공황장애 환자의 성격요인과 방어기제의 특성에 관한 연구

심진현,백상빈,신영철,오강섭,노경선,이시형 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 공황장애 환자들을 대상으로 성격요인과 방어기제 검사를 실시하였으며 우울 및 사회기능 정도를 측정하여 상관관계를 알아보았다. 방 법: 1997년 9월부터 1998년 8월까지 환자들중 공황장애로 진단된 35명을 대상으로 성격요인검사(Sixteen Personality Questionnaire 한국판) 및 방어기제검사(이화방어기제검사)를 시행하여 스텐점수(1-10)화 하였고, 우울증척도(Beck Depressive Inventory 한국판) 및 사회기능장애척도(Sheehan Disability 한국판)를 시행하였다. 결 과: 1) 개별항목 (1) 성격요인과 방어기제의 척도별 평균점수에서 정상보다 높거나(8점이상) 낮은(3점이하) 척도는 없었다. (2) 성격요인중 불안감이 높았고 자아강도, 신중성, 사변성은 낮은 점수를 보였다. (3) 방어기제중 신체화, 행동화의 점수가 높았고 유우머, 억제, 이타주의, 회피, 합리화는 낮은 점수를 보였다. (4) BDI의 평균점수는 18.25±9.97이었다. (5) SDS의 평균점수는 업무항목 4.88±3.11. 사회활동/오락활동항목 4.57±2.92였다. 2) 상관관계 (1) 성별간 비교에서 성격요인은 사변성, 죄책감을 방어기제는 허세, 부정, 수동공격, 투사를 남성 이 높게 보였다(p<0.05). (2) 연령증가는 성격요인중 낮은지능과 방어기제는 예견, 해리와 상관을 허세와 역상관을 보였다(p<0.05). (3) BDI 점수는 성격요인중 지능도, 자아강도, 도덕성, 죄책감, 통제력, 불안감등과 방어기 제중 해리, 신체화등과 유의미한 상관관계를 나타냈다(p<0.05). (4) 사회기능장애척도의 업무항목은 성격요인중 죄책감, 진보성, 불안감, 도덕성과 방어기제의 신 체화, 투사등과 유의미한 상관이 있었고, 사회/오락활동항목은 성격요인의 죄책감, 불안감과 방어기제중 허세, 투사 등과 유의미한 상관관계가 있는 것으로 나타났다(p<0.05). 3) BDI와 사회기능장애척도의 업무항목간에는 유의미한 상관관계가 있는 것으로 나타났다(p<0.05). 결 론: 공황장애 환자는 성격요인검사상 불안감이 높고 자아강도, 신중성, 사변성은 낮게 나타 났으며, 신체화 등의 신경증적 방어기제를 주로 사용하는 반면 유우머, 억제, 이타주의, 회피, 합리화의 방어기제는 적게 사용하는 것으로 나타났다. 증상의 강도와 관련이 있는 우울증상은 업무활동에 영향을 미쳐 이와 관련된 중등도의 사회기능의 장애를 초래하고 있는 것으로 보인다. Objectives : The purpose of this study was to evaluate the characteristics of personality factor and defense mechanism and relationship with depression and disability. Methods : Study subjects consisted of 35 panic disorder patients diagnosed with the criteria of DSM-Ⅳ. Data were collected through Sixteen Personality Factor Questionnaire, Ehwa Diagnostic Test of Defense Mechanism, Beck Depression Inventory and Sheehan Disability Scale. Statistics employed for the analyses were Pearson correlation and independent sample t-test. Results : In personality factors and defense mechanisms, there were no definitely abnormal range of scores. But, among personality factors, tension/anxiety factor scored high and unstableness/stableness, shyness/boldness and praxernia/atunia were in low range of score. In defense mechanism, somatization and acting-out scored high and humor, suppression, altruism, avoidance and rationalization scored low. The mean BDI score was 18.25±9.97. The mean score of SDS were 4.88±3.11 in work category and 4.57±2.92 in social/leasure category. Male patients were significantly correlated with guit-proneness and atuia in personality factor and passive-aggressiveness, projection, denial and show-off in defense mechanism, compared with female patients(p<0.05). The patients` age was correlated with low intelligence in persolity factor and dissociation and anticipation in defense mechanism. It was negatively correlated with show-off(p<0.05). The BDI score was correlated with low intelligence, superego, unstableness, self-conflict, high superego and atunia in personality factor and dissociation and somatization in defense mechanism(p<0.05). There was a significant relationship between BDI score and SDS work category(p<0.05). Conclusions: Panic disorder patients show high score of tension/anxiety factor and they frequently use neurotic defense style like somatization. The depressive symptom, which depends on symptom severity, appears to have influence on work category and to cause social disability.

