躁鬱病에 關한 臨床的 硏究

李奎恒,李丙允 고려대학교 의과대학 1972 고려대 의대 잡지 Vol.9 No.1

This clinical study of manic- depressive illness have revealed its incidence, prepsychotic personality, family history, age of onset, various aspects of recurrent types including their initial status, duration of their cycle and symptomatology. The 102 cases of manic-depressive illness included 57 cases of depression and 45 cases of mania. According to their recurrent types, the total cases were classified into 3 groups, which were 44 cases of depressed type, 16 cases of manic type and 42 cases of circular type. As to the types of initial attack of manic-depressive illness, there were 69 cases of depression and 33 cases of mania. The results were as following: 1. The manic-depressive were rated as 3.1% of the total 3265 patients seen in our paychiatric department from April 1, 1968 to March 31, 1971. There were 52 male patients and 50 female patients. 2. The diagnostic distribution of these total 3265 patients revealed that depressive neurosis had the highest rate and schizophrenia, psychotic depression, epilepsy, and anxiety neurosis had higher rates in this order. As to the distribution of psychotic diseases, schizophrenia and psychotic depression had the highest rates and manic-depressive illness, involutional depression and paranoid state had their rates in this order. 3. Among the various prepsychotic personality, obsessive compulsive personality and cyclothymic personality were most frequent ones, and hypomanic, depressive, schizoid and aggressive ones were also relatively frequent. 4. Family history of these manic-depressive patients revealed that 53.9% of them had suicidal cases and various psychotic disorders in their near relatives. And those of 53.9% were further classified as 36.4% of depressed patients, 81.4% of manic patients and 61.9% of circular patients. Out of these 53.9% of psychotic families, manic-depressive illness occupied 12.7% and rest of 35.3% included schizophrenics, alcoholics, drug addicts, mentally retarded, psychoneurotics and 5.9% of suicidal cases. 5. The ratio of the initially depressive patients and manic patients was 2.1 to 1. The initially depressive patients showed of milder state than the initially manic patients. 6. As to the age of onset in manic depressive illness, it was revealed that the initially depressive patients had the tendency to develop their illness between the ages of 26 to 35 and the initially manic patients had the tendency to develop their illness between the ages of 16 to 25. 7. As to the duration of cycles in manic-depressive illness, the duration of first cycle was 6.5 years, that of second cycle was 4.6 years, and that of third cycle was 2.3 years: in other words, it could be said that the more the recurrences repeated, the shorter the duration. About the duration of first cycle, the patients of depressed type had 7.5 years, the patients of manic type had 10.7 years and the patients of circular type had 4.9 years. 8. The patients with depression showed following symptoms and thought disorders in the order of their frequency: depressed mood, headache, difficulty in getting asleep, anxiousness and agitation, lack of energy and drive, awakening in the early morning, decreased psychomotor activity, many dreams during sleep, and guilt and self-blame. The patients with mania showed following symptoms in the order of their frequency: increased psychomotor activity, pressure of speech, elated mood, difficulty in getting asleep, idea of grandeur, flight of idea, verbally aggressive and destructive tendency, anxiousness and agitation, incoherence, physically aggressive and destructive tendency, many dreams during sleep, and circumstantiality. The relatively milder symptomatology of depressive state of initially depressive patients and the different figure of sex ratio of the manic-depressive of this study from that of many other reports, mostly western authors, were supposed to be the most characteistic pictures of this study.

