精神治療 個人指導監督에 대한 被監督者들의 意見調査Ⅱ

柳凡熙,趙斗英 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.2

This study is to investigate the opinions of supervisees on the individual supervision of psychotherapy. The subjects of the study are 3rd-year psychiatric residents working for the training hospitals all over the country in 1989 and psychiatric specialists certified in the same year. 112 persons, whose addresses were identified, were included in the study. The data for the investigation were collected from July 18 to October 28 in 1989 by means of a questionnaire sent by post. Among the 50 respondents, there were 28 psychiatric residents and 22 psychiatric specialists. We analyzed the content of the questionnaire. Results are as follows; 1) Among the respondents, the proportion of psychiatrists practicing psychotherapy is 70% in this study. This is lower than that from the previous study by the authors which was carried out on psychiatric residents working for Seoul National University Hospital and psychiatric specialists trained in the same university hospital. But It is higher than 58% derived from the other domestic study. 2) Conditions to be a good supervisor preferred by supervisees are `age of fifties' and `great experience'. The opinion that the sexual difference of supervisors is not important is somewhat more common than the opinion that men are preferred to women as supervisors. 3) The advantage of having more than one supervisor simultaneously is varieties of instructions' and `being more neutral and objective', and there are a lot of more positive responses. 4) The supervisees favor once per week as the ideal frequency of supervision and an hour per session as the ideal time. A standard for how to choose a case to be discussed in the supervision is to feel difficulty in treating patients. In the supervision, most of supervisees expect help from supervisors and have curiosity for learning, and some of them become tense or anxious. Most of them favor the 2nd-year residency as a good period for beginning supervision and believe that the individual supervision of psychotherapy is needed even after the residency training. 5) Most of supervisees favor 4-6 months as the ideal duration of supervision by one supervisor, but they want the supervision to be deeper and more analytic. Supervisees are usually satisfied with the psychotherapy supervision even though they often get angry with their supervisors. Considering these contradicting attitudes we are concerned that they are somewhat confused in understanding the nature of supervision. 6) The most appropriate method of the case presentation in supervision is verbatim-method and the best place for supervision is the personal office of a supervisor. 7) Most of the supervisees believe that the personal intimacy and good matching between supervisors and supervisees have a great effect on supervision. All of them expressed need to choose their supervisors freely for themselves, but they are skeptical about the practicality of the idea. 8) In the previous study by the authors, psychiatric residents tended to accept the opinions of supervisors more frequently than psychiatric specialists did when they had different ones, and the subjects of this study have a similar tendency to the psychiatric residents. Besides this, most of supervisees imitate supervisors more or less. 9) Among important learnings from supervisors, supervisees choose therapeutic attitudes to deal with patients' and `to know their own problems'. They believe that the most desirable improvement in supervision is to get deeper and more enthusiastic supervision.

주관적 각성도의 日週期 리듬이 교통사고 발생에 미치는 영향

유범희,조두영,정도언 大韓睡眠-精神生理學會 1994 수면·정신생리 Vol.1 No.1

Clozapine과 Haloperidol이 흰쥐의 미상피각과 측좌핵에서 Proenkephalin, Protachykinin 및 Proneurotensin의 유전자 표현에 미치는 영향

