고등학교 역사 교사의 인식

정희연,박현숙 한국역사교육학회 2014 역사교육연구 Vol.- No.19

This study examines the effectiveness of the ‘Intensive Course Program’ that was implemented for a brief period of time following the curriculum revision of 2009 by taking a close look into how history teachers carried out the program and how they perceived it. In doing so, this paper tries to find more effective ways of teaching history. For this study, a survey of 51 high school history teachers under the Gyeonggi Provincial Office of Education was conducted. The data obtained was entered into the Statistical Program for the Social Sciences (SPSS) and analyzed. Most of the high schools surveyed in Gyeonggi Province adopted the ‘Intensive Course Program’ for history. <Korean History> was taught as a compulsory subject in every school surveyed, whereas <World History> and <East Asian History> were taught in few schools. The average number of units for the intensive course was five. The supply of qualified teachers and the subject’s relations to other ones were found to be the main considerations in selecting the subject and the number of units for the program. This reveals that the philosophy of learner/consumer-oriented education was not materialized. The autonomy given to schools as regards curriculum allowed them to either increase or reduce the number of units of each subject by 20%. As a result, schools generally increased the number of units of major subjects while reducing the number of units of history, social studies, and other minor ones in order to balance the increase. Due to the reduction of units and the decrease in selection rate, the situation in history education is on the verge of rapid deterioration. Many schools did not put into practice the ‘Block Time’ program and the ‘Supplementary Course’ program for students who have not taken the intensive course that had been designed to supplement the ‘Intensive Course Program.’ As seen above, not only was the ‘Intensive Course Program’ not welcomed by teachers, but it was causing serious problems in history education. Some teachers suggested that the content of the subject be adjusted as a solution for the program but many teachers thought that only to abolish the Program and implement a program of dispersed course would set history education on the right track again. The implementation of the ‘Intensive Course Program’ is one of the notable examples to show how a one-sided curriculum revision and its implementation could lead to a negative outcome. 본 연구에서는 2009 개정 교육과정에 따라 잠시 시행되었던 역사과 집중이수제에 대한 실시 양상과 역사교사들의 인식을 통해 집중이수제의 실효성 확인과 효과적인 역사 수업을 위한 방안을 모색해 보고자 하였다. 연구를 위해 경기도교육청 소속 고등학교 역사교사를 대상으로 설문을 진행하여 51명에 대한 설문조사 결과를 SPSS를 이용하여 분석하였다. 계량적 연구방법을 통해 집중이수제의 학교별 운영양상과 역사교사들의 인식을 조사한 결과, 교과의 선택과 이수단위의 증감에 있어 학습자의 수요보다는 교사 수급문제 등 학교의 상황요인이 더 많이 작용하여 학습자의 수요에 맞춘 교육과정이 공급되지 못하고 있었다. 경기도 내의 고등학교들에서는 대부분 역사과 집중이수제를 실시하고 있었다. <한국사>는모든 학교가 필수로 선택하여 실시하였으나, <세계사>와 <동아시아사>는 선택률이 낮았다. 이수 시간은 5시수가 대다수였다. 교과의 선택과 이수시간의 조정에는 각각 교사 수급 문제와 타 교과와의 조정이 가장 큰 이유를 차지하였다. 이로써 수요자 중심의 교육과정 공급이라는 목표가 달성되지 못하였음을 확인할 수 있었다. 그리고 학교 교육과정의 자율화에 따라 교과별 이수단위를 20%씩 증감할 수 있게 되어 주요과목을 중심으로 교육과정이 편성되고 시수의 증가분을 역사와 사회 등의 과목 시수 감소로 조정하게 될 것이라는 우려가 현실로 나타났다. 시수의 부족과 선택의 축소 등으로 역사교육의 약화가 우려되는 상황이었다. 또한 집중이수제의 시행을 위한 보조적 제도였던 ‘블록타임제’와 ‘미이수 학생을 위한 보충학습’ 과정을 실시하지 않는 학교가 많았으며, 집중이수제 상황에서 담임교사로서 생활지도와 학급 관리에 큰 어려움을 겪고 있었다. 이와 같이 역사과 집중이수제는 교사들에게 환영받지 못하고 문제점만 야기하며 역사수업을 저해하고 있었다. 교사들은 역사과 집중이수제에 대한 개선책으로 교육 내용의 조정 등을 지적하기도 하였으나, 많은 교사들이 역사과 집중이수제를 폐지하고 분산이수제로 전환하는것이 역사학습을 정상화하는 최선의 방법이라고 전망하였다. 역사과에 집중이수제를 적용한 것은 역사교과의 특성을 고려하지 않은 일방적 교육과정 개정과 적용의 잘못된 대표적 사례라고 평가할 수 있을 것이다. 집중이수제와 관련된 일련의 과정들은 교육과정 개정 과정에서 충분한 논의와 검토가 진행되지 못해 교과의 특성이 무시되고 교육주체들의 의견이 수렴되지 못한 데에 원인이 있다. 이 연구를 계기로 앞으로의 교육과정 개정 과정에서는 각 교과의 특성과 근본적인 문제점들을 직시하고, 교과전문가와 교사 및 학생들의 의견을 충분히 수렴·검토하여 학교 현장에서의 혼란과 착오를 최소화하고 공교육을 정상화시킬 수 있도록 노력해야 할 것이다.

