태연혈(太淵穴)의 유침 시간에 따른 체온 변화 -적외선체열촬영(赤外線體熱撮影)을 중심으로-

이봉효 ( Bong Hyo Lee ),이경민 ( Kyung Min Lee ),박지하 ( Ji Ha Park ),김민서 ( Min Seo Kim ),김산들 ( San Deul Kim ),박병규 ( Byeong Gyu Park ),양현동 ( Hyun Dong Yang ),예성호 ( Sung Ho Yea ),이호정 ( Ho Jung Lee ),최재원 ( Jae 경락경혈학회 2012 Korean Journal of Acupuncture Vol.29 No.2

Objectives: This study was performed to find the desirable remaining time of needle in the acupuncture treatment. Methods: The 21 volunteers were given acupuncture at LU9 vertically and needles were remained for 2 min, 10 min, 15 min, 30 min, respectively. The thermographic change induced by acupuncture was measured with Digital Infrared Thermographic Image at the following acupoints: LU11, LU10, LU9, LU8, LU5, LU1, and PC7. The statistical significance of thermographi change was evaluated using paired t-test and post hoc Wilcoxon test. Results: The most significant changes after acupuncture were produced when needles were remained for 10 min or 15 min. LU11, LU5, LU1, and PC7 were the point at which all of the remaining time produced significant change commonly. At LU11, the biggest change was produced when needle was remained for 15 min, while at LU5, LU1, and PC7, the biggest change was produced when needle was remained for 30 min, and the smallest change was produced when needle was remained for 10 min at all of acupoints of LU11, LU5, LU1, and PC7. The unbalance between left side and right was decreased the most largely in 15 min group. Conclusions: The results of this study suggest that the desirable remaining time of acupuncture needle might be 15 min.

쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

Uncoupling Protein 3의 골격근 세포내 과발현이 OLETF 백서 및 배양된 골격근 세포에서 포도당대사에 미치는 영향

한정희,박혜선,고정민,김하영,강호경,이인규,박중열,홍성관,이재담,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:Uncoupling protein(UCP)는 미토콘드리아의 내막에 위치하는 단백질로 세포내의 과다한 에너지를 열로 발산시키는 기능을 가진다. 최근 동물의 갈색지방조직에만 존재하는 UCP와 유사성을 가진 아형들(UCP2,3)이 사람에게도 존재함이 알려져 큰 관심을 끌도 있는데 이중 UCP3는 그 발현이 골격근세포와 갈색지방조직에만 국한된다. 본 연구에서는 UCP3가 체내 인슐린 감수성을 결정하는데 가장 중요한 조직인 골격근에 국한되어 발현되는 점에 착안하여 UCP3를 골격근세포에 과발현시켰을 때 포도당 대사에 어떠한 영향이 나타나는 지를 조사하였다. 방법:25주령의 8마리의 OLETF 백서를 대상으로 하여 4마리는 골격근에 adenovirus 2mL(1×10¹²pfu/mL)를 주사하여 대조군으로 하였고 4마리는 골격근에 재조합법으로 제작된 adenovirus­UCP3 2mL(1×10¹²pfu/mL)를 주사하였다(UCP3 과발현군). UCP3를 투여한 백서에서 먹이섭취가 증가하는 경향이 있어 그 전날 대조군이 먹은 야의 먹이만큼 투여하였다. 골격근에 adenovirus를 주사한 10일 후에 euglycemic hyperinsulinemic clamp를 시행하였다. Adenovirus­UCP를 C2C12 골격근 세포에 transfection시켜 UCP3를 C2C12 골격근 세포에 transfection시켜 UPS3­C2C12를 만들고 C2C12 골격근 세포와 UPS3­C2C12 골격근 세포에서 포도당 수송 및 당원합성을 측정하였다. 결과:UCP3 과발현 OLETF에서 체중이 감소하는 경향을 보였고 인슐린 감수성이 증가하였다. C2C12세포에서 기저상태 포도당 수송은 1.28±0.17μmol/L/min였고 100nM 인슐린으로 2시간 처리한 후 2.67±0.20 μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 포도당 수송이 3.98±0.13μmol/L/min로 증가되었고 인슐린 처리 후 5.74±0.44μmol/L/min로 증가하였다. 인슐린을 처리한 UCP3­C2C12 세포에 P13K 억제제인 wortmannin을 첨가하였을 때 포도당 수송활성이 3.81±0.20μmol/L/min로 감소하였다. 기저상태 당원합성은 C2C12 세포에서 0.25±0.01μmol/L/min였고 인슐린 처리 후 0.45±0.01μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 당원합성이 0.62±0.01μmol/L/min였고 인슐린 처리 후 1.26±454μmol/L/min로 증가하였다. UCP3­C2C12세포에 wortmannin을 첨가하였을 때 당원합성율이 0.80±0.04μmol/L/min로 감소하였다. 결론:UCP3 과발현이 OLETF 백서에서 인슐린 감수성을 증가시켰고 골격근세포에서 포도당 수송 및 당원합성을 증가시켰다. wortmannin을 첨가하였을 때 포도당 수송 및 당원합성이 감소함으로 보아 이 과정이 인슐린 신호전달체계인 P13K에 일부 의존함을 알 수 있었다. Background : UC P3 is a mitochondrial membrane protein expressed selectively in the skeletal muscle and brown adipose tissue. Since the skeletal muscle is the main organ determining insulin sensitivity in the body, it was hypothesized that UCP3 overexpression in skeletal muscle cells would improve glucose metabolism. Methods : An adenovirus-UCP3 was produced by a recombinant DNA method. OLETF rats were divided into 2 groups. Four rats were injected with the adenovirus-UCP3 (UCP3 group) and others were injected with the adenovirus(control group) in the skeletal muscle. The UCP3 group was provided with the same quantity of food as that consumed by the control group on the previous day. Insulin sensitivity was evaluated by the euglycemic hyperinsulinemic clamp method. In a separate experiment, glucose transport and glycogen synthesis we evaluated in C2C212 cells transfected with ether an adenovirus or the adenovirus-UCP3. Results : The insulin sensitivity improved significantly and the body weight decreased in the UCP3 group. The glucose transport and glycogen synthesis were higher in the UCP3-C2C12 skeletal muscle cells at the basal state. After insulin treatment, glucose transport and glycogen synthesis were also higher in the UCP3-C2C12 cells but the increments were reduced after treatment with wortmannin, a PI3K inhibitor. Conclusion : Insulin sensitivity was higher in the UCP3-overexpressed OLETF rats in the in vivo study. UCP3 transfection also increased glucose transport and glycogen synthesis in the cultured skeletal muscle cells by a PI3K dependent mechanism(J Kor Diabetes Asso 25 :460~468, 2001).

정안침요법(整顔鍼療法)을 응용하여 호전된 후천성 사경환자 치험 2례

박서영,김재수,홍의재,이윤경,이봉효,임성철,정태영,이경민,Park, Seo-Young,Kim, Jae-Su,Hong, Eui-Jae,Lee, Yoon-Kyoung,Lee, Bong-Hyo,Lim, Seong-Chul,Jung, Tae-Young,Lee, Kyung-Min 대한침구의학회 2008 대한침구의학회지 Vol.25 No.4

Objectives : This report intended to estimate effects of Jung-an acupuncture on the acquired torticollis caused by muscle contraction. Methods : The patients were treated by Jung-an acupuncture, herb medication and Physical treatment daily. The improvement of the patients was judged by Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS), Tsui's score and Visual Analogue Scale(VAS). Results : After 7 days of treatment, the 2 patients' neck pain and cervical movement were improved. Also, TWSTRS score, Tsui's score and VAS were all reduced. Conclusions : As the Jung-an acupuncture's theological base is organized with meridian theory and myofacial release therapy, We considered the Jung-an acupuncture is effective not only for the skin disease but also for the muscle problem such as torticollis.

물리적 처리에 의한 강력분 밀가루 Gliadin의 항원성 변화

강보경(Bo-Kyeong Kang),김꽃봉우리(Koth-Bong-Woo-Ri Kim),김민지(Min-Ji Kim),박시우(Si-Woo Bark),박원민(Won-Min Pak),김보람(Bo-Ram Kim),안나경(Na-Kyung Ahn),최연욱(Yeon-Uk Choi),최정수(Jung-Su Choi),최호덕(Ho-Duk Choi),안동현(Dong-Hyun A 한국식품영양과학회 2014 한국식품영양과학회지 Vol.43 No.4

