치매환자에 대한 Indeloxazine hydrochloride의 임상효과

한상익,백인호,전태연,고효진,김용찬 최신의학사 1991 最新醫學 Vol.34 No.3

경남지역 벼 친환경재배시 고품질 유색미 생산을 위한 적정 품종

김상열,한상익,오성환,이종희,권영업 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

알코올의존 환자에서 알코올이 뇌파, 사건관련전위 P300 및 인지기능에 미치는 영향

한상익,전양환,이창욱 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

연구목적: 저자들은 알코올의존 환자들을 대상으로 뇌파, 청각사건관련전위 P300등 신경생리학적 검사와 신경 인지기능 검사를 실시하여 알코올이 뇌기능에 미치는 영향을 확인하고자 본 연구를 시도하였다. 방법: 알코올의존 환자군 33명과 정상 대조군 67명을 대상으로 하였다. P300의 잠복기를 고전적 방법, Glo-bal Field Power 방법, 그리고 기존의 방법을 변형시킨 수정된 방법 등 세 가지로 결정하였으며 다른 검사값들과의 비교는 Global Field Power방법으로 측정한 결과를 사용하였다. 지능검사는 한국판 웩슬러 지능검사를 사용하였고 웩슬러 기억검사와 Trail Making B검사를 이용하여 신경인지기능을 평가하였다. 뇌파분석은 주파수 영역별로 델타파(δ, 1-3.5Hz), 세타파(θ,4-7.5Hz), 알파파(α,8-13Hz),베타파(β,13.5-18Hz)의 4개 구역으로 나눈 후 상대적 Power로 분석하였다. 결과: P300 은 환자군에서 작고 늦게 나타났으며 측정 방법에 의한 차이도 없었다. 환자군에서 낮은 지능을 보였으나, P300은 지능에 의해 영향을 받지 않았다. 환자군에서 Trail Making B 검사 수행시간이 오래걸렸으나 웩슬러 기억검사에서는 차이가 없었다. 뇌파분석 결과 두 군간의 차이는 없었다. 결론: 알코올의존 환자들은 신경생리학적인 측면에서 뇌기능의 저하를 보이고 있었고 이는 지능에 의해 영향을 받지 않았다. 신경인지기능검사는 이들이 측두엽보다는 전두엽의 기능이 더욱 더 저하하고 있다는 것을 시사하고 있다. 중심단어:알코올 의존·정량적 뇌파·사건관련전위 P300·인지기능. Objective: The purpose of this study is to determine whether patients with alcohol dependence do have brain dysfunction by auditory event related potential P300, EEG, and neuro-cognitive function test or not. Method: Subjects were composed of patients with alcohol dependence(N=33) and normal controls(N=67). P300 was determined by conventional method, Global Field Power method,and modified method. Also Korea Wechsler Intelligence Scale, Wechsler Memory Scale, and Trail Making B were tested. Spectral EEG was analyzed by the ranges of Hz, delta(δ,1-3.5Hz), theta (θ, 4-7.5Hz), alpha(α,8-13Hz), and beta(β,13.5-18Hz), and compared by relative power. Results: In patients with alcohol dependence, P300 was smaller and later, and there was no difference between the measurement methods of P300. Lower IQ score was shown in patients with alcohol dependence, but it did not affect the P300 results. It took more time to perform Trail Making B test in patients with alcohol dependence, but there was no difference between groups in Wechsler Memory Scale. Spectrum EEG was shown as similar patterns. Conclusion: It suggests that patients with alcohol dependence have brain dysfunction in so-me neurophysiological aspects, regrdless of intelligence. And frontal lobe dysfunction might be more severe than temporal one in patients with alcohol dependence. KEY WORDS:Alcohol dependence·EEG·P300·Neurocognitive function.

茶山의 牧民論 : 民本을 넘어 民主로 Beyond Confucian Democracy to Modern Democracy

한상익 국제문화학회 2002 역사와 사회 Vol.28 No.-

A close examination on the issues, policies and the key variables of the mayor clection of Seoul on the June 13th reveals that the Six Articles of Yul-gi(律己; self-control) and 'Six Doctrines of love towards people' - both of them were proposed by a realist in Choso˘n Dynasty, Jung Yag Yong in his theory of governing the people - are the main theme of them. The fact that his theory can be applied to the local autonomy system, the base of modern democracy, suggests that his theory contains basic elements of modern democracy. He opposed the nature theory of Sung Confucianism, arguing that every man is equal as they all share common universal nature. And he went further to insist that every moral and social inequality should be abolished. He suggested basic principles of democracy when he saw the people as the subject of social contract and beings with the right and duty to participate in the politics. Thus, his theory is a way of organizing political communities under democratic principles rather than a way of ruling the subjects in feudal society, and it is a principle that should be kept in democratic society.

