한국인 여성 알코올 의존 환자의 단축효과에 관한 연구

김효정(Hyo-Jeong Kim),김성곤(Sung-Gon Kim),이덕기(Duk-Ki Lee),황인복(In-Bok Hwang),최용성(Young-Sung Choi),김정기(Jeong-Gee Kim),이해국(Hae-Gook Lee),제영묘(Young-Myo Jae) 대한생물치료정신의학회 2007 생물치료정신의학 Vol.13 No.1

목적 : 여성 알코올 의존 환자는 남성 알코올 의존 환자에 비하여 음주를 늦은 나이에 시작하더라도 알코올 의존으로는 더 빠르게 진행되었다는 단축효과의 선행 연구 결과들이 있다. 본 연구에서는 한국인 남녀 알코올 의존 환자를 대상으로 음주 시작시기와 알코올 관련 문제 발생 시기 등을 조사하여, 한국인 여성 알코올 의존 환자에서도 단축효과가 있는 지를 조사하였다. 방법 : 알코올 의존 환자 229명(남자 167명, 여자 62명)을 대상으로 병력지와 담당의사와의 면담을 통하여 대상자의 인구학적 특성 및 음주력에 대하여 조사하였다. 결과 : 1) 여성 알코올 의존 환자(이하 여성군)는 남성 알코올 의존 환자(이하 남성군)에 비하여 늦은 나이에 음주를 시작하였으나, 알코올 관련 문제가 처음 발생된 나이와 음주로 인해 처음 정신과 병원에 입원한 나이는 두 군간 차이가 없었다. 2) 최초로 음주를 시작한 후 알코올 관련 문제가 처음으로 발생될 때까지 걸리는 시간은 여성군에서 남성군에 비해 유의하게 짧았으며, 최초로 음주를 시작한 후 음주로 정신과에 처음 입원할 때까지 걸리는 시간도 남성군에 비해 여성군에서 유의하게 짧았다. 또 알코올 관련 문제가 처음 발생된 후부터 음주로 처음 정신과에 입원할 때까지 걸리는 시간도 여성군에서 유의하게 짧았다. 3) 여성군은 남성군에 비하여 평균 나이가 적었고, 음주 일일 평균 음주량이 적었다. 심각한 알코올 금단 병력이 있었던 경우 및 일차 친족에 알코올 의존의 가족력이 있었던 경우도 여성군에서 더 많았다. 결론 :이러한 결과는 한국인 여성 알코올 의존환자에서도 단축효과가 나타나는 것을 말한다. 따라서 남성에 비하여 여성 알코올 음주에 대한 치료자, 가족 및 사회의 관심이 더 필요할 것으로 생각된다. Objective : Previous studies have shown that in women, alcohol dependence develops faster than in men, even though women often start drinking at a later age than men. This is often referred to as the telescoping effect. The present study is based on data concerning the age of at which drinking began and the development of alcoholrelated problems in both male and female Korean alcohol-dependent patients. This study investigates whether the telescoping effect is present in female Korean alcohol-dependent patients. Methods : Through patients' histories and interviews with psychiatrists, information on dermographic characteristics and history of drinking were gathered in 299 alcoholic dependent patients(167males, 62females). Results : 1) Although the female alcohol-dependent patients(hereafter referred to as the female group) started drinking at later age than male patients(hereafter referred to as the male group), no difference was found regarding the time of the onset of alcoholic problems in both groups. 2) The t me at which the development of alcoholic problems occurred and the time at which patients were first admitted to a psychiatric hospital due to development of alcoholic problems was shorter in the female group than the male group. 3) The average age of th female group is younger than that of th male group. In addition, even though daily alcohol consumption per drinking day in the female group was smaller in terms of amount than in the male group, the female group had significantly more subjects having severe alcohol withdrawal syndrome. Also, there were more subjects who had first-degree relatives who have alcohol-related problems in the female group than in the male group. Conclusion : It has bean shown that the telescoping effect is also present in female Korean alcohol-dependent patients. Therefore, it is thought that more attention from physicians and family and more social interest should be given to female drinkers than to male drinkers.

