기관지천식 환자의 정신신체의학적 특성 : Focused on Alexithymia 감정표현불능증을 중심으로

이종명,김상헌,임효덕 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.1

본 연구는 감정표현불능증적 성격 경향이 정신신체질환을 가진 환자들의 고유한 성격적 특성인지를 알아보기위해, 단일 신체 질환인 기관지천식 환자군에서 지금까지 알려진 여러 가지 도구들을 사용하여 감정표현 불능증을 중심으로 한 정신신체의학적 특성들을 확인해보고자 하였다. 정상군(30명), 기관지천식 환자(30명), 정신분열증 환자(30명) 그리고 신경증 환자(33명)를 대상으로 하여 각 장애를 가진 환자들의 감정표현불능증적 경향을 알아보기 위하여 정신의학적 면담과 BIQ, MMPI-A, TAS, 주제통각검사를 실시하였고, 각 군의 특징적인 성격 경향 그리고 내재하는 정신병리를 확인하기 위하여 MMPI와 SCL-90-R을 시행하였다. MMPI와 SCL-90-R에서 각 군은 정상 범위안에 있었는데, 신경증 환자군의 정신병리의 수준이 가장 높았고 정상군이 가장 낮았다. 기관지천식 환자군과 정신분열증 환자군은 양 극단 사이의 중간 수준을 보여주었다. BIQ 평균점수에서 기관지천식 환자군이 정상군에 비해 유의하게 높았으며(p<0.05), 다른 군간에는 유의한 차이가 없었다. MMPI-A 평균점수 및 TAS 전체 합산 점수 모두에서 각 군은 정상군과 유의한 차이가 없었다. 주제통각검사에서 신경증 환자군은 가장 많은 정동 어휘를 기록하였지만 정상군과는 유의한 차이가 없었는데 비해, 기관지천식 환자군과 정신분열증군 환자군보다 유의하게 많은 정동 어휘 수를 기록하였다(p<0.0001). 즉 기관지천식 환자군은 감정표현불능증적 경향이 주제통각검사에서는 신경증 환자군에 비해서 유의하게 많고(p<0.001), BIQ에서는 정상군에 비해서 유의하게 많은 것으로 나타났으나(p<0.05), TAS, MMPI-A 검사 상에서는 정상군을 포함한 다른 대조군들과 유의하게 구분되지 않았다. 이러한 소견에 따라 본 연구는 감정표현불능증이 기관지천식 환자군만의 특징적 성격 특성이라는 추정에 대한 확실한 답을 얻지는 못하였지만, BIQ는 정상군과 정신신체질환군을 변별하는 데, 그리고 주제통각검사는 신경증군과 정신신체질환군간의 관계를 변별하는 데에는 유용함을 확인하였다. 본 연구는 대상의 수가 적고 보다 다양한 정신신체질환을 대상으로 하지 못하였다는 제한점을 가지고 있지만, 다음과 같은 4가지 연구 방향을 결론 내릴 수 있을 것이다. 첫째 향후 정신신체의학 연구에 있어서 다양한 집단 속에 존재하는 감정표현불능증을 감별해내는 데 있어서 각 도구들이 가진 특정한 변별 특이성을 고려하여 단일 도구가 아닌 각 도구들의 집합체를 종합적으로 이용해야 할 필요성, 둘째 향후의 연구로서 대규모 임상연구에 의한 정신신체질환과 정신병적 상태와의 관련성에 관한 연구, 셋째 외국 검사 도구들의 국내 임상에의 적용 과정에서 보다 철저한 신뢰도 및 타당도 검증과 한국화에 대한 연구 그리고 국내 독창적인 도구의 개발, 넷째 감정표현불능증적 경향이 실재로 정신신체질환에만 특정적으로 존재하는 성격적 소인이 아닐 가능성과 이런 방향으로의 국내 정신신체의학 연구 등이 그것이다. 앞으로 다양한 정신신체질환에서 감정표현불능증과 다른 정신과적 질환과의 관계에 대한 다각도의 연구와 함께 한국적인 상황에서 감정표현불능증을 평가하는 보다 신뢰성 있고 타당성 있는 도구의 개발이 필요할 것으로 생각된다. This study is designed to evaluate psychosomatic characteristics, especially alexithymic tendency, of the patients with bronchial asthma and to determine whether alexithymia is a unique personality characteristic of the patient with classical psychosomatic disorder, using various methods developed for measurement of alexithymia. Thirty normal healthy persons, thirty patients with extrinsic bronchial asthma, thirty schizophrenic patients, and thirty-three neurotic patients were studied to assess differences in alexithymic tendency using the methods of thirty minute psychiatric interview, BIQ, MMPI-A, TAS and TAT. They were also assessed by MMPI and SCL-90-R to evaluate general personality traits and underlying psychopathology. All the groups were in the normal range of the scores of MMPI and SCL-90-R. The neurotic patients showed the highest level of psychopathology, and the normal group the lowest in both inventories. Bronchial asthma and schizophrenic patients, were between the highest and the lowest extremes of the scores. The mean score of BIQ in the bronchial asthma group was significantly higher than that in the normal group(p<0.05) and no difference was found among the other groups. The mean scores of MMPI_A and the total scores of TAS showed no difference among all the groups. In TAT the neurotic patients scored the highest in affect word counts and showed significantly higher counts than ther bronchial asthma patients and schizophrenic patients(p<0.0001), while they showed no significant difference with normal persons. That is, in TAT the group of bronchial asthma had more alexithymic tendency than that of the neurotic patients(p<0.0001), and in BIQ it had more alexithymic tendency than that of normal(p<0.05). Bronchial asthma patients were found to express less emotional words than normal persons and neurotic patients, but were not differentiated any more from groups of the schizophrenic, neurotic, and normal by TAS and MMPI-A. The authors with the inconsistent results of this study, could not confirm the assumption that alexithymia is the personality characteristic of patients with classical psychosomatic disease. But we found that BIQ was useful in discriminating between the groups of normal and psychosomatic disease, and TAT was useful in discriminating between the groups of neurosis and psychosomatic disease with alexithymia construct. This study has some limitations in the number of subjects and the diversity of psychosomatic diseases, but in spite of those limitations the findings of this study suggest some considerations are needed for further investigation. They are as follows: First of all, a study on the need of the combination of multiple tools in consideration of the specific discriminating ability of each tool ; secondly, a clinical study on the relationship between pychosomatic diseases and the psychotic state in a large population ; thirdly, a study on the applications of foreign tools in the Korean culture and on the problem of the validity and reliability of such tools ; and a study is needed on the possibilities that alexithymic tendecy is not a specific predisposing factor of personalities with psychosomatic disorder. It is thought that more variegated studies on the relationships between diverse psychosomatic diseases and alexithymia, and on the development of reliable tools with validity in the measurement of alexithymia in the context of the Korean culture should be taken in further investigations.