이종범,조희중,임효덕 대한생물치료정신의학회 1995 생물치료정신의학 Vol.1 No.1

Clozapine의 약리장용기전을 보다 구체적으로 밝혀보기 위하여, in situ hybridization의 방법을 이용하여 clozapine과 전형적 항정신병약물인 haloperidol의 장기 투여(28일간)가 흰쥐 미상피각 및 측좌핵에서 pENK, pTAK, pNT의 유전자 표현에 미치는 영향을 비교 분석하여 다음과 같은 결과를 얻었다. 1. pENK 유전자 표현에 미치는 영향 대조군의 경우 미상피각 및 측좌핵에 많은 pENK-mRNA 함유신경세포가 관찰되었다. Haloperidol 투여군의 경우 대조군에 비하여 미상피각에서 pENK-mRNA 함유신경세포들이 유의한 숫적증가를 보였으며(P<0.05). 측좌핵에서는 pENK-mRNA 함유신경세포의 유의한 숫적증가는 관찰되지 않았으나 pENK-mRNA 함유신경세포상의 은입자수의 유의한 증가가 관찰되었다(P<0.05). Clozapine 투여군의 경우 대조군에 비하여 미상피각 및 측좌핵에서 pENK-mRNA 함유신경세포의 수 혹은 pENK-mRNA 함유신경세포상의 은입자수의 변화는 관찰되지 않았다. 2. pTAK 유전자 표현에 미치는 영향 대조군의 경우 많은 pTAK-mRNA 함유신경세포가 미상피각 및 측좌핵에서 관찰되었으며 미상피각에서는 외측부에서 내측부보다 더 많은 pTAK-mRNA 함유신경세포를 함유하고 있었다. Haloperidol 투여군의 경우 대조군에 비하여 미상피각에서는 pTAK-mRNA 함유신경세포의 유의한 숫적감소(P<0.05) 및 pTAK-mRNA 함유신경세포상의 은입자수의 유의한 숫적감소가 관찰되었다 (P<0.05). 측좌핵에서도 대조군에 비하여pTAK-mRNA 함유신경세포의 유의한 숫적감소(P<0.05) 및 pTAK-mRNA 함유신경세포상의 은입자수의 유의한 숫적감소가 관찰되었다(P<0.05). Clozapine 투여군의 경우 대조군에 비하여 미상피각 및 측좌핵에서 pTAK-mRNA 함유신경세포의 수 혹은 pTAK-mRNA 함유신경세포상의 은입자수의 변화는 관찰되지 않았다. 3. pNT 유전자 표현에 미치는 영향 대조군의 경우 pNT-mRNA 함유신경세포는 미상피각에서는 매우 드물게 관찰되었으며 측좌핵의 경우 대조군에 비하여 미상피각 및 측좌핵에서 pNT-mRNA 함유신경세포 및 이들 세포상의 은입자수의 변화는 관찰되지 않았고, clozapine 투여군의 경우도 대조군에 비하여 아무런 변화가 관찰되지 않았다. 이상과 같은 연구결과는 clozapine을 장기투여할 경우, ENK, TAK 및 NT의 합성에 아무런 영향을 미치지 않음으로써, clozapine은 dopamine계나 dopamine계와 관련이 많은 GABA계, acethylcholine계와는 무관한 기전으로 작용하며 따라서 extra-dopaminergic system과의 관련성이 보다 중요한 기전임을 시사하고 있다고 하겠다. The goal of this study was to clarify pharmacological action mechanisms of clozapine(atypical antipsychotics) compared with haloperidol(typical antipsychotics). The author observed the level of proenkephalin(pENK) mRNA, protachykinin(pTAK) mRNA and proneurotensin(pNT) mRNA in the caudate putamen(CP) and nucleus accumbens(NA) of the rat with in situ hybridization histochemistry after chronic treatment for 28 days with haloperido(1mg/kg) and clozapine(20mg/kg). The results were as follows: 1) Haloperidol induced the elevated level of pENK-mRNA in CP and NA, but clozapine made no significant changes in the level of pENK-mRNA in both areas. 2) Haloperidol decreased the level of pTAK-mRNA in CP and NA, but clozapine made no significant changes in the level of pTAK-mRNA in both areas 3) The level of mRNA was not changed in CP and NA after chronic administration of haloperidol or clozapine. The results suggest that the longterm phamacological action mechanisms of clozapine were not related with the dopaminergic system and might also be unrelated with GABA system and Ach system, which have close connections with the dopaminergic system. So, clozapine is suspected to have a more important effect on the extradopaminergic system.

엔로플록사신 액제의 닭 호흡기 및 소화기 감염증에 대한 예방 및 치료효과

윤효인,박병권,조준형,정상희,박경환,장범수,김종춘,황윤환,임종환,이내경,박승춘 충남대학교 수의과대학 동물의과학연구소 2000 動物醫科學硏究誌 Vol.8 No.-

We evaluated the efficacy of the liquid form of enrofloxacin against poultry respiratory and digestive infections, the major problems in the poultry industry, from diverse diagnosis viewpoints. Results obtained through this study were as follows: 1. The liquid form of enrofloxacin showed good acceptability to poultry owing to no abhorrence to the drug by chickens, which indicated its suitability for mixing in drinking water. 2. The application of the enrofloxacin formulation improved the productivity of the chicken farm to a great extent by lowering the death toll of chicken raised in the farm. 3. The use of the drug shortened the days to the market, and increased the body weight at the time of marketing. 4. Preventive and therapeutic effects of the liquid enrofloxacin were observed higher than ampicillin, a major antibiotic used in poultry farming. From above results, the liquid form of enrofloxacin would find its use for the prevention and treatment of digestive and respiratory infections, let alone the growth promotion and feed efficiency, especially in the chicken farming practice.

