한국에서 우울증의 특징과 비약물학적 치료

노성원,박용천,Roh, Sungwon,Park, Yong Chon 대한생물정신의학회 2006 생물정신의학 Vol.13 No.4

Depression is one of the most common mental disorders. Some characteristics of depression in Korea were elucidated. The tendency to express depressive feeling through somatic complaints is more prominent in Korea than in Western countries. Careful studies on depressive symptoms suggest that guilt and suicidal idea are apparent among Korean depressive patients as well as among Western subjects. But most depressive patients in Korea are reluctant to express suicidal idea, which is hidden under the somatic complaints. We should remember the possibility of research artifacts or cultural bias with regard to the evaluation of depressive symptoms of a country in comparison with other countries. Non-pharmacological treatment of depression includes dynamic psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, self-care treatment, etc. Some kinds of Korean culture relevant psychotherapies are introduced: Tea therapy, Imago therapy, Tao psychotherapy, and combined approach. Interest in the aged people is growing recently, and the research about the factors which affect the depressive disorders in older patients and treatment strategy for them is ongoing.

Compact Noise and Linearity Model of a Dynamic Amplifier for Behavioral ADC Modeling

노성원,김선경,김진태 한국과학기술원 반도체설계교육센터 2021 IDEC Journal of Integrated Circuits and Systems Vol.7 No.1

This paper introduces the behavioral model of dynamic amplifier which is designed in 28nm CMOS process. First, the gain of the dynamic amplifier is analyzed from various perspectives, such as input common mode voltage, input differential mode voltage and pulse width. Next, the method that is to implement the gain value non-linearity model of the amplifier and the noise model through SPICE simulations is described in detail. The gain model including nonlinearity exhibits –6.7%∼5.4% of modeling error rate and the noise model shows –11.2%∼13.5% of modeling error rate. The proposed model in this paper is applied to the 1.1Gs/s 7-bit pipelined ADC design verification to confirm the reliability. In addition, design efficiency of the proposed behavioral model is described.

컴퓨터 사용 사무직 근로자의 상지 통증과 삶의 질

노성원,박종우,한승훈,장성호,김미정,박시복,이규훈 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.3

Objective: To investigate the relationship between health- related quality of life (HRQOL) and upper extremity pain in workers using computer. Method: Ten thousand four hundred office workers using computer over 4 hours per day were enrolled, and two self-reported questionnaires were given to each candidate. First questionnaire included questions on location, duration, frequency and severity of pain, gender, age and history of alcohol, smoking and exercise. Second questionnaire used Korean job stress measurement scale (KJSMS) and medical outcome study 36 item short form health survey (SF-36) for assessing HRQOL. A total of 6,669 workers took part in interview. Results: Mean age of group with pain was lower than that of painless group. Male gender, working period of 11∼20 years, and smoking were associated with musculoskeletal pain, and similar result was found in group with no alcohol consumption, no exercise, and house chores for more than 2 hours per day. The short working period was associated with higher KJSMS Short Form score. For shoulder pain, only duty self-control showed significant difference according to pain scale in KJSMS. When adjusted with age, gender, working period, house chores and history of alcohol and smoking, there was no significant difference between musculoskeletal symptom and KJSMS, SF-36, respectively. Conclusion: Only shoulder pain and duty self-control score were related factors, comparing subjective symptoms of musculoskeletal pain and job stress. Additional investigation using strict definition and diagnostic criteria should be performed. (J Korean Acad Rehab Med 2010; 34: 325-335)

Clozapine과 연관된 확장성 심근병증

노성원,안동현,김양석,이방헌 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Clozapine is an atypical antipsychotic agent that is more effective than the typical neuroleptics in the treatment of refractory schizophrenia. However, clozapine is also a drug associated with potentially serious adverse effects, such as cardiac complications as well as agranulocytosis. Clozapine-related agranulocytosis has been reported in Korea, whereas clozapine-related cardiac complications have not. We report a 31-year-old male schizophrenia treated with clozapine who developed a dilated Cardio-myopathy. We also reviewed literatures on dilated cardiomyopathy associated with clozapine treatment. This report is an attempt to raise the awareness of clozapine-related cardiac complications.

