위식도역류질환과 관련 없는 비심인성 흉통 환자의 우울 및 불안

박주언,류한욱,이풍렬,유범희,Park, Joo-Eon,Ryu, Han-Wook,Rhee, Poong-Lyul,Yu, Bum-Hee 대한불안의학회 2006 대한불안의학회지 Vol.2 No.1

Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.

긴장성두통과 편두통의 바이오피드백 치료

박주언,이계성,신상은,Park, Joo-Eon,Lee, Kye-Seong,Shin, Sang-Eun 한국정신신체의학회 2006 정신신체의학 Vol.14 No.1

연구목적 : 두통은 일생 동안 90% 이상의 사람들이 경험하게 되는 임상 증후군이다. 이 논문은 긴장성두통과 편두통의 현재의 개념과 바이오피드백 치료 및 이완요법에 대해 요약하였다. 방법: Pubmed/Medline 검색에 포함된 용어는 바이오피드백(biofeedback), 이완(relaxation), 생리적(physiological), 행동적 (behavioral), 비약물의 (nonpharmacological), 두통(headache), 긴장성두통(tension-type headache), 그리고 편두통(migraine)이었다. 검색되지 않은 저술 중 적절한 논문과 바이오피드백을 수행하는 전문가의 의견도 포함시켰다. 결과 : 두통은 바이오피드백 및 이완요법을 포함한 행동치료적 개입에 의해 치료될 수 있는 정신생리장애(psycho-physiological disorder)로 볼 수 있다. 두통에서 이러한 치료들을 통해 임상적 호전을 보인다는 보고들이 지속되고 있다. 또한, 환자에게 실제 적용 시 고려할 점도 제시하였다. 결론: 바이오피드백 치료와 이완요법은 단독 또는 약물치료와 함께 두통 환자에게 제공될 수 있는 효과적인 치료법으로 제안된다. Objectives : Headache is a clinical symptom that more than 90% of all individuals experience during their life time. This article provides a current concept of tension-type and migraine headaches and summarizes the effects of biofeedback treatment and/or relaxation techniques. Methods : The following terms were used for Pubmed/Medline search : biofeedback, relaxation, physiological, behavioral, nonpharmacological, headache, tension-type headache, and migraine. A review of references from relevant literature was also conducted to collect reports not identified in the Pubmed/Medline search. Interviews with experts on biofeedback were also included in this review. Results : Headache is a psychophysiological symptom that can be treated by some behavioral interventions including biofeedback and relaxation. Literatures on biofeedback and/or relaxation have consistently reported significant therapeutic effects on headaches. Important factors that we have to consider, when we apply to headache patients with biofeedback and relaxation techniques, were also presented. Conclusion : The available evidence suggests that biofeedback and relaxation techniques are effective treatments for the patients with headaches and can be provided to the patients as monotherapy or combination therapy with medication.

전력기기용, 에폭시/마이크로 실리카 및 알루미나 복합제의 전기적·기계적 파괴 강도 특성

박주언,박재준,Park, Joo-Eon,Park, Jae-Jun 한국전기전자재료학회 2018 전기전자재료학회논문지 Vol.31 No.7

In this study, we prepared 40, 45, 50, 55, 60, 65, and 70 wt% content composites filled in epoxy matrix for two micro silica and three micro alumina types for use as a GIS heavy electric machine. As a filler type of epoxy composite, micro silica composites showed excellent AC breakdown strength properties compared to micro alumina composites in the case of electrical properties of micro silica and alumina. The electrical breakdown properties of micro silica composites increased with increasing filler content, whereas those of micro alumina decreased with increasing filler content. In the case of mechanical properties, the micro silica composite showed improved tensile strength and flexural strength compared with the micro alumina composite. In addition, mechanical properties such as tensile strength and flexural strength of micro silica and alumina composites decreased with increasing filler content. This is probably because O-H groups are present on the surface of silica in the case of micro silica but are not present on the surface of alumina in the case of micro alumina.