정신병 환자의 통합치료를 위한 낮병원 모델의 효과성 연구 : 1년 반 동안의 전향적 추적 연구

김선재,윤성철,이후경,성상경,함 웅,이규항 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

연구목적:, 낮병원은 환자의 위축된 심리적, 사회적 기능을 회복시키고 장기입원으로 인한 퇴행과 지역사회와의 단절을 피할 수 있는 장점이 있다. 저자들은 이전 연구에서 한국 실정에 맞는 정신병환자의 통합치료를 위한 낮병원 모델을 개발하였다 그러므로 본 연 구는 이전의 낮병원 모델에 대한 연구를 기초로 하여, 1) 입원치료만 받은 환자 및 보호자를 대조군으로,하고, 2) 전향적으로 추적조사를 하여. 3) 저자들이 개발한 통합치료를 위한 낮병원 모텔의 효과성을 연구할 목적으로 실시되었다. 연구방법: 1996년 5월부터 1997년 l1월까지 계요병원 낮병원에 참여하여 치료를 받았던 17명의 환자 및 보호자를 대상군으로(이하 낮병원군 및 낮병원보호자군이라 함) 하였으며 대조군은 동기간 동안 입원병동에서 퇴원한 후 외래치료만 받고 있는 환자 증 진단, 나이, 성별, 기능에 대한 평가가 일치하는 환자 및 보호자 (이하 입원군 및 입원보호자군이라 함)를 일대일로 짝지어 선발하였다. 두 군을 대상으로 삶의 질 척도 (quality of life scale)를 시행하였고 저자들이 제작한 병식, 약물에 대한 자세, 치료에 대한 만족도 설문지를 두 군 환자 및 가족들을 대상으로 시행하였다. 낮병원군 및 낮병원보호자군은 낮병원 치료를 받기 시작한 시점부터 입원군및 입원보호자군은 퇴원한 시점부터 2주,3개월,6개월,12개월,18개월 간격으로 위의 척도들을 전향적으로 시행하였다. 결과: 1) 삶의 질 평균점수에 있어서 낮병원군이 입원군에 비해 의미 있게 높았다. 낮병원군은 3개월에 의미있는 상승을 보인 후 큰 변화 없이 유지되다가 18개월에 의미 있는 하강이 나타났으나 입원군은 3개월에 의미있는 상승을 보였고 낮병원군에 비해 6개월이 빠른 12개월부터 의미 있는 하강을 보이기 시작했다. 2) 병식 평균점수에 있어서 낮병원군, 낮병원보호자군의 점수가 입원군,입원보호군에 비해 의미 있게 높았다. 낮병원군 및 낮병원 및 낮병원보호자군의 점수는 3개월,6개월에 의미 있게 상승하여 18개월까지 큰 변화없이 유지되었고 입원군 및 임원보호자군의 점수는 기준시점인 퇴원 당시와 변화없이 18개월까지 유지 되었다. 3) 약물에 대한 자세 평균점수에 있어서 낮병원군이 입원군에 비해 의미 있게 높았으나 낮병원보호자군의 경우에는 입원보호자군에 비해 의미있게 높게 나타나지 않았다. 낮병원군이 3개월,6새월에 의미 있게 사응하여 입원군에 비해 6개월부터 18개월까지 의미 있게 나타 났다. 4) 치료에 대한 마녹도 평균점수에 있어서 낮병원군, 낮병원보호자군의 점수가 입원군, 입원보호자군에 비해 의미 있게 높았다. 낮병원군의 경우에 3개월,6개월에 의미 있게 상승하여 6개월부터 18개월까지 입원군에 비해 높게 나타났다. 낮병원보호자군의 경우에 3개월,6개월에 의미 있게 상승하여 6개월부터 18개월까지 입원보호자군에 비해 의미 있게 나타났다. 5) 연구 기간 동안 낮병원군의 입원횟수. 입원기간이 입원군에 비해 의미 있게 더 낮았다. 결론: 저자들이 개발한 낮병원 모델이 정신병환자의 삶의 질을 높여주고 환자 및 보호자의 병식 수준을 높여주며 약물에 대해 올바른 자세를 갖게 하고 치료에 대한 만족도를 높여 주었다. 또한 재입원을, 재원기간을 낮춤으로써 정신병 환자 치료에 효과적인 것으로 생각된다. 0bjectives : A day hospital has been remodeled artier a vision to help psychotic patients quickly recover their psychologica1 and social functions and lessen their induced recessions caused by long-term hospitalization, thereby enhancing their social abilities. The authors concerned once developed a day hospital model of an integrated therapy for psychotic patients suitable for Korean situation in their previous paper. Based on it the present study was to determine how effective a day hospital would be, in comparison of the fo11owing two paired groups day hospital group with experience of hospitalization(hereinafter abbreviated as DH group) & day hospital parents group with experience of hospitalization(hereinafter abbreviated as DH parents group) and OPD group with experience of hospitalization(hereinafter abbreviated as OPD group) & OPD parents group with experience of hospitalization(hereinafter abbreviated as OPD parents group) . Methods : During the 18-month long research period(from May to 1996 October 1997), 17day hospital patients with experience of hospitalization & their parents and the same number of OPD patients with experience of hospitalization & their parents were corespondingly paired with at random, who identified themselves closest in the fo11owing categories : diagnosis, age, sex and function. All of them were asked to check questionnaires on their respective quality of life, insight, and their attitude about drug. Day hospital patients with experience of hospitalization and their parents were checked from the first day they were treated while OPD patients with experience of hospitalization and their parents were examined after discharge from hospital, commonly at the interval of 2 weeks,3 months,6 months,12 months, and 18 months. Results : 1) The quality of life scored higher in DH group than in 0PD group. It turned increased significantly at the 3rd month and continued the same until the 12th month. At the 18th month, it showed a significant downturn. Meanwhile, DH group showed a significant upturn at the 3rd month and it turned down at 12 month. 2) The insight of DH group and DH parents group scored higher compared with OPD group and OPD parents group between the 3rd and 18th month, with the 3rd and 6th month showing a particular strength as well. Meanwhile, it continued unchanging for day DH group and DH parents group from the date on, of their discharge from hospital. 3) Attitude towards drugs scored higher in DH group than in OPD group at the 3rd and 6th month. It continued unchanging between the 6th and 18th month. It didn't score significantly higher in DH parents group than in their counterparts. 4) Satisfaction on the therapy started upward in DH group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th and 18th month. It started upward as well in DH parents group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th to the 18 month. 5) Number, and duration of DH group totalled lower than those by OPD group during the research period. Conclusion : The day hospital model, developed by the authors concerned, has proved a highly effective treatment far psychotic patients, as the data scored higher in the day hospital patients and their parents than in the OPD patients with experience of hospital and their parents in terms of "Quality of life" by patients, insight, attitude toward drugs and satisfaction on its therapy.

