범법정신장애자의 정신의학적 특성분석

이길홍,이재광,박두병,나철,기백석,이재우,유영식,이영식,이헌재 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.1

범법 정신 장애자와 일반 정신 장애자의 약물 사용 양상에 관한 비교 분석

이길홍,박두병,나철,이재광,기백석,이재우,유영식,이영식,이헌재 중앙대부설한국의과학연구소 1991 한국의과학 Vol.23 No.1

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

가와사키병 환아중 치료 실패 및 재발하는 환아의 위험 인자

이훈영,김재철,이재호,길홍량 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Several cases of Kawasaki disease(KD) were unresponsive to the initial treatment with intravenous immunoglobulin(IV1G). We retrospecitvely analyzed all children admitted with KD to determine the occurrence and variables associated with the initial IVIG treatment failure. All patients who were diagnosed for KD and atypical KD between January 1995 and December 2002 were enrolled. A total of 235patients were enrolled during the study period. All patients had been treated with IVIG and high dose ASA in acute phase. 196 patients had a normal baseline echocardiogram before treatment. 12 patients(6.1%) of them had developed the new coronary abnormalities after treatment. We divided the patients into two group : Treatment success group(n=184) vs. treatment failure group(n=12). Patients who were younger and had few numbers of symptom and longer duration of fever after treatment, a high CRP, a high Harada score were at risk of failure to respond to IVIG treatment. We found no correlation among gender, WBC count, hematocrit,albumin,erythrocyte sedimentation rate (ESR) with failure of the initial IVIG treatment. We found that treatment failure was more common in atypical KD and high Harada score group.