안구의 비색소성 모양체 상피에서 발생한 유두상 선암종 -1예 보고-

최현주,최영진,이연수,이은정,강석진,김병기,심상인 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구

김우진,심주철,공보금,강제욱,문정준,김정은,김민걸,박민경,김성진,김현정,정도운 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:This study was to identify weight & metabolic changes in first-episode psychotic patients with antipsychotics use and investigate the differences of weight & metabolic changes between first-episode psychotic patients and controls with antipsychotics use. Method:In this retrospective study, twenty eight first-episode psychotic patients and twenty eight controls with schizophrenia, schizoaffective or bipolar disorder defined by DSM-IV criteria were included. Information about demographic and clinical characteristics of the subjects was gathered from the medical records. Also body weight, sBP, dBP, fasting glucose, lipid profile and WBC count were evaluated before and after antipsychotics use. Rogistic regression was conducted to assess factors associated with weight gain. Results:First-episode psychotic patients showed more weight and BMI changes than controls after antipsychotics use, and these changes continue over 12 months. On the other hand, there were no significant factors associated with weight gain. Conclusion:The results of present study suggest that antispychotics is one of the major causes inducing weight gain of psychotic patients and antipsychotics-induced weight gain is more vulnerable to drug-naive first-episode psychotic patients.

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

흰쥐 생체시료 중 5-플루오로우라실 및 테가푸르의 안정성

장지현,박종국,강진형,정석재,심창구,구효정 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.3

5-Fluorouracil (5-FU) is an antimetabolite anticancer agent active against many types of solid tumors. Tegafur (TF), a prodrug of 5-FU, is frequently used in combination with uracil as dihydropyrimidine dehydrogenase (DPD) inhibitory fluoropyrimidine. We studied the stability of 5-FU and TF in biological fluids of rats and determined their bioavailability (BA) and excretion into bile, and urine. The drug concentrations were analyzed by an HPLC method. At room temperature, there was a 14-30% decrease in the concentration of 5-FU and TF in bile, urine, and plasma specimen at 10 and 100 μg/ml over 240 min. No significant difference was noted among the sample types or between two different concentrations of 10 and 100 μg/ml. The decrease in drug concentration was significantly less in samples kept on ice (6-12%) for both drugs. These data indicate that biological fluid samples containing 5-FU or TF in plasma, urine, or bile should be placed on ice during the sample collection. Following these storage guidelines, samples were collected after administration 50 ㎎/㎏ of each drug via i.v. or oral route. BA was 1.5 folds greater for TF (60%) than that of 5-FU (42%). Approximately 0.52 and 3.3% of the i.v. doses of 5-FU and TF was excreted into bile, respectively. Renal clearance of 5-FU was about 16% of its total body clearance. These results suggest that instability of 5-FU and TF in biological fluids should be considered in pharmacokinetic or pharmacogenomic studies.

비·부비동 양성 종양의 임상적 고찰

김진국,신향애,임채형,장현종,심대보 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Background and Objectives: Benign tumors of the nose and paranasal sinues are rare in comparison with malignant growths. Authors aimed to investigate the incidence and characteristics of benign sino-nasal tumors. Materials and Methods: From 1994 through 2004, 25 cases of benign sino-nasal tumors (17 men and 8 women) were diagnosed and cared at the Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University. We reviewed medical records of patients to find out clinical features, radiologic findings, operative findings, therapeutic options, and outcomes. Postoperative observation was given for fifteen months on the average. Results: The most common symptom was nasal obstruction, followed by nasal mass, frequent nasal bleeding, headache, and rhinorrhea, and the mass mainly placed in the lateral nasal wall. There were 12 cases (48%) of inverted papilloma, 4 (16%) cases of squamous papilloma, 4 (16%) cases of hemangioma, 1 (4%) case of pleomorphic adenoma, 1 (4%) case of leiomyoma, 1 (4%) case of lipoma. All the tumors were surgically removed. For the treatment of inverted papilloma, medial maxillectomy had been performed before 1997(2 cases); however, most cases have been managed with endonasal endoscopic technique since 1997. Recurrence was observed in two patients with inverted papilloma and one patients with squamous papilloma. Conclusion: Inverted papilloma is the most common benign tumor in the nose and paranasal sinuses, followed by squamous papilloma and hemangioma. The optimal management of benign tumors is complete excision of tumor and endonasal endoscopic surgery is an effective treatment for an inverted papilloma.

