일부 산업재해 환자들에서 외상후 스트레스장애

최경숙,임채기,최재욱,강성규,염용태 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.3

연구목적 : 우리나라에서 산업 재해로 신체적 손상을 입고 입원해 있는 일부 근로자들을 대상으로 PTSD 발병여부를 조사하고, 산업 재해와 관련된 위험 인자를 파악하여 산업재해 이후 근로자들이 겪게 될 신체적 건강문제 뿐만 아니라 정신적 건장 문제 회복에 도움을 주고자 하였다. 방 법 : 2000년 7월에서 2000년 9월 사이에 산업 재해로 인해 신체적인 부상을 입고 입원 중인 인천 소재 산재병원의 남성 입원환자 47명을 대상으로 PTSD 발병여부와 관련 인자를 연구하기 위하여 구조화된 설문 조사와 CAPS를 이용한 진단적 면담을 시행하였다. 결 과 : CAPS를 이용한 면접조사 결과 최종 연구 대상자 47명중 12명(25.5%)이 PTSD로 나타났으며, 모두 증상의 지속 기간이 3개월 이상인 만성 외상후 스트레스장애로 분류되었다. PTSD군 12명과 non-PTSD군 45명을 비교한 결과 BDI, STAI-I, STAI-II, IES 점수는 PTSD 군에서 유의하게 높게 나타났다. 또한 SCR-90-R의 세부항목 중 편집 사고를 나타내는 PAR 점수가 유일하게 두 군 사이에 유의한 차이를 보이지 않았고 그 외의 항목들은 PTSD 군에서 유의하게 높았다. 산재 관련 위험 인자의 비교에서 환자가 주관적으로 보고한 의식의 상실 경험만이 PTSD군에서 유의하게 높게 나타나 이전의 다른 연구자와 일치된 소견을 보였다. 결 론 : 이상의 결과는 산재 사고 이후에 PTSD가 발생하고, 증상이 장기간 지속되어 만성화를 겪을 가능성이 있다는 것을 보여준다. 위험 인자 중에서 사고 관련 위험 인자로 의식의 상실에 대한 주관적인 보고만이 관련성이 있는 것으로 나타났으나, 그 외의 다른 인자들은 관련서이 없는 것으로 나타났다. 그러나 여러 가지 연구의 제한점이 많으므로 연구 시점을 달리하고 많은 대상자를 포함한 후속 연구를 시행해야 산업재해와 PTSD에 대한 이해를 높일 수 있을 것으로 사료된다. Objectives : This study was conducted to assess the development of posttraumatic stress disorder(PTSD) after occupational physical injuries and the risk factors in occupational accident patients for PTSD. Methods : Forty-seven occupational accident patients with physical injuries were administered BDI. STAI I and II, SCL-90-R, IES and questionnaires for risk factors and Clinician-Administered PTSD Scale(CAPS). Results : 1) 12 patients(25%) were diagnosed as PTSD. 2) The BDI, STAI I and II and IES scores are significantly high(<0.05) in PTSD group than non-PTSD group. 3) The subscales of SCL-90-R, with an exception of PAR subscale, showed higher scores(<0.05) in PTSD group. 4) The loss of consciousness(LOC) was only significant risk factor in the occupational accident related factors(<0.05). Conclusion : The results of this study show the development of PTSD among occupational accident patients. The loss of consciousness(LOC) was the only significant risk factor for PTSD in occupational accident patients.

