백서 해마절편에서 Methamphetamine의 Noreponephrine 유리효과

최말례 ( Mal Rye Choi ),최수진 ( Soo Jin Choi ),이진희 ( Jin Hee Lee ) 전북대학교 의과학연구소 2003 全北醫大論文集 Vol.27 No.1

Methamphetamine (MAP) is a well known psychostimulant, It has been reported that MAP induces release of various neurotransmitters from brain regions, and is capable of enhancement of cognitive function. Hippocampal noradrenergic system is involved in momory process. We examined the mechamism of MAP-induced [3H]norepinephrine([3H]NE) release in rat hippocampal slices. MAP induced the release of [3H]NE in a dose dependent manner (1-100 uM). At 10 uM concentration of MAP, [3H]NE was released over 85% of resting period. In the presence of 1 uM yohimbine, MAP-induced [3H]NE release was potentiated. MAP-induced [3H]NE release was not inhibited by 1 uM tetrodotoxin, indicating that the action site of MAP is located on the presynaptic terminal. The amount of MAP-induced [3H]NE release was not altered in the absence of Ca2, but was significantly increased in the absence of NaCI (replaced by equimolar N-methyl-glucamine) in the incubation media. MAP-induced [3H]NE release was not altered by voltage-sensitive calcium channel blockers (nitrendipine and ω-conotoxin GVIA). Desipramine (1 uM) and nisoxetine (0.1 uM), NE transporter blockers, significantly inhibited MAP-induced NE release. MAP-induced NE-release was inhibited by MK-801 (1 and 10 uM), but not by D-AP5 or removal of Mg2+ in the incubation media. Also, MAP failed to stimulate the release of [3H]aspartate even in 100 uM, and 10 uM of MAP failed to displace the specific binding of [3H]MK-801 in rat cerebral cortex membrane. Our results suggest that MAP induces NE release by reversal of NE transporter which is located in presynaptic terminal, and that glutamate is not involved as reported in other neurotransmitter system, such as dopamine in striatum.

폐쇄성수면무호흡증에 대한 지속적 양압치료가 삶의 질에 미치는 영향 : 단일기관 연구

신현석,최말례,김신일,홍세연,은헌정,Shin, Hyun Suk,Choi, Mal Rye,Kim, Shin il,Hong, Se Yeon,Eun, Hun Jeong 대한수면의학회 2020 수면·정신생리 Vol.27 No.2

목 적 : 본 연구에서는 OSA환자의 임상적 특징과 CPAP 사용 전·후의 삶의 질 정도를 비교하여 CPAP 사용에 따른 삶의 질의 개선 정도를 알아보고자 하였다. 방 법 : 진료기록부를 통한 나이, 성별, 신장, 체중, 체질량지수, 앱워스 주간졸림척도, 수정된 말람파티척도, 한국판 몬트리올 인지평가, 피츠버그 수면의 질 지수를 조사하여 분석하였다. CPAP 사용에 따른 삶의 질의 개선정도를 알아보기 위해 연구대상자에게 전화 연락을 취하여 CPAP 사용 전·후의 삶의 질에 대해 시각형 아날로그 척도(VAS)를 이용하여 조사하였다. 결 과 : 신장(Z = -4.525, p < 0.001), 체중(Z = -2.844, p < 0.05), 수면의 질(Z = -2.671, p < 0.05)과 각성 지수(Z = -2.105, p < 0.05)에서 통계학적으로 남·녀 간에 차이(p < 0.05)가 있으며 나머지 변수에서는 차이가 없음이 확인되었다. 교차분석에서 χ2 = 7.724, p = 0.024로 p < 0.05보다 작으므로 OSA의 수준별 심각도와 성별 간에 차이가 있음이 확인이 되었다. PreCPAP QOL, PostCPAP QOL, CPAPUse Months, CPAP4Hr/d (%)의 OSA의 수준별 심각도에 따른 크기에는 통계적으로 유의미한 순서가 존재하지 않는 것으로 확인되었다(p > 0.05). CPAP 사용 전 AHI와 사용 후 AHI의 차이가 36.48 ± 21.54 (t = 11.609, p < 0.001)이었고, CPAP 사용 전 QOL과 사용 후 QOL의 차이가 -25.43 ± 22.06 (t = -7.901, p < 0.001)이었으며 통계적으로 의미 있는 차이(p < 0.001)를 보였다. 결 론 : OSA환자 중 남녀간 임상적으로 신장(HT), 체중(BW), 수면의 질(PSQI), 각성지수(AI), OSA의 수준별 심각도에서 남녀 간의 차이가 있었다. 그러나 CPAP전·후에 삶의 질은 남녀간 차이가 없었다. 또한 OSA환자에서 CPAP 사용 후 삶의 질이 개선되었음을 확인하였다. Objectives: In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. Methods: Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. Results: In height (HT) (Z = -4.525, p < 0.001), weight (BW) (Z = -2.844, p < 0.05), sleep quality (PSQI) (Z = -2.671, p < 0.05), and arousal index (AI) (Z = -2.105, p < 0.05), there was a difference between men and women (p < 0.05). There was no difference in the remaining variables. Cross-analysis (Chi-square test) confirmed a difference between severity and sex of OSA. It has been found that there is no statistically significant order in size according to level-specific severity of OSA for PreCPAP QOL, PostCPAP QOL, CPAPUse Months, and CPAP4Hr/d (%) (p > 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was -25.43 ± 22.06 (t = -7.901, p < 0.001), both of which were significant (p < 0.001). Conclusion: Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP.

