정신과 입원 환자의 혈청 칼슘농도에 관한 연구

우행원,임원정 梨花女子大學校 韓國生活科學硏究院 1992 韓國生活科學硏究院 論叢 Vol.50 No.-

Serum calcium levels have been estimated in 273 successively admitted inpatient who met DSM-ⅢR diagnosis of Schizophrenia, Bipolar disorder, manic episode, Bipolar disorder, depressive episode, Major depression, DSM Ⅱ Diagnosis of Neurosis at Department of Neuropsychiatry, Ewha Womans University hospital. The mean serum clacium value was 9.28±0.6㎎/㎗. In regard to the relation between calcium level and psychiatric diagnosis, biolar disorder, depressive episode had the lowest serum calcium level(8.73±0.73㎎/㎗) and bipolar disorder, manic episode had the highest level (9.35±0.44㎎/㎗). The difference was significant(P<0.01). The patient with abnormally low serum calcium value were 6 cases(2.2%), consisting of 3 bipolar disorder, depressive episode, 1 Schizophrenia, 1 neurosis and 1 major depression. Certainly serum calcium level is associated with different psychiatric diagnosis. And this kind of relationship between serum calcium level and psychiatric diagnosis is prominent in mood disorder.

Transdermal Scopolamine(Kimite$^{(R)}$)으로 인해 유발된 섬망 2례

우행원,임원정,이유진,Woo, Haing-Won,Lim, Weon-Jeong,Lee, Yu-Jin 한국정신신체의학회 1999 정신신체의학 Vol.7 No.2

섬망은 두부손상, 혈관성 질환, 뇌종양 등의 중추신경계 질병뿐 아니라 여러 가지 신체 질병(대사 장애 및 내분비장애, 감염, 심혈관 질병)과 약물에 의해 야기되는 각성 수준의 감퇴, 지남력 장애, 수면-각성 주기 장애, 기억력 장애, 지각장애 등을 특징으로 하는 증후군이다. 1) 섬망을 일으킬 수 있는 약물의 하나인 scopolamine(Kimite$^{(R)}$)은 차멀미 예방을 위해 흔히 사용되며 피부 부착형으로 사용하는데 항콜린성 작용을 갖는belladonna akaloid제제이다. 저자들은 차멀미 예방 목적으로 사용된 transdermal scopolamine(Kimite$^{(R)}$)으로 유발된 섬망 2례를 경험하였기에 이를 문헌 고찰과 함께 보고하였다. 두 증례의 공통점은 여자 노인 환자였다는 점, 멀미 예방을 위해 transdermal scopolamine부착 후 여행지에서 갑자기 증상이 발생하였다는 점, 증상이 2~3일이내에 호전되어 추적 관찰상 아무런 이상이 없었던 점 등이다. Transdermal scopolamine(Kimite$^{(R)}$)으로 인한 섬망의 예방을 위해 사용자와 판매자 모두에게 올바른 사용법에 관해 교육하는 것이 필요할 것으로 사료된다. Delirium is a syndrome characterized by impairement of consciousness, disorientation, disturbance of sleep-wake cycle, memory impairement, disturbance of perception. It is induced by many causes, which are CNS diseases(head trauma, vascular disease, brain tumor, etc), medical diseases(metabolic disorder, endocrine disturbance, cardiovascular disease) and drugs(anticholinergics, anticonvulsant, antipsychotics, cimetidine etc). Transdermal scopolamine which is usually used to prevent motion sickness has anticholinergic property, and so it can induce delirium. The authors report two cases of delirium induced by transdermal scopolamine. The cases shared common characteristics which were as follows : 1. All of two patients were elderly women. 2. Delirium symptom was abruptly occurred during trip after attaching scopolamine patches. 3. Delirium symptom was rapidly improved within 2-3 days. It is important to educate for both users and managers about directions for transdermal scopolamine patch usage to prevent delirium. And careful history taking is needed to diagnose delirium induced by transdermal scopolamine accurately.

