정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

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.

제주도 지하수 질산염 농도의 시·공간적 변화 특성: 장기(1993-2015) 모니터링 자료의 평가

김호림(Ho-Rim Kim),오준섭(Junseop Oh),도현권(Hyun-Kwon Do),이경진(Kyung-Jin Lee),현익현(Ik-Hyun Hyun),오상실(Sang-Sil Oh),감상규(Sang-Kyu Kam),윤성택(Seong-Taek Yun) 대한자원환경지질학회 2018 자원환경지질 Vol.51 No.1

1993년부터 2015년까지 관측된 제주도 지하수 장기모니터링 관측정(N = 4,835)에서 수집된 지하수 수질자료(N = 21,568)를 기반으로 질산성질소의 시공간적 변동 특성을 평가하였다. 제주도 지하수의 질산성질소 농도의 중앙값은 2.5 mg/L로서 다른 국가나 대륙의 조사 결과에 비해 다소 높거나 유사한 것으로 나타났다. 또한 지하수 용도, 행정구역 및 고도 별로 유의한 차이를 보였다. 특히, 산간 지역에 비해 저지대 해안가에 위치한 농업 및 주거지역에서 농도가 높음을 확인하였다. Mann-Kendall 및 Sen’s slope 분석을 활용한 질산성질소 농도의 추세 분석 결과, 하류 저지 대에 비해 중산간지역에서의 질산성질소 농도 증가 경향이 뚜렷하였다. 제주도 내 토지 피복의 시계열 변화 특성과 결부 지어 보면, 중산간지역의 오염 증가 추세는 농업지역의 확장 등 인위적 활동 증가에 기인한 결과로 판단된다. 반면,기지정된 지하수자원특별관리구역에서는 전반적으로 질산성질소 농도의 감소 경향이 나타났는데, 이는 지하수 관리 측면에서 수질관리를 위한 적극적인 정책이 유효함을 시사한다. 본 연구에서는 제주도 지하수의 질산성질소 오염관리를 위한 적정 방안을 제안한다. The spatio-temporal variations of nitrate concentrations in groundwater of Jeju Island were evaluated by an analysis of time series groundwater quality data (N = 21,568) that were collected from regional groundwater monitoring (number of wells = 4,835) for up to 20 years between 1993 and 2015. The median concentration of NO 3 -N is 2.5 mg/L, which is slightly higher than those reported from regional surveys in other countries. Nitrate concentrations of groundwater in wells tend to significantly vary according to different water usage (of the well), administrative districts, and topographic elevations: nitrate level is higher in low-lying agricultural and residential areas than those in high mountainous areas. The Mann-Kendall trend test and Sen’s slope analysis show that nitrate concentration in mid-mountainous areas tends to increase, possibly due to the expansion of agricultural areas toward highland. On the other hand, nitrate concentrations in the Specially Designated Groundwater Quality Protection Zones show the temporally decreasing trend, which implies the efficiency of groundwater management actions in Jeju. Proper measures for sustainable groundwater quality management are suggested in this study.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

실과 재배영역의 실습에 대한 초등교사들의 인식

진익수,정연옥 晋州敎育大學校 初等敎育硏究所 2003 初等敎育硏究 Vol.13 No.-

임펄스 잡음이 존재하는 주파수 선택적 리시안 페이딩 채널에서 DS/SSMA 통신시스템의 성능해석

진익수 위덕대학교 산업기술연구소 2000 산업기술연구소 논문집 Vol.4 No.1

본 논문에서는 가우스 잡음과 임펄스 잡음이혼합된 주파수 선택적 리시안 페이딩채널에서 DS/ SSMA 통신 시스템에 대한 평균비트오율식을 유도하여 성능분석을 수행하였다. K 명의 비동기 동시 사용자에 의한 다중접속 간섭신호의 해석에는 특성함수 방법을 이용하였으며, 이를 가우스 근사법을 이용한 결과와 비교하였다. E_(b)/N_(o) 가 증가할수록 특성함수 방법이 가우스 근사법에 비해 보다 정확한 해석방법임을 확인할 수 있었다. In this paper, the average probability of bit error of direct sequence spread spectrum multiple access (DS/SSMA) communication system is derived over frequency selective Rician fading channels with impulsive noise. Multiple access interference due to K asynchronous users transmitting simultaneously is computed using the characteristic function method, and compared with the Gaussian approximation method. Numerical results show that the characteristic function method is more accurate than the Gaussian approximation method as E_(b)/N_(o) increases.