일 병원의 순환교대근무와 주간고정근무 여성 간호사의 근무형태에 따른 정신신체 증상

김병조,최말례,김태형,김형욱,은헌정,Kim, Byoung-Jo,Choi, Mal-Rye,Kim, Tae-Hyung,Kim, Hyeong-Wook,Eun, Hun-Jeong 한국정신신체의학회 2014 정신신체의학 Vol.22 No.2

연구목적 일 종합병원에 근무하는 여성 간호사 중 순환교대자와 주간고정근무자 두 군 간의 정신신체 증상의 차이를 조사하였다. 방 법 일 종합병원에서 근무하는 여성 간호사의 인구학적 정보를 수집하여, 두통의 강도(VAS), 두통의 유형, 두통의 빈도를 알기위한 질문지와 우울척도(BDI), 전반적 수면평가지(GSAQ)를 사용하였다. 통계분석은 Mann-Whitney test와 ${\chi}^2$ test를 사용하였다. 결 과 전체 대상군 84명 중 순환군이 37명, 주간군이 47명이었다. 순환군이 주간군보다 젊고 미혼이 많았고 근무연수가 적었다. 순환군이 주간군보다 두통, 불면, 과다 주간졸리움증, 우울, 불안과 같은 정신신체 증상이 통계학적으로 유의하게 많았다. 결 론 종합병원의 순환교대근무 여성간호사가 주간근무자보다 더 많은 두통, 불면, 과다 주간졸리움증, 우울, 불안을 보였다. Objectives : Shift work disorder occurs when you have difficulties adjusting to a work schedule that takes place during a time which most people sleep. Some people may have diverse psychosomatic symptoms, such as sleep problems, depression, anxiety, and headaches even after the shift work schedule ends. The aims of this study are to compare difference of psychosomatic symptoms between rotating shift and daytime working nurse groups. Methods : Volunteer nurses working in a general hospital were recruited in a general hospital. We collected sociodemographic data. We used questionnaires for headache type, headache frequency, and VAS(Visual Analog Scale) for headache intensity, BDI(Beck depression Inventory) and GSAQ(Global Sleep Assessment Questionnaire). We used Mann-Whitney test and Chi-square test for hypothesis testing. Results : Data collected from 84 women nurses. Rotating shift(N=37) working nurses showed younger, more unmarried, and shorter work periods than daytime working nurses (N=47). Also rotating shift group showed more problems of headache, insomnia, excessive daytime sleepiness, depression and anxiety than daytime group. The above results were statistically significant. Conclusions : The rotating shift work women nurses produced more headache, insomnia, excessive daytime sleepiness, depression, and anxiety than daytime working ones.

소아와 조기청소년에서 보이는 주의력결핍 과잉행동장애와 간질의 공통적 특성

김시형,김태형,최말례,김병조,송옥선,장영택,은헌정,Kim, Si-Hyung,Kim, Tae-Hyung,Choi, Mal-Rye,Kim, Byung-Jo,Song, Ok-Sun,Jang, Young-Taek,Eun, Hun-Jeong 한국정신신체의학회 2011 정신신체의학 Vol.19 No.2