재난정신건강 평가도구

박주언,강석훈,원성두,노대영,김원형,Park, Joo Eon,Kang, Suk-Hoon,Won, Sung-Doo,Roh, Daeyoung,Kim, Won-Hyoung 대한불안의학회 2015 대한불안의학회지 Vol.11 No.2

Objectives : After disaster, some people develop posttraumatic stress sequelae such as posttraumatic stress disorder (PTSD), major depression, substance use disorders, and suicide. To date, numerous screening and assessment tools for behavioral health issues including mental health problems, psychosocial maladjustment and status of recovery after disaster have been developed. In this condition, one of important topics is to choose instruments that can quickly and accurately measure the issues. Methods : This article reviewed several self-reported scales in adults for disaster behavioral health, which were searched using academic search engines like PubMed, Scopus, KoreaMed and KISS from the earliest available date of indexing through January 31, 2015. Results : More than 40 eligible instruments evaluating the disaster behavioral health issues containing posttraumatic stress sequelae, psychological and social resources, non-disaster stress, and general functions were presented in terms of availability, effectiveness, and expeditiousness. Also, we introduced basic frame aiming on practical usage, which includes standard version and brief version of the instruments for disaster behavioral health. Conclusion : We suggest the accessibility and the applicability of assessment instruments for disaster behavioral health. The systemic review of this article will provide further directions for them. 재난 경험자들의 정신건강은 개인적인 측면뿐만 아니라 재난 이후의 지역사회의 회복 측면에서 매우 중요하기 때문에 개인적 수준과 사회적 수준 양쪽에서 접근해야 한다. 또한 재난 경험자들을 이해하고 돕기 위해서는 PTSD, 우울, 불안과 같은 정신 건강 분야뿐만 아니라 심리적 및 사회적 자원 분야, 물질남용 및 중독 분야, 비재난스트레스 분야, 기능상태 분야 등 다양한 방면의 평가가 필요하다. 재난정신건강 평가를 위해서 최소한 1시간 이내에 평가할 수 있는 표준 버전과 30분을 넘지 않는 단축 버전과 같은 기본적인 패키지가 필요하다. 임상 현장보다 재난 현장에서 시간 및 비용이 더 중요한 요소이고 재난 현장의 특성상 실현 가능성도 고려하여야 하기 때문에 이 모두를 고려한 구성을 해야 한다. 적극적인 재난정신건강의 다면적 평가를 통해 조기에 위험군을 선별하고 이를 적절히 관리한다면 재난 이후에 발생하는 외상후스트레스후유증을 최소화할 수 있을 것이다.

심리외상 이후의 신체증상

박주언,안현의,김원형,Park, Joo Eon,Ahn, Hyun-Nie,Kim, Won-Hyoung 한국정신신체의학회 2016 정신신체의학 Vol.24 No.1

연구목적 심리외상에 노출된 이후 신체증상이 매우 빈번히 발생하곤 한다. 이러한 신체증상은 사회기능과 직업기능 및 환자-의사 관계와 종종 연관되지만 외상후스트레스장애 진단 범주에 포함되지 않은 상태이다. 본 논문에서는 이러한 신체증상의 기전, 흔한 임상양상, 그리고 치료에 대해 고찰하고자 한다. 방 법 PubMed, Scopus, Google Scholar, KoreaMed, KISS와 같은 학술검색엔진을 사용하여 2016년 3월 31일까지 검색된 심리외상 노출 이후 신체증상에 관한 자료를 바탕으로 연구하였다. 결 과 심리외상 노출 이후의 신체증상의 발생 기전은 심리적인 측면과 생리적인 측면으로 구분될 수 있었다. 심리기전은 정신역동이론, 인지행동이론, 그리고 다른 이론들이 포함되었다. 생리기전은 신경내분비 및 면역계, 자율신경계, 중추 신경계의 변화로 설명되었다. 심리외상과 연관된 신체증상은 두경부, 흉부, 복부, 기타 근골격계, 피부 및 면역계에서 나타나는 다양한 건강문제로 표현되었다. 이러한 신체증상의 표준화된 치료에 대한 연구는 매우 부족하였다. 결 론 임상의와 재난정신건강지원 실무자는 심리외상에 대한 개입이나 PTSD 치료 동안 동반된 신체증상에 대해 항상 염두에 두어야 한다. 심리외상과 PTSD에서 보이는 이러한 신체증상에 대해 더 많은 연구가 진행될 필요가 있다. Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

공황장애의 뇌영상 및 신경생물학적 식견

박주언,강은호,이인수,유범희,Park, Joo-Eon,Kang, Eun-Ho,Lee, In-Soo,Yu, Bum-Hee 대한불안의학회 2007 대한불안의학회지 Vol.3 No.2