일반인의 환경문제 의식과 사회환경교육의 필요성에 관한 연구

허명,최돈형,박소현,성효현,박석순,남상준,이숙임 이화여자대학교 환경문제연구소 1998 이화환경연구 Vol.2 No.-

Today, the gobal community is confront serious environmental crisis derived from related problems energy and resources. To deal this crisis, people must take action in order to preserve current environment with ecological understanding of the relationship between human and environment. The principle of this thesis is to observe public endeavor toward environmental education program, environmental perception and environmental preservation behavior, and the influential factors to those conducts. First of all, we will look into the perception toward environmental deterioration, environmental perception, environmental preservation behavior which thought to be a ground solution to lesson the problems, and then the environmental education program. In accordance with those research, it will be presented the feasible directions of environmental education program for general public. This research consists of 10 topics. The topics are the interests of public about environmental problem, perceived pollution level, general knowledge about environment, perception related to environmental problem, opinions about the environmental education program, attitude towards environmental organization, suggestions for future environmental education program, and campaign for environmental preservation. Through the research, we have reached some analytical conclusions are followed: First, the level of public concerns about environmental problems is high regardless its age and sex, and the level has been growing compared to the past one. The result also shows that people in urban and industrial areas feel much more seriously pollution problems than those in rural and coastal areas. In addition, according to the survey result, household and industrial sewage are regarded as the primary causes for water pollution. Secondly, the results show general public's understanding on environment have been universalized and thus the level of common knowledge on global environment has been increased, as environmental problems have been raised by newspapers and mass medias and various movements have been accomplished by environmental protection organizations. Thirdly, although the necessity of environmental education was emphasized the purpose of environmental education was unclearly appeared. Furthermore, actual participation to the environmental education program and taking courses by joining environmental organizations were rarely shown. Although some cases have the experience of taking education courses, the negative reactions came out in the opinion of education content and methodologies. Fourthly, the analysis on curriculum of future environmental education show various opinions. The attentions have drawn on the dealings of waste industrial and chemical waste which will cause environmental problem artificially, as well as on global environment, or natural environment such as resources, land, water, atmosphere. The results show many people recognized administration extent such as environmental policy, law and ethics as environmental categories. This implies the curriculum of those areas have not been properly founded and further researches should be followed. From above results, environmental problems should not be regarded as simple problems and it should bring out new recognition for general public in everyday life. In addition, environmental education courses, with practical environmental preservation should be developed and programs and organization which will utilize those educational materials should be more activated.