연구목적: 주의력결핍 과잉행동장애(Attention Deficit Hyperactivity Disorder, ADHD)와 간질 사이에서 나타나는 공통적 특성을 연구할 목적으로 Korea-Child Behavior Checklist(K-CBCL)과 ADHD Diagnostic System (ADS), Electroencephalogram(EEG)를 평가하여 두 질환군의 공통적 특성(Common features)을 알아보고자 하였다. 방 법: 6세부터 16세까지의 소아,청소년들을 대상으로 ADHD군 30명 간질군 34명 그리고 대조군은 29명이었다. 평가도구는 K-CBCL과 자가보고 도구인 ADS를 사용하였으며 뇌파를 측정하였다. 모든 결과의 분석은 다중변량분석(MANOVA)과 교차분석(${\chi}^2$-test)을 이용하였다. 결 과: 간질군, ADHD군 간의 공통적 특성으로 뇌파에서 비정상 뇌파 소견(대조군 13.8%, 간질군 97.1%, ADHD군 40%)을 보인 것과 ADS에서 부주의, 반응시간 표준편차 항목에서 유의미한 차이가 있음이 확인되었다. 결 론: 간질군과 ADHD군에서 비정상 뇌파 소견, 부주의, 반응시간 표준편차라는 공통적 특성이 있음을 확인하였다. Objectives:We conduct this study to investigate the common features between Attention Deficit Hyperactivity Disorder(ADHD) and epileptic patients compared to normal control. Methods:Epileptic patients were recruited from the department of pediatic in Jesus Hospital. ADHD patients were recruited from the department of neuropsychiatry in Jesus Hospital. We excluded mental retardation or brain organic pathology. We use ADHD Diagnostic System and Korean-Child Behavior Checklist(K-CBCL) to assess features of ADHD. Electroencephalogram(EEG) of ADHD, epileptic patients and normal control were analyzed and compared. Results:Compared to normal control group, inattention, reaction time deviation were increased in both ADHD and epilepsy group. EEG abnormalities(control 13.8%, epilepsy 97.1%, ADHD 40%) in three groups were reported. Conclusion:There are common features of ADHD and epileptic patients.

순환교대근무와 주간고정근무 여성 간호사의 회복탄력성에 대한 스트레스, 수면, 우울증의 영향

정주리,권혁민,김태형,최말례,은헌정,Jeong, Ju Li,Kwon, Hyuk Min,Kim, Tae Hyung,Choi, Mal Rye,Eun, Hun Jeong 대한수면의학회 2019 수면·정신생리 Vol.26 No.2

목 적 : 건강한 수면은 중요하며 회복탄력성에 긍정적인 영향을 줄 수 있다. 본 연구에서는 교대근무 간호사와 주간 고정 근무 간호사 두 집단에서 회복탄력성의 차이를 비교하고 회복탄력성에 영향을 줄 수 있는 요인들을 조사해보고자 하였다. 방 법 : 두 개의 종합병원에 근무하는 만 20세 이상의 여성 교대근무 간호사와 주간고정근무 간호사 400명을 대상으로 하였으며 2017년 6월 12일부터 2018년 6월 12일까지 설문조사하였다. 한글판 스트레스 자각척도, 스트레스 대처전략 축약형, 사회심리적 건강측정도구, 한국판 역학연구센터 우울척도, 상태불안척도, 피츠버그 수면의 질 지수, 엡워스 주간졸음 척도, 불면증 심각도 척도, 코너 데이비슨 리질리언스 척도 질문지를 적용하였다. 결 과 : 교대근무간호사와 고정근무간호사 두 집단 간의 변수 통계량을 비교한 결과 스트레스 자각, 수면의 질, 주간 졸음증을 제외한 모든 변수에서 통계적으로 의미 있는 차이를 나타내었다. 회복탄력성과 유의한 상관을 보인 요소들은 근무자들의 스트레스 대처전략, 사회 심리적 건강수준, 우울증, 불면증 심각도 이었다(p < 0.05). 다중회귀분석에서는 긍정적 재구성1이 커질수록(β = 0.206, p < 0.001), 우울증이 줄어들수록(β = -3.45, p < 0.001), 사회심리적 건강수준이 높아질수록(β = 0.193, p < 0.001), 수용적 대처2가 증가할수록(β = 0.129, p < 0.05), 주간졸음이 줄어들수록(β = -1.17, p < 0.05), 적극적 대처2가 증가할수록(β = 0.118, p < 0.05), 긍정적 재구성2가 증가할수록(β = 0.110, p < 0.05) 회복탄력성이 커지는 것으로 나타났다. 결 론 : 본 연구에서는 교대근무자에 비해 주간고정 근무자의 회복탄력성이 높음을 밝힐 수 있었다. 또한 특정 스트레스 대처 전략과 사회심리적 건강수준, 수면, 우울증이 회복탄력성과 연관이 있는 것으로 확인되었다. 향후 더 많은 수면과 회복탄력성과의 관계를 밝히는 전향적 연구들이 필요할 것으로 생각된다. Objectives: Healthy sleep is important and can have a positive effect on resilience. The aim of the present study was to compare the differences in resilience between two group nurses in rotating shift and daytime fixed work schedules and to investigate stress perception, coping factors, social and psychological health, and sleep factors that may affect resilience. Methods: A total of 400 female nurses having rotating shift and daytime fixed work schedules at two hospitals was surveyed from June 12, 2017 to June 12, 2018. All participants completed perceived stress scale (PSS), stress coping short form (Brief COPE), psycho-social wellbeing Index short form (PWI-SF) or general health questionnaire-18 (GHQ-18), center for epidemiologic studies depression scale (CES-D), STAI-X-1 in state-trait anxiety inventory (STAI), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI), Conner Davidson resilience scale (CD-RISC). Independent t-test, paired t-test, Pearson correlation analysis, and multiple regression analysis were applied to the results of the final 373 questionnaires of 400 nurses in two general hospitals. Results: Comparing the variable statistics between the two groups of rotating shift and daytime fixed work nurses, showed statistically significant differences in all variables except perceived stress, sleep quality, and daytime sleepiness. Factors that had a significant correlation with resilience were stress coping strategies, depression, and insomnia severity (p < 0.001). In multiple regression analysis, larger positive reframing1 (β = 0.206, p < 0.001), severe less depression (β = -3.45, p < 0.001), and higher psychosocial health (β = 0.193, p < 0.001). As acceptance coping2 increased (β = 0.129, p < 0.05), as daytime sleepiness decreased (β = -1.17, p < 0.05), and as active coping2 increased (β = 0.118, p < 0.05), as the positive reframing2 increases (β = 0.110, p < 0.05), the resilience increased. Conclusion: This study, it was found that resilience was higher in daytime fixed workers than in shift workers. In addition, specific stress coping strategies, psycho-social health, sleep, and depression factors were associated with resilience.