Diagnostic and Statistical Manual(DSM)Ⅲ 진단에 의한 노인입원 정신질환자에 대한 임상적 연구

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1986 EMJ (Ewha medical journal) Vol.9 No.4

This article reviewed the thoretical unerpinnings of the DSM Ⅲ classification system, with particular emphasis on psychogeriatic practice. Advantages of a descriptive approach, use of operational criteria, and the utility of a multiaxialsystem in developing comprehensive treatment program were examined. A retrospective study, 5 years after the implementation of DSM Ⅲ, was conducted on all consecutive admissions to the neuropsychiatry department of Ewha Womans University, College of Medicine, and the results were as follows. The thirty cases of the senile mental disorders showed the following characteristic pictures. 1) Majority of the cases(53.4%) were distributed in the decade of their sixties and male. 2) In the diagnostic distribution, 53.4% of the cases were categorized as organic mental disorder and 30.0% as major affective disorder. 3) The ratio of male patient and female patient was 4.3:1 in organic mental disorder and 2:1 in major affective disorder. 4) In the age distribution, 50.0% of the cases were categorized as organic mental disorder and 55.6% as major affective disorder. Both of the cases were aged between 60 and 64. 5) Their educational level revealed that 40.0% of the patients were primary school graduates. 6) As to the occupational distrubution, the jobless occupied the larger percentages, but patients who have job their age distribution was 60-64. 7) As to their religious affiliation the most population was 30.0% of protestant. 8) In the distribution of physical disorders, hypertension occupied the highest rate of 26.7%. 9) As to the marital status, 73.3% of the cases were living with their spouses. 10) There were no relation between premorbid social psychological stress and premorbid adaptation.

만성 가장성 신체장애, Munchansen 증후군 : Munchausen Syndrome

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1983 EMJ (Ewha medical journal) Vol.6 No.4

Chronic factitious disorder with physical symptoms is an appropriate diagnosis in patients who consciously distort their medical history and produce misleading physical finding and laboratory results through self-inflicted lesions. By simulating patterns of physical diseases, these patients may subject themselves to painful and dangerous diagnostic and treatment procedures. Munchausen syndrome represents a special pattern within the group of chronic factitious disorder with physical symptoms. The typical patient presents at a hospital as an acute emergency and usually has a lurid yet plausible medical and social history, which is laterfound to be entirely false and fabricated. After several fruitless investications with or without surgical operations, a diagnosis cannot be made and the patient eventually discharges himself and goes to another hospital where the process is repeated. It is importent to diagnose these patients early to avoid unnecessary medical and surgical interventions and to introduce psychiatric treatment. A typical case of Munchausen syndrome is reported with a brief review of literatures. This is believed to be the first reported case of Munchausen syndrome in Koera.

Tranquilizer를 투여한 백서 간 뇌조직의 3-Hydroxy-3-Methylglutaryl-Co A 및 Cholesterol 및 생합성에 대하여

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1981 EMJ (Ewha medical journal) Vol.4 No.3

The incidence of mental illness in the modern society has been increasing and the use of the tranquilizer for the treatment of these illnesses has been increasing also. The side effects of the tranquilizer are reportedly, minimal and the long term use of the medicine is widely practised in this field. But the question of its effect on cardiovascular system has been discussed previously and the level of cholesterol and triglyceride was found to increase in patients who have been on the tranquilizer for a long period of time. The current study was undertaken to find out the effect of tranquilizer(chlorpromazine, thioridazine, perphenazine, haloperidol, and pimozide) given to the animals for 4 weeks. And the results are summarized as follow: 1) In the animal group given chlorpromazine, thioridazine, and perphenazine, the level of total serum cholesterol was increased and the activity of microsomal HMG-Co A reductase was also increased. However, in the group given haloperidol and pimozide, there was no increase of cholesterol level or activity of microsomal HMG-Co A reductase. 2) The correlation of serum total cholesterol level and the activity of HMG-Co A reductase in the liver and brain was significant. From the Above results, it could be concluded that the effect of the long term use of tranquilizer on the cadiovascular systerm should be reevaluated.

우울증 환자에서의 호중구 및 임파구 기능장애

우행원 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.4

Regulation of the quantity of different types of leukocytes has not been adequately investigated in patients with psychiatric illness. Kronfol et al have noted a significant association between leukocyosis, neutrophilia, and mania, and lymphopenia and depression. In this study, leukocytes especially neutrophills and lymphocytes were counted in 20 untreated depressive patients, 43 untreated schizophrenic patients and 36 neurotic patients. A significant increase numbers of neurophils and significant decrease in the numbers of lymphocytes were found in the depressive patients. Furthermore, when compared to normative values from the general population, depressive patients showed higher frequencies of both reutrophilia and lymphopenia than the schizophrenic and neurotic patients. Glucocorticoids have for a long time been associated with hematologic changes consisting of neutrophlia and lymphopenia. Changes very similar to this, were observed in depressed patients in this study. Since depression is more frequently associated with hypercortisolemia than are the schizoprenic disorder and neurosis, it is reasonable to attribute the hematologic differences between depression and, schizophrenic disorder and neurosis, at least in part, to excess cortisol in the depressive patients. However, since cortisol levels were not obtained in my patients, this issue remains a matter of speculation but regardless of the mechanism involved, the present data indicate significant differencs in the regulation of blood cell elements in depressive, schizoprenic and neurotic patients.