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.

지형학적 청각 사건관련전위 P300 요소들의 결정방법

한상익,전양환 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

목 적 : 본 연구는 지형학적 청각사건관계전위 P300 요소들을 결정하는 방법들을 비교하기 위함이다. 방 법 : 44명의 정상인과 DSM-Ⅳ에 근거한 44명의 정신분열증 환자를 대상으로 하였다. 지형학적 청각사건관련전위 P300은 oddball paradigm으로 기록하였다. 잠복기, 전위, 그리고 X-Y 좌표에 따른 최대전위 위치 등을 포함한 P300요소들은 전산화된 Brain Mapping기기를 사용하였다. P300 잠복기는 global field power measurement와 고전적 방법으로 결정하였다. 결 과 : 잠복기(DF=1, F=35.28, P=0.0001)와 전위(DF=1, F=36.62, P=0.0001)에서 두 군간에 차이가 있었으나, X 좌표(DF=1, F=0.37, P=0.55)와 Y 좌표(DF=1, F=2.00, P=0.16)에서는 차이가 없었다. 잠복기(DF=1, F=0.04, P=0.85), 전위(DF=1, F=0.07, P=0.79), X 좌표(DF=1, F=0.07, P=0.79), Y 좌표(DF=1, F=0.03, P=0.86)에서 두 방법간에 차이가 없었다. 결 론 : 이 결과는 지형학적 청각사건관계전위 P300의 요소들을 결정하는 두 방법이 현재까지는 연구 및 임상 적용에 유용함을 시사한다. Objects : This study was designed to make a comparison between methods to determine the components of topographic auditory event related potential P300. Methods : The subjects were consisted of 44 normal controls and 44 patients with schizophrenia diagnosed by DSM-Ⅳ. The topographic auditory event related P300 was recorded in oddball paradigm. The components of P300, including latency, amplitude, and location of maximum amplitude in X-Y coordinates, were analyzed by computerized EP mapping system. The latency of P300 was determined by both global field power measurement and classic method. Results : There was difference between two groups in latency(DF=1, F=35.28, P=0.0001)and amplitude(DF=1, F=36.62, P=0.0001), but not in X coordinate(DF=1, F=0.37, P=0.55) and Y coordinate(DF=1, F=2.00, P=0.16). There was no difference between two methods in latency(DF=1, F=0.04, P=0.85), in amplitude(DF=1, F=0.07, P=0.79), in X coordinate(DF=1, F=0.07, P=0.79), and in Y coordinate(DF=1, F=0.03, P=0.86). Conclusion : The results suggested that two methods to determine the components of topographic auditory event related potential P300 should be available for both research and clinical application to date.