종교망상을 수반한 간질의 2례

이규항,김범진,이헌재,송남옥 중앙대부설한국의과학연구소 1971 한국의과학 Vol.3 No.7

Pharmacological evaluation of HM41322, a novel SGLT1/2 dual inhibitor, in vitro and in vivo

이규항,이상돈,김남두,서귀현,김영훈,심상수 대한약리학회 2019 The Korean Journal of Physiology & Pharmacology Vol.23 No.1

HM41322 is a novel oral sodium-glucose cotransporter (SGLT) 1/2 dual inhibitor. In this study, the in vitro and in vivo pharmacokinetic and pharmacologic profiles of HM41322 were compared to those of dapagliflozin. HM41322 showed a 10-fold selectivity for SGLT2 over SGLT1. HM41322 showed an inhibitory effect on SGLT2 similar to dapagliflozin, but showed a more potent inhibitory effect on SGLT1 than dapagliflozin. The maximum plasma HM41322 level after single oral doses at 0.1, 1, and 3 mg/kg were 142, 439, and 1830 ng/ml, respectively, and the T1/2 was 3.1 h. HM41322 was rapidly absorbed and reached the circulation within 15 min. HM41322 maximized urinary glucose excretion by inhibiting both SGLT1 and SGLT2 in the kidney. HM41322 3 mg/kg caused the maximum urinary glucose excretion in normoglycemic mice (19.32±1.16 mg/g) at 24 h. In normal and diabetic mice, HM41322 significantly reduced glucose excursion. Four-week administration of HM41322 in db/db mice reduced HbA1c in a dose dependent manner. Taken together, HM41322 showed a favorable preclinical profile of postprandial glucose control through dual inhibitory activities against SGLT1 and SGLT2.