흡연이 정신분열병 환자의 임상 증상 및 혈청 Prolactin에 미치는 영향

우행원,임원정,연규월,Woo, Haing-Won,Lim, Weon-Jeong,Yun, Kyu-Wol 한국정신신체의학회 1997 정신신체의학 Vol.5 No.2

본 연구는 정신분열병 환자의 흡연성향 및 흡연이 임상양상이나 증상, 혈청 prolactin에 미치는 영향을 조사해 보고자 하였다. 연구결과는 다음과 같다. 1) 흡연군과 비흡연군의 연령, 발병연령, 이환기간, 복용하는 항정신병 약물 및 항파킨슨 약물의 용량은 유의한 차이가 없었으나, 기호 식품인 커피를 매일 한잔이상 마신다고 답한 경우가 흡연군에서 유의하게 많았다(p<0.05). 2) 흡연 이유는 긴장 완화(85.7%), 권태로움을 피하고 싶어서(45.2%), 습관(38.1%), 친구들과 어울리고 싶어서나 또는 친구를 모방(23.8%)하여 담배를 피운다고 응답했다. 80.1%가 금연을 시도했었으나, 94%에서 craving때문에 금연에 실패하였다. 금단증상으로 불안감(52.9%), 정신과적 증상의 악화(23.5%), 환청의 악화(8.8%), 약물부작용의 악화(14.7%), 졸리움의 증가(47.1%)등이 있었다. 3) BPRS 총점수는 흡연군과 비흡연군에서 유의한 차이가 없었으나, 불안척도가 흡연군에서 유의하게 낮았다(p<0.05). HAM-D에 의한 우울증상 및 SCL-90-R의 대인관계 민감도 항목과 공포증 항목이 흡연군에서 유의하게 낮았다(p<0.05). PANSS. AIMS는 두군에서 유의한 차이를 보이지 않았다. 4) 흡연군에서는 혈청 prolactin이 비흡연군에 비해 유의하게 낮았고(p<0.01) 공변량분석결과 흡연이 혈청 prolactin에 의미 있는 영향을 미치는 것으로 나타났다.(p<0.05). 5) 정신 분열병 환자에서 금연 유도시 적절한 항불안 약물이나 항우울 약물의 일시적인 병합치료로서 금단증상을 최소화 시켜야 하며, 환자들의 낮은 자존심 및 높은 의존심을 충족시키는 정신치료가 병행되어야 될 것으로 사료된다.hromatography를 반복(反復)하여 stilbene 계열(系列)의 화합물(化合物)인 Rhapontigenin (Compound 1)과 Rhaponticin (Compound 2)을 얻었다. S. aureus SG 511에 대(對)해 Rhapontigenin은 50 mg/ml 이상(以上) 농도(濃度)에서 항균(抗菌) 효과(效果)를 나타내었고, Rhaponticin은 $200\;mg/m{\ell}$ 농도(濃度)에서 미약(微弱)하게 유효(有效)한 항균(抗菌) 효과(效果)를 나타내었으며, B. subtilis ATCC 6633에 대(對)해 Rhapontigenin은 50 mg/ml 이상(以上) 농도(濃度)에서 항균(抗菌) 효과(效果)를 나타내었고, Rhaponticin은 200 mg/ml 농도(濃度)에서 우수(優秀)한 항균(抗菌) 효과(效果)를 나타내었으며, 100 mg/ml 농도(濃度)에서 미약(微弱)하게 유효(有效)한 항균(抗菌) 효과(效果)를 나타내었다. 또한 E. coli 055에 대(對)해서는 Rhapontigenin과 Rhaponticin 모두 200 mg/ml 농도(濃度)에서 미약(微弱)하게 유효(有效)한 항균(抗菌) 효과(效果)를 나타내었다. 이상(以上)의 결과(結果)로 보아 선방활명음(仙方活命飮)의 항균(抗菌) 효능(效能)은 군약(君藥)인 대황(大黃)의 성분(成分) 중(中)의 하나인 stilbene 계열(系列)의 화합물(化合物)인 Rhapontigenin과 Rhaponticin의 작용(作用)에 의(依)한 것이며, 이는 한의학(韓醫學) 방제(方劑) 원리(原理)인 군신좌사(君臣佐使) 이론(理論)에서 군약(君藥)이 주증(主症)에 주(主)로 작용(作用)하는 약물(藥物)이라는 것을 밝혀주는 것이라고 사료(思料)된다. This study was performed to evaluate the characteristics of smoking behavior and the effects of smoking on clinical symptoms and level of serum prolactin in schizophrenic patients. Methods : 76 male schizophrenic patients answered the questionnaire about the characteristics of smoking patterns. And patients were assessed by brief psychiatric rating scale(BPRS), positive and negative syndrome scle(PANSS), Hamilton rating scale for depression(HAM-D), assessment for involuntary movement scale(AIMS) and symptom checklist 90 R(SCL-90-R). Serum prolactin levels were measured by enzymeimmunoassay. Results: 1) The frequences of drinking coffee were significantly higher in smokers. The reasons for smoking were to relieve tension, to avoid boredom, due to habit and to do with friends. 80.1% of smokers tried quitting, but smoking was relapsed due to craving and withdrawal symptoms. 2) No significant difference was seen in mean neuropeltic doses, scores of PANSS and AIMS. But as for BPRS, scores of anxiety/depression subscale were significanly lower in smokers. Scores of HAM-D and scores of interpersonal sensitivity and phobia among SCL-90-R were significantly lower. 3) Levels of serum prolactin were significanlty lower in smokers. Conclusion : These findings suggest that in schisophrenia smoking relieves anxiety and depression subjectively But decreased prolactin levels may suggest that the possibility of increased dopamine in CNS.

