주정 의존 환자의 충동성 및 스트레스 내인력

남궁기,이희상,전종호,현명호,천덕희,유계준 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.3

충동성과 스트레스는 주정 의존의 원인, 증상 혹은 위험 요인이나 재발 요인으로서 논란의 대상이 되고 있으나, 현재까지 국내에서는 이에 관한 연구가 없다. 따라서 만일 주정 의존의 원인 및 재발 요인으로 생각되는 충동성과 스트레스 내인력이 주정 의존 환자군과 대조군 사이에 의미 있는 차이가 나타난다면 주정 의존의 치료에 있어서도 충동성을 낮추고 스트레스 내인력을 증가시키는데 초점을 두는 새로운 사회 기술 훈련 방법 등을 고안 적용함으로써, 보다 효과적인 치료를 제공할 수 있을 것으로 생각된다. 이러한 배경에서 본 연구가 계획되었다. 이에 본 연구의 목적은 국내 주정 의존 환자군을 대상으로 하여 주정 의존 환자군은 대조군에 비해 충동성의 경향이 유의하게 높을 것이고, 스트레스 내인력이 유의하게 떨어질 것이라는 가설을 검정하므로써, 주정 의존군과 대조군 사이에서 충동성과 스트레스 내인력에 어떤 차이가 있는 지를 알아보는 것이다. 본 연구에서는 29명의 주정 의존 환자군과 29명의 대조군을 연구 대상으로 하였다. 충동성을 측정하기 위해서 충동성 척도(impulsivity scale)와 인식력 검사(Cognitrone test)를 사용하였다. 연구 결과 충동성 척도 검사에서 주정 의존군은 전체 충동성 및 무계획 충동성과 운동 충동성이 대조군에 비해 통계적으로 유의하게 높았다(p<0.05). 인식력 검사에서는 주정 의존군이 대조군에 비해 틀린 문항 수가 통계적으로 유의하게 많았는데(p<0.05) 이는 주정 의존군의 충동성이 높음을 시사한다. 운동 결정력 검사의 소검사-3에서 주정의존군이 대조군에 비해 시간 내에 반응한 옳은 반응의 수가 통계적으로 유의하게 적었으며(p<0.05), 이는 주정 의존군의 스트레스 내인력이 떨어짐을 시사한다. 이러한 본 연구의 결과는 주정 의존 환자가 정상인에 비해 충동성이 높고, 스트레스 내인력이 떨어진다는 기존의 연구 결과들과 일치한다. 이러한 결과들을 통해 볼 때 주정 의존 환자의 치료와 예후의 판단 및 치료 효과의 평가에 충동성과 스트레스 내인력을 그 지표로 사용할 수 있을 것이다. This study was attempted to make a comparison of the impulsivity and the stress tolerance between patients with alcohol dependence(alcoholic group) and control subjects(control group). The author examined 29 alcoholics and 29 control subjects by the impulsivity scale, Cognitrone test and Determination Unit test. The results were summarized as follows : The scores of IMPM(impulsivity-motor), IMPP(impulsivity-nonplanning) and IMP(impulsivity-total score) were significantly higher in alcoholic group than in control group(10.00±5.43 vs 6.38±4.84, t=2.56, d.f.=51, p<0.05 ; 15.22±6.68 vs 10.77±5.87, t=2.53, d.f.=51 p<0.05 ; 36.67±13.20 vs 27.12±11.73, t=2.78, d.f.=51, p<0.05). The number of incorrect responses(Incorrect) of the Cognitrone test was significantly higher in alcoholic group than in control group(25.52±13.26 vs 17.83±7.30, t=2.47, d.f.=43.53, p<0.05 in Student t-test). The number of timely right responses of the Determination Unit test, subset-3 was significantly lower in alcoholic group than in control group(62.79±43.13 vs 90.79±52.02, t=-2.23, d.f.=56, p<0.05 in Student t-test). These results mean that the impulsivity is higher and the stress tolerance is lower in alcoholic group than in control group. With these results, the impulsivity and the stress tolerance in alcoholic patients can be used as indicator of their treatment efficacy and prognosis.

일 대학병원에서 양극성장에 환자의 흡연 특성 : 정신분열병 환자와의 비교 연구

이강수,천덕희,김지혜,김현진,조현상 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : This study aimed to investigate smoking characteristics and nicotine dependence severity in bipolar disorder Comparing those of schizophrenia. Methods : 70 bipolar and 123 schizophrenic patients, diagnosed using DSM-IV-TR criteria and treated at the Severance Mental Health Hospital, were interviewed regarding socio-demographic variables, smoking characteristics and Fagerstrom Test for Nicotine Dependence (FTND), designed to evaluate the intensity of smoking. Results : The rate of current smoking was 60.0% in the bipolar group, and 50.4% in the schizophrenia group. No significant difference was seen in terms of the rate of current smoking between the groups. Rates of having ever smoked also did not differ between bipolar (73%) and schizophrenic patients (65%). Daily cigarette consumption of bipolar patients (15.9 cigarettes/day) was significantly lower than that of schizophrenic patients (21.2 cigarettes/day), but FTND score didn't appear to differ between bipolar and schizophrenic patients. Bipolar females showed higher rate of current smoking (44%) than schizophrenic females (17%). Among bipolar patients, antipsychotics dose was not correlated with daily cigarette consumption and FTND total score. Age of disease onset didn't appear to differ between smokers and non-smokers in bipolar group. Conclusion : Although daily consumption was significantly lower in the bipolar group, the rate of smoking and smoking severity in bipolar disorder were as high as in schizophrenia. This fact suggests that the bipolar disorder might be related to the nicotinic acetylcholine system dysfunction as like schizophrenia.