알코올사용과 의존에 미치는 유전적 영향:최근까지의 연구결과

노성원(盧聖元,Sungwon Roh),마츠시다 사치오(松下幸生,Sachio Matsushita),히구치 스스무(樋,口 進,Susumu Higuchi) 한국중독정신의학회 2008 중독정신의학 Vol.12 No.2

More than 100 studies have shown that alcohol dependence is a complex disorder that may be influenced by multiple polymorphisms of multiple genes. There is now abundant evidence for genetic influences on alcohol use and dependence. The over-all heritability of alcohol dependence has been estimated to be 50-60% with multiple genes each having a small effect. While genetics significantly contributes to elucidation of the mechanism of alcohol dependence, the role of the environment and of gene-environment interactions should not be ignored. Linkage approaches have been used to map chromosomal regions linked to alcohol use and dependence. Regions that can be confirmed include those on chromosome 1p, 4q close to the ADH gene cluster, 4p close to the GABA A receptor gene cluster, and 16p. These regions are definitely promising candidates for association stu-dies to identify narrower loci or single gene. Many genes have been suggested to possibly play roles in contributing to vulnerability to developing alcohol dependence. Yet, only two genes, ADH and ALDH2, have been identified as having defined effects on phenotypic variations in alcohol use and dependence. We, however, remain cautiously optimistic that current and novel methods of genetic analysis will add new genes to the list. Promising candidates include GABRA2 and CHRM2. Many genes combine to reach a threshold of clinical liability; therefore, no single gene is likely to be identified as the “alcoholism” gene. Nonetheless, neurobiological analyses of candidate genes will surely contribute to further understanding of the interindividual differences in risk and the cause of alcohol dependence.

뇌성마비 환자의 침흘림에 대한 경피적 스코폴아민 첩포의 단기효과

노성원,김찬우,김태곤,이문환,이규훈 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.2

Objective: To investigate the clinical usefulness of the transdermal scopolamine patch applied to control drooling of saliva in patients with cerebral palsy. Method: We enrolled twenty two patients with cerebral palsy residing in a rehabilitation center. The mean age of the patients was 24.0 years old. Transdermal scopolamine patch was applied to the patients for 2 weeks. We measured drooling quantity, severity of drooling, and visual analog scale of care givers’ labor intensity at pre-application, post 1 week, and post 2 weeks. Results: Drooling quantity decreased significantly from 4.1 ±1.9 ml to 2.8±1.5 ml at post 1 week (p<0.01), and 2.2±1.6 ml at post 2 weeks (p<0.01). Severity of drooling decreased from 4.1±0.8 to 2.9±1.1 at post 2 weeks (p<0.01). Visual analog scale of care givers’ labor intensity decreased from 78.2±17.4 (mm) to 52.7±18.6 at post 1 week (p<0.01), and 45.9±22.8 at post 2 weeks (p<0.01). Conclusion: These findings suggested that the transdermal scopolamine patch is effective to reduce the drooling of saliva in patients with cerebral palsy within short term. (J Korean Acad Rehab Med 2010; 34: 185-188) Objective: To investigate the clinical usefulness of the transdermal scopolamine patch applied to control drooling of saliva in patients with cerebral palsy. Method: We enrolled twenty two patients with cerebral palsy residing in a rehabilitation center. The mean age of the patients was 24.0 years old. Transdermal scopolamine patch was applied to the patients for 2 weeks. We measured drooling quantity, severity of drooling, and visual analog scale of care givers’ labor intensity at pre-application, post 1 week, and post 2 weeks. Results: Drooling quantity decreased significantly from 4.1 ±1.9 ml to 2.8±1.5 ml at post 1 week (p<0.01), and 2.2±1.6 ml at post 2 weeks (p<0.01). Severity of drooling decreased from 4.1±0.8 to 2.9±1.1 at post 2 weeks (p<0.01). Visual analog scale of care givers’ labor intensity decreased from 78.2±17.4 (mm) to 52.7±18.6 at post 1 week (p<0.01), and 45.9±22.8 at post 2 weeks (p<0.01). Conclusion: These findings suggested that the transdermal scopolamine patch is effective to reduce the drooling of saliva in patients with cerebral palsy within short term. (J Korean Acad Rehab Med 2010; 34: 185-188)

정신건강의학 연구의 활성화

노성원,한혜리,김예니,전홍진,김태,김현수 대한신경정신의학회 2014 신경정신의학 Vol.53 No.3

Objectives Dealing with mental diseases is an overriding concern which could bring about improvement in mental health, social equity, and quality of life. This paper analyzes the current state of research infrastructure of national mental health research in Korea and other developed countries and suggests activation plans for psychiatric research. Methods After performance of comparative analysis, shortcomings of Korean infrastructure are examined and activation plans are suggested. Results Korea is comparatively and absolutely lagging behind in terms of mental health Research and Development (R&D), owing to the small investment in R&D, inadequate government-led long-term developmental strategy and supporting system, absence of industrialization of developed techniques and government-led R&D project, and insufficient human resources, which impedes facilitation of mental health research. Thus, in order to facilitate mental health research, 1) Reinforce international cooperation and research capability through cultivation of professionals equipped with international competitiveness. 2) Construct a government-led R&D system by establishment of a comprehensive R&D system and mental health research institutes. 3) Build cooperative systems between industry and academic circles and promote translational research and its practical use in order to lay the cornerstone for industrialization. Conclusion Developed countries have achieved significant growth and superb investment performance in the mental health industry due to constant and active investment by government. In addition, basic-clinical-mental health research regarding early diagnosis, early intervention, and tailored treatment, is actively being put into practice. In Korea, government-led long-term investment plans in psychiatric research and researcher cultivation programs should be implemented. In addition, infrastructure for application of developed techniques should also be established. If so, it will provide momentum for growth and facilitation of psychiatric research.