치과주조용 Ag-Pd-Zn-Sn-In 합금의 시효경화 특성

이재호,김명진,이희경,김형일,설효정 大韓齒科器材學會 2004 대한치과재료학회지 Vol.31 No.1

Cu가 첨가되어 있지 않고, 대신에 상대적으로 많은 양의 Zn 그리고 소량의 Sn과 In이 첨가된 치과주조용 Ag-Pd-Zn-Sn-In 합금의 시효경화 특성을 경도 시험, X선회절 실험, 주사전자현미경 관찰, 전자탐침 미소분석법으로 조사하여, 다음과 같은 결과를 얻었다. 1. 950℃에서 용체화처리된 시편을 500℃와 550℃에서 등온시효처리하면, 시효 초기에 경도가 완만히 상승하여 최고 경도에 도달하였고 최고 경도를 일정 기간 유지하고 나서 서서히 하강하였다. 2. 용체화처리된 시편은 Pd 원자가 고용된 Ag-rich α1상, Pd3Sn인 α2상, Pd2Zn인 α3상의 3상 공존이었고, 등온시효처리함에 따라 Ag-rich α1상에서 Pd-rich 상으로 추정되는 β상이 석출하였다. 3. 시효 초기의 경화는 Ag-rich 기지에서 Pd-rich 상의 석출로 인한 격자변형에 기인하는 것으로 추정된다. 4. 시효처리 시간을 연장함에 따른 과시효 연화는 입계에 Ag-rich α1상과 Pd-rich β상으로 된 층상조직의 석출과 조대화에 기인하였다. 5. Pd3Sn인 α2상과 Pd2Zn인 α3상은 시효경화에 기여하지 않았다. Age-hardening characteristics of a dental casting Ag-Pd-Zn-Sn-In alloy without copper (52.0 wt% Ag - 39.9 wt% Pd - 4.0 wt% Zn - 2.0 wt% Sn - 2.0 wt% In - 0.1 wt% Ir) was investigated by means of hardness test, X-ray diffraction study, scanning electron microscopic observations and electron probe microanalysis. The specimen solution-treated at 950℃ was three phases of the Ag-rich α1 phase containing Pd element, the α2 phase based on Pd3Sn and the α3 phase based on Pd2Zn, and the Pd-rich β phase was precipitated from the Ag-rich α1 phase by the isothermal ageing,. The initial hardening seemed to be attributed to coherency strains which were formed in the Ag-rich matrix by the precipitation of Pd-rich phase. Overageing with softening was due to the formation and coarsening of the lamella precipitates at grain boundaries, which were composed of the Ag-rich α1 and Pd-rich β phases. The α2 phase based on Pd3Sn and the α3 phase based on Pd2Zn did not contribute to the age-hardening of this alloy.

Risperidone 조기 중단군 및 장기 유지군의 임상적 특성 비교

김광수,박원명,전태연,배치운,김대진,백인호,이철,김정수,한상익,최보문,장계호,고효진 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : Risperidone 투여후 조기 중단한 환자들과 장기적으로 계속 risperidone을 복용하고 있는 환자의 임상적 특성을 평가하고 나아가 risperidone장기 유지와 조기 중단의 요인을 분석하고 정신병리가 약물 투여에 미치는 영향을 조사하고자 하였다. 방 법 : 연구 대상자는 1996년 1월부터 1996년 12월까지 가톨릭대학교 의과대학 부속 8개 병원 정신과에서 risperidone을 투여 시작한 환자 580명중 DSM-IV기준에 의해 정신분열병으로 진단받고 투여 기간이 6개월 미만(조기 중단군)이거나 2년 이상(장기 유지군)을 경과하였으며 의무기록의 누락이 없는 210명을 선정하였다. 두 군간 임상적 특성을 조사하기 위하여 인구학적 변인, 정신병리학적 변인, 약물 투여기록 및 부작용 등을 과거 의무기록을 근거로 평가하였다. 결 과 : 대상환자 210명 중 조기 중단군이 67명(31.9%)이었고 장기 유지군은 143명(68.1%)이었으며 두 군간 인구학적 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 최대 용량은 유의한 차이가 없었으나 유지용량은 조기 중단군에서 4.49(±1.44)mg,장기 유지군에서 3.67(±1.50)mg으로 유의한 차이가 있었다(t=3.698, p<0.05). 또한, 이전 항정신병약물의 사용 기왕력 변인에서 조기 중단군은 기왕력이 없는 환자가 39명(58.2%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 27명(40.3%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 1명(1.5%)이었고, 장기 유지군은 기왕력이 없는 환자가 58명(40.6%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 77명(53.8%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 8명(5.6%)으로 유의한 차이가 있었다.(x²=6.559, df-=2, p<0.05). 결 론 : 본 연구결과에 의하면 가급적 환자 상태에 따라 낮은 최적 치료 용량을 투여하는 것이 장기잔의 투여를 바람직한 것으로 생각된다. 본 연구와 같은 대규모의 후향적 자연적 연구는 일반 실제 진료에서 risperidone의 효과 및 기타 다른 측면에서의 유용한 정보를 얻을 것으로 기대된다. Objective : This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. Method : Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. Results : Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The stating and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency amtipsychotic use was 27(40.3%), and the number of no previous use of antipsychotic was 58(40.6%), the number of high potency ntipsychotic use was 77(53.8%), the number of low potency antipsychotic use was8(5.6%) in long-term maintained group.(x²=6.559, df-=2, p<0.05). Conclusions : According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practial field.