근로청소년의 산업재해와 음주양상과의 상호관계에 관한 산업정신의학적 연구

이길홍,김헌수,이규항,민병근 중앙대부설한국의과학연구소 1983 한국의과학 Vol.15 No.1

소아ㆍ청소년기에 발병한 탈모증의 정신의학적 특성

이길홍,이헌재,이창훈 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: 소아 청소년기에 조기 발병한 탈모증과 성인기에 발병한 탈모증 환자들의 개인적 특성이나 탈모 양상, 정신의학적특성, 동반신체질환 및 치료 방법에 관한 비교 분석을 통해 조기 발병탈모증의 치료 및 예방지침을 수립하기 위해 본 연구를 시도하였다. 방법: 1998년 1월부터 1999년 6월까지 중앙대학교 용산병언 피부과에 내원하여 정신과로 의뢰된 탈모증 환자 93명(남 40명, 여 53명) 중에서 소아 청소년기에 발병한 31명(남 14명, 여 17명)을 연구대상 집단으로 선정하였고, 성인기에 발병한 탈모증 환자 62명(남 26명, 여 36명)을 대조군으로 선정하여 양군간의 임상 양상의 차이를 비교 분석하였다. 수집된 자료는 SPSSWIN 9.0V 프로그램을 통해 자료 처리를 하였고, 집단간의 차이는 교차 분석 및 t-검정을 통해 비교 분석 하였다. 결과: 1) 조기에 발병할수록 가을에 출생하고, 환자나 부모의 사회 경제 수준의 높으며, 형제수가 적다. 2) 조기에 발병할수록 전신성 탈모가 많고, 탈모 과거력이 있으며, 3회이상 재발하고, 탈모 정도가 심하며, 탈모기간이 2년 이상 장기간이고, 첫 탈모부위가 두정부이며, 탈모부위가 두군데 이상이고, 치료를 해도 변화가 없거나 악화되고, 치료를 자의 중단하거나 효과가 없어 중단한 경우가 많다. 3) 조기에 발병할수록 가정내 적응이나 인간관계에서 적응상의 어려움을 겪으며, 입시 부담이나 학교생활에서의 변화로 인해 학교 스트레스를 경험한 비율이 높다. 4) 조기에 발병할수록 불안장애가 많고, 불안증상과 우울증상을 많이 호소하며, 인격장애가 있을 때 탈모가 촉진되고, 특히 히스테리성인격이나 의존성인격을 지닐수록 조기에 탈모가 발생한다. 5) 조기에 발병할수록 지루성피부염등 동반 피부질환이 많고, 정신과약물인 alprazolam을 복용하고 있으며, polytar나 tretinoin을 처방한 비율이 높다. 결론: 일차 진료의사인 피부과 의사들은 공존하는 정신장애에 대해 깊은 관심을 갖고, 청소년기 이전부터 조기에 탈모증의 공동 치료 계획을 세워야 한다. Objectives: There have been growing interests about alopecia occured during childhood and adolescence in clinical practice. The purpose of this paper is to explore the clinical characteristics of early onset alopecia in order to establish effective psychiatric intervention strategy. Method: The subjects were 31 early onset alopecia patients(14 males, 17 females) and 62 late onset control patients(26 males, 36 females). These patients had visited psychiatric outpatient clinic consulted from the department of dermatology, Yongsan hopital, Chung Ang University, Seoul, Korea, from January 1998 to june 1999. The sociodemographic data, clinical pattern of alopecia, psychiatic characteristics, comorbid physical illnesses and treatment variables were assesed. The data was statistically analyzed using chi-squre test and t-test through SPSSWIN 9.0V. Results: 1) Early onset alopecia patients were more likly born in autum, had fewer siblings, and showed higher economical level of both patient and their parents than late onset patients. 2) Early onset alopecia patients were more likely to show diffuse hair loss, had more experienced past history of alopecia, more frequently had recurrence more than 3 times, were more severely damaged, had longer duration of hair loss had more loss of hairs on the vertex area at onset of alopecia, had more loss of hairs more than 2 areas, and had poorer prognosis such as no change or exacerbation in spite of treatment, spontaneous withdrawal of tratment and lack of efficacy to treatment than late onset patients. 3) Early onset alopecia patients were poorer in their adjustment in family life, or interpersonal relations, and more suffered from school stress such as changes of school life or test stress related with school entrance examination than late onset patients. 4) Early onset alopecia patients were more likely to show erious psychopathlology such as increased rate of the anxiety disorders, of anxiety symptoms or depressive symptoms, and of personality disorders including the hitrionic or the passive traits than late onset patients. 5) Early onset alopecia patients were more likely showed dermatits including seborrheic dermatits, and more significantly responding to the tratment with anti-anxiety drug, such as alprazolam, and dermatological therapies including polytar or tretinin than late onset patients. Conclusions: These findings suggest that dermatologists, as primary care physicians, are in unique position to recognize psychiatric comorbidity and to execute earlier intervention, in collaboration with psychiatrists, of early onset alopecia patients.