모유영양아와 인공영양아의 피하지방 및 상완위의 성장발육 상태 : 영아의 피하지방 및 상완위 발육상태

최경숙,최혜미,구재옥,임경숙,김주혜,김숙배 동아시아식생활학회 1997 동아시아식생활학회지 Vol.7 No.1

One- to three- month-old infants (n=232) were compared their upper arm cumference and skinfold thickness(triceps, subscapular) by feeding methods in cross-sectional study. There were two groups : breast-fed(BF) and formula-fed groups(FF). As reported previously^(7)), weight, length, head and chest circumferences of these infants were good, and overall growth status was not significantly different by feeding methods, but weight, weight velocity and chest circumference of formula-fed infants were higher than breast-feds at 3 month, significantly. Here, the triceps skinfold thickness of infants at 1, 2, and 3 postpartum months were 7.4, 9.5 and 10.5 ㎜, respectively. The triceps skinfold thickness of breast-fed infants were higher than formula-feds at 1 and 2 postpartum month, but at 3 month, that of formula-fed infants was greater than breast-fed infants, insignificantly. The subscapular skinfold thickness of infants were 6.4, 9.2 and 10.6 ㎜ at 1 to 3 postpartum months, respectively. The upper arm circumference of infants were 11.7, 13.4, 14.3㎝, and the arm muscle diameter were 34.5, 39.3 and 41.7㎝ at one to three postpartum months, respectively. The upper arm circumference of male infants was higher than females at 2, 3 postpartum months. Overall, there were no significant differences between feeding methods in triceps and subscapular skinfold thickness, upper arm circumference and arm muscle diameter. But 3-month-old formula-fed male infants showed bigger significantly in arm circumference than the breast-feds. From this survey, long-term survey on growth and body composition of large scales might be necessary to determine the effect of feeding methods of infants after 3 months and to set proper body composition standard for infant.

가족성 정신분열병 환자에서 임상 특성의 가족내 연관성

최경숙,이유상,장용이,조은영,전현옥,김창현,김상욱,홍경수 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study aims at examining familial associations of symptoms and clinical characteristics in affected sibling or relative pairs of schizophrenia as an effort to identify genetically homogeneous phenotypes. Methods : Forty-seven relative pairs with DSM-IV diagnosis of schizophrenia from thirty-five Korean families multiply affected with schizophrenia were ascertained. Direct interviews were done using the Korean version of Diagnostic Interview for Genetic Studies (DIGS). The Krawieka Rating Scale and the Schedule for the Deficit Syndrome were also applied for further evaluation of psychopathologies. Intra-familial concordances and correlations of clinical characteristics and symptoms were tested using χ² -test and Spearman's correlation. Results : Significantly high concordance rate within relative pairs was found for the diagnosis of paranoid vs. non-paranoidsubtype (χ²=7.623, P=0.006, df=1). Deficit vs. non-deficit syndrome also showed significant concordance (χ² =3.850, p=0.0497, df=1). Among single symptom items in DIGS, only 'auditory hallucination' showed significant concordance rate ( χ² =5.503, P=0.019, df=1). Factor analysis for symptoms items in the Rrawiecka Rating Scale indicated three symptom dimensions ; negative, psychotic and affective, Psychotic (P =0.442, P=0.003) and affective dimension scores (p =0.427, P=0.004) showed significant intra-familial correlations. Age at onset of recognized psychotic symptoms showed significant correlation only within the male sibling pairs. Conclusion : Familial factors, Possibly genetic factor contribute to the phenotypic characteristics of paranoid vs. non-para-noid subtype, deficit vs. non-deficit syndrome, auditory hallucination, and affective syndrome, It supports their use in the delineation of homogeneous subgroups for future genetic studies.

