카드뮴 급성폭로에 의한 Metallothionein 생성과 독성작용

민경준,박정덕,홍연표,장임원,Min, Kyung-Joon,Park, Jung-Duck,Hong, Yeon-Pyo,Chang, Im-Won 대한예방의학회 1993 Journal of Preventive Medicine and Public Health Vol.26 No.2

Thirty five male Sprague-Dawley rats were treated with cadmium chloride solution ranging from 0.2 to 3.2mg $CdCl_2/kg$ by intravenous single injection. At 48 hours after administration of cadmium, total cadmium, MT bound cadmium and histopathologic finding in liver, kidney, lung, heart, testis, metallothionein in liver, kidney and total cadmium in bleed were examined. Tissue cadmium concentration was highest in liver, followed by in kidney, heart, lung and testis. Cadmium bound to rnetallothionein (MT-Cd) and ratio of MT-Cd to total cadmium were increased in liver and kidney dependently of cadmium exposure dose, but not significantly changed in other organs. On histopathologic finding, the most susceptible organ was heart in considering cadmium exposed dose, but testis in considering cadmium concentration. Blood cadmium concentration was increased with dose-dependent pattern, and significantly correlated with tissue cadmium concentration, so that we may estimate tissue cadmium concentration by measurement of blood cadmium concentration. Metallothionein in liver and kidney was increased with dose-dependent pattern, higher in liver than in kidney, and was significantly correlated with tissue cadmium concentration. However, metallothionein induction efficiency of tissue cadmium(${\mu}g\;MT/{\mu}g\;Cd$) was eater in liver than in kidney, and reverse to tissue concentration or exposed dose of cadmium.

우울증 치료에서의 어려운 문제들

민경준,Min, Kyung-Joon 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

Whenever a clinician manages the patients with depression, he may meet various problems that make it difficult to treat them. Even though he has good skills and knowledge about depression, some barriers will be appear during his practice. In general, the difficulties in treating depression are treatment-resistance, adverse effects of antidepressants, pregnancy in female patients, comorbid medical conditions, poor compliance, drug-drug interactions, and so on, which are related with pharmacological treatments. Here, only the two of them, the treatment-resistant depression and difficult problems concerned with pregnancy, were discussed. Some level of treatment resistance is the norm rather than the exception. As the treatment failure stems from inadequate treatment, it is important that the clinician should prescribe medications with sufficient doseage and adequate duration. And to overcome the treatment resistant depression the polypharmacy is necessary, in that case, the side effects and toxicities should be explored and managed immediately. So the clinician have to learn more about the pharmacokinetic and pharmacodynamic mechanisms of each drugs used in treatment of depression. When the risk of the fetus by the exposure is higher than the risk of untreated maternal psychiatric disorder, psychotropic medications should be used during pregnancy. Women who are maintained on psychotropics and become pregnant, as well as women with the new onset of psychiatric symptoms during pregnancy, should be carefully reassessed. However, data concerning the potential risk of long-term behavioral changes following prenatal exposure to psychotropics is rare, so further longitudinal follow-up studies are needed.

연성 전기 경련 요법의 임상적 고찰과 마취제 pentothal과 propofol에 따른 경련기간의 비교에 관한 연구

송헌일,민경준,최인근,유태혁,Song, Hun-Il,Min, Kyung-Joon,Choi, Ihn-Geun,Yoo, Tae-Hyuk 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2

저자들은 1993년 5월 1일부터 1997년 4월 30일까지 한강성심병원 신경정신과 입원환자 중연성전기경련요법을 받은 60명을 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 전기경련요법을 받은 환자 60명중 정신분열증이 51.7%, 주요우울증이 21.6%, 양극성 정동장애, 조증이 16.7%, 기타 10% 이었다. 2) 전기경련요법의 시행 횟수는 1인당 평균 12.2회(정신분열증 14.9회 : 주요우울장애 12.2회 : 양극성 정동장애 13.6회 : 기타 8.2회)이었다. 3) 치료의 대상이 되었던 증상은 정신분열증의 경우 피해망상, 환청, 주요우울장애는 정신운동지체, 우울기분, 그리고 자살사고 또는 시도, 양극성 정동장애에서는 파괴적 행동, 흥분상태 순이었다. 4) 전기경련요법에 사용된 약제로 atropine $0.0093mgkg^{-1}$, 마취제 pentothal $2.76mgkg^{-1}$, 근육이완제 succinylcholine $0.80mgkg^{-1}$을 사용하여 만족할 만한 효과를 얻을 수 있었다. 5) 전기경련요법시 사용된 마취제중 propofol은 pentothal에 비해 seizure duration을 낮추었다. The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T. on seizure duration. The results were follows ; 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine $0.0093mgkg^{-1}$, pentothal $2.76mgkg^{-1}$ or propofol $1.42mgkg^{-1}$. 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal (35.7 sec)(p<0.001). This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.

