만성 정신분열병 환자에서 지연성 운동장애와 음성증상 및 인지기능 장애와의 연관성

심주철,반철식,성기수,이정구,정도운,정청,윤진상,김영훈 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: 정신과 전문병원에 입원해 있는 만성정신분열병 환자들을 대상으로 첫째 지연성 운동장애의 유병율과 위험인자들을 조사하고, 둘째 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성을 조사하고자 한다. 방법: 연구대상자는 마산동서병원에 입원 중인 환자 중 DSM-IV의 정신분열별 진단기준에 부합하며, 최근 3개월 이상 동일 용량의 항정신병약물 복용한 271명(남자 174명, 여자 97명)의 환자들이었다. 지연성 운동장애에 대한 평가는 Abnormal Involuntary Movement Scale(AIMS)을 이용하였고, DSM-IV와 Sc-hooler와 Kane(1982)의 진단기준 양자에 부합하는 환자들만을 지연성 운동장애군으로 분류하였다, 정신 분열병 정신병리에 대한 평가는 Brief Psychiatric Rating Scale(BPRS)와 Schedule for the Deficit Syndrome(SDS)을 이용하였고, 인지기능에 대한 평가는 Mini-Mental Status Examination(MMSE)을 이용하였다. 결과: 지연성 운동장애의 유병율은 50.9%이었고, 50세 이상, 남자에서 높았다. 그러나 입원기간과 항정신병 약물의 일일 사용량에 따른 차이는 없었다. 지연성 운동장애의 호발부위는 혀, 상지, 입술과 입 주위의 순이었다. BPRS 총점 및 소항목 척도점수와 SDS 척도점수는 지연성 운동장애의 유무에 따른 차이가 없었다. MMSE 총점 및 소항목 점수도 지연성 운동장애의 유무에 따른 차이가 없었다. 결론: 평균입원기간이 9년 이상인 만성정신분열병 환자들에게서의 지연성 운동장애의 유병율은 50.5%이었고, 연령이 가장 의미있는 위험인자임을 확인했다. 만성정신분열병 환자들이 주 대상인 본 연구에서는 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성은 입증하지 못했다. Objectives: The purpose of present study was to determine the prevalence rate of tardive dyskinesia and to search for its risk factors in chronically institutionalized schizophrenic subjects. We also examined the relationship between tardive dyskinesia and both negative symptoms and cognitive impairments in the same subjects. Methods: Subjects were 271 in-patients(174 males, 97 females) at Masan Dongsuh Hospital. They met DSM-IV criteria for schizophrenia and had been taking fixed doses of antipsychotics for at least 3 months. Tardive dyskinesia was assessed by Abnormal Involuntary Movement Scale(AIMS). Cases of tardive dyskinesia were ascertained by the criteria of Schooler and Kane (1982) and DSM-IV. The rating of psychopathology was acquired using Brief Psychiatric Rating Scale(BPRS) and Schedule for the Deficit Syndrome(SDS) and the assessment of cognitive function using Mini-Mental State Examination(MMSE). Results: The prevalence of tardive dyskinesia is 50.9% and the frequency of tardive dyskinesia was high est in male above the age of fifty. But there was no statistically significant relationship between the frequency of tardive dyskinesia and both the length of hospitalization and the daily dose of antipsychotics. The frequency order of abnormal movement in the patients with tardive dyskinesia was as follows : tongue, upper extremities, lips and perioral area. We couldn't find any significant difference in the total and subscale scores of BPRS between the groups with and without tardive dyskinesia. There were no differences in MMSE scores between the groups with and without tardive dyskinesia. Conclusion: This study gave us that the prevalence of tardive dyskinesia was high in chronically institutionalized schizophrenic inpatients and that age was the most significant risk factor of tardive dyskinesia. The relationship between tardive dyskinesia and both negative symptoms and cognitive impairment, however, was not revealed.

좌심실 이완기 장애 평가에서 Atrioventricular Plane Displacement의 임상적 중요성

정연손,조구영,이태유,김근숙,최창순,류제헌,최민호,박우정,임종윤,이영 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.12