LC, Acute : PE-120 ; Clinical severity according to age groups and risk factors for complicated hepatitis in patients with acute hepatitis A virus infection

( Byung Jun Jeon ),( Bum Su Choung ),( In Hee Kim ),( Dae Ghon Kim ),( Soo Teik Lee ),( Eun Young Cho1 ),( Gum Mo Jung ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Symptomatic acute hepatitis A virus (HAV) infection in adulthood is increasing in Korea recently. The aim of this study was to analyze the clinical severity according to age groups in patients with acute hepatic A and to investigate factors associated with complicated hepatitis A. Methods: We performed a retrospective analysis of 726 patients who were diagnosed with acute viral hepatitis A from January 2005 to September 2011 at three tertiary hospitals at Jeonbuk Province. We analyzed the clinical severity according to age groups, <20 year (n=84), 21-39 years (n=546), ≥40 years (n= 96). Complicated hepatitis was defined as hepatitis combined with one of three major complications, such as severe jaundice (peak total bilirubin level ≥15 mg/dL), acute renal failure, acute liver failure. Results: Of total 726 patients, mean age was 30.1 years, 453 (62.4%) were male, HBsAg was positive in 33 (4.5%). Severe jaundice occurred in 43 (5.95%), acute renal injury occurred in 16 (2.2%), and acute liver failure occurred in 24 (3.3%). The incidence of acute renal insufficiency was significantly increased according to the aging groups were <20: 1.2%(1/84); 21-39: 1.8% (10/546); ≥40: 5.4%(5/96) (p=0.032).The incidence of severe jaundice and hepatic failure were also significantly increased according to the aging groups [<20: 3.7% (3/84); 21-39: 5.2% (27/546); ≥40: 15.6%(13/96), p=0.003, and <20: 0.0% (0/84); 21-39: 3.6% (19/546); ≥40: 5.4% (5/96), p=0.045]. Multivariate analysis showed that old age (≥40years) (p=0.006), female (p=0.002), and HBsAg positivity (p=0.013) were significant risk factors for complicated hepatitis A. Conclusions: Old age group (≥40 years) showed more likely complicated with severe hepatitis A compared to younger age groups. In addition, female and HBsAg positivity were also significantly associated with complicated hepatitis A.

엔로플록사신 액제의 닭유래 병원세균에 대한 시험관내 항균효과 시험

윤효인,박병권,조준형,정상희,박경환,장범수,김종춘,황윤환,임종환,이내경,박승춘 충남대학교 수의과대학 동물의과학연구소 2000 動物醫科學硏究誌 Vol.8 No.-

In this study the antimicrobial spectrum and sensitivity of a liquid formulation of enrofloxacin against the major six pathogenic bacteria isolated from the diseased poultry in Korea were evaluated in comparison with ciprfloxacin (CFX), gentamicin (GM) and penicillin (PC). A liquid form of enrofloxacin, a test material and ciprofloxacin showed at least 83% antibacterial activity against all of six test pathogenic microorganisms at the fixed concentration of 10 ㎍/㎖. Gentamicin and penicillin revealed much lower antibacterial activity at the same condition. We evaluated the liquid form of enrofloxacin as having widespread antibacterial spectrum against poultry infections. The liquid form of enrofloxacin showed potent antibacterial activity, with the MIC range being 0.12∼2 ㎍/㎖ against Gram positives, 0.06∼2 ㎍/㎖ against Gram negatives and 0.5∼2 ㎍/㎖ against Mycoplasma spp. These values were equivalent to or somewhat higher than those of ciprofloxacin, but much lower than those of gentamicn and penicillin. This new liquid form of enrofloxacin would find its way in application of mixing with drinking water for the prevention and treatment of diverse infections in chickens.