Panic disorder is a common psychiatric illness that causes considerable morbidity. However, the biological basis of panic disorder remains unclear. In this report, we present and summarize the current literature on functional neuroimaging studies related to the neurobiology of panic disorder. The findings were summarized and divided into six groups : (1) known brain structures related to anxiety, especially panic disorder ; (2) structural results ; (3) functional imaging studies at rest ; (4) functional imaging studies with challenge testing ; (5) neuroreceptor studies ; and (6) changes in the treatment of panic disorder. Based on the findings of these neuroimaging studies, it seems as though panic disorder involves the hippocampal and parahippocampal areas, including the amygdala, as well as some cortical regions, such as the temporal and prefrontal cortices. Panic disorder is known to be associated with an imbalance between the right and left hemispheres of the brain at rest or during panic attacks. During a panic attack, patients with panic disorder are likely to experience an increase in local activity in the cingulate, insula, midbrain, and so on. On the other hand, a widespread reduction in the cortical areas has also been reported in most provocation studies. Thus, panic disorder may be related to the excess activation of the fear networks in response to subtle environmental cues and insufficient inhibition from higher cortical control areas ; however ; further studies are recommended in order to fully understand the neurobiology of panic disorder.

외상 후 초기중재

박주언,이병철,정영은,채정호,Park, Joo-Eon,Lee, Boung-Chul,Jung, Young-Eun,Chae, Jeong-Ho 대한불안의학회 2009 대한불안의학회지 Vol.5 No.2

In this article, we review the efficacy of early interventions after traumatic incidents and during acute stress disorder (ASD). There are some evidences that psychopharmacological medications such as propronolol, morphine, and hydrocortisone are effective in the prevention of posttraumatic stress disorder (PTSD). Considering the role of selective serotonin reuptake inhibitors in hippocampal neurogenesis and an animal model of PTSD, early administration of selective serotonin reuptake inhibitors is also fairly promising. Other pharmacological treatments including benzodiazepines did not treat ASD nor prevent PTSD. There are good evidences that cognitive behavioral therapy including cognitive therapy and prolonged exposure is a valuable intervention for ASD and the most effective prevention for PTSD. No contolled researches on eye movement desensitization&reprocessing, psychodynamic psychotherapy and hypnotherapy have performed. Recent randomized controlled studies using psychological debriefing did not prove as a useful intervention for the prevention of PTSD until now, although the efficacy of debriefing has been at the centre of controversy.

국내 청소년의 삶의 의미와 부모 양육행동 간의 상호관계

박주언(Joo-Eon Park),김형섭(Hyeong-Seob Kim),최병무(Byeong-Moo Choe) 대한사회정신의학회 2003 사회정신의학 Vol.8 No.1