본 연구에서는 가압가열 및 microwave 처리가 gliadin의 항원성에 미치는 영향을 살펴보기 위해 강력분에 가압가열과 microwave를 단독 또는 병행으로 처리하여 Ci-ELISA, SDS-PAGE 및 immunoblotting을 실시하였다. 가압가열 처리의 경우 시간이 길어질수록 IgG와의 결합력이 감소하였으며, 특히 50분 처리구에서 약 87%로 가장 낮은 결합력을 보였다. 또한 SDS-PAGE와 immunoblotting 결과에서도 무처리구에서 강하게 보였던 gliadin band가 가압가열처리에 의해 거의 소실되고 항체와 반응하지 않았다. 가압가열 및 microwave를 병행 처리 시도 마찬가지로 gliadin의 결합력이 감소하였으며, 처리구 중 가압가열 50분, microwave 5분 처리구에서 약 93%로 가장 낮은 결합력을 보였다. 반면 microwave를 단독으로 처리한 경우에는 일부 단백질의 변화는 관찰되었으나, 항원성 감소에는 효과가 없음을 확인하여 단백질 변화가 항원성에는 큰 효과를 준 것 같지 않다. 이상의 결과를 통해 가압가열 단독 처리 및 가압가열 및 microwave의 병행처리 시 gliadin의 항원성이 감소함을 확인하였다. This study was conducted to evaluate the effects of physical treatments on the antigenicity of gliadin in strong wheat flour. Strong wheat flour was treated with an autoclave (5, 10, 30, 50 min), a microwave (1, 5, 10 min), or both (10, 30, 50 min/ 5, 10 min), followed by SDS-PAGE, immunoblotting, and Ci-ELISA using anti-gliadin IgG. The results indicated that the binding ability of IgG to gliadin in strong wheat flour slightly decreased after autoclaving or autoclaving/microwaving. In particular, the binding ability was reduced to about 87% after autoclaving for 50 min and to 89% after autoclaving/microwaving (50/5 min). In addition, gliadin bands in the 50 min autoclaved group disappeared in both SDS-PAGE and immunoblotting. On the other hand, the antigenicity of gliadin was unaffected by microwaving alone. In conclusion, the results of this study suggest that autoclaving may reduce the antigenicity of gliadin in strong wheat flour.

Optimization of Electric Field-assisted Ultrasonication for Disintegration of Waste Activated Sludge

( Kyung-won Jung ),( Tae-un Jeong ),( Min-jung Cha ),( Kyu-hong Ahn ) 한국폐기물자원순환학회(구 한국폐기물학회) 2014 한국폐기물자원순환학회 심포지움 Vol.2014 No.1

In the present study, an electric field is applied in order to disintegrate waste activated sludge (WAS). As a preliminary step, feasibility tests are investigated using different applied voltages of 10 to 100 V for 60 min. As the applied voltage increases, the disintegration degrees (DD) are gradually enhanced, thereby the soluble N, P, and carbohydrate concentrations increase simultaneously due to the protein decomposition. Subsequently, an optimization process is conducted using response surface methodology with a Box-Behnken design (BBD). The total solid concentration, applied voltage, and reaction time are selected as independent variables, while the DD is selected as the response variable. The overall results demonstrate that the BBD with an experimental design can be useed effectively in the optimization of the electric field treatment of WAS. In the confirmation test, a DD of 10.26±0.14% is recorded, which corresponds to 99.1% of the predicted response value under the statistically optimized conditions. Finally, the statistic optimization of the combined treatment (electric field + ultrasonication) showed that even though this is limited to highly disintegrated WAS when being applied individually, a high DD of 47.28±0.20% was recorded where the TS concentration was 6,780 mg/l, the strength of ultrasonication was 8.0 W, the applied voltage was 68.4 V, and the reaction time was 44 min. E-SEM images clearly revealed that the application of the electric field is a significant alternative method for the combined treatment of WAS, and this is first attempt to increase disintegration using electric field for combined treatment with ultrasonication.