정신분열병 환자의 혈청에서 Brain-Derived Neurotrophic Factor 증가

김소연,민경준,기백석,박두병,김주희,Kim, So Youn,Min, Kyung Joon,Kee, Baik Seok,Park, Doo Byung,Kim, Joo Hee 대한생물정신의학회 2004 생물정신의학 Vol.11 No.2

Objectives:Abnormalities in neurotrophic factors that regulate neuronal development and synaptic plasticity are often implicated as some causes of schizophrenia. In previous studies, researchers reported that brain and serum BDNF levels underwent similar changes during maturation and aging processes in rats. They also found a positive correlation between serum and cortical BDNF levels. In this study, we investigated whether the serum levels of BDNF in Korean schizophrenic patients would be different from those of healthy controls. Methods:Using an ELISA kit, serum BDNF levels were assessed in schizophrenic group(N=49) and control group(N=50). Results:Serum BDNF levels in the schizophrenic group($36.29{\pm}19.78$ng/ml) were significantly higher than those in control group($22.4{\pm}14.4$ng/ml). The BDNF levels did not correlate with duration of treatment, age or daily dose of antipsychotics in patients with schizophrenia. Conclusions:This result suggests that schizophrenia is characterized by high serum BDNF levels and supports the hypothesis of neurotrophic factor involvement in psychotic disorder. Serum BDNF level is likely to be one of the possible biological markers for schizophrenia.

긍정적 사고가 운동 수행 능력의 향상과 불안조절에 미치는 영향

한덕현,조규현,민경준,나철,Han, Doug-Hyun,Cho, Kyu-Hyun,Min, Kyung-Joon,Na, Churl 한국정신신체의학회 2007 정신신체의학 Vol.15 No.2

서론 : 긍정적 사고는 수행능력에 많은 영향을 끼친다. 기질적 특성 중 위험 회피는 불안과 관련된 행동에 많은 영향을 끼친다. 여러 종목의 스포츠 중, 골프 선수는 다른 종목의 선수에 비해 높은 불안 수준과 낮은 위험회피기질을 보이고 있다. 따라서, 골프선수에서 긍정적 보상과 강화가 불안을 감소시키며 인간 행동 수행능력을 향상시키는 것을 알아보았다. 방법 : 15~19세의 51명의 골프 선수 중, 25명은 Zinsser의 긍정적 사고전환을 응용한 레슨과 Beswick가 제시한 긍정적 자기 말을 사용하였다(P-FB), 26명은 일반적 훈련 법을 따랐다. 위험회피(Harm avoidance), Spielberg's Trait and State Anxiety, 골프점수(드라이브 거리 및 OB 횟수, 아연 샷 횟수, 퍼팅 횟수) 등을 훈련법 전과 6개월 뒤에 조사하였다. 결과 : 훈련 법 전에 조사한 위험회피, 불안 수준, 그리고 골프점수에서는 두 그룹에서 차이가 없었다. 6개월 뒤, 양군 모두에서 전반적 골프점수는 향상을 보였다. 하지만 P-FB 군이 대조군에 비해 종합 점수와 퍼팅 횟수가 더욱 감소하였다. P-FB 군이 상태불안(State Anxiety)의 감소를 보인 반면 대조군에서는 상태불안의 변화가 없었다. P-FB 군에서 위험회피 점수는 상태불안과, 상태불안은 종합점수의 감소와 관련이 있었다. 결론 : 긍정적 보상과 강화는 행동 수행 능력과 상태불안을 향상시키며, 행동 수행 능력과 불안의 향상은 높은 위험 회피의 기질적 특성을 가지고 있는 골프선수에게 특히 도움이 되었다. 본 연구는 높은 위험회피를 가지고 있는 사람에서 긍정적 사고를 통한 불안의 조절이 수행능력의 향상에 직접적 도움이 됨을 알 수 있었다. Introduction : A positive thinking has been known to affect the enhancement of performance. One of temperament characters, harm avoidance is thought to be associated with anxiety related behaviors. Golfer showed highest anxiety and lowest score of harm avoidance, compared to any other sports. We hypothesized that positive feedback and reinforcement in golfer would decrease the anxiety and improve the performance. Methods : Fifty one golfers with the age from 15 to 19 were classified into two groups; 25 golfers who used Zinsser's Changing Negative thoughts to Positive thoughts and Beswick's positive self talk when exercise and competition (P-FB) and 26 golfers who had not (controls). Harm avoidance, Spielberg's Trait and State Anxiety, and Golf scores has been assessed at baseline and 6 months later. Results : There was no significant difference in baseline harm avoidance, anxiety, and golf scores between P-FB and controls. The total golf scores in both groups have improved after 6 month later. However, P-FB group showed greater improvement of total scores and putting scores, compared to controls. The state anxiety in PFB group has been decreased, while there was no change in controls. The change in the state anxiety was correlated with harm avoidance and the change in total golf scores. Discussions : The positive thinking has enhanced performance and state anxiety. The improvement of performance and anxiety in golfers was associated with high harm avoidance. The current study showed that the regulation of anxiety with positive thinking was helpful to the performance enhancement in subject with high harm avoidance.