만성정신질환자의 계속입원치료 심사에 관한 연구

정인원,박환규,정연복,김수일,원구연,김교형,신철진 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 정신보건법에 근거하여 매월 정기적으로 개최된 충청북도 정신보건심판위원회를 통하여 정신질환자의 계속입원치료 청구 심사의 현황과 문제점을 파악하고 개선사항을 지적함으로써 정신질환자의 효율적인 관리를 유도하고 인권남용의 여지를 차단하고자 한다. 방 법: 충청북도 내의 정신의료기관에서 계속입원치료 심사청구서 및 진단서, 보호의무자의 동의서 등을 제출한 정신질환자들을 대상으로 계속입원치료 청구에 대한 승인 여부를 매달 정기적으로 심사하였다. 1년 6개월여동안 심사한 자료를 정리하여 진단 및 보호의무자, 의료보장별 특성과 불승인률 등을 분석하였다. 결 과: 충청북도 심판위원회에 계속입원치료를 청구한 정신질환자는 21차례의 위원회 동안 총 7,981명이었으며, 진단별로 정신분열병은 80.9%, 알콜중독은 8.1%, 치매 등 기타는 11.0%이었다. 또한 보호의무자는 시장 또는 군수가 29.8%, 부모가 26.9%, 형제가 26.1%, 부부가 6.3%, 자녀가 5.9%, 기타가 5.0%로 나타났으며, 의료보장은 의료보호가 73.0%, 의료보험이 27.0%이었다. 이들 중에서 196명이 계속입원치료를 불승인받아서 전체 불승인률은 2.46%이었으며 정신분열병과 알콜중독 환자의 진단별 불승인률은 각각 0.73%와 17.6%이었다. 결 론: 정신과 병상의 대부분이 장기적으로 입원하는 만성 정신질환자들로 구성되어 있어서 이들에 대한 별도의 대책이 시급하다. 또한 계속입원치료가 불승인되어 퇴원한 환자들의 재활 및 사회적응을 위한 사회적 지지 체계가 부족하며, 특히 환자의 인권보호를 위한 구체적인 기준 등이 필요하다. Objectives: This study was to develop effective managements and to avoid the abuse of human rights in mentally-ill patients. The Mental Health Judgement Board of Chungchongbuk-do province has been held monthly since August, 1997 according to the Mental Health Act. In this study, the procedures and the problems of judging continuing hospitalization of chronic mentally-ill patients were reviewed. Methods: The mentally-ill patients who submitted the request for continuing hospitalization with the certificate of charged doctor and the agreement of caregiver were reviewed by the Mental Health Judgement Board of Chungchongbuk-do province. The analysis of the diagnoses, caregivers, medical care systems, and rejection rate for the patients were done. Results: Total mumber of mentally-ill patients who requested for continuing hospitalization were 7,981 from twenty-one monthly meetings. The diagnostic distributions were 80.9% for schizophrenic patients, 8.1% for alcoholics and 11.0% for others including dementia. As for the caretakers, the rate of majors was 29.8%, parents 26.9%, sibling 26.1%, spouse 6.3%, offspring 5.9%, and others 5.0%. And 73.0% of the patients were on Medicaid and 27.0% were insured. The patients who got the rejection for continuing hospitalization were 196 at the rate of 2.46%. And the rejection rates of schIzophrenic and alcoholic patients were 0.73% and 17.6%, respectively. Conclusions: New policies for decreasing longterm hospitalization of chronic mentally-ill patients are required. And the social support systems for psychiatric rehabilitation and readjustment are presently insufficient for the already discharged mentally-ill. Moreover, the practical guidelines for human rights of patients remains to be suggested.

초지연제의 응결시간차를 이용하여 수평분할 타설한 매스 콘크리트의 온도이력 특성

전충근,윤치환,신동안,오선교,한천구 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

In this paper, field application test of super retarding agent is discussed to reduce hydration heat of mass concrete considering setting time difference of super retarding agent by using horizontal placing layer in Megatrium building construction field at Yongsan in Seoul. Properties of fresh and hardened concrete and hydration heat are investigated, According to test results, both base concrete and flowing concrete meet the requirement of designed slump and air content, although some variances exist. As for compressive strength, it also satisfies the specified strength the consumer need in base concrete and hardened concrete. As for hydration heat, highest temperature of middle section in top placing layer is 65v at 28hours, and in bottom placing layer is 73℃ at 68hours.

Eugenol, Capsaicin 과 Demethoxy - NE가 치수동통 반응에 미치는 영향

이은구,이정식 大韓齒科保存學會 1992 Restorative Dentistry & Endodontics Vol.17 No.1

The purpose of this study was to invesigate the analgesic effect of eugenol, capsaicin and demethoxy-NE. Young about cats, weighing 2.0 to 3.0kg, were used. Each animal was anesthetized (α-chloralose 60mg per kg body weight) and divided into four groups; control, eugenol, capsaicin and demethoxy-NE group. The anterior digastric muscles were exposed and a pair of electrodes was inserted to record the electromyograms. To expose the pulp, each canine teeth was prepared with a low speed bur under cooling and used for recording anterior digastric muscular EMGs evoked by noxious stimulation of dental pulp. To observe effects on jaw opening reflex, inferior alveolar nerve of both sides were exposed for drug application and wire electrodes were inserted in anterior digstric muscle for recording the EMGs. To observe effects on action potential, saphenous nerves of both sides were exposed and three tissue pools were made from surrounding tissue. The most distal pool was used for applying stimulation, the most proximal one for recording of action potential, and the other one for drug application. One side of inferior alveolar nerve and saphenous nerve were used for eugenol, capsaicin, or demethoxy-NE application, the other side of nerve for control experiments(only vehicle application). Anterior digastric muscular EMGs evoked by noxious stimulation of dental pulp were recorded before drug application, immediate after drug application, at 60 and 120 minutes, and 5 days after drug application. Action potentials were recorded before application, immediate after 30 minutes drug application, at 30, 60 and 120 minutes after drug had been washed out. The results were as follows; 1. Eugenol had a continuous blocking effect on the anterior digastric muscular EMGs evoked by noxious pulp stimulation and after 5 days, showed completely blocking effect. 2. After 5 days, demethoxy-NE applied to dental pulp had a considerable blocking effect on the jaw opening refex evoked by noxious stimulation but capsajcin had no significant effect. 3. After 5 days, eugenol group showed the strongest blocking effect among the all experimental groups on the jaw opening reflex evoked by noxious stimulation of dental pulp and capsaicin group showed the weakest blocking effect. 4. Eugenol had a completely blocking effect on the action potential conductivity of peripheral nerve. Capsaicin and demethoxy-NE had the blocking effect on the action potential conductivity of Aδ and C-nerve fibers. 5. Capsaicin, demethoxy-NE and eugenol applied to inferior alveolar nerve surppressed the jaw opening reflex evoked by noxious stimulation of dental pulp.