정상 노인의 수면

정희연 순천향대학교 1993 논문집 Vol.16 No.2

The author reviewed sleep in the normal aged. The results obtained were as follows: 1. In waking EEG in the aged, there are the tendencies of decreased alpha frequency, decreased alpha amplitude and increased beta or fast activity. 2. In sleep EEG in the aged, there are decreased delta wave, decreased sleep spindle amplitude, decreased sleep spindle frequency and decreased frequency, amplitude, amount of alpha activity. 3. In sleep pattern in the aged, there are decreased total sleep, decreased slow wave sleep, decreased REM sleep and others. 4. In circadian rhythm in the aged, there are increased daytime sleep, decreased nocturnal sleep period. Elderly persons are reported to tall asleep and awake earlier, that is phase advance of circadian rhythm.

假神經症性 精神分裂症의 臨床的 硏究

정희연,곽동일 대한신경정신의학회 1976 신경정신의학 Vol.15 No.4

In this clinical study, it was intended to reveal the clinical characteristics of pseudoneurotic schizophrenia. Frequency of pseudoneurotic schizophrenia, age and sex distribution, birth order, educational level, marital status, religious background, socioeconomical status, occupation, family history, parental deprivation, premorbid personality, age of onset, predisposing factor, mental symptorr, organ of psychosmatic symptom and distribution of sympton were analyzed. Nature of hypochondriasis and phobia, duration of treatment, result of treatment, past history of treatment and experience of episodic psychosis were also examined. The subject of the study were 124 cases of pseudoneurotic schizophrenia out of 8,160 cases of out patients who visited the Department of Neuroᅳ psychiatry, Korea University hospital from Jan. 1971 to Oct. 1975. The result were as follows. 1. The frequency of schizophrenics occupied 9.36% of all out patients and the frequency of the latetnt schizophrenics occupied 3.00% of all out patients and the frequency of the pseudoneurotic schizophrenics occupied 1.51% of all out patients. 2. The mean age of the patients was 31.82 years old. As to the sex distribution, it was revealed that male occupied 58.87% and female occupied 41.13% of all patients. 3. There was no specific correlation with birth order. 4. The educational level of the patients were revealed higher than other psychosis. 5. According to the occupational distribution, among the male patients, student showed highest rate of 21.93% and among the female patients, housewife showed the highest rate of 62.3%. While 75.00% of them recorded as having certain kind of occupation it was revealed in careful observation that most of them either did poorly in their occupational role or frequently suspended due to their adjustment difficulties. 6. Family history revealed that 11.20% of their family members suffered from psychosis 7. As to the rate of parental deprivation before 15 years old, the rate of father deprivation was 14.52% and the rate of mother deprivation was 9.68%. 8. The mean age of onset was 26.6 years old, clearly older than other clinical types of schizophrenia. 9. Clear precipitating factors were elicited in 85.48% of them. The most frequent precipitating factors were those experience which were recognized as physical threats (31-46%).. The next frequent ones were personal seperation (27.42%) and frustrations associated with sexual experiences (16.13%). 10. Among the menta] symptoms, anxiety was 37.29%, hypochondriasis was 29.84%, depression was 13.71%, phobia was 12.90% and obsession was 7.26%, Most of their somatic complaints were rather bizarre. The most frequently cbosen bodily past and organs of their somatic complaints were head (33.87%) and cardiorespiratory organs (32.26%). 11. As to the nature of the hypochondrical nature, localized bizarre sensory nature was 37.84% and moving nature 35.14% As to the object of the phobia, the person occupied 50.00% and the death 31.25% 12. As to the duration of illness, 21.77% of the patient had the duration between 6 month and 1 year. 13. As to the past experience of their treatments 78.57% of the patient had taken drug from phar macist s shop and 75.00% had the other medical treaetment and; 69.64% had taken herb drug and 62.50% had psychiatric treatment. In the duration of the treatment from one month, to six monthes was 21.42% in the cases of psychiatric treatment less than one month was 66.07% in other medica:l treatment and intermittant herb and self-medicated drug users are 32.14% and 37.50% reciprocally. 14. Five of them (4.03%) had psychotic episodes. 15. The result showed many clinical significant differences comparing to the other schizophrenia, those are, age of onset is older, level of education is higher, tendency of superficial adaptation to their occupation is more frequent, prominent precipitating factors are more easil