한국 정신분열병 환자에서의 혈중 Homocysteine, 엽산, Vitamin B12 농도 비교연구

김태호,이영식,송성용,민경준,기백석,나철,채석래,Kim, Tae Ho,Lee, Young Sik,Song, Seong Yong,Min, Kyung Joon,Kee, Baik Seok,Na, Chul,Chae, Seok Lae 대한생물정신의학회 2004 생물정신의학 Vol.11 No.2

Objective:There have been a kind of transmethylation theory that high homocysteine serum concentration affects schizophrenia by neurotoxic mechanism and clinical reports that some schizophrenic patients with high homocysteine were improved by high folate ingestion. This study was done to confirm previous research results and find the clinical characteristics of schizophrenia showing high serum homocysteine and low folate. Method:We compared the serum levels of homocysteine, folate and vitamin B12 level between 234 schizophrenic patients(male 99, female 135) group and 234 normal controls(male 99, female 135) group. The subjects of two groups were age and sex matched. The evaluated clinical characteristics items were sex, age, onset of disease, hereditary loading, disease course, hallucination and subtype of schizophrenia. Results:1) Homocysteine level of the schizophrenia group was significantly higher than the normal control group and folate level of the schizophrenia group was significantly lower than the normal control group. Homocysteine level was more negatively correlated with folate level in the schizophrenia group than the normal control group. 2) The percentage of high homocysteine(above 12.46umol/L;90 percentile of normal control) was 33.8% of schizophrenia patients and 51.5% of male schizophrenia. The percentage of low folate(below 3.8nM/L;bottom tertile of normal control) was 66.2% of schizophrenia. 3) In low folate group and not-low folate group, schizophrenia showed significantly higher homocysteine level than normal control. Especially, low folate schizophrenia group showed significantly higher homocysteine level than low folate normal control group. Conclusions:Some schizophrenia patients with high serum homocysteine may be genetic defector and having low folate serum level. In that case, folate ingestion could be a good management for clinical improvement.

정신분열병 환자에서 갑상선기능과 기분증상 및 신체증상

김세희,한덕현,나철,민경준,주소연,Kim, Se-Hee,Han, Doug-Hyun,Na, Churl,Min, Kyung-Joon,Joo, So-Youn 한국정신신체의학회 2009 정신신체의학 Vol.17 No.1