중추성 요붕증이 동반된 랑게르한스 세포 조직구증 1예

김진호,문준성,문선중,이지은,최재원,은미정,천경아,조인호,윤지성,원규장,이경희 신덕섭,이형우 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased form 109mOsmol/Kg to 327mOsmol/Kg (300%). Brain MRI showed a thickened pituitary stalk and at hot bone CT.CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes, The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

Epidural Hematoma after Incidental Removal of an Epidural Catheter in a Patient Receiving Enoxaparin

( Duk-hee Chun ),( Jong Chan Kim ),( Sun Ok Kim ),( Eunsun So ),( Seongsu Kim ),( Sowoon Ahn ) 경희대학교 경희의료원 2016 慶熙醫學 Vol.31 No.1

We report a case of an epidural hematoma following a combined spinal-epidural anesthesia and analgesia. A patient undergoing total knee arthroplasty was postoperatively treated with enoxaparin for thromboprophylaxis. The patient developed the neurologic symptoms after 14 hours from the unintentional removal of an epidural catheter. And the diagnosis was delayed for 28 hours after the appearance of the first symptoms. The neurological recovery was complete even though the evacuation of the hematoma was only performed 30 hours after the appearance of the initial symptoms. One must pay attention to the delayed onset of neurologic symptoms when epidural catheters are removed earlier than intended during thromboprophylaxis. Prolonged close neurological observation, an additional fixation method and prophylactic protamine reversal may be considerable to manage the patients who use enoxaparin.

Heparin responsiveness during off-pump coronary artery bypass graft surgery: predictors and clinical implications.

Chun, Duk-Hee,Baik, Seong-Wan,Kim, So Yeon,Shim, Jae Kwang,Kim, Jong Chan,Kwak, Young Lan Science Press 2011 Acta pharmacologica Sinica. Vol.32 No.1

<P>Aim:To evaluate the clinical impact of reduced heparin responsiveness (HR(reduced)) on the incidence of myocardial infarction (MI) following off-pump coronary artery bypass graft surgery (OPCAB), and to identify the predictors of HR(reduced).Methods:A total of 199 patients scheduled for elective OPCAB were prospectively enrolled. During anastomosis, 150 U/kg of heparin was injected to achieve an activated clotting time (ACT) of ??00 s, and the heparin sensitivity index (HSI) was calculated. HSIs below 1.0 were considered reduced (HR(reduced)). The relationships between the HSI and postoperative MI, cardiac enzyme levels and preoperative risk factors of HR(reduced) were investigated.Results:There was no significant relationship between the HSI and cardiac enzyme levels after OPCAB. The incidence of MI after OPCAB was not higher in HR(reduced) patients. HR(reduced) occurred more frequently in patients with low plasma albumin concentrations and high platelet counts.Conclusion:HR(reduced) was not associated with adverse ischemic outcomes during the perioperative period in OPCAB patients, which seemed to be attributable to a tight prospective protocol for obtaining a target ACT regardless of the presence of HR(reduced).</P>

부랑인복지시설 종사자들의 인권민감성에 관한 연구

천덕희(Chun Duk-Hee),오영림(Oh Young-Rim),정선영(Jung Sun-Young),공상길(Kong Sang-Gil),임은경(Im Eun-Kyung) 한국사회복지학회 2010 한국사회복지학 Vol.62 No.1