한국판 리버풀 항정신병약물 부작용 평가 척도(LUNSERS)의 표준화 연구 - 리버풀 항정신병약물 부작용 평가 척도 -

정희연,주연호,신현균,정은기,강웅구,노명선,김용식 대한신경정신의학회 2002 신경정신의학 Vol.41 No.1

연구목적: 본 연구에서는 항정신병약물 부작용을 자기 보고식으로 평가하기 위한 리버풀 항정신병약물 부작용 평가 척 도(Liverpool University Neuroleptics Side Effect Rating Scale, 이하 LUNSERS)의 한국판을 제작하여, 항정신병약물로 치료 중인 정신분열병 환자와 정상 대조군을 대상으로 타당도와 신뢰도를 조사하고자 하였다. 방 법: 번역 및 역번역과 전문가들의 감수 과정을 거쳐 51문항, 4점 척도의 한국판을 제작하였다. 항정신병약물을 복 용중인 62명의 DSM-Ⅳ 진단 기준 정신분열병 환자를 대상으로 일주일 간격으로 두 번 LUNSERS를 완성하 게 하였다. 두 번째 LUNSERS 평가 시 동시에 정신과 전문의가 UKU side effect rating scale(이하 UKU)로 부작용을 평가하였다. 대조군은 LUNSERS를 완성하였다. 결 과: LUNSERS의 검사-재검사 신뢰도(r=0.86, p<0.01)와 UKU에 대한 준거 타당도(r=0.81, p<0.001)는 높았다. 그러나 항정신병약물 용량과 부작용 점수와는 통계적으로 유의한 상관이 없었다. ROC 커브 분석 결과 부 작용 점수 총점이 불특정 증상 총점보다 더 정확하게 항정신병약물에 의한 부작용을 보이는 환자를 감별할 수 있었다. 결 론: 한국판 LUNSERS의 신뢰도와 타당도가 검증되었고, 임상 연구에서 항정신병약물에 의한 부작용의 정도를 체계적으로 평가할 때 UKU를 대신하여 사용할 수 있는 유용한 도구임을 알 수 있었다. Objectives:This study was conducted to develop the Korean version of Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS) for measuring neuroleptic side effects by self-rating method and to examine the reliability and validity in the schizophrenic patients medicated by neuroleptics and normal controls. Methods:We made 51-item, 4-point scale of Korean version LUNSERS through translation, reverse translation and supervision by specialists. Sixty two schizophrenics diagnosed by DSM-Ⅳ criteria and medicated with neuroleptics completed LUNSERS twice with one week interval. Second LUNSERS and UKU side effect rating scale(UKU) by psychiatrist were administered to the schizophrenics at the same time. Normal controls also completed LUNSERS. Results:The test-retest reliability(r=0.86, p<0.01) of LUNSERS and the concurrent validity(r=0.81, p<0.001) against UKU were good. But the neuroleptic doses and total scores of side effect items didn’t show significant correlation. By the ROC curve analysis, the total scores of side effect items differentiated the medicated patients from non-medicated controls but not for the red herring items. Conclusion:Korean-version of LUNSERS has good reliability and validity. And it was also proved to be an useful assessment tool for measuring the extent of neuroleptic side effects systematically instead of UKU in clinical trials