압력센서의 디지털 인터페이스와 신호처리에 관한 연구

강형구,이종호,안광희,이충호,박찬원 江原大學校 産業技術硏究所 1997 産業技術硏究 Vol.17 No.-

A smart pressure measurement system is described, which provides a precise A/D conversion and is highly suitable for communication with microprocessors. In order to avoid unstable problems of remote pressure sensing we have developed a new interface board which performs the A/D conversion and smart signal processing of the measured pressure data Serial communication software which is based on ASCII code commands is also developed to process initial setup an calibration functions as well as multi-drop communication with PC. The test and evaluation of the proposed system has been shown as having the better performance compared to the other types of existing pressure measuring systems and will give good applications to the industrial use where a highly precision remote sensing is needed.

동국제강에서 배출되는 대기오염물질이 인접지역 환경에 미치는 영향

朴淸吉,李起浩,李濟根,許喆九 釜山水産大學校 1989 釜山水産大學 硏究報告 Vol.29 No.1-2

The environmental effect of air pollutants emitted from Dong-Kuk Steel Company on neighboring area was assessed by measuring air pollutants and using the computer simulation model. Some results from this study were summarized as follows; The concentration of sulfur dioxide in winter was mostly exceeded the Air Quality Criteria(0.05ppm) but its annual average concentration was far below the Criteria. However, the annual average concentration of total suspended particulates(TSP) in the atmosphere(170㎍/㎥) was largely exceeded the Criteria(150㎍/㎥) and the fluctuation of its concentration between months was very great. The results calculated from the computer simulation by TEM-8 Model showed that the air quality in this region was fairly good in view of the concentration of sulfur dioxide with the range from 0.01 to 0.03ppm. However, it was assessed by simulation that when the wind blew from the ESE direction the maximum concentration of sulfur dioxide might be reached up to 0.078ppm and then could be largely exceeded the Criteria. Fortunately, according to the data from in situ measuruement, those undesirable wether condition was little occurred during the term of research.

시멘트 킬른 더스트를 사용한 콘크리트의 역학적 특성에 관한 연구

전충근,차천수,차완호,손성운,한천구 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

This paper is intended to investigate the properties of fresh and hardened concrete, in which cement and fine aggregate are replaced with cement kiln dust(CKD), for effective using method of CKD, a by-product produced in the process of making cement. According to the results, as the replacing ratio of CKD increases, slump and air content of concrete decreases remarkably due to an increase of viscosity and filling of the pores respectively. As the properties of setting, setting time are shortened with an increase of the replacing ratio of CKD. Compressive strength increases due to the filling effect of the pores in comparison with plain concrete, and compressive strength ratio is high at early age.

고유동 콘크리트용 분리저감형 유동화제의 개발에 관한 기초적 연구

전충근,손성운,김성수,한천구 청주대학교 산업과학연구소 2001 産業科學硏究 Vol.19 No.1

The purpose of this paper is to develope segregation reducing type superplasticizer for high fluidity concrete and to manufacture high fluidity concrete by applying developed segregation reducing type superplasticizer using flowing concrete method in the rane go of 45% of W/C. According to test results, as dosage of superplasticizer increases, it shows that fluidity and bleeding increase, while air content and segregation resistance decrease. It also shows that adding of viscosity agent reduce bleeding and improve segregation resistance. Dosage of AE agent recovers loss of air contents during flowing Procedure. Combination of proper contents of superplasticizer, viscosity agent and AE agent make possible to develope segregation reducing type soperplasticizer According to experimental results, optimal proportion of superplasticizer, viscosity agent and AE agent show to be 1'0.60'0.027 Compressive strength of high fluidity concrete is simihar to comprssive strength of base concrete

우울증의 약물치료

이정구,공보금,김영훈 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

As The Celluar and molecular pathology of depression were revealed, the newer drugs will be adapted by the treatment of depression. For the adequate treatment of deperssion psychiatrist must know the typical symptoms of depression and the target symptoms of pharmacotherapy and the profile of adverse effects, the genetic inforamtion of individulas. The selection of antidepressant according to the indvidual variation of genetics will be very improtant.