응급실을 방문한 자살 기도자들에 대한 기술역학적 고찰

황걸,박상학,김학렬 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

The authors intended to analyze the suicidal attempter's demographic characteristics and causative factors. We chose and agalyzed 42 suicidal attempters and the results is as following: the sex ratio was similar and the Prevriling characteristics of the suicidal attempters were the age of the third decade, the academic background of high school or higher, unemployment, having no religion, unmarried state, middle socioeconomic status. The most common motive of the suicidal attempts was familial discord. The attempters usually didn't express their suicidal ideas in advance. Most of them chose drugs and poisons as suicidal methods. The attempts were undertaken from noon to 6 pm. most commonly. They have been found and were commited to the emergency room by others. When they were asked if they had any regret, a third replied they didn't regret of the suicidal attempts. The most common comorbid psychiatric disorder was depressive disorder, followed by schizophrenia.

정신분열병 환자의 집-나무-사람 검사 반응과 정신병리

황걸,박상학,김학렬,김상훈,조용래 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Objectives: This study was conducted to compare the characteristics of schizophrenic subjects with those of normal subjects in the H-T-P test. Materials and methods: Fifty-six schizophrenics and 53 normal subjects were examined and scored with the H-T-P test. And their drawings were scored by using 85 objectively scorable items developed by the author. Results: The House : The schizophrenic subjects depicted less frequently, the houses of 2 or more floors, doors, ways or pave stones leading to the doors, door knobs, windows, accessory trees and animals, chimneys, smoke, and fences. The pictures of House drawn by schizophrenic subjects showed slanted houses. The Tree : Contrary to the expectation, keyhole trees and the looping lines of the trees occurred with low frequency in the schizophrenic group. The Person : The most striking differences of the two groups were the sexual depictions, moving objects, smiling face, appendages of clothes (eg. button, pocket, belt, texture etc.), and the constructional acuity of bodies, which occurred less frequently in the scizophrenic group. Another difference is the absence of ears in the pictures of the schizophrenic group. Conclusions: In conclusion the H-T-P test can identify the psychological contents, cognitive functions, and social attitude of the schizophrenic subjects, based on the contents and structures of their drawings.

월경전 불쾌기분 장애에 대한 임상적 고찰

황걸,Hwang, Gul 한국정신신체의학회 2007 정신신체의학 Vol.15 No.1

Premenstural dysphoric disorder(PMDD) imposing 4-5% of women is possibly caused by an enhanced responsiveness to the changes of sex steroid hormones and the decrease of serotonin, melatonin and GABA. The common clinical features between PMDD and depression, seasonal affective disorder, panic disorder and anorexia nervosa suggest a relatedness between PMDD and each of them. The diagnostic criteria of DSM-IV-Tr for PMDD requires psychological symptoms, that commonly include irritability, anger, depression, mood swing, affect lability, tension, anxiety, fatigue and food craving. As of today, the best pharmacological treatment for PMDD is the selective serotonin reuptake inhibiter, and leuprolide, danazol, estradiol, spironolactone and bromocriptine are possible alternatives. Nonpharmacological treatments for patients with mild to moderate symptom severity are diet, exercise, light therapy, psychotherapy and keeping a diary. 월경전 불쾌기분 장애(premenstrual dysphoric disorder, PMDD)는 여성의 약 $4{\sim}5%$에서 발병하며 섹스 스테로이드 호르몬 양의 변화에 대한 증가된 반응성 및 세로토닌, 멜라토닌, GABA의 감소가 원인으로 생각된다. 우울증, 계절성 정동 장애, 공황장애, 신경성 폭식증은 질병 특성 상 공통점이 있어서 월경전 불쾌기분 장애와 상호 연관성을 암시한다. DSM-IV-TR의 진단 기준에 따라 월경전 불쾌기분 장애를 진단하려면 반드시 정신적 증상이었어야 한다. 흔한 정신적 증상은 이자극성, 분노, 우울, 기분 스윙, 정동 불안정, 긴장, 불안, 피로, 음식 갈망이다. 현재로서 최선의 치료 약물은 세로토닌 재흡수 차단제이며, leuprolide, danazol, estradiol, spironolactone, bromocriptine도 사용될 수 있다. 경증 및 중증도 환자에 대한 보조적 치료로는 식이요법, 운동, 광선요법, 정신치료, 일기 쓰기 등이 있다.