여성 알코올 의존 환자의 임상적 특성에 관한 연구 : - 일 정신병원 입원환자를 중심으로 -

성상경,신동환,송종호,이규항 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 남. 여 알코올의존 환자의 인구통계학적 특성, 음주력, 가족력, 음주양상, 음주동기, 공유질병 등을 포함하는 임상적 특성의 차이 및 여성 알코올의존에 대한 질병양상과 그 가족의 태도를 파악함으로써 향후 여성 알코올의존 환자의 치료 대책수립을 위한 기초자료를 제공하는데 그 목적이 있다. 방 법: 1991년 1월1일부터 1996년 5월31일까지 일 정신병원에 입원 치료한 남. 여 각각 51명의 알코올의존 환자를 연구대상으로 하였으며, 연구방법으로 병력기록지 및 설문지 조사를 통한 자료 수집을 이용하였다. 양군간의 비교를 위해 남. 여 인원 및 나이를 통제하였고, 여성 알코올의존자의 평균 연령은 44.45±11.02세였고 남성 환자군의 평균 연령은 44.17±10.08이었다. 진단은 DSM-Ⅲ-R에 의해 이루어졌으며 대상자 모두는 알코올 의존의 진단기준을 만족하였다. 결 과: 여성 알코올의존자는 남성 알코올의존자에 비해 음주시작 연령이 늦었고 과거 음주기간은 짧았으며 일 음주량이 적었다. 그리고 여성 알코올의존자는 남성 알코올의존자에 비해 자발적 입원이 많았으며 입원후 금단증상, 알코올성 간염, 당뇨등 신체적 합병증이 적었다. 또한, 입원후 가족의 태도에서 가족의 이혼위협 등 치료에 비협조적인 경우가 남성 알코올의존자에 비해 많았으며, 과거력상 사별, 이혼, 남편의 구타 등 상실의 경험이 많았다. 결 론: 남. 여 알코올의존자간에 인구통계학적 특성, 임상 특성, 가족의 태도 등 여러가지 면에서 차이가 나는 것으로 나타났다. 여성 알코올의존자 집단은 가족의 죽음, 부부생활의 갈등과 같은 심리 사회적 좌절 경험이 더 많고 가족들이 더 비협조적이었다. 그러므로 치료자는 이러한 여성알코올의존자의 특성을 치료와 예방에 반영하고 이들에 대한 세심한 배려를 해야할 것이다. Objectives: This study aimed to provide a basic data of female alcoholics by understanding the gender differences of the clinical characteristics including demographic characteristics, alcoholic history, family history, drinking patterns, reasons for drinking, and comorbidity in male and female alcoholics. It also ained to establish the therapeutic plans through understanding the patterns of disease and the patterns of family cooperation in female alcoholics. Methods: The study subjects consisted of 51 male and female alcoholics admitted to a mental hospital from January 1, 1991 to May 31, 1996. Subjects were age-and sex-matched. We reviewed patients charts and administered questionaires. Mean age of female alcoholics was 44.45±11.02 years and that of male alcoholics was 44.17±10.08 years. All male and female patients met with the DSM-Ⅲ-R criteria of alcohol dependence. Results: Female alcoholics were later in drinking-onset age, and to had shorter duration of previous drinking history and less average amount of daily drinking than male alcoholics. And female alcoholics were found to seek treatment more voluntarily, and to have less frequent delirium tremens after admission and less medical complications such as hepatitis and diabetes mellitus. Also female alcoholics had more frustration experiences of separation such as death of family member, divorce, and husband`s physical abuse. Female alcoholic`s families had more uncooperative attitude toward treatment such as threat to divorce after admission. Conclusions: There were many differences between male and female alcoholics of demographic characteristics, clinical characteristics, and patterns of family cooperation. Female alcoholics were found to have more experiences of psychosocial frustration including death of family member and marital conflicts, and more uncooperative attitude of her family members. Therefore, it is required that therapists consider the characteristics of female alcoholics upon treatment and prevention, and have more concern about female alcoholics.