Effects of Mechanical Stimulation on the Proliferation of Bone Marrow-derived Human Mesenchymal Stem Cells

Choi, Kyung-Min,Seo, Young-Kwon,Yoon, Hee-Hoon,Song, Kye-Yong,Kwon, Soon-Yong,Lee, Hwa-Sung,Park, Jung-Keug Korean Society for Biotechnology and Bioengineerin 2007 Biotechnology and Bioprocess Engineering Vol.12 No.6

To support and enhance the in vitro growth and activity of mesenchymal stem cells (MSCs), the cell culture medium may be supplemented with various proteins and factors to mimic the physiological environment in which the cells optimally proliferate and differentiate. In this study, the effects of mechanical factors on cellular metabolic responses were investigated experimentally using a bioreactor. The effects of various chemical factors, such as growth factors, cytokines, and hormones, were also investigated. Based on previous reports demonstrating the important roles of mechanical factors in the growth and activity of MSCs, we sought to evaluate the effects of mechanical stimuli on the proliferation of bone marrow-derived MSCs using a cell training bioreactor that imposed cyclic mechanical stretch, with parameters of 240 min/day, 0.03 Hz, and $5{\sim}15%$ strain. The application of cyclic stretch $(5{\sim}15%\;strain)$ to the MSCs enhanced their proliferation during the early stage(3 days), but not the late stage (14 days), of batch culture. Mechanical stretch did not increase the release of lactate dehydrogenase (LDH) from the MSCs during culture. Appropriate levels of mechanical stretch $(5{\sim}10%\;strain)$ increased collagen synthesis, but did not alter MSC stretch was able to serve as a potent positive modulator of MSC proliferation during the initial stages of culture.

P278 : Nonablative fractional laser as a tool to facilitate skin penetration of 5-aminolevulinic acid with minimal skin disruption

( In Jung Kang ),( Jeong Hwee Choi ),( Min Jae Gwak ),( Hee Kyeong Lim ),( Mu Hyoung Lee ),( Min Kyung Shin ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Effective penetration of photosensitizer is an essential step in photodynamic therapy (PDT). There have been trials of several methods, including laser treatment, to facilitate prompt and sufficiently deep transdermal drug delivery. Objectives: This study was performed to evaluate the effects of nonablative fractional laser pretreatment on aminolevulinic acid (ALA) penetration of the skin. Methods: Twelve identical treatment areas of 1 × 1 cm2 on the backs of 10 healthy male subjects were mapped. Each area received laser treatment with a different energy and incubation with ALA for different times. Laser treatment was performed with a 1550 nm fractional erbium glass laser, and the laser energy was set to 20 and 50 mJ with a spot density of 50/cm2. ALA incubation time was set to 30, 60, or 180 min. Porphyrin fluorescence was measured. Results: Nonablative fractional laser-pretreated areas showed significantly increased porphyrin fluorescence compared to non-pretreated areas. Laser energy strength and ALA incubation time were positively correlated with ALA absorption. Conclusion: Nonablative fractional laser treatment effectively enhanced ALA skin penetration. Pretreatment with a nonablative fractional laser can be used for ALA-PDT to achieve higher therapeutic efficacy and shortened ALA incubation times with minimal skin barrier disruption compared to ablative laser.

청소년의 스마트폰 중독과 우울 및 불안과의 관계

김경은,김필송,민주연,박수경,신서인,이지은,정해인,조호정,최정원,최정인 이화여자대학교 간호과학대학 2013 이화간호학회지 Vol.- No.47

Purpose: The purpose of this study was to investigate the relationships between the degree of smart phone addiction among adolescents and their depression and anxiety levels. Method: In this study, 379 high school students were selected using the convenient sampling method. The instruments used for this study were smart phone addiction measure, the CES-D (Center for Epidemiological Studies-Depression Scale), and the STAI (State-Trait Anxiety Inventory). Data were analyzed using the SPSS 20.0 program with descriptive statistics, t-test, ANOVA with Scheffe test, and Pearson’s correlation coefficient. Result: The mean score for smart phone addiction was 40.45±17.27, depression was 36.56±9.58, state anxiety was 44.00±9.61, and trait anxiety was 45.70±9.75. There were significant differences between the degree of smart phone addiction and the following variables: gender (t=-4.953, p<.001), hours of smart phone use per day (F=12.259, p<.001), types of frequently used features (F=3.485, p=.008), and satisfaction level for smart phone (F=5.18, p<.001). There were statistically significant relationships (p<.001) among degree of smart phone addiction, depression level, and state and trait anxiety levels. Conclusion: The results of this study suggested that there was a significant relationship between smart phone addiction and mental health, specifically, depression and anxiety among adolescents. Further research is needed to develop nursing strategies to provide care for adolescents who frequently utilize smart phones.

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.