탈모증의 정신의학적 특성 분석 : 원형탈모증과 전신성탈모증간의 비교 분석

이길홍,이헌재 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

연구목적 : 원형탈모증의 심한 정도와 환자의 개인적 특성, 탈모양상, 정신의학적 특성, 동반 신체 질환 및 치료방법 등과 같은 탈모증 상관변인간의 관계 분석을 통해 탈모증의 원인적 변인들을 탐색하여, 이를 토대로 탈모 호발 성향이 있는 환자들의 치료 및 예방 지침을 수립하기 위해 연구를 시도하였다. 방 법 : 정신병리적 심각도와 탈모증의 심한 정도간에 상호 연관성을 알아보기 위하여 1998년 1월부터 12월까지 최근 1년간 중앙대학교 용산병원 피부과에 내원하여 정신과로 의뢰된 탈모증이 경미한 원형탈모증 환자 60명(남 25명, 여35명)과 탈모증 정도가 심한 일반 전신성 탈모증 환자 33명(남 15명, 여 18명)간의 임상 양상의 차이를 비교 분석하였다. 수집된 자료는 SPSS-PC+90V 프로그램을 통해 자료 처리를 하였고, 집단간의 차이는 교차 분석 및 T-검증 분석을 통해 비교 분석하였다. 결 과 : 1) 탈모증이 심할수록 겨울에 발병하고, 사회 경제수준이 낮다 2) 탈모증이 심할수록 탈모 과거력이 있고, 3회이상 재발하며, 탈모 정도가 심하고, 조기에 발병하며, 탈모기간이 2년 이상 장기간이고, 탈모 악화기간이 9개월 이상이 많으며, 첫 탈모 부위가 두정부이고, 눈썹 탈모가 많으며, 탈모부위가 2군데 이상이고, 부모가 탈모 경험이 있는 경우가 많다. 그리고 치료해도 변화가 없거나 악화되고, 치료를 실패하는 비율이 높다. 3) 탈모증이 심할수록 스트레스 지각도가 높고, 인간관계나 인성관계에서 적응상의 어려움을 겪으며, 가정내 적응이 원만하지 못하고, 최근 가정내 갈등으로 인한 생활 변동으로 인해 스트레스를 받는다. 4) 탈모증이 심할수록 우울증이 많고, 불안 증상들이나 우울 증상들을 흔히 호소하며, 인격장애가 있을 때 탈모가 촉진되고, 특히 히스테리성 인격이나 피동 공격성 인격을 지닐수록 탈모 정도가 심하다. 5) 탈모증이 심할수록 신경증적인 MMRI소견을 보이고, 특히 히스테리 성향이나 건강염려 성향이 높다. 6) 탈모증이 심할수록 동반 피부질환이 적고, 정신과약물인 alprazolam을 복용하고 있으며, tretinin이나 polytar, soraren을 사용하고, ultra-violet A 광선치료를 하는 경향이 있다. 결 론 : 정신사회적 스트레스와 탈모증이 밀접한 연관이 있고, 인격 장애가 탈모증에 선행하는 예측 인자이며, 자신의 심리적 갈등을 직접 표현하지 못하고 신체증상으로 전환시킬수록 탈모가 촉진되고, 탈모가 심할수록 정신의학적 문제를 흔히 야기한다는 것은 정신과적 개입이 필요함을 말해주고 있다. 따라서 1차 진료 의사인 피부가 의사들은 병발하는 정신장애에 대한 깊은 관심을 갖고, 공동 치료 계획을 세워야 한다. Objectives : The present study was performed to reveal correlations between the severity of the alopecia and their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analyze correlation between the severity of psychopathogy and the severity of hair losses, the subjects were divided into two subgroups as the 60 case of alopecia areata and the 33 cases of alopecia totalis with more severely affected loss of hairs, who had visited to the department of psychiatry after they were consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Koera, from January 1998 to December 1998. In data analysis, the subjects were statistically assessed by chi-squre test and T-test through SPSS-PC+8.0V. Results : 1) Those with the more severely affected alopecia were more likely to visit to the department of dermatology in winter, and to show lower socio-economical level in comparison to the alopecia areata. 2) Those with the more severely affected alopecia were more likely to show past history of alopecia, to recur frequently more than 3 times, to be damaged more severely, to have an younger mean age at onset of alopecia, to have longer total duration of hair loss than 2 years, to have longer recent duration of hair loss than 9 months, to have more loss of hairs on the vertex area at onset of alopecia, to have more loss of hairs in eyebrows, to have more loss of hairs more than 2 areas, to have more family history of alopecia in their parent, and to have poorer prognosis in comparison to those of the alopecia areata. 3) Psychosocial stress were positively correlated with the severity of loss of hairs. In the more severely affected alopecia group, their degree of stress were perceived higher. The more severely affected patients with alopecia, were poorer in their adjustment in family life, interpersonal reations or heterosexual relations, and suffered more from intrafamilial life changes in comparison to those of the alopecia areata group. 4) Those with the more severly affected alopecia were more likely to show serious psychopathology such as an increased rate of the depression, to complain more frequently with anxiety symptoms or depressive symptoms, to have personality disorders including the histrionic or the passive aggressive traits in comparison to the alopecia areata. 5) Those with the more severly affected alopecia were more likely to show neurotic MMRI code profiles such as histrionic or hypochondriacal trends. 6) Antianxiety drug such as alprazolam and drung therapies including tretinin, polytar or oral sorarens plus ultra-violet light A photochemotherapy were significantly more effective in the treatment of those with the more severly affected alopecia group. Conclusion : The most important factors in developing a psychopathologic reaction to the hair loss due to alopecia seems to be the presence of mental disorders including depression, the presence of stressful life events such as intrafamilial life changes, the presence of a significantly higher percentages of personality disorders such as the hysterical or the passive aggressive, and the presence of the psychosocial sequele and maladjustment in various life situations. From the above facts, the authors suggested that dermatologists acting as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for patients with alopecia with psychiatrists.

