암 환자의 우울과 통증 : 일 예비적 연구

양문정,전양환,한상익,한치화,엄현석 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 암 환자에서 우울과 통증의 정도, 우울과 통증에 영향을 줄 수 있는 요인들을 조사하고, 우울과 통증사이에 어떤 연관이 있는지 알아보고자 하였다. 방 법 : 종양내과에 입원한 암 환자 25명(남자 : 10명, 여자 :15명)을 대상으로 하여 내과 병록지 거모, 환자 및 가족과의 면담을 시행하였다. 정신과적 진단은 DSM-IV진단 기준에 의하였으며, 우울의 정도는 Hamilton Rating Scale for Depression(HRSD)로 평가하였고 통증의 유무를 평가한 뒤, 통증이 있는 경우 Brief Pain Inventory(BPI)를 시행하여 통증의 강도(최대, 최소,평균,현재), 통증에 의한 기능 방해 정도, 진통제에 의한 호전정도를 점수로 평가하였다. 결 과 : 전체 환자중 주요 우울증이 32%(8명), 경도 우울증이 16%(4명), 적응장애가 16%(4명)이었다. HRSD점수는 통증의 최대강도, 평균강도, 현재강도, 통증에 의한 기능방해정도와 유의한 상관관계가 있었으나, 통증의 최소강도, 진통제에 의한 호전 정도와는 유의한 상관관계가 없었으며, 이환 기간과 HRSD점수 및 통증 점수 사이에도 유의한 상관관계가 없었다. 성별, 종교, 암의전이여부,병황의 인식 여부에 따라 HRSD점수와 통증 점수에 차이가 없었으나, 현재 미혼 또는 사별 상태에 있는 환자들에서 결혼하여 배우자가 있는 환자들보다 HRSD점수와 통증의 최소강도, 평균강도가 유의하게 높았다. 결 론 : 암환자에게서는 우울증과 통증이 있는 경우가 많았다. 우울증과 통증간에 밀접한 상관관계가 있음을 알수 있었다. 본 연구의 결과는 암 환자에서 우울증과 통증에 대한 보다 적극적인 평가와 개입이 이루어져야 함을 시사하는 것이다. Objective : This study was designed to evaluate how much depression and pain symptoms could be shown, what kink of factors affect them, and whether the correlation between them could be or not in patients with cancer. Methods : The subjects were composed of 25 patients with cancer who admitted a the department of oncology(male:10, female :15). We reviewed the medical record and interviewed patients and their family. A psychiatric diagnosis was made according to the criteria of the DSM-IV, and depressive symptoms were evaluated by Hamilton Rating Scale for Depression(HRSD). The intensity of pain(maximal, minimal, mean, present), disability due to pain, te effects of analgesics were measured by Brief Pain Inventory(BPI). Results : 32% of patients had major depressive disorders, 16% of patients had depressive disorders, NOS and 16% of the patients had adjustment disorders. The score of HRSD was significantly correlated wit the maximal intensity, mean intensity and present intensity of pain and disability due to pain, but not with minimal intensity and the effects of analgesics. Depression and pain were not correlated with duration of illness. Scores of depression and pain did not differ in sex, religion, metastasis, and the knowledge of illness. The widowed or unmarried patients showed significantly higher scores than patients living with the spouse in HRSD, minimal intensity and mean intensity of pain. Conclusion : In patients with cancer, depression and pain were highly prevalant. The relationship between depression and pain was shown in patients with cancer. These results suggest that more active evaluation and intervention of depression and pain should be carried out in patients with cancer.

