한국의 주정 사용 장애의 개념에 대한 문화 지학적 연구 (1) : 주요 정보 제공자 면담 조사 방법을 통한 연구

남궁기(Kee NamKoong),이만홍(Man Hong Lee),이호영(Ho Young Lee),현용호(Yong Ho Hyun),조은영(Eun Young Cho) 한국정신병리진단분류학회 1995 精神病理學 Vol.4 No.1

N/A N/A

알코올 의존의 치료에서 Naltrexone의 사용

남궁기(Kee Namkoong) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1

Two double-blind placebo controlled clinical trials have demonstrated that naltrexone, a pure opioid antagonist, appears to be an effective adjunct to treatment of alcohol dependence. Naltrexone alters endogenous opioids receptor activity, and its alteration blocks a positive reinforcing effect of alcohol in dopaminergic system. As a result, naltrexone reduces craving for alcohol and alcoholic high. Clinically, naltrexone, which is more compliant than disulfiram in alcoholics, results in fewer drinking days, less drinking amount and lower rate of relapse for alcoholic patients. Especially, those patients who initiatied drinking, patients who received naltrexone and concurrent coping skill/relapse prevention therapy are the least likely to relapse. In addition, a recommendation for morning dosing and the development of a pill taking routine are likely to increase the patients compliance with naltrexone and ultimately the outcome of their treatment for alcoholic dependence. In conclusion, the combined effects of naltrexone, psychosocial therapy and our patient support system need to be explored so that an optimal approach to the treatment of alcoholism, which is suitable for our own situation, should be developed.

한국 일 농촌지역(강화도) 노인 주정 중독의 역학적 연구

남궁기,이호영,이만홍,신승철,김병후 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.6

An epidemiological study of alcoholism in the elderly was done in Kangwha in 1987. The results are as follows: 1) The lifetime prevalence rate of alcoholism in elderly is 21.2%, which consists of 16.6% of alcohol abuse and 4.6% of alcohol dependency. 2) The lifetime prevalence rate of elderly alcoholism in male is about 7 times higher than in female(41.5% vs 6.6%). 3) Age-specific prevalence rate of elderly alcoholism decreases with age. 4) The lifetime prevalence rate of elderly alcoholism is significantly high in unmarried group and educated group, compared to those in married group and uneducated group (39.3% vs 4.4%, 41.6% vs 15.2%) 5) When elderly alcoholism is classified into 4 types by its onset and course, the rate of early-onset type(onset before 40 years old) is 72,6%. 6) The prevalence rate of other psychiatric disorders do not show any significant difference between alcoholic group and non-alcoholic group, but the prevalence rate of mild cognitive impairment in alcoholic group is significantly lower than that in non-alcoholic group) 12.5% vs 36,6%). 7) The 5 dimensional scores of social resources, economic resources, mental health, physical health and activities of daily functions do not show any significant differences between alcoholic group and non-alcoholic group.

알코올 사용 장애의 최신 지견

남궁기 대한신경정신의학회 2004 신경정신의학 Vol.43 No.6

Alcohol use disorders and related problems continue to constitute a significant public health problem, leading to many psychi-atiic conditions, physical illnesses, and social problems such as domestic violence and occupational disabilities. Here, we provide an update on alcohol use disorders ; 1) genetic and neurobiological aspect, 2) neuroimaging study findings, 3) treatment of medical complications 4) psychotherapeutic approaches 5) pharmacological treatment and 6) women and offsprings issues of alcohol use disorders.

