노년기 정신장애의 전기경련치료

주은정,김희철,강웅구,이남영,박승현,김정민,김용식,정인원,Joo, Eun-Jeong,Kim, Hee Cheol,Kang, Ung Gu,Lee, Nam Young,Park, Seung Hyun,Kim, Jung Min,Kim, Yong Sik,Chung, In Won 대한생물정신의학회 2020 생물정신의학 Vol.27 No.2

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

사료내 ${\beta}$-glucanase 활성 강화 고역가 복합효소제 첨가급여가 착유우의 유생산 및 체세포수 변화에 미치는 영향

주은정,정수진,윤병선,남기택,최일신,안종호,황성구,Joo, Eun-Jung,Jeong, Su-Jin,Yoon, Byung-Seon,Nam, Ki-Taek,Choi, Il-Shin,Ahn, Jong-Ho,Hwang, Seong-Gu 한국유기농업학회 2004 韓國有機農業學會誌 Vol.12 No.2

In recent years, many researches are actively undertaken for environmental-friendly animal production according to the increased understanding about food safety because of the outbreak of various diseases such as mad cow disease, Foot and mouth disease and Poultry Influenza virus. However, high quality(higher safety)- animal production may not be successful without increasing of disease resistance of animal and the improvement of feeding environment. To increase the disease resistance is able to be accomplished by stimulating the immune function. The present study was undertaken to investigate the effects of enzyme mixture reinforced with ${\beta}$-glucanase activity which degrade polysaccharide to release ${\beta}$-glucan known as stimulator of immune function on the change of milk production and somatic cell count. After 12weeks of experimental feeding, milk production tended to be increased and somatic cell count was decreased from average $227{\times}10^4$ to $37.1{\times}10^4$. Milk protein and solid-fat content were tended to increase but milk fat showed decreasing tendency by the feeding of enzyme mixture. All together, it has been suggest6d that the improvement of high quality milk production may be possible through the dietary addition of immune modulating enzyme mixture in lactating dairy cows.

정신분열병 환자에서 신체미세기형에 관한 연구

주은정,정성훈,맹소진,윤세창,김종훈,김철응,신영민,김용식,Joo, Eun-Jeong,Jeong, Seong Hoon,Maeng, So Jin,Yoon, Se Chang,Kim, Jong Hoon,Kim, Chul Eung,Shin, Youngmin,Kim, Yong Sik 대한생물정신의학회 2002 생물정신의학 Vol.9 No.2

Object and Method:Minor physical anomalies(MPAs) are frequently seen in patients with schizophrenia. MPAs are considered to arise from the anomalous development of ectoderm-originated tissues in the developing fetus. Since the central nervous system originates from ectoderm, MPAs can be regarded as externally observable and objective indicators of the aberrant development which might have taken place in the central nervous system. To investigate whether MPAs are more frequent in schizophrenic patients, the frequencies of MPAs were compared between schizophrenic patients and normal controls. Total 245 schizophrenic patients diagnosed with DSM-IV(male : 158, female : 87), and 418 normal control subjects(male : 216, female : 202) were included in this study. The MPAs were measured using the modified Waldrop scale with fifteen items in six bodily regions; head, eye, ear, mouth, hand, and foot. Result:The total scores of Waldrop scale were $4.40{\pm}1.93$($mean{\pm}standard$ deviation) in patients and $3.43{\pm}1.68$ in controls for females, and for males, $4.58{\pm}1.75$ in patients and $4.28{\pm}1.59$ in controls. For females, the excess of MPAs in schizophrenic patients was statistically significant(t-test : p<0.001). For males, schizophrenic patients also showed more MPAs than normal controls, but this tendency did not reach statistical significance (t-test : p=0.094). When the modified Waldrop total scores excluding head circumference were compared, the total scores in schizophrenic patients were significantly higher for both male and female subjects(t-test : male p<0.001, female p=0.001). The individual anomaly items included in Waldrop scale were also investigated. The items of epicanthus, hypertelorism, malformed ears, syndactylia were significantly more frequent in schizophrenic patients. In contrast, the items of adherent ear lobes, asymmetric ears, furrowed tongue, curved fifth finger, single palmar crease and big gap between toes did not show any differences in frequency between schizophrenic patients and normal controls. Since a lot of statistical analyses showed different results between male and female subjects, it seems to be necessary to consider gender as an important controlling variable for the analysis, however only the item of head circumference showed statistically significant gender-related difference according to log-linear analysis. Conclusion:With a relatively large sample size, the frequencies of MPAs enlisted in Waldrop scale were compared between schizophrenic patients and normal controls in this study. MPAs were more frequently seen in schizophrenic patients and, especially, several specific items in the Waldrop scale showed prominent excess in schizophrenic patients. Although definite conclusions cannot be drawn due to the inherent limitation of the study using Waldrop scale, these results seem to support the possibility that aberrant neurodevelopmental process might be involved in the pathogenesis of schizophrenia in some of the patients.