방어 기제와 관련한 최면감수성과 단어연상검사의 특징

황 걸 한국정신분석학회 2003 精神分析 (Psychoanalysis) Vol.14 No.1

남성 성기자해

김상훈 · 문남식 · 황걸 · 박상학 · 김학렬 · 김경환 조선대학교 의학연구원 2005 The Medical Journal of Chosun University Vol.30 No.2

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Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic Iron-Deficiency Anemia

배수진,황걸,강현식,송현주,장원영,맹영희,강기수 대한소화기내시경학회 2015 Clinical Endoscopy Vol.48 No.4

Cavernous hemangiomas of the gastrointestinal tract are extremely rare. In particular, the diagnosis of small bowel hemangiomas is very difficult in children. A 13-year-old boy presented at the outpatient clinic with dizziness and fatigue. The patient was previously diagnosed with iron-deficiency anemia at 3 years of age and had been treated with iron supplements continuously and pure red cell transfusion intermittently. Laboratory tests indicated that the patient currently had iron-deficiency anemia. There was no evidence of gross bleeding, such as hematemesis or bloody stool. Laboratory findings indicated no bleeding tendency. Gastroduodenoscopy and colonoscopy results were negative. To obtain a definitive diagnosis, the patient underwent capsule endoscopy. A purplish stalked mass was found in the jejunum, and the mass was excised successfully. We report of a 13-year-old boy who presented with severe and recurrent iron-deficiency anemia caused by a cavernous hemangioma in the small bowel without symptoms of gastrointestinal bleeding.

Sonographic Growth Charts for Kidney Length in Normal Korean Children: A Prospective Observational Study

오민수,황걸,한상훈,강현식,김승효,김영돈,강기수,신경수,이무숙,최국명,한경희 대한의학회 2016 Journal of Korean medical science Vol.31 No.7

Kidney length is the most useful parameter for clinical measurement of kidney size, and is useful to distinguish acute kidney injury from chronic kidney disease. In this prospective observational study of 437 normal children aged between 0 and < 13 years, kidney length was measured using sonography. There were good correlations between kidney length and somatic values, including age, weight, height, and body surface area. The rapid growth of height during the first 2 years of life was intimately associated with a similar increase in kidney length, suggesting that height should be considered an important factor correlating with kidney length. Based on our findings, the following regression equation for the reference values of bilateral kidney length for Korean children was obtained: kidney length of the right kidney (cm) = 0.051 × height (cm) + 2.102; kidney length of the left kidney (cm) = 0.051 × height (cm) + 2.280. This equation may aid in the diagnosis of various kidney disorders.

Long-term outcome of patients with p22phoxdeficient chronic granulomatous disease on Jeju Island, Korea

강현식,황걸,신경수 대한소아청소년과학회 2015 Clinical and Experimental Pediatrics (CEP) Vol.58 No.4

Purpose: This study investigated the long-term clinical outcomes of patients with p22phox-deficient chronic granulomatous disease (CGD) on Jeju Island and retrospectively evaluated the effects of interferon-gamma (IFN-γ) prophylaxis. Methods: The medical records of 15 patients with CGD were retrospectively reviewed. The efficacy of IFN-γ prophylaxis was evaluated by comparing the frequency of severe infections before and after starting continuous prophylaxis with IFN-γ. Results: At the time of the analysis, 14 patients were alive, with a median age of 14.3 years. The diagnosis of CGD was made at a median age of 2.4 years, and the median age at onset of severe infection was 0.3 years. Thirteen of the 15 patients had their first severe infection within the first year of life. The overall incidence of severe infection was 1.36 infections per patient-year; pneumonia, suppurative lymphadenitis, and skin and subcutaneous abscesses were the most common infections. Aspergillus species were the most frequently isolated microorganisms, present in 15.8% of isolates. IFN-γ did not significantly change the rate of severe infection. The survival rate for patients after 2 years of age was 93%; there was a prolonged survival plateau beyond the age of 2. Conclusion: Compared with cases of X-linked CGD reported in other studies, patients with CGD on Jeju Island did not show obviously different clinical manifestations, but they had a significantly higher survival rate. Further studies with a substantially longer period of observation, and with more patients under intensive surveillance are necessary to elucidate the prophylactic efficiency of IFN-γ.