Detection of c-K-ras Point Mutation in Ovarian Cancer

Namkoong, Sung Eun,Lee, Joon Mo,Kim, Jin Woo,Han, Sang Kyun,Kim, Heung Kee,Park, Jong Sup,Kim, Seung Jo CATHOLIC MEDICAL CENTER 1994 Bulletin of the Clinical Research Institute Vol.22 No.1

To detect the point mutation of c-k-ras in ovarian cancer, GGT of codon 12 was replaced by GAT, AGT, TGT and GTT, then we performed polymerase chain reaction and agarose gel electrophoresis and confirmed it using Southern blot hybrization with digoxygenin detection system. The frequency of c-k-ras point mutation was compared with the clinico-pathological characteristics of 37 ovarian cancer patients. The incidences of four-typed point mutations of K-ras oncogene in 37 ovarian cancers were 35.1%(13/37) and distribution were 32.4%(12/37), 2.7%(1/37), 0%(O/37) and 0%(O/37) in GGT to GAT, GGT to AGT, GGT to TGT, and GGT to GTT, respectively. The incidence of K-ras point mutations on codon 12 among 37 patients with ovarian cancer according to histological type was 35.5%(8/22) with serous cystadenocarcinomns, 28.6%(2/7) with mucinous cystadenocarcinomas. Comparing the positive rate of K-ras point mutations on code 12 among 37 patients with ovarian cancer in different clinical stages, point mutation was detected in 14.3%(1/7) with stage Ⅰ, 28.6%(2/7) with stage Ⅱ, and 43.5%(10/23) with stage Ⅲ/Ⅳ and there was statistically significant increasement of point mutations of K-ras oncogene with advance of the clinical stage of ovarian cancer (P<0.05). The incidence of K-ras point mutntions on codon 12 among 33 patients with ovarian cancer who were performed pelvic lymph node dissection was 52.4%(l1/21) of the patients with positive pelvic lymph node metastases and 16.7%(2/12) of the patients without pelvic lymph node metastasis and the difference was statistically significant (P<0.05). The activation of ras oncogene seems to be a major implication of the multistep process of ovarian carcinogenesis and tumor progression. Furthermore, the point mutation of c-K-ras gene could occur more frequently in the patients of ovarian cancer in far advance stage, and the those with pelvic lymph node metastases than in those without pelvic lymph node metastases, suggesting the role in tumor invasion and metastases.

강화도 정신과 역학 연구(Ⅱ) : 연구설계 Survey Design

남궁기,오희철,유승흠,이만홍,민성길,이호영,김일순,Yu, Elena 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.6

The Kangwha Psychiatric Epidemiologic Survey was done as the first step of Kangwha Health Project. Summary of the survey design were as follows. 1) 2195 subjects were selected by single stage random cluster sampling. 2) As a survey instrument the Korea version of NIMH-Diagnostic Interview Schedule were used, which was verified with a validity test by the present authors. 3) 30 lay-interviewers who were high school graduates or college students were trained for two weeks and 26 of them conducted home visiting survey for one month. 4) Out of total 2195 selected subjects, 1450 subjects were interviewed completely, thus the completion rate was 66.10%. 5) Data was sent to and analyzed in the University of Texas with DIS-Program which had been developed in Wasington University.

금단 증상을 동반한 헤로인 의존 1례

남궁기,한승진 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

저자들은 약 1년간의 헤로인 의존상태에서 갑작스런 약물 투여 중단 후 나타난 헤로인 금단증산을 가진 27세 여자환자를 경험하였다. 환자는 약물투여 중단 후 의식의 혼탁, 혼란, 이자극성, 불안, 초조, 불면, 오심, 구토, 복통, 사지통, 동공의 수축 등의 전형적인 헤로인 금단증상을 보였다. 헤로인은 미국과 동남아시아를 비롯한 세계각지에서 이미 흔한 남용약물로 사용되고 있으나, 아직 우리 나라에서는 흔히 경험할 수 없는 증례이므로 이를 문헌고찰과 함께 보고한다. The authors experience 27 year old female patient with heroin dependence accompanied by the typical heroin withdrawal symptoms such as confusion, irritability, anxiety, agitation, insomnia, nausea, vomiting, abdominal colicky pain, pain on both extremities and pupil constriction. Although heroin is one of the most popular illicit drug in the world, this is not the case in Korea. So we reported this case with literature review.