정신분열병의 비이환 형제 자매 집단에서 얼굴 정보처리 관련 뇌회로의 이상 : 기능적 뇌자기공명영상 예비 연구

최경숙,정범석,김지웅,최지욱 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.2

Objectives A neural circuit including amygdala, the hippocampal complex and prefrontal cortex was associated with deficits in facial processing in schizophrenia. These deficits have a significant impact on social functioning in schizophrenia. Both neuropsychological deficits and brain structural abnormalities in first-degree relatives of schizophrenia patients suggest that they may also have the deficit in facial information processing as genetic factors. The purpose of this study was to explore the dysfunction of facial information processing in first-degree relatives of schizophrenia patients using functional magnetic neuroimaging (fMRI). Methods Ten non-affected siblings of schizophrenic patients and 10 normal comparison subjects having no schizophrenic siblings underwent fMRI during the dynamic facial change procedure consisting of presentations of facial emotion and gender discrimination stimuli. The emotion discrimination condition consisted of the presentation of 12 happy faces and 12 disgust/fear faces. The gender discrimnation condition consisted of the presentation of 12 male faces and 12 female faces. Condition-specific brain activations were compared between non-affected siblings and normal comparison subjects Results The facial information processing related brain regions including fusiform gyrus, several areas of frontal, temporal, occipital, and cerebellar regions exhibited more activation during gender discrimination than emotion discrimination tasks in each group. During gender discrimination task, siblings of schizophrenic patients showed less activation in right fusiform gyrus, both middle and superior frontal gyrus, left cuneus, and left inferior frontal gyrus, compared with normal comparison subjects. Conclusion Dysfunctional facial information processing, such as a deficit in gender discrimination, might be an endophenotype of schizophrenia.

우리나라 산재보험의 정신질환 인정실태

최경숙,이현주,김세진,이창화 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

Objectives : The purpose of this study was to determine characteristics of work-related psychiatric injuries with Korean Workers' compensation data. Methods : We analyzed the distribution of sex, age, types of work-related psychiatric disorders, type of industry and occupation. Using the data of 3175 Korean workers' compensation cases who were compensated for work-related psychiatric injuries from 2001 to 2003. Results : Work-related psychiatric injuries have increased annually. 897 cases, 1099 cases and 1179 cases were compensated during three years (2001-2003). Men accounted for many more cases than women. The most common age group was 41 -49. The majority of work-related psychiatric injuries were 'organic, including symptomatic, mental disorders', 'neurotic, stress-related and somatoform disorders' and 'mood [affective] disorders'. For accidental psychiatric injury cases construction and manufacturing were the most common industries. Manufacturing, business activities, construction and transport were common in regard to work-related psychiatric disorders. In this study there was a high frequency of craft and related trades workers, elementary occupations and plant and machine operators and assemblers in accidental psychiatric injury cases. Work-related psychiatric disorders were frequent for elementary occupations, plant and machine operators and assemblers, craft and related trades workers, service workers, legislators, senior officials and managers. Conclusion : This investigation provided more information about the psychiatric injuries of Korean workers. These findings should help formulate intervention and prevention strategies of work-related psychiatric disorders.

한국전통생활문화에 관한 고찰

이숙,홍윤호,신윤숙,신효식,한경미,최정미,김은정 全南大學校家政科學硏究所 2002 生活科學硏究 Vol.12 No.-

This study is objected on preliminary research for more scientific and wider studies on the Traditional Living Culture of Korea. For this purpose, studies about clothing, food, home management, Traditional Living Culture were reviewed and analysed. The results were as follows : First, Clothing culture studies concentrated on ritual clothings, Second, Food Culture studies included history of traditional food development and recipes. Third, in the field of home management value system, attitudes and parent-child relations were studied,

마약성 진통제 사용에 관한 지식 및 태도의 비교

김경희,최경숙,이순실,이병구 한국병원약사회 2000 병원약사회지 Vol.17 No.4

Narcotic analgesics has been known as representitive drugs for pain control n terminally ill patient with palliative care, narcotic analgesics use is most effective and best, way to reduce pain in that patients However many patients are poorly complient with narcotic analgesics for lack of knowledgement of narcotics effect, perception of addictive drug, tolerence and adverse reaction. In addition to many doctors do not choose the adequate narcotics according to pain severity. It has been reported that effective pain management has not been achieved by doctors and nurses because of shortness of knowledgement of narcotic use on administration. This study was performed to identify pharmacist knowledgement of narcotic analgesics in respect that the pharmacist are responsible for patient education of narcotic medication, to identify the barrjers of narcotic dispensing and administration and then to compare the knowledgement between doctors, nurses and pharmacist. At first we surveyed the pharmacist's knowledgement and attitude by written questionnaire in SNUH in Sep. 2000, and then we compared this result and doctors and nurses' result has been taken already in SNUH in May 1999. The questionnaires are composed of narcotics classification 11, narcotic pharmacology 8, narcotic administration 5, more detail question 15 cited in Elliot study. The result is analysed by average, S.D., frequency, percentile, comparison of knowledgement of doctors, nurses and pharmacist is analysed by paire t-test, ANOVA. As a result, the pharmacist group has higher average in knowledgement of narcotic analgesics, however it was not different from doctor and nurse's significantly. According to result of attitude analysis, 48% of pharmacist has been hesitated in dispensing and administration of narcotics, that was because of the difficulty in management of narcotic prescription (25%). The role of pharmacist in pain management of patients who take narcotic analgesics is very important and great. We ought to obtain a certain of accurate knowledgement of narcotic analgesic use and perform a effective and responsible medication education and counseling.