입원중 정신과에 자문 의뢰된 65세 이상 노인환자에 대한 임상적 고찰

주은정(Eun-Jeong Joo),김영돈(Young-Don Kim) 대한노인정신의학회 2000 노인정신의학 Vol.4 No.1

Objective : This clinical study investigates the current status of geropsychiatric consultation in Korea, as the geriatric population and the needs for geropsychiatric consultation increase. Method : Hospital records of all geriatiric patients (≥65) consulted to psychiatric department during hospital stay in a general hospital for 18 months (1998. 9. 1-2000. 2. 1) were reviewed retrospectively. Data on somatic illness, psychiatric illness and patterns of consultation were collected and analyzed. Result : Total number of patients was 136 (M 50, F 86) and mean age was 72.5 years old. Psychiatric consultation rate for patients above 65 was 2.5%, it was 29.5% among the whole psychiatric consultations. 65.4% was consulted by the Internal Medicine, Orthopedic surgery was the second most frequent referral department. Nonpsychiatric consultations were frequent, a geriatric patient was consulted to 2.7 other different departments on average, during the same period of hospital stay. Sleep disturbance, depressive mood, anxiety/agitation, somatization with normal laboratory findings were the main reasons of psychiatric consultation. 40% of these cases were tried to manage psychiatric problems by consultee. 50% of patients were suffered from depression, followed by delirium and dementia in frequency. Mean lagtime for consultation was 8.4 days, drug compliance was 90.5%. 54.4% of consultations has been followed up more than twice, 7.4% of consultations has required to be followed up more than 5 times. Compliance for consultation follow up during hospital stay was 78.7% and complicance for OPD follow up after discharge was 52.4%. Mean number of drugs being used on the day of consultation was 7.8, among them, 0.9 were psychiatric drugs. psychiatric drugs were prescribed for 51.5% of patients before psychiatric consultation. 2.2 drugs were prescribed by consultant. Disorientation was shown at 33.8%, visual hallucination was shown at 18.4%, sleep disturbance was prevalent at 64.0% of patients. Disorientation found to be associated with age, sleep disturbance, number of nonpsychiatric consultations, number of psychiatric follow up consultations. Conclusion : Clinical Variables on geropsychiatric consultation at a general hospital were investigated. Further studies are warranted on geropsychiatric consultation in Korea.

전기경련치료에 대한 환자의 만족도 조사

주은정(Eun-Jeong Joo),김희철(Hee Cheol Kim),정성훈(Seong Hoon Jeong),박승현(Seung Hyun Park),이남영(Nam Young Lee),최영숙(Young Sook Choi),김용식(Yong Sik Kim),정인원(In Won Chung) 대한신경정신의학회 2021 신경정신의학 Vol.60 No.2