정신분열증 환자에서 지형학적 청각 사건관련전위 P300의 생물학적 표시자로서 임상적 의의

전양환,한상익,방승규 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적: 저자들은 정신분열증 환자에서 지형학적 청각 사건관련전위 P300의 소견이 생물학적 표시자로서 의의가 있는 지를 알아 보고, 이를 임상적으로 상태표시자 또는 성향표시자로서 사용할 수 있는 지에 대하여 조사하였다. 방 법: 대상은 정신분열증 환자군 30명(남자=12명, 여자=18명 ; 나이 30.2±9.9세)과 정상 대조군 30명(남자=12명, 여자=18명 ; 나이 33.5±7.6세)으로 연구하였다. 정신분열증 환자군은 입원후 1주 이내에 첫 검사를 한 초기군과 4주 후 추적검사를 한 추적기군으로 나누었다. 지형학적 청각 사건관련전위 P300과 N100은 표준화된 방법인 "oddball paradigm"으로 검사하였으며, 각 검사 시점에 양성 및 음성 증상 평가척도(Positive and Negative Syndrome Scale)를 사용하여 양성증상, 음성증상, 일반정신병리, 그리고 전체증상 등으로 나누어 임상증상을 평가하였고, 환자군의 초기와 추적기의 변화는 P300과 PANSS의 원점수를 Z 변환으로 표준화하여 사용하였다. 결 과: P300 잠복기는 대조군 315.8±24.2msec, 초기군 403.8±42.3msec, 추적기군 364.7±43.2msec로서, 각 군간의 유의한 차이가 있었으며(p<0.01), N100잠복기, 나이, CCP(correct counted percent) 등을 공변인으로 공분산분석후에도 이러한 차이는 여전히 유의하였다(p<0.01). P300 전위값은 대조군 8.8±2.7μV, 초기군 4.4±1.9μV, 추적기군 4.4±2.5μV로서, 대조군과 초기군, 대조군과 추적기군 간의 유의한 차이가 있었으나(p<0.01), 초기군과 추적기군간의 차이는 없었으며, N100 전위값, 나이, CCP 등을 공변인으로 공분산분석후에도 이러한 차이는 여전히 유의하였다(p<0.01). 정신분열증의 양성증상, 음성증상, 일반정신병리, 전체증상 등은 초기군에 비해 추적기군에서 유의하게 호전되었다.(p<0.01). 임상증상이 호전되면서 P300 잠복기는 감소하였으나, P300 전위값은 변화가 있었다. 결 론: P300은 정신분열증 환자에서 정상인과 다른 양상을 보이고 있었으며, 이러한 소견은 외부자극에 의한 영향을 배제한 뒤에도 나타났다. 정신분열증 환자에서 임상증상이 호전됨에 따라 P300 잠복기는 감소하였으나, P300 전위값은 변화가 없었으며, 이는 P300 잠복기가 정신분열증의 상태표시자이고 P300 전위값은 정신분열증의 성향표시자임을 시사하는 소견으로 생각된다. This study was designed to investigate the clinical availability of topographic auditory event related potential P300 as a biological marker in patents with schizophrenia. The subjects were composed of normal controls(N=30) and patients(N=30) with schizophrenia by DSM-IV. Topographic auditory event related potential P300 and N100 were measured by "oddball paradigm", which was known as a standard method. Schizophrenics were evaluated twice, initial and follow-up, by 4 week interval. P300 latency and N100 latency were determined by Global Field Power. At this time point the maximum amplitude and its location, according to X-Y coordinates, were determined in brain topography. Clinical symptoms were evaluated by Positive and Negative Syndrome Scale(PANSS). P300 latencies of normal controls, initial group of schizophrenics, and follow-up group of schizophrenics were 315.8±24.2msec, 403.8±42.3msec, and 364.7±43.2msec, respectively. P300 amplitudes of normal controls, initial group of schizophrenics, and follow-up group of schizophrenics were 8.8±2.7μV, 4.4±I.9μV, and 4.4±2.5μV, respectively. They had significantly different P300 latencies one another by measuring ANCOVA, of which covariables were N100 latency, age, and CCP(correct counted percent)(p〈0.01). X-Y coordinates was not significant. In P300, there were some different characters between normal controls and schizophrenics even though excluding N100, which was supposed to be exogeneous component by external stimuli. When clinical symptoms were improved, P300 latency was decreased. However, P300 amplitude was not changed. These results suggest that P300 woald be available clinically as biological marker, P300 latency be a state marker, and P300 amplitude be a trait marker in schizophrenia.

