전산화 신경인지기능검사를 이용한 주의력결핍/과잉운동 장애의 주의력결핍특성에 관한 연구

정선주,신민섭,하규섭,홍강의 대한소아ㆍ청소년정신의학회 1997 소아청소년정신의학 Vol.8 No.2

가정에 국한된 품행장애 1례

정선주,조수철 대한소아ㆍ청소년정신의학회 1997 소아청소년정신의학 Vol.8 No.2

주의력결핍/과잉운동장애, 주 부주의형과 혼합형간의 지속적 주의력 및 과잉운동의 비교

정선주,서동혁,홍강의 가천의과대학 2000 가천의학 Vol.2 No.1

백서 뇌에서 전기경련 충격에 의해 발현이 조절되는 새로운 유전자

정선주,박정은,강웅구,구영진,박주배,김용식 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

연구목적: 이 연구는 백서 뇌에서 전기경련 충격(Electroconvulsive shock, ECS)에 의해 발현이 조절되는 새로운 유전자를 검색하고, 발달단게 및 뇌 조직에 따른 발현양상을 관찰하기 위하여 시행되었다. 방법: 생후 7일, 21일된 어린 웅성 백서에 전기경련 충격을 가한 후 mRNS differential display-PCR(DD-PCR) 기법을 시행하여 발현의 차이를 나타내는 유전자를 검색한 후 서열분석을 실시하였다. 생후 7일 및 21일된 백서의 뇌와 성년 백서의 대뇌피질, 해마를 이용한 Northern blot 분석을 시행하여 검색된 유전자의 ECS 처치 후 시간경과에 따른 유전자 발현양상을 관찰하였다. 결과: ECS 처치군과 위충격군간에 발현의 차이를 나타낸 유전자 4개를 검색할 수 있었으며, 이중 ECS에 의해 발현이 증가되는 1개의 유전자를 선정하여 서열분석을 실시한 결과 EST 서열만이 보고된 새로운 유전자임이 밝혀졌다. 이 유전자는 생후 7일된 백서의 뇌에서는 ECS 처치 후 180분에 발현양의 증가가 최고치에 도달하였으나, 생후 21일된 백서의 뇌와 성년백서의 대뇌피질 및 해마에서는 360분 경과시까지 지속적으로 발현 양이 증가하였다. 결론: 이같은 결과는 ECS에 의해 생체 내에서 유전자 발현의 조절이 이루어짐을 시사하며, 향후 이러한 유전자의 세포 내 기능에 관한 연구를 시행함으로써, ECS에 의한 생체의 반응과 치료기전에 대한 이해를 넓힐 수 있을 것으로 기대된다. 중심단어:전기경련 충격·DD-PCR·유전자·백서 뇌. Objectives: This study was performed to identify genes regulated by electroconvulsive shock (ECS) and to observe the pattern of expression of genes according to different developmental stages and brain regions. Method: ECS(130V, 0.5 sec) was given to male Sprague-Dawley rats with age of postnatal day 7 and 21(P7, P21 respectively). After screening genes regulated by ECS with mRNA diffe-rential display-PCR(DD-PCR), we selected one clone among them and observed the induction of this gene after ECS by time-dependent Northern blot analysis of rat brain of P7, P21 and adult rat cortex and hippocampus. Results: By DD-PCR method, we have identified four clones whose expression was regulated by ECS. Among them, one(CP 10-2) was proved to be a new gene by sequencing and BLAST search. Its expression was increased after ECS in P7, P21, and adult rat brain. The expression of CP 10-2 reached peak level at 180 minutes after ECS in P7 rat brain, but was further increased until 360 minutes after ECS in P21 and adult rat brain. Conclusion: In this study, a new gene was identified in rat brain which showed up-regulated expression in response to ECS. Cloning and characterization of this new gene would be helpful to elucidate the effect of ECS in rat brain. KEY WORDS:Electroconvulsive shock·Differential display-PCR·Gene·Rat brain.