전기경련치료에 대한 환자의 인식과 태도를 파악하고자 설문 조사를 실시한 결과, 많은 환자들이 전기경련치료에 대한 만족도 및 부작용, 태도, 경험 등에서 대체로 긍정적인 응답을 하였다. 응답자 중에서 반수 이상이 전기경련치료 동안에 기억장애를 경험하였다. 본 연구에서는 전기경련치료의 만족도에 직접적으로 영향을 미치는 예측 요인을 확인하지는 못하였으나 전기경련치료 동안에 발생하는 일시적인 부작용들과 기억장애에 대한 예방, 조기 발견과 신속한 처치가 필요한 것을 알 수 있었다. 후속 연구에서 대상자 수의 확대와 다양한 변인들을 탐색함으로써 전기경련치료의 만족도를 높일 수 있는 예측 요인들을 규명할 수 있을 것으로 판단된다. Objectives This study examined the satisfaction of patients who had undergone electroconvulsive therapy to provide important information for improving the social misunderstanding about electroconvulsive therapy, to increase the effectiveness of treatment, and make a decision of effective treatment. Methods A questionnaire survey was conducted to determine the satisfaction, adverse effects, attitudes, and experiences toward electroconvulsive therapy in patients at 2 to 4 weeks after finishing an acute course of electroconvulsive therapy in three psychiatric hospitals. Results There were 85 respondents (38 males), whose average age was 42.0±13.6 years and average illness duration was 12.8±8.9 years. Fifty-two patients (61.2%), 19 (22.4%), 8 (9.4%), and 6 (7.1%) were diagnosed with schizophrenia, major depressive disorder, bipolar disorder, and other mental disorders, respectively. The average session number for acute electroconvulsive therapy was 12.6±6.0 sessions, and 61 patients (71.8%) had received maintenance electroconvulsive therapy. Among the respondents, 60.0% reported that they were satisfied with the electroconvulsive therapy. Satisfaction was similar according to sex, age, diagnosis, electrode placement, and use of anesthetic agents. Forty-three (53.8%) patients experienced memory impairment during acute electroconvulsive therapy. Conclusion This study showed that patients who received electroconvulsive therapy were generally satisfied with the treatment and that memory impairment should be detected early and managed promptly. Follow-up studies with a large number of subjects and variables will be needed to determine the predictive factors affecting satisfaction toward electroconvulsive therapy.

노년기 알코올 및 물질관련 장애

주은정(Eun Jeong Joo) 대한노인정신의학회 2005 노인정신의학 Vol.9 No.1

노년기의 알코올 및 물질관련 장애는 노인의 신체적, 심리적 그리고 사회적 특성을 고려하여 이해하여야 한다. 노년기 알코올 및 물질 남용은 임상적인 발현 양상이 젊은 성인과는 다르며 잘 드러나지 않는 경향이 있다. 신체적으로는 약물의 작용시간이 길어지고 중추신경계의 감수성이 증가하여 중독성이 높아진다. 노인에서는 처방약물의 남용이 흔하며 작용시간이 긴 벤조디아제핀이 특히 문제가 된다. 벤조디아제핀은 노인에서 불면증, 불안 이외에도 우울증에 대하여 가장 흔히 처방되는 약물 중 하나이다. 이외에도 자유판매 약을 남용하는 경우가 많으며 알코올이나 다른 처방약물과의 상호작용이 문제가 된다. 노인의 알코올 사용 문제의 유병율은 젊은 층에 비해서는 떨어지나 과거에 비해서는 높아지는 추 세이다. 알코올 및 약물 사용 장애에 대해서는 약물 치료를 비롯하여 인지행동치료, 가족치료 등 포괄적인 접근이 이루 어져야 한다. 노인에서 알코올 및 약물 사용 장애의 치료는 노인 자신의 심리적, 신체적인 이유 뿐 아니라 가족 및 치료 자의 허무주의적 태도로 인해 어려움이 많다. 향후 지역사회에서 노인이 사용할 수 있는 다양한 정신건강 프로그램의 개 발과 노년기 알코올 및 약물 사용 장애에 대한 체계적인 연구가 더 많이 이루어져야 할 것이다. Alcohol and substance related disorder in the elderly should be understood considering the physical, psychological and social characteristics of senile patients. In the elderly, alcohol, prescription drugs and over the counter drugs could be abused and cause a lot of serious physical and/or mental problems. Alcohol and substance related problems in the elderly are different in clinical manifestations and easily missed. Abuse of prescription drugs is more common in the elderly and the long acting benzodiazepines could cause problems. Benzodiazepine is one of the most abused drug prescribed by physicians because of treatment of insomnia, anxiety and even depression. Over the counter drug is commonly abused in the elderly and it is troublesome if there are drug interactions between these drugs and alcohol or other prescription drugs. Comprehensive approach including pharmacotherapy, cognitive behavioral therapy and family therapy would be helpful for the senile patients. There are unique difficulties based on characteristics of elderly for treatment of the patients with alcohol and substance related disorders. More efforts to develop resources for the better mental health for the elderly in community and more researches on alcohol and substance use disorder for the elderly are required.