임상가용 아동 및 청소년을 위한 외상 후 스트레스장애 척도를 통한 학교폭력 피해아동의 인지행동집단치료 효과 : 예비연구

김형욱,김태형,은헌정,최말례,권태완,구정일,조수진,송옥선,Kim, Hyoung-Wook,Kim, Tae-Hyoung,Eun, Hun-Jeong,Choi, Mal-Rye,Kwon, Tae-Wan,Ku, Jeong-Il,Cho, Soo-Jin,Song, Ok-Sun 대한불안의학회 2007 대한불안의학회지 Vol.3 No.2

Objective : The present study was carried out in order to assess the effects of Cognitive-Behavioral Group Therapy (CBGT) on victims of school violence, as assessed by the CAPS-CA. Methods : The subjects were 14 children who had experienced school violence and were subsequently diagnosed with PTSD and partial PTSD using the Clinician-Administered PTSD scale for Children and Adolescents (CAPS-CA). Seven children agreed to participate in CBGT, and they received 10 sessions of therapy. After CBGT, both the CBGT and non-CBGT groups were assessed using the CAPS-CA and School Adaptation Test. Results : The study results showed significant decreases in avoidance (p=0.010) and hyperarousal in the CBGT group (p=0.009) following the completion of CBGT. The analysis of school adaptation showed that there was a significant improvement in peer relationships after CBGT in the CBGT group (p=0.045). Conclusion : CBGT is effective in improving PTSD symptoms in children who experience school violence and subsequently suffer from PTSD.

새로운 Thebaine 유도체 HN-K14의 오피오이드 수용체 결합특성

이진희 ( Jin Hee Lee ),최수진 ( Soo Jin Choi ),최말례 ( Mal Rye Choi ) 전북대학교 의과학연구소 2003 全北醫大論文集 Vol.27 No.1

The purpose of the present study was to develop the novel centrally-acting analgesic drugs from thebaine derivatives. Receptor selectivity and affinity for opioid μ, δ and κ receptors were determined by employing type-selective radiolabeled ligands for μ-, δ-and κ-opioid receptor, [3H][D-Ala2, N-Me-Phe4, Gly-ol5]-enkephalin (DAMGO), [3H]naltrindole (NTI) or [3H]U69593 ([3H]U69) inguinea-pig cerebeal cortex membranes. For u opioiod recptors, HN-K14 displaced specific binding of [3H]DAMGO with Ki value of 56.7 nM. HN-14 was less potent than DAMGO and morphine. For δ opioid receptors, HN-K14 dose-dependently inhibited the specific binding of [3H]NTI, a selective antabonist for δ opioid receptor in rat cerebral cortex membranes. The affinity of HN-K14 for this site was 173 nM. HN-K14 was more potent than morphine in displacement of [3H]NTI binding. For κ opioid receptors, HN-K14 displaced the specific binding of [3H]U69 with Ki value of 192 nM. HN-K14 displaced [3H]U69 with more potency that morphine in guinea-pig cerebral cortex membranes. These results shows that thebaine derivatives are promising candidates for the development of new centrally-acting analgesic drugs.