Scientific Evidence for the Addictiveness of Tobacco and Smoking Cessation in Tobacco Litigation

노성원 대한예방의학회 2018 Journal of Preventive Medicine and Public Health Vol.51 No.1

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.

경피적 스코폴라민 첩포를 사용한 침흘림의 치료 1예

노성원(Seong-Won Roh),양명석(Myoung-Seok Yang),이규훈(Kyu-Hoon Lee) 대한임상노인의학회 2006 대한임상노인의학회지 Vol.7 No.2

침흘림은 뇌성마비나 정신지체, 안면신경마비, 뇌병변을 가진 환자에서 자주 보여지는 현상으로 연하기전의 조절 장애로 인한 구강분비물의 저류가 그 원인이다. 침흘림은 심미적인 측면에서나 기능적 측면에서 환자나 보호자에게 강한 심리적 부담으로 작용하기 때문에 침흘림을 교정하기 위해 다양한 방법이 사용된다. 그중에서 멀미약으로 사용되는 경피적 스코폴라민 첩포가 경구로 투여하였을 때 나타날 수 있는 구강건조, 기면, 흐린시력, 집중력 감소 등의 부작용을 최소화하면서 침흘림의 억제에 효과가 있다고 보고된 바 있어, 이에 스코폴라민 첩포의 적용을 시도하였다. 교통사고에 의한 양측성 소뇌 내출혈과 수두증으로 인하여 발생한 양측 상하지 위약과 연하곤란으로 입원하여 재활치료중인 56세 남자 환자로 많은 객담과 심한 침흘림을 호소하였다. 입원 후 여러 가지의 진해거담제를 사용하여 객담은 줄일 수 있었으나, 침분비가 지속되어 낮뿐만 아니라 밤에도 수면을 제대로 취할 수 없을 정도로 환자의 불편함이 심하여 경피적 스코폴라민 첩포를 적용하였다. 적용 24시간 후부터 침흘림의 감소가 나타났고, 흡인 횟수와 양 모두에서 현저한 감소양상을 나타내었다. 환자 및 보호자의 만족도는 불편감에 대한 시각상사척도로 나타내었는데, 7에서 2로 감소하였다. 경피적 스코폴라민 첩포는 침흘림이 있는 환자군에 있어서 삶의 질을 높이는데 매우 도움이 될 것으로 생각된다. Drooling of saliva is defined as the inability to control oral secretion due to dysfunction in the coordination of the swallowing mechanism, especially in the patients with chronic neurological disabilities. Among of various approaches to manage drooling of saliva, the application of anticholinergic drugs is one of the potential strategies to treat drooling of saliva. The effect of transdermal scopolamine patch as cholinergic muscarinic receptor antagonists is to inhibit the function of acetylcholine. So, the scopolamine patch has application to a 56 year-old male patient who suffers from drooling of saliva due to neurologically impaired disability. Drooling is decreased after 24 hours to application scopolamine without complication, and the patient is satisfied with this medical treatment. We have expectation that the preventive treatment with application of scopolamine patch may be an effective for control of drooling of saliva, and the quality of life for patients will be improved.

알코올정책의 개념과 효과성

노성원(Sungwon Roh),이해국(Hae Kook Lee),기선완(Seon Wan Ki) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

This article describes the concept and efficacy of alcohol po-licy, including a brief historical review of interventions for alcohol-related problems, the basic concept of alcohol-related problems, interventions from a public health perspective, comprehensive prevention, community systems, frameworks, and practical prevention strategies in terms of evidence for their effectiveness, research support amounts, implementation costs, and other feasibility issues. Alcohol-related problems cannot be solved only by treatment models. More comprehensive preventions and interventions are needed, because evidence shows such problems have complicated and diverse characteristics. The prevailing view-point on alcohol-related problems has changed, from its being a sin, in the past, to being a disease, in the 70’s, and, recently, to being a biopsychosocial concept. Prevention frameworks require intervention strategies, establishing the severity of patients’ problems, establishing a concrete target group, and a range of target. Overall, the interventions with the greatest amount of empirical support are (1) low legal limits on blood alcohol concentration levels for driving while intoxicated, (2) controls on alcohol availability, (3) age limits on alcohol purchases, and (4) relatively high alcohol prices. Policy efforts in the developing countries should focus on improving countermeasures against driving while intoxicated, measures that alter the drinking context, and limits on alcohol’s physical availability. For developed countries, the goal should be to prevent any backsliding with regard to current drinking patterns and to reduce the overall volume of alcohol consumed. Many evidence-based policies clearly seem to have the potential for communities to substantially reduce their alcohol-related problems.