두부외상후의 정신장애

한홍무 최신의학사 1978 最新醫學 Vol.21 No.1

죽음과 死亡過程

한홍무 서울대학교 의과대학 정신과학교실 1982 精神醫學報 Vol.6 No.6

Alcoholism의 증상론

한홍무 서울대학교 의과대학 정신과학교실 1983 精神醫學報 Vol.7 No.10

韓國 農村(珍島)에서의 重要 精神病者 頻度調査

金石植,韓弘武 大韓神經精神醫學會 1964 신경정신의학 Vol.3 No.1

The authers has field survey during 20th July 1063 to 24th July 1963 at Ko-Koom-Myun in the Island Chin-Do, which had 10517 of population. We investigated for the incidence of main psychosis in that population. The general incidence and corrected incidence by Weinberg's method are as following. -------------------------------------------------------------------------- Number General Most Affected Corrected of Cases Incidence(%) Range of Age Incidence(%) -------------------------------------------------------------------------- Schizopnrenic 16-40 0.47 Reaction 20 0.19 21-40 0.54 Manic Depressive 21-50 0.03 Reaction 1 0.01 16-50 0.03 General 0 0.0 31-50 0.0 Eqilepsy 19 0.18 5-30 0.3 5-20 0.26 -------------------------------------------------------------------------- We also could notice following facts ① Nearly half of epileptics in this area had its onset age more older than usual. ② Most of schizophrenics were chronic cases and half of them were older than 10 years. ③ At least 30% of schizophrenics had hereditary back ground. ④ Those who have religion seemed more prevalent in schizophrenics than in general population. ⑤ Only 1/8 of total patient was treated in reasonable way. ⑥ 72.5% of total patient could maintain social and/or home life in this rural area.

임신가토의 리티움청소율에 미치는 부로모크립틴의 영향

송지영,한홍무 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.4

In order to investigate the effect of dopamine on ?? balance during pregnancy, pregnant rabbits at 26 days of gestation were employed with 1㎖/㎏ of bromocriptine intravenously once a day for 3 days. On a study day, after an hour of third dose of bromocriptine, rabbits were infused with isotonic LiCl solution at a rate of 1㎖/㎏/min through jugular vein over an hour. During constant infusion of LiCl solution, arterial plasma and urine samples were cellected at 15, 30 and 60 minutes. Plasma and urine concentration of ?? and osmole were measured and with the volumes of urine collected at each time interval, changes of urinary excretion rate of ?? and osmole were calculated. Clearances of ??, osmole and free water during the time course of experiment were analyzed and compared with those of control rabbits. The results obtained were as follows : 1) Before LiCl infusion, urine flow rate and osmolar excretion rate were greater in bromocriptine treated pregnant rabbits than in control rabbits. 2) On the contrary, water and osmolar diuretic responses to ?? were lesser in bromocriptine treated pregnant rabbits than in control rabbits. 3) Bromocriptine treatment enhanced gradual rise in plasma ?? concentration, but reduced urinary concentration and excretion rate of ?? during entire course of LiCl infusion. 4) Significant decrease in ?? clearance shown in bromocriptine treated pregnant rabbits accompanied a considerable reduction in osmolar and negative free water clearance. The above findings suggest following tentative conclusions. A) Enhanced effect of bromocriptine on water excretion during pregnancy is mediated by prolactin depletion rather than by alteration of thyroid hormone or antidiuretic hormone release. B) However, role of bromocriptine in reduced diuretic response to ?? could not be explanied solely by prolactin depletion. It could be mediated by reduced glomerular filtration rate due to decreased thyroid hormone and remained activity of water and solute reabsorption by increased antidiuretic hormone. C) Therefore, elevation of plasma ?? concentration shown in bromocriptine treated pregnant rabbits may be associated with the reduction in glomerular filtration and acceleration in renal tubular reabsorption of ?? via the alteration of thyroid hormone and antidiuretic hormone.