목 적: 청소년들이 자기 삶의 목적을 이해하고 소지하는 것은 나머지 인생을 건강하게 만들어 준다는 점에서 상당히 중요한 의미를 지닌다. 이에 우리나라 일반 청소년들의 삶의 목적수준을 평가하고, 이러한 삶의 목적수준이 부모의 양육행동 간에 어떠한 상관 성을 나타내는지에 대해 알아보았다. 그리고 우리나라에서 현실적으로 청소년들을 평가하는 일반적 지표들인 비행이나 학업성 적과의 관계도 알아보고자 하였다. 방 법: 경기도 소재의 중학교 및 고등학교 학생 352명을 대상으로 삶의 목적 검사와 부모양육행동척도 및 일반적 지표들인 비행과 학업성적 등에 관한 자기보고형 설문조사를 시행하였다. 청소년의 삶의 목적과 청소년 평가 각 항목들 및 부모의 양육행동에 대해 분산분석과 상관분석 및 회귀분석을 실시하였다. 결 과: 1) 삶의 목적 검사 총점 평균은 전체 학생의 경우 89.70점이었고, 남자고등학생 89.20점, 여자고등학생 86.84점, 남자중학생 99.33점, 여자중학생 89.60점으로, 여자와 고등학생에 비하여 남자와 중학생의 경우 각각 통계적으로 유의하게(p<0.05, p<0.01) 높은 점수를 나타냈다. 2) 삶의 목적 검사의 하위요인 중 삶에 대한 주도성과 존재에 대한 가치감에서 남자가 여자보다 유의하게 높았고(p<0.05), 삶에 대한 태도, 삶에 대한 주도성, 존재에 대한 가치감에서 중학생이 고등학생보다 유의하게 높았다(p<0.05). 3) 삶의 목적 검사에서 기독교나 불교와 같은 종교를 가진 학생이 종교를 믿지 않은 학생보다 유의하게 높은 점수를 나타내 었고(p<0.05), 현재 삶에 대한 만족도가 클수록, 성적이 높을수록, 보고한 비행이 적을수록 통계적으로 유의하게(p<0.05) 높은 점수를 나타내었다. 4) 부모의 애정, 합리적 설명, 감독의 긍정적인 양육행동은 대부분의 청소년에 있어서 삶의 목적과 유의한(p<0.05) 정적 상관을 보였으나, 비일관성, 과잉기대, 과잉간섭, 학대, 방임의 부정적인 양육행동은 삶의 목적과 유의한(p<0.05) 부적 상관이 있었다. 5) 부모의 양육행동 중 아버지의 애정이 대체적으로 청소년기 삶의 목적을 가장 잘 설명할 수 있는 변인이었다. 결 론: 우리나라 청소년들의 삶의 목적 수준은 비교적 낮은 편이었다. 청소년이 지각한 부모의 긍정적인 양육행동이 청소년들의 삶의 목적이나 의미에 지대한 영향을 주고, 특히 아버지의 애정이 청소년이 건강한 삶을 살아가는데 중요한 역할을 할 수 있음을 시사하였다. 또한 청소년들의 삶의 목적은 비행 및 학교성적 등과 같이 현실적으로 청소년들을 평가하는 지표와도 밀접한 상관관 계를 나타내었다. Object:It is very important and meaningful for the adolescents to understand and have their purpose in life, which will make the rest of their life healthy. Thus, this study was done to look up the level of Korean adolescents’ purpose in life and also look over the correlations of their purpose in life with parenting behaviors. Method:The number of subjects were 352, who were the middle and high school students in Kyonggi province. Data were gathered by self rating scales such as purpose in life test(PIL), parenting behavior inventory, and demographic data including delinquent problems and academic achievements. Statistical treatments were done with ANOVA, correlation, and regression test. Results:1) PIL mean score was 89.70 in total, 89.20 in male high school students, 86.84 in female high school students, 99.33 in male middle school students, and 89.60 in female middle school students. There was statistical difference(p<0.05, 0<0.01) that PIL mean scores of male subjects and middle school students were higher than those of female’s and high school students, respectively. 2) Mean scores of male subjects were significantly higher than those of female’s in PIL factor scores such as the taking the initiative and the value of being(p<0.05), and mean scores of middle school students were significantly higher than those of high school students in the attitude about their life, the taking the initiative, and the value of being(p<0.05). 3) Mean scores of the students having a religion of Christianity or Buddhism were significantly higher than those of the students without any religions in the PIL score(p<0.05). The students with more satisfaction, higher academic achievements, or less problematic areas of delinquency were characterized as having higher PIL score(p<0.05). 4) There were significant positive correlations between the positive parenting behaviors such as parental affection, reasoning, and monitoring and the PIL score of adolescents. On the contrary, there were significant negative correlations between the negative parenting behaviors such as inconsistency, over-expectation, intrusiveness, physical abuse, and neglect and the PIL score of adolescents(p<0.05). 5) Father’s affection among the parenting behaviors was the most important variance for the adolescent PIL. Conclusion:The level of purpose in life of Korean adolescents might be relatively low. The positive parenting behaviors recognized by adolescents were revealed important factors to make adolescents keep the purpose and meaning of their life, especially father’s affection was more important for the healthy life of adolescents. Thus, higher PIL with positive parenting behaviors might correlate with more good behaviors such as higher academic achievements or less problematic behaviors such as delinquency in their life, which were the factors for evaluating the students in reality of Korea.

전자기파를 이용한 전력설비용 고체 절연물의 PD 측정 기법연구

박주언(Joo-Eon Park),민병운(Byoung-Woon Min),박지훈(Jee-Hoon Park),송태헌(Tae-Hun Song),양승오(Seung-Oh Yang),김병진(Byoung-Jin Kim) 대한전기학회 2017 대한전기학회 학술대회 논문집 Vol.2017 No.10

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