편평세포암 동물 모델에서 고려인삼잎-다당체(MB40)의 항암치료효과

주은정(Eun Jung Joo),최 준(Jun Choi),정은재(Eun Jae Chung),홍석진(Seok Jin Hong),조재구(Jae Gu Cho),백승국(Seung Kuk Baek),우정수(Jeong Soo Woo),정광윤(Kwang Yoon Jung),권순영(Soon Young Kwon) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.1

Background and Objectives:Panax ginseng C.A. Meyer is a medical plant that has been widely utilized as a tonic and nutritional agent since ancient times in Korea. Ginseng has anti-metastatic property of cancer and immunomodulating activity. The novel acidic polysaccharide compound(MB40) was isolated from the leaves of Panax ginseng C.A. Meyer. To determine immunomodulating activities of MB40, we evaluate anti-cancer and anti-metastatic effects of MB40 in tumor bearing immune competent mice. Material and Methods:C3H mice were divided into three equal groups(Cisplatin treatment group, MB40treat- ment group, Cisplatin and MB40 treatment group) and were transplanted SCC(Squamous Cell Carcinoma) cells(2×106) to the lateral side of abdomen. From day 4 after transplantation, MB40 was administrated at dose of 10mg/kg, respectively, every other day by intratumoral injection. Cisplatin was systemically administrated at doses of 1mg/kg, respectively, every week by intraperitoneal injection. Results:5 days after administration, tumors can be palpated in every mice group. After 13 days of administra-tion, the mice group to which MB40 were administrated exhibited reduction in tumor size respectively, com-pared to cisplatin group. Overall status of mice such as body weight and activity were superior in MB40 group than cisplatin group. Conclusion:The result of this study indicates MB40 may have significant therapeutic effect and decreases com-plications induced by systemic chemotheraphy. MB40 may be developed as a novel and potent immunotropics to improve the cell immune system and anti-cancer drug for the treatment of cancer patients in head and neck squamous cell carcinoma.

사료내 미량광물질 강화 복합미생물 첨가가 산란노계의 계란생산 및 난질개선에 마치는 영향

정수진,주은정,이우식,윤병선,이주삼,남기택,황성구,Jeong, Soo-Jin,Joo, Eun-Jung,Lee, Woo-Sic,Yon, Byeng-Sun,Lee, Ju-Sam,Nam, Ki-Taek,Hwang, Seong-Gu 한국유기농업학회 2004 韓國有機農業學會誌 Vol.12 No.2