신의 리치움처리와 리치움 : 유도성 이뇨에 미치는 부신적출의 영향

오홍근,한홍무 大韓神經精神依學會 1985 신경정신의학 Vol.24 No.3

The effect of adrenalectomy on renal handing of Li+ and associated Li+-induced diuresis was studied in rabbits. Bilateral adrenalectomy was performed on exper-imental rabbits and adrenals were identified but not disturbed on sham operated controls. On the fifty day of surgery, single intravenous injection of Li+(2mEq/㎏) in the form of chloride was given. After then 10,30,60 minutes samples were colle-cted from carotid artery and urinary bladder. Urinary flow rate, Na+, K+, Li+ and osmolarity at baseline after Li+ were measured together with the plasma concetration of them. Li+ and osmolar clearance were calculated and compared between groups. Followings are the results obtained: 1. Before single injection of Licl, urinary flow rate was lower in adrenalectomized roup than in control group, but urinary osmolar concentr-ation of adrenalectomized animal was somewhat higher than that of control. 2. In control group, single large dose of Licl produced a severs water diuresis, natriuresis and kaliuresis with decreased urine osmolarity. 3. In adrenalectomized group, Li+-induced diuresis was also observed but was far below the level shown by control rabbits. 4. In spite of higher concentration in urinary Na+, K+, and osmolarity of adrenalectomized rabbits,decreased urinary flow rate led their urinary excretion rates to be lower than those of control rabbits. 5. After single large dose of Licl, plasma Li+ concentration decayed more rapidly in adrena-lectomized group. On the contrary, urinary excretion decreased markedly compared to that of control gruop. 6. From above results, author conclude that fist load of Li+ to adrenalectomized rabbits result in a limited urinary excretion of Li+ probablely due to facilitating the accumulation of Li+ in renal medulla. Also, author conclude that limitation of Li+-induced inhibition of water reabsorption in collecting duct may be an important factor rather than limitation of inhibition of solute reabsorption incomplete Li+ -induced diuresis found in adrenalectomy.

방사선 치료 중인 암환자의 우울에 대한 연구

김윤원,양창국,최병무,한홍무 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

저자는 1994년 4월부터 9월까지 동아대학교병원 치료방사선과에서 방사선 치료를 받고 있는 암환자 50명을 대상으로 Endicott(1984)의 주요우울증 진단기준에 따른 정신의학적 면담과 HRSD, BDI등의 자가평가척도를 통해 우울증의 빈도, 암환자의 정서상태에 영향을 줄 수 있는 인구통계학적 자료 및 각 변인에 따른 우울의 정도와 특성을 비교 분석하였다. 그 결과를 요약해 보면 다음과 같다. 1) 50명의 환자 중 Endicott(1984) 진단기준으로는 20명(40%)의 환자가 주요우울증에 해당했고 24명(48%)이 경우울증으로 분류되었다. 즉 전체 환자의 88%가 어느정도 이상의 우울증이 동반된다고 판단되었다. 2) 암 자체의 증상이라고도 볼 수 있는 '건강에 대한 염려', '체중감소', '식욕감퇴', '소화기계 증상' 등의 문항이 우울군에서 유의하게 높았다. 이는 암환자의 신체증상이 반드시 암에 이차적인 증상만은 아님을 시사하기 때문에 이러한 증상이 호소될 때 반드시 우울증의 공존에 대한 고려가 필요하다고 생각된다. 3) 학교, 종교, 성별, 연령 등에 따른 BDI 및 HRSD의 평균과 정신의학적 진단은 통계적인 유의성이 없었으나 배우자와 사별한 환자 12명 중 83%가 주요우울증으로 진단되어 암환자에서 배우자로 부터 받는 지지의 경우가 우울증 발생에 중요한 역할을 함을 시사한다. 4) 암의 종류별로는 폐암군에서 높은 우울점수를 보였고 유방암군은 기타암군에 비해서 통계적으로 유의하게 낮은 우울점수를 보였으며 유방암 환자의약 83%가 비우울군으로 나타났다. 폐암군의 경우 신체적 합병증이 많았고 예후가 불량한 경우가 많았던 반면 유방암군은 경과가 양호한 환자들이 대부분이었다. 이로 보아 암의 종류에 따른 우울 정도의 차이가 나는 이유는 병의 치료 상태나, 경과, 예후등의 차이가 우울증에 영향을 끼치기 때문으로 추정된다. Objects : This study was intended to compare the prevalence rate of depression and to investigate the characteristics of depression in cancer patients on radiotherapy. Methods : The authors studied not patterns and prevalence of depression of the 50 cancer patients who were being treated by radiotherapy. Endicott's revised criteria for depression and rating scales for depression, Beck Depression Inventory(BDI) and Hamilton Rating Scale for Depression(HRSD), were used to evaluate depression. Also, the authors compared the mean scores of BDI and HRSD according to each selected variables which might influence on the affective state of cancer patients. Results : 1) According to Endicott criteria for depression, twenty patients(40%) were major depression, twenty-four patients(48%) were minor depression and six patients(12%) were non-depressed. 2) Items of hypochondriasis, weight loss, loss of appetite, and digestive symptoms in both BDI and HRSD, which indicate secondary symptoms induced by cancer itself, were significantly higher in both depressed groups as compared with non-depressed group. This suggests that we should not treat these symptoms simply as secondary symptoms dut to cancer itself but consider presentation of depression when cancer patients complain of these somatic symptoms. 3) Educational level, sex, age, duration of illness did not affect the rate of prevalence of major depression. But the widowed showed significantly higher prevalence of major depression than those who were in the married status(p<0.01). 4) Difference in rates of depression was noted among different cancer groups. The breast cancer group showed significantly lower rate of major depression(p<0.01) and much lower mean scores of BDI and HRSD than the lung cancer or other cancer groups(p<0.01). Conclusion : These above results suggest that depression is very common in cancer patients on radiotherapy and appropriate concerns is needed. The rate of depression was significantly higher in lung cancer group and in the widowed. We have to pay psychiatric concerns about somatic symptoms sush as weight loss, loss of appetite, and digestive symptoms which indicated secondary symptoms induced by cancer itself. Because these somatic symptoms were more prevalent in depressed groups.