CINEFLUOROSCOPY를 이용한 Ⅲ급 부정교합환자의 연하시 구강인두의 운동에 관한 연구

진익재,양원식,유동수 대한치과교정학회 1987 대한치과교정학회지 Vol.17 No.1

This study was undertaken to find out oropharyngeal movement of the class III malocclusion patients during swallowing by using the cinefluoroscopic method. The experimental group was composed of fifteen male adults with class III malocclusion whose mean age was 24.4 yrs. The control group was composed of fifteen male adults with normal occlusion whose mean age was 24.8 yrs. The results were as follows: 1. The horizontal position of the tongue tip was more anterior in the class III malocclusion group than in the normal group through all stages. 2. The tongue level was lower in the class III malocclusion group than in the normal group during stage 1, stage 3, and stage4. 3. The horizontal position of the hyoid bone was more anterior in the class III malocclusion group than in the normal group during stage 1 only. 4. The tip of the soft palate was lower in the class III malocclusion group than in the normal group during stage 1 only, and there was no significant difference in the velar movement between the class III malocclusion group and the normal group during swallowing. 5. There was a significant difference in the interincisal distance, but no significant difference in the intermolar distance between the class III malocclusion group and the normal group through all stages. 6. Among 4 stages of each group, there was a significant difference in the movements of the dorsum of the tongue, the hyoid bone, and the soft palate. And there was a significant difference in the movement of the tongue tip of the normal group, but no significant difference in the movement of the tongue tip of the class III malocclusion group.

축산분뇨중의 암모니아성 질소 제거

진양오,최성우,김성우,김익성,신남철,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

The purpose of thus study were to investigate the proper conditions of struvite formation in synthetic wastewater and then to apply these conditions to effluent of anaerobic digester of livestock wastewater The conditions of struvite formation had been studied by many researchers. But a little conditions were different among them. Especially, according to suspended solid variation in livestock wastewater was investigated by few researchers. In experiment of synthetic wastewater, the proper conditions of struvite formation were pH 105, l50rpm of mixing rate, 10 minutes of reaction time, and 20 minutes of precipitation time. At same time, the ammonia nitrogen removal rates were about 99.7%, 95.5%, and 96% of synthetic wastewater, raw wastewater, and effluent of anaerobic digester of livestock wastewater at molar ratio of 2(Mg):l(N)2(P) respectively. The larger factor of NH₄/SS constant was, the more effective the removal rate of ammonium nitrogen, SS was, but the less effective COD_(cr), and TOC was. By using XRD analysis, the most certain compound in precipitate of synthetic wastewater was struvite.

폐산과 폐알칼리를 이용한 폐지류의 전처리

진양오,윤철종,우성훈,최성우,김익성,박승조 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.1

The objective of this study were to treat waste paper with waste acid and alkali so to enhance maturity of the wastes. The sample was office paper and news paper which ratio was 1:1 and the reagents for pre-treatment were sulfuric acid and sodium hydroxide for waste acid and alkali. The maturity indices were taken volatile solid. cation exchange capacity, and gas production variation. The pre-treatment method was to dip the sample in the reagent according to time, concentration, and dosage. The methods of treatment were to dip the wastes in leachate and to landfill in soil. The result of this study were as follow. When waste paper was treated by acid and alkali, the proper treatment condition was 24hours and 0.1 normality of acid and alkali. The pre-treated samples with acid and alkali such as RSN and RSH were more effective in maturity than non-treated sample such as RS. The post-treated sample such as RSL, RSNL, and RSHL was more effective than nonpost-treated sample such as RS, RSN, and RSH.