우울증의 신경내분비적 고찰

정희연 순천향대학교 1989 논문집 Vol.12 No.1

I have previously noted that its possible involvement in depression is intriguing in light of the following four sets of findings taken from the disciplines of developmental psychology, clinical psychiatry, and neurophysiology: (a) Laboratory animals subjected to maternal deprivation during the neonatal period show significant hyperactivity of the HPA axis during stress throughout adult life Hence, such animals presumabley show a permanent change in the responsivity of their CRF neurons. (b) Clinical experience suggests that a history of early deprivation produces a diathesis to depression and a tendency to relive the intense anxiety and dysphoria associated with this early deprivation throughout adult life whenever a significant frustration or important loss occurs. Thus, such individuals also seem prone to a hyperresponisvity of their CRH neurons intermittently throughout of life. (c) CRH given ICV to experimental animals not only stimulates the HPA axis but also activates the locus ceruleus, produces decreased eating and sexual behavior, and causes significant changes in activity. (d) CRH has been reported to induce limbic seizures that cross sensitize with electrically kindled seizures. These findings, taken together, suggest that a CRH model of depression could help integrate dynamic formulations that take into account early losses and subsequent internal and external stress as factors that can predispose to or precipitate major depression, and the observations that depressed subjects often show hypercortisolism, significant anxiety, anorexia, diminished libido, hypo- or hyperactivity, and respond at times to limbic anticonvulsants.

질투망상과 성욕

정희연 순천향대학교 1993 논문집 Vol.16 No.4

After studying the relationship between the characteristics and sexual drive of patients with delusion of jealousy, we concluded the followings. 1) Number of patients with delusion of jealousy(patient group) was male 33, female 6, revealing male dominance than control group(schizophrenic patients without jealousy). 2) Mean age of patient group was greater than that of control group. 3) Patients' sexual drive state, as estimated by spouses and patient themselves, right before the onset of symptom, and sexual drive change after the onset of symptom in patient group were not different from control group. 4) Spouses' sexual drive states, as estimated by patients and spouses themselves, right before teh onset of symptom, and sexual drive changes after the onset of parients' symptom did not differ from that of spouses' of control group. 5) Frequency of sexual contact just prior to the onset of symptom in both patient and control group was not different. 6) Delusion of jealousy was mostly motivated by change of attitude and suspected extramarital problem of spouses, and the ratio was 30.6% and 25.0% each. 7) Premorbid personality type of patient group was not different from that of control group, but other than introverted and extroverted, paranoid type was most common. 8) Except for introverted, extroverted and dependent type was most common among personality types of spouses of patient group. 9) Among the diagnoses of patient group, alcohol intoxication, schizophrenia and delusional disorder were most common.

주정중독의 분류

정희연 순천향대학교 1993 논문집 Vol.16 No.2

The author reviewed about the classification of alcoholics and found that the following characteristics may be helpful in the classification of alcoholics. Those are : 1) age of onset (before and after 25 years), 2) presence or absence of family history of alcoholics, 3) personality typer of alcoholics (esp. passive-dependent or antisocial). 4) presence or absence of dependence syndrome, 5) psychiatric symptoms of alcoholics (esp. anxiety or depression), 6) binge type or continuous type. 7) acute or chronic, 8) childhood risk factor (by Tarter's Behavior Check List), 9) others.

다양한 조건에서의 줄기세포 분리 수율 비교

정희연,김경은,김진명,이경석,김완종 순천향대학교 기초과학연구소 2020 순천향자연과학연구 논문집 Vol.26 No.1

Mesenchymal stem cells were isolated from adipose tissue in rat to determine optimized conditions. Adipose tissue was removed from dorsal wall of anesthetized Sprague-Dawley rat. We confirmed the stem cells as a shape of spindle with light microscopic finding during cell culture. The differences in the treatment time 30 min and 60 min, respectively) and in the volume (10 ml, 20ml and 30ml, respectively) of enzymes (trypsin or collagenase) solution resulted in establishing the optimal conditions for stem cell extraction. Results have shown that single treatment of trypsin is 3.2 times higher than that of collagenase. In addition, it was confirmed that extraction yield is most efficient when treated at 30 ml for 30 min in single treatment of trypsin.