焦點性 癎疾의 腦波 : 病巢決定에 對한 腦波의 臨床的 價値 焦點性 棘波의 硏究 Study on focal spikes

韓弘武 大韓神經精神醫學會 1973 신경정신의학 Vol.12 No.1

EEG's of 611 patients showing focal spikes were reviewed and analysed. All the subjects got EEG examinations at EEG Laboratory, SNUH. during past 6 years (1965.1.1-1970.12.31). The greatest number of patient fell in the age group of 11∼15 years, and about half of the total number was between 6 and 15 years of age. Frontal area predominated over all other areas in the incidence of focal spikes no matter in what age group they were belonging to. Next came the temporal and the occipital areas in order of greater incidence. The least spike incidence was found in the central and the parietal regions, especially in age group of 21∼40 years which is the most active period in one's life and hence the greatest incidence of head injuries. Unilateral single spike focus was the most frequent form. On the contrary, incidence of real bilateral spike foci were almost negligible in all age groups. Frontal region was the most frequent site of spike foci in all ages and in all types of clinical seizures, except in psychomotor seizures which had spikes commonly in the temporal region. in case of psychomotor seizures spike foci in the temporal region tend to be migrating as the age increases and brain matures.

비정형 정신분열병과 성격장애

한홍무 大韓神經精神醫學會 1978 신경정신의학 Vol.17 No.3

Beck Depression Inventory 의 한국판 표준화 연구 -정상집단을 중심으로 (I) -

한홍무,염태호,신영우,김교헌,윤도준,정근재 대한신경정신의학회 1986 신경정신의학 Vol.25 No.3

Beck Depression Inventory (BDI) has become widely used tool for measuring the depth level of depression, yet there are no adequate data from Korean sample. The present study was carried out in Korea. The purposes were 1) to examine the scale’s reliability and validity in a different language and culture, 2) to make norms for normal adults group, and 3) to find out the underlying factor structure and to make a factor scale. BDI was translated into Korean. The scale was used in 539 normals and 171 psychiatric patients with depressive symptoms. The results show that BDI is 1) a internally consistent and 2) valid measure in that it sensitively discriminates between normals and psychiatric patients with depressive symptoms. Norms for normal adults were made. Korean was higher in BDI score than that of Western. Form of distribution was somewhat positively skewed (skewness 0.61). Factor analytic study finds out 5 factors underlying the BDI A factor scale was structured in the way most efficientte scoring the 5 factors. Authors discussed the BDI as a screening instrument and tried to decide the cut off score tentatively.