20km와 150km의 도로싸이클 주행이 혈중 렙틴, 지질과 호르몬 수준에 미치는 영향

최용어,권봉안,오재근,김범수,조준용,김문희 한국체육대학교 체육과학연구소 2000 韓國體育大學校附屬 體育科學硏究所論文集 Vol.19 No.1

Serum leptin, glucose, lipid profiles (free fatty acid, triglyceride, total cholesterol) were determined in two groups of subjects undergoing long and short strenous cycle race, 8 men who fasted overnight and then pedaled 20km cycle race and 8 men, 150km cycle race, respectively, Blood samples were collected before race, immediately after cessation of race and 2hr, 6hr after the end of race period. Cyclist pedaling 20km cycle race and cyclist pedaling 150km cycle race showed no statistical differences in leptin level. After 6hr of rest, leptin concentrations were gradually decreased but showed no statistical different in both groups. Epinephrine (p〈.01) and norepinephrine (p〈.001) concentration in comparison to pre-race levels were increased significantly. But insulin concentration in comparison to pre-race levels were decreased significantly (p〈.001). Glucose (p〈.01), free fatty acid (p〈.001), cholesterol (p〈.001) and triglyceride (p〈.01) were increased immediately after cessation of race in both groups.

측뇌실내 종괴의 감별진단 및 수술적 치료

김동규,김봉수,이상형,심기범,왕규창,정희원,김현집,조병규,최길수,한대희 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

We present a series of 42 patients with the lateral ventricular mass lesions who underwent operative removal between 1979 and 1992 at the Seoul National University Hospital. These lesions included 29 tumors, 10 benign cysts and 3 arteriovenous malformations. There were 20 lesions in the trigone, 14 in the frontal horn, 6 in the body, and 2 in the temporal horn. Together with the age of the patient, the location in the lateral ventricle and the CT or MR patterns, the range of the differential diagnosis of the lesions can be narrowed. The mass were removed by various surgical approaches ; 11 by the middle frontal gyrus, 10 by the superior parieto-occipital, 13 by the middle temporal gyrus, 4 by the anterior transcallosal, 2 by the posterior transcallosal and 3 by the combined approaches. The superior parieto-occipital approach left postoperative morbidities in 64% and other approaches in 20 to 25% of the cases. These morbidities included hemiparesis, hemianopsia, aphasia, memory distubance and seizure. Most hydrocephalus disappeared without the shunting procedure after removal of the lateral ventricular mass. The high frequency of postoperative complications in the superior parieto-occpital approach require meticulous consideration in the selection of this approach.

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.

Effect of Partial Dietary Substitution of Meat Meal for Fish Meal on the Growth and Body Composition of the Juvenile Olive Flounder Paralichthys olivaceus

Cho Sung Hwoan,Lee Sang-Mok,Park Bum-Hee,Park In-Seok,Choi Cheol Young,Lee Sang-Min,Min Byung Hee,Hur Sung-Bum,Lim Young Soo The Korean Society of Fisheries and Aquatic Scienc 2005 Fisheries and Aquatic Sciences Vol.8 No.3

This study was conducted to investigate the effect of partially substituting meat meal for fish meal on the growth and body composition of juvenile olive flounder Paralichthys olivaceus during the winter season. Twenty-five fish (initial body weight, 23 g) were distributed into twelve 250 L flow-through tanks. Four experimental diets were prepared in triplicate: the control, MM20, MM40, and MM60 diets. Sixty percent mackerel meal was used as the primary protein source in the control diet. Meat meal was substituted for 20, 40, and 60$\%$ of the mackerel meal in the MM20, MM40, and MM60 diets, respectively. Survival was not significantly affected by the experimental diets. However, the weight gain and specific growth rate of fish fed the control, MM20, and MM40 diets were significantly higher than those of fish fed the MM60 diet (P<0.05). The feed efficiency ratio of fish fed the control, MM20, and MM40 diets was significantly higher than that of fish fed the MM60 diet (P<0.05). The protein efficiency ratio for fish fed the control diet was significantly higher than that for fish fed the MM40 and MM60 diets (P<p0.05). Moisture, crude protein, crude lipid, and ash content, and blood chemistry of the flounder at the end of the feeding trial were unaffected by the experimental diets. Considering these results, it can be concluded that up to 40$\%$ substitution of meat meal for fish meal in the diet could be implemented without a reduction in growth or deterioration of the feed efficiency of juvenile olive flounder during the winter season.