한국어판 예일 틱 증상 평가척도 : 신뢰도 및 타당도 연구

정선주,이정섭,유태익,구영진,전성일,김봉석,홍강의 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 틱 증상의 심한 정도를 평가하기 위한 도구인 예일 틱 증상 평가척도(Yale Global Tic Severity Scale)를 한국판 가정 평가용 설문지 및 임상 평가용 척도로 개발하기 위하여 본 연구를 시행하였다. 방 법 : 예일 틱 증상 평가척도는 뚜렛 장애 및 기타 틱 장애에서 나타나는 운동틱과 음성틱 각각의 증상의 수, 빈도, 심한 정도, 복합성, 방해 정도 및 장해도를 포괄적으로 평가하도록 고안되어져 있다. 틱 증상을 주소로 정신과외래를 방문한 만 4.3세에서 19세까지의 100명의 환아 및 부모들을 대상으로 한국어로 번역한 예일 틱 증상 평가척도의 가정평가용 설문지를 평가전에 완료하도록 한 후, 면담을 통한 임상평가용 척도를 실시하였으며 수렴타당도 및 변별타당도의 검증을 위해 총괄적인 임상 인상척도-뚜렛 증후군, 강박장애, 주의력결립/과잉운동장애(Clinical Global Impression-TS, OCD, ADHD)를 시행하였다. 결 과 : 자료분석결과 내적일치도, 수렴타당도, 변별타당도 및 검사자간 신뢰도 모두 매우 높게 나타났으며 요인분석상 전 항목척도와 장해도는 운동틱과 음성틱에 해당하는 2개의 요인으로 묶여졌다. 결 론 : 본 연구결과 한국판 예일 틱 증상 평가척도의 높은 타당도 및 신뢰도가 입증되었으며 이는 향후 틱 증상의 객관적인 평가 및 정량화를 위해 유용하게 사용되어질 수 있을 것이다. Objectives : This study was carried out to develop the Korean form of Yale Global Tic Severity Scale(YGTSS)-family & clinical rating version. The severity of motor and phonic tics was rated according to five separate dimensions : number, frequency, intensity, complexity, and interference. Methods : The Korean form of YGTSS was applied to 100 children who visited psychiatric outpatient clinic with chief complaints of tic symptom. Together with YGTSS, Clinical Global Impression for Tourette's syndrome(CGI-TS), Obsessive-Compulsive disorder(CGI-OCD), Attention-Deficit/Hyperactivity Disorder(CGI-ADHD) were administered to all subjects for examining convergent and discriminant validities. Results : We could confirm high internal consistency, convergent and discriminant validities and interrater reliability of YGTSS by analysing data from 100 children with tic disorder. In factor analysis, items were clustered to 2 factors which were identical to motor and phonic tic subscales. Conclusion : The results of this study indicate the Korean form of YGSS is a reliable and valid rating scale for rating tic symptom severity. It can be used to evaluate tic symptom objectively and to quantify the tic severity in the studies for tic disorder.

성폭력 피해여성의 경험에 관한 연구

정연강,권혜진,지순주,남선영,김경희 韓國學校保健學會 1996 韓國學校保健學會誌 Vol.9 No.1

This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiousity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", 'avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging", "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "infromation availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporation the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthness. 6. The older the victims, The weaker the senses of being taken aback and filthness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 13. The more closed the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 17. The less available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The more familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 21.The less familiar the subjec is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 22. The more likely the response to 'being taken aback' and 'filthines' is 'informing' and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypothneses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined wit weak sexual curiosty and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness' , further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamilar. 3) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protecvice and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despit the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequnecy is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohension is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