양극성 정동장애에서 Lithium 투약에 따른 혈청 칼슘, 이온화 칼슘 및 인산염의 변화

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1992 EMJ (Ewha medical journal) Vol.15 No.4

This study was conducted to investigate the effect of lithium treatment on the serum total calcium, ionized calcium and phosphate in bipolar disorder. The subjects were 20 patients. The total calcium, ionized calcium and serum phosphate were measured before and after lithium treatment, and the values were statistically analyzed. The results are summarized as follows: 1) Serum total calcium level was significantly increased after lithium treatment(p<0.01). 2) Ionized calcium level was significantly increased after lithium treatment(p<0.05). 3) Phosphate level was significantly increased after lithium treatment(p<0.05).

정신분열증환자와 일반환자의 복용약물 認知에 관한 비교연구

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1979 EMJ (Ewha medical journal) Vol.2 No.1

Fifty schizophrenic inpatients receiving antipsychotic medications were evaluated as informed and or consenting drug consumers by means of structured interview, in comparison with a matched group of medical inpatients receiving nonpsychotrpic drugs. Medical patients were better informed about positive aspects of medication, such as relationship of drug treatment to a specific diagnosis and not better informed about positive aspects of medication, such as name and dose. Schizophrenic patients, however, were significantly better informed about side effects and risks. Although both groups felt that their medication had helped them, 84% of the medical patients but only 72% of the schizophrenic patients said they would take the medication if they had choice. The fact that schizophrenic inpatients readly shared their reluctance to take medication with an interviewer may offer an avenue for detection and intervention improve prospects for outpatient compliance.

동기간에 발생한 정신분열병환자들의 임상적 연구 : 가족역동과 가족병리를 중심으로 Focusses on Familydynamic and Familial Psychopathology

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1985 EMJ (Ewha medical journal) Vol.8 No.4

Author attempted of find out whether there were any characteristic findings in the sibling schizophrenics family(family in which more than two members of sibling were schizophrenia) including clinical features, interpersonal relationship and some of sociodemographyic aspects. Data for the sample were obtained 17 schizophrenics from 8 sibling schizophrenics families who were admilted to neuropsychiatric department EWHA Womens University Hospital from March 1st 1973 to February 28th 1983. Results obtained were summerized as follows; The members of sibling were larger in the schizophrenics families than that of normal and the first born childrens and last born childrens were affectes more frequently than subseguent ones. Sibling schizophrenics were tended to be heigh educates, no employed and low middle socioeconomic class. In the familial history, sibling schizophrenic's father proband had more frequently affectes than mother proband. Usually mother's characters were found to be over protective and active but father's were indifferent and passive. Their father and mother had mother dominent and hostile relationship. Interpersonal relationship between sibling schizophrenics had relative affective(41.2%) in the majority. Comparative analysis of the above finding showed no differences from the family in which only one child was afflicted schizophrenia.