중등체육교사의 수업현황및 학교체육실태

민춘기,이명효,임종은 忠南大學校體育科學硏究所 1994 體育科學硏究誌 Vol.12 No.1

In this study, researcher examined 50 phys:(a) teachers to check the dismissing class caused by teachers official trip and rate of missing lecture and supplementary lecture of physical class. Also, the researcher analysised the learning contents classified by learning territory and mode condusions and suggestions like followings. 1. The rate of physical teachers' official trip is outstanding on October by 166per a month (M=3.32) And September, May, July, June are followed 2. After comparing 28 teachers' official trip rate in the charge of an athletic club 22 teachers' official trip rate not in charge of an athletic club, it was shown that the former was higher than in O. T. R except for April, May November, December, Feburary between two group showed meaningful distinction (P〈0.05, P〈0.01) 3. In the rate of missing lecture and supplementary lecture of physical class, average dismissing class caused by physical teachers official trip was 22.06, and 32.42 for teachers in the charge of athletic club and 8.86 for teachers not in charge of athletic of athlectic club. This fact was considered as meaningful clistinction (P〈0.05) 4. After analysing the learning contents by grade, it was known that ball games were carried on most often by all grade. Gymnastic, tracks and athlectic theory class were followed. Outdoor activity, recreation activity, health edacation, audio-Visual education were hardly carried out but a few hours.

Linear Phrase Structure Grammar

Myong, Ro-Keun,Park, Hyo-Myong,Shin, Gyonggu 서울대학교 어학연구소 1988 語學硏究 Vol.24 No.2

The current model aims to give homomorphic explanation on syntax as well as semantics with linear operaition, which is based on filled and to-be-filled categories. Filled categories are similar to slash categories of GPSG but with different effect. To-be-filled categories are provided as default value from ID rules. A sentence is not considered complete until to-be-filled categories are satisfied. The rules in this model are not only contex-free but also binary so that default value assignment becomes possible.

Tense Operator in GPSG

Hyo-Myong Park 21세기영어영문학회 1985 영어영문학21 Vol.4 No.-

리스바, 다윗의 이야기를 전복시키다 (사무엘하 21:1-14)

임효명(Hyo Myong Lim) 한국여신학자협의회 2021 한국여성신학 Vol.- No.93

“아말렉, 타고난 도둑!” 청(독)자의 인종적 편견을 이용한 스토리텔링?

임효명(Hyo-Myong Lim) 연세대학교 신과대학(연합신학대학원) 2015 신학논단 Vol.79 No.-

에스겔 16장의 폭력적 야웨 상과 상징의 재고

임효명(Hyo-Myong Lim) 한국구약학회 2019 구약논단 Vol.25 No.2

Many recent readers have been troubled by the violence and lewdness of the language used in Ezekiel 16. The husband Yahweh"s horrific treatment of his wife Jerusalem is offensive to many. In this article I will closely read the text with the tools of feminist literary criticism to explore the problematic image of Yahweh. Then I will examine how the social and cultural context of the prophet and his audiences/readers functions in the construction and interpretation of the image of Yahweh. My aim is to show the validity of the metaphoric language of the prophet. A close reading of the story in Ezekiel 16 reveals that the marital relationship between Yahweh and Jerusalem is similar to that of a domestic violence. The prophet Ezekiel utilizes the marriage metaphor to effectively indict Judah and deliver a shocking verdict of imminent disasters. To make the judgment proportionate to the sins of Judah, the prophet portrays Jerusalem as an ungrateful lewd woman and Yahweh as a husband who harshly punishes his wife for her infidelity. I argue that the offensiveness of the narrative originates from the marriage metaphor itself. Since a metaphor operates in shared experiences, Ezekiel’s marriage metaphor is necessarily derived from a patriarchal society which is of the prophet and his intended audiences. Some metaphors are timeless (e.g., "The Road Not Taken"), while some are not. Marriage metaphor in which men are privileged to control and even abuse women, has lost its validity among many readers. This kind of Yahweh’s image molded by the figurative language as seen in Ezekiel 16 is culturally bound. Such an image is destined to be broken and remolded in order to carry the intended message into a changed context. Otherwise it becomes an (literary) idol.