구속된 비행 청소년들의 특성 및 석방 후 6개월간 재범여부와 관련된 변인

정선주,김원식,고승희,구영진,김홍창,서동혁 대한소아ㆍ청소년정신의학회 1999 소아청소년정신의학 Vol.10 No.2

틱 장애의 진단분류에 따른 임상특징과 질환 심각도와 연관된 변인들

정선주,정희연,황정민 대한소아청소년정신의학회 2001 소아청소년정신의학 Vol.12 No.1

연구목적 : 본 연구는 일과성 틱 장애(Transient tic disorder : TTD), 만성 틱 장애(chronic tic disoder : CTD), 뚜렛 장애(Tourette's disorder TD) 아동의 임상 양상을 비교하고, 틱 장애의 질환 심각도와 연관된 변인을 알아보기 위해 시행되었다. 방법 : DSM-IV 진단분류에 따라 틱 장애로 진단된 69명의 아동과 대조군 43명을 대상으로 인구학적 변인 및 틱과 관련된 임상적 변인을 조사하였다. 틱 증상의 심각도를 알아보기 위해 예일 틱 증상 평가 척도(Yale Global Tic Serverity Scale)을 시행하였으며 연구 대상 모두에게 동반된 정서/행동 문제를 평가하기 인해 아동 행동조사표(Child Behavior Checklist)를 시행하였다. 결과 : TTD군은 CTD및 TD군과 비교할 때 틱 증상의 지속 기간이 짧을 뿐 아니라 틱 증상의 심각도와 장해 정도도 미약하였다. TTD군의 동반된 정서/행동 문제 역시 CTD, TD군에 비해 유의하게 적었으며 공격성 소척도 점수를 제외하고는 정상대조군과 차이가 없었다. CTD군과 TD군간에는 틱 증상의 종류, 개수와 CBCL의 사회성 문제 소척도 점수외에는 통계적으로 유의한 차이를 나타내는 변인이 없었다. 틱 증상으로 인한 장해 정도를 가장 잘 예측해 주는 변인은 운동틱의 강도와 방해도, 틱 증상의 지속기간이었으며, CBCL 총 문제행동 점수와 가장 높은 연관성이 있는 변인은 주의력결핍/과잉운동장애(Attention deficit hyperactivity disorder : ADHD) 의 존재여부였다. 결론 : 본 연구의 곁과는 틱 증상의 심각도 외에 증상의 지속 기간이 틱 장애 아동들의 틱으로 인한 장해도에 큰 영향을 미치며, 동반된 ADHD의 존재가 이득의 임상상을 결정하는 데 있어 중요한 역할을 한다는 점을 시사한다. 또한 위와 같은 임상 변인들이 틱 장애의 진단적 분류보다도 틱 장애 아동의 질환 심각도를 판단하고 치료방침을 결정하는데 있어 더욱 중요함을 시사한다. 중심 단어 : 틱 장애 · 하위 진단 · 질환 심각도 · 장해. Objective : The purpose of this study was to compare the clinical features of children with three sub-diagnoses of tic disorder (transient tic disorder (TTD) , chronic tic disorder (CTD) and Tourette's disorder (TD)) and to exam the factors related with illness severity of them. Method : Subjects were 69 children who met DSM-Ⅳ criteria for tic disorder and 43 control chil-dren. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale (YGTSS) in tic disorder children. The Child Behavior Checklist (CBCL) was accomplished by parents of all subjects. Results : Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a pre-ictor of the total behavior problem score of CBCL. Conclusion : These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder. KEY WORDS : Tic disorder ㆍ Sub-diagnosis ㆍ Illness severity ㆍ Impairment.

선택적 함구증 아동의 임상특성 및 치료경과

홍강의,정선주 대한소아·청소년정신의학회 1995 소아청소년정신의학 Vol.6 No.1

Serratia marcescens에서 cAMP receptor protein(CRP)유전자의 클로닝 및 해석

유주순,문종환,정수열,김혜선,최용락 東亞大學校附設遺傳工學硏究所 1999 遺傳工學硏究 Vol.- No.6

전사조절인자로서 잘 알려져 있는 cAMP receptor protein(CRP)은 cAMP와 DNA에 결합하는 특별한 활성을 가지고 있으며, cAMP-CRP complex를 형성하여 수많은 유전자의 발현조절에 관여한다. 이러한 측면에서 cAMP-CRP의 조절은 어떤 면에서 총체적 조절체계라고까지 한다. 본 연구는 Serratia 균주에서 crp유전자의 분자적 특성 및 cAMP에 의한 발현조절을 받는 분자기구를 해석하고자 유전자를 클로닝하고 발현을 확인하였다. MacConkey배지에서 maltose를 탄소원으로 충분히 이용하지 못하는 대장균 TP2139(△crp,△lac)를 숙주로 이용하고, 염색체DNA를 library로 작성하여 얻은 형질전환체 약 일만개의 콜로니에서 red colony를 나타내는 5종류 의 양성 클론을 얻었다. 이들 클론을 Southern방법으로 확인한 결과 3kb의 단편을 가진 pCKB12클론이 crp유전자를 coding하고 있음을 확인하였다. glpD-lacZ 융합 plasmid인 pLDC6 의 BamHI부위에 pCKB12의 3kb 단편을 삽입시킨 재조합 plasmid pLDC 6-Scrp를 작성하여, 클로닝된 Serratia 의 crp 유전자가 대장균에서 유전자 전사조절에 미치는 영향을 확인한 결과 cAMP-CRP 복합체 형성에 의한 전사조절 기능이 확인되어졌다. One of the better-characterized transcription factor of E. coli is the cAMP receptor protein(CRP) and the CRP binds cAMP and DNA. The cAMP-CRP complex is involved in regulation of many genes at bacteria. The cAMP-CRP regulatory element represents, in some respects, a global regulatory network. The aim of this work was to study the structure and the mechanisms controlling the expression of CRP in Serratia marcescens. We have been get 5 different clones from Serratia which stimulated the cells to use maltose as a sole carbon source in E. coli TP2139. The crp gene clone, pCKB12, was confirmed by Southern hybridization with E. coli crp gene. The location of the crp gene was determined by constructing subclones carrying various portions of pCKB12. To investigate the potential role of CRP in E. cloi, lacZ fused plasmids were constructed and investigated the β-galactosidase activity of the fused plasmid. The Serratia marcescens cAMP receptor protein can substitute the E. coli CRP in transcriptional activation at the lacZ gene. These results suggest that Serratia marcescens cAMP receptor protein complex functions to regulate several promoters in E. coli.