정신분열병에서 결핍증후군의 진단적 안정성 평가 : 5년간 추적 조사 A 5-year Follow-up Study

박동연,최경숙,이동수,홍경수 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

둥시 장아찌 제조 과정 중 이화학적 특성 변화

차원섭,백신경,나경민,박준희,오상룡,이원영,천성숙,최웅규,조영제 한국응용생명화학회 2003 Applied Biological Chemistry (Appl Biol Chem) Vol.46 No.4

떫은감 품종의 하나인 등시를 이용하여 감장아찌 제조 중 과육의 이화학적 변화를 조사한 결과, 염도 변화는 저농도 간장 및 된장 침지의 경우 다소 완만한 증가를 보였고, 고농도의 간장 및 된장 침지의 경우 침지 기간내내 증가하는 것으로 나타났다. 간장 침지액 감장아찌의 경도는 간장 및 된장 모두 20-80% 농도에서는 침지 초기에는 증가하다가 침지 기간이 경과할수록 감소하는 경향을 나타내었다. 간장 침지 감장아찌의 색도 변화는 저장기간이 경과할수록 명도가 낮아지는 경향이었고, 적색도와 황색도는 침지액 농도를 달리하였을 경우 농도가 낮을수록, 침지 기간이 길어질수록 높았으며, 침지액 농도에 따른 차이는 크지 않았다. 침지액의 간장 및 된장의 농도를 달리하였을 때 감장아찌 중의 탄닌함량의 변화는 모든 침지액 농도에서 침지 기간이 지속될수록 탄닌의 함량은 저장 초기에 서서히 감소되다가 침지 기간이 길어질수록 급격히 감소하였으며, 첨가량에 따른 탄닌함량의 변화폭은 크지 않았다. 침지액의 간장 및 된장의 농도를 달리하였을 때 감과육에 존재하는 연화효소인 polygalacturonase와 pectinesterase 활성 변화는 간장침지 및 된장침지 모두 침지 초기부터 효소활성이 증가하기 시작하였으며 침지 기간이 경화할수록 효소활성은 더욱 높아지는 것을 알 수 있었고, 침지액의 농도가 높아질수록 효소활성이 억제되었다. Changes of physicochemical properties during the preparation of persimmon pickles were investigated. The salinity in persimmon pickles increased during storage time (0~50 days) with soy sauce and soy paste. When the fermented soy sauce and soy paste was added to the soaking solution with 80~100%, the salinity increased more rapidly. The hardness of persimmon pickles with soy sauce and soy paste was slightly increased up to the 20 or 30th day of storage and then decreased. L value of persimmon pickles was gradually decreased, but a and b value were slightly increased. The concentration of soluble tannin in persimmon pickles was slightly decreased down to the 20th day of storage and then decreased rapidly. The activities of polygalacturonase and pectinesterase as softening enzyme in persimmon pickles with soy sauce and soy paste increased during storage time (0-50 days) and enzyme activity was inhibited by high concentration of soaking solution.

도파민/세로토닌 길항성 비정형 항정신병약물로 치료 중인 정신분열병 환자에서 체중 증가의 관련 요인

김신겸,장원석,최경숙,박동연,한우상,이동수,홍경수 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3