연령증가에 따른 지형학적 청각 사건관련전위 P300 요소의 변화

한상익,전양환 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

목 적 : 본 연구의 목적은 정상인에서 연령증가에 따른 지형학적 청각관련전위 P300요소들의 변화를 알아보고자 함이다. 방 법 : 피험자는 85명(연령분포 : 18∼68세)으로 모두 오른손잡이였으며 교육수준은 최소한 12년 이상의 학력자로 하였다. 이들은 뇌기능에 영향을 미칠수 있는 내외과적 질병의 기왕력이 없었고 검사시점에서 어떠한 신체질환이나 정신질환이 없었다. 지형학적 청각사건관련전위 P300은 'oddball paradigm'으로 기록되었고 P300요소로서 잠복기, 전위, 최대전위의 X-Y좌표 등이 전산화된 기기에 의해 분석되었다. P300 잠복기는 global field power measurement(GFPM)와 고전적 방법에 의해 결정하였다. 결 과 : GFPM의 방법에서, 잠복기는 일년에 1msec씩 증가(잠복기=299.9+1×나이)하였다. 최대 전위의 X 좌표는 일년에 0.018씩 좌측편위(X=3.6-0.018×나이)를 보였고 Y좌표는 0.017씩 전방편위(Y=2.15+0.017×나이)를 보였다. 고전적 방법에서 잠복기는 일년에 0.81msec씩 증가(잠복기=304.76+0.82×나이)하였다. 최대전위의 X좌표는 일년에 0.011씩 좌측편위(X=3.35+0.011×나이)를 보였고 Y좌표는 0.025씩 전방편위(Y=1.86+0.025×나이)를 보였다. 전위는 두 방법 모두에서 변화가 없었다. 결 론 : 이 결과들은 P300의 잠복기와 연령증가 간에 강력한 양의 상관관계를 보이고 있고 최대전위 전극위치의 약간의 좌측 전방편위를 보이고 있다. 이 소견들이 시사하는 바는 P300에 의해 표현된 정신 생리기능이 연령증가 과정에서 감소하고 있으며, 정상대조군의 자료가 연구 및 임상적용에 필수적임을 의미한다. Objects : This study was to examine the changes of components of topographic auditory event related potential P300 in normal aging process. Methods : The subjects were consisted of 85(range of age ; 18-68), who were right handed and had education level at least over 12 years. They had no history of medico-surgical and psychiatric illness which could cause brain dysfunction, and had not any physical and mental illness on examination. The topographic auditory event related P300 was recorded in oddball paradigm and the components of P300 including latency, amplitude, and location of maximum amplitude in X-Y cordinates were analyzed by computerized EP mapping system. The latency of P300 was determined by both Global Field Power Measurement and classic method. Results : In global field power measurement, the latency has been increased about by 1m sec per year(latency=299.9+1×AGE). The location of maximum amplitude in X coordinate was moved by 0.018 per year toward left side(X=3.6-0.018×AGE) and in Y coordinate by 0.017 toward frontal direction(Y=2.15+0.017×AGE). In classic method, the latency has been increased about by 0.82m sec per year(latency=304.76+0.82×AGE). The location of maximum amplitude in X coordinate was moved by 0.011 per year toward left side(X=3.35-0.011×AGE) and in Y coordinate by 0.025 toward frontal direction(Y=1.86+0.025×AGE). The amplitudes were not changed in both methods. Conclusion : The results showed strong positive correlation between latency of P300 and aging process, and slight left frontal displacement of the location of maximum amplitude. These findings implicate that psychophysiological function expressed by P300 was declined in aging process and database of normal controls should be necessary for both research and clinical application.

다양한 정신증상들이 수반되었던 갑상선 기능저하증 1례

한상익,최수호 大韓神經精神醫學會 1984 신경정신의학 Vol.23 No.2

It is well known that hypothyroidism usually presents with depressive symptomatology and thyroid function screening has been an established practice to rule out depression secondary to hypothyroidism. Authors presented a 32 year old hypothyroid woman who showed various mental symptoms and was given psychiatric diagnoses. She showed schizophrenic symptoms on the first attack, depressive symptoms on the second, organic brain syndrome mixed with schizophrenic symptoms on the third, and on the last one, depression and anxiety. Literature review revealed there wre few, if any, that a patient with hypothyroidism showed different kind of mental symptoms on each different attack. Recently there have been many researches to study the relation between thyroid dysfunction and affective disorders. However, further studies focusing on the relation between hypothyroidism and mental symptoms other than depression would be important for diagnostic and therapeutic implication.