COVID-19 환자에서 나타나는 섬망에 대한 고찰

한명일(Myeong-Il Han),김용(Yong Kim),김철응(Choel Eung Kim),최말례(Mal-Rye Choi) 대한노인정신의학회 2021 노인정신의학 Vol.25 No.2

We reviewed the clinical features, prevalence, pathophysiology, and prevention and treatment of delirium in patients with coronavirus disease of 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, has neurotropic properties, and can penetrate the central nervous system and affect brain neurons. These characteristics may explain the fact that COVID-19 patients may be particularly susceptible to delirium. COVID-19 delirium occurred more frequently in intensive care unit and emergency room settings. Patients with neurologic disorders and the elderly were more vulnerable to delirium. Clinical symptoms of COVID-19 delirium may manifest as a hyper/hypoactive type. Prevention and treatment appear to be similar to conventional treatment strategies. And the patient’s feeling of isolation due to social distancing and a highly intensive labor force of medical personnel must be overcome. Melatonin, alpha-2 agonist, antipsychotics, and valproic acid have been recommended for the treatment of delirium symptoms. However, this article did not go through a systematic literature review.

백서 해마절편에서 Methamphetamine의 Norepinephrine 유리효과

최말례,정은용,김완호 의과학연구소 2000 全北醫大論文集 Vol.24 No.1

한국판 성격장애 검사(Personality Disorder Questionnaire-4+ : PDQ-4+)의 신뢰도와 타당도에 관한 예비적 연구

김동인,최말례,조은정 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

연구목적 : 본 연구의 목적은 한국판 성격장애 검사(PDQ-4+)의 신뢰도와 타당도를 알아보고자 하였다. 방 법 : 540명의 정상군과 39명의 성격장애군에 대하여 성격장애 검사를 실시하였다. 신뢰도 평가를 위하여 내적 일치도, 반분 신뢰도, 검사-재검사 신뢰도, 성격장애별 소척도들의 각문항과 평균간의 상관, 등을 구하였다. 또한 타당도 평가를 위해서 요인분석, 정상군과 성격 장애군의 총점 간의 차이를 보이기위해 t-test를 하였다. 결 과 : 540명의 정상군과 39명의 성격장애군에서 내적 일치도는 대부분의 성격장애 항목에서 .500이상(Cronbach alpha의 범위 : .4007에서 .6693까지)이었다. 반분 신뢰도는 짝수문항과 홀수문항 사이에서 .839 이었다. 2주 간격으로 시행한 검사-재검사 신뢰도는 .868이었다. 성격장애별 소척도들의 각문항과 평균간의 상관은 높은 상관계수를 보여 주었다. 정상군과 정격장애군의 총점 간의 차이는 매우 의미있는 차이를 보여 주었다. (t=9.146, df=76, p=.000). 결 론 : 성격장애 검사는 충분한 신뢰도와 타당도를 가지고 있으며 모든 성격장애를 선별하는데 유용한 도구라고 할 수 있다. Objectives : The purpose of this study was to examine the reliability and the validity of the Korean version of Personality Disorder Questionnaire-4+(PDQ-4+). Methods : PDQ-4+ was administered to 540 subjects of general population group and 37 subjects of personality disorder group. For measuring concurrent reliability, we tested internal consistency, split-half reliability, test-retest reliability and correlation of item score of subscale and mean of subscale. And also, we performed factor analysis for the evaluation of validity, and t-test to group difference of the total scores between general population group and personality disorder group. Results : In general population group and personality disorder group, internal consistency was above .500(range of Cronbach alpha : .4007 to .6693) in most of the Personality disorder categories. Split-half reliability was .839 between even and odd items. Test-retest reliability done 2 seeks interval was .868. Item scores of subscales and mean of subscales showed high correlation coefficient. Group difference of the total scores between general population and personality disorder group showed very significant difference(t=9.146, df=76, p=.000). Conclusion : The PDQ-4+ shows a reasonable degree of reliability and validity and could be a valuable tool in screening for overall personality disturbances.