In recent years, the consumption of livestock products were markedly decreased by awareness of world-widely occurred diseases including mad cow disease, Foot and mouth disease, Hog cholera, and Poultry Influenza virus. the consumers ara also wanting to have highly safe food such as organic animal products because of concerning about residual of antibiotics in animal products. However, disease control and impairment of productivity are the major problem in organic animal production. On these points of view, the present study was undertaken to investigate the effects of 1% or 2% of dietary probiotics fortified with various minerals on improvement of egg production and egg quality in old lay6r feeding low quality feed mainly composed of food waste, sesame meal, and rice bran. After 4 weeks of experimental feeding, the diameter of spreading of egg white was clearly decreased from 11.2cm of control eggs to 10.5m and 10.1m in 1% and 2% treatment group eggs, respectively. The color of egg yolk was 9.3 in control eggs but remarkably increased in treatment groups showing 10.1~10.2. Egg production was 75.8% in control layers but significantly increased to 79.8% of 1% treatment group and 82.9% of 2% treatment group layers. Egg weights (C : 66.3g, 1% : 73.2g, and 2% : 76.7g) and egg shell thickness (C : 0.33mm, 1% : 0.35mm and 2% : 0.36mm) were also increased by the addition of 1% or 2% of probiotics when compared to those of control group eggs. All together, it has been suggested that dietary addition of probiotics fortified with various minerals can improve the egg quality and egg production in layer's productivities by the recycling of organic waste resources such as food waste and agricultural by-products.

다문화가정 영유아의 수유 및 이유 실태에 관한 연구

김정현 ( Jeong Hyun Kim ),주은정 ( Eun Jung Joo ) 대한가정학회 2013 Human Ecology Research(HER) Vol.51 No.4

The purpose of this study is to investigate the infant feeding and weaning practices in multicultural families. We surveyed 159 married female immigrants in Jeonbuk province from April 2010 to April 2011. They are from Vietnam (49.7%), China (25.8%), Cambodia (8.8%), Japan (8.2%), and the Philippines (7.5%). The average rate of colostrum feeding of all the subjects was 91% and there were significant differences between nationalities(p <.05), family types (p <.01), and delivery methods (p <.001). 41.5% of those answered did breast feeding, while 49.1% combined breast and bottle feeding, and 9.4% did bottle feeding only. The reason for bottle feeding is either because they are unable to produce enough breast milk or because they think the formula isbetter than breast milk. Average period of breast feeding was 10.3 months. There were significant differences of breast feeding duration between maternal age (p <.05) and economic level (p <.001). The mean onset time of weaning was 7.8 months, and there were significant differences between nationalities (p <.05), family types (p <.05), and feeding methods (p <.05). There was no significant difference in methods of supplementary food preparation between nationalities, family types, jobs, and education levels. The mean onset time of commercial milk was 12.8 months, and there were significant differences between nationalities (p <.05), the duration of marriages (p <.05), education levels (p <.05) and feeding methods (p <.001).

폐쇄성 수면무호흡증 환자에서 일주기 리듬 특성에 따른 주간 졸음과 우울감의 차이

김성호,주은정,이규영,구영진,김의중,Kim, Seong Ho,Joo, Eun-Jeong,Lee, Kyu Young,Koo, Young Jin,Kim, Eui-Joong 대한수면의학회 2012 수면·정신생리 Vol.19 No.2