알코올 사용 장애의 약물치료

남궁기 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Alcoholism, a major public health problem throughout the world, causes enormous damage to health and quality of life and undermines the well-being of families and society, It is associated with liver disease, cancer, cardiovascular problems, acci-dental deaths, suicides, and homicides. Over the last 20 years, rational drug treatment have arisen from better understanding of the neurobiological substrates of alcohol dependence, including adaptive changes in amino acid neurotransmitter systems, stimulation of dopamine and opioid peptide systems, and, possibly, changes in serotonergic activity. Disulfiram, naltrexone and acamprosate are currently the only treatments approved for the management of alcohol dependence. Data from studies of ondansetron and topiramate in alcohol dependence are somewhat promising, but it appears that these drugs have not yet demonstrated evidence of efficacy in large controlled clinical trials. Trials with SSRIs and some antipsychotics have yielded disappointing results. Because the biological basis of alcohol dependence appears to be multifactorial, the future of management of alcoholism may be combination therapy, using drugs acting on different neuronal pathways, such as acamprosate and naltrexone. Phannacothe-rapy should be used in association with appropriate psychosocial support and specific treatment provided for any underlying psychiatric comorbidities.

주정사용장애의 임상적 연구

남궁기,이호영,노재성 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.1

A single stage random cluster sampling was conducted and 1,450 samples were selected from Kangwha Island. A psychiatric epidemiologic survey was done using Korean version of NIMH-Diagnostic Intervies Schedule. Sociodemographic characteristics, natural course, and frequencies of DIS alcoholic symptoms were compared among alcohol dependence, alcohol abuse and non-alcoholic groups. The results were as follows; 1) In comparison of sociodemographic characteristics between alcohol dependence and alcohol abuse group, marital status and age distribution showed significant differences but there were no significant differences in sex and occupation between two groups. 2) There were no significant differences in mean age of first heavy drinking episode and onset of symptoms in alcohol abuse and alcohol dependence group. 3) Mean duration of alcohol use disorder was significantly different between alcohol dependence and alcohol abuse group(13.5±12.2 years and 9.2±10.8 years). And it was also significantly different between male alcohol dependence and male alcohol abuse group(13.1±11.9 years and 9.2±10.7 years). 4) The latency period of alcohol use disorder in alcohol abuse and alcohol dependence group were 7.0±10.3 years and 8.7±10.1 years in each, which was not significantly different and in comparison of latency period in only male, there was no significant difference between two groups(7.3±10.4 years and 9.5±9.4 years). 5) In comparison of frequencies of alcoholic symptoms between alcohol dependence and alcohol abuse group, frequencies of symptoms such as `think oneself as a excessive drinker', `bender at least two days', `continue to drink even with serious physical illness' were significantly higher in alcohol dependence group. 6) In comparison of prevalence of medical complications between alcohol dependence and alcohol abuse group, prevalence of peripheral neuropathy, stomach disease, liver disease and memory impairment were significantly higher in alcohol dependence group.

먼저 정신분열증 입원환자를 대상으로한 정신사회 치료프로그램의 효과

남궁기,오병훈,김도훈 大韓神經精神醫學會 1995 신경정신의학 Vol.34 No.6

In recent years, a lot of attention have been paid to development and evaluation of the appropriate psychosocial treatment program for the chronic schizophrenics because treatment with only antipsychotic drugs has a limitation in regards to functional improvement of the chronic patients and psychosocial treatments can prevent relapse and improve social function with higher social adaptation. This study was designed to develop more effective psychosocial treatment programs in the future by investigating the effect of various psychosocial treatment programs and their treatment factors and by classifying psychosocial treatment programs according to their therapeutic factors. Data were collected from 31 chronic schizophrenics participating in 14 psychosocial treatment programs in Kwangju Severance Psychiatric Hospital, using the Short-form of Yalom's Curative Factors and their self-report questionares asking for treatment experience of patients. As a result, the therapeutic effects of psychosocial treatment programs for the chronic schizophrenics were found to mainly come from existential awareness, instillation of hope, guidance and these facors were thought to be important therapeutic factors treating negative symptoms of the patients. In conclusion, cognitive, education-directed treatment programs of the chronic schizophrenics should be strengthened and psychosocial treatment programs emphasizing cohesion and universality would be more effective.