혈액투석기간에 따른 불안의 변화

한상익,이성필,유태열 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.4

Hemodialysis has become one of the indispensible choice of treatment for the patients with chronic renal failure and also has become popular and practical in the clinical field. However, it has been know that during hemodialysis most patients develop various neuropsychiatric problems, of which depression and anxiety are the most fequent and serious responses to the situation of survival dependent on dialysis machine. Most of the reports about the change of depression according to the period of time of hemodialysis has been consistent but that of anxiety has been controversial. This study was designed to evaluate whither there are change of severity of anxiety following hemodialysis. Subjects were consisted of 17 short-term hemodialysis patients, 18 mid-term hemodialysis patients and 19 long-term hemodialysis patients who were undergoing maintenance hemodialysis at Kangnam St. Mary's hospital, St. Vincent hospital and Holy family hospital from March to July 1987. Two different self-rating scales, Spielberger's state-trait anxiety inventory and Zung's self-rating anxiety scale, were applied to the subjects for elucidating the change of severity of anxity according to the period of time on hemodialysis. The results were as following: 1) On Spielberger's state anxiety inventory, the scores of short-term hemodialysis patients was 41.8±2.1, mid-term hemodialysis patients was 41.1 ±2.0 and long-term hemodialysis patients was 44.9±2.1 There were no statistically significant differences among 3 groups. 2) The scores of Spielberger's trait anxiety inventory for short-term, mid-term and long-term hemodialysis patients were 41.9±2.4, 44.8±2.3 and 48.7±2.4 respectively. 3 patient groups did not showed statistically significant differences. 3) The scores of Zung self-rating anxiety scale were 40.0±2.1 in short-term hemodialysis patients, 43.6 ±2.0 in mid-term hemodialysis patients and 46.6±1.9 in long-term hemodialysis patients. They also had no significant differences in statitics. 4) But all the scores of 3 sets of psychological tests were similar to those of Korean high school students, chronic medical patients and cancer patients but lower than those of the anxiety disorder patients. In conclusion, it was implicated that most of hemodialysis patients have mild to moderate anxiety with superimposed transient episodic severe fear for death during maintenance hemodialysis, which appeared to be not significantly changed during the course of hemodialysis.

'1998 한국인 우울증 선별의 날' 참가자들의 사회인구통계학적 특성과 우울증 선별검사 결과

한상익,이성필,고효진,박원명,장계호,유태열,전태연,채정호,방승규,김광수,최보문,이정태,백인호 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 1998년 정신건강의 날 기념 한국인 우울증 선별의 날 행사에 자발적으로 참여한 참가자들의 사회인구 통계학적 특성을 분석하고 우울증 선별검사 결과를 평가하기 위하여 본 연구를 시행하였다. 방 법 : 8개 병원에서 얻어진 619명의 자료를 사용하여 선별검사로 밝혀진 우울증의 유병율과 사회인구통계학적 특성 및 응답자의 정신과적 치료를 포함한 과거력 등을 조사하였다. 결 과 : 우울증 척도 점수는 응답자 전체 평균 57.5±13.8로 경도의 우울 증상이 있는 것에 해당되었다. 전체 응답자의 69.5%(430명)가 최소한 경도 이상의 우울 증상을, 43.1%(267명)가 중등도 이상의 우울 증상을, 18.4%(114명)가 고도의 우울 증상을 보였다. 고도의 우울 증상이 있는 응답자의 56.8%와 중등도의 우울 증상이 있는 응답자의 63.9%가 정신과 치료를 받은 적이 전혀 없었다. 나이가 29세 이하인 것과 전임근무 중인 직업상태는 각각 나이가 60세 이상인 것과 직업이 없는 것에 비교하여 우울증으로부터 보호하는 인자임을 시사하였다. 결 론 : '1998 한국인 우울증 선별의 날' 행사를 통하여 많은 우울증 환자들을 선별해낼 수 있었고, 이들의 우울 증상은 몇몇 사회인구통계학적 특성과 유의한 관계가 있음을 확인하였다. 우울증 선별의 날 행사를 통한 우울증에 대한 교육과 우울증 선별검사는 치료받지 못하고 있는 우울증 환자 및 기존의 치료 중인 환자 모두에게 유용한 프로그램임을 알 수 있었다. Objectives : This study was performed to analyze the sociodemographic characteristics of participants in '1998 Korean Depression Screening Day' and to evaluate the results of the screening test. Methods : By using the survey results of 619 volunteers from 8 hospitals, the authors examined the prevalence of depression detected at the screening test and sociodemographic characteristics and the psychiatric treatment history of respondents. The assessment measure was the Zung Self-Rating Depression Scale. Results : The mean depression score of all participants was 57.5±13.8 and it came under mild depression. Of all participants, 69.5%(N=430) had at least mild depressive symptoms, 43.1%(N=267) had at least moderate symptoms, and 18.4%(N=114) had severe symptoms. Never have 56.8% of respondents in the severely depressed range and 63.9% of those in the moderately depressed range had psychiatric treatment. The results suggest that the age group of 29-year-old or younger(relative to 60-year-old or older group) and full-time employment status(relative to unemployment) are protective factors of depression. Conclusions : By '1998 Korean Depression Screening Day', many depressed patients were detected and their depressive symptoms had statistically significant relationships with some sociodemographic characteristics. The results suggest that the education and screening test programs for depressive illness facilitated by Depression Screening Day are useful to the patients regardless of being under current treatment or not.