후천성 면역결핍증의 공포증 4례 : 정신역동을 중심으로 From a Psychodynamic Point of View

안석철,이규항 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.5

The authors experienced 4 cases of male patients who have severe fear of acquired immune deficiency syndrome(AIDS). Three of them are the youngest in the family. All of them have harsh and tyrannical images and emotionally hostile attitudes towards their fathers in contrast to the loving and dependent relationship that they have with their mothers suggesting unresolved conflicts in oedipal situations. These oedipal conflicts are characterized by preoedipal fixation and continued maternal over-protection after phallic phase. Their guilty feelings originating from hostility to their fathers and incestuous wishes are so severe that having the idea of AIDS infection, which is the symbol of sex and death as punishment, seems to be the only escape for them.

지방자치제실시공청회에 나타난 주민여론 지방재정운영

이규항 대한지방행정공제회 1986 地方行政 Vol.35 No.397

N/A

F/1.4와 30$^{\circ}$ $\sim$ 110$^{\circ}$의 시야각을 갖는 반사굴절식 LWIR 전방위 광학계의 설계 및 공차분석과 비열화 해석

이규항,강종구,조재흥,류재명 한국물리학회 2017 새물리 Vol.67 No.6

For night time security and surveillance, we designed a catadioptric long-wavelength infrared (LWIR) omnidirectional optical system with F/1.4 and a field of view of 30$^{\circ}$ $\sim$ 110$^{\circ}$ in the wavelength range from 8 $\sim$ 12 $\mu$m. The optical system is divided into a mirror part to transfer a wide angle of view into a narrow angle of view and a lens part that images the narrow angle of view obtained from the mirror part into a sensor. Firstly, we used geometric optical methods in order to calculate the radius of curvature of the primary spherical mirror for the imaging lens part. We used a patented LWIR optical system for the imaging part so as to match well with the various calculated specifications of the mirror part. From analyses of the tolerance and the athermalizaton with an auto-focusing lens, we have verified that the optical system is suitable for a LWIR omnidirectional optical system. 전방위 야간 감시 시스템을 위한 8 $\sim$ 12 $\mu$m의 파장 범위에서 F/1.4와 30$^{\circ}$ $\sim$ 110$^{\circ}$의 넓은 시야각을 갖는 반사굴절식 원적외선 (long-wavelength infrared, LWIR) 전방위 광학계를 구면거울과 구면렌즈만 사용하여 설계하였다. 이 광학계는 크게 거울부와 렌즈부로 구성되어 있으며, 거울부는 광각의 물체를 협각의 물체로 만들어 렌즈부로 전송해주는 역할을 하며, 렌즈부는 이를 받아서 촬상 소자에 결상하는 역할을 한다. 먼저 렌즈부의 사양을 고려하여 구면거울인 주경의 곡률반경을 계산하였고, 이에 적합한 기존의 LWIR 결상렌즈를 변형하여 설계하였다. 그리고 최적화 설계된 전체 광학계의 공차분석 및 마지막 렌즈를 보정렌즈군으로 선택하여 궤적이동을 한 비열화 해석 결과, 이 광학계가 LWIR 전방위광학계로 적합함을 확인하였다.

정신 증상을 수반한 당뇨병 1례

안석철,박행욱,한원선,이규항 大韓神經精神醫學會 1971 신경정신의학 Vol.10 No.2

The authors report a case of Diabetes Mellitus with Psychotic Manifestations seen in 34 years old single woman. The causative factors of this case are discussed and major contributions of psychiatric management of those difficult cases with diabetes mellitus are emphasized.

韓國 精神 障碍의 疫學的 調査 硏究(ⅩⅧ) : Cross National Epidemiology of Social Phobia 社會恐怖症과 國家別 比較