Objectives : Thyroid function is associated with psychiatric disturbance such as mood symptoms, cognitive functions, anxiety and sleep problem. We evaluate the effects of thyroid dysfunction on negative symptoms of schizophrenia, mood symptoms and somatic symptoms in patients with schizophrenia. Methods : Sixty five patients with schizophrenia were recruited. The patients were classified into two groups; the patients with the history of abnormal thyroid indices level(group of abnormal thyroid function) and the patients without the history of normal thyroid indices level(group of normal thyroid function). At baseline and 8 weeks later, psychiatric symptoms were assessed with the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms(SAPS), and Beck Depression Inventory(BDI), Somatosensory Amplication Scale(SSAS). Results : During 8 weeks, there were significant differences in the changes of SANS, BDI, SSAS between group of abnormal thyroid function and group of normal thyroid function. Compared to group of normal thyroid function, group of abnormal thyroid function showed greater reduction of the scores of SANS(23.3%), BDI (19.6%), and SSAS(16.2%), respectively. However, there was no significant correlation between the scores of SANS, BDI, and SSAS. Conclusion : Our study suggested that abnormal thyroid indices would predict the prognosis of negative symptoms, mood symptoms, and somatic symtpoms in patients with schizophrenia. 연구목적 : 갑상선기능은 기분, 인지기능, 불안, 수면 등의 증상과 관련된다. 갑상선기능이상 시에 정신분열병 환자에서 음성증상, 기분, 신체증상에 어떤 차이가 있는지, 또 각각의 증상 변화와 어떻게 연관되는지를 연구하였다. 방법 : 정신분열병으로 입원했던 환자 65명을 입원 당시의 갑상선호르몬 수치에 따라 갑상선기능불안정 군과 갑상선기능정상 군으로 나누었다. 두 군의 입원 당시와 8주 후에 평가했던 음성증상평가척도(Scale for the Assessment of Negative Symptoms ; 이하 SANS), 양성증상평가척도(Scale for the for the Assessment of Positive Symptoms ; 이하 SAPS), 벡우울증척도(Beck Depression Inventory ; 이하 BDI), 신체감각증폭척도(Somatosensory Amplication Scale ; 이하 SSAS)의 변화를 비교하였다. 각 환자들은 항정신병약물 치료를 포함한 입원 치료를 받았으며, 갑상선기능이 불안정했던 경우 4주 후에 갑상선호르몬의 정상화를 확인하였다. 결과 : 8주 뒤에 갑상선기능정상 군과 갑상선기능불안정 군에서 SANS, BDI, SSAS 변화 차이가 의미 있게 나타났다. 갑상선기능정상 군에서 갑상선기능불안정 군에 비해 척도 점수가 크게 낮아졌는데, SANS는 23.3%(F=57.0, p<0.01), BDI는 19.6%(F=12.9, p<0.01), 신체감각증폭척도는 16.2%(F=17.1, p<0.01) 더 변화가 컸다. SANS, BDI, SSAS 세 지표 간에 유의한 상관관계는 없었다. 결론 : 정신분열병 환자들에게서 갑상선기능이 음성증상, 우울감, 신체증상에 관련된 예후에 표지가 될 수 있을 것이다.

폐경기 여성에서 에스트로젠 치료가 우울증상과 주의집중력에 미치는 영향

기백석,김성엽,이상훈,남범우,민경준,Kee, Baik Seok,Kim, Sung Yeop,Lee, Sang Hoon,Nam, Bum Woo,Min, Kyung Joon 대한생물정신의학회 1999 생물정신의학 Vol.6 No.2

본 연구는 폐경기 여성에서의 에스트로젠 치료에 따른 우울정도와 주의집중력의 차이를 평가하기 위해 폐경이 된 지 1년이 지난 폐경기 여성을 대상으로 사용군과 비 사용군으로 나누어 각각 30명을 대상으로 했다. 검사 도구는 한흥무 등(1986)이 표준화 한 Beck의 Beck depression inventory(BDI)를 사용하여 사용군과 비사용군으로 나누어 평가하였다. 그리고 주의 집중력의 평가는 K-WAIS(염태호 등 1992)의 소검사 항목인 숫자외우기와 바꿔쓰기을 사용하였다. 에스트로젠 사용군과 비사용군에서 각각의 검사 항목에 대해 t-test로서 유의한 차이가 있는지 비교하였다. 더불어 사용군과 비사용군에서 혈중 에스트라디올 농도를 측정하여 각 검사항목과 상관관계가 있는지 Pearson's correlation(r)를 통해 확인하였다. 결과는 BDI와 숫자외우기 중 바로 따라 외우기에서만 유의한 차이가 있었으며 다른 항목에서는 차이가 없었다. 그리고 혈중 에스트라디올 농도와 검사 항목간의 유의한 상관관계는 없었다. 본 실험을 통해 에스트로젠이 폐경기 여성에서 우울증상의 경감에 효과적이나 기억력 및 주의집중력에는 효과가 없음을 확인할 수 있었다. Objectives : The purpose of this study was to evaluate the difference of depressive symptoms and attention between estrogen user and non-user in postmenopausal women. Methods : 30 Estrogen users and 30 non-users were participated in this study. They were all menopausal for at least 1 year and have 12 or more education years. We used BDI(Beck depression inventory), digit span and digit symbol to evaluate depressive symptoms and attention in both groups. We also measured the plasma estradiol level and identified the correlation between estradiol level and BDI, digit span and digit symbol. Results : The demographic data was not different between both groups. Estrogen users scored higher than non-users in digit span(forward) and lower than non-users in BDI. The correlation between estradiol level and BDI, digit span and digit symbol was not significant. Conclusion : Estrogen replacement therapy was effective in alleviating depressive symptoms but ineffective in improving attention in postmenopausal women.

