防腐劑가 消化酵素 Amylase 의 作用에 미치는 영향

최말례 이화여자대학교 약학회 1963 梨花藥學會誌 Vol.- No.4

백서 해마절편에서 Methamphetamine의 Norepinephrine 유리효과

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

전주시 청소년 생활만족도와 문제행동에 관한 연구

최말례,은헌정,이선미,박경훈 전북대학교 사회과학연구소 2003 지역과 세계 Vol.29 No.-

防腐劑가 消化酵素 Amylase 의 作用에 미치는 영향

최말례 梨花女子大學校 藥學硏究所 1963 梨花藥學硏究 Vol.- No.4

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.

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.

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.

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.

치매환자 가족조호자의 우울 및 불안과 연관요인

홍수정,고요한,최말례,성남주,한명일 대한신경정신의학회 2022 신경정신의학 Vol.61 No.3

Objectives This study examined the level of depression and anxiety and the related factors, especially the knowledge and attitudes towards dementia, of people caring for a family member with dementia. Methods Data on the demographics, care burdens, and clinical characteristics of dementia patients and their family caregivers were collected. The Center for Epidemiologic Studies Depression Scale (CES-D) and Korean Screening Tool for Anxiety disorders (K-ANX), Dementia Knowledge Scale (DKS), and Dementia Attitudes Scale (DAS) were performed. This study investigated whether depression and anxiety of caregivers differed according to the caregivers, patients, and the burden of caregivers. Multiple regression analysis was performed to investigate the potential factors that may influence the psychological symptoms in family caregivers. Results There were 135 respondents. The scores of CES-D and K-ANX were 19.18±12.05 (probable depression) and 11.48±8.88 (mild anxiety), respectively. There was a significant difference in the degree of depression according to the level of education (F=4.14, p<0.05), the severity of dementia (F=3.63, p<0.05), and cohabitation with patients with dementia (t=2.07, p<0.05). On the other hand, the difference in the degree of anxiety was not significant depending on the stratified potential factors. The degree of depression in caregivers was positively associated with severe dementia (β=0.252, p<0.01) and negatively associated with the DAS score (β= -0.392, p<0.001). Anxiety was only inversely affected by the DAS score (β=-0.369, p<0.001). Conclusion This study shows that family caregivers of people with dementia experience high levels of depression and anxiety, which are influenced by the patient’s severity of dementia and the caregiver’s attitude toward dementia.

수면무호흡증과 수면변수가 인지기능에 미치는 영향과 우울증의 매개효과

박경원,김형욱,최말례,김병조,김태형,송옥선,은헌정 대한수면의학회 2017 수면·정신생리 Vol.24 No.2

목 적:본 연구는 폐쇄성 수면무호흡증 환자에서 수면무호흡지수, 수면관련척도, 기분관련척도, 그리고 인지기능간의 연관성을 보고자 하였다. 방 법:폐쇄성 수면무호흡증후군을 보이는 105명의 환자를 선정하였다. 수면무호흡지수로 RDI, AHI가 사용되었고, 수면관련척도로는 PSG에서 측정되는 TST, Duration N1, Duration N2, Duration N3, Duration R, Arousal Index, PLM Index, Snoring Index, Mean SpO2, Minimum SpO2 와 설문지로 측정되는 PSQI, ESS, SIS (snoring index by scale)를 사용하였으며 기분관련척도로는 BDI, 인지기능관련 척도로는 Moca-K, MMSE-K, CDR을 사용하였다. 이를 이용하여 수면무호흡증 환자에서 수면무호흡지수, 수면및 기분관련척도와 인지기능간의 상관관계를 분석하였으며수면무호흡증 환자에서 보이는 인지기능장애의 기전을 밝히고자 우울증의 매개효과를 분석하였다. 결 과:Duration N1가 증가할수록 그리고 TST가 감소할수록 MOCA-K에 부적 인과관계를 나타내었다(p < 0.01). BDI와 Supine RDI가 증가할수록 MOCA-K에 부적인과관계를 보였다(p < 0.01). PSQI가 증가할수록(p < 0.001) 그리고 MMSE-K가 감소할수록(p < 0.01) 또한 SIS가 증가할수록(p < 0.01) BDI에 정적 인과관계를 보였다. 폐쇄성수면무호흡증 환자에서 나이가 MOCA-K에 미치는 영향에BDI가 부분 매개하는 것으로 확인되었다. 결 론:수면무호흡증 환자에서 Duration N1, TST, BDI, Supine RDI가 인지기능과 연관성이 있었으며, 특히 BDI로측정되는 우울증상이 수면무호흡증 환자의 인지기능저하에 부분적으로 매개 하였다. Objectives: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. Methods: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. Results: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. Conclusion: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.