학생청소년의 폭력 기사에 관한 환경생태학적 연구

이길홍,이헌재 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

목 적 : 일간 신문에 게재된 청소년 범죄 기사의 내용 분석을 통해 청소년 폭력을 미연에 예방 및 선도하기 위한 지침을 설정하기 위하여, 최근 11년간 동아일보 및 충청일보에 게재된 청소년 범죄 기사를 대상으로 전수 조사를 실시하였다. 방 법 : 자료 분석에서는 12세에서 21세에 이르는 청소년 연령층의 범죄 기사 681건(남 642건, 여 39건)중에서 학생 범죄기사 261건(남 238건, 여 23건)을 연구 집단으로 선정하고, 비학생 범죄기사 420건(남 401건, 여 16건)을 대조군으로 선정하여 비교 분석하였다. 결 과 : 1) 학생집단은 연령이 연소하고 여성이 많은 반면 비학생집단은 고연령층이 많았고 남성이 많았다. 범죄 청소년중에서 학생집단의 비율은 계속 증가 추세를 보인 반면 비학생집단은 최근 감소하고 있었다. 2) 학생집단은 폭력범이나 절도범이 많았고 집단범죄가 많은 반면 비학생 집단은 강력범이 많았고 단독 범죄가 많았다. 학생집단의 범행 시간은 오후가 많은 반면 비학생집단은 밤중에 흔히 범행을 하였다. 3) 학생집단은 심리적 갈등이나 경제적 문제로 인해 범행을 한 반면, 비학생집단은 호기심이나 정신적 문제, 이성 문제로 범행을 한 경우가 많았다. 범행 방법은 학생집단은 육체적 공격성향을, 비학생 집단은 도구적 공격성향을 보였다. 4) 학생집단은 집단 범죄가 많았고, 저연령 학생과 공범이 많은 반면, 비학생 집단은 단독 범죄가 많았고, 고연령군 무직자와의 공범이 많았다. 5) 학생집단은 가해자가 면식범이고, 첫 피해자가 저연령층 학생이 많았고, 비학생 집단은 모르는 사람이 많았고, 피해자가 고연령층인 경우가 많았다. 결 론 : 증가일로에 있는 학생청소년들의 폭력행위를 예방 및 선도하기 위해선 학교 및 가정에서 심리적 안정감을 줄 수 있도록 노력해야하며, 교우관계 개선과 더불어 방과후 저녁 시간대의 여가 선용 방안에 대한 집중적인 선도 계몽이 필요할 것으로 지적되었다. Objective : The present study was performed to identify the socio-psychiatric aspects of adolescent criminal offences reported on daily newspapers and to use them as basic materials for prevention of adolescent criminal offences. Methods : The author analysed 681 cases of adolescent criminal offenders, including 642 males and 39 females who reported on daily newspaper such as DongA Ilbo and Chung-Cheong Ilbo, aged from 12 through 21, In data analysis, the subjects were divided into two subgroups as the student(261 cases) and the non-student(420 cases). Results : 1) The rate of student were more common in female and younger in their age group comparing with the non-student. Recently, the incidence of student's offences of all adolescent offences were remarkably increased, while those of the non-student was decrease. 2) Violence and theft or group offences were more common in the student, while felony or solitary offences were more frequently observed in the non-student. The more vulnerable time of criminal offences in the student were more in afternoon, while the non-student were more in midnight. 3) The psychological conflicts and the economical causes were the most ones in the student, while the curiosity, the personality problems and the heterosexual conflicts were more common in the non-student. Physical aggression were more prominent ones in the student, compared with the instrumental aggression in the non-student. 4) The student committed offense more in patterns of group offences with peers, younger in their age and were more often with their peer students, while the non-student committed offense more in the patterns of solitary crime, more prevalent with older aged jobless peers. 5) Most of the victims in the student were more abused to the intimate persons, and more younger students, while those in the non-student were more abused to the unknown persons and more older aged adolescents. Conclusion : In order to prevent and correct increasing tends of violence in school, nationwide guidance programs should be promptly applied through promotion of psychological wellbeing in family and school, proper guidance to peer relationship, and providing more opportunities for sound recreational activities in evening time to help dissipate the frustration of the adolescents.