Objectives: Recent studies have reported a correlation between obstructive sleep apnea syndrome (OSA) and depression. In attempt to verify the suggestion that eveningness is related to depression, we examined the effect of morningness-eveningness on their depressive mood in patinets with OSA. Methods: The examination was based on the medical records and polysomnography reports of 211 OSA patients. Information was gathered from the patients who filled out the H$\ddot{o}$rne and Ostberg questionnaire (HOQ), profile of mood states-Korean version (K-POMS), and Epworth sleepiness scale (ESS). We compared mean values of K-POMS total, subscales of K-POMS, ESS, and OSA severity variables among the 3 morningness-eveningness groups (morningness, eveningness, and neither groups). Partial correlation analysis was performed between variables and ANCOVA was performed among the 3 groups after adjustment with age and weight. Results: There were significant negative correlations between HOQ and the followings : K-POMS total, POMS-T (tension-anxiety), POMS-D (depression-dejection), POMS-A (anger-hostility), POMS-F (fatigue-inertia), POMS-C (confusion-bewilderment), spontaneous arousal index, average O2 saturation. There were significant positive correlations between HOQ and the followings : POMS-V (vigor-activity), apnea-hypopnea index, respiratory arousal index, snore time. There were significant negative correlations between POMS-D and the followings : HOQ, POMS-V, stage 1 sleep (%), AHI, TAI (total arousal index), oxygen desaturation index, respiratory arousal index, neck circumference, average O2 desaturation, snore time (%). There were significant positive correlations between POMS-D and K-POMS total, POMS-T, POMS-A, POMS-F, POMS-C, sleep latency, stage 2 sleep (%), heart rate, spontaneous arousal index. There were significant differences in K-POMS total, POMS-T, POMS-D, POMS-F, POMS-C, spontaneous arousal index among the three HOQ groups in ANCOVA. Conclusion: The depressive correlates of OSA patients might be affected, not by excessive daytime sleepiness or OSA severity indexes, but by eveningness circadian characteristics. It would be important to take into account the morningness-eveningness tendency when we manage the depressive mood of OSA patients. 목 적: 저녁형일수록 우울해지기 쉽다는 경향성이 일반 인구집단이 아닌 폐쇄성 수면무호흡증 환자들에서도 동일하게 나타나는지를 알아보고, 수면다원검사를 통해 획득한 데이터와 상황별 졸음 평가지 등을 통해 얻은 자료 중 저녁형일수록 증가되는 항목과 우울할수록 증가되는 항목을 알아보고자 하였다. 방 법: 2008년 1월 1일부터 2011년 2월 18일까지 을지병원 수면장애 클리닉에 내원한 환자들 중 수면다원검사를 통해 OSA로 진단받은 환자 211명을 대상으로 인구학적 자료와 신체 계측 자료를 얻었으며, 상황별 졸음 평가지(ESS). 아침형-저녁형 설문지(HOQ), 한국판 기분상태척도(K-POMS), 수면다원검사를 통해 얻은 자료를 분석하였다. 일원배치 분산분석을 통해 아침형군과 저녁형군, 중간형군 별로 인구학적 자료 및 신체계측자료, 수면다원검사 자료에 대한 평균값 비교를 시행하였다. 이후 연령과 체중을 보정하여 인구학적 자료 및 신체계측자료, 수면다원검사 자료들간의 편상관분석을 시행하였다. 또한 연령과 체중을 보정한 공분산분석을 통해 아침형군과 저녁형군, 중간형군 별로 각각의 인구학적 자료 및 신체계측자료, 수면다원검사 자료에 대한 평균값 비교를 시행하였다. 결 과: 나이와 체중을 보정한 편상관분석에서 HOQ점수에 따라 저녁형일수록 K-POMS, POMS-T, POMS-D, POMS-A, POMS-F, POMS-C 점수가 상승되는 경향이 나타났다. 반대로 아침형일수록 POMS-V, AHI, respiratory arousal index, snore time(%)이 증가되는 경향이 나타났다. 또한 우울할수록 POMS 총점과 POMS-T, POMS-A, POMS-F, POMS-C, sleep latency, stage 2 sleep(%)가 증가되는 경향성이 나타나고, 우울할수록 HOQ점수가 낮아지므로 저녁형이며, 우울할수록 stage 1 sleep(%), AHI, TAI, respiratory arousal index, 목 둘레가 감소된다고 생각할 수 있다. 공분산 분석을 통해 나이와 체중을 보정한 뒤 아침형, 중간형, 저녁형 사이에 유의한 차이가 있는 항목은 K-POMS, POMS-T, POMS-D, POMS-F, POMS-C, spontaneous arousal index이다. 결 론: 폐쇄성 수면무호흡증 환자에서도 일반인구집단에서처럼 저녁형일수록 우울한 경향성이 나타난다. 이러한 경향성은 주간 졸음 등과는 무관하며, 무호흡의 심각도와도 관련성이 적은 것으로 생각할 수 있다. 그러므로 폐쇄성 수면무호흡증 환자를 평가할 때 무호흡의 심각도를 평가하는 것과는 별도로 아침형-저녁형의 일주기리듬을 확인하고 저녁형인 경우 환자의 우울감에 대한 추가적인 접근을 하는 것이 의미가 있을 것으로 생각된다.