李定均,李奎恒 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.3

한국에서 DIS-Ⅲ 한국어판을 사용하여 얻은 사회공포증과 미국, 캐나다, 및 푸엘토리코에서 DIS-Ⅲ를 사용하여 얻은 결과를 비교 연구하여 다음과 같은 결과를 얻었다. 1) 대상 연구 인원은 한국 5100명, 미국 18571명, 캐나다 3285명 및 푸엘토리코 1513명이었다. 2) 반응률은 푸엘토리코 91%로서 가장 많고 다음이 한국 83%, 미국 76%, 태나다 72%의 순이다. 3) 남녀별은 여자가 미국과 캐나다 59%, 푸엘토리코 57%이고 한국은 52%이다. 4) 사회공포증의 평생유병률은 미국이 가장 많아 2.6%, 캐나다 1.7%, 푸엘토리코 1.0%이며 한국 이 가장 적어서 0.5%이다. 남자에서는 미국이 2.1%, 캐나다 1.3%, 푸엘토리코 0.8% 및 한국 0.1%의 순이며 여자에서는 미국 3.1% 캐나다 2.1% 푸엘토리코 1.1% 한국은 1.0%이다. 5) 평균 발병 연령은 캐나다가 14.6세로 가장 빠르고 다음이 미국 15.8세 푸엘토리코 19.8세, 한국은 가장 늦어서 24.3세이다. 남자에서는 미국이 가장 빨라 15.9세, 캐나다 16.9세, 푸엘토리코 20.6세이고 한국이 가장 늦어 23.2세이다. 여자에서는 캐나다 13.3세로 가장 빠르로 미국 15.8세, 푸엘토리코 19.4세이고 한국이 가장 늦어 24.8세이다. 다른 정신장애 발병보다 먼저 발병하는 것은 푸엘토리코 81%로 가장 많고 미국이 72%, 한국 53%이고 캐나다 50%로 가장 적다. 6) 사회공포증의 다른 정신장애와의 평생 병발 이환률은 미국 2.5%, 캐나다 1.4%, 푸엘토리코 1.0% 한국 0.7%이며 단독 발병은 캐나다 1.1%, 미국 1.0%, 푸엘토리코0.3%, 한국 0.1%이다. 7) 다른 정신장애에서 자살 기도와 사회공포증의 관계는 미국에서 사회공포증이 있는 경우 17%, 없는 경우 7%, 캐나다에서는 있는 경우 20%이고 없을 때는 9%, 푸엘토리코에서는 있는경우 30%이고 없는 때는 16%이다. 한국에서는 있는 경우 31%이며 없을 때는 6%이다. 8) 증상의 차이는 국가에 따라 다르다. 타인 앞에서 음식을 먹을 때의 두려움은 미국, 캐나다, 한국, 푸엘토리코의 순으로 많다. 타인 앞에서 말하는 두령움은 푸엘토리코에서 가장 많고 미국, 캐나다, 한국의 순이다. 모르는 사람에게 말하는 두려움은 한국이 가장 많고 캐나다, 미구, 푸엘토리코의 순이다. The nationwide epidemiological study of mental disorders including social phobia in Korea using DIS-Ⅲ Korean Version was conducted in the Capital City of Korea(Seoul and 20 rural areas and compaired to the other 3 countries. The results were as follows : 1) Total number of study of Korea was 5.100, USA 18571, Canada 3258 and Puerto Rico 1513. 2) The highest response rate was Puerto Rico and Korea, USA and Canada in order. 3) Female ratio was highest in the USA and Canada, next is Puerto Rico and Korea. 4) The lifetime prevalance of social phobia of the USA was 2.6%, Canada 1.7%, Puerto Rico 1.0% and Korea 0.5%. The Highest ratio was the USA and Canada, Puerto Rico and Korea in male and in female in order. 5) Mean age of onset, Canada was earliest(14.6yrs. old) and USA(15.8), Puerto Rico(19.8) and Korea(24.3). In male the earliest was USA and Canada, Puerto Rico and Korea. Onset of social phobia before onset of other psychiatric disorder, the highest was Puerto Rico and USA, Korea and Canada. 6) Comorbidity was the highest in the USA and Canada, Puerto Rico and Korea. 7) The effect of social phobia of the risk of suicide attempts in persons with any other psychiatric disorder, in case of comorbid with social phobia was much more frequent than not comorbid with social phobia. 8) Eating fear in front of people was the highest in the USA and Canada, Korea and Puerto Rico in order. Fear of speaking in front of group was the highest in Puerto Rico and USA, Canada and Korea. Fear of speaking to strangers was the highest in Korea and Canada, USA and Puerto Rico.