정신분열병 환자에서 청각 사건관련전위 P300의 비대칭성

전양환,한상익 대한신경정신의학회 2001 신경정신의학 Vol.40 No.1

연구목적: 본 연구는 정신분열병 환자들에게 청각 사건관련전위 P300의 비대칭성이 있는지를 알아보기 위해 시도 되었다. 방법: 대상군은 DSM-VI에 의해 진단된 정신분열병 환자군 20명과 나이와 성별을 일치시킨 정상인 대조군 20명으로 하였다. 청각 사건관련전위 P300은 'oddball'모형을 기록하였다. P300의 결정은 고전적 방법에 의해 결정하였으며 5군데에 위치한 전극(Fz, Cz, Pz, T₃,T₄)에서 측정하였다. 결과: 정신분열병 환자군의 P300 전위는 정상 대조군 보다 5개 전극 부위 모두에서 감소되어 있었다. 두 군사이에 비대칠성의 차이는 없었다. 결론: 이 소견은 정신분열병 환자에서 청각 사건관련전위 P300과 그 정보처리 과정이 비대칭적으로 나타나지 않는다는 것을 시사한다. Objectives : The present study was designed to investigate whether asymmetry of auditory event-related potential P300 was shown in patients with schizophrenia or not. Methods : The subjects were composed of patients(N=20) with schizophrenia by DSM-IV and normal controls(N=20). The auditory event related potential P300 was measured by "oddball paradigm". P300 component was determined by classic method at 5 electrodes(Fz,Cz, Pz, T3, T4). Results : P300 amplitudes of patients were smaller than those of controls across all electrodes. Asymmetry of auditory event-related potential P300 was not shown between patients with schizophrenia and normal controls. Conclusion : It is implicated that auditory event-related potential P300 and its information processing should not be elicited asymmetrically in schizophrenia.

大邱市 北郊의 都市化에 關한 硏究 : a case of chilgok myeon, Chilgok county

李奐基,楊辰錫 慶北大學校 師範大學 地理敎育科 1979 地理敎育 Vol.6 No.-

This study was concerned about characteristices of Urbanization in regions around metropolitan. It has the purpose to make clear the structure of Urbanization in the northern outskirt of Daegu, Chilgok myeon, chilgok country, after searching the procedure of urbanization(1966-1976) and the actual Condition of urbanization. 1) In examining closely the procedure of urbanization, the comparative method was used and tried to understand the urbanization phenomenon as a regional phenomenon, As this study was geographic research in Urbanization. 2) Materials were dependent on existing statisties and those that I myself collected in the field by field-work. 3) In order to analyze actual conditions and procedure of urbanization, the following two indexs were used: (1) Changes of population-changes of total population, increase and decrease of population of each Dong(village), and change of industrial population. (2) Increase of Urban fuctional element-increase of houses, of shops, of factories of traffics and a jump of land price. The result of the analysis by the above method and indexes could be summarized as follows: 1) For nine years from 1966 to 1975, the population went on an an increase of 51.5%. In other words 7,124 persons increased from 13,828 persons in 1966 to 20,952 persons in 1975. such a rapid population increase was affected by the suburban explosin of Daegu. The density of population increased 152.4 persons/㎢ from 295.7 persons/㎢ in 1966 to 448.1 persons/㎢ in 1975. As for industrial population, the rate of the rural industrial population(1966-1971) was 13.7% down from 84.4% to 70.7%. On the other hand, the rate of urban industrial population was 5.3% up from 19.3% to 24.6%. In changes of population, the differences of each village being great, it was possible to divide the whole area into the growing, the nongrowing and the declining region. 2) Of urbanizing functional element increase; House increase rate from 1966 to 1976 was 39.5% but the house shortage rate increased 24% for the same period. And so the great house shortage took place. As for shop increase, all shops(84 shops) are retail trades, related with Daegu city. With factories and houses increasing, in this area we can find out the seperated urbanization phenomenon. As of 1976 August, the total of 79 factories were built in chilgok myeon dependent on the zoning program of Daegu city urban design. These factories are closely related with the technical development of Daegu. Traffics a day were 3,230 cars and so increased 15.6% a year. As the roads in this area were the most convenient, when compared with those in other area from Daegu. The urbanization on this area is growing rapider than in other area. During 1966-1976 the land price jumped 400-8300%. In other words this means the growing rate of urbanization. The urbanization of Chilgok myeon will continue in the future and social problems caused by the urbanization should be taken consideration in the policy.