세부 전공에 따른 자궁경부상피내종양의 처치로써 환상투열 절제술에 대한 태도 분석

전용탁 ( Yong Tark Jeon ),민경준 ( Kyung Joon Min ),지병철 ( Byung Chul Jee ),김용범 ( Yong Beom Kim ),박교훈 ( Kyo Hoon Park ),서창석 ( Chang Suk Suh ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.3

목적: 부인종양 전임의 과정을 거친 산부인과 전문의와 그렇지 않은 경우에 있어서 자궁경부상피내종양의 처치로써 환상투열 절제술 (LLETZ)에 대한 태도에 차이가 있는지를 알아보고자 하였다. 연구 방법: 2003년 6월부터 2004년 9월까지 분당서울대학교병원 산부인과에서 LLETZ를 시행한 81명의 환자를 대상으로 하였다. LLETZ와 질확대경하 조직생검 소견을 의무기록을 통해 조사하였고, 부인종양학 전임의 과정을 거친 의사에게 시술을 받은 군 (GO Objective: The aim of this study is to compare the clinician`s attitude to the large loop excision of transformation zone (LLETZ) according to the subspecialty; gynecologic oncology or not. Methods: Eighty-one patients who had LLETZ at Seoul National Univ

정신분열병 환자에서 비정형 항정신병 약물이 프로락틴과 테스토스테론 농도에 미치는 영향

한덕현,박두병,김영돈,민경준,이길홍,Han, Duck-Hyun,Park, Doo-Byung,Kim, Young-Don,Min, Kyung-Joon,Lee, Kil-Hong 대한생물정신의학회 2000 생물정신의학 Vol.7 No.1

본 연구의 목적은 치료 용량의 비정형적 항정신병 약물(risperidone, olanzapine)의 성 호르몬(prolactin과 testosterone)에 대한 효과를 알아보기 위해 총 91명의 정신분열병 환자들의 혈청에서 prolactin과 testosterone의 농도를 측정하였다(haloperidol 28명, 4~20mg/day ; risperidone 31명, 2~6mg/day ; olanzapine 32명, 5~20mg/day). 그 결과 남자 환자에서 olanzapine 복용자의 혈청 prolactin 농도가 risperidone이나 haloperidol 복용자의 혈청 농도보다 낮았으나 risperidone 복용자와 haloperidol 복용자의 혈청 prolactin 농도는 상호 유의한 차이가 없었다. 여자 환자에서는 olanzapine 복용자의 혈청 prolactin 농도가 risperidone이나 haloperidol 복용자의 혈청 농도보다 낮았으며 risperidone 복용자의 prolactin 농도는 haloperidol 복용자보다 낮았다. 또한 남자, 여자 환자 모두에서 haloperidol, risperidone, olanzapine을 각각 복용한 사람들의 혈청 testosterone 농도는 유의한 차이가 없었다. 위의 결과로 저자는 치료 용량에서 risperidone은 혈청 prolactin 농도를 haloperidol 만큼이나 증가시키지만 olanzapine의 경우 혈청 prolactin 농도에는 영향을 끼치지 않으며 비정형적 항정신병 약물은 testosteron의 농도에는 영향을 끼치지 않는다는 것을 알 수 있었다. Objectives : The dopamine-blocking effects and the associated side effects(amenorrhea, lactation, sexual dysfunction) of classical antipsychotics in schizophrenic patients have been studied for a long time. The purpose of this study was to find out these effects of new antipsychotics(risperidone, olanzapine) in schizophrenic patients treated with clinically relevant doses. Method : Plasma levels of both prolactin and testosterone were measured in 91 schizophrenic patients(28 taking haloperidol, 4-20mg/day ; 31 taking risperidone, 2-6mg/day ; 32 taking olanzapine, 5-20mg/day). Results : In male schizophrenic patients, the prolactin levels of risperidone group($76.44{\pm}38.85ng/ml$) and haloperidol group($60.26{\pm}20.74ng/ml$) had no significant difference, but were significantly higher than that of olanzapine($26.90{\pm}5.36ng/ml$). In female, the prolactin level of olanzapine group($36.66{\pm}17.55$) was significantly lower than those of risperidone($121.7{\pm}48.33$) and haloperidol group($161.66{\pm}37.53$). And prolactin level of risperidone group was lower than that of haloperidol group. While the testosterone plasma level of risperidone, haloperidol and olanzapine in both male and female schizophrenic patients had no significant difference. Conclusions : At doses known to be effective in popular clinical setting, prolactin level in patients taking risperidone was higher than that of haloperidol, while olanzapine showed no significant difference in terms of prolactin plasma level from haloperidol. New antipsychotics may not influence the testosterone plasma level.