본 연구는 부랑인복지시설 종사자들의 인권의식의 정도를 파악할 수 있는 인권민감성을 조사함으로써 그들의 인권의식을 살펴보고 부랑인복지시설 생활인의 인권의식 향상을 위한 기초 자료로 활용함을 목적으로 하였다. 전국 38개 부랑인복지시설 종사자 390명의 인권민감성을 비교ㆍ조사하였다. 그 결과, 종사자들의 인권민감성은 총점 150점에 평균 64.55점으로 매우 낮은 점수를 나타냈다. 종사자들의 학력별 인권민감성은 유의미한 차이를 보이고 있었으며, 직책별 인권민감성에서 실질적인 운영자들의 인권에 대한 의식이 매우 낮게 나타났다. 부랑인복지시설 내에서의 인권교육 유무별에서는 인권교육을 받은 경우가 그렇지 못한 경우에 비해 유의하게 인권민감성이 높은 것으로 나타났다. 따라서 부랑인복지시설 내의 인권교육을 정규 커리큘럼으로 일괄적으로 시행할 수 있는 프로그램이 정례화 되어야 하고 종사자들의 효율적이고 실질적인 인권침해상황과 관련된 사례나열식 인권교육 매뉴얼의 개발이 필요함을 제언하였다. This study did by purpose to be utilized to basic data for elevation of human rights consciousness of homeless facilities employees through examining their human rights consciousness by investigating human rights sensitivity that can grasp degree of human rights consciousness of homeless facilities employees. The human rights sensitivity of 390 homeless facilities employees who are working at 38 facilities around the whole country is compared and investigated. As a result, human rights sensitivity of employees displayed very low score by average 64.55 points in total score 150 points. Human rights sensitivity academic career of employees was shown meaningful difference, and human rights consciousness of substantial administrator is appeared very low in human rights sensitivity by duties. According to the existence and nonexistence of human rights education at the homeless facilities, the employs who had got human rights education shows higher human rights sensitivity than the employs who had not go human rights education. Therefore, regular program that can enforce human rights education collectively as a formal curriculum in homeless facilities should be established and it’s proposed to develop practical and efficient human rights education manual case by case related with the violation of human rights.

증례보고 : 승모판 부전 환자에서 간정맥으로 이탈된 폐동맥 카테터

전덕희 ( Duk Hee Chun ),정금희 ( Kum Hee Chung ),이종연 ( Jong Yun Lee ),송지은 ( Ji Eun Song ),김준영 ( Jun Young Kim ),이정향 ( Jung Hyang Lee ),박정현 ( Chung Hyun Park ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5

A 47-year-old woman was scheduled for mitral valvoplasty. Before induction of anesthesia, a pulmonary artery catheter (PAC) was placed via right internal jugular vein. Central venous pressure or right atrial pressure was traced until about 60 cm of PAC insertion and right ventricular pressure curve appeared without arrhythmias. We withdrew and advanced the catheter several times, but pressure tracing showed the same pattern. And we could not obtain the pulmonary artery pressure. We decided to leave the PAC in the right ventricle. No ventricular arrhythmia was detected. Postoperative chest x-ray revealed that PAC traveled through inferior vena cava and looped in the hepatic vein with the tip of the catheter in the right ventricle. Under fluoroscopic guidance, PAC was inserted to the pulmonary artery. No sign of hepatic vein obstruction was detected. (Korean J Anesthesiol 2009;57:633∼6)

Clinical Research Article : The relationship between symphysis-fundal height and intravenous ephedrine dose in spinal anesthesia for elective cesarean section

( Sung Hee Chung ),( Hyeon Jeong Yang ),( Jong Yeon Lee ),( Kum Hee Chung ),( Duk Hee Chun ),( Byeong Kuk Kim ) 대한마취과학회 2010 Korean Journal of Anesthesiology Vol.59 No.3

Background: A decreased lumbosacral subarachnoidal space volume is a major factor in the cephalad intrathecal spread of local anesthetics in term parturients and their subarachnoidal space is decreased due to the compressive effect of huge uteri. Therefore, they show a higher level of sensory block and hypotensive episodes. The purpose of this study is to investigate whether the symphysis-fundal height (SFH) correlates with the highest sensory level and the amount of ephedrine administered under spinal anesthesia. Methods: Fifty-two uncomplicated parturients who consented to spinal anesthesia for elective cesarean section were studied. The SFH of all parturients had been measured just before the spinal anesthesia administered by one person. Hyperbaric bupivacaine with fentanyl 20 μg, was administered for spinal anesthesia. The amount of 0.5% bupivacaine was adjusted according to the patient`s height and weight. The level of sensory block and the amounts of ephedrine to treat hypotension, nausea and vomiting were assessed. Linear regression and correlation analysis were applied to analyze the data. Results: According to the results of correlation analysis, there was no significant correlation between the level of sensory block and SFH. There were statistically significant positive correlations between the amount of ephedrine administered due to hypotension and SFH. Conclusions: In term parturients choosing elective cesarean section, the SFH is not correlated with the sensory level of spinal anesthesia, but is correlated with the amount of ephedrine administered during spinal anesthesia. (Korean J Anesthesiol 2010; 59: 173-178)

Changes of Pigment Composition and Potential Quantum Yield in ‘Changhoweonhwangdo’ Peach (Prunus persica) Leaves to a Shade-to-sun Transition by Summer Pruning

Duk Jun Yu,Sun Woo Chung,Ju Young Hwang,Min Kyo Chun,Seok Kyu Yun,Hee Jae Lee 한국원예학회 2013 한국원예학회 학술발표요지 Vol.2013 No.10

각종 습진 환자에 있어서 0.25% prednicarbate 연고의 임상효과

전덕규,은희철,조광현,윤재일,이유신 최신의학사 1991 最新醫學 Vol.34 No.5