유전적 불안정성과 세포 사멸사

김승곤,황걸 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Genome integrity and cell proliferation and survival are regulated by an intricate network of pathways that include cell-cycle checkpoints, DNA repair and recombination, and programmed cell death. Permanent or transient genomic instability, which represents one of the fundamental characteristics of cancer, might be ascribed to deficiencies in numerous cellular processes including mitotic-checkpoint regulation, and DNA-damage signalling and repair, as well as telomere maintenance and centrosome function. This review will focus on the complex interplay between genomic instability and apoptosis regulation that participates in carcinogenesis. The relationship between genomic integrity and cell-death regulation can follow at least three different non-exclusive patterns, all of which might be important for the development of cancer. First, genomic instability can lead to the mutation, or altered expression levels, of cell-death regulators. Second, disabled apoptosis can favor genomic instability. Indeed, numerous cellular mechanisms enforce the rule 'better dead than wrong', which means that cells that have a damaged genome or are afflicted by many disorders will be aborted by apoptosis - thereby avoiding the propagation of potentially oncogenic mutations. DNA double-strand breaks (DSBs), telomere dysfunction, illicit polyploidy or abnormal mitoses can directly trigger apoptosis through a default pathway. However, if apoptosis is inhibited for some reason, this increases the risk of chromosomal instability (CIN) at several levels, and cells that are sufficiently fit to survive can be at a growth advantage, which can lead to cancer. Third, a single protein or process might be involved in the control of both apoptosis and genomic instability, which allows 'crosstalk' between the processes. Here, we will discuss these different possibilities, their molecular mechanisms and their possible impact on carcinogenesis.

남성 성기자해

김상훈,문남식,황걸,박상학,김학렬,김경환 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: Intentional self-mutilation of the genitals in male is exceedingly rare. As the authors experienced 3 cases of male genital self-mutilation while psychotic, we investigated with psychiatric points of view including general and psychiatric characteristics of genital self-mutilation in Korea. Materials and Methods: Total 21 cases of the genital injury were obtained from the index book of Journal of Korean Neuropsychiatric Association and the Electronic Library Search Engine. From these, excluding the 4 accident-caused cases of penile amputation, the authors investigated 17 cases in terms of general epidemiological characteristics, the type of mutilation, diagnostic classification, psychodynamics of their behavior. Results: Epidemiological data showed that the most of the genital self-mutilation cases are twenties (52.9%); most are single (64.7%). In terms of the mutilation types, complete transection of penis type were committed most frequently (72.1%). The formal diagnoses were mainly schizophrenia (82.3%) and schizoid personality disorder(11.8%). Psychodynamically, lots of cases could be explained as to punish failures in the male role (20.6%), related to religiosity (14.7%), and related to physical pain or somatic illness (14.7%). Conclusion: We are unable to say exactly what prompts a man to divest himself of his genitals. On the basis of 17 cases, we are willing to hazard several risk factors. For individuals psychotic at the time of act there seem to be at least three paradigmatic at-risk groups: (1) younger acutely psychotic men with related to cure or punish failures in the male role, (2) the men with personality disorders who act rageful feelings against themselves and/or close objects, and (3) sociocultural factors known to contribute to such an act include some complex religious belief regarding purification or resisting temptation. Psychological factors yet undetermined may be' equally important.