학생 폭력 기사에 대한 내용분석

이상훈,이길홍 중앙대학교 의과대학 의과학연구소 1996 中央醫大誌 Vol.21 No.3

The present study was performed to identify the socio-psychiatric aspects of student violence and to use them as basic material for prevention of adolescent violence. The author analysed adolescent violence cases reported on daily newspaper, Dong-A Ilbo and Chung-Cheong Ilbo, from 1991 to 1995. The total number of cases were 335, including 312 males and 23 females. The cases were devided into three age subgroups by Werkman's classification : early (12-14), middle(15-17), late(18-21). The results of the study were as follows : 1) The cases of adolescent violence were more often in male. The ration of male to female was 13.6 : 1 and the most frequent age population was late group(18-21). The age difference between groups is younger in student group than control group. In student group, the violence incidence was more prevalent in early and middle subgroup in contrast to late subgroup of control group. As concerns occupation and education status, the jobless was the most frequent (36.4%) and among student group, high school adolescents (58.5%) were most common. The most common growth place of violent adolescents was city(42.7%), followed by town(35.2%), Seoul(20.3%). The most premorbid personality of violent adolescents was antisocial personality (35.9%). In psychosocial stressors, the student group was more stressful in school and home, compared with heterosexual confilicts, economic problem in control group. 2) In the analysis of criminal offences, felony(23.3%) was most prevalent, followed by theft(24.2%), violence(20.0%). In student group, violence and theft were more common, but murder and rape were more frequent in control group. In any type of criminal offences. violent behaviors were more often in winter than in any other season, more in weekends than weekdays. And the most vulnerable time of criminal offence in violent adolescents was from 7 PM to 12 PM. Major motivation of crime was economic problem(45.7%). In student group, environmental stressors including home, school and society were more ofter and in control group, pecularity and sexual conflict, economic problem were more prevalent. In terms of accompanied person participating in criminal offence, self crime(46.3%) is most prevalent, followed by peer group(37.0%), peer(15.5%). In the analysis of space condition of crime, the most frequent place was outdoor(38.2%). In student group, school and outdoor were more often, compared with victim's indoor in control group. In the method of offenses, the first(30.1%) was the most common tools and stolen money(30.7%) was most frequent method, followed by forced rape(21.5%), knife or sharp material use(11.9%). 3) The major characterictics of victimized people of violent adolescents were as followed : The cases of victimized people were more often in male(51.3%) and most prevalent age group was more than 22yrs(37.6%). In occupation status, the jobless was most common, followed by student(30.4%), clerk(14.3%), merchant(6.9%), labor(5.7%), housewife(5.4%). The most frequent number of victimized people was one and the degree of awareness between abuser and victim was mostly unknown(71.6%). Victims suffered mostly from mild injury but it was more severe in control group. In response for victims to violent crime, most people requested other's help(89.9%).

의·간호계 종사자 및 학생들의 죽음 인지도에 관한 연구

이길홍,김헌수,나철,권혜진,김성희,민병근 중앙대부설한국의과학연구소 1983 한국의과학 Vol.15 No.3