한국인에서 CC-SIT와 비교한 KVSS Test의 임상적 유용성 평가 : 예비연구 Pilot study

김진국,장현종,임채형,남태욱,심대보 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Background and Objectives: Sniffin' Sticks test is the test of nasal chemosensory performance based on pen-like odor dispensing devices. KVSS(Korean Version of Sniffin' Sticks) Test was developed as the "Korean olfactory test" using the odorants which are familiar to Korean. Authors evaluated the clinical validity of KVSS Test compared with CC-SIT (Cross-Cultural Smell Identification Test) in Korean. Materials and Methods: The subjects of this study were 25 normosmic volunteers who were divided into five groups according to age. Each group was 5 normosmic volunteers. And they consisted of 12 men and 13 women. KVSS Test and CC-SIT were used for the evaluation of olfactory function. Results: Our study showed the negative correlation between age and olfactory function test (CC-SIT score, KVSS Test I score and KVSS Test II score). Normosmia rate of KVSS Test was more higher than that of CC-SIT. Also KVSS Test had more familiar items for Koreans compared with that of CC-SIT. CC-SIT score and KVSS Test score showed showed the positive corrclation. And each test revealed high reliability in test-retest evaluation. Conclusion: The KVSS Test can be used as an olfactory function test for Koreans.

구강 및 악안면 영역의 감염증에 관한 임상적 연구

백진현,이영수,심광섭 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

This is a retrospective study on the patients with infection of the oral and maxillofacial region with the purpose of obtaining some useful data for diagnosis and treatment plan of that relatively common disease in dentistry. The used materials of study were 87 in total, including 52 male patients, 35 female patients who diagnosed and treated at the Department of the Dentistry in Hanyang Medical College Hospital for the period of Jan. 1990 to Dec. 1994. The author analyzed the distribution and incidence of sex, age, admission period, etiologic factors, etiologic teeth, treatment method of infections, pus culture, antibiotics sensibilities and medication. The result obtained as follows : 1. The developmental incidences by sex was superior in male by the ratio of 1.5 : 1 and the infection was most frequently occurred during the third decades(35.6%). 2. The number of admitted patients elevated in February, March, and April, and average of admission period was 9.8 days. 3. Main etiologic teeth showed on lower molar region in adult(63%) and upper molar region in primary dentition(46.1%). 4. Medications were administrated in all of the cases, and surgical incision and drainage were performed in 53% and extraction of the causative teeth were performed in 63.6% of all cases. 5. The most common involved fascial spaces were Buccal space(41.4%), Infraorbital space(27.6%), Submandibular space(16.1%),in order, and 9 cases(10.3%) were Ludwig's Angina. In 68.2% of the patients, and infection involved only one fascial space and in 21.8% of the patients, it involved to more fascial spaces. 6. The most causative organisms isolated from pus culture were Gram-positive facultative cocci(55.5%), and antibiotics sensitivities on the total isolated bacterial strains were exposed chloramphenicol(88.6%), Cephalothin(88.6%), Erythromycin(81.5%), Lincomycin(77.8%) in order, but it showed resistant on Gentamycin(58.3%), Tetracycline(56.5%), Methicillin(38.5%).

후두결핵의 임상적 고찰

이동건,심우영,조재민,박현민,이진춘,왕수건 釜算慶南耳鼻咽喉科學會 1996 임상이비인후과 Vol.7 No.2

Escherichia coli 패혈증 환자에 합병된 대칭적 하지 말단 괴사증 1예

남해성,유진홍,권순석,민준기,조현선,박민경,심병주,남유정,이지인,김진수,길욱현,조근종,신완식 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

We have encountered a rare case of symmetrical peripheral gangrene complicating Escherichia coli sepsis in a 47-years-old male. He was successfully treated with antibiotics, anticoagulants, and vasodilator. To our knowledge, this is the first report on symmetrical peripheral gangrene complicating E. coli sepsis in Korea.