알코올 의존 환자의 수면 장애와 하지불안증후군

이문인,정홍주,김한석,황인복,신재정,강상범,윤우상,김상훈,Lee, Moon-In,Jung, Hong-Joo,Kim, Han-Sok,Hwang, In-Bok,Sin, Jae-Jung,Kang, Sang-Bum,Yun, Woo-Sang,Kim, Sang-Hoon 대한수면의학회 2010 수면·정신생리 Vol.17 No.1

1) 알코올 의존 환자에서 불면은 68.6%의 환자들이 호소하고 있는 중요한 치료적 목표 중 하나이다. 2) 알코올 의존 환자에서의 불면과 관련된 중요한 원인은 RLS(38.4%)와 이와 흔히 동반되는 PLMD(34.9%)였다. 3) 지속되는 RLS 증상은 환자의 수면의 질적 저하를 가져오며, 불안과 같은 정서에 부정적인 결과를 가져온다. 이에 알코올 의존 환자에서 수면관련 장애들에 대한 진단적 고려와 적극적인 치료적인 접근이 반드시 필요하다. Objectives: We review the sleep problems of the alcohol dependence patients. Especially we are interested in the prevalence, the severity of symptoms, anxiety, depression, and sleep quality of restless legs syndrome (RLS) in the alcohol dependence patients. Methods: We recruit 86 alcohol dependence patients who were admitted from October 6th, 2008 to October 17th, 2008. We interviewed each patient and evaluated sleep questionnaires such as the Sleep Disorder Questionnaire (SDQ), the Pittsburgh Sleep Quality Index (PSQI) and the International Restless Legs Syndrome Study Group (IRLSSG) rating scale. The presence of RLS and its severity were assessed using the IRLSSG diagnostic criteria and the IRLSSG severity scale, respectively. Depression and anxiety were evaluated by the Beck Depression Inventory (BDI) and the Beck anxiety inventory (BAI). Results: Of all 86 patients, 59 patients have insomnia, 33 patients have RLS, 30 patients have Periodic limb movement disorder (PLMD), 29 patients have nightmare. RLS patients have more high score in the BAI ($21.70{\pm}10.36$ vs $14.67{\pm}11.98$), and their sleep quality was poor in the PSQI ($11.09{\pm}4.08$ vs $7.92{\pm}3.91$) than non-RLS patients. Conclusion: This study shows that alcohol dependence patients show many sleep problems such as insomnia and RLS. So we should notice that the sleep problems of alcohol dependence patients are important in clinical approach and treatment.

한국인 남녀 알코올 의존 환자에서의 알코올 대사 효소 유전자 다형성에 관한 연구

강철중(Cheol-Joong Kang),김성곤(Sung-Gon Kim),김현경(Hyeun-Kyeung Kim),황인복(In-Bok Hwang),변원탄(Won-Tan Byun) 대한생물치료정신의학회 2006 생물치료정신의학 Vol.12 No.1

Objective : Alcohol is metabolized in hepatocyte through alcohol dehydrogenase(ADH), microsomal ethanol oxidizing system (MEOS) and catalase. In cases of alcohol dependence, the activity level of the MEOS increases, especially Cytochrome P₄?? 2E1 (CYP2E1). The goal of this study was to investigate whether the CYP2E1 polymorphism is associated with alcohol dependence, and to investigate gender differences in the frequencies of CYP2E1 genotypes and allels. Method : The subjects were Korean male(n=104) and female(n=40) alcohol dependent patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-Ⅳ). Control groups were healthy Korean male(n=79) and female(n=59) subjects who do not drink over five standard drinks per month. Subjects' CYP2E1 polymorphisms(RsaⅠ+PstⅠ, OraⅠ and TaqⅠ) were determined by a polymerase chain reaction(PCR) and restriction fragment length polymorphism (RFLP). Results : 1) In male subjects, there was no association between alcoholics and control groups in the genotype frequency and the allele frequency of the three polymorphisms of CYP2E1. 2) In female alcoholics, the frequency of the A1A1 and A1A2 genotypes of the Taql polymorphism was significantly higher than in the female control groups(df=2, χ²=6.42, p=0.04), while other frequency levels of genotypes and alleles were not significant. Conclusion : These findings suggest genetic associations between CYP2E1 polymorphism and female alcohol dependence but not male. 목적 : 알코올 의존의 발생에서 유전적 원인이 남녀간에 다를수 있음을 보여주는 선행 연구 결과들이 있다. 따라서 알코올 대사 효소 유전자들의 유전적 중요성이 남녀간 차이가 있을 것이라는 가설 하에 한국인 알코올 의존 환자와 정상인을 대상으로 cytochrom P4502El(CYP2E1) 유전자의 5’ -flank 부위(제한효소 Rsa Ⅰ과 Pst Ⅰ), intron 6 부위 (제한효소 DraⅠ) 및 intron 7 부위 (제한효소 Taq Ⅰ)의 유전자형의 빈도를 조사하고 남녀 각각 차이가 있는지를 비교 분석하였다. 방법 : 알코올 의존 환자 144명 (남자 104명, 여자 40명)과 정상인 138영(남자 79명, 역자 59명)을 대상으로 CYP2E1유전자의 5’ -flank 부위(제한효소 Rsa Ⅰ과 Pst Ⅰ) 의 c1c1과 c1c2 및+c2c2(이하 c2+) 유전자형, intron 6 부위(제한효소 Dra Ⅰ) 의 DD와 DC+CC(이하 C+) 유전자형 및 intron 7 부위(제한효소 Taq Ⅰ) 의 A2A2와 A2A1+A1A1(이하 A1+) 유전자형에 빈도를 남녀 각각 비교하였다. 유전자형의 분석은 말초혈액 백혈구에서 DNA를 분리한 후 PCR-RFLP 방법을 이용하여 실시하였다. 결과 : CYP2E1 유전자의 5’ -flank 부위의 유전자형의 빈도와 intron 6 부위 유전자형의 빈도에서는 남자 혹은 여자 알코올 의존환자 모두 남자 혹은 여자 정상대조군과 유의한 차이가 없었다. 한편, intron 7 부위 유전자형의 빈도에 있어서는 여자 알코올 환자가 여자 정상대조군에 비하여 A1A1, A1A2의 빈도가 유의하게 높게 나타났으나, 남자는 유의한 차이가 없었다. 결론 : 이러한 결과는 여성에서의 알코올 의존 발생에 CYP2E1 유전자의 intron 7 부위(제한효소 Taq Ⅰ) 유전적 다형성이 중요하다는 것을 제시하고 있다.