정신분열증의 증상을 보인 측두엽간질 : LIKE SYMPTOMS

전양환,이정태,김광수 한국의학사 1993 診斷과治療 Vol.13 No.12

정신지체에서의 정신분열증 : PROPF-SCHIZOPHRENIA

전양환,이정태,김광수 한국의학사 1993 診斷과治療 Vol.13 No.10

Isoniazid 복용후 나타난 정신증상

전양환,김은혜,김광수 한국의학사 1992 診斷과治療 Vol.12 No.6

홍국균의 최적배양조건에 관한 연구

정순택,임종환,박양균,황금택,박현진,안찬영,강성국,문길만 木浦大學校 工業技術硏究所 1994 工業技術硏究誌 Vol.4 No.-

Cell growth and pigment productivity of Monascus anka KCCM 11832 and Monascus sp. has isolated from the Korean Maeju(soybean koji) were determined for effect of culture medium composition and incubation conditions. Increase of NH₄NO₃, and KH₂PO₄ concentration as mineral source promoted mycelium growth, and the highest cell growth was showed in the medium with 0.05% KH₂PO₄ when C/N ratio is 20:1, but pigment production was significantly inhibited at higher concentration than this level. Cell growth and pigment production in porato dextrose medium were higher than those in czapeck-dox broth and malt extract medium. In terms of temperature, the highest cell growth was showed at 34℃, but pigment productivity was the highest at 26℃.

유방암종에서 p53, cyclin D1 및 cathersin D 단백발현의 의의

문경래,김환정,이미자,기근홍,서재홍,양정원,조현진 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives: Breast carcinoma is a heterogenous disease. The prognosis of this carcinoma correlates with various prognostic factors. The aim of this study was to assess the prognostic significance of expression of p53, cyclin Dl and cathepsin D protiens in association with various prognostic factors in invasive breast carcinoma. Materials and Methods: The relationship is presented between expression of p53, cyclin D1 and cathepsin D by immunohistochemistry and various established prognostic factors such as tumor size, histologic grade, lymph node status and extensive intraductal component in 55 cases of invasive breast carcinoma. Results: No significant correlations were observed between expression of p53, cyclin Dl and cathepsin D and tumor size. The expression of p53 correlated with high histologic grade. The expression of p53 and cyclin Dl correlated with lymph node metastasis. Conclusion: These results indicate that expression of p53 and cyclin Dl in invasive ductal carcinoma may be an important prognostic factor, closely related to the high histologic grade and lymph node metastasis.

골분진과 섬유소 접합물을 이용한 두안면부 골결손의 치료

권성택,박양수,김진환 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

In the field of plastic surgery, various forms of craniofacial bone defects may be encountered under such conditions as trauma, congenieal defect, and postoperative condition. Until now, autogenous bone graft, processed homograft or heterograft, and alloplastic implants have been used for the reconstruction of those defecrs. Although each method has its own pros and cons, autogenous bone graft is most widely used because of its high survival rate, low postoperative complication rate, and longterm stability, Recently, the calvarium has become the favorite source of autogenous bone graft since it has many advantages. However, it is not easy to fabricate bone graft to fit in the defect accurately, paricularly for cystic or irregularly shaped depressions of craniofacial bone defects. In 1970, Shehadi reported the use of calvarial bone dust in reconstruction of cranial defects. Bone dust is harvested easily and in reasonably sufficient amount, but has not been used widely due to problems in fixation and survival rate. In our previous study, authors experimentally proved that a miture of fibrin sealant and autogenous bone dust plays an effective role to form a new bone in bone healing process. Fibrin controls bleeding, serves as a surface for adherence and degranulation of platelets, and accelerates would healing in general. In the healing process of bone grafting, fibrin trellis is known to contribute to osteoconduction and osteoinduction by supplying moving channels for undifferentiated mesechymal cells and bone morphogenic protein. Clinically, authors successfully treated 7 cases of craniofacial bony defects using bone dust and fibrin sealant and concluded as follows ; 1. Bone dust is easy to harvest in sufficient amount and is useful in reconstruction of various forms of bony defects. 2. Bone dust can be easily fixed when mixed with fibrin sealant. 3. Fibrin sealant stimulates bone union of bone dust graft. 4. Bone dust can also be harvested simultaneously when harvesting calvarial bone graft and be used in various craniofacial reconstruction as mixture with fibrin sealant.