사회적 변화에 따라 정신질환자들의 피해망상 속에 나타난 박해자 유형변화

강승범,황인복,김한석,김승곤,김학렬,박상학,김상훈,황걸 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

Objective: The authors investigated the frequency of persecutors in persecutory delusions of the psychiatric patients who didn't undergo the arrest or traumatic injury, reside in Gwangju Jeonnam area, and were admitted to the hospital after the 5.18 prodemocracy movement in Gwangju in 1980 upward 10 years. Also this study investigated the frequency of the persecutors before and after the prodemocracy movement and in capital and Gwangju Jeonnam area. Subjects and Methods: Among the 896 patients who were admitted to department of psychiatry, Chosun University Hospital from Jan. 1. 1989 to Dec. 31. 1991, we choosed 144 patients with persecutory delusion who had lived in Gwangju Jeonnam area for 10 years after 5.18 prodemocracy movement as subjects. Persecutors were classified into 7 class: unspecified, family, neighbors, communist or spy, police or army or secret agent, impersonal, others. Results: 1) In our study, the frequency of persecutors was family, unspecified, neighbors, police or army or secret agent, impersonal, others, communist or spy in descending order. As compared to previous studies (1956-2003) including our study about frequency of persecutor at capital area and Gwangju Jeonnam area, and before and after 5.18 prodemocracy movement, 2) At capital area, in the early 1980s, police, family, neighbors, unspecified person was frequent in descending order. In the both of early 1970s, 1990s, neighbors, family, unspecified person, police was frequent in descending order. 3) At Gwangju Jeonnam area, in the early 1970s, family, unspecified person, neighbors, police was frequent in descending order. In the early 1990s, unspecified person and family, neighbors, police was frequent in descending order. 4) The police class was most frequent at capital area in the early 1980s. Conclusions: We suppose that class of persecutor in persecutory delusions of psychiatric patients are changing according to social change, and frequency of police class was decreasing in both of capital and Gwangju, Jeonnam area.

한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

과산화수소의 정량을 위한 토끼의 간-조직 전극

황인복,권효식,김두영 충북대학교 과학교육연구소 2002 과학교육연구논총 Vol.18 No.1

The response characteristics of the new biosensor developed by the co-immobilization of rabbit liver tissue and ferrocene in a carbon paste matrix for the amperometric determination of hydrogen peroxide were evaluated. In the range of electrode potential examined (-0.35∼-0.05V vs. Ag/AgCl), the length of the response was relatively short (t95% = 12 s) and it responded in the wide range of pH and its biocatalytic stability was superior. Also, it's detection limit was 2.25×10­5M (S/N=3) and it had relatively good selectivity to the materials considered to disturb the response. The result of this study using rabbit liver tissue can be utilized as the basic informatin for the determination of hydrogen peroxide.

알코올효과에 대한 인지적인 기대가 음주행동에 미치는 영향

황인복,이민규,주경채 大韓神經精神醫學會 1993 신경정신의학 Vol.32 No.6

This study was conducted to assess the relationships between a person's expectation about the effects of alcohol and their drinking behavior. A questionaire inquiring the anticipated effects of alcohol was administered to 41 alcoholic male patients and 56 nonpatient male adults, including 45 subjects with drinking problems and 11 subjects with light drinkers. The questionaire showed that problem drinkers expected alcohol to enhance social pleasure more than did light drinkers and alcoholics. In the analysis of expectancy about alcohol's tension reduction effects, alcoholics expected alcohol to reduce their tension more than did light drinkers and problem drinkers. These results suggest that anticipated reinforcement influence people's drinking behavior, which then suggest that it may be more effective to explore personal expectancy of alcohol while assessing and treating alcohol related problems.